Trance surgery in Brazil

This report presents the results of fieldwork in Brazil on healer-mediums who perform crude forms of surgery, often employing sharp instruments. We found that these healer-mediums were in a hyperaroused brain state while they were engaged in behaviors commonly described in the anthropology literature as "possession trance"; therefore, this practice is termed "trance surgery" in this report. The research was conducted at widely scattered sites throughout Brazil. We observed several thousand patients being treated by 9 trance surgeons and videotaped several hundred of these cases. In addition to background information and our own observational material, this paper includes 2 medical case reports, physiological data gathered from healers and patients, and results of a pathologist's examination of a surgically excised tumor. Topographic brain mapping revealed increased brain activity (36-44 Hz) when healer-mediums were engaged in trance behaviors, compared to resting baseline conditions at midline scalp locations (Cz, P < .009 and Pz, P < .004; both matched t tests). These results suggest the presence of a hyperaroused brain state associated with the trance behaviors of the healers. We believe that such a state is required for this unusual practice, but other factors may also be involved. In contrast, a small sample of patients monitored during possession trance surgical procedures revealed no high-frequency brain activity; instead, there were indications of cortical quieting, suggesting relaxation, despite the absence of anesthesia. Pathohistological examination of a tumor excised from a patient in our presence revealed a human fibroadenoma. We conclude that these practices are usually benign and that pain is often absent, despite the lack of sterile procedures and anesthesia. Although during the period of our investigation we were informed anecdotally of 3 cases involving serious complications or death, we personally observed no cases of shock, hemorrhage, or death. The cases presented in this paper, as well as others we have followed, suggest that serious illnesses, not likely to improve without treatment, may do so after trance surgery procedures are performed. If the major benefit of trance surgery is to initiate self-healing processes, it would have to do so in powerful ways, which possibly can be elucidated with positron emission tomography and functional magnetic resonance imaging scans. Positive findings would be helpful in understanding large-scale healing effects and may lead to new treatment protocols.