Skull trepanation in the Bismarck archipelago

Area of Science:

• Anthropology
• Medical History
• Archaeology

Background:

• Skull trepanation, an ancient surgical practice, was documented in Papua New Guinea during the late 1800s.
• European cranial surgery was in its nascent stages during this period.

Observation:

• The study reviewed historical accounts and video evidence of trepanation practices.
• Observations were made by traders, anthropologists, and missionaries in regions like Blanche Bay and Duke of York Islands.

Findings:

• Trepanation was performed for trauma in New Britain and for epilepsy/headaches in New Ireland, often on young children.
• Surgical tools included obsidian, shark teeth, shells, rattan, coconut shells, and bamboo.
• Irrigation with coconut juice and observation of brain pulsations were key procedural elements.

Implications:

• Papua New Guinean trepanation achieved a 70% survival rate, exceeding London's 75% mortality in the 1870s.
• Evidence of healed skulls suggests long-term survival post-procedure.
• Good outcomes likely resulted from careful patient selection and skilled surgical debridement.