trephining - psychotropic drugs - self-injurious behavior - anthropology, cultural
trepanação - psicotrópicos - comportamento autodestrutivo - antropologia cultural
- Linda and me came over for dinner once and John said, “You fancy getting the trepanning
thing done?” I said, “Well, what is it?” He said, “You kind of have a hole bored in
your skull and it relieves the pressure.” We’re sitting at dinner and this is seriously
being offered! Now this wasn’t a joke, this was like, “Let’s go next week, we know
a guy who can do it and maybe we could all go together.” So I said, “Look, you go
and have it done, and if it works, great. Tell us all about it and we’ll all have
it.”
Paul McCartney, 1986 (Musician Magazine Interview)
Trepanation is an ancient surgical procedure, perhaps the first one done frequently
(along with limb amputation and circumcision), dating back 7,000 to 10,000 years.
The operation has been well documented in Europe, Africa, Asia, and Meso and South
America[1],[2]. In ancient cultures, it was performed for alleged mystic or religious reasons (e.g., demonic possession) but also for the treatment of madness, severe headaches and
other chronic ailments[3]. It has been estimated that up to 6% of people were trepanned in some populations[4],[5]. Although non-medical and ritualistic motivations for the procedure have been amply
suggested, traumatic brain injury appears to have been one of the major reasons[5],[6].
The surgical act (single or multiple holes drilled, mainly in the frontal or parietal
regions) was made with careful avoidance of muscles, brain meninges and the brain
itself. Estimated survival rates reached 40% for early procedures, a figure that probably
increased to around 80% during the sixteenth to seventeenth centuries[4],[6]. It is a well-documented procedure in Oceania and Africa well into the twentieth
century, with an estimated survival of more than 90%[7],[8]. There is good documentation of the tools used and of the antiseptic precautions
regularly taken by witch doctors.
The use of trepanation in Western medicine has its main roots in Egyptian and Greek
practices for the treatment of traumatic brain injury[9],[10],[11],[12]. The procedure was regularly done during the Roman Empire (Celsius), throughout
the Middle Ages and beyond[3],[10]. Figures declined sharply in the second half of the nineteenth century, paralleling
the increasing shift to in-hospital care[13].
A putative increase in mental power was first used as a justification for trepanation
(including self-operation) in recent times in the Western world. In the 1960s and
1970s, a huge interest in methods to “open the mind” and increase perception and insight
developed. Mostly, this was attempted pharmacologically, with LSD, marijuana, peyote
and other hallucinogens. However, a much smaller group opted for trepanation, a more
radical and definitive approach as an answer to that need. This initially included
rock musicians, artists, and current or former drug users. Trepanation to enhance
brain function is still being performed on dozens of individuals nowadays. In fact,
there are institutions that facilitate access to it and promote research on the theme.
Current interest in trepanation is found both in North America and Europe. I describe
here some of the main personages of this social phenomenon.
HUGO BART HUGES (1934-2004)
HUGO BART HUGES (1934-2004)
The pioneer and most influential proponent was “Professor Huges”. This Dutch librarian
was refused a medical diploma in Amsterdam, either because of his advocacy of the
alleged psychiatric benefits of marijuana, or because of his failure to pass the obstetric
exams. Huges had long been interested in trepanation as a method of surpassing psychological
problems and achieving a higher level of consciousness. The theory was based on the
concept that an infant’s putative higher state of consciousness is related to its
unsealed skull allowing free expansion of the brain and hence of cerebral blood flow
and metabolism. As we grow older, sutures limit this expansion and flow becomes restricted,
even more so because of our upright stance. Methods that increase cerebral blood flow
such as jumping, passing from a hot tub to a cold one or using psychoactive drugs
like LSD would only temporarily reverse this problem. Trepanning, on the other hand,
would allow a persistent increase in blood volume and restore pulsation and metabolism
as a result of the increased cranial compliance. This would lead to a higher state
of perception and conscience — although perhaps not as intense as that induced by
pharmacological methods.
Huges successfully trepanned himself with an electric drill in January 6, 1965 ([Figure 1]). He affirmed the beneficial effects were immediate: his consciousness was heightened
and his neuroses had been overcome. He started to preach about trepanation (e.g., John Lennon considered being trepanned after talking to him[14],[15]) and published documents on it, the most influential being “ Homo Sapiens Correctus
(The Mechanism of Brainbloodvolume)” in 1962, a manuscript scroll in which he discusses
the benefits of the procedure and its mechanisms (sidebar)[16]. He also published a book called “Trepanation (looking for treatment for insanity)”
in 1971 and an autobiographic book (“With the Hole”) in 1972. Huges died at age 70,
possibly from heart disease.
Figure 1 Hugo Bart Huges: a. Huges and his scroll. b. Self-trepanation. Photos by Cor Jaring
(www.madscientistblog.ca/mad-scientist-6-bart-buges/#sthash.JNSVuOjN.dpbs).
JOSEPH MELLEN (1939-)
The English citizen Joey Mellen first met Huges in Ibiza after dropping out of Oxford
University and rapidly became a close friend and follower. After some years talking
about trepanation, he decided to act. The first two attempts were made under the influence
of LSD, using local anesthesia and a manual corkscrew bought in a surgical store.
After the first unsuccessful attempt, he asked for the help of Amanda Feilding (discussed
below), but at the final moment he fainted and was briefly hospitalized and then imprisoned
for possession of marijuana. He finally succeeded in completing the trepanation soon
after and described the immediate effects as bubbling and schlurping noises[17]. Despite his apparent success (a small and asymmetric piece of bone was collected),
he doubted whether the well-being that followed was really related to the small hole
made. In 1970, he made a second hole (now with an electric drill). This was deemed
most satisfactory, as it was at least one inch deep and much pulsating blood came
out. The mental effects were also the expected, as he felt his spirits progressively
rising until he reached a feeling of perennial freedom and serenity. All this experience
is described in a book called “Bore Hole” (1970), which has recently been reissued
([Figure 2]).
Figure 2 Cover from the first edition of “Bore Hole” by John Mellen (www.vice.com/read/meet-the-man-who-drilled-a-hole-in-his-own-skull-to-stay-high-forever.).
The first sentence of the book reads: ‘This is the story of how I came to drill a
hole in my skull to get permanently high’17.
AMANDA FEILDING (1943-)
This successful English artist and gallerist of noble ascent (now the Countess of
Wemyss and March, by marriage) was long interested in mysticism and psychology. Joseph
Mellen introduced her to Huges in 1966. At that time, she (also an Oxford dropout)
was already sharing her flat in London with Mellen. She went to Amsterdam and had
a relationship with Huges. When she came back to London, she was so impressed by the
evident changes in Mellen’s personality soon after his final and successful trepanation
that she decided to have it herself. The messy procedure was documented in a short,
hard-to-find cult film (“Heartbeat in the Brain”). Feilding and Mellen bought and
ran an art gallery[18]. They lived together up to the early 1990s and had two sons (born in 1979 and 1985).
After their separation, both convinced their next partners to trepan themselves[19]. She apparently had the trepanation redone two decades later because of bone regrowth[14].
Feilding published a book on trepanation (“Blood and Consciousness”, 2001) and ran
twice (1979 - 40 votes, 1983 - 139 votes) for British Parliament, with a platform
fighting specifically for public funding of trepanation (“Trepanation for the National
Health”) ([Figure 3A]). She now financially supports and co-authors Russian researchers on the relationships
between blood and cerebrospinal fluid dynamics and consciousness[20],[21],[22], and supports research on consciousness and psychoactive drugs and the creation
of balanced drug policies via the Beckley Foundation (http://beckleyfoundation.org).
Figure 3 Amanda Feilding and Paul Halvorson. a. Amanda Feilding’s campaign poster. (www.vice.com/read/meet-the-man-who-drilled-a-hole-in-his-own-skull-to-stay-high-forever.)
b. Peter Halvorson. Photo by M Williamson (www.washingtonpost.com/wp-srv/style/features/trepan.htm).
PETER HALVORSON (1947?-)
Peter Halvorson is an American diamond-setter and farm-owner in Pennsylvania. In his
twenties, he suffered from depression and dropped out of the University of Cincinnati
in 1968. Halvorson met Huges and finally trepanned himself with an electric drill
in 1972 in Amsterdam ([Figure 3B]). The operation led to increased energy, focus and drive, and he was convinced that
it could frequently lead to freedom from antidepressants and psychotherapy. In an
interview in 1998, he estimated that several dozen people had already done the operation[19]. At least once he helped a young lady, Heather Perry, to trepan herself in England
(2000). He and William E. Lyons pled guilty to the unlicensed practice of medicine
and were put in jail (2001), despite Perry’s testimony on the positive effects of
the procedure[14],[19],[23],[24].
Halvorson created the International Trepanation Advocacy Group (ITAG) in 1997. As
stated in its official site, the original mission was to provide information about
the procedure (www.trepan.com). From 2000 to 2004, the ITAG established relations
with medical facilities and funded a pilot study of 15 volunteers submitted to elective
trepanation in Mexico. The study could not prove physiological changes using MRI methods
(not described) but all the individuals are said to be satisfied with the procedure.
Halvorson and Feilding co-authored a number of studies on brain blood and cerebrospinal
fluid dynamics[20],[21],[22],[25]. The one most quoted by the ITAG (a translation from an article first published
in Russian) concerns people submitted to neurosurgery for different and unstated reasons[20]. The fight for scientific proof of the effects of trepanation did not prevent the
ITAG from actively helping interested individuals to undergo the procedure. In fact,
even today, it is actively getting people operated on abroad (now in Ecuador) in a
kind of medical tourism, whose particulars - trip, facilities, staff, and cost - are
easily found[26].
FINAL REMARKS
Except for Huges, none of the other persons mentioned in this article seems to have
made an open apology for self-trepanation. However, all of them actually helped others
in their self-operations. Also, there are other reports of individuals doing it in
their houses, with support of friends and with variable psychic effects[23]. Based on interviews made with individuals who had undergone trepanation decades
earlier or more recently, and even though many of the pioneers had been actively using
LSD and other psychoactive drugs when they were operated upon, no overt sign of disruptive
mental disease can be found in most people who voluntarily submitted to the procedure[24].
After this initial heroic phase, however, the main proponents of trepanation turned
their efforts towards legitimizing the procedure and its institutionalization. Funding
for research and publication in scientific magazines and the democratic fight for
its legalization in England are examples of this phenomenon in recent decades[27]. Researchers from the I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry,
St. Petersburg, published a number of papers coauthored by Feilding and Halvorson
and, with funding provided by their foundation, evaluated changes in cranial compliance
and blood flow after craniectomy or during aging[20],[21],[22],[23],[24],[25]. The ITAG supported another unpublished study evaluating MRI changes in 15 people
who voluntarily submitted to trepanation, and its site includes pdf versions of studies
on perivascular cerebrospinal fluid dynamics presented as supportive evidence for
trepanation.
The interest in trepanation may or may not decline after major enthusiasts or proponents
such as Feilding and Halvorson die. However, despite great resistance from the medical
profession in the USA and Europe, authorities eventually made favorable comments[27], and there are reports of trepanation being done by neurosurgeons in a number of
countries[19],[24],[26]. People are actively invited by organizations such as the ITAG to get the procedure
done in Mexico or in Ecuador[23],[26].
The disease burden related to drug use is increasing worldwide[28]. Hallucinogen use is considered a core element of relatively well-structured religions,
such as the Brazilian Amazon Santo Daime Church. Interest on the beneficial psychic
effects of ayahuasca is actually increasing in Europe and North America, as are reports
of intoxication from the drug[29],[30]. Also, a naive belief in “scientifically supported” information, especially among
internet fans, and a persistent interest in mystic theories such as the third eye,
may contribute to creating a favorable scenario that increasingly incites people to
resort to radical acts such as trepanation. In addition, even nowadays, traditional
medicine may lead to unexpected and extreme treatments being given for epilepsy or
other diseases[31].
In conclusion, the wide availability of information on the Web, the relative success
of internet videos and interviews with pioneers and proponents of trepanation, and
modern day interest in easy solutions for difficult problems such as chronic depression
and social maladaptation may boost the search for trepanation in the future. Doctors
should be aware of this, as they may be surprised in the emergency room by complications
from self-operation. Or by someone entering their offices and gently asking: “Doctor,
would you please make a hole in my head?”
SIDEBAR: TRANSCRIPTION OF THE ORIGINAL MANUSCRIPT SCROLL FROM HUGO BART HUGES (SCROLL’S
DIGITAL IMAGE KINDLY SENT BY MAX HARTSHORN). ORIGINAL ORTHOGRAPHY WAS RESPECTED (WWW.MADSCIENTISTBLOG.CA/MAD-SCIENTIST-6-BART-HUGES/#STHASH.TYLQQCCJ.DPBS).
SIDEBAR: TRANSCRIPTION OF THE ORIGINAL MANUSCRIPT SCROLL FROM HUGO BART HUGES (SCROLL’S
DIGITAL IMAGE KINDLY SENT BY MAX HARTSHORN). ORIGINAL ORTHOGRAPHY WAS RESPECTED (WWW.MADSCIENTISTBLOG.CA/MAD-SCIENTIST-6-BART-HUGES/#STHASH.TYLQQCCJ.DPBS).
BRAIN BLOOD VOLUME
THE MECHANISM OF BRAIN BLOOD VOLUME
The Large Mechanism:
I. Man’s position is upright. II. The cranium seals at the end of growth. III. Blood
is heavier than cerebrospinal fluid. These three factors cause the brainbloodvolume
to decrease as a mouthful of cerebrospinal fluid replaces it. The brainmetabolism
slows down, originality and creativity diminish, youth has come to an end. By an increase
of the brainbloodvolume the metabolism is accelerated, due to the intake of more oxygen
and glucose from the blood and the output of more carbon dioxide to the blood, and
more brain functions, including consciousness, are improved. The Handstand: Stand
on your head for ten minutes. The columns of blood and cerebrospinal fluid that press
on the cranial cavity in that position differ in length, the column of cerebrospinal
fluid reaching only the base of the spine. In the cranial cavity, the blood capillaries
expand slowly, whilst cerebrospinal fluid is pressed out and the brainmetabolism remains
at higher level for several hours. The Handgrip: Keep the neck veins closed with two
fingers pressed against the windpipe. Maintain the grip with short interruptions for
ten minutes. The capillaries in the cranial cavity are filled with more blood by the
force of the heart and an equal volume of cerebrospinal fluid is pressed out of the
central nervous through the nerve channels. Pressing Up: Apply the handgrip, keep
the abdomen contracted, exhale and suck vigorously as much blood as possible from
the body to the lungs. Now inhale deeply, release the hand-grip and press the blood
out of the lungs. The bigger volume of blood the heart pumps out after that meets
an increased resistance from the abdominal contraction and more blood finds its way
into the cranial cavity than by means of the hand grip alone. Osmotical: For a few
days eat very little protein and then so much of it, that the blood gets overloaded
with urea, the main product of protein metabolism. This attracts by osmotical means
a portion of the cerebrospinal fluid, instead of which an equal volume of extra blood
remains “hanging” in the cranial cavity. Operatively: The effect of making a hole
in the skull is to restore the expansion possibilities of the brain membranes. History:
The trepanation hole in each of the many skulls found together in Peruvian tombs show
that the operation was part of the initiation into a higher caste. It is still a common
practice in parts of Central Africa. With today’s knowledge of operating techniques
one can easily do this by oneself. The Adrenal Reflex: After a hot bath take a cold
bath. By reflex the adrenal glands then release so much adrenaline at once that the
brainbloodvolume increase noticeably. With daily use of adrenaline one must provide
the raw materials for its synthesis by eating sufficient fruits. Drugs: The brainbloodvolume
is also increased by the use of alcohol, but the accelerated brain metabolism leaves
the user drunk. Hemp does not lead to narcotic effects, as alcohol does, nor to addiction
as tobacco does. Addiction to toxic drugs (narcotics) can lead to death on withdrawal,
whereas using the non-toxic “Psychovitamins” (substances that temporarily increase
the brainbloodvolume by constricting the neck veins) one will never need more than
the standard dose and one can stop at any time without disagreeable after effects.
Synthetic psychovitamins like psilocybin, mescaline and L.s.d. produce a bigger increase
in the brainbloodvolume than hemp does. As a result of its accelerated metabolism,
the brain takes more glucose from the blood. By eating a mouthful of sugar at the
onset of agitation or fatigue, one prevents the progressively worse symptoms of hypoglycaemia,
such as cold hands, chills, trembling and paranoia, which occur when adrenalin is
secreted as an emergency reaction to supply the brain with new glucose from the liver.
If no sugar is taken, the action of adrenalin may strain the heart, and when the adrenalin
is exhausted, the ego may get lost. By eating enough sugar the experience is made
more positive. Pregnancy: The pregnancy hormones constrict the neck veins of the mother.
THE EGO
The Small Mechanism
A reflex, by constricting the arteries leading to the rest of the brain, concentrates
the brainbloodvolume in the parts of the brain which are in action. (Decreased brainbloodvolume
limits the number of brain centres that can function simultaneously, and reduces the
volume of blood directed into those centres). A closed circuit is formed by one’s
perception of the word one speaks as one speaks it perception of the word is simultaneous
with the reflex action that concentrates the brainbloodvolume in the speaking centre,
word recognition in turn becomes the stimulus that triggers the reflex. A chain of
word associations establishes and maintains a priority in the direction of brainbloodvolume
to the centres for speaking, listening, writing and reading. Ego Loss: The control
of the speaking centre (and the other word-communication centres) over the coordination
of the brain functions is a conditioned reflex which is deconditioned not only when
the meaning of the word is lost, but also by prolonged “sugarlack”, since the reflex
action fails to supply the centres with more energy as long as the blood contains
too little glucose. The Third Eye: Trepanation restores the intra-cranial pressure
which is necessary to replace the blood lost to gravity as the cranium sealed, and
all brain centres are again able to function independently of the conditioned reflex,
still using it for more effective concentration. Origin of The Ego: Talking and the
ego are developed by the meaning the parents give to the word. The child is made to
change his behaviour at the same time that a formula is repeated in his ears, until
the recognition of it in his listening centre causes the change in behaviour. Once
conditioned by the formulas the child recognizes them among the sounds he produces
himself by the occurrence of the changes in his own behaviour. The ineffectiveness
of the child’s repetition of the formulas to cause the same behaviour-change in an
outside projected image of himself makes his own reaction dependent on whether he
identifies with himself or with the image. Identification with the image is effected
by a constriction of the arteries to the parts of the brain that are threatening the
ego resulting in repression from consciousness and exclusion from function.
