January 15, 2019

"The Extraction of the Stone of Madness."



That's a painting by Hieronymus Bosch (c.1488–1516). I'm seeing it this morning because I'm hearing about a friend's surgery and thinking about how (and when) human beings got the idea that cutting (or drilling) into the interior of the human body might improve person's medical condition. You'd think the idea "first, do no harm" is so strong and obvious that no one would dare intrude into a living human body.

The title of Bosch's painting suggests that the daring arises out of the belief that something alien has already broken in and is causing damage and needs extracting. I found the painting at the Wikipedia page "Trepanning." I knew that drilling into the human cranium is a very old practice, seen in prehistoric skulls, and I knew the distinctive term:
Trepanning... or making a burr hole... is a surgical intervention in which a hole is drilled or scraped into the human skull... At one burial site in France dated to 6500 BCE, 40 out of 120 prehistoric skulls found had trepanation holes... Hippocrates gave specific directions on the procedure.... During the Middle Ages and the Renaissance, trepanation was practiced as a cure for various ailments...

The practice of trepanning also continues today....  One of the most prominent advocates of trepanning was Dutch librarian Bart Huges. In 1965, Huges drilled a hole in his own head with a dentist drill.... Huges contend[ed] that children have a higher state of consciousness and since children's skulls are not fully closed, one can return to an earlier, childlike state of consciousness by self-trepanation....

[In] a book called Bore Hole... Joey Mellen.... describes his third attempt at self-trepanation:
After some time there was an ominous sounding schlurp and the sound of bubbling. I drew the trepan out and the gurgling continued. It sounded like air bubbles running under the skull as they were pressed out. I looked at the trepan and there was a bit of bone in it. At last!
Not just slurp... schlurp.

62 comments:

Kevin said...

No boring tag?

robother said...

I assume it originated as necessary to relive pressure caused by internal bleeding from head wounds, which would've been pretty common in hunter-gatherer territorial disputes resolved with stone age weaponry.

rehajm said...

As kids, when a mechanical toy stops working the first thought is to open it up and take it apart.

rehajm said...

You'd think the idea "first, do no harm" is so strong and obvious that no one would dare intrude into a living human body.

People think socialism is a good idea, too. People are stupid.

tcrosse said...

I need this like a hole in the head.

Meade said...

First, do no socialism.

Phil 314 said...

"You'd think the idea "first, do no harm" is so strong and obvious that no one would dare intrude into a living human body."

All surgery does "harm"

Char Char Binks, Esq. said...

The patient oughta have his head examined!

Earnest Prole said...

I would caution against viewing Bosch as a documentary artist.

Wince said...

I don’t know about the “extraction of the stone of madness”, but I just had a kidney stone and with that excruciating pain (and madness from the toxicity) I could definitely understand the medieval instinct to cut the body open in search for relief.

mockturtle said...

Just as bleeding lowered dangerously high blood pressure, increased intracranial pressure can be relieved by opening the skull. A lot of those barbaric-sounding procedures had at least some foundation in science, even when the science itself wasn't understood. Craniotomies were performed in ancient Egypt.

Anthony said...

Just for the record, as a professional archaeologist, I hate hate hate "BCE" and "CE". They're both ridiculous terms meant only to prevent delicate little academic snowflakes from using Christian terms.

I've read it argued that this is more accurate; it's not. It's the same exact dating scheme as BC/AD, counting from the same event.

I Have Misplaced My Pants said...

I'm no psychiatrist, but it seems pretty clear to me that anyone who feels there is something amiss with his or her mind/body requiring the mutilation of healthy flesh in order to remedy meets a pretty low bar for mental illness/maladaptation.

Lloyd W. Robertson said...

The things that come up on this blog. The actress Natasha Richardson died after what seemed a minor skiing accident near Montreal. She had a headache, but she actually refused treatment within the first hour or two in a fairly remote resort, then was transported by ambulance and helicopter, eventually to New York where she died. She suffered from internal bleeding under the skull, serious enough that it called for more immediate intervention. (Epidural more serious than subdural). https://ask.metafilter.com/217358/Severe-Head-Trauma

I believe she might have been saved if someone had trepanned her--but in smaller centres no one had the guts or training to do it, and in New York it may have been too late. Both respect for credentials and rear of lawsuits may have been factors: no real treatment until you get to the special place! Even people who note that effective treatment took too long don't seem to say this.
https://people.com/celebrity/natasha-richardson-tragic-delays-after-her-fatal-fall/

I Have Misplaced My Pants said...

Also: there's a lotgoing on in that painting.

madAsHell said...

I assume it originated as necessary to relive pressure caused by internal bleeding from head wounds

I'll bet it had more to do with tattoos, piercings, body dysmorphia.

madAsHell said...

......AND body dysmorphia.

aarrrrggghhh!

traditionalguy said...

4,000 years ago the Egyptians beat the Greeks to good medical practices. They probably a lot learned from doing the Mummies.

tcrosse said...

It's the standard procedure for rocks in the head.

madAsHell said...

but I just had a kidney stone and with that excruciating pain

Well.....that explains your avatar!!

Fernandinande said...

"What he extracts from the patient’s head is not a stone but a type of waterlily like the one on the table, which is left over from a previous operation. ...

In this case, rather than curing the patient’s madness the surgeon is castrating him by ridding him of his sexual desire -lust- and thus returning him to the right paths of society and Christian morality. This idea is further suggested by the name of the patient, Lubbert Das, which some authors have translated as castrated badger."

Darrell said...

Auntie Da Shitter Face drills Ritmo's skull while Inga watches and improves her posture. Chuck colludes and stands ready with a flask of Russian hooker piss that will finally prove that Trump is guilty as charged.

Rob said...

We should test it out as a cure for Trump Derangement Syndrome. First, New York Times editors and reporters.

Bob Boyd said...

It looks to me like the Stone of Madness may have fled into the guy's codpiece to escape the trepan.

stevew said...

It occurred to me that perhaps the surgery was taken up as a result of things discovered via human dissection, but then I looked it up and see that dissection was generally prohibited in the most advanced societies (Roman, Greek, Egyptian) until about the third century BC. These procedures seem to have begun earlier.

I'm getting this image in my head of the first guy who decided cutting open his buddies skull was a good idea. In my head this guy resembles someone from the back woods of the Southern US, wears the ancient equivalent of a flannel shirt, and says, "hold mah beer" before attempting the first trepanation.

Otto said...

Once you get pass the skull it's all fun and games - there are no nerves in the brain!

SayAahh said...

Surgeon's motto: When in doubt cut it out.

NorthOfTheOneOhOne said...

stevew said...

I'm getting this image in my head of the first guy who decided cutting open his buddies skull was a good idea. In my head this guy resembles someone from the back woods of the Southern US, wears the ancient equivalent of a flannel shirt, and says, "hold mah beer" before attempting the first trepanation.

Bigot much?

But, hey, we know it's the good kind of bigotry, right?

John said...

From my observations, the "Do no harm" statement is a recommendation, not a statue. I can think of a number of medical doctors who encourage and participate in the doing of harm, either to self (assisted suicide) or the unborn.

Tom T. said...

The whole reason for articulating "first, do no harm" is because human instinct runs strongly the other way: "we have to do something!"

Lucid-Ideas said...

I could while away the hours
Conferrin' with the flowers,
Consulting with the rain;
And my head I'd be a drillin'
To see if there was any fillin'
But turns out I have no brain.

joshbraid said...

So, does it help when done intelligently?

Jim said...

Darryl Revok approved! Go watch Scanners!

Bob Boyd said...

In those days the experts agreed, not wearing a large funnel on your head during surgery was strongly associated with bad outcomes.

Andrew said...

What's with the book on top of the woman's head? Is she an intellectual?

Lucid-Ideas said...

The friar is clearly upset. He knows the doctor shouldn't be operating without drinking more. Performing brain surgery while sober!?!? What is this, the dark ages!?!?

Bob Boyd said...

"What's with the book on top of the woman's head? Is she an intellectual?"

I assume she's the head librarian.

Amadeus 48 said...

My head hurts

etbass said...

Is this the same Bosch who works for the LAPD?

Amadeus 48 said...
This comment has been removed by the author.
walter said...

I hope Tin Man is board certified.
Surgery ain't funnel games.

robother said...

"What's with the book on top of the woman's head? Is she an intellectual?"

More likely a pioneer in feminine deportment studies.

cacimbo said...

The heartless surgeon.

Skookum John said...

That odd funnel hat looks like the pileus cornutus that Jews were made to wear in many European cities in the Middle Ages.

walter said...

"Joseph "Joey" Mellen (born September 1939) is the British-born author of Bore Hole, a book about his attempts at self-trepanation, influenced by Bart Huges, and his eventual success with the help of his partner Amanda Feilding. Mellen then filmed Amanda's own self-trepanation for a documentary "

So..is this guy responsible for the common reference to the head as a melon?
Or did his name fixate his thoughts toward it?
if only we could ask the head librarian.

walter said...

I Drilled a Hole in My Own Skull to Stay High Forever

With the hand trepan it took a lot of muscle, but the final time I was using an electric drill with a 6mm bit and that was a lot more straightforward. Unfortunately, the drill cable broke, so I had to stop, wrap a towel around my head, and take the drill to Mr. Lea, a man who had a flat in the basement of my building. He was brilliant—he could fix anything. He didn't ask me what I was doing. So he repaired the drill and then I got back on with it. It's really obvious when you get all the way through the skull. Quite a lot of blood comes out, and the drill bit goes in by an inch. I bandaged it all up. It took two or three days for the skin to heal over the hole. I didn't need any analgesia, and there were no complications; I was very, very careful to sterilize everything. The main danger is infection. I didn't even get a headache. It took half an hour all in all, including clearing up afterwards.

I was feeling great because I'd done it, but then I noticed after about an hour I started to feel a lightness, like a weight had been lifted off me. And then it grew a bit more and a bit more and it ended up being more than I expected. I did it in the evening and went to bed at 11 PM feeling good, and I could still feel it when I woke up the next morning. And then I realized, This is it. It's done.

walter said...

If he's still alive, should go on Rogan's podcast

Curious George said...

"Otto said...
Once you get pass the skull it's all fun and games - there are no nerves in the brain!"

“You ain't never the same when the air hits your brain.”

bagoh20 said...

"...one can return to an earlier, childlike state of consciousness by self-trepanation...."

This is pretty obvious.

BarrySanders20 said...

"What's with the book on top of the woman's head? Is she an intellectual?"

Maybe she just had the procedure and that is the way they are closing the wound. Yet the book is not centered and stays level, suggesting it is somehow mounted on the skull. Clever surgeon.

Or maybe thats how they texted people back in the day, still unsure about how surgery and digital communication worked.

walter said...

There's a hole
In my life
There's a hole
In my life
Be a happy man
I try the best I can
Or maybe I'm just looking
For too much
There's something missing from my life
Cuts me open like a knife
It leaves me vulnerable
I have this disease
I shake like an incurable
God help me please
Oh, there's a hole
In my life
There's a hole
In my life

stevew said...

NorthOfTheOneOhOne said:

Bigot much?

But, hey, we know it's the good kind of bigotry, right?


Sheesh, it was just a joke about the sort of uninformed leap it took to decide to cut a hole in a living person's skull. I mean, the joke is so obviously ridiculous because they didn't even have flannel in BC times.

grimson said...

The more extreme and chronic the pain, the more extreme the procedures to which a patient will agree.

In the movie "Pi," the central character suffers from migraines. By the end of the movie, he did his own trepanning.

Bilwick said...

Over the past year or so people here have expressed concerns over the health of Hillary Clinton. Perhaps the kind of medical procedure depicted here by Bosch would be just the remedy Queen Cacklepants needs to restore her. And while they're in there, poking around, if the surgeons could remove whatever tumor causes her statism, those of us in the pro-freedom camp would appreciate it.

DanDotDan said...

Wikipedia offered these interpretations:

It is possible that the flower hints that the doctor is a charlatan as does the funnel hat. The woman balancing a book on her head is thought by Skemer to be a satire of the Flemish custom of wearing amulets made out of books and scripture, a pictogram for the word phylactery. Otherwise, she is thought to depict folly.

Michel Foucault, in his History of Madness, says "Bosch's famous doctor is far more insane than the patient he is attempting to cure, and his false knowledge does nothing more than reveal the worst excesses of a madness immediately apparent to all but himself."

Andrew said...

Some great comments here. Ann, maybe you should make this a feature. Post a medieval painting (or any painting with peculiar features) and let the commenters go at it.

It's occurred to me that the woman in the painting is the patient's wife. Not sure how, but this is all her fault. And she will never admit it.

Ingachuck'stoothlessARM said...

tonsorially speaking, "a little off the top" had a different meaning back then

Ingachuck'stoothlessARM said...

they all seem like they are getting bored

...and what did they replace the Stone of Madness with? The Hole Of Death?

Ingachuck'stoothlessARM said...

The King issued the decree that year

"If Thou liketh thine Doctor, Thou mayest keepeth thine Doctor"

Josephbleau said...

In Chicago they have a medical instrument museum on Lake Shore Drive. In it they play a black and white movie of an outdoor trepanning, it looks like a French colonial environment. The patient is black. The doc drills the hole, removes the skull core, and punctures the dura matter with a needle. Then he sqweezes with his fingers to get the excess blood out of the brain. In the Capt. Aubrey novels Dr Maturin is the expert at this and when done he melts a silver piece to make a plug for the hole and sews the scalp flap back on. I guess it can save the brain from damage by the excess blood volume accumulating by an injury.

Ingachuck'stoothlessARM said...

judging from their expressions this looks like quite a routine affair.

our dentist sometimes makes mistakes like this, and still uses the silver amalgam plug.

Ingachuck'stoothlessARM said...

Wait! I got it!!!

It's Althouse (with the book, natch)
Meade, (with the flagon O'mead)
and Drago...
but I cant figure out who the guy in the chair is.