Surgeries and treatments come and go. A new BMJ guideline, for example, makes “strong recommendations” against the use of arthroscopic surgery for certain knee conditions. But while this key-hole surgery may slowly be scrapped in some cases due to its ineffectiveness, a number of historic “cures” fell out of favor because they were more akin to a method of torture. Here are five of the most extraordinary and unpleasant.
Trepanation (drilling or scraping a hole in the skull) is the oldest form of surgery we know of. Humans have been performing it since neolithic times. We don’t know why people did it, but some experts believe it could have been to release demons from the skull. Surprisingly, some people lived for many years after this brutal procedure was performed on them, as revealed by ancient skulls that show evidence of healing.
Although surgeons no longer scrape holes in peoples’ skulls to release troublesome spirits, there are still reports of doctors performing the procedure to relieve pressure on the brain. For example, a GP at a district hospital in Australia used an electric drill he found in a maintenance cupboard to bore a hole in a 13-year-old boy’s skull. Without the surgery, the boy would have died from a blood clot on the brain.
It’s hard to believe that a procedure more brutal than trepanation was widely performed in the 20th century. Lobotomy involved severing connections in the brain’s prefrontal lobe with an implement resembling an icepick (a leucotome).
Antonio Egas Moniz, a Portuguese neurologist, invented the procedure in 1935. A year later, Walter Freeman brought the procedure to the US. Freeman was an evangelist for this new form of “psychosurgery”. He drove around the country in his “loboto-mobile” performing the procedure on thousands of hapless patients.
Instead of a leucotome, Freeman used an actual icepick, which he would hammer through the corner of an eye socket using a mallet. He would then jiggle the icepick around in a most unscientific manner. Patients weren’t anaesthetised – rather they were in an induced seizure.
Thankfully, advances in psychiatric drugs saw the procedure fall from favour in the 1960s. Freeman performed his last two icepick lobotomies in 1967. One of the patients died from a brain haemorrhage three days later.
Ancient Greek, Roman, Persian and Hindu texts refer to a procedure, known as lithotomy, for removing bladder stones. The patient would lay on their back, feet apart, while a blade was passed into the bladder through the perineum – the soft bit of flesh between the sex organ and anus. Further indignity was inflicted by surgeons inserting their fingers or surgical instruments into the rectum or urethra to assist in the removal of the stone. It was an intensely painful procedure with a mortality rate of about 50%.
The number of lithotomy operations performed began to fall in the 19th century, and it was replaced by more humane methods of stone extraction. Healthier diets in the 20th century helped make bladder stones a rarity, too.