A Hole in the Head

Prehistoric people believed that pain and disease originated outside the body - not only from injuries but also from evil spirits. Witch doctors and shamans were employed to exorcise malevolent beings, but if they failed, there was an operation that might do the trick.

Trepannation - one of the very few prehistoric medical practices, for which we have archaeological evidence - involved cutting a small hole in the skull, often with an instrument resembling a carpenter's bit with a handle. The procedure was used to treat headaches, skull fractures, epilepsy and some forms of mental illness, and it was employed around the world - in Neolithic Gaul and Bohemia, North Africa, Asia, Tahiti, New Zealand and South America.

It was particularly popular in ancient Peru, where sharp knives of obsidian, stone and bronze were used. Skulls have been found with as many as five trepanned holes. Those who survived the operation (and some did, as healed skulls attest) had their wounds covered with a piece of gourd, stone, shell or even silver and gold. In Europe, the excised rounds of skull bone were worn as amulets.

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• Mental health