Prince Rupert and the Surgeons

The history of a technology is often written by a practitioner of that technology; yet familiarity with the unspoken assumptions of modern practice may blind him to the very different assumptions of another age. Without an understanding of that vanished viewpoint, some bygone things may seem foolish, stupid, naive or even knavish, and be treated as subjects fit only for light amusement. Instead, the lesson for the modern technologist is that under other circumstances there were other solutions.

These thoughts arise from the attempt to reconstruct the technique of the trephining operation performed on Prince Rupert in 1667. The author, a practising neurosurgeon, found that the reconstruction was possible when he began to read old surgical texts in order to understand something that had puzzled him for a long time. The question was, why did surgeons of past ages recommend boring holes in skulls, or trepanning, under circumstances where modern surgeons would expect no benefit to the patient and, indeed, probable disaster?