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=== Cultural perspectives on trepanation === The motivations behind trepanation varied significantly across cultures, often tied to beliefs about health, spirituality, and the treatment of ailments. Early instances of the practice may have been influenced by a combination of supernatural beliefs and early understandings of physical ailments, leading to its acceptance in various medical traditions. In many cultures, it was believed that drilling a hole in the skull will let out the evil spirits that caused pain and illness. It can be explained as most head injuries and diseases, such as migraine, felt like pounding, so cutting a hole in head may help to relieve the pain and pressure. In Africa and Europe, not only this procedure was performed for spiritual reasons, but also the discs made of cranial bones were commonly used as shield from demons and evils.<ref>{{Cite journal |last1=Apuzzo |first1=Michael L.J. |last2=Liu |first2=Charles Y. |last3=Sullivan |first3=Daniel |last4=Faccio |first4=Rodrick A. |date=July 2007 |title=Surgery of the Human Cerebrum β A Collective Modernity |url=https://journals.lww.com/00006123-200707001-00002 |journal=Neurosurgery |language=en |volume=61 |issue=1 |pages=31 |doi=10.1227/01.NEU.0000255493.34063.7B |issn=0148-396X}}</ref> In China, twelve shaman corpses in a tomb were found with trephined bodies because they also had duties of doctors.<ref name=":0" /> This tells about connection of cranial surgery to religion; there was conception that open hole in head contributes to communication with god and souls of dead people. Trepanation was also associated in Chinese medicine with the balance of vital energy, or qi.<ref>{{Cite journal |last=Bates |first=Ann |date=2024-06-04 |title=Beneath the surface: A historical exploration of trepanation practices across cultures and eras |url=https://journals.sagepub.com/doi/10.1177/17504589241253486 |journal=Journal of Perioperative Practice |language=en |doi=10.1177/17504589241253486 |issn=1750-4589}}</ref> They understand trepanation as a way to balance the body and energy, spiritual and physical health. On the other hand, it was thought that cerebral disorder arise from the loss of spiritual image in ancient Peru, illness developed after being separated from body.<ref name=":6">{{Cite journal |last=Rifkinson-Mann |first=Stephanie |date=October 1988 |title=Cranial Surgery in Ancient Peru |url=http://journals.lww.com/00006123-198810000-00001 |journal=Neurosurgery |language=en |volume=23 |issue=4 |pages=411β416 |doi=10.1227/00006123-198810000-00001 |issn=0148-396X}}</ref> Trepanation would have been done in order to allow the spirit to reenter the body. In these cases, the patient may have suffered from paralysis, cerebral palsy, severe depression, or mental retardation.<ref name=":6" />
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