Holes in the Head: Mending Head Injuries from Pericles to Bonaparte

NEW YORK CITY, August 31, 2005???As a complement to the Metropolitan Museum???s fall exhibition on The Art of Medicine in Ancient Egypt, The New York Academy of Medicine spotlights head and neck injuries in its illuminating display of books from the Historical Collections of the Library. Holes in the Head: Mending Head Injuries from Pericles to Bonaparte will run from September 27, 2005, through January 16, 2006. Hours are 9 AM to 5 PM, Monday through Friday, with extended hours until 7 PM on Wednesdays. The exhibition is free and open to the public on the 3rd floor in the Main Reading Room of the Academy Library, 1216 Fifth Avenue at 103rd Street.

Holes in the Head draws from the Academy???s extensive collections, which are also the source of the 1600 BC Edwin Smith Surgical Papyrus on loan from the Academy to the Metropolitan Museum for The Art of Medicine in Ancient Egypt. That exhibition runs from September 13, 2005, through January 15, 2006, with the Smith Papyrus as its highlight.

A major theme of Holes in the Head is trepanning???cutting a hole in the skull to relieve pressure on the brain or to lift a compression fracture of the skull. Beginning with Renaissance editions of those parts of the Hippocratic corpus that deal with head wounds, the exhibition treats the subject of trepanning as discussed from the 4th century BC through the early 19th century. Chronologically, the exhibit closes with the works of Dominique-Jean Larrey, Chief of the Medical Corps during Napoleon???s Egyptian campaign of 1799. One of Larrey???s early 19th century biographers reported that he performed 70 amputations and seven trepanations at Acre in 1799.

???Hippocrates was quite aggressive in his treatment of head wounds and generally advocated the liberal use of the trephine, ???comments Miriam Mandelbaum, the Academy???s Curator of Rare Books and Manuscripts. ???Later practitioners such as Galen (129???200 AD) were more conservative in their advocacy of trepanning; Aurelius Cornelius Celsus (25 BC???AD 50) completely rejected its use except in the most extreme cases. The fear of infection, a very real threat to a successful outcome, outweighed the possible benefits of trepanning.???

Trepanning was used in ancient Egypt and in other parts of the world from as early as the Stone Age. However, the Edwin Smith Surgical Papyrus does not mention it. For the treatment of head injuries the author of the Papyrus recommends instead the bandaging of head wounds and, in the case of less serious injuries, the application of raw meat. The Papyrus deals prominently with head injuries in 27 of the 48 cases described.

Works by other military surgeons will also be featured. These include books by Hieronymus Brunschwieg from the 15th century, Has von Gersdorff and Ambroise Par?? in the 16th century, and John Browne in the 17th century. Browne's book, A compleat discourse of wounds . . . whereunto are added the severall fractures of the skull . . . (London, 1678), contains the earliest printed image of a surgeon trepanning the skull of a patient. Earlier works illustrate the procedure rather generically without reference to the surgeon, or they show an illustration of a trepanned skull with the appropriate trephines, which are the tools used to perform the procedure.

The New York Academy of Medicine, the country???s premier urban health policy and intervention center, focuses on enhancing the health of people living in cities through research, education, advocacy, and prevention. Visit us at www.nyam.org.

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Editors: Interviews with Academy experts are available by appointment. Call Maria Dering at (212) 873-6715.

Posted on August 31, 2005

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