Researchers can only speculate on how or why this grisly form of brain surgery first developed. As far back as 7,000 years ago, civilizations around the world engaged in trepanation-the practice of boring holes in the skull as a means of curing illnesses. Humanity’s oldest form of surgery is also one of its most gruesome.

The practice finally fell out of vogue after new research showed that it might be doing more harm than good, but leeching and controlled bloodletting are still used today as treatments for certain rare illnesses. Medieval doctors prescribed blood draining as a treatment for everything from a sore throat to the plague, and some barbers listed it as a service along with haircuts and shaves. While it could easily result in accidental death from blood loss, phlebotomy endured as a common medical practice well into the 19th century.

In some cases, leeches were even used to suck the blood directly from the skin. To restore bodily harmony, their doctor would simply cut open a vein and drain some of their vital fluids into a receptacle. With this in mind, patients with a fever or other ailment were often diagnosed with an overabundance of blood. Influential physicians like Hippocrates and Galen maintained that the human body was filled with four basic substances, or “humors”-yellow bile, black bile, phlegm and blood-and these needed to be kept in balance to maintain proper health. For thousands of years, medical practitioners clung to the belief that sickness was merely the result of a little “bad blood.” Bloodletting probably began with the ancient Sumerians and Egyptians, but it didn’t become common practice until the time of classical Greece and Rome.

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