A trephine was used for operations on the skull. It is presumably the oldest operation known. It was practised, even in the stone-age, to allow the escape of a demon causing headaches, melancholia or epilepsy. In the 19th century however these instruments were used to open the skull and remove tumours and swellings. These examples have both brass and wooden handles (ebony and wallnut), the actual drill from metal and adjustable.