In medieval and Renaissance Europe it was a commonly held belief that madness resided in the ‘Stone of Madness’ or the ‘Stone of Folly,’ a hard lump thought to be found in the prefrontal cortex. Charlatan doctors would perform a surgery to extract this ‘stone’ from the patient who exhibited behaviors of mental illness, depression, stupidity, or dementia. These doctors performed a trepanation, which is scraping out a burr hole in the skull. In ancient times trepanation was believed to release evil spirits that caused madness.
No one has been able to definitively attribute this painting to a particular artist, although we know that it is from 17th Century Holland. The quack leans in over the patient, who screams out in agony; after all, this was before anesthesia and must have been quite a painful procedure to endure. The table is littered with the doctor’s tools of the trade and a servant boy stands at the ready to receive the stone upon extraction.