Ancient brain surgery, dating back thousands of years, represents an early and surprising chapter in human medical history. This practice, involving direct intervention with the skull and brain, reveals ingenuity and medical understanding for its time. Exploring these ancient procedures offers insights into our ancestors’ resourcefulness and their efforts to alleviate suffering.
The Practice of Trepanation
The primary form of ancient brain surgery was trepanation, a procedure involving the intentional creation of a hole in the human skull. This was achieved through methods such as drilling, scraping, or cutting away a section of the cranial bone. Evidence suggests these operations were performed on living individuals, as indicated by signs of bone healing found on ancient skulls. Trepanation is one of the oldest surgical procedures known, with archaeological findings dating back at least 7,000 to 10,000 years.
This practice was geographically widespread, appearing across diverse ancient civilizations from the Neolithic period onward. Skulls bearing evidence of trepanation have been discovered in regions including Peru, Greece, Rome, and Siberia. The procedure exposed the dura mater, the membrane surrounding the brain, to address intracranial conditions.
Reasons and Rituals
Ancient brain surgery was performed for both medical and non-medical reasons. Medically, it addressed conditions such as head injuries, including skull fractures, and relieved pressure on the brain following trauma. It also treated symptoms of diseases like epilepsy, severe headaches, and certain mental disorders. The procedure aimed to drain fluid or remove skull fragments.
Beyond physical ailments, trepanation was also undertaken for ritualistic or spiritual purposes. Some ancient societies believed the procedure could release evil spirits thought to cause abnormal behavior or illness. Fragments of trepanned bone were sometimes kept and worn as charms to ward off these spirits.
Ancient Surgical Techniques and Instruments
Ancient practitioners employed various techniques to perform trepanation, adapting to available materials and knowledge. Common methods included scraping the bone surface with an abrasive tool, boring a circular hole, or making intersecting cuts to remove a square or rectangular section of the skull. Other techniques involved incising a circular groove to remove a disk of bone or drilling several small, connected holes which were then joined. The depth and intensity of these cuts often varied based on the surgeon’s experience and cultural practices.
Instruments were crafted from readily accessible materials. Early tools included sharpened flint blades, obsidian knives, and harder stone implements. Later, metals such as bronze and copper were utilized for instruments like bronze knives and specialized trephine drills. In ancient Peru, a ceremonial knife called a tumi was sometimes used for scraping or cutting, while in the South Pacific, sharpened seashells served as cutting tools.
Evidence of Survival and Healing
Archaeological evidence from trepanned skulls provides insights into the outcomes for individuals who underwent this ancient surgery. Many skulls show clear signs of bone regrowth and healing around the trepanation site, indicating patient survival. Forensic anthropology helps determine if the surgery was performed on a living person and if they lived long enough for bone regeneration to occur. The presence of extensive bone remodeling or rounded margins around the opening confirms long-term survival.
Survival rates varied across different periods and cultures, but some regions show surprisingly high success rates given the limited technology and absence of modern anesthesia or antiseptics. For example, studies of ancient Peruvian skulls suggest survival rates ranging from 62.5% to 83%. In Late Iron Age Switzerland, a survival rate of 78% has been observed. While many individuals recovered and lived for years after the operation, other skulls without signs of healing indicate the procedure was not always successful.