To relieve pressure from bleeding after a blow to the head, surgeons often drill or cut into the skull to allow fluids to drain. But people figured out the advantages of the procedure long before the advent of modern surgery. Trepanation, the removal of bone from the skull, is the most ancient surgical technique known. Archeologists have found trepanned skulls dating from the late Neolithic, some 5,000 years ago. Now a team of French and German researchers has suggested that the procedure goes back even further, to at least 7,000 years ago.
The evidence comes from the French village of Ensisheim. To date, archeologists there have unearthed 45 graves containing 47 individuals. One grave held the remains of a 50-year-old man who had two holes in his skull. Both holes were remarkably free of surrounding cracks and were clearly the result of surgery, not violence. One hole, in the frontal lobe, is about 2.5 inches wide; the second, at the top of the skull, is about an inch wider.
Most questionable trepanations are rather small, and with some you cannot tell the shape of the original hole that was made within the skull, or whether it was a fracture, says archeologist Sandra Pichler of Freiburg University in Germany, a member of the team. But in our case you can still see the very straight, slanting edges of the larger trepanation, and this is artificial. There is no natural explanation for a hole like that.
Both holes had time to heal before the man died--the smaller hole is completely covered over with a thin layer of bone; the larger is roughly two-thirds covered--and neither shows signs of infection. So they must have had a very good surgeon, and there must have been some way or another of avoiding infection, Pichler says. Pichler and her colleagues estimate that it would take at least six months, and perhaps as much as two years, for such extensive healing. Since the two holes did not heal to the same degree, it’s likely they were made during two separate operations.
The team doesn’t know why the man was operated on. Nor can they be sure exactly how the trepanations were performed, although the cut marks indicate that the bone was removed by a mixture of cutting and scraping. Stone Age tools were certainly up to the task: flint knives are actually sharper than modern scalpels.
The trepanations were done so perfectly that this can’t be the oldest one, Pichler says. They must have practiced somehow, and the knowledge of how to do this kind of operation must have been passed down, Pichler says. The fact that there are two trepanations is further corroboration: if there had been just one, you could say that they were lucky. But if you survived two such operations, your surgeon must have known what he was doing.