Researchers in Turkey have unearthed yet another trepanned skull. But was this brutal operation the work of magicians or medics? While the academic disciplines of neurology and neurosurgery didn’t begin until the 16th century, trepanation was practiced in many parts of the ancient world and is widely acknowledged as the oldest known neurosurgical procedure.
‘Successful’ trepanation was when a surgeon cut or sawed a section of bone from the skull of a living individual, without damaging underlying soft tissue. Now, archaeologists in Turkey have discovered a 3,200-year-old skull with a triangular section sawed out. The big question is: who undertook this complex and seriously risky prehistorical procedure?
The Extraction of the Stone of Folly by Pieter Quast, circa 1630 ( Public Domain )
Trepanned Skulls in Turkey: From Neolithic times to the Middle Ages
Ancient Anatolia (modern Turkey) was one of the first regions in the world developed by early Neolithic agriculturists after the last Ice Age. In 1958, the first publication on trepanation in ancient Anatolia was released, and subsequent anthropological studies on Anatolian skeletal remains show that trepanation was practiced from Neolithic times up to the Ottoman Empire. According to a 2020 NovoScriptorium article, the skulls of “forty individuals from 23 different Anatolian settlements are identified to have been subjected to trepanation.”
In 2009, a team of archaeologists announced the discovery of “the earliest trepanation of a living human” had been unearthed at the Neolithic Aşıklı Höyük archaeological site in Turkey. This particular cranial operation was carried out during the Aceramic Neolithic period , around 8000 BC. Now, showing the progression of the craft over thousands of years, another trepanned skull has been unearthed during excavations at an Early Iron Age necropolis in the İçimli hamlet of Uzuntekne Village, in the Çatak district of Van.
The newly discovered trepanned skull found in Turkey, dating to the Iron Age. What will it teach us about ancient brain surgery? ( Ministry of Culture and Tourism, Turkey )
Medical and Spiritual Motivations for Trepanation
This recent trepanned skull in Turkey was discovered during rescue excavations at the Early Iron Age necropolis , which began in 2016. The find was recently posted on the Twitter account of the Excavations and Research Department of the General Directorate of Cultural Heritage and Museums of the Ministry of Culture and Tourism. Dr. Gulan Ayaz from the Department of Archaeology at Van Yüzüncü Yıl University said the discovery is an “extraordinary example” of trepanation dating back 3,200 years. However, the team has not yet established why the skull was trepanned.
According to the authors of a 2011 study, trepanation in the ancient world aimed to treat complaints ranging from “physical injuries to mental health problems and epilepsy.” The researchers listed three primary reasons for trepanation in the Neolithic period. The first was magical or religious attempts to relieve negative spirits from the body. A second reason was initiation rites; then, the least common reason was as therapy, to treat trauma, tumors, convulsions, epilepsy, migraine, loss of consciousness, and behavioral changes.
The Extraction of the Stone of Madness, detail from a painting by Hieronymus Bosch depicting trepanation, circa 1488. ( Public Domain )
Were Trepanned Skulls of Patients – or Victims?
Another unanswered question about the 3,200-year-old trepanned skull discovered in Turkey’s Van province is whether or not the person survived their surgery. While the removed section looks quite clean today, the act of drilling, cutting, sawing, and scraping a hole in the skull meant not every patient survived. However, evidence from Peru suggests “many did, including more than 100 subjects of the Inca Empire.”
In 2018, a team of US archaeologists and scientists systematically studied trepanation’s success rate across different cultures and time periods. Hundreds of skulls from around Peru were analyzed that dated to between 400 BC to the mid-1500s AD. These researchers stated that if the bone around the surgical hole showed no signs of healing, then the patient had died either during or shortly after the surgery. However, when smooth bone was identified around the opening, this indicated that the patient had survived for many years after the procedure. In the Peruvian sample, increasing rates of trepanation survival seemed to show “over 1,000 years of refining their methods,” said Corey Ragsdale, a bioarchaeologist from Southern Illinois University in Edwardsville.
Three trepanation patients from Peru. These surgical marks are quite different from the trepanned skull recently found in Turkey. (Paulo Guereta / CC BY 2.0 )
We will have to wait to find out whether the surgical subject of this trepanned skull in Turkey survived their operation or not, but we will probably never know whether this trepanation was an act of magic or medicine.
Top Image: Trepanned skulls have been found worldwide, from Siberia to Turkey to Peru. Pictured: Peruvian trepanation patients. Source: University of Miami
By Ashley Cowie
Altunas, L. November 12, 2022. A 3200-year-old trepanned skull discovered in eastern Turkey’s Van province . Arkeo News. Available at: https://arkeonews.net/a-3200-year-old-trepanned-skull-discovered-in-eastern-turkeys-van-province/
Belén López, L. and Pardiñas, A. 2011. Two trepanned skulls from the Middles Ages are found in Soria, Spain . Anthropological Science, 119(3): 247-257, 2011. Available at: https://www.sciencedaily.com/releases/2012/05/120509092522.htm
Cohut, M. September 6, 2019. Curiosities of Medical History: Trepanation . Medical News Today. Available at: https://www.medicalnewstoday.com/articles/326281?c=482728563544
Skull of first brain surgery patient reconstructed in Aşıklı Höyük . August 26, 2021. Daily Sabah. Available at: https://www.dailysabah.com/arts/skull-of-first-brain-surgery-patient-reconstructed-in-asikli-hoyuk/news
Trepanation in Anatolia, Turkey: From the Neolithic to the Middle Ages . April 4, 2020. Novoscriptorium. Available at: https://novoscriptorium.com/2020/04/04/trepanation-in-anatolia-turkey-from-the-neolithic-to-the-middle-ages/
Wade, L. June 8, 2018. South America’s Inca civilization was better at skull surgery than Civil War doctors . Science. Available at: https://www.science.org/content/article/south-america-s-inca-civilization-was-better-skull-surgery-civil-war-doctors