Nowadays, when it comes to surgical intervention, a sterile operating room immediately appears in front of your eyes, where a patient under the influence of anesthesia is operated on by specialists armed with the finest medical instruments. But it was not always so. The first surgical experiments, including such as suturing, amputation of limbs, cauterization of open wounds, date back to ancient times. However, the oldest procedure in the history of medicine is trepanation, that is, the formation of an artificial hole in the bone tissue of the skull.
I once read on a skull with holes found in PERU, it turns out that the Incas were specialists in craniotomy!
But not only there this procedure was often used and was perfected to the smallest detail …
Hieronymus Bosch. Removing the stone of stupidity. Prado Museum in Madrid
The word trepanation comes from the Greek word "trypanon" which means "drilled hole". The trepanation process involves the removal of part of the bone structure of the skull by drilling or scraping. As a result of the operation, the ancient healer reached the dura mater - an unusually strong layer of tissue that protects the soft tissues of the brain from injury. As a rule, craniotomy was used to treat intracranial diseases.
There is a widespread belief that trepanation is characteristic mainly of some regions of Peru, since it was there that the skulls with the most impressive deformities were found. The surgical skill of the ancient Peruvians certainly fascinates modern scientists, but it must be admitted that skulls with clear signs of trepanation were also found in Europe, Russia, Africa, Polynesia, China and South America. And in some cultures this practice still exists today.
- Trepanation done two thousand years ago in the Nazca desert of Peru, presumably to relieve inflammation of the anterior cranial cavity
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The study of this phenomenon began in France in the 17th century. In 1685, a member of the Benedictine monastic order, the French philologist and historian Bernard de Montfaucon discovered during excavations in Kosherel a skull with a characteristic hole. Experts began to seriously study cases of trepanation only a century and a half later, so the scientific community then did not attach any importance to de Montfaucon's discovery. It was necessary to wait for 1816, until the French geographer and cartographer Jean-Denis Barbier du Bocage discovered a second similar skull at Nogent-le-Vierge. Examination of the skull revealed that the hole in its bone tissue was deliberately made and not the result of any trauma, accident or combat injury. The researchers were most struck by the fact that trepanation operations were performed on living people, and in most cases the patients survived.
Archaeological excavations of ancient French settlements have provided new material for researchers. Hundreds of skulls with signs of trepanation have been found in the cave of the Dead Man in the south of France, as well as in ancient burial and religious buildings in the department of Lozere. All of them belong to the Neolithic era. Scientists estimate the age of the remains at 4000-5000 years. So, in one of the burials there were one hundred and twenty skulls, forty of which had traces of trepanation. Often, the holes were made by scraping the bone with a very hard pointed stone such as flint or obsidian, and the size of the lesions could range from a few centimeters in diameter to almost half of the skull.
More than eighty percent of patients who underwent trepanation in the Neolithic era, whose skulls were found during excavations, lived for months, if not years, after surgery. This is evidenced by the beginning of the healing process around the damaged area. So, on many turtles, scientists have found foci of calcium deposits - a clear indicator of new bone growth and healing. In some cases, the holes formed as a result of trepanation were completely tightened. If no signs of healing were observed, it was logical to assume that the person died during the operation or immediately after it.
Skull of a girl who survived after trepanation with a flint burin. Neolithic era (3500 BC). Natural History Museum in Lausanne
Until recently, the burial discovered in Ensisheim, France, was considered the earliest example of trepanation. Now the primacy belongs to the burial found on the territory of Ukraine. Scientists date the remains from Ensisheim 5100 - 4900 BC, and we are talking about a man who was operated on twice, and in both cases successfully underwent surgery.
When it comes to deep antiquity, the further scientists advance in their research, the more questions arise before them. There are many hypotheses to explain why ancient civilizations resorted to this highly delicate surgical procedure. Modern indigenous people, whose healers still practice trepanning, claim that this procedure lowers intracranial pressure, relieves headaches, epilepsy and mental disorders. In some cases, trepanation is used for ritual purposes to tame evil spirits that cause disease.
Amulets from fragments of a human skull, carved during trepanation. The culture of the fields of burial urns (IX century BC). Quintana Museum in Bavaria
The latest worldwide research shows that this practice has been used to relieve pain from head injuries. This hypothesis is indirectly supported by statistical data, since adult men who regularly take part in hostilities were much more likely to be trepanned than women and children.
The rapid development of science in the 19th century led to advanced discoveries in the field of medicine, in particular, anesthesia began to be widely used, and doctors were able to operate under sterile conditions. In the old days, patients for whom trepanation was a necessary measure were operated on according to the antiseptic standards of the 18th-19th centuries, in other words, in unsanitary conditions. Mortality from sepsis as a result of such operations was almost one hundred percent. Unfortunately, antibiotics and other drugs that prevent the development of infections were not yet included in the arsenal of doctors.
Today, researchers and physicians are puzzling over the mystery of where the ancient doctors acquired the skills necessary for such a complex surgical operation, if such skills were not possessed by doctors in the 18th-19th centuries. How, using only a sharpened stone, did they remove the required amount of bone matter and get to the brain without damaging the blood vessels, the dura mater and the brain? The most surprising thing is that modern scientists do not have evidence to show the evolution of this procedure, about the numerous experiments and mistakes of ancient doctors. At the same time, the ancient methods of trepanation, received by indigenous healers from their great-grandfathers and still used today, continue to provide incredibly high patient survival.
the most complex operation associated with increased risks and requiring jewelry surgical skill, resorting to it only when there is no other means left. The amazing successes of the ancient doctors, who did not have at their disposal any antibiotics, or anesthesia, or surgical instruments, testify to the phenomenally extensive scientific knowledge of our distant ancestors from the Neolithic era.