New study reveals trepanation surgery in ancient Siberia
Russian scientists are examining ancient human skulls and testing bronze tools on a modern skull to see how doctors in Siberia more than 2,000 years ago performed brain surgery on three adults. It is still unknown what anesthetic, if any, was used to dull the pain during the surgery.
The Siberian Times reports that the surgeries were carried out using the same principles as those found in the Hippocratic Corpus, which requires strict adherence to medical ethics and techniques. Hippocrates wrote the oath around 500 B.C.
"Prominent Novosibirsk neurosurgeon Aleksei Krivoshapkin, who was asked to examine the skulls, said: 'Honestly, I am amazed. We suspect now that in the time of Hippocrates, Altai people could do a very fine diagnosis and carry out skilful trepanations and fantastic brain surgery," according to The Siberian Times.
The ancient doctor or doctors who performed the surgeries did them at a location on the skull that minimized damage to the brain and assured longer survival. Remarkably, it appears one of the men lived for years after the trepanation surgery because some of the bone grew back.
The Institute of Archaeology and Ethnography of the Siberian Branch of the Russian Academy of Science concluded the surgeons were highly skilled, especially considering they used only one primitive tool to scrape the skulls.
Trepanation is the oldest form of neurosurgery. Scholars, including archaeologists, anthropologists and doctors, speculate early nomads of the Altai Mountains learned the technique from the medical centers of the ancient world. Alternatively, they may have developed trepanation techniques contemporaneously with prominent doctors in Greece and the Middle East, The Siberian Times says.
The trepanned skulls were of two men and a woman who lived 2,300 to 2,500 years ago.
"Analysis last year showed one of the males, who was aged between 40 and 45, had suffered a head trauma and had developed a blood clot that likely left him suffering headaches, nausea, sickness and movement problems," The Siberian Times article states.
“It was surmised that the trepanation would have been carried out to remove the hematoma, with evidence of later bone growth indicating the man survived the surgery and lived for years afterwards.”
Skull of middle-aged man with evidence of trepanation found in the Altai Mountains of Siberia (Credit: Institute of Archaeology – Will Stewart)
Doctors think the other man had surgery not because he suffered trauma but because he had a congenital skull deformation. There were no signs of trauma to the skull.
In both skulls doctors made a relatively small hole, allowing surgeons to access the brain where damage to joints and the membrane was minimal.
Modern scholars examined the skulls under a microscope to determine who the ancient surgeons were that conducted the operations. Of course there was no hint as to how the skin was removed, but they found the trepanation was done in two stages with one tool. First the surgeon or surgeons removed the surface layer of bone with a sharp tool, they then cut a hole in the skull, apparently to give access to the brain.
Krivoshapkin told The Siberian Times:
All three trepanations were performed by scraping. From the traces on the surface of the studied skulls, you can see the sequence of actions of the surgeons during the operations. It is clearly seen that the ancient surgeons were very exact and confident in their moves, with no traces of unintentionally chips, which are quite natural when cutting bone.
Krivoshapkin tried using a Tagar blade from the region that had been in a museum, on a modern skull, but the knife was too flimsy.
A replica of a bronze knife from the time was then made using modern elements by archaeologist Andrei Borodovsky, a doctor of historical sciences. Krivoshapkin then re-enacted the surgery. He said it took effort and about 28 minutes. He said the Altai region at the time was a place where the people worked in bone a lot, and that helped them understand how to do the trepanation surgery.
Featured image: Skull of male with trepanation, who had a hereditary deformation of the skull (Credit: Institute of Archaeology – Will Stewart)
By Mark Miller