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Skull of male with trepanation, who had a hereditary deformation of the skull

New study reveals trepanation surgery in ancient Siberia

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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

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



I always wondered if the ancient survivors with the larger trepanation holes had some (obviously sterilized) skullcap patch to cover where the surgery took place. That would make sense. Who knows what material they may have been made with but if they did make "skull patches" then it seems it was material that biodegraded into nothingness over time.

Peter Harrap's picture

Time, old age. The questions of mortality. WE operate, we treat cancers, we transplant everything. People survive for a time and die. They survive long enough for the roughedges to regrow, and then die of infections, or they are killed by such experiments.

It is of course a form of torture. I like the Bosch engraving you referred me to April, the "surgeon has an upturned funnel on his head, the woman a book. They do not look too keen to receive like treatment. The skull with the big hole and the fractures looks to me like a murder victim, the one where it is claimed there was regrowth? Well, I would like to examine it under an electron microscope and see if its true, or just sanded smooth...

Even if the victim survived and the regrowth was real, for how long before he/she succumbed to the wound since the regrowth affords no protection from infection.

I think you will grant the difference between a tiny hole where the cerebellum was and these gaping chasms? in which case I doubt they are trepanation.


Roberto Peron's picture

I must admit Peter that you have some points.  For one, if these individuals lived then they lived with holes in their skulls.  I'm not an MD but wouldn't that heighten the risk of infection? Further, I wonder if this scenario is possible.....a hole is put into a human skull for whatever reason, the person dies, is it possible the skull continued to grow (heal) after death?  

I also wonder about something else.  Some of the holes are round and appear precise while others appear jagged and not precise at all.  Regarding the ones that are not precise then it is possible these people were killed by weapons or animals or even falls.  But, then how do we explain the skulls with precise and rounded holes?


ancient-origins's picture

Hello Peter,

There is very firm evidence for trepanation surgery, dating all the way back to the Neolithic period. Some holes are extremely precise, others show scrape and drill marks, and in other cases the actual drill tool has been found. In Peru, they have found 'practice skulls', with holes drilled at varying depths and in different spots on the skull. 

Sizes of holes vary from very small to very large. Here is an example of a very large one:

Evidence of survival comes from signs of regrowth and healing around the drill site. They are able to determine approximately how many more years the individual survived based on the amount of regrowth that has occurred.

April Holloway


Peter Harrap's picture

I have to disagree. I must.

1.Nobody could survive with a hole in their head like that.

2.There was no such "surgery" then at all, because of 1. and because the evidence does NOT prove the hole was created and that then the victim lived a long and healthy life.

3.Trepanation existed to release pressure in the brains of certain individuals. A very small hole was made where you naturally had one as a baby, but it was very small, and with knowledge of yoga the practise was discontinued anyway. It did not work very well.

4.Go and work in an E.N.T. operating theatre for several months and observe, preferably through a microscope. then do the same in a normal operating theatre where chest cavities and skulls are opened. I have done both, and really therefore cannot credit this idea as at all knowledge-based (scientific- a word too lightly used!)



Mark Miller's picture


Mark Miller has a Bachelor of Arts in journalism and is a former newspaper and magazine writer and copy editor who's long been interested in anthropology, mythology and ancient history. His hobbies are writing and drawing.

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