Editorial Science (EFE).- The patient died shortly after the operation, but the indications show that he underwent a trephination of the skull around the year 1,500 a. C., during the Bronze Age, which represents the oldest example of this surgical procedure in the Near East.
A team of archaeologists coordinated by Brown University (United States) describes in the magazine Plos One their discovery at the Megiddo site (Israel) of the tomb of two brothers, one of whom was subjected to a toothed angular trephination.
The researchers consider that both belonged to a powerful class or even royalty, since the tomb was adorned with fine ceramics, but also because they were able to access rare medical treatments.
The tomb – dating from between 1,500 and 1,450 B.C. C. (Late Bronze Age) – was found under an elite residence at the site and DNA tests suggest that the remains are those of two brothers, whose skeletons show signs that they were seriously ill.
The skull of one of them has a square hole of about 30 millimeters in the frontal bone, from which a piece of bone was surgically removed, a procedure used to relieve pressure buildup in the head.
Angular serrated trephination involves cutting through the scalp, using an instrument with a sharp beveled edge to carve four intersecting lines in the skull, and prying out a square-shaped hole.
Trephination, an uncommon procedure at the time
This procedure, rare at the time, was performed on an individual who presented both developmental abnormalities and infectious diseases, “which leads us to suggest that this operation could have been an intervention in the face of deteriorating health,” write the authors of the investigation.
If the goal of the trephination was to keep him alive, it was not achieved, as the individual died shortly after the procedure, within days, hours, or even minutes.
The analysis of the remains revealed the poor state of health of the brothers. The eldest had an extra skull suture and an extra molar at one corner of his mouth, suggesting that he may have suffered from a congenital syndrome such as cleidocranial dysplasia.
The bones of both show minor evidence of sustained childhood iron deficiency anemia, which may have affected their development.
All of this could explain why they died young, one in their teens or early 20s and the other in their 20s and 40s, but the researchers consider it more likely that the reason was an infectious disease.
The skeletons could be the world’s first documented examples of leprosy
A third of the skeleton of one and half of the other show porosity and signs of previous inflammation in the membrane that covers the bones, which suggests that they suffered from systemic and sustained cases of an infectious disease such as tuberculosis or leprosy.
Although some bone evidence points to leprosy, it is difficult to deduce cases of this disease using only the bones, so Rachel Kalisher, coordinator of the study, is now conducting more specific analyses.
If bacterial DNA compatible with leprosy is found in them, these brothers “will be among the first documented examples of leprosy in the world,” the university said in a statement.
Few cases of trephination in the Middle East
Archaeologists know that cranial trephination has been practiced for thousands of years, evidence of which has been found from South America to Africa, but in the “Middle East you don’t see it that often: there are only a dozen examples,” Kalisher points out.
Despite all the evidence of trepanning discovered in the last 200 years, there is still much that archaeologists don’t know, such as why some are round and others are square or triangular.
The scientist is conducting a project that will investigate trephination in multiple regions and time periods that she hopes will shed more light on ancient medical practices.
“You have to be in a very serious situation to have a hole drilled in your head,” so Kalisher is interested in knowing “what can we learn if we analyze all the examples of trephination from antiquity in the scientific literature, comparing and contrasting the circumstances of each person who underwent the operation.”
