Was this trepanned skull found in Turkey the work of magicians or doctors?

Researchers in Turkey unearthed another trepanned skull. But was this brutal operation the work of magicians or doctors? While the academic disciplines of neurology and neurosurgery only began in the 16th century, trepanation was practiced in many parts of the ancient world and is widely recognized as the oldest known neurosurgical procedure.

A “successful” trephination occurred when a surgeon cut or sawed through a section of bone from the skull of a living individual, without damaging the underlying soft tissue. Today archaeologists in Turkey discovered a 3,200-year-old skull with a sawn-off triangular section. The big question is: who undertook this complex and seriously risky prehistoric procedure?

The Extraction of the Stone of Folly by Pieter Quast, circa 1630 ( Public domain )

Trepanned skulls in Turkey: from the Neolithic to the Middle Ages

Ancient Anatolia (modern Turkey) was one of the first regions of the world developed by the first Neolithic farmers after the last ice age. In 1958, the first publication on trepanation in ancient Anatolia was liberated, and later anthropological studies of Anatolian skeletal remains show that trepanation was practiced from Neolithic times until the Ottoman Empire. According to a 2020 NovoScriptorium article, the skulls of “forty individuals from 23 different Anatolian colonies are identified as having been subjected to trepanation”.

In 2009, a team of archaeologists announced the discovery of “the first trepanation of a living human being” had been unearthed in the Neolithic period. Asıklı Höyük archaeological site in Turkey. This particular cranial operation was performed during the Aceramic Neolithic Period , around 8000 BC. Today, showing the craft’s progress over thousands of years, another trepanned skull has been unearthed during excavations at an Early Iron Age necropolis in the hamlet of İçimli in the village of ‘Uzuntekne, in the Çatak district of Van.

The newly discovered trepanned skull found in Turkey, dating back to the Iron Age.  What will we learn about ancient brain surgery?  (Ministry of Culture and Tourism, Turkey)

The newly discovered trepanned skull found in Turkey, dating back to the Iron Age. What will we learn about ancient brain surgery? ( Ministry of Culture and Tourism, Turkey )

Medical and spiritual motivations for trepanation

This recent trephined skull in Turkey was discovered during early salvage excavations iron age necropolis which began in 2016. The discovery was recently published on the Twitter account of the Department of Excavations and Research of the General Directorate of Cultural Heritage and Museums of the Ministry of Culture and Tourism. Dr Gulan Ayaz from the Department of Archeology at Van Yüzüncü Yıl University said the find is an “extraordinary example” of trepanation dating back 3,200 years. However, the team has yet to establish why the skull was trepanned.

According to the authors of a 2011 study, trepanation in the ancient world was intended to address complaints ranging from “physical injuries to mental health problems and epilepsy.” Researchers have listed three main reasons for Neolithic trepanation. The first was magical or religious attempts to relieve negative spirits from the body. A second reason was initiation rites; next, the least common reason was therapy, to treat trauma, tumors, seizures, 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)

The Extraction of the Stone of Madness, detail from a painting by Hieronymus Bosch depicting trepanation, circa 1488. ( Public domain )

The 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 operation. Although the removed section looks fairly clean today, the drilling, cutting, sawing and scraping of a hole in the skull meant that not all patients survived. However, evidence from Peru suggests that “many did, including over 100 Inca Empire subjects”.

In 2018, a team of American archaeologists and scientists systematically studied the success rate of trepanation in different cultures and time periods. Hundreds of skulls from all over Peru have been analyzed, dating from 400 BC to the mid-1500s AD. These researchers said that if the bone around the surgical hole showed no signs of healing, the patient died during or shortly after surgery. However, when smooth bone was identified around the opening, it indicated that the patient had survived for many years after the procedure. In the Peruvian sample, the increasing trepanation survival rates seemed to show “more than 1,000 years of refinement in their methods,” said Corey Ragsdale, a bioarchaeologist at Southern Illinois University at Edwardsville.

Three trepanned patients from Peru.  These surgical marks are quite different from the trephined skull recently discovered in Turkey.  (Paulo Guereta / CC BY 2.0)

Three trepanned patients from Peru. These surgical marks are quite different from the trephined skull recently discovered in Turkey. (Paulo Guereta / DC BY 2.0 )

Whether or not the surgical subject of this trepanned skull in Turkey survived their operation will have to wait to be known, but we will probably never know if this trepanation was an act of magic or medicine.

Top image: Trepanned skulls have been found all over the world, from Siberia to Turkey to Peru. Pictured: Trepanned Peruvian patients. Source: University of Miami

By Ashley Cowie

References

Altunas, L. November 12, 2022. 3,200-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 Middle 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 the first reconstructed brain operated patient in Aşıklı Höyük . 26 August 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-age/

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

Brian L. Hartfield