People Have Been Performing Brain Surgery for Thousands of Years!

If you want to describe something as simple, you’d probably say, “It’s not exactly brain surgery.” There’s just nothing else that better encapsulates a practice demanding advanced training and knowledge of modern science. Except there’s just one thing: People have been practicing brain surgery for thousands of years. Even more surprising? They’ve had a pretty decent success rate.

Bronze Age skull from Jericho, Palestine, 2200-2000
Science Museum, London

Hole-y Medicine!

Fair warning: This story about prehistoric cranial surgery, known as trepanation, might not be for the faint of heart. Believe it or not, people have been drilling holes into each other’s skulls for at least 5,000 years, and not as a punishment or a way of dealing with enemies. Actually, it was done with enough care that the patients often survived — we know because their skulls show signs of healing around the hole. And while some parts of the world practiced the art a lot more frequently than other parts, it made an appearance everywhere from Peru to Russia to Scandinavia to China. Not rarely, either: Paleontologists have discovered approximately 1,500 skulls from the Neolithic era with signs of the surgery. That’s 5-10 percent of all the skulls found from that time period. We’re willing to bet that out of 50 random people you know, the number who have had brain surgery is a whole lot less than 10. Clearly, ancient people were gritting their teeth to perform this technique for a reason.

But why? That’s a mystery scientists are still struggling to figure out. There are two favored explanations, and the truth is likely somewhere in the middle. On the one hand, the surgery might have been done for medical reasons. At one site in Rostov-on-Don, nine trepanned (that is, hole-bearing) skulls were discovered in burial grounds near the Russia-Georgia border. Five of those skulls belonged to people who had experienced some kind of physical trauma, suggesting that the procedure might have been meant to cure them. That’s in line with findings at other sites around the world as well as with the better-documented medieval practice of trepanation, which was used to treat conditions such as seizures and severe headaches (sounds like the cure is worse than the disease if you ask us).

The thing is, the other five trepanned skulls from Rostov-on-Don didn’t have any kind of injury associated with them. And what’s more, they all were performed at a point on the skull called the obelion, which is high and to the back, roughly where you might gather a high ponytail. If you have to drill into your skull, that’s one of the worst places to choose. It’s very dangerous, which suggests that the people who underwent the procedure did so for a purpose they found exceedingly compelling. The fact that the hole was drilled at the exact same place in each person also suggested that there may have been a religious or ritualistic reason — and since most of these people survived long after their surgery, they may well have occupied a place of honor in the tradition.

Human skull showing different methods of trephination, Canary Islands, 1871-1930. This skull was owned by Dr. Thomas Wilson Parry (1866-1945), an English doctor who did extensive practical research into Neolithic trephination instruments and techniques.

An Ancient Talent

It might be horrifying to learn about this gruesome ancient practice, and even more so to discover that the tradition has carried on into the current day, among people who really should know that their skulls have about as many holes as they need already. But trepanation wasn’t always as unsafe as you might think. It turns out that people practicing trepanning in the classic-era Inca Empire (around 1400 C.E.) were a lot better at brain surgery than Civil War doctors nearly 500 years later. To discover that, the archaeologists compared trepanned skulls from several different eras, which showed them how practice slowly made perfect. Skulls from 400 B.C.E. to 200 B.C.E. showed only about a 40 percent survival rate, gradually rising to 75 to 83 percent by 1400 C.E.

By comparison, Civil War doctors performing similar procedures were a lot closer to those 2,000-year-old success rates: about 50 percent. Speaking with Science Magazine, bioarchaeologist Corey Ragsdale pointed out that even several centuries later, surgeons can appreciate the craft the ancient drillers practiced. “What we’re looking at is over 1,000 years of refining their methods … They’re not just getting lucky. … The surgeons performing this are so skilled.” We’re just happy that today’s surgeons have anesthesia at their disposal.

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