Horror or impressive early progress? Neurosurgery is older than you might think. Already 12,000 years ago, specialists drilled into the skullcaps to carry out internal interventions – the name of the operation was “trepanning”. A team with Austrian participation is enriching knowledge of Bronze Age neurosurgery with a detailed documented finding, which at the same time provides insight into patient care at the time.
The remains of two brothers were found in a tomb in the Bronze Age city of Megiddo. Genetic analysis shows the degree of relatedness. The men were scarred to the bone by disease and developmental disabilities. Not even a skull operation could save the elderly, researchers report in the journal “Plos One”.
Megiddo is an important site of biblical Israel with temples, palaces and fortresses. The trading center controlled the land connection between Egypt, Syria, Mesopotamia and Anatolia 4,000 years ago. The brothers lived in the palace grounds in the 15th century BC, reports Rachel Kalisher of the Joukowsky Institute of Archeology at Brown University in New York, who led the analysis of the bones. She assumes that both men belonged to the elite and possibly even the royal family.
About 3,500 years ago, proper burial in this region meant that the dead were buried under the floor of the house where they lived, along with offerings of food, Cypriot pottery and valuables, says Mario Martin of the Institute of Ancient History at the University of Innsbruck for the “Austria Press Agency”. Martin, co-director of the excavations at Megiddo from 2016 to 2022, assumes that this “rather peculiar tradition” had to do with ancestor worship and property claims.
The brothers received medical treatment unavailable to most other citizens. The older man’s bones were placed underground in an intact skeleton, the younger man’s in a chaotic pile. From this, archaeologists conclude that the youngest died one to three years before the older brother and was buried elsewhere, only to be exhumed after the elder’s death and buried along with him in a corner of the house.
The older brother was aged between 21 and 46 when he died. The degradation of the bony layer that covers the eye sockets reveals that he suffered from anemia or malnutrition as a child, explains Kalisher. The halves of the front bones of the skull did not grow completely together, in the upper right jaw he had an extra molar. A large part of his supporting apparatus was probably attacked by ongoing inflammation. Bone dissolution made the skeleton porous, the periosteum was hardened by inflammatory or degenerative processes. Leprosy, tuberculosis and syphilis, among others, “can leave that appearance on the bones”, explains Kalisher.
A case of successful operation, patient died
Shortly before his death, the older brother underwent trepanning. In front of the skull is a square hole with a side length of a good three centimeters. The skull was apparently surgically opened, for example to relieve excessive pressure on the brain or to prevent a deterioration in health.
The operation was performed with great precision by an experienced person, Kalisher said. However, it is not clear what exactly should help. Since the bone did not heal, it can be assumed that the man died shortly after or during the operation.
The youngest brother – who died in his teens or in his early 20s – also showed signs of anemia and disability. He was missing a molar bud and also had bone damage, presumably due to an infection. The effects on the skeleton were not as severe, possibly because he died more quickly.