A publication of the Archaeological Institute of America

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Neolithic Surgery Volume 50 Number 5, September/October 1997
by Amélie A. Walker

[image] Earliest trepanned skull found. (Courtesy Kurt W. Alt) [LARGER IMAGE]

A 7,000-year-old burial at Ensisheim, in the French region of Alsace, has yielded the earliest unequivocal evidence for trepanation, according to Kurt W. Alt of Freiburg University and his colleagues. Trepanation is a surgical operation that involves the removal of a rectangle or disk of bone from the cranial vault. Most previous claims to cases predating the Late Neolithic age have been shown to be untreated head injuries or the results of decomposition.

In trepanation the section of bone may be extracted with flint or metal blades by drilling a series of small holes, making intersecting incisions, or scraping through the bone. Why the Ensisheim individual was operated on is unknown, but in African communities that practice trepanation today, including the Kissii of western Kenya, there are two traditional motives: therapeutic (to relieve pressure due to skull fractures) and magical-spiritual (to cure headaches, epilepsy, intracranial tumors, and mental illness). On the Ensisheim skull, there are no indications of trauma or disease that might have prompted the trepanations.

The burial contains the well-preserved skeleton of a man who died at roughly 50 years of age, as well as an arrowhead and an adze typologically dated to 5100-4900 B.C., a date corroborated by a radiocarbon sample from the bone. Two trepanations had been carried out. One toward the front, measuring 2.6 by 2.4 inches, had healed completely. The second had only partially healed, probably because of its enormous size (3.7 by 3.6 inches). The larger trepanation appears to have been produced by intersecting incisions, and the smaller one may have been made in the same way. The long-term healing evident from the bone indicates the operations were successful.

© 1997 by the Archaeological Institute of America