Skull shows man survived surgery to ease brain pressure 2700 years ago

A skull found in China shows signs of healing after part of it was removed 2700 years ago, suggesting that a man survived at least eight weeks after surgery to relieve pressure in his head.

A man who lived in what is now China 2700 years ago had a hole cut in his skull to treat a head injury and survived. This suggests that shamanic doctors in that era could do advanced brain surgery.

This ancient skull shows signs of healing within the walls of fracture lines inflicted by a blunt force injury
Qian Wang

The Yanghai cemetery in Xinjiang, China, is a large, ancient burial ground containing the graves of a clan that practised shamanism, generally defined as a belief system using trance to communicate with the supernatural. Qian Wang at Texas A&M University and his colleagues used CT scans to analyse a skull found in the cemetery from a man aged between 30 and 35 years who lived sometime around 750 to 800 BC.

The man had experienced a blunt force injury causing an epidural haematoma, when blood accumulates under the skull. This puts pressure on the brain and can be life-threatening.

To repair the injury and relieve the haematoma, what was probably a shaman doctor removed part of the skull in a similar way to how this condition would be treated today. In modern surgery, this is called a craniotomy.

Signs of healing were seen within the walls of the fracture lines, indicating that the man made a full recovery from the procedure and went on to live for at least eight weeks.

“In order to successfully remove the haematoma, the doctor was able to design a bone flap according to the injury by using the fracture lines,” says Wang. He and his colleagues believe this is the most advanced and skilled craniotomy ever found in the Xinjiang region and in the wider Eurasian steppe.

Wang thinks this and similar discoveries make it highly likely that meticulous head surgeries were commonly performed by shamans in what is now China during the Bronze and Iron ages. Advanced procedures like this may have separated medicine from witchcraft and pioneered a more methodical and scientific approach towards healthcare, he says.

Although there is no direct evidence that the procedure was done by a shaman doctor, other discoveries nearby back up the idea it was, says Wang. One individual in the Yanghai cemetery was identified as a shaman based on a bronze knife and pointed tool, called an awl, hanging from his waist, which were probably surgical tools.

Cannabis has been found in the cemetery, which may have been used as an anaesthetic. Shamans of the Subeixi culture, from another part of China at the same time, used horsehair to suture wounds as early as 1000 BC.

Trepanation, the removal of part of the skull as a medical procedure, has been performed for thousands of years in many parts of the world, but it is less commonly found in archaeological excavations in Asia than in Europe, says Charlotte Roberts at Durham University, UK. “This is a really well-contextualised study supported by excellent visual evidence,” she says.

Journal reference:

Archaeological and Anthropological SciencesDOI: 10.1007/s12520-023-01856-8

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