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        Prehistoric Surgery: (The Ancient Art of Medicine)

On prehistoric brain surgery anatomist Professor Kappers reminisced, "It is even probable that the trephine holes found in prehistoric skulls 50,000 years old were made for curative purposes".

(Ref: http://www.time.com )

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Mesopotamian medicine was taken very seriously. Practitioners were priests and were ruled by the strict laws included in the code of King Hannurabi. This code, carved on a black stone eight feet high which was discovered at Shush in what is now Iran in 1901, can be seen today at the Louvre Museum in Paris. At its top can be seen the emperor Hannurabi receiving the laws from the sun god Shamash. His code details family law, the rights of slaves, the penalties for theft and the rewards for success and the severe punishment for failure on the part of the surgeon. We have evidence from these writings that surgical conditions such as wounds, fractures and abscesses were treated. Thus we read:

If a doctor heals a free man's broken limb and has healed a sprained tendon, the patient is to pay the doctor five shekels of silver. If it is the son of a nobleman, he will give him three shekels of silver.

If the physician has healed a man's eye of a severe wound by employing a bronze instrument and so healed the man's eye, he is to be paid ten shekels of silver.

If a doctor has treated a man for a severe wound with a bronze instrument and the man dies and if he has opened the spot in the mans eye with the instrument of bronze but destroys the mans eye, his hands are to be cut off. (2)

 

Article: (Dec 18, 2012) Denverpost.com. 

'Archaeologists find Prehistoric Humans Cared for Sick and disabled'

Archaeologists have established that prehistoric people living with congenitally crippling diseases, making them unable to care for themselves, were looked after for as long as ten years  before their deaths. Skeletal remains from Vietnam, dating back over 4,000 years show the unnecessary provision of health care, reflecting some of the most important aspects of human social culture. Among archaeological finds there are at least "30 known cases in which the disease or pathology was so severe, they must have had care in order to survive".       (Quick-link)

 

 

Article: (July 20, 2012) National Geographic. 

'Neanderthals Were Self-Medicating'

'A cave in northern Spain that previously yielded evidence of Neanderthals as brain-eating cannibals now suggests the prehistoric humans ate their greens and used herbal remedies. Not only did our extinct cousins prefer grilling vegetables to steaks, they were also dosing themselves with medicinal plants, according to a team led by Karen Hardy, an archaeologist at the Catalan Institution for Research and Advanced Studies in Barcelona.

The cave dwellers' diet was found to include yarrow and chamomile, both bitter-tasting plants with little nutritional value. "We know that Neanderthals would find these plants bitter, so it is likely these plants must have been selected for reasons other than taste"—probably medication, Hardy said in a statement. "It fits in well with the behavioural pattern of self-medication by today's higher primates, and indeed many other animals."

It's impossible to know what cures Neanderthals sought from the plants, but people use them today to treat a variety of ailments, she noted. "Chamomile is very well known as a herbal treatment for nerves and stress, and for digestive disorders," while yarrow is used to treat colds and fevers and works as an antiseptic, she said'      (Quick-link)

 

Article: (Oct, 2007), 'Nature Proceedings'.

'Neolithic France; The Earliest Amputation'. 

Scientists unearthed evidence of the surgery during work on an Early Neolithic tomb [4900-4700 BC] discovered at Buthiers-Boulancourt, about 40 miles (65km) south of Paris. They found that a remarkable degree of medical knowledge had been used to remove the left forearm of an elderly man about 6,900 years ago. The patient seems to have been anaesthetised, the conditions were aseptic, the cut was clean and the wound was treated, according to the French National Institute for Preventive Archaeological Research (Inrap).

The revelation could force a reassessment of the history of surgery, especially because researchers have recently reported signs of two other Neolithic amputations in Germany [Sondershausen in eastern Germany] and the Czech Republic [Vedrovice, in Moravia]. It was known that Stone Age doctors performed trephinations, cutting through the skull, but not amputations. “The first European farmers were therefore capable of quite sophisticated surgical acts,” Inrap said. The discovery was made by Cécile Buquet-Marcon and Anaick Samzun, both archaeologists, and Philippe Charlier, a forensic scientist. It followed research on the tomb of an elderly man who lived in the Linearbandkeramik period, when European hunter-gatherers settled down to agriculture, stock-breeding and pottery. The patient was important: his grave was 2m (6.5ft) long — bigger than most — and contained a schist axe, a flint pick and the remains of a young animal, which are evidence of high status. The most intriguing aspect, however, was the absence of forearm and hand bones. A battery of biological, radiological and other tests showed that the humerus bone had been cut above the trochlea indent at the end “in an intentional and successful amputation”.  Mrs Buquet-Marcon said that the patient, who is likely to have been a warrior, might have damaged his arm in a fall, animal attack or battle.

“I don’t think you could say that those who carried out the operation were doctors in the modern sense that they did only that, but they obviously had medical knowledge,” she said. A flintstone almost certainly served as a scalpel. Mrs Buquet-Marcon said that pain-killing plants were likely to have been used, perhaps the hallucinogenic Datura. “We don’t know for sure, but they would have had to find some way of keeping him still during the operation,” she said. Other plants, possibly sage, were probably used to clean the wound. “The macroscopic examination has not revealed any infection in contact with this amputation, suggesting that it was conducted in relatively aseptic conditions,” said the scientists in an article for the journal Antiquity. The patient survived the operation and, although he suffered from osteoarthritis, he lived for months, perhaps years, afterwards, tests revealed. Despite the loss of his forearm, the contents of his grave showed that he remained part of the community. “His disability did not exclude him from the group,” the researchers said. The discovery demonstrates that advanced medical knowledge and complex social rules were present in Europe in about 4900 BC, and that major surgery was likely to have been more common than we realised, Mrs Buquet-Marcon said. (3)

 

 

 

   Trepanning: Prehistoric Brain Surgery:

Trepanation is perhaps the oldest surgical procedure for which there is evidence, and in some areas may have been quite widespread.

An ancient site in Ishtikunuy, located near Lake Sevan, in Armenia yielded two particular skulls from approx' 2,000 BC that showed evidence of head surgery. The first was he skull of a woman with a head injury which made a hole a quarter of an inch wide. A plug of animal bone had been inserted in its place. The fact that the woman survived was evident from the cranial growth around the plug before she died. The second skull as another woman, who had had a blunt object that had splintered the inner layers of the cranial bone. The 'Surgeon' cut a larger hole around the puncture and removed the splinters. Evidence shows that she survived another 15 years. Obsidian razors have been found at the site that are still sharp enough to be used today. (9)

The well-preserved skull of Gadevang Man, a prehistoric 'bog body', dated 480-60 BC, found in Denmark (Left). The skull shows signs of surgical trepanning.

The precise cuts that can be seen on some of the trephined skulls, and the re-growth of the bone (which proves that the patient/victim survived the operation), indicate that prehistoric people had the ability and knowledge to be successful surgeons.  

 

"This operation involves the removing of one or more parts of the skull without damaging the blood vessels, the three membranes that envelope the brain – the dura matter, pia mater and arachnoid – or the actual brain; not surprisingly, it is a procedure that requires both skill and care on the part of the surgeon" (Rudgely 1999, p-126).

 

Out of 120 prehistoric skulls found at one burial site in France dated to 6500 BC, 40 had trepanation holes. Surprisingly, many prehistoric and pre-modern patients had signs of their skull structure healing; suggesting that many of those that proceeded with the surgery survived their operation.  (1)

 

Extract: 'Archaeologists have found trepanned skulls dating from the late Neolithic, some 5,000 years ago. Now a team of French and German researchers has suggested that the procedure goes back even further, to at least 7,000 years ago.

The evidence comes from the French village of Ensisheim. To date, archeologists there have unearthed 45 graves containing 47 individuals. One grave held the remains of a 50-year-old man who had two holes in his skull. Both holes were remarkably free of surrounding cracks and were clearly the result of surgery, not violence. One hole, in the frontal lobe, is about 2.5 inches wide; the second, at the top of the skull, is about an inch wider.

Most questionable trepanations are rather small, and with some you cannot tell the shape of the original hole that was made within the skull, or whether it was a fracture, says archaeologist Sandra Pichler of Freiburg University in Germany, a member of the team. But in our case you can still see the very straight, slanting edges of the larger trepanation, and this is artificial. There is no natural explanation for a hole like that.

Both holes had time to heal before the man died--the smaller hole is completely covered over with a thin layer of bone; the larger is roughly two-thirds covered--and neither shows signs of infection. So they must have had a very good surgeon, and there must have been some way or another of avoiding infection, Pichler says. Pichler and her colleagues estimate that it would take at least six months, and perhaps as much as two years, for such extensive healing. Since the two holes did not heal to the same degree, it’s likely they were made during two separate operations.

The team doesn’t know why the man was operated on. Nor can they be sure exactly how the trepanations were performed, although the cut marks indicate that the bone was removed by a mixture of cutting and scraping. Stone Age tools were certainly up to the task: flint knives are actually sharper than modern scalpels.

The trepanations were done so perfectly that this can’t be the oldest one, Pichler says. They must have practiced somehow, and the knowledge of how to do this kind of operation must have been passed down, Pichler says. The fact that there are two trepanations is further corroboration: if there had been just one, you could say that they were lucky. But if you survived two such operations, your surgeon must have known what he was doing'.

 Ref: http://discovermagazine.com

 

Trepanation in the Indus Valley culture: The skull on the right was found in a Harrapan setting,  circa 4,000 B.P. The link below leads to fascinating article describing a Neolithic skeleton with multiple-trepanated skull found in Kashmir, the archaeological circumstances of the find, the dating, the background, the skeletal evidence, the details of the trepanation and possible affiliations to the Indus civilization. It speculates briefly about possible medical grounds for the surgery.

Ref: http://www.andaman.org/BOOK/reprints/sankhyan/burzahom.htm

 

 

 

Open Heart Surgery.

 The Soviet Academy of Sciences announced in 1969 that a number of ancient skeletons, found in central Asia showed signs of surgery having been performed in the area of the heart. Every feature corresponded to what today is called a 'Cardiac Window', enabling surgeons to perform open heart surgery. (9)

 

 

 

   Dentistry:
 

Article (April, 2012): Beeswax as Dental Filling on a Neolithic Human Tooth

The finding of a human 6,500 year old partial mandible associated with contemporary beeswax covering the occlusal surface of a canine, could represent a possible case of therapeutic use of beeswax during the Neolithic period in Slovenia. Although the possibility of treatment of sensitive tooth structure by means of some type of filling has been supposed, there is no other published evidence on the use of therapeutic-palliative substances in prehistoric dentistry. In ancient Egypt, external applications, composed of honey mixed with mineral ingredients, were used to fix loose teeth or to reduce the pain, as reported in the Papyrus Ebers, dating back to the XVI century BC. (Source: http://www.plosone.org)

 

Article: MSNBC (2006) - Proving prehistoric man’s ingenuity and ability to withstand and inflict excruciating pain, researchers have found that dental drilling dates back 9,000 years.

Primitive dentists drilled nearly perfect holes into live but undoubtedly unhappy patients between 5500 B.C. and 7000 B.C., an article in Thursday’s issue of the journal Nature reports. Researchers carbon-dated at least nine skulls with 11 drill holes found in a Pakistan graveyard.

That means dentistry is at least 4,000 years older than first thought — and far older than the useful invention of anaesthesia.

(Ref: http://www.msnbc.msn.com/id/12168308/)

 

(Extract from 'THE TIMES', Thurs April 12th 2001).

Prehistoric dentists may have been using stone drills to treat tooth decay up to 9,000 years ago, a team of archaeologists has discovered.

Excavations at a site in Pakistan have unearthed skulls containing teeth dotted with tiny, perfectly round holes. Under an electron microscope, they revealed a pattern of concentric grooves, that were almost certainly formed by the circular motion of a drill with a stone bit.

The discovery, which was made at an archaeological dig in Mehrgarh, in Baluchistan Province, offers the earliest evidence of human dentistry.

The excavated village belonged to a civilisation that thrived between 8,000 and 9,000 years ago, whose members cultivated crops and made jewellery from shells, amethyst and turquoise.

Andrea Cucina, of the University of Missouri-Columbia, who found the molars with telltale marks, said: “At this point we can’t be certain, but it is very tantalising to think they had such knowledge of health and cavities and medicine to do this”.

Dr Cucina, whose research is reported in New Scientist magazine, said the holes would probably have been filled with some sort of medicinal herb to treat tooth decay. Any filling would long ago have decomposed.

The dental discovery was made while Dr Cucina was washing teeth from the Mehrgarhing and spotted the tiny hole in the biting surface of a molar. The hole was too perfectly round to have been caused by bacteria and the tooth had been found in a jawbone, ruling out the possibility that it had been pierced to be strung on to a necklace.

The Top of the hole was rounded from chewing, suggesting that it was made while the owner was still alive.

(Examples of Prehistoric Drilling)

 

 

   Prehistoric Egyptian Surgery:

In ancient Egyptian medicine the skills and knowledge of doctors developed from the legacy of the prehistoric age. Doctors in ancient Egypt were usually also priests, and religious rituals continued to be used alongside rational treatments as both were believed necessary for a cure. Important deities invoked in medicine included Imhotep, the god of healing, who was formerly doctor to Pharaoh Zoser in the 3rd millennium BC, and Thoth, god of wisdom and learning.

A system of medical training was established in the temples and a written language developed using hieroglyphics. Medical treatments were recorded on papyri such as the Papyrus Ebers and the Papyrus Edwin Smith. The standard work used by Egyptian doctors was the Book of Thoth, a collection of ritual and rational treatments. The religious practice of mummification, in which the organs of the body were removed, helped Egyptian doctors to gain an understanding of human anatomy, although dissection was banned for religious reasons. However, Egyptian doctors began to practise basic surgery such as the removal of growths on the skin or cataracts from the eyes. Egyptian doctors believed that illness was often caused by the body's channels becoming blocked because of rotting food in the stomach, a practical theory based on their observation of the River Nile. Patients affected were given emetics to make them vomit or laxatives to loosen their bowels and clear the blockage.

Ref: http://encyclopedia.farlex.com

 

Article: (Oct, 2012) - 'MessageToEagle.com'.

'Evidence of Sophisticated Prosthetics in Ancient Egypt'

'In 1996, scientists discovered that the 2600-year-old mummy of an Egyptian priest Usermontu in the Rosicrucian Egyptian Museum drew a worldwide attention when an x-ray revealed an ancient nine-inch metal screw connecting the mummy's thigh and lower leg. And according to Dr. Richard Jackson, orthopedic surgeon for BYU's athletic team, the pin was made with a lot of biomechanical things we still use to make sure we get good fixation in stabilizing bone! Now, the results of scientific tests using replicas of two ancient Egyptian artificial toes, including one that was found on the foot of a mummy, suggest that they’re likely to be the world’s first prosthetic body parts'.

 

Images of 2600 year old Egyptian surgical screw (left) and prosthetic toe (right).

(Link to Full Article)

Circumcision:

Circumcision might well be claimed to be the most ancient 'elective' operation and was practiced in Ancient Egypt by assistants to the priests on the priests and on members of Royal Families. There is remarkable evidence for this carved on the tomb of a high ranking royal official which was discovered in the Saqqara cemetery in Memphis and is dated between 2400 and 3000 BC.

This represents two boys or young men being circumcised. The operators are employing a crude stone instrument. While the patient on the left of the relief is having both arms held by an assistant, the other merely braces his left arm on the head of his surgeon. The inscription has the operator saying 'hold him so that he may not faint' and 'it is for your benefit'. (2)

(Ancient Egypt Homepage)

 

 

(Shamanism)

(Healing With Sound)

(Tattooing and Acupuncture)

(Prehistoric Drug Use)

(Healing Homepage)

 

(Prehistoric Science and Technology Homepage)

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References:

1). Restak, Richard (2000). "Fixing the Brain", Mysteries of the Mind. Washington, D.C.: National Geographic Society.
2). Harold Ellis. The Cambridge Illustrated History of Surgery. Cambridge University Press. (978-0-521-89623-8)
3).  http://precedings.nature.com/documents/1278/version/1/html
9). Rene Noorbergen. Secrets of the Lost Races. 1977. New English Library.
 
 
Further Research:
 
Study of Peruvian trepanation in 1000 year old skulls: http://www.pasthorizonspr.com/index.php/archives/12/2013/study-peruvian-trepanation-1000-year-old-skulls

 

 

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