Skull surgery used to treat post-traumatic osteomyelitis 4,900 years ago

Did Chalcolithic surgeons possess medical knowledge which remains poorly-understood to this day?

It sounds counter-intuitive, but there is some evidence to suppose that long-bone fractures heal faster if patients have also sustained traumatic skull injuries. The exact mechanism is not fully-understood, but may involve the cytokine interleukin-6, bone morphogenic proteins, and prolactin, all of which are released in response to a brain injury. What is remarkable is this might have been known in Chalcolithic times – and used as a treatment.

In 1992, archaeologists discovered the Early Chalcolithic cemetery of Pontecagnano in southern Italy, associated with the Gaudo Culture and dating to around 4,900 to 4,500 years ago. PC 6589.1 is a 25-year-old male, whose skull shows two lesions. The right thigh bone shows a poorly healed mid-shaft fracture, which had resulted in a chronic infection of the bone marrow known as osteomyelitis affecting both thigh bones.

The condition would have been disabling and was probably the ultimate cause of death, but an evidently-skilled prehistoric surgeon had attempted a cure. The skull lesions were the result of surgical trepanations of the skull cap, where holes had been made in the skull to expose the dura mater. One hole was apparently produced by scraping; the other by drilling with a stone point. There is evidence of significant bone regrowth, suggesting lengthy postoperative survival of the patient.

While the procedure was undoubtedly carried out with the intention of freeing the patient from his painful and disabling condition, the exact reason is not clear. The traditional explanation is that trepanning releases evil spirits associated with the symptoms affecting the patient, but it is possible that healers were aware of a strange curative phenomenon which modern medical science is only now rediscovering.

References:

Petrone, P. et al., Early Medical Skull Surgery for Treatment of Post-Traumatic Osteomyelitis 5,000 Years Ago. PLoS One 10 (5), e0124790 (2015).

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