Bone find points to skull surgery in the Bronze Age

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A team of archaeologists has made an interesting discovery at the former Bronze Age palace settlement of Megiddo in present-day Israel. There they found 3,500-year-old bones of a pair of brothers who had died after a long illness. A square hole in the older man’s skull indicates that the man apparently underwent surgery at the time.

The brothers were scarred to the bone by a long illness and developmental disabilities when they died. Not even professional cranial surgery could save the older brother. Despite their ailments, they were integrated into society and buried with dignity, the research team reports with Austrian participation in the journal PLOS One.

Buried under the floor in the house
Burying them with dignity at that time (about 3,500 years ago) in this region meant they were buried under the floor in the house where people lived, along with food offerings and fine ceramic vessels, explained Mario Martin of the Institute of Ancient History and Ancient Oriental Studies at the University of Innsbruck: “This rather peculiar tradition must have had something to do with ancestor worship and property claims,” ​​says Martin, who was co-director of the excavations at Megiddo from 2016 to 2022.

The bones of the older man were still an intact skeleton in the earth, while those of the younger man were wildly smashed together. The latter probably died one to three years before his big brother and was buried elsewhere, only to be dug up after the death of the older brother and buried with him in a corner of the house. Genetic analyzes show that they were siblings.

Suffered from anemia or malnutrition
A team led by Rachel Kalisher of Brown University in Providence, Rhode Island, inspected the skeletons. The older brother was 21 to 46 years old when he died. According to the researcher, signs of deterioration of the covering bone in the roof of the eye sockets indicate that he suffered from anemia or malnutrition in childhood. The two halves of his front skull have not grown together, but this does not affect brain development.

Much of its supporting apparatus was probably compromised by years of inflammation: bone decomposition (osteolysis) made the skeleton porous, the periosteum was sclerotic (hardened) due to inflammatory or degenerative processes. “There are several infectious diseases that can leave such an appearance on the bones,” explains Kalisher: leprosy, tuberculosis, and syphilis, for example.

Square hole in anterior skull
In the front skull is a square hole with a side length of more than three centimeters. It comes from a procedure doctors call trepanation. The skull was apparently surgically opened to relieve excessive pressure on the brain and halt the deterioration of health.

“In such an operation, a skin flap is first removed and two grooves are made. Practitioners stopped indenting when they reached the inside of the skullcap so as not to damage the soft tissue directly below it. When all the pieces of bone were mobile, they were removed all at once with a lever,” says Kalisher.

Died during or shortly after surgery
The operation was performed with great precision by an experienced person. Two pieces of bone were found near the skeleton. They may have been put back in the hole to help the wound heal better. But this no longer happened. The operation could not save the seriously ill man’s life, he died during or shortly afterwards.

The younger brother — who died in his teens or a little over 20 — had similar ailments: Showing signs of childhood anemia or deficiency, he was missing the bud of a molar, and he also had bone damage, likely from an infectious disease. The effects on the skeleton were not as severe, possibly because he died more quickly.

House was next to the palace
“The house they were buried under and may have lived in was in the prime location of the city of Megiddo, right next to the gate and palace. They must therefore have been among their elite.” This arguably made it possible for the brothers to live with the disease for at least a few years, likely affecting their mobility.

At least they had access to the best medical care, such as cranial surgery, even if it ultimately failed. Despite their weakness, they were not rejected by their contemporaries in the city and finally buried with valuable gifts according to the customs typical of the time.

Megiddo was a rich and powerful fortified city with temples and palaces in northern Israel during the Bronze and Iron Ages. It lay on and partially controlled a trade route that was important at the time, the Via Maris (Street of the Sea), connecting Egypt to Mesopotamia and Anatolia.

Source: Krone

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