(CNN) When archaeologists unearthed the burial site of two brothers who lived during the 15th century BC in Israel, they were surprised to discover that one of them had undergone brain surgery shortly before his death.
This discovery represents the oldest example of trephination, a type of cranial surgery, found in the ancient Near East.
Necrosis, also known as trepanation, involves cutting a hole in the skull — and there are examples of the medical procedure dating back thousands of years.
The remains of the two brothers, who lived during the Bronze Age between 1550 BC and 1450 BC, were found during the excavation of a necropolis in the ancient city of Tell Megiddo.
The older brother, estimated to be between 20 and 40 years old, had angular rollover. His scalp was cut off and then a blunt beveled tool was used to make four criss-cross lines on the frontal bone of the skull which made a 30 mm (1.2 in) square hole.
A detailed study of the findings was published Wednesday in the journal Plus one.
“We have evidence that this type of surgery was universal and widespread thousands of years ago,” study author Rachel Kaleicher said in a statement. She is a doctoral student at the Zhukovsky Institute for Archeology and the Ancient World in Providence, Rhode Island at Brown University.
“But in the Near East, we don’t see it very often—there are only about a dozen examples of trephination in this entire region. I hope adding more examples to the scientific record will deepen our field’s understanding of medical care and cultural dynamics in the ancient cities of this area.”
Oddly enough, the pieces of bone removed from the skull were included in the tomb – but that wasn’t the only unusual discovery made about the two brothers as researchers studied their bones.
Bronze Age Brothers
The city of Tel Megiddo was part of the Maris Road 4,000 years ago. This crucial land route connected Egypt, Syria, Mesopotamia and Anatolia, according to study co-author Yisrael Finkelstein, director of Haifa University’s School of Maritime Archeology and Cultures.
Tel Megiddo dominated part of this trade route, making it a rich and cosmopolitan city filled with palaces, temples, and fortifications.
“It is difficult to overstate the cultural and economic importance of Mujaddidu in the Late Bronze Age,” Finkelstein said.
The tomb was found in the vicinity of a late Bronze Age palace at Tell Megiddo, leading researchers to believe that the two men were either members of the high-ranking elite of society or perhaps even members of the royal family. DNA testing revealed that the two were brothers and were likely related.
the men She was buried with Cypriot pottery, food, and other valuable possessions similar to those found in other local tombs of high status.
And in life, both brothers were seriously ill. Skeletons are characterized by signs of disease, including extensive lesions that are indicative of chronic, debilitating conditions. But both were able to survive for many years despite their illnesses.
“It is clear that these brothers were living with some severe disease conditions that would have been hard to bear at this time without wealth and status,” Kalischer said. “If you’re elite, maybe you don’t have to work as much. If you’re elite, maybe you can eat a special diet. If you’re elite, maybe you can survive severe illness for longer because you have access to care.”
The younger brother died in his teens or early twenties, likely succumbing to an infectious disease such as tuberculosis or leprosy.
According to the researchers, the older brother had an extra molar, so he may have suffered from a genetic condition such as craniofacial dysplasia that affects the teeth and bones.
Researchers can’t figure out why Big Brother requested an excavation. This practice has been used to relieve pressure in the skull or treat symptoms of epilepsy and sinusitis. The ancient Mesopotamian texts also indicate that the process may have been “therapeutic for supernatural or otherworldly conditions,” Kalischer said.
“The skeletal evidence tells us that this individual has had the disease for a long time, which, assuming it is left untreated, is likely to progress,” Kalischer said. “This elite individual was privileged enough to endure the infection for a long time and also underwent high-level cranial surgery, which leads us to hypothesize that the drilling was done as a direct response to a deteriorating condition.”
Regardless of why Big Brother had the surgery, he died within days or hours afterward, based on the researchers’ lack of bone healing during their analysis.
Cracking old medical cases
Kalischer said many questions remain after studying the two brothers’ bones.
While structural evidence points to both brothers having leprosy, more research is needed to make a clear determination. If the analysis reveals bacterial DNA that is consistent with leprosy, the brothers may have experienced one of the first documented cases of the disease.
“Leprosy can spread within family units, not only because of close proximity but also because your susceptibility to the disease is influenced by your genetic landscape,” Kalischer said.
Kalischer is also puzzled as to why the pieces of the skull removed from the older brother were included in his burial. Only two other examples of this are found in the past, in England and Peru.
“In our study, we consider whether the pieces of removed bone were reinserted into the head because the practitioner thought it would facilitate healing,” Kalischer said. “But I also go back to the medical/magical dichotomy that we superimpose on the past. It is possible that the excised bones also had some other, non-medical purpose, which led to their inclusion with the individual. It is simply unknown to us. So far, this mystery remains unsolved.”
There are larger questions about the search for ancient pits that researchers want to answer, such as why some were made using analog drills to create circular holes, while others are square or triangular.
But with regard to the two brothers, it is clear that the two men were not considered outcasts or “others” because of their health problems. The researchers said that people close to the brothers took care of them and made sure they were buried according to proper burial traditions.
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