Rare medieval trepanned skulls found in Spain

Trepanned woman's skull found in SoriaTwo skulls from the 13th and 14th centuries have been unearthed in a cemetery in Soria, north-central Spain. The skulls each have a hole in them from trepanation, the oldest surgical procedure known.

Trepanation involves the removal of a piece of skull by scraping or cutting with a sharp tool and has been practiced at least since the early Neolithic 10,000 years ago. It was common in prehistoric and ancient Europe, but there’s considerably less evidence for it in the Middle Ages, possibly due to a philosophical rejection of surgery in favor of “pure medicine” like leeches sucking the bad humours out of people along with their blood. In some parts of Europe, for example modern Hungary, the practice almost entirely disappears from the historical record after the onset of Christianity.

Thus researchers from the Universities of Oviedo and Leon were surprised when they found two trepanned skulls in the medieval San Miguel hermitage cemetery. They were even more surprised when they found that one of the skulls belonged to a woman. Even when trepanation was widely performed, most of the patients were men.

The two skulls found in the cemetery in Soria belong to a male between 50 and 55 years and a woman between 45 and 50 years. The expert points out that “another interesting aspect of this finding is that trepanation in women is considered rare throughout all periods in history. In Spain, only 10% of those trepanned skulls found belonged to women.”

Diagram of the trepanned skullsThe trepanation technique differs in each of the skulls. The skull of the male has been grooved with a sharp object and it is unknown whether trepanation occurred before or after his death. López Martínez confirms that “if the procedure took place whilst still alive, there is no sign of regeneration and the subject did not survive.”

In the woman, a scraping technique was used while she was still alive. According to the researchers, she survived for a “relatively long” amount of time afterwards given that the wound scarring is advanced.

Trepanation was performed to repair skull fractures by removing the fragmented section, and has a solid record of effectiveness as emergency surgery on head wounds. (It is still used today, in fact, to clear bone pieces and relieve subdural hematoma.) It was perhaps less effective as a remedy for a variety of other conditions like seizure disorders and mental illness.