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A shaman’s surgical art? A neurosurgical and osteoarchaeological study of a therapeutic trepanation from the Yanghai cemetery in Turpan Basin, China

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Abstract

Shamans, or religious leaders among practitioners of shamanism, had a medical role in addition to their religious duties. Prehistoric surgeries might have been performed by these shaman-doctors. In this study, the trepanned cranium of an adult male (M31:C) from the Late Bronze Age (800–750 BCE) was investigated for its unusual injury pattern and surgical procedures. The cranium was found from Yanghai cemetery in Xinjiang, an important locale for the era of shamanism in China during the Late Bronze Age (800–750 BCE). Results indicated that the individual suffered from blunt force trauma on the left side of the head during his lifetime. Subsequently, a surgeon performed a therapeutic craniotomy including trepanation and bone flap to treat the hematoma. The surgical area showed signs of well-preserved healing, and the individual survived at least eight weeks. This case from Yanghai cemetery was revolutionary for its time by the combination of trepanation and bone flaps; it is the most advanced and skilled craniotomy ever found in the Xingjiang regions as well as the rest of the Eurasian Steppe. This complicated surgical procedure suggested the general anatomical knowledge and high surgical skill of the surgeon, most probably a shaman-doctor. This complicated yet successful craniotomy case from the Yanghai cemetery not only provides archeological evidence of refined neurosurgery but also embodies shamanistic medicine. On the basis of cranial anatomy and traumatic conditions during the Bronze Age, the surgery enlightens the relationship between ritualistic trepanation and its medicinal properties.

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Research data and images will be available in the public domain after the completion and publication of the findings. Entities include Jilin University and Texas A&M University.

References

  • Aidonis A, Papavramidou N, Moraitis K, Papageorgopoulou C (2021) Trepanations in the ancient Greek colony of Akanthos: skull surgery in the light of Hippocratic medicine. Int J Paleopathol 35:8–21

    Article  Google Scholar 

  • Arnott R, Finger S, Smith C (2003) Trepanation: history, discovery, theory. CRC Press, London

    Book  Google Scholar 

  • Bédécarrats S, Miclon V, Travers N, Gaultier M, Herrscher E, Coqueugniot H (2021) 3D reappraisal of trepanations at St. Cosme priory between the 12th and the 15th centuries, France. Int J Paleopathol 34:168–181

    Article  Google Scholar 

  • Benecke N (2019) Inventory of the animal remains buried in the Yanghai Cemetery. In: Turfan City Bureau of Cultural Relics, Xinjiang Institute of Cultural Relics and Archaeology, Academy of Turfanology, Turfan Museum. Report of archaeological excavations at Yanghai cemetery. Culture Relics Publishing House, Beijing

  • Campillo D (1984) Neurosurgical pathology in prehistory. Acta Neurochir 70:275–290

    Article  Google Scholar 

  • Carrillo-Ruiz JD, Muratti-Molina EB, Cojuc-Konigsberg G, Carrillo-Márquez JR (2023) Trephinations, trephines, and craniectomies: contrast between global ancient civilizations and pre-hispanic Mexican cultures. World Neurosurg 179:49–59

    Article  Google Scholar 

  • Cartwright S, Hom RS (2008) The origins of medicine; assessment and implications of the Eurasian evidence from the Upper Palaeolithic to the Bronze Age. Unpublished. https://www.oxford-homeopathy.org.uk/PDF/the-origins-of-medicine.pdf. Accessed 9 Sep 2023

  • Chikisheva TA, Zubova AV, Krivoshapkin AL, Kurbatov VP, Volkov PV, Titov AT (2014) Trepanation among the early nomads of Gorny Altai: a multidisciplinary study. Archaeol Ethnol Anthropol Eurasia 42(1):130–141

    Article  Google Scholar 

  • Chikisheva TA, Krivoshapkin AL, Pozdnyakov DV, Volkov PV (2018) Craniotomy as a prehistoric medical practice: a case of antemortem cranial trepanation in Southern Siberia in the Late Bronze Age. Archaeol Ethnol Anthropol Eurasia 46(1):133–143

    Article  Google Scholar 

  • Dittmar JM, Zhan XY, Berger E, Mao RL, Wang H, Zhao YS, Yeh HY (2019) Ritualistic cranial surgery in the Qijia Culture (2300–1500 BC), Gansu. Acta Anthropologica Sinica 38(3):389–397

    Google Scholar 

  • Espino PH, Toro-Perez JE, Shkrum S, Burneo JG (2022) Cranial trepanation in pre-Columbian Peruvian cultures: was it an option to treat epilepsy? Brain 145(10):3335–3338

    Article  Google Scholar 

  • Faria MA (2015) Neolithic trepanation decoded-A unifying hypothesis: has the mystery as to why primitive surgeons performed cranial surgery been solved? Surg Neurol Int 6

  • Fernández-de Thomas RJ, Munakomi S, De Jesus O (2023) Craniotomy. In StatPearls [Internet]. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560922/. Accessed 9 Sep 2023

  • Fu Y, Hui H (1990) Manchu shaman (in Chinese). Heihe J 02:104–111+117

  • Gokhman I (1989) Paleoantropologiya i doistoricheskaya medicina (Palaeoanthropology and prehistoric medicine). In: Alexeeva TI (ed) Anthropology for medicine. Moscow University, Moscow

    Google Scholar 

  • Gresky J, Batieva E, Kitova A, Kalmykov A, Belinskiy A, Reinhold S, Berezina N. (2016). New cases of trepanations from the 5th to 3rd millennia BC in Southern Russia in the context of previous research: possible evidence for a ritually motivated tradition of cranial surgery? American Journal of Physical Anthropology 160(4): 665–682

  • Gross CG (2012) A hole in the head: more tales in the history of neuroscience. MIT Press, London

    Google Scholar 

  • Han K (2017) Han Kangxin anthropological anthology (in Chinese). Science Press, Beijing

    Google Scholar 

  • Han K, Chen X (2007) The archaeological evidence of trepanation in early China. Bull Indo-Pac Prehistory Assoc 27:22–27

    Google Scholar 

  • Han K, Tan J, He C (2007) Trepanation in ancient China (in Chinese). Fudan University Press, Shanghai

    Google Scholar 

  • Hobert L, Binello E (2017) Trepanation in ancient China. World Neurosurg 101:451–456

    Article  Google Scholar 

  • Iorio S, Licata M, Ciliberti R, Gazzaniga V (2019) Cranial trepanation: an ancient neurosurgical therapy? Thoughts of a follower of positivist medicine and anthropology. J Craniofac Surg 30(6):e570–e573

    Article  Google Scholar 

  • Jiang H, Li X, Ferguson DK, Wang YF, Liu CJ, Li CS (2007) The discovery of Capparis spinosa L. (Capparidaceae) in the Yanghai Tombs (2800 years bp), NW China, and its medicinal implications. J Ethnopharmacol 113(3):409–420

    Article  Google Scholar 

  • Jiang H (2006) The plant remains of the Yanghai Tombs (2500 yrs B. P.), and their relationship to the ancient Yanghai people and environment (in Chinese). Doctoral dissertation, Institute of Botany, the Chinese Academy of Sciences, Beijing

  • Jørgensen JB (1988) Trepanation as a therapeutic measure in ancient (pre-Inka) Peru. Acta Neurochir 93(1–2):3–5

    Article  Google Scholar 

  • Kipfer BA (2021) Encyclopedic dictionary of archaeology. Springer International Publishing, Cham

    Book  Google Scholar 

  • Krivoshapkin AL, Chikisheva TA, Zubova AV, Kurbatov VP (2014) Trepanations in the population of the Altai Mountains in the Vth-IIIrd centuries BC. Probl Neurosurg Named After NN Burdenko 78(3):62–71

  • Kurbatov VP, Titov AV, Volkov PV (2014) Scythian trepanations in the Gorny Altai at hippocratic times: modern expert appraisal of ancient surgical technologies. World Neurosurg 82(5):649–650

    Article  Google Scholar 

  • Kurin DS (2013) Trepanation in South-Central Peru during the early late intermediate period (ca. AD 1000–1250). Am J Phys Anthropol 152(4):484–494

    Article  Google Scholar 

  • Kushner DS, Verano JW, Titelbaum AR (2018) Trepanation procedures/outcomes: comparison of prehistoric Peru with other ancient, medieval, and American civil war cranial surgery. World Neurosurg 114:245–251

    Article  Google Scholar 

  • Li X, Lü E, Zhang Y (2011) Excavation on the Yanghai cemetery in Shanshan (Piqan) county, Xinjiang (in Chinese). Acta Archaeol Sinica 1:99–150

    Google Scholar 

  • Li H, Xiao X, Huang Y, Zhang H, Lv E, Wang Q (2022) First case of boring-and-cutting trepanation in ancient China. Archaeol Anthropol Sci 14(1):1–9

    Article  Google Scholar 

  • Lindekleiv H (2005) Neurosurgery in antique medicine. Tidsskr nor Laegeforen 125(24):3494–3496

    Google Scholar 

  • Liu X (1998) Trepanation in skulls from archaeological discoveries (in Chinese). Xinjiang Cultural Relics 2:49–67

    Google Scholar 

  • Liu X (2009) Religious studies in the prehistoric era of Xinjiang (in Chinese). The Ethnic Publishing House, Beijing

    Google Scholar 

  • Lv E, Zhang Y, Zulipiya XuDL (2004) New achievements in the archaeological exploration of the Yanghai cemeteries in Shanshan County, Xinjiang (in Chinese). Archaeology 5:3–7

    Google Scholar 

  • Maples WR (1998) Trauma analysis by the forensic anthropologist. In: Reichs KJ (ed) Forensic osteology: advances in the identification of human remains. Charles C Thomas, Springfield

    Google Scholar 

  • Mednikova M (2003) Prehistoric trepanations in Russia: ritual or surgical? In: Arnott R, Finger S, Smith C (eds) Trepanation: history, discovery, theory. CRC Press, London

    Google Scholar 

  • Meng H, Wu F (2015) The medical treatment of shamanism from the anthropological perspective (in Chinese). Social Sciences Academic Press, Beijing

    Google Scholar 

  • Missios S (2007) Hippocrates, Galen, and the uses of trepanation in the ancient classical world. Neurosurg Focus 23(1):1–9

    Article  Google Scholar 

  • Moutrey S (2017) The fundamentals of surgical instruments: a practical guide to their recognition, use and care. TFM Publishing Limited, Shrewsbury

    Google Scholar 

  • Nikova A, Birbilis T (2017) The basic steps of evolution of brain surgery. Maedica 12(4):297

    Google Scholar 

  • Partiot C, Lepetit A, Dodré E, Jenger C, Maureille B, Liguoro D, Thomas A (2020) Cranial trepanation and healing process in modern patients—bioarchaeological and anthropological implications. J Anat 237(6):1049–1061

    Article  Google Scholar 

  • Petrone P, Niola M, Di Lorenzo P, Paternoster M, Graziano V, Quaremba G, Buccelli C (2015) Early medical skull surgery for treatment of post-traumatic osteomyelitis 5,000 years ago. PLoS ONE 10(5):e0124790

    Article  Google Scholar 

  • Polosmak NV (1999) The burial of a noble Pazyryk woman. Ancient Civilizations from Scythia to Siberia 5(2):125–163

  • Price NS (2001) The archaeology of shamanism. Routledge, London

    Google Scholar 

  • Rolle R, Walls FG (1989) The world of the Scythians. B.T. Batsford, London

    Google Scholar 

  • Rudenko SI (1970) Frozen tombs of Siberia: the Pazyryk Burials of Iron Age horsemen. Univ of California Press, Berkeley

    Google Scholar 

  • Rutherford L (2014) Principles of shamanism. Crescent Moon Publishing, Kent

    Google Scholar 

  • Sauer NJ (1986) The timing of injuries and manner of death: distinguishing among antemortem, perimortem and postmortem trauma. In: Reichs KJ (ed) Forensic osteology: advances in the identification of human remains. Charles C Thomas, Springfield

    Google Scholar 

  • Steinbock RT (1976) Paleopathological diagnosis and interpretation: bone diseases in ancient human populations. Charles C Thomas Pub Limited, Illinois

    Google Scholar 

  • Sun XF, You S, Wang JP, Zhang QC, Wang Q (2023) A commoner with advanced surgery: a bioarcheological study of a trepanation case with special reference to the medical care system during the Western Zhou Dynasty of China (1045–771 BCE). J Archaeol Sci: Rep 47:103830

    Google Scholar 

  • The cultural Relics Bureau of Turpan (1998) Collecting antiques on the graveyard of Yanghai in Shanshan County. Cult Rel Xinjiang 3:28–40

    Google Scholar 

  • Touw M (1981) The religious and medicinal uses of Cannabis in China, India and Tibet. J Psychoact Drugs 13(1):23–34

    Article  Google Scholar 

  • Tsoucalas G (2019) The Siberian lancet: one more possible innovative example of scalpel’s contribution to the evolution of surgical anatomy and neurosurgery. World Neurosurg 121:169–172

    Article  Google Scholar 

  • Turfan City Bureau of Cultural Relics, Xinjiang Institute of Cultural Relics and Archaeology, Academy of Turfanology, Turfan Museum (2019) Report of archaeological excavations at Yanghai cemetery (in Chinese). Culture Relics Publishing House, Beijing

  • Ubelaker DH, Adams BJ (1995) Differentiation of perimortem and postmortem trauma using taphonomic indicators. J Forensic Sci 3:509–512

    Google Scholar 

  • Viale GL, Deseri SE, Gennaro S et al (2002) A craniocerebral infectious disease: case report on the traces of Hippocrates. Neurosurgery 50:1376–1379

    Google Scholar 

  • Walker AE (1976) A history of neurological surgery. Hafner Publishing, New York

    Google Scholar 

  • Wang N (1983) Guang Ya Shu Zheng (in Chinese). Zhonghua Books, Beijing

    Google Scholar 

  • Wang J (2005) Concerning the halucinogens for shamanic ecstasy in ancient China (in Chinese). Stud Hist Nat Sci 24(1):13–28

    Google Scholar 

  • Wang B (2012) Demystifying Turpan (in Chinese). Zhejiang Literature and Art Publishing House, Hangzhou

    Google Scholar 

  • Wang L (2016) Research on the culture of witch doctors in Pre-Qin Dynasty (in Chinese). Master thesis. Qingdao University

  • Wei R, Wang G, Gong W (2012) Selection of neurosurgical instruments. China Pract Med 7(14):267–268

    Google Scholar 

  • White TD, Folkens PA (2005) The human bone manual. Elsevier Academic Press, Cambridge

    Google Scholar 

  • Yang K (1984) Introduction to ethnology (in Chinese). China Social Sciences Press, Beijing

    Google Scholar 

  • Yang SY, Sun Y, Dong H, Sun XF, Zhang QC, Wang Q (2023) Trepanation during the late Neolithic Age from the Mapai cemetery in the Gan-Qing region, northwestern China—a bioarcheological and experimental study. Int J Osteoarchaeol 33(1):70–82

    Article  Google Scholar 

  • Ye Y (2012) Trepanation in Xinjiang archaeology (in Chinese). Master dissertation, Minzu University of China

  • Zhang Q, Han T, Zhang Q (2018a) Micro marks analysis on the dental wear of human bone unearthed in Shanshan, Xinjiang (in Chinese). West Reg Stud 3:83–88

    Google Scholar 

  • Zhang Q, Wang Q, Kong BY, Wang CX, Yang DY, Zhu H, Zhang QC (2018b) A scientific analysis of cranial trepanation from an Early Iron Age cemetery on the ancient Silk Road in Xinjiang, China. Archaeol Anthropol Sci 10:1319–1327

    Article  Google Scholar 

  • Zhang WX, Zhang Q, McSweeney K, Han T, Man XY, Yang SY, Wang L, Zhu H, Zhang QC, Wang Q (2021) Violence in the first millennium BCE Eurasian steppe: cranial trauma in three Turpan Basin populations from Xinjiang, China. Am J Phys Anthropol 175(1):81–94

    Article  Google Scholar 

  • Zhao J (2007) Neurosurgery. People’s Medical Publishing House, Beijing

    Google Scholar 

  • Zhuang J (1996) A historical research of Shamanism (in Chinese). The Liberal Arts Press, Taipei

    Google Scholar 

  • Zias J, Pomeranz S (1992) Serial craniectomies for intracranial infection 5.5 millennia ago. Int J Osteoarchaeol 2:183–186

    Article  Google Scholar 

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Acknowledgements

We would like to thank the excavation team members from the Xinjiang Institute of Cultural Relics and Archaeology. Ms. Meghann Holt is thanked for editing the English. We are also grateful to Dr. Li Sun for help and support of various kinds.

Funding

This study received financial support from China Scholarships Council (X.S.); Fok Ying Tung Education Foundation for Young Teachers, Grant/Award Number: 141111 (Q. Z.); and Texas A&M University, Grant/Award Number: T3 (Q. W.)

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Authors and Affiliations

  1. Bioarchaeology Laboratory, Jilin University, Changchun, 130012, China

    Xiaofan Sun & Quanchao Zhang

  2. School of Archaeology, Jilin University, Changchun, 130012, China

    Xiaofan Sun & Quanchao Zhang

  3. Department of Neurosurgery, China-Japan Union Hospital of Jilin University, Changchun, 130012, China

    Ping Wang

  4. Research Center for Governance of China’s Northwest Frontier in the Historical Periods, School of History, Xinjiang University, Ürümqi, 830046, China

    Anqi Wang

  5. Department of Neurosurgery, The Second Hospital of Jilin University, Changchun, 130012, China

    Yongchuan Guo

  6. Department of Biomedical Sciences, Texas A&M University School of Dentistry, 3302 Gaston Ave, Dallas, TX, 75246, USA

    Qian Wang

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Contributions

X.S. contributed to data acquisition, analysis, and interpretation and drafted the manuscript. Q.Z. contributed to conception, design, data acquisition, analysis, and interpretation and critically revised the manuscript. P.W. contributed to data acquisition, analysis, and interpretation. A.W. contributed to data acquisition, analysis, and image rendering (Fig. 5). Y.G. contributed to data acquisition, analysis, and interpretation. Q.W. contributed to conception, design, data acquisition, analysis, and interpretation and drafted and critically revised the manuscript. All authors gave final approval and agreed to be accountable for all aspects of the work.

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Correspondence to Yongchuan Guo or Qian Wang.

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Xiaofan Sun and Quanchao Zhang joint first authors contributed equally to this article.

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Sun, X., Zhang, Q., Wang, P. et al. A shaman’s surgical art? A neurosurgical and osteoarchaeological study of a therapeutic trepanation from the Yanghai cemetery in Turpan Basin, China. Archaeol Anthropol Sci 15, 155 (2023). https://doi.org/10.1007/s12520-023-01856-8

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