News Release

Two high status brothers had access to “brain surgery” in Bronze Age Israel

Both brothers suffered chronic illness, and one underwent rare trephination around 1500 BC

Peer-Reviewed Publication

PLOS

Cranial trephination and infectious disease in the Eastern Mediterranean: The evidence from two elite brothers from Late Bronze Megiddo, Israel

image: Bioarchaeological context of this study. A: The Area H (H-15) domestic structure, with Tomb 45 highlighted in yellow. B: In-situ photograph of early exposure of burial context. C: Composite drawing featuring all layers. Individual 1 is blue, Individual 2 is green, faunal remains are orange. view more 

Credit: Kalisher et al., 2023, PLOS ONE, CC-BY 4.0 (https://creativecommons.org/licenses/by/4.0/)

Two high status brothers buried in a Bronze Age tomb in Israel were severely ill but apparently had access to rare treatments including trephination, according to a study published February 22, 2023 in the open-access journal PLOS ONE by Rachel Kalisher of Brown University, Rhode Island, and colleagues.

In this study, authors examined the remains of two individuals buried in a tomb beneath an elite residence in the archaeological site of Tel Megiddo in Israel. The tomb dates to the Late Bronze Age (around 1550-1450 BC), and DNA testing suggests the buried individuals are brothers. Both skeletons show evidence of disease, providing an opportunity to study how illness was treated during this time period.

Extensive lesions on the bones of both individuals are evidence of chronic, debilitating disease, possibly a condition to which the brothers shared susceptibility. The advanced state of the lesions indicates that, despite the severity of the condition, these individuals survived many years, possibly due to the privileges of wealth and status.

Additionally, one of the individuals has a ~30mm square hole in the frontal bone of the skull where a piece of bone was surgically removed, a procedure known as trephination which has been used to treat various medical disorders by relieving pressure buildup in the skull. This was likely intended to treat the patient’s ailment, but the lack of bone healing suggests the individual died during or shortly after surgery.

It is notable that the brothers’ tomb was adorned with high quality food and fine ceramics similar to other nearby high-status tombs. This suggests these individuals were not “othered” nor excluded from burial traditions due to their poor health. This serves as an important case study for continuing investigation into the intersections of status, illness, and treatment in societies through time.

The authors add: “Among the study’s multiple findings, we wish to highlight the special type of cranial trephination, the earliest of its kind in the region. This uncommon procedure was done on an elite individual with both developmental anomalies and infectious disease, which leads us to posit that this operation may have been an intervention to deteriorating health.”

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In your coverage please use this URL to provide access to the freely available article in PLOS ONE: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0281020

Citation: Kalisher R, Cradic MS, Adams MJ, Martin MAS, Finkelstein I (2023) Cranial trephination and infectious disease in the Eastern Mediterranean: The evidence from two elite brothers from Late Bronze Megiddo, Israel. PLoS ONE 18(2): e0281020. https://doi.org/10.1371/journal.pone.0281020

Author Countries: USA, Israel, Austria

Funding: The excavation of Burial 16/H/45 was funded by the Shmunis Family Foundation. In 2016 the Megiddo Expedition was also supported by the Dan David Foundation, Mr. Jacques Chahine and Mr. Mark Weissman. Finally, the purchase of the Leica microscope used in this study was possible through the support of the Society for Classical Studies, Women’s Classical Caucus. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.


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