Technology & Medicine › Prehistory
Trepanation (skull surgery)
by c. 7000 BC (many skulls show healing)· Invention or discovery· Medicine & surgery
Mostly agreedGood evidence; some details, dates or numbers uncertain.
Cutting or scraping a hole in a living person's skull: the oldest known surgery, practised on every inhabited continent.
See it on the Technology & Medicine map →How it works
Prehistoric surgeons removed a disc of skull bone by scraping, cutting grooves or drilling with flint or obsidian blades. Skulls from about 7000 BC show the practice, and many have regrown bone at the edges, meaning the patient survived for months or years. In Peru, survival reached roughly 75 to 80 percent by Inca times, in the 1400s. Likely purposes included treating head injuries and relieving pressure on the brain; some may have been ritual.
Why it mattered
It shows prehistoric people attempted, and often survived, deliberate surgery thousands of years before anesthesia or antiseptics.
How we know
Over 1,500 trepanned skulls found worldwide, with healing visible in the bone; John Verano's study of more than 800 Peruvian skulls shows survival improving over centuries.
Still unknown or debated
Motives rarely show in bone, so whether a given operation was medical, magical or both is usually unknown.
Connections (2)
▸Stone tools were the instruments of Trepanation (skull surgery)Mostly agreed
The connection
Prehistoric surgeons opened skulls with sharp flint or obsidian blades, scraping or cutting grooves until a piece of bone came free. Obsidian, a volcanic glass, takes an edge finer than a modern steel scalpel. Such sharp stone edges made a delicate operation survivable.
When and how
Europe and the Near East by about 7000 BC; later Peru, where obsidian blades were used for centuries.
How sure are we?
Cut marks on trepanned skulls match stone blades, and experiments with flint on skulls reproduce the same grooves and scraping patterns.
Debates and open questions
Which tools were used at which sites is usually inferred from marks, since instruments are rarely found with the skulls.
▸Trepanation (skull surgery) foreshadowed the head-wound cases in the Edwin Smith Surgical PapyrusMostly agreed
The connection
Trepanation shows people had operated on heads for thousands of years before writing. The Edwin Smith Papyrus puts a practical head-injury tradition into writing, with careful cases of skull fractures and wounds, though it does not describe trepanation itself. The link is a shared focus on head injury, not proven descent.
When and how
Prehistoric trepanation by about 7000 BC in Europe and the Near East; the papyrus copied in Egypt about 1600 BC from older texts.
How sure are we?
Both deal with head injuries, but no direct evidence shows Egyptian surgeons drew on trepanning traditions.
Debates and open questions
Whether Egyptians practised trepanation at all is debated, since few convincing trepanned Egyptian skulls are known.