A scientific analysis of cranial trepanation from an Early Iron Age cemetery on the ancient Silk Road in Xinjiang,China

This study uses multiple scientific methods to analyse a case of trepanation from a cemetery located at the westernmost point along the ancient Silk Road in China dating back to the Early Iron Age. The skull of interest belonged to a middle-aged male; the opening is located on the left posterior side of the skull in the occipital bone. Computer tomography (CT) and microscopic observation show that the incision was unhealed, indicating an immediate death either during or after the operation. The procedure of trepanation might have been used to treat a depressed fracture from inflicted trauma on the individual’s right parietal bone, suggesting the presence of surgical trepanation in early Western China.     

Ante Mortem Cranial Trepanation in the Late Bronze Age in Western Siberia

We report a case study of cranial trepanation in a male subject 30 to 40 years of age from the Nefteprovod II burial ground in the Anzhevsk archeological site. This burial dates back to the Late Bronze Age, in particular the Karasuk culture located in the Minusinsk Basin on the Yenisei River and on the upper reaches of the Ob River. The left parietal bone had an opening with evident signs of bone healing, as well as signs of inflammatory reaction from both bone plates of the calvarium. The strongest signs of inflammation were located around the trepanation opening at the exocranium, suggesting that it occurred after, rather than before, the operation. Although trepanation was the main cause for the development of the changes noted in the preceding texts, there are no reasons to believe that the subject died from complications arising from infection after trepanation. The patient survived and later died for reasons that may never be determined. Medical necessity was the most likely justification for trepanation. Immersion in altered states of consciousness may also have been a necessary part of the trepanation process as a mode of sedation, along with other shamanic practices, such as consumption of psychotropic substances or ecstatic dance. These data, together with reports of other ante mortem burials, raised questions about the application of anaesthesia and possible techniques of cranial trepanation. These issues and possible postoperative complications are discussed in the following text. Copyright © 2016 John Wiley & Sons, Ltd.     

A review of trepanations in Anatolia with new cases

In this study, trepanations in ancient Anatolia were discussed from a historical perspective. Trepanations were studied in respect to temporal and spatial distribution, sex and age distribution, techniques and reasons, completeness, healing and number of holes. Forty individuals from 23 different Anatolian settlements are identified to have undergone trepanations. Cranial trepanations in Anatolia show a distribution over a period of 10 000 years ranging from the Aceramic Neolithic period to the Late Ottoman period and spread to whole Anatolia. The greater majority of the individuals had single trepanation orifices while only four individuals were identified with multiple holes. It is observed that the surgical procedure was predominantly carried out on males in Anatolia. Main techniques of trepanations used in Anatolia are drilling and cutting. Early cases of trepanation were made by drilling; however, this technique has been used for cranial surgery until the Ottoman period. Scraping and rectangular sawing techniques first applied in the Early Bronze Age. The boring‐and‐cutting technique was only applied in the Iron Age. More than half of the trepanations practiced due to cranial trauma. Training and treatment besides of cranial trauma are also considered as likely causes of trepanations in Anatolia. It is concluded that trepanation techniques are similar to South America and the Mediterranean region rather than Europe. Copyright © 2010 John Wiley & Sons, Ltd.     

The Ciempozuelos Necropolis skull: a case of double trepanation?

The focus of this study is the analysis of a trepanation performed on the skull of an adult male from the famous Bell Beaker necropolis of Ciempozuelos (Madrid) excavated at the end of the 19^th century. The unusual characteristics of the pottery and other associated grave goods gave rise to the use of the name ‘Ciempozuelos’ to define the regional Bell Beaker style; this refers to similar finds from other sites on the Meseta of central Spain. Although trepanations from Chalcolithic contexts in the Iberian peninsula are not infrequent, they are unusual in Bell Beaker inhumations. Furthermore, this skull is exceptional not only for the type of trepanation performed, but also for the subsequent cranial deformation apparently resulting from the operation, as well as evidence of a second subsequent trepanation which indicates a very short post‐surgical survival period for the individual. Copyright © 2003 John Wiley & Sons, Ltd.     

An interesting case of prehistoric trepanation from Poland: re‐evaluation of the skull from the Franki Suchodolskie site

The skull described here was excavated in Central Poland (archaeological site Franki Suchodolskie) in 1951, and was known as one of the oldest cases of healed trepanation. This skull, with later excavations from the Ukraine (cemeteries of Vasilyevka II and Vasilyevka III), was the basis for dating the beginning of the practice of trepanation in the Mesolithic period. The skull was never comprehensively described and dated, although it was scientifically extremely important. The skull has been reassessed by the authors of this paper has brought thorough verification of the knowledge concerning this excavation. According to radiocarbon analysis it is much younger than previously thought and has now been dated to the Late Neolithic or the Bronze Age. Earlier opinions about the healing and survival after the operation have not been confirmed: the hole in the squama of the frontal bone made by scraping and then by grooving has no evidence of healing. Radiological studies as well as computer tomography indicate lack of any healing processes in the bone tissue around the trepanation opening. The results of the analysis significantly modify ideas regarding the earliest skull operations in Central Europe, and change the time of the first trepanation to the Late Neolithic, as for most of the continent. Copyright © 2005 John Wiley & Sons, Ltd.     

Gustaf Dalman, Anti-Semitism, and the Language of Jesus Debate

The theory that Jesus of Nazareth spoke and taught exclusively in Aramaic rather than Hebrew achieved its present dominant position just over a century ago due largely to the labour of Gustaf Dalman. His primary motivation was not the recovery of the historical Jesus, however, but to support his deep commitment to the Protestant movement to convert Jews. This movement did not escape the impact of escalating anti-Semitism in society, intensified by rapid progress towards German national unification. One Christian response to anti-Semitism was to "extract" Jesus from Judaism by contrasting him with "Jewish" attitudes and values held by Jewish spiritual authorities. Dalman's contribution was to extract Jesus from the ethnically exclusive Hebrew language by insisting that he spoke only the more widely used lingua franca of the region, Aramaic. By overstating his case and going beyond the evidence, Dalman revealed his indebtedness to the anti-Semitic spirit of his age.     

Cranioplasty in ancient Peru: a critical review of the evidence,and a unique case from the Cuzco area

Cranioplasty is a well‐known procedure in modern neurosurgery. Although some authors have claimed it was also performed by prehistoric trepanners in various parts of the world, there is little hard evidence to support this. Here we review various claims of cranioplasty in Peru, where trepanation was widely practised in Prehispanic times. We find little support for assertions that cranioplasty was common. One recently discovered burial from the Cuzco region, however, provides the first documented case of the reinsertion of a bone plug into a trepanation opening. Copyright © 2008 John Wiley & Sons, Ltd.     

"The Defendant Has Seemed to Live a Charmed Life": Hopt v. Utah: Territorial Justice, The Supreme Court of the United States, and Late Nineteenth-Century Death Penalty Jurisprudence

On March 7, 1887, the Supreme Court of the United States decided Fred Hopt's fourth appeal to that Court. The Utah Territory murderer's conviction had been reversed three times over seven years-his "charmed life"-but this time both his luck and his legal argument had run out: his fourth conviction was upheld. Justice Stephen J. Field dismissed Hopt's four major claims: that several members of the jury were improperly seated in spite of bias; that a doctor's evidence of cause of death was beyond the scope of his expertise; that the trial judge's "reasonable doubt" jury instruction was inadequate; and that the prosecutor's reference to the "many times the case had been before the courts" was prejudicial. Five months later, on August 11, Hopt was executed by a firing squad in the yard of the Utah Penitentiary. Hopt was only one of over two thousand convicted criminals, mostly murderers, who were legally executed in the United States in the two decades between 1880 and 1900. However, his defense team of court-appointed Salt Lake City lawyers had kept him alive for seven years. During that time he had four jury trials, four appeals to the Supreme Court of Utah Territory, and four appeals to the Supreme Court of the United States. He is the only death penalty litigant ever to be the subject of four full opinions of the Supreme Court of the United States.     

Trepanation in the Chachapoya region of northern Perú

This paper discusses trepanation frequency data from the Chachapoya region of the northern highlands of Perú. New data from three skeletal samples are presented: Kuelap, Laguna Huayabamba, and Los Pinchudos, as well as isolated crania housed at the Chachapoya Museo Instituto Nacional de Cultura. The vast majority of the trepanations are circular in shape, except for one individual exhibiting as many as three roughly square trepanations. Evidence for healing is prevalent, with examples of both associated periosteal reaction of nearby outer table bone, as well as for healing of the insult itself. Only one case demonstrates a clear association between a traumatic injury and a trepanation event. The purpose or function of the remaining cases of trepanation, however, remains elusive. Copyright © 2006 John Wiley & Sons, Ltd.     

Neurosurgical aspects of trepanations from Neolithic times

Trepanation of the cranial vault is the oldest known surgical procedure and has often been reported in the literature. We present two skulls with trepanations from Neolithic excavations in southwestern Germany. One skull exhibits a healed fracture in association with the trepanation. Both skulls show clear signs of healing without evidence of osteolytic inflammatory reaction. We discuss conditions relating to survival from trepanation in Neolithic times and some potential complications such as intraoperative bleeding and wound infection, in the context of modern neurosurgical knowledge. We conclude that neolithic skull surgery was probably mainly extradural. Copyright © 2006 John Wiley & Sons, Ltd.     

The role of Herman Hoppe of Cincinnati in the initial clinical recognition of myasthenia gravis

One of the earliest papers describing a case of what came to be known as myasthenia gravis was written in 1892 in the German language by an American, Herman Hoppe, who at the time was an assistant in the Berlin polyclinic of the prominent German neurologist. Hermann Oppenheim. At Oppenheim's instigation, Hoppe published the pathology of a case that Oppenheim had diagnosed during life; he collected all the reported similar cases and tried to establish a symptom-complex, for which he was given credit in Oppenheim's great neurology textbook of 1894. Upon his return to Cincinnati, Ohio, Hoppe's European experience qualified him as a specialist in nervous and mental diseases. His private practice of "neuropsychiatry" was his main occupation, but he also volunteered to teach as Professor of Nervous and Mental Diseases at the University of Cincinnati. In 1901 Oppenheim published the first monograph about what he called "Die Myasthenische Paralyse (Bulbarparalyse ohne anatomischen Befund)", summarizing 60 cases described in the medical literature up to that time. Hoppe, on the other hand, wrote on myasthenia gravis only once again, a review article in 1914 in a Cincinnati weekly, giving Oppenheim credit for the establishment of the disease as a clinical entity.     

Trepanation in Italy: A Review

This paper reviews and discusses cases of skull trepanation in ancient Italy on the basis of information provided by the literature. A total of 54 individuals from 43 different Italian archaeological sites were found to have evidence of trepanation. The analysis of evidences of trepanation in Italy has demonstrated that no differences can generally be perceived between the trepanned individual and the social context of the burial, leading to exclude a special role of the former within the group. Trepanation in Italy covers a time span of approximately 7000 years, the most ancient cases dating back to the fifth millennium bc and the most recent to the 18th–19th centuries ad . The geographic distribution appears quite homogeneous, with a prevalence of cases in Central Italy and abundant evidence from prehistoric Sardinia. The majority of individuals show a single trepanation, whereas others present skulls with multiple holes. Trepanation in Italy was reserved to adult individuals, except for some rare cases, and shows a relevant preponderance for the male sex. The most diffused technique is scraping; cutting and drilling are less attested, especially as unique techniques for trepanation, but they were used more frequently in combination with scraping. Trepanation could in some cases be hypothesised as therapeutic intervention for the treatment of a traumatic wound or of other pathologies, whereas in other cases, a number of evidences are attested of trepanation performed as probable ritual intervention or as experimental surgery; in the remaining cases, the reasons for trepanation are unclear or not determinable. A high percentage of long‐term healing associated with trepanation has been evidenced. Copyright © 2017 John Wiley & Sons, Ltd.     

宛西自治"三自主义""理论群体"初探

彭禹廷作为“自卫”、“自治”、“自富”“三自主义”自治理论的创立,不仅在家乡镇平率先示范,而且还倡导、推动宛西地区联防自治。虽其本人不幸遇害,但自治并未“人亡政息”．而是继续下去并有所发展。穷其原因,有赖“三自主义”“理论群体”的努力和贡献．     

Trepanations from Oman: A case of diffusion?

Trepanations have been described from various locations around the world leading to a suggestion that this is a cultural practice that has widely diffused from one or two centres ( 1 ). In the UAE the earliest trepanations date to the Neolithic, significantly earlier than trepanations in surrounding areas. The discovery of at least two crania in Oman, dating apparently to the early third millennium and resembling in technique and placement trepanations from north India may be evidence of the diffusion of a therapeutic practice from the Gulf to the subcontinent. However, the lack of any trepanation among the numerous contemporary skeletons from Bahrain suggests that any diffusion has distinct limits and that, as anthropological work from the South Pacific ( 2 ) indicates, practices like trepanation are often heavily embedded in broader, culturally located explanatory models.     

民族英雄的尺度：《白话本国史》教科书案研究

1935年,国民党上海市党部以吕思勉《白话本国史》"丑诋岳飞,推崇秦桧"为由而责令修改;有人以此控告商务印书馆与吕思勉,法院决定不起诉。《白话本国史》中的岳飞叙述,不利于在民族危机中激发民族意识来抵抗日本侵略;但其中反军阀思想,有利于国民党加强中央权力,又为南京政府所需要。该案的处理方式反映了国民党政府对民族英雄叙述的尺度:尊崇岳飞为民族英雄,突出其反抗外族侵略的一面,希望借助其抗金形象来振发国民志气;同时把岳飞叙述限制于抗金事迹中,弱化其武将身份,警惕其对军阀政治的影响,以加强国家统一。     

A case of cranial trepanation in a Roman necropolis (Cassino,Italy, 3rd century BC)

The aim of this study was to investigate an individual from a Cassino necropolis of the 3^rd century BC. The inhumation shows a rectangular wound between the sagittal and lambdoid sutures of the cranium. Furthermore a series of pathological traces on the post‐cranial skeleton are present. The trepanation of the skull seems intentional: probably a healed surgical procedure to treat a sword wound. Copyright © 2007 John Wiley & Sons, Ltd.     

Between Galen, Geddes, and the Gael: Arthur Brock, modernity, and medical humanism in early-twentieth-century Scotland

Arthur Brock (1879-1947) is generally remembered as the physician who treated poet Wilfred Owen for shell shock and as the translator of Galen and other ancient physicians. He was also a key figure in the early-twentieth-century humanist revival within medicine. Brock's interest in humanism, I argue, was inspired by a broader concern about modernity and by a desire to return medicine and society to the more harmonious, organic existence that he believed was characteristic of ancient Greece and could still be found among "primitive" peoples, such as the Scottish Gaels. This article explores Brock's anxieties about modernity and its relations to his interests in ancient and "primitive" peoples; to his medical thought and practice; to his interests in history, sociology, language, and translation; and to his involvement in the social and political life of Edinburgh and North Queensferry, where he moved in 1925. Crucially, it shows how all these interests and activities were influenced by Brock's mentor, Edinburgh polymath Patrick Geddes. The article concludes with a discussion of Brock's place in early-twentieth-century medical humanism.     

Richard Wiseman and the medical practitioners of restoration London

The case histories used to illustrate Richard Wiseman's Several Chirurgicall Treatises (1676) reveal not only pathological and therapeutic detail but much information about the range of occupational relationships between Wiseman and the many London physicians with whom he collaborated on cases (more than forty are identified in an appendix to this article). His interaction with the two physicians with whom he had most to do, Francis Prujean and Walter Needham, exemplifies the extremes of such relationships. With Prujean, an older man and a leading figure in the College of Physicians, a formal and hierarchical relationship was observed, in which distinct occupational lines were maintained. In the case of Needham, a younger physician whose devotion to anatomical study was shared by Wiseman, a friendship developed between the two men that carried over into practice and tended to break down occupational and intellectual distinctions, so that Needham sometimes involved himself in Wiseman's surgical practice, and Wiseman initiated medical research later reported by Needham to the Royal Society.     

Causation and cleanliness: George Callender, wounds, and the debates over Listerism

This article reexamines the surgical and historiographic debate over antisepsis and the germ theory through the work of the prominent London surgeon George W. Callender (1830-1879) and the statistical records of St. Bartholomew's Hospital. Surgeons in the mid-nineteenth century faced a rising incidence of wound infection and its systemic complications. Examining mortality and complication rates by type of wound, however, suggests that the extent of this crisis is often overstated. Callender himself occupied a frequently overlooked middle ground in the debate over Listerism. On the one hand, his program of cleanliness, which antedated Lister's work and extended from the wound to the ward, produced excellent and influential results. On the other, while he was never an explicit critic of the germ theory, his writings demonstrate why Lister's collapse of causation into a single etiologic agent was so difficult for surgeons to accept.