A new case of prehistoric trepanation and scalping in the Iberian Peninsula: The tomb of La Saga (Cáseda, Navarre)

Abstract

Trepanation is considered one of the oldest surgical procedures in the world, of which the earliest evidence goes back to the Mesolithic. Over 130 cases of trepanated crania have been documented in the recent prehistory of the Iberian Peninsula, one of the areas with the highest number of cases. This paper analyses and discusses a new case from northern Spain. The cranium was found in the site of La Saga, Cáseda, Navarre, a small tomb where nine individuals were simultaneously placed at the end of the Bronze Age. It belongs to an adult female and displays a pentagonal hole in the central area of the cranial vault over the sagittal suture. The pentagonal shape of the injury, its regular outline, and the presence of 10 fusiform and two rounded grooves suggest that the bone was intentionally removed by means of cutting and leverage, a technique documented in another example from the Iberian Peninsula. Neither cranial lesions nor pathological evidence have been identified to justify the surgical procedure. Furthermore, the case is exceptional due to the presence of superficial and parallel cut marks in longitudinal and transversal directions across the parietal and temporal bones, unequivocally associated with scalping practice, and which would be performed prior to the trepanation in order to facilitate it. The absence of any kind of healing or bone regeneration points towards the death of the individual during the procedure. Together with the presence of marks of violence and manipulation of the skeletal remains of some individuals buried in the same grave, this leads us to propose that the trepanation was possibly performed to heal a previous trauma resulting from a violent conflict that caused the death of this and eight other individuals from the community.

The first otologic surgery in a skull from El Pendón site (Reinoso, Northern Spain)

“…Cranial trepanations have been documented with Mesolithic chronologies in Ukraine, Portugal, and Northern Africa 29 , 30 , even though most prehistoric cases date back to the Late Neolithic and Bronze Age. This intervention is well documented in Europe, and the Iberian Peninsula stands out with 184 identified cases of trepanation in 135 skulls 31 . The case of the Dolmen of Las Arnillas is exceptional (Sedano, Burgos).…”

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

“…A small portion of the inner cranial table was still preserved on the upper-right edge ( Fig 6c and 6d ). Accompanying the trephination are smaller longitudinal scratches consistent with the opening of the scalp, a necessary step prior to bone excision [ 32 ]. We classify this as a trephination, which is defined as the removal of a piece of skull of a living individual without affecting the underlying soft tissue [ 33 , 34 ].…”

“…are smaller longitudinal scratches consistent with the opening of the scalp, a necessary step prior to bone excision [32]. We classify this as a trephination, which is defined as the removal of a piece of skull of a living individual without affecting the underlying soft tissue [33,34].…”

3D reappraisal of trepanations at St. Cosme priory between the 12th and the 15th centuries, France

“…Archaeological discoveries regularly provide new cases of trepanation (e.g. Díaz-Navarro, 2021). For the medieval period (5th-15th centuries), at least 134 cases of trepanation have been published (Table 1).…”