How cranial surgery was performed in Italy during the centuries after the Roman Empire but before the rise of the medieval universities: Integrating paleopathology and medical history

Intermittently, we witness how evidence from one academic field can have a significant impact on researchers working in other specialties; this case, the fields of osteoarchaeology and medical history. In issue, an article by Micarelli et al. (2023) entitled “An Unprecedented Case Cranial Surgery Longobard Italy” presents fascinating example surgery early medieval period. A cross-shaped area inflammatory change outer table skull 6th–8th century female Castel Trosino is described. This cruciform also contains linear parallel scratch marks suggestive use surgical instruments. At center cross oval where bone markedly thinned way that would be compatible with healing trepanation, was previously scraped as part procedure. While population-level studies trepanation cranium been undertaken at number European contexts such CE Germany (Weber & Czarnetzki, 2001) Bronze Age to Byzantine period Greece (Aidonis al., 2021), what special about case inflammation likely indicates incision used allow surgeon peel away scalp deeper tissues expose bone. not something found those earlier cases shows us operations could actually performed. 1100s, tradition writing texts began Italy, which over next 200 years developed became known “rational surgery” (McVaugh, 2006). followed translation into Latin 10th-century Arabic practitioners Al-Majusi (Burnett Jacquart, 1994). revolution started Salerno Constantine African 1070s then later spread newly created schools universities northern Bologna Padua. The resulting series Roger Frugardi (1180s), Bruno da Longobucco, Theodoric Borgognoni (both mid-1200s), others were written style did merely pass classical, Greek, Roman, authors but gave real sense being performed these Italian surgeons earliest for approach cranial Bamberg Surgery, mid-1100s. section treatment compound fracture skull, find words “If contusion flesh small great, should divided cruciate down everywhere elevated bone” (Corner, 1937). described text Frugardi, dating 1180s, illustrations (Figure 1) are included copies manuscript (e.g., British Library MS Sloane, 1977). However, until now, had no idea whether first or if it origins just never few survive Europe. indeed whole Europe, has much less surviving textual forms care than classical high (Fischer, 2000; Pilsworth, 2014; Skinner, 1997). One interesting medicines providing pain relief during procedures 9th-century held Benedictine monastery Monte Cassino Italy. describes soporific sponge, infused plant extracts henbane, hemlock, mandrake, opium poppy. useful undergoing “to sleeper feel while cut” (Sudhoff, 1921). do detail kinds excavated human remains provide key after Roman Empire before period—at time when paucity Europe left dark treatments It bones Italy several hundred describing written. For reason, archaeological here will great interest historians investigating development degree medicine may transmitted within prior 11th onwards. We so grateful Monica Green Michael McVaugh sharing their expertise Data applicable datasets generated analysed current study.