An archaeologist from from Ankara University, Fikri Kulakolu, reports the discovery of a 4,000 year old skeletonwhich has evidence of “a successful brain operation” in which the patient survived.
This sort of trephination isn’t unheard of in the ancient world, but it’s probably the oldest example of medically purposed trephination that I’ve heard of. Still, it isn’t too big a stretch to imagine that it might have been done. The technology wouldn’t have needed to be more complex than a sharp stone. The understanding that such an operation might be beneficial can seem to be a stretch of imagination, but it speaks to the cognitive ability of humanity.
We see ourselves as existing within our heads. Not our feet, stomach, or even our chest -but behind the two eyes and between the two ears that we use to sense the world around us. Perhaps the first person to be trephined this way in this Assyrian tradesman’s culture was done so in an effort to remove a foreign object, behind which cerebral fluid collected (what we would, today, call a subdural hematoma). Patients suffering a hematoma show almost immediate improvement with draining, so all it would take is a single observation to make a connection that a local “healer” can exploit.
Brain injuries that result in subdural hematoma are also frequently accompanied by seizures. So it isn’t improbable that the connection between seizures and built up fluid would be made. This might explain evidence of trephinations where obvious injuries aren’t present in the cranial remains. But then it might also be that the injured bone was removed, leaving no evidence of the injury itself.