Prehistoric trepanation in the Iberian Peninsula: a new case from the (Extremadura, ) Tomé, Tiago; Silva, Ana Maria; Giraldo, Hipólito Collado; Oosterbeek, Autor(es): Luiz Publicado por: Imprensa da Universidade de Coimbra URL persistente: URI:http://hdl.handle.net/10316.2/42120 DOI: DOI:https://doi.org/10.14195/2182-7982_32_3

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Prehistoric trepanation in the Iberian Peninsula: a new case from the province of Badajoz (Extremadura, Spain) 47

Trepanações pré-históricas na Península Ibérica: um novo caso proveniente da província de Badajoz (Estremadura, Espanha)

Tiago Tomé1-4,*, Ana Maria Silva2,5, Hipólito Collado Giraldo6, Luiz Oosterbeek3,4

Abstract Trepanation is a recurrent Resumo: A trepanação é um tema recorrente subject in the literature, with the earliest na bibliogra a cientí ca especializada, known examples of this surgical procedure pertencendo os exemplos mais antigos belonging to the Mesolithic/Neolithic sodicehnoc oa .ocitíloeN/ocitíloseM periods. The Iberian Peninsula is no exception A Península Ibérica não é exceção a essa to this tendency, where most of the known tendência, com a maioria dos casos de trepanation cases were found in coastal areas trepanação identi cados provenientes de (Silva, 2003; Campillo, 2007). regiões próximas do litoral (Silva, 2003; We present the results of the human Campillo, 2007). 1 osteological assessment of Cueva de los Neste artigo será descrito um crânio exibindo Postes, a cave located in southern Badajoz uma lesão traumática no osso parietal direito

1 Universidade Federal do Pará, Belém (PA), Brasil. 2 Centro de Investigação em Antropologia e Saúde, Departamento de Ciências da Vida, Universidade de Coimbra, Coimbra, . 3 Centro de Geociências, Departamento de Ciências da Terra, Universidade de Coimbra, Coimbra, Portugal. 4 Instituto Terra e Memória, Instituto Politécnico de Tomar, Tomar, Portugal. 5 UNIARQ – WAPS. Centro de Arqueologia da Universidade de Lisboa. 6 Consejeria de Educación y Cultura — Gobierno de Extremadura, Mérida, España. * Corresponding autor: [email protected]

DOI: https://doi.org/10.14195/2182-7982_32_3 Artigo Recebido a 22 de janeiro de 2016 e aceite a 8 de setembro de 2016 province, inland Spain, with a particular focus compatível com uma trepanação, exumado on a skull with a traumatic lesion compatible de Cueva de los Postes (Fuentes de León), with a trepanation on the right parietal bone. uma gruta localizada no Sul da província This is the first reported case of a prehistoric de Badajoz. Trata-se do primeiro caso de trepanation in this region. A brief comparative trepanação pré-histórica identificado nesta analysis with other known Iberian prehistoric província de Espanha. Realiza-se uma breve 48 trepanations is included, regarding location análise comparativa com outros casos de of the lesions and method of trepanation trepanação conhecidos da pré-história da selected to the procedure. Península Ibérica, incidindo em aspetos como a sobrevivência do indivíduo, o método de trepanação e a localização da lesão.

Keywords: Trepanation; drilling method; Palavras-chave: Trepanação; método de Mesolithic; Neolithic; Iberian Peninsula. perfuração; Mesolítico; Neolítico; Península Ibérica.

Introduction In 2001, a group of caves in the town of Fuentes de Léon (Badajoz, Spain) The study of Neolithic communities was considered Natural Monument in the Spanish Extremadura region of Extremadura by the regional was limited, until a few decades ago, authorities. Karstic cavities are quite to the Megalithic phenomenon and rare in this Spanish region, thus making Tiago Ana Maria Silva, Tomé, Hipólito Collado Giraldo, Luiz Oosterbeek later communities. Much like in the the caves of Fuentes de Léon the neighboring Portuguese region of most important example of this type Alentejo, no Holocenic settlement prior to of feature in Southern Extremadura. the construction of megalithic monuments Five main caves are known: Cueva was recognized, thus leading to the de los Caballos, Cueva de los Postes, notion that these areas were destitute of Cueva del Agua, Cueva de la Lamparilla people until, at least, the beginning of and Cueva Masero (Algaba Suárez et the IV millennium cal BC. Recent works, al., 2000). however, allowed the identification of Since 1997, a research project (“Estudio some sites containing evidence of earlier de la Ocupación Humana en el Monumento occupations in the Spanish Extremadura Natural Cuevas de Fuentes de León”) is region (González Cordero, 1996; Cerrillo- under development, with the objective Cuenca, 2005; Cerrillo-Cuenca and of providing an archaeological and González Cordero, 2011). palaeoenvironmental characterization of this cave complex. Intensive surveys have they resemble posts. Excavation revealed the presence of archaeological in the first room revealed a long and paleontological remains in four caves stratigraphic sequence, over 4.2 m (Postes, Caballos, Agua and Masero), as deep, complemented with the deposits well as rock art in one of them (Agua). identified in the second room. Such results led to excavations in both Material culture, absolute dating, 49 Cueva de los Postes and Cueva de los sedimentology and palaeoenvironment Caballos in 2004. Ever since, Cueva de studies (Duque Espino, 2011; Collado los Postes has been excavated and is Giraldo, 2014; Ortega Martínez et al., in now known to hold a long stratigraphic press) have allowed the definition of four sequence. major phases in the occupation of Cueva The human remains recovered from de los Postes: Cueva de los Postes were the subject of Phase 1: Corresponding to the a recent osteological analysis, revealing uppermost layers, this phase comprises the presence of a minimum number Stratigraphic Units 1 to 4. This is a highly of more than 50 individuals including disturbed deposit, due to the action of both sexes and all age groups (Tomé, archaeological looters, the use of the 2011). Among them, an incomplete cave for herding purposes and animal skull fragment presented a traumatic activities, such as burrowing, resulting lesion — perforation — consistent with in the mixing of materials from different a complete trepanation. The aim of this chronologies. These included Modern/ article is the description of the observed Contemporary ceramics, but most of the cranial lesion and its comparison with the materials corresponded to the Roman available data on prehistoric trepanation Era, including lamps, terra sigillata vessels cases in the Iberian Peninsula. and coins. Some materials seem to correspond to indigenous occupations as well, due to their similarity with the materials recovered from the nearby Archaeological chronostratigraphy of excavations at the Capote Hillfort, in Cueva de los Postes Higuera la Real (-Rangel, 1992; 1994; 1998; Berrocal-Rangel and Ruiz

Cueva de los Postes has an area Triviño, 2003). Prehistoric trepanation in the Iberian a new Peninsula: case from the province of Badajoz (Extremadura, Spain) of 180m2, composed of two rooms, Phase 2: Grouping together separated by an alignment of stalactites Stratigraphic Units 5 to 10, this phase and stalagmites. Such speleothems corresponds to a collective burial have given the cave its name, since deposit, including at least 50 individuals, 33 adults and 17 sub-adults. Radiocarbon from this funerary deposit, with lithic dating indicates a Neolithic chronology industry being limited to geometric to this deposit, ranging from the V to the microliths and a majority of macrolithic III millennium cal BC (Table 1). Material tools, produced on local pebbles. culture was predominantly composed Such tools are characterized by limited 50 of small to medium sized oval/spheric flaking, mostly on the distal edge. ceramic pots, mostly undecorated, Additionally, three small limestone slabs although incised, impressed and almagra presented engraved motifs, of both a decorations are present. Lithic industry symbolic and figurative nature (Collado includes microliths, blades, bladelets, Giraldo and García Arranz, 2010: 1184). arrow points, halberds and polished Phase 4: For the time being, the axes. Several types of beads were also identification of this phase is limited recovered. to a small test-pit performed on the Phase 3: This includes Stratigraphic deeper room of Cueva de los Postes. Units 11 to 14 and represents what seems This occupation was covered by a to be the earliest funerary deposit in calcite coating, dated with the Uranium- Cueva de los Postes. The sub-sample of thorium series method (193 +/– 14 ky). human remains contained in this horizon The presence of flint tools along with the corresponded to a MNI of 6 individuals, remains of large mammals suggests that 5 adults and 1 sub-adult. Radiocarbon there may have been an occupation of dating of charcoal samples (Table 1) Cueva de los Postes during the Middle indicates a VII millennium cal BC interval. Paleolithic. Although apparently the funerary Tiago Ana Maria Silva, Tomé, Hipólito Collado Giraldo, Luiz Oosterbeek ritual presents similarities with the one recorded for Phase 2, the material culture accompanying the deceased is different. Indeed, ceramics are completely absent

Table 1. Radiocarbon dates from the burial deposits of Cueva de los Postes (Collado Giraldo, 2014; Ortega Martínez et al., in press).

Phase Sample Provenance Reference BP CAL BC 2 σ Homo SU5 Poz-44045 4140 ± 35 2875–2620 2 Charcoal SU8 Poz-13703 5455 ± 40 4370–4230 Charcoal SU12 Poz-14616 7360 ± 50 6370–6080 3 Charcoal SU13 Poz-18774 7440 ± 50 6420–6220 Charcoal SU14 Poz-33226 7780 ± 60 6770–6460 Materials and methods assume without caution that this skull has indeed a 7th millennium BC dating, As abovementioned, Cueva de los although no disturbances were recorded Postes held a large Holocenic human in this deposit and the material culture is skeletal sample, comprising over 50 consistent with a Mesolithic chronology. individuals, representing both sexes and Even so, issues such as the “old wood 51 all age groups. These skeletal remains effect” must not be overlooked in were disarticulated and exhibited the interpretation of this specimen. high levels of fragmentation. Skeletal Direct radiocarbon dating of the human reassembly was mostly impossible, with remains recovered in these deposits only limited secondary connections being should be performed if possible, in identified during the paleobiological order to provide a better insight on the assessment. In the present study, one chronology of this funerary context. incomplete skull, comprised of a portion The presence of a perforation of the frontal, both parietals, occipital and suggestive of a complete trepanation left temporal bones, was considered. Skull on this cranial vault led to a detailed C6.165 was recovered from Stratigraphic differential diagnosis of this lesion, aiming Unit 12, corresponding to the earlier at the clarification of its aetiology. funerary horizon — Phase 3 — of Cueva de los Postes and belonging to an adult individual of unknown sex. No postcranial remains could be associated with this skull Description of the lesion and, as such, age-at-death estimation was limited. We can only establish that this The lesion is located on the right individual died somewhere between his parietal, circa 18mm away from the thirties and fifties based on the degree of sagittal suture and 48mm from the obliteration of the sutures (Ferembach et bregma. With a sub-circular shape al., 1979; Masset, 1982). and beveled edges, the lesion has an Regarding chronology, one must anteroposterior diameter of 12 mm and bear in mind that radiocarbon dating for a mediolateral diameter of 11 mm on the this deposit was so far only achieved on exocranial surface, with slightly smaller charcoal samples, with samples taken dimensions on the endocranial surface Prehistoric trepanation in the Iberian a new Peninsula: case from the province of Badajoz (Extremadura, Spain) from human remains revealing insufficient (Figures 1 and 2). preserved collagen from which to extract The perforation was complete. a sufficient amount of carbon as to allow Some traces of bone remodeling are radiocarbon dating. As such, one cannot observable around the edges of the 52

Figure 1. Superior view of the skull C6.165 from Cueva de los Postes, presenting a perforation on the right parietal bone compatible with a complete trepanation.

lesion, including some areas of the diploe appearance of the lesion suggests the covered by compact bone, indicating use of the drilling method. remodeling and thus that the individual Previous studies on the time course of survived the procedure. The general bone remodeling following trepanation Tiago Ana Maria Silva, Tomé, Hipólito Collado Giraldo, Luiz Oosterbeek

Figure 2. Close-up view of the described lesion of skull C6.165 from Cueva de los Postes with visible bone remodeling. suggest that slight remodeling, as is the throughout the world, with the case with the skull presented here, can oldest known examples dating to the occur up to one year after the trepanation Mesolithic/Neolithic periods (Campillo, procedure (Nerlich et al., 2003). As such, 1976; 1984; 2007; Ortner, 2003; Weber and one may not exclude that this individual Wahl, 2006; Andrushko and Verano, 2008; had a somewhat lengthy survival to this Bennike, 2008). 53 procedure. No evidences of infection Regarding the Iberian Peninsula, the were identified. earliest example comes from the Moita Differential diagnosis of the lesion do Sebastião Mesolithic shell midden, included taphonomic perforation and but trepanations occur predominantly in fracture. Although some taphonomy- later contexts (Crubézy et al., 2001; Silva, related alterations were visible in the area 2003; Campillo, 2007). Trepanation can of the lesion, such as several fractures be performed for a variety of reasons, radiating from the perforation, these namely the removal of bone splinters seem to have been related to depositional or blood accumulations resulting from conditions — possibly relating to the traumatic injuries, as well as for ritual pressure overlying these remains, reasons (Weber and Wahl, 2006; Campillo, coupled with the structural fragility that 2007; Bennike, 2008; Waldron, 2009). the presence of a perforation in that Techniques for performing trepanations area would imply. A taphonomic origin include scraping, grooving, sawing, of the perforation was excluded due to drilling, boring or chiselling (Campillo, the visible signs of bone remodeling. 2007; Bennike, 2008). The characteristics of the perforation, The location of Cueva de los Postes a circular opening with the external raises some issues in terms of the most table slightly wider than the inner appropriate contexts for comparative one, permitted to exclude the fracture purposes. Indeed, most of the Spanish hypothesis. Therefore, trepanation seems trepanation cases come from funerary to be the more reasonable diagnosis. sites located further away from Cueva de los Postes than their Portuguese counterparts. As such, both Portuguese and Spanish contexts must be taken into

Prehistoric trepanation in Iberia — a consideration (Figure 3). Prehistoric trepanation in the Iberian a new Peninsula: case from the province of Badajoz (Extremadura, Spain) short review The most recent review of Portuguese prehistoric trepanations (Silva, 2003) lists Trepanation has been consistently a total of 22 cases, found exclusively described in archaeological literature in coastal areas. However, differential

54

Tiago Ana Maria Silva, Tomé, Hipólito Collado Giraldo, Luiz Oosterbeek

Figure 3. MapFigure of 3.sites Map ofcontaining sites containing prehistoric prehistoric trepanned trepanned skulls in the skulls Iberian Peninsula.in the Iberian Peninsula

The most recent review of Portuguese prehistoric trepanations (Silva, 2003) lists a total of 22 cases, found exclusively in coastal areas. However, differential preservation can play an important role in this issue. Indeed, several coastal areas of Portugal correspond to limestone massifs, while inland areas are mostly composed of granite and schist massifs, usually associated with poor bone preservation. Until the present day, no trepanations are known from Portuguese territories in closer vicinity to Cueva de los

Postes. Nevertheless, this may change in the near future, as new prehistoric burial sites are being discovered and studied in Portuguese territories close to the Badajoz province

(Gonçalves and Sousa, 2000; Valera et al., 2000; Miguel and Godinho, 2009; Valera,

11 preservation can play an important role commonly found in sites located at in this issue. Indeed, several coastal areas peripheral, coastal areas (Liesau von of Portugal correspond to limestone Lettow-Vorbeck and Pastor Abascal, massifs, while inland areas are mostly 2003; Campillo, 2007). It is worth noting composed of granite and schist massifs, that Spanish prehistoric trepana­tions usually associated with poor bone were performed mostly with the drilling 55 preservation. Until the present day, no method (Campillo, 1976; 1986; 2007), the trepanations are known from Portuguese same technique applied to the individual territories in closer vicinity to Cueva de from Cueva de los Postes. Sites such as los Postes. Nevertheless, this may change Cova de la Pastora (Alicante), for instance, in the near future, as new prehistoric are indicative of this predominance of burial sites are being discovered and drilled trepanations (Campillo, 2007; studied in Portuguese territories close McClure et al., 2011). A few other examples to the Badajoz province (Gonçalves are known from inland Spanish areas, and Sousa, 2000; Valera et al., 2000; such as the Meseta, from either Late Miguel and Godinho, 2009; Valera, 2010; Neolithic megalithic burials or from cave Valera and Filipe, 2010). Regarding the burials, possibly of a Neolithic chronology Portuguese coastal examples, scraping (Liesau von Lettow-Vorbeck and Pastor and incision are the most common Abascal, 2003; Campillo, 2007). trepanation methods, although some Regarding the Spanish Extremadura, cases of drilled trepanations are known, there is only one other described mostly on more ancient cases (Silva, trepanation, found at the Cave of 2003). As for the location of lesions, Maltravieso, in Caceres. It is from a female parietals are clearly the most commonly individual that presents a left parietal affected bones (85%). Survival to the lesion, larger (38 x 28 mm) than the procedure also seems to be frequent in one described for Cueva de los Postes. these individuals. Trepanation seems to Bone remodeling is also noted (Álvarez have been performed mostly on male Rojas, 1984; Campillo, 2007). This skull individuals. As is the case with the Cueva is associated with a Bell Beaker context de los Postes specimen, most of the (Liesau von Lettow-Vorbeck and Pastor Portuguese cases exhibit no indications Abascal, 2003). Up until now, prehistoric

of the justification for the performance of trepanations were unknown in the Prehistoric trepanation in the Iberian a new Peninsula: case from the province of Badajoz (Extremadura, Spain) cranial surgery, such as traumatic injuries province of Badajoz. Nevertheless, a (Silva, 2003). reference is necessary to a case located A similar tendency seems to occur quite close to the one now presented. in Spain, with trepanations being more Cueva de la Mora (), in the province of , yielded a skull terms of the technique, the Cueva de belonging to an adult male, presenting los Postes specimen seems to fit within a large trepanation, produced with the tendency for Spanish prehistoric incision technique, affecting the frontal trepanations being mostly performed and both parietal bones. This trepanation with the drilling method (Campillo, 56 is described as having been performed 2007). This method was also used in postmortem (Campillo, 2007; Guillén Portuguese prehistory, although not in Arenas, 2015). such a predominant way and apparently In terms of chronology, the specimen in the oldest cases (Silva, 2003). One other from Cueva de los Postes may represent common feature of several prehistoric one of the earliest cases of trepanation trepanned skulls is the presence of bone known in the Iberian Peninsula, given remodeling, indicating the survival of the that the earliest examples come from individual to this surgical procedure or sites with a contemporary chronology other complications, such as infections to the intervals obtained for the Phase (Campillo, 1976; 1984; 2007; Silva, 2003). 3 of Cueva de los Postes (VII millennium The Cueva de los Postes individual cal BC). described here also shows these traces. Although coastal areas concentrate the majority of prehistoric trepanations known in the Iberian Peninsula, examples Final remarks such as the case described here from Cueva de los Postes, the female individual from Maltravieso — both in the Spanish Tiago Ana Maria Silva, Tomé, Hipólito Collado Giraldo, Luiz Oosterbeek Trepanation occurred in the Iberian Peninsula at least from the Mesolithic Extremadura —, among others known onward. Several prehistoric cases were from the Spanish Meseta and Andalucia, described ever since the 19th century, demonstrate that trepanations were concentrating mostly on coastal regions also a practice of inland communities. (Crubézy et al., 2001; Liesau von Lettow- The preservation issues that are known Vorbeck and Pastor Abascal, 2003; Silva, to affect human skeletal remains in 2003; Campillo, 2007). inland Iberian regions are, quite likely, The specimen reported here also responsible for the shortage of represents the first known case of a trepanation cases thus far confirmed in prehistoric trepanation in the province such areas. The ongoing development of Badajoz (Spain). Other known cases of projects focusing on prehistoric from the Iberian Peninsula suggest that funerary practices on inland territories parietal lesions are predominant. In of the Iberian Peninsula will likely lead to further identification of trepanation natural y arqueológico. Oxford, British being performed by such communities. Archaeological Reports, International The case described here from Cueva Series (826). de los Postes represents a contribution Álvarez Rojas, A. 1984. Análisis de los restos to our understanding of the medical óseos hallados en la Cueva de knowledge of prehistoric communities Maltravieso, Cáceres. Revista de Estudios 57 in inland Iberia, suggesting that cranial Extremeños, XL(1): 170–179. surgery was performed by both coastal Andrushko, V.; Verano, J. 2008. Prehistoric and inland communities at least as far trepanation in the Cuzco region of back as the VII millennium cal BC. Peru: a view into an ancient Andean practice. American Journal of Physical Anthropology, 137(1): 4–13. DOI: https:// doi.org/10.1002/ajpa.20836. Bennike, P. 2008. Trauma. In: Pinhasi, R.; Acknowledgements Mays, S. (eds.) Advances in Human Palaeopathology. Chichester, John The study of the human remains Wiley & Sons: 309–328. exhumed from Cueva de los Postes Berrocal-Rangel, L. 1992. Los pueblos célticos was integrated in the “Landscapes of del suroeste de la Península Ibérica. 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