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Review of Causes and Origins of Cranial Trepanation in the Sarmatian Culture of the Lower Volga Region

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Review of Causes and Origins of Cranial Trepanation in the Sarmatian Culture of the Lower Volga Region JOURNAL OF CRITICAL REVIEWS ISSN- 2394-5125 VOL 7, ISSUE 12, 2020 REVIEW OF CAUSES AND ORIGINS OF CRANIAL TREPANATION IN THE SARMATIAN CULTURE OF THE LOWER VOLGA REGION Evgeny V. Pererva1 1Volgograd Institute of Management, Branch of the Russian Presidential Academy of National Economy and Public Administration»Gagarin Street, building 8, Volgograd, Russia 400066, ORCID 0000-0001-8285-44612 [email protected] Received: 14 Feb 2020 Revised and Accepted: 25 April 2020 ABSTRACT:The cranial trepanation is one of the most frequently performed operations on human skull by modern and ancient surgeons. In the scientific literature trepanation is often associated with the widespread manipulations in ancient peoples` bodies, such as deliberated head or extremities deformation, scalping, artificial scarification, decapitation, truncation of limbs, etc. Nowadays it is known that trepanation is the therapeutic or ritual manipulation performed in vivo or posthumously by various techniques. Reconsideration of all these criteria allows anthropologists evaluating the nature of development of medical knowledge of ancient societies; determining the degree of technical sophistication of ancient doctors and comprehending the traditions and customs of peoples who lived on earth in the distant past. The paper endeavors to summarize and consider cases of craniotomy on the materials dating back to the Sarmatian era. The presented study also provides an evaluation of the cases described from the point of view of the technique of carrying out the surgeries and other manipulations, and the reasons for their conduct. An attempt was made to find the sources of the spread of the tradition of skull trepanation in the nomadic peoples of the Early Iron Age inhabited the Lower Volga region. KEYWORDS: Trepanation, the Sarmatians, ancient societies, skull, Early Iron Age, the Lower Volga region. I. INTRODUCTION Paleoanthropological materials belonging to the Sarmatian culture are a unique source of information that allows anthropologists and historians to study the way of life of the early nomads of the Lower Volga region. In virtue of the study of the Sarmatian bone remains, ancient authors` data on the physical appearance of the population who had burial mounds in the South Russian steppes has been confirmed. The anthropologists have proved the widespread existence of the Sarmatian tradition to deliberate artificial skull deformation using scalping techniques; such tradition at a late stage of the Sarmatians’ history was described by Herodotus and Ammianus Marcellinus. Paleoanthropological analysis of the nomadic remainings dating back to the early Iron Age also confirmed that the Sarmatians practiced military field medicine. Currently the main focus of archaeological and anthropological research is concentrated on the discovered skulls with traces of trepanation; those skulls belong to the Sarmatian nomads originating from the territory of the Lower Volga region. 3 internal capsules with perforations dating from the first centuries AD were discovered over the past 25 years. Trepanation of the head is one of the oldest operations performed on the human skull [Brothwell, 1972; Mednikova, 1997]; along with the deliberated and unintentional artificial deformation of the skull, limb amputation and scalping it was known in many ancient peoples of all the continents across the globe [Lisin, 2004; Fialkov, 2010]. The very first mentions of trepanation were found in the works of ancient Greek healers Hippocrates and Galen. Hippocrates, who lived between 460-370 BC, gives evidence for trepanation in the chapter 9 of his treatise ‘On the wounds of the head’. The ancient doctor described in details the causes and methods of conducting therapeutic operations on the head; he also gave some recommendations on monitoring the patient after the surgery [Hippocrates, 1994]. Greco-Roman physician Galen lived six centuries later, in 129-200 AD. In his scientific work on head injuries he also cites the methods of trepanation and suggests the reasons for this surgery. In addition, the doctor gave a description of various instruments for trepanation: chisel, crown trephine, drill trephine, etc. [Mission, 2007, p. 5- 7]. 1812 JOURNAL OF CRITICAL REVIEWS ISSN- 2394-5125 VOL 7, ISSUE 12, 2020 Trepanation of the skull was carried out for various purposes in the ancient peoples. M.B. Mednikova [1997] indicates cause-effect fact that underlies the most classifications of trephine holes and the reasons for such manipulations. As a matter of fact, there are two main ways at the present time to classify such trepanations: 1. Technique or method of performing surgeries on the skull [Wilson, Cantab, 1923; Lisovski, 1967; Brothwell, 1972, Verano, 2003, Erdal, 2011]. 2. Classification of trepanation by purpose (Nemeskeri, Kinga-Kralovansky, Brothwell, 1972; Boev, 1992; Aufderheide, Rodriguez-Martin 1998, Mednikova, 2001, 2004; Rubini 2008]. Russian scientific studies of trepanation cases of the skull as a historical source of data reveal the level of knowledge in such fields of science as traumatology and anatomy of the human body, the level of development of religious ideas and customs - and generally, as a historical phenomenon. The studies began with the work of Dmitry Anuchin who attempted to interpret the findings made by Filipp Nefedov during excavations of the ancient settlement near the Vetluga River in 1883, namely pendants or amulets made from the human skull (1895). Anuchin analyzed this subject in detail referring to similar findings and descriptions of trepanized skulls from Western Europe and South America. In the same work Anuchin also considered a case of incomplete trepanation, performed on the skull from the Princes Hill (hillfort in the Novgorod region), suggesting that in this case the surgery was carried out using a tool similar to a chisel [Anuchin, 1895]. The earliest cases of trepanation in the Lower Volga area were localized in the north of Saratov region. So, A.L. Nechitailo described the case of trepanation on the skull which was found by Igor Dremov in 1985 in an Eneolithic burial on the Volga River near the town of Engels. The internal capsule of the brain belonged to a male; the surgery was performed in vivo by scraping with a flint scraper [Nechitailo, 2004, p. 61-62]. Another ancient manipulation of a therapeutic nature carried out on the cranium and dating to the Khvalynsk culture was studied by A.A. Khokhlov. On the skull from the burial 21 of Khvalynsk II burial grounds the anthropologist revealed superficial trepanation at the wound site which testifies to the good medical skills of the ancient healers [Khokhlov, 2012, p. 121-122]. The presented paper is an attempt to determine the causes and possible origins of the trepanation tradition using the materials of Sarmatian culture from the Lower Volga region. II. RESEARCH METHODS AND MATERIALS 4 cases of trepanation in Sarmatians discovered in the findings from the territory of the Lower Volga region are considered in the paper. Case 1. The skull from the Don region (the modern territory of the Volgograd region, the Kalmyk republic and the Rostov region) presumably comes from the burial grounds of the flood zone of the future Tsimlyansk Reservoir; the skull was dug by the Volga-Don archaeological mission under the guidance of Mikhail Artamonov in 1949-1951 (2009, p.18). The radiography of the skull was published by D.G. Rokhlin in 1965; the bone remains is originating from the burial dating back to the early Sarmatian time of the 3rd-1st centuries BC. Case 2. L.V. Gurenko conducted archaeological mission in the Kumylzhensky District of the Volgograd region near the Glazunovskaya village in 1996; the mound of the Late Sarmatian burial of the 3rd-4th centuries has been excavated. A skull with traces of trepanation and a lower jaw with holes were discovered in the burial (Gurenko, 1997). The source of the case was an ‘Act of Forensic Medical Examination No. 8’ of 5-10 February of 1998, prepared by forensic medical expert V.V. Sidorov. The medical expert conducted a macroscopic examination of a 30-year-old man's cranial capsule. Case 3. Protective excavations of mounds near the village of Peregruznoye of the Oktyabrsky District of Volgograd Region have been conducted in 2010. Bone remains of a 25-30 year-old woman with skull defects identifiable as trepanations were recovered during the archeological works in the burial mound 3 and mound 45. The burial was attributed to the Middle Sarmatian culture dating back to the 1st century AD. The cranium of the woman was examined macroscopically. Radiographic study of the skull was carried out in 2 projections: left lateral and straightforward from the distance to the object of 1 m. The radiation power used was at 70kW, 40 mА with the holding time of 0.16 sec. The X-ray device Medics-P-AMIKO was used to conduct radio graphical study. Case 4. During archaeological works in 2017 on the territory of the Verbovsky I burial ground, a burial mound No. 26 with one tomb dating back to the early 2nd century AD has been discovered. The tomb contained a skull of a 35-45-year-old woman with three trepanation holes; this skull was thoroughly examined. For differential diagnosis the method of computed tomography was applied; the study was carried out on a 128- slice Computed Tomography Scanner SOMATOM Definition (Siemens) with two X-ray tubes, collimation slide 5 mm, 2 mm and 0.6 mm width and a 0.4 mm increment in the reconstruction of raw data. Multiplanar reformations (MPR's) in the sagittal and frontal projections and three-dimensional reformation using the three-dimensional visualization method were performed. The recommendations set forth in the works of M.B. Mednikova [1997, 2001] were utilized when describing the deformation performed on the skull from the Verbovsky I burial ground. Also, the methods of forensic medical 1813 JOURNAL OF CRITICAL REVIEWS ISSN- 2394-5125 VOL 7, ISSUE 12, 2020 examination and traumatology of mechanical injuries were used on skeleton bones when determining post-mortem or in vivo nature of the revealed cranium deformations (Smolyaninov 1959, Pigolkin 2002 et al.).
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