In the 282 paragraphs of his famous collection of laws, the Great King Hammurapi I of Babylon (ca. 1792–1750 BC) also devoted himself to medicine. Paragraph 215 of the Codex states: “If a doctor … someone opens a tumor with a surgical knife made of bronze and gets the eye of the man, he shall receive ten shekels of silver.” This leads to the conclusion that already in the 2nd millennium BC BC Surgeons dared to operate on the human head.

A team led by Rachel Kalisher from Brown University in Providence (US state of Rhode Island) has now analyzed an example of such interventions. The remains of two men were found in a tomb near Megiddo in northern Israel. They were probably brothers. One of the two features a roughly three-centimeter square hole in the frontal bone of the skull. The find is dated to the middle of the 2nd millennium BC. dated.

The piece of bone was probably surgically removed from the skull, the scientists write in an article for the journal PLOS ONE. According to bone analysis, both brothers had been seriously ill for a long time. One died as an older teenager or in his early 20s, the other between the ages of 21 and 46. They may have succumbed to an infectious disease such as tuberculosis or leprosy.

Traces of high-quality food and fine ceramic vessels were found in the grave of the two men, the researchers write. This suggests that they belonged to the upper class and that, despite their illness, they were not excluded, which was particularly the case with leprosy sufferers. In the first millennium B.C. This disease is represented in the Old Testament as proof of impurity. The team therefore calls its finding “an important case study for further exploring the intersections of status, disease and treatment in societies over time.”

Examples of trepanations, in which a hole is cut in the skull, are very rare in ancient times, explains Rachel Kalisher. It is also unclear why some of the holes are round – which indicates the use of a kind of drill – while others are square or triangular. It is therefore also unknown which diseases should be treated in this way.

In contrast to Mesopotamia, there is no written evidence of such operations from Bronze Age Egypt, writes the medical historian Florian Steger from the University of Ulm: “In all probability, trepanations were not part of the medical scope.”

When the two men from Megiddo underwent the life-threatening operation, Palestine was caught between the aspiring New Kingdom of Egypt and the great powers of Asia Minor and Mesopotamia. Especially in Mesopotamia, a differentiated healing system had developed since the 3rd millennium, in which doctors played a prominent role.

Megiddo in the Jezreel plain was on the great military road that connected Syria with the Nile country. It must have been relatively easy for the wealthy to enlist the services of physicians. Rachel Kalisher and her team believe that the reason for the trepanation may have been the patient’s deteriorating health. However, the lack of bone healing indicates that the man died during or shortly after the operation.

This could have had unpleasant consequences in King Hammurabi’s Babylonia, as he warns in paragraph 219 of his codex: “If a doctor makes someone a serious wound with a surgical knife and kills him, or someone opens a tumor with a bronze surgical knife and eye is destroyed, his hands should be cut off.”

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