Medicine Through the Ages 🩺🏺 | The Strange History of Ancient Healing | Boring History for Sleep

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Hey there, night owls. Tonight we're digging into the strangest chapter of human history, the thousands of years when medicine was trying its absolute best and mostly making things worse. 9,000 years ago, people drilled holes in living skulls with sharpened stone, and about half the patients survived. The first emperor of China drank liquid metal to live forever, and it killed him. And when the Black Death arrived, real doctors treated their patients by strapping live chickens to them. The chicken did not consent. So here is the question. Why did smart, educated people spend centuries curing the sick with things that quietly killed them?

We will sort out what worked, what did not, and how medicine finally learned to check itself. Hit that like button, and drop a comment telling me what city you're watching from and what time it is right now.

The oldest operation in the human record does not come from a hospital, a university, or even a city. It comes from a burial pit in eastern France, near a small town called Ensisheim, where archaeologists lifted a skull out of the ground that had been sitting there for roughly 7,000 years. The man it belonged to was about 50 when he died, which for the Neolithic period counted as a long and successful career. And in the top of his skull there were two holes, not fractures, not the ragged damage left by a falling rock, or a bad decision involving a mammoth. Two deliberate openings, one considerably larger than the other, cut with intention and precision, positioned on the upper left side of the vault. The remarkable part is not the holes, it is the edges. Around both openings the bone had grown back, thickened and rounded off into the smooth rolled margin that living tissue produces when it heals. That regrowth takes months. It takes a functioning immune system, a blood supply, and a person walking around doing ordinary Neolithic things while it happens. This man did not die on the table, assuming there was a table. He survived the first procedure. Then, at some later point, somebody opened his head again in a second location, and he survived that one too. Which means that after the first operation, the community looked at the results and decided the whole experience had gone well enough to schedule a repeat. The oldest surgery we know about also gave us the oldest known returning patient, which is either a testament to the skill of the operator, or to the extremely limited entertainment options available in 5100 BC.

Before going further, it is worth being clear about what this procedure actually involved, because the modern imagination tends to fill in the gaps with something far more dramatic than what the evidence supports.

The operation is called trepanation, and it means removing a section of bone from the skull without damaging what lies underneath. That last part is the entire craft. Beneath the bone sits a tough fibrous membrane called the dura mater, and beneath that sits the brain, and the difference between a successful ancient surgeon and an unsuccessful one was almost entirely a matter of knowing exactly when to stop pressing. Go too shallow, and you accomplish nothing. Go one enthusiastic millimetre too far, and you have created a very different situation. There were no second chances and no supervising consultant standing nearby to tap you on the shoulder. Ancient operators developed at least four distinct approaches to the problem, and the fact that there were four tells you people were experimenting, comparing results, and passing techniques down.

The first method was scraping. You take a flake of stone with a working edge, you press it against the bone, and you abrade the surface in slow circular strokes, thinning the vault layer by layer until the last wafer lifts away. It is tedious beyond description, and can take a very long time, but it is also the safest method, because the rate of progress is so gradual that it is almost impossible to punch through by accident. The second method was grooving. Instead of thinning a whole area, you carve a circular channel around the section you want to remove, going deeper with each pass until the disc in the middle comes free like a plug. The third method involved boring a ring of small perforations around the target area, and then connecting them, essentially the same principle as the perforated line on a sheet of stamps, which is a comparison the original practitioners would have found baffling but accurate. The fourth was rectangular cutting, where four straight incisions were made in the bone, and the square between them lifted out. Different regions favoured different methods, and some sites show two techniques used on the same individual, which suggests the operator switched approaches partway through after deciding the first one was not working. The tools were whatever the local geology provided. In Europe that meant flint, in the Andes it meant obsidian, and obsidian deserves a moment of appreciation here because volcanic glass fractures to an edge that is genuinely, measurably finer than modern surgical steel. It is also brittle enough to shatter if you lean on it wrong, which introduces its own excitement to the proceedings. Andean surgeons also used metal blades of the type known as tumi, with copper and bronze working edges, alongside their stone instruments. What none of them had was anything resembling anesthesia in the modern sense. There is reasonable evidence for plant preparations that dulled sensation, coca leaves in the Andes, alcohol and various herbal concoctions elsewhere. And there is the simple biological fact that the brain itself has no pain receptors. So once the scalp and the bone were dealt with, the deepest part of the procedure was not the worst part. That is a genuinely strange consolation, but it is a real one. This was not a local eccentricity practiced by one unusual village. Trep and skulls have been recovered by the thousand across an absurd geographic spread. Western Europe has them in quantity, from France and Germany through to Scandinavia and the British Isles. North Africa has them. The steppe burials of Russia and Ukraine have them. They turn up in China, in Polynesia, in parts of Sub-Saharan Africa, across Mesoamerica and above all in South America. Cultures separated by oceans and by thousands of years, with no possible contact and no shared tradition, independently arrived at the same conclusion, which is that when something goes badly wrong inside a head, one reasonable response is to make an opening in it. Humans keep reinventing this idea. That fact alone should tell us that it was producing results often enough to be worth repeating, because societies operating close to the survival margin do not maintain elaborate, labour-intensive customs that reliably kill people. Nowhere is the evidence richer than in Peru.