As discussed in an earlier post explaining the various types of this cranial modification, trephination occurs all around the world in a variety of time periods. Trephination is the removal of pieces of cranial bones from a living individual without penetrating into the soft tissue. Throughout history it has been done using a variety of tools, and done for a variety of reasons. However, most of these surgeries are for medical purposes such has releasing evil spirits, removing bad blood, or in modern times- to relieve pressure on the brain.
In Hungary, during the Conquest period (late 9th–10th c. AD), there was a unique type of trephination. It consisted of removal of an external layer of bone, was not complete and likely had symbolic meaning. So far there have been 130 cases of surgical trephination and 157 cases of symbolic trephination found from Hungary during this period. Bereczki et al. (2013) examine these unique superficial trephinations. To date, this is the first study to comprehensively analyze all of the trephinations in order to determine patterns and whether these were symbolic.
Performance of this type of superficial and ectocranial trephination was done using a scraping or carving technique. The skin would be cut and folded away from the skull, the shape of either a circle or almond was carved in, and the external bone was removed. After completion the skin would be sewed back on. Once healing begin, the rough open bone would get covered with a new layer of compact bone but would never completely re-fill the area that had been removed- leaving a depressed area.
The goal of this study is to synthesize over a century of research into this type of operation, and determine whether it is related to a similar practice seen among Avar groups in an earlier period. The sample includes individuals from the 8th c. AD Late Avar cemetery of Bélmegyer, the 10th c. AD Hungarian cemetery of Algyő, the 10th c. AD Hungarian graveyard of Szabadkígyós and the 10–11th c. AD Hungarian cemetery of Eperjes-Ifjú Gárda. From this sample there wer 14 individuals with a total of 27 symbolic trephinations. The trephinations were found on 9 males and 5 females. Only one individual was in the 30-40 year range, and the rest were 40-60 years old. 8 of the skulls had single lesions, and 6 ranged from 2 to 5 lesions. Most of the lesions were near and bregma, and all were on the topmost portion of the skull. All were healed or mostly healed at time of death.
Before assuming a ritual or symbolic purpose behind these lesions which are quite similar, Bereczki et al. (2013) propose a differential diagnosis (exploration for other possible causes). Depressions from blunt force trauma or bone loss due to tumors could have a similar appearance. However both of these would likely cause a periosteal reaction of new bone growth above the cranium, and have other symptoms. Hematoma or trauma to the external soft tissue could result in bony change, but usually these are irregular in shape. Tuberculosis and syphilis also affect the skull, creating rounded lesions, but these are not usually found solely in the external cranium.
They propose these are symbolic because they appear in a short period of time, only from the 8th to 11th c. AD, they have similar shapes and distributions, and all individuals survived a long time to allow complete to nearly complete healing. This also fits with Hungarian beliefs that the soul resides in the head, and scraping portions of the skull away from the top of the head could improve communication with the spirits. While they can’t say this act was symbolic or ritualistic without a doubt, the evidence is mounting in their favor. Future studies will examine whether this is indicative of cultural contact or similar origins between the early Hungarians and the Avars. Both cemeteries had similar trephinations, and they appear similar to earlier 6th to 9th c. AD Avar traditions. The researchers intend to create a database for these trephinations in order to further analyze them- so hopefully in the future we will learn more about the origins and meaning of this practice.
Bereczki, Z., Molnár, E., Marcsik, A., & Pálfi, G. (2013). Rare Types of Trephination from Hungary Shed New Light on Possible Cross-cultural Connections in the Carpathian Basin International Journal of Osteoarchaeology DOI: 10.1002/oa.2304