A skull reveals how sophisticated early medicine could be, says Nigel Hawkes

A PEASANT on the wrong end of a violent assault 1,000 years ago had his brain surgeon to thank for his survival.

The skull, unearthed from a medieval cemetery at Wharram Percy, near Malton in North Yorkshire, shows unexpected sophistication in cranial surgery in Anglo-Saxon times. Simon Mays, skeletal biologist at English Heritage's Centre for Archaeology, said:"This skull is the best evidence we have that such surgery to treat skull fractures was being performed in England at the time.

"It predates medieval written accounts of the procedure by at least 100 years and is a world away from notions that Anglo-Saxon healers were all about spells and potions."

The evidence comes from detailed analysis of the skull of a 40-year-old man, who lived in the village of Wharram Percy some time between AD960 and AD1100.

An entire cemetery was excavated at the now-deserted village between 1950 and 1990, yielding nearly 700 skeletons that have thrown new light on the health, lifestyle and diet of medieval man. They have revealed high levels of disease, malnutrition and stunted growth in children, and show that life could certainly be nasty, brutish and short.

The skull of the man had been struck a near-fatal blow with a blunt instrument, sustaining a severe depressed facture on its left-hand side. However, closer examination revealed that he also had life-saving surgery, involving lifting a rectangular area of the scalp 9cm by 10cm and carefully scraping away at the skull to remove depressed bone fragments and relieve pressure on the brain.

The technique, called trepanning, was known in Ancient Greece and Rome, but gets no mention in Anglo-Saxon literature. Some historians have suggested that this knowledge did not penetrate to Western Europe for centuries after the fall of Alexandria in the 7th century.

But Wharram's peasant not only survived, he apparently lived for many more years, eventually dying of other causes. Fracture lines radiating from the impact area on the skull are well-healed, showing that he made a good recovery.

Bone remodelling, evidence of long-term healing, can also be seen in the area opened up by the surgeon. The hole that remained would have eventually closed over with hard scar tissue.