Bones of ancient brothers found in Israel could show world's earliest case of leprosy

One of the pair underwent an early form of brain surgery

Evidence of early brain surgery in Israel. Rachel Kalisher
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The bones of two brothers who were alive in the 15th century BC found near Israel's Haifa show evidence of early brain surgery and could be the earliest recorded case of leprosy.

Archaeologists discovered the example of ancient cranial trephination during a dig in the area of the ancient city of Megiddo. The pair were probably high status individuals owing to the location of their burial near the ancient palace and the fine Cypriot pottery and other valuable possessions buried with them.

Megiddo was an important stop on a land route connecting Egypt, Syria, Mesopotamia and Anatolia 4,000 years ago, and thereby became vastly wealthy by the 19th century BC.

Types of trephination, where a hole is cut in the skull, have been discovered in ancient cultures around the world. But the team from Brown University’s Joukowsky Institute for Archaeology and the Ancient World say this is the earliest example of its kind found in the Ancient Middle East.

“We have evidence that trephination has been this universal, widespread type of surgery for thousands of years,” leader of the expedition and PhD candidate Rachel Kalisher said.

“But in the Middle East, we don’t see it so often — there are only about a dozen examples of trephination in this entire region. My hope is that adding more examples to the scholarly record will deepen our field’s understanding of medical care and cultural dynamics in ancient cities in this area.”

World's earliest documented case of leprosy?

The evidence of surgery also shows one of the men had access to elite medical care — particularly important given the analysis of their skeletons shows both brothers likely had leprosy or tuberculosis.

The team is working with the German Max Planck Institute for Evolutionary Anthropology to analyse DNA from lesions found on the brothers' bones to determine what infection they had. If the lesions found on the brothers' bones prove to be caused by leprosy, it would be the among the earliest documented examples of leprosy in the world.

One of the brothers died in his late teenagers or early 20s, and the other between 20 and 40, the research, published in journal PLOS ONE, found.

Rachel Kalisher on site in Haifa. Rachel Kalisher et al

“These brothers were obviously living with some pretty intense pathological circumstances that, in this time, would have been tough to endure without wealth and status,” Ms Kalisher said.

It is unclear what illness the surgery was supposed to alleviate, but it involved cutting the scalp, using an instrument with a sharp bevelled edge to carve four intersecting lines in the skull, and using leverage to make a square-shaped hole.

It was not successful. The study showed he died shortly after the surgery, probably within days, hours or perhaps even minutes.

“You have to be in a pretty dire place to have a hole cut in your head,” Ms Kalisher said.

“I’m interested in what we can learn from looking across the scientific literature at every example of trephination in antiquity, comparing and contrasting the circumstances of each person who had the surgery done.”

Updated: February 22, 2023, 7:15 PM