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Surgically Marked Skull

Forensic analysis of a small piece of human skull discovered by archaeologists in a 400-year-old trash pit at Historic Jamestowne has confirmed that it is the earliest known evidence of surgery and autopsy in early 17th-century English America, according to Dr. William M. Kelso, director of archaeology for the Association for the Preservation of Virginia Antiquities (APVA Preservation Virginia).

It also tells a painful story about the final moments of one settler's life.

Dr. Douglas W. Owsley, forensic osteologist at the National Museum of Natural History, Smithsonian Institution, and Dr. Ashley H. McKeown, forensic anthropologist at the University of Montana, determined that it was a piece of occipital bone from the back of the skull of a European man. This individual received a traumatic blow to the back of his head with a celt-like object, like an axe made of stone, that fractured his skull.

Circular cut marks in the bone show that a surgeon attempted to drill two holes in the skull using a trepan to relieve pressure. He did not complete the procedure, probably because the patient died. Saw marks on the top (superior) edge of the bone indicate that an autopsy was subsequently performed.

McKeown explained that they know he was a male because of the shape of the occipital bone and the pronounced muscle markings on the skull. "We can also tell that he was an adult because of the thickness of the skull fragment and closure of some of the visible cranial sutures. He apparently died soon after he was injured, since the fractures do not show any sign of healing, and the trepanation was aborted," she said.

Kelso said the hand-size fragment of bone, about 4" x 4 3/4", was found in a bulwark trench surrounding the west corner of the James Fort site and was discarded there with other trash no later than about 1610 based on other artifacts found in the same context. No other bones or skull pieces belonging to the individual have been found. "It appears to have been discarded as medical waste," he said.

"It's incredible to think that so much information could come from such a small piece of bone," said Bly Straube, APVA senior curator. She added that the skull is believed to be that of a European male because testing revealed that the bone contains traces of lead. "This could be a result of eating and drinking from lead-glazed pottery or pewter, which was a common practice in Europe," she said.

Archaeologists have also unearthed medical tools and objects at the James Fort site including a Spatula mundani, part of a bullet extractor (terrabellum) and numerous pieces of pottery from apothecary jars, which were typically used to contain herbs and medicines.

Straube explained that the Spatula mundani, devised and named by 17th-century surgeon John Woodall, was used to treat severe constipation. The spoon end of the instrument was to withdraw "hard excrements," while the spatula was probably for stirring preparations and applying ointments and plasters. The bullet extractor was used for grabbing and removing a bullet from a wound.

It is likely that the tools were sent to Jamestown in a surgeon's chest that Woodall outfitted for the expedition and sent with his servant John Liste, she said. The gift is recorded in a list of instructions to Sir Thomas Gates from the Virginia Council in May 1609, and probably included the surgical instruments illustrated in the 1617 edition of Woodall's book, "The Surgeon's Mate."

Both tools found at Historic Jamestowne are shown in the illustration of the chest. Trepanning tools are also depicted, but none have been found at the James Fort site, yet.

The skull fragment and the medical objects substantiate historical documents that indicate the presence of barbers, surgeons (chirurgeons), doctors and apothecaries in Jamestown as early as 1607-1610.

Catherine Correll-Walls, biographical researcher for the project, said early medical men at Jamestown included Thomas Wotton, Surgeon General at Jamestown, Thomas Couper, barber, and William Wilkerson, chirurgeon, who arrived in 1607. Anthony Bagnall, chirurgeon, arrived in 1607-08. Thomas Field, apothecary; Post Ginnat, chirurgeon; Thomas Harford, apothecary; and Dr. Walter Russell arrived in the first supply in 1608. George Liste, an apprentice to Woodall, arrived in 1609, and Dr. Laurence Bohun arrived in 1610 and was named Physician General to Virginia in 1620.

According to written accounts, Correll-Walls said that Dr. Russell treated Captain John Smith for a stingray wound on the June 1608 expedition of the Chesapeake Bay. Bagnall accompanied Smith on his second expedition of the Chesapeake Bay in July of 1608. During this trip, Bagnall's hat and sleeve were pierced with arrows in a skirmish with the Nansemond Indians. He also treated an Indian prisoner who had been shot in the knee and was left for dead.

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