DJARKUTAN — Archaeologists have uncovered the 4,000-year-old skull of a Bronze Age child in Djarkutan, Uzbekistan, bearing clear signs of cranial trepanation performed with stone or bone tools. The discovery represents the oldest documented evidence of surgery in Central Asia and one of the oldest examples of surgical intervention in all of Asia.
The skeleton of the 5-year-old child was unearthed in April in a single grave at the Djarkutan archaeological site in southern Uzbekistan, near the border with Afghanistan. Buried alongside was the skeleton of a younger child who died at about age 3. Researchers dated the grave to the late third millennium B.C., placing it within the height of the Oxus civilization, an Early Bronze Age culture that flourished between approximately 2500 and 1500 B.C.
Djarkutan was an urban center of the Oxus civilization—also known as the Bactria-Margiana Archaeological Complex—at the time of the burial. The civilization was centered along rivers and in oases and is recognized for its advanced agricultural economy and rich material culture. Its eventual decline is thought to have been triggered by climatic changes that caused critical rivers to dry up.
The excavation was conducted by a research team from Italy and Uzbekistan as part of a project launched in 2024 to investigate Djarkutan and other aspects of the Oxus civilization. Enrico Ascalone, an archaeologist at the University of Salento who led the excavation, said, “Djarkutan continues to surprise us. A cranial trepanation on a child, four thousand years ago, in Central Asia: until yesterday it was unthinkable. Today it is in our data.”
Trepanation—the practice of drilling or scraping a hole into the skull—was commonly performed in ancient times, possibly to treat conditions such as epilepsy, migraines, or behavioral problems. Researchers noted that the frontier between medicine and ritual would have been far less defined in the Bronze Age than it is today. The research team also posed a series of unanswered questions: “Which group of ‘specialists’ within the town could have practiced such an intervention? What anatomical and surgical knowledge did such an operation presuppose? And why a five-year-old?”