Head Injuries in Ancient Mesopotamia: What do we Really Know?

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By: Arkadiusz Sołtysiak

Three millennia of documented history of Sumer, Akkad, Babylonia and Assyria are dominated by the accounts of war, and violence seems to have been present in the everyday life of all Mesopotamians. What do the bodies of ancient Mesopotamians tell us about this violence?

Historical texts from ancient Mesopotamia provide us with endless record of wars, massacres, rebellion, and everyday cruelty. For example, the earliest documents from Girsu (c. 2500-2350 BCE) give the impression that war between the states of Lagash and Umma was permanent. The Stele of the Vultures from the Early Dynastic III period (ca. 2600-2300 BCE) also shows grim details of scavenging of birds on heaps of dead bodies.

Stele of the Vultures (Early Dynastic III)

Stele of the Vultures (Early Dynastic III)

During the first and second millennia BCE Mesopotamia was occasionally unified, but it mostly consisted of separate kingdoms, sometimes fighting against each other, sometimes endangered by external forces as Gutians, Elamites, Hittites, or Arameans. The Assyrians during their period of maximum expansion (9th-7th century BCE) notoriously depicted themselves as bloody butchers who decapitated, skinned alive, and impaled those who did not obey their rule.

Sennacherib’s siege of Lachish showing impaled prisoners

Sennacherib’s siege of Lachish showing impaled prisoners

If violence was so common in ancient Mesopotamia, as we deduce from historical sources, the expected rate of physical trauma left on skeletal materials should be high. Of course, not every kind of trauma is related to violence and bone fractures and other injuries may also be the consequence of everyday activity. But trauma to the head is an especially telling indicator of interpersonal violence. The number of published reports on crania retrieved from Mesopotamian sites is relatively low, but it has been possible to gather data from 25 sites dated from the Pre-Pottery Neolithic to the Modern period.

Surprisingly, the rate of healed cranial trauma was very low: in almost 1300 preserved crania there are only 31 lesions in 28 individuals (2.2%). This rate is much lower than in neighbouring regions, for example the Southern Levant and Armenia, where more than one out of four crania exhibited some kind of violence-related lesions. It seems therefore that in spite of all military conflicts recorded by the historical sources, life in Mesopotamia was much less violent than in the surrounding regions.


Antemortem trauma (and some postmortem damage) in a cranial fragment from Tell Majnuna (Late Chalcolithic). Courtesy Arkadiusz Sołtysiak.

Antemortem trauma (and some postmortem damage) in a cranial fragment from Tell Majnuna (Late Chalcolithic). Courtesy Arkadiusz Sołtysiak.

Perimortem trauma in a cranium from Tell Barri (Islamic period). Courtesy Arkadiusz Sołtysiak.

Perimortem trauma in a cranium from Tell Barri (Islamic period). Courtesy Arkadiusz Sołtysiak.


There is also a very interesting pattern of trauma observed in Mesopotamia. Most traumatic lesions to the head were noted in the early periods, the Neolithic, Chalcolithic and Early Bronze Age (ca. 10,000-2,000 BCE) while the rate of trauma during the Middle Bronze Age and later was much lower. This evidence stands in opposition to the common view that the early inhabitants of Mesopotamia were peaceful farmers and inter-personal violence only increased with the establishment of early states.

Another interesting pattern concerns the spatial distribution of cranial trauma incidents. Most cranial lesions were noted at the sites located on the northern and north-eastern frontier of Mesopotamia. These were areas that were only occasionally under control of some Mesopotamian states; for long periods state control was illusory or absent. The core areas of Mesopotamia (the southern alluvium and dry farming plains in the north) consequently show the rate of cranial trauma below 2%.

Molla Kheil (Mazandaran, Iran) (Parthian period). Courtesy Arkadiusz Sołtysiak.

Molla Kheil (Mazandaran, Iran) (Parthian period). Courtesy Arkadiusz Sołtysiak.

Graph showing chronological distribution of skulls with cranial trauma. Courtesy Arkadiusz Sołtysiak.

Graph showing chronological distribution of skulls with cranial trauma. Courtesy Arkadiusz Sołtysiak.

This significant temporal and spatial pattern suggests that the risk of being struck on the head was not related to a generalized presence or absence of violence, but rather to the organization of violence. Most skeletons excavated at Mesopotamian sites represent the local populations of farmers, herders, and city dwellers. Some of them were perhaps occasionally engaged in military activities as conscripts. But since at least the Early Bronze Age (if not since the Chalcolithic, ca. 5500-3200 BCE) the military power of Mesopotamian states was based on professional armies, sometimes supplemented by conscription among farmers who undertook militery service in return for grants of land. All others were expected only to pay taxes and occasionally provide food or fodder for the army.

The unexpectedly low rate of cranial trauma in Mesopotamia, as compared with other areas of the Near East, shows that the organization of violence and the presence of state administration differentiated the risk of trauma inside the society. Professional soldiers were likely much more exposed to injuries than common peasants. Unfortunately, there are only a few burials of soldiers (or supposed soldiers) thus far identified in Mesopotamia and none have been properly studied by human osteologists.

There is also another mechanism that makes this difference even more striking: in developed states the central authority (such as a king or temple) used violence as a tool of social control. This means that intra-group violence (e.g., conflicts between farmers) was moderated by states and perhaps even organized religion, which provide mechanisms to resolve conflicts, to limit their spread, and mitigate their impacts. Even if this moderation was not perfect, the system of social control at least decreased the rate of violence in the everyday life of common people.

What we can learn from the pattern of cranial trauma in ancient Mesopotamia? First, the urban civilization that flourished in Mesopotamia made people less subject to violence than in other regions of the Near East. Second, the presence of state administration modified the pattern of violence through the differentiation between professional soldiers and other parts of the society and through moderation of intra-group conflicts. Very low rate of cranial trauma among Mesopotamian commoners suggests that the social order developed during the Late Chalcolithic and Early Bronze Age was a successful tool for control of inter-personal violence.

Arkadiusz Sołtysiak is on the faculty of the Department of Bioarchaeology, Institute of Archeology, University of Warsaw.

For further reading:

• Antemortem trauma in ancient Mesopotamia

• Symbols of Conquest in Sennacherib’s Reliefs of Lachish – Impaled Prisoners and Booty

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