Surgeons were carrying out complicated skull operations in medieval times, the remains of a body found at an archaeological dig show.
The peasant's skull had been operated on
A skull belonging to a 40-year-old peasant man, who lived between 960 and 1100AD, is the firmest evidence yet of cranial surgery, say its discoverers.
The remains, found in Yorkshire, show the man survived an otherwise fatal blow to the head thanks to surgery.
Nearly 700 skeletons were unearthed by English Heritage at a site near Malton.
Scientists have been examining the remains from the now deserted village of Wharram Percy.
Once a thriving community built on sheep farming, it fell into steep decline after the Black Death and was eventually completely abandoned.
The village of Wharram Percy
The skull in question, dating back to the 11th century, had been struck a near-fatal blow by a blunt weapon, causing a severe depressed fracture on the left hand side.
Closer examination revealed the victim had been given life-saving surgery called trepanning.
A rectangular area of the scalp, measuring 9cm by 10cm, would have been lifted to allow the depressed bone segments to be carefully removed.
This would have relieved the pressure on the brain.
Roman and Greek writings document the technique of trepanning for treating skull fractures, but there is no mention of it in Anglo-Saxon literature.
Some historians have theorised that western Europe was deprived of such surgical knowledge for centuries after the fall of Alexandria in the 7th century.
Dr 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.
How the village would have looked at the time
"It predates medieval written accounts of the procedure by at least 100 years and is a world away from the notions that Anglo-Saxon healers were all about spells and potions."
Skulls dating back to Neolithic times show trepanning was performed on individuals with no head wounds.
Historians believe this was presumably to treat other ailments, possibly including mental illness.
The skull of the 40-year-old Yorkshire peasant shows the fracture healed well.
Scientists believe the hole that remained would have eventually closed over with hard scar tissue.
But they have questioned how a peasant would have been able to afford this complicated medical treatment.
Examination of the other skeletons at the site revealed high levels of malnutrition, disease and stunted growth.
Dr Mays said: "Medical skills were largely reserved for the elite.
"So the treatment handed out to Wharram's peasant doesn't square at all with our knowledge of the period.
"It seems most probable that the operation was performed by an itinerant healer of unusual skill, whose medical acumen was handed down through oral tradition."
Ten of the other skeletons, including a child, also showed signs of head injury caused by blunt objects.
Dr Mays said: "Violence at Wharram seemed to involve objects that were near at hand, like farming tools.
"The peasant was probably involved in the medieval equivalent of a pub fight, or could have been the victim of a robbery or a family feud."