Medical ceramic representation of nasal 



leishmaniasis and surgical amputation 



in ancient Peruvian civilization 



Oscar Urteaga-Ballon 



From 3000 years ago until the Spanish 

 conquest, the central part ot the mighty 

 Andean Mountains of South America 

 was the center of some of the most 

 splendid, ancient American civiliza- 

 tions. The Inca empire was the last of 

 those civilizations. It began in the Peru- 

 vian lands and spread throughout parts 

 of Ecuador, Colombia. Bolivia, Argen- 

 tina and Chile (Larco-Hoyle 1938- 

 1939; Mason 1957; Tello and Mejia 

 1960; Bird 1962; Sawyer 1966). The 

 Incas considered themselves the direct 

 descendants of the sun and moon, 

 which they worshipped as their gods. 

 The ancient Peruvians did not leave a 

 written language, but in their metal art, 

 pottery and textiles, they did leave a 

 graphic sculptural language, which, if 

 one is prepared to do so, can be read 

 like the pages of a book. In the north 

 coast valleys of Peru began one of the 

 most splendid civilizations of ancient 

 Peruvians. The Mochica culture had 

 left beautiful, realistic ceramic sculp- 

 tures, which covered broad aspects of 

 Mochica life, including special medical 

 collections. In 1968 we published a 

 complete review of some chapters of 

 the sexual behavior of ancient Peru- 

 vians as shown in their ceramic art 

 (Urteaga-Ballon 1968). These ancient 

 people were [wwerful warriors with 

 large conquering armies, but during pe- 

 riods of peace they dcveU)pcd an out- 



standing civilization rich in artistic cul- 

 ture. 



Much of what we know about the 

 remarkable medical history of pre- 

 Columbian Peru is the result of research 

 on the ceramic pieces of the ancient 

 Peruvian civilizations. Many infectious 

 diseases have been portrayed in 

 ceramic art. As a result of chronic war- 

 fare, many people suffered serious le- 

 sions which demanded different types 

 of surgical operations. Mutilation and 

 amputation of the limbs were frequent. 

 The most dramatic representations of 

 the medical pottery are the cranial oper- 

 ations (trephination), which were con- 

 ducted by members of the Paracas civil- 

 ization beginning more than 2000 years 

 ago. 



Two different types of ceramic medi- 

 cal art serve to illustrate this rich and 

 important source of information on an- 

 cient medical traditions in the New 

 World. We first present some examples 

 of ceramic art showing evidence of 

 leishmaniasis, a condition well known 

 in modem Peru and often seen by me 

 during my career as a pathologist in 

 Peru. We follow this with a brief review 

 of a few cases of ceramic art exhibiting 

 amputated limbs and the prosthetic de- 

 vices that were often made to assist the 

 patient with at least some use of the 

 limb following healing of the amputa- 

 tion stump. 



Nasal leishmaniasis 



Mucocutaneous leishmaniasis is a 

 chronic infectious disease caused by 

 the protozoan Leishmania hraziliensis. 

 The disease was endemic in the ancient 

 Peruvian lands, as it is found in the 

 ceramics of those cultures. 



Between 1 962 and 1 974 in the Muse- 

 um of Paleopathology of Lima, Peru, I 

 studied 67 ceramic pieces in which the 

 pre-Columbian Peruvian craftsmen 

 represented different lesions of infec- 

 tious and parasitic diseases. In this pa- 

 per I show four ceramic representations 

 of mucocutaneous leishmaniasis repre- 

 senting different stages of lesions af- 

 fecting the nasal and oral cavities. As a 

 comparative reference I include two 

 other paleopathological ceramic repre- 

 sentations which prove the skill and 

 knowledge of the ancient Peruvian phy- 

 sicians. 



Figure 1 corresponds to the famous 

 portrait-head vessel of the Mochica 

 ceramic described by Larco-Hoyle 

 (1938-1939) and Sawyer (1966). It 

 represents a congenital cleft of the up- 

 per palate and lip. Figure 2 represents a 

 punitive case with surgical mutilation 

 of the nose and lips. Both pieces are 

 examples of the graphic realism of the 

 ancient Peruvian craftsmen. 



Figure 3 is also a Mochica portrait- 

 head ves.sel which shows the first stage 



Zagreb Paleopathology Symp I9H8 



95 



