; 

PERFORATED AND DISTORTED CRANIUM. 45 
The differences among the several cases are mainly differences in size, the 
holes varying from mere enlargement of the parietal foramen to perforations 
measuring, as in one of our cases, 4°0 by 3:2 and 3:2 by 3 em. 
Possibility of Trephining—We should not enter into the question of 
the possibility of trephining having occurred in one of our specimens, 
had not the cranium been figured in Dr. Robert Munro’s Prehistoric Problems, 
1897 (13), and cited as the solitary example of double trepanning known in 
an English skull. The “trepanned apertures show clean cut and slightly 
round edges. . . , the production of which seems to me to have entailed the 
use of surgical instruments of a higher order than were to be had either in 
the Bronze or Stone Age.” As the deformity of the skull “ was probably due 
to pathological causes, it is interesting to note that the operation (of trepan- 
ning) had been resorted to as a means of treatment.” 
Broca, who was among the first anthropologists who investigated the 
occurrence of artificial perforations of the cranium, clearly recognises the 
difference between such holes and the congenital symmetrical double perfora- 
tions of the parietal bones, of which the cranium in question is in our opinion 
an undoubted example. The cranium was found in the churchyard at Eastry, 
near Sandwich, and the inference is that it is at any rate not prehistoric.* 
There is no evidence of inflammatory change in the neighbourhood of the 
perforations ; in short, the position, and the symmetrical nature of the 
foramina, associated with other similar instances, one diagnosed during life 
and known to be congenital, along with the evidence (positive and negative) 
derived from an examination of the perforations themselves, compel us to 
dismiss at once the view of their formation suggested by Dr. Munro, and to 
place the perforations in this cranium among those of congenital origin. 
Relation to Parietal Depressions.—It does not appear as if parietal perfora- 
tions were related in any way to the symmetrical parietal depressions 
recorded by Humphry (6), Shepherd (9), and others (10). The latter appear 
to be congenital depressions in some cases, though they are regarded by 
Shepherd as due frequently to senile changes in the temporal artery. They 
are due to a deficiency in the outer table ; and the inner table is not affected. 
The normal parietal foramina may be present along with them, and the 
examples recorded do not agree in position with the situation of parietal per- 
forations, being situated further forward on the bones. 
Relation to the Parietal Foramina.—The situation of parietal perforations 
in relation to that of the normal parietal foramina has led to the very natural 
suggestion by Turner, Humphry, and others, that the perforation is due to 
an alteration in vascular conditions, an enlargement in size of meningeal 
vessels, or an increase in the number of vessels in the position of the parietal 
foramina. 
Broca (4) indeed regards the parietal foramina themselves as abnormal. 
While they are not an essential characteristic of the mammalian parietal bone 
as a rule—we have only found them in a bear, an ox, and a leopard among 
the skulls in our possession—there can be no doubt that they are a normal 
occurrence in the human parietal bone. Out of 204 adult parietal bones 

* There is little or no history attaching to the Eastry skull in the Museum. The 
words Hastry Churchyard are in the handwriting of Brian Faussett, by whom the 
splendid collection of Anglo-Saxon objects from mound graves in Kent now in the 
Mayer Museum was so carefully and methodically made. The skull was included in 
the collection when it was acquired by Mr. Mayer ; but in the MS. volume describing 
and figuring the objects in detail there is no mention of it. It is, therefore, almost 
certain that it had no connection with the Anglo-Saxon interments. Eastry Church- 
yard has existed, however, from a very ancient date.—Eb. 
