470 ANNUAL REPORT SMITHSONIAN INSTITUTION, 1957 



Central Highlands (Vidal Seneze, 1877), and shows a large unhealed 

 circular opening in the left parieto-occipital region made by the drill- 

 ing technique, a somewhat uncommon procedure. Although larger 

 openings made by other techniques have been reported, this one seems 

 to be the largest made in this way. It should be noted also that 

 the appearance of the opening in the scalp indicates that the opera- 

 tion was made in life. However, since the bone gives evidence of 

 being unhealed, the operation, as the saying goes, was successful, 

 but the patient died. 



The writer's contribution to this subject, mentioned above, is based 

 on a series of 75 Peruvian skulls in the United States National 

 Museum — many previously undescribed — and introduces the idea that 

 evidence has been preserved regarding the nature of the incisions 

 made through the scalp to expose the bone for trephining. Involved 

 in this new addition to our knowledge of an ancient practice is a dif- 

 ferent way of looking at skulls that have been operated upon. The 

 nature of the reorientation will be explained later and here it will be 

 mentioned only that the rarity of specimens filling in certain parts 

 of the surgical picture led the writer to seek verification in other unde- 

 scribed collections. His quest took him first to the American Museum 

 of Natural History in New York where he was enabled to study 23 

 skulls with artificial openings collected in the region of Lake Titicaca 

 in the 1890's by A. F. Bandelier, and then to the Peabody Museum, 

 Harvard University, where he studied 102 such skulls collected in the 

 Central Highlands of Peru prior to 1912 by Julio Tello. Subse- 

 quently the writer saw a few more specimens at the British Museum 

 (Natural History) in London and at the Musee de l'Homme in Paris. 

 For courtesies received at these institutions he is indebted especially 

 to Dr. Harry L. Shapiro, Dr. W. W. Howells, Dr. Kenneth Oakley, and 

 Dr. Henry V. Vallois, respectively. 



The present paper will give a broad summary of skull surgery as 

 practiced in ancient times and among certain recent people still having 

 a Stone Age culture. In the part dealing with the New World some 

 of the new observations on the collections mentioned above will be pre- 

 sented. In addition, some new observations on putative examples of 

 trephining from North America will be presented. 



DISTRIBUTION 



Europe. — The publicity that Broca gave to Squier's trephined skull 

 from Peru led soon to the recognition of skulls showing evidence of 

 surgery from the Neolithic period in France. It began with Pru- 

 nieres' report of 1873 (1874) of such specimens from the dolmens of 

 Lozere in southern France and was followed by Broca's (1876) expla- 

 nation of the perforations and the often accompanying rondels or 



