STONE AGE SKULL SURGERY — STEWART 475 



of that country and to the neighboring part of Bolivia in the region 

 of Titicaca. Within this general area, as in Europe and Melanesia, 

 the surgical specimens have been found concentrated in certain 

 places — for example, around Huarochiri in the Central Highlands, 2 

 at Paracas on the Southern Coast, and around Cuzco in the Southern 

 Highlands. Very likely these concentrations reflect cultural patterns 

 (Weiss, 1953). 



The oldest skulls from Peru showing artificial openings or areas 

 with the outer table scraped away probably are those from Paracas 

 (ca. fifth century B. C. to fifth century A. D.). However, it is not 

 clear that the Paracas specimens represent a surgical practice for 

 therapeutic purposes. Although Tello states that bone regeneration is 

 present in some cases (Stewart, 1943), in all those seen by the writer 

 the cuts looked fresh. Perhaps, therefore, the trephined skulls of 

 Paracas represent a phase of the locally well-developed head-trophy 

 cult rather than true surgery. Elsewhere in Peru the custom appears 

 to be much later, and even associated with the rise of the Incas. 



Bolivian, and possibly also Peruvian, Indians continued to operate 

 on living heads into post-Columbian times (Bandelier, 1904). How- 

 ever, very little reliable information has been recorded by eyewitnesses. 

 A few pottery jars ornamented with representations of surgical scenes 

 have been found (Morales Macedo, 1917; Velez Lopez, 1940), but 

 these add little to our knowledge of the practice. It should be added, 

 also, that on at least two occasions present-day Peruvian surgeons 

 have operated on living heads with primitive implements obtained 

 from ancient sites (personal communication from Sergio A. Quevedo 

 in 1944; Grana et al., 1954). Since the ancient skulls had already 

 proved that the operation could be accomplished by the use of such 

 tools, it is difficult to understand why these additional demonstrations 

 were undertaken. 



North America. — Evidence for the practice of skull surgery in the 

 New World outside of Peru has not been summarized recently and 

 hence deserves extended consideration here. Reference was made 

 above to Gillman's early descriptions of skulls with artificial openings 

 from the State of Michigan in the United States. These cases usually 

 have a small circular opening in the midline near bregma. In 1936 

 Hinsdale and Greenman showed that the distribution of such skulls 

 includes the regions adjoining the State on the south and east. Al- 

 though it was claimed almost from the beginning (Gillman, 1876) 

 that these openings were made post mortem and were probably in- 



* The collections obtained by Hrdlicka in 1910 and 1912 for the U. S. National 

 Museum and the San Diego Museum, and the collections obtained by Tello before 

 and after 1912 and now in the Peabody Museum (Harvard) and the Museo 

 Nacional d'Antropologia in Lima, respectively, are mainly from this area. 



