476 ANNUAL REPORT SMITHSONIAN INSTITUTION, 1957 



tended for suspending the skulls, Hinsdale (1924) has claimed that 

 one of them is an example of "real trephining" and that "the edges of 

 the opening show unmistakable evidence of a well-advanced healing 

 process, which could have gone on only during life" (p. 13) . Hrdlicka 

 (1939) agreed with Hinsdale, as might have been expected, since he 

 was one of the first to report a case of trephining from North America 

 (Lumholtz and Hrdlicka, 1897). Indeed, Hrdlicka seems to have 

 seen in many skull perforations, and even in some shallow depressions 

 in the skull vault (Anonymous, 1935) , widespread evidence of the prac- 

 tice of skull surgery. These and other cases, totaling 17, that have 

 come to the writer's attention in the literature, are listed chronologi- 

 cally in table l. 3 



Now, obviously, 17 (or 19, when Komero's other cases are included) 

 is not an impressive number of cases of trephining to have been as- 

 sembled in 60 years from the vast area stretching from Mexico to 

 Alaska and across the United States from coast to coast. One is in- 

 clined to wonder, too, why only two cases have turned up in the South- 

 west among all the hundreds of skulls found there. On this point the 

 writer noted in 1940, in presenting the case from Maryland, listed in 

 table 1 (pi. 3), that— 



this one Is perhaps the most convincing example of [trephining] yet found in the 

 northern continent. Yet as an example of primitive surgery it is singularly 

 isolated among the hundreds of skulls from this site. It would seem unreasonable 

 to expect such a successful end result on a first attempt at cranial surgery, but 

 according to modern pathological knowledge no other diagnosis fits as well. 

 (P. 16.) 



It is difficult to describe the feeling of dissatisfaction with the evi- 

 dence and arguments which one gains in reading the individual reports 

 and in examining the accompanying illustrations. Some of the cases 

 undoubtedly represent old healed injuries in which there was no 

 surgical intervention; others are fresh openings which, since they 

 could have been made after death, do not prove the existence of sur- 

 gery in the real sense. Only two or three look anything like what is 

 often seen in Peruvian specimens. 



Twenty years ago the writer reexamined the first three cases from 

 British Columbia listed in table 1. In none of these cases had objec- 

 tive proof of the findings, in the form of photomicrographs, been 

 given. Herewith (pis. 4-8) this deficiency is corrected. Inspection 

 of these plates should convince anyone that, with the exception of the 

 larger opening in the Eburne skull, evidence of healing is lacking or 



* In a paper read at the reunion of the Mesa Redonda of the Mexican Anthro- 

 pological Society in Oaxaca in September 1957, Javier Romero summarized five 

 cases of trephining from Monte Albfin, including one case from the Mixteca and 

 presumably the three cases listed here. When this paper is published, two more 

 cases can be added to those in table 1. 



