STONE AGE SKULL SURGERY — STEWART 477 



very doubtful. Histological study is needed here, as well as in some 

 of the other cases, to distinguish true healing from the surface smooth- 

 ing resulting from a cord passing through the opening. 



From all these considerations the writer is inclined to be skeptical 

 about most of the cases cited being examples of real trephining. Al- 

 though healed openings such as occur in the Eburne and Accokeek 

 skulls look real, their isolation in large skull collections argues strongly 

 in favor of a natural process rather than surgery. Especially signifi- 

 cant is the absence of cases showing bone infection around the opening 

 or, in other words, showing survival for a short time following an 

 operation in life. 4 



Africa. — The practice of skull surgery is not known to be represented 

 in the whole of the continent of Africa, except at two points very close 

 to western Europe: (1) Among the Kabyles in the Djebel Aouras 

 (Mount Aures), in the province of Constantine, in Algeria (Malbot 

 and Verneau, 1897) ; and (2) on the island of Tenerife in the Canaries 

 (Beattie, 1930). In Algeria, where the practice has persisted into 

 modern times, trephined skulls have been found in archeological set- 

 tings antedating Roman times. How much further back in time the 

 custom goes, and whether it is entirely independent of Europe, is not 

 known. In Tenerife the existence of the custom is known from at 

 least 11 trephined specimens of uncertain age and probably over 30 

 others with bregmatic scars possibly indicating cauterization. 



Drennan (1937) has tried "to demonstrate that the trepanation cult 

 was also practiced in a primitive form by the Bushman race" in South 

 Africa. However, his examples are not impressive, and look more 

 like healed wounds than surgery. 



Asia. — In 1897 Zaborowski reported to the Anthropological Society 

 of Paris that the inhabitants of Dagestan, just west of the Caspian 

 Sea, practiced a form of cauterization of the vertex of the head, some- 

 what like the sincipital T, in order to prevent illness. According to 

 Guiard (1930), these people also practiced trephining for all sorts 

 of circumstances as late as the end of the nineteenth century. Whether 

 the practices here connect back with that of the Neolithic period in 

 Europe is unknown. 



For a long time Dagestan was the only place where skull surgery 

 was known to have existed in Asia. Then in 1936 Starkey and Parry 

 reported the recovery of three trephined skulls from a seventh-century 

 B. C. ossuary at Tell Duweir in Palestine. Amazingly, two of the 



4 The writer has a picture of the first female skull from Monte Alban which 

 shows a sinuous excavation surrounding the circular, steep-sided opening. The 

 specimen needs to be examined again to see whether this line represents bone 

 infection following operation. If indeed infection, the practice of skull surgery 

 would have considerable time depth in Mexico — at least to 700-1000 A. D. 



