STONE AGE SKULL SURGERY — STEWART 481 



interpreted as having been caused by cauterization, as Moodie (1921) 

 and Weiss (1955) seem to imply. Any damage to the scalp leading to 

 loss of blood supply to the bone followed by osteitis can end in bone 

 scarring (Stewart, 1956). 



From these considerations it is understandable that similar appear- 

 ances of perforated and scarred skulls from widely scattered places 

 may hide variations in surgical motivations. Almost certainly the 

 alleviation of pressure on the brain caused by skull fracture was the 

 most frequent reason for the operation in Peru and Melanesia ; it may 

 have been the reason less frequently in Europe. Probably in Peru, as 

 in Melanesia, the operation was undertaken for additional reasons, 

 otherwise it is difficult to explain why the individual whose skull is 

 shown on plate 1 would have had his head opened seven times. Just 

 what these reasons were in Peru, whether headaches, epilepsy, or 

 dementia, is not known. 



Operations on the head to obtain rondels or amulets seem to have 

 been restricted mainly to Europe. These round pieces of skull, often 

 polished and sometimes perforated for suspension, have been found in 

 burials there and sometimes accompanying surgically opened skulls. 

 In these European examples apparently it was important that the 

 rondel include a bit of healed edge from a previous operation, thus 

 assuring to the possessor some quality connected with the operation. 5 

 Judging from certain European skulls in which signs of altered growth 

 accompany healed openings, Broca (1876) concluded that the operation 

 often was made in infancy. Perhaps, therefore, the practice was 

 somewhat comparable to that in Melanesia where, according to Ford 

 (1937), women cut openings through the foreheads of some of the 

 children, 3 to 5 years of age, to ward off future trouble from trauma ; 

 in other words, the European custom may have been an extension of a 

 surgical procedure from therapy to prophylaxis. 



The Peruvians also operated on children. The United States Na- 

 tional Museum collection includes the skulls of three children close 

 to 6 years of age and three near 12 years of age. Only two of these, 

 including an incomplete specimen, lack a clear sign of fracture. 

 The Tello collection at Peabody Museum, Harvard University, in- 

 cludes the skulls of 4 children close to 6 years of age and 11 around 

 12 years of age (another lacks the face and hence the age is uncer- 

 tain). Signs of fracture are evident in seven of these. Plate 9 



5 In 1899 Thomas Wilson, then curator of prehistoric archeology in the U. S. 

 National Museum, prepared an extensive manuscript on "Prehistoric Trepanned 

 Skulls," which includes summaries of most of the European finds to that date. 

 Wilson had seen many of the original specimens and had even helped recover 

 some of them. This manuscript, which is now in the division of physical anthro- 

 pology, has been of help in preparing the present paper. 



