12 PRIMITIVE TREPHINING IN PERU (ETH. ANN. 16 
edge for cutting the umbilical cord, Lastly, they possessed a perfect 
process of mummification. It does not therefore seem strange, surgical 
science being so advanced in prehistoric Peru, that on the presentation 
of a broken skull they should attempt first to extract the fragments of 
bone, to raise and draw out successively the sunken plates, to adjust 
the points, and, in a word, with their primitive instruments, as primi- 
tive as those of ancient Greece and Persia, to accomplish the linear 
readjustment of the edges of the fracture, forming a quadrangular or 
polygonal orifice. After this they could easily make the orifice circular 
or ellipsoidal, etc, by means of strong chisels or estiletes of copper, 
silver, gold, or champi (a mixture of gold, silver, and copper, the only 
metals known to them); also an instrument called twmi, which con- 
sisted of a blade, straight or curved like a crescent, edged and fur- 
nished with a short central haft in the form of a T, together with 
knives and lances of obsidian. 
It would be an extensive undertaking to attempt an analysis of this 
subject, and, indeed, the last works of Fletcher, Mantegazza, Mason, 
Wyman, and Munro have saved me the task. 
Now, at first sight, or by examination with the lens, it is possible to 
distinguish cranial perforations due to a pathologic operation from 
those which have been made artificially. The difference is obvious and 
very clear. But it has been supposed that when they were not patho- 
logic perforations they were post-mortem operations. I repeat, it is not 
difficult to know whether the bone has been separated while the indi- 
vidual was living and whether he survived the operation; the length of 
time could even be determined approximately. There are histologic 
features which a lens discloses and which will prove without a shadow 
of doubt the survival of the individual. Moreover, the exaggerated 
veneration of the ancient Peruvians for their dead completely disproves 
the supposition, which has been advanced in regard to some other 
countries or peoples, that trephining was performed only for the pur- 
pose of procuring amulets consisting of segments of bone extracted 
after death from persons noted for valor, intelligence, or virtue. This 
profanation, if we’may so call it, of the bodies of the dead was impossi- 
ble in ancient Peru, and this fact is proved, since to this day there has 
never been found any fragment of human bone which could have been 
used as an amulet. 
While forming my collection of ancient crania, seeking them in the 
various provinces of Peru, I have succeeded in making the collection 
of trephined crania illustrated in the accompanying plates. I have not 
attempted for the present to make a craniometric study of them, and 
take into consideration only the different forms of trephining employed, 
some of which have not been recognized up to the present time in pub- 
lications on this subject. 
The well-known cranium of Squier was found in the valley of Yucay, 
near Cuzco, and in the districts adjoining this city, the metropolis of the 
ancient Inca empire, were found those numbered 7, 10, 12, 13, and 18 in 
