MUNIZ— MC GEE] METHODS OF TREPHINING 1% 
Trephining is well known among certain savages. For example, the 
South Sea islanders were, when first seen by white men, acquainted with 
the operation, which was performed by scraping with a flint implement, 
a Shark tooth, or (after contact with the whites) a piece of broken glass. 
The aperture was commonly covered with a carefully prepared piece of 
cocoanut shell, The purpose was to relieve headache, neuralgia, ver- 
tigo, and the like, yet the operation appears to have been essentially 
thaumaturgic. The mortality has been estimated at 50 percent, yet the 
treatment is said to have been so common in early days that most of the 
male adults had undergone one or more operations. 
Even in prehistoric times trephining was not uncommon in various 
parts of the world, as has been shown by Broca, Pruniéres, and others 
in Europe, and by Fletcher and some other investigators in this country. 
While there are indications that the motives varied, satisfactory evi- 
dence has been adduced to show that prehistoric trephining, particu- 
larly in Europe, was essentially thaumaturgic, and that in many cases 
the operation was post-mortem and designed to yield rondelles for use 
as amulets. The instruments used in removing the rondelle were those 
pertaining to the current cultural stage. 
Thus the distribution of trephining with respect to time, territory, 
and culture-grade shows that the operation is common to several 
countries and to all stages in the development of mankind from the 
unwritten past to the present and from savagery to civilization, and that 
the methods and motives have varied widely with cultural progress. 
CLASSIFICATION 
The operation of trephining, as performed by different peoples in the 
several culture stages, may be regarded from different points of view, 
and so classed in different ways: 
Classed with respect to period, the operation may be considered as 
(1) prehistoric and (2) modern. 
Classed with respect to the methods employed, trephining may be con- 
sidered as (1) primitive and (2) specialized. Primitive trephining may be 
defined as that performed by means of implements or tools either undif- 
ferentiated or specialized for other functions; specialized trephining 
may be defined as that performed by means of instruments designed and 
made for the purpose. Under these definitions, primitive trephining 
comprises allthe known prehistoric operations, the operations performed 
by the South Sea islanders, and the rude, rural trephining of domestic 
animals; while specialized trephining embraces not only the highly 
developed operations of modern surgery, but also such crude operations 
as those of the Kabyle, when performed by trained shamans with 
special apparatus. These primary classes are so broad as to be sus- 
ceptible of subdivision. Accordingly, primitive trephining may be 
considered as (a) archaic, or that performed anciently or without 
knowledge or use of metal, including the prehistoric operations and 
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