46 PRIMITIVE TREPHINING IN PERU [ETH. ANN. 16 
were abandoned; since the last described just intersects the extremity 
of the fracture, which it might have revealed to the operator, it seems 
probable that the line of exploration was then turned toward the right 
along the fracture. Thirty-five mm. from the last incision there is an 
irregularly cireular aperture, averaging 9 or 10 mm. in diameter, pro- 
duced by scraping. This process extended over an area 25 or 30 mm. 
across, over most of which the outer table and diploe are removed and 
the inner table reduced to paper-like thinness. Thence a series of 
scratches and stri, as if produced by scraping with a rather blunt tip 
or grinding with an irregularly rough surface, follow the fracture to 
and a little way across the lambdoid suture. At the intersection of the 
fracture with this suture the bone is gouged and seraped to a depth of 
+ or 5 mm., or through the outer table and diploe. Thence several nar- 
row scratches pass horizontally across the lower portion of the parietal, 
terminating about the temporo-parietal suture, beyond which the oper- 
ation seems not to have been carried (these scratches are but indis- 
tinetly shown in the reproduction, plate XX xtr). 
The sequence of events and movements in the case may be deter- 
mined from the specimen with considerable certainty. The initial inci- 
dent was apparently a blow or shock producing the linear fracture; and, 
while there is some doubt as to the character of the shock, and also as 
to the point of impact assuming it to have been a blow, it seems probable 
that the wound centered about the intersection of the fracture with the 
lambdoid suture, where the bone is depressed and where the character 
of the subsequent operation suggests that the outer table was crushed ; 
and the fracture appears to be such as might have been produced by a 
violent blow at this point. It seems certain that this wound antedated 
the incision in the scalp, and that this incision was largely exploratory, 
since if was inaccurately located; and it seems probable that in the 
early stages the operation on the bone was random. In like manner it 
Seems certain that the operation was abandoned incomplete; for not 
only is there no indication of finish in the work on the bone, but the 
scalp remained open when the victim was transferred from the pre- 
sumptive battlefield to the cemetery; it is certain that he did not 
survive. 
On the whole it appears impossible to regard the operation displayed 
by this specimen in any other light than as a erude, clumsy attempt, 
with rude tools, to explore or perhaps to treat a serious wound; and it 
is unquestionable that either the initial wound or the treatment proved 
fatal before the operation was complete. It can not, of course, be con- 
sidered certain that the operation was not early post-mortem, but there 
is absolutely nothing to indicate this date; and not even the lowliest 
mind could have designed the cuts and scratches displayed by the bone 
for the purpose of obtaining portions of the skull for amulets or for any 
purpose. There is, of course, a possibility that the operation represents 
a post-mortem examination; but there is neither evidence nor presump- 
tion in favor of this supposition. 
