54 PRIMITIVE TREPHINING IN PERU [ETH. ANN. 16 
extends horizontally for 16 mm., or nearly to the median line, as 
shown in plate Xxx1x, while immediately above it the tables are sepa- 
rated and a scale of the inner table 6 or 7 mm. across is depressed, as 
shown in plate xt. The antero-inferior margin of the aperture is 
defined for 15 mm. back of the vertical fissure by an undercut fracture 
in which the outer table projects 1 to 3 mm. It seems possible, though 
by no means probable, that some of this fracturing might have been 
produced in the operation. Below the posterior portion of the aperture 
a conspicuous crack in the outer table may be traced from the point at 
which the margin of the aperture coincides with the coronal suture 
horizontally backward for about 50 mm., as imperfectly shown in 
plate xu. There are indications also of a fracture coinciding with the 
coronal suture 30 mm. downward from the lower side of the aperture. 
Finally, an irregular crack extends from the posterior margin of the 
aperture backward for 5 or 6 mm., as faintly shown in plate xt. The 
character and distribution of these fissures suggest an extensive 
depressed fracture on the right frontal, aft a point nearly opposite 
the indentation on the left, with radial fissures extending in several 
directions. There are numerous indications that such a wound was 
explored rather extensively, either before the operation or in connec- 
tion with it, especially forward and downward toward the orbit. The 
clearest marks are three or four horizontal scratches midway between 
the anterior end of the aperture and the outer angle of the orbit 
(somewhat indistinctly shown in plates XxxIx and XL); and less 
distinct marks are found over the superciliary ridge and the adjacent 
surface of the bone nearly to the median line (as obscurely shown 
in plate XXXIX). 
On considering the various features displayed by the specimen, it 
becomes evident that the fracture antedated the operation, since (1) most 
of the lines could not be produced by any conceivable impact against the 
remaining portion of the skull, while (2) some of the fractures (notably 
that extending backward from the coronal suture) show indications of 
subsequent physiologic process. It is certain, also, that the operation 
was completed to the satisfaction of the operator, since no rough edges 
of bone were left save a few projections of the inner table, which was 
necessarily difficult of access. Finally it may be considered as estab- 
lished that the individual survived the operation, since in this case, and 
this only (so far as the Muniz collection is concerned), a plate of shell 
was found fitted to the aperture.’ Judging from the specimen the 
operation was not long survived, since there is no definite trace of 
reparative growth, and since traces of periostitis, apparently con- 
nected with the wound or with the subsequent operation, may be 
detected, especially about the coronal suture below the aperture and 
along the principal fissure extending backward into the parietal. 


1 Unfortunately this plate, together with all the rest of the collection excepting the nineteen tre- 
phined crania, has been destroyed. 
