MUNIZ—MC GEE] RECKLESSNESS OF THE OPERATORS 63 
defective diagnosis and ill-directed treatment, while, with the possible 
exception of crania 14 and 15 (in which the indications may easily be 
illusive), no examples are found to prove or even to suggest diagnostic 
skill—there is much evidence against and no evidence in favor of the 
competence of the primitive practitioner. 
A striking feature of the collection is the magnitude and boldness of 
the operations displayed by the crania. In one instance (cranium 2) 
the operator evidently sought to minimize the area affected by his treat- 
ment; in another instance (cranium 8) the operation suggests studied 
economy of vital force; in two cases (crania 14 and 15) the treatment 
was coextensive with the traumatism; while in three cases (crania 16, 
17, and 19) the treatment was more restricted than the antecedent 
lesion. In nearly all the other cases the treatment seems to have been 
unnecessarily extravagant, while in several instances (already noted) 
the cutting was so reckless as almost necessarily to invade the cerebral 
tissues and occasion the death of the subjects. Even in the three cases 
in which the antecedent lesion was more extensive than the treatment, 
the recklessness of procedure is indicated by aberrant location, as well 
as by the fact that the operation was undertaken in connection with 
almost necessarily fatal wounds, as must have been clearly indicated 
by unmistakable conditions and symptoms. So, too, complete disre- 
gard of suffering on the part of the patients is attested by the rude 
and wide-reaching scratches and the violent outwrenching of the but- 
tons, while the extensive wounding of the periosteum was barbarous, 
largely needless, and wholly irrational. The only definite suggestion 
of post-mortem operation found in the collection arises in the reckless 
and inhuman slashing of integunent, bone, and brain by evidently 
needless operations. 
In short, Peruvian trephining, as exemplified in the Muniz collection, 
can only be regarded as crude in plan and bungling in procedure; and 
study of the procedure only occasions surprise that the results were 
not worse, and awakens admiration for the powerful vitality which 
enabled so large a proportion of the victims to survive. 
THE MOTIVE FOR OPERATING 
GENERAL INDICATIONS OF MOTIVE 
The characteristics of the crania throw some light on the question 
as to the motives actuating the primitive practitioners of Peru. Six- 
teen and probably 17 or 18 of the 19 specimens are almost certainly 
masculine, and represent early and vigorous maturity; all of the well- 
preserved examples are remarkable for the thickness and strength of 
the bone and the rugosity of the ligament attachments, while the ill- 
preserved specimens apparently differ only by reason of the weathering 
and erosion to which they have been subjected. The first specimen of 
doubtful gender is the fragmentary cranium 6, which is questionable 
