66 PRIMITIVE TREPHINING IN PERU [ ELH. ANN. 16 
running through all trephining operations, there is not the slightest in- 
dication that these primitive operations were influenced by the refined 
methods of civilization, and strong indications that some of them— 
notably the operations by rectangular cutting—were autochthonous. 
Accordingly the inherent evidence of the collection appears to prove 
that all of these cases of trephining antedated the advent of white men, 
and were thus essentially prehistoric. ! 
Another indication of motive may be derived from the period of the 
operation with respect to the life of the individual treated. Out of the 
24 cases represented by distinct operations, 8—recorded by crania 7 
(two operations), 10, 12 (the earliest operation), 15 (two operations), and 
18 (the two earlier operations)—survived long enough to permit more 
or less extensive reparative changes and considerable bony growth, 
while 6 other cases—recorded in crania 8,9, 11, 12, 18 (the third opera- 
tion), and 19—apparently survived for days or months, and in some 
‘ases perhaps for years. Excluding the case exemplified by cranium 19 
(in which the antecedent lesion was almost necessarily fatal) this gives 
a ratio of 13 survivals out of 24 operations, or a percentage quite as 
high as that of modern practice. In one case (that exemplified in cra- 
nium 16) it is clear that the patient died under the operation, and that 
the treatment was abandoned without closing the integument; in at 
least 2 cases (those of crania 1 and 5) there is practically conclusive 
evidence in the condition of the bone that the victim died in or very 
soon after the operation; while in 5 other cases (recorded in crania 14, 
15, and 17) the relation between the cutting and evidently antecedent 
wounds indicates that the patients died in the hands of the operators. 
Accordingly, in 6 (7 if cranium 19 be reckoned) out of 23 cases, either 
the operatious or the immediately antecedent lesions were undoubtedly 
fatal. In one case (represented by cranium 2) death seems to have 
supervened on an operation connected with the diseased condition of 
the bone; and there remain 3 cases (those of erania 3, 4, and 6) in which 
the state of preservation is hardly such as to indicate the relation of 
the operations to the life of the individual with certitude, though in 
two of these there is forcible suggestion of death under the knife. On 
the whole, it is certain that over half of the operations were long ante- 
mortem, and that most of the remainder were ante-mortem at least in 
their inception, and there is not the slightest indication, except in the 
otherwise explicable rudeness of the treatment, that any of the opera- 
tions were post-mortem. 
Still another indication concerning motive appears in the form and 
character of the buttons or bony fragments removed by the operators. 


It may be noted that the above inference from the trephined crania is in accord with voluminous 
and indubitable evidence obtained by Dr Muniz that all of the arts of the people represented by the 
erania were archaic, and of prehistoric ty pe exclusively—indeed, according to Dr Muniz, the associations 
clearly indicate not only a pre-Spanish but a pre-Incan age for the ancient trephiners. The only 
notable suggestion of less antiquity is that of the designation given by Squier tothe skull obtained by 
him from Senora Zentino, and said to have been taken some time before from an ‘‘ Inca cemetery in 
the valley of Yucay”’ (‘‘ Peru—Incidents of Travel and Exploration in the Land of the Incas,” 1877, 
page 456) ; and it is clear that in this case the evidence of Incan age is far from complete. 
