MUNIZ—MC GEE] OPERATIONS PROBABLY FOR MENTAL SYMPTOMS fiolt 
a gangrenous wound in the foot of an Indian was treated by incision 
through the flesh and scraping of the bone in order toextract a maleficent 
maggot has been recorded by Cushing. ! 
CLASSIFICATION OF PERUVIAN TREPHINING 
On reviewing the foregoing evidence as to the culture-grade and 
antiquity of the Peruvian practitioners whose professional work is 
recorded in the Muniz collection, it becomes clear that the instruments 
were chiefly or wholly of stone, and hence that the culture-grade was 
uncivilized; and since the use of metal quickly followed the Spanish 
invasion, it follows that the trephining must be considered prehistoric. 
This conclusion is sustained and established by the associations with 
the other products of Dr Muniz’ work. 
On reviewing the evidence as to method, it appears that there is no 
indication of the use of differentiated instruments or of skillful procedure. 
Tt follows that the trephining must be regarded as primitive rather than 
specialized; and, since the operation is known from collateral evidence 
to have been performed in prehistoric times, it must be regarded as 
archaic. 
On reviewing the indications of motive, it is found that the evidence 
is somewhat vague and illusive, yet, when considered comparatively, 
fairly satisfactory. There are suggestions of therapeutic treatment in 
a few of the crania, yet on the whole stronger indications that even 
in these cases the operations were thaumaturgic, while in the great 
majority of the specimens the operations can only be interpreted as 
wholly thaumaturgic; and, since there is nothing to indicate different 
culture-grades or differentiated methods, it seems necessary to conclude 
that all the operations belong to the earlier stage in the development 
of sophiology, and were essentially thaumaturgic. It is clear that most 
of the operations were ante mortem, and there is nothing to indicate 
that any were post-mortem. At the same time there is, in several 
eases, conclusive evidence that the motive for the treatment was con- 
nected—albeit in a thaumaturgic way—with the individual treated, 


'This case is especially significant as an indication of theory and procedure in primitive surgery. 
The disorder was a tumor resulting from a local bruise, so advanced as to disorganize tissues and 
threaten general septicemia. The theory was that a ‘‘mysterious’’ maggot or worm, burrowing in 
flesh or bone, caused this disorder. The treatment was wholly thaumaturgic in plan, though partly 
(and incidentally) therapeutic ia procedure. It began with the making of scalpels and lancets from 
bottle glass and obsidian, and with many incantations; next the tumor was cleansed; then a T-shape 
incision was made in such manner as to lay open the tumor, and the pus and serum were removed 
and the gangrenous tissue cut away, exposing the bone, with discolored periosteum, which was care- 
fully seraped. At this stage a fetich, symbolizing the ‘‘mysterious’’ maggot, was laid in the wound 
and presently removed ceremoniously. Atterward the wound was repeatedly cleansed, sprayed with 
a red infusion of willow-root bark, and dried with scraped buckskin; finally the openings were stuffed 
and closed with pinion gum and neatly bandaged, the dressing being dusted with an astringent yellow 
powder. The infusion, gum, and powder were antiseptic, and combined with the excision of diseased 
tissue to effect a cure; yet the theory controlling the use of these substances was no more rational than 
the primary diagnosis: The red infusion symbolized healthy blood or vitality, the gum symbolized 
constructive process (in prescriptorial ideation), and the powder symbolized fructifying pollen. The 
complete cure was due partly to subsequent dieting, which was incidentally hygienic, though the 
design was, like that of the treatment, wholly symbolic or thaumaturgic. The bearing of this case 
on primitive trephining is manifest. (‘'A Case of Primitive Surgery,” Science, N. s., vol. v, 1897.) 
