rii-TCMPiii TREPniNIN(! FOR DISEASE OF BONE. 19 



wliicli has been subjected to disease is excessively thin, and was broken in 

 two or three places in the process of extraction No trace was left of the 

 coronal suture, the disease having entirely obliterated it. D^it the most 

 interesting feature was the evidence tliat surgical trephining had been per- 

 formed, ai)parently for the relief of the disease. The opening made involved 

 the frontal and left parietal bones; it was of the usual oval shape, but its 

 size could not be exactly ascertained, as the posterior portion of it was lost 

 in a large, irregular hole, produced, no doubt, when the skull was removed 

 from the earth. The trephining was performed partly on sound and partly 

 on the diseased bone, and the edges of the aperture (what remains of them) 

 are perfectly cicatrized, so that it is 'evident that the patient long survived 

 the operation. It cannot be held that the disease was the result of the opera- 

 tion. In the large number of trephined skulls which have been examined 

 there is no instance of disease of the bone, and in this particular case, as 

 M. Parrot observes, if the disease had resulted from the operation it would 

 have spread all around the opening-, which is not the case, as what remains 

 of the aperture is in sound bone. 



The disease, which was probably an exfoliative osteitis or inflammation 

 of the bone, was, M. Parrot thinks, of traumatic origin. There is a depres- 

 sion on the frontal bone which may have been caused by a hatchet-stroke. 

 Whether the operation was performed to arrest the disease, or to remove 

 some of its symptoms, is, of course, a matter of conjecture; but as the dis- 

 eased bone and the edges of the aperture had all become firmly cicatrized, 

 it is certain that the patient lived for some years aftei\ 



M. Parrot dwells upon the importance of this discovery as proving that 

 trephining was employed as a therapeutic measure in disease, and not only 

 for the relief of imaginary causes of evil, as in convulsions or epilepsy. 

 It is possible, however, that the subjective symptoms attending such exten- 

 sive disease of the cranium may have required the usual remedy for eviction 

 of the supposed malignant spirit. 



In Germany a few examples have been met with of prehistoric trephin- 

 ing. Prof H. Wankel discovered in the grotto of Bytchiskala, in Bohemia, 

 the skeleton of a girl of about twelve years of age. The skull bore unmis- 

 takable evidence of sui-gical trephining having been performed during life. 



