[From Fern&us’ Universa Medicinn, Geneva, 1679.1

BOOKSHELF BROWSING STUDIES IN PALEOPATHOLOGY, XXIII AN UNUSUAL SKULL FROM PRECOLUMBIAN PERLJ

ROY L. MOODIE, PH.D.

SANTA MONICA, CALIF.

I HAVE considered in a previous paper’ on “Surgery in pre-Columbian Peru,” the association of skull injuries with

trephined openings in an attempt to determine the exact relations of primitive surgery to depressed fractures. I have given there a number of Uustrations showing an undoubted reIationship; sup- porting the contention that prehistoric trephining was a deliberate attempt on the part of the primitive surgeon to relieve pain by elevating or removing the de- pressed cranial area, due to sling-shot wounds, club or mace injuries or by blows with other weapons.

After that paper had been sent to press I learned of a skull in the American Museum of Natural History, a pre-Col- umbian maIe skull in the Bandelier collec- tions, which showed a most remarkable association of features which I consider sufficiently interesting to be separately described. I am under obligations to Dr. H. L. Shapiro, of the department of An- thropology, for a photograph of the right side of this Peruvian skull, given herewith.

There are three important features combined in this skull. First: the skuI1 is

’ hloodie, R. L. Studies in paIeopathoIogy, XXIII. Surgery in pre-Columhian Peru. Ann. LWed. Hist., II. s. I: 698, 1929.

deformed artificiaIly in the Aymara type, brought about by I bandaging’ the plastic cranium of the voung with a soirallv y_ ” I v

wound cloth. SkulIs of this type are seldom injured, and almost never trephined. The exceptions are given in my forthcoming

paper. This skull (No. 99 Amer. Mus. 3161

Nat. His.), however, shows both trephining and injury, as may be seen in the photo- graph. I have never seen another example in which Aymara deformation, injury (depressed fracture) and trephining were so definitely associated, and I have examined several hundred ancient Peruvian skulls and have studied ilIustrations of many more.

The depressed fracture, itself, is inter- esting and unusual. A large, triangular area had been crushed in by a blow from a club. No radiating fracture-lines, nor cornminuted fragments are evident. The lesion is partially healed. The edges are smoothly rounded and new bone in places has bridged the fracture line. No depressed fracture has been seen like this. It has no counterpart in the more than 160 crania in the San Diego Museum examined for skull lesions.

Near the middle line there is an oval trephined opening made by a cutting

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904 American Journal of Surgery Moodie-Studies in PaIeopathoIogy APRIL, 1930

instrument, possibly a copper knife or an cIass or the wea1th-y group who were obsidian Aake. It appears to have heaIed exempt from the occupations of the major- somewhat, but we surmise that the tre- ity of the peopIe. The present example

FIG. I. Photograph of right side of ancient, male, pre-Columbian skull showing unusual association of (I) Aymara deformation, (2) depressed skuI1 fracture and (3) trephining by the cutting method. (Courtesy Dr. H. L. Shapiro, Amer. Mus.)

phining was done after the injury, and probably to relieve pressure symptoms.

The peopIe who modified the skuI1 into the Aymara deformation were for some reason, apparently, reheved of the occupation of fighting, since injured crania of this type are rare. They may have beIonged to the priesthood who were devoted to the worship of the Sun. They may aIso have been members of the ruling

is not an extreme instance of Aymara deformation, but is suffciently we11 marked in the far-backwardly extending vauIt, to justify the classification.

Trephining was undoubtedIy stimuIated by war injuries, and since from the nature of the weapons most of the injuries were cranial, this phase of primitive surgery may have developed as a miIitary measure.