Existing comment:
Peruvian Techniques:
There were several methods used by Peruvians for opening the skull. The most frequent was by cutting the skull with four grooves, releasing a four-sided section of bone which was elevated and removed. There were a number of modifications of this method. Sometimes the grooves were curved rather than straight. Also, considerable bone was at times removed by scraping before the cuts were made. A rare method was drilling a number of small holes through the bone in a circular pattern and breaking through the walls separating the holes. This method, although used only occasionally in primitive trephinations, most closely resembles the technique used for larger trephinations in modern surgery.
The South American surgeon of pre-Columbian times apparently used instruments of both stone and metal. Sharp flakes of obsidian (volcanic glass) were quite efficient cutting and scraping implements. Chisels, tweezers, and knives of copper or bronze were also made and apparently used in trephinations. A classic tool, the tumi, was in the shape of a half circular blade formed at the end of a handle that was either flat or at times sculptured with an animal or human effigy. The drilling instrument used -- whether a rotating drill or a bow drill -- is unknown. Bandages and gauze as well as tourniquets made of closely woven llama wool have been discovered and are associated with Peruvian trephination.
It is not known whether the patient was given any form of anesthetic during the operation. Coca, which has local anesthetic properties and which was native to the Andes, would have been used to decrease the pain of cutting through the scalp where the sensitive nerves in the head would be severed. Strong beer, chicha, made form corn, and a large variety of medicinal and hallucinogenic plants also existed. Speculations abound as to anesthesia, suturing, use of protective plates, and other practices. One protective plate of gold over the operative site has been reported, and several reports about the use of pieces of gourd are found in the literature. Tourniquet-type cords were also reported, but whether they were used to control bleeding is unknown. |