Existing comment:
Why Surgery?
The reason for performing trephination -- a difficult operation to remove a section of the skull -- has been the subject of speculation. There is considerable evidence that many of the operations in Peruvian practice were performed for the therapeutic purpose of removing a bone fragment that had been driven below the surface of the skull vault as the result of an injury. Many such injuries presumably occurred during hand-to-hand fighting with weapons that often had sharp projecting points, such as sling stones, stone-headed war clubs, and star maces. Depressed fractures that resulted from the use of such weapons may have created intracranial pressure that led to illness. The Peruvians may have felt the conditions were relieved by cutting free and removing the portion of the skull where the impact occurred.
Other fractures, not necessarily depressed, may have caused blood clots and pressure on the brain, resulting in headaches. In some instances, the operative area was in the region of larger fracture that could have been the result of a blow with a heavy club or perhaps a fall unconnected with warfare. Magico-therapeutic reasons -- those related to beliefs -- are sometimes given as an alternative explanation for skull surgery performed on individuals with headaches, delirium, epilepsy, and various mental disorders. Another purpose of skull surgery may have been ritual surgical practice on cadavers.
It is quite possible trephination was an attempt at healing through supernatural means. Some early European trephinations were apparently done in order to obtain the bone disk that was removed from the skull. The resulting bone amulet, called a roundel, was thought to have some magical power or supernatural symbolism. This purpose, however, has not been indicated in the New World trephinations. It is possible that some of the South American operations were based on the theory that a malicious spiritual entity had taken possession of the patient and was causing his or her illness.
Opening the skull was considered a means of releasing the disease-causing force. Also, since the agency causing the illness was sometimes thought to reside in the blood, the release of blood from the body was often a curative procedure. Since the trephination likely involved a considerable flow of blood, this might have been why the skull was opened. There may have been a number of reasons for trephining in aboriginal surgical practice, varying from natural to supernatural, depending on the features of the illness and the personality of the surgeon. |