PERU: PREHISPANIC TREPANATION

Pictures taken from Der Spiegel (From top-down, trepanated skulls showing techniques: I, II and III, respectively). Click up (title, to see article and more photos from Der Spiegel).

The anthropologists Valerie Andrushko (Conn/State-University/New Haven) and John Verano (Tulane University/N.Orleans), published in the AJPA, the results of a study carried out in 411 individuals (400 years b.C-1400 years a.C), coming from 11 prehispanic cemeteries located in and around Cuzco (southern highlands of Peru), in those that 66 individuals (16%), exhibit cranial trepanations (removal of bony disks), with the aim of reducing the intracranial pressure. Some individuals exhibit but of one trepanation (total = 109 observed perforations). Some few skulls have 4 and 7 simultaneous perforations. But of 90% of having operated survived (they present new bone, appropriately covered) and took a normal life. They registered lower infection rates and only 4.5%, exhibited wound inflammations. Vegetable principles were used to disinfect wounds (saponine, cinamonic acid, tannins).

It was easy to distinguish 3 techniques: I) circle cuts with scraping with and without bevel, made layer after layer (hole drilled), predominant method, highly successful with survival of up to 83%, rate that ascends with the time for improvements in the technique. The surgeons avoided certain areas of the skull - leaving alone bony bridges, extirpated only at the end -for not damaging the meninges and large vein sinuses II) rectangular piece, of right cuts. A single skull presents rectangular hole of 3.98 x3, 90 cm. The patient died before the wound healed III) round cuts with bony graft at the end of the treatment. A rude technique, practiced in acutely affected patients. In these cases the total piece of the fractured skull was extracted, being scraped the edges until smoothing them. According to the researchers the surgeons used stone blades: obsidian and flint and carcass of animals. In 44% of those affected, the causes of the trephination were left cranial traumas caused with overwhelming objects, to effects of tribal wars. Were also object of trepanations, affections like mastoiditis, migraine and sickness.

Peru :Trepanaciones craneanas.

Los antropólogos Valerie Andrushko (Conn/State-University/New Haven) y John Verano (Tulane University/N.Orleans), exhiben en el American Journal of Physical Anthropology, los resultados de un estudio realizado a 411 individuos (400 años a.C-1400 años d.C), procedentes de 11 cementerios prehispanicos ubicados en y alrededor del Cuzco, en los que 66 individuos (16%), exhiben trepanaciones craneanas (remoción de discos oseos), a efectos de reducir la presión intracraneal. Algunos individuos exhiben mas de una trepanación (total = 109 perforaciones observadas). Unos pocos cráneos tienen 4 y 7 perforaciones simultaneas. Mas del 90% de operados sobrevivieron (presentan neohueso, adecuadamente cubierto) y llevaron una vida normal. Se registraron bajas tasas de infección y apenas 4.5%, exhibieron inflamaciones de herida. Se emplearon principios vegetales para desinfectar heridas (saponina, acido cinamonico, taninos).

Fué fácil distinguir 3 técnicas: I) corte circular por raspado con y sin bisel, capa tras capa (hole drilled), metodo predominante, altamente exitoso con sobrevivencia de hasta 83%, tasa que asciende con el tiempo por mejoras en la tecnica. Los cirujanos evitaban ciertas areas del cráneo -dejando puentes oseos, extirpados solo al final- para no dañar las meninges y senos venosos II) pieza rectangular, de cortes rectos. Un solo cráneo presento agujero rectangular de 3.98 x3, 90 cm. El paciente murio antes que la herida cicatrizara III) corte redondo con injerto al final del tratamiento. Tecnica ruda, practicada en pacientes agudamente injuriados. En estos casos se extraía la pieza total del cráneo fracturado, raspándose los bordes hasta aplanarlos. Según los investigadores -para trepanar- los cirujanos emplearon hojas de piedra :obsidiana y pedernal y huesos de animales. En 44% de los afectados, las causas de la trepanación eran traumas craneales izquierdos ocasionados con objetos contundentes, a efectos de guerras tribales. Fueron también objeto de trepanaciones, afecciones como mastoiditis, Cefalea y mareos.