John W. Verano

Prehistoric trepanation in the Cuzco region of Peru: a view into an ancient Andean practice.

In this study, patterns of prehistoric trepanation in the southern highlands of Peru were examined through an analysis of 11 Cuzco-region burial sites. Trepanations were found in 66 individuals, with several individuals exhibiting more than one trepanation, for a total of 109 perforations observed. The predominant methods used were circular cutting and scraping-methods that proved highly successful with an overall 83% survival rate and little ensuing infection. Survival rates showed a significant increase over time, apparently reflecting improvements in trepanation technique through experimentation and practical experience. Practitioners avoided certain areas of the cranium and employed methods that reduced the likelihood of damage to the cerebral meninges and venous sinuses. In many cases, trepanation as a medical treatment appears to have been prompted by cranial trauma, a finding that corroborates other studies pointing to cranial trauma as a primary motivation for the surgical procedure.

Violence and Weapon-Related Trauma at Puruchuco-Huaquerones, Peru

Conquest of indigenous peoples in North America is understood primarily through ethnohistorical documents, archaeological evidence, and osteological analyses. However, in the Central Andes, the colonial enterprise and its effects are understood only from postcontact historical and ethnohistorical sources. Few archaeological and bioarchaeological studies have investigated Spanish Conquest and colonialism in the Andean region [for exceptions see Klaus and Tam: Am J Phys Anthropol 138 (2009) 356-368; Wernke, in press; and Quilter, in press]. Here we describe bioarchaeological evidence of violence from the cemeteries of Huaquerones and 57AS03 within the archaeological zone of Puruchuco-Huaquerones, Peru (circa A.D. 1470-1540). A total of 258 individuals greater than 15 years of age were analyzed for evidence of traumatic injuries. Individuals were examined macroscopically and evidence of traumatic injuries was analyzed according to the skeletal element involved, the location of the injury on the skeletal element, and any additional complications of the injury. This study examines and compares the evidence of perimortem injuries on skeletonized individuals from the two cemeteries and focuses specifically on the interpretation of weapon-related perimortem injuries. Evidence of perimortem trauma is present in both cemeteries (18.6%, 48/258); however, the frequency of injuries in 57AS03 is greater than that in Huaquerones (25.0% vs. 13.0%). Several injuries from 57AS03 are consistent with documented cases of injuries from firearms and 16th Century European weapons. We believe that the nature and high frequency of perimortem trauma at 57AS03 provide evidence of the violence that occurred with Spanish Conquest of the Inca Empire.

Advances in the paleopathology of Andean South America

Over the past 100 years, paleopathology has grown from the occasional description of the odd and curious to what is today a dynamic and multidisciplinary field. South American skeletal and mummified remains played a key role in stimulating the development of the discipline in the late nineteenth and early twentieth centuries. The past 20 years have witnessed a renewed interest in the paleopathology of prehistoric Andean populations. Recent studies are characterized by growing sophistication in both research methods and theory, and significant advances have been made in understanding diet, disease, and general health patterns in the prehistoric Andean world.

Foot amputation by the Moche of ancient Peru: osteological evidence and archaeological context

Three probable cases of foot amputation, with healing, in skeletal remains associated with the Moche culture (AD 100–750) of northern coastal Peru are described. Each case exhibits non-functional tibio-talar joints with proliferative bone occupying the normal joint space. The robusticity of the tibiae and fibulae suggest renewed weight-bearing and mobility following recovery. The osteological evidence is consistent with details shown in Moche ceramic depictions of footless individuals. A footless Moche skeleton with wooden prostheses, described in 1913 by Peruvian physician Velez Lopez, appears to represent a fourth example of this procedure. The Moche surgical approach was similar to a technique that would be pioneered in western medicine by the Scottish surgeon Sir James Syme some 1500 years later. Copyright

Chronology, mound-building and environment at Huaca Prieta, coastal Peru, from 13 700 to 4000 years ago

Renewed in-depth multi-disciplinary investigation of a large coastal mound settlement in Peru has extended the occupation back more than 7000 years to a first human exploitation ~13720 BP. Research by the authors has chronicled the prehistoric sequence from the activities of the first maritime foragers to the construction of the black mound and the introduction of horticulture and monumentality. The community of Huaca Prieta emerges as innovative, complex and ritualised, as yet with no antecedents.

Human skeletal remains from Tomb 1, Sipán (Lambayeque river valley, Peru); and their social implications

The Moche tombs at Sipan, on the north Peruvian coast, are a major addition to our knowledge of high-status elite burial rituals. Its Tomb 1 contains the remains of nine individuals - three adult males, one adult female, three adolescent females and one child - besides the principal burial. Who are these people, as their biological remains instruct us ?

Differential diagnosis: Trepanation

Trepanation is the scraping, cutting, or drilling of an opening (or openings) into the neurocranium. World surveys reveal that a number of ancient cultures experimented with cranial surgery, and that in some areas these practices continued into modern times. Archaeological discoveries of possible trepanations continue to be made, often from geographic areas or time periods from which the practice was not previously known. Unfortunately, most of these reports describe single crania with healed defects interpreted as trepanations. When evaluating a possible trepanation in a skull that lacks medical history or comes from an archaeological context where there is no other evidence that such operations were performed, a thorough differential diagnosis is essential. Identification of unhealed trepanations is a relatively straightforward exercise, since tool marks provide direct evidence of surgical intervention. A confident diagnosis is more difficult in healed defects of the skull, where the mechanism that produced an opening may be obscured by bone remodeling. There are many possible causes of defects of the skull vault, including congenital and developmental anomalies, trauma, infection, neoplasm, and taphonomic damage. For this reason, a careful differential diagnosis is essential for identifying surgical intervention and distinguishing it from cranial defects caused by other mechanisms.

PALEONTHOLOGICAL ANALYSIS OF SACRIFICIAL VICTIMS AT THE PYRAMID OF THE MOON, MOCHE RIVER VALLEY, NORTHERN PERU

En 1995-96, las excavaciones dirigidas por Steve Bourget, de la Universidad de Anglia del Este (Inglaterra), recuperaron los restos esqueletales de mas de 60 adolescentes y adultos jovenes masculinos que fueron sacrificados cerca del 500 D.C., en la Huaca de la Luna, en el Valle del Rio Moche, costa norte del Peru. Este trabajo presenta los datos del analisis de los restos esqueletales, incluyendo informacion de las caracteristicas demograficas de las victimas, evidencia de trauma curada y trauma perimortem, e indicadores tafonomicos. De particular interes son los varios ejemplos de lesiones en proceso de cicatrizacion al momento de la muerte, asi como evidencias de mutilacion, desmembramiento, y descarnamiento de alguna de las victimas. Los patrones observados en las lesiones antemortem y perimortem son usados para interpretar los eventos que produjeron este deposito

Chapter 1 Ancient trepanation

Cranial trepanations began to be performed more than 5000 years ago in Europe and as early as the 5th century BC in the New World. It was only in the mid-19th century, however, that men of medicine began to realize that the openings in some of the unearthed ancient skulls were made by individuals skilled in surgery, and that the practice was routinely performed on the living. Some of the first reports on these unusual skulls and their significance came from pioneer neurologists and neurosurgeons, including Paul Broca and Victor Horsley. However, from the start, Broca and Horsley did not agree on why the operations were performed, and the logic behind these early cranial surgeries has continued to generate debate. In Peru, where more trepanned crania have been found than anywhere else, numerous skulls have been associated with head injuries from battles, a finding of special significance for neurologists, neurosurgeons, and neurohistorians.

Reprint of-Differential diagnosis: Trepanation

Trepanation is the scraping, cutting, or drilling of an opening (or openings) into the neurocranium. World surveys reveal that a number of ancient cultures experimented with cranial surgery, and that in some areas these practices continued into modern times. Archaeological discoveries of possible trepanations continue to be made, often from geographic areas or time periods from which the practice was not previously known. Unfortunately, most of these reports describe single crania with healed defects interpreted as trepanations. When evaluating a possible trepanation in a skull that lacks medical history or comes from an archaeological context where there is no other evidence that such operations were performed, a thorough differential diagnosis is essential. Identification of unhealed trepanations is a relatively straightforward exercise, since tool marks provide direct evidence of surgical intervention. A confident diagnosis is more difficult in healed defects of the skull, where the mechanism that produced an opening may be obscured by bone remodeling. There are many possible causes of defects of the skull vault, including congenital and developmental anomalies, trauma, infection, neoplasm, and taphonomic damage. For this reason, a careful differential diagnosis is essential for identifying surgical intervention and distinguishing it from cranial defects caused by other mechanisms.