The incas mastered the gruesome practice of drilling holes in skulls

Old skulls from Peru signs of trepanation. The chances of surviving trepanation were better in the old Peru during the American civil war. Credit: University of Miami

If you had a hole drilled through your skull in historical times, the chances of surviving the ordeal were much better in the old Inca Empire of South America than in North America during the American civil war, a new study found.

The researchers made the determination by studying more than 800 Inca skulls found in Peru that had undergone trepanation — a practice in which a surgeon cuts, abrasions or drilling a hole in someone’s head. Between 17 and 25 percent of this Inca patients died before their skulls to heal, the researchers found.

In comparison, during the American civil war (1861 to 1865), more than double the percentage between 46 and 56 percent of the soldiers died, so soon after trepanation that their skulls had no time to heal, the researchers found. [25 Grisly Archaeological Discoveries]

“That is a big difference,” study researcher Dr. David Kushner, a clinical professor in the physical medicine and rehabilitation at the University of Miami Miller School of Medicine, said in a statement. “The question is: How have the ancient Peruvian surgeons have results that far exceeded that of surgeons during the American civil war?”

The old practice

Trepanation is thousands of years old and historically was done to suppress, headaches, epilepsy and mental illness, as well as to drive out perceived demons. Given the fact that the Inca Empire was a good 300 years before the American civil war, it is impressive that the Inca trepanation patients had twice the survival of the civil war patients, Kushner said.

That difference probably comes down to hygiene, sanitary facilities were notoriously terrible on civil war battlefields, the researchers said. For example, civil war surgeons regularly used unsterilized medical tools and even their bare fingers, to dig into the head wound or break up blood clots, said study co-researcher John Verano, a world authority on Peruvian trepanation to Tulane University in New Orleans.

Almost every civil war soldier wounded by gunfire later suffer from an infection, but the Inca seem to have experienced a much lower infection rate, the researchers said.

“We do not know how the ancient Peruvians prevent infection, but it seems that they do a good job,” Kushner said. “We also do not know what they used as anesthesia, but because there are so many [cranial operations], they must have something — be coca leaves. Perhaps there was something else, perhaps a fermented drink. There are no written records, so we simply do not know.”

The Inca skulls, the researchers studied, some with as many as seven holes in them — date back to 400 B. C. These skulls indicate that the Inca refined their trepanation skills through the centuries. For example, the Inca learned not to perforate the dura, or the protective membrane covering the brain — a directive that of Hippocrates, codified in ancient Greece around the same time, in the fifth century, B. C.

However, in the beginning of the Inca trepanation patients — who lived about 400 B. C. 200 B. C. — did something worse than a civil war patients, as about half of this ancient Inca-patients died. It was much better to have a trepanation patient of A. D. 1000 to A. D. 1400, when to 91 percent of the patients survived.

“In time, from the first to the last, they learned which techniques were better and less likely to perforate the dura,” Kushner said. “They seemed to understand the head anatomy, and purposefully avoided the areas where there is more bleeding. They also realized that larger trepanations are less likely to be as successful as smaller ones. Physical evidence definitely shows that these old surgeons have refined the procedure for the course of the time. Their success is truly remarkable.”

Doctors still practice trepanation today, although now, when they remove a piece of someone’s skull, it is usually called a craniotomy. This operation and other types of modern brain surgery “very low” risk of mortality historic times, Kushner said.

“And, as in ancient Peru, we continue to advance our neurosurgical techniques, our skills, our tools and our knowledge,” he said.

The study was published in the June issue of the journal World Neurosurgery.

Original article on Live Science.

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