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Trephination in Mesoamerica has been practised by a number of
pre-Columbian In the history of the Americas, the pre-Columbian era spans from the original settlement of North and South America in the Upper Paleolithic period through European colonization, which began with Christopher Columbus's voyage of 1492. Usually, th ...
cultures in the
Mesoamerica Mesoamerica is a historical region and cultural area in southern North America and most of Central America. It extends from approximately central Mexico through Belize, Guatemala, El Salvador, Honduras, Nicaragua, and northern Costa Rica. W ...
n region, dating from at least the mid-Preclassic era (ca. 1500
BCE Common Era (CE) and Before the Common Era (BCE) are year notations for the Gregorian calendar (and its predecessor, the Julian calendar), the world's most widely used calendar era. Common Era and Before the Common Era are alternatives to the or ...
), and continuing up to the late Postclassic, or ca. 1200 CE. Trephination involves an intentional and planned operation to open or bore into the
skull The skull is a bone protective cavity for the brain. The skull is composed of four types of bone i.e., cranial bones, facial bones, ear ossicles and hyoid bone. However two parts are more prominent: the cranium and the mandible. In humans, the ...
on a live subject, using
tools A tool is an object that can extend an individual's ability to modify features of the surrounding environment or help them accomplish a particular task. Although many animals use simple tools, only human beings, whose use of stone tools dates ba ...
specifically designed for the purpose. This can be accomplished by several techniques, such as drilling, incising and abrasion, or some combination of these. The purpose of such operations ranges from the medicinal (intended to relieve pressure, or address a number of other ailments) to the ritualised and experimental. In pre-Columbian Mesoamerica, evidence for the practice of trephination and an assortment of other cranial deformation techniques comes from a variety of sources, including physical cranial remains of pre-Columbian burials, allusions in iconographic artworks and reports from the post-conquest period.


Overview

Trephination Trepanning, also known as trepanation, trephination, trephining or making a burr hole (the verb ''trepan'' derives from Old French from Medieval Latin from Greek , literally "borer, auger"), is a surgical intervention in which a hole is drill ...
has been practised by a variety of historical cultures and societies across the globe, with evidence for it dating back to the
Neolithic The Neolithic period, or New Stone Age, is an Old World archaeological period and the final division of the Stone Age. It saw the Neolithic Revolution, a wide-ranging set of developments that appear to have arisen independently in several parts ...
period, and its use has continued up to the present era under certain limited circumstances by a few cultures. If the patient manages to survive the procedure, the bone begins to slowly grow back from the rim of the hole towards the center. This new bone growth is measurably thinner than the undamaged bone at the rim, providing scientists examining a trephinated skull with a means to establishing whether or not the person lived beyond the operation. Among
New World The term ''New World'' is often used to mean the majority of Earth's Western Hemisphere, specifically the Americas."America." ''The Oxford Companion to the English Language'' (). McArthur, Tom, ed., 1992. New York: Oxford University Press, p. 3 ...
societies, trephination is most commonly found in the
Andean The Andes, Andes Mountains or Andean Mountains (; ) are the List of mountain ranges#Mountain ranges by length, longest continental mountain range in the world, forming a continuous highland along the western edge of South America. The range i ...
civilizations such as the
Inca The Inca Empire (also known as the Incan Empire and the Inka Empire), called ''Tawantinsuyu'' by its subjects, (Quechua for the "Realm of the Four Parts",  "four parts together" ) was the largest empire in pre-Columbian America. The admin ...
, where it is frequently associated with pre-existing cranial damage, indicating that it had a use as a reasonably-successful medical procedure— by one estimate, more than 70% of the patients survived the operation. Recently, anthropologists have discovered evidence which suggests that survival rates may have been as high as 80 to 90 percent. Its prevalence among Mesoamerican civilizations is much lower, at least judging from the comparatively few trephinated crania which have been uncovered. The archaeological record is further complicated by the practice of skull mutilation and modification which was carried out ''after'' the death of the subject, in order to fashion "trophy skulls" and the like, of captives and enemies. This was a reasonably widespread tradition, illustrated in pre-Columbian art which on occasion depicts rulers adorned with or carrying the modified skulls of their defeated enemies, or of the ritualistic display of
sacrificial Sacrifice is the offering of material possessions or the lives of animals or humans to a deity as an act of propitiation or worship. Evidence of ritual animal sacrifice has been seen at least since ancient Hebrews and Greeks, and possibly ex ...
victims. Several Mesoamerican cultures used a skull-rack (known by its
Nahuatl Nahuatl (; ), Aztec, or Mexicano is a language or, by some definitions, a group of languages of the Uto-Aztecan language family. Varieties of Nahuatl are spoken by about Nahua peoples, most of whom live mainly in Central Mexico and have smaller ...
term, ''
tzompantli A () or skull rack was a type of wooden rack or palisade documented in several Mesoamerican civilizations, which was used for the public display of human skulls, typically those of war captives or other sacrificial victims. It is a scaffold-l ...
'' ) on which skulls were impaled in rows or columns of wooden stakes. Even so, some evidence of genuine trepanation in Mesoamerica (i.e., where the subject was living) has been recovered.


Survey


Early colonial reports

Sixteenth-century Spanish colonial accounts like those of
Bernardino de Sahagún Bernardino de Sahagún, OFM (; – 5 February 1590) was a Franciscan friar, missionary priest and pioneering ethnographer who participated in the Catholic evangelization of colonial New Spain (now Mexico). Born in Sahagún, Spain, in 1499, he ...
and Bishop
Diego de Landa Diego de Landa Calderón, O.F.M. (12 November 1524 – 29 April 1579) was a Spanish Franciscan bishop of the Roman Catholic Archdiocese of Yucatán. Many historians criticize his campaign against idolatry. In particular, he burned almost al ...
contain references to the use of trepanation techniques among Mesoamericans to alleviate pain, such as for persistent headaches and that which results from the practice of deliberately deforming the cranium (for aesthetic purposes) by using compression boards and other methods.


Central Mexico and Oaxaca

The earliest archaeological survey published of trepanated crania was a late 19th-century study of several specimens recovered from the Tarahumara mountains by the Norwegian
ethnographer Ethnography (from Greek ''ethnos'' "folk, people, nation" and ''grapho'' "I write") is a branch of anthropology and the systematic study of individual cultures. Ethnography explores cultural phenomena from the point of view of the subject o ...
Carl Lumholtz Carl Sofus Lumholtz (23 April 1851 – 5 May 1922) was a Norwegian explorer and ethnographer, best known for his meticulous field research and ethnographic publications on indigenous cultures of Australia and Mexico. Biography Born in Fåberg, N ...
. Later studies documented cases identified from a range of sites in
Oaxaca Oaxaca ( , also , , from nci, Huāxyacac ), officially the Free and Sovereign State of Oaxaca ( es, Estado Libre y Soberano de Oaxaca), is one of the 32 states that compose the political divisions of Mexico, Federative Entities of Mexico. It is ...
and central
Mexico Mexico (Spanish: México), officially the United Mexican States, is a country in the southern portion of North America. It is bordered to the north by the United States; to the south and west by the Pacific Ocean; to the southeast by Guatema ...
, such as
Tilantongo Tilantongo was a Mixtec citystate in the Mixteca Alta region of the modern-day state of Oaxaca which is now visible as an archeological site and a modern town of Santiago Tilantongo. It is located at 17°15' N. Lat. and 97°17' W. Long. Its Mix ...
, Oaxaca and the major Zapotec site of
Monte Albán Monte Albán is a large pre-Columbian archaeological site in the Santa Cruz Xoxocotlán Municipality in the southern Mexican state of Oaxaca (17.043° N, 96.767°W). The site is located on a low mountainous range rising above the plain in the ...
. Two specimens from the
Tlatilco Tlatilco was a large pre-Columbian village in the Valley of Mexico situated near the modern-day town of the same name in the Mexican Federal District. It was one of the first chiefdom centers to arise in the Valley, flourishing on the western sho ...
civilization's homelands (which flourished around 1400 BCE) indicate the practice has a lengthy tradition, although the cultural
provenance Provenance (from the French ''provenir'', 'to come from/forth') is the chronology of the ownership, custody or location of a historical object. The term was originally mostly used in relation to works of art but is now used in similar senses i ...
of these particular specimens has been disputed. A 1999 study of seven trepanated crania from Monte Albán showed a combination of single and multiple
elliptical Elliptical may mean: * having the shape of an ellipse, or more broadly, any oval shape ** in botany, having an elliptic leaf shape ** of aircraft wings, having an elliptical planform * characterised by ellipsis (the omission of words), or by conc ...
holes drilled or worn into the cranial cap, performed exclusively on the upper
Parietal bone The parietal bones () are two bones in the Human skull, skull which, when joined at a fibrous joint, form the sides and roof of the Human skull, cranium. In humans, each bone is roughly quadrilateral in form, and has two surfaces, four borders, an ...
s. The sample crania were from both male and female adults, and evidence of healing around the perforations suggested that about half had survived the operation. Most of the skulls in the study showed signs of earlier cranial damage, indicating (as with the Andean examples) that the operations were an attempt to repair or alleviate this head-trauma.Tiesler (1999). From these analyses, it appears that a technique of straightforward abrasion was employed in the earliest-dated finds, to be combined later on with drilling and incision techniques. Crania recovered from Cholula show another form of trepanation ("supra-inial lesion"), where a depression has been worn into the back of the skull, without however substantially perforating it.


Maya region and Yucatán Peninsula

Specimens identified from the
Maya civilization The Maya civilization () of the Mesoamerican people is known by its ancient temples and glyphs. Its Maya script is the most sophisticated and highly developed writing system in the pre-Columbian Americas. It is also noted for its art, archit ...
region of southern Mexico,
Guatemala Guatemala ( ; ), officially the Republic of Guatemala ( es, República de Guatemala, links=no), is a country in Central America. It is bordered to the north and west by Mexico; to the northeast by Belize and the Caribbean; to the east by H ...
and the
Yucatán Peninsula The Yucatán Peninsula (, also , ; es, Península de Yucatán ) is a large peninsula in southeastern Mexico and adjacent portions of Belize and Guatemala. The peninsula extends towards the northeast, separating the Gulf of Mexico to the north ...
show no evidence of the drilling or cutting techniques found in central and highland Mexico. Instead, the pre-Columbian Maya seemed to have utilised an abrasive technique which ground away at the back of the skull, thinning the bone and sometimes perforating it, similar to the examples from Cholula. Many of the skulls from the Maya region date from the Postclassic period (ca. 950–1400), and include specimens found at
Palenque Palenque (; Yucatec Maya language, Yucatec Maya: ), also anciently known in the Itza Language as Lakamhaʼ ("Big Water or Big Waters"), was a Maya city City-state, state in southern Mexico that perished in the 8th century. The Palenque ruins dat ...
in
Chiapas Chiapas (; Tzotzil language, Tzotzil and Tzeltal language, Tzeltal: ''Chyapas'' ), officially the Free and Sovereign State of Chiapas ( es, Estado Libre y Soberano de Chiapas), is one of the states that make up the Political divisions of Mexico, ...
, and recovered from the
Sacred Cenote The Sacred Cenote ( es, cenote sagrado, , "sacred well"; alternatively known as the "Well of Sacrifice") is a water-filled sinkhole in limestone at the pre-Columbian Maya archaeological site of Chichen Itza, in the northern Yucatán Peninsula. It ...
at the prominent Postclassic site of
Chichen Itza Chichen Itza , es, Chichén Itzá , often with the emphasis reversed in English to ; from yua, Chiʼchʼèen Ìitshaʼ () "at the mouth of the well of the Itza people" was a large pre-Columbian city built by the Maya people of the Terminal ...
in northern Yucatán. The practice of deliberate cranial deformation or flattening is well documented among the pre-Columbian
Maya peoples The Maya peoples () are an ethnolinguistic group of Indigenous peoples of the Americas, indigenous peoples of Mesoamerica. The ancient Maya civilization was formed by members of this group, and today's Maya are generally descended from people ...
, and is evidenced from the Preclassic era onwards. By the use of cradleboards and other compression techniques applied to the growing skull from infancy, a variety of head-shapes were fashioned, with different regions and time-periods exhibiting a difference in style and ideal. The practice was applied to both males and females, and was not thought to be particularly associated with class or social standing. It was widely adopted however, to the point where one particular study which examined over 1,500 skulls drawn from across the Maya region determined that at least 88% exhibited some form of intentional cranial deformation. These practices have no known therapeutic value although they may have been intertwined with the expression of Maya cultural values, beliefs and identity. It is argued by some scholars in the field such as Vera Tiesler,See Tiesler 1999, 2003a and in particular 2003b. that trepanation among the Maya was also imbued with a culturally-significant meaning apart from any medical benefit.


Notes


References

* * * * * * * * * {{refend Science and technology in Mesoamerica Mesoamerican society Mesoamerican medicine