"Peruvian Incas better than ACW Surgeons at trepanning " Topic

Even with a highly skilled neurosurgeon, the most effective anesthesia, and all the other advances of modern medicine, most of us would cringe at the thought of undergoing cranial surgery today.

After all, who needs a hole in the head? Yet for thousands of years, trepanation—the act of scraping, cutting, or drilling an opening into the cranium—was practiced around the world, primarily to treat head trauma, but possibly to quell headaches, seizures and mental illnesses, or even to expel perceived demons.

But, according to a new study led by the University of Miami Miller School of Medicine's David S. Kushner, M.D., clinical professor of physical medicine and rehabilitation, trepanation was so expertly practiced in ancient Peru that the survival rate for the procedure during the Incan Empire was about twice that of the American Civil War—when, more three centuries later, soldiers were trepanned presumably by better trained, educated and equipped surgeons.

Nice to know, but I would prefer to not have holes cut in my skull at all.

But seriously…
It's interesting how the Inca could do that without steel tools.

Perhaps that lack made the Inca better practitioners
of the procedure.

Or perhaps steel instruments introduced variables into
the process which caused some patients to expire
(infections, etc.)

Do we know what caused the deaths of trepanned cases
during the ACW or was it just a blanket statement that
a patient underwent the procedure and then died ?

Could it be that on average the injuries sustained during the ACW was far more serious and so generally had lower chances of survival.
Even today. Chances of surviving brain surgery as treatment for gunshot wound to the head. Is probably lower then surviving brain surgery for a begin tumour.

They also had access to coca leaves and crushed sea shells. That helped the chasquis messengers run without feeling muscle pain during their stretch.

The pre-Inca Andean cultures had a very long history of trepanning. Much of it to get rid of spirit possession, not tumors or to relieve swelling. And lot of them weren't survived. So the Incas had the benefit of learning from the successes and failures of previous cultures.

Plus, one of their main weapons was the stone-headed club. So head injuries were a lot more common with them. Their surgeons had better get good at their craft with so much repetition.

Dan

As the article explains, infections may have been the key.
ACW surgery, as all battlefield surgery, was very lax about sterile conditions. Surgeons operated bare handed, didn't know about NOT puncturing the dura, and would poke around inside looking for clots, bone fragments, bullets…
And they did not have single use latex gloves.

Inca brain surgery was almost certainly not assembly line NEXT! procedure. Patient was numbed with coca leaves, one on one, and as centuries went on, they got better.
Doing one patient at a time would certainly cut down on infections. And it's lijely that Inca medicine had a grasp on how to deal with infections.
It's also likely that Inca surgeons did not qualify for the office by having been a butcher six months ago. Just as many ACW commanders were unfit for command, it's just as likely that many ACW surgeons were unfit to wipe bloody hands on their aprons.

As the article explains, infections may have been the key.

This, this and this.

I'll go out on a limb and say that the title of this thread is inaccurate. The level of skill of trepanation, or any brain surgery for that matter, may have been higher in the US of the mid 1800's compared to the Incas.

Joseph Lister noticed that post partum infant deaths were actually less when midwives were involved than when actual medical doctors were. The skill level would have been much higher with the MD's, however, midwives washed their hands prior to the delivery. Pasteur's work was just putting the last nails in the coffin of the "miasma theory" of disease. Lister's first controlled experiments in using carbolic acid as a disinfectant for surgical equipment took place in 1865, the last year of the ACW.

My guess would be the same as Winston's, that the Inca used some sort of disinfectant. I bet that complex surgery was the province of the upper classes, just like the drinking of chicha (fermented corn beer). It's not too much of a stretch that the Inca may have washed their copper (and possibly obsidian) surgical tools and the patient's wounds in some type of alcohol.

Plus, one of their main weapons was the stone-headed club. So head injuries were a lot more common with them. Their surgeons had better get good at their craft with so much repetition.

I agree. By the way, that star headed club is called a "champi". I actually own one…..albeit a modern facsimile.

An interesting test would be to compare the survival rates of head surgery between the ACW and the Franco-Prussian War just 5 years later. I'll bet that Lister's influence was beginning to be felt in the European medical community. I wonder if the survival rates of the FPW were higher.

I just found out that The Lancet (England's premier medical journal) mocked Lister's protocols in 1873. However, he got support from various heads of Hospitals much earlier than that. They could probably see the increased survival rates much faster than the establishment.

Bowman: "I agree. By the way, that star headed club is called a ‘champi'. I actually own one…..albeit a modern facsimile."

They are amazing, aren't they? Specially the museum ones. Do you have yours mounted?

The copper and bronze ones are nice, and the Chavin copper mace heads are spectacular, but the stone ones are always my favorite.

Dan

Mine is a stone one, pentangle shaped, with a wooden handle and a rawhide grip.

Well the Incas had Obsidian blades which are far sharper that any steel blade can be made and probably cleaner. They may also have used hardened copper instruments which have anti-septic properties.

Obsidian is an amazing material. You can cut into leather and ivory with relative ease, despite it being just volcanic glass.

Dan

……despite it being just volcanic glass.

Ahh……but it is much more than that. It is volcanic glass that cooled and hardened so quickly that the molecules couldn't organize themselves into a crystal lattice. This allows for two things: a medium hard material that is easy to work with, and a glass that breakes conchoidally into very sharp edges.

This is critical to the usefulness of any obsidian tipped weapon. If the sharp edge strikes a hard surface (like a conquistador's breast plate) it doesn't dull, like a steel sword. It chips into new razor sharp edges, prolonging the usefulness of the weapon in battle.

The Aztecs and the Maya were dependent on obsidian. The Inca weren't as they had some metallurgy skills.

Sorry for the slight derail, but Meso-American and South American warfare is one of my great interests. I have 28mm armies for all the major belligerents (except the Tarascans). Dan, some of your former Aztecs are now in my army!

They may also have used hardened copper instruments which have anti-septic properties.

Not sure that there is conclusive evidence for the antiseptic properties of copper. Interest groups like "antimicrobialcopper.org" say there is plenty of long standing research to show this. When looking at PubMed, not so much. There is also some (insufficient) evidence that copper aids in healing and bone growth, according to WebMD. Of course the internet is full of the wondrous things that copper does for us and TV is full of copper bracelet ads.

Here is the most cited paper on the web:

link

Bowman: "Dan, some of your former Aztecs are now in my army!"

I had 28mm Aztecs? I don't recall Aztecs.

I bought loads of Foundry and Outpost Incas though, which I never got to paint. I have no idea what I did with them.

Dan

Then it was the Incas. Lol! It was about 10 years ago? Yes they were Foundry. That much I do know. You shipped them to Canada. I bought them through the TMP marketplace.