Trephining in the South Seas
Author(s): J. A. Crump
Source: The Journal of the Anthropological Institute of Great Britain and Ireland, Vol. 31
(Jan. - Jun., 1901), pp. 167-172
Published by: Royal Anthropological Institute of Great Britain and Ireland
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TREPHINING IN THE SOUTH SEAS.
BY THE IREv.
J. A. CRUMP.
[PRESENTED MARCH 12TH, 1901. WITH PLATES XII, XIII.]
ABOUT
eighteen months ago I wrote a short article on " Native Surgery in New
Pommern" (New Britain) to the small monthly periodical issued by the Missionary
Society of which I am an agent. That article has excited so much interest in the
colonies-and even in Europe-that perhaps I am right in assuming that a more
detailed account, containing the results of my further research, may be found of
value to the cause of science and acceptable to the Anthropological Institute.
My previous inquiry was limited to New Britain itself, and in that part of
the district the operation of trephiniing is practised on the skull solely in cases of
fracture.
In the native fights the ling is the most formidable weapon used, a smooth
stone as large as a pullet's egg being thrown with moderate accuracy but
considerable force. A blow from a sling-stone is generally the 'cause of the
fracture for which the operation is found necessary; the depressed portionis of bone
or haemorrhage
beneath the skull causing compression, and death alm
ost invariably
results if the injury is not attended to. Injury caused by the stone-headed club is
almost instantly fatal, but the flat two-edged club is not so deadly and permits of
an occasional operation.
The man who performs the operation is the wizard or " tena-papait " of the
tribe or district, using a piece of shell or a flake of obsidian for a trephitie.
An incision is made over the seat of the fracture generally in the shape of a
Y or V, and then perhaps some loose fragment is picked out with the finger nail,
andi while assistants hold back the scalp, the fractured bone is scraped, cut and
picked away, leaving the brain exposed to the size of half-a-crown. Then, all loose
pieces having been removed, the scalp is careftglly laid down and the wound
bandaged with strips of the banana stalk about 4 inches wide. These strips are
when dry of a spongy nature, the water which formerly filled the cells being
replaced by air. Moreover the inner surface is silky to the touch and forms an
admirable dressing for tender surfaces. It is astringent in its action and nlon-
absorbent, all discharge escaping below the bandage. Sometimes a few bruised
leaves are applied before bandaging. The patient is generally insensible from the
time of the injury, and, if consciousness returns during the operation, soon faints
away again.
In five or six days the bandages are renewed and in two or three weeks a
complete recovery is the result, The number of deaths is about 20 per cent., most
Journal of the Anthropologieal lns4itute, T-ot. XXXI, Plate XII.
a b c
2.t SKULL OF TORORUKE, OF KABAKADA, IN NEW BR2ITAIN: HIE LIVED SEVEN YEARS AFTER OPERATTON.
a b c
1. SKUILL OF TOARA, OF KABAKADA, IN NEW BRITAIN: HE DIED TWO HOURS AFTER OPERATION.
Jourxal of theAxooioical Iiftu .XXX, F .t .
- -Er
;~~~~~~~A
2. SKULL OF TOROItUKE: SHOWING SUBSEQUENT GROWTH OF NEW BONE.
1 ~~~~~~~~~~~~~~~~~~~~~~4
1. SKULL OF TOARA: SHOWING UNHEALED WOUND WIThI FRESI[ SCRATCHES.
168 REv. J. A. CRUMP.-Trephining in the South Seas.
of these resulting from the first injury and not from any complication after the
operation. Nearly all the deatlhs take place during or immediately after the
operation, and I am assured that if a patient once becomes conscious he never fails
to make a good recovery.
I have recently discovered that on New Ireland (Neu Mecklenburg) the
operation is performied
not only in the case of fracture but where there is epilepsy
and certaini forms of insanity as the result of pressure on the brain. I have in
my possession a skull which has been successfully trephined in no less than five
places, the man meeting his death some years after the last operation by a blow
fromn
an axe. This man suffered from severe headache with local throbbing,. The
operation was performed each time in the region of the pain, and though no cure
seems to have been effected, the operation was at any rate perfectly successful.
The most common form trephinilng takes on Gerrit Demp Island and the central
part of New Ireland is cutting two or three channels down the forehead 3 to
4 inches long. This is done for headache and what is described as a beating or
plucking sensation.
There seems to be some benefit in cases of trephining for epilepsy at least for
a time. One native at Falabog on the west coast of New Ireland with whomn
I conversed had been trephined on the top of tlhe skull for this malady and had
had no recurrence since the operation. In no case is it thought necessary to avoid
the course of the sutures in performing this operation.
After trephining has been performed there is frequent partial temporary
paralysis which almost invariably passes away, though in a few cases it is
permanent. Idiocy is an occasional result also. But the natives affirm that while
the cures of insanity and epilepsy are many, the instances where either malady
supervenes after the operation are exceedingly few.
I have pleasure in forwarding herewith three skulls bearing indisputable
evidence of the performance of the operation and its success.
No. 1 is the skull of Toara, a native of Kabakada on the north coast of New
Britain, who was struck with a sling-stone aind trephined. He never became
conscious, and died two hours after the operation had been performed. The man
wlho threw the sling-stone is still living as is also the " tena-papait " who
performed the operation. From the latter I got my information. The marks of
the instrument are easily visible.
No. 2 is the skull of Toruruke, a native of Kabakada, and shows the growth of
new bone. He was trephined about seven years before his death.
No. 3 is the skull of Tighan, from the village of Olotai, situated about six miles
inland from Palabog on the west coast of New Ireland. This operation was
performed to cure headache. There are many people in this village who have been
trephined. It has become fashionable, and a handsome girl or boy is generally
persuaded to submit to the operation as an aid to longevity, there being no absolute
need for its performnance.
REV. J. A. CRuMP.-Trephining in the South Seas. 169
DISCUSSION.
Mr. VICTOR HORSLEY,
after having read Mr. Crump's paper to the Fellows
of the Institute present, said:-The paper by Mr. Crump which I have had the
honour of readiing to you is descriptive of the three skulls which are here before
you. They are skulls of Melanesian natives. We are informred also that the
individual natives fromi
whom these specimens were obtained have been operated
on by the wizard or high priest; further the history of each of these three cases
is known to Mr. Crump. When I received this paper together with the specimens
I recognised at once its great importance to anthropology, important because, as
far as I know of such surgical operations of the Pacific Islanders, these are the
first specimens of which we have absolutely reliable clinical histories. Mr. Crump's
paper is of very great value because among these clinical histories there is evidence
that the opening of the skull was done for the condition of headache. From the
time of the original publication on the subject of neolithic skulls by Broca
this possibility of the operation having been done for headache has been discussed
and has been rejected by many anthropologists. To-niight we are in the position
of being able to discuss this question with much more certainty than we could do
before to illustrate this point in regard to headache. I venture to show to you
some lantern slides of Peruvian skulls which I have collected, irn which the
operation of trephining has been performed in the same region as in these skulls.
As you will not be able to see at a distance the points in the specimens I have
made photographs of each, and we will now put them on the screen (Plates XII,
XIII).
No. 1 is the skull of Toara, a native of Kabakada on the north coast of New
Pommern, who was struck with a sling-stone and trephined. He never became
conscious, and died two hours after the operation had been performed. The man
who threw the sling-stone is still living,