E. George Squier and the Discovery of Cranial Trepanation: A Landmark in the History of Surgery and Ancient Medicine

One of the greatest discoveries in the history of cranial trepanation was the Inca skull fragment (Fig. 1) obtained in 1865 in Cuzco, Peru, by Ephraim George Squier (1821–1888). This specimen, now dated between 1400 CE and 1530 CE, and currently housed in the American Museum of Natural History in New York City, possesses a rectangular opening measuring 15 mm by 17 mm. The opening could only have been made by human hands, and the individual subjected to this surgery seemed to survive it by about two weeks.

Squier's specimen caused an immediate sensation as the first skull from an ancient, “primitive” culture to be widely recognized as a case of trepanning, a word that derives from the Greek trypanon, meaning to auger or bore. Although a trepanned skull from Peru had been depicted by Samuel George Morton (1799–1851) in his Crania Americana of 1839, the opening was misinterpreted as an example of a battlefield wound. ¹ In addition, there were a few much older trepanned skulls unearthed in Europe, but they, too, had been misinterpreted prior to 1865. In a very real way, Squier's large cranial fragment stimulated scientists to look for other examples of trepanned skulls and to reconsider existing skull specimens thought to have been broken by animals, injuries, or natural forces.

Although the Squier specimen is now often shown or described verbally in books and articles on the history of trepanation, little if any information is provided about Squier as the man behind the skull or about his theory of cranial fracture. The first purpose of this essay is to present biographical information about Squier, an American writer, diplomat, and self-taught archaeologist, in cultural context. The second is to chronicle the sequence of events that led him to South America and to his famous example of Peruvian trepanning. The third is to show how the specimen was received and interpreted, first by members of the New York Academy of Medicine in 1865, then by Paul Broca (1824–1880) in 1867, and subsequently by others. Its fourth purpose is to present Squier's own explanation for trepanation, which differs from that of Broca and, as will be seen, now has solid scientific support.

It will be shown that Squier began his career in archaeology by studying the mounds, artifacts, and skulls of the Indians living in Ohio. Hypothesizing that landmarks south of the border might have been made by the descendants of these early Americans, he jumped at the opportunity to go to Central America and then to South America when given a chance to serve in the American diplomatic corp. It was after officially representing the United States in Peru that he encountered the trepanned Inca skull. His specimen drew widespread interest because it suggested that some sort of “brain surgery” had been performed in the Americas before the European Conquest. It also raised questions about race, brain size, and intelligence, subjects that greatly interested scientists and laymen at the time.

If there were a single theme that emerged and was sustained throughout Squier's multifaceted life, it was his patriotic fervor. His patriotism could be seen in his journalism, in his diplomacy, and in his archaeology. ² He was a fiercely nationalistic individual who believed that the United States was a great country with an even greater future. Where he parted from most of his contemporaries was in his strong belief that he could actually show that his homeland also had a great past, one that flourished even before the famous explorers crossed the Atlantic from Europe. Squier's ethnocentric approach to the world around him would guide him from his initial excavations in...