Medicocultural Innovations to Cope with Collapse

Abstract

Trepanation, the intentional removal of a piece of the cranial vault, is a surprisingly nuanced form of prehistoric surgery that emerged sui generis in the aftermath of Wari’s imperial retraction from Andahuaylas. Comprehensive bioarchaeological evaluation of well-contextualized human remains informs on the development of these operations within Chanka and Quichua society. This approach allows us to more fully understand the cultural contingencies that motivated medical intervention, reconstruct the ordeals and outcomes of patients, and broadly elucidate the complex system of medical knowledge attained by practitioners as well as the therapeutic treatments developed by caregivers. The dataset from Andahuaylas, where about 10% of the population shows signs of trepanation, suggests that the physiological impacts of head wounds, the sequela of lingering infections on the skull, and potentially lethal “soul loss” caused by fear of violence, were primary factors that motivated surgical intervention. These stressors intensified throughout the region due to widespread conflict and the overall decreased quality of life after Wari’s collapse. Yet despite the fact that these traumata equally impacted men, women, and children, trepanations were almost exclusively limited to adult males. Trial-and-error experimentation with different cutting techniques, increasing standardization on where trepanations were placed, and peri-operative procedures like poultice and prosthetic use quickly became widespread and successful endeavors, evinced by bony healing—patient survival. These results speak to the maturation of distinct, culturally-informed understandings on wellness and healing and, importantly, highlight the in situ development of innovative techniques to cope with novel challenges in the aftermath of state collapse.