, 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. “There are still many unknowns about the procedure and the individuals on whom trepanation was performed, but the outcomes during the Civil War were dismal compared to Incan times,” said Kushner, a neurologist who has helped scores of patients recover from modern-day traumatic brain injuries and cranial surgeries. But hygiene, or more accurately the lack of it during the Civil War, may have contributed to the higher mortality rates in the later time period. According to the study, which relied on Verano’s extensive field research on trepanation over a nearly 2,000-year period in Peru and a review of the scientific literature about trepanation around the world, Civil War surgeons often used unsterilized medical tools and their bare fingers to probe open cranial wounds or break up blood clots. Published in 2016, the book analyzes the techniques and survival rates of trepanation in Peru through the demise of the Incan Empire in the early 1500s.
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