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Dental morphology and pathology of pre-Spanish Peru.

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This study is based on the examination of the skeletal collection from Peru i n the Museum of Anthropology of the
University of California, Berkeley. There are roundly 900
skulls in the collection; not a few of these are a broken, senile
and infantile, which are not suitable for anthropometric
measurements, but all of which were observed for morphological and pathological features. Dr. Max Uhle, director of
the Hearst Peruvian expedition, collected most of them. The
study was made under the guidance of Prof. A. L. Kroeber,
director of the museum; and to him and the curator, E. W.
Gifford, I am indebted for unfailing aid and courtesies. Exact
provenience of all specimens is authenticated. The archaeological and cultural background and the estimated chonology,
are indicated in the monograph “The Uhle Pottery Collection
from Inca” by A. L. Kroeber and W. D. Strong with appendices by Max Uhle.
The empire of the Inca of Peru extended from southern
Ecuador to what is now northern Chile, including modern
Peru and Bolivia. Of their civilization, Holmes, page 137,
succinctly summarizes: “. . . no other American people
. . . . had achieved a system of government so highly perfected as that of the Inca, and their agriculture and cermaic,
textile, and metallurgic arts compare favorably with the best.”
Due to a particularly arid climate conjoined with burial
customs, much of the material art and culture of the Inca have
come down from ancient times intact. Because of the proximate functional effects of foods and narcotics on the dental
system, and the many potentialities of diet in characterizing
the osseous and other systems, notes on food and narcotics are
Plentiful examples of the more imperishable foods have
been recovered from the old Peruvian graves. They include
several varieties of maize and of Lima beans, beside sweet
potatoes and other tubers, gourds, peanuts and coca-leaf
bundles. This evidences an independent agricultural development covering a considerable period. Their agriculture was
based on maize, beans, potatoes, squash, peppers, cotton.
Mama Sara was the mythical concept of the life-giving element in the maize, literally, ‘mother maize.’ This revered
concept of a vital element of the maize is common to all agricultural areas in ancient America.
Fauna and flora and cultivated crops varied with altitude.
There are three longitudinal zones or physical divisions of
the Andean area: The coast, 10s llanos; highlands, sierra;
and the eastern forests, la montafia. Only 60 miles from the
sea the altitude is 15,000 feet. The coastal river valleys are
habitable and cultivated. It literally never rains on the coast,
but in ancient times irrigation was developed to raise bountecrops on the alluvian fans bordering the coast. In the sierra
considerable terracing was necessary to form arable plots.
Agricultural economics under the Inca was such as to support
a population of several millions.
The Peruvian littoral supported a fairly dense population.
Off-coast, running northward, is the cool Humboldt current
which teems with marine life. Large game fish as bonitos,
sea bass and sea mammals abound; and, as Means says, “have
formed an important part of the diet of the coastal folk from
earliest times. ” Fishing was one of the principal occupations
of the coast people. Thus to one of the best vegetable diets
the world has ever seen, the coastal people added a vast
variety of sea food, and also game birds, venison and other
meats from the higher parts of the valleys.
Maize of several kinds formed the staple food. Owing to
the labor involved in grinding, maize was usually eaten
wholeparched. ‘‘On certain religious festivals a special
bread was prepared from it. At ceremonial banquets enormous quantities of chicha, a maize brew, were consumed.”
I n the higher altitudes-above 11,000 feet, where maize could
not thrive, the hardy quinoa, a kind of buckwheat, took its
place. The potato flourished in the high alt.itudes, up to
14,000 feet, as well as in the lower country; and the oca,
another tuber, was of importance. Concerning the preparation of the potato for food Joyce says: “From the potato a
preparation made called chuno, which even now forms the
staple food in the high sierra. After the potatoes were exposed for some time to the frost, they were pounded and
dried in the sun; so treated, they provided a fare which, if
extremely insipid, was at any rate nourishing, and could be
stored for a long time.”
Sierra fauna which was the source of food, and otherwise
useful to people, included the burden-bearing, wool and fleshproducing llama, and the vicuiia ; the viscacham, a large edible
rodent; deer of several kinds; the cui, an edible guinea pig
that abounds in the houses of the Indians; the p t a , a sort
of partridge; and several sorts of lake fish. Charqui, ‘jerked’
meat, was the staple.
There was no trade in food products in the empire-each
section subsisted on its own fauna and flora. Delicacies from
the littoral were sometimes taken by relays of couriers to the
royal seat of the Inca at Cuzco. It is to be noted that milk
was not used by any American aborigines.
Thus in the Inca empire indigenous peoples in considerable
numbers were sustained by a husbandry peculiar to their
geography and climate, and this husbandry was stabilized for
a period of possibly two millenia. Many generations, in most
localities closely inbred, lived in the same habitat, carried on
the same sort of life, and were nourished by the same diet,
which is now definitely known. Of the physical bodies, the
osseous and dental systems, as well as the complete mummies,
come down in numbers a s evidence a s to the adequacy of that
diet. Correlation of this diet with the state of the osseous
and dental systems is indicated in the section on pathology.
Life was unmarred by European influence until Francisco
Pizarro arrived on the scene’in 1531.
The most highly prized product of P e r m i a n agriculture
was coca, the narcotic and anesthetic properties of which are
well known to medical science today. The leaves were chewed
with lime. Coca was held in such high estimation that it was
ordinarily reserved for the Inca. Large plantations were
prepared, esepecially in the eastern province-la montaiia,
and were tended with the greatest care; the leaves were
plucked one by one, dried in the sun and preserved in baskets.
Coca figured a s a n offering in most religious ceremonies.
Around the necks of mummies are found coca bags containing
the leaves, accompanied with lime gourds and needle-like
Kroeber and Olson verbally relate the coca-lime chewing
technique as follows: The lime is obtained from sea shells on
the coast, from lime stone or bones in the sierra, and by burning the root of the banana palm on the eastern montaiia. The
coca leaves are first chewed into a bolus (quid) and held in
the vestibule of the mouth; then the needle applicator i s
moistened, dipped into the gourd, and the lime adhering is
side-swipped into the mouth and into the bolus; and this is
repeated five to ten times, always with an accurate side-swipe
into the quid so a s not to touch the mucous membrane directly
with the undiluted lime. The lime is thus enveloped into the
bolus of leaves and dissolves therein slowly. The process may
be repeated three or four times for the same quid; and the
reliming may be accompanied with addition of more dried
coca leaves.
Presumably the lime frees the potent alkaloid cocaine from
the leaves of Erythroxylum coca. The coca-lime habit of
Peru simulates the betel nut-lime habit of the Orient and
Oceania (vide Leigh, ‘Guam’). The Indians of California
mixed lime with tobacco. These habits appear to be instances
of cultural parallelism.
Certain facial measurements only were made of this group ;
and an attempt through description, at approaching a n appreciation of non-measurable morphologic characters peculiar
to the race. Anthropologists decry the unwarranted importance placed on measurements as criteria in determination
of race characters; whereas more reliance should be placed
on morphologic characters which, though incapable of being
measured, may be described. HrdliEka believes that certain
dental characters are of definite and important value in detecting relationship between the American Indian and Asiatics.
The cranio-metric measurements were made in accordance
with the definitions and technique outlined in HrdliEka’s
‘Anthropometry.’ The instruments and aid used in this study
were : Compass d’dpaisseur, compass glissikre, metric rule,
copper wire, and hand lens.
Cranial types. I n general it may be said that head form in
Peru is often difficult to classify due to the wide-spread
practice of head deformation in infancy. The coast stock was
of moderate stature and normally brachycephalic. Nasca is
typical of the coast people ; they are fairly homogeneous, and
seem to represent the oldest part of the southern coast population. Intermingled with the brachycephals are individuals
with fine oblong heads, usually undeformed. HrdliEka has
shown that these come from the mountains.
Mandible. With respect to racial variation, G . Elliot Smith
says of the mandible: “It is a part of the skeleton which
lends itself most admirably to the display of those racial
contrasts, such as are associated with other differences of
skull and skeleton. ” HrdliEka describes the mandible of the
American Indian as being, on the average, somewhat larger
than in whites. The osseous system of the Peruvian is rather
smaller and less rugged than that of some American stocks.
However, the Peruvian type mandible is rugged: It is
squarish, the rami in comparison with the body are rather
low but broad, the angle is prominent and everted, the areas
of insertion of the musculature are fairly rough.
It would appear that in some skulls extreme occipital
flattening and broadening has had a broadening effect on the
posterior part of the mandible. No. 3386, male, 60, has a
bigonial width of 120, post-mortem change may be responsible
in part only.
Sex characteristics of the mandible are of interest. The
female mandible as evidenced in my records are smaller, it is
more delicate in surface markings and outline, smoother, the
areas of insertion of the musculature are not so rough. The
genio-hyoid tubercles are blunter in the female; the cingulum
over the mandibular foramen is absent or rounded, while in
the male it is usually long, sharply pointed, in many of this
group it is severely angular. The mental prominence is
smaller, rounder and smoother; the mental foramen is much
smaller ; and the teeth may be slightly or much smaller in the
The angle of the ramus with the body is more obtuse in the
female as a general rule; and the anterior border of the
ramus is straighter ;in the male the anterior border is usually
in the form of an open S, but this varies markedly with races.
The apex of the coronoid process tends to be blunt in the
female, due, in part, to a shallower notch. The articular surface of the condyloid process possesses secondary sexual
characteristics that form a valid criterion for aiding in sex
determination : In the female this surface is smaller-both
antero-posteriorly and externo-internally ;it is more regularly
convex antero-posteriorly ; it is smooth and even without
marked nodules or depressions, the detail is altogether h e r .
The posterior portion of the mandible is thinner, the gonoid
is more obtuse and smoother in the female. These sex differences are strong in the Peruvian mandibles listed in my
records ; and the same may be said of most American Indians.
Many modern whites, ancient Egyptians, peoples of southeast
Asia, do not have marked sexual characters of the mandible.
An anatomical feature of both morphologic and surgical
interest was given special study-the mental foramen. This
foramen with a n issuing groove directed backward and
slightly upward, for the emergence of the terminal branches
of the inferior dental nerve and artery, is located on a plane
about one-third the height of the body above the inferior
border, and its antero-posterior position varies from a point
below the apex of the first premolar to below the mesial root
of the first molar. The mode is the position below the second
premolar; in this group the frequency of this occurrence is
somewhat over 50%. I n some 40% of those carded the foramen is below and between the first and second premolars ; in
others it is located at the extreme of the range. About 12%
of mandibles are asymmetrical as to location of the foramina.
It is not uncommon for the foramen to be larger on the right
side ; and there are occurrences of accessory foramina.
Gnathic index. The gnathic index of Flower is an important cranial criterion for determining racial relationship.
This index is the ratio of the basion-prosthion length to the
basion-nasion length ; the greater the ratio, per cent, or index,
the greater is the projection of the jaw, and consequently the
more ape-like is the countenance. I n short, the gnathic index
is an indication of facial prognathism. The range of this
index is divided as follows : Orthognathous below 98, mesognathous 98.1 to 103, prognathous above 103. As with other
American Indians, the Peruvians tend to be mesognathous ;
my average for males (126) being 101.1, and for females
(119) 101.9. The range for the group is 89.6 to 115. My
records indicate homogeneity in the group: 49.2% of males
come within the mesognathous scale, 47.1 of females are
within this scale; but 28.6% of males are prognathous while
36.1% of females have protrusive faces. There is in most
races a slightly greater tendency to prognathism in the female.
Falling within the orthognathous range is 22.2% of males,
16.8 of females. There is apparent in many skulls a decided
sub-nasal, alveolar, prognathism. The alveolar process investing the superior teeth is long and rather procumbent, this,
of course, increases the basion-prosthion length and therefore
the index. The nasion is depressed particularly in females.
If the f ronto-occipital deformation has brought the basion
forward, it is not thought that would materially alter the
gnathic index, as both measurements would be shortened.
Dental index. This index is the ratio, expressed in
hundredths, of the dental length to the basi-nasion length.
The dental length is the distance from the mesial surface of
the maxillary first premolar to the distal surface of the third
molar, all post-cuspid teeth in situ. The range of the dental
index is classed as follows : Microdont up to 41.9 ; mesodont
42.0 to 44; megadont above 44. Racial types of these classes
are : Microdont, Europeans, Egyptians ; mesodont, Chinese,
American Indians ; megadont, Australian, Negroes. Due to
post mortem loss of teeth data for the dental index in the
Peruvian group are not extensive. Some 50% of males are
within the mesodont class; but 60% of females fall in the
megadont class. As a matter of fact the teeth of the Peruvians
are somewhat smaller than most American Indians and a
lower index is expected. I n many instances the maxillary
second molar is much smaller than the first, and the third is
very small or sometimes a mere vestige.
The fronto-occipital deformation of most skulls examined
has tended to displace the foramen magnum anteriorly, and
thus the basi-nasion length is shortened. Therefore, the ratio
of the dental length to the shortened basi-nasion length is
higher than in undeformed persons of the same stock. I n
females, most of whose heads are smaller than males, this
discrepancy is accentuated. Good examples of tooth size,
dental length, in this group are: no. 1965, a fine oblong skull,
a n intruder at Pachacamac, has a dental index of 42.1; no.
1953 has a dental index of 43.5.
The teeth probably have not been influenced in size by the
cranial deformation. Of all organs of the body the teeth are
most stable in size and morphology; these features of the
teeth are not readily affected by environmental factors
operating within the life of the individual. However, their
form is doubtless modified over a long period of time by function o r afunction. After referring to the ample palate and
large well-formed teeth of the black race and pre-historic
inhabitants of Europe, Duckworth remarks : “It is therefore
impossible to overlook the inference that reduction in the size
of the teeth is at least attendant (if not dependent) upon the
acquisition of higher grades of civilization and directly upon
diet and the preparation of food.”
Palate. There is a n architecture of the palate which is
peculiar to each race: form, size height, surface detail vary.
Sexually, the female arch is smaller, shallower and less severe
in outline curvature. Height of the vault and curvature form
are best conveyed by photographs o r projection drawings.
The palate of the coast people is fairly high and broad and
inclined to be rotund. The palate of the sierra people is
characterized by its shallowness-almost a flat plane, and
thus is in sharp contrast with the typal coast palate. This
is especially true of the palate of those with the Aymara
deformation. It is probable that vigorous functioning of the
nasal passages in breathing the rarefied atmosphere of the
sierra has flattened the floor of the nose, the roof of the palate.
I n mouth breathers, with little nasal functioning, the palate is
very high, the nasal passages small. The Peruvian palate is
rough ; grooves, foramina, sutures, margins, are prominent,
and the surface detail generally studded with sharply terminating projections. These rather primitive palate features
are characteristic of the brachycephalic coast stock. I n the
cases identified in the records on maxillary measurements,
an elliptic arch occurs in 45% of males, 65% of females;
hypsiloid occurs in 35% of males, 25 of females; strictly rotund
in about 8% of the group, a few are horseshoe-shaped, a
smaller number are parabolic.
The extreme fronto-occipital deformation practiced on the
Peruvian littoral has patently influenced palate form. I n
many instances a widening and asymmetry of the arch is
produced, which roughly conforms to the plagiocephaly.
No. 3165 is an example. The arch is bulged facially in the
region of the first molar on the side of the asymmetric flattening of the occiput. No. 2023 has the typical fronto-occipital
deformation resulting in asymmetry of the cranium, the right
side of the skull is shorter than the left. The nasal septum
is markedly deviated to the right, and the palate is shorter
and shallower on the right, the left side is longer and much
higher. The septum, deviated to the right, is accompanied
by a raising of the left palate. Considering the apparent influence of deformation on palate form, it is remarkable there
is no more frequent malocclusion of the teeth resultant (vide
infra, occlusion). My records indicate a correlation between
broad heads and broad palates; and this condition has been
accentuated by the f ronto-occipital flattening, which has produced further broadening of the cranium as well as palate.
Similarly, the longish head of the sierra people, in the
minority in the group studied, has a palate in conformation
with the head; however, the Aymara deformation had no
marked influence on palate form.
Torus palatinus is not present in this race. Neither remnants of the intermaxillary suture nor abberations to disturb
the conventional cruciform arrangement of the palatal sutures
are present.
On the posterior margin of the palatal process of the palate
bone is a sharp, thin, bevel-lip; it occurs more frequently at
the lateral angles of the palate border, and is longer in specimens in which it extends entirely across the distal end of the
palate. It averages about 4 mm. in depth. This bevel-lip
partially roofs the posterior palatine foramen.
The posterior nasal spine is characteristically broad and
rounded, varying from 5 to 9 mm. in width; and is, on the
average, 4 mm. in length, terminating in a convex or squarish
The hamulus pterygoideus is relatively coarse in this race ;
it measures about 2 mm. by 5 to 10 mm. in length.
The tuber maxillare in a majority of skulls is insignificant:
The distal alveolar investment of the third molar is not appreciably thicker than that of the buccal. However, there are
some exceptions, a range from a thin covering to an extension
of 8 mm. In this respect the dental arcade of the American
Indian as represented in this group is in contrast to that of
African and Melanesian Negroes and Australian aboriginals
in whose jaws the tuber maxillare extends far beyond the
third molar.
Occlusio~z. The mesio-distal relationship of mandible to
maxilla common to the species is constant in this group, only
one exception, class I1 (Angle) case occurring. Statements
to the effect that the norm of occlusion of American Indians is
an edge-to-edge relationship, without slight overlapping of the
superior incisors and the facial cusps of the posterior teeth,
are incorrect. In persons of middle age and beyond, an edgeto-edge relationship is resultant from age, function and particularly attrition due to foods containing abrasives (vide,
attrition); but this is not normal for young individuals.
There are evidences of changes in the tempora-mandibular
joint accompanying advanced attrition. This occlusion of
wears occurs more frequently in the dolichocephals of the
sierra who have a longish mandible than in the brachycephals
of the coast. The arch of the Peruvian is of ample size to accommodate a perfect arrangement of its units, and, except
where influenced by head deformation, is symmetrical in outline and efficient in function. Thompson made observations
on Peruvian jaws and notes on page 7 relative to the arch:
“The arch was full and normal and of beautiful outline in
nearly all that had full dentures.”
Malocclusion is infrequent, and, when present, involves
not more than one or two teeth, e.g., no. 3196 in which a premolar is rotated, due to prolonged retention of a deciduous
molar. In this group of 328 skulls there are thirty-two with
malocclusion, equally distributed between the sexes. Of these
occurrences, twenty-nine are class I (Angle) cases, one class
I1 case. This incidence of malocclusions is roundly lo%, and
is the same as occurs in North American stocks and including
the Eskimo. I had suspected a higher occurrence of malocclusion in Peru as a result of the almost universal practice
of head deformation in infancy. The deformation practiced
on the coast generally produced plagiocephaly. The skew of
the cranium has brought about a s p m e t r y of the dental
arches in many instances. But these are not true cases of
malocclusion as the units of each arch are in alignment, and
functional harmony exists between the arches.
Relative to the causative factors of malocclusion, the following was observed. I n three skulls supernumerary teeth
occur between the superior central incisors, causing crowding.
No. 3198 has a supernumerary incisiform element between the
central incisors ; it is in a n edgewise position and has forced
a facial rotation of the left central. HrdliEka has observed
this element infrequently in American Indians. One supernumerary occurred distal to the first maxillary premolar.
Infrequently unduly retained maxillary deciduous cuspids
produce malposition of their successors and neighbors. Some
deciduous roots are retained indefinitely. I n no. 3095 a malposed right mandibular second premolar produced afunction
of the whole right side of the denture.
There are two occurrences of impacted cuspids lying horizontally in the palate, and occurrences of impacted mandibular
third molars lying horizontally. There are mandibular third
molars unerupted or partially erupted lying a t all depths and
angles. I n no. 3041 the unerupted left molar presents its occlusal surface toward the sagittal plane ; the right is impacted
against the root of the second molar. No. 3031 has the left
third molar in a horizontal position, completely buried in the
bone with the occlusal surface discernible in the wall of the
empty alveolus of the second molar. There is usually incongruity of size between the mandibular and maxillary third
Not a few persons have a characteristic torsion of the
superior central incisors ; their mesial edges have been turned
lingually. The arches in these cases are not narrow, but it
would seem that this malplacement of the central incisors i s
resultant from unusually broad lateral incisors which crowd
the centrals toward the sagittal plane. The mesial margins
of the lateral incisors have assumed a position lingual to the
distal margins of the central incisors, tipping this edge
facially and the mesial margin lingually. However, torsion
occurs in some individuals with average size lateral incisors.
I have elsewhere described this characteristic malposition in
North American Indians and in the Eskimo. The incidence is
appreciable and constant throughout the two continents; it
may be posited an inherited racial character.
No diastema were observed in this group. I n some races a
space occurs distal to the mandibular cuspid which accommodates the interdigitation of the larger superior cuspid. It is
a simian character of phylogenetic significance.
Dental morphology. The enamel on the cervical one-third
to one-half of the facial surfaces of the cuspids and molars
particularly is roughly corrugated ; there are horizontal depressed lines or grooves alternating with rough elevations.
Vertical ridges frequently intersect horizontal markings.
The surface has a decided roughened or crenated appearance.
Some teeth are irregularly indented. A whitish ring a t the
enamel border is present.
Many and irregular are the developmental lines and ridges
on the occlusal surfaces of molars. The central and distolingual grooves of the maxillary molars are deep, but not
necessarily pitted or fissured at the bottom. The tips of the
cusps present a gnarled appearance with indented pits. The
same features prevail in unworn deciduous molars. The
general appearance is of creiiated or convoluted enamel ; some
anatomists would describe these features as simian or primitive. Occasionally the enamel is frankly hypoplastic, the
facial surfaces in these cases are nodular.
The cervical margin of the enamel of molars frequently
streams into the bifurcation of the roots terminating in an
acute V-shaped point. Infrequently a small enamel pearl
is nestled between the roots beyond the terminal point.
HrdliEka in his monograph “The Origin and Antiquity
of the American Indian” characterizes the teeth as follows:
“The teeth are from medium to above medium size when
compared with those of primitive man in general, but perceptibly larger when contrasted with those of the cultured
white h e r i c a n or European; the upper incisors of the Indian
present throughout the two continents, With infrequent in&vidual exceptions, an especially important feature : They are
on the inside, or lingually, characteristically shovel-shaped,
that is deeply and peculiarly concave, with a marked border
surrounding the concavity.” I n speaking of the type of man
in Asia which resembles the American Indian, Hrdli6ka says :
“The type is characterized, among other things, by similar
frequency of the hollowed-out upper front teeth.” As an
aid in using this feature with reference to racial affinity, Milo
Hellman has arranged a scale, with type photographs, of size
of the lingual marginal ridges. In the Peruvians the marginal
ridges of the superior incisors enclosing a triangular fossa,
are medium to marked on Hellman’s scale. There may or may
not be a cingulum on either central or lateral incisor. Not so
many superior incisors are in situ because of post mortem
The typal form of the superior lateral incisor is broad,
sometimes extremely so, with large well-rounded lingual
marginal ridges. Occasionally the cingulum is prominent.
I n a study of contemporary San Carlos Apache and Pima
Indians, HrdlZka observed such a prominent cingulum that
he described it as a ventral cusp, “which when more pronounced gives the tooth nearly the appearance of a bicuspid.’’
From the bottom of the lingual fossa I observed a deep pit
extending into the tooth; this pit in reality is a tube of
enamel, oval to circular in cross section, invaginated into and
completely surrounded by dentin. From this pit a bifurcation
line extends up the mesio-lingual aspect of the root to or near
the apex. These developmental markings are suggestive of
the specialized ‘fang’ of snakes, which is a hollow tube formed
by a curving development of what otherwise would be a simple
tooth. The Peruvian lateral incisor, as in modern white
races, not infrequently evidences decadency : It assumes a
blunted, formless or peg shape. Thus there are two extreme
forms of the superior lateral incisor : 1) Typal-broad, morphologically vigorous tooth, characteristic of the Indian
throughout the two continents of North and South America
(vide supra, occlusion-torsion) ; and 2) the rounded, formless, abortive type, indicative of involution.
The superior central incisor is rather broad with the characteristic prominent lingual marginal ridges which form a deep
triangular fossa.
Reduction of the dental formula
It is believed by some that the dental formula of man may
be changing from
I-2 C -1 Pm 2- M 3-to I -1 C -1 Pm 2- M 22
Duckworth (op.cit., p. 269) states that the numerical reduction
it met with so frequently that a definite trend in evolution is
suggested. I n man and especially in the white races, he
states, the teeth first to be suppressed are the third molars,
and there is a distinct tendency to the disappearance of the
lateral incisor teeth. As to actual disappearance of these
units, i.e., reduction in number of the series, I cannot agree.
It may be definitely stated that what has been considered true
suppression, i.e., agenesia, occurs very infrequently in any
race, extent or extant. C. J. Lyons has shown that more
searching and critical methods of diagnosis of apparently
missing teeth in the living, as now being applied in scientific
dental surgery, generally elicits evidence of these teeth having
been formed, but remaining in obscure position in the facial
bones, or having been destroyed or removed. Critical examination of the crania of primitive peoples discloses evidence
as to formation of all units of the series. Diminutive third
molars frequently are lost early in adult lift; occasionally a
superior cuspid is impacted and non-erupted. I have observed
diminutive third molars in process of exfoliation continuous
with eruption. There ensues a complete regeneration of bone
in their small alveoli with apparent negative evidence of the
NO. 2
teeth having been formed. Without extensive and intensive
observations of crania one is apt to invoke a diagnosis of noneruption o r suppression in case of teeth missing. Actual reduction of the formula has not yet taken place to the extent
Duckworth and others would imply ; but there is a decided reduction in size as well as occurrence of aberrant forms of
the teeth mentioned. There is also a decided reduction in
size and modification of form of both the maxillary and the
mandibular second molars in various races. Involution of
form and size of the mandibular second molar of Caucasians
especially is known.
Duckworth (op.cit., p. 250) further states: “ I n size, the
second upper tooth is the largest, next to this the first molar
tooth.” Patently this statement is not based on wide observation of many races. In the American Indian, in many white,
and other races, the norm of the maxillary second molar is
considerably smaller than the first. I n the Peruvians the
molar series diminishes rapidly and uniformly in size from
first to third ; this is precisely true of ancient Egyptians. The
second molar is often compressed-shortened
antero-posteriorly-assuming a trapezoidal to triangular form. The
Peruvian maxillary third molar is variable in form; frequently it is an abortive vestige : A compact peg of uncertain
morphology and measuring only 2 or 3 mm. at the cervix.
Thus the tendency to reduction in size of any of the dental
units is by no means limited to the white, formerly referred
to as the ‘higher’ races. I have elsewhere recorded the
marked reduction in size of the third molar in ancient
Cusps. I n primordial and in Negro races the maxillary
molars are quadricuspid, the mandibular quinquecuspid :
5-5-5. From this basic formula cusp morphology varies with
different races. I recorded the cusp pattern of all molar teeth
in the Peruvian collection. The possible number of molars
observable in the 328 crania carded was reduced through the
absence of not a few mandibles, ante and post mortem loss
of teeth, and advanced attrition of the occlusal surfaces. The
form of the maxillary first molar is stable and is the same for
most races In the Peruvian, and the American Indian generally, it has four cusps in 100% of persons. A superimposed
cusp on the lingual aspect of the mesio-lingual cusp of the
first molar, known as the tuberculus anomalus of Carabelli, is
a racial character of the ancient Egyptians, and occurs not
infrequently in some of the white races. This cusp does not
occur in America. I n the group studied the crown of all teeth
flare near the occlusal surface of incisal edge; and the
spreading is accompanied by more o r less torsion in the occlusal third particularly. These features, together with
others, impart a characteristic crude or primitive appearance.
The maxillary premolars are very small in the brachycephalic
coast people.
The maxillary second molar is smaller in size and less
stable in morphology than the first; it has a compressed,
trapezoidal form, with the hypocone degenerating. I n 70%
of the number observed it has four cusps; i n the other 30
it shows degeneracy from the primitive form of four, 15%
evidence a vestige of the hypocone, and 15% is devoid of the
disto-lingual cusp. The resultant tricuspid is triangular in
occlusal outline. Thus there is a marked tendency to trituberculism of the maxillary second molar.
The maxillary third molar is most degenerate in both form
and size of the molar series. The degenerate forms are not
always bilaterally symmetrical, e.g., no. 3029, the left is
minute, cylindrical, the right simulates a large maxillary premolar. I n this group the third molar i s degenerate beyond
the average in Caucasians. Involution is clearly evident in
the following stages : 1) Small quadricuspid forms, which occurs in only 15%; 2) condensed trapezoidal form, still exhibiting a vestige of the hypocone, disto-lingual cusp; 3) a n
unmistakable tricuspid form ; 4) a bicuspid tooth simulating
a large premolar; 5 ) a single cylindrical element of indeterminate morphology, which is often exfoliated early in
adult life. The mode, 4576, is the triangular, tricuspidate
pattern in which the hypocone is markedly degenerate or en-
tirely absent. In Andean crania, then, the maxillary third
molar is degenerate, but not absent.
Of the human molar series the mandibular first molar is
the most stable; it has five cusps in all races. The cusp
pattern of the mandibular second molar is worthy of special
note. Its morphology is considered a positive criterion of
racial relationship. In modern Caucasians this tooth has become stabalized with four cusps only, with a characteristic
crucial arrangement of the grooves. In primordial and in
Negro races it has five, similar to the other two molars. The
Peruvians second mandibular molar simulates the first in occlusal outline; it is quite as large and possesses the B t h
tubercle in 63% of skulls; of this number 11%possess only
a well-marked vestige of the B t h cusp; 37% of the second
molars have only four cusps. The Peruvian mandibular
second molar is, then, in a transitional stage from five to
four cusps. The fifth cusp of the second, as of the first, is a
small element intercalated posteriorly and somewhat buccally ;
it is an element in a transitory state, sometimes well defined,
more often vestigial, frequently divided. Not infrequently
on both second and third molars is a small middle buccal
The mandibular third molar is transitional also, only 51%
have five cusps, 49% have four. But its involution in relative
size and cusp morphology is not so marked as that of the
maxillary third molar. It usually is comparable in size to
those anterior to it, and concomitantly is not infrequently impacted, and partially o r wholly unerupted. But aberration
of form is the rule, infrequently some are diminutive in size.
The Peruvian mandibular third molar occasionally distressed
the individual with pathological eruption, as it is wont to do
more often in the Caucasian and the Japanese. Table 1gives
the complete data for molar cusps. It is evident the Peruvian
cusp formula tends to be: 4-4-3
Cusps on molars
Bifid roots. Duckworth (p. 265) observes: “In the Simiidae the upper premolar teeth have three roots, thus resembling the upper molar teeth in those animals and in the
Hominidae. The occurrence of three-rooted upper premolar
teeth in the Hominidae is by no means unknown.” It has
been my observation that this form of maxillary premolar
occurs much more frequently than has been recorded. I
have elsewhere described its occurrence in the Eskimo, Sioux
and the ancient people of Guam. I have observed completely
divergent three-rooted premolar teeth in old Hawaiians. I n
these races, where the roots are not distinctly divergent, there
is a deep, well-defined bifid groove throughout the length of
the broad-faced buccal root, and the latter is divergent or bifid
from a lingual root. This morphology in these races is of
almost constant occurrence. It is not infrequent in aboriginal California and in the ancient Peruvians under discussion. I n modern white people evidence of this form of
premolar is by no means lacking.
The maxillary first premolar usually presents a broad
flattened facial aspect from the cervix, and throughout its
length is a distinct indented bifurcation line; and, of course,
there is the usual indicated or actual division of the whole
root into lingual and facial moieties. This root in the
Peruvians is not as large nor the demarcations so distinct
as in the Eskimo and Sioux, which is in consonance with the
smaller and more delicate osseous structure generally of the
Peruvians. Thus the maxillary first premolar is reminiscent
of a molar form: I t s phylogeny is suggested in its decadent
tri-radial form. The maxillary second premolar has usually
a narrow rounded facial aspect; the root is compact and
tapered with no bifurcation lines. A n exception is no. 2989;
it has two facial roots which are fused; the first premolar
has a distinct bifurcation line the extent of the facial aspect.
This exception to the type form of the second premolar
is an instance of reversion to the primitive or anthropoid form.
The mandibular first premolar usually has a distinct bifurcation line on the facial aspect, while the apical third to
one-half of the lingual surface only is actually bifurcated,
thus forming a characteristic U-shaped opening in the apical
third. This lingual surface opening simulates an incomplete
root canal and apical foramen, but is to be distinguished
therefrom. The facial aspect of the second premolar is
similarly flat with a bifurcation line less distinct, while its
lingual contour is narrow and smoothly rounded mesiodistally.
Dental attrition is the gradual wearing away of the hard
parts of the teeth through the physical and physiological
agencies of mastication of food. Dental attrition in Peru
is not nearly so extreme as with several North American
stocks I have studied. Wear began quite early in life, but
destruction was moderate, first and second degree of my classification; but there were not s o many instances of third and
fourth degree wear. Fourth degree involves the pulp with
pernicious sequelae consequent. This moderate wear in Peru
is probably attributable not so much to differences in food
from other areas but to differences in preparation. Neither
the mortar and pestile nor metate were much used in Peru;
nor was gruel made of maize meal by means of boiling with
hot stones ; hence much less abrasives were admixed with the
food. Whole kernals of parched maize were freely eaten;
this was the main staple of the masses.
Attrition was not increased by the coca-lime chewing habit,
as the dried leaves of the coca plant, sprinkled with lime,
were held as a quid in the oral vestibule for considerable
periods of time, rather than chewed (vide supra coca chewing).
On the coast, attrition seems to have been more extensive
at Inca. The teeth of the people of the sierra were worn more
than those of the coast people. Attrition is evident in deciduous teeth at 6 years of age. The first permanent molar, which
erupts at 6 years of age, was affected to a much greater extent than any other one of the series. However, in the age
group beyond 40, there are occurrences of pulp exposure in
all of the maxillary teeth. Attrition is always more extensive
in maxillary than mandibular teeth; but in this group many
mandibles were missing.
There is a protective reaction on the part of the pulp which
tends to prevent its exposure. This consists of consolidation
of the primary dentine and the formation of secondary
dentine around its periphery, at the expense of its size. But
the rate of centripetal wear often overtakes the centrifugal
Dental caries. HrdliEka (’14,p. 62) found caries of the
teeth ‘decidedly infrequent’ in some 278 crania examined in
the Chicama valley. But at Lomas, a port 280 miles south
of Lima, he notes (p. 2 6 ) : “Dental caries, curiously, was
rather common in this locality.”
I n this California group of 329 skulls, carefully examined,
carded individually, approximately 35 % have one or more
carious lesions in the teeth in situ. Only four individuals
under 25 years of age at decease had carious teeth. There
were more than twice as many persons with carious teeth in
the age group beyond 40 as in the group 20 to 40 at decease.
Increasing frequency of occurrence is distinctly concomitant
with advancing age. I n contrast with susceptible modern
white youth, ancient Peruvian youth were non-susceptible.
Caries is a discretely localized pathological destruction of
the hard parts of teeth. Factors influencing its localization
are function, character of food, peculiarities of surface areas
permitting initial nidi. Few anterior teeth in this group were
attacked by caries. Many more lesions occurred in maxillary
than in mandibular teeth. The maxillary first molar was
affectedmost frequently, followed in turn by the second molar,
second premolar and third molar. The carious process had
its beginning in two characteristic locations : 1) In formative
defects of the enamel at the bottom of fossae and grooves,
breaks in continuity in the form of pits or fissures respectively,
on the occlusal and facial surfaces of molars and, rarely,
premolars. Occasionally the enamel of the whole occlusal
surfaces of second and third molars is frankly hypoplastic
on which caries is superimposed. 2 ) On cervical areas, more
frequently proximal, just beyond the enamel margin, in the
more vulnerable dentin or cementum. Caries beginning in
this locus extended both occlusally and horizontally, destroying enamel and involving the pulp, with the attendant
pernicious series of sequelae. Caries at the cervix was abetted
by food impaction induced by destruction of proximal contact by advanced attrition, as also through atrophy of the
gingivae in the aged, hence occurrence increased with age.
As the maxillary first molar is shortened to a greater extent
by attrition than other teeth, it and its neighbor on either side
were affected by caries to a grea.ter extent than other teeth.
The exposed dentin at the cervix in persons of middle age
and older is much mors susceptible than the enamel of youth
and young adults. This predominating locus of caries in Peru
is characteristic of primitive peoples. Its occurrence in
primordial races of southern Europe has been described by
Broca and other French anthropologists, designated caries
du collet. Some 60% of individuals with carious teeth had
periapical osseous lesions consequent thereto, many of which
lesions had extended into the maxillary sinuses (q.v.) .
This study is in agreement with Stewart’s observations of
caries in Peruvian skulls in major aspects: 1) Youth and
young adults are relatively free of caries; 2) in middle and
old age, the incidence increases directly with age ; 3 ) the locus
is predominantly approximo-cervical ; 4) the anterior teeth
are practically free of caries.
Periapical osteitis. Osseous lesions surrounding the root
apices of teeth are resultant from infection, the primary atria
of which are in the crowns of the teeth involved. Exposure
and infection of the dental pulp in living races is brought
about through the ravages of caries, occasionally by traumatic
injury and paradental infection. Generally speaking, with
primitive peoples pulp exposure is usually caused by attrition,
not infrequently by trauma, and, in some races, t o a considerable extent by caries, I n Peru all three primary causes
were operative. Caries resulted in as many osseous lesions
as the other two causes combined. Often it is difficult to
distinguish the primary cause; and the cause of the loss of
teeth entirely is frequently not determinable.
Typical periapical lesions resultant from fourth degree attrtion are in nos. 3189, 3194, 3195. The osseous lesions vary
in size from a few millimeters to 12 mm. in diameter. There
is most always an aperture through either the facial or
palatal bone, which marks the site of a fistula, and through
which the denuded root end is exposed. In life the cavity is
filled with a granulomatous proliferation of the dento-alveolo
Radicular cyst is a variant of the periapical lesion.
Epithelial elements from embryonal rests in the periodontal
membrane, or epithelial cells which may have migrated
through a fistulous tract, proliferate, degenerate, liquefy and
cause pressure atrophy of the surround bone. The wall of
the cavity is smooth, the covering parchment-like. No. 3006
has a radicular cyst surrounding the apex of the left cuspid.
No. 1889 has a cyst 8 mm. in diameter above left incisors
which domes the floor of nose ; attrition was the primary cause.
Mazillary sinusitis chronic. I n many instances the pathological process surrounding tooth roots by direct extension
penetrates the floor of the maxillary sinus with suppurative
sinusitis ensuing. Old fistulae leading from the maxillary
sinus, in the region of the first molar more frequently, are
plainly in view; and doubtless others not plainly evident exist.
In the age group of 40 years and older, about 10% had fistulae
draining maxillary antra.
No. 3030 is a typical instance of involvement of the maxillary sinus by extension from periapical osteitis consequent
upon pulp infection and petrefaction; which, in turn, is usually resultant from attrition, caries, or trauma. I n the
previous site of the right first molar is an old aperture with
smooth margin, evidencing continuous healing, 9 mm. in
diameter, through the floor of the sinus. This fistula is evidence of chronic sinusitis which the person bore f o r many
No. 3008 has a well-rounded fistula with sclerosced margin,
4 111111. in diameter, leading from the left maxillary sinus in the
location of the first molar, which had been lost several years
previously. KO.3185 has an antral fistula 5 mm. in diameter
in the site of the left first molar. The primary cause was
pulp exposure through attrition, followed by periapical infection which extended through the floor of the antrum.
E f e c t s of coca-lime chewing on the teeth. Thompson, page
16, speaks of the coca leaf being chewed with a substance
called llute, made of potato, calcined shells and askes of cacti,
or other plants rich in alkali. Accretions on the teeth occur
which are colored brown or green; the pigment probably
comes from the coca leaves. I observed instances in which the
teeth were stained a dark green or sometimes blue; this is
resultant from oxidation of a copper disk laid on the tongue
a t burial. Tschudi, a South American authority, says “That
all who masticate coca have pale lips and gums and greenish
teeth. ”
Lime accretions on the facial surface of the molars particularly were increased in size over that from salivary
sources only. Not infrequntly skulls are seen wherein the
teeth on one side evidence afunction, without any apparent
pathological cause, other than large accretions of lime on the
facial as well as the occlusal surfaces. Of course these deposits would continue as a result as well as a cause of afunction. Entrenched habit of the addict is here evident. Accretions and afunction result in degeneration of the investing and
supporting tissues of the teeth ; and such conditions stress the
importance of untoward proximate causes of periodontoclasia.
Skulls with heavy lime deposits on their teeth are: nos.
2958,3029,1906,1903,1936. There was a characteristic brown
to greenish stain on nos. 3031, 2939, 3077, et al. However, it
is certain that only a relative small number have unduly
large accretions on their teeth; this may be true because
of less coca chewing on the coast than in the sierra, as most
of the skulls were of coast stock.
Peridont oclasia
Periodontoclasia is chronic, destructive, degeneration of
the investing tissues of teeth which eventuates in exfoliation.
Alveoloclasia is the breaking down of the osseous support,
which is plainly observable in skeletal material. There is,
however, a gradual physiological recession of the alveolar
crest from childhood to senility. This physiological change
in height of the alveolus represents in part a continued eruption of the teeth, which is compensatory f o r their shortening by
attrition and functional changes in position. I n a child of 7
the distance at the mesiofacial angle of the maxillary first
molar is 0 ; at 16 about 0.5 mm.; at 30 years of age 1.5 mm.
In older persons in which the condition of the alveolar support
appears stable, I observed the following measurements : At
age 45, 2.5 mm. ; age 55, 3 mm. ; age 60, 4 mm. This physiological increase in distance from crest to enamel with advancing age is to be distinguished from rampant pathological
loss of support, including resorption of the cortical plates and
interseptal cancellous bone which permits mobility and
eventually exfoliation of the involved teeth.
Alveolar crest resorption is accelerated by active bone
lesions already present in the region: First molars with periapical lesions, secondary to pulp exposure, are the most
frequent in this group to lose their entire alveolar support, as
destruction extends from the crest and fuses with the existing
periapical lesion. Osteoclastic activity at the apex, resultant
from infection atria through the apical foramina, stimulates
resorption at the cervical border of the alveolus.
Resorption about the mandibular third molar is often produced by active osteoclasis incident to eruption and furthered
by low grade chronic inflammation of the surrounding redundant soft tissue. Lessened function at the ends of the
arches decreases stimulation and circulation of the alveolar
support in these regions which in consequence tends to
atrophy of the transient alveolar process. Also, the last tooth
in the arch, particularly the maxillary, has no wedging structure on its posterior, which appears to further earlier loss
of its osseous support. All of these causative factors, and
probably others, hasten periodontoclasia of the third molars.
I n the Peruvians, as in other primitive peoples, the teeth
in the order of frequency of involvement by alveoloclasia are:
First, third and second molars, and second premolar. Involvement of other teeth of the series is insignificant. Definite, proximate, etiological factors are : 1 ) destruction of
interproximal contact by attrition, sometimes caries, which
induces food impaction, followed in course by inflammation,
infection and osseous resorption; 2 ) pulp exposure with resultant periapical lesion which stimulates osteoclastic activity
in the alveolus of the involved tooth and frequently in the
alveoli of its neighbors ; 3) calcareous accretions, augmented
by the coca-lime chewing habit; 4 ) chronic inflammatory
processes or afunctional atrophy of the support of the third
molars o r other teeth. The incidence of frequency of involvment of the molars is thus explicable.
Only a dozen persons under 40 years of age at decease had
alveolar degeneration, and then only about one or more of the
molars, with the proximate cause evident. The majority of
persons older than 45 had well-preserved dental alveoli,
evidenced by lack of undue mobility of teeth and a relatively
short distance between crest and enamel margin, with the
exceptions noted. No. 1955, male, age 55, is typical of periodontoclasia. No. 1910 exemplifies alveoloclasia secondary to
accretions. No. 3210 has osteoporosis of the alveolar crest.
Extensive and intensive examination of crania impresses an
observer with the importance of dental physiology in the
preservation of the dentition to old age. Causes of both
periodontoclasia and caries are so obvious and proximate.
Carbohydrate food retention on undisturbed surfaces is the
alpha of all causes of dental caries; intimate, constant, undisturbed contact are the requisites. With the American
Indian, as is true of predynastic Egypt, untoward attrition
of teeth is a predisposing cause of both caries and periodontoclasia, as well as direct cause of its own train of periapical sequelae. The architecture of the dental mechanism,
the interplay and dependence of the units in each arch, the
mutual influences imposed by the two arches, the chemical
and physical character of the food ingested, narcotics,
hygiene, are dental physiological items requiring analysis.
More remote factors influencing the dentition are exceptional
and insignificant.
Exfolktion and senility
The dentition is a transitory organ not designed to be
taken to the grave by the senile. In the life cycle of the individual the alveolar process is built up and resorbed in due
course twice-once for each dentition. As old age approaches
the teeth are subjected not only to the cumulative effects of
pernicious influences detailed above, but their supporting
structures are then subjected to the generalized physiological
state of calcium resorption, evidenced in the cranium by
thinning of the vault, a salient phase of the involution of
Persons younger than about 35 at decease had lost no teeth.
In the age group from 35 to 45, a few third, second and first
molars, were lost, most frequently by the interrelated causal
factors of attrition, caries and alveolar degeneration. In
any race, a few teeth are lost through trauma. In the age
group older than 45, the teeth lost, in the order of their frequency, were: maxillary third, first and second molars;
mandibular third, second, and first molars. The series of
mandibles were smaller than the maxillae, but the above trend
is evident. In a group of 300, fewer than a dozen were
edentulous o r nearly so. Of the anterior teeth the superior
central incisors were lost most frequently.
Dental interference
In the California Peruvian collection there is no evidence of
any surgical or restorative dentistry having been attempted.
The slightest interference would have been beneficial to many
individuals ; namely, elimination of abscessed deciduous teeth
which seriously interferred with the normal eruption of
permanent teeth; knocking out of malposed teeth which detracted from appearance and function, removing carious roots.
A distinct aversion to surgical dental treatment is obvious;
and this is in contrast with the extensive practice of radical
cranial trephining.
Toothache undoubtedly was both accidentally and purposively relieved by the narcotic effect of coca (vide supra, coca
chewing). There were also other dental therapeutic measures.
Means, page 4.45, describes a method of cauterization of the
gums. “Ractania, a sort of geranium, was a plant whose
roots were charred and, while still very hot packed around
the teeth and left there until cool. This was painful, but it
was a treatment often resorted to by people suffering from
bad gums, for it burned away the diseased flesh and allowed
new, healthy flesh to come in its stead.’’
In considering their materia medica in general Means says
their medicaments were simple herbs. They practiced purging and bleeding. Cuca, coca, was the most highly prized by
them of all the plants; it relieved them of much anguish.
Trephining was brought to a high state of perfection; and
was probably a heroic panacea for many ills. Trephining was
practiced more frequently in the Collao where it evidently
Ethnic deformation of the teeth. There is no evidence in
the skeletal or cultural remains of ethnic dental mutilation
or adornment of teeth with stones or metallic inlays in Peru
as was practiced by tribes of the north Andean-Pacific area,
who, like the Inca, were skilled in metallurgy. This negative
evidence of dental adornment in the University of California
collection is in conformity with the wide observations of
M. H. Saville, the eminent South American archaeologist. In
his article on Pre-Columbian Decoration of the Teeth in
Ecuador he says: “We have never heard of this custom in
Columbia or Peru, but in Esmeraldas, in Atacames (Ecuador),
skulls have been found with tiny discs of gold set into the
teeth in the same manner as in Mexico and Central America,
with the exception of the material. To our knowledge, among
the thousands of mummies and skulls from Peru, inlaid or
filed teeth have never been found . . . .” More recently,
Doctor HrdliEka, who in 1910 collected and examined 3400
skulls in Peru, and in 1913 examined some 4800 more, states
on page 52 of his report, after speaking of the ethnic practice
of fronto-occipital head deformation : “They practiced no
filing, cutting o r chipping of the teeth, and no other mutilation which would leave marks on the skeleton.”
Morturary paint was used plentifully on many of the
mummies examined ; a heavy vermillion pigment was not only
smeared on the face but extended to the facial and lingual
surfaces of the teeth. No. 2061 typifies the practice. This
mummy was the possessor of an attractive gold bracelet-an
example of Peruvian metallurgy.
W. L. H. 1915 Morphology and Anthropology. Cambridge.
HOLMES,W. H. 1919 Handbook of Aboriginal American Antiquities. Part. I.
Bull. 60, Bur. Am. Ethnol.
HRDLIEKA,ALES 1914 Anthropological work in Peru in 1913, with notes on
pathology of the ancient Peruvians. Smithsonian Misc. Coll., 61 :1-69.
1920 Anthropometry. Philadelphia.
JOYCE, T. A. 1912 South American Archaeology. London.
A. L. 1930 Archaeological Explorations in Peru. Field Museum of
Natural History publ., 11, 2.
A. L. AND W. D. STRONO 1924 The Uhle Pottery Collection from Inca.
Univ. Cal. Publ. in Am, Arch. and Ethnol., Berkeley, XXI, 3.
LFJQH,R. W. 1925 Dental pathology of the Eskimo. Dental Cosmos, LXVII,
1925 Dental pathology of Indian tribes. Am. J. Phys. Anthrop.,
VIII, 179-199.
1928 Dental pathology of aboriginal California. Univ. Cal. Publ.
in Am. Arch. and Ethnol., Berkeley, XXIII, 10, 399440.
1929 Dental morphology and pathology of prehistoric Guam. Mem.
Bishop Mns., Honolulu, XI.
A. 1931 Ancient Civilizations of the Andes. New Pork.
E. 1921 Copper and bronze ages in South America, Giiteborg.
W. H. 1847 Hietory of the Conquest of Peru. New Pork.
M. H. 1913 Pre-Columbia Deeoration of the Teeth in Ecuador. Am.
Anthrop. n. s., XV, 3.
T. D. 1931 Dental caries in Peruvian skulls. Am. J. Phys. Anthrop.,
X V , 315-326.
A. H. 1903 Ethnographic odontology; the Inca Peruvians. Dental
Digest, January.
Uam, MAX 1903 Pachaeamac. Philadelphia.
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