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While much is known about the rise and expansion of the Inca Empire (AD 1438–1532) throughout the Andean region of South America, the health effects of the empire in its capital region remain unclear. The present study addresses the Inca Empire's impact on health in the Cuzco region of Peru through an analysis of four conditions (dental enamel hypoplasias, cribra orbitalia, porotic hyperostosis and periosteal lesions) in 929 pre-Inca and Inca burials. The study results show little change in health from the Late Intermediate Period (AD 1000–1438) to the Inca Imperial Period (AD 1438–1532). When the location of the Inca burial sites was analysed, individuals from sites closest to the centre of the empire's capital showed lower frequencies in pathological conditions compared with individuals from sites in the countryside. These results suggest that individuals centred in the Inca imperial sphere benefited from their position and experienced better health. A similar finding was also seen with the previous Wari occupation of Cuzco in the Middle Horizon (AD 600–1000), as burials within the Wari imperial sphere exhibited fewer non-specific stress indicators than those outside of it. Overall, the frequencies of pathological conditions in the Cuzco region, which ranged from 4.6% for porotic hyperostosis to 18.8% for periosteal lesions, were lower than frequencies from many coastal Peruvian sites. These differences may relate to a diverse diet provided by the Cuzco region ecosystem, as well as the absence of ecological challenges that affected coastal populations. © 2021 John Wiley & Sons, Ltd.

This article addresses the bioarchaeological evidence for Inca warfare through an analysis of 454 adult skeletons from 11 sites in the Inca capital region of Cuzco, Peru. These 11 sites span almost 1000 years (AD 600-1532), which allows for a comparison of the evidence for warfare before the Inca came to power (Middle Horizon AD 600-1000), during the time of Inca ascendency in the Late Intermediate Period (AD 1000-1400), and after the Inca came to power and expanded throughout the Cuzco region and beyond (Inca Imperial Period, AD 1400-1532). The results indicate that 100 of 454 adults (22.0%) showed evidence of cranial trauma. Of these, 23 individuals had major cranial injuries suggestive of warfare, consisting of large, complete, and/or perimortem fractures. There was scant evidence for major injuries during the Middle Horizon (2.8%, 1/36) and Late Intermediate Period (2.5%, 5/199), suggesting that warfare was not prevalent in the Cuzco region before and during the Inca rise to power. Only in the Inca Imperial Period was there a significant rise in major injuries suggestive of warfare (7.8%, 17/219). Despite the significant increase in Inca times, the evidence for major cranial injuries was only sporadically distributed at Cuzco periphery sites and was entirely absent at Cuzco core sites. These findings suggest that while the Inca used warfare as a mechanism for expansion in the Cuzco region, it was only one part of a complex expansion strategy that included economic, political, and ideological means to gain and maintain control. Copyright © 2011 Wiley-Liss, Inc.

In this study, patterns of prehistoric trepanation in the southern highlands of Peru were examined through an analysis of 11 Cuzco-region burial sites. Trepanations were found in 66 individuals, with several individuals exhibiting more than one trepanation, for a total of 109 perforations observed. The predominant methods used were circular cutting and scraping-methods that proved highly successful with an overall 83% survival rate and little ensuing infection. Survival rates showed a significant increase over time, apparently reflecting improvements in trepanation technique through experimentation and practical experience. Practitioners avoided certain areas of the cranium and employed methods that reduced the likelihood of damage to the cerebral meninges and venous sinuses. In many cases, trepanation as a medical treatment appears to have been prompted by cranial trauma, a finding that corroborates other studies pointing to cranial trauma as a primary motivation for the surgical procedure.

The expansion of states and empires often has important consequences for local populations, including increased violence, greater stress, or dietary modifications resulting in changing health conditions. This paper presents the analysis of 73 skeletons from the Cusco site of Ak’awillay, shedding light on diet, health, and violence in the Middle Horizon. Results indicate that the people of Ak’awillay led a rigorous lifestyle and suffered from more nutritional deficiencies compared to previous populations, possibly pointing to increased maize consumption. However, the low incidence of trauma at Ak’awillay and other Cusco sites suggest that the Wari presence in Cusco was not entrenched in violence.

We document evidence for trophy-taking and dismemberment with a new bioarchaeological database featuring 13,453 individuals from prehistoric central California sites. Our study reveals 76 individuals with perimortem removal of body parts consistent with trophy-taking or dismemberment; nine of these individuals display multiple types of trophy-taking and dismemberment for a total of 87 cases. Cases span almost 5,000 years, from the Early Period (3000-500 BC) to the Late Period (AD 900-1700). Collectively, these individuals share traits that distinguish them from the rest of the population: a high frequency of young adult males, an increased frequency of associated trauma, and a tendency towards multiple burials and haphazard burial positions. Eight examples of human bone artifacts were also found that appear related to trophy-taking. These characteristics suggest that trophy-taking and dismemberment were an important part of the warfare practices of central Californian tribes. Temporally, the two practices soared in the Early/Middle Transition Period (500-200 BC), which may have reflected a more complex sociopolitical system that encouraged the use of trophies for status acquisition, as well as the migration of outside groups that resulted in intensified conflict. Overall, trophy-taking and dismemberment appear to have been the product of the social geography of prehistoric central California, where culturally differentiated tribes lived in close proximity to their enemies.

Porosities in the outer table of the cranial vault (porotic hyperostosis) and orbital roof (cribra orbitalia) are among the most frequent pathological lesions seen in ancient human skeletal collections. Since the 1950s, chronic iron-deficiency anemia has been widely accepted as the probable cause of both conditions. Based on this proposed etiology, bioarchaeologists use the prevalence of these conditions to infer living conditions conducive to dietary iron deficiency, iron malabsorption, and iron loss from both diarrheal disease and intestinal parasites in earlier human populations. This iron-deficiency-anemia hypothesis is inconsistent with recent hematological research that shows iron deficiency per se cannot sustain the massive red blood cell production that causes the marrow expansion responsible for these lesions. Several lines of evidence suggest that the accelerated loss and compensatory overproduction of red blood cells seen in hemolytic and megaloblastic anemias is the most likely proximate cause of porotic hyperostosis. Although cranial vault and orbital roof porosities are sometimes conflated under the term porotic hyperostosis, paleopathological and clinical evidence suggests they often have different etiologies. Reconsidering the etiology of these skeletal conditions has important implications for current interpretations of malnutrition and infectious disease in earlier human populations. Am J Phys Anthropol 139:109-125, 2009. (C) 2009 Wiley-Liss, Inc.

Human sacrifice in the Inca Empire at times took the form of the capacocha, a sacrificial rite involving the most beautiful children in the empire. In this study, we investigate a possible capacocha at the pre-Columbian site of Choquepukio in the Cuzco Valley of Peru. During excavations at Choquepukio in 2004, seven children (aged 3-12 years) were discovered buried together; accompanying them was an elaborate assemblage of high status artifacts similar to those from other recent archaeological finds that are believed to be capacocha sacrifices. Since colonial documents indicate that capacocha children were selected from diverse regions of the empire, we initiated a radiogenic strontium isotope analysis to determine the origins of the children found at Choquepukio. Our analysis showed that, indeed, two children in the assemblage had non-local origins. When considered together, the osteological, archaeological, and isotopic evidence suggest that a capacocha event occurred at Choquepukio, representing the only lower-elevation capacocha to have been found in the Cuzco region. (C) 2010 Elsevier Ltd. All rights reserved.