Scalping - Medical Treatment

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. . . Despite the fact that scalping had been practiced for centuries and some victims lived through their ordeal, the literature of the period is mostly silent on the techniques for treating the wound.  Samuel Sharpe’s 1769 Treatise on the Operations of Surgery does not mention any scalping treatments.[1]  Likewise, John Jones’ Plain Concise Practical Remarks on the Treatment of Wounds and Fractures written in 1776 for the Patriot surgeon facing battle casualties ignores the possibility of a live scalping victim.[2]

. . . If the scalped head was left untreated the exposed bone would eventually become necrotic and separate from the healthy bone or it could cause osteomyelitis, an inflammation of the bone and marrow.  Either of these conditions would be fatal.[7]  In 1769 James Robertson saw a young South Carolinian who had been scalped in 1761.  The exposed bone of his skull was “perfectly bare, dry, and black.”  Robertson believed the man could have been successfully treated even after eight years.  However, the man was not treated and died less than a year later.  The bare bone of his skull had become necrotic and separated exposing the man’s brain.

James Robertson was a pioneer not a medical doctor. He founded the city of Nashville and is known as the “father of Tennessee.”  He learned the procedure to treat scalping victims from one Dr. Patrick Vance.  James Robertson’s son, Felix, was a medical doctor and recorded his father’s experiences and treatments in Remarks on the Management of a Scalped-Head, published in 1806.[8]

Robertson’s first experience with treating a scalping victim was in 1777.  The patient was scalped so “nearly the whole of his head skinned.”  Dr. Vance was treating the man but could not remain for a prolonged period of time so instructed Robertson in the art of skull boring.  Vance demonstrated how to bore holes as the skull became black.  Robertson described the method, “I have found that a flat pointed straight awl is the best instrument to bore with, as the skull is thick, and somewhat difficult to penetrate.  When the awl is nearly through, this instrument should be borne more lightly upon.  The time to quit boring is when a reddish fluid appears on the point of the awl.  I bore, at first, about one inch apart, and, as the flesh appears to rise in those holes, I bore a number more between the first.”[9]  Besides boring holes in the skull the wound had to be cleaned and dressed at least once a day to prevent infection.  The patient recovered from the scalping.

Apparently, the success rate for this treatment was very good.  The scalped head, according to Robertson, “cures very slowly” and the average recovery period was two years.  Remarkably, Robertson reported that hair would even grow back, although not as thickly, on the new scalp.  The patient would regain feeling once the new skin grew sufficiently to attach to the edge of the uninjured part of the original flesh remaining on the skull.

This method of boring, or pegging, used during the colonial period continues to be practiced today.