Anthropologists have uncovered an astonishingly early case of surgical treatment on the island of Borneo: a young patient had his left foot and part of his lower leg removed about 31,000 years ago, according to a study of a skeletal find. The amputation was apparently carried out in an amazingly professional manner and was associated with subsequent care: the individual lived on for years to come. According to the scientists, the findings thus suggest that some Paleolithic hunter-gatherers already possessed complex medical knowledge.
When we are sick or injured, we usually get help quickly: medical care is one of the foundations of our society today. As is well known, it has a tradition that goes back a long way. Beyond historical times, studies of human remains sometimes provide clues to early medical practices. The oldest known case of a targeted amputation was a finding on an approximately 7,000-year-old skeleton of a Neolithic farmer from France. Apparently, his left forearm had been successfully removed, as evidenced by traces of subsequent healing. According to this, the early sedentary people already had appropriately effective medical procedures and knowledge to master the considerable challenges of an amputation. But as the current study shows, some hunters and gatherers were apparently able to do this much earlier.
An amputation patient emerges
The focus is on the Indonesian island of Borneo. For several years, researchers have been conducting excavations and investigations in caves where prehistoric people once lived. Among other things, artistic traces on the walls bear witness to them, which have been dated to be up to 40,000 years old. As the scientists around Tim Maloney from the Australian Griffith University report, they came across a human skeleton in the course of their investigations in the Liang Tebo cave. According to the characteristics, he was about 19-20 years old at the time of his death. The sex cannot be determined exactly, but the size could have been a young man.
According to the accompanying finds, the individual with the designation TB1 was deliberately buried in the cave. Dating showed that this happened around 31,000 years ago. It is the oldest known grave in Borneo, the researchers write. But the find has an even more exciting aspect: TB1 did not have a left foot. Apparently it had been removed from the individual along with part of the lower leg. A closer examination of the bone structures showed that this had been done with a sharp object. According to the scientists, an accident or an animal attack therefore seems unlikely, since bruises are usually recognizable. They therefore assume that the foot was deliberately amputated.
In addition, signs of healing are clearly recognizable: TB1 probably lived on for six to nine years after the loss of the foot, the findings show. At the time of the amputation, the individual was probably still a child, further evidence suggests. In combination with the apparently careful care and the later burial of the person concerned, a form of punishment as a cause of the mutilation therefore seems rather unlikely. Apparently, the young patient's foot had been surgically removed in the course of a life-threatening injury or inflammation, the scientists conclude.
Amazing knowledge and skills
As they point out, it required considerable medical knowledge and technical skill. At first it must have been clear that the removal of the foot was necessary for survival. "Whoever then performed the amputation must have had a detailed knowledge of the anatomy of the limbs and the muscular and vascular systems to prevent fatal blood loss and infection," the researchers write. According to them, it is obvious that medicinally effective natural substances were used. It also seems clear that the patient had to be cared for and looked after extensively during the recovery.
It is now becoming apparent that effective medical practices were not only able to develop as people settled down. However, it remains unclear to what extent such skills could actually have been widespread among humans 31,000 years ago. The scientists say that it may also be a special feature of the inhabitants of the tropical region: "It seems possible that the colonization of the rainforests of Borneo triggered or facilitated early advances in medical technology that were only possible in this region. For example, the rapid spread of wound infections in the tropics may have stimulated the development of new substance applications, with people taking advantage of the medicinal effects of Borneo's rich plant diversity," the scientists conclude.