In the dense Bornean rainforests, 31,000 years ago, a stone tool struck a bone, causing the amputation of a limb but sparing a young child’s life. Before developing modern surgical instruments, antibiotics, or painkillers for tens of thousands of years, researchers discovered evidence for the first known surgical amputation.
According to Charlotte Roberts, a bio-archaeologist at Durham University who was not involved in the research but is knowledgeable about the technique because she previously worked as a nurse, the findings highlight the early hunter-gatherers’ medical knowledge and compassion. “We have no reason to mistrust their sophistication.”
The discovery dates back to early 2020, when scientists from Australia and Indonesia dug the Liang Tebo cave’s floor in a remote, heavily forested area of eastern Borneo. Team member Andika Arief Drajat Priyatno, an East Kalimantan Cultural Heritage Preservation Center archaeologist, said, “There are no villages, no telephone signal, and no electricity.”
Other researchers had already examined the cave and found zig-zag decals and red-outlined hand stencils adorning its limestone walls and roof. Those paintings haven’t been dated yet, but rock art portraying figures such as wild cattle and other creatures from nearby caves in the region is at least 40,000 years old. Thus, the world’s first known figurative artists were the hunter-gatherers who inhabited this region.
A stunningly complete human skeleton was found lying down in a kneeling position with stones placed over its head and hands as burial markers. Workers, including Andika and others, scraped away a part of the cave floor inch by inch. The person died in their early 20s, though the gender could not be determined from their bones. Near the person’s face was a tiny piece of ochre, a natural color. According to the study’s principal author, Maxime Aubert, a geochemist and archaeologist at Griffith University, Gold Coast, Australia, this suggests that some of the patterns on the cave walls may have been made by them.
When the skeleton was fully exposed, the researchers discovered that the left leg’s bottom, from the middle of the shin to the ankle, was missing. According to co-author Melandri Vlok, a bioarchaeologist at the University of Sydney, the shin bones had fused at the bottom, which is an obvious indicator of healing after a violent injury. However, when the COVID-19 pandemic spread and Indonesia closed its borders, the team’s work had to be put on hold.
The following year, when the researchers returned, Vlok discovered the leg’s end was neatly and precisely severed in a straight line, showing no signs of crushing or breaking, as would be expected if a boulder had fallen on it or an animal had chewed it off. She explains that it appears to be exactly what you would anticipate from a precise cut made perpendicular to the bone. It assured us that this was surgery.
The researchers cannot determine if the Borneo limb was removed due to sickness or a severe injury in ancient times. According to Vlok, the person continued to grow and live for another 6 to 9 years, depending on how much their shin bones had fused. It’s unclear what caused the death.
The tropical climate of the area makes it quite simple for wounds to grow infected, according to Vlok. She recalls cutting her finger during excavation and rushing to the hospital to seek antibiotics. According to co-author and archaeologist India Dilkes-Hall of the University of Western Australia, Perth, surviving surgery would have been nearly impossible without something to clean the wound and reduce pain.
Fortunately, Borneo’s diverse ecosystem provides a wide range of medicines. According to Dilkes-Hall, the generally poisonous fruit of the Pangium edule tree can be used as an antiseptic when appropriately treated. She points out that considering humans had been in the area for a very long time; they might have picked up on the medicinal qualities of the native flora.
Haagen Klaus, a George Mason University anthropologist who was not involved with the work, calls the argument made here “exceptionally well-constructed.” They presented a strong argument in favor of surgical amputation 31,000 years ago.
According to him, some anthropologists tend to write off early hunter-gatherer communities as being primitive, but research like this suggests that wasn’t the case. The complexity and sophistication of their cultures and lives, including their grasp of human anatomy and medicine, have become evident.
Researchers discovered that the left shin of a skeleton clearly showed signs of amputation and healing.
Although the team hasn’t yet discovered the Stone Age counterpart of a bone saw, Aubert believes the ancient surgeon used a stone or bone tool to cut through the leg.
Charcoal fragments found in the sedimentary layers immediately above and below the cemetery were radiocarbon dating roughly 31,000 years ago. One of the skeleton’s teeth was also directly dated using a different method known as electron spin resonance dating; the outcomes matched the radiocarbon dates from the silt.
The team writes in today’s issue of Nature that all the evidence points to inhabitants on the island being the first to perform an amputation successfully. The oldest known confirmed amputation, of a man’s arm below the shoulder, was previously thought to have occurred around 7000 years ago in what is now France.