Oldest amputation was performed 31,000 years ago

(ORDO NEWS) — The oldest evidence of a complex and successful surgical operation was found in Borneo.

The risk of death from injury and disease has always accompanied the genus Homo . The development of medical knowledge could reduce it.

However, it was believed that they are very specialized, so they appeared mainly after the emergence of civilization.

For example, amputations require a good knowledge of human anatomy, considerable technical proficiency, as well as decontamination of the surgical field and instruments, provision of anesthesia and postoperative care.

Before the advent of modern antiseptics and painkillers, many people who underwent amputations died from blood loss and traumatic shock or from subsequent infection.

Oldest amputation was performed 31 000 years ago 2
The skeleton of a man whose leg was cut off about 31,000 years ago

Previously, the most ancient case of a successful amputation of a limb was considered an operation performed on a Neolithic peasant who lived on the territory of modern France about seven thousand years ago. Part of the arm was removed from the man, and the wound healed safely.

Now, a paper has been published in the journal Nature that describes an older operation of this kind. Its authors studied a human skeleton found in Borneo and dated at 31,000 years old.

Traces on it testify to the surgical amputation of part of the leg and the recovery of the patient. This means that advanced surgical procedures were performed in tropical Asia tens of thousands of years earlier than recorded for Neolithic Europe.

Tim Maloney and his colleagues discovered the skeletal remains of a young man who died at the age of 19-20, who had the lower third of his left leg surgically amputated.

They assume that the operation was performed when he was still a child. Judging by the marks on the bones, after the amputation, he lived for another six to nine years, after which he died of some other (unclear) reasons and was buried in the Liang Tebo limestone cave, located in the province of East Kalimantan.

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Comparison of the bones of the right and left (partially amputated) legs of an ancient patient

The authors suggest that the person (or group of people) who amputated the lower part of the child’s left leg must have had detailed knowledge of the structure of the limbs, muscles and blood vessels in order to prevent fatal blood loss and infection.

They believe that the amputation is unlikely to have been caused by an animal attack or other accident, since crushing fractures usually occur in such cases.

When it comes to amputation of great antiquity, it is often assumed that the operation was carried out as a punishment. Archaeologists find evidence of such practices everywhere. Moreover, the first written evidence of amputation speaks precisely of punishment.

In the 218th article of the Laws of Hammurabi, it is said : “If a doctor performed a heavy operation on a person with a bronze knife and killed this person, or he opened a thorn in a person with a bronze knife and gouged out a person’s eye, then his hand should be cut off.”

In the case of a boy from Borneo, this is unlikely: apparently, he was able to provide thorough postoperative care. The arrangement of the burial also indicates that the tribesmen treated him with respect.

The left limb shows no signs of infection, the most common complication of an open wound without antibiotic treatment.

The absence of infection additionally eliminates the possibility of an animal attack: usually, when bitten by, for example, a crocodile, microorganisms from the animal’s teeth enter the wound, which leads to inflammation.

The absence of traces of inflammation is all the more surprising because, we recall, this happened in Asia, in a tropical rainforest, where infections, including wound infections, usually spread very quickly.

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The normal healing of the postoperative wound is all the more surprising because it took place in tropical rainforests

The authors of the work suggest that it was the environmental conditions in which wounds healed poorly and ordinary (non-surgical) wounds could push the inhabitants of Borneo to search for and use natural antiseptics. And the richest plant biodiversity surrounding them contributed a lot to this.

A similar situation could arise with anesthesia. Anesthetizing the patient – especially the child – is important for the success of such operations. However, plants with sufficient pharmacological potential are not so common. Their great diversity in the tropical zone could ease the situation for the ancient inhabitants of the island.

Scientists believe that the comprehensive knowledge of anatomy, physiology and surgical skills that allowed people of the late Pleistocene to carry out successful amputations was probably acquired by trial and error over a long time and passed down from generation to generation.

They write that it is not clear whether this operation was a rare event in the region’s Pleistocene history, or whether complex medical procedures such as limb amputations were more common in our species’ pre-agricultural past than is generally believed today.

“Our understanding of this aspect of the developmental history of Homo sapiens, however, may suffer from the poor preservation of the bones, as well as from prejudices about the ‘primitive’ nature of early medico-sociocultural practices among populations in tropical Asia.

On the other hand, we cannot rule out the possibility that human colonization of the ancient rainforests of Borneo both stimulated and facilitated early advances in medical technology that were unique to this region,” the paper says.


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