Archeologists from Australia and Indonesia have unearthed evidence of the earliest known case of amputation—thought to have occurred at least 31,000 years ago—in a cave on the island of Borneo.
The skeletal remains revealed a young adult whose lower left limb had been surgically removed, after which evidence shows the person lived at least six to nine years before being buried inside Liang Tebo cave in East Kalimantan.
These findings predate the previously oldest known surgical amputation by 24,000 years, which was that of a farmer whose arm was amputated in France approximately 7,000 years ago.
Dr India Ella Dilkes-Hall from the University of Western Australia's (UWA) School of Social Sciences, who co-led the Liang Tebo excavations in 2020, said in a UWA release on Thursday the discovery proves early humans had medical knowledge and skills that were far more advanced than what scientists previously thought.
“The prevailing view around the evolution of surgical practice has been that it is intimately linked to the emergence of agricultural societies around 10,000 years ago during what is known as the Neolithic Revolution, which gave rise to a host of health problems previously unknown in non-sedentary foraging populations,” she said.
“Our find, illustrating a deliberate amputation, demonstrates that an advanced level of medical expertise and skills was possessed by early modern human foraging societies.”
Dilkes-Hall said the archeologists, aided by experienced local guides, were looking for evidence of early human groups in the area when they found three limestone burial markers deliberately positioned above the head and each arm of the individual, who was found to be lying on their back.
“It was incredibly exciting noticing that as careful excavation proceeded the foot and lower left leg were missing entirely, we couldn’t quite believe what we were seeing," she said.
Amputation, Not Trauma Injury
After excavation and with the agreement of the Indonesian government, the remains were flown to Griffith University in Queensland, where a more detailed analysis confirmed an amputation had been carried out.“The evidence indicates that the person, whose sex we aren’t able to determine, had their lower left leg removed through deliberate surgical amputation of the distal tibia and fibula,” Dilkes-Hall said.
“There was no evidence for infection of the limb, the most common complication of an open wound without antiseptic treatment, which indicates traditional ecological knowledge of plant-based medicinal remedies.”
Meanwhile, Tim Maloney of Griffith University in Queensland said that if the separation of the lower leg had been caused by blunt force trauma from an animal attack or accident, crushing features in the bones would be visible.
“Instead, remodelled (healed) bone covers the amputation surfaces,” he said. “The cutting margins indicate the use of a sharp instrument, with lithic and shell, edges found in association providing a possible source, although the exact nature of the surgical implements remains unknown.”
Dilkes-Hall said the archaeologists now think that these early non-sedentary foraging societies possessed a comprehensive knowledge of human anatomy, physiology, and surgical procedures, as well as a mastery of medicinal plant use, all developed over a more extended period than previously thought and passed down through oral tradition.
