Buried in a shallow grave deep within a remote Indonesian cave, archaeologists have found the bones of a young individual they say could rewrite medical history.
Using radiocarbon dating techniques, scientists estimate the body has lain undisturbed for 31,000 years inside the Liang Tebo cave in eastern Kalimantan province in Borneo, according to research published in the journal Nature on Wednesday.
But the most striking aspect of the discovery was that the young man or woman was missing their lower left leg, with signs it had been carefully amputated when the person was a pre-teen or early teen before their death from unknown causes between 19 and 21, researchers said.
The otherwise remarkably intact skeleton was found by in 2020 by Australian and Indonesian archaeologists, who say the amputation reveals considerable surgical skill and is the earliest example in the archeological record, shaking up our understanding of sophistication of Stone Age humans.
“It’s significant because it considerably pushes back our species’ knowledge about surgery and complex medicine,” said Maxime Aubert, a professor at Griffith University’s Centre for Social and Cultural Research in Queensland, via email.
It was only 100 years ago that surgical amputation became a medical Western norm. Before developments like antibiotics, the study said, most people would have died at the time of amputation.
“Blood loss, shock and subsequent infection were the chief sources of amputation being fatal up until quite relatively recently in human history,” said Tim Maloney, researcher at Griffith University and one of the study’s co-authors.
The individual had their lower left leg amputated as a child and survived for six to nine years after the surgery, according to the research.
There was no trace of infection in the bones, and new bone growth had formed over the amputated area – something that takes considerable time. Plus, while the rest of the skeleton was adult sized, the amputated bones stopped growing and retained their child size.
The surgeon or surgeons who performed the operation 31,000 years ago, likely with knives and scalpels made from stone, must have had detailed knowledge of anatomy and muscular and vascular systems to expose and negotiate the veins, vessels and nerves, and to prevent fatal blood loss and infection, the study said.
After the amputation, intensive nursing and care would have been vital, and the wound would have had to have been regularly cleaned and disinfected.
“I think what’s most amazing is this is real, direct archaeological, tangible evidence for a really high degree of community care,” said Maloney.
The skeleton was discovered in a region that’s become an exciting locale for paleoanthropology: Liang Tebo, a large limestone cave with human hand stencils on the walls, located in a remote, mountainous landscape accessible only by boat at certain times of the year.
The world’s oldest figurative rock art has been found in caves elsewhere in Indonesia and extinct human species like the small-sized Homo floresiensis and Homo luzonensis have been found on islands in the same region.
“It is from this area that humans departed by boat to cross Island South Asia to reach the mainland of Papua and Australia (the first successful major maritime voyage),” Aubert said via email. “They were advanced artists, and now we know (they) had advanced medical knowledge.”
“At Liang Tebo, we encountered this 31,000 years old prehistoric amputee less than 1 metre from the surface and we know we still have another 3-4 meters of sediments to dig before bedrock,” he added.
The dig in 2020 was cut short by alarm over the spread of Covid-19, and the Australia-based archeologists raced home to avoid border closures that would last more than two years.
“We can’t want to go back. Maybe we will find more humans remains and perhaps remains of unknown species.”