31,000-year-old skeleton found in famous Borneo rock art caves shows earliest evidence of amputation surgery

Evidence of what is believed to be the earliest known amputation in human history has been found by a team of Australian and Indonesian archaeologists in Borneo. The 31,000-year-old skeleton missing its left foot was found in caves on the island famous for its rock art.

The discovery, which predates other instances of stone age surgery across Europe and Asia by tens of thousands of years, is published in Nature.

The individual died in their early twenties, six to nine years after their foot was amputated. Remarkably, the body shows that the wound fully healed with no signs of infection and indications that the individual would have occasionally hobbled on the stump that was left behind after the surgery.

Lead author Dr Tim Maloney, an archaeologist from Griffith University in Queensland, said the find might change our perceptions of ancient communities.

The lower body remains of the young hunter-gatherer whose lower left leg was amputated. Credit: Tim Maloney.

“This is a really strong case that this individual and their community had developed advanced medical understanding to be able to successfully amputate the lower left leg of a child, enabling them to not only survive the procedure, but live a quite a thriving life in this environment into their adulthood,” he said.

Low mortality rates after amputation surgery is a relatively modern development as antiseptic techniques developed in the early 20th century. “There’s a very strong case we make for understanding of the needs for antiseptic and antimicrobial management.”

“It rewrites our understanding of the development of this medical knowledge, all of which is otherwise known to archaeologists from more recent agricultural and settled societies,” Maloney adds.

He says the find challenges the idea that complex medical procedures developed in large, settled agricultural societies.

The individual’s body was found in Liang Tebo cave, a “cathedral-like” cavity famous for some of the world’s earliest rock art, in East Kalimantan in Indonesian Borneo. Though the art, which includes depictions of deer hunting, is difficult to date, the scientists are certain it is more than 10,000 years old. On the neighbouring Indonesian island of Sulawesi are the world’s oldest known rock art dated at around 45,000 years old.

(A two-metre-long painting of a kangaroo in Western Australia’s Kimberley region has been identified as Australia’s oldest intact rock painting at 17,500 and 17,100 years old although beyond engravings, the oldest reliably-dated rock art in Australia is 28,000 years old.)

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Associate Professor Renaud Joannes-Boyau from Southern Cross University explains that they were able to accurately date the human remains in Borneo from a tooth. This is because teeth are the hardiest part of the body, most resistant to decomposition.

While it is tricky to say for sure if the amputated individual lived alongside the rock artists, they did find a connection between the body and the early artistic communities of the region. One piece of vibrant red ochre was found placed very close to the individual’s jaw.

Maloney explains that there is strong evidence to suggest that the missing left foot is the result of a primitive “operation” as opposed to some other scenario.

“The skeletal signatures we’ve discovered completely lack signals otherwise indicative of animal attacks and injuries, which would otherwise present, with skeletal signals of infection and crushing fractures absent from this individual,” Maloney says. “This is a clear and a strong case that the community had a thorough understanding of negotiating veins, vessels, muscles and tissues of a child’s left leg. It reveals that this individual was a valued member of their community. It’s very unlikely that they could have lived without a high degree of community care.”

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“There’s a reasonable case to support the existence in the understanding of controlling blood loss and shock, some kind of antiseptic and or anti-microbial management occurring in an area of the Earth’s tropics home to a huge diversity of plant life, some of which possessing those medicinal properties,” Maloney explains.

The scientists also believe that the cutting edge used to perform the amputation would have most likely been a sharpened stone.

Researchers suggest that the unique environmental conditions in the region may have played a role in stimulating advances in medicine.

“We use plants for medicinal purposes. We always have. Proving it in archaeological records is difficult, but it can be done,” says co-author Dr India Ella Dilkes-Hall, an archaeologist and archaeobotanist from the University of Western Australia.

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“Like most archaeological riddles, there’s a fascinating record from the living indigenous cultures of Australia, in particular of a range of tooth avulsion and symbolic mourning rituals associated with with complex surgical applications in living indigenous memories,” says Maloney. “Many islands of the Indonesian archipelago similarly have fascinating living and recent records, particularly botanical medicines.”

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