A human skeleton found in Borneo, dated to about 31,000 years ago, shows that the left foot had been surgically amputated and that the patient recovered, reports an article in Nature Posted this Wednesday. The findings, announced in a scientific preprint last April, suggest that advanced surgical procedures occurred in tropical Asia thousands of years earlier than previously recorded.
Amputations require extensive knowledge of human anatomy and surgical hygiene, as well as considerable technical skill. Before modern clinical advances such as antiseptics, most people undergoing an amputation operation died from blood loss and subsequent shock or infection.
Until now, the oldest known complex operation was performed on a Neolithic farmer in France about 7,000 years ago, who had his left forearm surgically removed and partially healed.
In a press release, Tim Maloney and colleagues report the discovery of the skeletal remains of a young Borneo individual who had the lower third of his left leg surgically amputated, probably as a child, at least 31,000 years ago.
They found that the individual survived the intervention and lived another six to nine years before being buried in Liang Tebo limestone cave in East Kalimantan.
Knowledge of muscles and blood vessels
The authors suggest that the individual or individuals who amputated the left lower leg must have had a detailed knowledge of the limb’s structure, muscles, and blood vessels to avoid fatal blood loss and infection.
They suggest that it is unlikely that the amputation was due to an animal attack or other accident, as these often cause crush fractures. It is also unlikely that the amputation was carried out as a punishment, as the individual appears to have received careful treatment after surgery and during burial.
The findings suggest that some of the earliest modern human groups foraging in Asia developed advanced medical knowledge and skills in a late Pleistocene rainforest environment.
The authors suggest that rapid wound infection rates in the tropics may have stimulated the development of new pharmaceuticals, such as antiseptics, that harnessed the medicinal properties of Borneo’s rich plant biodiversity.