Photos: Archaeologists discover a 31,000-year-old amputee


In a recent study published in Nature, scientists have revealed evidence of the oldest known surgery performed by humans. A team of archaeologists based at Griffith University, Australia, have discovered 31,000-year-old skeletal remains with the left foot surgically removed above the ankle at the fibula and tibia.

This discovery reshuffled commonly accepted conceptions of medicine, the complexity of foraging societies, and the evolution of human cognition.

Borneo, 2020

In early 2020, the team of researchers embarked on canoes stacked with archaeological material for a six-day paddle through a remote part of the rainforest in hopes of gaining insight into the ancient history of the ‘humanity. Their destination was Liang Tebo, a limestone cave in the remote Sangkulirang-Mangkalihat region of East Kalimantan, which is the Indonesian part of Borneo. The cave is known to have one of the oldest rock art in the world, dating back to 40,000 years ago.

Dr. Tim Maloney told MeatEater the discovery happened just when the COVID pandemic was at its peak. Being in such a remote location, the team had no idea the rest of the world was fighting over toilet paper and experiencing the medical crisis of our generation. Instead, researchers carefully unearthed evidence of the oldest known medical procedure performed by humans.


Patient TB1

The individual, believed to be “TB1”, was buried with “apparent grave markers” such as large limestone boulders, flaked chert artifacts and a red ocher nodule. This individual was not buried by accident or sudden death. People took the time and care to bury them there.

The team classified the skeleton as an anatomically modern human (Homo sapiens) of undetermined sex. Through various methods, the researchers determined that TB1 was approximately 19 to 20 years old at the time of death.

Where the amputation occurred was significant bone growth, leading researchers to believe that TB1 died at least 6-9 years after the initial trauma. In addition to the relatively small size of the left tibia and fibula compared to the right, the patient was likely a child at the time of the initial injury and surgery. They then continued to survive in the rugged climate of Borneo for an impressive number of years after being amputated.

stone age surgery

How do they know it was surgical?

“First, human burials and human skeletal records from this age in the tropics are exceptionally rare. This is the oldest deliberate human burial ever discovered in Southeast Asia,” Dr Maloney said. .

The researchers were shocked by the quality of the preservation of the remains of TB1. Thus, a missing left foot immediately intrigued the team.

“We spent days carefully digging out the right leg. Each of the 26 bones in the right foot was fully articulated. His terminal, pointed toes stood up. Everything was perfect,” Dr. Maloney said. “Spending days meticulously recording and excavating this and then having the left foot missing in this neat grave… We knew like, oh crikey, there is something interesting here.

Even more confusing was the clean cut through the left fibula and tibia which reflected modern examples of surgical amputations.

Accidents do not cause sharp cuts as this skeletal evidence demonstrates. Animal bites or breaks create fragments, not the clean cut shown here. These types of incidents have never been clinically shown to sever both the fibula and the tibia. Additionally, there is no skeletal evidence of infection, suggesting a rigorous care regimen. The bone growth on the fibula and tibia demonstrates healing and aging, indicating that TB1 lived for a long time with this amputation.

The researchers also ruled out punishment or sacrifice as a reason for the procedure. “Amputation as a punishment is considered unlikely, especially given the careful treatment of the individual in life after amputation and at burial, which is not consistent with a person considered as deviant,” the study said.

Researchers could not definitively identify a surgical instrument because the procedure took place so many years before the burial.

“I can hypothesize a prominent and probable surgical instrument, but we don’t have directly preserved surgical or medical technology, it’s all inferential,” Dr. Maloney explained. “But of the benefits available to people living in this area 31,000 years ago; marine shells, bamboos and sharp lithic ridges, these sharp lithic ridges seem the most likely.


Sophisticated Stone Age Surgery

Until this discovery, the earliest evidence of surgery was a 7,000 year old amputation of an old French farmer’s arm, just above the elbow. Academics have generally assumed that surgery of this level was beyond the capabilities of foraging societies and that if surgery did take place, it was usually limited to the removal of fingers as punishment or for some symbolic reason. .

This evidence debunks these assumptions and demonstrates a rare example of Late Pleistocene medicine. To perform a surgery as complex as an amputation with the limited resources available 31,000 years ago is a truly remarkable feat.

For immediate amputation success, the surgeon must first understand the need to remove the limb and also possess knowledge of how the skeletal, muscular, and vascular systems work to prevent fatal blood loss.

The long-term success of this surgery demonstrates an incredible level of community care. Postoperative treatment for the patient would have included temperature regulation, diet, bathing and movement to prevent pressure sores.

Warding off a serious infection in a hot, tropical environment was an incredible feat on its own. “The wound would have been regularly cleaned, dressed and disinfected,” the study said. “Perhaps using locally available botanical resources with medicinal properties to prevent infection and provide anesthetics for pain relief.”

Upper Pleistocene surgery

A Stone Age revival

“The community most likely painted and hunted game,” said Dr Maloney, a stone tool specialist whose passion for hunting led him to study archeology in the first place. “This area is just a hub for human innovation and achievement.”

In this incredible example of environmental determinism, it was likely the island’s rich biodiversity combined with the extreme tropical climate that created a landscape that forced humans to adapt their understanding of medicine in order to survive.

“Any scratch on the hand almost instantly becomes inflamed and infected,” Dr. Maloney said of working in such an environment. “Plant diversity and the tropics appear to be reasonable drivers of what could be very early use of plants in a medical context.”

While Dr. Maloney will continue to conduct extensive research into the stone tools used by this foraging society, fellow researcher Dr. India Ella Dilkes-Hall is an expert in paleobotany. She will continue her research by examining macro botanical records such as seeds and pieces of charcoal and sediment samples containing microscopic traces of plants to better understand what kind of plants they might have used medicinally there. is 31,000 years old.

Dr. Maloney and his team of researchers will continue to elaborate on this fascinating discovery in this land rich in human history and evolution. Stay tuned for future studies from Liang Tebo, and if you want to take a closer look at this one, check out this Youtube video.

Liang Tebo
Illustration via Vera Planert.

All images via and copyright Dr. Tim Maloney.


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