Earliest recorded human amputation

The skeleton of a teenager, showing signs of the world's earliest amputation has been uncovered in a cave in Borneo. Researchers had been searching the area for cave paintings when they stumbled instead on a burial site. Archaeologist Charlotte Roberts, from Durham University, has written a commentary on the findings and gave us her reaction to what's been discovered…

Charlotte - An absolutely fascinating find. Evidence for the earliest amputation that anybody has known in a skeleton. And this is 31,000 years ago.

Chris - What have they found and where?

Charlotte - They found a 19 to 20 year old person. And this person seems to have had part of their lower leg and foot amputated. And what's more, this amputation has healed extremely well. The person survived for a number of years before they died. The office suggests that the amputation was done when this person was between 11 and 14 years old. And then the evidence of the healing suggests they lived for another six to nine years afterwards. It's quite incredible.

Chris - How do we know it was an amputation and not, for example, a wild animal?

Charlotte - Well, the cut made by whatever tool they used is very straight. And if an animal had grabbed this person's leg and ripped it off, it would have been a much more irregular break to the end of the bone.

Chris - We wouldn't have had any kind of metal instruments. They would've been using stone tools. Wouldn't they? So how on earth do you hack through bone with a stone tool?

Charlotte - Well, yes. We assume that it's a stone tool or some other thing that they found around, which could be used. It would take a long time, because obviously nowadays people use very sharp instruments to do amputations in a much more controlled environment than you would expect 31,000 years ago.

Chris - So how would they have done basic things like anaesthesia? They wouldn't have had any formal anaesthesia. Do we have any sort of documented evidence of how they might have controlled pain for what must have been an excruciating thing? If this took a long time to carve through the leg bone of an 11 year old, what would they have perhaps done?

Charlotte - Obviously we haven't got contemporary historical documents like you have more recent periods of time to tell us what sort of medicine surgery was being practiced and how they managed pain and maybe how it sedated people. But we can only assume that like today, uh, people use resources from the natural environment. Herbs that would induce anaesthesia that would manage the pain that would happen during this operation.

Chris - Do you think this was therapeutic or could it have been some kind of ritual or some other kind of tradition?

Charlotte - There are a number of reasons why you might amputate someone's limb and it could be to remove a diseased body part or an injured body part could be because of death. And today someone who has diabetes and has poor circulation may actually have to have part of their body amputated, usually their foot. But we do know from historical records that people also had amputated limbs for a punishment. So we don't really know why they did this amputation. We can only hypothesise according to what we know today.

Chris - So what do you think this tells us about how people were behaving, what they did? How does this move us forward in terms of our view of what our ancestors more than 30,000 years ago were doing and how they were conducting themselves?

Charlotte - Well, first of all, we have to remember that medicine was a key development for societies. And we assume that when people started to live in settled communities and farmed animals and plants, then they developed methods of treating ailments as time went on. But this is very, very early evidence for deliberate intervention in the form of an amputation of this person's limb. But I do think that caring is really an inherent part of being human. And to assume that people in the past didn't do these sorts of things to help their kids and kin seems ridiculous. This person was obviously looked after during their life. They survived this amputation and then they were carefully buried in a cave when they died. So I think this really shows some incredible care from the community where this person lived. So I think it really challenges the view that medicine came late in our history. It's obviously a rare find. This is a hunter gatherer society. And you think, well, if you're a hunter gatherer society, you are usually on the move. So they obviously invested in the care of this person, even though they couldn't do what they would normally do in that society. We don't know whether they were given some support, um, to walk with afterwards, an artificial limb of some sort made out again of natural resources. But I think this is an astounding find. And I think it just changes our views generally about what people could achieve in the past in terms of treatment developments.

Chris - And also presumably they must have had quite good communication as well. They must have been linguistically quite able in order to seek someone out who could help reassure this person, then perform this procedure and then rehabilitate them. That must have involved quite a lot of rich communication. So does that inform any of those aspects of our understanding?

Charlotte - Yes. You just wonder whether it was someone in their particular community or another community nearby that was willing to do this sort of operation or whether it was someone who just came forward and said, look, I'll try this and see if it works. Thinking again, in more recent periods of time in 16th, 17th century Europe, there were bone setters who went around villages, setting bones that were broken. That knowledge and skill was passed down the generations, whether that was happening all that time ago in Borneo, we'll never know, but it it's nice to reflect on that as a possibility.