Surgical amputation of a limb 31,000 years ago in Borneo
The prevailing view regarding the evolution of medicine is that the
emergence of settled agricultural societies around 10,000 years ago (the
Neolithic Revolution) gave rise to a host of health problems that had
previously been unknown among non-sedentary foraging populations,
stimulating the first major innovations in prehistoric medical practices1,2.
Such changes included the development of more advanced surgical
procedures, with the oldest known indication of an ‘operation’ formerly
thought to have consisted of the skeletal remains of a European
Neolithic farmer (found in Buthiers-Boulancourt, France) whose left
forearm had been surgically removed and then partially healed3.
Dating to around 7,000 years ago, this accepted case of amputation
would have required comprehensive knowledge of human anatomy and
considerable technical skill, and has thus been viewed as the earliest
evidence of a complex medical act3.
Here, however, we report the discovery of skeletal remains of a young
individual from Borneo who had the distal third of their left lower leg
surgically amputated, probably as a child, at least 31,000 years ago.
The individual survived the procedure and lived for another 6–9 years,
before their remains were intentionally buried in Liang Tebo cave, which
is located in East Kalimantan, Indonesian Borneo, in a limestone karst
area that contains some of the world’s earliest dated rock art4.
This unexpectedly early evidence of a successful limb amputation
suggests that at least some modern human foraging groups in tropical
Asia had developed sophisticated medical knowledge and skills long
before the Neolithic farming transition.