Medical expertise in Upper Paleolithic period

Tim Ryan Maloney and colleagues reported in the Nature magazine on September 7, 2022, the case of surgical removal of the lower limb of a child some 31000 years BP. The find of skeletal remains was of a person laid to rest in a burial from Liang Tebo cave, which is located in East Kalimantan, Indonesian Borneo, in a limestone karst area.Probably the amputation was done on the person when he was a child who survived some 6-9 years thereafter. This find presents a contrarian view on medical expertise which till now has been holding the view that the first surgical amputation of a limb took place somewhere around 7000 years BP during the Neolithic period along with the advancement of agriculture.This evidence of a successful limb amputation suggests that at least some modern human hunter gatherer groups in tropical Asia had possessed the medical knowledge and expertisemuch before the Neolithic agricultural tradition.

When the skeletal remains of this subject were recovered, the left tibia and fibula shaft fragments were flexed underneath the left femur. The area of the trauma on tibia and fibula bones shows an oblique cut. Remodeling of the bones took place on the amputated area which indicates that the person recovered, healed from the wound and survived. The bones were not crushed as would have happened during an animal attack or a natural injury. Moreover animal attack may have infected the wound probably resulting in the death of the person. All these evidences point towards a successful surgical amputation.The cortical area of the bones of left tibia and fibula were relatively much smaller indicating the situation of incapacitation and restricted use of the left lower limb.

The authors opine that for doing this amputation surgery the people must have possessed the knowledge of human anatomy such as the musculature and blood vessels to prevent the blood flow and infections to the wound. Besides, a lot of group and community care must have been given to help him feed, bath and move. Those foraging societies must be having a good expertise of medicinal flora to prevent infections and provide anesthesia. It is a basic human curiosity to know how our ancient ancestors have lived in the past and how they countered and endured injuries with community sharing knowledge.