Surgical Amputation of a Limb 31,000 Years Ago in Borneo

Tim Ryan Maloney1, India Ella Dilkes-Hall2, Melandri Vlok3, Adhi Agus Oktaviana4, Pindi Setiawan5, Andika Arief Drajat Priyatno6, Marlon Ririmasse4, Made Geria4, Muslimin A.R. Effendy6, Budi Istiawan6, Falentinus Triwijaya Atmoko6, Shinatria Adhityatama1, Ian Moffat7, Renaud Joannes-Boyau8, Adam Brumm1, Maxime Aubert1

1Griffith University, Australia

2University of Western Australia, Australia

3University of Sydney, Australia

4BRIN, OR Arkeologi, Bahasa dan Sastra, Indonesia

5Bandung Institute of Technology, Indonesia

6Balai Pelestarian Cagar Budaya, Indonesia

7Flinders University, Australia

8Southern Cross University, Australia

The prevailing view regarding the evolution of medicine holds that the emergence of settled agricultural societies around 10,000 years ago (the ‘Neolithic Revolution’) gave rise to a host of health problems previously unknown among non-sedentary foraging populations, stimulating the first major innovations in prehistoric medical practices. Such changes included the development of more advanced surgical procedures, with the oldest known indication of an ‘operation’ formerly held to consist of a Neolithic farmer from France whose left forearm had been surgically removed and then partially healed. 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 for a complex medical act. 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, living for another six to nine years before intentional burial within Liang Tebo, a limestone cave in East Kalimantan. This unexpectedly early evidence for successful limb amputation implies that at least some anatomically modern human foraging groups in tropical Asia had developed sophisticated medical knowledge and skills long before the Neolithic farming transition.