Research press release



Anthropology: Oldest evidence of surgical limb amputation found in Borneo

インドネシアのボルネオ島で発見され約3万1000年前のものとされた人骨について、左足が外科的に切断されており、本人は回復していたという研究報告を示した論文が、Nature に掲載される。この研究知見は、熱帯アジアで高度な外科的処置が実施され、現存する記録よりも数千年も前のことだったことを示唆している。


今回、Tim Maloneyたちは、少なくとも3万1000年前、おそらく子どもの頃に左下肢の下3分の1を外科的に切断する手術を受けたボルネオ島の若年者の骨格遺物が発見されたことを報告している。この若年者は、手術後も6~9年間生き続けた後、東カリマンタン州にあるリアンタボ鍾乳洞内に埋葬されたことが分かった。Maloneyたちは、この手術を実施した者は、致命的な失血や感染を防ぐために、四肢の構造、筋肉、血管に関する詳細な知識を持っていたに違いないと考える一方で、この左下肢の切断が、動物の攻撃や事故によるものである可能性は低いとする。動物の攻撃や事故であれば、粉砕骨折を起こすのが通常だからだ。この若年者は、手術後に丁寧な治療を受け、丁重に埋葬されたことからは、この手術が懲罰として行われたとは考えにくい。


A human skeleton found in Borneo, dated to about 31,000 years ago, shows that the left foot had been surgically amputated and that the patient recovered, reports a Nature paper. The findings suggest that advanced surgical procedures were happening in tropical Asia thousands of years earlier than previously recorded.

Amputations require a comprehensive knowledge of human anatomy and surgical hygiene, and considerable technical skill. Before modern clinical developments, such as antiseptics, most people undergoing amputation surgery died from blood loss and shock or subsequent infection. Previously, the oldest known complex operation happened to a Neolithic farmer from France about 7,000 years ago, whose left forearm had been surgically removed and then partially healed.

Tim Maloney and colleagues report the discovery of skeletal remains of a young individual from Borneo who had the lower third of their left lower leg surgically amputated, probably as a child, at least 31,000 years ago. They found that the individual survived the procedure and lived for another six to nine years, before being buried within the Liang Tebo limestone cave located in East Kalimantan. The authors suggest that the individual(s) who amputated the lower left leg must have possessed detailed knowledge of limb structure, muscles and blood vessels to prevent fatal blood loss and infection. They suggest that the amputation was unlikely to have been caused by an animal attack or other accident, as these typically cause crushing fractures. The amputation was also unlikely to have been carried out as a punishment, as the individual seems to have received careful treatment after surgery and in burial.

The findings suggest that some early modern human foraging groups in Asia developed advanced medical knowledge and skills in a Late Pleistocene tropical rainforest environment. Rapid rates of wound infection in the tropics may have stimulated the development of novel pharmaceuticals, such as antiseptics, that harnessed the medicinal properties of Borneo’s rich plant biodiversity, the authors suggest.

doi: 10.1038/s41586-022-05160-8

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