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The Stone Age Surgeon's Knife

See the earliest evidence of successful surgical amputation

By Archaeological, Language and Literature Research Organization

tribute to Dr Pindi Setiawan, Dr Tim Maloney and Pak Ham

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Deep within the ancient limestone karsts of East Kalimantan, Indonesian Borneo, lies Liang Tebo cave. This isn't just any cave; it's a place that has unveiled a profound secret about our distant ancestors, pushing back the known timeline of medical sophistication by tens of thousands of years.

Tim Maloney and Andika, exposing the skeleton of human burial at Tebo cave (2020) by India Ella Dilkes-HallArchaeological, Language and Literature Research Organization

In 2020, a team of Indonesian and Australian archaeologists, were meticulously excavating in this remote region—an area already famed for some of the world's oldest dated rock art. As they carefully brushed away layers of earth, just days before pandemic border closures would halt their work, they uncovered something extraordinary: the skeletal remains of a young adult.

The excavation process in Tebo cave (2020) by India Ella Dilkes-HallArchaeological, Language and Literature Research Organization

The skeleton was largely intact, but there was a startling anomaly. The lower part of the left leg and the left foot were missing. This wasn't a simple break or a loss due to decay. Dr. Melandri Vlok, a bioarchaeologist from the University of Sydney invited to study the bones, noted the tell-tale signs: the cut on the remaining tibia and fibula was clean, and the bone showed clear evidence of healing and regrowth. There were no signs of the crushing fractures typical of an accident or an animal attack, nor evidence of infection that would likely have been fatal.

Tim Maloney and Andika, exposing the skeleton of human burial at Tebo cave (2020) by India Ella Dilkes-HallArchaeological, Language and Literature Research Organization

Dating techniques revealed the skeleton was approximately 31,000 years old. Astonishingly, the evidence indicated that this individual, likely a child at the time of the operation, had not only survived the surgical amputation of their lower left leg but had lived on for another six to nine years, eventually dying in their early twenties.

Dr Tim Maloney while excavating the human remainsat Tebo Cave (2020) by India Ella Dilkes-HallArchaeological, Language and Literature Research Organization

This discovery, published in the prestigious journal Nature, was revolutionary. Before this find, the oldest known evidence of a complex surgical amputation was a 7,000-year-old skeleton from a Neolithic farmer in France. The Liang Tebo skeleton catapulted our understanding of prehistoric medical capabilities back by a staggering 24,000 years.

Dr India Ella DIlkes-Hall recording the skeleton (2020) by Tim MaloneyArchaeological, Language and Literature Research Organization

Dr. India Ella Dilkes-Hall documented and completed the samples for dating on human remains from Tebo Cave.

The vertebrae remains at Tebo Cave, Tim Maloney, 2020, From the collection of: Archaeological, Language and Literature Research Organization
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The human burial site at Tebo Cave, Tim Maloney, 2020, From the collection of: Archaeological, Language and Literature Research Organization
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Imagine the scene 31,000 years ago. A young member of a foraging community faces a life-threatening injury or illness affecting their lower leg. Someone within that community possessed the sophisticated knowledge and skill to perform an amputation. They would have needed a detailed understanding of limb anatomy, how to manage blood loss, and how to prevent infection—all without modern antibiotics or surgical tools as we know them. The surgeons of Liang Tebo likely used sharpened stone tools.

The missing left tibia and fibula from the 31,000 years old skeleton, Tebo Cave, Tim Maloney, Melandri Vlok, 2020, From the collection of: Archaeological, Language and Literature Research Organization
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The left foot shows a trace of amputation 31,000 years ago, Tim Maloney, Melandri Vlok, 2020, From the collection of: Archaeological, Language and Literature Research Organization
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Survival for so many years after such a procedure also speaks volumes about the society. This individual would have required intensive post-operative care, regular cleaning and dressing of the wound, perhaps using local botanical resources with medicinal properties known to the community. They were cared for, supported, and remained an integral part of their group despite their altered mobility in challenging, mountainous terrain.

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The findings at Liang Tebo offer a remarkable glimpse into the ingenuity and resourcefulness of early modern humans in Southeast Asia. It adds to a growing body of evidence suggesting that these ancient foraging groups possessed sophisticated cultural lifeways and a deeper understanding of their world than previously imagined, as also evidenced by the stunningly old rock art found in the same region.

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The discovery at Liang Tebo is not just an archaeological find; it is a powerful reminder of the shared history of human innovation and care. It challenges long-held assumptions about the development of medicine and highlights the remarkable capabilities of our ancestors who walked the Earth tens of thousands of years ago in the lush rainforests of Borneo. The story of the Liang Tebo amputee is a testament to human resilience, knowledge, and the enduring power of community.

Aerial Leang Karampuang (2024)Archaeological, Language and Literature Research Organization

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The story featured may in some cases have been created by an independent third party and may not always represent the views of the institutions, listed below, who have supplied the content.
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