Ancient civilizations practised a surprising variety of surgical procedures, including suturing or cauterizing wounds and amputating limbs. Evidence of this knowledge from about 5,000 years ago is fairly widespread, and includes Stone Age needles in Africa that seem to have been used for sewing-up cuts. (For the same purpose, some tribes in both India and South America sealed wounds from minor injuries by placing termites or scarabs around the edges of the cut, then detaching the heads from the bodies mid-bite, leaving the locked jaws to seal the flesh.)
Trepanation (drilling a hole in the skull) is one of the earliest known surgical procedures practised by humans. A burial site from about 6500 BC contained 120 skulls, of which 40 had the characteristic burr holes. In some societies it was believed that this practice would release evil demons or spirits. However, it was also used for the more legitimate aim of releasing blood from the area around the brain after cranial injuries, making it the first example of brain surgery in history.
Amputation is also an ancient practice. A skeleton from about 7,000 years ago that was found in a grave at Buthiers-Boulancourt, south of Paris, had had its left forearm intentionally amputated, probably with a flint knife. Scientists have examined and tested the remains speculated that the patient might have been anaesthetised using pain-killing plants such as Datura, a poisonous vespertine with hallucinogenic properties, while herbs such as sage could have been used to clean the wound (which remarkably showed no signs of having become infected).
However, bones found in the Shanidar cave in Iraq suggest that surgery may have been practised even earlier in history by our Neanderthal cousins. The skeleton known as Shanidar-1 (nicknamed ‘Nandy’ by the archaeologists who found him) had numerous injuries – including a severe blow to the face which would have caused partial blindness, blockages in the ear canals that would have led to a degree of deafness, and a withered right arm with several healed fractures and a missing lower arm and hand. This discovery has already transformed our understanding of Neanderthal culture – all of these injuries were sustained a long time before ‘Nandy’ died, suggesting that sick or elderly members of their tribes were looked after. In addition, it has been speculated that the lower arm and hand were deliberately amputated, given the way in which it had healed after the loss. The skeleton’s date is between 60,000 BC and 30,000 BC, so if this was a surgical operation, it would be the earliest known within any of the human or near-human species.