Surgery in prehistoric times

Abstract

The word ‘surgery’ derives from the Greek cheiros, a hand, and ergon, work. It applies, therefore, to the manual manipulations carried out by the surgical practitioner in the effort to assuage the injuries and diseases of his or her fellows. There seems no reason to doubt that since Homo sapiens appeared on this earth, probably some quarter of a million years ago, there were people with a particular aptitude to carry out such treatments. After all, there is an innate instinct for self-preservation among all mammals, let alone man, so that a dog will lick its wounds, limp on three limbs if injured, hide in a hole if ill and even seek out purging or vomitmaking grasses and herbs if sick. We are talking about times many thousands of years before written records were kept and, indeed, evidence of disease or injuries to soft tissue of that period has long since rotted away with the debris of time. Palaeopathologists (students of diseases in the long distant past) have, however, uncovered abundant evidence in excavations of ancient skeletons that fractures, bone diseases and rotten teeth tortured our oldest ancestors. Of course, animals were also subject to all sorts of diseases. Indeed, a bony tumour was obvious in the tail vertebrae of a dinosaur that lived millions of years ago in Wyoming. Other excavations also reveal that injuries were inflicted by man upon man (Figures 1.1, 1.2) and, as we shall see, that broken bones were splinted and skulls operated upon. We can make a reasonable guess at what primitive healers may have done from studies carried out by anthropologists and ethnologists (students of primitive tribes) who, at around the beginning of the 20th century, carried out detailed studies of communities as far apart as West and Central Africa, South America and the South Pacific who had never had contact with ‘modern’ man. It is surely reasonable to surmise that treatments found in such communities, often amazingly similar in very different parts of the world, might well match the care given by our prehistoric ancestors in man’s fundamental instincts of self-preservation. The assumption might be wrong but it would require a great deal more research before a distinction between ‘modern’ primitive and prehistoric medical and surgical treatments could be made. It goes without saying that these early studies are immensely valuable to us today since few if any primitive communities nowadays remain untainted by Western civilisation. Injuries inflicted by falls, crushings, savage animals and by man upon man, demand treatment; among primitive tribes in the aforementioned studies, open wounds were invariably covered by some sort of dressing. This might take the form of leaves, parts of various plants, cobwebs (which may well have some blood-clotting properties), ashes, natural balsams or cow dung (Figure 1.3). Indeed, even in recent times, the use of dung as a dressing for the cut umbilical cord in West African village babies still took place and was responsible for many cases of ‘neonatal tetanus’ – lockjaw in babies – from the tetanus spores that are almost invariably present in faeces. Among the Masai of East Africa, wounds were stitched together by sticking acacia thorns along