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Up to 94% of Neanderthals suffered at least one traumatic injury in their lifetime. How did their healthcare keep up?
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Hey, it's Flora and you're listening to Science Friday. If you try to look up where medicine originated, or the earliest medical interventions, you'll probably find yourself reading about ancient Greece, or Egypt, or Mesopotamia. But what about before that, like way before that? How did early humans treat disease, or cope with injuries? What did a Neanderthal do if she broke a rib, or needed a root canal? Was there prehistoric healthcare? Today, we're digging into those questions, and what these medical interventions tell us about our ancient relatives, and how the practice of medicine evolved.
Here to field all things medical is Dr. Penny Spikens. She studies the origins of medicine and healthcare at York University in England. And if you're going to talk about ailments, you cannot sleep on teeth. So for our dental needs, we have Dr. Laura Wyrick, who studies ancient oral microbiomes at Penn State University. Welcome to Science Friday.
Thanks so much for having us. Yeah, thank you. Brilliant to be here.
Penny, what's the oldest evidence of medical care?
Oh, that's a fantastic question. Well, I think it depends how you define medical care. Because actually, we might not be the only species that have medical care, if you're quite broad about your definition. Because when we look at our cousins chimpanzees, our nearest living cousins chimpanzees, with whom we share a common ancestor of seven to eight million years ago, they have some practices that we might begin to call medical care. That is, if they've got internal parasites, they can pick some really, really spiky leaves to eat deliberately, to flush out those internal parasites. And they can also use leaves to dress as wound dressings, not just on themselves, but
on other chimps. So it may be that actually, when you say how far back does it go, it's like, ooh, could be more than seven to eight million years, really.
Well, as always, the question is more complicated than it seems, it sounds like. Well, let's talk about our human ancestors. What kind of practices do we see and when do they appear?
Well, some of our best early evidence comes from about 1.7, 1.8 million years ago. And that's when we see, you know, Homo gesta in Kenya, KMNE, our 1813. She'd had hypervitaminosis. Now, we don't quite know how she got that, but she was really, you know, she was in a lot of pain, probably unconscious for various periods for several weeks, perhaps even months. And she couldn't possibly have survived that long without others helping her. So I think we can really take back some of those examples to at least one and a half million
years ago, perhaps 2 million years ago, which actually is really early when we think about our evolutionary past. That's when we first start to say, this is what we call human, you know, members of the genus Homo. And it begins to make us think, doesn't it, that perhaps it's actually quite critical to how we evolved, perhaps caring for others wasn't just a side thing. It might have been really important to perhaps even what made us successful if it goes back that early.
Wow. Laura, what about dental care?
I think the teeth tell a very similar story as well. You know, I think a lot of our visions of ancient teeth are of everybody having cavities in every tooth, right? And having, you know, gangly horrible teeth. And Neanderthals actually have beautiful teeth. Like, I wish I had teeth as good as a Neanderthal, for the most part. They have amazing oral health. And, you know, it tells you something about, about the health of their diet, right? And their foraging and what they're going through and what they're, what they're eating.
That's amazing.
Yeah.
They had, their teeth were great because I think of teeth as such a liability.
Yeah, exactly. They can be, totally. But when you have great oral health, you know, they're something that really help you and benefit you. They're tools you carry around with your body. Our work really shows that Neanderthals had very different types of microorganisms in their mouths, and so they weren't probably able to get tooth decay and able to get gum disease in the same way that modern humans are. And they also have really great, you know, sort of healthy diets, right? Probably lots more leafy greens and protein than what the average person's eating today.
I just saw this new study about the oldest root canal in a Neanderthal. Did you see this?
Yeah, there was a really exciting new paper that showed that maybe Neanderthals were actually taking care of their teeth in ways dentists still do today. So actually creating, you know, small tools enough to drill down into the top of a tooth where you have tooth decay and you have a lot of pain. It probably would have been an enormously painful process to give yourself effectively a root canal.
With like a tree branch, what was the tool like?
I think it was probably made out of jasper. So, you know, like a hard, a hard rock-like substance, right? That you could sharpen and kind of whittle down, right? To be a little bit of a drill that you would have massaged between your fingers and rotated back and forth to get it to drill down through that sort of enamel and release that pain, right? The researchers also estimated it would have taken somewhere between like 30 and 40 minutes to drill these holes, right? And so it's not just a quick, you know, mechanical drill that's in your mouth. This is something where someone's probably holding you down and the other person is probably, you know, needling back and forth with this rock tool in your tooth to release that pain and pressure. So, you know, who knows if they were able to find some, you know, plants that helped with that pain resolution after it?
I sure hope so.
I mean, I feel like we're giving people nightmares already in this segment. We talk about DIY medical, DIY dental drills.
I mean, Penny, what about, you know... Laura brought up Neanderthals. What do we see in Neanderthal medical care? Like, what's in their doctor bag?
It's actually surprised. I mean, I'm surprised by how much we see. I probably shouldn't be, should I? But I am quite surprised by what keeps coming up. We know that there's that basis of desire to care for each other. I mean, if we look at the whole spread of Neanderthals, kind of like 70, 80% at least of them have had an injury that's healed. And so a lot of those are probably only healed because other people have looked after them. I mean, our best example of that is Shanadar Wan. But there are quite a lot of other examples, actually. Shanadar Wan is this man who, when he was a late teenager, suffered a whole series of debilitating injuries. So he ended up blind in his left eye, probably deaf,
with one arm that was either sort of completely lost part of it or was amputated and one withered leg. So when we put that together, that's someone with quite high needs even in our society, and lived for at least a decade and probably maybe 15 years. And a lot of Neanderthals seem to have these patterns. Lashapalosans had osteoarthritis in their lower spine, really quite severely, probably looked after for several months. So there's this big pattern of provisioning and care and looking after individuals that end up ill or injured. But then we ask, okay, so as you're saying, well, what was their medical abilities?
So, you know, if we look at the Elsidron Neanderthals, and we look at the dental calculus, you can see remains of things like yarrow and chamomile, and they're kind of like calming agents. There's even painkillers and antibiotics in one of the individuals. So they're really very fine tuned to their kind of how they can use herbs and plants in ways that we would see as quite medicinal. We know for one thing, they must have had assisted childbirths, because we know from the shape of the Neanderthal pelvic canal that babies were born having to twist as they come out the pelvic canal, like with us. So they're very likely to have had assisted childbirth. How they managed that, we don't know, but it seems quite likely.
Should we be thinking like an OB? Penny, like an OB or a midwife?
Well, that's interesting, isn't it? Because when we start to talk about medicine, we've got this evidence for kind of medical things. But what we don't know is, was there a specialist? Was there a medical specialist? But these are really small groups. So, you know, we don't know for certain, but you know, maybe there's sort of 12 to 15 in a group. It just doesn't seem possible that they would have had a specialist medical person. There may have been some people who are a bit more specialized than others, but it's probably a knowledge that's just passed on culturally. This particular, you know, flower or bark can heal pain. This particular thing has antimicrobial properties. And they probably just experimented and learned over thousands of years.
But I'm surprised by the range of medical abilities they seem to have picked up, developed and passed on.
Laura, I know teeth are your jam. I mean, tell us more about what ancient teeth tell us, reveal about what medicines were used or what medical care was available.
Yeah, absolutely. From our perspective, teeth are not just teeth. They're also all of the bacteria and viruses and fungi that are living on the outside of them. And, you know, those microorganisms bind together and form a film that grows on your teeth, you know? And you'll feel it yourself. If you ever drink a sugary drink, you kind of feel that grossness, you know? Dental plaque, that is a film. That is a microbial biofilm. The really awesome thing about that, though, is it calcifies at night when you sleep and it turns into this rock hard matrix, locking all those bacteria, as well as anything else that might be in the local environment in it, in place. So if you don't have modern dentistry, it never gets removed. So, you know, Neanderthals and very ancient humans would have had this dental plaque,
which when it's calcified, we call it dental calculus. And it would have built up over their entire lifetime. We also study all these really healthy microbes in your body called the microbiome, and many of those live on your teeth. And those are directly linked to chronic disease development. So now, for the first time, we can look at Neanderthals' teeth and not just know about, you know, whether or not they had cavities or tooth decay, but we might know something. Something about whether or not they suffered from a chronic disease, or someday we might be able to tell whether or not they had mental health disorders, or whether or not they had aches in their bones that would be directly attributable to these microbes that live in their mouths. So we're really excited about looking at what all of these little bits and pieces stuck between your teeth can tell you about somebody
and what ancestors can tell us from long ago, based on what was stuck between their teeth.
Oh, my gosh, I want to hear more about what ancient plaque can tell us. I can't believe fossil plaque is revealing all the secrets. It's amazing. But I have to take a quick break. When we come back, we're going to ask more about that. Stick around.
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Okay, Laura, what can the little bits stuck in our teeth tell us about medicine? Do we find evidence of actual medicines in ancient teeth?
Absolutely. So one of the amazing things about the Alcideron Neanderthals that Penny mentioned earlier was that we had the ability to study the dental calculus that was on some of their teeth. And one of those individuals had quite a big abscess. They would have been in a lot of pain. If you've ever had tooth pain, you know exactly what that Neanderthal was feeling. And in that particular individual, we were able to find DNA that wasn't just from the microbes or the bacteria in his mouth, but also from probably what we think was medicine that was being used to treat that abscess. And so we found things that associated with tree bark that would have had these properties of painkilling. We also found molds, things like penicillium, which have antibacterial properties, which probably were trying to kill that infection.
Now, it's unlikely for things that quickly pass through your mouth to get stopped and incorporated in dental calculus. So we actually think it's much more likely that there was maybe a pulp or some sort of bolus that might have been put in the mouth near that tooth, really sat there to hopefully reduce the pain and treat that abscess. And so it just speaks to their incredible intelligence, I think, and their ability to read the world around them and bring in plants and care for someone who's suffering and struggling in a medical context.
As always, we got a PSA. Stop underestimating Neanderthals.
Yes, absolutely. I think, yeah, if there's one thing people take away from today, it's that Neanderthals are not that, you know, club-toting, grunting, caveman-type mentality, right, that was the picture of them that was drawn using, you know, really the first Neanderthal who's arthritic and probably was hunched over, but it's not because that was a representation of the species, it's because that person was, you know, in a lot of pain and very elderly, right? And so our narrative today, you know, is really being reshaped as we speak, as new science comes out, to speak to Neanderthals' intelligence, to speak to their ability to care and to interact with their environments and to learn and to really, you know, from my perspective, integrate within human society when anatomically modern humans, you know, showed up.
Yeah, Penny, let's take a step back and talk about the big picture. I mean, we've been talking about the details of, you know, early root canals, early medical interventions, but what does it mean for a species to be taking care of their own like this?
I think it's fascinating the way in which we can look at this dental procedure and what goes into it, takes a huge amount around it, which is all kind of part of kind of evolution and cultural evolution and social evolution, because just for that one practice to happen, we need to have evolved the motivation to care for someone else, we need to have the courage to kind of take on all of that pain. I mean, whoever's like, you know, having that done and whoever's going to do that, that's quite, I mean, that's brutal, it's quite courageous what's happening there. We need to have the social support around, somebody was probably holding them, somebody else was encouraging that this would happen,
there's a kind of all sorts of social support afterwards for looking after them until they felt a little bit better. I mean, to be able to stand back and think this is going to hurt more. In order to make it hurt less in the future. And that's quite, um, of itself shows a lot of intelligence. And it fits into a much bigger picture of us people that were genuinely caring for each other. And integrating that capacity to care with intellect. Um, in ways that's probably quite unique to us, isn't it? It's quite unique to humanity to be able to integrate our emotional capacity to care with the intellect to kind of bring it, bring it out, bring it forward and be able to help people in a really thoughtful way.
So, you know, it's fascinating, I think.
Just tracking these injuries also tell us sort of what life was like for Neanderthals or early humans. You know, the fact that, that our ancestors are getting injured so much, you know, what does that tell us about what their day to day was like?
Well, it's not necessarily an easy life, is it? I mean, they are, um, at risk of being injured and we know there are all sorts of predators around as well. And there are various Neanderthals that have actually, you know, been quite possibly killed or certainly hurt by predators. Um, and they're taking on quite risky hunting behaviours. So life isn't necessarily easy in those terms, but we really do get that sense that they've got each other's backs as well. And that's really interesting to see. This is not, you know, we kind of imagine both ourselves and our evolutionary past as a time of kind of like invulnerability, you know, independence. And when you have this kind of like, I don't know, particularly today,
we have this idea of this paleo fantasy that, you know, back in our past, we were like really strong, really independent, really invulnerable, you know, and really competitive. And actually, when we look at the archaeological record.
Yeah, eating a high protein diet, obviously big and muscly, like, you know, and when we look at the archaeological record, what we see is a set of people who were vulnerable individually. They needed other people to help them. They needed social support, but together as a group, they were really strong. And that's so different from our image, isn't it? So different from each individual person's going to be completely competitive and fine. It's really not true. And there's a real message there, I think about, do you know what? We're quite vulnerable. We need other people. We're not naturally competitive. We're not naturally hard and tough. But together we can make things work. And you really see that with Neanderthals.
This was so fascinating. Professor Penny Spikens is an archaeologist at the University of York, and Professor Laura Wyrek is a microbiologist at Penn State. Thank you both for joining me.
Thank you so much, Flora. That was fascinating.
Thanks so much for having us. I really appreciate it.
This episode was produced by Rasha Aridi. And if we can help you excavate an answer to a science question in your life, please leave us a voicemail. 8774-CY-FRY is our number, 8774-CY-FRY. Look, we answer a lot of questions on the show, so please call us. We'll catch you next time. I'm Flora Lichtman.
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