Archaeological findings confirm that humans have used amputation and prosthetics for a (very) long time, according to our partner The Conversation.
It has even been established that prehistoric men used flint trepanation and that 70% of "patients" survived it!
The analysis of this phenomenon was carried out by Valérie Delattre, archaeo-anthropologist at the National Institute for Preventive Archaeological Research and the Bourgogne Franche-Comté University.
Even as the Tokyo 2020 Paralympic Games are taking place, the theme of disability has been a subject of research for several years, anchoring inclusion, exclusion, fitting, compensation and care to the farthest distance. that it is possible to study the human being. If Paralympic athletes benefit from advanced technologies and futuristic materials, what about societies of the past?
The long history of prostheses is closely linked to that of men: the first standing humans very early on invented support sticks, crutches, canes and improvised devices to replace an absent or failing limb.
Recognized in Shanidar (Iraq) more than 45,000 years ago on a subject presenting heavy traumatic injuries, attested in France around 4700 BC.
our era, amputation will be deployed in the Middle Ages as evidenced by funerary archeology: it will benefit, over the centuries, from surgical techniques which will bring out, in particular on the battlefields of the Renaissance, the know-how daring of the barber Ambroise Paré, then those of the surgeons of the Invalides, fitting the many disabled people of the wars of Louis XIV.
Teeth and skulls
The simplest, obviously, is to replace a tooth, lost or pulled out: if the greatest orthodontists, before the prowess of modern dentists, remain the Etruscans (especially those of Tarquinia) and the Egyptians, a shell implant, in place in a jawbone, has already been found in a necropolis of 5000 BC.
Our era.
Skull of a young girl trepanned with flint, Neolithic (3500 BC); the patient survived! © Rama / Wikimedia CC BY-SA 3.0
In the same way, trepanation is one of the first intrusive gestures, inventoried since prehistoric times, throughout the world and in all cultures, practiced by real neurosurgeons: it was a question of piercing the skull to relieve the injured brain. , because compressed.
The removal of the bone washer - sometimes replaced - was first carried out with a flint, by scraping or scraping or piercing.
The outcome of such a neurosurgery operation remained uncertain, even though nearly 70% of the patients survived.
It was often fraught with functional sequelae, sometimes leading to hemiplegia, facial paralysis requiring personal assistance.
Representation of paired subjects
Amputated and / or fitted subjects have never been concealed and can be found on all types of supports.
Italiote Skyphos from the 4th century BC (Primato painter) depicting a crippled crippled satyr © H. Lewandowski / RMN (via The Conversation)
The inventory is plethoric and offers, for example, an Egyptian funerary stele (1000 BC) representing a subject suffering from polio using a wooden crutch to move, a Greek skyphos (4th century BC). and his satyr whose right leg, atrophied, is wrapped around a stick, a pre-Columbian mochica vase (-200 to 600 AD) depicting a small amputated subject fitting on his stump a sheathed ceramic prosthesis or a small crippled acrobat on its wooden pestle drawn on a 7th century bible.
left: Book “Once upon a time there was a difference” © V. Delattre / éd. Actes Sud / Inrap - right: Mochica vase-jug depicting an individual with an amputated left lower limb fitting a sheathing ceramic prosthesis © American Museum of Natural History
Thus the medieval West will multiply the disabled subjects whose prostheses are wooden shells or hoops, sometimes sheathing, provided with a pestle on which the amputated limb is folded over a textile: like those deployed on the famous
Mendiants
de Brueghel (circa 1558), they are fully representative of devices made of perishable material, long used to alleviate tibial amputation.
Care, practitioners and prostheses
Funerary archeology confirms the strong presence of what it is premature to call “handicap” within societies whose members, affected by congenital diseases and life accidents, are taken care of and integrated.
It is in Buthiers (Seine-et-Marne) that the oldest amputation was recorded in France.
An elderly man, from the ancient Neolithic era, buried in a fetal position, had his left forearm amputated, thanks to a surgical intervention, with flint, aimed at cutting the muscles and tendons at the level of the elbow joint.
Burial of the amputated Neolithic subject of Buthiers © Inrap (via The Conversation)
Multiple are the amputated subjects, unearthed fitted or not, in their tomb, after their home community (a clan, a village, a parish, an abbey ...) had diagnosed them, amputated, treated and taken care of and this for all the periods studied.
The practitioners, since the healers of the Neolithic, including Gallien (surgeon of the gladiators of Pergamon), the French Guy de Chauliac and the Arab-Muslim Albucassis, are often skillful and ingenious, despite very disparate techniques and instruments!
Burial of a subject with both lower limbs amputated in the early Middle Ages necropolis of Serris-les-Ruelles (Seine-et-Marne) © F. Gentili / Inrap (via The Conversation)
In fact, in parallel with the paleopathological study of interventions, treatments and techniques, a real archeology of prostheses and compensatory devices is developing. As we know, the oldest unearthed in situ were found on Egyptian mummies, such as the Cairo toe, articulated and functional (1069-664 BC). In general, the ingenuity of craftsmen and blacksmiths always seems to have been in demand: in Capua (Italy), in the 4th century BC. Our era, a lower limb prosthesis, made up of several bronze elements connected to each other by metal nails was even sculpted in the shape of a calf and then decorated with warrior motifs. The same creativity and, let us underline it, a form of solidarity, seems to have been exercised in Cutry (Meurthe-et-Moselle),where a man with a two-handed amputation was fitted with a right forearm prosthesis made using a small bifid (two-ended) iron fork held in place by leather straps, a belt buckle and a loop of recycled shoes.
The real break with these devices is established with the appearance of new so-called military prostheses, close to armor, which develop in parallel with the surgical progress generated by the devastation of the battlefields and the invention of heavy artillery: the war is the prosthesis's best friend!
The prosthesis of the rich
Around the powerful men of war of the Renaissance, the trades surpass themselves to forge breastplates, weapons, sew harnesses ... their cost, their splendor and their uniqueness.
These new prostheses are modeled on the armor of knighthood of which they adopt the technology, such as that found in Balbronn (Alsace) in the tomb of the knight Hans von Mittelhausen who died in 1564.
Articulated hand (and its reconstruction) dated XVIth century of the knight Hans von Mittelhause (Balbronn) kept at the historical museum of Strasbourg © M. Bertola - Museums of Strasbourg (via The Conversation)
The decisive turning point was initiated by Ambroise Paré (1510-1590): orthopedist and surgeon by training, he traveled the battlefields and observed the devastation on the human body caused by the introduction of new firearms. Humanist and ingenious, he develops restorative techniques, working to advance the ligation of vessels and by devising "artificial means to add what is missing naturally or by accident". His hand prostheses, in particular, made by the locksmith Le Lorrain, initiate the modern era of equipment: the fingers are independent, mobile and articulated. Paré abandons heavy metal, in favor of boiled leather, wool, skin or velvet. His "leg of the poor" is an inexpensive wooden shorts offered to the greatest number.He wants these devices to be used "not only for the action of amputated parts, but also for the beautification of their appearance ..."
The disabled
After the Thirty Years' War (1618-1648) crippled soldiers swelled the ranks of beggars in unsanitary Parisian neighborhoods.
Louis XIV created in 1670 the Hôtel des Invalides for “those who exposed their lives and shed their blood in the defense of the monarchy [so that they] could spend the rest of their days in peace”.
It can accommodate 4,000 soldiers who are fitted out and who will still have to serve the State by working in workshops for clothing, embroidery and calligraphy.
Even today, it welcomes soldiers seriously injured in foreign operations and those whose lives have been frozen forever, for example, on the terrace of a café or at the Bataclan on the evening of a fatal November 13 ...
Our "HANDICAP" file
Far from devastating epidemics, deadly wars and climatic disturbances which destabilize the necessary solidarity of societies and ostracize the vulnerable dependent, sometimes with cruelty and barbarism, the history of men is also a long story of behavior, often organized in solidarity.
In accordance with the old adage "depending on whether you are powerful or miserable ...", disability, and especially lack of disability in that it involves compensatory devices that are sometimes sophisticated and expensive, is always a social and economic marker: affected by the same. In this way, the survivor of an earthquake in Haiti will not benefit from the same advanced technology as a Paralympic champion equipped with carbon blades!
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This analysis was written by Valérie Delattre, archaeo-anthropologist at the National Institute for Preventive Archaeological Research and the University of Bourgogne Franche-Comté.
The original article was published on The Conversation website.
Declaration of interests
Valérie Delattre does not work, does not advise, does not own shares, does not receive funds from an organization that could benefit from this article, and has not declared any affiliation other than her research organization.
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