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Early medical practice in the Neolithic period (2000-4000 BC)
Sex, Drugs, Rot and Roll: An investigation into Neolithic Doctoring practices via
visual and chemical analysis.
By Ellen-Jayne Bryant
PhD Proposal
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Abstract
This study will use a selection of injured and diseased skeletons from the Neolithic
period (4000-2000BC) to ascertain signs of medical intervention and assistance, the
results will support the theory that this period in time represents the first type of “care
in the community”, in which basic human anatomical structure and knowledge of
medicinal plants would have been essential. This study will use a combination of
two methods, the visual anthropological assessment of the bone (to indicate the
injuries/disease) which will be used in conjunction with samples of the bone taken to
analyse using direct Gas Chromatography – Mass Spectrometry (GC-MS), for trace
elements of simple chemical compounds, namely narcotics that could have been
administered and ingested at the time of death.
Skeletal material from the Neolithic period would be sought from, The Museum of
London, Salisbury Museum, and The Museum of Devises. Anthropological analysis
via a visual method can be challenging, although broken bones can be apparent, the
interpretation of whether these bones have been “set” in accordance with our current
medical practices awaits to be seen, the skeletal remains will also be assessed for
other injuries and infections which could have been treated with medicinal narcotics,
specifically those that could be tested using the GC-MS technique. This study will
focus on testing the inner sections of the spongy bone material in the long bones;
this section has the highest blood supply and offers the best source for identification
of simple chemical compounds that are associated with medicinal and poisonous
plants that would have been widely available during the time period.
Overview of the general area and discipline
Ortner (2011) concludes that proposed research which incorporates linked
scholarly/scientific disciplines offers “added value and frequently provocative,
exciting new knowledge” . The proposal here links the scientific disciplines of
Archaeology, Anthropology and Chemistry, with a view to offer insight into early
medical practices.
In Archaeology the Neolithic period (4000 - 2000 BC) is widely recognised as being
pivotal in human history because it marks the time when large populations of people
shifted from a nomadic, hunter-gatherer lifestyle to a more settled existence
dependent on agriculture as a major food source. As communities came together
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evidence has suggested that these events would sometimes be problematic with
fighting and even possible warfare (Jordana et al 2009). Evidence for this has been
gathered from archaeological excavations from around the world during the last
century often, however, the human remains and artefacts do not provide complete
answers to exploratory research questions, and so holistic techniques from the field
of anthropology can be used to make sense of supplement sparse findings (Gravlee
2011).
Archaeologists and anthropologists use both empirical data from the field, in the form
of bones and monuments to make basic descriptions and classifications, to try and
piece together what kind of medical behaviours and practices were common in this
period. This has given rise to the discipline of paleomedicine/paleopathology,
however it is worth noting that much of the current research demonstrates an
understanding of inter-social upheaval concentrating on the specific causes of the
injuries themselves and how they could have been inflicted, which gives rise to the
popular belief of a rather turbulent time in prehistory, often avoiding the more caring
side a larger community settlement could offer. This research does not seek to
counter this argument but to provide insight into the other side of human nature,
which demonstrates empathy and the willingness to help those in need, which
fundamentally separates humans from most animals. It is important to the present
and future of paleopathology (archaeological skeletal remains which link interactions
of pathology from the past to the present and vice versa) to move beyond the
boundaries of basic descriptions and general classification into more engaging and
integrating themes using broader interdisciplinary approaches (Ortner 2011)
Aim
The aim of the study is to explore the evidence that is present in Neolithic
skeletal remains, both visually and chemically, in order to illuminate medical
practices of the Neolithic period in particular.
Objectives
The objectives are to conduct a visual survey and then a targeted analysis using
GC-MS, looking for narcotic or other chemical traces, and to interpret the remains
holistically including any new evidence found.
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Literature review
The Neolithic period (4000 – 2000 BC) has been a major topic for discussion
in academic papers for many years. As the period has no written records
interpretation of lifestyle and health often comes from archaeological and
anthropological assessments, triggering academic minds to offer their version of
events that occurred so long ago. The literature available offers a vast and extensive
library dominated somewhat by the concentration on burial practices of the time
(Thomas 1999), indeed excavations of burial sites, especially in Egypt but also
across Europe and in the Americas provide the largest sources of human bone
material for analysis (Lubell et al 1994). Funerary rights and the deposition of human
remains is, however, not without its problems, like access to ancient burial grounds,
such as those in the Valley of the Kings, in Egypt to the more common problems that
face most archaeologists and anthropologists during excavations, in that the bones
are subjected to various processes ranging from burning, poor preservation, selected
preservation of specific body parts, and differential mortuary treatments. All of which
have a significant impact on the bone material available (Murphy and Gaither 2011).
Various kinds of positioning in different types of ground leave traces on the bones
which add layers of complication to scientific analysis, which is particularly evident in
the excavation of graves across a cemetery (Pers. com Betlovaic 2010). In some
cases incomplete samples survive, with uneven distribution due to geological rather
than historical variation, which makes it difficult to form a complete picture.
Human bones are very strong with fracture and healing rates being a topic of
extensive research over the past 50 years. Skeletal fractures happen when bone
absorbs sufficient energy under mechanical loading to fail resulting in cortical
discontinuity (fractures) (Harwood et al 2010). Traumatized bone has a specific
sequence of healing events through haemostasis, inflammation, clearance and
repair, regeneration and finally resulting in remodelling (Winet 1996) after
remodelling has occurred the scarring cannot be seen microscopically or
macroscopically, which eventually leads to no evidence that the injury existed in the
first place (Harwood et al 2010), it is also worth noting that the rate of healing
decreases with age (Mayer et al 2001).
Bone has a high blood supply and simple fractures are healed enough to function at
around 6 weeks, although the health and age of the individual will have an extensive
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impact on this rate (Skak and Jenson 1988) the high blood supply differs between
cortical and trabecular bone according to Oflaherty (1991) blood flow differs to the
two types of bone with estimates of 0.090 ml/min/g to trabecular bone and 0.013
ml/min/g to cortical bone, therefore the trabecular bone would offer a better chance
of finding trace chemical compounds absorbed and deposited at the time of the
individuals death (Baselt et al 1975).
Chemical compounds from narcotics found in blood have been a focus of medical
research for some time; (Foerster et al 1978, Christians et al 2000, Baselt et al 1975,
Gergov and Vuori 2003), however the chemical compounds found in bone are more
limited and tend to focus on heavy metal poisons. One study looked at the aluminum
absorption and retention in the brain and bone of rats the results showed the a
significant uptake of aluminum, the samples of bone were tested using graphite
furnace atomic absorption spectroscopy (Slanina et al 2009) with similar studies
completed on lead and other heavy metals (Freeman 1996). to date there has been
no attempt to identify anesthetics and analgesics in human bone, either in a modern
sample or an archaeological sample, it must be assumed that concentrations of
simple chemical compounds (simple because more complex compounds are likely
broken down by the surrounding soil components) that are found in medicinal plants
that would have been used in the Neolithic could be indentified in bone samples of
the same period. Lessa and Guidon (2002) asked whether there is evidence of
prehistoric pathology which would have needed treatment; in conclusion they
identified a wide range of ailments including dental abscesses, osteoarthritis, and
fractures, and some work has been done on dental evidence and diet (Lubell et al.,
1994)
Paleopharmacology is the study of medicinal remains from archaeological sites
(Reinhard et al 1991). Evidence has suggested that knowledge of medicinal plants
extends far beyond the ancient Egyptians (Nunn 1996, Merlin 2003). The
development of such knowledge could have been trial and error, but some plants
offer key insights into their healing abilities, known as the doctrine of signatures for
example yellow plants like dandelions (Taraxacum Officinale) have properties that
aid in Jaundice and urinary infections, the heart shaped leaves and red flowers of the
Hearts Ease (Viola Tricolour) have medicinal properties that aid cardiac problems
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and blood disorders, both of these plants and more have been used by the ancient
Mayan, Chinese, Inca and Indian tribes for thousands of years (reference……).
Merlin (2003) looked at the Eastern Hemisphere for use of psychoactive plant usage
in pre-historic cultures and indicates that pottery depicting particular medicinal plants
is evidence of this, while Shafik and Elseesy (2003) accredited the Ancient Egyptians
with the use of caster oil, Marijuana, opium, and beer all of which have medicinal
uses. It has been known for some time that primates use medicinal plants with
Monkeys and Apes using plants that act as analgesics, anti-microbials, antiinflammatorys, and fertility regulators (Chaves and Reinhard 2005). Further research
in Brazil looked at skeletons and hair samples which provided evidence of pathology
that would have needed knowledge of traditional medicines (Chaves and Reinard
2005), however the ancient Egyptians developed the earliest known recorded
systems which details medical treatments, with scholars having various
interpretations from the hieroglyphs dating around 1820 BC, from which 2000
remedies from preparation to dosage have been deciphered, covering a wide range
of ailments (Rosalie 2008).
Some Neolithic bone samples excavated show evidence of healing, but it is not
certain that this is a result of medical intervention. The large number of trephined
skulls found in Europe in Neolithic deposits, and somewhat later also in Peru, is
however, incontrovertible evidence of medical activity (Ackerknecht 1968). McKenzie
(1936) theorizes that the purpose of scraping a hole in the skull was to cure
giddiness or epilepsy but it is unclear what evidence can be drawn to point to this
conclusion, other than that no trauma is evident in the bones, which could otherwise
explain the hole. The Peruvian examples do show evidence of bone trauma. The
differences in these two methods can be seen in the shape of the hole, which is
shallow and pond-shaped when scraped, and jagged in later techniques. There is
some evidence of medical and surgical practices in cave painting, such as finger
amputations, but it is presumed that these are motivated by religious meanings
rather than any pathology (Ackerknecht 1968).
It has been noted that various protocols exist for reporting palaeo-trauma but the
majority of investigators modify these methods to suit their own needs and research
problems, thus creating incomparable primary data (Judd 2002), however specific
studies range from bone loss to fracture patterns and healing rates, Agarwal et al
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(2010) looked at Neolithic bone samples to ascertain whether cortical bone loss
(associated with old age) from the Catalhoyuk community in Turkey led to
observable fractures in the bones, the results were interesting with the eldest
females showing signs of bone loss but there were no evident fractures. further
studies have compiled extensive evidence of warfare and violence, via interpretation
of skeletal injuries and fractures, with some notably recognising healing patterns in
various fractured bones, but failing to state or investigate any possible intervention
from a medical stance, for example Jordana et al (2009) studied Iron age nomadic
tribes and interpreted long bone trauma on 10 individuals from Pazyryk tumuli in the
Mongolian Alti, they note peri-mortem trauma with 43% of the sample showing
evidence of fractures with evidence of healing but there is no suggestion of medical
intervention, yet they acknowledge this is a high percentage to have healing injuries,
Judd (2011) also observed healed/healing injuries on a skeletal collection dated from
the Kerma period 2500- 1750 BC, noting the stages of healing but again no
explanation as to whether medical intervention had occurred.
One particular discovery in 1991 of a mummified Neolithic body in the Tyrolean Alps,
named “Ötzi” is a very valuable source of information on Neolithic medicine, not least
because it preserves a man in the middle of his life extremely well along with his
clothing, tools and possessions, but the body was found with a pouch containing
fungus samples (Whittle 1996). The mushrooms were not of the hallucinogenic type
but were known to have antibiotic properties (Fowler 2000). A recent article in the
lancet highlights the fact that the iceman’s woody bracket fungus Piptoporus
betulinus contains an active compound, agaric acid, which has laxative effects and
may have been a deliberately administered medicine against intestinal parasites, the
eggs of which were found in the Ice Man’s rectum (Capasso 1998).
Another feature of this specimen is that it shows intriguing evidence of tattoos.
Some of the tattoos may have been purely decorative, but some of them seem to be
suitable as location points for a procedure akin to acupuncture because they consist
of simple geometric shapes arranged in linear formation on the back and legs, in a
manner strikingly close to modern acupuncture charts (Dorfer et al 1999). Further
tattooed specimens have been found in Siberia (Rudenko 1970).
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This proposal aims to investigate the Neolithic period in relation to discovering the
earliest medical society, as there are no written records the assessment will use a
combination of thorough visual examination and modern GC-MS testing. The
skeletal remains would have to have evidence of trauma that would have needed
medical assistance, however the individual would have died as a direct result of the
injuries (within a defined timescale of no more than 2 months) the injuries would
have to be evident to support the possibility of ingestion of narcotic material for the
relief and recovery of the individual. GC-MS testing techniques have been used on
organic residues of 958 British prehistoric pots to trace dairy material (Copley et al.,
2002) and a similar method applied to Neolithic bone may bring to light significant
information on medical practices of that time.
Statement of methodology
Timescale
3 Years
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References
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