How did Neanderthals deal with illness and injuries?

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? 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 health care? Today we're digging into this.

And what these medical interventions tell us about our ancient relatives and how the practice of medicine affects. Tear 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 gonna talk about ailments, you cannot sleep on teeth, so for our dental needs, we have doctor Laura Werick, who studies ancient oral microbiomes at Penn State. Welcome to Science Friday. Thanks so much for having us.

Yeah, thank you. It's 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 sort of cousins, chimpanzees, our nearest living cousins, chimpanzees, with whom we share a common ancestor sort of seven to eight million years ago.

They have some practices that we might begin to call medical care. That is like, you know, if they've got internal parasites, they can pick some really, really sort of spiky leaves to eat. deliberately to kind of flush out those internal parasites. And they can also use leaves to kind of dr 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, it's always the the question is more complicated than it seems, it sounds like. Well, let's talk about our our human ancestors.

What kind of practices do we see and when do they appear? Well Early evidence comes from about 1.7, 1.8 million years ago. And that's when we see, you know, homogaster in Kenya, KMNER 1813, she 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, uh, 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 two 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. 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 Neandertals 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 and their foraging and what they're going through and and what they're what they're eating. Um That's amazing. Yeah. They had their teeth were great'cause I think of teeth as such a liability. Yeah. Yeah, exactly. Um they 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 know, that 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 than what the average person's eating today. I just saw this news 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, you know, effectively a root canal.

With like a tree branch? What was Um they 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 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?

Um the researchers also estimate it would have taken somewhere between like thirty and forty minutes to drill these holes, right? And so it's not just a quick, you know, mechanical drill that's a 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 um 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 um resolution after it. I sure hope so. I mean I feel like we're giving people nightmares already in this segment when we talk about DIY medical DIY dental drills. Yeah. 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 bed? It's actually w surprised I mean, I'm surprised by how much we see. I probably shouldn't be, should I, but I am quite qu 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 Neanderthal, it's kind of like seventy, eighty percent 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 One, but there are quite a lot of other examples actually. Shannadar One is this man who When he was a late teenager suffered a whole series of debilitating injuries, so he ended up um blind in his left eye, probably deaf.

um 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 a lot of Neanderthals seem to have these patterns. Um La Chapalo Saint had like 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. Bye.

individuals that end up ill or injured. But then we ask, okay, so as you're saying, well, what was their medical ability? So, you know, um if we look at the Elsidron Neanderthals and we look at the dental calculus, you can see remains of things like yarrow and chamomile, um, 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 is 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 manage that, we don't know, but it seems quite likely. Should we be thinking like an O B? Penny? Like an Obi 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 thing.

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. It may have been some people who are a bit more specialized than others, but it's probably a knowledge that's just

On culturally. This particular 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 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 medicine. 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 as a film. That is a microbial bowel. 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, um in place. So if you don't have modern dentistry, it never gets removed. So you know, Neanderthals and and very ancient humans would have had this

dental plaque, which when it's calcified, we call it dental calculus. And it it would have built up over their entire life 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 Neanderthal's teeth and not just know about whether or not they had cavities or or tooth decay, but we might know something about whether or not they suffered from a chronic disease, or you know, someday we might be able to tell whether or not they had mental health disorders.

or, you know, whether or not they had um, you know, aches in their bones, um, that would be directly attributable to these microbes that that live in their mouths. So We're really excited about you know looking at at what all of these little bits and pieces stuck between your teeth can tell you, you know, about somebody and what ancestors can tell us from long ago based on what was stuck between their teeth.

Oh my gosh, I wanna hear more about what ancient plaque can tell us. I can't believe fossil plaque is like revealing all the secrets. It's amazing. But I have to take a quick break. When we come back, we're gonna ask more about that. Stick around. Yeah. Every story from Shortwave and Peer Science podcasts starts with a question like, why do we have nightmares? How does AI affect my energy bill?

At NPR, we are here for your right to be curious about the world around you. Follow Shortwave wherever you get your podcasts, because the more you ask, the more interesting the world gets.

Okay, Laura, what can the little bits stuck in our teeth tell us about medicine? Do we find evidence of actual medicines in in ancient teeth? Absolutely. So one of the amazing things about the Alcidron Neanderthals that Penny mentioned earlier was that we had the ability to study the dendal 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. You know, if you've ever had sort of 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, you know, these properties of painkilling. We also found molds, um, things like penicillium, which have antibacterial properties, which probably were trying to sort of 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, you know, a pulp or or some sort of bolus that might have been put, you know, in the mouth near that tooth.

um really sat there to hope hopefully, you know, reduce the pain and and sort of treat that abstract And so, you know, it's it just speaks to their incredible intelligence, I think, and and their ability to to to read the world around them and bring in, you know, plants and and care for someone who's who's suffering and struggling in a in a medical context. As always we got a PSA, stop underestimating Neanderthals. Yes, absolutely. Yeah.

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, um, 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 is because that person was, you know, in a lot of pain and very elderly, right? Um and so our our narrative today, you know, is really being reshaped as we speak, as new science comes out, to speak to Neanderthal's intelligence, to speak to their ability to care and to interact with their environments and to learn and and to to really, you know, from my perspective, um, integrate within human society when anatomically modern humans um 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, earlier 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 um 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 a bring it out, bring it forward and be able to help people in a really thoughtful way. So it's you know, it's fascinating, I think. Does 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. W 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 behaviors. 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 we 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 we're We're looking at the high protein deck.

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 a 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 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 the Anderson. This was so fascinating. Professor Penny Spikins is an archaeologist at the University of York, and Professor Laura Weyrick 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 Arridi, and if we can help you excavate an answer to a science question in your life, please leave us a voicemail. 877-4SYFRI is our number. 8774SciFRI. Look, we answer a lot of questions on the show, so please call us. We'll catch you next time. I'm Flora Lichtmann.

Science Friday brings the joy of discovery to millions of curious listeners every week. When you sponsor Science Friday, you connect with a dedicated audience that values knowledge, exploration, and learning. These are folks who love getting into the details, who actively engage with ideas, and who value trustworthy information. Learn more at sponsorship.wnyc.org.