Prehistoric medicine refers to the ways in which people understood illness, treated injuries and attempted to maintain health before the development of written records. Archaeological evidence, including human remains, tools and burial sites, provides clues about their health and medical practices, although many aspects of prehistoric beliefs and treatments remain uncertain.
Prehistory covered thousands of years and many different societies. There was no single system of prehistoric medicine. The evidence provides a starting point for studying the history of medicine, but it must be interpreted carefully: evidence that someone survived an injury, for example, does not necessarily reveal how that injury was treated.
What can archaeology tell us about prehistoric medicine?
Human remains are one of the most important sources of evidence. Bones can reveal fractures, injuries and changes associated with some diseases. Teeth provide information about diet, dental health and childhood development. Researchers can also examine ancient DNA and other biological material where preservation allows.
A healed fracture shows that a person survived long enough for the bone to begin repairing itself. Changes to bone can sometimes indicate prolonged illness or infection, although not every disease leaves visible evidence on a skeleton. Conditions affecting soft tissue may leave little trace, while some changes to bones can have more than one possible cause.
Archaeologists also examine tools, plant remains, burial sites and other objects found at settlements. These discoveries can help reconstruct people’s lives and environments. However, an object does not necessarily reveal its purpose. A tool might have served several functions, and an object found in a burial cannot automatically be identified as a medical instrument or charm.
Burial practices may offer clues about how communities treated their dead and understood death. They do not, by themselves, establish what people believed about illness or the afterlife. Researchers must distinguish between what the evidence demonstrates and what remains a possible interpretation.
What caused illness?
Prehistoric people experienced injuries, infections, dental disease and other health problems. Their health was affected by factors such as diet, living conditions, physical activity and exposure to infectious disease. The particular risks varied between communities and changed as people adapted to different environments and ways of life.
Some injuries had an obvious cause. A person who fell or suffered a wound could recognise the physical event that had caused the damage. Other illnesses were more difficult to explain, particularly when symptoms appeared without an apparent injury or developed over time.
Spiritual or supernatural explanations may have influenced how some prehistoric communities understood illness, but the evidence is limited. Human remains cannot tell us whether a person believed that an illness was caused by a spirit, and prehistoric burial practices do not provide a straightforward record of religious beliefs.
It is also important not to assume that all prehistoric communities shared the same ideas. Prehistory encompasses different peoples, places and periods. Explanations of illness may have varied considerably, and practical observations could have existed alongside spiritual beliefs. The themes in medical history provide a framework for comparing explanations of disease across different periods, but interpretations of prehistoric beliefs must remain cautious.
How were injuries treated?
People needed ways to respond to cuts, wounds, broken bones and other injuries. Knowledge could develop through experience and observation, with practical skills passed between generations. However, the archaeological evidence rarely reveals the exact treatment given to a particular person.
Natural materials, including plants, may have been used to treat injuries or relieve symptoms. Establishing that a particular plant was used medicinally in prehistory is difficult unless there is specific archaeological evidence. The presence of plant remains at a site does not, on its own, demonstrate that they were used as medicine.
Fractures provide clearer evidence of the body’s response to injury. When a broken bone heals, new bone forms around the damaged area. Archaeologists can study these changes to determine whether someone survived for a period after the injury. Healed fractures demonstrate survival, but do not necessarily prove that a healer deliberately set the bone or applied a splint.
Recovery would have depended on the severity of the injury, the person’s general health and the care available. Some fractures could heal while leaving lasting disability; serious wounds could become infected or cause death. People who were unable to carry out everyday tasks may also have depended on assistance from others, although the extent of such care is difficult to establish from skeletal evidence alone.
Trephination: prehistoric surgery
Trephination, also called trepanation, involves making an opening in the skull by scraping, cutting or drilling the bone. Archaeologists have identified examples of possible trephination in human remains from different parts of the world, including prehistoric contexts. The practice was not confined to one place or period.
The reasons for carrying out trephination are not always known. It may have been used in some cases following a head injury, but the purpose of an individual procedure cannot usually be established with certainty. Other explanations have been proposed, including ritual purposes, but these must be assessed against the evidence rather than assumed.
The condition of the bone around the opening is particularly important. Signs of remodelling can indicate that a person survived long enough for healing to begin after the procedure. This provides evidence that at least some individuals survived trephination. Where there is no sign of healing, it may be difficult to establish whether the person was alive when the opening was made.
Identification is not always straightforward. Damage, disease and other changes to the skull can resemble surgical openings. Researchers therefore examine the shape and edges of a lesion, the surrounding bone and its archaeological context before concluding that trephination took place.
Trephination is significant because it demonstrates that some prehistoric communities performed procedures involving the skull. It does not establish that they understood the brain in modern medical terms or that every operation had the same purpose. The evidence shows that the procedure occurred; the reasons behind it remain uncertain in many cases.
What does prehistoric medicine tell us?
The evidence does not support a simple picture of prehistoric medicine as either entirely superstitious or equivalent to modern healthcare. People experienced illness and injury, and some survived serious conditions and procedures. Practical knowledge may have developed through experience, while beliefs about the causes of illness could also have influenced how people responded.
There are limits to what can be established. Bones can reveal some diseases and injuries, but they rarely identify the precise treatment used. Objects and burial practices may offer clues about beliefs, but their meaning is not always clear. The absence of written records makes it difficult to identify individual healers or reconstruct their explanations of illness.
The archaeological record is also incomplete. Not every person’s remains survive, and many illnesses leave no visible trace on bones. Conclusions must therefore be based on the available evidence rather than assumptions about what prehistoric people must have believed or done.
The next period in this chronology, Ancient Egyptian medicine, provides a different body of evidence, including written medical texts. Comparing these sources helps historians examine how knowledge of illness and treatment can be investigated across the history of medicine.
Further Reading
- John W. Verano, Differential diagnosis: Trepanation, International Journal of Paleopathology, 14 (2016), pp. 1–9.
- Caroline Partiot, Aliénor Lepetit, Emilie Dodré, Camille Jenger, Bruno Maureille, Dominique Liguoro and Aline Thomas, Cranial trepanation and healing process in modern patients—Bioarchaeological and anthropological implications, Journal of Anatomy, 237 (2020), pp. 1049–1061.