Hektoen International

A Journal of Medical Humanities

Bioarchaeological findings support ancient representations of surgical limb amputation, part one: Examples from the Old World

Peter de Smet
Nijmegen, Netherlands

Surgical amputation is defined here as the cutting or chopping off a protruding part of the body (as a whole or partial limb). It has been known for a long time that surgical amputees can be represented in the artifacts of ancient cultures.1,2,3 These representations raise the following two general questions:

  1. do they really depict the result of surgery?
  2. if so, is the act of surgery situated in the real world of the living or in some imaginary otherworld?

The first question is aimed at the exclusion of representations that are not the result of a surgical procedure. A good example is a Corinthian terracotta figure from the 7th-6th century BC that is missing one arm and both lower legs (Musées d’Art et d’Histoire, Geneva, inv.no. HR79). If this figure is real-to-life, it more likely portrays a rare congenital disorder (phocomelia) than a person with severed limbs.4 A compelling contemporary example is an Akan goldweight with a missing arm in the Bernisches Historisches Museum5 that may represent adjustment of its weight rather than a sign of surgery.6

The most convincing answer to the second question is provided by a scientific discipline known as bioarchaeology, which studies the archaeological remains of humans and other living beings. Recent bioarchaeological reports have shown that amputations actually took place in early times, which sheds new light on the depiction of amputations in ancient iconography. This two-part survey presents a selection of examples including the issue of whether these new findings show that early amputees could survive their surgery.

Case 1: Hand amputation in pharaonic Egypt


The temple relief in Fig. 1 depicts an Egyptian scribe who records the number of right hands cut off defeated enemies to document how many adversaries have been killed in battle.

Fig. 1. This relief on the Medinet Habu temple near Thebes depicts a pile of right hands that have been cut off defeated enemies and brought before pharaoh Ramesses III (New Kingdom, 19th Dynasty). Photo by kairoinfo4u on Flickr. CC BY-NC-SA 2.0.

A relief about the Battle of Kadesh on the temple of Ramesses II (the father of Ramesses III) near Thebes shows how severed hands were sometimes strung on a rope to be worn by victorious soldiers.10 A reconstructed relief from the lost temple of Tutankhamun (late 18th Dynasty) portrays soldiers who hold up enemy hands skewered on the ends of their spears.11 The literature often implies that the severed hands were obtained from dead enemy corpses.12 However, reliefs on the Ramesses II temples at Abydos and near Thebes suggest that the hands may sometimes have been taken from living captives (Fig. 2).8,10

Fig. 2. This relief on the Ramesses II temple at Abydos shows Egyptian soldiers cutting off the hands of enemies. The enemy on the right is still alive.8 There is a similar relief scene on the Ramesses II temple near Thebes.10 Reproduced from Wreszinski 1935, Tafel 20.10

Furthermore, a Dapur relief on the Ramesses II temple near Thebes portrays an enemy soldier who is missing a hand while still standing upright.9,13


The literature about ancient Egypt contains several possible cases of partial therapeutic limb amputation with evidence of successful healing. These sources comment, however, that such amputations were probably not carried out routinely but only under extraordinary circumstances.12,14,15

A recent bioarchaeological report about severed right hands from ancient Egypt analyzed twelve hands found in the forecourt of a palace dating to the foreign 15th Dynasty (c. 1640–1530 BC), when the northern part of Egypt was ruled by Hyksos kings from the Near East. In other words, the find was older than the New Kingdom reliefs with severed hands. The investigators could not establish whether the hands had been taken from dead or living individuals. They concluded that the hands had most likely been cut off to account for a military victory or as a form of punishment.16 Candelora favors the latter possibility.17

Case 2: Hand amputation in the Neo-Assyrian empire


The perimortem harvesting of enemy body parts is not only well-documented for ancient Egypt, but also for the Neo-Assyrian empire. The Neo-Assyrian soldiers most often practiced decapitation, but hand and foot amputation is seen in a bronze scene from Balawat (near modern Mosul in North Iraq) which depicts the conquest of Kulisi by king Shalmaneser III in the middle of the 9th century BC. The centre portrays amputated hands and feet below two amputees (one of whom is impaled), while on the right severed heads are displayed on the city walls (Fig. 3).

Fig. 3. Bronze band from the Balawat Gates of Shalmaneser III; embossed scene of the expedition to the source of the Tigris. © The Trustees of the British Museum, British Museum, London, inv.no. 124656. CC BY-NC-SA 4.0.

Supportive textual evidence comes from two inscriptions of King Ashurnasirpal II (the father of Shalmaneser III, who also reigned in the 9th century BC): “I captured 200 soldiers alive (and) cut off their arms” and “I captured 200 soldiers alive [and ….] cut off one arm from each of them.”21


The skeleton of an adult male with traumatic injuries to the skull, left forearm, vertebrae, and ribs was reported in 2015. The remains had been found in the Samaria Highlands of modern Israel and were dated to the second half of the 8th century BC, when that area became part of the Neo-Assyrian empire. The most likely explanation for the combination of injuries to this individual is that he was a captive combatant who had been submitted to a series of tortures by his Neo-Assyrian conquerors.20

An earlier find of amputation in modern Israel dates back to ca. 1600 BC. It involved the skeleton of an adult male that was missing the right hand and had shortened lower arm bones. It remains unclear whether the amputation had been performed as punishment or for another reason.22

Case 3: Foot amputation in early China


Some bronze vessels dating back to the Chinese Western Zhou Dynasty (ca. 1046–771 BC) are decorated with a male human figure who is missing his left foot or part of his lower leg. He is mostly portrayed as a guard at a door (Fig. 4.1-5) and is sometimes depicted with a crutch (Fig. 4.3).27

Fig. 4. Bronze vessels dating back to the Chinese Western Zhou Dynasty (ca. 1046–771 BC) which are decorated with a male human figure who is missing his left foot (or part of his lower leg). Fig. 4.6 shows an exceptional bronze dish, where four kneeling figures (each missing their two feet) function as short legs. © Reproduced with permission from Li et al. 2022.23

This iconography of missing one or two feet is generally associated with an ancient Chinese penalty called yue (刖), in which these body parts were cut off with a knife or saw as punishment for a crime. Yue belonged to the five corporal punishments (五刑 or wuxing) in ancient China28 and was especially popular in the Shang and Zhou Dynasties. The cutting point varied from the ankle and the midshaft of the tibia to the patella and the femur.24

Ancient Chinese texts state that yue amputees could be employed to guard a park, such as the royal animal park.29 This is reflected in the Chinese labeling of the bronze Zhou figures as 刖人守门 (yue ren shoumen) which means “gatekeeper with yue amputation.”23 More importantly, the implication is that the convicted had a chance to survive the yue type of corporal punishment.


Four cases of possible amputation (one female from the Western Zhou Dynasty and three males from the Eastern Zhou Dynasty) were reported in the scientific literature in 2022–2024. In all cases, part of a lower leg (left or right) had been removed distally with signs of healing.23,24,25 One of these reports lists seven earlier cases of missing limb(s) from the times of the Shang Dynasty (16th to 11th centuries BC) and Western Zhou Dynasty (11th to 8th centuries BC) that were published between 1956 and 1999: one “limb” (no details); one right foot; one left tibia and fibula; one leg; two hands and feet; one upper limb.25


The author is grateful to Li Nan (National Centre for Archaeology, Beijing) for permission to reproduce Fig. 4.


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PETER AGM DE SMET is a retired Dutch drug information pharmacist, clinical pharmacologist and emeritus professor of pharmaceutical care at the UMC Radboud Nijmegen. He is still active as ethnomedical and ethnopharmacological researcher.

Summer 2024



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