Peter de Smet
Nijmegen, Netherlands
See Part Two for examples from the New World
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:
- do they really depict the result of surgery?
- 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
Iconography7,8,9
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.
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
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
Bioarchaeology
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
Iconography18,19,20
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).
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
Bioarchaeology
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
Iconography23,24,25,26
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
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.
Bioarchaeology
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
Acknowledgments
The author is grateful to Li Nan (National Centre for Archaeology, Beijing) for permission to reproduce Fig. 4.
References
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- Kirkup J. A history of limb amputation. London: Springer-Verlag; 2007.
- Markatos K, Karamanou M, Saranteas T, Mavrogenis AF. Hallmarks of amputation surgery. Int Orthop 2019; 43: 493-9.
- Dasen V. Autour de l’estropié du Musée d’art et d’histoire de Genève: une représentatin archaïque grecque d’hémimelié? Gesnerus 1997; 54(1-2): 5-22.
- Haaf E, Zwernemann J. Krankheitsdarstellungen an afrikanischen Masken und Figuren. Tribus (Stuttgart) 1971; 20: 35-62.
- Von Graffenried C. Akan: Goldgewichte im Bernischen historischen Museum. Bern: Benteli; 1990.
- Abdalla MA. The amputated hands in ancient Egypt. In: Daoud KA, Bedier S, Abd el-Fattāḥ S, eds. Studies in honor of Ali Radwan SASAE 34. Le Caire: Conseil Suprême des Antiquités de l’Égypte; 2005: 25-34.
- Janzen MD. The iconography of humiliation: the depiction and treatment of bound foreigners in New Kingdom Egypt. Available at: https://digitalcommons.memphis.edu/etd/661 [accessed Jun 12 2024]. Memphis: University of Memphis; 2013.
- Candelora D. Grisly trophies: severed hands and the Egyptian military reward system. Near East Archaeol 2021; 84(3): 192-9.
- Wreszinski W. Atlas zur altägyptischen Kulturgeschichte. Zweiter Teil. Leipzig: Verlag der J.C. Hinrichs’schen Buchhandlung; 1935.
- Johnson WR. Tutankhamun-period battle narratives at Luxor. KMT 2009; 20(no.4): 20-33.
- Blomstedt P. Orthopedic surgery in ancient Egypt. Acta Orthop 2014; 85: 670-6.
- Maspero G. History of Egypt: Chaldea, Syria, Babylonia, and Assyria Vol. V. London: The Grolier Society; 1903.
- Forshaw R. Trauma care, surgery and remedies in ancient Egypt: a reassessment. In: Price C, Forshaw R, Chamberlain A, Nicholson P, eds. Mummies, magic and medicine in ancient Egypt. Manchester: Manchester University Press; 2016: 124-41.
- Messina C, Abd El-Moneim SM, Pozzi M, Tomaino A, Biehler-Gomez L, al e. Evidence of possible lower limb amputation in a tomb in an ancient Egyptian necropolis: the case report of an on-site radiographic analysis. BJR Case Rep 2022: 10.1259/bjrcr.20220090.
- Gresky J, Bietak M, Petiti E, Scheffler C, Schultz M. First osteological evidence of severed hands in ancient Egypt. Sci Rep 2023; 13(1): 5239.
- Candelora D. Hands off! The severed hands of the Hyksos capital. Available at: https://library.biblicalarchaeology.org/department/hands-off-the-severed-hands-of-the-hyksos-capital/ [accessed Jun 16 2024]. Bib Archaeol Rev 2024; 50(1).
- King LW. Bronze reliefs from the gates of Shalmaneser, King of Assyria, BC 860-825. London: Trustees of the British Museum; 1915.
- Belibtreu E. Grisly Assyrian record of torture and death. Bib Archaeol Rev 1991; 17(1): 52-61.
- Cohen H, Slon V, Barash A, May H, Medlej B, Hershkovitz I. Assyrian attitude towards captive enemies: a 2700-year-old paleo-forensic study. Int J Osteoarchaeol 2015; 25: 265-80.
- Grayson AK. The royal inscriptions of Mesopotamia: Assyrian periods. Vol. 2: Assyrian rulers of the early first millennium BC I (1114-859 BC). Toronto: University of Toronto Press; 1991.
- Bloom AI, Bloom RA, Kahila G, Eisenberg E, Smith P. Amputation of the hand in the 3600-year-old skeletal remains of an adult male: the first case reported from Israel. Int J Osteoarchaeol 1995; 5: 188-91.
- Li N, Li C, He J. A suspected case of the yue penalty in the Western Zhou period Acta Anthropol Sin 2022; 41: 826-36.
- Zhang X, Zhan X, Ding Y, Li Y, Yeh H-Y, Chen L. A case of well-healed foot amputation in early China (8th-5th centuries BCE). Int J Osteoarchaeol 2022; 32: 132-41.
- Zhou Y, Liu Y, Yan F, Wang Q. Surviving punishment by body reduction in a hierarchical society: a bioarcheological study of two punitive amputation cases in Eastern Zhou Dynasty (771–256 BCE) with references to the penal and medical systems of ancient China. Archaeol Anthropol Sci 2024; 16: 55.
- Anonymous. 卞和献玉、孙子膑脚的真相是什么?从甲骨到青铜,看商周刖刑演变 [What is the truth about Bian He Xianyu and Sun Tzu’s feet? From oracle bones to bronze, look at the evolution of mutilation in the Shang and Zhou dynasties]. Available at: https://wapbaike.baidu.com/tashuo/browse/content?id=e557d738b715028063140a38 [accessed Jun 20 2024]. Undated.
- Von Falkenhausen L. Action and image in early Chinese art. Cahiers d’Extrême-Asie 2008; 17: 51-91.
- Theobald U. ChinaKnowledge.de: an encyclopaedia on Chinese history and literature. Available at: http://www.chinaknowledge.de/Art/Bronze/bronze.html [accessed Jun 21 2024]. 2000ff.
- Hung W. From the Neolithic to the Han. In: Howard AF, Song L, Hung W, Hong Y, eds. Chinese sculpture. New Haven: Yale University Press; 2006: 17-104.
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.
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