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Des sources du savoir aux médicaments du futur

Jacques Fleurentin
Jean-Marie Pelt
Guy Mazars

1. Origine des pharmacopées traditionnelles

Evolution of mankind: can we have a medico-archeological approach?

Henry de Lumley


Man's evolution is examined, following the main stages of development, from the first hominids to Homo habilis and Homo erectus. To study prehistoric man from a medical angle, we can investigate pollens, coprolithes and bone pathologies.
Ethnobotanic research carried on the Ice Man - who died 5,300 years ago - provides information about the plants used to make the clothes that he wore, the objects and the weapons that he carried.
The medical approach gives information on the parasitic diseases and the pathologies he had suffered.

Texte intégral

1The medical approach of prehistoric men is an original but difficult issue as we have so little evidence and source of information about the subject.

Man's morphological and cultural evolution

2The group of hominids - i.e. the primates that acquired the biped station - separated itself from the other superior beings some 6 million years ago, possibly somewhat earlier. We have no fossils of sufficiently old age to provide a more accurate dating; molecular approaches show that the divergence between man and the larger monkeys such as chimpanzees - man closest relatives, occurred 6 to 7 million years ago.

3The first hominids are called Australopithecus. They were short, probably about 1 meter tall. The oldest representatives, such as Ardipithecus ramidus did not exceed 80 centimetres in size, and more recent representatives were hardly more than 1 meter to 1.20 meter tall. They were bipeds, as their anatomy indicates; however, occasionally they were tree-climbers. The anatomical study of their cranium shows that they could not possibly have developed an articulated language; the main areas, such as Broca's area, had not developed yet. The base of the cranium had not started bending back and the pharynx had not shifted down yet. These Australopithecus were primarily vegetarians, eating no meat, as tooth wear shows, and they lived in various environments; current research shows that oldest representatives - such as Ardipithecus ramidus in Ethiopia - lived in an open forest, whereas more recent representatives lived in wooded savannah as the forest has shrunk.

4Beginning some 2.5 million years ago, at a time when the Australopithecus went through a period of expansion, homo habilis appeared in a more advanced form in some areas. This hominid was taller - between 1.40 m and 1.70 m - and it walked upright, was perfectly biped and had given up life in trees. The anatomical study of the cranium shows that all the anatomical conditions for the mergence of articulated language were met. We can observes in particular, on the surface of the brain (as can be reconstituted with an endocranial moulding) 2 of the areas significant for language. The flexure at the base of the cranium also begins to appear, entailing a downshift of the pharynx and the emergence of a resonance chamber for the utterance of articulated sounds. Their way of life changed considerably as they became omnivorous, i.e. if they continued being gatherers, but were also meat-eaters and, for the first time, they manufactured tools. We can consider that the manufacturing of tools, or manufactured objects, being designed and fashioned starting from a model and projected in time, was the work of these first Homo habilis. These two basic acquisitions - articulated language and the invention of tool - are a landmark for the beginning of man's cultural adventure 2.5 million years ago. About 1.8 million years ago, at a time when the robust Australopithecus still existed, Homo habilis experienced rapid progress and developed into the first Homo erectus; the latter were again somewhat taller, exceeding 1.60 meter in size. They had a cranial capacity that was even more developed, exceeding 800 cm3, whereas Homo habilis had a capacity of 600 cm3 and the Australopithecus 450 cm3. Homo erectus were thus characterized by a more voluminous cranium and this particular protrusion above the orbits. There were the beings who, some 1.6 million years ago, in Africa and somewhat later in Europe, acquired the concept of symmetry. They were able to select beautiful rocks, attractive colours, obsidians, jaspers and red ochre to manufacture their tools. They took care to perfect them and tools became increasingly regular, symmetrical, due to minute fashioning and a quest for beauty and a kind of harmony in shape and size.

5This suggests that the mental capacities of Homo erectus was much more advanced than that of Homo habilis. These Homo erectus - particularly the most archaic representatives that appeared some 1.8 million years ago in East Africa, on both sides of Lake Turkana - were probably the first to leave the African cradle of mankind. Evidence for this was provided by the discovery of 2 whole or almost complete craniums of archaic Homo erectus called Homo erectus ergaster in the Dmanissi, Georgia site (80 km south of Tbilissi) in May and July 1 999. They testify to the arrival of man in Europe, coming from East Africa, at a very early time.

6Then these Homo erectus developed and spread in all the intertropical and moderately warm areas of the old world, especially on the African continent; however pithecanthropes were also found in South-East Asia, in particular in Java. Sinanthropes were also discovered in China and Europe; they were ante-Neanderthalians. The excavations in the various sites made it possible to provide information about their behavior, way of life and also to remap their circulation areas. We know that they lived in territories of approximately 30 km in radius, i.e. 60 km in diameter. These areas can be remapped by studying the origin of the rocks they used to manufacture their tools. For instance, the Tautavel man, who lived 450 thousand years ago in southern France, close to Perpignan, went to the north-east to look for flint, in the Roquefort-des-Corbieres area, and jasper 30 km to the south-west. This is an illustration of the extent of their hunting territory. Similar observations were made in other parts of Europe or the world.

7About 100 thousand years ago, the Neanderthalians appeared; they were the first in the history of the man to bury the dead. This action is an extremely important phenomenon in man's evolution as it shows that man starts wondering about his existence, his position in the history of the universe and life; he wants to carry on the course of his life beyond death and refuses to die. The appearance of the first funerary rituals testifies to the emergence of metaphysical anguish and the development of religious thought. The funerary rituals prepare burial ceremonies including making offerings for the trip to the other world. For example, the chest of a reindeer and the thigh of a bison were found close to the dead body at La-Chapelle-aux-Saints. In the Chalcea, Palestine cave, the skull of a stag with its antlers was found in the grave of a modern man (not a Neanderthalian). The abundance of pollens from small field flowers found in a grave in Iraqi Kurdistan betrays the fact that flowers had been laid down there.

8Modern men invaded various parts of the world about 30 thousand years ago. In Europe, they are represented by the Cromagnon man. They invented art - cave painting, furniture - developed industry, stone quarrying, invented tools mode of bone. They were also the first navigators, which gave them access to remote lands such as Sardinia and Corsica. For the first time, man reached the Australian continent.

9In the course the seventh millenium before our era, men domesticated nature throughout the world; they stopped living simply on gathering, hunting and fishing, but became food producers, farmers and breeders. This emerged in Southern Anatolia where growing corn, barley, lentils, vetch, chickpeas was invented; they also became breeders rearing goats and sheep. The same kind of phenomenon occurred in Africa south of the Sahara, around Lake Chad, where agriculturers cultivated millet, or in South-East Asia and China, where people cultivated rice and raised sheep and pigs, or in Central America with the cultivation of beans, marrow, water melon, pepper and especially Indian corn, and also in the Southern Pacific with the cultivation of tubers.

10These ancient farmers and breeders invented copper working in the 4th millennium in the Near East and the 3rd millennium in Europe.

11The development of prehistoric man thus covers a period of over 6 million years from the point of view of morphological evolution. Cultural evolution started somewhat later - some 2.5 million years ago - with the invention of the first tools.

Medical approach

12In the present state of our knowledge, we cannot provide a safe answer as to whether prehistoric men had a notion of health care.

Resources for investigation

13One of the major elements is the study of pollens that can be found, on the one hand in the soil of prehistoric habitats, and on the other hand in some burial places. The contribution of certain plants or flowers in these burials place can be evidenced, but it is difficult to establish whether they were put there for medical purposes or in homage to the deceased.

14Another significant element is research on coprolithes. Numerous animal coprolithes have been found in prehistoric sites; some human coprolithes were also found, in particular on the Terra Amata site, close to Nice, France, dating back to 400 thousand years. So far, research on the parasites in these human coprolithes has failed to provide much interesting information. The studies in parasitology have been extended to recent periods, for example to the Paleo-lndians of America or certain historic or protohistoric sites, but the results did not contribute much to research on the diseases and medical practice of prehistoric men.

15The best works on the paleopathology of prehistoric men are those based on bone pathology. For instance, it could be established that the Cro-magnon man had suffered from an actinomycosis which had induced a reshaping of the external face of the forehead, the jawbone and the mandible. But did he try to treat the problem, or did someboy take care of that? We know that other bone illnesses existed, such as the problem that affected the Lazaret child, discovered in Nice, France (dating back to 150 thousand years) who died at the age of 9 years of a benign menigeal tumour - ameningiome.

16Research was also carried out on the ways used to set bone fractures. It could be established that early prehistoric men did not practise bone- fracture setting; when a fracture occurred, it was left to knit by itself, without intervention. It is only in recent times - at the Roman Age or possibly in the Iron age - that real fracture setting appeared.

17Another possible approach about the diseases of fossil men is the sequencing of fossil DNA. Research has been undertaken, in particular on the Neolithic periods, as it is difficult to sequence very old DNA, and genetic diseases were then evidenced in certain populations, but we have no way of saying whether they were medically treated.

18It is thus difficult to answer the question but there is still a case for which pre-historians can offer an answer and this specific situation could be generalized: we refer here to the the mummies that were preserved naturally. Specimens dating back to the Bronze age that had been thrown into peat bogs were found in Denmark. There is a possibility to study these bodies and establish whether they received some sort of medical care in their lifetime before being sacrificed. Mummies were also found in the Andes in Peru and Chile; they had been naturally preserved due to a very dry climate. Targeted studies could be carried out on them.

Breaking the secret of the mummy found in the Austrian Alps

19A mummy was also discovered in Europe - in the Austrian Alps; it had been preserved in the ice of a glacier and was delivered for scientific investigation on September 19, 1991, after part of the ice of the glacier had melted away. It was discovered by two German mountaineers trekking in the upper Senals Valley north of Bozen, Italy who saw the body sticking out of the ice of the Similaum glacier. They reported about their finding at the closest Italian police station. The Italian police officers sent them to Austria, as no missing person had been reported. They then went to Innsbruck, Austria and the Austrian police officers went to the site and extracted the body from its icy prison. They first stripped him looking for his documents, and then transferred him to the mortuary. An Austrian anthropologist was dispatched to the place to offer an estimation of the time of death. But when observing the body, he noticed that the man had a long axe and he told the police that death dated back to about 5,000 years. In fact, more recent work has suggested by the man must have died some 3,300 years before our era.

20He is a man of average size - about 1.60 meter tall - and his weight is estimated 40 kg. The study of the fossil DNA has shown that he was a man of the Alps coming from either North Italy or Austria. The axe which he had is made of dappled copper, with a very long handle made of yew-tree wood. It has a very characteristic shape and similar specimens can be on rock engravings in Vallée des Merveilles in the Mount-Bego area, north of Nice, France. The man also had as a bow of 1.80 meter in height, i.e. larger than himself, also cut out of yew-tree wood, but it was left finished and did not have the eyes necessary to fasten the string. The bow was found wrapped in a satchel made of vegetable fibres. He also had a quiver fashioned out of fine chamois leather, containing 14 arrows, including two finished and having a flint point. The others ones were not finished but points made of stag antlers were found in the quiver, undoubtedly meant to be fastened to the other arrows. There was also a dagger with a finely wrought flint point and a handle made of yew wood, itself in a raffia sheath sewn with a vegetable thread. He also had a kind of finishing tool composed of a point made of antler material set in a piece of lime wood; some scrapings made a flint stone can be seen; the tool was probably sharpened as you would do for a pencil. In his satchel, there was a small flint splinter which might have been used as a sharpener for the finishing instrument. Closeby, investigators also found some of the components of a back-basket, with small wooden sticks and small boards; the basket must have been empty when he abandoned it, but it was probably meant to transport the objects that he gone to fetch. We may wonder whether he was not a metal prospector in the Copper Age. He also carried a net with a large mesh size, possibly to catch birds. A cylindrical box made of birch bark with maple leaves was also found closeby. The study of the chlorophyl contained in the leaves showed that they were fresh at the time of collection. The leaves contained some pieces of charcoal which were probably still smouldering at the time. It must have been a kind of container to transport fire in the mountain. Finally, he had around his neck some dried Pictoporus betulanus birch mushrooms. He obviously carried these birch mushrooms for a specific purpose as they had been perforated and were beautifully fashioned.

21He wore a nice coat made up of rectangular bands cut out of goatskin and sewn together with animal sinews. The vertical bands were alternating between light and dark colour, with the padding on the outside. The garment is knee long and fastened with a leather belt. The man wore leggings also made out of goatskin. He also had a two-meter long belt likewise made of goatskin, and a leather bag fixed waist-high, comfortable shoes made of 2 pieces of skin sewn with an interwoven grass thread, padded with hay and shoe vamp made of deer skin fastened to the sole with a narrow leather strap. He wore a hat made of brown bear skin, with the fur turned outside and a cape made of intertwined vegetable cords; it was probably for protection against the rain and could be used for bedding.

22The contents of his stomach was examined to determine at which time the man had entered the mountain area and in what circumstances he had met his doom: it was established that his last meal has consisted of a mashed spelt and that ha had ingested some hornbeam pollen, either by inhalation or when drinking and eating. However, the hornbeam blossoms until late June at the latest, and no flowers are left in July. Now, two plums were found in his pocket and this fruit is good for picking from July to September. The fresh maple leaves in the small cylindrical contained can be found only from June to September. We can thus suppose that the man died at the beginning of July or, more exactly, at the beginning of the summer time.

Did the "Ice Man" suffer from any pathology?

23He was young, 35-36 years, rather short and thin and not in a very good physical condition. He suffered from several pathologies.

24The exploration of his intestines revealed the presence of many eggs of trichine Trichuris trichira He must have had severe trichinosis which probably caused periods of severe stress; four lines on his nails could be observed, most probably corresponding to recurring periods of general stress. According to the paleopathologists who examined the nails, 3 stressful periods must have occurred at intervals of 8, 12 and 16 weeks before he died. He thus suffered from chronic trichinosis with recurring acute episodes; three of them could be identified, the fourth one must have occurred just at the time of death. He might have had one of these attacks when he was travelling in the mountain.

25The study of the skeleton was not easy as the body was mummified.

26Using sophisticated techniques, it was possible to reconstruct bones and a complete skeleton out of synthetic polymerised resin on the basis of scanned images, without having to make casts that would surely have been damaging for the mummy. Specialists could then observe that osteoarthritis had cause significant damage to the lumbar vertebrae and knees. The feet showed signs of necrosis, probably a consequence of chilblain due to the cold. Finaly, rib discontinuity was also observed, betrayed broken ribs that had never really healed. The fractures must have occurred not so long before death and they could even have been one of the causes of death, but this is not sure as there is not sign of wound on the skin. But it might have happened later on.

27The pathologies suffered by this man are therefore primarily trichinosis, osteoarthritis attacking the lumbar vertebrae and the knees and the significant lesions seen on his feet.

Did he have any medical care in his lifetime?

28On the one hand, we refer to this necklace made of Pictoporus betulanus. This is a toxic mushroom having strong laxative properties when used in moderate amounts (it was still used as such in Poland in the last few decades). We can thus surmise that this man transported these mushrooms after preparing and arranging them on a string, to cure his trichinosis. This could then be taken as evidence for the fact that prehistoric man 5,300 years ago used a plant as a medecine.

29In addition, several tattooings can be observed on the skin, either as parallel lines or as crosses. They were not made for an aesthetic purpose because they are in hidden places, under the knees, on the ankles and calves, and along the lumbar vertebrae. But a precise mapping of the lesions caused by osteoarthritis and the tattooings shows there is nearly perfect overlapping; with the exception of the calves, the osteoarthritis lesions and tattooings are always at the same place. The tattooings most probably had therapeutic purposes. Such practice still exist in other civilizations - for instance in Tibet - and mummies dating back to the Iron age and having such marks have recently been discovered in Pasirenk, Russian Siberia. The procedure consists in incising the skin, putting selected plants into the incision and then cauterising the skin. It was not possible to identify the plants used as they were charcoaled. Researchers have shown that there were similarities between the points where these tattooings were made (corresponding to the arthrosic lesions) and the traditional points of Chinese acupuncture. We may wonder whether this is not an ancient origin for acupuncture. However, the tattooings on the calves do not correspond to places affected by osteoarthritis; they might have been related to severe cramps occurring after long treks in the mountain.

30The discovery of this frozen man who had been preserved in ice for 5 300 years is a unique and extraordinary event as it gives indications that prehistoric people already used plants to try and cure certain affections.

© IRD Éditions, 2002

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