Most Peruvian mummies come bundled in cloth, with their legs folded up to their chests and their arms around their knees. But the young boy we now know only as the Nasca Boy was buried in a position he probably occupied in life: on a contoured, cushioned adobe stool, with his lower legs tucked beneath his seat. It’s the only burial of its kind that archaeologists have ever seen, and it immediately suggests two very important things about this child: he lived with a disability that would have required additional care and resources, and he was well cared for and valued by the people around him, even during a period of their history when food was scarce and life was uncertain.

That’s the conclusion of a new study, which revisits the original 1973 research on the mummified remains of the young boy, who died around 700 CE. The original archaeologists, led by the late Marvin Allison, focused on identifying evidence of tuberculosis in the boy’s remains; they provided the first evidence that the disease had stalked South American populations long before Europeans arrived.

Archaeologist Lorna Tilley and her colleagues have taken a second look at that study in an effort to reconstruct details of the child’s experience with his illness and disability, the kind of care he probably received, and what that reveals about the culture in which he lived. “I rely on taking the information available from the work of other archaeologists and synthesizing it, hoping that I've understood their research results and providing copious references so that readers can go to the sources themselves,” Tilley told Ars Technica.

A short, difficult childhood

An autopsy in the early 1970s found evidence of tuberculosis infection in the Nasca Boy’s spine, a condition called Pott’s Disease. Allison and his colleagues suggested that the child's ordeal began as a mild respiratory infection when the boy was a year or two old. Tuberculosis bacteria in his bloodstream must have spread to his spine, where it eventually left a 5cm-wide abscess in his lower spine, having eaten away at several vertebrae and the discs between them.

Allison and his colleagues also found lesions (called tubercles) and Mycobacterium tuberculosis bacteria in the boy’s lungs, heart, liver, and right kidney. This widespread infection, called miliary tuberculosis, may have spread through his bloodstream from the abscess in his spine, and it probably killed him within weeks.

Tilley and her colleagues didn't do any new analysis of the boy’s remains. Their focus is on re-examining the work of earlier archaeologists, whose research often is directed at identifying signs of disease in ancient populations; Tilley and her colleagues comb that earlier research for overlooked clues about health care in past societies.

Caring for the Nasca Boy

The Nasca Boy probably lived with Pott’s disease for a few years before losing mobility in his legs, and it would have taken a heavy toll on his early childhood, forcing him to live with back and chest pain, fevers, weight loss, and fatigue. It’s likely that he would never have been able to keep up with his peers, either at play or in the work often expected of children in agricultural communities. Tilley and her colleagues compared the Nasca Boy’s case to studies of modern children facing chronic disease, and they speculate that he may also have dealt with depression, anxiety, and grief.

A child with such an illness would have needed additional care and support from his family members—sick children need to be comforted when they’re in pain, cooled when they’re feverish, and probably coaxed to eat.

When Pott’s disease left him immobilized, the Nasca Boy would have required an even higher level of care: help with bathing and personal hygiene, frequent massages and repositioning to help with circulation, and much closer supervision to make sure he was safe, hydrated, and getting enough nutrition. “Without massaging, repositioning, constant hygiene monitoring and maintenance, pressure sores are inevitable when a subject is immobilized, and if left untreated rapidly become infected,” Tilley told Ars Technica. “Similarly, when someone is effectively immobilized, their circulatory and respiratory (as well as other!) systems are very rapidly compromised.”

The fact that the Nasca Boy survived eight to ten years with such a serious illness is proof that he received the care he needed, and it seems he was cared for well; his skin, preserved by natural mummification for nearly 1,300 years, shows no sign of bedsores, which means he likely benefited from good hygiene and frequent position changes. And the stool itself tells a story.

“The stool speaks of an understanding and acceptance of the Nasca Boy’s needs and of the readiness to work around them,” wrote Tilley and her colleagues.

Medicine in the pre-Columbian Andes?

There’s no evidence of what sorts of medicines he might have taken for pain, fever, or digestive problems, because the 1973 study focused on looking for evidence of disease, not treatment.

“Allison et al. approached their subject’s remains with one objective in mind and perceived information extraneous to that as irrelevant,” wrote Tilley and her colleagues. But Tilley says the Nasca almost certainly had access to medicines, either locally or through trade, and biochemical analysis of his hair could yield some clues about whether his body metabolized certain chemical compounds, including alcohol, in his final months. Hair also contains cortisol, which can offer insights into a person’s stress levels, and stable isotopes of strontium and oxygen which could suggest what he ate. Those answers may not be forthcoming any time soon, though.

“While this would satisfy curiosity, I don't think it would be seen as a priority,” Tilley told Ars Technica.

Analysis of his gut contents also could produce evidence of medicinal plants or his last meals, but that opportunity may have been lost; it's not clear whether Allison and his colleagues removed and discarded the mummy's entire stomach and intestines in the 1970s.

It took a village

There’s no evidence of who would have cared for the Nasca Boy during his short, challenging life, but Tilley and her colleagues suggest it was probably a joint effort by his mother and some mixture of older siblings, elderly relatives, and possibly others. In a society where survival depended on crops and livestock, any time away from the work of growing food would have been a costly prospect for a family. That would have been especially true for the Late Nasca, living under the strain of drought and a fickle climate, which had troubled the region since around 640 CE.

The fact that the care happened despite these hardships may suggest something important about the Nasca. “The Nasca Boy’s survival suggests this particular child was sufficiently loved and prized for those responsible for looking after him to make this commitment,” wrote Tilley and her colleagues. “There is no reason to suppose that all children were not equally valued.

That is informed speculation at best, but it’s potentially the clearest insight we have into the family life of a culture that left behind almost no record of such things. All of the art the Nasca have left us has to do with religious or ritual matters—women show up only rarely, and children and daily life are completely absent.

“At this distance in time—over 1,200 years ago, and with no written evidence to fall back on—we can never be sure we're right in the fine detail of analysis,” Tilley told Ars Technica. “But at the broad-brush level, and focusing on the practical and emotional aspects of looking after a very sick child over an extended period in which their decline is obvious, we can surmise a society in which children were valued in their own right; recognized as individuals with individual needs; and supported by the use of possibly scarce resources in their maintenance.”

International Journal of Paleopathology, 2018. DOI: 10.1016/j.ijpp.2018.08.001 (About DOIs).