In 1991 a body was found in the ice high in the Alps. It turned out to be around 5,300 years old. Ötzi, as he became known, is now one of the most studied people of the ancient world, and his skin carries some of the oldest tattoos ever found. A few researchers have suggested those tattoos were an early form of acupuncture. It's a fascinating idea, and one that deserves a careful look.
Who was Ötzi?
Ötzi's body is kept at the South Tyrol Museum of Archaeology in Bolzano, Italy. He lived around 5,300 years ago and was probably about 46 years old when he died. Because the ice preserved him, his skin and even the contents of his gut survived, giving scientists an unusually detailed picture of one person's life in the Copper Age.
The tattoos
So far 61 tattoos have been found on his body, all of them lines or crosses. They sit near his ribcage and lower spine, and on his wrist, knee, calves and ankles. The full count only came in 2015, when Italian researchers used multispectral imaging to find marks that had become invisible to the naked eye as the skin darkened over thousands of years.
The 1999 Lancet paper
In 1999 a team led by Leopold Dorfer, with colleagues including Maximilian Moser, published "A medical report from the stone age?" in The Lancet. They looked at 15 groups of tattoos and asked acupuncture societies to compare their positions with traditional acupuncture points. They reported that:
- nine of the tattoo groups lay on the channel traditionally called the Bladder meridian, and three on the Gall Bladder meridian;
- nine of the tattoos were judged to be directly on, or within 6 mm of, traditional acupuncture points;
- X-rays showed Ötzi had moderate wear-and-tear arthrosis in his hips, knees, ankles and lower spine;
- whipworm eggs were found in his colon, which the authors suggested might explain tattoos linked in acupuncture tradition to the abdomen.
From this, the authors raised the possibility that the tattoos were a form of treatment, placed deliberately at points that acupuncture would later use. Notice the question mark in the title. They offered it as a hypothesis, not a conclusion.
Why scholars are cautious
The idea is appealing, but there are good reasons not to treat it as settled.
- The point maps are much later. The Huangdi Neijing, the classic text of Chinese medicine, dates from around the 3rd century BCE. Ötzi lived roughly 3,000 years before that and thousands of miles away. Matching his marks to a much later system tells us about overlap, not about what he or his community believed.
- The count has changed. The 1999 paper worked with 15 tattoo groups. Researchers now count 61 tattoos, including a set on the chest found in 2015, and that changes the picture.
- Painful places are painful places. The museum's own suggestion is that the tattoos were placed at sites of wear and tear that were probably painful, perhaps in a bid to soothe pain.
- Other meanings are possible. Ideas about the tattoos range from early acupuncture or healing rituals to religious or ritual belief, and one tattoo historian thinks their meaning is likely to remain at least partly a mystery.
Even how the tattoos were made is still up for debate. The museum has them as fine cuts rubbed with charcoal. A 2024 study in the European Journal of Archaeology, led by archaeologist Aaron Deter-Wolf with tattoo artists, compared experimental tattoos with Ötzi's skin and concluded they were more likely hand-poked. Speaking to Smithsonian magazine, Deter-Wolf said he didn't disagree that the tattoos could have been therapeutic, but that therapeutic and symbolic purposes weren't mutually exclusive.
So, was Ötzi an acupuncture patient?
Nobody can say for certain yet. What Ötzi does show is that people 5,300 years ago were marking the body at painful places, deliberately and with care. That's a striking thought for anyone interested in the long history of touch-based and point-based traditions, but it isn't evidence that acupuncture as we know it existed in Copper Age Europe.
If you enjoy this kind of history, you might like my piece on how Five Element acupuncture came to Britain through a man born here in Coventry.