Twelve thousand years ago, deep inside a limestone cave in northern Vietnam, a man was struck by a quartz arrow. But he did not die right away. His body tried to heal the festered wound, but the injury spread infection through his bones. Months later, he succumbed.

Archaeologists call him TBH1, after the cave of Thung Binh 1 where they found his remains in 2018. His skeleton, preserved in remarkable detail, is now reshaping what we know about conflict and deadly violence at the end of the last Ice Age.

Violence at the Dawn of Southeast Asia

When researchers carefully lifted the bones from the cave floor, they found the man buried in a fetal position, his face resting on his hands. A fallen rock had crushed his skull. However, his skeleton was otherwise complete enough to reconstruct his face, measure his stature, and even recover some of his DNA.

TBH1 stood about 174 centimeters tall (5 feet 7 inches) and was around 35 years old when he died. Other than a minor ankle injury, his bones showed few signs of disease. He belonged to a hunter-gatherer population native to Southeast Asia. His mitochondrial DNA linked him to a genetic lineage known as haplogroup M, shared by early foragers across South and Southeast Asia.

But researchers also noticed something strange. Near his neck, he carried an extra rib—an uncommon congenital variation called a cervical rib. This rib had a fracture. The break had not healed cleanly. Instead, the bone showed evidence of infection: a draining passage where pus once leaked.

Alongside the rib, in the same sediment block, the archaeologists discovered a tiny shard of quartz. Barely 18 millimeters long, it had been carefully notched. To the researchers, it looked like a micropoint—likely once fixed to a dart or arrow.

“The trauma and subsequent infection are the likely cause of death and, to our knowledge, the earliest indication of interpersonal conflict from mainland Southeast Asia,” the study authors wrote.

An Exotic Weapon

The quartz point raises as many questions as it answers. “It doesn’t match any other stone tools from Thung Binh 1 or nearby sites, raising questions about who made it and where it came from,” said Benjamin Utting of the Smithsonian National Museum of Natural History in a statement.

Its exotic nature suggests connections—or conflicts—between distant groups of hunter-gatherers. Archaeologists have documented microlithic weapons of this kind more often in island Southeast Asia, where obsidian points appear in assemblages from the same period. If the shard in Vietnam really was part of a projectile, it could represent a moment when long-distance contacts carried not only ideas and tools, but also violence.

Still, some experts are more cautious. “This quartz projectile could have been the culprit leading to an infected rib, but whether or not this was an act of violence or an accidental injury is difficult to assess, in my opinion,” Michael Rivera, a bioarchaeologist at the University of Hong Kong, who was not involved in the study, told Live Science in an email.

Survival and Care

What is clear is that TBH1 survived long enough for infection to set in. That survival likely required help. With a broken rib near his neck, daily activities such as carrying loads or even breathing deeply would have been painful. Rivera noted that TBH1 “was likely cared for by his community,” who helped him live for months after the initial wound.

His burial, too, suggests respect. Though not marked by grave goods, the careful placement of his body in the cave aligns with other evidence that Thung Binh’s limestone hills were used as burial grounds for centuries afterward.

The find belongs to a growing but still rare record of prehistoric violence. Mass graves in Europe from 6,000 years ago and skeletons from Kenya’s Lake Turkana, about 10,000 years old, show massacres among hunter-gatherers. In Egypt’s Nile Valley, skeletons from Jebel Sahaba reveal some of the world’s earliest evidence of organized conflict.

TBH1 now adds Southeast Asia to that story. His wound may represent the earliest direct sign of interpersonal violence on the mainland of the region. At the same time, his survival reminds us that Ice Age societies were capable of compassion as well as conflict.

“This is an exciting new report from a time and place in which we have very few well-preserved skeletons to study,” Rivera said.

In the end, the man from Thung Binh 1 lived long enough for his story to endure thousands of years. A fractured rib and a tiny piece of quartz now offer a rare glimpse into the human drama—violence, resilience, and care—at the edge of the Pleistocene.

The researchers published their findings in the journal Proceedings of the Royal Society B: Biological Sciences.