A 700-year-old female skull discovered in a Chinese cemetery is believed to be the first archaeological evidence of punitive nose amputation, according to a recent study. The middle-aged woman survived the punishment, which may have been given for stealing or for adultery. The skeleton was found among 300 others in 2019 during an excavation at the Sanzhiyuan cemetery in Henan province, eastern China. She was buried face down in a wooden coffin on the southern edge of the cemetery, with only a copper hairpin. Radiocarbon dating placed her life between 1298 and 1404, during either the Yuan dynasty or the early Ming dynasty. The unusual skull was not identified as a case of nasal amputation until study lead author Yawei Zhou, an archaeologist at Zhengzhou University, analyzed the skeletons from the cemetery in 2024. The most noticeable feature was an enlarged piriform aperture, the anatomical term for the nose opening. Researchers observed that the woman's two nasal bones had been partially amputated, leaving about half of the bridge of her nose intact. Further examination revealed that several bones inside her nose had been broken, with signs of healing at the edges. These injuries would have created a "hollow appearance" in the center of her face. Although the researchers could not completely rule out the possibility that the woman’s facial disfigurement was due to a disease or a birth defect, they concluded that the most likely explanation, especially considering her unusual face-down burial position, was punitive nasal amputation as a punishment for a crime. In ancient China, theft of livestock such as cattle and donkeys was common, but adultery could also result in severe punishment. At the end of the Yuan Dynasty, nasal amputation was used as a penalty for such offenses. Archaeologists are familiar with punitive nasal amputation because it was first recorded in ancient Chinese oracle bone inscriptions. During the Shang dynasty (1600–1046 B.C.), the punishment was depicted in Chinese characters as a knife placed on the left or right side of the nose. Co-author Qian Wang, a biological anthropologist at Texas A&M University, expressed surprise at this discovery, noting that no scientific reports or descriptions of penal nasal amputation in archaeological skeletons had previously been published. However, since nasal amputation without anesthesia was one of the "Five Punishments" in early dynastic China—alongside tattooing, foot amputation, castration, and death—Wang suggested there may be many more cases in history. Elizabeth Berger, a bioarchaeologist at the University of California, Riverside, who was not involved in the research, said the study presents a compelling argument that the woman’s disfigurement was the result of punitive nasal amputation. She emphasized that this case study could inspire future research to uncover more evidence about who was subjected to such punishments, how they were carried out, and how they were medically managed, including the use of prosthetics. The unusual skull was assessed as part of the Global History of Health Project's Asia Module, which Wang leads. She noted that more skeletons will be examined in the future for diseases and trauma, and hopes that similar cases will be found in a clearer archaeological context.