Since his discovery nearly 30 years ago, the Tyrolean Iceman has been helping researchers piece together human civilization’s ancient puzzle. Now, an extensive review of “Ötzi” studies indicates the world’s oldest glacial mummy could have belonged to an ancient society with a sophisticated health care system. The paper is published in the International Journal of Paleopathology.

Arguably the world’s most heavily studied human corpse, Ötzi was discovered in the Ötztal Alps in Italy in 1991 at an altitude of 3,210 meters (10,530 feet). The ancient mountain man lived more than 5,000 years ago during the Copper Age, a period of time marked by societal shifts. During this time, metal extraction and smelting helped new technologies arise which in turn led to stronger trade and the emergence of social groups.

It’s no secret Ötzi’s health was failing him. His teeth were rotting, he had arthritis in his joints, parasites in his intestines, and stones in his gallbladder. He was also lactose intolerant and had genetic predispositions to several diseases, not to mention the serious wound in his hand and the arrow in his shoulder, which probably caused him to die of rapid hemorrhagic shock. Ouch.

What has been more elusive to scientists is how – or if – people during this time treated such ailments. To find out, researchers looked at the assortment of tools and herbs that were found near the brown-eyed mummy and how those, along with dozens of tattoos carved on his body, might have treated his many illnesses.

Since his discovery, researchers have debated whether the iceman’s 61 tattoos were decorative or therapeutic – this review argues for the latter. Nine of the 19 categorized groups are placed “close to, or exactly on, the area of traditional acupuncture points,” such as along traditional meridians or on top of organs and joints. Their simple geometric form suggests they were probably used to treat lower back pain, degenerative joint disease, and other aches and pains 40 to 50-year-old Ötzi might have suffered from.

The authors note there is no archaeological evidence for the presence of tattoos during this time period, so no conclusions can be drawn as to whether it was a common practice or “how widespread the knowledge of the application and the potential use for the treatment of pain was around Europe.” If the tattoos are indeed therapeutic, they would predate the earliest Chinese acupuncture and imply a “dedicated, systematic” approach to maintaining and passing down the knowledge of medicinal treatments.

Samples taken from the mummy’s digestive tract show us what he ate before he died. Along with fatty meats and domesticated plants, Ötzi had a number of medicinal herbs and plants in his stomach, such as a kind of toxic fern called bracken, which could have been used to kill the number parasitic eggs found in his intestines. Birch polypore, which has anti-inflammatory and antibiotic properties, was found fastened to a leather band, suggesting he carried these herbs and others with him to self-medicate.

Several tools and clothing made of fur and leather were found nearby, all of which are indicative of an advanced society with a shared system of learning.

“This picture of an orderly, skilled and strategic form of operation puts [the] provision of care into perspective,” the authors conclude.