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▶ health and disease

introduction
Many common themes run through discussions of health
and disease in the ancient world. Th e fi rst is low life expec-
tancy. Infant mortality rates were extremely high by mod-
ern standards, and many women lost their lives in giving
birth. Among those who survived their fi rst year of life,
the prospects for a long life were limited. In most ancient
civilizations people in their mid-thirties would have been
considered old. Among the most ancient cultures death
by starvation was a constant threat; even when food was
somewhat plentiful, diets were oft en unbalanced, leading
to medical conditions that result from the lack of essential
vitamins or minerals.
A second common theme is a lack of sanitation, usually
refl ecting ignorance about the causes of infectious diseases.
In many parts of the world clean drinking water was scarce.
As human communities grew and became more crowded,
unsanitary conditions were commonplace. Even the ancient
Romans, known for their plumbing and water systems, of-
ten lived in unsanitary conditions, with latrines located in
kitchens and water wells dug in the vicinity of cesspools.
Further, insects and rodents frequently invaded homes and
food-storage facilities, bringing waste and therefore diseases
with them. Th ese conditions gave rise to a host of infectious
diseases, such as malaria, as well as parasites. Before the de-
velopment of antibiotics, a person could die as a result of a
simple infection from an unhealed wound.
A third theme is that ancient cultures sought cures for
the diseases that affl icted them. Many of these treatments

involved substances derived from plants, including herbs,

thought to have medicinal value. In some cases, the ancients

were correct. Chewing the bark of a willow tree relieved pain,

and modern scientists discovered that willow bark contains

a chemical that is closely related to the chemical in aspirin.

Healers who acquired knowledge about medicinal substances

occupied a high place in most ancient cultures, the ancient

Chinese providing a good example. Th ey were oft en thought

to possess special wisdom from the gods. In some cases, these

healers were sought out, giving rise to the earliest hospitals.

Th e earliest-known hospital dates to the fourth century b.c.e.

in modern-day Sri Lanka.

A fourth theme concerns the role of shamans and med-

icine men (and women) in ancient cultures. At a time when

people believed that they were subject to mysterious forces in

nature and that their affl ictions were the work of the gods, sha-

mans were oft en looked on as healers because it was believed

that they could read the will of the gods in omens and signs.

In a sense, these early healers were the world’s fi rst psycholo-

gists, for they oft en linked illness with the mental condition of

the patient. In ancient Africa illness was seen as the result of a

combination of physical, mental, and even social factors. While

their cures may have lacked medicinal value, they provided pa-

tients with the will to fi ght their illnesses. In many instances,

the patients’ improved mental state helped them recover.

AFRICA

BY JULIAN M. MURCHISON

Health and disease in African prehistory has been largely un-

derstudied. As a result of historical stereotypes and miscon-

H