made from spirit, phlegm, and bile, with health relying on
the balance of the three substances. Medicines later took the
form of herbal drugs, animal remedies, and even mineral
concoctions. Drugs were oft en used to sedate patients, some
of them made from such plant extracts as cardamom and cin-
namon. In 2001 archaeologists found evidence from a burial
ground in the Indus Valley that dentists had been at work in
about 2000 b.c.e. and had managed to deal with problems in
molar teeth. It is unknown exactly how they did this, but it is
presumed that they used quite advanced dental hand drills.
China has had a long history of the use of medicine.
Much of it was herbal, and many early treatises survive that
describe the use of various herbs for curing particular dis-
eases. Th e fi rst emperor of China, Qin Shi Huang (r. 220–207
b.c.e.), ordered the “burning of the books” in 213 b.c.e. and
particularly excluded works of a medical nature, showing
the importance of them at that time. Indeed, he helped put
together the major medical work the Nei ching su wen (Yel-
low Emperor’s Classic of Internal Medicine). Th is treatise still
forms the basis of many other Chinese medical tracts, such as
the Mo ching (Pulse Classic), written in about 300 c.e.
Chinese medicine essentially relied on the dualist cosmic
concepts of the yin and the yang—the “hot” and the “cold.”
Th e former is the female principle, represented by the earth;
the latter, the male principle, is represented by the heavens.
Th e body itself is made up of fi ve elements, wood, fi re, earth,
metal, and water, which are associated with fi ve planets. As
with the Indians, most Chinese were forbidden by religious
beliefs from dissecting dead bodies, and hence the knowledge
of many diseases remained limited. However the Nei ching
did refer to circulation of the blood, anticipating the discov-
ery of the English physician and anatomist William Harvey
by 13 centuries.
Chinese doctors traditionally relied heavily on herbal
cures, especially using Ephedra vulgaris (mahuang), and Can-
nabis sativa (Indian hemp). Th e root ginseng has also been
used in China, Korea, and Japan for many years. Early Chi-
nese medical practices likewise included diet regimens, the
use of mineral “cures,” and acupuncture. Acupuncture has a
histor y dat ing to 250 0 b.c.e. a nd, it is t hought, was discovered
when several soldiers were hit by arrows in battle and found
themselves cured of other ailments. Th e idea behind using
needles inserted into various points in the body was essen-
tially to free blocked energy, bringing the yin and yang back
into balance. Th e needles would work on particular nerves or
cause activity in another part of the body, which would allow
the person’s inbuilt defenses to cure the body naturally. Start-
ing in about 180 b.c.e. hydrotherapy was also used, with cold
baths serving as a cure for some fevers.
Mention should also be made of Chinese alchemy. Th e
practice seems to have started at least as far back as the War-
ring States Period (the fi ft h to the third centuries b.c.e.); it
was closely associated with the Daoist philosophical ideas of
Laozi. One early alchemist, Ge Hong (382–343 b.c.e.), came
up with a large number of potions from which to make elix-
irs. Some of the many mineral elixirs in ancient China were
poisonous, and several emperors died from taking them in
search of immortality.
Th e fi rst-known hospital where patients were brought for
treatment was developed by King Pandukabhaya during the
fourth century b.c.e. in modern-day Sri Lanka. An ancient
Sinhalese royal chronicle, the Mahavansha, records that the
king established hospitals for ill people in parts of his lands
and also at his capital, Anuradhapura. Many people believe
that the Sri Lankan hospital at Mihintale may be the oldest
in the world for which a site is known. Located in north-cen-
tral Sri Lanka, near the city of Anuradhapura, the remains of
the buildings have inscriptions on the walls showing that the
institution had a bone and muscle specialist and also a leech
doctor.
While Korean medical practices were similar to those
in China, in Japan diagnoses were based on expelling evil
spirits from the bodies of suff erers. Gradually, however, the
Japanese began to follow Chinese medicine. Similarly, in
Southeast Asia, many people used Chinese and Indian medi-
cines and practices, and some doctors from China and In-
dia settled in the area. None of these practitioners were able
to deal with what is thought to be the main cause of death
in the region, malaria. Some Chinese and Indian medical
practitioners may also have lived on various Pacifi c islands,
but medical care in the Pacifi c remained well behind that
on mainland Asia. Although ancient medical practices have
long been dismissed by 19th-century and early-20th-century
historians, archaeological work has unearthed a far more ad-
vanced state of medical treatment in India and China, as well
as in other parts of Asia, than was previously thought to exist
in ancient times.EUROPE
BY MICHAEL J. O’NEAL
Th e health of the ancient Europeans was not especially good.
Among prehistoric peoples life was precarious, a constant
struggle against starvation, famine, accident, disease, and
early death. And this state of aff airs assumes that a person
lived long enough to carry on the struggle. Th e rate of in-
fant mortality was extremely high, with perhaps as many as
a quarter of children either stillborn or dying shortly aft er
birth and as many as a quarter more dying during their fi rst
year of life. Th ings were not much better for women, many of
whom died while giving birth.
A person who survived the fi rst year of life had a life ex-
pectancy much lower than life expectancies in the modern
world. Archaeologists, for example, have discovered a burial
pit in Austria that dates to the Bronze Age. Th e pit contains
seven skeletons of people whose ages are estimated at three,
six, eight, nine, 30, and 40, respectively. In Scotland an Iron
Age burial chamber yielded skeletons of people estimated to
have been 10, 19, 30, 35, 40, and 45, respectively; three ad-
ditional skeletons were of people who were older than 45.550 health and disease: Europe