eli5 How can historians know the medical causes of death of people who lived before the existence of modern medicine?

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For example I was watching a documentary about Japanese warlords and it said that one of them died from liver cancer. How could they know that?

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Paleopathology, which is the study of disease in ancient populations, is a huge multi-discipline field. It takes aspects of, human osteology, social anthropology, epidemiology, etc, and more.

The short of it is that diseases leave plenty of traces before it kills someone. Social traces in the way they may have acted (lead poisoning in ancient Greek populations being a good example), changes to bones and internal organs (which could then effect bone growth), any signs of traumatic injury, and on and on. Paleopathologists use many methods to figure out likely cause of death.

I don’t know the specific warlord youre talking about, and am unsure if liver cancer leaves a mark on bones, but I would think that in the above case there was some writing/patient history that would have went along with the diagnosis

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The cancer probably spread to the bone before death and left marks on the bones. That evidence paired with written accounts that discribe symptoms is how they can tell.

Ancient medicine may not be perfect, but it was not completely off either. They were certainly able to recognize signs and symptoms of patients, and make certain diagnoses. They may not have been able to cure cancer, or know exactly how cancer affected the body, but could identify it. Through observation, they could tell how a bad liver made a person sick. When dissecting a body, some older doctor might have made a note about how the liver looked weird or diseased.

An historian might look at old medical records, and might notice that many people died of something called bile fever (I am making this word up just for this example). They look at medical books and the symptoms for bile fever are very similar to liver cancer. They track this word bile fever over many year of medical books, and eventually they might find a modern source saying something like, “we diagnosed this person with liver cancer, or as the locals call it, bile fever.” The similarities between the description of the disease to liver cancer, and the connect to liver cancer with an older term often found in the records allows historians to come up with a modern diagnosis of ancient diseases.