Is the world’s first hospital hidden on an island?

25 Purattasi 2026 Introduction When asked, “Where was the world’s first hospital?”, most people think of the healing temples known as “Asklepieia” in ancient Greece, or the military medical centers of the Roman Empire. However, based on archaeological evidence, the oldest fully organized hospital building discovered anywhere in the world to date is located at Mihintale in Sri Lanka. This fact is rarely mentioned in Western histories of medicine, but it is well known among archaeologists. This article introduces this seldom-discussed historical achievement from a new perspective. Literary evidence: Fourth century BCE According to Sri Lanka’s ancient chronicle, the historical text known as the “Mahavamsa,” King Pandukabhaya (fourth century BCE), whose capital was Anuradhapura, is recorded as having built “Sivikasothi salas” (maternity homes) and public treatment houses in various parts of his kingdom. This is considered the world’s oldest literary evidence for the concept of accommodating patients in one place and treating them collectively. According to historians, no literary or archaeological evidence has so far been found to show that a similar system existed anywhere else in the world before King Pandukabhaya’s time or during the same period. Archaeological evidence: The hospital ruins of Mihintale Beyond literary sources, tangible, visible archaeological ruins have been discovered at Mihintale in Sri Lanka. This hospital, built by King Sena II (853 to 887 CE), has been identified as dating to the ninth century. The foreign archaeologist Hens Müller-Dietz, in his book History of Hospitals (published in 1975), described the Mihintale hospital as “perhaps the oldest in the world.” Extraordinary precision in architectural design The architectural layout of the Mihintale hospital continues to astonish archaeologists even today. It had thirty-one rooms, arranged on an elevated platform. A consultation room, hot-water bathrooms, an inner verandah, a courtyard, and a medicinal bathing room were all separately situated within the hospital complex. Patient beds were arranged in rows around the outer courtyard, and massive water tanks were used to meet water needs. A pharmacy was also located near the entrance. Surgery and steam therapy During archaeological excavations, a stone medicine trough and surgical instruments were found at Mihintale—solid evidence that surgery was already practiced in ancient Sri Lanka. Studies also indicate that a “steam therapy” method using hot water was employed here—something that may be regarded as an ancient precursor to today’s modern “steam therapy” techniques. Royal physicians: A tradition linking medicine and the state Another remarkable feature of Sri Lanka’s ancient history is that several kings themselves were accomplished physicians. Historical records state that King Buddhadasa (340 to 368 CE) possessed expertise in general medicine, surgery, obstetrics, and veterinary medicine. Performing obstetric surgery on a low-caste woman and surgically removing a tumor from a snake’s belly are recorded as notable medical achievements of his. Records also state that King Dutugemunu (161 to 137 BCE) built eighteen hospitals for patients. Other similar hospital ruins Not only at Mihintale, but similar hospital-complex ruins have been found at several other ancient Buddhist monasteries in Sri Lanka—at Medirigiriya, Mahavihara, Thuparama, and Alahana Pirivena (Polonnaruwa). Among these, the Medirigiriya hospital is considered the second oldest after Mihintale. The existence of these many hospitals itself demonstrates that in ancient Sri Lanka, medical care was not an isolated phenomenon, but a well-developed, systematic institution. Why is this fact not widely known? There may be several reasons why this important historical fact is not widely known. Western research on the history of medicine has traditionally been written with a focus on the Greco-Roman tradition. In addition, studies on South Asian archaeological discoveries have received relatively limited attention internationally. Nevertheless, over the past few decades, archaeologists and historians of medicine have increasingly begun to acknowledge this fact. Buddhist monastic tradition and integrated healing Interestingly, the Mihintale hospital was situated as part of a large Buddhist monastic complex. The Chinese traveler Fa-Hien, who visited Sri Lanka in the fifth century, recorded that more than two thousand Buddhist monks lived at Mihintale. To meet the medical needs of such a large monastic community, a fully functioning hospital would have been essential. The inner chamber of this hospital was arranged around a Buddha statue shrine—reflecting a philosophy of care in which medicine and spiritual tranquility were integrated. A lesson for today’s medicine The story of the Mihintale hospital offers an important lesson for modern healthcare systems. The concepts of caring for patients in a centralized place within a calm, organized environment; coordinating medicines and treatment methods in a single location; and linking spiritual tranquility with medical care were already being implemented in Sri Lanka twelve hundred years ago—principles that remain foundational and valued in modern hospital design even today. Conclusion To the question of the world’s first hospital, a surprising answer—one that most history books do not provide—lies hidden at Mihintale in Sri Lanka. From fourth-century BCE literary evidence to ninth-century archaeological ruins, this long, continuous tradition of the ancient Sri Lankan medical system is a proud yet rarely celebrated chapter that presents South Asian civilization’s medical achievement to the world. Remembering this forgotten history anew is the fitting respect we can pay to the scientific achievements of ancient South Asia. Publication: Arivuppasi Media