Medicine in the American colonies in 1776 meant living with constant low-level discomfort. Chronic indigestion, itchy skin, lice, bed bugs and slow-healing wounds were ordinary, and about one in three colonial babies died before their second birthday. Doctors widely believed in humoral medicine, the idea that blood, phlegm and two kinds of bile had to be kept in balance, so bloodletting was routine and stayed accepted well into the 1800s. Surgeons often operated without knowing about germs, and they wiped bloody hands on their aprons. Tools such as fleams, used to open veins, and trocars for draining fluid were heavy and imprecise, and the same bone saws were used on animals. Scurvy, from a lack of vitamin C, caused bleeding gums and tooth loss, and home remedies for mouthwash often used tobacco ash, alum and sage.

Hampi is a UNESCO World Heritage Site in Karnataka, India, with more than 1,600 surviving remains spread over 4,100 hectares. It was the capital of the Vijayanagara Empire from 1336 to 1565. Travellers from Persia and Portugal described it as a prosperous, wealthy and grand city with temples, markets and farms along the Tungabhadra River. By 1500 it was estimated to be the world's second-largest city after Beijing, and probably India's richest at the time. In 1565 a coalition of Muslim sultanates defeated the Vijayanagara Empire, its capital was conquered and destroyed, and the city was left in ruins. Hampi remains a religious centre, with the active Virupaksha Temple at its heart.