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Despite its perceived magical properties, people noticed early on that exposure to asbestos could be dangerous. Roman historian and doctor Pliny the Elder (23AD to 79 AD) warned that slaves who worked in asbestos mines suffered disproportionally from serious lung ailments. He argued that it was risky to buy a slave that worked in these mines because they died young.<ref>Tannapfel, <i>Malignant Mesothelioma</i> at p. 2</ref> Plinny's observation was remarkably prescient, but medicine was not able to diagnosis what was causing this malady for almost 2000 years. Mesothelioma resisted being diagnosed because the tumors associated with it were easily confused with tuberculous.<ref>Tannapfel <i>Malignant Mesothelioma</i>, p. 13</ref> It was impossible for physicians to diagnosis accurately the condition without microscopes. The symptoms of asbestosis would have been readily apparent because it caused people severe difficulties in breathing. Alternatively, mesothelioma was fatal and it could be mistaken for other diseases such as tuberculous or other cancers.

In 1767, Joseph Lieutaud, a renowned French pathologist and King Louis XVI's personal physician, published 2 cases of "pleural tumors" in the <i>Précis de médecine pratique</i>. Leiutaud wrote that the pleural tumors consisted of finding "fleshy masses" adhering to "the pleura and ribs."<ref>Ed. Harvey I. Pass, Nicholas Vogelzang, & Michele Carbone, <i>Malignant Mesothelioma: Pathogenesis, Diagnosis, and Translational Therapies</i> (Springer, New York City, 2005), p. 13.</ref> The tumors described by Lieutaud resembled tumors now known to cause mesothelioma. A German pathologist, von Rokitansky, in 1854 identified tumors that he described as "tumors of the peritoneum" and called "colloid cancer." While he correctly described the tumors, he misidentified them. In 1870, another German doctor, E. Wagner, published a paper that accurately distinguished mesothelioma tumors from tuberculous. Using a microscope, he discovered that the patients that had been diagnosed with tuberculous actually had malignant tumors in the pleura.<ref>Ed. Pass, <i>Malifnant Mesothelioma</i></ref>