PERFORMANCE-ENHANCING substance abuse famously began in the Garden of Eden, where Eve gave Adam an apple to confer great powers on him. As the 2008 Olympics in China have unfolded, allegations of illegal use of anabolic steroids, erythropoietin, human-growth hormone and other unethical behaviors have surfaced. Begun in 776 B.C. as one of many local religious festivals, the earliest Games viewed unfairness or corruption as a sacrilege against the gods. Ancient Greek Olympian concepts of boosting performance seem, well . . . ancient.

The ancient Olympians trained and ate to enhance performance. Mushrooms and wine were believed to be helpful. Starting around 600 B.C., large amounts of meat, absent from the typical vegetarian diet of the time, were consumed. The Greeks understood the need for protein in meat to increase strength, muscle mass and to repair exercise-induced damage to muscle. It is unclear whether the diet had adequate carbohydrates, needed as a prime energy source to build glycogen in muscles and maintain blood sugar for optimal performance.

Legend proclaims that Milo of Croton, an oft-honored wrestling victor, was an early practitioner of progressive modern training, of using increased time, distance or weight as conditioning improved. After the birth of a baby calf, he is said to have carried it on his shoulders every day as it grew. Some wrote that, after four years, he consumed the entire bull in one day after carrying it around the Olympic stadium.

According to the famous physician Galen in the Third Century A.D., Olympians drank large quantities of herbal teas, providing fluid for exercise in the heat and having high caffeine content. This practice predates the contemporary belief that caffeine intake may improve or sustain performance while decreasing perceptions of fatigue, especially in endurance events. Caffeine enhances the ability to burn fat for fuel rather than depleting carbohydrate stores in muscle. Modern Olympic drug-testing sets limits for caffeine in the blood. We now read of the modern use of intravenous fluid administration before competition to combat dehydration. This practice is much more efficient and technologically advanced than tea, the simple fluid -replacement method of the Greeks.

The heat and humidity of Beijing in summer mirrors that of ancient Olympus, where sweat was viewed as a sacred body essence. Champions were revered. A mixture of oil, dust and sweat was collected from their bodies with the strigilo, a metallic instrument in shaped like L. The slurry was sold to lesser athletes, who believed that drinking this slurry would give them the power of the victor.

The ancient Olympians, however, believed that sweating in competition was an unhealthy loss of vital fluid and a cause of exhaustion. According to Solon around 560 B.C., to block skin pores and prevent sweating, a mixture of clay and dirt “was sprinkled on when the sweat is profuse . . . so it would not leak away.”

Today, we know that exercising muscles build up heat. Evaporation of sweat is a major cooling mechanism to protect against life-threatening increases in body temperature. In hot, dry conditions, evaporation may account for as much as 80 percent of heat loss. We can imagine an ancient stadium of exhausted, dangerously overheated wrestlers without the vital protection of sweat to be evaporated.

Early Olympic training was sport-specific, such as the actual practice of wrestling or the discus throw. The goal was not physical excellence, but ideal condition for a particular event. Only centuries later did conditioning, strength and cross-training exercise become the usual practice. The concept of therapeutic exercise for health benefit was a late feature in ancient Greek culture.

Professionalism and diminishing reverence for purity and athletic ideals eventually permeated the ancient Olympics. Hippocrates condemned athletics as unnatural. He believed that fatigue in exercise must be avoided. Galen, six centuries later, mocked athletes for leading lives like swine, “except swine do not exercise to excess.” Hence, Plato’s remark that “exclusive attention to physical prowess may make a man brutish.”

Are there modern lessons to be learned about performance enhancement in the ancient Olympics, so much simpler, although inappropriately idealized as a paragon of amateur purity? The Beijing Olympics have showcased extraordinary athletic achievement. Nonetheless, a persistent back story exists of illegal use of drugs to enhance performance or body appearance. We should not overlook the mixed message of the adulation accorded to Olympians by millions of would-be champions, especially the young. Estimates in the U.S. of illegal anabolic-steroid use, associated with potentially disastrous health consequences, are as high as 3 million. One in 10 users may be a teenager. Some data suggest that as many as 4.9 to 6.6 percent of teenage boys have used anabolic steroids.

During the Beijing Olympiad, The New York Times published an opinion piece titled “Let the games be doped,” questioning whether we should have an “anything goes“ competition for athletes over age 25. How is this concept viewed by adolescents?

Illegal use of performance- or appearance- enhancing drugs has many causes. We know too little about the unintended contribution of role models such as Olympians and other elite athletes in the formation of harmful attitudes and behaviors of our young athletes.

Edward Feller, M.D., is a clinical professor of medicine and community health at the Brown Medical School.