Category Archives: Medicine

The Falling Sickness: Revisited

Welcome to Rome Across Europe!

Having courses to take for my teaching certification, working full-time, along with trying to be a good husband and father sometimes leaves me with little time for writing new articles for the site. While this is not a new article, it just may be new for you.

In light of events that have recently taken place at my workplace, I thought we should revisit The Falling Sickness.

Me and Caesar Augustus in Roma
Me and Caesar Augustus in Roma

Now this may not sound like it has anything to do with Ancient Rome, but please trust me when I say that it does. The easiest way to begin is to say I have epilepsy.

Unlike some people, I was not born with this condition. I was initially diagnosed when I was 18 years old.

The reason I mention this is because recently a co-worker of mine had a seizure at the end of the school day. It was a big thing since it was her first seizure and, from what I could tell, the first at the school.

It got me thinking about when my primary care doctor sent me to see a neurologist about my condition. At first I was a bit down about it, well a lot down actually.

I tried to hide it and not let anyone know I was “different”. People, no matter what I told them, treated me like I was fragile due to this new illness I had.

Just like my co-worker now, my life was turned upside down. When you grow up not having seizures, or any traumatic injuries, the first time it happens is a really big deal.

Your drivers license gets taken away. Depending upon the severity of the condition, you may miss quite a lot of work or school, and you have an almost endless succession of doctors appointments to attend.

Back when this started for me, my passion for all things Roman had not yet developed into what it is today. I had always loved history though, and recalled hearing that the great and powerful Gaius Julius Caesar had seizures.

He came. He saw. He conquered.

I thought to myself that if this man could conquer and rule such a large portion of the known world, while having seizures, why could I not do great things too? Why could I not live the life I wanted, without the diagnosis of epilepsy weighing me down?

It was then that I decided having epilepsy did not mean my life was done. Big things could still await me.

Veni, Vidi, Vici was to now be my motto. This led me to look deeper into Caesar’s life and find out how he lived with what the ancients called the “Falling Sickness”.

A picture depicting Jesus helping a man with seizures. The unconscious jerking motions were thought to be of a different world, so were often associated with the Church.

Epilepsy dates back to prehistoric times, roughly 2000 BC. It is also known as the “Sacred Disease” since it was believed seizures were “thought to be an illness sent by the gods”.

Because of this, animal sacrifices would be made before priest-doctors in or near temples. Just to let you know, I have never tried this to ease or cure my epilepsy.

Found in an ancient Mesopotamian text an “unknown author describes some symptoms of a patient mid-seizure: sporadic, jerky movements and muscle rigidity.” This is actually a very accurate description, and is basically how modern experts would describe it.

Sticking with the illness being brought on by the gods, the Mesopotamians believed the vengeful god of the moon caused this to happen.

The oldest known detailed record of the disease itself is in the Sakikku, a Babylonian cuneiform medical text from 1067–1046 BC. This text gives signs and symptoms, details treatment and likely outcomes, and describes many features of the different seizure types.

Greek goddess Selene, known to Romans as Luna.

When ancient Greece rose to power a larger number of accounts of epilepsy and seizures were recorded. The majority of the Greek population associated the condition with genius and the divine, and believed that seizures were brought about by gods, in particular the goddess Selene.

These people believed that if the afflicted spent the night in Selene’s temple the goddess would come to you in a dream, thus removing the illness. There was obviously something about the moon bringing on seizures in the eyes of ancient people.

In all honesty, most of my seizures have come on in the later part of the evening. If you had not already realized it, epilepsy is called “The Falling Sickness” since people typically fall down while having a seizure.

Greek physician Hippocrates

Hippocrates, a well-respected Greek physician, looked at the illness differently however.  He believed everything had a natural cause to it, hence why he is considered “The Father of Western Medicine”.

Hippocrates believed that diet, lifestyle and medicine (many of which were herbal) was how to treat the sick. Again, this sounds very similar to modern medicine.

Statue of Caesar where he was assassinated (Roman Forum). He probably would’ve preferred another seizure instead.

When the Romans rose to power those having seizures were shunned and looked down upon. This is probably a solid reason for Julius Caesar not wanting to make his illness known to the public.

In Ancient Rome people did not eat or drink with the same pottery as that used by someone who was affected. People of the time would spit on their chest believing that this would keep the problem from affected them.

According to Apuleius and other ancient physicians, in order detect epilepsy it was common to light a piece of gagates, whose smoke would trigger the seizure. Occasionally a spinning potter’s wheel was used, perhaps a reference to photosensitive epilepsy.

Call him Aelius Galenus or Claudius Galenus, but just call him.

Aelius Galenus or Claudius Galenus, he is referred in history by both names, came to describe epilepsy accurately in his writings Medical Definitions. Galen was a Greek philosopher living in the Roman Empire.

He “was able to discern 3 forms of epilepsy: 1) Idiopathic, attributed to primary brain disorder (an analogue to grand mal epilepsies); 2) Secondary forms, attributed to disturbance of cardiac function transmitted through the flow of liquids secondarily to the brain (epilepsy by sympathy); and 3) a third type attributed to disturbance of another part of human body which is secondarily transmitted to the brain”.

Aretaeus of Cappadocia
Aretaeus of Cappadocia

During the reign of Nero or Vespasian, Aretaeus of Cappadocia was the earliest to describe premotionary symptoms of epilepsy (hallucinations which occasionally can precede the seizures).

He also noted the tendency of seizures to recur, once established, and the phenomenon of epileptic insanity. After the fall of the epileptic to the ground, Aretaeus, distinguished three main periods: manifestation, abatement, cessation.

Ruta graveolens, commonly known as Rue.

Ruta graveolens, a strongly scented herb, was then used by the Romans upon its discovery within the Empire. Rue is native to Southern Europe and used for many ailments.

Thought to cure cancer, remove warts or repel insects, Rue was also used for treating epilepsy.

In a modern study done with Rue and its effects on the central nervous system (CNS) of mice, it was found that Rue “induces a depressant activity on the CNS” thus helping reduce seizures. This also supports the Romans use of the herb.

Medical evidence suggests that epileptic seizures are usually not a random event. Seizures are often brought on by factors such as stress, alcohol abuse, flickering light, or a lack of sleep, among others.

The Falling Sickness has been around for quite some time, and has afflicted many people across the planet. From then till now the cause has not truly ever been known but a variety of remedies has been used.

It really just depends on how the culture at the time which one lives helps to determine the treatment. Those that had epilepsy that came before me did not give up, and hopefully those that come after me will not even have to ever live with the illness.

Courtesy of Matthew Rodriguez

One thing is for certain, though, seizures should only serve as a hiccup in a person’s life, depending on their frequency that is. I wish others like me will use it as a challenge to live life to its fullest.

As for my co-worker, her life is about to change but it doesn’t have to be for the worse. The course she is now on is simply a new road, not totally new to anyone, just for her.

We are doing our best to help her during this adjustment. We here at RAE are also doing our best to keep people aware of various medical conditions that seem to have a stigma attached to them.

Thank you for allowing me to take the time and share a little about myself within the context of history. Remember to come on back to see what journey we’ll be onto next.

Till next time, Don’t Stop Rome-ing!


Chang BS, Lowenstein DH. “Epilepsy”. New England Journal of Medicine. 349 (13), 2003. doi:10.1056/NEJMra022308.

Eadie, Mervyn J.; Bladin, Peter F. A Disease Once Sacred: A History of the Medical Understanding of Epilepsy. John Libbey Eurotext, 2001. ISBN 978-0-86196-607-3.

Magiorkinis, E; Kalliopi, S; Diamantis, A. “Hallmarks in the history of epilepsy: epilepsy in antiquity”. Epilepsy & behavior : E&B. 17 (1), Jan 2010. doi:10.1016/j.yebeh.2009.

Michael, GE; O’Connor, RE. “The diagnosis and management of seizures and status epilepticus in the prehospital setting”. Emerg Med Clin North Am. 29 (1), Feb 2011. doi:10.1016/j.emc.2010.08.003

Pandolfo, M. “Genetics of epilepsy”. Semin Neurol. 31 (5), Nov 2011. doi:10.1055/s-0031-1299789.

Temkin, Owsei. The Falling Sickness: A History of Epilepsy from the Greeks to the Beginnings of Modern Neurology. JHU Press. ISBN 9781421400532.

“Epilepsy: An historical overview”. World Health Organization. Feb 2001.

Epilepsie Museum


Plague of Cyprian: A Plague Blamed on Christianity

Welcome to Rome Across Europe!

So Christmas has passed and we are preparing for New Year’s Eve. If you’ve eaten as much as we have this holiday season then you may be feeling a little sick.

Hopefully that’s not the case, and everyone is still in good health and spirits. If you have been sick, then we’ve got something to help bring perspective.

Recently we discussed a sickness that helped bring down the Roman Empire with the article Antonine Plague: An Indiscriminate Killer Throughout the Empire and the Plague of Justinian: Attacking the Eastern Roman (Byzantine) Empire.

We discovered both the cause (an unknown virus) and effect (30% of Empire’s population perished) of the Antonine Plague. We also learned that the Plague of Justinian has been considered one of the deadliest plagues in history, resulting in the deaths of an estimated 25 million to 50 million people.

Today we continue our look into Roman Medicine as we explore the final plague of the Roman era, the Plague of Cyprian!

The modern name for the 3rd Century plague is derived from early Christian writer Saint Cyprian, Bishop of Carthage, who vividly described the pandemic in a series of accounts. Cyprian believed that the pestilence signaled the end of the world as he wrote, “The kingdom of God, beloved brethren, is beginning to be at hand.”

The Plague of Cyprian afflicted the Roman Empire from AD 250 onwards during the larger Crisis of the Third Century. It took the life of Emperor Hostilian in AD 251 and was still raging in AD 270, when it claimed the life of Emperor Claudius II Gothicus.

Saint Cyprian, namesake of the plague.

The severe devastation to the European population from the plagues may indicate that the people had no previous exposure or immunity to the plague’s cause. The microbe responsible the Plague of Cyprian remains stubbornly unidentifiable despite various historians’ guesses ranging from smallpox to measles.

Historian William Hardy McNeill asserts that the Antonine Plague and the Plague of Cyprian were the original transfers from animal hosts to humanity of 2 different diseases, one of smallpox and one of measles, although not necessarily in that order.

Many Roman authorities blamed the plague itself on Christianity. Despite this, the threat of imminent death from the plague and the unwavering conviction among many of the Christian clergy in the face of it won more converts to the faith.

Burial site for victims of the Cyprian Plague in Thebes.

Archaeologists working in Thebes (modern Luxor) in Egypt have discovered evidence of the Cyprian Plague. During excavations of the Funerary Complex of Harwa and Akhimenru, the Italian Archaeological Mission to Luxor (MAIL), led by Francesco Tiradritti, uncovered charred human remains saturated in lime.

The lime, historically used as a disinfectant, was made in 3 kilns discovered in the complex which archaeologists were able to date the burial to the 3rd Century AD. A huge bonfire where the victims were burned was also found.

Publishing their findings in Egyptian Archaeology, the MAIL researchers believe they have uncovered the burial site of the Theban plague victims. “We found evidence of corpses either burned or buried inside the lime. They had to dispose of them without losing any time,” Tiradritti told LiveScience.

Cave in Thebes where plague victims where found.

The MAIL team found no evidence that the corpses at the Theban funerary complex had received any religious rites, indicating that those who buried them did so quickly in the hopes of curbing the plague’s spread. After its use during the plague, the burial monument appears to have been abandoned, and was never used again.

Grey fragment of decoration from within the monument found inside of the lime kilns.

Tissue taken from skeletons buried around the time of the epidemic in recently uncovered mass graves in Egypt and Rome will surely be analyzed thoroughly. Since we are relying on ancient descriptions of the disease, it is unlikely to say for certain what the sickness actually was.

To be sure, the frightening list of symptoms provided by Cyprian will sound familiar to anyone who followed the recent West African outbreak of the Ebola virus.

“As the strength of the body is dissolved, the bowels dissipate in a flow; a fire that begins in the inmost depths burns up into wounds in the throat… the intestines are shaken with continuous vomiting … the eyes are set on fire from the force of the blood … as weakness prevails through the failures and losses of the bodies, the gait is crippled or the hearing is blocked or the vision is blinded …”

Woodcut of Pontius witnessing the martydom of St. Cyprian (15th Century).

The Plague of Cyprian swept across the Roman Empire from AD 250 to 266, reportedly claiming more than 5,000 victims a day in Rome alone. Cyprian’s biographer, Pontius of Carthage, wrote of the plague at Carthage:

“Afterwards there broke out a dreadful plague, and excessive destruction of a hateful disease invaded every house in succession of the trembling populace, carrying off day by day with abrupt attack numberless people, everyone from his own house. All were shuddering, fleeing, shunning the contagion, impiously exposing their own friends, as if with the exclusion of the person who was sure to die of the plague, one could exclude death itself also. There lay about the meanwhile, over the whole city, no longer bodies, but the carcasses of many, and, by the contemplation of a lot which in their turn would be theirs, demanded the pity of the passers-by for themselves. No one regarded anything besides his cruel gains. No one trembled at the remembrance of a similar event. No one did to another what he himself wished to experience.”

The dead and dying litter the streets.

At the time of the outbreak, it was said people were quick to turn over their friends and even family to the authorities in the hope they could avoid the deadly plague themselves. The streets were strewn with carcasses, many of which were burned to try and destroy the disease.

In Carthage, the Decian Persecution unleashed at the onset of the plague, sought out Christian scapegoats. Fifty years later, when North Africa converted to Christianity, Arnobius defended his new religion from pagan allegations:

“that a plague was brought upon the earth after the Christian religion came into the world, and after it revealed the mysteries of hidden truth? But pestilences, say my opponents, and droughts, wars, famines, locusts, mice, and hailstones, and other hurtful things, by which the property of men is assailed, the gods bring upon us, incensed as they are by your wrong-doings and by your transgressions.”

The Plague of Rome (by Jules Elie Delaunay, 1869).

Cyprian drew moralizing analogies in his sermons to the Christian community and drew a word picture of the plague’s symptoms in his essay De Mortalitate (On the Plague):

“This trial, that now the bowels, relaxed into a constant flux, discharge the bodily strength; that a fire originated in the marrow ferments into wounds of the fauces; that the intestines are shaken with a continual vomiting; that the eyes are on fire with the injected blood; that in some cases the feet or some parts of the limbs are taken off by the contagion of diseased putrefaction; that from the weakness arising by the maiming and loss of the body, either the gait is enfeebled, or the hearing is obstructed, or the sight darkened;—is profitable as a proof of faith. What a grandeur of spirit it is to struggle with all the powers of an unshaken mind against so many onsets of devastation and death! what sublimity, to stand erect amid the desolation of the human race, and not to lie prostrate with those who have no hope in God; but rather to rejoice, and to embrace the benefit of the occasion; that in thus bravely showing forth our faith, and by suffering endured, going forward to Christ by the narrow way that Christ trod, we may receive the reward of His life and faith according to His own judgment!”

Cyprian went on to add that those afflicted by the plague suffered from incessant vomiting, bleeding from the eyes and limbs taken off due to contagion. He also claimed that the plague signaled the end of the world, stating that “The kingdom of God, beloved brethren, is beginning to be at hand; the reward of life, and the rejoicing of eternal salvation, and the perpetual gladness and possession lately lost of paradise, are now coming, with the passing away of the world…”

Bronze bust of Claudius II “the Gothic” (AD 268/269).

The plague still raged in 270: in the account of the wars against Goths waged by Claudius II Gothicus given in the Historia Augusta, it is reported that “in the consulship of Antiochianus and Orfitus the favor of heaven furthered Claudius’ success. For a great multitude, the survivors of the barbarian tribes, who had gathered in Haemimontum were so stricken with famine and pestilence that Claudius now scorned to conquer them further…. during this same period the Scythians attempted to plunder in Crete and Cyprus as well, but everywhere their armies were likewise stricken with pestilence and so were defeated.”

Plagues in Classical Antiquity, as in many other periods of history, were frequently understood to be supernatural as well as physical disasters. Because the 3rd Century AD was a crucial time of growth and definition for the early Christian church, the Plague of Cyprian came to take on a deep spiritual meaning for pagan and Christian alike.

Cyprian the Bishop of Carthage.

For Bishop Cyprian, the plague that came to bear his name was hard proof of the superiority of Christianity over traditional Roman religion. Seeing the pestilence as an opportunity to put their most deeply-held beliefs into action, early Christians beatifically set about caring for the sick and giving proper burials to the dead.

On the other side of the religious divide, the pagan establishment was overwhelmed with fear. Traditionally, Roman priests interpreted epidemics as a sign of displeasure from the gods.

Evidence in the form of new iconography on coins and references to extraordinary state-organized sacrifices suggests that the Plague of Cyprian was no different. Sources agree that, “the epidemic undermined the social fabric of pagan society” while “the orderly response of the Christian community, especially in the burial of the dead, presented a stark contrast.”

Roman Empire (3rd Century AD)

The clearly biased language of both Christian and pagan sources has caused many scholars to discount them as religious propaganda—despite the fact that, if you strip away the pontification, the Christian and pagan accounts agree on all major points, most importantly how contagious, painful, and deadly the disease was.

The tendency of some witnesses to slip into stock phrases taken from classic literary descriptions of plagues in Thucydides and Virgil has similarly worked to discredit the textual evidence because quoting major cultural touchstones was an extremely common way of processing and even emphasizing the severity of shared trauma in antiquity. The disease was one of the nails in the Roman Empire’s coffin, and an important milestone in the growth of early Christianity.

Though the plague did not turn out to be a harbinger of the world’s end, many historians believed that it weakened the Roman Empire and hastened its fall.

Thanks for sticking it out with us and getting through the chaos. We hope you enjoyed the journey and look forward to having you back on our next adventure.

Till next time, Don’t Stop Rome-ing!



Arnobius (Translated by Hamilton Bryce and Hugh Campbell, c. 1885). Adversus Gentes 1.3Online at Christian Classics Ethereal Library.

Cyprian (Transl. Ernest Wallis, c. 1885). De MortalitateOnline at Christian Classics Ethereal Library.

Ngo, Robin. The Cyprian Plague. Bible History Daily. 7 December 2016.

Pontius of Carthage (Transl. Ernest Wallis, c. 1885). Life of CyprianOnline at Christian Classics Ethereal Library.

Pruitt, Sarah. “Ancient Plague Victims Found in Egypt”. 18 June 2014.

Sherman, Irwin W. The power of plagues. ASM Press, 2006.

Stathakopoulos, D. Ch. Famine and Pestilence in the late Roman and early Byzantine Empire. 2007.

Wazer, Caroline. “The Plagues That Might Have Brought Down the Roman Empire”. The Atlantic. 16 March 2016.

Zosimus (scanned and published online by Roger Pearse). The New History, Book 1. Green and Chaplin, 1814.

Saint Cyprian”. Encyclopedia Britannica.

Plague of Justinian: Attacking the Eastern Roman (Byzantine) Empire

Welcome to Rome Across Europe!

By now you are probably in the midst of the holiday season. With so much going on it may feel as if your head will explode or the stress might be making you sick.

Hopefully that’s not the case, and everyone is still in good health and spirits. If not, then we’ve got something to help bring perspective.

Recently we discussed a sickness that helped bring down the Roman Empire with the article Antonine Plague: An Indiscriminate Killer Throughout the Empire. It was here that we discovered both the cause (an unknown virus) and effect (30% of Empire’s population perished) of the Antonine Plague.

Today we continue our look into Roman Medicine as we explore the Plague of Justinian!

The Red Sea and the Port of Clysma, possible gateways for Justinian's Plague.
The Red Sea and the Port of Clysma, possible gateways for Justinian’s Plague.

From 541–542 AD the Eastern Roman (Byzantine) Empire was stricken with a pandemic. Not only was the capital of Constantinople afflicted, but it also hit the Sassanid Empire and port cities around the entire Mediterranean Sea.

The Plague of Justinian has been considered one of the deadliest plagues in history. This devastating contagion resulted in the deaths of an estimated 25 million to 50 million people.

At the time of the initial outbreak, 25 million people was equal to at least 13% of the world’s population. The estimate of 50 million people was due to over 200 years of recurrence.

The outbreak in Constantinople was thought to have been carried to the city by infected rats on grain ships arriving from Egypt. To feed its citizens, the city and outlying communities imported massive amounts of grain, mostly from Egypt.

Yersinia pestis and its carrier the rat help bring down Constantinople.
Yersinia pestis and its carrier the rat help bring down Constantinople.

Grain ships may have been the original source of contagion, as the rat (and flea) population in Egypt thrived on feeding from the large granaries maintained by the government. The principal Byzantine historian during the 6th Century, Procopius, initially reported the epidemic in AD 541 from the port of Pelusium (near Suez in Egypt).

Two firsthand reports of the plague’s ravages were by the Syriac church historian John of Ephesus and Evagrius Scholasticus, who would later become a church historian

As a child in Antioch at the time, Evagrius was afflicted with the buboes associated with the disease but survived. During the disease’s 4 returns in his lifetime, Evagrius lost his wife, a daughter and her child, other children, most of his servants and people from his country estate.

Procopius, in a passage closely modeled on Thucydides, recorded that at its peak the plague was killing 10,000 people in Constantinople daily. However, the accuracy of the figure is in question and the true number will probably never be known.

Emperor Justinian
Emperor Justinian

Modern historians named this plague incident after the Byzantine Emperor Justinian I for more than just the sickness coming about under his reign. The Emperor actually contracted the disease himself yet miraculously survived despite the tons of deaths around him in the capital city.

Procopius noted that because there was no room to bury the dead, bodies were left stacked in the open. Funeral rites were often left unattended to, and the entire city smelled like the dead.

In his Secret History, Procopius records the devastation in the countryside and reports the ruthless response by the hard-pressed Justinian:

“When pestilence swept through the whole known world and notably the Roman Empire, wiping out most of the farming community and of necessity leaving a trail of desolation in its wake, Justinian showed no mercy towards the ruined freeholders. Even then, he did not refrain from demanding the annual tax, not only the amount at which he assessed each individual, but also the amount for which his deceased neighbors were liable.”

Plague of Justinian leaving death in its wake.
Plague of Justinian leaving death in its wake.

As a result of the plague in the countryside, farmers could not take care of crops and the price of grain rose at Constantinople. Justinian had expended huge amounts of money for wars against the Vandals in the region of Carthage and the Ostrogoths‘ kingdom in Italy.

He had also dedicated significant funds to the construction of great churches, such as Hagia Sophia. As the Empire tried to fund the projects, the plague caused tax revenues to decline, possibly by the massive number of deaths and the disruption of agriculture and trade.

Devastating Constantinople
Devastating Constantinople

Justinian swiftly enacted new legislation to deal more efficiently with the glut of inheritance suits being brought as a result of victims dying intestate. Having been a plague victim himself, the people should have maybe been a bit more understanding of Justinian.

The plague’s long-term effects on European and Christian history may have been enormous. As the disease spread to port cities around the Mediterranean, the struggling Goths were reinvigorated and their conflict with Constantinople entered a new phase.

Byzantine Empire in AD 550 (a decade after the Plague of Justinian) with Justinian's conquests shown in green.
Byzantine Empire in AD 550 (a decade after the Plague of Justinian) with Justinian’s conquests shown in green.

The plague weakened the Byzantine Empire at a critical point, just as Justinian’s forces had nearly retaken all of Italy and the western Mediterranean coast. Justinian’s evolving conquest would have reunited the core of the Western Roman Empire with the Eastern Roman Empire.

Although the conquest occurred in AD 554, the reunification did not last long. In 568 the Lombards invaded Northern Italy, defeated the small Byzantine Army that had been left behind, and established the Kingdom of the Lombards.

The plague may have also contributed to the success of the Arabs a few generations later in the Byzantine-Arab Wars. With a reduced population and supplies diminished, it would be hard for any head of state to put together a force of any significance.

Artwork portraying Justinian Plague
Artwork portraying Justinian Plague

Some scholars have suggested that the plague facilitated the Anglo-Saxon conquest of Britain, as its aftermath coincided with the renewed Saxon offensives in the 550s, while the Saxons were contained. Maelgwnking of Gwynedd in Wales, was said to have died of the “Yellow Plague of Rhos” around 547, and from 548 to 549 the plague devastated Ireland as well.

Saxon sources from this period are silent. It seems that there are no 6th Century English documents around today.

The Romano-British may have been disproportionately affected because of trade contacts with Gaul and other factors. An example of this is shown in British settlement patterns being more dispersive than English ones, which could have served to facilitate plague transmission by the rat.

The differential effects may have been exaggerated for British sources were then more likely to report natural disasters than Saxon ones. In addition, there is much evidence of artifact trade between the British and the English which implies significant interaction, yet even minimal interaction would surely have involved a high risk of plague transmission.

Excavations at Calleva Atrebatum.
Excavations at Calleva Atrebatum.

Scholars state that the plague damage done on the Sub-Roman Britons was greater than the one suffered by the Anglo-Saxons. The sudden disappearance around 560 AD of the important Roman town of Calleva Atrebatum was probably due to the Plague of Justinian, which later created a kind of curse on the city “damned” by the Anglo-Saxons.

Recent investigations relate this severe plague epidemic to extreme weather events of 535–536, considered as an example of volcanic winter. The global climatic shift of this period, theorized as the Late Antique Little Ice Age, may have caused a disruption of ecology in human-populated environments, bringing the conditions for the pandemic.

Recent research has confirmed that the cause of the pandemic was Yersinia pestis, the bacterium responsible for bubonic plague. The plague’s social and cultural impact during the period of Justinian has been compared to that of the similar Black Death, devastated Europe 600 years after the last outbreak of Justinian plague.

A characteristic of the Plague of Justinian was necrosis of the hand.
A characteristic of the Plague of Justinian was necrosis of the hand.

Even as it was happening, Procopius viewed the pandemic as worldwide in scope. The primary source of the contagion has pointed to origins in China by genetic studies.

The plague returned periodically until the 8th Century AD. The waves of disease had a major effect on the future course of European history.

The Plague of Justinian is generally regarded as the first recorded instance of bubonic plague. This conclusion is based on the historical description of the clinical manifestations during the epidemic and the detection of Yersinia pestis DNA from human remains at ancient grave sites dated to that period.

A genetic study of the bacterium causing bubonic plague based on samples taken from the remains of 14th Century plague victims in London and a survey of other samples suggests that the Plague of Justinian, and others from antiquity, arose from either now-extinct strains of Yersinia pestis. These are genetically distinct from the 14th Century strain, or at least came from pathogens entirely unrelated to bubonic plague.

However, further work by the same researchers noted that the spread of several unusual modern variants of plague worldwide can be dated to an evolutionary radiation event approximately coinciding with the Plague of Justinian. This finding supports the notion that it was caused by a strain of bubonic plague.

The sick litter the streets.
The sick litter the streets.

The number of deaths is uncertain, but modern scholars believe that the plague killed up to 5,000 people per day in Constantinople at the peak of the pandemic. The initial plague ultimately killed perhaps 40% of the city’s inhabitants and caused the deaths of up to a quarter of the human population of the Eastern Mediterranean.

Frequent subsequent waves of the plague continued to strike throughout the 6th, 7th and 8th Centuries. It appears the disease became more localized and less virulent, before ultimately dying out itself.

The last recurrence of the Justinian Plague was in AD 750. After that pandemics on this scale did not appear again in Europe until the Black Death of the 14th Century.

We realize that this may not be the most pleasant article to read, but we thank you for sticking it out. Be sure to check us out again soon because we never know what’s coming next.

Till next time, Don’t Stop Rome-ing!



Drancourt, M; Roux, V; Dang, LV; Tran-Hung, L; Castex, D; Chenal-Francisque, V; et al. “Genotyping, Orientalis-like Yersinia pestis, and plague pandemics”Emerging Infectious Diseases.

Harbeck, M; Seifert, L; Hänsch, S; Wagner, DM; Birdsell, D; et al. “Yersinia pestis DNA from Skeletal Remains from the 6th Century AD Reveals Insights into Justinianic Plague”. PLoS Pathog, 2013. 9 (5): e1003349. doi:10.1371/journal.ppat.1003349.

Little, Lester K., ed. Plague and the End of Antiquity: The Pandemic of 541–750. Cambridge, 2006. ISBN 0-521-84639-0.

McNeill, William H. Plagues and Peoples. Bantam Doubleday Dell, 1976. ISBN 0-385-12122-9.

Moorhead, J. Justinian. London, 1994.

Orent, Wendy (2004). Plague, The Mysterious Past and Terrifying Future of the World’s Most Dangerous Disease. New York: Simon & Schuster. ISBN 0-7432-3685-8.

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Antonine Plague: An Indiscriminate Killer Throughout the Empire

Welcome to Rome Across Europe!

Over the course of this site being created, we have covered a varying range of topics. We’ve uncovered personal effects from Ancient Rome as we’ve checked out fashion, along with food & drink. We’ve explored various battle sites and organized the Legio Romanus and the Exercitus Romanus.

We’ve checked out people and places that impacted the Imperium Rōmānum, but till now we’ve never ventured to examine non-human influences on the Empire. That all ends now as we’ve added a category about medicine to inspect.

Today we bring back to life a killer of 30% of the population that spread across the Empire leaving bodies in its wake as we scrutinize the Antonine Plague!plague2

Believe it or not, the Romans did a pretty decent job keeping the people healthy. From ingesting a diet that has become popular in modern times to keeping up with sanitation, the Roman world was the most modern of its time.

The influence of Rome spread with its almost unstoppable string of military victories. However, nobody could have foreseen the catastrophic effect tiny germs could have on the largest superpower the world had ever seen.

Movement of the Antonine Plague
Movement of the Antonine Plague

Around AD 165 a sickness hit the Roman Empire. By AD 180, this plague had killed 30% of the population. A pandemic, possibly smallpox or measles but the true cause remains undetermined, followed soldiers returning home from campaigns in the Near East.

The Antonine Plague last from AD 165–180, and was also known as the Plague of Galen (from the name of the Greek physician living in the Roman Empire who described it). The epidemic may have claimed the life of a Roman EmperorLucius Verus, who died in AD 169 and was the co-regent of Marcus Aurelius Antoninus, whose family name of Antoninus, has become associated with the epidemic.

Eastern Roman Legionaries fighting Parthian Light Horse soldiers (Angus McBride).
Eastern Roman Legionaries fighting Parthian Light Horse soldiers (Angus McBride).

Lasting into the rule of Commodus, son of Marcus Aurelius, the Antonine Plague played such a major role that the pathocenosis in the Ancient World was changed. The spread of the epidemic was favored by the occurrence of 2 military episodes in which Marcus Aurelius himself took part: the Parthian War in Mesopotamia and the Marcomannic Wars in northeastern Italia, Noricum and Pannonia.

Ancient sources agree that the epidemic originally appeared during the Roman siege of Seleucia in the winter of AD 165–166. Ammianus Marcellinus reports that the plague spread to Gallia and to the Legiones along the Rhine.

Relief frieze of the Parthian monument depicting the the Roman counter-attack against the Parthians.
Relief frieze of the Parthian monument depicting the the Roman counter-attack against the Parthians.

When the forces of Vologases IV of Parthia attacked Armenia, Imperial forces under the command of Emperor Lucius Verus moved east to face them. Roman defense of the eastern territories was hampered when large numbers of troops succumbed to the disease.

According to the 5th Century Spanish writer Paulus Orosius, many towns and villages in the Italian Peninsula and the European provinces lost all their inhabitants. As the disease swept north to the Rhine, it also infected Germanic and Gallic peoples outside the Empire’s borders.

For several years, those northern groups had pressed south in search of more lands to sustain their growing populations. With their ranks thinned by the epidemic, Roman Armies were now unable to push the tribes back.

Romans fighting with the Germans (relief from the Column of Marcus Aurelius).
Romans fighting with the Germans (relief from the Column of Marcus Aurelius).

From AD 167 to his death, Marcus Aurelius personally commanded Legions near the Danube, trying, with only partial success, to control the advance of Germanic peoples across the river. A major offensive against the Marcomanni was postponed until AD 169 because of a shortage of Imperial troops.

Historian Eutropius asserts that a large population died throughout the Empire. From Assyria to Hispania and from Britannia to Aegyptus, nobody was exempt from the plague’s reach.

Galen (top center) and a group of physicians
Galen (top center) and a group of physicians

Accounts of the clinical features of the epidemic are scant and disjointed, with the main source being Galen, who witnessed the plague. Unfortunately, the great physician provides us with only a brief presentation of the disease.

In AD 166, during the epidemic, Galen traveled from Rome to his home in Asia Minor only to be summoned by the 2 Augusti back to Rome in AD 168. He was present at the outbreak among troops stationed at Aquileia in the winter of AD 168-169.

Galen records observations and a description of the epidemic in the treatise Methodus Medendi, and his other references to it are scattered among his voluminous writings. He describes the plague as “great” and of long duration and mentions feverdiarrhea, and pharyngitis, as well as a skin eruption, sometimes dry and sometimes pustular, appearing on the 9th day of the illness.

Galen and the spread of the disease
Galen and the spread of the disease

His aim was to supply therapeutic approaches, thus passing over the accurate description of the disease symptoms. Paleopathological confirmation is lacking, so any reports of clinical cases treated by Galen would be speculative at best.

Some archaeological evidence, such as terracotta finds, from Italy might reinforce this opinion. In these finds some details can be observed suggesting the artist’s purpose to represent the classic smallpox pustules, typical signs of the disease.

Historian William McNeill asserts that the Antonine Plague and the later Plague of Cyprian (251–ca. 270) were outbreaks of 2 different diseases, one of smallpox and one of measles, not necessarily in that order. The severe devastation to the European population from the 2 plagues may indicate that people had no previous exposure to either disease, which brought immunity to survivors.

Other historians believe that both outbreaks involved smallpox. The latter view seems more likely to be correct given that molecular estimates place the evolution of measles sometime after 500 AD.

The Angel of Death striking a door during the plague of Rome; engraving by Levasseu.
The Angel of Death striking a door during the plague of Rome; engraving by Levasseu.

The Antonine Plague promoted increasing religious fervor which split Romans from their traditional martial and pragmatic values, further undermining social disintegration. In their consternation, many turned to the protection offered by magic.

Lucian of Samosata‘s irony-laden account of the charlatan Alexander records a verse of his “which he dispatched to all the nations during the pestilence… was to be seen written over doorways everywhere”, particularly in the houses that were emptied, Lucian further remarks.

The disease broke out again 9 years later, per Roman Senator & historian Cassius Dio, causing up to 2,000 deaths a day in Rome. The total deaths have been estimated at 5 million, and the disease killed as much as one-third of the population in some areas and devastated the Roman Army.

Romans versus the plague
Romans versus the plague

The extent of the epidemic has been extensively debated. Most authors agree that the impact of the plague was severe, influencing military conscription, the agricultural and urban economy, and depleting the coffers of the State.

The results were catastrophic. Rome’s Army was reduced by 1 in 10, which now consisted mostly of non-Italians.

The epidemic had drastic social and political effects throughout the Roman Empire. Barthold Georg Niebuhr concluded that “as the reign of Marcus Aurelius forms a turning point in so many things, and above all in literature and art, I have no doubt that this crisis was brought about by that plague….The ancient world never recovered from the blow inflicted on it by the plague which visited it in the reign of Marcus Aurelius.”

Marcomannic Wars depicted on the Column of Marcus Aurelius
Marcomannic Wars depicted on the Column of Marcus Aurelius

During the Marcomannic Wars, Marcus Aurelius wrote his philosophical work Meditations. Passage IX.2 states that even the pestilence around him is less deadly than falsehood, evil behavior, and lack of true understanding.

As he lay dying, Marcus uttered the words, “Weep not for me; think rather of the pestilence and the deaths of so many others.”

Attacking towns as if it was a physical enemy.
Attacking towns as if it was a physical enemy.

The Antonine Plague cut a naturally dwindling population by a third, wiping out whole villages and towns. It weakened trade, shrank the labor force, diminished the reliability of transport links, thus wrecking the whole economy.

The plague affected ancient Roman traditions leaving a mark on artistic expression, plus a renewal of spirituality and religiousness was recorded. These events created the conditions for the spread of monotheistic religions, such as Mithraism and Christianity.

This period, characterized by health, social and economic crises, paved the way for the entry into the Empire of neighboring barbarian tribes and the recruitment of barbarian troops into the Roman Army. These events particularly favored the cultural and political growth of these populations.

Roman Trade Map (AD 180)
Roman Trade Map (AD 180)

Historian  Rafe de Crespigny speculates that the plague may have also broken out in Eastern Han China before AD 166, given notices of plagues in Chinese records. The plague had an impact on Roman culture and literature, and may have severely affected Indo-Roman trade relations in the Indian Ocean.

Rafe de Crespigny muses that the plagues afflicting Eastern Han China during the reigns of Emperor Huan of Han and Emperor Ling of Han (with outbreaks in 151, 161, 171, 173, 179, 182, and 185) were perhaps connected to the Antonine Plague on the western end of Eurasia. Crespigny suggests that these plagues led to the rise of the cult faith healing millenarian movement led by Zhang Jue, who instigated the disastrous Yellow Turban Rebellion.

He also states that “it may be only chance” that the outbreak of the Antonine Plague in AD 166 coincides with the Roman Embassy of “Daqin” (i.e. the Roman Empire) landing in Jiaozhi (northern Vietnam) and visiting the Han court of Emperor Huan. Roman Ambassadors claimed to represent “Andun” (安敦; a transliteration of Marcus Aurelius Antoninus or his predecessor Antoninus Pius).

Trade relations between Rome and the East, including China, according to the 1st Century BC navigation guide Periplus of the Erythraean Sea.
Trade relations between Rome and the East, including China, according to the 1st Century BC navigation guide Periplus of the Erythraean Sea.

Raoul McLuaghlin writes that this event of Roman subjects visiting the Han Chinese court in AD 166 could have ushered in a new era of Roman Far East trade, yet it was a “harbinger of something much more ominous” instead. McLaughlin surmises that the origins of the plague lay in Central Asia, from some unknown and isolated population group, which then spread to the Chinese and Roman worlds.

The plague would kill roughly 10% of the Roman population, as cited by McLaughlin, causing “irreparable” damage to the Roman maritime trade in the Indian Ocean as proven by the archaeological record spanning from Egypt to India, as well as significantly decreased Roman commercial activity in Southeast Asia.

However, as evidenced by the 3rd Century Periplus of the Erythraean Sea and the 6th Century Christian Topography by Cosmas Indicopleustes, Roman maritime trade into the Indian Ocean, particularly the silk and spice trade, certainly did not cease and continued up until the loss of Egypt to the Rashidun Caliphate. Chinese histories also insist that further Roman Embassies came to China by way of Rinan in Vietnam in 226 and 284 AD, where Roman artifacts have been found.

Antonine Plague mass grave in Gloucester, England.
Antonine Plague mass grave in Gloucester, England.

No matter the extent of future events, the decline of Roman Empire began with the Antonine Plague. Ultimately, the Fall of the West in the 5th Century AD was completed by the chaos and conditions the plague created.

We know death and disease are not the best of topics, but they due hold lots of information and history within them. Hopefully, you will come check us out again when we venture off to explore some part of the Empire or uncover the secrets of some artifact.

Till next time, Don’t Stop Rome-ing!



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Zinsser, HansRats, Lice and History: A Chronicle of Disease, Plagues, and Pestilence (1935). Reprinted by Black Dog & Leventhal Publishers, Inc. in 1996. ISBN 1-884822-47-9.