Disease and the Fall of the Roman Empire


A map of the territories controlled by Eastern and Western Roman Empires as of 476 CE.



The Roman Empire suffered the severe and protracted Antonine Plague, CE 165-180, also known as the Plague of Galen, who described it, as an ancient pandemic, either of smallpox or measles,brought back to the Roman Empire by troops returning from campaigns in the Near East. The epidemic may have claimed the life of Roman emperor Lucius Verus, who died in 169 and was the co-regent of Marcus Aurelius Antoninus, whose family name, Antoninus, was given to the epidemic. The disease broke out again nine years later, according to the Roman historian Dio Cassius, and caused up to 2,000 deaths a day in Rome, one quarter of those infected.Total deaths have been estimated at five million.The disease killed as much as one-third of the population in some areas and decimated the Roman army.


Ancient sources agree that the epidemic appeared first during the Roman siege of Seleucia in the winter of 165-66.Ammianus Marcellinus reports that the plague spread to Gaul and the legions along the Rhine. Eutropius asserts that a large population died throughout the Empire. In 166, during the epidemic, the Greek physician and writer Galen traveled from Rome to his home in Asia Minor. He returned to Rome in 168 when summoned by the two Augusti and ended up being present at the outbreak among troops stationed at Aquileia in the winter of 168/69. Galen’s observations and description of the epidemic in the treatise Methodus Medendi is brief, and his other references to it are scattered among his voluminous writings. He describes the plague as “great” and of long duration and mentions fever, diarrhea, and inflammation of the pharynx, as well as a skin eruption, sometimes dry and sometimes pustular, appearing on the ninth day of the illness. The information provided by Galen does not clearly define the nature of the disease, but scholars have generally preferred to diagnose it as smallpox.


The severe devastation to the European population from the two plagues may indicate that people had no previous exposure to either disease, which brought immunity to survivors. Many historians believe that both outbreaks were of smallpox.This latter view seems more likely to be correct given that molecular estimates place the evolution of measles sometime after 500 AD.


In their consternation, many Romans turned to the protection offered by magic. Lucian of Samosata’s irony-laden account of the charlatan Alexander records that a verse of his “which he dispatched to all the nations during the pestilence – was to be seen written over doorways everywhere”- particularly in those houses which were emptied, Lucian remarked. The epidemic had drastic social and political effects throughout the Roman Empire: Barthold Georg Niebuhr concluded that “as the reign of M. 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 M. Aurelius.”Edward Gibbon and Michael Rostovtzeff assign the Antonine plague less influence than political and economic trends, respectively.


In the view of the editors of ON TARGET, the confluence of so many forces, political, social, economic, military and religious, were all made weaker by the onslaught of these ancient plagues. Disease could have contributed the final pounding to an already disintegrating way of life in the ancient world


Some direct effects of the contagion stand out, however. When Imperial forces moved east under the command of Emperor Verus after the forces of Vologases IV of Parthia attacked Armenia, the Romans’ 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 a number of years, these 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. From 167 until his death, Emperor 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 169 because of a shortage of Imperial troops.


During the Germanic campaign, Marcus Aurelius also 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.”


For about twenty years, waves of one or more diseases, possibly the first epidemics of smallpox and/or measles, swept through the Empire, ultimately killing about half the population. Similar epidemics, such as the Plague of Cyprian, also occurred in the 3rd century. It has been argued that the severe fall in population left the state apparatus and army too large for the population to support, leading to further economic and social decline that eventually killed the Western Empire. The Eastern half survived due to its larger population, which even after the plagues was sufficient for an effective state apparatus.


Archaeology has revealed that from the 2nd century onward, the inhabited area in most Roman towns and cities grew smaller and smaller. Imperial laws concerning “agri deserti”, or deserted lands, became increasingly common and desperate. The economic collapse of the 3rd century may also be evidence of a shrinking population as Rome’s tax base was also shrinking and could no longer support the Roman Army and other Roman institutions. Rome’s success had led to increased contact with Asia though trade, especially in a sea route through the Red Sea that Rome cleared of pirates shortly after conquering Egypt. Wars also increased contact with Asia, particularly wars with the Persian Empire. With increased contact with Asia came increased transmission of disease into the Mediterranean from Asia. Romans used public fountains, public latrines, public baths, and supported many brothels all of which were conducive to the spread of pathogens. Romans crowded into walled cities and the poor and the slaves lived in very close quarters with each other. Epidemics began sweeping though the Empire.


The culture of the German barbarians living just across the Rhine and Danube rivers was not so conducive to the spread of pathogens. Germans lived in small scattered villages that did not support the same level of trade as did Roman settlements. Germans lived in single-family detached houses. Germans did not have public baths nor as many brothels and drank ale made with boiled water. The barbarian population seemed to be on the rise. The demographics of Europe were changing. Economically, depopulation led to the impoverishment of East and West as economic ties among different parts of the empire weakened.


Increasing raids by barbarians further strained the economy and further reduced the population, mostly in the West. In areas near the Rhine and Danube frontiers, raids by barbarians killed Romans and disrupted commerce. Raids also forced Romans into walled towns and cities furthering the spread of pathogens and increasing the rate of depopulation in the West. A low population and weak economy forced Rome to use barbarians in the Roman Army to defend against other barbarians.


Culturally, the decline of Roman urban life and of the Roman educational system made it prohibitively difficult for rulers to maintain Roman civilization in its various manifestations. German barbarians were more easily able to integrate into the uneducated Roman aristocracy and demand land and, later, demand kingdoms of their own. This theory can also be extended to the time after the fall of the Western Empire and to other parts of the world.


Similar epidemics caused by new diseases may have weakened the Chinese Han Empire and contributed to its collapse. This was followed by the long and chaotic episode known as the Six Dynasties period. Later, the Plague of Justinian may have been the first instance of bubonic plague. It, and subsequent recurrences, may have been so devastating that they helped the Arab conquest of most of the Eastern Empire and the whole of the Sassanid Empire. Archaeological evidence is showing that Europe continued to have a steady downward trend in population starting as early as the 2nd century and continuing through the 7th century. The European recovery may have started only when the population, through natural selection, had gained some resistance to the new diseases.


Adding to the calamitous falling Roman Empire, the extreme weather events of 535–536 were the most severe and protracted short-term episodes of cooling in the Northern Hemisphere in the last 2,000 years. The event is thought to have been caused by an extensive atmospheric dust veil, possibly resulting from a large volcanic eruption in the tropics, or debris from space impacting the Earth.Its effects were widespread, causing unseasonal weather, crop failures, and famines worldwide.


This patient presented with symptoms of plague that included gangrene of the right hand causing necrosis of the fingers.


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