Tag Archives: pandemics

A World Of Pandemics: Part V

What Sex Was Like During The Black Death

Have you ever wondered what sex during the Black Plague was like? It sounds sick and twisted, but life goes on, as they say, even during an epidemic. People are still people, even when a ton of people are swept away (at least 75 million died during the epidemic). Engaging in physical relationships during the Black Plague (another common name for it) was in many ways a lot like how it was during the rest of the Middle Ages, but the extreme conditions led to some extreme expressions of sexuality.

“Bedroom activity” during the Black Plague was in some ways pretty wild, with some “revelers” deciding to hump the rest of their seemingly short lives away. But doctors at the time also told people to avoid overexerting themselves in the bedroom because they thought the “bad air” would reach them easier if they did. Read on to learn more about what making love during the Black Plague was really like.

There Were “Gatherings” In Graveyards

There Were

The Black Plague was a stressful time to be alive, for obvious reasons. One way to cope, according to historian David Herlihy in The Black Plague and the Transformation of the West, was by celebrating life in cemeteries. “Group activities” were one of the ways people celebrated life. At Avignon’s Champfleur cemetery, for example, things got so bad that a papal official had to threaten the “fornicators and adulterers” with excommunication for committing “unseemly acts” on the graves.

Street walkers even took advantage of this desire by hanging out at cemeteries. It wasn’t all fornication: revelers also dared to dance, fight, throw dice, and play other games among the graves as well.

Medical Experts Advised Limited “Physical Activity”
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Medical logic at the time said that too much “physical activity” “overheated the body,” according to Joseph Patrick Byrne’s The Black Plague, and this allowed “bad air” to enter the body through one’s pores, increasing the chances of catching the plague. Heavy breathing during the act might also lead to inhaling too much of that same “bad air.” A German physician even advised that “all physical exertions and emotions of the mind,” including running, jumping, jealousy, and promiscuity, should be totally avoided or risk catching the dreaded Black Plague. What could people do? They could spend their downtime “relating tales and stories and with good music to delight their hearts.”

“Selling Yourself” Was Institutionalized

As the casualty toll of the plague increased, working girls benefited more and more, according to Jeffrey Richards. They began to enjoy a “seller’s market” due to a general lack of labor in the era, leading to “a general improvement of their conditions.”

Leah Lydia Otis wrote that as the Black Plague waned, there was a “quantum leap in the institutionalization of [working girls.]” Municipally-owned “parlors” were built, complete with “royal safeguards.” Otis did note, however, that the demand for girls began to wane at that time, as well.

Some Thought Immorality Helped Cause The Plague
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Joseph Patrick Byrne wrote that many lawmakers at the time adopted the “Christian belief that sin angered God, who expressed his divine wrath through plague,” and they turned those beliefs into legislation. Many older “moral laws” essentially became just plain laws. This meant sexual immorality was heavily legislated. This “sanitary” legislation targeted sodomy and selling one’s body in particular. In Florence, for example, working girls were “kicked out” of the city in the waning years of the Black Plague. When the industry reemerged in the decades that followed, they were still forbidden to work on the streets. Certain establishments, however, were still allowed to legally operate.

There Was Still An Active Gay Subculture
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According to the Encyclopedia of Homosexuality, Volume 2, a “vital urban subculture” of homosexuals existed during the Black Plague. It wasn’t until the Renaissance that “more detailed records of the life and attitudes of homosexual men and women” emerged, but this vital subculture was alive, despite “only fleeting glimpses of it in the literature” of the period.

A few decades before the Black Plague, King Edward II of England was murdered, and centuries-old rumors say he was executed for homosexual activity. (Mel Gibson’s Braveheart received a lot of criticism for its negative portrayal of Edward.) The belief that “sexual immorality” such as “sodomy” helped cause the Black Plague surely was another factor in keeping the subculture hidden during the period.

‘Pseudo-Flagellants’ Performed Acts In Public
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So-called “flagellants” during the Black Plague were, according to Professor Mark Damen of Utah State University, “professional self-torturers” who went around whipping themselves for a fee in order to “bring God’s favor upon a community hoping to avert the bubonic plague.” They were literal whipping boys that people employed to buy “remission from sin.” The Church, of course, outlawed this behavior, but that didn’t have do much to stop the practice. There was also another group of lesser-known “pseudo-flagellants” that went from town-to-town performing “physical acts” in public for a fee. The Church outlawed them, as well.

Incidents Of Incest Increased
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In Domestic Violence in Medieval TextsEve Salisbury, Georgiana Donavin, and Merrall Llewelyn Price wrote that incest in England actually increased during the Black Plague. Why? Simple arithmetic. The plague “destroyed between one-third and one-half” of the population, making exogamy (marrying only outside their clan or community) “improbable.” The problem, Donavin wrote, wasn’t keeping cousins from marrying, but instead “finding living cousins with whom one might preserve the patrimony.” A lot of noble families died off during the plague years, meaning “intrafamilial marriages greatly increased.”

Fines For Fornication Increased
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Richard M. Smith wrote in Land, Kinship and Life-Cycle that the severity of fines for fornication in England increased as the severity of other legal fines generally decreased in the middle of the Black Plague period (1349). Smith interpreted the high fines during this period as a punishment for acts that were seen as morally improper. The courts, essentially, decided to ramp up the punishment for immorality in response to the Black Plague. Blame the fornicators, basically. Smith did note, however, that attitudes about unseemly acts such as fornication, and thus the inclination to increase the fines for such acts, may have been changing even before the plague struck.

The Most Intense Symptoms Suffered By Victims Of 14th-Century Black Plague

Responsible for eliminating anywhere between 30 to 60% of Europe’s population between 1346 and 1353, the bubonic plague was a cause of terror. Gruesome symptoms led to mass panic and widespread fear. What happened to people with the black plague? From oozing boils to decaying skin, gross symptoms of the black plague were a common sight in Europe during the 1300s. 

The disease occasionally crops up again today. While not always fatal, bubonic plague symptoms can have lasting consequences for sufferers. Early black plague signs include odd lumps and bumps, but also very common ailments. Many plague sufferers initially experience normal symptoms of a cold or flu, like a fever and chills, only to have their health start deteriorating rapidly. Learning about the black plague will leave you second-guessing waiting to see a doctor the next time you come down with a seemingly mild sickness. 

Gangrene Is An Unpleasant Side Effect

Photo: Unknown/Wikimedia Commons/Public Domain

Sufferers often end up with gangrene as a result of the virus, which is sometimes treated via drastic measures like amputation. Gangrene causes the skin to turn shades of blue, purple, green, red, or black. Swelling and blisters may also occur, and these emit a foul-smelling pus. Skin may also become cold and tender. 

One reason amputation is often necessary is that gangrene can lead to septic shock, an often fatal complication.  

Bumps And Boils Eventually Start To Ooze

After their initial appearance, the egg-sized lumps found on plague sufferers get worse. The bumps and boils spread throughout the body. Over time, they begin to rupture and emit blood and pus. 

One Complication Will Promptly Shut Down Bodily Functions

Photo: Paul Fürst (1608–1666)/Wikimedia Commons/Public Dom

Disseminated intravascular coagulation is a medical condition sometimes caused by the plague. This is a serious and potentially fatal complication in which blood clots throughout the body and – as a result – internals organs begin to shut down. This was a death sentence in the early days of the plague, and is often still fatal today.

However, the condition is sometimes successfully treated via a medically induced coma. 

Bumps The Size Of An Egg Present As The First Symptom

If you’ve contracted the plague, the first symptom is a little hard to miss. You develop what are called “buboes,” which generally develop a week after you’re exposed to the virus. These are large bumps, about the size of a chicken egg, that are found around the groin, armpit, or neck. In addition to being massive, they’re sensitive.

The bumps are also warm to the touch and tender.

Sufferers Engaged In Self-Flagellating Religious Rituals

Photo: Unknown 15th-Century Engraving/Wikimedia Commons/Public Domain

When you’re suffering intensely for unknown reasons, it’s not uncommon to look to the skies for an answer. In the 1300s, some sufferers concluded the Black Death was a punishment brought on by an angry God for the impurities in their own souls. Their solution? Intense acts of self flagellation.

Sufferers, especially those in the upper class, would march from town to town. In front of a public audience, they would beat one another and themselves with heavy straps of leather covered in shards of metal. This ritual was repeated three times a day for a 33-and-a-half-day period.

As more and more people began participating, the pope caught wind. Concerned the self flagellants could usurp his power, he condemned the practice. It fizzled out shortly thereafter.

Mutant Bacteria Was Especially Harmful

Plague bacteria spreads rapidly throughout the body, shutting down nearly every vital function. While complications like gangrene and dehydration often led to the end for sufferers, many people were more or less poisoned.

This is due to yersinia pestis, a mutant bacteria that causes the plague. This bacteria is particularly violent as it is unable to survive outside a host, and it can penetrate and hide in a host’s cells. In order to survive, the bacteria multiplies quickly and disables a sufferer’s immune system. Yersinia pestis bacteria then clot underneath the skin, in hopes of being picked up by a passing flea.

Even Survivors Have Lasting Side Effects From The Vomiting

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Vomiting is par for the course for a wide variety of common illnesses, but this is no minor ailment when it’s related to the black plague. Depending on the duration of the infection, the consequences of months of acid reflux and vomiting can last for years. 

Take the case of Katie Simon, a woman who caught the plague on a backpacking trip she took shortly after college in the early 2000s. Her stomach was afflicted that she had to stick to a strict diet comprised of mostly bland foods free of gluten, dairy, alcohol, caffeine, and processed sweeteners. Her upper digestive system was completely inflamed, and she had ulcers covering her stomach and esophagus. Recovery took two and a half years. 

Sufferers Bleed Pretty Much Everywhere

In the disease’s later stages, bleeding is common. Septicemic plague occurs when plague bacteria begin multiplying in a sufferer’s body. They may bleed from the nose, mouth, rectum, or even under the skin. 

Extremities Blacken As Bacteria Multiply

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After an initial infection, bacteria begins to multiply in a sufferer’s bloodstream. This can cause a number of side effects associated with more common illnesses, such as fever, chills, and diarrhea. However, one symptom distinct to the black plague is a change in body color. 

Sufferers often experienced the blackening of their fingers, toes, and nose. 

Overall Skin Color Sometimes Changes

Blackening of the extremities is a common side effect, but some sufferers experience complete changes in skin color.

Take the case of Paul Gaylord, an Oregon man who contracted the plague from his cat in 2012. After the initial fever, his skin began to turn grey throughout his body. This caused his wife to rush him to the hospital, where he luckily received life-saving treatment. 

The Initial Symptoms Mimic Those Of Normal Colds And Flus

Photo: Leo Van Aken/Wikimedia Commons /Public Domain

One of the scariest things about the black plague is that initial symptoms aren’t really that different from the run-of-the-mill flu or cold. You may experience fever, shaking, general weakness, and increased sweating.

Next time you experience these symptoms, especially if you’ve been near rats or fleas recently, you might want to see a doctor just in case.  

Reference

A World of Pandemics: Part I

Inside The Brutal Realities of the Spanish Flu That Killed 100 Million People

Of all the horrors of World War I, it wasn’t the bombs, bullets, or even the mustard gas that ended up as the greatest killer. In reality, the act of moving that many people around the world turned out to be the most deadly fruit of war. The last year of the war, 1918, saw the most deadly pandemic the world has ever known. With all those millions of soldiers being shipped around the globe, it spread like wildfire.

This was the Spanish influenza pandemic. In terms of sheer numbers killed, the Spanish influenza beats out the Black Death as the king of historical epidemics. The statistics of the Spanish flu are just brutal, and the disease touched every corner of the globe. Survivors tell of heartbreaking scenes of misery and quarantine, and today the flu ranks as one of the worst diseases in history, a reminder of how deadly influenza can really be.

The Pandemic Killed 5% Of The World’s Population

Photo: Stevan Aleksić/Wikimedia Commons/Public Domain

The Spanish influenza pandemic killed people on the scale of the fourth rider of the Apocalypse. It is estimated to have killed between 50 and 100 million people worldwide between 1918 and 1919 alone. To put that into perspective, the four years of WWI only killed 17 million people total. Just in the US, over half a million people were killed by the flu, five times as many Americans as were killed in the war.

The flu infected (but didn’t necessarily kill) even more: about 1/3 of the world’s population was believed to have been infected by some form of the Spanish flu. That’s 500 million people at a time when there were only about 1.5 billion people on the entire planet.

The Disease Targeted Young Adults

Photo: CDC/Wikimedia Commons/Public Domain

The normal victims of the flu are typically babies and really, really old people – like, spare hip, dinner at 4:00 pm kind of old. When a 50 year old dies of the flu, it’s a pretty big deal. And a 25-year-old gym rat might think of the flu as a crummy week or two in bed, but the term “life threatening” wouldn’t even come to mind. The Spanish flu turned all that on its head. Young, healthy guys would get home from work one day feeling a little sluggish, and then get carried off in a body bag the next morning. Suffice it to say, that freaked a lot of people out.

Unlike normal flu viruses, Spanish influenza seemed to target those between 20 and 35. The reason for this is that people born after 1889 had no exposure to anything similar to the 1918 virus strain. Those born before that date had some exposure to a similar flu strain; therefore, they had some immunity. That discovery didn’t come until 2014, though, so people at the time were left guessing why Johnny-six-pack next door just dropped dead while Aunt Gertrude was still going strong.

The First Recorded Outbreak Occured In Kansas

Photo: U.S. Army photographer/Wikimedia Commons/Public Domain

Like college basketball champions and the world’s supply of corn, the Spanish flu seems to have come from unassuming Kansas. While the state boasts many fine and comfortable establishments, Fort Riley was not one of them. In 1918, the army camp housed 26,000 men and was described as bone-chilling in the winter and sweltering in the summer. Oh yeah, and they burned tons of manure from the many horses and donkeys on the base, so it probably always smelled like a paper mill.

On March 9, conditions at the base got a lot worse. The cook, Albert Gitchell, reported to the infirmary with a bad cold. By noon, there were over 100 soldiers in the infirmary, apparently suffering from the same malady. In total, 1,127 soldiers came down with the flu, 46 of whom died.

The condition spread to other camps but, given that war was declared, the brass kept a tight grip on the information. Besides, an outbreak of illness among a bunch of men closely quartered in less than ideal living conditions was hardly that unusual.

The Flu Traveled To Europe With American Soldiers

Photo: U.S. Army/Wikimedia Commons/Public Domain

In March of 1918, 84,000 American soldiers were shipped off to Europe. In April, another 118,000 crossed the pond. Along with them, the soldiers brought a chance at victory for the Allied Powers. That, and also the deadly influenza virus.

Imagine that you’ve been living in a muddy trench for the past three years, dodging bullets, ducking artillery, and chasing off rats. Somehow, you are still alive. Finally, some serious reinforcements are coming in, and things are looking up. Then, out of the blue, you catch the worst flu you could possibly imagine. Before you know it, you are lying on an army cot jammed next to a bunch of fellow flu victims, dying in a state of complete delirium because of your high-grade fever.

In the month of June, 31,000 influenza cases were reported in Great Britain. The virus rapidly spread across enemy lines and beyond into Russia, India, and North Africa. By July, the disease had spread across the Pacific to China, Japan, the Philippines, and New Zealand.

Spain Was The First Country To Announce The Epidemic

Photo: Gerardo Chowell, Anton Erkoreka, Cécile Viboud and Beatriz Echeverri-Dávila/Wikimedia Commons/CC BY 4.0

Though Spain was not the first place to be stricken with the illness, it was the first country to openly report it. That is because it was the first country that was not actively involved in WWI to experience the flu’s incredibly high mortality rate. Where other countries (including the US) censored the news for fear of damaging “public morale,” Spain reported on the outbreak freely, which is how the infamous influenza gained the name Spanish flu.

Even Remote Villages Were Not Immune To The Disease

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It wasn’t only the large population centers that suffered from outbreaks of the Spanish flu. Even Inuit villages in Alaska suffered from outbreaks of the disease. In some cases, entire villages were completely wiped out from the disease. In other cases, all the adults were killed, leaving only orphans behind to fend for themselves.

One such infected village was the small, Inuit town of Brevig Mission, Alaska. The disease claimed the lives of 90% of the town’s Inuit population. It was so bad that the Alaskan Territorial government had to pay gold miners from Nome to go up and bury the bodies. When the miners arrived, they tossed the bodies into a pit two meters deep and covered it with permafrost.

The Second Wave Of The Flu Was Much Deadlier Than The First

Photo: Centers for Disease Control and Prevention/Wikimedia Commons/Public Domain

By the end of the summer, the first wave of the flu was starting to die down. People who hadn’t been tagged by the disease undoubtedly felt pretty good about themselves, having dodged that bullet. Then the second wave of the pandemic hit.

It began at a naval facility in Boston in September of 1918, and it pretty much wrecked everyone. Around this same time, the flu hit the port towns of Brest, France, and Freetown, Sierra Leone. It was at this point that the situation escalated from standard pandemic to full-blown crisis of biblical proportions.

In the month of October, 195,000 Americans died from the flu. The death rate during the second wave was a full five-times higher than that of the first. The “lucky” ones who escaped the first wave were much more likely to catch the second wave and subsequently die from it. With such high communicability and mortality rates, things quickly got out of hand.

Symptoms Included Turning Blue And Bleeding Internally

Photo: National Photo Company/Wikimedia Commons/Public Domain

Catching Spanish influenza was not fun. Initial symptoms were similar to normal influenza (fatigue, fever, and headache) but more severe. When the coughing and sneezing set in, things started to get really nasty. People would cough with such force that their abdominal muscles tore.

The flu was so virulent that it would cause internal bleeding around the lungs. People would bleed from their mouths, noses, and sometimes ears. People’s skin would actually turn blue, to the point where it was hard to identify their initial skin color. With all that damage to the lungs, pneumonia set in pretty quickly. People would usually die within a day or two of developing their first symptoms, sometimes mere hours after figuring out they were sick.

They Couldn’t Bury The Bodies Fast Enough

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The world’s worst day is the undertaker’s best day, but the booming coffin industry simply could not keep up with the staggering rate of death caused by the Spanish influenza. We’re talking tens of thousands of people dying in a matter of a month or two…  in just about every big city around the world. To prevent the infectious bodies that were slowly rotting in the morgue corridors from causing secondary infections, many places restored to digging mass graves.

In 2015, a mass grave was rediscovered in Pennsylvania. Located around 100 miles northwest of Philadelphia, the bodies were uncovered after a heavy rain washed away the topsoil near a highway embankment. There were no coffins, just human bones jutting up from the soil.

The War Had Created A Shortage Of Medical Staff

Photo: St. Louis Post Dispatch/Wikimedia Commons/Public Domain

Many of the trained medical personnel at the time the Spanish influenza struck had already joined up with the military to help the war effort. Even before America entered the war, many doctors and nurses volunteered to serve in field hospitals through the Red Cross. So when the flu hit, a great deal of those medical resources were tied up in the trenches of Europe.

As a result, many of those tending for the sick at home were volunteers. They had varying degrees of experience in medicine, from retired doctors pulled back into service to medical students who were still in training.

In some cases, women whose only medical experience was tending to their families found themselves nursing for entire communities. These volunteers risked and sometimes gave their lives caring for the infectious sick. In many cases, their care was the difference between life and death for flu victims.

In The US, Philadelphia Had The Highest Rate Of Sickness And Death

Photo: National Museum of Health and Medicine/Wikimedia Commons/Public Domain

Philadelphia really dropped the ball on this one. City officials knew about the second-wave outbreak of the flu in Boston; they had even issued a bulletin about the dangers of Spanish influenza as early as July, but they still figured that it was no big deal in late September of 1918. They didn’t even have it listed as a reportable disease. Sh*t was about to get real.

In late September, the public was getting mixed signals about the influenza problem. Assurances were made that the disease was contained to military personnel. Dr. Paul Lewis, director of the Philips Institute of Philadelphia announced that they had identified the cause of influenza (incorrectly of course). Then on September 28, the city threw a massive parade, of all things, where 200,000 people gathered to support the war effort. Within days, hundreds of new influenza cases were being reported. The city was forced to admit that they had a problem. Churches, schools, and theaters were all closed.

Unfortunately, about 75% of the city’s medical personnel were unavailable due to the war. Hospitals quickly became overcrowded, necessitating churches and state armories to double as shelters for the sick. The corpses started piling up, posing a real public health problem. The city appealed to the federal government to send embalmers, and individuals were being conscripted to dig graves for $15 a pop. By the time the epidemic abated in early November, almost 13,000 people were dead.

Public Spitting And Coughing Were Banned

Photo: Wikimedia Commons/Public Domain

In some cities, schools, churches, and other public places were closed, and additional quarantine measures were also put into place. The medical community knew enough to realize that public gatherings and bodily fluids contributed to the spread of the disease. Aggressive public information campaigns were disseminated akin to the hand-washing and “cover your cough” campaigns in circulation today.

Perhaps the most hilarious of the public health measures, though, was an ordinance adopted in several locations that banned spitting. In New Castle, Pennsylvania, spitting in public was met with a $1 fine and possible jail time. In all fairness, though, spitting isn’t just bad manners. Apparently, it actually does kill people.

Like The Bubonic Plague, Children Created A Nursery Rhyme About It

Photo: Hans Thoma/Wikimedia Commons/Public Domain

As the Black Death had “Ring Around the Rosey” to commemorate it’s destruction, so too did the Spanish Flu develop a cute diddy.

   I had a little bird
   And its name was Enza.
   I opened the door
   And in-flew-Enza.

The Medical Community Didn’t Understand What Caused The Flu

Photo: Board of Public Health, Victoria/Wikimedia Commons/Public Domain

The Spanish flu came around before penicillin and viruses were even discovered. No viral vaccines even existed, let alone one for the flu. The vaccinations that did exist were bacteria-based, and, at the time, people actually thought that influenza was caused by a bacterium called Bacillus Influenzae. Though they may have helped prevent secondary infections in some cases, they had no hope in stopping the viral influenza.

It wasn’t until 1933 that scientists discovered that influenza was caused by a virus. The first vaccine was developed in 1938, but due to the countless strains and mutations of the ever adapting influenza viruses, the vaccine remains a hit-or-miss proposition to this day. Influenza simply mutates too quickly for a vaccine with broad universality to effectively eradicate it.

It Is Literally The Mother Of All Modern Pandemics

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Almost all modern strains of the Influenza A virus descend in some way from the Spanish flu. The 1918 strain was of the H1N1 variety, with its genetic descendants still alive and infectious to this day. Pretty much any flu you get is a mutated version of the 1918 H1N1 virus. The 1918 outbreak, though, was much more infectious and virulent than any other H1N1 strain to date. Part of this has been attributed to a lack of immunity to the strain in the human population of the time.

The Spanish flu taught people at the time a very important lesson that is still applicable today. That is, at any given point, influenza is pretty much just a mutation or two away from a massive blight of death that humans are powerless to stop. That’s something to chew on the next time your employer asks you to come in because, “it’s just a cough.”

Like All Influenza Viruses, It Ultimately Came From Birds

Photo: Shpernik088/Wikimedia Commons/CC BY-SA 4.0

Ultimately, all human borne influenza originated as avian influenza. Yes, those cute, chirping, balls of feathers are really disease-ridden harbingers of the apocalypse. Sometimes the virus hangs out in some pigs before jumping to humans, giving us the swine flu. There are two key factors that make an influenza strain hit with the pandemic force of the 1918 variety: infectivity and virulence.

In order for a disease to pose the danger of a pandemic, it really needs to be readily transmissible from human to human. While bird flu can sometimes be transferred from birds to humans (or swine flu from pigs to humans), that danger is generally limited to those who work in the food industry. It is only after the influenza strain develops the ability to be transmitted easily between humans that a real pandemic breaks out.

The second factor, virulence, is basically how bad the virus is (how likely is it to kill you). A global pandemic of the sniffles might be inconvenient, but it is hardly something to stay up at night about. A flu that kills over 50% of the people infected by it… well, that’s another story.

These two aspects combined in the Spanish flu in a way that has not been seen since. Certainly, there have been more virulent and more infectious pandemics, but no other pandemic had both these qualities in such a high degree. For example, the H5N1 virus has had periodic outbreaks where the fatality rate is over 50%. That virus, however virulent, is not very infectious as it has not become easily transmittable from human to human. All it takes, though, is a few small mutations.

Reference

The Antonine Plague Claimed 5 Million Ancient Romans — And Scientists Still Don’t Know Its Origin

The Roman Empire was so crippled by the Antonine Plague that many scholars believe it hastened the empire’s demise.

At the height of the Antonine Plague, up to 3,000 ancient Romans dropped dead every single day

The disease was first cited during the reign of the last of the Five Good Emperors, Marcus Aurelius Antoninus, in 165 or 166 A.D. Even though how the pandemic began remains unknown, one Greek physician named Galen managed to document the outbreak itself in startling detail.

Victims suffered for two weeks from fever, vomiting, thirstiness, coughing, and a swollen throat. Others experienced red and black papules on the skin, foul breath, and black diarrhea. Nearly ten percent of the empire perished this way.

Known as both the Antonine Plague and the Plague of Galen, the pandemic did eventually subside, seemingly as mysteriously as it had come.

The Antonine Plague rendered the empire of Ancient Rome a kind of Hell. Indeed, the most powerful empire of its time was utterly helpless in the face of this invisible killer.

The Antonine Plague Spreads Through Ancient Rome

An 1820 portrait of Galen, the Greek physician who documented the Antonine Plague.

Sources largely agree that the disease first appeared in the winter of 165 A.D. to 166 A.D. It was the height of the Roman Empire.

During a siege of the city of Seleucia in modern-day Iraq, Roman troops began to take note of a disease among the locals and then its own soldiers. They consequently carried that disease with them to Gaul and further legions stationed along the Rhine river, effectively spreading the plague across the empire.

Though modern epidemiologists haven’t identified where the plague originated, it is believed that the disease likely developed first in China and was then carried throughout Euroasia by the Roman troops.

There is one ancient legend that attempts to describe how the Antonine Plague first infected the Romans. The legend proposed that Lucius Verus — a Roman general and later the co-emperor to Marcus Aurelius — opened a tomb during the siege of Seleucia and unwittingly liberated the disease. It was thought that the Romans were being punished by the Gods for violating an oath they’d made not to pillage the city of Seleucia.

Meanwhile, the ancient doctor Galen had been away from Rome for two years, and when he returned in 168 A.D., the city was in ruin. His treatise, Methodus Medendi, described the pandemic as great, lengthy, and extraordinarily distressing.

Galen also observed victims suffer from fever, diarrhea, a sore throat, and pustular patches all over their skin. The plague had a mortality rate of 25 percent and survivors developed immunity to it. Others died within two weeks of first presenting symptoms.

Galen (top center) and a group of physicians in an image from the sixth-century Greek-Byzantine medical manuscript, Vienna Dioscurides.

“In those places where it was not ulcerated, the exanthem was rough and scabby and fell away like some husk and hence all became healthy,” M.L. and R.J. Littman wrote in The American Journal of Philology of the disease.

Modern epidemiologists have largely agreed based on this description that the disease was probably smallpox.

By the end of the outbreak in 180 A.D., close to a third of the empire in some areas, and a total of five million people, had died.

How The Plague Of Galen Wounded The Empire

Both Marcus Aurelius Antoninus (represented here in a bust from France’s Musée Saint-Raymond) and his co-emperor Lucius Verus may have died from the plague.

Of the millions that the plague claimed, one of the most famous was co-Emperor Lucius Verus, who ruled beside Emperor Antoninus in 169 A.D. Some modern epidemiologists also speculate that Emperor Marcus Aurelius himself perished from the disease in 180 A.D.

The Plague of Galen also heavily impacted Rome’s military, which then consisted of around 150,000 men. These legionaries caught the disease from their peers returning from the East and their resultant deaths caused a massive shortage in Rome’s military.

As a result, the emperor recruited anyone healthy enough to fight, but the pool was slim considering so many citizens were dying of the plague themselves. Freed slaves, gladiators, and criminals joined the military. This untrained army then later fell victim to Germanic tribes who were able to cross the Rhine river for the first time in over two centuries.

This Roman coin commemorated the victories of Marcus Aurelius Antoninus during the Marcomannic Wars, which lasted from 166 to 180 A.D. — the year he died.

With the economy in trouble and foreign aggressors taking hold, financially maintaining the empire became a serious issue — if not impossible.

The Aftermath Of The Antonine Plague

Unfortunately, the Antonine Plague was only the first of three pandemics to destroy the Roman Empire. Two more would follow, devastating the economy and army.

The Antonine Plague begat a shortage in the workforce and a stagnant economy. Floundering trade meant fewer taxes to support the state. The emperor, meanwhile, blamed Christians for the pandemic, as they supposedly failed to praise the Gods and subsequently enraged them enough to unleash the disease.

Christianity, however, actually garnered popularity during this crisis. Christians were among the few willing to take in those suffering from or left destitute by the plague. Christianity was thus able to emerge as the singular and official faith of the empire following the plague.

As people from high classes fell to lower ones, the nation experienced collective anxiety about their own stations. This was previously unimaginable to those entrenched in Roman exceptionalism.

Ironically, it was the empire’s expansive reach and efficient trade routes that facilitated the spread of the plague. Well-connected and overcrowded cities once hailed as the epitome of culture quickly became the epicenters for disease transmission. In the end, the Antonine Plague was only a predecessor of two more pandemics — and the demise of the biggest empire the world had ever seen.

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