Antonine Plague
Encyclopedia
The Antonine Plague, AD 165–180, also known as the Plague of Galen
Galen
Aelius Galenus or Claudius Galenus , better known as Galen of Pergamon , was a prominent Roman physician, surgeon and philosopher...

, who described it, was an ancient pandemic
Pandemic
A pandemic is an epidemic of infectious disease that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic...

, either of smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...

 or measles
Measles
Measles, also known as rubeola or morbilli, is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses...

, brought back to the Roman Empire
Roman Empire
The Roman Empire was the post-Republican period of the ancient Roman civilization, characterised by an autocratic form of government and large territorial holdings in Europe and around the Mediterranean....

 by troops returning from campaigns in the Near East
Near East
The Near East is a geographical term that covers different countries for geographers, archeologists, and historians, on the one hand, and for political scientists, economists, and journalists, on the other...

. The epidemic may have claimed the life of Roman emperor
Roman Emperor
The Roman emperor was the ruler of the Roman State during the imperial period . The Romans had no single term for the office although at any given time, a given title was associated with the emperor...

 Lucius Verus
Lucius Verus
Lucius Verus , was Roman co-emperor with Marcus Aurelius, from 161 until his death.-Early life and career:Lucius Verus was the first born son to Avidia Plautia and Lucius Aelius Verus Caesar, the first adopted son and heir of Roman Emperor Hadrian . He was born and raised in Rome...

, 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
Dio Cassius
Lucius Cassius Dio Cocceianus , known in English as Cassius Dio, Dio Cassius, or Dio was a Roman consul and a noted historian writing in Greek...

, 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
Seleucia
Seleucia was the first capital of the Seleucid Empire, and one of the great cities of antiquity standing in Mesopotamia, on the Tigris River.Seleucia may refer to:...

 in the winter of 165–66. Ammianus Marcellinus
Ammianus Marcellinus
Ammianus Marcellinus was a fourth-century Roman historian. He wrote the penultimate major historical account surviving from Antiquity...

 reports that the plague spread to Gaul
Gaul
Gaul was a region of Western Europe during the Iron Age and Roman era, encompassing present day France, Luxembourg and Belgium, most of Switzerland, the western part of Northern Italy, as well as the parts of the Netherlands and Germany on the left bank of the Rhine. The Gauls were the speakers of...

 and the legions along the Rhine. Eutropius asserts that a large population died throughout the Empire.

Epidemiology

In 166, during the epidemic, the Greek physician and writer Galen
Galen
Aelius Galenus or Claudius Galenus , better known as Galen of Pergamon , was a prominent Roman physician, surgeon and philosopher...

 traveled from Rome
Rome
Rome is the capital of Italy and the country's largest and most populated city and comune, with over 2.7 million residents in . The city is located in the central-western portion of the Italian Peninsula, on the Tiber River within the Lazio region of Italy.Rome's history spans two and a half...

 to his home in Asia Minor
Asia Minor
Asia Minor is a geographical location at the westernmost protrusion of Asia, also called Anatolia, and corresponds to the western two thirds of the Asian part of Turkey...

. He returned to Rome in 168 when summoned by the two Augusti
Augustus (honorific)
Augustus , Latin for "majestic," "the increaser," or "venerable", was an Ancient Roman title, which was first held by Gaius Julius Caesar Augustus , and subsequently came to be considered one of the titles of what are now known as the Roman Emperors...

; he was present at the outbreak among troops stationed at Aquileia
Aquileia
Aquileia is an ancient Roman city in what is now Italy, at the head of the Adriatic at the edge of the lagoons, about 10 km from the sea, on the river Natiso , the course of which has changed somewhat since Roman times...

 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
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...

, diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...

, and inflammation
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...

 of the pharynx
Pharynx
The human pharynx is the part of the throat situated immediately posterior to the mouth and nasal cavity, and anterior to the esophagus and larynx. The human pharynx is conventionally divided into three sections: the nasopharynx , the oropharynx , and the laryngopharynx...

, as well as a skin eruption, sometimes dry and sometimes pus
Pus
Pus is a viscous exudate, typically whitish-yellow, yellow, or yellow-brown, formed at the site of inflammatory during infection. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collection of pus within or beneath the epidermis is known as a pustule or...

tular, 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 .

Historian William McNeill
William H. McNeill
William Hardy McNeill is an American world historian and author and is Professor Emeritus of History at the University of Chicago, where he has taught since 1947.-Biography:...

 asserts that the Antonine Plague and the later Plague of Cyprian
Plague of Cyprian
The Plague of Cyprian is the name given to a pandemic, probably of smallpox, that afflicted the Roman Empire from AD 250 onwards. It was still raging in 270, when it claimed the life of emperor Claudius II Gothicus . The plague caused widespread manpower shortages in agriculture and the Roman army....

 (251–ca.270) were outbreaks of two different diseases, one of smallpox and one of measles, although not necessarily in that order. 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. Other 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.

Effects

In their consternation, many turned to the protection offered by magic
Witchcraft
Witchcraft, in historical, anthropological, religious, and mythological contexts, is the alleged use of supernatural or magical powers. A witch is a practitioner of witchcraft...

. Lucian of Samosata's irony-laden account of the charlatan Alexander records that a verse of his "which he despatched to all the nations during the pestilence... was to be seen written over doorways everywhere"—particularly in those houses which were emptied, Lucian remarks.

The epidemic had drastic social and political effects throughout the Roman Empire: Barthold Georg Niebuhr
Barthold Georg Niebuhr
Barthold Georg Niebuhr was a Danish-German statesman and historian who became Germany's leading historian of Ancient Rome and a founding father of modern scholarly historiography. Classical Rome caught the admiration of German thinkers...

 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
Edward Gibbon
Edward Gibbon was an English historian and Member of Parliament...

 and Michael Rostovtzeff
Michael Rostovtzeff
Mikhail Ivanovich Rostovtzeff, or Rostovtsev was one of the 20th century's foremost authorities on ancient Greek, Iranian, and Roman history....

 assign the Antonine plague less influence than political and economic trends, respectively.

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
Vologases IV of Parthia
Vologases IV of Parthia ruled the Parthian Empire from 147 to 191. The son of Mithridates IV of Parthia , he united the two halves of the empire which had been split between his father and Vologases III of Parthia...

 attacked Armenia
Armenia
Armenia , officially the Republic of Armenia , is a landlocked mountainous country in the Caucasus region of Eurasia...

, 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
Italian Peninsula
The Italian Peninsula or Apennine Peninsula is one of the three large peninsulas of Southern Europe , spanning from the Po Valley in the north to the central Mediterranean Sea in the south. The peninsula's shape gives it the nickname Lo Stivale...

 and the Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...

an provinces lost all their inhabitants. As the disease swept north to the Rhine, it also infected Germanic and Gallic
Gaul
Gaul was a region of Western Europe during the Iron Age and Roman era, encompassing present day France, Luxembourg and Belgium, most of Switzerland, the western part of Northern Italy, as well as the parts of the Netherlands and Germany on the left bank of the Rhine. The Gauls were the speakers of...

 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
Danube
The Danube is a river in the Central Europe and the Europe's second longest river after the Volga. It is classified as an international waterway....

, trying with only partial success to control the advance of Germanic peoples across the river. A major offensive against the Marcomanni
Marcomanni
The Marcomanni were a Germanic tribe, probably related to the Buri, Suebi or Suevi.-Origin:Scholars believe their name derives possibly from Proto-Germanic forms of "march" and "men"....

 was postponed until 169 because of a shortage of Imperial troops.

During the Germanic campaign, Marcus Aurelius also wrote his philosophical work 'Meditations'
Meditations
Meditations is a series of personal writings by Marcus Aurelius, Roman Emperor 161–180 CE, setting forth his ideas on Stoic philosophy....

. 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."
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