In Time of Plague

IN TIME OF PLAGUE

We are presently in a time of plague caused by an airborne virus that mutates easily, and we should look back at the great plagues of the ancient and medieval world, which dwarf anything we have today. This excerpt comes from my The Power Game in Byzantium: Antonina and the Empress Theodora , published by Bloomsbury,   and it describes the outbreak of bubonic plague in the reign of the emperor Justinian (527-565)

  

Yersinia pestis, the bacillus which causes bubonic plague, was likely present in the Mediterranean basin long before 542, when it smote Constantinople , for it is a disease endemic among burrowing rodents that live in large underground colonies. Its closest relative in the bacterial world – and its probable ancestor -- is Yersinia pseudotuberculosis which causes gastroenteritis and diarrhea. Yersinia pestis, its deadlier cousin, is carried by fleas, and has acquired an extra gene which produces an enzyme allowing it to survive in a flea’s stomach, so that when the flea finds a host for dinner, it can pass it on. More than one kind of flea can serve as a carrier, but the flea of choice is Xenopsylla cheopis, a prodigious jumper, but winglesss, and hence must depend on a rodent host if it is to move any distance. Rats do very well as transporters, particularly rattus rattus, the black rat which is now almost extinct in Europe, though it still flourishes in places like Hawaii, and on the Gulf Islands off the west coast of Canada, where it is known as the roof rat. The flea alights on a rat, and takes up residence as its uninvited guest, sucking the rat’s blood for nourishment, until it is infected by yersinia pestis, and its sucking tube is blocked by bacteria. When the sick flea tries to suck blood, it fails. Instead, it vomits the contents of its stomach into the rat’s blood stream, and starves to death, but not before it has passed on the bacteria to the rat which is infected with plague, and any healthy flea that sucks its blood becomes infected, too.. In the stricken Algerian town that Albert Camus describes in his novel, The Plague, the first sign of the epidemic was the appearance of great numbers of infected rats, turning up everywhere in houses or on the roads, dead or dying.[i]

Once the rats die, the hungry fleas must find new victims, and humans are acceptable substitutes. Eventually fleas and rats both die, and so do the human victims whose immune systems are not robust enough to fight off the infection, and the plague subsides until there is a new crop of fleas, rats and humans that can serve as its prey. Thus the plague epidemic that appeared in Europe for the first time in 542, when it struck Constantinople, reappeared in regular waves until the mid-eighth century. A scourge in Naples about 767 was its last outbreak before it disappeared from Europe as mysteriously as it came, only to reappear as the Black Death in the mid-fourteenth century.[ii]

              The earliest description we have of bubonic plague is found in a second-century medical writer dating to the reign of the emperor Hadrian, Rufus of Ephesus, who in turn cited earlier writers, one belonging to the third century BCE, Dionysios the Hunchback, and a couple dating two centuries later, Poseidonius and Dioscorides. Rufus used the term bubon for the swollen lumph nodes in the groin which are the distinguishing feature of the disease,[iii] though he probably did not coin it. He reported that the disease was to be found in the regions of Libya, Egypt and Syria, occurring frequently enough, but never as a pandemic.[iv] Hans Zinsser,[v] in his classic Rats, Lice and History, written before orthodox historians paid much attention to the effect of disease on the course of history, took Rufus seriously and claimed that plague was prevalent in the Near East and the northern coast of Africa three centuries before Christ. Dioscorides, who lived about the time that Julius Caesar was assassinated, investigated a plague in Libya. Probably this Dioscorides should be identified with a physician of that name at the court of Antony and Cleopatra in Alexandria, and we can give our imaginations free rein when we try to conjure up what sort of report he made to that ill-fated pair.

Yet it was not until 541 that plague become epidemic in the Mediterranean basin. The “Endless Peace” which Justinian had purchased from Persia at a high price had collapsed. The fragile victory in Italy that Belisarius had swindled the Ostrogoths into accepting, fell apart. Plague arrived as a third calamity. This is not to suggest that there was any connection among the three, though a Byzantine, who believed in the wrath of God, and sin causes death, may have thought so.[vi] Yet for some mysterious reason, the plague was transformed into a pandemic in Justinian’s reign. Hans Zinsser thought it may have been the arrival in Europe of the black rat (Rattus rattus), which he believed, came as an immigrant from India into the Mediterranean region no earlier than the sixth century. The black rat is a sociable rodent which lives agreeably in urban centres, dwelling alongside humans, unlike the misanthropic and much nastier brown rat, Rattus norvegicus, a later immigrant into Europe, which eventually displaced its rival. Rattus rattus is generally believed to have been the plague carrier in the mid-fourteenth century pandemic known as the “Black Death”. It was an efficient carrier of plague, particularly in crowded cities where people and rats shared a congested living space. Unfortunately for Zinsser’s theory, however, there is now archaeological evidence for black rats in the classical world, long before the Justinianic plague.[vii]  Yet though bubonic plague and the black rat both existed in the classical world, plague did not become epidemic until the reign of Justinian. .

In any case, the black rat is only an innocent agent in the transmission of plague.The carrier is a flea, and though other fleas can also carry the bacteria, Xenopsylla cheopis is particularly efficient, for once it is infected, in less than five days, its sucking tube becomes blocked by colonies of bacteria, causing it to inject the infection into its host. Nor is the black rat the only possible carrier: gerbils and marmots[viii] can also carry the fleas that transmit plague. In California, ground squirrels were found to be infected in 1900, and they continue to this day to serve as host to the bacillus. Yersinia pestis is not so specialized that it cannot exist without an ideal carrier. Yet Zinsser was partly right. Some phenomenon must have taken place in years immediately before the plague outbreak that caused a population explosion of plague carriers, and transformed the plague into a pandemic.

We can only guess what it was. We have already noted that the year of the great siege of Rome, when the Ostrogoths shut Belisarius and his little army up in the city for just over a year, was exceptionally cold and dry.[ix] So much we can infer from dendrochronology, the study of the growth rings on trees. Abnormally cold temperatures persisted until the end of the decade; 540 and 541 were both cooler than usual. A dust veil, like a fog without moisture, hung over the Mediterranean for eighteen months in 536-537, filtering the sunlight and causing crop failures. An enormous volcanic explosion such as happened at Krakatoa in the late 19^th century could have caused it, for the dust particles from a volcano can prevent sunlight from penetrating the atmosphere.[x] But we have no record of a great volcanic eruption at this time.[xi] Atmospheric dust from comets or asteroids is another possibility, and for that there is some evidence.[xii] But whatever the reason for the dust veil, the cooler temperatures that it triggered may have provided an ideal ambience for the flea, causing a population upsurge. Or could the bacillus that caused the Justinianic plague have been a new, mutant strain? DNA analysis may eventually be able to provide some sort of answer, for archaelogists have found pits where plague victims were buried. But what the origin was of the plague bacillus that wandered over Europe from the mid-sixth to the mid-eighth century remains a mystery, though its ultimate source must have been one of the two plague reservoirs that existed at the time, one in north-eastern India and the other in central Africa.  

    The pestilence appeared first at Pelusium at the north-east corner of the Nile delta, and from there it migrated westwards to Alexandria which it reached in 541. The death toll was heavy. From Egypt, the plague spread up the coast of Palestine into Syria, always starting in the coastal ports and then moving inland. In 542, in the middle of spring, after the opening of the navigation season, it arrived in Constantinople. The next year it reached Italy, and from there it migrated to Merovingian France. It left behind it a trail of death.

There were tales of ghostly beings and phantasms that roamed the streets, striking persons they encountered, and these persons immediately took sick.[xiii] One story told that a black boat was sighted offshore, rowed by men without heads. These were the fearful headless fiends that terrified the popular imagination – the awful attendants of the Evil One himself. It made no difference if people wore amulets bearing magical prayers to ward off devils. Even the houses where copper bells hung over the doorways were not safe, though demons were known to hate the jangle of copper. Nor did it avail to seek sanctuary in a church, or invoke the holy names of the Trinity or the Theotokos. Even within churches, men and women died. As time went on, people would lock themselves in their rooms and pay no heed when they heard someone pounding on the door. It might be a friend, but equally likely, it might be a demon that had come to make a terrible visitation.

              For most people, the disease came without warning. Suddenly they felt feverish. It was not a high fever, nor particularly alarming. But then on the same day or the next, they developed a swelling in the groin. This was the bubo, the swelling of a lymph node which is the tell-tale symptom of bubonic plague – the word “bubonic” derives from the Greek boubon, meaning ‘groin’. When bacteria attack lymph nodes, the nodes distend, and since the legs the part of the body most vulnerable to flea bites, the nodes of the groin are nearest the bite and hence are generally the first to intumesce, though the nodes in the armpits and behind the ears might also become swollen. The Greek doctors, knowing nothing about lymph nodes, thought that the disease was centred in these buboes, and they cut them open on some cadavers to see what was inside. What they found was a kind of hard dark ganglion. It was beyond their comprehension.

              After the buboes appeared, some victims fell into a coma, while others became delirious, and would run off with loud cries of terror, imagining that some assailant was chasing them. Some, with no one to care for them, simply died of neglect. Still others, who escaped the delirium or the coma, expired when their buboes gangrened and the pain grew unbearable. There were cases, too, where black pustules broke out all over the body. These victims always died quickly. On the other hand, if the buboes suppurated, the victims often survived. Pregnant women were particularly vulnerable. The plague caused either miscarriage, resulting in the death of the mother, or death in childbirth if the mother carried the fetus to term.  The caregivers who nursed the ill grew utterly exhausted, for the patients needed constant care, and their poor, harassed attendants aroused almost as much pity as the patients themselves.

Procopius’ observation[xiv] that doctors attending plague victims rarely contracted it themselves is fairly good evidence that this was bubonic plague, which kills when the infection enters the bloodstream and results in septicaemia. Without antibiotics to treat it, it can kill from 40 to 70 percent of its victims. Its deadlier cousin, pneumonic or pulmonary plague, which kills all its victims, occurs when the bacteria invade the lungs and cause plague pneumonia. It is highly contagious, for its bacilli are airborne, and when a victim coughs, he ejects saliva droplets full of thousands of germs. The observation that doctors were not noticeably susceptible shows that this plague was most likely bubonic, not the more terrible pulmonary type.[xv] Yet it was terrible enough. It could well have destroyed half the population of Constantinople.

The countryside suffered terribly as well. As Yersinia pestis made its way from Egypt northwards along the Mediterranean coast on its way to Constantinople, the Syriac historian John of Ephesus travelled in its wake. He saw villages with only a few people left alive, and they busied themselves removing corpses from the streets; in other villages, all the houses were empty. Fruits ripened in the orchards with no one to harvest them. In Syria, grain in the fields was ready to be reaped, but no reapers came to gather in the crops. Sheep, oxen and pigs had no one to tend them and returned to the wild.There were signs of catastrophe everywhere.  

              The epidemic gripped the city for four months. At first the dead were buried properly, each household looking after its own, but soon the number of deaths overwhelmed the living. In some houses there was no healthy person left to perform funeral rites. Some houses became habitations of the dead, and they were discovered only when the stench of the decomposing bodies behind their closed doors betrayed their presence. Bodies with swollen, gaping mouths sprawled, neglected, on the streets or lay in piles by the seashore, where feral dogs gnawed at them. Animals too: rats, dogs and wild beasts could be found dead with swollen groins.[xvi] The young toughs belonging to the Blue and Green parties forgot their rivalry and worked together to dispose of the corpses. No one had time for the usual rites of burial.

              Streets were deserted. Tradesmen abandoned their shops, and there was a shortage of bread and other foodstuffs. Victims who might have recovered from the plague with proper care, died of neglect and starvation. The poor died first. There were some who turned to the old religion for help. It was reported that in some cities in Palestine, demons appeared disguised as angels, and told the desperate people to worship a bronze image of a pagan god – Apollo, perhaps? -- but when they obeyed, death fell upon them.[xvii] In Constantinople, the population was cut in half, or perhaps more, and it did not easily recover. The plague advanced westwards: in 543, it reached Italy, where the Byzantines were losing ground to a Gothic insurgency, and in the same year, it appeared in southern Gaul and parts of Spain, though it failed to gain a foothold there. Before the end of the century there would be four more onslaughts of plague and it would be two hundred years before Europe got a reprieve..

 Most epidemics follow a demographic pattern similar to war: the death rate soars, but so does the marriage rate and the birth rate. Thus the population makes up its losses quickly. But with bubonic plague, pregnant women are particularly susceptible, and so while the marriage rate may go up, the birth rate drops, and the population fails to recover swiftly from its losses. At the end of the sixth century, the Byzantine Empire numbered only about sixty percent of what it was in the year 500.[xviii]

Justinian ordered an official named Theodore to organize the disposal of the bodies, and he filled all the available tombs, and then ordered pits dug north of the city beyond Sycae,  where the bodies might be dumped. John of Ephesus reports that each pit was filled with seventy thousand corpses, piled one layer on top of another. When the diggers could not cope with the great multitude of cadavers, the roofs were torn off the towers on the fortification walls and the bodies were jettisoned there. As they decomposed, a foul miasma spread over the city whenever the wind blew from the north.

              Theodora’s habit of personal cleanliness stood her in good stead during the plague. Every morning before breakfast she luxuriated in her bath. Fleas were strangers in the women’s quarters of the palace, and Theodora herself did not rub shoulders with hoipolloi. But Justinian who was more approachable, fell ill and developed a bubo. For several days, his life hung in the balance. If he died, who would his successor be? In the corridors of the palace, there must have been many half-concealed whispers and numerous covert glances.

 

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[i] Albert Camus’ novel,  La peste, (The Plague) was published in 1947. It describes an outbreak of bubonic plague in an Algerian town during World War II.

[ii] Stathakopoulos 2007, pp. 104-105; cf. Horden 2005, pp. 134-139. The intervals between plague outbreaks averaged 11.6 years.

[iii] Hooker, 1958, p. 81,argued that the plague I fifth-century BCE Athens described by Thucydides, was biubonic plague, claiming that when Thucydides used the word helkos for the bubo. In 2006, fossilized dental pulp from the time of the plague yielded the bacterium that causes typhod fever, Salmonella enterica. See Rosen, 2007, p. 191.

[iv] Sallares, 2007, p. 251, n. 79, prints the relevant passage from Rufus, reporting that Poseidonius and Dioscorides investigated plague in Libya.

[v] Zinsser’s book was published in 1935 and went through thirty-one printings by 1965. His eleventh chapter on rats is worth reading. Little 2007, is a collection of papers presented (with one exception) at an interdisciplinary conference at the American Academy in Rome in 2001, published  under the title Plague and the end of Antiquity. It has put the study of the Justinianic plague on a new footing. Rosen 2007 is also an  invaluable contribution – a reminder of how far the study of plague has come since Zinsser.

[vi] For reactions to the plague, see the excellent article by Kaldellis, “Piety and Plague” (Kaldellis, 2007b).

[vii] Rosen, 2007, p. 186.

[viii] The genes of the plague strain that infects marmots differ from those that infect rats, but the flea that transmits the disease can play host to both. Cf. Orent, 2001, p. 75. See McNeill, 1976, pp. 163-168, who mentions a plague originating with Manchurian marmots that might have spread world-wide in 1894-1921 except for the intervention of modern medical techniques.

 

[ix] See pp. 00. above.

[x]  Keys, 1999, suggests a dust-veil event in 536, causing severe drought in east Africa, followed by increased rainfall that caused a population explosion of plague-bearing rodents. This might have triggered a plague epidemic which was carried north by trading vessels bringing ivory from Zanzibar. Rosen, 2007, pp. 200-203 argues that the drop in average temperature allowed the flea to move north overland from east Africa. See also Sallares 2007, pp. 284-286; cf. Arjava, 2005..

[xi] Since this was written, not one but two eruptions in El Salvador, in Central America, dating from 535 and late 539 or 540, must be the cause of the dust veil of 536 that enveloped the Mediterranean. Lake Ilopango, not 10 km. from San Salvador, is the remains of one caldera. See Sarah Zielinski, Anthropocene (Smithsonian Magazine) July 8, 2015)

[xii] Procopius, Wars 2.4.1., reports a great comet in thw year 5039. Halley’s comet appeared on 27 September, 530 and cannot be the comet thaSeet Procopius reports.iwlinski

[xiii] The main sources for the Justinianic plague are Procopius, Wars 2.22.1-23.21  John of Ephesus, whose description was copied by Ps. Dionysius of Tel-Mahre, Chronicle Part III, pp. 74-98, and Evagrius, HE 4.29. Corippus describes the plague in North Africa: Iohannis 3.343-400. Michael the Syrian’s (Chronicle, 9.28) is dependent on John of Ephesus.

[xiv] Cf. n. 150

[xv] There is one morsel of evidence from John of Ephesus that may indicate pulmonary plague. He reports that for some, none of the signs of bubonic plague were apparent, but “as [persons] were looking at each other, they (began to) totter and fell, either in the streets or at home, in harbours, on ships, in churches and everywhere.”  (Pseudo-Dionysius of Tel-Mahre, Chronicle Pt. III, p. 96, trans. W. Witakowski). Sudden death of this sort is more symptomatic of pulmonary than bubonic plague. Allen, 1979, in her valuable study of the plague, think that pulmonary plague played a major role, but Procopius’ evidence suggests not.

[xvi] Pseudo-Dionysius (see n. 176) who reproduces John of Ephesus, reports “cattle … even rats” dying with the tell-tale swellings. (Witakowski trans., p. 87).

[xvii] Michael the Syrian, Chronicle, 9.28.

[xviii]  The estimate is taken from Russell, 1958, p. 42. Turtledove. 1983, also makes the case for a precipitous population decline after Justinian, which he attributes to the effects of plague, and the war in the west.