The Power of Plagues. Irwin W. Sherman

however, were citizens; slaves and women did not have the same rights.) The city-states of Greece, insulated from the barbarians, consisted of urban centers dedicated to commercial transactions with limited local farming; as they prospered, the population grew. The inhabitants of the city-states were healthy but naive to the diseases that were endemic in the Middle East, and this was to prove decisive in the Peloponnesian War.

      Before the Greeks of historical times (~750 B.C.), civilizations had flourished in Mycenae (1600 to 1200 B.C.) and before that in Crete (the Minoans). Later, the Dorians invaded from the north, destroying the Mycenaean cities and society, and this conquest ushered in for 450 years (1200 to 750 B.C.) what is called the Dark Age. At the close of the Dark Age there emerged two powerful city-states that were essentially military garrisons governed by a commander and his captains. These were Athens (in Attica) and Sparta (on the Peloponnesus). Sparta was settled by the Dorians, and Athens gave refuge to Mycenaeans. Each city-state represented opposing philosophies: stern military discipline in Sparta versus intellectual and political freedom in Athens. As the population of Athens grew too large for the limited space of Attica, the Athenians began sailing out of their port of Piraeus to colonize the Aegean islands and the western coast of Asia Minor (in what is today Turkey). These Greek colonies were called Ionia.

      Belief in liberty and freedom made Greek city-states resist domination by others. And since each state had its own habits, rules, and government, the loyalties of the citizens were to a particular city-state, the polis. (People engaged in the civic life of the polis give us the term “politics.”) As a consequence, war between Athens and Sparta was inevitable. In 431 B.C. the Peloponnesian War began between these two city-states, and it lasted for 27 years. The cause of the war was probably economic, although of this we cannot be certain, but what is known is that its outcome was determined by disease.

      The Greeks, apparently against all odds, managed to defeat the numerically far superior Persian forces in two battles, in 490 B.C., at Marathon, and again in 480 B.C., in the great naval battle of Salamis. This led a number of Greek city-states to join together with Athens in a sea league both to punish the Persians and to obtain recompense for the cost of the war. In time, however, Athens turned this league into an instrument of its own imperial power, appropriating the funds of the league for the creation of monuments of imperial splendor (notably, the Parthenon). This naturally provided a focal point for the jealousies and rivalries of the various city-states, especially Sparta.

      Corinth was a commercial and colonial power and an ally of Sparta. Because of this, its interests were in competition with those of Athens. Athens began to interfere in the affairs of Corinth. Corinth naturally objected and threatened Athens, so in retaliation Athens began an embargo of Corinth and other city-states on the Isthmus of Corinth. This crippling embargo caused Corinth to urge Sparta to declare war on Athens. The Athenians had a great fleet but a poorly trained army, whereas the Spartans were an effective military power on the land but lacked a fleet, and so were not a sea power. Pericles, the leader of the Athenians, decided to rely mainly on Athenian naval supremacy. His strategy was to bring all the people in Attica into the city, abandon the outlying countryside to destruction by the Spartans, and rely on the navy to supply the city with food and other necessities that would be carried through the fortified corridor from the port of Piraeus into the city itself. The hope was that Sparta would eventually be worn out and frustrated. Sparta did invade Attica from the north, and the Athenians gathered themselves and remained secure within the walled fortifications of their city. But when the Spartans destroyed the olive and grape orchards in the outlying countryside, the source of Athens’ wealth came into jeopardy. Further, as the large numbers of peasants from the countryside sought refuge within Athens, the city became overcrowded. In 430 B.C. disaster struck. An epidemic that started in Ethiopia moved into Egypt, and from there it was brought by ship to Piraeus. The epidemic raged for about 2 years and killed about a fourth of the Athenians, including, in 429 B.C., Pericles.

      In 1994-1995 a mass grave was uncovered prior to construction of a subway station just outside Athens’ ancient cemetery. There were some 90 skeletons, 10 belonging to children; the grave may have contained as many as 150 people. The skeletons in the graves were placed helter-skelter with no soil between them, and the bodies were placed in the pit within a day or two, suggesting burial in a state of panic. The grave was dated to between 430 and 426 B.C. It is believed these are the remains of Athenians killed by the plague. The historian Thucydides, himself a survivor of the plague, wrote:

The bodies of the dying were heaped one on top of the other, and half-dead creatures could be seen staggering about in the streets or flocking around the fountains in their desire for water. … The catastrophe was so overwhelming that men, not knowing what would happen next to them, became indifferent to every rule of religion or of law. All the funeral ceremonies which used to be observed were now disorganized, and they buried the dead as best they could. Many people, lacking the necessary means of burial because so many deaths had already occurred in their households, adopted the most shameless methods. They would arrive first at a funeral pyre that had been made by others, put their own dead upon it and set it alight; or, finding another pyre, they would throw the corpse that they were carrying on top of the other one and go away. … Seeing how quick and abrupt were the changes of fortune which came to the rich who suddenly died and to those who had previously been penniless … people began openly to venture on acts of self indulgence which before they used to keep in the dark. … No fear of god or law of man had a restraining influence. As for the gods, it seemed to be the same thing whether one worshiped them or not, when one saw the good and bad dying indiscriminately.

      What was this devastating plague? Despite Thucydides’ detailed description, the precise identity of the disease is not known. It was clearly not the bubonic plague, for the characteristic symptom of the bubo (swelling of the lymph nodes in the region of the groin and armpits) is not found in Thucydides’ description. Other suggested candidates are measles, typhus, Ebola, mumps, and even toxic shock syndrome. The case for typhus seems strongest both epidemiologically—the age group is similar—and from the standpoint of the symptoms. Typhus is characterized by fever, pustules, and a rash of the extremities; it is known as a “doctors’ disease” from its frequent incidence among caregivers. But the fit is not exact. The rash in Thucydides’ description does not precisely match that of typhus, nor does the state of mental confusion.

      The plague of Athens demoralized the citizenry, destroyed the fighting power of the Athenian navy, and prevented the launching of an attack against Sparta. Though the war dragged on for many more years, the spirit of Athens had already been broken, and by 404 B.C. defeat was complete. Sparta deprived Athens of her navy, and her land defenses were razed to the ground. The plague of Athens clearly changed the course of history.

      The Roman Fever

Of the antiquity of human malaria there is no doubt. Enlarged spleens, presumably due to malaria, have been found in Egyptian mummies more than 3,000 years old, and the Ebers papyrus (1570 B.C.) mentions fevers. More recently, evidence of malaria has been detected in lung and skin samples from mummies dating from 3204 B.C. to 1304 B.C. Clay tablets from the library of Ashurbanipal (2000 B.C.), king of Assyria, mention enlarged spleens, headaches, as well as periodic chills and fever, indicating that more than 4,000 years ago the region between the Tigris and Euphrates Rivers was already malarious. Malaria probably came to Europe from Africa via the Nile Valley or resulted from closer contact between Europeans and the people of Asia Minor. Early Greek poems from the end of the 6th century B.C. describe intermittent fevers, and Homer’s Iliad (ca. 750 B.C.) mentions malaria, as do the writings of Aristophanes (445-385 B.C.), Plato (427-387 B.C.), and Sophocles (496-406 B.C.). The Greek physician Hippocrates (460-370 B.C.) discussed in his Book of Epidemics the two kinds of malaria, one with recurrent fevers every third day (benign tertian) and another with fevers on the fourth day (quartan), which are today called Plasmodium vivax and Plasmodium malariae. He also noted that those living near marshes had enlarged spleens, but he never speculated as to the relationship. Indeed, Hippocrates believed that the intermittent fevers were the result of an imbalance in the body’s fluids (bile, blood, and phlegm) brought about by drinking stagnant