The Story of 3 Plagues Across Centuries

Posted by Powee Celdran

Story and Analysis of the Antonine Plague, Plague of Justinian, Black Death in the time of an Epidemic 


Welcome back to another article by the Byzantium Blogger! This one here is a special edition article made for times like this when a pandemic is ongoing and seems to be getting worse. Now that you are all at home as a safe way to contain the spreading virus, here’s something to read, now that you have time and it is something relating to the world issue now, the spread of COVID-19. If you think the Coronavirus nightmare is scary, read this and see that these 3 epidemics of the past were so much more deadlier going as far as having 5,000 death each day! Back then, without much medical science and knowledge of the disease, these epidemics spread even faster killing a lot more to the point of depopulating entire areas and damaging the economies of countries heavily. With the Coronavirus now, the impact in the economy will be very heavy as stocks will drop in certain companies especially since people will be at home and stop spending on travel in which many companies earn from but back in history, the plagues had an even worse effect on economies as they wiped out thousands, therefore the workforce was reduced and with so few people left to work and farm the fields, their pay had to increase a lot. Now since my site is about Roman and Byzantine history, this article will focus on 3 different pandemics particularly in Roman history which includes Byzantine history as well since the history of the Roman Empire continues up to 1453 as the empire moved east with Constantinople as its capital. The first of the 3 major pandemics here is the Antonine Plague from 165-180 which took place in the era of the Roman Empire while the next 2 happened in the time of the Eastern Roman Empire or Byzantine Empire during the Middle Ages which will be the Plague of Justinian in 542 and the most remembered major epidemic in the Middle Ages, the Black Death from 1347-1351. This article will use information from historians of those times who describes the epidemic and its effects as well how people in different parts of the world saw the ongoing epidemics; here some historians write exact details of the epidemic, number of deaths, symptoms, as well as trying to track down its origins, while other historians on the other hand write about the tragic effects of the epidemic, but modern historians and scientists also prove what really caused these epidemics. In history, there have been a lot of more major epidemics than these 3 but I am only choosing these 3 because my site is mostly about Roman and Byzantine history and in Roman and medieval history these were the 3 most significant epidemics that had a major impact on society. In this article, I will also do my best to mention exact details of the epidemic and the place of origin in which many of these epidemics began in either China or Central Asia and through trade routes spread west to the Roman and later Byzantine Empires. Also, this article will mention where these epidemics spread to, how badly hit places were, and the emperors and rulers during these times in which some had even contacted the plague and some even died from it. The first of these 3 epidemics which was the Antonine Plague was the deadliest epidemic in Roman history since it killed a large population of the Empire which was at its height in that time and because of it, it began the decline of the original Roman Empire while the second epidemic here which was the Plague of Justinian devastated the Byzantine Empire a lot undoing the great plans the Emperor Justinian had in mind, while the third which was the Black Death was said to be the most deadly in the Middle Ages because it spread all over Europe and took years to disappear and at the same time the Black Death hit the Byzantine Empire too when it was in its final years and therefore was one of the factors that severely weakened the Byzantine Empire in the 14th century. In a previous article I made which was on Natural Disasters in Byzantine History, I have also mentioned the Plague of 542 and the Black Death as part of the many natural disasters but since this is a time of another epidemic like these ones and is worldwide, I thought that it would be best to write an article on historical epidemics particularly those that took place in Byzantine history, and repeat some topics from the former articles I wrote but also as a way to learn from these pandemics and to show you all that this one right now would end like those did and back then it was even much scarier as people had no idea what it was or what caused it. Aside from writing about the stories of these pandemics in Roman/ Byzantine history, I will also discuss medical science in the Middle Ages and how Byzantium was quite advanced in medicine for their time but still could not stop the rise of plagues. Also, this article will have some interesting amount of trivia including some absurd medieval cures for the plague and how the idea of quarantine began. Now this article will be divided in 3 sections, 1 per epidemic but will also mention a bit of story. Also for this article, I am using as much sources as possible including some books that have detailed and interesting information on these plagues in history such as A Cabinet of Byzantine Curiosities by Anthony Kaldellis in which I have made many articles out of topics from that book and here I am using it for some information on the 6th century Plague of Justinian while for the 14th century Black Death, some information will come from another interesting book, Horrible Histories: Measly Middle Ages, but of course these pieces of information come from historians of those respective time periods.

Byzantine Imperial flag and symbols
Reminder from a Byzantine empress to prevent the spread of the Coronavirus


Other Articles from the Byzantium Blogger:

Natural Disasters in Byzantine History

The Sieges of Constantinople

7 Reasons to be Interested in Byzantium

Byzantine Science and Technology

Crime, Punishment, and Medical Practice in the Byzantine World

12 Turning Points in Byzantine History


I. The Antonine Plague (165-180)


In the 2nd century, the Roman Empire was at its height controlling a massive amount of land north to south from Britain to Egypt, west to east from Portugal to Iraq. For a long time (96-180), the Roman Empire was ruled by what is known as the “5 good emperors” which were Nerva (r. 96-98), Trajan (r. 98-117), Hadrian (r. 117-138), Antoninus Pius (r. 138-161), and Marcus Aurelius (r. 161-180) in which none of them were biological sons of the former. At this point in time, the Roman Empire was at a time of stability as its legions successfully protected the empire’s northern borders from the Germanic tribes and eastern borders from Rome’s mortal enemy, the Parthian Empire. However, the one foreign thing the legions couldn’t protect the empire and its people from was plague and in fact it was even the soldiers that brought the pandemic to the Roman Empire after a fighting a long war in the Middle East against the Parthians (the Persian Empire at that time). The name of the pandemic meanwhile which is “The Antonine Plague” is associated with the dynasty of the Roman emperors then, the Antonine Dynasty and not with the emperor Antoninus Pius as he had already been dead by the time of the plague. This plague began in the Middle East in 165 and in the next years spread across the Roman Empire by the legions marching through it and came to an end in 169, however 9 years later the plague returned and turned out to be even worse but by 180 it completely ended. This plague was documented by the historian Cassius Dio and the physician Galen which is why it is also called “the Plague of Galen”. According to Cassius Dio, in Rome itself there were 2,000 deaths a day which makes up to ¼ the population, therefore the mortality rate of this pandemic was 25% and at the end the total deaths in the Roman Empire was about 5 million, meaning 1/3 of the Roman Empire’s population was wiped out. Till today, the cause and exact kind of disease it is still remains undetermined but modern scientists suspect it was either measles or small pox but back then without much knowledge on how to stop it, it spread fast and especially since roads and sea routes connected the entire Roman world, travelers and soldiers who had easier access to travel the empire carried it around. Meanwhile, not only the Roman world was affected but the major empire in the east too, which was China.

Watch this to know how the Romans dealt with the Antonine Plague (from Invicta).

The Roman Empire at its height, 117
The 5 Good Emperors of the Roman Empire
The Antonine Plague in Rome


The Spread of the Plague and its Symptoms  

The epidemic was said to first appear in the winter of 165-66 in the Roman siege of Seleucia on the west bank of the Tigris River in today’s Iraq as Roman soldiers contacted it there probably from the enemy, the Parthians. The Parthians though could have got the disease from further east from traders coming possibly from China as around the same time, outbreaks of the same kind of epidemic were happening in China which was then the Han Empire. In China meanwhile, a scholar named Ge Hong describes the symptoms of this epidemic as similar to the symptoms of smallpox in which people who are infected develop a fever and later have scares on their bodies. In China however, according to the modern historian Rafe de Crespigny, the outbreaks happened in different years and not all at the same time which were in 151, 161, 171, 173, 179, 182, and 185 during the reigns of emperors Huan (146-168) and Ling (168-189); de Crespigny also suggests that this plague led to the rise of cult faith healing movement led by Zhang Jue who’s movement started the disastrous Yellow Turban Rebellion (184-205). De Crespigny also came up with a theory that the ambassadors from Daqin which is what the Chinese called the Roman Empire brought the plague to it from China, however where the plague began was most likely in Central Asia and from there it spread east to China and west to the Roman Empire. In 166, the plague was already present in the Roman Empire and in that same year, the famous Greek physician of that time Galen of Pergamon (real name: Klaudios Galenos) travelled west to Rome from his native Asia Minor. Now the physician Galen is famous for being one of the first to systematize medicine in general and to study how body parts cooperate with each other, and it was in this plague that Galen made more discoveries on the human body. In 168, he arrived in Rome summoned by the emperor Marcus Aurelius and his co-emperor Lucius Verus (both adopted sons of the former emperor Antoninus Pius) and at that time he was present in the outbreak of the plague among the troops in the Roman city of Aquileia in Northeast Italy. Here, Galen mentions in detail the symptoms of this disease and how the whole body is affected; here he mentions that its duration is long and the symptoms include fever, diarrhea, pharyngitis or sore throat, skin eruption, and sometimes pus oozing out in the 9th day of the illness. Galen however describes the symptoms clearly but did not state what is, so up to this day it is suspected that this kind of disease that spread across the Roman Empire was smallpox. From Italy, the plague spread further north along the River Rhine, the frontier of the Roman Empire infecting not only the inhabitants of the empire but the Gallic and Germanic people beyond the river as well stopping their attacks on the Roman borders. It is unclear if this plague had even spread to Britain, Spain, or North Africa but it was heavily present in Gaul, Italy, the Danube borders, and the eastern provinces of the Roman Empire.


The Effects of the Plague

This plague not only depopulated the Roman Empire by killing off a third of its population but it had also weakened the empire’s defenses. First of all, in the east, when the emperor Lucius Verus led the attack against the Parthians in the east, the troops succumbed to the disease and the defenses were weakened. In the north meanwhile, the other emperor Marcus Aurelius was in a campaign against the Germanic Macromanni people beginning 167 but in 169 he had to postpone it due to the outbreak of the plague among his troops there stationed along the Danube. Lucius Verus too was with him in this campaign and was among those who contacted the plague and in early 169 when returning to Italy, he died of the plague leaving Marcus Aurelius as the sole ruler of the empire. The plague thus killed many Roman legionnaires in the frontiers and this weakened the defense of Danube as the emperor had to call off the war with the Macromanni. However, when the disease subsided, Marcus Aurelius now as sole ruler returned to the Danube frontier and spent almost his entire reign fighting the Macromanni, but the end he was successful but however he died in 180 while on the Danube frontier and not in Rome. While in his campaign against the Macromanni, Marcus Aurelius as the “philosopher king” wrote his famous philosophical work Meditations saying “even the pestilence around him is less deadly than falsehood, evil behavior, and lack of true understanding. Here, even Marcus Aurelius makes a point that what is deadlier than the spread of the disease is how people perceive it, which is true even today because the spreading virus is not as bad as how people see or how the media portrays it.The plague on the other hand returned in 178 and Rome was badly hit as Cassius Dio mentions about 2,000 people died each day though in 180, the same year Marcus Aurelius died, the plague disappeared. This plague however was not the kind of plague we all know caused by fleas transported by rats but it spread the same way as a plague did, and this one like the Coronavirus right now was also spread when humans make contact with each other, and back then the Romans probably had no idea of what social distancing was despite them being more hygienic people than the barbarians beyond their borders. On the other hand, this plague heavily affected and slowed down the Indian Ocean trade between the Roman Empire and India as a number of traders were killed by the plague as well and the plague was also mainly transmitted by people travelling.

In the next century, another pandemic broke out in the Roman Empire and this was one of the factors that severely weakened the strength of the Roman Empire during the 3rd century crisis. This major epidemic happened between 249 and 262 known as the “Plague of Cyprian” named after St. Cyprian, the bishop of Carthage who witnessed and described this plague. According to St. Cyprian, the symptoms of this plague were similar to the Antonine Plague being something similar to smallpox except in this one, people who were infected suffered a viral hemorrhagic fever similar to the E-bola virus. This plague on the other hand took a very long time for it to die out lasting for 13 years but its place of origin was unknown and in Rome itself it was said that there were about 5,000 deaths each day, worse than the Antonine plague. The Plague of Cyprian occurred during the reigns of 6 Roman emperors: Philip (244-249), Decius (249-251), Trebonianus Gallus (r. 251-253), Aemilianus (253), Valerian (253-260), and Gallienus (260-268). During the reign of Decius, Christians were blamed for causing the plague leading Decius to declare a massive persecution of Christians. This plague on the other hand heavily affected the Roman army killing off many soldiers thus making the army have to downsize, many workers too were killed so there was not enough man power anymore to maintain the empire, also prices had increased due to a decrease in workforce. The Plague of Cyprian too happens to be one of the reasons the Roman Empire declined in the 3rd century wherein the army had to downsize while at the same time the empire was at a succession crisis with takeovers and changes of emperor very frequently which led to the eventual formation of the Roman Diarchy in 284 and eventually the Tetrarchy in 293 both by Diocletian to stabilize the chaotic empire. In the 3rd century, the Roman Empire fell to its knees too not only because of plague and succession crisis but of constant wars as well with the Goths in the north and with the new Sassanid Persian Empire in the east which replaced the Parthians, thus a lot of spending was needed for these campaigns and with the plague, a large amount of the army was gone to protect the empire.

Indian Ocean trade route between the Roman Empire and China
Map of the divided Roman Empire in the 3rd century
Division of the Roman Empire under the 1st Tetrarchy, 293


II. The Plague of Justinian (541-542)


Watch this to learn more about the Plague of Justinian (from Voices of the Past).

In the 4th century, Roman history took a very big turn when the capital was moved east to the new city of Constantinople in 330 by Emperor Constantine I the Great and in 395, the entire Roman Empire was divided between east and west, the western half became the weaker one gradually loosing territory until it fell in 476 once the Romans lost control of Italy while the Roman Empire in the east based in Constantinople stayed strong becoming the Eastern Roman Empire which we know as the Byzantine Empire. In the 6th century, the Byzantine Empire reached its height of power under the emperor Justinian I (r. 527-565), the second ruler of the Justinian Dynasty who succeeded his uncle Justin I (r. 518-527), who was of humble origins and so was his nephew Justinian who was born Flavius Petrus Sabbatius in what is today’s Republic of Macedonia. It was under Justinian I the Great that the Byzantine Empire was at its largest in terms of territory stretching north to south from Ukraine to Egypt and west to east from Southern Spain to Syria but before the 550s when his empire was this large, his empire suffered one of history’s worst pandemics which was “the Plague of Justinian” named after him who ruled at that time and had even been a victim of the plague but survived it. Before the reign of Justinian I, the Byzantine Empire suffered yet survived a couple of epidemics but none of them were recorded as much as the 541-42 plague. In fact, one of the Byzantine Emperors before Justinian I, being Leo II died of an epidemic which was not recorded, although he was only a child when he became emperor and died. Leo II was only 7 years old when he became emperor in 474 succeeding his grandfather Leo I (r. 457-474) after his death, although 7-year-old Leo II only ruled for a couple of months as before the year 474 ended he died of an epidemic and since he was only a child, his immunity to disease wasn’t strong; the mortality rate on children from epidemics were really high back then as children before age 7 were bound to die from any disease no matter who they were since their immunity hasn’t yet been built up, even if they were rulers like Leo II. After his untimely death, Leo II was succeeded by his father as Emperor Zeno (r. 474-491) who was married to Leo II’s mother Ariadne, daughter of Leo I; here is one strange case in history where a father succeeds his son as ruler. Now back to the plague of Justinian, this happened to be significant in not only Byzantine history but world history as well not only because it was written about but because it finished off a large percent of the world’s population. This plague was said to have originated in the port city of Pelusium near Suez in Egypt according to the contemporary historian Procopius of Caesarea (500-570) but modern scholars suggest it actually originated in the Tian Shan mountain range located in Central Asia found along the borders of China, Kazakhstan, and Kyrgyzstan. Back in the 6th century, no one knew what was the cause of the plague and only in 2013 it was discovered that it was caused by the bacterium Yersinia Pestis, the same one responsible for creating and spreading the Black Death plague of the 14th century. Wherever it was where the disease started, its first appearance was first recorded in the Egyptian port of Pelusium which was then part of the Byzantine Empire and from there spread across the ports of the Mediterranean before arriving in Constantinople in 542 in which people back then say it was brought there by grain shipments from Egypt, which is most possibly true because the disease was transmitted by fleas carried by small mammals especially rats in which many were on these grain ships. This plague was not transmitted from person to person like many viruses such as the Coronavirus but rather transmitted by fleas infecting people when these fleas cling on to them which is why doctors were not affected more than others. In 542 the plague was at its worst killing thousands each day in Constantinople only, though in that same year its spread all over the ports in the Mediterranean including Antioch and parts of Spain along the coast while in 543 it arrived in Rome which had been reconquered by the Byzantines and from Rome it spread north around Italy, while in the same year it arrived in Marseilles and travelled north around Gaul (France) which was then part of the newly formed Frankish kingdoms. The plague was reported to have spread as far north as Britain in 547 as it was said that the king Maelgwn of Gwynedd in Wales had died from this same plague. Meanwhile not only the Byzantine Empire was hit hard by this plague, their neighbor and mortal enemy the Sassanid Persian Empire was hit even worse than Byzantium that the war between both empires was put on hold. Why Sassanid Persia was hit worse with more people dead was probably because their cities were more populated. At the end, this plague had wiped out 10% of the world’s population in the year 542 and in the next years it reoccurred, it finished off 13-26%. This plague would have recurrences up until the year 750.

Byzantine Constantinople
Byzantine Empire at its height (555) under Emperor Justinian I
Spread of the Plague of Justinian
The Plague of Justinian, 542
Plague of Justinian basic facts


The Plague According to Procopius and its Effects in Constantinople

The famous historian of Justinian’s reign, Procopius of Caesarea, who had documented the reconquest of Justinian’s armies of North Africa and Italy had witnessed the plague but remained careful to not get in contact of it, which is why he survived it and in his book Wars he writes in detail. Procopius mentions that the first symptoms shown on those who get the plague are a light fever in which those who get it or doctors who treat them do not worry about it thinking it will pass, however if the fever persists those who have it would fall into a deep coma, or strangely develop an acute dementia where they would imagine people attacking them causing them to scream and flee; the dementia is probably because people did not know what to do with themselves when being afflicted. Because of developing some sort of dementia, victims of the plague would throw themselves into water as soon as they see it, and this is what worried doctors more because these symptoms were unfamiliar to them. Procopius further explains that the plague’s symptoms include fever, headache, chills, swollen or tender lymph nodes, abdominal pain, and gangrene. The doctors meanwhile studied the plague by cutting up the buboes of the dead victims discovering a kind of malignant carbuncle had developed inside, then doctors had also predicted that many would die after they were freed from the bacteria due to blood loss and true enough it did happen, though doctor had also claimed that many would survive the illness although still die shortly afterwards. Women who were pregnant on the other hand would die if they were taken with the disease but unusually, if they gave birth, they would survive the plague but their newborns would not but also there were instances that the newborn infants would survive but their mothers did not. Now those who had survived the plague would still live normally and speak normally except the only difference would be that they would be talking with a lisp for life and barely be able to articulate some indistinct words. On the other hand, according to the other contemporary historian John of Ephesus, a rumor spread around Constantinople that monks were causing the plague, so people would flee from them on sight.

Only in Constantinople itself, the mortality rate reached to 5,000 deaths a day and its worst up to 10,000 deaths a day according to Procopius. With the crisis on going, people were assigned to be posted at gates to count the dead being brought out risking their lives. Later on, with the death toll rising so high, mass graves had to be created in the less populated Pera district across the Golden Horn from the city center of Constantinople but there they were poorly covered and when the south wind blew towards the city center, the stench of death blew all over the city. Some more dead bodies were stacked into rooms within fortresses with so much dead to fill up the rooms all the way to the ceilings. With so much deaths each day, groups were formed to search each house in the capital to take out any corpses they found and sometimes they even saw parents dead and their children still alive and even infants still suckling the breasts of their already dead mothers. People too were told by the city administration to wear nametags so that they could be identified if they died away from home. Procopius also mentions that the disease carefully picked out the worst people and spared them, which is probably a reference to the empress Theodora, wife of Justinian who Procopius despised, yet she did not get infected by the plague. The emperor Justinian I who at that time was around 60 however was one of the plague’s victims and had fallen into a comma for a long time, though not specified but at the end with proper medical treatment he survived. It is not clear how Justinian himself got the plague despite remaining most of the time at the palace, but most likely he had been inspecting the situation in the city, and that way he got in contact with the plague as the fleas got to him. In the eastern frontiers of the empire, the generals hearing that Justinian was infected by the plague had already brought up rumors saying he had died leading them to plot and take the throne for one of them but when hearing of Justinian’s recovery, their plans failed. Justinian however had recovered but took time to heal while his wife Theodora, the generals Belisarius and Narses, the tax reformer John of Cappadocia, and historian Procopius luckily did not get infected, but among the famous personalities of this time, Justinian’s jurist Tribonian who had codified the laws in 529 to create the Corpus Juris Civilis was another victim of the plague and he died of it in 542.

Transmission of the Plague


The Aftermath of the Plague 

The plague of 542 though lasting quicker was more deadly that the 14th century Black Death because only within months this one had killed up to 10,000 each day, although modern estimates say only 5,000 but still that was a lot of deaths in medieval standards when the world’s population wasn’t as much as it is today and the deaths per day of today’s Coronavirus isn’t yet at that level. However, the worst thing about the Plague of Justinian was it had undone all the great work Justinian had already been doing. Before the plague of 542, Justinian on track in expanding the Byzantine Empire by the reconquests of Italy and North Africa and creating grand monuments all over the empire most notably the church of the Hagia Sophia in Constantinople but because of the plague a lot of his progress had been undone. First of all, the plague had killed off many farmers across the empire meaning less grain was produced for its inhabitants which meant Justinian had to increase the grain tax. Also, the plague had affected the soldiers badly killing many of them meaning the conquests had to be postponed including the Lazic War against the Sassanid Persians in the east. Before the plague broke out, Byzantium’s eastern borders were threatened as the ambitious Sassanid king Chosroes I (r. 531-579) had invaded Byzantine Syria however it was the general Belisarius who had recently reconquered North Africa and came to close to reconquering Italy who was sent to the east and stop Chosroes I’s invasion the same time the plague broke out. Here, in one story Belisarius is said to have tricked the Persian army of Chosroes I that if they continue marching west, they would get the plague although Belisarius made it clear he and his army were not affected by the plague. Although when the plague had already devastated the Byzantine Empire and began killing its soldiers, the war with Persia had to be put on hold as not only Byzantium was heavily affected, the Persians too were. Now that the plague had heavily devastated Byzantium, Justinian had to put his projects, both military and construction projects on hold due to lack of funds from taxes as many people who pay those taxes had been killed. The Byzantine reconquests then had to be delayed for some years later but while it was delayed, this gave time for the Ostrogoths in charge of Italy under their new king Totila to regroup and begin retaking Italy again one by one after being previously defeated by Belisarius. Now onto the construction projects, one evidence of it is seen today with a partially completed basilica in Thrace which was one of Justinian’s works, today it still remains incomplete where its construction is believed to be halted because of the plague. Meanwhile trade in the Mediterranean had also collapsed with plague killing off many traders and also having to be stopped because the plague was spread commonly by sea trade.

Now if Procopius writes about exact details on the plague, the other contemporary historian John of Ephesus (507-588) writes the dramatic effects from the plague all over the empire. In his Chronicle he mentions that corpses laying all over the streets split open leaking puss everywhere, ships stuck at sea with their entire crews dead from the plague, houses that have become tombs where plague victims were rotting in their beds, villages where only one child survived, herds of cows that ran off to the wild now that the people to look after them were dead, and highways completely empty. If the world may be dead now because everyone is in their homes, back then in 542 the world was dead because people were dead. Another account of this plague was written by an actual survivor of it, the historian Evagrius Scholasticus (536-594) who was a child in Antioch by the time the plague broke out and he got in contact with it developing buboes yet he survived it and lived his entire life surviving the recurrences of this plague which at the different times it came back killed his wife, daughter, grandchild, his other children, and servants, and farmers on his estate. After the plague, it took years for Constantinople to recover, yet this did not stop Justinian from fulfilling his dream as by 553, the Byzantine reconquest of Italy had been completed not by Belisarius though but by the older and more experienced Armenian eunuch general Narses. The empress Theodora however died in 548, 6 years after the plague possibly because her immunity had been slowly weakened by it while Justinian survived her for 17 years dying in 565 at age 83. By the time Justinian I died, the Byzantine Empire had already completed its reconquest of Southern Spain leaving it at its largest territorial extent, which would not last for a long time. In his reign, Justinian I had faced many natural disasters including the plague yet he survived all of them and knew how to handle his empire in times of these kinds of situations wherein another less capable emperor, in which Byzantium had a lot of would not know how to handle a plague situation.


III. Black Death (1347-1351)  


About 800 hundred years after the Plague of Justinian came another epidemic as deadly as it, the well-known Black Death also known as the “Bubonic Plague” and the “Great Plague” which killed more in total than the Plague of Justinian, killing about 200 million in total in every place it spread. Justinian’s Plague was said to be worse because more people died in a short amount of time but Black Death raged for 4 years nonstop affecting almost all of Europe as whole as well as the Byzantine Empire which at that time had already been so reduced and weakened by war, yet it had still been alive at that time. The Byzantine Empire apparently lived through 2 of the world’s greatest pandemics in the Middle Ages and have suffered heavily from both, although the 14th century Black Death affected the European continent much more than it did to Byzantium. Apparently, Black Death began the same way the Plague of Justinian did and was transmitted by the same bacterium Yersinia Pestis which is carried by mammals particularly rats and infects people. Like the plague of Justinian, the Black Death mostly likely began in Central Asia as well as historical records say the plague had already been spreading in China and India in the early 1340s. A theory about how Black Death moved to Europe was because of climate change in Asia that dried out the grasslands causing the rodents to flee to more populated areas bringing the fleas with them. How it got to the Byzantine Empire and to the rest of Europe was through ships that came from the trading ports in the Crimean Peninsula in the Black Sea which was close to the steppes of Central Asia and at that time was held by the Republic of Genoa in Italy and the breakaway Byzantine Empire of Trebizond. Apparently, the ships that later brought the plague had come from the port city of Kaffa (known to the Byzantines as Theodosia) in the Crimea which had been previously besieged by a Mongol army that catapulted bodies into the city infected by the same disease. However, the trade along the Silk Road from China to Europe had also transmitted the plague. From there, the ships sailed and had docked in the ports of the Byzantine Empire including Constantinople spreading it there and later in 1347, the ships had arrived in the ports of Europe including Sicily, Genoa, and Marseilles. In 1348, the plague had spread to the rest of the Byzantine Empire from Constantinople including Greece as well as to Byzantium’s neighbors, the Serbian and Bulgarian Empires in the Balkans while in the west it spread all over Italy, Switzerland, France, and Eastern Spain. In 1349, the plague had gone even further reaching Western Spain and Portugal, Germany which was then the Holy Roman Empire, Hungary, and England and later that year, the plague had travelled to Ireland and Northern England as well as deeper into Germany. By 1350, the plague had reached Scotland, Denmark, Norway, Sweden, and Poland and by 1351 it began to subside but spread further to Lithuania, the Baltic countries, Finland, and Russia. While Europe had been heavily affected by it, North Africa and the Middle East too were hit as badly as well going as far as to Mecca in the Arabian Peninsula hitting it badly. The plague was most commonly brought around Europe by ships along trade routes and it was always the port cities that were affected at first which is why isolated mountain areas such as the Basque region between France and Spain and the inland parts of Poland were barely affected. At the end, the plague had extremely reduced Europe’s population within its 4 years of spreading killing off 75-80% of the population of France and Spain combined, 40% of Mamluk Egypt’s population, and much less in England and Germany which was only about 20% of it. The cities in which its populations were most affected by the plague include Paris, Florence, Hamburg, Bremen, and London where more than 100,000 of its inhabitants had died at the end of it Meanwhile, the economic effects of this plague were far worse than in 542 as a large percent of Europe’s population was killed and the workforce had been reduced which led to increased wages for peasants and laborers as well as reforestations in some areas due to the deaths of people there. Afterwards, it took 200 years for Europe to recover in population to the same level it was before the plague.

The spread of Black Death (1347-1351)
Map of the Silk Road in the Middle Ages
Spread of Black Death across the world


Black Death in Byzantium 

Watch this to learn about the Black Death situation in Byzantium (from Eastern Roman History).

From the Crimea, some of the Genoese ships docked there sailed to Constantinople bringing the plague there and from Constantinople, the plague was brought by ships to other Mediterranean ports. Meanwhile, the Black Death came at the worst time for Byzantium as the empire by this time had already been weakened after years of constant war, Constantinople falling to the Crusaders in the 13th century, civil wars between members of the Palaiologos imperial family, and the rising threat of the Ottomans from Asia Minor. 1347, the year the plague began in Europe was the same year a deadly civil war that severely weakened Byzantium ended and because of this, Byzantium was even weaker to protect itself from the plague. This civil war began in 1341 after the Byzantine emperor Andronikos III Palaiologos (r. 1328-1341) suddenly died, apparently also because of disease, in this case it was malaria that he apparently had but did not know it until he suddenly was hit by an illness after attending a meeting and 4 days later, he died. Andronikos III in his reign brought some stability to the empire but his biggest mistake was not naming an official successor thinking he would live much longer but death came to him suddenly at only age 44 and without naming a successor, conflict broke out between his 9-year-old son John V who had a claim to throne and Andronikos III’s close friend and advisor John Kantakouzenos (1292-1383), who was also a Byzantine chronicler. The young John V however came to power after his father died but his claim to the throne was challenged once his mother Empress Anna of Savoy declared John Kantakouzenos a public enemy therefore starting a civil war where the nobles and landowners of the Byzantine countryside supported John Kantakouzenos as emperor while the people in the city and traders supported young John V and his mother. The civil war ended in 1347 with John Kantakouzenos victorious and crowned Emperor John VI (r. 1347-1354), although he won the war by asking the enemy, the Ottoman Turks to support him and giving them Gallipoli in Thrace in exchange. John VI winning the war with the support of the Ottomans married his daughter Theodora to the Ottoman sultan Orhan and giving Gallipoli to them came to power at the worst time possible as when Black Death had arrived in Constantinople, the empire was already heavily weakened by the civil war. Among the victims of the Black Death in Constantinople was Emperor John VI’s youngest son Andronikos who was still a child and back then the mortality rate for children were higher than it was with adults. Accounts on Black Death from Byzantium were written by the historian Nikephoros Gregoras (1295-1360) and by the emperor himself some years later when he became a monk describe swelling occurring all over people’s bodies which later led to their deaths, yet this plague killed anyone it in infected no matter if they were rich or poor, however John VI describes the plague the same way the ancient Greek historian Thucydides described the Plague of Athens in the 5th century BC. In Byzantium though with more advanced medical practice, the plague did not last as long as it did all over Europe but there is although no record of the death toll in Constantinople, Thessalonike, or other cities in the empire. Black Death had reduced around 2/3 of Constantinople’s population at the end further weakening Byzantium’s economy at that time; John VI however did his best to keep the empire strong again despite the plague and the Ottomans already in Europe, but all of this was too much for him to handle. In 1354, John VI was overthrown by his son-in-law John V returning to power after he was defeated in 1347, though after this Byzantium would never recover again and hundred years later, the Byzantine Empire itself ended after falling to the Ottomans.

Byzantine Empire at the beginning of the 14th century (purple)


Symptoms and Causes of the Black Death

The symptoms of the plague are described more accurately by western writers like the Italian Giovanni Boccaccio (1313-1375) rather than by Byzantine writers. Boccaccio describes that the symptoms people develop are certain tumors growing in the groin or armpits, some growing the size of a small apple but growing as large as an egg, other than the swelling, the symptoms too include spots and rashes most likely caused by the flea bites. After the swelling, it was reported that the victims would develop an acute fever and later would vomit blood, and between 2-7 days of getting in contact with the disease, the victims would die. Another account on the plague written by the Flemish monk Lodewijk Heyligen describes that the plague had also mutated into a respiratory disease causing its victims to suffer an infection of the lungs causing a difficulty in breathing, which is how his master Cardinal Colonna had died after he was infected with the plague. Meanwhile monks and nuns had the highest risk of contacting the plague because they cared for the sick and dying patients, and true enough a lot of them had died from it as they did not have much means to protect themselves unlike doctors who were equipped with gloves, an entire face mask where only the eyes could be seen, and long cloak protecting them from head to toe.

Back in the Middle Ages, people were not familiar with what caused the plague, same thing in the 6th century Plague of Justinian and only modern research shows that both were caused by fleas brought in from different parts of Asia that were transmitted through rats and after infecting them, transferring to humans and infecting them with the rat’s blood too. Modern research meanwhile suggests that the fleas that caused the Black Death had originated in Southern China before reaching India and later Central Asia. However, in medieval Europe, no one knew it was caused by fleas that were carried by rats and instead believed that either God was punishing them or it was a miasma theory caused by bad air. In France, a medical faculty suggested to the king of France Philip VI (r. 1328-1350) that the plague was caused by bad air which was caused by a conjunction of 3 planets in 1345. On the other hand, what made the plague spread so quick affecting almost everyone more in Western Europe than in Byzantium was because of the differences in hygienic practices. In the Byzantine Empire, people had always been more hygienic than the people of Western Europe as the Byzantines- being descendants of the Greeks and Romans- knew how to wash their hands and bathe more while people of medieval Europe barely bathed and if they did, they would take a bath in rivers that were dirty, also people in medieval Europe did not also have toilets and toilet flushes which meant their waste was thrown into streets which suggests why the plague hit cities more, and also people had kept animals with them even in cities which made the transmission of this fleas more highly possible. On the other hand, children were more likely to be affected by the plague which is why children were easily affected by it more than adults basically because their immunities haven’t been built up yet. In the middle ages, people though did not understand why children were more vulnerable to the plague or other diseases which lead some priests to believe that children have it more as their punishment for being disobedient to their parents.


The Black Death around Europe

People all over Europe where Black Death had reached all had different perspectives of the plague but at the same time many events had happened at the same time of Black Death including the hundred-years’-war between England and France, however because both the people of England and France were affected by the plague, the war had to stop. In 1348 England, the people including soldiers had been suffering from the plague which gave an opportunity for the Scots in the north to invade England as its army was too weak to defend itself but the moment the Scottish soldiers marched into England, the plague struck them too and returning to Scotland they brought the plague there with them. Meanwhile in the Italian port city of Messina in Sicily, the people believed the plague appeared as a large black dog wiping out everything in its way and some people claimed to have actually seen, probably because of the dementia they suffer from the plague. In Scandinavia and Lithuania which had also been hit by the plague, people saw the plague in the form of a kind of maiden wherein Scandinavia they saw it come out from the breath of a person who died from the plague in the form of flame which would drift on to the next house infecting the people there while in Lithuania they saw the same kind of maiden waving a red scarf from a window waving it to let in the plague, though one story says a man sliced off the maiden’s hand and died after doing it thus saving his village. Around Europe, the plague had killed off thousands that there was not enough coffins or spaces to bury the dead so some had to be dropped into pits or even dumped in the river as seen in Avignon, France which made it even worse by contaminating the river. Without knowing how to cure the plague, some people had believed that the plague was caused by the devil possessing them so they thought they could get rid of it by whipping themselves and each other with spiked whips for 33.3 days (the number of years Christ lived on Earth). These people became known as the Flagellants and at first, they blamed the priests for giving them the plague but the priests fought back threatening to excommunicate them so the flagellants instead blamed an easier target, the Jews going as far as going to the Jewish communities and murdering anyone they could find. During Black Death, people especially in Germany had blamed the Jews for being the cause of the plague by poisoning wells since they were mysterious and only stayed amongst each other and mysteriously did not get the plague. In some places in Germany like Worms, Mainz, and Erfurt in 1349 the Jews who were blamed for causing the plague cheated on the flagellants and instead of being killed by them, they set fire to their houses as a form of mass suicide. At the end, 6,000 Jews died by mass suicide in Mainz and the entire 3,000 Jewish population of Erfurt did not survive. People had also thought the plague was caused by looking at victims, breathing bad air, drinking poisoned wells, but most commonly people blamed lepers for causing it. Since the Hundred-years’-war was happening then between England and France, the French and English blamed each other, in Spain they blamed the Arabs (Moors), and in Germany people had also nailed suspected poisoners into barrels and threw them off into rivers. One of the most famous things that came from Black Death and is well known till today is the nursery rhyme “Ring o’ Roses” which sings of people dying from the plague.

Illustrated map of Black Death in Europe


Medieval cures in Europe and Byzantium 

People in the middle ages had no idea on what caused the plague while at the same time, they also had no idea on how to cure it leading to doctors, especially in Western Europe to come up with all sorts of cures that never really seemed to work. Doctors suggested that people could be cured from the plague by throwing sweet smelling herbs or setting bonfires to clean the air, sitting in sewers to flush out the bad air of the plague by the bad air of the drains, drinking medicine of a 10-year-old treacle, killing all the cats and dogs in town, and for the rich to swallow powder of crushed emeralds, but worse than this one of the suggested cures was to shave a live chicken’s bottom and strap it to the plague sores, or like mentioned earlier to go around town whipping yourself. Some of the cures in the middle happened to be worse on patients such as making them eat arsenic powder or cutting them up to let out blood since medieval doctors believed people grew sick by having too much blood but at the end, these kinds of cures had ended up killing patients by poisoning them or by severe blood loss. The more effective solutions doctors had back then to test if people had the plague was to check their urine and if they saw blood in it, then there was no hope. Easier solutions though back then to avoid the plague was to do the same thing now and just stay at home but in the middle ages it was very much easy to catch the plague in the overcrowded cities so it was best to flee to your house in the countryside but only the rich who had country homes could do this while the poor especially those who were in the cities were left to die. A better solution to stop the spread of the plague was however only thought of after the Black Death by the Republic of Venice, this concept would become what we know today as “quarantine” which comes from the Venetian word quarantena meaning “40 days” though originally it was a 30 day period which in Venetian is trentine. The first mention of this quarantine period which was at first 30 days was in 1377 with the return of the plague and here in the city of Ragusa which is now Dubrovnik in Croatia, to avoid the plague or any disease from affecting the city, newcomers on ships had to dock at the harbor and stay on their ships or on the islands along it and not leave so that authorities would observe if they would develop any signs of the plague or not and if not, they were allowed into the city. The concept of quarantine we now know today thus was born in 1448 when the Venetians extended the period to 40 days, which proved to be more effective.

In medieval Byzantium on the other hand, the medical situation was a lot more different wherein people had a better understanding of medicine and how to treat sick people since there, major cities like their capital Constantinople had actual hospitals as Byzantine emperors invested heavily on them. Byzantine hospitals had wards with bed for patients, practiced sanitation, and had actual trained medical doctors. Some hospitals in the empire were associated with monasteries where monks and nuns acted as nurses as part of their religious duties. One of the hospitals in Byzantine Constantinople which was the hospital of St. Sampson and associated with the Church was found between the 2 most important churches of Constantinople, Hagia Sophia and Hagia Eirene. Another famous hospital of Byzantine Constantinople was part of the Pantokrator Monastery in which both the hospital and monastery were founded in 1136 by Emperor John II Komnenos (r. 1118-1143) and his Hungarian wife Irene; it had 50 beds and 5 wards, while one ward was for women, each ward had 2 doctors and assistants, also the hospital had a chief pharmacist. Byzantine hospitals were also required to have medical equipment such as lancets, cauterizing irons, catheters, and for the teeth forceps and were required also to have sharpeners for these tools in case they grew dull. The other medical tools in Byzantine hospitals included a tonsil knife, tooth file, a small scalpel for the eyelids, a rectal speculum, uterine dilator, rib saw, a clyster for irrigating genital passages, tweezers, various types of forceps, needles, and a kind of “skull breaker” which was something used to break a dead fetus and make its extraction easier. As part of Byzantine law which was decreed by Emperor Leo VI the Wise (r. 886-912) in 900 was that Byzantium needed female doctors to specialize in matters like childbirth and other medical issues only relating to women. It was also stated in the code of laws of Leo VI called Basilika that Byzantine law would punish with exile or death any doctor who cheated their patients or gave them the wrong drug that would end up killing the patients as this fell under the law of murder. Basically, Byzantium was medically more advanced because they kept with them the knowledge of the Greek and Roman medical sciences from Hippocrates and Galen which had been lost in the west, also the Arabs had learned the medical science of the Greeks and Romans possibly after their attempts to conquer Byzantium in the early Middle Ages.

Comic strip of medieval plague cures


Well, this now ends my special edition article on these 3 major pandemics in history, and hope you have all learned a lot especially in a time like this. Of course these 3 pandemics that had happened before were definitely much worse than what is happening now as back then medical science hasn’t developed yet and people were unfamiliar with what was happening, which led to thousands of deaths each day. Whatever is happening now, just remember people back than had it worse while emperors in charge had no way of containing the spreading virus and it was only later on that people came up with solutions like quarantines to slow down the spread of the plague. Although in the Middle Ages, a small difference can be seen in medical science and handling diseases such as in the Black Death where Byzantium and Western Europe handled it differently. The Byzantine Empire having suffered badly in the 542 Plague and after encountering many plagues had learned how to handle epidemics and over the centuries before Black Death have developed medical technology advanced for the Middle Ages while Western Europe during Black Death had no idea what it was and how to cure it leading them to come up with all sorts of remedies no matter how stupid or deadly it turned out. At the end however, the solution to stop the spread of the plague was actually quite simple which was to keep cities cleaner as medieval cities were terribly dirty with human waste thrown into the streets. Medieval people too had no idea on how to stop the plague by creating lockdowns in cities which is why the plague just kept spreading and people kept dying. The effects of these 3 major pandemics in history though were severe and if the coronavirus would affect the economy heavy today, these plagues in history have done even worse since it killed off thousands which was large percent of the world’s population back in the Roman era and Middle Ages. The 2nd century Antonine Plague was a hard hit for the successful Roman Empire as its death toll started the decline of wealth and military power of the Roman Empire while the 542 Plague of Justinian undid a lot of progress the emperor Justinian had planned and would be one of the factors for the quick decline of the Byzantine Empire after his death. The 14th century Black Death meanwhile had a lot more consequences than the 2 other plagues I mentioned since it killed off so much people not only in Europe but in Asia, North Africa, and the Middle East as well meaning the workforce was severely reduced and it would take 200 years for the population of the areas affected to recover to the number it was before the plague. In Europe, the Black Death’s major impact was that it had ruined the centuries old medieval feudal system as many peasants were killed and those who survived became so valuable as there were only so little of them that farms and landowners all over Europe needed them more, so this meant peasants were no longer part of the land of the feudal lords and instead could sell off their services to anyone. People in the Middle Ages were a lot more superstitious and did not know the science behind the plague until only modern science discovered what it was, however the superstitious medieval people also saw the plague as a sign that things needed to change and afterwards, people had learned to keep their cities cleaner and be cleaner as well. Before ending, as an honourable mention, ironically the patron saint of pandemics is St. Corona who had also ironically lived in 2nd century Roman Syria during the time of the Antonine Plague. Now with the coronavirus happening, it could also be a sign that the world needs to rest and recover from all the pollution we have left on it whereas after this is all over, the world would have also recovered and be much cleaner same thing with the Black Death, whereas many people died leading to reforestations. Well, this is all for now and I hope you are all safe from the virus as I am, and hopefully will remain this way. Anyway, up next will be an article I have always wanted to do which would be a Rome vs Byzantium comparison table. Well stay safe everyone and thanks for viewing!

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