Ancient Pandemics: their effects on the prevailing World order

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Today we're living in a world where medicine is as common as any other thing in the entire world, sometimes not fully accessible to everyone but we must agree it is a common thing as it wasn't in the past, where only wealthy families or the royalty had access to the few doctors practicing some “kind” of medicine by that times.

Today, despite medicine being quite advanced is a reality it is not fully accesible for some people around the world, mainly from people living in developing countries and for poor people living in wealthy countries as well. No matter what, diseases sometimes spread easily among the population no matter if you are wealthy or poor, everybody can caught one and no matter if you are a rich citizen living in a great city or a peasant, sometimes disease leads you to death equally.

*...spreading all over the world, deathly, unstoppable?*... this happens when a pandemics calls to our door, and as you will see, dear reader, pandemics are not a “thing” of our days: they're as old as humanity itself and it happens that during the development of humanity there have been some pandemics/epidemics that make pale those that happen in our days. Those pandemics were so bad that, in addition to eliminating entire populations, they ruined real empires of that time.

❶ The first one registered as truly mortal: ANTONINE PLAGUE (165 AD)

Also known as the Plague of Galen(from the name of the Greek physician living in the Roman Empire who described it), the Antonine Plague was an ancient pandemic that affected Asia Minor, Egypt, Greece, and Italy and is thought to have been either Smallpox or Measles, though the true cause is still unknown.

We must say that before this plague there was another one named “The Plague of Athens” occurred in the city of Athens(430AD), and killed 75,000 to 100,000 people. This epidemic is thought to be the first form of the bubonic plague, but although numbers sound really high(if we compare with total population of Athens by that time), Antonine Plague was more deadly and last even more, so we include it here just as a reference :)

Fig 1. *An artistical representation of the Antonine Plague in action(*

“Antonine Plague” was brought back to Rome by soldiers returning from Mesopotamia around 165AD; unknowingly, they had spread a disease which would end up killing over 5 million people and decimating the Roman army.

This went on for fifteen years, spreading by the entire Roman Empire

and their vassal nations. In some places, it wiped out entire towns. There was estimated at least 2,000 deaths per day in Rome at the height of the outbreak. Mortality rate for the infected was low at 25% according to recent studies, but death may have been the least of their concerns if someone contracted this plague.

Symptoms described by Galem included fever, diarrhea and pharyngitis. You may also have developed pustules, yellow-brown inflammations of pus from fungal infection. At that time there were no antibiotics, so your best bet for fighting the symptoms was magic. :(

The most important consequence of this plage for the Roman Empire as a powerful nation was the weakening of the army leading to manpower shortages especially along the German frontiers. The lack of available soldiers caused Marcus Aurelius(the Emperor by that time) to recruit any able-bodied man who could fight: freed slaves, Germans, criminals, and gladiators.

According to

“Depleting the supply of gladiators resulted in fewer games at home, which upset the Roman people who demanded more, not less, entertainment during a time of intense stress. The patchwork army failed in its duty: in 167 CE, Germanic tribes crossed the Rhine River for the first time in more than 200 years. The success of the external attacks, especially by the Germans, facilitated the decline of the Roman military, which, along with the economic disruptions, contributed ultimately to the decline and fall of the Empire.”

The lack of population led to Emperors to establish high taxes for those who remains alive to support the army and general goverment institutions which obviously became a general discontent among survivor population. This plague had a deep impact too in Roman religion and in the belief that the Roman people were superior to others because both romans and vassals get infected and died as well.

Some authors like Edward Gibbon’s in his book “The History of the Decline and Fall of the Roman Empire”, consider the Antonine Plague as the beginning of the end of the Roman Empire.

❷ Another for the Romans, now Byzantines: THE PLAGUE OF JUSTINIAN (541-542)

By the time the Plague of Justinian struck the Byzantine Empire and the port cities of the Mediterranean, plagues were new and improved. This one wiped out somewhere between 25-50 million people, over 10% of the Earth’s population at the time.

The cause of all the chaos? A bacterium, the same one that caused the bubonic plague.

Thought to have killed perhaps half the population of Europe, the Plague of Justinian was an outbreak of the bubonic plague that afflicted mainly the Byzantine Empire. Generally regarded as the first recorded incident of the Bubonic Plague this pandemic devastated the city of Constantinople, where at its height it was killing an estimated 5,000 people per day and eventually resulting in the deaths of 40% of the city’s population.

Fig 2. Extract from the painting “Saint Sebastian Interceding for the Plague Stricken” *a painting referencing the Justinian Plague(The Walters Art Museum)*

The plague had a tremendous impact economically on the Byzantine Empire. For an empire that was still highly agrarian and depended heavily on taxation, one of the immediate effects from the plague was the loss of farmers.

With almost nobody to take care for crops and work lands, famines extended quickly for all over the empire. The diminished population also increased the financial hardships of an empire already paying heavily for the military campaigns, due to the loss of a larger taxpayer base. Although the army suffered the severe effects of the plague, Justinian manage himself to kept an army of at least 30 000 soldiers but, tired and sick too, they were defeated by a much smaller Persian force in 544 wich lead to the great Bizantine Empire to pay tribute to Persia.

The territorial empire created by Justinian barely outlasted him, and his dreams of reconquest were never fully realized. All the problems Bizantines had during this time-lapse stemmed from one major factor, and that is the loss of manpower caused by the plague. The famines and subsequent inflation that followed put the empire in trouble financially which also contributed to the shrinkage of the military force. Bizantines were able to recover from the plague years later and claim more land than before but the plague kept it from achieving greater glory.

❸ The deadliest: The Black Death(1346-1353)

The Black Death was a devastating global epidemic of bubonic plague that struck Europe and Asia in the mid-1300s. It begun by the Sicilian port of Messina when a group of 12 ships from the Black Sea docked at this port. Sailors were heavily infected by a disease wich caused them to get covered in black boils that oozed blood and pus...and this was only the beginning.

Fig 3. *Miniature out of the Toggenburg Bible (Switzerland) of 1411 showing the effects of The Black Death Plague(*

The Black Death was terrifyingly, indiscriminately contagious: even touching a piece of clothes could get you infected. It was also terrifyingly efficient: people who were perfectly healthy when they went to bed at night could be dead by morning.

The bacillus causing the plague travels from person to person pneumonically, or through the air, as well as through the bite of infected fleas and rats. Both of these pests could be found almost everywhere in medieval Europe and given Europe by that time was not a really clean and pleasant place to live the plague extended very quickly...sadly, in a very efficient way. :(

People started moving from cities to countryside trying to avoid this disease but, unfortunately, they were not able to escape the consequences of this disease because it affected cows, sheep, goats, pigs and chickens as well as people. In fact, by that time was even a shortage of wool supply in whole Europe.

The consequences of this truly devastating epidemic were tremendous: the plague ends population growth in Europe killing more than 20 million just in this continent. However, the lack of workforce lead to an increase in wages paid to workers because there was almost nobody capable to take care of the land, crops and animals left behind by those who succumbed to the disease. So, the few ones capable of taking care of those tasks were paid generously.

Many empires and kingdoms suffered and even dissapear because of the Black Death:

- The Golden Horde got divided into several small kingdoms after several civil wars and those small kingdoms suffered heavily the epidemic probably due to the fact that those kingdoms had a more urbanized population, and they were more susceptible to the plague. The Blue Horde, as an example, was never able to fully revive the kingdom’s former prosperity and the era of large cities and long distance trade came to an end.

- The population of the Chinese Empire was cut in half between 1200 and 1393 by the plague and even the first Ming Emperor lost both of his parents to the disease, that´s why historians think this may have intensified the strict Confucianism that characterized his reign

- The Delhi Sultanate dissapeared because of the weakening of the surrounding kingdoms and a sharp decline in trade because of the severe effects of the plague in the Indian region.

- A series of disasters in Egypt began with the Black Death that eventually plunged the Mamluk Sultanate into a general crisis from which they never fully recovered. The Egyptian peasants suffered not only from the plague but also from the death of draft animals and drought which increased the indebtedness and poverty of the peasantry.

- The Serbs, Turks and Bulgarians, unlike the highly urbanized Byzantines, were mostly spared from the worst of the plague, and this enabled them to firmly establish themselves within the boundaries of the Byzantine Empire and eventually to overrun it. While we cannot state that the Byzantine Empire was taken down by the plague we can assure that the adverse effects of this pandemic lead to this empire become a negligible power from small one that it was by that time.

❹ The Spanish Flu(1918)

In 1918 First World War was about to an end. Hostilities were declining while people started to feel save but then, suddenly, another war started.

Deadly silent a disease started to spread over the battlefields, trenches, cities and towns, a disease that almost last a couple of years(1918-1919) whose effects would be felt years later even. Worldwide and incorrectly known as The Spanish Flu, the influenza epidemic appeared between 1918-1919 was a devastating disease which caused millions of deaths and a turnover in WWI.

The Spanish Flu infected over a third of the world’s population and ended the lives of 20 – 50 million people. Of the 500 million people infected in the 1918 pandemic, the mortality rate was estimated at 10% to 20%, with up to 25 million deaths in the first 25 weeks alone. What separated the 1918 flu pandemic from other influenza outbreaks was the victims; where influenza had always previously only killed juveniles and the elderly or already weakened patients, it had begun striking down hardy and completely healthy young adults, while leaving children and those with weaker immune systems still alive.

Between 1889-1890 the first deadly know Influenza epidemic spread all over the world. Known as “Asiatic Flu” or “Russian Flu” it claims the lives of more than 1 million people, but mostly the people infected were juveniles and the elderly, differentiating it from the Spanish Flu which will come into a scene many years later and infected young and healthy people as well as infants and elderly.

Fig 4. *Victims of the Spanish Flu at a barracks hospital on the Campus of Colorado Agricultural College, USA, 1918(*

How did it get it´s name? As belligerent countries were reluctant to spread news than could harm the war efforts, they impose a strict wartime censorship, but Spain, being not involved directly in the Great War, was more open to publish in national media any news coming from the front, including those ones about a flu epidemic spreading among fighting troops in the spring of 1918...soon people started to call that disease: The Spanish Flu, thinking that the disease started on Spain. :)

Over 1918 to 1919 the flu struck in 3 waves being the second one the deadliest of all. As the whole world was involved in a massive war this was not helpful to stop the spread of the flu but increased the chances of a wide spread of a disease which then, turned to be extremely contagious.

It´s impact was huge in terms of lost lives mainly in the fighting armies where the degree of mortality was exacerbated. In the American Army it was hugely significant: more American soldiers died of the influenza than died from German actions. The Spanish Flu didn't change the outcome, but it did eventually kill more people than the War did. No one can doubt that the influenza pandemic shortened The War by itself.

Sick soldiers can’t fight. American army did a better job of keeping healthy troops in the frontlines than the Germans, although mortality was high. The Base Hospitals of the American Army, far from the front but reached swiftly by special ambulance trains, had special wards for influenza patients and, with excellent nursing care, were able to return the majority of them to the front after brief periods of convalescence. By the end of 1918 summer, with the terrible toll of morbidity and mortality exacted by the influenza virus, the Allied forces attacked the dispirited German army in the Meuse-Argonne offensive and in the period of six weeks leading to the 11 November 1918 Armistice, overran the Germans, forcing them to sue for peace.

How Coronavirus(COVID-19) compares?

These pandemics seem like a “thing” of the past, but we, as humans, are exposed every day to thousands of germs, bacteria and viruses of all kinds. At the time of writing this article(2020) we are under the attack of a new virus called COVID-19, a variant of the influenza virus. It has proven to be extremely contagious and deadly. If you are a nowadays reader you know what are we talking about...if you are a reader from the future i suggest you to do a search on COVID-19.

The effects of COVID-19 on patients can vary from no symptoms at all, a shortness of breath and fatigue to a progression into pneumonia and multi-organ failure in the most vulnerable people.

Just over two months since its inception, COVID-19 has infected over 90,000 people in 80 countries on six continent, killing over 3,000 and for the moment vaccines are planned but it is not safe to trust on this assessment. By the time the Spanish Flu was striking world population several laboratories take in charge the duty of develop a vaccine against this disease but all failed in their efforts. The only thing left was to treat the effects and hope that the immune system of every sick person takes down the virus by its own.

Bubonic Plague will hardly ever be a plague in today's world because it was mainly due to insane and dirty life conditions that the plague spread out so quickly. Besides, today we have antibiotics which are effective in treating Bubonic Plague....but we have almost nothing for influenza contagious diseases.

According to National Center for Biotechnology Information(NCBI) ”...even with modern antiviral and antibacterial drugs, vaccines, and prevention knowledge, the return of a pandemic virus equivalent in pathogenicity to the virus of 1918 would likely kill >100 million people worldwide.”

Final now...

As you can see dear reader, we as humans are not free from a world pandemic right now and even in the future, no matter what, diseases are part of our lifes whether we want it or not. We can only rely on human inventiveness and the high capacity to face problems and overcome them effectively...STAY SAFE!!!

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