The belief in astral influence over terrestrial phenomena and on the affairs of humanity was general and dates from prehistoric times. Hippocrates held that every physician should be versed in astrology. The dependence of season on the heavenly bodies, and the seasonal prevalence of epidemic disease were facts patent to every one, so that it was seemingly reasonable for the ancients to assert the influence of the heavenly bodies on disease, though when pushed to excessive lengths it became absurd. When pestilence was seldom absent, it must needs at times coincide with certain conjunctions of planets. How deeply the belief took root in medicine is shown by the words of the preface of the German Herbarius,[70] first published in a.d. 1485.

‘Many a time and oft have I contemplated inwardly the wondrous works of the Creator of the universe: how in the beginning He formed the heavens and adorned them with goodly, shining stars, to which He gave power and might to influence everything under heaven. Also how He formed afterwards the four elements: fire, hot and dry—air, hot and moist—water, cold and moist—earth, dry and cold—and gave to each a nature of its own: and how after this the same Great Master of Nature made and formed herbs of many sorts and animals of all kinds, and last of all Man, the noblest of all created things. Thereupon I thought on the wondrous order, which the Creator gave these same creatures of His, so that everything, which has its being under heaven, receives it from the stars, and keeps it by their help.’

Dionysius of Halicarnassus[71] records another fearful pestilence in 451 b.c., which carried off all the slaves and half the citizens of Rome. The pollution of the Tiber by the dead bodies seemed to intensify its ravages. Men and cattle perished alike, in and around Rome, and famine followed, because the land was left untilled. As long as the people had any hopes in the assistance of their own gods, they approached them with sacrifices and all manner of expiation. But when these proved of no avail, they set themselves to introduce foreign innovations into the established religion of Rome. We shall see in the succeeding visitation, in what direction the disillusioned Romans first cast their eyes.

From 435-430 b.c. pestilence,[72] following on a drought and cattle epizootic, raged in Rome and the surrounding country beyond the power of human endurance. Frequent earthquakes preceded a great access of virulence in 431 b.c.: the very powers of nature seemed to have declared war on Rome. The people offered a general supplication to the gods, repeating the formulas word for word after the duumvirs, so that no mistake of word or syllable might invalidate the office: but in vain. So the worship of Apollo was brought from Greece to Rome, and a temple erected in his honour in 431 b.c. Apollo cannot have been a wholly unfamiliar god, for the Sibylline books must at least have introduced his name to Rome. But from this time he becomes naturalized as a leading Roman god. From his temple, in times of pestilence, expiatory processions paraded the streets of the city; and as plague succeeds plague, he supplants step by step the older native gods.

In 395 b.c. pestilence[73] worked such havoc, that the Senate ordered the Sibylline books to be consulted. This collection of oracular utterances in Greek, given forth by inspired prophetesses or Sibyls (Σίβυλλα = Doric Σιὸς βόλλα = Διὸς βουλή = will of the god), had found its way from the Troad to Cumae. Thence Tarquinius Superbus transferred part to Rome, and laid it up in sacred custody, to be used by order of the Senate, in times of national emergency. As these books recognized the gods and ritual of the Asiatic Greeks, they played a leading part in the introduction of Greek gods and Greek ritual into the religion of Rome. On this occasion the Sibylline books prescribed the celebration of a lectisternium.

The lectisternium, which now first appeared in Rome, was a festival of Greek origin. A public banquet of great magnificence was set before the deities, whose images were placed on couches. The exhibition of three pairs of alien gods, Apollo and Latona, Diana and Hercules, Mercury and Neptune, betrayed its foreign origin. The imaginative populace saw them accept the food or turn away from it in anger. Meantime domestic feasts were spread throughout the city, to which strangers and friends alike, and even liberated prisoners, came each to have his share. Doors lay open everywhere, offering a home to every casual comer. All things were had in common. No sound of discord marred the perfect peace. The people were admitted to solemn communion with the gods, as the Greek warriors before Troy shared with their gods in the eucharistic feast, in token that the plague was stayed.

Coincidently with this epidemic at Rome, Diodorus Siculus[74] describes with some clinical detail a pestilence that attacked the Carthaginian army, while besieging Syracuse. The Lacedaemonians were assisting Dionysius and the Syracusans against the Carthaginians. The record is of interest as exhibiting Diodorus in the rôle of a flagrant plagiarist of Thucydides.

‘But as to the Carthaginians, after they had ruined the suburbs and rifled and plundered the temples of Ceres and Proserpine, a plague seized upon the army, and to intensify and sharpen the vengeance of the gods upon them, both the season of the year and the multitudes of men crowded together contributed greatly to the aggravation of their misery: for the summer was hotter than ordinarily, and the locality itself occasioned the distemper to rage beyond all control. Not long before the Athenians were swept away in the self-same place by a plague, for it was marshy and low-lying ground. At the commencement of the distemper, before the sun rose, their bodies would fall a-shaking and trembling, through the coldness of the air that came off the water: but about noon they were stifled with the heat, because they were pent up so closely together. The south wind brought in the infection among them, and swept them away in heaps, but for a while they buried their dead. But when the number of the dead increased to such an extent that even those in attendance on the sick were cut off, none durst approach the infected, for the distemper seemed to be incurable. For first catarrhs and swellings about the neck (περί τὸν τράχηλον ὁἰδήματα) were caused by the stench of the bodies that lay unburied, and by the putrefaction of the soil. Then followed fever, pain in the muscles of the spine, heaviness of the limbs, dysentery and pustules (φλύκταιναι) over the surface of the whole body. The majority suffered in this manner, but others became raving mad and forgot everything, and rushing about distracted struck every one that they met. All the help of the physicians was in vain, both by reason of the violence of the distemper and the suddenness with which it carried many off: for in the midst of terrible suffering they commonly died on the fifth or at latest the sixth day: so that those who died in battle were accounted fortunate by all. And it was further a matter of observation, that all who attended on the sick died of the same distemper, and what aggravated the misery was that none would willingly come near the distressed and exhausted, to minister to them. For not only strangers, but even brothers and familiar friends were driven by fear of infection to forsake one another.’

Diodorus seems to have drawn on the clinical symptoms of several different diseases, to heighten the effect of his description. The combination of pustules on the body with swellings about the neck suggests true plague, but there the likeness ends. There are other descriptions of pestilence in Diodorus Siculus, that exhibit this same eclectic tendency.

In 363 b.c., after one or two intervening milder outbreaks, another period of pestilence[75] set in in Rome. Plutarch says that it carried off a prodigious number of the people, most of the magistrates and Camillus himself. When all else failed to appease the gods, scenic plays were imported from Etruria. Hitherto the Roman people had had only the games of the circus. Livy describes their introduction to Rome in minute detail, tracing the development of regular stage plays from these rude scenic shows. ‘Actors’, he says, ‘were sent for from Etruria, who without any song or imitative gestures regulated their movements by the measures of the music, and exhibited in Tuscan fashion by no means ungraceful dances.’ To the ancients the movements of the body spoke a language as familiar as the movements of the tongue. ‘It seemed to me’, he continues, ‘that the first origin of plays should be noticed, that it might appear how from a modest beginning they have reached their present extravagance. However, the first introduction of plays, intended as a religious expiation, neither relieved their minds from religious awe, nor their bodies from disease.’ Indeed the Tiber inundated the circus and interrupted a performance, as though the gods despised their efforts at atonement. So popular amusement had come at last to supplant popular atonement, giving birth in the process to dramatic entertainment. In this respect we shall find history repeat itself with striking similarity in the plague times of the Middle Ages.