The great Antonine plague—the long plague, as Galen calls it, for it lasted no less than fifteen years[104]—was brought to Rome from the East by the Syrian army of Verus, about a.d. 165. Ammianus Marcellinus[105] sets its commencement in the sacrilegious folly of some Roman soldiers at the sack of the city of Seleucia. These men wrenched from its site a statue of Apollo, and from a narrow aperture beneath its pedestal the pestilence escaped, carrying death wherever it went. Julius Capitolinus (c. a.d. 300) confirms the statement of Ammianus Marcellinus, except in that he traces the source of origin to a small golden coffer in this same temple of Apollo. Carried thence by the victorious army to Rome, it found there conditions favourable to its propagation in an already existing famine, in the accumulation of the soldiery, and in the concourse of spectators, who had come to see the triumph of the joint emperors duly celebrated. Of the mortality at Rome no figures exist, but it is said to have been very great. Dead bodies were so numerous, that they were carried to burial heaped up in carts. Aurelius[106] paid the dead the tribute of a public funeral, and erected statues to the memory of many men of high estate. His philosophy, though proof against religious belief, showed itself not proof against religious superstition. The whole pagan ritual of expiation was paraded on behalf of the distracted city. The neglected worship of the gods was revived with renewed vigour, and the aid of those most powerful to help in such circumstances was eagerly invoked. A lustration was solemnly performed for the purification of the city, and a lectisternium celebrated for seven whole days. The people were readily infected with the contagion of their sovereign’s superstition, and from this time may be dated a brief revival of the worship of the effete pagan deities. Aurelius sought even to appease the anger of the national gods by a persecution of the Christians, whose religion was an insult to their majesty. The Christian chronicler, Orosius,[107] attributes the pestilence actually to the persecution of the Christians that had broken out in Asia and Gaul before its commencement. All that is known for certain is, that such a persecution was a consequence, if not a cause as well. An engraved blood-coloured jasper, preserved in Paris, and figured in the Histoire de l’Académie des Inscriptions et Belles-Lettres, survives to commemorate the sacrifices by which Marcus Aurelius sought to charm away the plague. Duruy[108] describes its features:
‘Marcus Aurelius as sovereign pontiff: on his veiled head a globe, symbol of his sovereign power: behind him an augur’s staff: facing the Emperor Rome helmeted and Aesculapius with horns: under Aurelius, Hygieia or Health: lastly the head of Faustina. The Sagittarius, who occupies the centre, marks the time of the sacrifices, offered in November or December.’
Some have inferred from a passage of Julius Capitolinus that Marcus Aurelius himself died of this pestilence in a.d. 180. In describing his death-bed, Capitolinus says that he took a hasty farewell of his son, for fear of communicating his malady to him.
Niebuhr considers that the ancient world never recovered from the havoc of this pestilence. To it he traces the decadence of Roman literature and art in the years that followed, and points to analogous results in Greece from the plague of Athens, and in early German and early Florentine literature from the Black Death of a.d. 1348. But the seeds of decay in the empire of Rome had already been sown, as they had been in the empire of Athens before the Peloponnesian War. Pericles himself had warned the Athenians at the outset of the far-reaching consequences of failure. We shall see too hereafter that in the case of the early Florentine literature other more potent influences than pestilence were concerned in its temporary effacement. The lesson to be learnt from a comprehensive survey of the history of pestilence would seem rather to be this, that with the community, as with the individual, the sound constitution throws off the effects of a sickness that strikes right home, when the resisting power is impaired. Such was assuredly the case with the interminable sequence of plagues that assailed Rome in adolescence as well as in adult life. But as decadence and decrepitude beset the body politic, the wounds of pestilence went deeper and left abiding scars.
The Antonine plague bequeathed one ill-starred legacy to the profession of medicine. Every sovereign has the physicians he deserves, and Galen was physician to Marcus Aurelius. At the first onset of the pestilence Galen made off to Campania, and finding no safety there took ship to Pergamus. Thence, after two years’ absence, he returned at the summons of the emperors, and after a brief stay in Rome joined them at Aquileia, where pestilence tracked him down again.
Cowards die many times before their death.
Courage, however, and medical acumen are by no means constant companions, and for many centuries, in face of pestilence, physicians, and among them Morgagni and Sydenham, were doomed to follow the example of Galen as faithfully as they cherished his precepts.
Galen has been regarded generally as the leading authority on the medical aspects of the Antonine plague, but the value of Galen’s testimony is not enhanced by the investigation of these attendant circumstances. The physician who takes flight at the outset is little likely subsequently to observe the disease carefully, constantly, and at close quarters: nor is it surprising to find that much of his symptomatology is borrowed directly either from Thucydides or Hippocrates. The striking picture of Thucydides must needs dominate the mind of the man who studies medicine in his arm-chair, so that we are prepared to find Galen asserting the identity of the Antonine pestilence with the plague of Athens. Here and there passages are lifted almost verbatim from Thucydides. For example, Galen[109] says that the sick man’s body did not seem hotter than normal to the touch, but that he suffered an intolerable inward burning. The skin was not yellow, but reddish and livid. The transference of οὔτε χλωρόν from Thucydides shows that he is copying Thucydides, and is not describing what he himself saw. Again, the description of the eruption, though far more precise and complete than that by Thucydides, shows his influence closely, and now and again falls into his actual words, as in ἐξήνθησεν ἕλκεσιν ὅλον τὸ σῶμα. The same also is true of the more general symptoms[110] of the disease, such as the insistence on the characteristic appearance of the inflamed eyes, and the redness of mouth, tongue, and fauces.
There is the ring of the charlatan, too, in Galen’s use and advocacy of Armenian bole as an antipestilential specific, in striking contrast to the crude disavowal of all remedies by Thucydides. Galen[111] says that ‘all those who used it were promptly cured’—one wonders at Galen’s flight—‘those who felt no effect from it died: no other remedy could replace it’—and then he sublimely concludes, ‘that those, with whom the remedy failed, were incurable.’ This Armenian bole was merely an argillaceous earth brought from Persia and Armenia, which owed its red colour to oxide of iron. Galen used it as an astringent for wounds and ulcers before he vaunted it as a specific for pestilence. Internally, at any rate, it must have been almost inert in medicinal doses, and as Galen adduces no evidence in support of his crude dictum, we need be at no pains to justify our incredulity.
There is reason to think that the Antonine plague was not one and the same disease throughout its course. Had it been so, we should have expected from Galen something in the nature of a single clinical picture, rather than casual references scattered throughout his voluminous writings.