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  Fortunately for us, despite his best efforts, Galen didn’t succeed in avoiding the pestilence entirely. Instead, he studied and wrote extensively about the Antonine plague. From his records we know specifics about the symptoms and progression of the disease. We know that the plague caused victims to break out, very suddenly, in small red spots all over their bodies, and after one or two days, the spots would turn into a rash. Fever blisters would then swell for the next two weeks, before scabbing over and breaking off, leaving an ashy appearance all over the body. We also know that victims would develop a fever, though perhaps not one that was immediately obvious. Galen wrote: “Those afflicted with the plague appear neither warm nor burning to those who touch them, although they are raging with fever inside, just as Thucydides describes.”7

  Galen’s remarks upon Thucydides’s description are most likely in reference to the latter’s devastating account of the Plague of Athens in 430 BC, which wiped out around two-thirds of Athens’s population. Galen might have understandably thought the two afflictions were one and the same. I love that Galen was just casually familiar with a text written six hundred years before his time! Reading history books is great! However, the two plagues don’t have much in common other than victims developing a high fever and then dying. Today, the Plague of Athens is usually thought to have been bubonic plague or possibly the ebola virus, whereas modern physicians suspect the Antonine plague was smallpox.

  Still, it is interesting that Thucydides is referenced, because the Plague of Athens was regarded as an apocalyptic event. Thucydides writes:

  Mortality raged without restraint. The bodies of dying men lay one upon another, and half-dead creatures reeled about the streets and gathered round all the fountains in their longing for water. The sacred places also in which they had quartered themselves were full of corpses of persons that had died there, just as they were; for as the disaster passed all bounds, men, not knowing what was to become of them, became utterly careless of everything, whether sacred or profane.8

  By comparing the two, Galen gives a sense of the magnitude of the Antonine plague—unless he is wildly hyperbolic. Given his personality, I can see how that might give one pause. But although Galen was a showboater, he wasn’t deliberately inaccurate about anything except the greatness of his own skills.

  Galen is less interested in the historical and societal impact of “his” plague than Thucydides was. His writings focus instead on how certain ailments progressed and what factors might indicate a patient’s potential survival. Galen writes: “Black excrement was a symptom of those who had the disease, whether they survived or perished of it … if the stool was not black, the exanthem always appeared. All those who excreted black stool died of it.”9 This kind of writing is great. This is one of the first times in the historical record that a figure writes about a disease as a physician rather than as a historian. Doubtless that information was of great interest to anyone who was tending to a loved one, insofar as if their feces turned black, you would know to start making funeral arrangements.

  Today, experts turn to Galen’s writings to determine the precise nature of the plague. Through the precision of his descriptions, we know that about two weeks after the first symptoms of the Antonine plague (the blisters), a rash would begin to coat the tongue and throat of the afflicted. Galen also noted that many victims coughed up blood. He describes one man as vomiting up scabs, which is maybe the foulest image I can give you.

  As horrible as the disease sounds, not everyone died from it. If you had what Galen called “black exanthema” (which means a “breaking out” or a widespread rash), you had a good likelihood of surviving. Galen even tells, happily, of a man rising from his bed on the twelfth day of the disease. He claims:

  On those who would survive who had diarrhea, a black exanthema appeared on the whole body. Due to a remnant of blood, which had putrefied in the fever blisters, like some ash that nature had deposited on the body. Of some of those who became ulcerated, the part of the surface called the scab fell away and then the remaining part nearby was healthy and after one or two days became scarred over. In those places where it was not ulcerated the exanthema was rough and scabby and fell away like some husk and hence all became healthy.10

  There’s debate today over whether the plague that led to Rome’s fall was typhus or measles or smallpox. I am on Team Smallpox!

  However, no matter which disease it was, the debate would have made no difference to anyone at the time. There was no medicine that would come close to treating any of them. Before 1600, people would have difficulty differentiating any type of disease from another; any quickly spreading epidemic would simply be referred to as a plague.

  Scholars also continue to debate over the total death toll from the Antonine plague. Frank McLynn notes, “Even if we split the difference between the most impressive scholarly studies, we can’t get lower than a total mortality of 10 million.”11 It was probably higher! McLynn himself estimates the total death toll as around 18 million. At the height of the outbreak, slightly later in 189, Cassius Dio claimed it caused around two thousand deaths a day in Rome. There’s certainly no estimate that makes the death toll from this plague anything short of overwhelming.

  I’d love to tell you about how the disease was treated, cured, or even prevented with any degree of effectiveness. But I can’t! It was the year 166, and that optimism is reserved for future chapters in history. The Roman people may have prayed for a cure, but the best they could hope for was someone who was able to keep society minimally functional. Because if you are a citizen of any time, you really don’t want a repeat of the Plague of Athens, where corpses were piling up in the temples. In almost every plague throughout history, it takes a remarkably strong leader just to keep the bodies out of the streets.

  Rome was fortunate. That leader was Marcus Aurelius, the last of those described by Machiavelli as the Five Good Emperors. Beyond being the emperor who employed Galen, Marcus Aurelius practiced a philosophy you’re probably familiar with: Stoicism. If not, some freshman taking Philosophy 101 is going to tell you about it with great excitement one of these days. I will preempt that student by saying that the basic tenet of Stoicism is to exercise reason and employ restraint over emotions, especially the negative ones like anger and greed. One should attempt to behave in accordance with nature, accepting and being prepared for the unchangeable aspects of existence, such as death. The philosophy is beautifully summarized by Marcus Aurelius in his Meditations: “Say to yourself in the early morning: I shall meet today inquisitive, ungrateful, violent, treacherous, envious, uncharitable men. All of these things have come upon them through ignorance of real good and ill. But, because I have seen the nature of what is good and right, I can neither be harmed by any of them, for no man will involve me in wrong, nor can I be angry with my kinsman or hate him; for we have come into the world to work together.”12

  Stoics attempted to be guided by logic and reason rather than fleeting worldly pleasures. The practice of Stoicism supposedly allowed people to lead more peaceful, rational lives. Some citizens thought this philosophy made Marcus Aurelius hard to relate to, but, on the whole, Stoicism is straightforward and sensible, and the philosophy was popular. Certainly, it seems like it would be extremely useful in crisis situations.

  I like to think that, across the ages, the Roman people considered this endorsement of Stoicism, collectively shook their heads, and responded, “Nah.” As soon as the plague broke out, the population almost immediately abandoned calm, rational Stoicism in favor of believing in magic and killing Christians.

  Hucksters like the mystic Alexander of Abonoteichos emerged selling useless charms for everyone to hang on their doorways. They contained simple protective sayings like “Long-haired Phoebus chases the cloud of pestilence.”13 Alexander became rich and famous. Of course he did. Charlatans preying upon people’s fear with false hope during plague times often do. (This is the “career advice for sociopaths” portion of the book.)

>   When they weren’t busy buying charms, people blamed the Christians for bringing the disease upon the city by angering the Olympian gods. This claim is absurd because anyone who has read D’Aulaires’ Book of Greek Myths knows that Olympian gods’ anger was more often expressed by “turning women into spiders as punishment for describing themselves as too beautiful” or “catching people in a net while having sex” rather than “raining down pustules and deadly disease over the empire.” However, Christians were easy scapegoats. Marcus Aurelius already held Christians in contempt, regarding them as foolishly eager to rush into martyrdom. As a result, their treatment during his reign was so horrible it is referred to as “the Fourth Persecution” in Foxe’s Book of Martyrs, which claims:

  Marcus Aurelius followed about the year of our Lord 161AD: a man of nature more stern and severe, and, although in the study of philosophy and civil government no less commendable, yet, towards the Christians sharp and fierce … The cruelties used in this persecution were such that many of the spectators shuddered with horror at the sight, and were astonished at the intrepidity of the sufferers. Some of the martyrs were obliged to pass, with their already wounded feet, over thorns, nails, sharp shells, etc. upon their points, others were scourged until their sinews and veins lay bare, and after suffering the most excruciating tortures that could be devised, they were destroyed by the most terrible deaths.14

  Persecuting religious minorities is always ill-advised, every single time it occurs in history. I have never in my research found an instance where a historian says, “Wow, we were on the right side of history for torturing Group X back then.” Marcus Aurelius should have probably done something to protect these vulnerable citizens. But he didn’t. He disliked them, and he had other pressing duties to contend with.

  Aside from tacitly or overtly condoning the persecution of a religious sect, Marcus Aurelius responded to the plague with the kind of calm collection I think all of us should strive for while, say, on the phone with Time Warner Cable. He immediately busied himself signing new laws to keep the city livable. For instance, he forbade people from turning their villas into giant tombs. He excused anyone from a court summons who had a funeral to attend, and common people who died of the plague were given burials at the public’s expense. A law was passed that you could not dig up bodies to use their graves for your own dead, which was apparently common enough to require legislation. All these laws were important, as undertakers were charging outrageous prices for the citizens’ increasing need for burials, and, again, the main responsibility of a plague-time ruler is to stop bodies piling up in the streets. (Both because it’s unsanitary and because it causes people to panic.)

  More terrifying than the fatalities in cities was the fact that the army was afflicted and dying. Soldiers on furlough to visit their families later brought the disease back to camp with them, and they carried it to new legions. This led to a signifigant manpower shortage at an especially unfortunate time: the Germanic tribes had become increasingly restless and were attempting to cross the Danube.

  By 167, Germanic tribes led by the Marcomanni advanced past the Roman borders. This was the first time Germanic tribes had successfully invaded the Italian peninsula in about 250 years. They razed Oderzo and proceeded to lay siege to Aquileia, one of the largest cities in the world at that time.

  Marcus Aurelius went to the frontier. Under duress and in an attempt to replace the soldiers killed by the plague, he recruited just about anyone who could carry a sword to join the army.

  That entailed recruiting gladiators, which seems like an obvious and excellent idea. Gladiators knew how to fight! They were very good at fighting. Unfortunately, this policy infuriated the people in Rome. They loved their gladiatorial games, and now, as if it weren’t bad enough that their compatriots were dying in droves, Marcus Aurelius was sending their sports heroes away to fight on the border. The fact that few remained meant that gladiatorial matches became rarer and extremely expensive to attend. Society’s need for “bread and circuses” doesn’t go on hold when a plague surfaces. If anything, in uncertain and terrifying times people want more entertainment that allows them to escape reality. Marcus Aurelius dealt with the unrest by persuading authorities to force criminals already condemned to death to fight in the arena for the public’s amusement, and promised the government would cover the cost of the spectacles. Marcus Aurelius also staged another, nonhuman-based amusement that featured hundreds of lions being shot by archers. Christians didn’t fare well during these spectacles. The second-century scholar Tertullian recalled the resounding cry “Christianos ad leonem,” which loosely translates as “throw the Christians to the lions!” That is horrific. However, these methods satisfied the public bloodlust while the trained gladiators continued to defend the borders.

  Marcus Aurelius also recruited bandits, offering them a bounty to join the army. He enlisted freed slaves and even rival Germanic tribesmen for the army. Now, the problems with bandits are obvious: they are outlaws and may not be great at following the strict rules of an army. The problems with enlisting Teutonic people had more to do with how the Roman soldiers would respond to them. Enlisting freed slaves may seem less troublesome, but many of them had been granted liberty because they had grown old and their masters no longer wanted to spend money on their caretaking. Marcus Aurelius basically turned the once-formidable Roman army into the Night’s Watch from the television show Game of Thrones (2011 to present).

  Given the reduction in troop size due to the plague, all of these measures were necessary and sensible. However, if you were a man who had spent the last twenty years of your life fighting in the most glorious military in the world, and you noticed that your dead comrades had been replaced by octogenarian former slaves and horse thieves, you might get a sense that the place the army occupied in the Roman world had changed dramatically.

  Economic problems also loomed. The plague meant that expenses for the military kept increasing; some units required two times as many recruits as they had in the past. Meanwhile, the plague also caused significantly less governmental income to come in from estates, because if your populace is crippled by disease no one’s number one priority is making sure that their vineyards are superprofitable. The empire was forced into debt.

  Marcus Aurelius, in a surprising move, began selling off his imperial property in the Forum of Trajan. According to the fourth-century historian Eutropius, the emperor

  held an auction in the Forum of the Deified Trajan of imperial furnishings, and sold gold, crystal, and myrrhine drinking vessels, even royal vases, his wife’s silk and gold-embroidered clothing, even certain jewels … the sale went on for two months and such a quantity of gold was acquired that after he had carried through the remainder of the Marcomannic war in accordance with his intentions, he gave permission to buyers to return their purchases and get their money back, if they wanted. He did not cause trouble to anyone, whether he returned what he had bought or not.15

  I can’t quite believe a ruler financed a war by having a crazy yard sale, but ancient Rome is surprising in many ways.

  At least temporarily, the auction worked. Marcus Aurelius formed a new defensive zone, the Praetentura Italiae et Alpium, to respond to the crisis on the border. There were setbacks—like the killing of twenty thousand Roman troops by the Marcomanni and their leader, Ballomar, near Carnuntum in 170—but by 172 the Marcomanni tribe was vanquished. A peace treaty was signed with the remaining warring tribes (the Quadi and Sarmatians) in 175, whereupon the tribes agreed to release approximately 160,000 captured Romans.16 (I am end-noting the preceding sentence as much for my own benefit as yours, because the number is so large that I keep going back to make sure I read it correctly.)

  A column was the highest honor available at the time.

  Rome was ultimately victorious in the wars against the Marcomanni. If you visit the column of Marcus Aurelius—and you have either a towering ladder or excellent binoculars—you can see carvings of the barbarian princes su
rrendering to the emperor.

  So the Romans won in the end. But the Germanic tribes, by capturing hundreds of thousands of Romans and crossing the Danube, had dealt a decisive blow to any notion of Roman invulnerability, which was vital to the people of ancient Rome. I am going to quote from the television show The West Wing (1999–2006) here. It was historically accurate when President Josiah Bartlet said: “Two thousand years ago a Roman citizen could walk across the face of the known world free of the fear of molestation. He could walk across the Earth unharmed, cloaked only in the protection of the words civis romanus [sum] ‘I am a Roman citizen.’ So great was the retribution of Rome, universally understood as certain should any harm befall even one of its citizens.” Lest you reply, “That is not historically accurate, Jennifer. That is The West Wing’s brilliant but erratic screenwriter Aaron Sorkin writing whatever he wants, and you just like it when President Bartlet says stuff like that.” The Roman lawyer Cicero himself speaks of this sense of entitlement about two hundred years before the fall of Aquileia. When indicting a warlord named Verres for torturing a Roman citizen, Cicero writes: