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  No groan was heard, no expression was heard from that wretched man, amid all his pain, and between the sound of the blows except these words, “I am a citizen of Rome.” He fancied that by this one statement of his citizenship he could ward off all blows … and you, Verres, you confess that he did cry out he was a Roman citizen … you suspected he was a spy. I do not ask what were your grounds for that suspicion. I impeach you by your own words. He said that he was a Roman citizen.17

  There were nightmarish aspects to Roman society. Romans killed one another all the time. Shit flowed through their streets. But no empire has ever rivaled Rome for making its people believe that as long as they were Roman citizens, they were, to the extent one could be in a dangerous world, safe. How, after the siege of Aquileia, could any Roman citizen truly believe that again? About 160,000 Romans had been captured. Their borders had been breached. Their army would never be the same again. It wouldn’t even look the same: the Marcomannic Wars would be the last time the lorica segmentata and rectangular shields would be used by the legionnaires. According to McLynn, “The legions lost both their clear social status and their clearly differentiated appearance.”18

  If Marcus Aurelius had lived longer, the empire might have recovered, if not its population, at least the sense of what it meant to be a Roman citizen. The nineteenth-century historian Barthold Georg Niebuhr wrote, “There can be no doubt that, during the last years of the war, the Romans were victorious, though not without the most extraordinary exertions, and that if M. Aurelius had lived longer, he would have made Marcomannia and Sarmatia Roman provinces.”19 That last part is speculative, but, sure! Maybe! Sensible rulers like Marcus Aurelius are without doubt a godsend in times of plague. Rome was fortunate to be led by a man who was able to respond calmly to each crisis with a rational—if sometimes unexpected—solution. People speak often about Marcus Aurelius’s philosophical genius, his sense of morality, and his all-around greatness, and I’m sure all of that is true, but on a practical level the man was just an excellent problem solver. Like Matt Damon’s character in The Martian (2015) good. During crises like the Antonine plague, being a problem solver is the best thing you can be. When we are electing government officials, it is not stupid to ask yourself, “If a plague broke out, do I think this person could navigate the country through those times, on a spiritual level, but also on a pragmatic one? Would they be able to calmly solve one problem, and then another one, and then the next one? Or would bodies pile up in the streets?” Certainly, it would be better than asking yourself if you would enjoy drinking a beer with them.

  Unfortunately, despite Niebuhr’s hopeful speculation, Marcus Aurelius didn’t live longer. He died in 180, most likely of the plague. While he continued to believe that immorality was a greater evil than any disease, the plague was certainly on his mind. Supposedly his last words were, “Weep not for me; think rather of the pestilence and the deaths of so many others.”20 Gibbon claimed, “The ancient world never recovered from the blow inflicted on it by the plague which visited it in the reign of M. Aurelius.”21

  Gibbon got it right. Whether you attribute the beginning of the fall of Rome to the weakening of its military, the increased confidence and aggression of people outside its borders, the Romans’ damaged national psyche, economic issues, or the untimely death of Marcus Aurelius—every one of those things was tied or directly attributable to the plague. The first lesson of this book is that plagues don’t just affect a population’s health. If they are not quickly defeated by medicine, any significant outbreak of disease sends horrible ripples through every aspect of society.

  In the wake of the Antonine plague, Rome began a dizzying downward spiral.

  The empire was not going to recover under the reign of Commodus, Marcus Aurelius’s nineteen-year-old successor. Steering a civilization while a plague is constantly undermining it is like trying to captain a boat with a hole in its hull. Not only do you need to be able to pilot, you also have to devote an ungodly amount of time and effort to triaging the compounding emergencies. And even in the best of times, Commodus couldn’t have captained a paddle boat across a kiddie pool. Dio writes that, when dealing with the Marcomanni immediately following Marcus Aurelius’s death: “Commodus might easily have destroyed them, yet he made terms with them; for he hated all exertion and craved the comfortable life of the city.”22 Commodus is played by Joaquin Phoenix in Gladiator as a man whose defining trait is his desire to have sex with his sister, Lucilla. (That’s debatable—he more likely had sex with his other sisters, not the one in the film.) My real quibble with the movie is that it left out so many more of Commodus’s horrible traits. Dio claimed he was “not naturally wicked, but … [his] great simplicity, however, together with his cowardice, made him the slave of his companions … [by whom] he was led into lustful and cruel habits, which soon became second nature.”23 He frittered away his time as emperor in increasingly bizarre ways, such as, according to Dio, randomly changing his name to “Lucius Aelius Aurelius Commodus Augustus Herculeus Romanus Exsuperatorius Amazonius Invictus Felix Pius” and then demanding that the names of months on the calendar be changed to correspond with his made-up name. Maybe you think, He was like the artist formerly known as Prince! No. Prince changed his name because of a contract dispute. Commodus changed his name because his brain was full of dumb ideas and positive reinforcement. He spent the rest of his time poisoning his perceived political enemies and killing extremely unthreatening animals in gladiatorial games. Dio recalls an incident where he killed an ostrich and paraded it proudly before the senators, who had to restrain their laughter.

  While Commodus was being a cowardly, banana-brained, ultimately assassinated monster, the Antonine plague segued into the Cyprian plague and didn’t really end until 270. And, unlike during Marcus Aurelius’s reign, rulers weren’t constantly working to solve the myriad of issues a plague produces. By the time 270 rolled around, the emperor Valerian had already been captured and held hostage by the Persians, so that notion about the citizens of Rome being safe had flown way out the window. Barbarian tribes had become more aggressive; and while some integrated into Roman society, the far-flung portions of the empire began to break away. By 410 the city of Rome—Rome itself! Once home to over a million people during Marcus Aurelius’s reign!—would be sacked by Visigoths. The city was sacked again by Vandals in 440 and then again by the Ostrogoths in 547. By the time the Ostrogoths left, there were only a few hundred people left in the city. Thus the curtain rose on the Dark Ages, now euphemistically called the “Early Middle Ages” (which seems a lot like calling a mass unmarked grave an “early flower garden”).

  If someone were to exclaim, “I am a citizen of Rome!” today, it would not so much as gain a reprieve from a traffic ticket.

  The takeaway from this story is that there is really only one thing we should collectively fear ending civilizations. It’s not licentious behavior. If the biggest problem in your civilization is people having sex, you are doing great. It isn’t even necessarily other countries attacking you because they hate you and all that you stand for. If you’ve got a big enough army you can fight them off. The real terror is plague. It’s waiting out there, somewhere, under the ice or in a jungle. If it strikes and it can’t be combatted effectively, it can take down an empire.

  Bubonic Plague

  “I guess I’m the Black Death,” he

  said slowly. “I don’t seem to bring

  people happiness anymore.”

  —Tender Is the Night, F. SCOTT FITZGERALD

  One social media trick that makes me furious is when I encounter little pop-up ads saying that some doctor has found the cure for Alzheimer’s disease. These messages enrage me because I know I’m going to click on them. I can’t help it. I respond because I am absolutely terrified of getting Alzheimer’s. I will click on those ads every single time.

  Generally, the link takes you to a very long video of a man saying he has studied Alzheimer’s for years and now you should buy
his book. Which I’m not going to buy because there is currently no cure for Alzheimer’s; if there were, it would be widely reported in the press, so that man would not have to make a homemade video to share his “cure.” But … I am sure that if I clicked one of those messages and it just read in bold font, unsupported by any medical expertise, Eat More Bananas, I would eat more bananas.

  I would do that even though I am a person of the twenty-first century who knows that you should look for some reliable proof of a treatment’s effectiveness before you start any regimen. People—even fairly sane ones—seem to have an irrational tendency to respond to a fearsome disease by latching on to any supposed “cures” without proof of whether or not they would actually be helpful. It is hard to “keep calm and carry on” when you are scared.

  This may explain why, when the bubonic plague began spreading through Europe in 1347, the average medieval person latched on to treatments that were absolutely, utterly insane.

  During the fourteenth century, when the bubonic plague was at its most destructive, 90 percent of western Europeans were living off the land, mostly as farmers. There was a very small class of intelligentsia (who were probably dismissed as “not the REAL western Europeans”). If you were a peasant and someone said, “If you live in a sewer, the bubonic plague won’t kill you,” your reaction likely wouldn’t be, “I am curious to hear the science behind that.” Your response would be, “Point me to the nearest sewer.” Terror over the devastating disease and a lack of scientific knowledge, as well as some people’s truly evil tendency to prey upon people’s fears, resulted in safeguards that seem ludicrous today.

  In no particular order, these were some fourteenth-century methods thought to be effective against the bubonic plague:

  DRINKING A SMALL AMOUNT OF GOOD WINE.

  Fourteenth-century chronicler Gilles Li Muisis claimed that no one who drank wine in Tournai died. Sure! This is a great cure, actually. This one is valid for everything from minor colds to terminal illnesses. Or, if it’s not (it is not), it at least seems to be fun. I wanted to begin with a cure that is fun.1

  LIVING INSIDE A SEWER.

  The reasoning behind this lifestyle choice seemed to be that your body would become so accustomed to filth and untold horrors that the plague could not harm it. This was wrong, especially as the plague is thought to have been carried by fleas on rats, many of which made their homes in sewers. So you’d be more likely to contract the plague, and you’d be living in a really awful place during your final days.2

  EATING CRUSHED EMERALDS.

  Yes, this behavior seems cool. It sounds like something a rich man in Greek mythology would do. But it is not a good idea at all. Emeralds have no value outside of humans’ perception of their worth. They are just rocks. People were voluntarily swallowing shards of rocky glass, which had the potential to kill them by ripping their gastrointestinal tract and causing internal bleeding. Unless of course the emeralds were ground very, very finely—in which case there would be no effect whatsoever. (Fun fact: you can’t kill someone by finely grinding up glass and mixing it in their food. Either they’d be able to detect it, or it would be too finely ground to kill them. I’m too smart for you, potential murderers who are after my history-book-writing fortune.)3

  EATING EGGS, FRUITS, AND VEGETABLES.

  Do we see a glimmer of the modern world? Eating these foods seems like common sense because they are packed with nutrients! But, no, that had nothing to do with that reasoning. Instead the advice had to do with avoiding foods like milk, cheese, and meat, or anything that would smell bad if it was left out in the sun. That’s because it was believed that bad smells caused the plague. This notion, known as the miasma theory, regarding bad air, would persist, irritatingly, into the nineteenth century. People kind of lucked into this healthy eating regimen.4

  NOT LOOKING AT SICK PEOPLE.

  One doctor believed that “an aerial spirit” could fly out of a sick person’s eyes and into another person’s body, especially if you looked at that sick person while they were dying. This is not true, but I suppose you could avoid looking at anyone ever, just in case, as certain rock stars do.5

  CHOPPING UP RAW ONIONS AND PLACING THEM THROUGHOUT YOUR HOUSE.

  Since many people thought that the plague was spread through bad smells, they hoped that placing onions around the house would purify the air. It didn’t. But the myth about chopped-up onions having healing properties became shocking prevalent. Even today the National Onion Association has to explain in its Frequently Asked Questions that placing chopped onions around your house will not prevent diseases. It is so strange and, I guess, quite selfless of the organization to do that. We should buy lots of onions to reward it for being honest. Sometimes, bubonic plague sufferers were given onion broth to drink. That was both because fourteenth-century people vastly overestimated onions’ healing properties and because—as I learned from the National Onion Association—it is delicious and contains “layers of flavor.”6

  DRINKING YOUR URINE/BUBOES PUS.

  In an attempt to expose their bodies to the disease and make them hardier, some people would drink pus from burst boils or their own urine (twice a day!). Needless to say, this tactic did not work, and it makes drinking onion broth or wine sound truly delightful in comparison.7

  * * *

  These guys were lucky—they had pillows and an in-home wizard.

  For those of you who, having heard of these “cures,” are curious about the real science of this plague, it is generally spread by flea bites. Certain rats carry—and can live with—a bacterium called Yersinia pestis. Fleas also live on rats, and when they suck rats’ blood, they absorb that bacterium, which then multiplies in those fleas’ stomachs. Then the rats carry the fleas to areas populated by humans. When a rat dies, the fleas jump to a new host, like a human. They bite the human host and leave traces of the bacteria in the wound. Some hosts then scratch or rub that area, driving the bacteria farther into the wound (though, honestly, not scratching doesn’t seem to make much difference). The bacteria then make their way through the lymphatic system. This results in buboes, which appear on the body like boils. Hence the name “bubonic plague,” although at the time the disease was more often referred to as “the Great Mortality” or, in France, “Le charbon,” meaning coal or carbon, likely because of the buboes’ lumpy, coal-like appearance. (And yes, the word boo-boo is thought to possibly be derived from buboes. You should never kiss a bubo to make it better.) The disease would come to be known as the Black Death.

  Buboes are swollen lymph nodes, which usually develop in the armpits, genitals, or neck. So this disease began rather revoltingly with a golf ball–sized goiter under your armpit or in your groin. Jeuan Gethin, a Welshman living in 1349, recorded: “Woe is me of the shilling in the arm-pit; it is seething, terrible, wherever it may come … It is of the form of an apple, like the head of an onion, a small boil that spares no-one. Great is its seething, like a burning cinder, a grievous thing of an ashy colour.”8

  Here is an unsurprising fact: Gethin died of the bubonic plague almost immediately after writing this. Most people died within four days of exhibiting the first symptoms, and many died within twenty-four hours. The fourteenth-century author Boccaccio also writes about the same buboes Gethen describes, saying, “some waxed to the bigness of a common apple, others to the size of an egg.”9

  In addition to egg-sized buboes that oozed pus and blood, victims of the plague could expect a fever, vomiting, muscle aches, and delirium. There would also be subcutaneous hemorrhaging. That’s because the bubonic plague inhibits the body’s ability to clot blood. According to Boccaccio, this would result in “purple spots in most parts of the body: in some cases large and but few in number, in others less and more numerous, both sorts the usual messengers of death.”10 If the plague spread to the lungs and became pneumonic, it could be transmitted from person to person through an infected cough. The plague would kill somewhere between 20 and 50 million people in the f
ourteenth century, or approximately 30 percent of Europe’s population.

  Given the level of fear induced by this plague, the “eat more bananas/emeralds” prevention steps don’t seem all that unreasonable. The more extreme steps to purportedly avoid the plague were based in religious fervor. It’s not surprising that when a massive plague is killing even the wealthy emerald eaters, people turn to God. Many carved crosses on their doors in the hopes that the sign would cause the plague to pass by. That generally seems pretty harmless!

  Seems like they had cool shoes, though.

  But fourteenth-century life quickly became weirder. Many hoped that by flagellating themselves they might earn God’s pardon. Largely from Holland, the flagellants spread through Europe during the mid-fourteenth century. They marched naked through cities, whipping themselves until they bled. They also weren’t allowed to wash their wounds or talk to women. They would fling themselves facedown with their arms spread out like the cross. They would do this over and over, for thirty-three and a third days in each place they visited. The number of days was supposed to represent the number of years Christ lived on earth. Pope Clement VI officially forbade the activity in October 1349, but by then, zealots had largely turned their attention from hurting themselves to harming the Jews. The widespread rumor was that the Jews were going around dumping the plague into wells. Seemingly, medieval Christians remembered essentially nothing from the horrors of their own persecution in Rome because they did not hesitate to form large mobs and attack Jews.

  Pope Clement attempted to stem this outbreak of anti-Semitism by issuing a bull saying that anyone who thought the Jews were actually responsible for the plague “had been seduced by that liar, the devil,”11 and that the killings should stop. That was a wonderful move. Pope Clement’s well-intentioned bull was said to calm tensions in some regions, like France and Italy, but other parts of Europe weren’t as receptive. If you do a quick Google search on this topic, you will find that some hateful people still believe—today!—that the bubonic plague was deliberately spread by Jews poisoning wells. That rumor, though medically implausible, is apparently sufficiently compelling to continue to appeal to poorly informed people. So it is horrifying but not wholly unexpected that in February 1349, nine hundred Jews were burned to death in Strasbourg. A chronicler wrote: “They were led to their own cemetery into a house prepared for their burning and on their way were stripped naked by the crowd which ripped off their clothes.”12 In the same year, in Mainz, six thousand Jews were supposed to have been killed on a single day, and over twenty thousand were murdered in total.