Infectious Diseases in Ancient Times

With the recent fear of a coronavirus outbreak, I thought it would be interesting to trace the history of infectious diseases. Infectious diseases date back to the ancient civilizations. The earliest reference to influenza, which the coronavirus is a form of, came from none other than the father of modern medicine, Hippocrates. As early as 412 B.C.,  Hippocrates described a highly contagious disease with flu-like symptoms afflicting residents of Perinthus in northern Greece. It is the first known influenza epidemic in history. The name, influenza, came much later in 1357 AD, when people in Florence named the epidemic “influenza di freddo”, or influence of cold.

Infections spread quickly and widely in the ancient world, and influenza was certainly not the first epidemic in history. The Great Plague of Athens in 430-426 BC, caused by an outbreak of typhoid and other diseases, is the earliest known major epidemic. The outbreak came in the middle of the Peloponnesian War between the Spartans and the Athenians and crippled the Athenian army. It spread rapidly through contaminated food, water supplies, and close contact with infected people. The epidemic wiped out a third of the population of Athens and is believed to have contributed to the fall of classical Greece. We know a lot about the epidemic because of a first-person account by the great Greek historian Thucydides, whi was infected but survived to describe the epidemic in great detail in the History of the Peloponnesian War. The disease originated in Africa, swept through Egypt and Libya and across the Mediterranean Sea into Persia and Greece, and entered Athens through the port of Piraeus, which was the sole source of food and supplies for Athens. The outbreak claimed the life of the great Athenian leader, Pericles, ending The Golden Age of Pericles, and handing the Spartans victory over Athens.

The Plague of Athens, Michiel Sweerts

The epidemic also affected Athens’ society in many other ways. Living under the shadow of death, the people of Athens gave up following laws, they began spending money indiscriminately and even stopped behaving honorably. The epidemic was so contagious that people stopped caring for the sick and the dead, leaving corpses to pile up and rot in mass graves. It caused religious strife with people blaming the gods for not doing anything to ease their misery. So the first epidemic had a lasting influence on society.

Another highly contagious disease, malaria, that still threatens people in many countries, also existed in ancient times and accounted for the decline of many populations. First documented in the ancient medical text, Nei Ching, in 2700 BC, malaria became known as the dreaded Roman Fever in the Roman Empire. Hippocrates described malaria in great detail and studied the effects of antimalarial agents. Malaria led him to conceive the idea of hygiene or “an influence of the atmosphere, soil, and water on human health” and the concept of contagion rather than the magical nature of infectious diseases. He also observed the seasonal nature of infectious diseases and the systematic progression of symptoms.

More infectious diseases like tuberculosis are also described by Hippocrates. The Romans were responsible for spreading tuberculosis around the world. After originating in Africa, it was restricted to that continent for nearly 5000 years, before the Romans got it during their conquest.  As the Roman Empire expanded in the first century AD, so did the deadly disease. The Roman soldiers took it with them to distant lands across three continents, and their practice of using public baths and close barracks certainly helped in spreading it.

While the Romans were responsible for spreading one infectious disease, another caused its own demise. The deadly smallpox had its origin in ancient Egypt, with Pharaoh Ramses V who died in 1145 BC, being one of its earliest known victims- his mummy bears evidence of the pockmarks that are the telltale signs of smallpox. Smallpox came to Rome around 165 AD in the form of the Antonine Plague. The epidemic lasted for fifteen years and claimed the lives of almost 7 million people, including Emperor Marcus Aurelius, and contributed to the downfall of the mighty Roman Empire.

Infectious diseases continued through the Middle Ages, claiming a huge number of lives, and affecting the development of the Western civilizations for centuries. With the looming coronavirus threat, it is interesting and a little reassuring to note that we have come a long way in combating these diseases- the current death rate of 2-3% for coronavirus is minuscule compared to the fatality rates of infections in ancient times.