The Antonine Plague of AD 165 to 180, also known as the Plague of Galen (after Galen, the Greek physician who described it), was a prolonged and destructive epidemic, which affected the Roman Empire. It was possibly contracted and spread by soldiers who were returning from campaign in the Near East. Scholars generally believed the plague was smallpox,. Downloaded from Cambridge Core. due to the skin eruptions over the entirety of the body which appeared to be red and black (Horgan), although measles has also been suggested,"There is not enough evidence satisfactorily to identify the disease or diseases", concluded J. F. Gilliam in his summary (1961) of the written sources, with inconclusive Greek and Latin inscriptions, two groups of papyri and coinage.At least one study finds the origin of measles post-dates the plague. See A more recent study finds that measles emerged well before the Antonine Plague. and recent genetic evidence strongly suggests that the most severe form of smallpox arose in Europe much later. As yet, there is no genetic evidence from the Antonine plague.
Ancient sources agree that the plague is likely to have appeared during the Roman siege of the city of Seleucia in the winter of 165–166, during the Parthian Empire campaign of Lucius Verus. Ammianus Marcellinus reported that the plague spread to Gaul and to the Roman legion along the Rhine. Eutropius stated that a large proportion of the empire's population died from this outbreak.Eutropius XXXI, 6.24. According to the contemporary Roman historian Cassius Dio, the disease broke out again nine years later in 189 AD and caused up to 2,000 deaths a day in the city of Rome, 25% of those who were affected.Dio Cassius, LXXII 14.3–4; his book that would cover the plague under Marcus Aurelius is missing; the later outburst was the greatest of which the historian had knowledge. The total death count has been estimated at 5–10 million, roughly 10% of the population of the empire. The disease was particularly deadly in the cities and within the Roman army.
The Antonine plague occurred during the last years of the Pax Romana, the high point in the influence, territorial control, and population of the Roman Empire. Historians differ in their opinions of the impact of the plague on the empire in the increasingly troubled eras after its appearance. Based on archaeological records, Roman commercial activity in the Indian Ocean extending to the Indian subcontinent and Southeast Asia from ports of Roman Egypt seems to have suffered a major setback after the plague. This disruption likely contributed to a broader economic decline and social instability throughout the empire in the years that followed.
The economic prosperity of the Roman Empire notwithstanding, the conditions were propitious for a pandemic. The population was unhealthy. About 20 percent of the population — a large percentage by ancient standards — lived in one of hundreds of cities; Rome, with a population estimated at one million, being the largest. The cities were a "demographic sink" even in the best of times. The death rate exceeded the birth rates and a constant in-migration of new residents was necessary to maintain the urban population. As perhaps more than one-half of children died before reaching adulthood, the average life expectancy at birth was only in the mid-twenties. Dense urban populations and poor sanitation contributed to the dangers of disease. The connectivity by land and sea between the vast territories of the Roman Empire made the transfer of infectious diseases from one region to another easier and more rapid than it was in smaller, more geographically confined societies. Epidemics of infectious diseases in the empire were common, with nine recorded between 43 BC and 148 AD. The rich were not immune to the unhealthy conditions. For example, only two of emperor Marcus Aurelius' fourteen children are known to have reached adulthood.
A good indicator of nutrition and the disease burden is the average height of the population. The conclusion of the study of thousands of skeletons is that the average Roman was shorter in stature than the people of pre-Roman societies of Italy and the post-Roman societies of the Middle Ages. The view of historian Kyle Harper is that "not for the last time in history, a precocious leap forward in social development brought biological reverses". This decline in average height during the Roman era may reflect the stresses of urbanization, warfare, and economic inequality. Despite increasing development, average height did not increase in Europe between 1000 and 1800, while it increased in the 5th and 6th centuries during late antiquity.
The plague endured until about 180 and another epidemic, possibly related, is reported by Dio Cassius to have struck the city of Rome in 189. Two thousand people in the city often died on a single day. Whether this new epidemic, or recurrence of the Antonine plague, impacted the empire outside the city of Rome is unknown. Downloaded from JSTOR.
The historian William H. McNeillMcNeill, W.H. 1976 Plagues and Peoples. New York Anchor Press. asserts that the Antonine Plague and the later Plague of Cyprian (251–c. 270) were outbreaks of two different diseases, one of smallpox and one of measles but not necessarily in that order. The severe devastation to the European population from the two plagues may indicate that people had no previous exposure to either disease, which brought immunity to survivors. Other historians believe that both outbreaks involved smallpox.D. Ch. Stathakopoulos Famine and Pestilence in the late Roman and early Byzantine Empire (2007) 95 The latter view is bolstered by molecular estimates that place the evolution of measles sometime after 1000 AD. However, Galen's description of the Antonine Plague is not completely consistent with smallpox.
The traditional view was expressed by Barthold Georg Niebuhr (1776–1831) who concluded that "as the reign of Marcus Aurelius forms a turning point in so many things, and above all in literature and art, I have no doubt that this crisis was brought about by that plague ... The ancient world never recovered from the blow inflicted on it by the plague which visited it in the reign of Marcus Aurelius."Niebuhr, Lectures on the history of Rome III, Lecture CXXXI (London 1849), quoted by Gilliam 1961:225 More recently, scholar Kyle Harper said something similar: the pandemic "in any account of Rome's destiny ... merits a place squarely in the forefront." To the contrary, a team of six historians questioned the "extreme" position of Harper and others on this plague as "ignoring scholarship that suggests it had a less than catastrophic outcome," but the historians affirmed that "we do not doubt that disease and climate had some of the impact Harper describes." DOI: 10.1111/hic3.12508
Some historians have hypothesized that the epidemic resulted in a surge in the popularity of the cult of Asclepius, the god of medicine; the epigraphic record, however, shows no evidence of such increase in the cult's popularity.
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