Plague of Athens

The Greek historian Thucydides interrupts his history of the Peloponnesian War between Athens and Sparta to describe the following epidemic in 430 B.C.:

It was generally agreed that in respect of other ailments no season had ever been so healthy. Previous diseases all turned off into the plague; and the rest of the people were attacked without exciting cause, and without warning, in perfect health. It began with violent sensations of heat in the head, and redness and burning in the eyes; internally, the throat and tongue were blood-red from the start, emitting an abnormal and malodorous breath. These symptoms developed into sneezing and hoarseness, and before long the trouble descended into the chest, attended by violent coughing. Whenever it settled in the heart, it upset that organ, and evacuations of bile ensued, of every kind for which the doctors have a name; these also together with great distress. Most patients suffered an attack of empty retching, inducing violent convulsions, in some cases soon after the abatement of the previous symptoms, in others much later. The body was neither unduly hot externally to the touch, nor yellowish in color, but flushed and livid, with an efflorescence of small blisters and sores. Internally, the heat was so intense that the victims could not endure the laying-on of even the lightest wraps and linens; indeed nothing would suffice but they must go naked, and a plunge into cold water would give the greatest relief. Many who were left unattended actually did this, jumping into wells, so unquenchable was the thirst which possessed them; but it was all the same, whether they drank much or little. The victims were attacked throughout by inability to rest and by sleeplessness. Throughout the height of the disease the body would not waste away but would hold out against the distress beyond all expectation. The majority succumbed to the internal heat before their strength was entirely exhausted, on the seventh or ninth day. Or else, if they survived, the plague would descend to the bowels, where severe lesions would form, together with an attack of uniformly fluid diarrhea which in most cases ended in death through exhaustion. Thus the malady that first settled in the head passed through the whole body, starting at the top. And if the patient recovered from the worst effects, symptoms ap peared in the form of a seizure of the extremities: the private parts and the tips of the fingers and toes were attacked, and many survived with the loss of these, others with the loss of their eyes. Some rose from their beds with a total and immediate loss of memory, unable to recall their own names or to recognize their next of kin. (Text of Thucydides [book 2, chap. 49], trans. W. L. Page, 1953)

Expanding rapidly in the early summer, the epidemic was far more lethal than others Thucydides had known, and he claimed that the novelty of this disease left Greek physicians powerless to deal with it. The epidemic was said to have begun in Africa, south of Ethiopia, spreading first to Egypt and Libya, then to Persia, then to Greece.

The stricken initially complained of "violent heat in the head," coryza, swollen and inflamed eyes, throat, and tongue, proceeding to violent coughing. Then the victims usually began to vomit, the disease bringing on "all the vomits of bile to which physicians have ever given names." Death claimed many of the sufferers in 7 to 9 days, a merciful end to wrenching convulsions, intense internal heat, and extreme thirst. Thucydides described an exan-them characterizing many cases: The skin, not hot to the touch, took on a livid color, inclining to red, and breaking out in pustules and ulcers. However, he did not offer clear comment about the distribution of the rash, thus permitting much disagreement in the literature.

Causing almost equal difficulty for medical observers today is Thucydides' description of the behavior of sufferers, hurling themselves into wells and cisterns in order to assuage the "inner heat" and satisfy their thirst. Thucydides does not identify any age group, sex, or socioeconomic category among those most at risk, rather emphasizing that the previously healthy were as likely to suffer and die as those previously debilitated by illness. He claims that 1,050 out of4,000 adult male soldiers perished of the Plague - a high mortality rate even if all were afflicted. Pericles, the great orator and leader of Athens, apparently perished from the sickness, but Thucydides and Socrates did not. Thucydides assumes that the disease was contagious, and no one has questioned that assumption.

The epidemic lingered for 4 years in southern Greece, killing up to 25 percent of the population (if one accepts the highest mortality estimates). No subsequent epidemics in the Hellenic and Hellenistic Greek hegemony are comparable to this epidemic in magnitude. Because the epidemic, according to Thucydides and to many later historians of ancient Greece, was responsible for Athenian mili tary losses to Sparta, many have judged the Plague of Athens to be a "turning point" in the history of Western civilization.

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