‘The First Great Pandemic in History’

In the spring of 2003, on a visit to Toronto, I was startled by the sight of passersby in the streets with mouths and noses hidden under medical face masks. My trip, it emerged, had coincided with an outbreak of severe acute respiratory syndrome (SARS). Those nervous Torontonians were reacting to speculation in the mass media that this might be the start of a pandemic which could wipe out entire populations, send world financial markets crashing, and form the prelude to the imminent collapse of civilization.

These apocalyptic terrors were, happily, unrealized, but from time to time the fears of plague recur. In Britain, alarm in the press and on television has focused on long-distance migratory wildfowl arriving to winter here in salt marshes, estuaries, and wetlands. Commentators have emphasized the possibility that these migrants from the East might infect domestic chickens and turkeys in intensive farms with the virulent H5N1 strain of avian flu, and so set off a lethal pandemic. The H5N1 virus is in fact not easily transmitted among humans, but in these doom scenarios it mutates into a strain lethal to human beings. And even in sober reality, we have become more conscious than ever that there is a price to the dense network of communication which has given us almost instant access to even the remotest parts of the world. In the global village, bird flu in the shanties of rural China may well turn out to be very bad news indeed for London, Los Angeles, or New York.

Pandemic disease is not, of course, a twenty-first-century novelty. Everyone has heard of the Black Death, which decimated the populations of Europe and Asia in the fourteenth and following centuries. Yet the actual historical consequences of such nightmare mortality rates are hard to nail down, and have proved curiously resistant to integration into wider frames of historical explanation and analysis. The worldwide flu epidemic of 1918–1919 was responsible for between twenty and fifty million deaths, a death toll far greater than that caused by all the guns and bombs of World War I put together. Yet while the impact of the war is endlessly explored, flu seldom features as one of the determining forces shaping the problems and character of the early twentieth century.

Plague and the End of Antiquity is a fascinating collection of essays by specialists in history, archaeology, epidemiology, and molecular biology who gathered in 2001 at the American Academy in Rome—of which Lester K. Little, the editor, was then director—to see what light the pooling of their very different kinds of expertise might cast on one of the most significant of history’s forgotten pandemics. Their focus is the recurrent waves of plague which ravaged Europe and Asia for two centuries, appearing suddenly in the Egyptian port of Pelusium in 541 AD. It spread from there to Alexandria, probably from an incubation center somewhere in central Africa, then moved rapidly through Syria, north and east into Greek Asia Minor, Mesopotamia, and Persia, and west into Europe. By 542 the plague had reached Constantinople. The emperor Justinian was the renewer of the greatness of Rome’s empire and patron of the world’s greatest religious building, Hagia Sophia: but the disease was no respecter of persons, and he himself contracted it. Justinian recovered to rule for another twenty years, unlike his enemy the king of Persia, who perished from plague the same winter.

The death toll from this “Justinianic plague” was terrible. Eyewitnesses speak of the depopulation of entire regions, a third of the people of Palestine dead, whole villages and towns utterly deserted. When the disease reached the capital of the empire, we get the facts and figures itemized graphically here by Michael G. Morony: deaths climbing from five thousand, to seven thousand, to twelve thousand, until as many as sixteen thousand corpses, mostly of the poor, were being removed every single day.

At first the authorities stationed officials at the city gates and the harbors to count the bodies, but when the count reached 230,000, it was abandoned. To begin with, a combination of hygiene and piety had prompted the city authorities to provide free burial and religious rites for the corpses of the poor, who lay where they had died in streets and houses. But as the mortality rates mounted, the dwindling numbers of clergy could not cope, and the overwhelming priority anyway became simply to rid the beleaguered living of the murderous presence of the dead. Panic stashing of corpses in the guard towers around the city walls filled Constantinople with the stench of death. Every available form of transport was mobilized to get the mountains of dead out of the city. The corpses were heaped along the seashore in piles of up to five thousand, then loaded onto ships and dumped at sea or on unpopulated shores as far away as possible. The emperor sent the commander of his palace guard to oversee the disposal.

Contract laborers from outlying regions were hired (for a king’s ransom) to dig vast plague pits, some of which were said to hold as many as seventy thousand bodies. Successive layers of corpses were trodden down like grapes to make room for the next, gaps were plugged with the bodies of children, and the chroniclers offer harrowing descriptions of corpses whose putrid bellies burst open when they landed in the pits, of new batches of the dead sinking into a queasy sea of corruption.

The early waves of this plague “by which the whole human race came near to being annihilated”—as the gossipy Greek historian Procopius put it—were vividly documented by a cluster of eyewitnesses. Procopius, recently returned from a spell on the staff of Justinian’s great General Bellisarius during his reconquest of Italy, was probably in Constantinople when the disease arrived there in 542: to him we owe many of the details of the imperial administration’s handling of the crisis. Outside the capital, Evagrius Scholasticus, a Syrian lawyer and historian, contracted the plague while still a schoolboy during the first outbreak at Antioch. He recovered, but his life was to be dogged by recurrence of the disease. His own childhood infection had apparently immunized him, but the rest of his family were not so lucky. In one epidemic after another he lost his wife, several of his children, and many more distant relatives, as well as an assortment of domestic servants and farm staff whose loss greatly impoverished him. Fifty years after his own first brush with plague and just before he commenced work on his great Ecclesiastical History, a fresh outbreak at Antioch carried off two more much-loved children “besides those who had died previously.”

The fullest eyewitness account of all comes from the Syriac writings of a Monophosyte Christian bishop, John of Ephesus, who happened to be in Alexandria on business when the plague arrived there in 541. John, whose writings are discussed here by Michael G. Morony, journeyed back to Constantinople, more or less keeping pace with the spread of the disease north through Syria and on into Thrace, where, he wrote, “day after day we…used to knock at the door of the grave.” His haunting evocations of abandoned villages, domestic herds turning feral, and whitening crops standing unharvested in an eerily empty landscape burned themselves into the literary imagination of late antiquity, and would resurface in many later accounts of epidemics.

For the plague persisted for two centuries, hectically and chronically, turning back on itself to revisit earlier hotspots but also to devastate regions which until then had escaped, all the time spreading inexorably. It may not have penetrated the newly Islamicized Arab world until the late 630s, but then took hold and recurred frequently, though tracing its progress is complicated by the fact that the earliest Arabic accounts survive for the most part embedded and recast in much later compilations. Its progress north and west was probably more rapid, though here too the literary sources are fragmentary and require a good deal of interpretation. The plague may have reached Gaul as early as 543: certainly by the 570s it was rampant there, its inroads chronicled in Gregory of Tours’s contemporary History of the Franks. As John Maddicott writes in his contribution to the collection, the plague was also sweeping through northern Italy in the 570s and 580s; the Lombard historian Paul the Deacon recorded, “You might see the world brought back to its ancient silence: no voice in the field; no whistling of shepherds…human habitations become places of refuge for wild beasts.”

The plague was virulently present in Rome by 589, when its victims included Pope Pelagius II. More than eighty citizens are said to have dropped dead during the first of the great supplicatory processions ordered by Pelagius’ successor, Pope Gregory the Great. Gregory’s processions were an attempt to turn aside the wrath of God, and would be imitated all over Christian Europe for the rest of the Middle Ages, but the summoning of such large crowds almost certainly helped instead to spread the infection.

By the mid-seventh century the plague had arrived at the western fringes of the known world: it was in England by July 14, 664, in Ireland by August the same year. Saint Cuthbert of Lindisfarne, at that time a monk of Melrose in the Scottish borders, contracted the disease, but recovered. His abbot, Boisil, succumbed, along with many other monks. The monasteries were by now the largest concentrations of population in England, since most vestiges of Roman urban civilization had faded, and it is by the disease’s impact on the monasteries that we can trace its progress. The historian Bede records that at the great community of Jarrow only the abbot and one small boy survived to recite the daily office: the boy may well have been Bede himself.

From its first appearance in Egypt the chroniclers had commented on the devastating psychological effects of plague: dissolving social convention and established morality, numbing the feelings of survivors so that mothers might watch with passive indifference the sufferings of their children. In Britain, mass mortality on an unprecedented scale struck at the still-precarious Christianity of a nation only recently converted. The apparent powerlessness of the new religion in the face of this devastating visitation turned many back to the ancient gods. The king of the East Saxons, Sighere, came from a line of Christian kings which included his uncle Redwald, probably the grandee commemorated by the famous ship-burial at Sutton Hoo. But Sighere now took his whole kingdom back to paganism, and the work of conversion would have to begin all over again in the following generation.

Given the fragmentary nature of the literary evidence, a host of unanswered questions hang over the nature, progress, and persistence of this, the first great pandemic in history. Even the identity and continuity of the disease over two centuries and two continents can be questioned. Many of those who left descriptions of the Black Death of the fourteenth century were qualified medical observers, unable to cure the disease but practiced in precise description. On the basis of their accounts, historians can be reasonably sure that the Black Death was in fact bubonic plague, carried by fleas from infested rats (though even this conclusion has been contested).

As it happens, none of the surviving accounts of the Justinianic plague was written by an observer with medical training, and though all the contributors to the symposium are convinced that this plague was also bubonic, they are frank about the difficulties of the diagnosis. The early Syriac sources do include unmistakable descriptions of victims suffering with swellings—the “buboes” from which bubonic plague takes its name—in the groin, armpit, or neck. A century later, Bede described a similar swelling in the groin as one of Cuthbert’s plague symptoms. But literary descriptions of many outbreaks of the disease lack any such tell-tale indicators, or include details less obviously consistent with bubonic plague—the “yellowness” of the plague mentioned in Irish sources, or the sudden death of apparently healthy victims, stricken in mid-breath with no external symptoms, or the marking of sufferers not with buboes but with black or purple spots on abdomen, limbs, or even the palms of the hands. In some sources the great speed of the spread of the disease seems inconsistent with bubonic plague, which spreads relatively slowly through the bite of infected rat-fleas.

These are not insuperable difficulties: bubonic plague may develop into pneumonic plague, which kills with few external warning symptoms, and which is far more virulent than the bubonic form, being spread not by fleabites but by airborne water droplets from the lungs of the infected. Nevertheless, the deficiencies of the documentary sources make recourse to other types of evidence very desirable: hence the centrality in this symposium of archaeology, epidemiology, and molecular biology.

Archaeology, it has to be said, is of only rather limited help. As John Maddicott observes in his wonderfully wide-ranging essay on plague in seventh-century England, “archaeology cannot tell us much about the progress of epidemic disease in any period. If we relied on it alone, we would hardly be able to detect the Black Death.” Maddicott does his best, assembling a list of nine archaeological sites from Anglo-Saxon England which may have been settlements abandoned suddenly at the end of the seventh century. These sites may therefore provide evidence for the decline of the rural population one would expect in the wake of epidemic: but Maddicott concedes that this remains no more than “an open possibility.”

The impact of the disease in seventh- and eighth-century Britain has to be deduced from scattered references to it in Bede, and from ambiguous material evidence such as the few burial sites containing disordered corpses and shoddy or shallow burials indicating some sort of crisis, which may or may not have been the plague. Negative evidence of a sort is perhaps provided by the comparatively small number of English settlements discovered so far which can be firmly dated to the eighth or ninth centuries, suggesting a reduced population.

Archaeological absences, however, can be double-edged assets. An archaeological obstacle to firmly identifying the seventh-century British epidemic as bubonic plague, for example, is the fact that though rats are known to have existed in Roman Britain, and again in early medieval England, “no rat bones have been recovered from any early Anglo-Saxon site.” There may well, therefore, have been no rats in Bede’s England to spread the disease, perhaps because they had died out with the fading of the Romano-British towns, and the consequent disappearance of concentrations of population large enough to support rodent colonies.

Rats of course are fine-boned animals, and the damp English climate is not particularly conducive to the preservation of the fragile remains of small mammals. It seems likely, nevertheless, that the contributors to this volume would heave a collective sigh of relief if a rat bone or two were to turn up in a datable English seventh-century site. The situation is even worse for Ireland, where there is no pertinent archaeological evidence at all, and the progress of the disease has to be inferred from what might or might not be thought suspiciously high levels of mortality among the ruling caste of the late seventh century, as recorded in later succession lists and dynastic poetry.

In Spain, according to another contributor, Michael Kulikowski, tracing the Justinianic plague “is a matter of guesswork and extrapolation from a very small body of evidence.” This includes a puzzling group of plague sermons, so badly written that the likeliest explanation for their preservation in a much more sophisticated collection of sermon texts might be that plague sermons were often needed. More concretely, Kulikowski offers the suggestive evidence of two burial sites within the ancient city walls of Valencia, where thirty or so bodies deposited on more than one occasion, jumbled ignominiously into a ditch and hastily covered over, may date from the sixth century, and so may be from a plague pit.

Even relatively firm archaeological evidence, however, may seem to the layman to require an act of faith in its interpretation. The sole evidence for the spread of the first outbreak of the epidemic to Sicily, for example, consists of a single tombstone recording the deaths there of three young boys, perhaps brothers, in December 542. The presence of the disease in Rome the following year is inferred from the survival there of nine epitaph inscriptions datable to a period of four months from November 543 to February 544. This cluster may seem to the nonspecialist a shaky enough basis on which to deduce the presence of a devastating epidemic, but in fact this is the densest surviving concentration of such epitaphs in the whole of the very rich corpus of sixth-century Roman inscriptions. As Dionysios Stathakopoulos, another contributor to the collection, writes, the cluster of deaths probably does therefore establish (though not of course explain) an unusually high mortality rate in Rome in the winter and spring of 543–544.

Advances in the biological sciences may one day perhaps come to the aid of both historians and archaeologists. In 1998 a team of molecular biologists based in Marseilles collaborated with archaeologists and historians on a mass burial site associated with the quarantine hospitals operating during outbreaks of bubonic plague there in 1590 and 1720. Analysis of the DNA in dental pulp from unerupted teeth in these burial pits allegedly identified traces of the Y. pestis bacterium, which causes bubonic plague. The Marseilles findings did not go unchallenged, but the group subsequently extended their analysis to three skulls taken from a fourteenth-century plague pit, and once again claimed to have identified traces of Y. pestis DNA. In 2005 scholars at Munich using the same techniques on a burial in Upper Bavaria dated by archaeologists to the sixth century claimed to have detected Y. pestis DNA there too. If their findings are sound, this would constitute the sole evidence for the presence of the disease in sixth-century Germany.

A generation accustomed to Jurassic Park fantasies of dinosaur DNA recovered from the bloodstream of mosquitoes preserved in amber may have no imaginative difficulty in accepting that diseases might be diagnosed from fragments of DNA a millennium and a half old. But it is far too soon to start the cheering: an Oxford laboratory specializing in the analysis of ancient biomolecules and using a far larger sample of more than sixty victims from five suspected plague pits has failed to replicate the Marseilles and Munich findings. While this failure does not in itself invalidate the results from Marseilles and Munich, it does underline the precarious nature of such analysis, and suggests the need for caution in theorizing from the alleged results.

The molecular biologists support the historians and archaeologists in thinking that Justinian’s plague was probably humanity’s first bubonic pandemic. Analysis of the structure of Y. pestis DNA suggests that the disease was a very late arrival in the history of evolution, and that it mutated from a far less virulent gastrointestinal pathogen somewhere between 20,000 and 1,500 years ago. It may be that refinements in the ability of scientists to read the time by the “molecular clock” will supply a more precise date for the first emergence of the disease. Whether or not this becomes possible, the historians still have to set themselves to explain what it was about the mid-sixth century that provided the conditions for the eruption and spread of the pandemic on so vast a scale.

They will also have to work harder to provide a convincing account of the impact which such overwhelming mortality may have had on the subsequent course of human history. Lester Little announces boldly in his preface that “plague helped carry out Antiquity and usher in the Middle Ages,” but his contributors are hard pressed to say exactly how. There is plenty of speculation here, of varying degrees of plausibility, about how the disappearance of a third or more of the population may have shaped the course of the next few centuries. Did the Justinianic plague make possible the spread of Islam, by fatally undermining the armed force of Byzantium? Did it trigger the great flowering of monastic culture in England and Ireland which produced the Lindisfarne Gospels and the Book of Kells, by stimulating a more anxious and interiorized spirituality, wiping out small scattered monastic houses, and concentrating the survivors and their talents in larger and more vigorous communities?

Did the plague inaugurate a new and positive work ethic in the Latin West? Was the emergence of a new and intense Christian devotion to the Virgin Mary in sixth- and seventh-century Byzantium the direct consequence of a desperate search for consolation in the face of an angry God? Or was even so devastating a depopulation no more than a blip on the demographic scale, as John Maddicott says of its impact in England: “a brief and temporary intermission in an upward trend”? It is all so elusive. If the Justinianic pandemic did indeed strike on the scale that some of these essayists suggest, it must have felt to those who endured it a catastrophe on a par with the sinking of Atlantis. It speaks volumes about the fragility of human knowledge and the shortness of human collective memory that so vast a calamity has left so little trace, and must be reconstructed with so much effort and uncertainty. That’s a thought to season our anxious watch for signs of sickness among the migrating wildfowl.