The Great Plague of Athens

An earlier version of this paper was delivered at a meeting of the Pybus Club, University of Newcastle upon Tyne, on 12 May 1977. I should like to record here my debt to fellow members for the lively debate which ensued resulting in some change in emphasis. I should also like to express my gratitude to the Wellcome Trust for the award of a Research Fellowship, which has provided me with the leisure to pursue these, and other, researches into Greek medicine.

References to Galen are cited according to Claudii Galeni Opera omnia, ed. by Kühn C. G. (20 vols, Leipzig, 1821–33).

For this interpretation cf. the scholiast's comment ad loc. and Lichtenthaeler's C. recent article in Hermes, Band 107, Heft iii (1979), 270–86.

Birks P. H. , “Dengue in Northern Assam tea gardens”, Transactions of the Royal Society of Tropical Medicine and Hygiene, xlvi (1952), 195–200.

See especially The Peloponnesian War, Book II.47.4 (partly quoted in Preface).

This is especially true of typhus and typhus-like diseases, but less so of smallpox. Rhazes's description of smallpox in the tenth century ad displays a close accord with modern accounts of the disease. See A treatise on the smallpox and measles by Abu Becr Mohammed ibn Zacariya al Rázi (commonly called Rhazes), translated by Greenhill W. A. (London, 1948).

The Peloponnesian War, Book III.87, where Thucydides informs us that during this second outbreak of the Plague 4,400 hoplites (out of c. 13,000) and 300 cavalry (out of c. 1,000) were stricken by the disease and died. Since in any epidemic higher losses are almost invariably sustained among the very young, the very old, the poor and the sick, than among the richer and able-bodied, it is tempting to suppose that the proportion of the dead was even higher than this—but caution must be enjoined: See II.51.3 where we are told that strong and weak constitutions proved equally incapable of resistance. On the above figures see Gomme A. W. , A historical commentary on Thucydides (Oxford, 1956), vol. ii, note ad loc.

On literary accounts of plague in general, see Crawford R. , Plague and pestilence in literature and art (Oxford, 1914), and Grimm Jürgen , Die literarische Darstellung der Pest in der Antike und in der Romania (Munich, 1965).

For example, see Shrewsbury J. F. D. , “The Plague of Athens”, Bulletin of the history of medicine, xxiv (1950), 1–25, p. 5. Galen, it may be noted, regards Thucydides as a layman (idiotes) who wrote for laymen (idiotais). See De difficultate respirationis, II.7 (vii, 854K.), cited by F. Kudlien in “Galens Urteil über die Thukydideisches Pestbeschreibung”, Episteme, v (1971), 132–3.

Page D. L. , “Thucydides' description of the Great Plague at Athens”, Classical quarterly, n.s., iii (1953), 97–119.

For example, see Gomme A. W. , op. cit. (ref. 5), 150; Lichtenthaeler C. , Thucydide et Hippocrate vus par un historien médecin (Geneva, 1965), 33; and Scarborough John , “Thucydides, Greek medicine, and the Plague at Athens”, Episteme, iv (1970), 77–90, p. 80. The position is stated most emphatically by Lichtenthaeler, who maintains “il est donc établi comme une certitude que l'Historien athénien a écrit la peste à l'aide de la terminologie scientifique contemporaine”.

Parry A. , “The language of Thucydides' description of the Plague”, Bulletin of the Institute of Classical Studies, xvi (1969), 106–18, pp. 112ff.

See for example the beginning of Prognosticon: “I now consider it an excellent thing for a physician to practise forecasting. For, if he foreknows and foretells at the sick-bed the present, the past and the future, and describes in detail what the sick have omitted to mention, he will create confidence that he understands what is the matter with his patients, so that they will then have the courage to entrust themselves to him for treatment. Moreover he will best carry out the treatment if he has the ability to fortell what will occur from the present symptoms.” See, too, Epidemics, I.xi.

See “A semantic study of prophasis to 400 bc”, Hermes, Einzelschriften Heft xxxiii (1975). See especially ch. iii, 51–60, and ch. iv, 76–81.

See, too, De Romilly J. , Thucydide (Budé edition, Paris, 1962), bk ii, pp. xxx & xxxi.

See Jaeger W. , “Aristotle's use of medicine as a model of method in his Ethics”, Journal of Hellenic studies, lxxvii (1957), 54–61.

See my article, “Philosophy and medicine: Some early interactions”, in Harvard studies in classical philology, lxvii (1963), 147–75, pp. 158f.

For these parallels see the above article (pp. 162f.) and Versényi L. , Socratic humanism (New Haven, 1963), 33–35, 43. Versényi maintains that Ancient medicine was influenced by Protagoras; but its conclusions arise directly and naturally from preoccupations with medical practice (so too Guthrie W. K. C. , A history of Greek philosophy, iii (Cambridge, 1969), 169, n. 1). Guthrie's standpoint seems unnecessarily cumbersome: I.e., he accepts that there are close parallels between Ancient medicine and the sophist; he rejects Versényi's thesis that the medical work is influenced by the sophist and believes it “beyond doubt” that Protagoras was influenced by contemporary medicine. Given the uncertainty of the date of Ancient medicine, it is surely arbitrary to postulate the (lost) common source which is implicitly entailed by Guthrie's hypothesis—the similarities in thought and wording are much too close to have resulted from a more general influence hypothesized by Guthrie.

See too Hippolytus , Refutatio omnium haeresium, ix, 9 (DK22B56); Aristophanes, Plutus, 537; Plato , Sophist, 227B, and, generally, Keil H. , “The louse in Greek antiquity, with comments on the diagnosis of the Athenian Plague as recorded by Thucydides”, Bulletin of the history of medicine, xxv (1951), 305–23.

Op. cit. (ref. 7), 10.

It has been maintained by some that the rat was not present in Europe before the twelfth century when it was imported by the Crusaders on their way home. But see MacArthur W. P. , “The occurrence of the rat in early Europe”, Transactions of the Royal Society of Tropical Medicine and Hygiene, xlvi (1952), 209–12.

See for example Williams E. W. , “The sickness at Athens”, Greece and Rome, xxvi (1957), 98–103, who points especially to Thucydides's description of the death of birds and animals which he sees as a striking feature of bubonic plague.

Cochrane C. N. , Thucydides and the science of history (London, 1929), 27, followed by Page , op. cit. (ref. 8), 98, overpresses the evidence in seeing here what the Hippocratics called the katastasis—the general conditions prevailing at the outbreak of a disease. See Parry , op. cit. (ref. 10), 106, who quotes the first katastasis of Epidemics I. The second katastasis is even more detailed and is cited below, exempli gratia: In Thasos early in autumn occurred unseasonably wintrystorms, suddenly, with many north and south winds bursting out into rains. These conditions continued until the setting of the Pleiades and during their season. Winter was northerly; many violent and abundant rains; snows; generally there were fine intervals. With all this, however, the cold weather was not exceptionally unseasonable. But immediately after the winter solstice, when the west wind usually begins to blow, there was a return of severe wintry weather, much north wind, snow and copious rains continuously, sky stormy and clouded. These conditions lasted on, and did not remit before the equinox. Spring cold, northerly, wet, cloudy. Summer did not turn out excessively hot, the Etesian winds blowing continuously. But soon after, near the rising of Arcturus, there was much rain again, with northerly winds. The whole year having been wet, cold and northerly, in the winter the public health in most respects was good, but in early spring many, in fact, most suffered illnesses … (W. H. S. Jones's translation in Hippocrates, Loeb, vol. i (London and Cambridge, Mass., 1957), 153–5). Thucydides, by contrast, begins his account of the Plague (II.49) as follows: Of all years, it was agreed, this one was especially free from sickness of every other kind. Such few cases as occurred, all were resolved into this. Other people in good health were suddenly attacked, from no ostensible cause, first by violent fevers in the head and redness and inflammation in the eyes….

According to Galen (De Hippocratis et Platonis placitis, II.8 (v, 275K.)), kardia in this context carries the recondite meaning of “cardiac orifice of the stomach”; but the more usual and, indeed, commonplace meaning makes perfectly good sense and is preferable to Galen's erudite conjecture (with Page , op. cit. (ref. 8), 100). See Lonie's I. M. discussion of kardia in his forthcoming edition, translation, and commentary on The seed and The nature of the child (Diseases IV), in the series Ars medica (de Gruyter, Berlin).

The word phluktainai with its synonyms phluktis, phluktainis, phluktainidion, is the standard term for an exanthem of the blister type. Its usual meaning is a raised blister such as caused by rowing (see Aristophanes , Frogs, 236–8); or that caused by fire (see Theophrastus , De igne, 57, and also 39 where he uses its counterpart phluktides). In Ancient medicine, 16.35 phluktainai caused by frostbite are noted as “like those caused by burning in fire” (see too Epidemics, 2.1.1). Helkos is a term of general reference most commonly used to denote a lesion in the soft parts of the body (see Galen's definition in De methodo medendi, 4; x, 232K.), and the word is clearly employed here by Thucydides in this general sense of sore or lesion.

Op. cit. (ref. 7), 16ff.

Op. cit. (ref. 8), 117f.

ibid., 102f.

Salway P. and Dell W. , “Plague at Athens”, Greece and Rome, xxiv (1955), 62–70.

See Barger G. , Ergot and ergotism (London, 1931), 112ff., and Creighton C. , A history of epidemics in Britain (second ed., London, 1965), 58.

Finley J. H. , Thucydides (Cambridge, Mass., 1942), 158, n. 2.

See Williams E. W. , “The sickness at Athens”, Greece and Rome, xxvi (1957), 98–103, and Hooker E. M. , “Buboes in Thucydides?”, Journal of Hellenic studies, lxxviii (1958), 78–83.

Op. cit. (ref. 8), 115.

Persica, 2.22.

Op. cit. (ref. 30), 78ff.

Apud Oribasium, 44.18.

MacArthur W. P. , “The Athenian Plague: A medical note”, Classical quarterly, n.s., iv (1954), 171–4. Lichenthaeler (op. cit. (ref. 9), 23 and 37) and Scarborough (op. cit. (ref. 9), 90) are persuaded by MacArthur's arguments, as is Radt S. L. , “Zu Thukydides' Pestbeschreibung”, Mnemosyne, xxxi (1978), 233–45, pp. 240 ff. MacArthur in support of this identification has argued that “‘violent convulsions’ (whatever their cause) cannot occur if the brain is normal”. But his translation seriously begs the question. It is a perverse form of arrogance on the part of MacArthur, after claiming with Page that spasmos is used in this particular technical sense of “convulsion”, then to maintain that “Thucydides is, of course, wrong in supposing that spasmos ischuros was induced by the retching”. MacArthur fathers his own interpretation upon Thucydides, and then criticizes him for making a mistake. Of course, Thucydides is not claiming that the retching caused severe convulsions, but rather that it produced violent muscular spasms—which is a perfectly acceptable interpretation of the Greek. See for example (Hippocrates), De morbis, I.22 for a usage which makes good sense of the whole context and removes the need to assume that Thucydides is in error here.

Zinsser H. , Rats, lice and history (Boston, 1942), 123.

Op. cit. (ref. 36), 122, 124.

See Ebbell B. , “Beiträge zur ältesten Geschichte einiger Infektionskrankheiten”, Skrifter utgitt av det Norske Videnskapakademi, Oslo, n.s., ii (1967: But written 1941), 39–52.

See Littman R. J. Littman M. L. , “The Athenian Plague: Smallpox”, Transactions of the American Philological Association, c (1969), 261–75.

See Ricketts T. F. and Byles J. B. , The diagnosis of smallpox (London, 1908), 39.

ibid., 59.

A German scholar, B. von Hagen, with impressive, but misplaced Teutonic zeal, in an attempt to confirm the identification with smallpox, travelled to Italy to scrutinize the Naples bust of Thucydides for pockmarks! Alas, he records it gave no clue—it “gab keinen Anhaltspunkt”: cf. “Die sogennante Pest des Thucydides”, Gymnasium, xlix (1938), 120–31, p. 127 n. 3.

Cochrane C. N. , Thucydides and the science of history (London, 1929); Weidauer K. , Thukydides und die hippokratischen Schriften (Heidelberg, 1954), arrives at a similar conclusion.

In support of their standpoint the Littmans points out that in the account of smallpox in van Rooyen C. E. and Rhodes A. J. , Virus diseases of man (New York, 1948), 286–98, there is no mention at all of the characteristic pockmarks. An ancient parallel might have been more appropriate: The plague that ravaged Rome in ad 153–168 was almost certainly smallpox, yet Galen in his description of it makes no mention of the scarring. Cf. De methodo medendi, 5.12 (x, 360K).

Op. cit. (ref. 36), 120.