Pandemics and the Shape of Human History ~ The New Yorker

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What’s often referred to as the first pandemic began in the city of Pelusium, near modern-day Port Said, in northeastern Egypt, in the year 541. According to the historian Procopius, who was alive at the time, the “pestilence” spread both west, toward Alexandria, and east, toward Palestine. Then it kept on going. In his view, it seemed to move almost consciously, “as if fearing lest some corner of the earth might escape it.”

The earliest symptom of the pestilence was fever. Often, Procopius observed, this was so mild that it did not “afford any suspicion of danger.” But, within a few days, victims developed the classic symptoms of bubonic plague—lumps, or buboes, in their groin and under their arms. The suffering at that point was terrible; some people went into a coma, others into violent delirium. Many vomited blood. Those who attended to the sick “were in a state of constant exhaustion,” Procopius noted. “For this reason everybody pitied them no less than the sufferers.” No one could predict who was going to perish and who would pull through.

In early 542, the plague struck Constantinople. At that time, the city was the capital of the Eastern Roman Empire, which was led by the Emperor Justinian. A recent assessment calls Justinian “one of the greatest statesmen who ever lived.” Another historian describes the first part of his reign—he ruled for almost forty years—as “a flurry of action virtually unparalleled in Roman history.” In the fifteen years before the pestilence reached the capital, Justinian codified Roman law, made peace with the Persians, overhauled the Eastern Empire’s fiscal administration, and built the Hagia Sophia.

As the plague raged, it fell to Justinian, in Procopius’ words, to “make provision for the trouble.” The Emperor paid for the bodies of the abandoned and the destitute to be buried. Even so, it was impossible to keep up; the death toll was too high. (Procopius thought it reached more than ten thousand a day, though no one is sure if this is accurate.) John of Ephesus, another contemporary of Justinian’s, wrote that “nobody would go out of doors without a tag upon which his name was written,” in case he was suddenly stricken. Eventually, bodies were just tossed into fortifications at the edge of the city.

The plague hit the powerless and the powerful alike. Justinian himself contracted it. Among the lucky, he survived. His rule, however, never really recovered. In the years leading up to 542, Justinian’s generals had reconquered much of the western part of the Roman Empire from the Goths, the Vandals, and other assorted barbarians. After 542, the Emperor struggled to recruit soldiers and to pay them. The territories that his generals had subdued began to revolt. The plague reached the city of Rome in 543, and seems to have made it all the way to Britain by 544. It broke out again in Constantinople in 558, a third time in 573, and yet again in 586.

The Justinianic plague, as it became known, didn’t burn itself out until 750. By that point, there was a new world order. A powerful new religion, Islam, had arisen, and its followers ruled territory that included a great deal of what had been Justinian’s empire, along with the Arabian Peninsula. Much of Western Europe, meanwhile, had come under the control of the Franks. Rome had been reduced to about thirty thousand people, roughly the population of present-day Mamaroneck. Was the pestilence partly responsible? If so, history is written not only by men but also by microbes.

Just as there are many ways for microbes to infect a body, there are many ways for epidemics to play out in the body politic. Epidemics can be short-lived or protracted, or, like the Justinianic plague, recurrent. Often, they partner with war; sometimes the pairing favors the aggressor, sometimes the aggressed. Epidemic diseases can become endemic, which is to say constantly present, only to become epidemic again when they’re carried to a new region or when conditions change.

To this last category belongs smallpox, dubbed the speckled monster, which may have killed more than a billion people before it was eradicated, in the mid-twentieth century. No one knows exactly where smallpox originated; the virus—part of the genus that includes cowpox, camelpox, and monkeypox—is believed to have first infected humans around the time that people began domesticating animals. Signs of smallpox have been found in Egyptian mummies, including Ramses V, who died in 1157 B.C. The Romans seem to have picked up the pox near present-day Baghdad, when they went to fight one of their many enemies, the Parthians, in 162. The Roman physician Galen reported that those who came down with the new disease suffered a rash that was “ulcerated in most cases and totally dry.” (The epidemic is sometimes referred to as the Plague of Galen.) Marcus Aurelius, the last of the so-called Five Good Emperors, who died in 180, may also have been a smallpox victim.

By the fifteenth century, as Joshua S. Loomis reports in “Epidemics: The Impact of Germs and Their Power Over Humanity” (Praeger), smallpox had become endemic throughout Europe and Asia, meaning that most people were probably exposed to it at some point in their lives. Over all, the fatality rate was a terrifying thirty per cent, but among young children it was much higher—more than ninety per cent in some places. Loomis, a professor of biology at East Stroudsburg University, writes that the danger was so grave that “parents would commonly wait to name their children until after they had survived smallpox.” Anyone who made it through acquired permanent immunity (though many were left blind or horribly scarred). This dynamic meant that every generation or so there was a major outbreak, as the number of people who had managed to avoid getting infected as children slowly rose. It also meant, as Loomis rather cavalierly observes, that Europeans enjoyed a major advantage as they “began exploring distant lands and interacting with native populations.”

Alfred W. Crosby, the historian who coined the phrase “the Columbian Exchange,” also coined the term “virgin soil epidemic,” defined as one in which “the populations at risk have had no previous contact with the diseases that strike them and are therefore immunologically almost defenseless.” The first “virgin soil epidemic” in the Americas—or, to use another one of Crosby’s formulations, “the first New World pandemic”—began toward the end of 1518. That year, someone, presumably from Spain, carried smallpox to Hispaniola. This was a quarter of a century after Columbus ran aground on the island, and the native Taíno population had already been much reduced. The speckled monster laid waste to those who remained. Two friars, writing to the King of Spain, Charles I, in early 1519, reported that a third of the island’s inhabitants were stricken: “It has pleased Our Lord to bestow a pestilence of smallpox among the said Indians, and it does not cease.” From Hispaniola, smallpox spread to Puerto Rico. Within two years, it had reached the Aztec capital of Tenochtitlán, in what’s now Mexico City, a development that allowed Hernán Cortés to conquer the capital, in 1521. A Spanish priest wrote, “In many places it happened that everyone in a house died, and, as it was impossible to bury the great number of dead, they pulled down the houses over them.” Smallpox seems to have reached the Incan Empire before the Spaniards did; the infection raced from one settlement to the next faster than the conquistadores could travel.


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