A History of Disease in Ancient Times

More Lethal than War

Philip Norrie

• Publisher: Palgrave Macmillan
• Year: 2016
• ISBN:
  9783319289373
• Topic: History
• Subtopic: European History
• Index: History

This book shows how bubonic plague and smallpox helpedend the Hittite Empire, the Bronze Age in the Near East and later theCarthaginian Empire. The book will examine all the possible infectious diseasespresent in ancient times and show that life was a daily struggle for survivaleither avoiding or fighting against these infectious disease epidemics. Thebook will argue that infectious disease epidemics are a critical link in thechain of causation for the demise of most civilizations in the ancient worldand that ancient historians should no longer ignore them, as is currently thecase.

© The Editor(s) (if applicable) and The Author(s) 2016

Philip NorrieA History of Disease in Ancient Times10.1007/978-3-319-28937-3_1

Begin Abstract

1. Introduction

Philip Norrie^{1, 2}

(1)

Faculty of Medicine, University of New South Wales, Sydney, Australia

(2)

Faculty Affiliate, School of Public and Community Health Sciences, College of Health Professions and Biomedical Sciences, University of Montana, Missoula, MT, USA

End Abstract

“Historians find war exciting and pestilence dull; they exaggerate the effects of the former and play down the latter”. (Grove and Rackham 2001)

This book will explore the way in which infectious diseases affected the course of ancient Mediterranean and Near Eastern history. The general hypothesis is that most major changes in the Ancient World were precipitated by infectious disease epidemics, for example, the end of the Mycenaean Palatial Empires, the end of the Hittite Empire and the end of the Near Eastern Bronze Age in c.1200 bce; Egypt’s withdrawal from the Levant, the fall of Athens, the end of Carthage, the fall of the Western Roman Empire, the invasion of Islamic forces into Europe during the Plague of Justinian; and even the end of the Sumerian and Indus Valley Civilizations. And if the Ebola virus gets out of control—it may be 1200 bce all over again!

In ancient times it would have been a daily struggle for survival either through avoiding or fighting against infectious diseases: sepsis from Staphylococcus aureus or tetanus from a graze; childhood infectious diseases such as whooping cough, diphtheria and measles; the infections from contaminated food and water; let alone major infections such as leprosy, tuberculosis and malaria or the big two killers—smallpox and bubonic plague.

The plea of this book is that, in future, ancient historians consider the potential role of infectious disease in the histories they research and subsequently write. If disease is not considered and is ignored, as is the current situation, then the resultant history may be incomplete and thus flawed; because you cannot administer or feed let alone defend your empire if your citizens are dying en masse due to an infectious disease epidemic.

The latest book about the end of the Bronze Age, thus covering a similar area in ancient history as this book, is Professor Eric Cline’s book 1177 B.C.–The Year Civilization Collapsed.¹ It gives a very good summary of the current state of conventional historical thinking about the end of the Bronze Age in the Near East; but it fails to discuss the role of infectious disease. This book will hopefully fill that void. Professor Cline and I have had profitable discussions about this topic via email. He agrees with me that it would be useful to consider this and suggested that I collect more evidence and proof.

Some ancient historians and archaeologists might argue that what I have to say is speculative, with an added “what if” factor. However, they cannot ignore that what I am providing is a plausible alternative hypothesis—that infectious disease epidemics could have ended the Near Eastern Bronze Age, along with the other empires mentioned previously. This attitude is understandable and is not unusual when new ideas challenge established ideas. To use an appropriate analogy from medical history—when Ignaz Semmelweis said that puerperal fever was caused by the infected hands of the doctors, the obstetric establishment scorned and criticized him, rejecting his ideas, until he was proven correct.

Throughout history disease has killed many more people than have been killed in wars.

More lethal than any firearms, viruses and bacteria have accompanied soldiers and traders around the world, and the epidemics they caused have changed the course of history.²

Using mainly the vast quantity of secondary literature on this topic, this book, then, will show that a historiographical approach to looking at the impact of disease will not only produce a much needed summary and synthesis of the current literature but, in doing so, will also present a coherent description and explanation of the influence of disease on civilization.

This book will show how a study of the medical history of particular places and periods can expand the understanding of historical events. “Historians study change”³ and the key to this change is causation, “how chains of interaction become pathways of historical development”,⁴ this is, what factors were involved to make things turn out the way they did. Diseases, as will be demonstrated, are links in these chains.

This book will also explore the issue of disease causation, examining both the understanding of disease processes in the past and also what our current etiological approach might be, while maintaining an awareness of the dangers of retrospective diagnosis and the diagnostic limitations due to poor records and the depth of medical knowledge in different periods of history. The ancient texts talk of “plagues” meaning, in current western terminology, an infectious disease affecting and killing large numbers of people at the same time; currently “plague” is understood to refer to many different specific diseases such as smallpox or Ebola virus or the classic Bubonic plague but in ancient times it was used as a general descriptor. It is not possible to be sure which specific organism was responsible for “plague” in early times. It is also important to remember that infectious diseases evolve over the centuries while populations develop immunity; so what would have caused devastation in ancient times in a virgin population due to its virulence and the lack of resistance in the population (such as the measles virus) may be a lot milder today with populations with improved immunity.

The causes of historical events are multifactorial but medical aspects must always be considered as a major contributing factor. As Prof. Roy Porter has noted:

Writing this book … has bought home the collective and largely irremediable ignorance of historians about the medical history of mankind. Perhaps the most celebrated physician ever is Hippocrates yet we know literally nothing about him. Neither do we know anything concrete about most of the medical encounters there have ever been. The historical record is like the night sky: we see a few stars and group them into mystic constellations. But what is chiefly visible is the darkness.⁵

This book will try to fill in some of the gaps and thus reduce the darkness. The findings of medical history have shown how much disease and resulting death have greatly influenced events in the past, most basically because it is disease that determines the fitness of a society and whether its citizens, both great and small, who make up that society and its history, live or die and how they lived or died. Disease has killed more people, over the ages, than all the wars, famines and other disasters put together. For example, smallpox alone killed an estimated 300 million people in the twentieth century before it was eradicated. This is approximately three times more than all the people killed in all the wars in the twentieth century.⁶

Traditional history tended to concentrate on the politics, military campaigns, royalty, Empires, religions, science, economics, art and exploration, but not medicine. Recently, however, this situation has changed. The change was led by such prolific writers as the late Prof. Roy Porter of University College in London, Prof. Charles Rosenberg from Harvard University in Boston and Emeritus Prof. Barry Smith of the Australian National University in Canberra. Nevertheless, the incorporation of medical issues into mainstream history still lags behind incorporation of the issues mentioned above. For example, the history section in the Encyclopedia Britannica states, in the Macropedia section “Special aspects of history are also dealt with in articles under the classifications of military affairs, economics, law, literature, sciences, art, philosophy, religion and political science”.⁷ Note medical history is not mentioned, while one of Australia’s most respected historians, Prof. Geoffrey Blainey, shows a similar lack of recognition of medical history’s importance when in the Preface to his book A Short History of the World (669 pages long) he talks about putting emphasis on the important things that “have done so much to shape the world”⁸ namely: technology and skills, religion, geographical factors or “the tyranny of distance”, eating habits, work and empires. There is no mention of medicine or the effect of disease on events in the past although he does note, albeit in a strangely dismissive tone that “such profound and symbolic events as the invention of anaesthetics, surely call for at least one paragraph; but they receive scant or no attention in this book”.⁹ However as the late Prof. Roy Porter, an equally eminent historian noted “Medicine has played a major and growing role in human societies and for that reason its history needs to be explained so that its place and powers can be understood”.¹⁰

Prof. Roy Porter (1946–2002) was a British medical historian who eventually became Professor of Social History and the Director of the Wellcome Institute for the History of Medicine at University College, London. He wrote eighteen books on the history of medicine.

Medicine contributes much to social progress because society cannot advance and progress as rapidly if the people in it are unhealthy. Samuel Johnson, a notable eighteenth century “social commentator”, once referred to the medical profession as “the greatest benefit to mankind”¹¹ and it is difficult to see how a complete history of any civilization could be contemplated without its inclusion.

This book will offer new perspectives, possibilities, points of view and insights into ancient Near Eastern history: first, by updating current knowledge about the end of the Bronze Age and the Hittite Empire for example; second, by expanding the infrequently recognized effects of disease in past periods, that is, debilitation and subsequent death in the Hittite Army; third, by showing how disease influenced major historical events such as the end of Carthage. This book will also construct a synthesis of existing knowledge concerning reasons for the ending of the Near Eastern Bronze Age. All of these examples will be expanded upon later in this book.

Finally, this book provides an insight into the role of disease in the history of the ancient Mediterranean and Near East showing its significance as a major contributing causal factor in the end of the Near Eastern Bronze Age, the end of the Hittite Empire and the end of Carthage and why it should be given more recognition and focus in the future by historians.

Footnotes

1

Cline, E. H., 1177 B.C. – the year civilization collapsed, Princeton and Oxford: Princeton University Press, 2014).

2

Daniels, P.S. and Hyslop, S.G., (2003) National Geographic Almanac of World History, (Washington D.C.: Nation...

Table of contents

• Cover
• Frontmatter
• 1. Introduction
• 2. Common Diseases in Ancient Times
• 3. How Disease Affected the History of the Egyptian Empire
• 4. How Disease Affected the History of the Hittite Empire
• 5. How Disease Affected the End of the Bronze Age
• 6. How Disease Affected the History of Ancient Carthage
• 7. Conclusion
• Backmatter