Roman mosaic of the 1st century BC representing the Wheel of Fortune which, as it turns, can make the rich (symbolized by the purple cloth on the left) poor and the poor (symbolized by the goatskin at right) rich; in effect both states are very precarious, with death never far and life hanging by a thread: when it breaks, the soul (symbolized by the butterfly) flies off. And thus are all made equal. Public domain
A very common disease in Ancient Rome was malaria. We know that from the DNA analysis of the bones of ancient Romans. Malaria still exists today, especially in the Third World, and is usually transmitted by mosquitoes. Symptoms include shaking chills, muscle aches, headaches and tiredness, and the disease can lead to mental confusion, seizures, kidney failure, coma and death. There were also a number of life-threatening respiratory diseases such as tuberculosis and brucellosis. Tuberculosis was a common disease in the ancient world and it still exists today. It is a contagious infection that usually attacks the lungs and that can also spread to other parts of the body, like the brain and spine. The Greeks called it phthisis to describe a feeling of intense heat, as if being burned by a flame. Brucellosis was prevalent in Ancient Rome even though it is not as common today. It is usually contracted from dairy products or contaminated meat and begins with a fever and sweating, joint pain and body aches, and can end with organ failure.
Other diseases that are common today such as cancer and diabetes were not as common in Ancient Rome. The Greeks and the Romans recognized cancer but had little understanding of it. Hippocrates (410 - 360 BC) described cancer (carcinos) as having a a range of tumors and swelling that could spread to other parts of the body. Diabetes was also known in Ancient Rome. Galenus describes the disease in his book in great detail but noted that he had only ever seen two people with this disease in his entire life, which suggests that it was relatively rare in those days. The absence of air pollution and most of all the diet, and the fact that Romans ate smaller quantities and did not eat processed foods or as much meat as we do today, probably explains the rarity of cancer and diabetes back then.
Prostitution, which is closely linked to slavery, was very widespread in Rome and facilitated the spread of sexually transmitted diseases. Recent studies have shown that syphillis was prevalent in the ancient world and is not an STD that came from the Americas to Europe in the late 1400s. Palladius describes the disease in the Lausiac History 262 and French researchers from the CNRS have said that it was not leprosy described in the book, but in fact, venereal syphilis. Analysis of bones by researchers in Pompei and France have revealed that people died from syphilis. Unlike syphillis, gonorrhea does not leave decisive skeletal traces. But, along with many other STDs, it probably existed in Ancient Rome.
The Antonine Plague (165 - 180 AD) a.k.a the Plague of Galen (or Galenus) from the name of the Greek physician who provided a detailed account of the disease. It was an ancient pandemic brought to the Roman Empire by soldiers returning from campaigns in the Near East (modern day Iraq). In the treatise Methodus Medendi, Galenus describes the pandemic as affecting a very large number of people and lasting for a long time (15 years!). Based on Galenus' account, the terrifying symptoms of the disease were at the onset a fever, a sore throat and diarrhea. By the ninth day, the disease evolved to blisters of pus (pustular psoriasis) surrounded by red skin. Modern scholars generally diagnose the disease as smallpox. According to historian Dio Cassius3 (155 – 235 AD), the Antonine Plague caused up to 2,000 deaths per day in Rome and had a mortality rate of 25%. The plague spread throughout the Roman Empire killing five million people and may have even reached China in 166 AD. It also most probably killed Roman co-Emperor Lucius Verus who ruled the empire with Marcus Aurelius Antoninus during the Roman Principate hence the name "Antonine" Plague. Historians also believe that the plague fueled the growing popularity of Christianity.
The Plague of Cyprian (249 - 262 AD) was named after an early Christian writer called St Cyprian4, bishop of Carthage, who described the pandemic in his book De mortalitate. St Cyprian described the symptoms as follows: constant vomiting, diarrhea, red eyes, limping, gradual loss of sight and hearing, decaying feet or limbs. At the height of the outbreak, 5,000 people a day were reportedly dying from the disease in Rome. The pandemic was so severe that it created labor shortages, which affected food production, and wreaked havoc in the army. Historians are not sure what the disease was, but suspect that it could have been smallpox, pandemic influenza such as swine flu or even a filovirus such as the Ebola virus.
The Plague in Rome, Jules Elie Delaunay (1869) Public domain
The Plague of Justinian (541 - 542 AD) was one of the deadliest, if not the deadliest pandemic in human history. It lasted two years but with recurrences until 750 AD and resulted in the deaths of an estimated 25 to 100 million people. Emperor Justinian himself contracted the disease but managed to survive it. The disease affected mainly Constantinople, the Sasanian Empire and port cities in the Mediterranean as merchant ships harbored rats that carried fleas infected with plague. At its peak the pandemic killed an estimated 5,000 people per day in Constantinople. Dead bodies littered the streets of the capital and burial pits were dug by soldiers to handle the large number of deceased people. Animals of all types, including cats and dogs, could be seen lying dead throughout the city. In 2013, researchers confirmed the identity of the plague as yersinia pestis, a bubonic plague which was later responsible for the Black Death of 1347 – 1351 AD. The symptoms of the Plague of Justinian were terrifying and included chills, headaches, abdominal pain, swollen lymph nodes and gangrene.
The Roman Plague (590 AD) mainly affected the city of Rome. The epidemic killed a large number of people in the city with many dying shortly after contracting the disease.
However, the standards of cleanliness were much lower than the standards that are generally accepted today. The Romans did not have chemicals such as chlorine to disinfect the heated water and bacteria often thrived at the public baths, sometimes causing disease. Also, the latrines, which used the sewer system and where people would sit right next to each other, could be quite filthy by modern standards. The use of such latrines probably contributed to spreading disease. Still, things would have been probably a lot worse without any form of public hygiene.
Back then the food was not monitored by a food agency such as the Food and Drug Administration. As a result, the Romans were often exposed to food poisoning due to contamination with microbes and parasites. The presence of parasites in the food was often made worse by the use of human feces as fertilizer, something that is unthinkable today, thereby exposing the produce to human pathogens.
Moreover, the quality of the water supplied by the aqueducts could vary. Some were known to supply excellent quality water while others were less well-maintained or prone to muddy water, especially after heavy rain. Many of the water pipes were made of lead exposing the population to lead poisoning. However, it must be noted that even though the lead carried by the water in the aqueducts was 100 times higher than what is acceptable today, it wasn’t enough to cause lead poisoning as lead pipes built limescale over time, reducing the risk of poisoning. The real cause of lead poisoning was the use of pots made of lead for cooking or of lead powder in place of modern sugar, as the Romans appreciated the taste of lead.
Portrait of Galen, Georg Paul Busch (1756) CC 4.0
Not all doctors went to medical school or received training from well-known doctors. Wealthy Romans had access to the best doctors in Rome, which often were part of their household staff. Those doctors were usually Greek. For example, Galenus was the personal physician of several emperors including Emperor Commodus (reign: 161 –192 AD). Average Romans had access to public doctors whose reputation and competency could vary greatly. In Ancient Rome, there was no regulatory board or official licensing for physicians, and doctors were often illiterate. Back then, everything was based on the doctor's reputation and healing rate. Some doctors did a pretty decent job and provided effective treatments. Good doctors coud go private and charge a price for their treatments. However, there were also many doctors that would claim healing powers and scam the needy. Unfortunately, it can be said that many Romans did not have access to good healthcare and often resorted to unproven remedies and prayer to cure themselves.
Roman medicine was quite elaborate and, just like today, contained many branches. The Romans even practiced surgery and used surgical intruments, which were surprisingly similar to the ones used today to include tweezers, forceps, scalpels and catheters. The Romans did not have hospitals through and surgery would be practiced at the doctor's office or even at home. The only hospitals were military hospitals called valetudinarian where permanent physicians would be present and where surgery was extensively practiced. The Romans understood that being able to care for the wounded gave them an advantage on the battlefield. Just like today, military hospitals often provided the most advanced medical treatments and were the places where medical advances were made.
As we previously mentioned, Roman medicine was based on the concept of humors or the treatment of imbalances in bodily fluids by applying specific herbal remedies. For example, gentiana, named after the Illyrian king Gentius, who discovered the tonic properties of the plant, was used to treat fever, digestive problems, ulcers, poisonous bites, parasitic worms, and even malaria. Autumn crocus, which contains colchicine and morphine, was used to treat gout (podagra) and a number of other diseases. Chamomile was used to decrease heat and lower excessive bile. Aloe, still extensively used today, was used to heal wounds and to treat alopecia. The Romans had no knowledge of microbes or viruses but knew about contagion and understood the importance of sanitation to curb the spread of diseases. During the various plagues, they even practiced quarantine and restricted travel to and from certain regions. For example, during the Plague of Justinian, a law was enacted that banned or isolated people from plague-infested regions.
Interesting fact about Roman diseases and pandemics