What diseases contributed to the fall of ancient Greece and Rome, and how did they do so?

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Disease has the power to test civilizations. If a government is strong, it can withstand the spread of disease. If a government is weak, oftentimes disease exposes these problems and can lead to drastic decline or change, such as the famous Black Death that undermined the European feudal system and helped usher Europe into the Early Modern phase of monarchies and budding nation-states. Disease tests us still, with the rise of spread of Ebola and many mosquito-born viruses. However, the ancient world also experienced major outbreaks of disease, and two famous cases help demonstrate this: the plague of Athens and the Antonine Plague of Rome.

In the 400s BCE, the Athenian city-state was embroiled in war with the Spartan city-state. As the Spartans and her allies moved north to attack Athens, Athens walled herself in, connecting the port of Piraeus to the main city. While this was a brilliant military tactic, as the Spartans relied on a land-based army, General Pericles did not anticipate a dangerous killer within the city walls: disease. In 430 BCE, plague broke out within Athenian walls, killing about one-third of the population (around 100,000 people). The plague came through the port of Piraeus, thanks to traders restocking Athenian supplies during wartime. Among those killed were General Pericles, and with him dead, military loss against the Spartans was ensured. Once plague died out in 426, the Spartans were a much larger and stronger force than the Athenians. While this wasn't the only reason Sparta won the war, it contributed heavily to Athenian decline and was a factor in Athens' loss.

Plague also had a massive impact on the fall of Rome. The Antonine Plague spread through Rome near the end of the Pax Romana in the years 165-180 CE. An increase in trade between East and West on the Silk Road brought plague to Europe, and returning Roman troops brought the disease home as well. As a result, plague killed approximately twenty-five percent of the population. Roman historian Dio Cassius estimates that 2,000 people died per day. Edward Gibbon, in his famous book The Rise and Fall of the Roman Empire, writes that

Pestilence and famine contributed to fill up the measure of the calamities of Rome.

Plague, then, had a major impact in the ancient world. It tested both Athens and Rome, and while disease was not the only factor in the fall of both societies, it contributed heavily to their decline.

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There were many factors that contributed to the weakening and fall of Greece (Byzantium) and Rome. While disease certainly is not the lone culprit, it likely did play a factor in making these civilizations less stable overall.

One epidemic that quite possibly helped contribute to the ultimate fall of the Roman Empire involved the bubonic plague. Also known as Yersinia pestis, this bacterium is the same one that is responsible for the more famous Black Death in Europe during the 1300s. In 541 CE, this disease showed up in the Mediterranean after likely traveling along the Silk Road from East Asia or on grain ships from Egypt.

Named after the Byzantine emperor of the time, the Plague of Justinian, killed as many as half the population of the Roman Empire. The eastern capital of Constantinople was particularly hard hit. With such a massive population shortage that ensued, combined with a reduced tax base, the East and West Roman Empire was left severely weakened. This left them very susceptible to the ongoing raids and invasions of various barbarian groups. In the years just prior to this plague, the Byzantine army had just about retaken the central and western Mediterranean. Weakened and underfunded by this contagion, they ended losing their grasp of the region and the Goths and Lombards were able to seize a serious amount of real estate that the Romans were never able to reclaim.

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Disease was an important factor in the course of ancient civilizations. First, it affected warfare. Although ancient weapons were not particularly deadly by modern standards, infection caused by wounds killed far more soldiers than the immediate damage of wounds themselves. Diseases could also decimate soldiers who traveled to regions where they lacked immunity to prevalent strains, as often happened in the Roman empire with its far flung armies. Rather famously, Alexander the Great died at the young age of 32 from a fever (possibly caused by foul play but probably disease).

Sieges, which caused the defenders to be crowded into small areas with limited sanitation, could result in epidemics. During the second year of the Peloponnesian War (430 BC), the Plague of Athens, which recurred in 429 and 427, killed the great leader Pericles and many Athenians, causing a stalemate in the war against Sparta. Athens did not recover from the plague sufficiently to mount an offensive again until 415 and the plague killed far more people than did the Spartans.

Two major disease outbreak, the Antonine plague and the Plague of Cyprian weakened the western Roman Empire, leading to its ultimate collapse. The plague of Justinian, an outbreak of bubonic plague, killed almost half the population of the Byzantine Empire and may have contributed to its decline.

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Contagion and a lack of understanding of disease vectors, combined with the related inability to treat them, were all factors contributing to illnesses becoming fatal. For newly introduced diseases, lack of immunity was a primary factor in rapid spread of diseases. The high population density in the largest cities, including Athens and Rome, as well as unsanitary conditions, exacerbated the spread. Once infection rates reached epidemic proportions, curing was impossible.

Even common problems such as parasites and related gastrointestinal diseases could be fatal when left untreated. The combination of rapidly depleted populations in the cities and the spread through the rural work force both contributed to weakening the empire’s people. Military and political expansion were curtailed, and the centers could not sustain their web of control over the outlying areas. Loss of faith in the leaders also undermined political stability, sometimes leading to rebellions or coups.

In ancient Greece, Hippocrates compiled records of diseases. Among the most dangerous ones were cholera, meningitis, and tuberculosis. The Great Plague that affected Athens from 430 to 428 BCE is likely to have been bubonic plague. Sophocles also described a plague in Oedipus Rex. Hippocrates noted severe respiratory distress that was often fatal; this was probably influenza.

The primary potentially fatal diseases that affected ancient Rome were malaria, plague, and tuberculosis; leprosy was probably present as well. Because of the wide-ranging trade in the empire, ships from distant ports routinely docked in Rome. Malaria most likely spread from North Africa via Sardinia. Infected passengers or water carrying mosquito larvae could have brought the disease.

What is known as plague, such as the Antonine Plague of the second century BCE, may have been smallpox. At its worst, it apparently took up to 2,000 lives a day in Rome. In the sixth century AD, the plague reported may have been bubonic plague.

Grmek, Mirko. 1991. Diseases in the Ancient Greek World. Baltimore: Johns Hopkins University Press.

Harper, Kyle. 2017. The Fate of Rome: Climate, Disease, and the End of an Empire. Princeton: Princeton University Press.

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