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Reassessing Roman Plagues


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The natives who lived in the Western Hemisphere at the time of the arrival of European colonists were all but wiped out through decades and then centuries of conquest. But disease did the majority of the work: germs killed off millions of people, from the North Atlantic Coast to the mountains of Peru. Historians believe these illnesses were a wide variety of contagions, from smallpox, chickenpox, influenza, measles, sexually transmitted diseases, and even the common cold – but little physical evidence exists to confirm what outbreak killed off which tribe.

A particularly virulent outbreak that devastated huge swaths of Mexico and Guatemala in 1545 was known only at the time as the “cocolitzli” – a Nahuatl word for “pestilence.” Now a team of scientists using a novel method to scan for clues of disease in the deceased said they have isolated the DNA evidence from bones that points to the bug: a specific enteric fever called Salmonella enterica Paratyphi C, they report in the latest Nature Ecology and Evolution.

I always believed that the infection that destroyed the indigenous populations in the Western Hemisphere was smallpox. Similarly, I thought that smallpox was the most likely culprit for Galen's Antonine Plague and as well as probably many of the other plagues of Ancient Rome.

This article makes me reconsider this notion. 

https://www.archaeology.org/issues/298-1805/trenches/6524-trenches-mexico-colonization-salmonella

This bacterium, relatively uncommon today, causes an extremely virulent paratyphoid fever.

https://en.wikipedia.org/wiki/Paratyphoid_fever

AA.jpg.190f774c6556f0d70d2785797fe5901d.jpg

Excavated structure at the northern edge of the Grand Plaza at Teposcolula-Yucundaa. Architectural investigations of the Grand Plaza resulted in the unexpected discovery of a large epidemic cemetery associated with the 1545-1550 cocoliztli epidemic. The cemetery was found to contain numerous mass burials, attesting to the catastrophic nature of the epidemic. Photo: Christina Warinner/Teposcolula-Yucundaa Archaeological Project

 

 

guy also known as gaius

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Kyle Harper presents a strong case for "Antonine smallpox" in last year's Fate of Rome: Climate, Disease, and the End of an Empire, but in the end we'll have to wait for scientific discovery (Walter Scheidel in the introduction to The Science of Roman History, 2018). Hard to argue with that. :)

Incidentally, Salmonella enterica serovar Typhi was proposed as the causal agent of the Plague of Athens.

https://www.ijidonline.com/article/S1201-9712(05)00178-5/fulltext 

Which proved controversial.

https://www.ijidonline.com/article/S1201-9712(06)00053-1/fulltext

 

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On 4/25/2018 at 1:54 PM, Flavius Inismeus said:

Kyle Harper presents a strong case for "Antonine smallpox" in last year's Fate of Rome: Climate, Disease, and the End of an Empire, but in the end we'll have to wait for scientific discovery (Walter Scheidel in the introduction to The Science of Roman History, 2018). Hard to argue with that. 

Thank you for reading my post.

I certainly recommend Harper's book. I appreciate his enthusiasm and study ... but neither are proof alone. (If both enthusiasm and study were sufficient, I would believe in Ancient Aliens.)

For those who have not read his book, here is Harper's argument for smallpox being a source of plague in the ancient Rome:

http://www.kyleharper.net/uncategorized/smallpox-resources-and-thoughts/

 

Here is some of the many arguments against the smallpox theory:

https://classicalstudies.org/annual-meeting/149/abstract/galen-adna-and-plague

 

If I find the time, I will later share my reasons for at least my skepticism..

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I think this quote from the Harper article cited above is important:

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"Around AD 165, the Roman Empire was rocked by a pandemic mortality event known as the Antonine Plague (so called after the family name of the emperors Marcus Aurelius and Lucius Verus). It marks a point of rupture in Roman history, and ancient historians have increasingly identified the pandemic itself as a kind of turning point. Much more could be said, but I’ll briefly sketch some of the main outlines, because what is of interest here is that Roman historians working today have reached a virtual consensus on the point that the agent of the mortality was smallpox. Until there is positive genomic evidence, it is important to keep an open mind. There is a real chance that the agent of the pandemic was not smallpox, and until genomic evidence confirms or excludes that hypothesis, all possibilities need to remain in consideration. However, I do think the reasons for believing the biological agent of the Antonine Plague was smallpox or a near ancestor of it are ultimately convincing." [Emphasis mine.]

 I agree strongly with Harper's initial point "it is important to keep an open mind." Then, his argument becomes based more on speculation that actual evidence.

 

 This is an important bit of clinical evidence from Galen that the Antonine plague was, in fact, caused by smallpox:

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In his treatise On Black Bile, Galen described the black pustules covering the entire body that then dried and fell off like scales, sometimes many days after what Galen considered the “crisis” or turning point of the disease. These clinical observations describe the course of vesicular and then pustular lesions that characteristically scabbed off, leaving scarred but no longer pathological dermis in their place

These 'black pustules" from the above quote could be describing hemorrhagic smallpox picture below:

5ae4b3b6b341e_HemorrhagicSmallpoxProlongedsevereprodrome.thumb.jpg.42fc92399911552950ef3acb6e5cbec4.jpg

From the picture above, one can easily see the hemorrhagic vesicles and bullae that Galen might have called "black pustules."

So, case closed, right? Not so fast. This hemorrhagic form of smallpox is extremely rare (around 5%) and is certainly not the typical presentation of smallpox.

 

This is the more typical presentation (> 90% of the cases):

ABsmallpox.thumb.jpg.7bd241f1029a0dc8ef7a8bf974db67ca.jpg

From the pictures above, one can see the typical presentation of smallpox: innumerable pustular vesicles and bullae. These lesions do crust and scab over, There are not, however, the  "black pustules" that Galen described.

To be continued ....

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  • 4 weeks later...

I have long been surprised at Galen's failure to mention the almost near-universal horrific scarring associated with smallpox infections. This scarring was most prominent on the face. Also, eye complications (5-9%) with potential blindness was a devastating complication. (It has been estimated that a third of all cases of blindness in 18th century Britain were from smallpox.)

These frequent findings were not described by the usually observant Galen. What could explain these lapses? Could this plague, therefore, have been another hemorrhagic eruption other than smallpox ? (To be continued ....)

 

5b0acc81c40f9_smallpox.gif.ab26d3a5d9cbf2a4cba53eb8b6b0a6cf.gif

(Smallpox: scarring on face A 50-year-old Indian male with a history of smallpox as a child has multiple depressed scars on face 40 years after smallpox)

 

Other individuals with smallpox scars:

Smallpoxscar.jpg.e2a16d1436a6bfb3b3ac07f98bf3f037.jpg smallpoxC.thumb.jpg.2599e81de5640b304003dad4905914ec.jpg

 

guy also known as gaius

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  • 1 year later...

Reviewing my post from last year, I have now become increasingly convinced that Galen's plague was NOT smallpox as currently believed.

There are two features from Galen's clinical description of the plague that still need to be explained:

-Lack of blisters typical of smallpox with its near universal scarring and frequent blindness as sequelae.

-The typical appearance of "black pustules" consistent with a hemorrhagic fever and not from smallpox.

Picture of Ebola:

Ebola.jpg.60f1a7e7943be0fb77f7136fb57096c0.jpg

 

 

I feel that Galen's plague was almost certainly a form of hemorrhagic fever (such as Ebola). It has been suggested that the hemorrhagic form of the bubonic plague could have also have been a culprit. The bubonic plague, referred to as the "Black death" in Europe  (1347-1670), was either a more virulent form of bubonic plague (caused by Yersinia pestis) or actually a rarer, now extinct form of hemorrhagic fever:

 

 

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Abstract

For the whole of the 20th century it was believed that the Black Death and all the plagues of Europe (1347-1670) were epidemics of bubonic plague. This review presents evidence that this view is incorrect and that the disease was a viral haemorrhagic fever, characterised by a long incubation period of 32 days, which allowed it to be spread widely even with the limited transport of the Middle Ages. It is suggested that haemorrhagic plague emerged from its animal host in Ethiopia and struck repeatedly at European/Asian civilisations, before appearing as the Black Death. The CCR5-Delta32 mutation confers protection against HIV-1 in an average of 10% of the people of European origin today. It is suggested that all the Deltaccr5 alleles originated from a single mutation event that occurred before 1000 BC and the subsequent epidemics of haemorrhagic plague gently forced up its frequency to 5 x 10(-5) at the time of the Black Death. Epidemics of haemorrhagic plague over the next three centuries then steadily raised the frequency in Europe (but not elsewhere) to present day values.

 

 

 

https://www.ncbi.nlm.nih.gov/pubmed/15879045


 

It must be emphasized the reason for the various clinical manifestations of the bubonic plague has also been recently debated:

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This finding comes about a year after another genetic study, led by Stephanie Haensch of Johannes Gutenberg University in Germany, found evidence of two previously unknown strains of Yersinia pestis in the remains of European victims, and hints at a solution that could allow both sides to be right.

"People have always assumed the two diseases were the same," said Cohn, the medieval historian, referring to modern plague and the Black Death. "Even if it is the same pathogen, the diseases are very different."

Bossak, who has questioned the role of plague in the Black Death, agrees.

"This new (study) seems to support these earlier claims, and reinforces the notion that what we know of the epidemiology in modern Y. pestis plague may not fit the Black Death, perhaps because these ancient strains of Y. pestis are no longer present (assuming Y. pestis was indeed the causative agent)," he wrote in an email.

 

 

https://www.livescience.com/15937-black-death-plague-debate.html

 

guy also known as gaius

 

 
 
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Just an interesting tangent on Salmonella enterica. (Thanks to Lapham's Quarterly for bring this article to my attention).

This article shows how infections can be transmitted between species and evolve to become more lethal. This is important especially in light of the recent coronavirus outbreak. :

 

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A new study suggests early farmers in Eurasia brought a more deadly form of salmonella on themselves when they switched from a nomadic lifestyle of hunting and gathering to farming. By settling down in close quarters with domestic animals and their waste, they gave Salmonella enterica, which was lurking in an unknown animal host, easy access to the human gut where it adapted to humans. Pigs picked up the pathogen later, perhaps from people or another animal.

Researchers have long thought that the transition from foraging to agriculture made humans sicker. By relying on a few crops and domestic animals, early farmers ate a less varied and healthy diet than hunter-gatherers. They also lived closer to human and animal poop where pathogens persist. But few infectious diseases leave marks on skeletons, so these pathogens have been hard to detect in fossils.

 

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The ancient progenitor strains of paratyphi C had not yet adapted specifically to humans: The pathogens infected a number of animals and lacked genes that cause the typhoidlike fever. This suggests humans initially got a milder form of a disease that also infected their livestock.

Anthropological geneticist Anne Stone at Arizona State University, Tempe, hopes that the team can extract more S. enterica samples from foragers. But the new study sheds light on how bacterial pathogens shift hosts, Stone says. It may also help researchers learn more about when and why pathogens are likely to jump from another species into humans—a timely lesson given the current coronavirus outbreak, she says.

 

https://www.sciencemag.org/news/2020/02/farming-gave-us-salmonella-ancient-dna-suggests

 

 

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In an excellent National Geographic article "What History Has Taught Us: Stopping Pandemics" by Richard Conniff (August 2020), there is a reference to cocolitzli epidemics that devastated Mexico in the 16th century.

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The cocoliztli epidemic or the great pestilence[1] is a term given to millions of deaths in the territory of New Spain in present-day Mexico in the 16th century attributed to one or more illnesses collectively called cocoliztli, a mysterious illness characterized by high fevers and bleeding. 

https://en.wikipedia.org/wiki/Cocoliztli_epidemics#:~:text=The cocoliztli epidemic or the,by high fevers and bleeding.

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The epidemic of cocoliztli from1545 to 1548 killed an estimated 5 million to 15 million people, or up to 80% of the native population of Mexico (Figure 1). In absolute and relative terms the 1545 epidemic was one of the worst demographic catastrophes in human history, approaching even the Black Death of bubonic plague, which killed approximately 25 million in western Europe from 1347 to 1351 or about 50% of the regional population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730237/#:~:text=The 1545 and 1576 cocoliztli,of Mexico (Figure 1).

Mexico.jpg.11391e1b5dc236434fb07249b6f2b2cb.jpg

 

Conniff writes: Cocolitzli 1 (1545-48, Mexico) The little-understood disease killed up to 80% of the native population. Symptoms included high fever, headaches, and bleeding from the eyes, nose, and mouth. (15 million deaths)

Cocolitzli 2 (1576-78, Mexico) The disease killed up to 2.5 million people, half of population remaining after the 1540s pandemic. It caused hemorrhagic fevers and possibly was carried by rodents. (2.5 million deaths)

This devastating epidemic in Mexico makes me reconsider the long-accepted belief that it was smallpox that devastated the Roman Empire. Other possibilities include the hemorrhagic fevers (possibly now extinct) that devastated Mexico in the more recent past.

Here are a list of known viral hemorrhagic fevers:

Picture1.png.21855cfff7f218189b2d170dbd2410d5.png

Source: Great Courses: "An Introduction to Infectious Disease" by Dr. Barry C. Fox

 

If nothing else, COVID-19 has taught us that we have a lot to learn about infectious diseases.

 

 

Addendum: As discussed in a previous post, parathyphoid fever seems like a possible culprit. This interesting blog suggests a "mixed infection," with both parathyphoid and a hemorrhagic fever being the culprits

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Paratyphoid fever would seem to explain a lot of cocoliztli symptoms, including fever, abdominal pain, slow heart rate, and diarrhea, and is even known to cause parotitis (or inflammation of the salivary glands) during the septicemic stage, accounting for the nodules behind the ear, as well as jaundice from deranged liver function and bleeding because of ulcers in the digestive system. However, these last three are not common, and the bleeding is usually internal, in the intestines, rather than expelled by the mouth and nose and ears. Therefore, there is still some question of whether a paratyphoid fever really provides a final explanation. One possible alternative explanation might be a mixed epidemic, that in the wet conditions following the end of a megadrought, circumstances aligned for a simultaneous outbreak of paratyphoid fever and some unidentified hemorrhagic fever.


:http://www.historicalblindness.com/blogandpodcast//cocoliztli-the-mystery-pestilence

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