The World’s First Plague: The Antonine Plague

Joe Scaglione
The Technical
Published in
3 min readNov 22, 2021
Skeleton of a plague doctor

We’ve all heard of the Bubonic Plague.

The Black Death that killed between 75 to 200 Million people in Eurasia and set the course of European history.

The bacillus Yersinia Pestis started the plague, and it is still an endemic in south and north American rodent populations.

During epidemics, plague is spread to humans via the bite of a rodent or flea, whose primary host is the rat.

Plague is also given from person to person in its pneumonic form.

This is why the first plague, the plague of Antonine, was not really a plague like that of the Bubonic Plague.

It wasn’t fear of rodents, but fear of fellow man.

The Beginning of The Antonine Plague

Portrait of ancient Rome

The Antonine plague began at the end of 165 AD.

Galen, a Greek physician and author, witnessed the outbreak through its course and detailed its symptoms.

Fever, diarrhea, vomiting, thirstiness, swollen throat, and coughing were among the ailments.

The diarrhea itself had a black tint, which is a sign of gastrointestinal bleeding.

Coughs had a foul smell, and rashes formed over the entire body.

The infected suffered these symptoms for an average of two weeks.

Not everyone who contracted the illness died, and the survivors developed immunity from further outbreaks.

But based on Galen’s description, researchers conclude the disease affecting the Roman Empire did not stem from Yersinia Pestis.

It was most likely smallpox or measles.

The key detail?

Pustules or boils on the skin.

The Spread of The Plague

Ancient china

The epidemic emerged in China, spreading westward via trading ships heading to Rome.

The Roman military came into contact with the disease during its siege of Selucia, a major city on the Tigris River.

Troops returning from wars in the East spread the disease northward.

High death tolls resulted from the diseases’ novelty to Mediterraneans, known as the virgin population, who lacked immunity.

It is estimated that a quarter to a third of the entire population perished.

Somewhere between 60–70 million people, including emperor Marcus Aurelius himself.

The Fall of Rome & Rise of Christianity

A tableau in Rome

The disease affected the Roman military, whose weakened numbers could no longer hold borders.

It also destroyed the economy.

Many businessmen died and the government couldn’t collect taxes.

The disease sparked a rise of Christianity, with multiple Christians taking comfort in knowing their loved ones, who died of the plague, will receive their reward in Heaven.

The Antonine Plague marked the beginning of the end for the Roman Empire.

In the book “The Route to Crisis: Cities, Trade and Epidemics of the Roman Empire”, Eriny Hanna argues Roman culture, urbanism, and interdependence between cities and provinces facilitated the spread of the disease, creating the blueprint for the empire’s collapse.

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Joe Scaglione
The Technical

A content writer interested in what everyone else is interested in.