The Deadly Justinian Plague

Many people regard the Black Death as one of history’s deadliest epidemics. However, there was an equally devastating but less-known plague – the Justinian Plague, that killed an estimated 30-50 million people in total, about half of the world’s population at that time.

What was the Justinian Plague?

The plague was named after the current Byzantine emperor at the time, Justinian I. However, the emperor’s actions were perhaps also as infectious as the plague. By 542, he had reconquered most of the previous Roman Empire’s land, but since his workers and farmers were all sick and dying, Justinian was left with no workforce to complete the projects he had in mind, and it became impossible to establish his rule over those areas. As a result, he began to raise the taxes and change the tax code.

DNA analysis of victims of the Justinian Plague has revealed it to be the bubonic plague, just like the Black Death. Procopius, a scholar of that time, wrote accounts of the plague’s symptoms: the victims suffered from swellings in their armpits, groin and behind their ears. They experienced delusions, nightmares, and fevers. While some victims were highly delusional, others lapsed into comas. Some would suffer for days before death, while others would die almost immediately after the first onset of symptoms. Procopius blamed the plague on the emperor, claiming Justinian to be either a devil or receiving punished from God for his evil deeds.

Where, when and how did the plague occur?

The Yersinia pestis disease is believed to have first occurred in China and northeast India in 541 CE, which then travelled through the trade routes to Africa. The disease was mostly transmitted via the black rat, which travelled on crates and shipments that were sent to Constantinople from North Africa. Crates of grain were stored in huge warehouses and left untouched, providing ideal breeding grounds for the rats within by the time the shipments reached the Byzantine empire.

It is from this disease that the Justinian Plague began in Pelusium on the northern and eastern shores of the river Nile in Egypt. The plague spread to the outer provinces of the Byzantine empire and was brought to Constantinople in 542.

In the early years of Justinian’s reign, he set out to war with neighboring enemies and conquer their lands. It is believed that this early period of battle facilitated the transmission of the plague through soldiers and the supplies that went with them. Although there was relative peace by 542 CE, trade and commerce started up and this was also a contributing factor to the spread of the plague, as rats and fleas then followed the goods into other regions.

The climate was also a contributing factor to the plague – the summer brought with it unusual incidents of snow and frost, decreased amounts of sunlight, and lower temperatures than normal. The cold weather affected crop yields, resulting in food shortages and the need for some people to migrate around the region. The rats travelled with these cold and hungry people, causing outbreaks of infectious disease and eventually, an epidemic that killed a quarter of the population.

What were the impacts of the plague?

Five thousand people died from the plague every day, and the overall effects were dire – the plague killed around 30-50 million people in total, about half of the world’s population at that time. Although the outbreak lasted four months in Constantinople, the plague would carry on for another two centuries, with the last outbreak reported in 750 CE.

Since many of Justinian’s people succumbed to the disease, his empire began to fall apart by 568 when the Lombards invaded Northern Italy. The Byzantine empire still held strong for almost a millennium after that, but it never fully recovered the population it had lost to the plague, nor the strength the empire would have had if the plague had not thwarted Justinian in his attempts to better exert his rule.

The plague spread everywhere the black rats went and nobody was safe from it – even Justinian himself caught the disease, although he did not die from it. There were dead bodies littering the streets, and Justinian ordered the troops to assist in clearing away the dead. There was barely enough space to dispose of all the dead, so once the graveyards, tombs, burial pits and trenches were filled, bodies were disposed of in the sea, in buildings, and buried at sea on boats. It was not just human bodies – animals such as cats and dogs also caught the plague and died, and their bodies also required proper disposal.

How was the plague treated?

The options for medical treatment in the 6^th century were limited. Affected people could either see a medical practitioner or turn to home remedies. The medical physicians available then were mostly trained under the teachings of the Greek physician Galen, taught to them over a four-year course at Alexandria, the premier center for medical training at the time. Galen’s understanding of the human body involved the four humors, bodily fluids which were thought to represent one’s state of disease.

If victims of the plague could not see a medical physician to treat them, they sought for various home remedies such as taking cold-water baths, using blessed powders, magical artifacts and drugs, especially alkaloids.

People still suffering from symptoms of the plague despite all treatment would then turn to hospitals or be subject to quarantine. Unfortunately, many did not survive. Those who did were credited with good fortune, strong health and a healthy immune system.

Will we ever see a repeat of the plague?

Although the plague did resurface some centuries later as the Black Death in the 14^th century CE, it is unlikely that we will ever face an epidemic as devastating as those seen in history. Bubonic plague – and the other two types of plague, septicemic and pneumonic – are still around today, and in fact have recently surfaced in a handful of cases in China.

Fortunately, our advances in medicine, science and technology have greatly reduced the chances of such a devastating sickness ever affecting the world’s population again. For one, our modern standards of hygiene mean that rats and fleas will be less likely to remain untouched in food sources for months. We also have antibiotics readily available, which diseases such as the bubonic plague are susceptible to. Additionally, people are more aware of falling prey to such diseases and various measures are periodically taken to decrease the chances of a plague outbreak. For example, routine checks are conducted on food to make sure it is safe for consumption. People travelling to other countries where diseases are common tend to get vaccinations and health checks to protect against various conditions. Many countries also employ methods of quarantine if certain people are suspected of carrying infectious diseases with them.

While this does not make us immune to ever falling ill – consider the deadly 2003 and 2009 outbreaks of SARS and H1N1 – it is unlikely that we will see an epidemic on the scale of Justinian’s Plague or the Black Death, killing around 5,000 people per day.