Here’s the difference in a nutshell. Until the 20th century, we didn’t have a science of epidemiology. Plagues came out of nowhere, devastated populations, and finally magically disappeared, as President Trump predicted for coronavirus before it got out of hand in the United States. Nobody knew what caused epidemics or exactly how they spread. There were no cures and barely any treatments. Although social distancing and quarantines were employed to prevent contagion, the twin tools of hygiene and antisepsis were largely unknown.
We are fortunate. We know how pandemics work. We understand how they intersect the biology and chemistry of the human organism. We can identify a virus and explain how it works. We can locate their geographic hot spots and often the region, sometimes even the village, where they originated. We understand how vaccines work in general and we can design vaccines that neutralize specific viruses. We have centers for disease control.
It might be instructive to examine three historical plagues to learn what, if anything, they teach us. If nothing else, they should give us assurance and confidence, because it is clear that until very recently, we did not understand them at all.
It Starts with the Greeks
Two of the first plagues recorded in western literature occurred in ancient Greece. In Book One of Homer’s Iliad, a plague decimates the Greek contingent at Troy. This one was sent among the Greek huts on the beach by the god Apollo in anger. The daughter of one of his priests had been taken as a war prize by the Greek military leader Agamemnon. When her father came to the Greek camp to ransom her, not only did Agamemnon refuse to release her, but he publicly dishonored the priest of Apollo. The holy man prayed to Apollo for retribution. Apollo responded by bringing a plague:
He came as night comes down and knelt then
Apart and opposite the ships and let go an arrow.
Terrible was the clash that rose form the bow of silver.
First he went after the mules and the circling hounds, then let go
A tearing arrow against the men themselves and struck them.
The corpse fires burned everywhere and did not stop burning.
Eventually another priest explains that the plague will not be lifted until Agamemnon returns the sex slave to her father. He finally does so — reluctantly, petulantly — but rashly decides to take the slave of Achilles, one Briseis, to compensate for his loss and to punish Achilles for calling the public meeting. Proud, heroic Achilles, the greatest of the Greek fighters, withdraws from the war to punish Agamemnon. That set up the plot of the Iliad, the first and greatest epic in literature.
What do we learn from this episode? First, I’ve read the Iliad a couple of dozen times, and taught it in humanities courses, but I’ve never really thought about the plague until now. Somehow, out of nowhere, it popped into my head the other day. The coronavirus is like a new vocabulary word. When you look up a word you don’t know, suddenly you find it everywhere in the next weeks and months. The virus has caused lists of books about plagues and pandemics to rise to the surface of my consciousness from a lifetime of reading.
Second, in the Iliad, the plague comes directly from the god Apollo. It is visited upon the Greeks as divine punishment. It is not just a random virus that somehow found its way into the human population. It is a deliberate chastisement — with plagues and other catastrophes are God’s way of punishing human sinfulness — that have had a long, ignominious history. Until very recently, it was common for what Thomas Jefferson called the “priestcraft” to tell stricken humans they had it coming. That way of thinking has not altogether disappeared. Remember Pat Robertson’s claims after 9/11 that the attacks on the Pentagon and World Trade Center were God’s way of expressing his displeasure for homosexuality.
Third, from a modern scientific perspective, the plague that visited the Greek army at Troy probably had to do with the crowding of ships and huts in a confined space on the shore of the Aegean Sea. Think of a colossal tailgate party with too few “Porta-Potties.”
Fourth, the plague in the Iliad was overcome not by science or social distancing, but by sacrifice — and some better hygiene. Agamemnon has to give the slave girl back to her father along with a ritual butchering of bulls (a hecatomb) before Apollo will end the plague. We also learn that in the aftermath of the dispute with Achilles, Agamemnon orders the Greek warriors “to wash off their defilement. And they washed it away and threw the washings into the salt sea.” Not perfect: it would have been smarter to gather the wash rags and bury or burn them, but Agamemnon had the right general idea.
The Iliad is fiction (maybe, partly, mostly?) but classical scholars now conclude that it was based on shadowy memory of actual events. While most of the epic is a fictionalized account of a war between East and West at the portal that linked Europe with Asia (Troy at the Hellespont), there appears to have been a cultural memory that a plague occurred that upset the social order of the Greek contingent (but did not affect the Trojans) and nearly caused the Greeks to lose the war. Needless to say, epidemiologists have not been able to identify this plague, but a few have suggested that since Apollo was sometimes known as “the mouse god,” the mythology may have identified the plague with Apollo because it was transmitted by rodents.
The Greek historian Thucydides (c. 460-400 BCE) describes an actual plague in the second book of his monumental (and seminal) History of the Peloponnesian War. In the late fifth century BCE, the city states of Athens and Sparta were locked in a grim and protracted war, eventually won by Sparta with disastrous consequences for Athens, the cultural center of the ancient world.
Thucydides approached the plague of 430-427 BCE as he approached everything in life — with admirable objectivity, commitment to truth and detail, a thoroughly secular outlook, and without any desire to moralize the crisis. His account has a really eerie resonance with the first months of the coronavirus pandemic. Things Thucydides reported 2,500 years ago in his lucid Greek seem to characterize the plague we are all facing together. His account is worth reading not just because it is fascinating, but also because he explores the ways in which a protracted epidemic leads to significant social breakdown.
He began by writing, “So great a plague and mortality of men was never remembered to have happened in any place before.” Modern historians estimate that one-third of the population of Athens perished in the plague.
Thucydides prefigured modern analysis in ways that remind us how much we owe to the ancient Greeks. He wants to know where the plague began and how it got to Athens. He wants to report and discount rumors about its origins. He declares that he will only report what people can actually rely on as truth and that he knows whereof he speaks, “having been both sick of it myself and seen others sick of the same.” Thucydides caught the plague and lived to tell about it.
He reports that the plague came at a time when the people of Athens were otherwise healthy. Thucydides provides a very detailed account of symptoms: headache, inflammation of the eyes, sore and bloody throats and tongues, labored and fetid breath, hoarseness and sneezing, then “a mighty cough” settling in the chest, vomiting “and with great torment came up [from the stomach] all manner of bilious purgation that physicians ever named. And many that presently upon their recovery were taken with such an oblivion of all things whatsoever, as they neither knew themselves nor their acquaintance.” This sounds like Post-Traumatic Stress Syndrome.
Think of this masterful account. Remember that it appears in a book-length account of war, not disease.
Thucydides writes that physicians were prominent among the victims He reports that birds and other scavenger animals tended to avoid feasting on the corpses. Those that did so died of the infection. The plague had an especially severe effect on dogs “because they are familiar with men.” Some died because there was no medical help available; others died “with all the care and physic that could be used.” Medicines that seemed to help some individuals worsened the condition of others. Nor was the disease less pronounced among people who enjoyed great previous health and vitality.
Thucydides gave considerable attention to the psychological effects of the plague. “The greatest misery of all was the dejection of mind in such as found themselves beginning to be sick, for they grew presently desperate and gave themselves over [i.e., gave up] without making any resistance, as also their dying thus like sheep, infected by mutual visitation, for the greatest mortality proceeded that way” [by dense social contact]. Those whom nobody came to help died alone and forlorn; those who were visited and comforted often passed the infection on to their caregivers.
Some Athenians ministered onto the sick and dying even though they knew they were putting themselves at risk. “For out of shame they would not spare themselves but went in unto their friends, especially after it was come to this pass that even their domestics [i.e., servants], wearied with the lamentations of them that died and overcome with the greatness of the calamity, were no longer moved therewith.” In other words, family servants, hardened by the unceasing suffering they witnessed, eventually became indifferent to the plight of their masters. The social structure of Athens was beginning to break down.
Thucydides reported that the ubiquity and devastation of the plague — no respecter of persons — led to at least a temporary loss of religious feeling in Athens. People stopped consulting the oracles and praying to the gods because they realized that no remedy could be expected from that quarter.
Those who survived the disease were thereafter immune, Thucydides reports. Country people who came to the city for treatment only worsened the problem. “Dying men lay tumbling one upon another in the streets, and men half-dead [crowded around] every conduit through desire of water. The temples also where they dwelt in tents were all full of the dead that died within them. For oppressed with the violence of the calamity and not knowing what to do, men grew careless both of holy and profane things alike. The laws which they formerly used touching funerals were all now broken, everyone burying where he could find room,” survivors often throwing their dead in other families’ graves.
Eventually, things broke down altogether. Men committed crimes openly rather than by subterfuge and wealthy individuals spent their money recklessly because they reckoned they would be dead long before they ran out of wealth.
Values like virtue and honor broke down. “Neither the fear of the gods nor laws of men awed any man, not the former [fear of the gods] because they concluded it was alike to worship or not worship from seeing that alike they all perished, nor the latter [obedience to the laws] because no man expected that life would last till he received punishment for his crimes.”
This remarkable account of the plague of Athens occupies just four pages of a 580-page history of the Peloponnesian War. All the elements of plagues are painstakingly reported: the sudden onslaught; rumors and false reports; conspiracy theories and the blame game; social panic; the inability of health care providers to avoid the disease; the health and undertaking infrastructure overwhelmed until it begins to collapse; the loss of faith; social decay followed by looting, lawlessness and social breakdown, a kind of apocalyptic nihilism: eat, drink, fornicate, blaspheme, for tomorrow you may die.
Pepys, the Great Plague and Some Good Times
Samuel Pepys (1633-1703) kept the most famous diary in English history. It is a rollicking, fascinating portrait of Britain at the time of the restoration of the monarchy (1660-1670). Aside from being a remarkably intelligent, observant, witty and lusty man, Pepys was fortunate (as a writer) to live through and record two of the great events of the 17th century in England, the Great Plague of 1665 and the Great Fire of 1666.
What makes his journal so interesting as a plague document is how cheerful he was in the face of an epidemic that killed off one in seven citizens of London, how little actual inconvenience he suffered and how completely he was able to maintain the basic rhythms of his life. Pepys was an important figure in the civilian administration of the British Navy during the Dutch Wars of the period. He reported that in spite of the plague, “everything else hath conspired to my happiness and pleasure, more of these last three months then in all my life before in so little time.” Later he wrote, “I do end this month with the greatest content, and may say that these last three months, for joy, health, and profit, have been much the greatest that ever I received in all my life.”
Englishman Samuel Pepys. Famous for his diaries which cover the years 1659 - 1669.
Such diary entries may sound both complacent and inappropriate when we consider that at least 68,596 people died in the plague out of a total London population of 460,000. Bodies were stacked like cordwood in empty lots. The cry of “Bring out your dead” resounded through London for six months. The death rolls are chilling to read even after three hundred years.
Pepys’ diary also tells us something of great importance about human resilience. Life goes on. The basic rhythms of life are unquenchable. People eat, sleep, fornicate, dance, work, raise children, make music, read books, and find ways to communicate with family and friends. If Pepys can write, “I have never lived so merily [sic] (besides that I never got so much [money]), as I have done in plague-time,” we pause to realize that even in the first long weeks of the coronavirus pandemic, many Americans have followed the CDC guidelines about hygiene and social distancing, but after the initial panic — not a roll of toilet paper to be had in America or a sack of beans — the great bulk of the people, except in the three or four most virulent hot spots, have accepted social distancing as the new normal.
Pepys’ biographer Claire Tomalin concludes that plague, like other catastrophes, has the effect (on some) of heightening experience, “an adrenaline high that gives extra intensity to every experience.” She does not fault Pepys. “While something like a sixth of the population of London died around him, [Pepys] experienced months of euphoria, reveling in his own success and pleasure,” including a fair amount of sex with partners other than his wife Elizabeth.
We also learn from Pepys’ famous diary that rogues and scoundrels exist everywhere and at all times. An aristocratic woman of Pepys’ acquaintance supplied him with a bottle of “plague water,” said to be efficacious in warding off the disease. Mountebanks sprang up throughout London to exploit terrified citizens. Pepys chewed tobacco as a prophylactic. He worried that wigmakers might be taking advantage of what to them was a windfall by using the hair of victims in their wigs.
The Great Plague led Pepys to write one of the finest entries in his diary, one of the finest passages in the whole of plague literature:
"I having stayed in the city till above 7400 died in one week, and of them above 6000 of the plague, and little noise heard day nor night but the tolling of the bells; till I could walk Lombard Street and not meet twenty persons from one end to the other, and nor fifty upon the Exchange; till whole families (ten and twelve together) have been swept away; till my very physician, Dr. Burnet, who undertook to secure me against any infection [one wonders how?] died himself of the plague; till the nights (though much lengthened) are grown too short to conceal the burials of those that died the day before, people thereby constrained to borrow daylight for that service; lastly, till I could find neither meat nor drink safe, the butcheries being everywhere visited, my brewer’s house shut up, and my baker with his whole family dead of the plague. Yet, Madam, through God’s blessing and the good humours begot in my attendance upon our late Amours [he had made arrangements for a patron family’s wedding] your poor servant is in a perfect state of health.”
How Samuel Pepys was able to maintain his equanimity through all of this is hard to fathom.
Learning from Philadelphia’s Pandemic
In the yellow fever epidemic in Philadelphia in 1793, people took muskets into the streets and fired them into the air. Fireworks were set off. Cannons were fired. Partly this was just desperation, but some people thought the miasma could be dispersed by gunfire, some thought that explosions might increase the supply of available oxygen, and some were undoubtedly trying to get God’s attention.
Philadelphia had a population at the time of about 50,000. Before the plague dissipated in late November 1793, at least one in 10 Philadelphians had died. Philadelphia was the nation’s capital at the time. No government figure died, though Secretary of the Treasury Alexander Hamilton survived a bout of the fever, and every member of the government eventually fled to healthier climates away from the city.
Several lessons can be drawn from the 1793 epidemic. First, all that can be said for the medical treatments is that some people survived in spite of them. Dr. Benjamin Rush’s regimen of bleeding and purging cannot have helped anyone. In fact, these treatments had the effect of weakening his patients.
Second, in their urgent attempts to understand how the disease came to Philadelphia, how it spread and what factors made it more intense in some neighborhoods than in others, Rush and other doctors and intellectuals approached a scientific understanding of the plague, but never quite connected all the dots. They understood that it probably came from the wharf district, where ships, including ships from Haiti, were docking. They sensed that it had something to do with poor drainage and pools of fetid standing water. Rush even tapped on the door of the truth, that the yellow fever had something to do with mosquitoes, but he did not quite reach that conclusion.
We now know that it was the female of the mosquito species Aedes aegypti, found usually in the tropics and sub-tropics. Modern epidemiologists have concluded that the fever came to Philadelphia from the Caribbean, probably with crews carrying refugees from the Haitian Revolution to the eastern seaboard of the United States.
Third, the most effective response to the yellow fever outbreak was social distancing and the use of quarantines. So far, in the coronavirus pandemic, the same two responses are most effective, together with vigorous hand washing with disinfectant soap — a procedure entirely unknown and unavailable to the terrified citizens of Philadelphia.
Fourth, people intuitively realized that body contact spread the disease. Many surviving documents report that people crossed the street to avoid houses that were known to be infected. People ceased to shake hands until the epidemic was safely passed.
Fifth, what Thucydides did in the fifth century BCE — write down every detail he could, even ones that were seemingly irrelevant — continues to be extremely important in combating epidemics. Dr. Rush eventually published a 300-page report of the plague in Philadelphia. Much later, in 1881, a Cuban doctor named Carlos Finlay cracked the case after reading Rush’s 1793 report. When he read Dr. Rush’s sentence, "Mosquitoes (the usual attendants of a sickly autumn) were uncommonly numerous,” Dr. Finlay had his Eureka moment and — for the first time — identified the mosquito as the agent of the disease.
We are fortunate to live in the era we do. As long as people accept a few weeks or months of social distancing, we are certain to get through this catastrophe with a comparatively minimal global death toll. No rational person doubts that medical science will produce a vaccine that will, in the next couple of years, transform the coronavirus from a threat to civilization to a serious but handleable global annoyance. Thanks to wide streets, excellent water treatment and sewer systems, a nearly universal understanding of hygiene and antisepsis, and the nearly miraculous capacity of modern science and engineering, a pandemic that might have decimated the planet will now be contained by the ingenuity of modernity.
Join Clay this Friday evening, April 24, for the beginning of a special four-week online humanities course: "History & Literature of Pandemics." REGISTER.
For more of Clay Jenkinson's views on American history and the humanities listen to his weekly nationally syndicated public radio program and podcast The Thomas Jefferson Hour.