Hektoen International

A Journal of Medical Humanities

Ancient Greek plague and coronavirus

Patrick Bell
Belfast, Northern Ireland

Plague in an Ancient City by Michael Sweerts, ca 1650. Credit Los Angeles County Museum of Art.

Introduction

Homer’s Iliad, Sophocles’ Oedipus the King, and Thucydides’ History of the Peloponnesian War have been termed “the three earliest, and arguably most influential, representations of the plague in Western narrative.”1 This essay uses these historical sources to examine attitudes toward plague in ancient Greece and parallels in the modern response to the coronavirus (COVID-19) pandemic.

Along with famine and war, plague was one of the great disasters of ancient societies. Descriptions of plague date to the Old Testament and encompass other calamitous events (e.g. infestations with insects) as well as highly infectious diseases.2 Plague, in the sense of an infectious disease with rapid spread, was not common in scattered agrarian settlements making up most of the ancient world. Rather, it was in cities and among armies on campaign that conditions for the spread of infectious disease were present. Although archaeological evidence of disease in ancient times is available from vases, gravestones, and votive offerings, these usually depict chronic conditions and rarely the victims of epidemic disease, whose remains were disposed of promptly.3 Therefore, to examine attitudes toward plague in ancient Greece, these three well-known literary sources have been chosen.

Iliad

Homer’s Iliad, composed in an oral tradition around the eighth century BCE, is based on a conflict that may have taken place around 1200 BCE near Hisarlik in Asia Minor. Often considered to be about war and by some to be anti-war, the tone of the poem is set in the first fifty-two lines by the dramatic description of plague among the Greeks assembled outside Troy. A crisis is reached when the responsibility of the Greek king, Agamemnon, is exposed: the gods are angry that he has rejected the priest of Apollo Chryses’ request that his daughter Chryseis, abducted earlier by the Greeks, should be returned in exchange for a ransom.

Homer’s portrayal of plague as divine punishment does not prevent a search for mortals to blame. Homer refers to the impact of plague as loigos, devastation, but later uses loigos repeatedly to describe the devastation of war.4 The association of war and disease suggests the contagious nature of war as one terrible event begets another. Thus, Agamemnon is blamed for the consequences of protracted war as well as plague. The enduring power of words related to infectious disease is well illustrated by the use of “contagion” to describe the economic crisis of 2008, or “viral” to describe the rapid spread of ideas, words, or images through social media.5

What would today be recognized as effective measures against plague do not feature in the Iliad. Corpse fires might destroy contagion, but they were intended as funeral pyres. When the hero Achilles calls the Greeks together to decide what to do about the plague, the outcome is to seek divine help. Nevertheless, the poem later refers to human intervention to alter the course of battlefield injuries, e.g. when Agamemnon’s brother Menelaus is wounded, Machaon, a son of the mythical physician Asclepius, removes the arrow, sucks out blood, and applies a healing ointment. This expertise is not considered relevant to combatting plague. That requires divine resolution when, after Chryseis is returned, Apollo is propitiated.

Oedipus

Oedipus the King was first produced around 430-425 BCE, shortly after a great plague struck Athens. Sophocles charts Oedipus’ transition from a position of popularity and security as King of Thebes to the discovery of his parricide and incestuous relationship with his mother before self-inflicted blindness and exile. The plague for which Oedipus is responsible is likened to divinely-inspired elemental forces. Nevertheless, Sophocles seeks rational explanation of plague, noting its origins in animals and spread from unburied corpses. Oedipus’ reference to pollution may signal awareness of the importance of unsanitary conditions. Moreover, even if the ancient biographical tradition that Sophocles’ was responsible for establishing the cult of Asclepius in Athens is fanciful, his frequent depiction of health problems in his heroes suggests an interest in contemporary medicine.6

Plague in Oedipus the King can also be considered a metaphor for sickness in the body politic. Sophocles insists on integrity and morality in public life as well as reverence for the gods. Oedipus’ fate has been compared to that of human scapegoats, or pharmakoi, being chased from Athens to protect the city against plague and famine.7 The victims were usually chosen from the poor, but myth includes instances of aristocrats and kings sacrificing themselves for the city.8

The early part of the play is dominated by talk of action to combat the disease. Oedipus tells suppliants to stop praying and suggests calling the Assembly so that he may lead the fight against plague. Once Oedipus realizes his own responsibility, the process of restitution he chooses in blinding himself is by any standard radical. Sophocles’ use of plague sets up what Artaud terms a “total crisis . . . after which nothing remains except death or an extreme purification.”9 In these terms, the tragedian can be considered the real healer.

Thucydides

Thucydides claims to have begun writing his History at the outset of the war with Sparta in 430 BCE. An active participant in the war, he also suffered from, and survived, the plague. Thucydides suggests the Athenian plague originated in Ethiopia and spread through the Persian Empire, reaching Athens via Piraeus. The disease struck suddenly with fever, headache, and suffusion of the eyes, followed by hoarseness and cough before moving to the abdomen, causing retching and diarrhea. Thucydides considers the ensuing breakdown of cultural norms in Athens a consequence of plague, unlike Sophocles’ inference that it is causal.

The microbiology of the Athenian plague has been exhaustively debated. DNA evidence from the dental pulp of victims from a mass grave dated to 430-426 BCE suggests typhoid fever, but that conclusion remains controversial.10 Thucydides avoids specifying a cause, but his use of medical terms implies familiarity with Hippocratic teaching. Natural rather than divine causation is supported by several observations: overcrowding contributed to the spread of disease, physicians attending the sick were often affected, and survivors acquired immunity. Nevertheless, Thucydides was writing in a society where worship of traditional gods was the norm. His dramatic language has been likened to elemental forces falling on victims like divine visitation.11 Moreover, Thucydides gives weight to religious aspects, e.g. reference to the oracle of a Dorian War bringing plague and Apollo’s sparing of the Spartans from plague.12

Thucydides’ account facilitates exploration of political tension in Athens and the attribution of blame. The city’s leader, Pericles, was an obvious target; according to Plutarch, his policy of protecting citizens within the city and long walls was exploited by critics. In Thucydides’ version of Pericles’ speech to the Assembly, it is impossible to know whether the negative effects of overcrowding on the spread of infection entered his calculations. Thucydides exonerates Pericles, accepts that his decisions reflected strategic necessity, and extols the importance of city over individual.

Divisions among science, philosophy, and medicine were not sharply drawn in fifth century BCE Greece. Those in authority would have been aware of new medical thinking. Despite knowledge of the plague’s contagious nature, Thucydides’ account provides little evidence of a preventive strategy. Physicians adhered to the tradition of treating individuals and avoided advising on public health. It appears Athens was simply not set up to deploy effective preventive measures despite recognizing the reality of contagion.

Modern parallels

Several aspects of how plague was viewed in ancient Greece have parallels in the modern response to the COVID-19 pandemic. First, understanding the contagious nature of a disease does not exclude irrational behavior in reaction to it. Even with some awareness of the importance of contagion in the Athenian plague, Thucydides still emphasized a divine and religious perspective. Today, while rational causation is nearly universally accepted, supernatural explanations still hold power. Just as notions of infectious diseases as punishment for moral failing were used in the 1980s to explain the AIDS epidemic,13 early in the coronavirus pandemic an elected councilor from Ballymena, Northern Ireland, used Facebook to link the pandemic to divine punishment for the legalization of abortion and same-sex marriage.14

Secondly, faced with calamity, human beings tend to attribute blame to others. The ancient sources make more-or-less convincing cases against Agamemnon, Oedipus, and Pericles for causing or exacerbating plague. It should be no surprise to see blame for COVID-19 apportioned to those in leadership positions. More unlikely targets, such as 5G masts,15 are as fantastic as any in Greek myth.

Finally, ancient sources demonstrate sophisticated societies such as Athens failing to take effective action. Like COVID-19, specific therapy for plague was unavailable, but opportunities to curb the spread of infection were missed. Modern societies, unaccustomed to having no specific treatment for infectious diseases, have struggled to initiate effective and timely preventive strategies. This is probably because relatively complex behavioral change is involved. Despite employing the rhetoric of war as Oedipus did, there is reluctance among some elected leaders to introduce measures considered impractical or unpopular. Avoiding catastrophic climate change, for example, for which the coronavirus crisis has been called a “rehearsal,”16 will involve many unpopular decisions.

Endnotes

This paper started life as a submission to the Open University (UK) Stephen Kassman Memorial essay prize, open to all Open University undergraduate classics students.

Bibliography

  1. P. Michelakis, “Naming the plague in Homer, Sophocles and Thucydides,” American Journal of Philology 140, no. 3 (2019): 318-414.
  2. V. Nutton, Ancient Medicine, 2nd. ed. (London and New York, Routledge. 2013), 25.
  3. S. Geroulanos, “Ancient Greek votives, vases and stelae depicting medical diseases,” in Medicine and Healing in the Ancient Mediterranean, ed. D. Michaelides (Oxford and Philadelphia, Oxbow Books, 2014), 24-9.
  4. D. R. Blickman, “The role of the plague in the Iliad,” Classical Antiquity 6, no. 1 (1987): 1-10.
  5. Michelakis, “Naming the plague,” 383.
  6. R. Mitchell-Boyask, “Heroic pharmacology: Sophocles and the metaphors of Greek medical thought,” A companion to Sophocles, ed. K. Ormand, (West Sussex, UK, Wiley-Blackwell, 2012), 317-320.
  7. Ibid, 323.
  8. J. Bremmer, “Scapegoat rituals in ancient Greece,” Harvard Studies in Classical Philology, 8 (1983): 299-320.
  9. S. B. Garner, “Artaud, germ theory, and the theatre of contagion,” Theatre Journal 58, no. 1 (2006): 1-14.
  10. M. J. Papagrigorakis, C. Yapijakis, P. N. Synodinos, and E. Baziotopoulou-Valavani, “DNA examination of ancient dental pulp incriminates typhoid fever as a probable cause of the Plague of Athens,” Int J Infect Dis 10 (2006): 206-14.
  11. Michelakis, “Naming the plague,” 384-389
  12. L. Kallet, “Thucydides, Apollo, the plague, and the war,” American Journal of Philology 134, no. 3 (2013): 355-382.
  13. S. Sontag, Illness as Metaphor and AIDS and its Metaphors (Penguin Classics, London, 2002 [1989]), 146-156.
  14. Irish Times. “DUP politician did not intend to ‘cause hurt’ when linking coronavirus to abortion law,” 2 April, 2020. https://www.irishtimes.com/news/ireland/irish-news/dup-politician-did-not- intend-to-cause-hurt-when-linking-coronavirus-to-abortion-law-1.4219288
  15. BBC, Coronavirus: 20 suspected phone mast attacks over Easter, 14 April, 2020. https://www.bbc.co.uk/news/technology-52281315
  16. Hewson, J. “Coronavirus is a dress rehearsal for what awaits us if governments to continue to ignore science,” Guardian (UK edition) 27 April, 2020. https://www.theguardian.com/commentisfree/2020/apr/22/coronavirus-is-a-dress-rehearsal-for-what-awaits-us-if-governments-continue-to-ignore-science

PATRICK BELL, BA, MSc, MD, FRCP, graduated with honors from Queen’s University, Belfast, in 1977. After training in internal medicine and endocrinology/diabetes, he developed a research interest in insulin action as Fulbright Fellow at the Mayo Clinic. Appointed consultant physician at the Royal Victoria Hospital, Belfast, in 1986 he worked there until retirement in 2016. He enjoyed the challenge of maintaining generalist skills in the face of increasing subspecialization. From a full-time clinical position he guided over a dozen fellows to higher degrees. His contribution to research and teaching led to his appointment as Honorary Professor in 2002. He completed an MSc in clinical education in 2014 and, in retirement, a BA in Classical Studies in 2020. He continues to help with undergraduate medical student teaching.

Winter 2021

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