Hektoen International

A Journal of Medical Humanities

Clausoque stomacho: An unrecognized factor in the death of the Elder Pliny

Andrew Williams
Robert Arnott

United Kingdom

The Elder Pliny (c. AD 23/24–79) was a naturalist and naval commander in the Roman Principate. In addition to his civic and military duties, he spent much of his time investigating, studying, and writing on nature and geography, which he published in his Naturalis Historia.

In a letter from the Younger Pliny (c. AD 61–c. 113) to Tacitus, the Roman historian and public official (c. AD 56–c. 120), he narrates the death of his uncle, the Elder Pliny.1 This letter gives the history and describes the heroic characteristics of his uncle’s behavior.2 In relating the death of the Elder Pliny twenty-five years earlier, when the younger man was seventeen and which he did not witness, he does not offer the source of his information, and it is disputed.3 It therefore leaves open the possibility that Tacitus’ now lost published history and interpretation could be different from Pliny’s own experiences. A later work offers the possibility of Pliny having edited Tacitus’ book of these very events.4

The Elder Pliny was a naval commander in the Roman fleet stationed at Misenum. After witnessing the eruption of Mount Vesuvius, his plan was to take a single ship to observe the eruption, but this was changed to sending in the fleet in an attempt to rescue survivors. His ship landed at Stabiae, approximately twelve kilometers from Mount Vesuvius, but the wind prevented their departure. The situation then deteriorated with a likely decrease in air quality and an increase in volcanic ash. The following day, the Elder Pliny suddenly collapsed and died while being supported by two slaves.5

In her 1978 Latin text giving a possible pathological cause, Radice does not offer a translation for clausoque stomacho.6 Some scholars only consider the possibility that the Younger Pliny is discussing windpipe pathology.3,7 Other scholars recognize the Younger Pliny’s error, where he states it was the lungs and not the windpipe that were affected.3,7 Only the distinguished American surgeon John Bigelow (1818–1890) explored the possibility of a gastrointestinal co-morbidity with “…his breath being obstructed, as I conjecture, by the thick mist [caligine], and his stomach being shut up, which in him was by nature weak, narrow, and subject to frequent commotion.”8 Bigelow also explained what he called “the theory of Pliny.…who was not much versed in anatomy” and that the Elder Pliny died from obstruction of his breath by the “caligo,” a word which means darkness, fog, mist, and metaphorically blindness, dizziness, and ignorance, but does not mean a noxious or irrespirable vapor.8

The Younger Pliny does not tell us if the slaves supporting the Elder Pliny or anyone else nearby were affected by toxic fumes.9 Radice, citing Plin. Ep, 6.16.20, states that the postmortem appearance was “more like sleep than death.”6 No further information is given. The impression is that Elder Piny died bravely, in the tradition of other Roman commanders facing defeat.

The Elder Pliny’s body was never recovered. We know he was obese, with a history of asthma or asthma-like symptoms.10,11 The multifactorial effects of obesity are increasingly recognized.12

We probably will never know the precise cause of the Elder Pliny’s death. Any medical discussion must be speculative.11,13,14 However, because the Elder Pliny died suddenly,8,13 it is correct to consider either cardiovascular collapse or a cerebrovascular accident.15,16 But what if the Younger Pliny did actually mean the stomach after all? The described abdominal symptoms do fulfill features of irritable bowel syndrome.17 Where abnormal bowel function becomes a potential comorbidity is when the large bowel becomes bloated by air. This will “splint” the diaphragm and add to the strain placed on the cardiorespiratory circulation.18,19

The historian Suetonius related a rumour of suicide, but ascribed the Elder Pliny’s death to suffocation.20 He did not give his sources. However, Suetonius was a correspondent of the Younger Pliny21,22 and his scholarship and character was praised.23 The Elder Pliny had written, “A quick death is the sovereign blessing of human life.”24,25 Suicide would have prevented suffering and avoided disgrace.26 The Younger Pliny did not mention whether Elder Pliny’s venture rescued anyone, and there remains the possibility that Elder Pliny inflicted a preventable maritime disaster upon the Roman state.27 The Elder Pliny was also knowledgeable about poisons28,29 and would have known that poisons can leave a body unmarked. Furthermore, from a Roman perspective, suicide may have been considered a selfless act, giving his companions a greater chance of survival.

The present usage of “Plinian plumes” in volcanology demonstrates that the Younger Pliny gave an accurate description of the Mt. Vesuvius eruption.30 However, the cause of death of the Elder Pliny remains speculative. The potential role of a hitherto unrecognized gastrointestinal co-morbidity has not been previously considered. We only have the Younger Pliny’s testimony that he was requested by Tacitus to “leave an accurate account of it for posterity,” a claim reasserted in Pliny’s own recollections.6,31,32 Furthermore, was the Younger Pliny deliberately concealing the wider consequences of Elder Pliny’s ill-fated decision? We know the Younger Pliny constructed his books of letters with great care.33 The Younger Pliny achieved his aim of giving the Elder Pliny, his beloved late uncle, a eulogy untarnished by wider realities of a bad decision and physical suffering.34

References

  1. Plin. Ep. 6.16.
  2. Jones, NF. (2001) “The Younger Pliny’s Vesuvius ‘Letters’ (6.16 and 6.20),” The Classical World, 95: 38-40.
  3. Sherwin-White, A. N. (1966) The Letters of Pliny: A Historical and Social Commentary, Oxford, Oxford University Press. pp. 374- 375.
  4. Plin. Ep. 7.20.
  5. Plin. Ep. 6.16.19.
  6. Radice, B. (1978) The letters of the Younger Pliny, Harmondsworth, Penguin Classics). Harmondsworth, Penguin Books. p. 166-168.
  7. Hutchinson, WML. (1952) Pliny Letters, Cambridge, Harvard University Press (Loeb Classical Library). p. 483.
  8. Bigelow, J.(1859) “On the Death of The Elder Pliny,” Memoirs of the American Academy of Arts and Sciences, New Series., 6: 223-227.
  9. Plin. Ep. 6.16.19.
  10. Plin. Ep. 6.16.13.
  11. Friedman, B.(1989) “The first recorded death from asthma? The Elder Pliny and sulphur dioxide,” British Medical Journal, 299: 311.
  12. Dixon, AE and Peters, U.(2018) “The effect of obesity on lung function,” Expert Review of Respiratory Medicine, 9: 755-767.
  13. Zirkle, C.(1967) “The Death of Gaius Plinius Secundus (23-79 A.D.)” in Notes 60 and Correspondence, Isis 58: 553.
  14. Retief, FP and Cilliers,L. (2006) “The eruption of Vesuvius in AD 79 and the death of Gaius Plinius Secundus,” Acta Theogica, 26: 107-114.
  15. Søholm, HJ Kjaergaard, J Thomsen, Bro-Jeppesen, J Lippert, FK Køber, L Wanscher, M and Hassager, C. (2014) “Myocardial infarction is a frequent cause of exercise related resuscitated out-of-hospital cardiac arrest in a general non-athletic population,” Resuscitation, 85:1612-1618.
  16. Thompson, PD Franklin, BA Balady, GL Blair, N Corrado, NAM Fulton, JE Gordon, NF Haskell, WL Link, MS Maron, BJ Mittleman, M Pelliccia, MA Wenger, NK Willich, SN and Costa, F. (2007) “Exercise and acute cardiovascular events placing the risks into perspective: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology,” Circulation, 115: 2358–2368.
  17. Enck, P Aziz, Q Barbara, G Farmer, AD Fukudo, S Mayer, EA Niesler, B Quigley, EMM Rajilić-Stojanović, M Schemann, M Schwille-Kiuntke, J Simren, M Zipfel, S and Spiller, RC. (2016) “Irritable bowel syndrome,” Nature Reviews Disease Primers 2: Article number 16014.
  18. Dewey, J and Prahlow, JA. (2021) “Acute colonic pseudo-obstruction (Ogilvie syndrome) leading to respiratory compromise and death,” Journal of Forensic Science, 66: 2515-2520.
  19. Wells, CI O’Grady, G and Bissett, IP. (2017) “Acute colonic pseudo-obstruction: a systematic review of aetiology and mechanisms,” World Journal of Gastroenterology, 14: 563-564.
  20. Suet. De Historicis, 80.3.
  21. Plin. Ep. 1.17.
  22. Plin. Ep. 5.10.
  23. Plin. Ep. 10.94.1.
  24. Plin. Hist. Nat. 7.53.
  25. Screech, MA. (1991) Michel de Montagne. The Complete Essays, Harmondsworth, Penguin Books (Penguin Classics) p. 688.
  26. Hope, VM. (2009) Roman Death: The Dying and the Dead in Ancient Rome, London, Bloomsbury.
  27. Plin. Ep, 6.16.
  28. Plin. Hist Nat, 24.
  29. Plin. Hist Nat, 27.2.5-9.
  30. Carazzo, G Tait, S Michaud-Dubuy, A, Fries, A and Kaminski, E. (2020) “Transition from stable column to partial collapse during the 79cal CE P3 Plinian eruption of Mt. Pelée volcano (Lesser Antilles),” Journal of Volcanology and Geothermal Research, 392: 106764.
  31. Plin. Ep. 16.6.1.
  32. Plin. Ep. 6.20.1.
  33. Gibson, R and Morello, R. (2012) The Elder Pliny: Themes and Contexts, Cambridge, Cambridge University Press.
  34. Plin. Ep. 6.16.1.

ANDREW N. WILLIAMS, MA Candidate, The Classical Mediterranean, Department of Archaeology and Ancient History, University of Leicester (UK)

ROBERT ARNOTT, Associate Fellow, Green Templeton College, University of Oxford (UK). Robert “Bob” Arnott (1951–2024) was Professor of the History and Archaeology of Medicine and Director of the Centre for the History of Medicine at the University of Birmingham (UK) before becoming an Associate Fellow at Green Templeton College, Oxford (UK). He was educated at University College London, the University of Warwick, the University of Pittsburgh, and the British School at Athens. He contributed in various capacities as an archaeologist, paleoepidemiologist, medical historian, teacher of medical students, and expert patient. His life’s work not only successfully deepened understanding of the history of medicine but also improved present and future healthcare delivery.

Winter 2025

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