Disease in Imperial Rome

Sewer system

Hygiene in ancient Rome was not ideal for combating diseases. Their sewer system, praised for its longevity, had many flaws. As Water History’s Roger Hanson explains, street drainage and sewage flowed through the same pipes, which led to sewage openings on the streets. Also, since most sewer systems were privately owned, they were also privately maintained and in turn neglected. Instead, citizens would turn to their latrines; if they lived on anything but the ground floor they would even throw their excrement onto the street. This led to exposure of sewage to flies, dogs, and bacteria, all of which helped spread disease among Romans.^[2]

Bathing

The high poverty rate in Rome led to a need for public baths, or thermae since it was uncommon for the middle class citizens to own one of their own according to journalist Jay Stuller. When the heated bath water was not chemically cleansed or filtered with chemicals such as chlorine, bacteria thrived and spread. When Christianity came to Rome, it saw the public nudity of the bathing system and saw it as debauchery and therefore frowned upon. While the bathing system may not have been pristine, abstaining from cleanliness altogether brought upon many more potentially fatal diseases, especially in infants. This trend started and ended in Rome. As the necessity for bathing became recognized, the protests of the Christian church died down and a new elaborate bathing system was designed under the rule of Emperor Augustus. Even an imperial-version sauna was created for cleansing the body of toxins.^[3]

Diet

In contrast to today's diet, Romans ate little meat. According to scholar Linda Gigante, they consumed large amounts of grain, fruits, and some vegetables. Similar to the diet encouraged by modern United States' food stamps, the poor were given monthly supplies of grain and hardly had money to pay for anything else. Due to this, many Romans suffered from malnutrition and multiple vitamin deficiencies. Even those who had money for food didn’t always have the best choices. There was no food and drug regulatory agency in ancient times, so low food standards brought contamination and parasites. Also apparent is the water quality. The Roman Army’s drinking from the contaminated Tiber River contributed to their vulnerability to many diseases.^[4]

Population density

Rome had an extremely high population, and remnants of buildings suggest the average living space was very small.^[1] Many people crammed into small spaces led to very high rates of infection for transmittable diseases. The Antonine and Cyprian plagues were transmitted through touch, so a dense population rate would contribute highly to their spread.

Deforestation

Deforestation of Rome’s cities, particularly near the Tiber River, led to higher disease rates. The causality is as follows: deforestation lead to a rising water table, which increased marshes. This increased the larva in Rome, and in turn increased disease borne from blood-sucking bugs. As in many of today’s third world countries, mosquitos and other vectors were carriers of various diseases, such as malaria and the Ross River virus.^[5]

The Antonine Plague

The Antonine Plague, possibly the most widespread and catastrophic outbreak of disease in Imperial Rome, was named after the emperor whose reign it originated in, Aurelius Antoninus according to Louise Cilliers and Francis Retief. Historical sources suggest that Roman soldiers returning from campaign in Mesopotamia spread the disease, which lasted from 165-180 AD.^[6] Based on the written observations of fever, diarrhea, and boils by the Greek physician Galen, historians infer that smallpox caused the plague.^[7] Including substantial army deaths, the outbreaks decimated an estimated two thirds of the Roman population, killing roughly 2000 people per day.^[8]

The Plague of Cyprian

Cilliers and Reteif go on to describe that the second great plague affecting Rome. The Plague of Cyprian, mainly occurred from 251 to 266 AD with some traces lingering as late as 270 AD; although considered to be separate from the Antonine Plague, it is very similar and also believed to have originated from smallpox, or perhaps measles. Saint Cyprian makes the most vivid description of the effects of the disease as dysentery, loss of motor skills, and of course fever, and in turn has the disease named after him (also possibly due to the oppression of Christianity at the time). Notably, his list does not include skin rashes or swelling, which is the main separation from the bubonic plague and Antonine Plague.^[9] This plague was very widespread, possibly originating in Ethiopia and spreading to Scotland. With the skin contact-spreading nature of the disease and the crowded civilization style in Rome, the death toll was tremendous in the empire.^[8]

Morbus Gallicus

Morbus Gallicus, better known in modern times as syphilis, or the "French Disease" was not prominent in ancient Europe but with recent bone studies, it has been found that a type of European treponematoses bacteria may have even affected children.^[10] However, according to an article published by Kristin Harper in 2008, ancient European civilizations may have suffered from a related form of the bacteria but not venereal syphilis itself, which may have had its origin in the pre-Columbian Americas.^[11] The term ‘syphilis" was coined later on by a 15th century Italian poet Girolamo Fracastoro, who wrote an epic poem of a boy named Syphilus who insulted Apollo, and was in turn punished with the disease. During the Medieval and Renaissance periods the likely mutated forms of the treponematoses resulted in epidemics.^[12]

Malaria

The earliest known case of malaria is from Roman DNA dated to 450 AD. An excavation of a village shows signs of a serious malaria problem, with bone tests and traces of honeysuckle, a plant used to treat fevers. Also noted is that the area was a "zone of pestilence".^[13] Deforestation and sanitation issues were the main causes of malaria.

Mentagra

Mentagra, notably thought by the Imperial Romans to be spread by kissing, was a skin disease most commonly starting in the chin and moving on to the entire face and sometimes other body parts. The aesthetic factor was very unappealing, while the disease was hardly adverse to health at all. Even though it was not dangerous, Romans ironically went as far as scar-inducing cauterizations to rid them of the abhorrent disease.^[8]

Anti-inflammatory

Disease prevention

Cough treatment

Performance enabling supplements

Wound treatment

Military use