An excerpt from the History of the Medieval World

I have now been sick since the Monday before Thanksgiving. In fact, I may never get well. So instead of racking my cough-syrup-addled brain for a topic to post on, I’m posting a highly relevant excerpt from my upcoming History of the Medieval World.

Now I feel slightly more cheerful about the flu.

In 542, just as Khosru was crossing over the Euphrates for yet another assault on the Byzantine frontier, a ship docked at the Golden Horn. It brought much-needed grain from the mouth of the Nile; the cold dark summers of the previous years had already reduced food supplies, and the population of the eastern Empire was already hungrier and weaker than normal. But not long after the ship threw down its anchor, a sickness began to spread along the waterfront. It was an illness known to the ancients, but new to the people of Constantinople: sudden fever, swellings in the groin and armpit, coma and death.

Physicians, dissecting the bodies of the dead in an effort to find the cause, found strange abscesses filled with pus and dead tissue at the center of the swellings. They were at a loss: nothing seemed to stop the spread of the disease. At first, the deaths from the illness were no worse than from any other epidemic making its way through the crowded suburbs of Constantinople. But within days the mortalities had doubled and then doubled again. This was no mere epidemic. It had become a catastrophe without parallel: a pestilence, writes Procopius, “by which the whole human race came near to being annihilated.”

The sickness burned through the city at full force for three entire months. “The tale of dead reached five thousand each day,” Procopius tells us, “and then came to ten thousand, and still more than that.” Some victims broke out with black pustules, “about as large as a lentil,” and died vomiting blood. Others, driven delirous by high fever, died screaming in pain when the swellings grew gangrenous and burst. Some took agonizing days to die. Others walked from their houses healthy, and were struck down in the road by fever so sudden that they fell in their tracks and lay on the road until they died. “Nobody would go out of doors without a tag upon which his name was written, and which hung on his neck or arm,” writes John of Ephesus, who lived through the plague; that way, their disfigured bodies could be identified and claimed by surviving relatives.

The sickness of Constantinople was bubonic plague, named for the swellings or “buboes,” carried by the fleas which travelled from port to port on ship’s rats. Bubonic plague had not struck Constantinople before, but the cold wet summers after 535 had a three-sided consequence: the drop in temperature provided the Yersinia pestis bacterium, the active agent of the plague, the perfect environment in which to flourish; years of poor harvests had forced Constantinople to increase its grain imports, bringing ships from all over the Mediterranean to the Golden Horn; and the people of Byzantium were weaker, hungrier, and more vulnerable than ever before. It was only a matter of time before one of those ships brought death to the city.

The population died, and died, and died. The historian Evagrius Scholasticus suffered from the swellings but survived, one of the few to live through the sickness. But he lost his wife, his children, and his grandchildren. “Some were desirous of death,” he wrote, in his otherwise dispassionate chronicle, “on account of the utter loss of their children and friends, and placed themselves as much as possible in contact with the diseased, and yet did not die, as if the pestilence struggled against their purpose.” The bodies of the dead were at first buried in Constantinople’s tombs. When those were filled, mass graves were dug all over the city. Ceremony was nonexistent; the bodies were slung into the graves as fast as possible. When Justinian (who himself suffered from buboes, according to Procopius, but recovered) realized that there was nowhere left to dig new graves, he ordered the tops of the towers just across the Golden Horn ripped off, and the towers themselves filled with bodies. “An evil stench pervaded the city,” Procopius writes, “and distressed the inhabitants still more.”

Plague brought a temporary end to the war with Persia. The sickness appeared in Ctesiphon, and Khosru himself abandoned the battlefield, retreated back across the Euphrates, and went home to take care of his people. By the following year, plague had spread westward, as far as the lands of the Franks: Gregory of Tours records outbreaks of “swellings in the groin” in Arles in 543.

But the deadliness of the plague was also its weakness. By 543, it had killed so many people (as many as two hundred thousand in Constantinople alone) that it could no longer remain at full strength; it had run out of uninfected hosts, and began to decrease.