In AD 542 a plague struck Constantinople that was so overwhelming, it changed the face of history forever. This plague occurred in the 15th year of the emperor Justinian's reign. At the height of the contagion's rampage, the daily death toll may have reached 10,000 or more. Justinian himself, was stricken with this disease. The final death count is not clearly known, but some historians feel that it may have reached into the upper hundreds of thousands.
Much of the information that is known about this plague comes from Procopius. Procopius was the legal advisor to the general Belisarius. He accompanied Belisarius on his missions throughout the Mediterranean Basin at the time that the plague erupted. It is through his accounts that the course of the disease, and the reality of the suffering became public to Europe.
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The disease was first noticed in Pelusium. This is an Egyptian harbor town, which was infected with a huge rat problem (as was most of Europe at this time). It then ripped through Alexandria on its northern invasion towards Syria and Palestine. (1) Procopius wrote "From there it seemed to spread all over the world, this catastrophe was so overwhelming that the human race appeared close to annihilation." The problem with this plague was that no one was sure of what caused it. In later years we have found out that the disease was caused by bacteria and parasites that used rats as hosts. These rats would then infect our drinking and eating sources, thus spreading the bacteria to hundreds of thousands of people. It was written by Procopius that all victims appeared to experience similar symptoms. (2) "They had a sudden fever, some while sleeping, some while walking, and others while engaged without any regard of what they were doing." Soon after, the symptoms would escalate into a type of swelling. The abdomen, armpits, thighs, and ears were the most common body parts affected. The lymph glands were also commonly affected. They were called buboes and for this part of the body the illness was named. (3)
Normally the disease would then take a sharp turn for the worse. Some would die suddenly, while others would remain alive in a violent state of deliriousness. Some victims would fall into coma and die in their sleep. The most excruciating death, though, came from the victims who remained conscious and mentally awake as the contagion ravaged their bodies. In some cases, a discharge of puss signified that the victim was on the mend, in others the swelling simply disappeared, but the victim suddenly died, as if he was poisoned.
Finally, some survivors regained perfect health. These people that recovered were then believed to be immune. They were then put to work carrying off and burying the thousands of new bodies daily. Soon these "undertakers" were again taken ill, this time though often falling the fatal victim to the plague. Many problems now would arise: what to do with the bodies since there was no one who could dispose of them, and the mass-graves were soon going to be filled. The people of Constantinople began to place bodies anywhere they could. Bodies were placed in towers, on roofs, in water, and burned. Some were not dealt with at all, simply left in houses to rot. Famine set in to the city too, because mills where corn was ground stopped operating. (4) Money and food were handed out to these brave souls in the name of Justinian.
Just as the disease seemed to be at its peak, it disappeared. Winter halted the disease, along with the dispersion of people to the neighboring rural areas. The plague, however, held on to life. Though the bacteria retreated, it was by no means conquered. It would attack again in the 14th century with such fury that it would earn a new name. That name would strike terror in the hearts and minds of people for years to come -- Black Death.
Barker, John W. Justinian and the Later Roman Empire, (Madison; University of Wisconsin, 1966).
Great Disasters, (McGraw-Hill, 1989).
Browning, Robert. Justinian and Theodore, (New York; Praeger Publishers, 1971).
Byzantium, (New York; Time-Life, 1966).
"Medicine" in: World Book Encyclopedia (1989).