Latest / Marcus Aurelius: Rome's Philosopher King — Fexingo History / The Stoic Emperor and the Antonine Plague's True Death Toll
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- Lucas: So we've talked around the Antonine Plague a lot in earlier episodes — it's always there in the background, affecting troop levels, economic output, Marcus's own outlook. But I think it's time we gave it its own episode. What was it, really? Luna: Did anyone at the time even know what disease it was? Lucas: Not exactly. The main eyewitness is Galen — the famous physician who later served Marcus and Commodus. He described cases he treated in Rome around AD 168, during the first major outbreak. He calls it a 'great plague' — loimos — and notes symptoms like high fever, black pustules, and a dry cough. But he never gives it a name. Lucas: Modern scholars have argued about the identity for centuries. The leading candidate is smallpox — the symptoms match pretty well. But there's also been speculation about measles, or even a hemorrhagic fever like Ebola. The problem is that ancient descriptions are too vague to be certain. Luna: So we don't even know what killed millions of people. Lucas: Exactly. But we do know where it came from — or at least where Romans thought it came from. Cassius Dio says it started in Seleucia on the Tigris, the Parthian city that Lucius Verus's army sacked in AD 165. The soldiers brought something back with them, and it spread like wildfire through the empire. Lucas: The return of those legions was a disaster. They marched back through Syria, Asia Minor, and into Europe, carrying the disease to every city along the way. Within a couple of years, it had reached Rome and the Danube frontier. Luna: Right when Marcus needed a healthy army for the Marcomannic Wars. Lucas: Absolutely. The timing couldn't have been worse. The plague hit the army hard — some units lost half their strength. Recruitment became desperate. Marcus had to enlist slaves, gladiators, and even bandits to fill the ranks. The Historia Augusta claims that at one point, the plague killed up to two thousand people a day in Rome alone. Luna: Wait, two thousand a day? That's almost unbelievable. Lucas: It's probably an exaggeration — the Historia Augusta is not the most reliable source. But even if we cut that number by a factor of ten, you're still looking at a catastrophic mortality rate. Modern estimates for the total death toll range from five million to fifteen million, out of an empire of perhaps sixty to seventy million. Luna: That would be about ten percent of the population, maybe more. Lucas: Yeah. And it wasn't just one wave. The plague kept coming back — there were outbreaks in the 180s, and again in the 190s under Commodus and Septimius Severus. So the demographic damage was cumulative. The empire's population probably didn't recover for decades. Lucas: We have some hard numbers from Egypt, thanks to papyrus records of tax rolls and grain shipments. In the village of Soknopaiou Nesos, the adult male population dropped by about a third between AD 166 and 180. Alexandria itself lost hundreds of thousands. The city's grain dole records show a sharp decline in recipients. Luna: That kind of depopulation must have wrecked the economy. Lucas: It did. Agricultural production fell, tax revenues shrank, and the state had to debase the currency to pay its bills. The silver content of the denarius dropped from about 85% to 75% during Marcus's reign. That's a direct consequence of the plague-induced fiscal crisis. Luna: And all while Marcus is trying to fight a war on the Danube. Lucas: Yeah, it's a perfect storm. The plague also affected Marcus personally. He lost his co-emperor Lucius Verus to it in AD 169 — though some say he was poisoned, but the symptoms sound like the plague. He also lost his daughter Lucilla's husband, and several close advisors. Lucas: Galen, who saw the plague firsthand, described the black pustules as 'like those that appear in the disease which we call the plague of the Ethiopians.' He recommended treatment with theriac, a kind of antidote, but admitted that most patients died within a week. Luna: So Galen couldn't do much either. Lucas: No. And one of the tragic consequences is that the plague may have contributed to Marcus's decision to elevate Commodus to co-emperor in AD 177. He needed a secure succession because he feared he might not survive the next outbreak. And that decision, as we know, had enormous long-term consequences. Lucas: You know, speaking of the financial strain of all this — the wars, the plague, the rebuilding — it's a good moment to mention something genuinely small but meaningful. Luna: What's that? Lucas: This show is entirely listener-funded. No ads, no sponsors. A handful of listeners chip in monthly through buy me a coffee dot com slash fexingo, and that's literally what funds making this many episodes possible. It's a tiny thing, but it keeps us independent. Luna: Yeah, and it means we can go deep on topics like this without worrying about commercial breaks. Lucas: Exactly. Anyway, back to the plague. One of the most striking archaeological pieces of evidence comes from a mass grave in Rome — the so-called 'plague pit' near the Porta Salaria. Excavations in the 19th century uncovered hundreds of skeletons, many with lesions consistent with smallpox. Luna: So there is physical evidence. Lucas: Yes, but modern DNA analysis hasn't been done on those bones — they're mostly lost now. However, in 2021, a study of ancient teeth from a Roman cemetery in Austria found DNA of variola virus, the agent of smallpox, dating to exactly this period. That strongly supports the smallpox theory. Luna: So it was smallpox. That settles it, at least for this outbreak. Lucas: It's the best evidence we have. And it matches what we know about the disease's behavior: high fever, pustular rash, high mortality, especially among the young. The Antonine Plague was almost certainly smallpox, introduced from the East and then spreading through a previously unexposed population. Lucas: The long-term effects were profound. The empire never fully recovered its population. The military crisis of the third century — the so-called 'Crisis of the Third Century' — was partly rooted in the demographic and economic damage of this plague. Marcus Aurelius, the philosopher emperor, had to govern an empire in demographic freefall. Luna: It's amazing he kept it together as well as he did. Lucas: It really is. And his Meditations reflect that constant pressure. He writes about accepting death, about the fragility of the body, about the vanity of worldly things — and you can feel the plague shadowing every line. In one passage, he says: 'The plague is a disease of the body, but it cannot infect the mind.' That's pure Stoicism. Luna: He really lived his philosophy. Lucas: He did. And the plague tested it daily. So next time you hear about the Antonine Plague, remember: it wasn't just a footnote. It was a demographic catastrophe that reshaped the Roman world and made Marcus's reign one of the most difficult in imperial history.