The art of healing - Roman and Byzantine Military & General Medicine

A scene from Book XII of the Aeneid: the physician Iapyx treats the
wounded Aeneas, who is supported by his weeping son Ascanius.

A Matter of Life and Death

Good health has always been a concern. But keeping the troops 

ready to fight is a priority for governments.

(From the Daily Sabah)  -  The Suna and İnan Kıraç Foundation Pera Museum is hosting an exhibition titled "Life is Short, Art Long: The Art of Healing in Byzantium" to shed light on the medical history of the world during its 10th year anniversary. Curated by Brigitte Pitarakis, the display explores the healers of antiquity from Apollo and Asklepios to the founders of rational medicine, Hippocrates and Dioscorides, as well as the healing methods of the Byzantines including faith, magic and rational medicine, healing and miracle centers in Constantinople as well as the roles of physicians and saints in medicine through icons, reliquaries, amulets, marble carvings, medical equipment, plants and herbs and medical and botanical manuscripts.

Health has been always one of the most important subjects for mankind. Studying a civilization through a perspective of their approach to the body in terms of health and illness reveals the depths of its identity. "Life is Short, Art Long: The Art of Healing in Byzantium" offers a brief glance to Byzantine civilization and its community through three traditional healing methods: Faith, magic and medicine. The display reveals the effects of the Byzantine Empire's ancient cultural heritage on religious and rational thinking as well as contemporary scientific developments and innovations around the Mediterranean. Moreover, the important role of the Byzantine Empire in passing down the secrets of art of healing to the future generations is emphasized through the exhibition as well. 

The exhibition exposes that the belief that illnesses used to be caused by demons, which was a common thought based on the teachings of Hippocrates. This belief coexisted alongside a rational understanding of health and medicine. The display also explores the daily rituals conducted by physicians, saints and magicians in order to cleanse body and soul.

Basil of Caesarea
Byzantium was the first empire in which dedicated medical establishments flourished. These were usually set up by individual churches or the state and parallel modern hospitals in many ways. The first hospital was built by Basil of Caesarea in the late a.d. 4th century.  By the 8th and 9th centuries hospitals began to appear in provincial towns as well as the cities.

Religious images in Byzantine times

Representations of Christ, his miracles and the saints had the function of conveying the biblical story as well as teaching about saints and the Church calendar commemorating them. They also served as an accompaniment to prayer and veneration in church and in private worship. In addition to the conventional nimbus evoking divine grace, the main features of saints, their dress and their attributes, were individualized and consistently represented to allow the faithful to recognize and relate to as well as venerate. Each saint's dress and attributes identified the nature of his or her power. The bishops and deacons recall the recitation of the liturgy, warriors in full military attire do battle with the devil and physicians, their surgery instruments and medicine pots in hand, stand ready to heal the bodies and souls of the faithful.

Demons, symbols and the cosmos

Beliefs surrounding illness and healing in Byzantium stem from the myths, astrology and magic practiced around the Mediterranean by Jews, Egyptians, Mesopotamians and Greeks. Amulets were widely prescribed, even by medical treatises, against demonic invasion, thought to be a primary cause of illness. One also finds green jasper gemstones featuring the lion-headed serpent Chnoubis, hematite stones showing Herakles fighting the Nemean lion and octagonal rings invoking solar symbolism and resurrection that feature astral lions.

Wondrous cures in Constantinople

The shrines that created the glory of Constantinople through their lavish beauty were also repositories of precious relics and thus, sources of healing. Early on, the city was placed under the protection of the Virgin Mary, who sanctified the waters of numerous springs there. In addition to such all-encompassing healing places as the shrine of the physician saints Kosmas and Damian near Eyüp, there were also specialized shrines, like St. Artemios for curing male-oriented diseases and St. Anastasia for mental illness.

Fear of pain, surgery, hemorrhages and infection led many among the faithful to turn to the saints whose healing interventions were painless, immediate and free of charge. Expressions of thanksgiving after miraculous cures contributed to shrines' wealth and fame. Often, the imperial couple influenced devotional practices at healing shrines, as did Leo VI and Zoe, whose son Constantine VII Porphyrogennetos (b. 905) was born after the intervention of the Virgin of Pege.

The medical art

Hippocrates was born on the Aegean island of Kos around 460 B.C., the golden era of ancient Greece. Celebrated as the "father of medicine," he developed a system of rational medicine in which supernatural precepts played a minimal role. Hippocrates characterized the substance of medicine as a "techne" (art) with distinct limits. The medical art requires particular skills that involve training, and the incurable is beyond the boundaries of this art.

Byzantine surgery to separate conjoined twins.

The physician must not only have specialized knowledge of the body, but also a broad understanding of the workings of nature and the cosmos. Hippocratic medicine requires that physicians treat the patient as a whole, not merely its parts. The aim of therapeutic practices is to restore the body's natural balance, a peculiar kind of art. The first aphorism of Hippocrates declares that a lifetime would not be long enough to achieve perfection in this art.

The practice of rational medicine
Byzantine medical art was grounded in the Greco-Roman medicinal tradition transmitted by Hippocrates and Galen and new concepts introduced by such physicians as Oribasios of Pergamon, Aetios of Amida, Alexander of Tralles and Paul of Aegina. The 12th century ushered in a significant transfer of knowledge between Byzantium and the Arab and Persian worlds as well.

Men as well as women practiced medicine. Theoretical teaching was coupled with a practical internship in a hospital. Diagnosis relied on analysis of the pulse and urine. Diet and bathing were integral parts of remedies. External remedies included casts, ointments and eyewashes, while internal treatments ranged from pills, powders and oils to gargles, enemas and infusions.

Ophthalmological diseases, epilepsy, hernias and gout were among the most common afflictions. The Byzantines' successful system of hospitals performed more than 100 different surgical procedures, including mastectomy, aneurysmectomy and trepanation along with ear and nose reconstructions. Moreover, some surgical instruments of great utility are still used today.

Treatment with medicinal herbs

Knowledge of plants and the practice of healing are closely entwined. The toxic or hallucinogenic nature of some roots and the dangers associated with picking them conferred a mythical or magical character and power. Pedanius Dioscorides (ca. 40A.D. to 90 A.D.), a physician from Anazarbus,in Cilicia, described more than 500 plants and alimentary products, including medicinal uses, preparations and dosages in "De Materia Medica" (On Medical Substances). Those recorded included varieties from the Mediterranean basin and an array of prized exotic plants. The transmission of "De Materia Medica," including its translation into Arabic and Latin, was made possible through Byzantine manuscripts, the earliest surviving witnesses of the text.

Galen of Pergamon (ca. 129 A.D. to 216 A.D.), a physician and surgeon, employed medicinal plants individually and as complex concoctions devised for specific therapies. His "theriac" (antidote) for Emperor Marcus Aurelius consisted of more than 70 ingredients, among them opium. His pharmacopoeia also covered cosmetics and commotics.

Roman Auxiliary reenactors - Photo timetrips.

Roman Military Medicine

Under Emperor Augustus for the first time occupational names of officers and functions began to appear in inscriptions. Caches of surgical instruments have been found in some legion camps. From this indirect evidence it is possible to conclude to the formation of an otherwise unknown permanent medical corps.

k

The term medici ordinarii in the inscriptions must refer to the lowest ranking military physicians. No doctor was in any sense “ordinary”. They were to be feared and respected, just as they are today. During his reign, Augustus finally conferred the dignitas equestris, or social rank of knight, on all physicians, public or private. They were then full citizens (in case there were any Hellenic questions) and could wear the rings of knights. In the army there was at least one other rank of physician, the medicus duplicarius, “medic at double pay”, and, as the legion had milites sesquiplicarii, "soldiers at 1.5 pay", perhaps the medics had that pay grade as well.

kk

Trajan's Column depicts medics on the battlefield bandaging soldiers. They were located just behind the standards; i.e., near the field headquarters. This must have been a field aid station, not necessarily the first, as the soldiers or corpsmen among the soldiers would have administered first aid before carrying their wounded comrades to the station. Some soldiers were designated to ride along the line on a horse picking up the wounded. They were paid by the number of men they rescued. Bandaging was performed by capsarii, who carried bandages (fascia) in their capsae, or bags.

From the aid station the wounded went by horse-drawn ambulance to other locations, ultimately to the camp hospitals in the area. There they were seen by the medici vulnerarii, or surgeons, the main type of military doctor. They were given a bed in the hospital if they needed it and one was available. The larger hospitals could administer 400-500 beds.

.

The posts of medicus legionis and a medicus cohortis were most likely to be commanders of the medici of the legion and its cohorts. They were all under the praetor or camp commander, who might be the legatus but more often was under the legatus himself. There was, then, a medical corps associated with each camp. The cavalry alae (“wings”) and the larger ships all had their medical officers, the medici alarum and the medici triremis respectively.

From Roman Empire.net

The Roman Legions were highly structured and very efficient. By the time the Roman military medical service became a standard part of the legions, the Roman military medical service was also highly organized and efficient. Most sources suggest that the Roman medical service expanded on the Greek military variety of purposes.

The Roman author Vegetius wrote that the Roman army should be "preserved" by providing a good, clean water supply, taking seasonal considerations into account, the use of medicine, and exercise for the troops. Specifically, Vegetius suggested that commanders not march the troops in the hot sun or in freezing weather and that they provide the troops with clean drinking water at all times. Once more, he said that sick soldiers should be "brought back to health by suitable food and cured by the skills of doctors." Likewise, it was recognized that soldiers could get sick from overeating after experiencing a famine. Most important, as recognized in today's best armies, the ranks of the Roman armies were filled with only the most physically fit soldiers, who had to pass a medical examination before their service began.

In the early days of Roman military medicine, there was little distinction between medical and veterinary services, and human and animal hospital services were set up side by side. Later, when formal medical service became as highly organized as the rest of the Roman army, a praefectus castrorum was placed in overall charge of medical services. The optio valentudinarii were responsible for running the hospitals at legion fortresses. Wounded soldiers were cared for by medics called capsarii, who carried bandage boxes.

Archaeologists have found medical instruments at Roman forts and campsites that are classified as probes, spatulas, spoons, tweezers, scalpels, lances, curved and straight needles, medical glassware, small vessels, and ointment boxes. One of the most prolific Roman army medical service archaeology sites is at Baden, Germany, where the remains of a Roman military hospital were excavated. Artifacts described as earscoops, catheters, spoons, and other medical equipment were found. Coins found in association with the medical equipment showed the fort was active between A.D. 100 and 200.

A military hospital unearthed at Vetera (now Xanten, Germany) revealed hospital wards, rooms full of medical instruments, surgical suites, convalescence rooms, and possibly mortuaries. Among the discovered artifacts were levers and scoops thought to be used for extracting missiles from the body and notched probes that may have been used for extracting arrowheads after the arrow shaft was broken off. Although later than the heyday of the Roman legions, surgeon Paul of Aegina described how stones and other missiles from slings were to be removed by an ear probe, modified for the job at hand by adding a scoop.

.

Roman army records show that Celsus suggested using a "weapon extractor." Celsus noted that missiles that have entered the body and become fixed inside "are frequently troublesome to extract," because of their shape, size, or the way they have penetrated. "If the head of the weapon has fixed in the flesh," he wrote, "it is to be drawn out with the hands or by laying ahold of the appendage which is called the shaft, if it has not fallen off. When it has fallen out we make the extraction by means of a toothed forceps." 

Celsus went on to say that when he saw a curable wound he looked at two things: preventing hemorrhage and preventing inflammation. He suggested vinegar to staunch the flow of blood yet said that to prevent inflammation, blood must flow. He noted that inflammation was more likely when bone, sinew, cartilage, or muscle was injured. "If the wound is in a soft part, it must be stitched," he noted. "But if the wound is gaping, stitching is not suitable." Celsius also wrote on bandages, preferring bandages of wide linen "sufficiently wide to cover in a single turn not only the wound but to a little extent the edges on both sides."

From Roman Empire.net

Roman industrial arts also aided in the cause of treating wounded soldiers. New metal alloys of bronze and silver provided sharper edges and were less expensive to manufacture. Because of rust, iron was not used for medical instruments. Artwork as well as poetry from just before and after the first century A.D. depict Roman army doctors removing arrows from soldiers.

Amputations were also performed by Roman military doctors. Celsus may have been one of the first military surgeons to discuss the merits of amputating above or through the damaged flesh. He advocated cutting only through good flesh and then sawing through the bone as close as possible to the good flesh, but leaving enough good flesh as a flap to cover the bone.

Roman army doctors also had a firm knowledge of pharmacology. Many medicines mentioned by Celsus are not unlike those of today made for the same purposes. Archaeologists have found the remains of five medicinal plants at Roman fort excavations. St. John's wort, used for blood ailments; fenugreek for poultices; figs for treating wounds; and plantain for dysentery have been found. Medicated wine was also thought to have been used. Some historians have suggested that the courtyard of each Roman army hospital was laid out as a garden for growing medicinal herbs.

The axiom "an army marches on its stomach" could well date to Roman times. Records show that Roman doctors knew that a balanced diet was necessary for healthy troops. Sources suggest that Roman soldiers were kept fed with corn, cheese, ordinary wine, fresh fruit, and vegetables. Bread was considered the most nutritious food, and each soldier received a ration of panis militaris--army bread made of wholemeal. Special diets were prepared for sick and wounded soldiers. Garden peas, lentils, and figs seemed to be popular for treating the sick.

Roman army doctors also understood that soldiers were prone to overeating after a battle or after going without food for a long time. The Roman historian Appian wrote after the siege of Mutina in 43 B.C. that a number of soldiers fell sick after "excessive eating." The Roman remedy--drinking a concoction of wine and olive oil--probably cured many.

Not only did Roman military medical instruments influence military doctors for the next millennium, their experience and their records, particularly those kept by Celsus and Galen, directly influenced future military surgeons, who improved the art and science of military medicine in the eighteenth and nineteenth centuries.

Modern reconstruction of 15th century Byzantine archer.

Byzantine Military Medical Corps

The Western Empire may have fallen in 476AD, but there would have been no sharp break in military formations, organization and command structure for the surviving armies of the Eastern Empire. 

Soldiers were still being wounded and treatment would still be needed. The medical units attached to Eastern Roman Legions would have continued. The medical lessons learned on the Roman battlefields would naturally have been passed down to future generations of military doctors.

k

Serious detailed contemporary Byzantine military histories are thin at best. It is hard enough to get an account of a battle. Reports on the medical care given to the troops after the battle are neglected.

k

Byzantines at Sea - A 7th century manuscript by Paul of Egina remarks on medical men at sea. In his De Re Medica Paul reminds the seagoing physician of the importance of taking with him text books on healing. Ships would be in remote locations where immediate treatment was needed to prevent death. Paul's remarks were directed at government officials (navy) as well as private merchant ships.

.

The large Byzantine Navy, with thousands of men, was a vital part of the defense of the Empire. It is logical to assume that there would be a degree of medical care to keep the sailors fit for battle and to treat the wounded. Though we lack details we can assume some type of naval medical service would have been active at sea.

k

Byzantine Army - The many lessons learned over the centuries would have continued in the Eastern Armies.

We do not have a lot of detail, but both the Emperors Maurice (582-602) and Leo IV (886-912) wrote on medical subjects. The Eastern Army had deputati and scribones - first-aid men.  

Maurice says it was their duty to rush into the thick of battle are carry out wounded soldiers to the rear. For the cavalry there would be a unit of 8 to 18 men assigned to each detachment of 200 to 400 men. They would follow some 200 feet behind the front line troops in order to bring the badly wounded away from danger. To that end, the saddles of their horses had two ladder-stirrups on the left side, and flasks of water to revive the faint.

The bearers received a piece of gold for every wounded soldier rescued. After the battle they collected the arms of the wounded and of the survivors to prevent plundering. They would also get a share of any booty.

The same organization is described 300 years later by Leo and showed the rigidity of Byzantine administration.

Army surgeons were classified as non-combatants. The litter bearers were selected from the weaker elements of the command and the old arrangement of the ladder-stirrups and water flasks was still in place.

The Emperor Leo writes: "Give all the care you possibly can to your wounded, for if you neglect them, you will make your soldiers timorous and cowardly before the battle, and, not only that, but your personnel, whom you might preserve and retain by proper consideration for their health and welfare, will otherwise be lost to you through your own negligence."

k

I suspect that many of the wounded troopers (perhaps based on rank?) many have been referred to the system of Byzantine hospitals. The Byzantines appear to have provided asylums for disabled soldiers. Emperor Justin II (565-578) had the Lobotropheion. Emperor Alexis Comneus I (1081-1118) had the Orphanotropheion for sick and invalided soldiers.

A
The Hospital of Sampson was located between the Hagia Eirene and Hagia Sophia.  
All were destroyed by fire during the Nika Riot in 532. They were subsequently restored by Emperor Justinian.
.
This image used under FAIR USE from Byzantium1200.
'
Doctors themselves were well trained. Some attended the University of Constantinople, as medicine had become a scholarly subject by the period of Byzantium. Despite the prominence of the great physicians of antiquity, its status as a science was greatly improved through its application in formal education, particularly in the University of Constantinople. This rigidity through professionalism (similar to the professionalism exhibited in the Byzantine bureaucracy) bears many hallmarks of today's modern hospitals, and many comparisons are made by modern scholars studying this field.
.
We know that in the 12th century, Constantinople had two well organized hospitals staffed by medical specialists (including women doctors), with special wards for various types of diseases and systematic methods of treatment.
.
The Princess Anna Komnene was capable not only on an intellectual level but also in practical matters. Her father placed her in charge of a large hospital and orphanage that he built for her to administer in Constantinople. The hospital was said to hold beds for 10,000 patients and orphans. Anna taught medicine at the hospital, as well as at other hospitals and orphanages. She was considered an expert on gout. Anna treated her father during his final illness.

(daily sabah)      (Military Surgeon)      (Military Medicine of Ancient Rome)

(Byzantine medicine)      (Medical community of ancient Rome)    (Military Medicine)

The Black Death of the Roman Empire



Illustration of the Black Death from the Toggenburg Bible (1411)

The Great Pestilence (A.D. 542‑543)

Long before the famous Black Death of the Middle Ages, the Eastern Roman Empire was devastated by the plague.  The massive deaths weakened the Empire and its economy.

History of the Later Roman Empire
by J. B. Bury
(1923)

Justinian had been fourteen years on the throne when the Empire was visited by one of those immense but rare calamities in the presence of which human beings could only succumb helpless and resourceless until the science of the nineteenth century began to probe the causes and supply the means of preventing and checking them.

.

The devastating plague, which began its course in the summer of A.D. 542 and seems to have invaded and ransacked nearly every corner of the Empire, was, if not more malignant, far more destructive, through the vast range of its ravages, than the pestilences which visited ancient Athens in the days of Pericles and London in the reign of Charles II; and perhaps even than the plague which travelled from the East to Rome in the reign of Marcus Aurelius. It probably caused as large a mortality in the Empire as the Black Death of the fourteenth century in the same countries.

.

The infection first attacked Pelusium, on the borders of Egypt, with deadly effect, and spread thence to Alexandria and throughout Egypt, and northward to Palestine and Syria. In the following year it reached Constantinople, in the middle of spring, and spread over Asia Minor and through Mesopotamia into the kingdom of Persia. Travelling by sea, whether from Africa or across the Adriatic, it invaded Italy and Sicily.

.

It was observed that the infection always started from the coast and went up to the interior, and that those who survived it had become immune. The historian Procopius, who witnessed its course at Constantinople, as Thucydides had studied the plague at Athens, has detailed the nature and effects of the bubonic disease, as it might be called, for the most striking feature was a swelling in the groin or in the armpit, sometimes behind the ear or on the thighs.

.

Hallucinations occasionally preceded the attack. The victims were seized by a sudden fever, which did not affect the colour of the skin nor make it as hot as might be expected.

The outbreak in Constantinople was thought to have been carried to the city by infected rats on grain boats arriving from Egypt. To feed its citizens, the city and outlying communities imported massive amounts of grain—mostly from Egypt. Grain ships may have been the original source of contagion, as the rat (and flea) population in Egypt thrived on feeding from the large granaries maintained by the government. The Byzantine historian Procopius first reported the epidemic in AD 541 from the port of Pelusium, near Suez in Egypt.

The Roman Emperor Justinian I
The Emperor contracted the disease himself yet survived.  The plague, which lasted from 541 to 543 decimated the Empire's population, and probably created a scarcity of labor and a rising of wages. The lack of manpower also led to a significant increase in the number of "barbarians" in the Byzantine armies after the early 540s

The Angel of Death comes.

_______________________________________

The Historian Procopius Says -

 

 

"The fever was of such a languid sort from its commencement and up till evening that neither to the sick themselves nor a physician who touched them would it afford any suspicion of danger. . . . But on the same day in some cases, in others on the following day, and in the rest not many days later a bubonic swelling developed. . . . Up to this point everything went in about the same way with all who had taken the disease. But from then on very marked differences developed. . . . There ensued with some a deep coma, with others a violent delirium, and in either case they suffered the characteristic symptoms of the disease. For those who were under the spell of the coma forgot all those who were familiar to them and seemed to be sleeping constantly. And if any one cared for them, they would eat without waking, but some also were neglected and these would die directly through lack of sustenance."

.

"But those who were seized with delirium suffered from insomnia and were victims of a distorted imagination; for they suspected that men were coming upon them to destroy them, and they would become excited and rush off in flight, crying out at the top of their voices. And those who were attending them were in a state of constant exhaustion and had a most difficult time. . . . Neither the physicians nor other persons were found to contract this malady through contact with the sick or with the dead, for many who were constantly engaged either in burying or in attending those in no way connected with them held out in the performance of this service beyond all expectation. . . . [The patient] had great difficulty in the matter of eating, for they could not easily take food. And many perished through lack of any man to care for them, for they were either overcome with hunger, or threw themselves from a height."

.

Procopius continues, "And in those cases where neither coma nor delirium came on, the bubonic swelling became mortified and the sufferer, no longer able to endure the pain, died. And we would suppose that in all cases the same thing would have been true, but since they were not at all in their senses, some were quite unable to feel the pain; for owing to the troubled condition of their minds they lost all sense of feeling."

 

"Now some of the physicians who were at a loss because the symptoms were not understood, supposing that the disease centred in the bubonic swellings, decided to investigate the bodies of the dead. And upon opening some of the swellings they found a strange sort of carbuncle [ἄνθραξ] that had grown inside them."

"Death came in some cases immediately, in others after many days; and with some the body broke out with black pustules about as large as a lentil, and these did not survive even one day, but all succumbed immediately. With many also a vomiting of blood ensued without visible cause and straightway brought death. Moreover I am able to declare this, that the most illustrious physicians predicted that many would die, who unexpectedly escaped entirely from suffering shortly afterwards, and that they declared that many would be saved who were destined to be carried off almost immediately. . . . "

 

"While some were helped by bathing others were harmed in no less degree. And of those who received no care many died, but others, contrary to reason, were saved. And again, methods of treatment showed different results with different patients. . . . And in the case of women who were pregnant death could be certainly foreseen if they were taken with the disease. For some died through miscarriage, but others perished immediately at the time of birth with the infants they bore. However they say that three women survived though their children perished, and that one woman died at the very time of child-birth but that the child was born and survived."

.

"Now in those cases where the swelling rose to an unusual size and a discharge of pus had set in, it came about that they escaped from the disease and survived, for clearly the acute condition of the carbuncle had found relief in this direction, and this proved to be in general an indication of returning health. . . . And with some of them it came about that the thigh was withered, in which case, though the swelling was there, it did not develop the least suppuration. With others who survived the tongue did not remain unaffected, and they lived on either lisping or speaking incoherently and with difficulty."

_____________________________________

 

Dead?  -  You Must Still Pay Taxes.
"When pestilence swept through the whole known world and notably the Roman Empire, wiping out most of the farming community and of necessity leaving a trail of desolation in its wake, Justinian showed no mercy towards the ruined freeholders. Even then, he did not refrain from demanding the annual tax, not only the amount at which he assessed each individual, but also the amount for which his deceased neighbors were liable."
Procopius
Secret History

This description shows that the disease closely resembled in character the terrible oriental plague which devastated Europe and parts of Asia in the fourteenth century. In the case of the Black Death too the chief symptom was the pestboils, but the malady was generally accompanied by inflammation of the lungs and the spitting of blood, which Procopius does not mention.

.

In Constantinople the visitation lasted for four months altogether, and during three of these the mortality was enormous. At first the deaths were only a little above the usual number, but as the infection spread 5000 died daily, and when it was at its worst 10,000 or upward. This figures are too vague to enable us to conjecture how many of the population were swept away; but we may feel sceptical when another writer who witnessed the plague assures us that the number of those who died in the streets and public places exceeded 300,000.

If we could trust the recorded statistics of the mortality in some of the large cities which were stricken by the Black Death — in London, for instance, 100,000, in Venice 100,000, in Avignon 60,000 — then, considering the much larger population of Constantinople, we might regard 300,000 as not an excessive figure for the total destruction. For the general mortality throughout the Empire we have no data for conjecture; but it is interesting to note that a physician who made a careful study of all the accounts of the Black Death came to the conclusion that, without exaggeration, Europe (including Russia) lost twenty-five millions of her inhabitants through that calamity.

At first, relatives and domestics attended to the burial of the dead, but as the violence of the plague increased this duty was neglected, and corpses lay forlorn not only in the streets, but even in the houses of notable men whose servants were sick or dead.

Aware of this, Justinian placed considerable sums at the disposal of Theodore, one of his private secretaries, to take measures for the disposal of the dead. Huge pits were dug at Sycae, on the other side of the Golden Horn, in which the bodies were laid in rows and tramped down tightly; but the men who were engaged on this work, unable to keep up with the number of the dying, mounted the towers of the wall of the suburb, tore off their roofs, and threw the bodies in.

Virtually all the towers were filled with corpses, and as a result "an evil stench pervaded the city and distressed the inhabitants still more, and especially whenever the wind blew fresh from that quarter." It is particularly noted that members of the Blue and Green parties laid aside their mutual enmity and co-operated in the labour of burying the dead.

During these months all work ceased; the artisans abandoned their trades. "Indeed in a city which was simply abounding in all good things starvation almost absolute was running riot. Certainly it seemed a difficult and very notable thing to have a sufficiency of bread or of anything else." All court functions were discontinued, and no one was to be seen in official dress, especially when the Emperor fell ill. For he, too, was stricken by the plague, though the attack did not prove fatal.

Our historian observed the moral effects of the visitation. Men whose lives had been base and dissolute changed their habits and punctiliously practised the duties of religion, not from any real change of heart, but from terror and because they supposed they were to die immediately. But their conversion to respectability was only transient. When the pestilence abated and they thought themselves safe they recurred to their old evil ways of life. It may be confidently asserted, adds the cynical writer, that the disease selected precisely the worst men and let them go free.

.

Fifteen years later there was a second outbreak of the plague in Constantinople (spring A.D. 558), but evidently much less virulent and destructive. It was noticed in the case of this visitation that females suffered less than males.

 

Inspired by the Black Death, The Dance of Death, an allegory on the universality of death, is a common painting motif in the late medieval period.

Bubonic plague victims in a mass grave from 1720-1721 in Martigues, France

.
The plague weakened the Eastern Roman Empire at a critical point, when Justinian's armies had nearly retaken all of Italy and the western Mediterranean coast; this evolving conquest could have credibly reformed the Western Roman Empire and reunited it with the Eastern under a single Emperor for the first time since 395.
.
As a result of plague in the countryside, farmers could not take care of crops and the price of grain rose at Constantinople. Justinian had expended huge amounts of money for wars against the Vandals in the Carthage region and the Ostrogothic kingdom of Italy. He had dedicated significant funds to the construction of great churches, such as Hagia Sophia.
.
As the empire tried to fund these projects, the plague caused tax revenues to decline, possibly due to so many deaths and the disruption of agriculture and trade. Justinian swiftly enacted new legislation to deal more efficiently with the glut of inheritance suits being brought as a result of victims dying intestate.
.
The number of deaths will always be uncertain. Modern scholars believe that the plague killed up to 5,000 people per day in Constantinople at the peak of the pandemic. The initial plague ultimately killed perhaps 40% of the city's inhabitants and caused the deaths of up to a quarter of the human population of the eastern Mediterranean. Frequent subsequent waves of the plague continued to strike throughout the 6th, 7th and 8th centuries, with the disease becoming more localized and less virulent. One high estimate is that the Plague of Justinian killed as many as 25 million people across the world.
^.
After the last recurrence in 750, major epidemic diseases did not appear again in Europe until the Black Death of the 14th century.

 

J.B. Bury - The History of the Later Roman Empire

(The Plague of Justinian)

The Roman Suppression of Paganism

The Pagans were right about the Christians

• Once in power the Christians of the Roman Empire did everything possible to prevent freedom of religion with persecutions of their fellow Christians, Jews and Pagans of all types.

Yes, the Pagans were right.  Christianity was a threat to to the Empire.

Freedom of Religion  -  Considering 2,000 years of Christian propaganda, as strange as it may sound, the Roman Empire mostly practiced freedom of religion.

As we all know Rome ruled over an enormous Empire from Scotland to the Pillars of Hercules to Persia.  The Empire consisted of hundreds and hundreds of languages, races, tribes, ethnic groups and religions.  As long as the locals paid their taxes and did not present a political threat to the Empire their local religions and customs were pretty much ignored.

But Christians believed they were the "True Faith".  As true believers tolerating other faiths was not high on their list.  The Romans rightly felt Christians wanted to undermine the government and persecutions of Christians occurred.

Mars - the Roman god of war.
 Mars was also an agricultural guardian. He
was second in importance only to Jupiter,
and he was the most prominent of the
military gods worshipped by the
Roman legions.

With the adoption of Christianity by Constantine I, heresy had become a political issue in the late Roman empire. Adherents of unconventional Christian beliefs not covered by the Nicene Creed like Novatianism and Gnosticism were banned from holding meetings, but the Roman emperor intervened especially in the conflict between orthodox and Arian Christianity, which resulted in the burning of Arian books

The persecution of pagans by the Christian Roman Empire began late in the reign of Constantine the Great, when he ordered the pillaging and the tearing down of some temples.

The first anti-Pagan laws by the Christian state started with Constantine's son Constantius II, who was an unwavering opponent of paganism.  He ordered the closing of all pagan temples, forbade Pagan sacrifices under pain of death, and removed the traditional Altar of Victory from the Senate. Under his reign ordinary Christians started vandalizing many of the ancient Pagan temples, tombs and monuments.

From 361 till 375, Paganism was relatively tolerated, until three Emperors, Gratian, Valentinian II and Theodosius I, under Bishop of Milan Saint Ambrose's influence, reinstituted and escalated the persecution.

Under pressure from the zealous Ambrose, Theodosius issued the infamous 391 "Theodosian decrees," a declaration of war on paganism, the Altar of Victory was removed again by Gratian, the Vestal Virgins were disbanded, and access to Pagan temples was prohibited.

In 382, Emperor Gratian appropriated the income of the Pagan priests and Vestal Virgins, confiscated the possessions of the priestly colleges and ordered the Altar of Victory removed again. The colleges of Pagan priests also lost all their privileges and immunities. Gratian declared that all of the Pagan temples and shrines were to be confiscated by the government and that their revenues were to be joined to the property of the royal treasury.

In the year 391, Emperor Valentinian II issued a law that not only prohibited sacrifices but also forbade anyone from visiting the temples. This again caused turbulence in the West. Valentinian II quickly followed this law with a second one, which declared that Pagan temples were to be closed, a law that was viewed as practically outlawing Paganism.

Worship in Rome (HBO) 

Neptune - the Roman god of water and the sea.
He is the counterpart of the Greek god Poseidon. Neptune was the brother of Jupiter and Pluto, each of them presiding over one of the three realms of Heaven, Earth and the Underworld.

The Christian persecution of paganism under Theodosius I began in 381, after the first couple of years his reign in the Eastern Roman Empire. In the 380s, Theodosius I reiterated Constantine's ban on Pagan sacrifice, prohibited haruspicy on pain of death, pioneered the criminalization of Magistrates who did not enforce anti-Pagan laws, broke up some pagan associations and destroyed Pagan temples.

Between 389-391 he emanated the infamous "Theodosian decrees," which established a practical ban on paganism; visits to the temples were forbidden, remaining Pagan holidays abolished, the eternal fire in the Temple of Vesta in the Roman Forum extinguished, the Vestal Virgins disbanded, auspices and witchcraft punished. Theodosian refused to restore the Altar of Victory in the Senate House when asked to do so by Pagan Senators.

In 392 he became emperor of the whole empire (the last to do so). From this moment till the end of his reign in 395, while Pagans remained outspoken in their demands for toleration, he authorized or participated in the killing of pagan priests, destruction of many temples, holy sites, images and objects of reverence throughout the empire and participated in actions by Christians against major Pagan sites. He likely suppressed the Ancient Olympic Games; the last record of the Olympics being celebrated in ancient Rome is from 393.

Temple of Isis  -  Pompeii
Image from Ancientvine.com - Temple of Isis.

Persecution in the Eastern Roman Empire

Theodosius II anti-Pagan laws since 425

Theodosius II enacted two anti-Pagan laws in the year 425. The first of these stipulated that all Pagan superstition was to be rooted out. The second law barred Pagans from pleading a case in court and also disqualified them from serving as soldiers. Theodosius II then left Valentinian III to rule the west and returned to Constantinople.

The numerous laws against Pagans seems to have had only limited immediate effect in stamping out the old religion. Many people simply conformed outwardly and pretended to become Christian while secretly continuing to practice their beliefs. The numerous laws against apostasy, that had been continuously promulgated since the time of Gratian and Theodosius, is evidence that the emperors were having a hard time even keeping Christians from going astray.

Bust of Germanicus defaced by
Christians with a cross on the head.

In the year 426, Theodosius II made it illegal for Christian apostates to convert to the old religion, and against those who pretended to become Christian but continued to perform Pagan sacrifices. He found it necessary to reiterate his prohibition of Pagan rites and sacrifices in 435, this time increasing the penalty to death.

This law also ordered that all Pagan shrines, temples and sanctuaries that still existed were to be destroyed by the magistrates. Magistrates who failed to carry out this order were ordered to be punished with death. In 438 Theodosius legislated again, forbidding Pagan sacrifice once more.

Theodosius seems to admit that Pagan sacrifices were still seemingly being openly celebrated in places.


It reads:

Hence our clemency perceives the need of keeping watch over the Pagans and their heathen enormities, since by natural depravity and stubborn lawlessness, they forsake the path of true religion. They disdain in any way to perform the nefarious rites of sacrifice and the false errors of their baleful superstition by some means or other in the hidden solitudes, unless their crimes are made public by the profession of their crimes to insult divine majesty and to show scorn to our age. Not the thousand terrors of laws already promulgated nor the penalty of exile pronounced upon them deter these men, whereby, if they cannot reform, at least they might learn to abstain from their mass of their crimes and the multitude of their sacrifices. But their insane audacity transgresses continually; our patience is exhausted by their wicked behavior so that if we desired to forget them, we could not disregard them.

Anti-Pagan laws by Marcian (450-457)

The continued vitality of pagans led Marcian, who became emperor of the east in 450 upon the death of Theodosius II, to repeat earlier prohibitions against Pagan rites. Marcian decreed, in the year 451, that those who continued to perform the Pagan rites would suffer the confiscation of their property and be condemned to death.

Marcian also prohibited any attempt to re-open the temples and ordered that they were to remain closed. In addition to this, in order to encourage strict enforcement of the law a fine of fifty pounds of gold was imposed on any judge or governor, as well as the officials under him, who did not enforce this law. However, not even this act by Marcian had the desired effect, as his successor Leo I the Thracian will have to issue a new anti-Pagan law in 472.

Two more laws against Paganism, which may be from this period, are preserved in the Justinian Code. After the deposition of Avitus, who ruled as emperor of the West from 455 to 456, there seems to have been a conspiracy among the Roman nobles to place the Pagan general Marcellinus on the throne to restore Paganism; but it came to nothing.

Temple of Bacchus  -  Lebanon
The Baalbeck’s temples were built around the first millennium B.C. The enclosed court was built on the ancient tell. The more accurate history of Baalbeck first begins during the Hellenistic period (333-64 B.C.). The Greeks identified the god of Baalbeck with the sun god and enlarged the court. The temple was begun in the last quarter of the first century B.C., and was nearing completion in the last years of Nero’s reign. The Great Court Complex of the Temple of Jupiter was built in the second century A.D. The other addendum courts to the Jupiter Temple were added in the third century.
.
Antoninus Pius (138-161) built the Temple of Bacchus, the best preserved of the sanctuary's structures, for it was protected by the rubble of the site's ruins. It is enriched with refined reliefs and sculpture. Septimius Severus (193-211) added a pentagonal temple of Venus, who as Aphrodite had enjoyed an early Syrian role with her consort Adonis ("Lord", the Aramaic translation of "Baal."). Emperor Philip the Arab (244–249) was the last to add a monument at Heliopolis: the hexagonal forecourt. When he was finished Heliopolis and Praeneste in Italy were the two largest sanctuaries in the Western world.
.
     The Baalbeck temples were closed in 313 A.D. by order of the Emperor Constantine.

Attempted Pagan revival by Anthemius

Anthemius, one of the last Roman emperors of the West who ruled from 467 to 472, seems to have planned a Pagan revival at Rome. He was a descendant of Procopius, the relative of Julian.

Anthemius gave Messius Phoebus Severus, a Pagan philosopher who was a close friend of his, the important offices of Praefectus urbi of Rome, Consul and Patrician. Anthemius placed the image of Hercules, in the act of vanquishing the Nemean lion, on his coins. The murder of Anthemius (by Ricimer) destroyed the hopes of those Pagans who believed that the traditional rites would now be restored.

Emperor Leo I
A loving "Christian", Leo ordered the
torture of Pagans and sent them to
work in the mines for life.

In 472 Leo I published a new law in 472 which imposed severe penalties for the owner of any property who was aware that Pagan rites were performed on his property. If the property owner was of high rank he was punished by the loss of his rank or office and by the confiscation of his property. If the property owner was of lower status he would be physically tortured and then condemned to labor in the mines for the rest of his life.

Shortly thereafter, in 476, the last emperor of Rome, Romulus Augustulus, was deposed by Odoacer, who became the first "barbarian" king of Italy. In spite of this disaster, the Pagans made one last attempt to revive the Pagan rites.

In 484, the Magister militum per Orientem, Illus, revolted against Eastern Emperor Zeno and raised his own candidate, Leontius, to the throne. Leontius hoped to reopen the temples and restore the ancient ceremonies; as such, many Pagans joined in his revolt against Zeno. Illus and Leontius were compelled, however, to flee to a remote Isaurian fortress, where Zeno besieged them for four years. Zeno finally captured them in 488 and promptly had them executed.

Following the revolt, Zeno instituted a harsh persecution of Pagan intellectuals. With the failure of the revolt of Leontius, some Pagans became disillusioned and many became Christian, or pretended to do so, in order to avoid persecution. The subjugation of the Roman Empire to Christianity became complete when the emperor Anastasius I, who came to the throne in 491, was required to sign a written declaration of orthodoxy before his coronation.


The Suppression of Paganism under Justinian

From  -  History of the Later Roman Empire
by J. B. Bury

We saw in a former chapter how throughout the fifth century the severe laws against paganism were not very strictly enforced. So long as there was no open scandal, men could still believe in the old religions and disseminate anti-Christian doctrine.

This comparatively tolerant attitude of the State terminated with the accession of Justinian, who had firmly resolved to realise the conception of an empire in which there should be no differences of religious opinion. Paganism was already dying slowly, and it seemed no difficult task to extinguish it entirely. There were two distinct forms in which it survived. In a few outlying places, and in some wild districts where the work of conversion had been imperfectly done, the population still indulged with impunity in heathen practices. To suppress these was a matter of administration, reinforced by missionary zeal; no new laws were required.

A more serious problem was presented by the Hellenism which prevailed widely enough among the educated classes, and consequently in the State-service itself. To cope with this Justinian saw that there was need not only of new administrative rigour, but of new legislation. He saw that Hellenism was kept alive by pagan instructors of youth, especially in teaching establishments which had preserved the Greek tradition of education. If the evil thing was to be eradicated, he must strike at these.

Emperor Justinian
Showing true Christian charity, Justinian
murdered and stole the property of Jews,
Christians and Pagans alike.

Not long after his accession, he reaffirmed the penalties which previous Emperors had enacted against the pagans, and forbade all donations or legacies for the purpose of maintaining "Hellenic impiety," while in the same constitution he enjoined upon all the civil authorities and the bishops, in Constantinople and in the provinces, to inquire into cases of pagan superstition. This law was soon followed by another which made it illegal for any persons "infected with the madness of the unholy Hellenes" to teach any subject, and thereby under the pretext of education corrupt the souls of their pupils.

The persecution began with an inquisition at Constantinople. Many persons of the highest position were accused and condemned. Their property was confiscated, and some may have been put to death; one committed suicide. Among those who were involved were Thomas the Quaestor and Phocas, son of Craterus. But Phocas, a patrician of whose estimable character we have a portrait drawn by a contemporary, was speedily pardoned, for, as we saw, he was appointed Praetorian Prefect of the East after the Nika riot.

Some of the accused escaped by pretending to embrace the Christian faith, but we are told that "not long afterwards they were convicted of offering libations and sacrifices and other unholy practices." There was, in fact, a second inquisition in A.D. 546. On this occasion a heretic was set to catch the pagan. Through the zeal of John of Ephesus, a Monophysite, who was head of a Syrian monastery in the suburb of Sycae, a large number of senators, "with a crowd of grammarians, sophists, lawyers, and physicians," were denounced, not without the use of torture, and suffered whippings and imprisonment.

Then "they were given to the churches to be instructed in the Christian faith." One name is mentioned: Phocas, a rich and powerful patrician, who, knowing that he had been denounced, took poison. The Emperor ordered that he should be buried like an ass without any rites. We may suspect that this was the same Phocas, son of Craterus, who had been involved in the earlier inquest and knew that death would be the penalty of his relapse. There was yet another pagan scandal in the capital in A.D. 559; the condemned were exposed to popular derision in a mock procession and their books publicly burned.

It may be considered certain that in all cases the condemned were found guilty of actual heathen practices, for instance of sacrificing or pouring libations in their private houses, on the altars of pagan deities. Men could still cling to pagan beliefs, provided they did not express their faith in any overt act. There were many distinguished people of this kind in the highest circles at Constantinople, many lawyers and literary men, whose infidelity was well known and tolerated.

The Pagan Athenian University
The edicts of Justinian sounded the doom of the Athenian schools, which had a continuous tradition since the days of Plato and Aristotle.   The property of the schools was confiscated and their means of livelihood withdrawn.  Seeking protection from persecution, the teachers fled to the Persian Empire.  

The great jurist Tribonian, who was in high favour with the Emperor, was an eminent example. He seems to have made no pretence at disguising his opinions, but others feigned to conform to the State religion. We are told that John the Cappadocian used sometimes to go to church at night, but he went dressed in a rough cloak like an old pagan priest, and instead of behaving as a Christian worshipper he used to mumble impious words the whole night.

It can hardly be doubted that by making the profession of orthodoxy a necessary condition for public teaching Justinian accelerated the extinction of "Hellenism." Pagan traditions and a pagan atmosphere were still maintained, not only in the schools of philosophy, but in the schools of law, not only at Athens, but at Alexandria, Gaza, and elsewhere. The suppression of all law schools, except those of Constantinople and Berytus, though not intended for this purpose, must have affected the interests of paganism.

But philosophical teaching was the great danger, and Athens was the most notorious home of uncompromising Hellenists. After the death of Proclus (A.D. 485) the Athenian university declined, but there were teachers of considerable metaphysical ability, such as Simplicius and Damascius, the last scholarch, whose attainments can still be judged by their works.

The edicts of Justinian sounded the doom of the Athenian schools, which had a continuous tradition since the days of Plato and Aristotle. We do not know exactly what happened in A.D.
529.



Temple of Zeus Ammon  -  Egypt
Justinian ended Pagan worship at the Temple by force and
built a church at the site.
.
Alexander the Great traveled through the desert of Egypt to the
oracle at the temple of Zeus Ammon.  While traveling, there was a
lot of rain and Alexander took this as a good sign. He was also
led to the temple by ravens. Once at the temple, the oracles told
Alexander that he was in fact the son of Zeus and that he
was destined to rule the world.

We may suppose that the teachers were warned that unless they were baptized and publicly embraced Christianity, they would no longer be permitted to teach; and that when they refused, the property of the schools was confiscated and their means of livelihood withdrawn.

This event had a curious sequel. Some of the philosophers whose occupation was gone resolved to cast the dust of the Christian Empire from their feet and migrate to Persia. Of these the most illustrious were Damascius, the last scholarch of the Academy, Simplicius, and Priscian. The names of four others are mentioned, but we do not know whether they had taught at Athens or at some other seat of learning.

These men had heard that king Chosroes was interested in philosophy, and they hoped, protected by his favour and supported by his generosity, to end their days in a more enlightened country than their own. But they were disappointed. Chosroes was flattered by their arrival and begged them to remain. But they soon found the strange conditions of life intolerable. They fell homesick, and felt that they would prefer death on Roman soil to the highest honours the Persian could confer. And so they returned.

But the king did them a great service. In his treaty with Justinian in A.D. 532 he stipulated that they should not be molested or forced to embrace the Christian faith. We are told that they lived comfortably for the rest of their lives, and we know that Simplicius was still writing philosophical works in the later years of Justinian.

In western Asia Minor, in the provinces of Asia, Phrygia, Lydia, and Caria, there was still a considerable survival of pagan cults, not only in the country regions, but in some of the towns, for instance in Tralles. In A.D. 542 John of Ephesus, the Monophysite whose activity in hunting down the Hellenes at Constantinople has already been noticed, was sent as a missionary to these provinces to convert the heathen and to put an end to idolatrous practices.

He tells us in his Ecclesiastical History that he converted 70,000 souls. The temples were destroyed; 96 churches and 12 monasteries were founded. Justinian paid for the baptismal vestments of the converts and gave each a small sum of money (about 4s.).

In Egypt, in the oasis of Augila, the temple dedicated to Zeus Ammon and Alexander the Great still stood, and sacrifices were still offered. Justinian put an end to this worship and built a church to the Mother of God. At Philae the cult of Osiris and Isis had been permitted to continue undisturbed. This toleration was chiefly due to the fact that the Blemyes and Nobadae, the southern neighbours of Egypt, had a vested interest in the temples by virtue of a treaty which they had made with Diocletian.

Every year they came down the river to worship Isis in the island of Elephantine; and at fixed times the image of the goddess was brought back to the temple. Justinian would tolerate this indulgence no longer. Early in his reign he sent Narses the Persarmenian to destroy the sanctuaries. The priests were arrested and the divine images sent to Constantinople. Much about the same time the Christian conversion of the Nobadae and Blemyes began.

Justinian was undoubtedly successful in hastening the disappearance of open heathen practices and in suppressing anti-Christian philosophy. Although in some places, like Heliopolis, paganism may have survived for another generation, and although there were inquisitions under his immediate successors, it may be said that by the close of the sixth century the old faiths were virtually extinct throughout the Empire.

(History of the Later Roman Empire by J.B. Bury)        (Religion in ancient Rome)

(Persecution of pagans by the Christian Roman Empire)

(History of persecutions by Christians)