The Antonine Plague: History, Start, Spread & Facts

Instructor: Christopher Muscato

Chris has a master's degree in history and teaches at the University of Northern Colorado.

The Black Plague wasn't the only epidemic to have a huge impact on European history. In this lesson, we'll learn about the Antonine Plague and see how it influenced the Roman Empire.

The Antonine Plague

When we talk about ''the'' plague, we're usually talking about the one that killed off millions of Europeans in the medieval era. It was a big deal. However, it was not the only epidemic to reshape European history. Around 165 CE, a mysterious disease broke out across the Roman Empire. Referred to as the Antonine Plague (after emperor Marcus Aurelius Antoninus Augustus), this epidemic did what hordes of roving armies could not. It nearly broke the Roman Empire apart.


In 165 CE, Rome was flourishing. The empire was shared between two co-rulers, the philosopher-warriors Marcus Aurelius and Lucius Verus. Verus was just returning from what is now Iran after quelling a renewed rebellion among the Parthians. He brought with him massive spoils of war, including the treasures of the Parthian temples. Unknowingly, however, his troops had picked up another souvenir in West Asia. They were carrying a disease which had severely impacted East Asia years before.

Bust of Marcus Aurelius

As the army marched back to Rome, the disease manifested and spread everywhere they went, first in Asia Minor, then Greece, and finally into Italy itself. The mysterious epidemic spread like wildfire, particularly through the densely populated Roman cities of Italy. The Romans controlled the entire Mediterranean, and as their trading ships and armies busily swarmed across it, so did the disease. For the next two decades, the Roman Empire was racked with an outbreak unlike anything it had ever seen. The disease slowed after 180 CE, but flared up again in 189 before finally settling down.

At the height of the epidemic, there were fatalities of up to 2,000 people per day, according to Roman sources. In total, about 7-10% of the population of the Roman Empire was killed, expanding from Spain and Italy to Greece, Asia Minor, and even Egypt and North Africa. In dense urban centers, fatality rates may have been as high as 15%. Even the emperors may not have been spared. Lucius Verus died in 169 CE, and Marcus Aurelius died in 180 CE. It has been speculated that both deaths were caused by the disease.

So, what was it? What mysterious ailment caused such havoc? We don't know for sure, but many scholars believe it was an outbreak of smallpox. The most definitive account we have of this epidemic comes from the Greek physician Galen, who witnessed multiple outbreaks firsthand. Galen described numerous unpleasant symptoms, but one that stands out is pustules or boils which sound a lot like the characteristic markers of smallpox. Some historians think that Galen actually described two different strains of the smallpox virus in his notes, which would explain how the disease remained so deadly over a 20-year period.

Most of our knowledge of the disease itself comes from the physician Galen

Impact on Rome

Obviously this was pretty unpleasant, but did a smallpox outbreak really have that big of an impact on the Roman Empire? Actually, yes it did. We can see the devastation of the epidemic in several facets of Roman society, but let's start with the army. The soldiers of the army lived in tight quarters and often fought or trained to exhaustion. They moved between different units and traveled all over the empire. The disease spread rapidly through the military, absolutely decimating it.

The disease spread all across the Roman Empire, which was expansive under Marcus Aurelius

As a result, the Marcus Aurelius had to increase conscription. Rome's army was fighting wars on every border of the empire, and it needed soldiers— lots of them. Soldiers in the military were delayed in getting their retirements, and when even that didn't stop the loss of numbers the Romans turned to unlike sources for help. For the first time, the Roman military started accepting massive auxiliary units in the forms of Germanic tribes who had once been their enemies. These Germanic warriors fought under Germanic commanders, beginning the process of de-Romanizing the Roman army. This was a major precedent in the making, and by the time Rome fell its military was almost entirely composed of similar auxiliary units which turned against the once-great empire.

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