[Authors and titles are listed at the end of the review]
Plague in Antiquity is a timely volume that investigates epidemic disease in the ancient world, with a primary focus on the ancient Near East from the Bronze Age through Late Antiquity. The book project was conceived in the shadow of the COVID-19 pandemic, and as noted in the introductory chapter, the volume’s twin goals are “relieving the social anxiety caused by pandemics” and using present insights to view ancient evidence in a new light (1). Since historians and archaeologists of antiquity understand that epidemic disease is not a new phenomenon, this book aims to contextualize plague, pestilence, disease, and disability within a broader historical context to demonstrate that such crises, far from being anomalous, were a regular part of life in pre-modern civilizations. The volume brings together a diverse set of case studies and approaches, textual records, archaeological findings, and comparative modern perspectives on how ancient societies experienced and responded to epidemic disease. The text consists of a foreword, maps, an introduction, and ten chapters, arranged alphabetically by the authors’ last names, each accompanied by its own bibliography. The essays will be reviewed thematically rather than alphabetically by the authors’ last names. Authors and titles are listed at the end of the review.
The first chapter, “Revisiting Epidemics in Cuneiform Sources: Ancient Attestations, Approaches, and Innovations,” written by Troels Pank Arbøll, offers a broad review of plagues in Mesopotamia, which presents “the first coherent overview” (13) of cuneiform sources on epidemics in ancient Mesopotamia and surveys how Babylonians and Assyrians understood, approached, and averted epidemics. Arbøll examines plague terminology in Sumerian and Akkadian, such as mūtānu (the “plural form of death” [14]), collates references to specific outbreaks in letters and chronicles, and considers preventive rituals and healing practices. Erica Couto-Ferreira’s “Plagues and Epidemics in Ancient Mesopotamia: An Overview” (chapter three) adopts a similar, complementary approach to that of Arbøll. Her synthesis of the historical occurrences and societal impacts of disease in that region offers a text rich in significant data and insightful observations that allows the reader to get a glimpse at how the “Mesopotamian elites thought, wrote about, and understood epidemics, and in what ways they coped with them” (50). Couto-Ferreira studies the vocabulary associated with plagues in ancient Mesopotamia, reviews the mythological texts on the “coming-into-being of plague and disease” (51), lists common traits found in plague outbreaks and what were believed to be the causes of these outbreaks, and briefly touches on therapeutic treatments (amulets, rituals, restrictive measures, the burning of belongings).
In the second chapter, “Malaria, Sickle Cell Disease and the Harappan Civilization, 2600–1900 BC,” Robert Arnott supplies a fascinating analysis of malaria and its relationship to the genetic prevalence of sickle-cell trait. Bioarchaeological, climate, and environmental data, according to Arnott, reveal that endemic malaria posed different types of challenges to the Indus population, perhaps even hindering the “huge expansion that eventually occurred in the Mature Harappan Phase” (45) from taking place at an earlier point in that civilization. In “Gripped by the Hand of Nergal: What a Transhistorical Approach Tells Us about Disease, Commerce, and Social Upheaval in Late Bronze Age Cyprus” (chapter four), Louise Hitchcock, one of the volume’s editors, explores the implications that Amarna letter EA 35 has on our understanding of plague in antiquity and contemporary times. This letter, sent from Cyprus to Egypt, explains why a shipment of copper to Pharaoh was delayed: the Hand of Nergal (the Mesopotamian god of pestilence) was in Cyprus and had “slain all the men of my country, and there is not a (single) copper-worker” (71). The plague had also entered the house of the King of Alašiya and killed the king’s young wife and his brother. Hitchcock’s chapter locates the letter within historical, social, and economic contexts, both ancient and modern, to examine the ripple effects of disease on an interconnected trade network. Of special interest to classicists will be the quick survey of possible connections between the god Apollo, as a god of plague, and the Mesopotamian pestilence deities.
Chapter five, Brandon McDonald’s “The Justinianic Plague and Societal Decline in the Late Antique Negev,” focuses on possible causes for the troubles that disrupted life in sixth-century Negev. It is relatively undeniable that something happened around the middle of the sixth century AD in the Negev, which affected a “region that had been doing well economically for much of late antiquity” (86). Scholars have posited plague (Yersinia pestis, “the evil / death of the groin and armpits” [94]) and climate change (Late Antique Little Ice Age [LALIA]) as two likely explanations. Based on archaeological and material culture evidence, as well as textual evidence, McDonald concludes that during this period and in this location, settlement contraction and vast economic change were most likely triggered by the plague rather than by climate change. This is not to say that climate change, in the form of “high-intensity flash floods” (99) and not aridification, did not play some role. The tenth chapter, Valeria Zubieta Lupo’s “Management of and Response to an Epidemic: The Kingdom of Ḫatti,” uses the Hittite cuneiform “Plague Prayers” of King Mursili II as the basis for an analysis of how the Hittite empire managed and responded to an epidemic that lasted around twenty years. Prayers, oracular inquiries, and ritual purifications shed some light on the practical and religious dimensions of how the empire confronted epidemic disaster. Interestingly, Lupo uses the “WHO’s five stages of epidemic management” (anticipation, early detection, containment, control and mitigation, and elimination or eradication) (260) in a multi-pronged examination of an epidemic that was probably brought into the empire by prisoners of war. Like McDonald, Lupo bridges textual history to ongoing debates on epidemic demography and economic impact in the far reaches of the late antique world.
Strahil V. Panayotov’s “Cuneiform Demons and Modern Viruses,” chapter six, establishes a comparative and conceptual framework for three chapters. This chapter analogizes cuneiform demons to modern viruses by establishing a connection between ancient concepts of invisible evil agents (such as disease demons in Mesopotamian texts) and contemporary microbiological pathogens. The demonic entities depicted in cuneiform medical and magical texts can serve as metaphors for how the modern world perceives viral contagion. Klaus Wagensonner’s “Unchain Divine Wrath: Texts Concerning Amulets to Counteract Evil and Other Afflictions,” the eighth chapter, returns to cuneiform texts on how ancient Mesopotamians took proactive measures, rooted in magic and religion, to prevent or cure disease, which is a theme that recurs throughout the book: the blurred line between the religious and the medical in antiquity. The ninth chapter, “Etiological Divination in Mesopotamian Medicine and Its Critique in the Hippocratic Treatise On the Sacred Disease,” by John Z. Wee, closely scrutinizes and situates Mesopotamian medical divination within a historiographic and cross-cultural context, alongside Greek classical medicine. Mesopotamian etiological divination, which involves diagnosing an illness by determining which spirit or deity is believed to have caused it, is compared to the Hippocratic text On the Sacred Disease to show that, according to Wee, in the Greek text, the attribution of diseases to gods is a falsehood employed by charlatans rather than focusing on natural causes. Most importantly, Wee demonstrates that the Hippocratic polemic against identifying a god for a particular disease was the inverse of thinking found in ancient Near Eastern medicine. Another way of looking at this is that the Mesopotamian sources practice what the Hippocratic author condemns: associating ailments with specific gods via symbolic links. However, Wee does note that the Greek text both criticizes divine attribution while still functioning within its own cultural set of symbols and ideas. This is a fascinating chapter that sheds some light on how Greek medicine simultaneously broke from but was influenced by earlier types of divinatory models of disease diagnosis.
The chapter by Nicholas Vlahogiannis, “Mesopotamia and Egypt: Models of Disability and Disease,” explores the Mesopotamian and Egyptian models of disease, disability, and impairment, and reviews how these models positioned the “disabled within society” to “examine how disability was explained” (127). Vlahogiannis provides a learned and worthwhile analysis of medical texts, artistic depictions, and social attitudes from these two cultures. The only unusual thing about this chapter is that it does not actually treat the topic of the collection, which is plague in antiquity. Vlahogiannis’ text is recommended for scholars interested in disability and impairment in Mesopotamia and Egypt.
A strength of Plague in Antiquity is its consciously interdisciplinary approach to ancient epidemics. The editors and contributors come from diverse specialties (Assyriology, Egyptology, archaeology, ancient history, and history of medicine), and this diversity is reflected in their methodologies. Many chapters center on the textual analysis of ancient sources, including cuneiform tablets (letters, omen texts, incantations, royal inscriptions, and medical recipes), Hittite prayers, and Greek treatises, all of which receive close readings. These philological investigations yield insights into how ancient people described symptoms, identified causes (often supernatural), and prescribed remedies or rituals. For instance, Arbøll’s survey of cuneiform sources reveals a lexicon of plague in Sumerian and Akkadian (e.g., the Akkadian term mūtānu or “death” used as a generic word for epidemic) and shows how Mesopotamians recorded outbreaks (in year names, chronicles, or letters) often without clearly distinguishing specific diseases. From these records, we can learn about official responses (such as kings performing purification rites or consulting oracles during plagues) and widespread fears (e.g., the demon Nergal invoked as personification of pestilence). Likewise, John Wee’s comparative work is firmly rooted in textual criticism and intellectual history; the essay explains ancient medical reasoning in both Mesopotamian and Greek texts to understand shifting notions of disease causality.
The breadth of the volume inevitably means that specialists in one area may find some chapters more relevant than others. A classicist seeking information on, say, the Antonine or Cyprianic plagues will not find those topics here (the Graeco-Roman world appears mainly via the Hippocratic text and the Byzantine Negev case). Conversely, the heavy emphasis on Mesopotamian evidence (at least five chapters draw deeply on Mesopotamian cuneiform sources) reflects the book’s series (Ancient Near Eastern Studies). It may be dense for readers unfamiliar with Assyriology. The decision to include multiple Mesopotamian-focused chapters (Arbøll, Couto-Ferreira, Panayotov, Wagensonner, Wee) risks some overlap, but in practice, each has a distinct emphasis: Arbøll and Couto-Ferreira give broad overviews, while Panayotov, Wagensonner, and Wee delve into specific facets (demonology, magic, comparative medicine). As a result, redundancy is minimal, and one instead gets a multi-dimensional view of Mesopotamian epidemic culture. As noted, the one chapter that felt somewhat tangential to “plague” in the strict sense is Vlahogiannis’s discussion of disability; an important topic, certainly, but less directly about epidemic outbreaks than the others. However, by including disability, the volume usefully reminds us that disease is not only limited to catastrophic pandemics; endemic illnesses and their long-term effects (e.g., deformities from poliomyelitis or complications from infectious diseases) were also part of the social fabric. Thus, even that chapter contributes to a holistic understanding of health in antiquity.
In conclusion, Plague in Antiquity is an insightful addition to the field of ancient epidemic research. It does a solid job of providing both a general summary and an in-depth analysis of particular ancient plague cases, contributes to our understanding of how ancient societies perceived and addressed widespread diseases—epidemics were a significant part of ancient history, rather than merely sporadic or unusual occurrences, and demonstrates that studying the distant past can offer fresh perspectives and perhaps some solace regarding the ongoing relationship between humans and plagues as we continue to investigate how diseases affect societies.
Authors and titles
Introductory Chapter. ‘“When it Standeth Beside a Man, Yet None can See it… When it Entereth the House Its Appearance is Unknown…’: Introducing Plague in Antiquity” (Andrew S. Jamieson, Caroline Jane Tully, and Louise Hitchcock)
- “Revisiting Epidemics in Cuneiform Sources: Ancient Attestations, Approaches, and Innovations” (Troels Pank Arbøll)
- “Malaria, Sickle Cell Disease and the Harappan Civilisation, 2600–1900 BC” (Robert Arnott)
- “Plagues and Epidemics in Ancient Mesopotamia: An Overview” (Erica Couto-Ferreira)
- “Gripped by the Hand of Nergal: What a Transhistorical Approach Tells us about Disease, Commerce, and Social Upheaval in Late Bronze Age Cyprus” (Louise Hitchcock)
- “The Justinianic Plague and Societal Decline in the Late Antique Negev” (Brandon McDonald)
- “Cuneiform Demons and Modern Viruses” (Strahil V. Panayotov)
- “Mesopotamia and Egypt: Models of Disability and Disease” (Nicholas Vlahogiannis)
- “Unchain Divine Wrath: Texts Concerning Amulets to Counteract Evil and Other Afflictions” (Klaus Wagensonner)
- “Etiological Divination in Mesopotamian Medicine and Its Critique in the Hippocratic Treatise On the Sacred Disease” (John Z. Wee)
- “Management of and Response to an Epidemic: The Kingdom of Ḫatti” (Valeria Zubieta Lupo)