Revelation of the Plague of Justinian

In the long history of human development, plague has repeatedly brought serious threats to people's lives and health, and to a large extent, the game between plague and people is essentially a game between plague and human medicine and public health management. The plague is the devil, the medicine is the Tao, and the struggle between the two is never stopped. The Byzantine Empire in the mid-6th century AD staged such a game. From that time, the Byzantine Empire lacked awareness of the plague, and its medical skills were not enough to control and conquer the plague, so that it eventually evolved into a huge disaster with a large number of deaths and extremely heavy losses, which wrote a heavy mark in human history.

The plague broke out and spread in 541-542 AD, when the Byzantine Empire was under the reign of Justinian I (reigned 527-565 AD), so it was called the "Justinian Plague" by later generations. From a historical point of view, the records of those who personally experienced the plague are invaluable, and the 8-volume "History of War" by the historian of the Byzantine Empire, Prokobi, more completely records the occurrence of the plague.

In documenting the plague, Prokoby begins his History of War by saying that "a great plague nearly exterminated mankind occurred," which shows how tragic the plague was and the severe reduction in the population of the Empire. He believes that the plague originated in the ancient Egyptian city of Peleus am. Located at the mouth of the Nile, it was Egypt's main fortress against foreign invasion and a gateway to tax goods from the East. The plague then spread in two branches, one to alexandria and the rest of Egypt, and the other to Palestine along the Egyptian border, and then to the "whole world." Today, Italy, Serbia, Bulgaria, Greece, Turkey, Syria, Libya and other countries have been hit by this great plague. In the spring of 542, the Great Plague reached Constantinople, the capital of the Byzantine Empire, and raged for four months, 3 of which were severely contagious.

In the History of War, Prokobi describes the symptoms of the patient's infection, that is, first the body fever, followed by swelling, pus, ulceration in many places on the body from top to bottom, especially the side of the ear, neck, armpits and groin where the lymph glands are concentrated. Coma, insanity, madness, and hysteria are common, and there are not a few people who jump into the sea. If you are lucky enough to escape death, many people will gradually dry their thighs or have difficulty pronouncing. Other experiencers have similar accounts of the patient's symptoms, and through their descriptions, people know that this plague is what modern medicine calls the plague, which has long been established in academic circles. John, who was a few years younger than Proctor, was also a first-hand witness to the plague, and he provided information that when the death toll counted by government officials reached 230,000, it would not continue because it was too difficult to count, and he estimated that the total number of deaths in the capital Constantinople exceeded 300,000, which showed the huge population loss caused by the plague to the Byzantine Empire.

Objectively speaking, in the history of human medicine, Byzantine medicine has made no small contribution, with the role of inheriting the upper and lower levels, inheriting the ancient Greco-Roman medicine, the lower Arab medicine and European medicine, on the basis of inheritance, it has its own innovation and has made obvious achievements. In the middle of the 6th century AD, the Byzantine Empire's medical skills were still limited, the understanding of acute infectious diseases such as plague was insufficient, the knowledge reserve was insufficient, and there was no power in the face of the great plague, and the doctors watched as the plague spiraled out of control, spreading to the whole country and even the entire Mediterranean world, evolving into a terrible human disaster. At that time, Byzantine medicine did not cover all fields, according to the relevant documents that have been preserved, around the 6th century, doctors focused on gynecology, obstetrics, ophthalmology, internal medicine, etc., mostly common diseases.

A typical clinical manifestation of plague is the decay and suppuration of lymph nodes, and the Byzantine Empire doctors have no cure for such conditions, and the treatment methods they have mastered are still traditional cauterization therapy. According to the Byzantine historian Nikitas Houniadis in his book Chronicles, the Byzantine Emperor Alexius III was still soldering a soldering iron while treating his leg ulcerated and soldering wounds, more than 600 years after the plague in 542.

From these accounts, it can be seen that when the plague broke out in the mid-6th century, the medical techniques of the Byzantine Empire, although to a certain extent, were mainly common diseases. Because the plague was the first outbreak in the Empire, the Byzantines were unfamiliar with such epidemics, and the Empire, from the court to the people, was helpless. According to Prokobi in the History of War, doctors were overwhelmed by the plague because they did not know the cause of the disease. Doctors are deeply overwhelmed, not only there is no way to save, not even a way to alleviate the pain of patients, all they can provide is ordinary nursing, the patient's epilepsy makes doctors tired, coupled with the lack of clear understanding of the plague, protective measures are not in place, and the doctors themselves are infected with a lot.

This game between plague and medicine had a great influence on the Faith of the Byzantines. The outbreak of the plague was so sudden that it was unprecedented in the Byzantine Empire and was so ferocious that the whole country was caught off guard and panicked. As a first-hand witness to the plague, Prokobi was extremely pessimistic and desperate after witnessing the sudden catastrophe, believing that the cause of the catastrophe could not be expressed in words or other explanations unless it was described as a punishment from God. The same view was shared by three Byzantine historians of Prokobi's contemporaries, John Malalas, Agasseas, and Ewaglius, who all believed that the plague was controlled by God, and that only God knew the cause and direction of the plague.

Not only his subjects, but even Emperor Justinian thought so, and he issued an edict in 544 AD with the main purpose of restoring prices and wages to pre-plague levels, and punishing those who violated them severely. In this edict, Justinian also described the plague as a punishment of God. It can be seen that this was the general understanding of the Byzantines at that time, from the emperor to the subjects. This phenomenon shows us not only the Christian faith of the Byzantines, but also the fear and helplessness of the empire in the face of this great plague. After the infection, there was no cure, no medicine, and only waiting for death, in the final analysis, it was determined by the medical level of the Byzantine Empire at that time.

From then until the end of the 6th century, the plague recurred in the Byzantine Empire four times in 558, 573, 590, and 599, killing and injuring countless people everywhere and mourning, resulting in a decline in the total population of the empire by 40% to 50%. The lessons of history are tragic, the Byzantine Empire at that time in this game between plague and medicine, the medical understanding of acute infectious diseases such as plague is not enough, there is no effective preventive measure against the menacing plague, resulting in the plague outbreak has no ability to block and eliminate, can only let it rage and spread, and explain the occurrence of the plague as God punishing mankind, which is useless.

Looking at the history of China and beyond, the struggle between mankind and the plague has never stopped, and if it succumbs to the plague, it will lead to the crisis of human existence. Only by conscientiously summing up historical experience, drawing lessons from history, applying scientific thinking to treat and study the plague, striving to improve the level of national medical skills, finding out the laws of major epidemic prevention and control, and enhancing the ability to prevent and fight the epidemic can we not allow the plague to rage, seize the opportunity to reverse the situation in the game with the plague, and turn passive into active, can we create a safe and stable environment for economic and social development.