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Turning Points in Ancient History
Pox Romana: The Plague That Shook the Roman World
A wide-ranging and dramatic account of the Antonine plague, the mysterious disease that struck the Roman Empire at its pinnacle
In the middle of the second century AD, Rome was at its prosperous and powerful apex. The emperor Marcus Aurelius reigned over a vast territory that stretched from Britain to Egypt. The Roman-made peace, or Pax Romana, seemed to be permanent. Then, apparently out of nowhere, a sudden sickness struck the legions and laid waste to cities, including Rome itself. This fast-spreading disease, now known as the Antonine plague, may have been history’s first pandemic. Soon after its arrival, the Empire began its downward trajectory toward decline and fall. In Pox Romana, historian Colin Elliott offers a comprehensive, wide-ranging account of this pivotal moment in Roman history.
Did a single disease—its origins and diagnosis still a mystery—bring Rome to its knees? Carefully examining all the available evidence, Elliott shows that Rome’s problems were more insidious. Years before the pandemic, the thin veneer of Roman peace and prosperity had begun to the economy was sluggish, the military found itself bogged down in the Balkans and the Middle East, food insecurity led to riots and mass migration, and persecution of Christians intensified. The pandemic exposed the crumbling foundations of a doomed Empire. Arguing that the disease was both cause and effect of Rome’s fall, Elliott describes the plague’s “preexisting conditions” (Rome’s multiple economic, social, and environmental susceptibilities); recounts the history of the outbreak itself through the experiences of physician, victim, and political operator; and explores postpandemic crises. The pandemic’s most transformative power, Elliott suggests, may have been its lingering presence as a threat both real and perceived.
In the middle of the second century AD, Rome was at its prosperous and powerful apex. The emperor Marcus Aurelius reigned over a vast territory that stretched from Britain to Egypt. The Roman-made peace, or Pax Romana, seemed to be permanent. Then, apparently out of nowhere, a sudden sickness struck the legions and laid waste to cities, including Rome itself. This fast-spreading disease, now known as the Antonine plague, may have been history’s first pandemic. Soon after its arrival, the Empire began its downward trajectory toward decline and fall. In Pox Romana, historian Colin Elliott offers a comprehensive, wide-ranging account of this pivotal moment in Roman history.
Did a single disease—its origins and diagnosis still a mystery—bring Rome to its knees? Carefully examining all the available evidence, Elliott shows that Rome’s problems were more insidious. Years before the pandemic, the thin veneer of Roman peace and prosperity had begun to the economy was sluggish, the military found itself bogged down in the Balkans and the Middle East, food insecurity led to riots and mass migration, and persecution of Christians intensified. The pandemic exposed the crumbling foundations of a doomed Empire. Arguing that the disease was both cause and effect of Rome’s fall, Elliott describes the plague’s “preexisting conditions” (Rome’s multiple economic, social, and environmental susceptibilities); recounts the history of the outbreak itself through the experiences of physician, victim, and political operator; and explores postpandemic crises. The pandemic’s most transformative power, Elliott suggests, may have been its lingering presence as a threat both real and perceived.
320 pages, Kindle Edition
First published January 23, 2024
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Displaying 1 - 30 of 92 reviews
March 5, 2024
A mighty empire at the peak of its' power, the center of an increasingly interconnected world, suddenly crumbles under the combined weight of an erratic and idiotic ruler, the blowback from decades of unrealistic policy, and a sudden pandemic. It's not America 2020, it's Rome AD 165, and though the parallels are perhaps somewhat stretched, there's still a lot of valuable lessons, and a good ancient medical and economic mystery around the Antonine Plague.
Rome in 160 was at the height of the Pax Romana, a century and a half of expansion and peace since Augustus turned the Republic into the Empire. The empire was ruled by Marcus Aurelius and Lucius Verus, adopted brothers who seemed uncommonly able to split the duties and benefits of the Imperium.
Marcus Aurelius. Be suspicious of dudes with this as their profile pic
Elliott spends plenty of time setting the stage, and makes a convincing argument that the Pax Romana was more of a gilded age than a golden age. While the imperial core was peaceful and prosperous, that prosperity did not reach to the masses of urban poor, who either slept rough or in crude and unsafe tenement apartments. Sanitation was poor, despite investment in aqueducts and sewers. Administration was ad hoc, the semi-private affairs of local elites and imperial delegates, who lacked training, data, and resources to react to crises. And crucially, the grain supply in Rome was dependent on Egyptian harvests, and the Nile floods had been either too little or too much for decades prior. So in 165, when victorious soldiers returning from Parthia came back with an unknown disease, it was a more fragile empire than appearances suggest that took the blow.
And the disease is truly unknown. Elliott makes a convincing case for an orthopox virus, like smallpox but not modern smallpox, though measles is another common suggestion. Despite being associated with the great physician Galen, descriptions of symptoms is vague, including fever, rashes, and then in fatal cases bloody coughs and stools. How many people died is another unknown, with ranges between 1 million and over 25 million. For such a massive event, there is little direct evidence.
Yet the indirect evidence is compelling, including tangled mass graves in cities corresponding to the dates of the plague. Census records show declines across the period, as cities shrunk and entire towns disappeared. Mines and quarries ceased production, coinage was debased, the military had trouble recruiting for wars and peacekeeping against raiders, and conflict between orthodox Pagans and early Christians who refused to perform public sacrifices to appease the gods is recorded.
Though Elliott argues for a deathcount at the lower end of the range, he makes a case that the plague really did a number on the Roman economy, and more explicitly, the Roman political system. Commodus, who succeeded Marcus Aurelian, was a clown rather than a stoic, and his assassination triggered ongoing political stability on the basis that whoever could best bribe the army deserved to rule. The Crisis of 3rd century was clearly set up by the plague.
I will note that one thing that seems amiss is when Elliott draws more direct connection between the Antonine Plague and COVID-19, which is set in a very orthodox Chicago school economic framework. Roman macro-economics were surely bad, but it seems unfair to fault them for not reading Hayek. Similarly, the failures of pre-germ theory divine intervention have little bearing on evidence-informed public health measures. But I will say that while Elliott and I likely have significant differences in perspective over the recent pandemic, he is a gentleman and a scholar, so I'll avoid concluding this review with a rant.
After all, we probably don't spend enough time thinking about Rome.
Rome in 160 was at the height of the Pax Romana, a century and a half of expansion and peace since Augustus turned the Republic into the Empire. The empire was ruled by Marcus Aurelius and Lucius Verus, adopted brothers who seemed uncommonly able to split the duties and benefits of the Imperium.
Marcus Aurelius. Be suspicious of dudes with this as their profile pic
Elliott spends plenty of time setting the stage, and makes a convincing argument that the Pax Romana was more of a gilded age than a golden age. While the imperial core was peaceful and prosperous, that prosperity did not reach to the masses of urban poor, who either slept rough or in crude and unsafe tenement apartments. Sanitation was poor, despite investment in aqueducts and sewers. Administration was ad hoc, the semi-private affairs of local elites and imperial delegates, who lacked training, data, and resources to react to crises. And crucially, the grain supply in Rome was dependent on Egyptian harvests, and the Nile floods had been either too little or too much for decades prior. So in 165, when victorious soldiers returning from Parthia came back with an unknown disease, it was a more fragile empire than appearances suggest that took the blow.
And the disease is truly unknown. Elliott makes a convincing case for an orthopox virus, like smallpox but not modern smallpox, though measles is another common suggestion. Despite being associated with the great physician Galen, descriptions of symptoms is vague, including fever, rashes, and then in fatal cases bloody coughs and stools. How many people died is another unknown, with ranges between 1 million and over 25 million. For such a massive event, there is little direct evidence.
Yet the indirect evidence is compelling, including tangled mass graves in cities corresponding to the dates of the plague. Census records show declines across the period, as cities shrunk and entire towns disappeared. Mines and quarries ceased production, coinage was debased, the military had trouble recruiting for wars and peacekeeping against raiders, and conflict between orthodox Pagans and early Christians who refused to perform public sacrifices to appease the gods is recorded.
Though Elliott argues for a deathcount at the lower end of the range, he makes a case that the plague really did a number on the Roman economy, and more explicitly, the Roman political system. Commodus, who succeeded Marcus Aurelian, was a clown rather than a stoic, and his assassination triggered ongoing political stability on the basis that whoever could best bribe the army deserved to rule. The Crisis of 3rd century was clearly set up by the plague.
I will note that one thing that seems amiss is when Elliott draws more direct connection between the Antonine Plague and COVID-19, which is set in a very orthodox Chicago school economic framework. Roman macro-economics were surely bad, but it seems unfair to fault them for not reading Hayek. Similarly, the failures of pre-germ theory divine intervention have little bearing on evidence-informed public health measures. But I will say that while Elliott and I likely have significant differences in perspective over the recent pandemic, he is a gentleman and a scholar, so I'll avoid concluding this review with a rant.
After all, we probably don't spend enough time thinking about Rome.
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February 12, 2024
I was sick with covid that turned into pneumonia, so I figured this was the perfect book to listen to while I was stuck in bed, miserable. A worthwhile listen for those that are interested in Roman history.
February 1, 2024
I got a pre-release galley of this from the publisher.
This is well-researched exploration of one of history's most mysterious and devastating pandemics. This book delves deep into the Antonine Plague, which struck the Roman Empire at its height and ultimately contributed to its decline. The author skillfully weaves together historical accounts, archaeological evidence, and modern medical understanding to create a vivid picture of the plague's impact on the Roman world. He strikes a great balance between scholarly rigor and engaging storytelling.
In addition to its compelling narrative, Pox Romana also provides valuable insights into the social, political, and economic consequences of the Antonine Plague. Elliott explores how the pandemic affected various aspects of Roman life, from the military to the economy, and how it contributed to the eventual decline of the empire.
This is well-researched exploration of one of history's most mysterious and devastating pandemics. This book delves deep into the Antonine Plague, which struck the Roman Empire at its height and ultimately contributed to its decline. The author skillfully weaves together historical accounts, archaeological evidence, and modern medical understanding to create a vivid picture of the plague's impact on the Roman world. He strikes a great balance between scholarly rigor and engaging storytelling.
In addition to its compelling narrative, Pox Romana also provides valuable insights into the social, political, and economic consequences of the Antonine Plague. Elliott explores how the pandemic affected various aspects of Roman life, from the military to the economy, and how it contributed to the eventual decline of the empire.
December 6, 2024
I was so excited to read this (disease + ancient Rome, does it get any better?) but unfortunately it kind of fell flat for me. The author is an economic historian, and while I respect economic history as a discipline it is not for me, and I got kind of weird pro Christian and pro capitalist vibes. Part of the problem I think is also that I know too much about ancient Rome to enjoy popular media about it without a significant suspension of disbelief. I disagreed with his takes on a lot of the evidence, especially around rural life, which made it harder to just read and enjoy. It was very well researched and a really interesting topic though.
February 7, 2024
no doubt well researched, but from the standpoint of someone more interested in the macabre details of an ancient plague, this just didn’t scratch that itch. there was a major focus on lots of other factors, like the roman economy, agriculture, religion, government, etc, which was fine. but again, not quite what i’d hoped for. i did enjoy some of the political content, but it didn’t have that tone that makes politics seem like juicy gossip, so it still lacked in that department. listening to the audiobook was a bit of a chore, almost like reading a textbook :/ not fun! but educational!
July 3, 2024
I don’t know who asked for a book on the Antonine plague from an economist but there’s some weirdo out there that’s happy with it. Absolutely wild the asides about how free markets would have helped the Roman Empire weather the plague when *gestures towards the American economy during COVID*
Anyways, it was still pretty interesting but I’m definitely using this book as exhibit a when folks ask why I didn’t pursue a PhD in classics. I may be many things but I am never going to talk about how the ancient world needed more modern economic theory
Anyways, it was still pretty interesting but I’m definitely using this book as exhibit a when folks ask why I didn’t pursue a PhD in classics. I may be many things but I am never going to talk about how the ancient world needed more modern economic theory
February 4, 2026
Very well written non fiction! I’m already interested in pandemics, plagues, bugs in general so it wasn’t a stretch to pick this up. He walks you through the Antonine pandemic and a bit of light Roman history as you go. It’s fascinating to think about how the pandemic didn’t cause the demise of Rome but definitely could have been the extra weight to the ice that caused the break. The research that went into this was fascinating considering how few and far between any mentions of a pandemic were in what information we have from Rome. The part that stuck out to me was looking into end of military career plaques and awards and using that to compare a drop in military service completion (i.e increase in death). The information with Galen (famous doctor) was really interesting as well. It got a bit preachy from time to time so I took a ⭐️ away. But overall I recommend!
February 14, 2026
Pax Romana is a fascinating read. It’s very detailed while still being highly readable, and I always enjoy getting a deeper look into the everyday lives of ordinary Romans
January 11, 2025
I “read” Pox Romana as an audiobook on my morning walks.
It’s an interesting look at the Antonine Plague, which rocked the Roman Empire from the mid-160s CE to the 190s (as Elliot interprets the evidence). It was but one of the many crises that afflicted the empire and brought the pax romana to an end, ushering in more than a century of political, economic and social upheavals.
It’s impossible to say what the plague was though the author believes (with others) that it was a variant of the pox. Not the more well known and infamous smallpox but a kissing cousin that wasn’t quite as lethal but was bad enough that its effects reverberated down through the decades into the 3rd century CE.
And it’s the latter that perforce Elliot discusses in the book. There’s almost no direct evidence of the plague but there’s plenty of indirect indications of disruption from a close reading of surviving texts and prosopography correlated with archeological, genetic and climatic clues.
Recommended.
It’s an interesting look at the Antonine Plague, which rocked the Roman Empire from the mid-160s CE to the 190s (as Elliot interprets the evidence). It was but one of the many crises that afflicted the empire and brought the pax romana to an end, ushering in more than a century of political, economic and social upheavals.
It’s impossible to say what the plague was though the author believes (with others) that it was a variant of the pox. Not the more well known and infamous smallpox but a kissing cousin that wasn’t quite as lethal but was bad enough that its effects reverberated down through the decades into the 3rd century CE.
And it’s the latter that perforce Elliot discusses in the book. There’s almost no direct evidence of the plague but there’s plenty of indirect indications of disruption from a close reading of surviving texts and prosopography correlated with archeological, genetic and climatic clues.
Recommended.
March 3, 2024
Very interesting read about how the Roman Empire dealt with the Antonine plague. I liked how this author explores multiple scopes of the Roman Empire’s demise with context to the plague and though this book asserts an examination of the plague as a strong factor in the Roman Empire’s downfall, the author also provides evidence that ranges from letters and documentation of the socioeconomics, political turmoil, warfare, classism structure, etc in relation to the Antonine plague’s influence to the fall of the empire.
It’s important to note that this author is not wanting you to read this and believe that the Antonine plague was the sole reason for the Roman Empire’s collapse, but rather a consideration that dealt its blow at the right time and place to weaken an already fractured empire that once triumphed over many. I appreciate that the author does a great job at providing more evidence than just the plague, proving that the complexities to the collapse of the Roman Empire was multifaceted.
It’s important to note that this author is not wanting you to read this and believe that the Antonine plague was the sole reason for the Roman Empire’s collapse, but rather a consideration that dealt its blow at the right time and place to weaken an already fractured empire that once triumphed over many. I appreciate that the author does a great job at providing more evidence than just the plague, proving that the complexities to the collapse of the Roman Empire was multifaceted.
August 13, 2024
Really fascinating topic and definitely an interesting read in a similar vein to 1177 BC, in that you’ll spend most of it hearing how scattered archeological and textual evidence fit into the author’s broader argument.
With that said, I’m not sure I come away by the author’s core arguments about the impact of the plague or the overall vulnerability of the Roman system. I think he makes an interesting case on both but I come away feeling like it is truly one of those topics that we do not know enough about and indeed may never know enough about to feel certain enough to offer any one broad narrative.
Still a fun book though.
With that said, I’m not sure I come away by the author’s core arguments about the impact of the plague or the overall vulnerability of the Roman system. I think he makes an interesting case on both but I come away feeling like it is truly one of those topics that we do not know enough about and indeed may never know enough about to feel certain enough to offer any one broad narrative.
Still a fun book though.
October 29, 2025
A fascinating theory, but rather dry and academic. Unfortunately there just isn't enough hard evidence here, and the author uses a great metaphor about trying to put together a puzzle with too many missing pieces.
February 19, 2024
Very interesting book and full of new info but audiobook narrator was pretty painful to listen to! I would pick up a physical copy.
February 16, 2026
This is far from a linear description of a pandemic (or “pestilence”, in the classical terminology). I don’t fault it at all for that, because what you get is a leisurely exploration of the Roman world in the second century.
One learns, for instance, about how essentially fragile were the institutions of governance. Or maybe not governance, but just institutions. Is how you get food an institution? Reading about how the Roman world got food sure makes you grateful for the modern world, if also it raises some uneasiness about how much our modern system resembles magic: that one can go to any number of clean, well-stocked cornucopias of food and buy fresh vegetables in winter. The Roman world was built largely on simple extortion: the peasant’s crop output was taxed. Hand it over, Sanchez.
Rome, and other large Roman cities, thus depended for their bread upon sullen peasant masses who were only too happy to pass off inferior stuff, if they could get away with it, or (worse) adulterate it with a bit of water to increase the weight. Spoilage by mold would come later, in Roman warehouses. This grain, then, was distributed by a system of patronage, whereby nobles got a share and that share supplied their household and anyone else they felt like supporting.
I believe this system of patronage wasn’t the only way of getting grain: one could also buy. But good luck with that if you were poor. And there were a lot of poor, people simply living in the streets. Bottom line was that, poor or wealthy, a Roman was never more than one bad harvest season away from famine. As are we all, still, but in the case of Rome, they depended very heavily and specifically on Egypt.
Another way of saying this is that Rome was running a command economy, rather than a market-driven one. The emperor decreed the price of grain. We have the Soviet Union to thank for modern illustrations of how and why that works poorly. In Rome’s case, you were allowed to pay money (at the fixed rate) instead of the grain you owed. In years of plenty, it would be to your advantage to hand over grain, but in drought years, you could hand over money and make out like a bandit on the open market: this was a loophole not closed for decades.
One learns about climate, and about how the Southern Oscillation (El Nino) ties back to Egyptian climate. Fascinating stuff: there were some very bad harvest years during the first century.
Why are we going into all these side topics? Because to understand the impact of the Antonine Plague from this distance in time, one is best to understand the social context into which a novel pathogen burst.
Novel pathogen? We really don’t know whether the plague of A.D.165 to 180 was smallpox, measles, or some other virus. Smallpox was the favorite theory until it was realized that the most virulent form of smallpox did not emerge until at least a thousand years later. And none of the Roman writers of the time referred to “bubos”, that characteristic feature of Bubonic Plague. Elliott mentions orthoreovirus as a possibility, but no one is really sure.
Speaking of those Roman writers – they were maddeningly vague about the plague’s symptoms. Galen, that famous physician, turns out to be quite the blowhard, much more interested in self-aggrandizement (“here’s how I cured this person” but not “what they were specifically showing as symptoms”) and other writers left even less relevant information while delivering (one suspects) hyperbolic accounts of their own sufferings and vast suffering in the Empire at large. Of course, being too voluble and specific about problems in the Empire could get you killed, so there’s that.
Elliott shows how the plague was a slow-moving disaster spanning decades, contributing uniquely to the decline of an Empire that was already fragile for other structural reasons. The book is slow-moving in its own way: careful and scholarly. Overall, a very agreeable experience.
One learns, for instance, about how essentially fragile were the institutions of governance. Or maybe not governance, but just institutions. Is how you get food an institution? Reading about how the Roman world got food sure makes you grateful for the modern world, if also it raises some uneasiness about how much our modern system resembles magic: that one can go to any number of clean, well-stocked cornucopias of food and buy fresh vegetables in winter. The Roman world was built largely on simple extortion: the peasant’s crop output was taxed. Hand it over, Sanchez.
Rome, and other large Roman cities, thus depended for their bread upon sullen peasant masses who were only too happy to pass off inferior stuff, if they could get away with it, or (worse) adulterate it with a bit of water to increase the weight. Spoilage by mold would come later, in Roman warehouses. This grain, then, was distributed by a system of patronage, whereby nobles got a share and that share supplied their household and anyone else they felt like supporting.
I believe this system of patronage wasn’t the only way of getting grain: one could also buy. But good luck with that if you were poor. And there were a lot of poor, people simply living in the streets. Bottom line was that, poor or wealthy, a Roman was never more than one bad harvest season away from famine. As are we all, still, but in the case of Rome, they depended very heavily and specifically on Egypt.
Another way of saying this is that Rome was running a command economy, rather than a market-driven one. The emperor decreed the price of grain. We have the Soviet Union to thank for modern illustrations of how and why that works poorly. In Rome’s case, you were allowed to pay money (at the fixed rate) instead of the grain you owed. In years of plenty, it would be to your advantage to hand over grain, but in drought years, you could hand over money and make out like a bandit on the open market: this was a loophole not closed for decades.
One learns about climate, and about how the Southern Oscillation (El Nino) ties back to Egyptian climate. Fascinating stuff: there were some very bad harvest years during the first century.
Why are we going into all these side topics? Because to understand the impact of the Antonine Plague from this distance in time, one is best to understand the social context into which a novel pathogen burst.
Novel pathogen? We really don’t know whether the plague of A.D.165 to 180 was smallpox, measles, or some other virus. Smallpox was the favorite theory until it was realized that the most virulent form of smallpox did not emerge until at least a thousand years later. And none of the Roman writers of the time referred to “bubos”, that characteristic feature of Bubonic Plague. Elliott mentions orthoreovirus as a possibility, but no one is really sure.
Speaking of those Roman writers – they were maddeningly vague about the plague’s symptoms. Galen, that famous physician, turns out to be quite the blowhard, much more interested in self-aggrandizement (“here’s how I cured this person” but not “what they were specifically showing as symptoms”) and other writers left even less relevant information while delivering (one suspects) hyperbolic accounts of their own sufferings and vast suffering in the Empire at large. Of course, being too voluble and specific about problems in the Empire could get you killed, so there’s that.
Elliott shows how the plague was a slow-moving disaster spanning decades, contributing uniquely to the decline of an Empire that was already fragile for other structural reasons. The book is slow-moving in its own way: careful and scholarly. Overall, a very agreeable experience.
May 24, 2025
Content warnings: pandemic, mass death
I was so excited about reading this, and for the most part I found it really interesting given how little is know about the Antonine Plague.
But I *do* wish there had been more emphasis on the social impact of the disease because this - perhaps unsurprisingly given that the author is an economic historian - focused very much on the impact of the disease economically on the Roman empire. And, like, FINE. But don't promise me a good plague-y time and then make me learn about money.
I was so excited about reading this, and for the most part I found it really interesting given how little is know about the Antonine Plague.
But I *do* wish there had been more emphasis on the social impact of the disease because this - perhaps unsurprisingly given that the author is an economic historian - focused very much on the impact of the disease economically on the Roman empire. And, like, FINE. But don't promise me a good plague-y time and then make me learn about money.
January 22, 2026
This book is in the weeds with details and I’m here for it. It may not be everyone’s cup of tea but I found the level of research interesting and the way the author explained her points were pretty clear. I enjoyed the cat and mouse of trying to figure out from the limited resources and the questions they asked in lieu of answers. The lack of evidence doesn’t mean there is no evidence- maybe we just haven’t found it.
All that to say this, humans are dumb and we will continue to be arrogant monkeys and catching the plague is gonna happen again.
All that to say this, humans are dumb and we will continue to be arrogant monkeys and catching the plague is gonna happen again.
May 28, 2025
Very interesting !
Enjoyed all the lil nuggets of info along the way (Roman emissaries in China for one!; the subsidised grain fleets to feed the eternal city for another).
Aware that sources are pretty poor, but I almost wish that a book about the Antonine Plague, well, spoke more about the Antonine Plague.
Enjoyed all the lil nuggets of info along the way (Roman emissaries in China for one!; the subsidised grain fleets to feed the eternal city for another).
Aware that sources are pretty poor, but I almost wish that a book about the Antonine Plague, well, spoke more about the Antonine Plague.
December 31, 2025
Elliott identifies the framework of evidence we have - primarily in the form of “proxies” - for the Antonine Plague of the late 2nd century. Comparisons to our experiences in 2020 are perhaps unavoidable, but I think the author crossed a line a few times in presenting his political outlook as superior and dismissing ancient Roman religions (except for Christianity).
September 4, 2024
4.5 stars. Review to come
September 11, 2025
This book was the first audiobook I have been able to finish as I often lose focus when listening.
March 24, 2024
Those who think about the Roman Empire often lack a deep understanding of its history. Marked by religious persecution, scapegoating, poverty, inequality and deeply rooted corruption, the Roman imperial system was far from perfect and its complexities challenge straightforward analysis. While this book proposes several speculative theories, of which many are difficult to be validated through archaeological or literary evidence, the author's audacious thesis and unique interpretations are truly noteworthy. It prompts reconsideration of the existence of Pax Romana, distorted by historical propaganda. The book's examination of Roman political upheavals and societal psychology offers valuable lessons relevant to modern pandemic management.
January 13, 2026
i found this to be a fairly multifaceted book, with a lot of coverage on the social and cultural factors that exacerbated the plague. it really helped to paint a zeitgeist of the pax romana era, so much that I don't mind the lack of discussion on the actual plague itself. there's definitely moments where you can see the author's own biases seep in though.
February 25, 2024
Thanks to Libro.FM for the ARC.
This was very interesting and not what I'd normally pick up. Pandemics are never just the virus or illness - layers of cultural, social, and economic norms are often behind why they spread so quickly and so far.
This was very interesting and not what I'd normally pick up. Pandemics are never just the virus or illness - layers of cultural, social, and economic norms are often behind why they spread so quickly and so far.
December 3, 2024
An interesting book but a slow read.
January 4, 2025
Good writing, and very good use of evidence
May 5, 2024
Pox Romana by Colin Elliott
Focusing on the Antonine Plague of 160s through potentially 190 AD, Pox Romana zeros in on a variety of issues that could have exacerbated the major wave that hit Rome in 165 under Marcus Aurelius and Lucius Verus.
This book was somewhat of challenge to get through as it reads a bit dry and more like an academic text book at many points. More than likely due to limited sources about the plague, the author seemingly said the same thing over and over just with different locations or years. Due to that, I am now fully knowledgeable on Nile optimal flood levels (15 cubits)!
I’m a bit of a nerd so did enjoy parts of it and like pieces of the economic and social aspects that Elliott highlights, however I don’t think I can recommend this books for others. There also seems to be an expectation that the reader has decent previous Roman history knowledge. Overall, I would have provided more praise if it was about half its size as I think around 125-150 pages could have covered all relevant aspects sufficiently.
Last note, if you find yourself interested in this book, 100% avoid the audio version. I started Pox on audio and almost gave up a chapter or so in as the book reader made the dry content seep even deeper into dullness.
Focusing on the Antonine Plague of 160s through potentially 190 AD, Pox Romana zeros in on a variety of issues that could have exacerbated the major wave that hit Rome in 165 under Marcus Aurelius and Lucius Verus.
This book was somewhat of challenge to get through as it reads a bit dry and more like an academic text book at many points. More than likely due to limited sources about the plague, the author seemingly said the same thing over and over just with different locations or years. Due to that, I am now fully knowledgeable on Nile optimal flood levels (15 cubits)!
I’m a bit of a nerd so did enjoy parts of it and like pieces of the economic and social aspects that Elliott highlights, however I don’t think I can recommend this books for others. There also seems to be an expectation that the reader has decent previous Roman history knowledge. Overall, I would have provided more praise if it was about half its size as I think around 125-150 pages could have covered all relevant aspects sufficiently.
Last note, if you find yourself interested in this book, 100% avoid the audio version. I started Pox on audio and almost gave up a chapter or so in as the book reader made the dry content seep even deeper into dullness.
February 13, 2025
This book contains SIGNIFICANTLY more info about the self inflicted woes of early Christians than I expected or even wanted. information about the Plague of Galen and how it related to the fall of Rome was interesting. Another book that makes you say "Ope," when looking back at COVID.
March 16, 2024
Valid historiography, but a lot of information for not a lot of satisfaction (spoiler alert: there's still a lot nobody can really say for sure).
Want to read
February 15, 2025Paused on this one, I don't know enough about the Roman Empire for the level of detail to interest me, but that's not the book's fault.
August 26, 2024
No matter how you might personally feel about the experience of the COVID-19 pandemic, none of us can doubt its profound and significant influence on the world of today, over four years later. Economies took deep hits; families experienced significant disruption. Educational and mental health outcomes were often challenging and compromised. Confidence in public health departments has likewise been compromised.
But in the grand scheme of things, SARS-CoV-2 and its COVID-19 infection barely register as pandemics. Such is not an attempt to diminish the difficulties and grief which attended to COVID-19; it is a warning about what the potential rise of another pathogen far more pervasive and far more deadly. We know it could happen because it has happened so many times in history.
In Pox Romana: The Plague That Shook the Roman World, Colin Elliott thus explored the Antonine Plague of the 160s CE and its ramifications for the Roman Empire.
The author took stock of the Roman Empire in the final days of what has been deemed the Pax Romana, the period of relative stability from around 0-150 CE, and made plain how the Roman Empire was never as peaceful or as firmly established as might be imagined. Plenty of diseases and other conditions were endemic, and Romans were shorter and less healthy than those who came before and after them. Urban areas were significant vectors for disease spread. Nutrition for most people wasn’t the greatest. Conditions were ripe for pandemic illness.
The author set forth what we know about the Antonine Plague, and it is not much. One might commend the author for his creativity in trying to make much out of little, but also might fairly wonder if he is making a bit too much out of a little. From what we know it would seem the Antonine Plague would have been in what we deem the “smallpox” category: not smallpox as we would later understand it, but a similar virus. The author presented the Antonine Plague as the first experience of pandemic disease: if the characterization is accurate, it is more about how it was the first time the world had sufficiently developed civilization in various places as to be able to experience such a thing, for no doubt all sorts of diseases had spread around the world, but perhaps never before as efficiently and widely as in the Antonine Plague.
The author did well attest to how it would have been easy for a virus to spread widely in the world on account of trade and military exploits. Legend associated the plague with the defeats inflicted on the Parthians to the east, and the author demonstrated how it would have been quite easy for the soldiers to get exposed to such an infection in Mesopotamia and then quickly bring it back to the barracks of the east and northern parts of the Empire, with further dispersal ongoing.
The author throughout is bedeviled by a lack of first person accounts; such is why we are still not entirely sure what the disease was, and we cannot know how widely it spread, or how many died with any level of confidence. But the author does do well at demonstrating from what evidence we do have about the significant downturn in many aspects of the Roman Empire and its life after the 160s: fewer military diplomas; significant population declines in many cities; permanent reduction in mining and lead emissions; debasement of money; and the like.
The author thus well argued how the Antonine Plague, combined with many other factors, brought an end to the pax romana and ushered in a new, less stable, less populated, less robust era of the Roman Empire. The author did well to remind everyone how it is quite extraordinary for the Empire to have endured the barbarian incursions, imperial instability, famine, the plague, and to continue to persevere. But it helps to show how the scenes we deem unimaginably apocalyptic in the Book of Revelation reasonably fit the experience of those in the Roman Empire beginning in the second half of the second century.
Public health developments over the past two hundred years have been some of the most significant means of saving and preserving life ever experienced in human history. As a society we would be very stupid to conclude from our COVID-19 experience that we should put less energy and funding into public health and the quest for vaccines and medicines for common bacterial and viral infections. We may not know exactly how many died in the Antonine Plague, but it was almost certainly far more than the 1% death rate we experienced with COVID-19. And there will be pandemic-level pathogens which are or will develop in the future, and there will be the prospect of future pandemics. And next time we might experience something more like what the Romans did, and how well would our culture and society endure?
But in the grand scheme of things, SARS-CoV-2 and its COVID-19 infection barely register as pandemics. Such is not an attempt to diminish the difficulties and grief which attended to COVID-19; it is a warning about what the potential rise of another pathogen far more pervasive and far more deadly. We know it could happen because it has happened so many times in history.
In Pox Romana: The Plague That Shook the Roman World, Colin Elliott thus explored the Antonine Plague of the 160s CE and its ramifications for the Roman Empire.
The author took stock of the Roman Empire in the final days of what has been deemed the Pax Romana, the period of relative stability from around 0-150 CE, and made plain how the Roman Empire was never as peaceful or as firmly established as might be imagined. Plenty of diseases and other conditions were endemic, and Romans were shorter and less healthy than those who came before and after them. Urban areas were significant vectors for disease spread. Nutrition for most people wasn’t the greatest. Conditions were ripe for pandemic illness.
The author set forth what we know about the Antonine Plague, and it is not much. One might commend the author for his creativity in trying to make much out of little, but also might fairly wonder if he is making a bit too much out of a little. From what we know it would seem the Antonine Plague would have been in what we deem the “smallpox” category: not smallpox as we would later understand it, but a similar virus. The author presented the Antonine Plague as the first experience of pandemic disease: if the characterization is accurate, it is more about how it was the first time the world had sufficiently developed civilization in various places as to be able to experience such a thing, for no doubt all sorts of diseases had spread around the world, but perhaps never before as efficiently and widely as in the Antonine Plague.
The author did well attest to how it would have been easy for a virus to spread widely in the world on account of trade and military exploits. Legend associated the plague with the defeats inflicted on the Parthians to the east, and the author demonstrated how it would have been quite easy for the soldiers to get exposed to such an infection in Mesopotamia and then quickly bring it back to the barracks of the east and northern parts of the Empire, with further dispersal ongoing.
The author throughout is bedeviled by a lack of first person accounts; such is why we are still not entirely sure what the disease was, and we cannot know how widely it spread, or how many died with any level of confidence. But the author does do well at demonstrating from what evidence we do have about the significant downturn in many aspects of the Roman Empire and its life after the 160s: fewer military diplomas; significant population declines in many cities; permanent reduction in mining and lead emissions; debasement of money; and the like.
The author thus well argued how the Antonine Plague, combined with many other factors, brought an end to the pax romana and ushered in a new, less stable, less populated, less robust era of the Roman Empire. The author did well to remind everyone how it is quite extraordinary for the Empire to have endured the barbarian incursions, imperial instability, famine, the plague, and to continue to persevere. But it helps to show how the scenes we deem unimaginably apocalyptic in the Book of Revelation reasonably fit the experience of those in the Roman Empire beginning in the second half of the second century.
Public health developments over the past two hundred years have been some of the most significant means of saving and preserving life ever experienced in human history. As a society we would be very stupid to conclude from our COVID-19 experience that we should put less energy and funding into public health and the quest for vaccines and medicines for common bacterial and viral infections. We may not know exactly how many died in the Antonine Plague, but it was almost certainly far more than the 1% death rate we experienced with COVID-19. And there will be pandemic-level pathogens which are or will develop in the future, and there will be the prospect of future pandemics. And next time we might experience something more like what the Romans did, and how well would our culture and society endure?
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