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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
218 people are currently reading
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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
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.
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.
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.
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).
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?
August 22, 2025
I throughly enjoyed this book with a few quibbles. The author is upfront about the fact that historians don’t know what type of disease cause the Antonine plague. He reviews all of the current theories. I found the idea that it was a primitive form of smallpox intriguing.
The shadow of COVID lies over this book, of course. At times, I did wonder how COVID influenced the side topics that the author decided to focus on.
Quibbles:
He gives Edward Jenner credit for solving the problem of smallpox. A memory made me go back to wikipedia to find “Onesimus (late 1600s–1700s[1]) was an African (likely Akan) man who was instrumental in the mitigation of smallpox in Boston, Massachusetts.” Jenner get the credit for replacing the inoculation method of Onesimus with a vaccination method. The author only mentions Jenner.
The author is keen to explain that true capitalism might have solved some of the problems that Rome faced. They had no idea how periodic fluctuations in the Nile affected grain yield. They allowed taxes to be paid in grain or in cash. Which meant if grain was worth more, farmers paid in cash and promptly took the grain to market and sold it for much more. I was listening to an audiobook, so I don’t have the quote in front of me, but he mentions how the Romans could not envision a world where a citizen could find food in any market close at hand. And I wondered if the author was unfamiliar with food deserts in our current capitalistic system.
Imagery
The description of what a Roman bath was really like was striking. Not the spa-like image given in sword and sandal movies.
The descriptions of people living in the streets and gutters reminded me of a trip to north Africa where people were living and begging in the streets immediately outside posh hotels.
The author mentions an aqueduct built to “nowhere” which reminded me of the bridge to nowhere scandal in my youth. Governments will spend profligately in every time period.
History Rhymes?
I found it interesting that Christians were blamed for the plague because they did not participate in the universal sacrifices to the gods. As described by the author, it sounds like the anger that some of us had at citizens who would not vaccinate against COVID. The sacrifices were a sort of herd immunity. He describes a historical document that everyone had to carry indicating that they had completed their sacrifice to the gods done to ameliorate the plague.
The plague killed during the reign of Marcus Aurelius who was followed by his son Commodus. A summary online indicates “Economically, Commodus's reign was characterized by financial irresponsibility…..His rule saw an increase in the use of imperial edicts, often issued to settle personal scores or reward loyalty, undermining the legal traditions and stability of the Roman state.
The emperor's arbitrary use of power extended to the Senate, where he marginalized and intimidated senators, further eroding the traditional checks on imperial authority. His foreign policy was typified by a preference for diplomacy and appeasement over military engagement.”
Sound familiar?
The author does print the celebratory rant published by the Roman Senate after Commodus was killed. I can see someone pulling that out again one day.
The shadow of COVID lies over this book, of course. At times, I did wonder how COVID influenced the side topics that the author decided to focus on.
Quibbles:
He gives Edward Jenner credit for solving the problem of smallpox. A memory made me go back to wikipedia to find “Onesimus (late 1600s–1700s[1]) was an African (likely Akan) man who was instrumental in the mitigation of smallpox in Boston, Massachusetts.” Jenner get the credit for replacing the inoculation method of Onesimus with a vaccination method. The author only mentions Jenner.
The author is keen to explain that true capitalism might have solved some of the problems that Rome faced. They had no idea how periodic fluctuations in the Nile affected grain yield. They allowed taxes to be paid in grain or in cash. Which meant if grain was worth more, farmers paid in cash and promptly took the grain to market and sold it for much more. I was listening to an audiobook, so I don’t have the quote in front of me, but he mentions how the Romans could not envision a world where a citizen could find food in any market close at hand. And I wondered if the author was unfamiliar with food deserts in our current capitalistic system.
Imagery
The description of what a Roman bath was really like was striking. Not the spa-like image given in sword and sandal movies.
The descriptions of people living in the streets and gutters reminded me of a trip to north Africa where people were living and begging in the streets immediately outside posh hotels.
The author mentions an aqueduct built to “nowhere” which reminded me of the bridge to nowhere scandal in my youth. Governments will spend profligately in every time period.
History Rhymes?
I found it interesting that Christians were blamed for the plague because they did not participate in the universal sacrifices to the gods. As described by the author, it sounds like the anger that some of us had at citizens who would not vaccinate against COVID. The sacrifices were a sort of herd immunity. He describes a historical document that everyone had to carry indicating that they had completed their sacrifice to the gods done to ameliorate the plague.
The plague killed during the reign of Marcus Aurelius who was followed by his son Commodus. A summary online indicates “Economically, Commodus's reign was characterized by financial irresponsibility…..His rule saw an increase in the use of imperial edicts, often issued to settle personal scores or reward loyalty, undermining the legal traditions and stability of the Roman state.
The emperor's arbitrary use of power extended to the Senate, where he marginalized and intimidated senators, further eroding the traditional checks on imperial authority. His foreign policy was typified by a preference for diplomacy and appeasement over military engagement.”
Sound familiar?
The author does print the celebratory rant published by the Roman Senate after Commodus was killed. I can see someone pulling that out again one day.
September 24, 2025
A thankless task, performed adequately. At the end, sadly, I found this attempt to reckon with the consequences of an 1800 year old plague pretty unsatisfying. The author has done heroic work trying to reconstruct the details of the Antonine plague, but again and again, he bumps into the fact that there just isn't enough in the historical record to write a book about.
Unlike the sixth century Plague of Justinian, that has been illuminated by recent biological discoveries, we have no new information on the disease that made the reign of Roman emperor Marcus Aurelius, between 161 and 180 CE, such an unrelenting hell. Maybe it was small pox? We still don't know. We know that there was a disease, in part because one of the most famous doctors in history, Galen, lived through it and talked about it a lot. Elliott gamely surveys the climate data, the numismatic data, and all recovered inscriptions to try to tell the story, but at the end of the day, there just isn't much information.
Elliott's fruitless pursuit is no doubt valuable academically, but in a work of popular history, it's kind of pointless. He's not really telling us much with this book. Because the evidence of the nominal subject is so scant, he gives us a serviceable account of the challenges faced by Marcus Aurelius, and the hideous failures of his son and successor Commodus, famously dramatized in the 2000 film Gladiator. This account of the failure of the Roman empire is very learned, but it's also suffused with late Reagan era economic anachronisms. There are vastly more references to Austrian economists like Hayek and Schumpeter than there should be in a volume on Roman history (there should be zero).
I think the great failing of this book is attempting to talk about just the decade or three (we don't know) of the Antonine plague, and trying to make it a turning point without adequate evidence. I couldn't help but be reminded of Kyle Harper's vastly superior "Fate of Rome" which was published in 2017. The author references Harper's book at least once. It uses the same new research on climate and diseases that this book does. But it takes a much larger view, pointing out how these dynamics took place over a couple of centuries rather than a couple of decades. In 200 years rather than 20, there's a lot more information to work with, and a more compelling case can be made. This book was fine, but it mostly made me want to re-read Harper.
Unlike the sixth century Plague of Justinian, that has been illuminated by recent biological discoveries, we have no new information on the disease that made the reign of Roman emperor Marcus Aurelius, between 161 and 180 CE, such an unrelenting hell. Maybe it was small pox? We still don't know. We know that there was a disease, in part because one of the most famous doctors in history, Galen, lived through it and talked about it a lot. Elliott gamely surveys the climate data, the numismatic data, and all recovered inscriptions to try to tell the story, but at the end of the day, there just isn't much information.
Elliott's fruitless pursuit is no doubt valuable academically, but in a work of popular history, it's kind of pointless. He's not really telling us much with this book. Because the evidence of the nominal subject is so scant, he gives us a serviceable account of the challenges faced by Marcus Aurelius, and the hideous failures of his son and successor Commodus, famously dramatized in the 2000 film Gladiator. This account of the failure of the Roman empire is very learned, but it's also suffused with late Reagan era economic anachronisms. There are vastly more references to Austrian economists like Hayek and Schumpeter than there should be in a volume on Roman history (there should be zero).
I think the great failing of this book is attempting to talk about just the decade or three (we don't know) of the Antonine plague, and trying to make it a turning point without adequate evidence. I couldn't help but be reminded of Kyle Harper's vastly superior "Fate of Rome" which was published in 2017. The author references Harper's book at least once. It uses the same new research on climate and diseases that this book does. But it takes a much larger view, pointing out how these dynamics took place over a couple of centuries rather than a couple of decades. In 200 years rather than 20, there's a lot more information to work with, and a more compelling case can be made. This book was fine, but it mostly made me want to re-read Harper.
September 26, 2024
---Plot/Intro---
Most likely an idea the author had germinating (no pun intended) for quite awhile saw inspiration ignite and spread to encompass a historical zeroing in on an era that most assume was prosperous and peaceful, but in reality was anything but. The Pax Romana, almost 200 years of ‘peace’, was actually about as peaceful as a cadaver inflicted with plague. Just how deadly was the Antonine plague of the late 2nd century? Was this the straw the broke the camel’s back and sent a seemingly prosperous Rome on a slow and steady collapse over the next few centuries?
---Bottom Line---
Many a person assumes Pax Romana was a ‘golden age of peace’ where living in Rome was glorious for most anyone, a time when most anyone of any age and of any class could travel from Jerusalem to Londinium on well-built roads, experience little to no hardship, and arrive in style. Huge buildings (most are now gone), grand baths (in reality, literal cesspits), successful industries aplenty (slave-powered), and ruled by benevolent emperors (who had a thing for engaging in nearly nonstop war).
For most, there was nothing peaceful about this era. The Roman Empire—and especially this part of it—could best be thought as ‘late stage capitalism’ where we saw the final form of the extreme ambition at any cost that destroyed the Roman Republic reach fever pitch. Endless conquest has its limits and an empire already in a perilous situation only needed one thing to push it to the brink.
Colin P. Elliott makes a good claim that the ‘thing’ that did the Empire in—at least what began the downward trend that concluded Pax Romana was indeed ‘Pox’ Romana—the Antonine plague. Before this book I figured it was just a combination of economic factors and the rise of Christianity that were the most major of factors when going by Elliott it was not much of the latter (though it was a factor to be sure) and more of the former mixed with tons of people...well, dying quickly and unexpectedly.
There are tons of books on Rome, but probably not many that precisely zero in on such a specific era for such a specific reason. This may not be the end-all be-all book on the Roman Empire, but it paints a vivid picture and advocates a good reason why things began to collapse soon after it.
Most likely an idea the author had germinating (no pun intended) for quite awhile saw inspiration ignite and spread to encompass a historical zeroing in on an era that most assume was prosperous and peaceful, but in reality was anything but. The Pax Romana, almost 200 years of ‘peace’, was actually about as peaceful as a cadaver inflicted with plague. Just how deadly was the Antonine plague of the late 2nd century? Was this the straw the broke the camel’s back and sent a seemingly prosperous Rome on a slow and steady collapse over the next few centuries?
---Bottom Line---
Many a person assumes Pax Romana was a ‘golden age of peace’ where living in Rome was glorious for most anyone, a time when most anyone of any age and of any class could travel from Jerusalem to Londinium on well-built roads, experience little to no hardship, and arrive in style. Huge buildings (most are now gone), grand baths (in reality, literal cesspits), successful industries aplenty (slave-powered), and ruled by benevolent emperors (who had a thing for engaging in nearly nonstop war).
For most, there was nothing peaceful about this era. The Roman Empire—and especially this part of it—could best be thought as ‘late stage capitalism’ where we saw the final form of the extreme ambition at any cost that destroyed the Roman Republic reach fever pitch. Endless conquest has its limits and an empire already in a perilous situation only needed one thing to push it to the brink.
Colin P. Elliott makes a good claim that the ‘thing’ that did the Empire in—at least what began the downward trend that concluded Pax Romana was indeed ‘Pox’ Romana—the Antonine plague. Before this book I figured it was just a combination of economic factors and the rise of Christianity that were the most major of factors when going by Elliott it was not much of the latter (though it was a factor to be sure) and more of the former mixed with tons of people...well, dying quickly and unexpectedly.
There are tons of books on Rome, but probably not many that precisely zero in on such a specific era for such a specific reason. This may not be the end-all be-all book on the Roman Empire, but it paints a vivid picture and advocates a good reason why things began to collapse soon after it.
December 26, 2025
Refreshingly scholarly work that examines what we know (surprisingly little) and what we don't know (a lot ) about the 2nd century plague that knocked Rome off it's alleged pedestal.
I really enjoyed Elliott's approach here. It was very nice to see a scholar admit that there are things we just don't know, and to openly state that his theories are just that, and will never be confirmed one way or the other. He would present evidence to Acclaim, and then immediately follow it with the reasons why it could potentially not be. It was incredibly vigorous and left things open to the interpretation of other scholars and the reader. I also like his sober analysis of the Pax Romana, and how it was probably much more poles of human feces than shining cities of marble.
His analysis is only let down by a somewhat bizarre fixation on markets and Hayek especially. It doesn't overly creep into the work, but it appears and sticks out because it's the few things he takes a definite stance on. We would have 30 pages of very academic writing that considers the evidence and makes very rational educated guesses, and then a closing sentence worshipping the free market and if pining that if only the Romans let the invisible hand drive. In the context of a pre-industrial economy, it doesn't really make much sense and was very distracting.
Still, It's very nice to see truly academic works being published again. A few quibbles aside, this is a very serious scholarly work and was a treat in a sea of Pop history
I really enjoyed Elliott's approach here. It was very nice to see a scholar admit that there are things we just don't know, and to openly state that his theories are just that, and will never be confirmed one way or the other. He would present evidence to Acclaim, and then immediately follow it with the reasons why it could potentially not be. It was incredibly vigorous and left things open to the interpretation of other scholars and the reader. I also like his sober analysis of the Pax Romana, and how it was probably much more poles of human feces than shining cities of marble.
His analysis is only let down by a somewhat bizarre fixation on markets and Hayek especially. It doesn't overly creep into the work, but it appears and sticks out because it's the few things he takes a definite stance on. We would have 30 pages of very academic writing that considers the evidence and makes very rational educated guesses, and then a closing sentence worshipping the free market and if pining that if only the Romans let the invisible hand drive. In the context of a pre-industrial economy, it doesn't really make much sense and was very distracting.
Still, It's very nice to see truly academic works being published again. A few quibbles aside, this is a very serious scholarly work and was a treat in a sea of Pop history
September 17, 2025
This is a book only nominally about the Antonine Plague and mostly about the end of the Pax Romana.
Elliott brings in climate research, biology, public health, and economics (and boy does he have a lot to say about that) to discuss the end of the Pax in an impressively multidisciplinary fashion, but honestly when it comes to the plague itself, there doesn't really seem to be much meat. Questions like "when did the plague start?", "where did it come from", "how many people did it effect?", "who did it effect?", "what was it?" all go unanswered. I don't blame Elliot for this- I know that these are hard questions to answer and are part of the allure of ancient diseases- but it does make the book feel a bit pointless. He's left repeating the same things over and over as things that *could* indicate something, while also providing the reasons it might not mean anything at all. There seems to be some tacit admission of this when the end of the book gets padded by a tenuously linked mini biography of Commodus.
All that is to say that it left me wanting more, as someone that's interested in historical plagues. But if you can put aside any economic disagreements with the author, I do think that this makes for a readable history on some perhaps less discussed aspects of the end of the Pax.
Elliott brings in climate research, biology, public health, and economics (and boy does he have a lot to say about that) to discuss the end of the Pax in an impressively multidisciplinary fashion, but honestly when it comes to the plague itself, there doesn't really seem to be much meat. Questions like "when did the plague start?", "where did it come from", "how many people did it effect?", "who did it effect?", "what was it?" all go unanswered. I don't blame Elliot for this- I know that these are hard questions to answer and are part of the allure of ancient diseases- but it does make the book feel a bit pointless. He's left repeating the same things over and over as things that *could* indicate something, while also providing the reasons it might not mean anything at all. There seems to be some tacit admission of this when the end of the book gets padded by a tenuously linked mini biography of Commodus.
All that is to say that it left me wanting more, as someone that's interested in historical plagues. But if you can put aside any economic disagreements with the author, I do think that this makes for a readable history on some perhaps less discussed aspects of the end of the Pax.
May 29, 2025
¿Que tan seguido piensas en Roma antigua?
Bueno, leyendo este libro, diario.
El autor intenta reconstruir la posible evolución de la Peste Antoina durante sus periodos mas destructivos. Eso significa hablar sobre Marco Aurelio. Eso significa hablar sobre las guerras Marcomanicas, eso significa hablar sobre la demencia que fue el reinado de Comodo.
Para ser un libro tan.... academico el autor hace muy buen trabajo de mantenerte entretenido escuchando sobre sistemas de distribución de grano e impuestos en el antiguo egipto.
Esta es una historia contada en brochazos amplios - el autor esta intentando demostrar que la Pax Romana no era particularmente próspera, y que un monton de factores higienicos, militares, sociales y alimenticios se juntaron para crear la primer peste mortifera de occidente.
Eso significa que no hay tanto enfasis en personajes - tenemos a Marco Aurelio, Comodo, Galen, pero no mucho más. No importa, la historia que cuenta es bastante amena y te pone a reflexionar sobre lo que en realidad era "la gloria" de Roma.
Altamente recomendado si eres fan del imperio.
Bueno, leyendo este libro, diario.
El autor intenta reconstruir la posible evolución de la Peste Antoina durante sus periodos mas destructivos. Eso significa hablar sobre Marco Aurelio. Eso significa hablar sobre las guerras Marcomanicas, eso significa hablar sobre la demencia que fue el reinado de Comodo.
Para ser un libro tan.... academico el autor hace muy buen trabajo de mantenerte entretenido escuchando sobre sistemas de distribución de grano e impuestos en el antiguo egipto.
Esta es una historia contada en brochazos amplios - el autor esta intentando demostrar que la Pax Romana no era particularmente próspera, y que un monton de factores higienicos, militares, sociales y alimenticios se juntaron para crear la primer peste mortifera de occidente.
Eso significa que no hay tanto enfasis en personajes - tenemos a Marco Aurelio, Comodo, Galen, pero no mucho más. No importa, la historia que cuenta es bastante amena y te pone a reflexionar sobre lo que en realidad era "la gloria" de Roma.
Altamente recomendado si eres fan del imperio.
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