Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
1 CALIFORNIA STATE UNIVERSITY SAN MARCOS “THE BIG HISTORY OF INFECTIOUS DISEASE AND THE ATHENIAN PLAGUE” A THESIS SUBMITTED TO THE FACULTY OF THE COLLEGE OF HUMANITIES, ARTS, BEHAVIORAL & SOCIAL SCIENCES IN CANDIDACY FOR THE DEGREE OF MASTER OF ARTS IN HISTORY DEPARTMENT OF HISTORY BY BREE FOTH SAN MARCOS, CA DECEMBER 2013 2 Table of Contents Introduction ..................................................................................................................................... 3 Chapter 1: Plague in Prehistory .................................................................................................... 12 Chapter 2: The Athenian Plague ................................................................................................... 21 In Conclusion ................................................................................................................................ 30 Appendix ....................................................................................................................................... 32 Appendix A ............................................................................................................................... 32 Appendix B ............................................................................................................................... 33 Appendix C ............................................................................................................................... 34 Bibliography ................................................................................................................................. 35 Primary Sources: ....................................................................................................................... 35 Secondary Sources: ................................................................................................................... 35 3 Introduction It is not widely known that infectious disease predates human existence. Cellular interactions that resemble what modern scientists now consider “infection” has been present in the universe since the first appearance of life. These earliest interaction existed as a relationship between two or more cells that resulted in a positive, negative, or neutral result. As life forms became more complex on earth, microbes also evolved and increased in complexity. The appearance of mammals presented optimal host organisms for infectious microbes, and environmental changes created regions with warm, humid climates near the equator, allowing bacteria to thrive. In prehistory, disease affected only small populations of humans due to their living in small, nomadic groups. As humans slowly transitioned to living in sedentary communities where populations became denser the nature of infectious microbes also evolved; infectious microbes became more virulent as their hosts were now able to develop natural immunities to the diseases that were common in the regions they inhabited. Outbreaks became more deadly, causing mass destruction of life as dense populations and changes in living conditions allowed for microbes to be easily transmitted among individuals; these destructive outbreaks are considered plagues. The Athenian plague is the first recorded plague in human history and was a significantly destructive outbreak of what was likely Typhoid fever during the Peloponnesian War from 430 B.C.E. to 426 B.C.E. While there is a large amount of secondary literature available about the Athenian plague, few historians have taken an interdisciplinary approach by incorporating prehistory and the science of infectious disease in their analyses. However, there is one field of history that focuses entirely on applying multidisciplinary perspectives in examining historical trends and events and that would be particularly useful for a study of the Athenian plague; this field is big history. An application of the multidisciplinary 4 approach of big history to an analysis of the Athenian plague allows me to illustrate the gradual evolution of infectious disease outbreaks throughout prehistory, shedding new light on the various causes of the Athenian plague and the biological and cultural reasons for its lethality. Big history and other fields of historical study that examine large scales of time or large geographic areas have become increasingly relevant since the late twentieth century. Contemporary global crises such as anthropogenic global warming, environmental destruction, and overpopulation have encouraged scholars to study the past in a broader timeline in order to better understand how earth and mankind have come to be as they are and how mankind is disrupting the natural order. As Daniel Smail recently wrote in Perspectives on History, “The urgency of the contemporary situation, moreover, exposes the inadequacy of the short view.” 1 Big historians have not yet studied infectious disease, and classical historians have yet to apply interdisciplinary fields, such as ecological and environmental history, to the narrative of the Athenian plague. My project will fill a gap in the existing big history historiography as I utilize the big history timeline, as well as biological sciences, to contribute to a more complete history for the Athenian plague than exists currently. This thesis studies a substantial period of time beginning with the Big Bang, or the birth of the universe, approximately fourteen billion years ago and concluding with the end of the first breakout of the plague in Athens in 426 B.C.E. Studying this large span of time and area will allow me to emphasize the gradual changes that occurred during this period. The geographic region of my study emphasizes the unique expanse of big history; geographically, the scope of my thesis will begin as an examination of the universe in its entirety for several billion years 1 Smail, Daniel L, "Beyond the Longue Duree: Human History in Deep Time." Perspectives on History 50, no. 9 (December 2012): 59. 5 following the Big Bang. My focus will narrow to planet Earth at its formation 4.5 billion years ago and the emergence of life four billion years ago. Finally, I will narrow my examination to the Athenian Empire as it existed in 450 B.C.E. My work applies the framework of big history and the historical timeline of the universe’s existence that has been established by historians and scientists as I consider the Athenian plague in terms of its geographic, ecological, and biological causes. In studying the history of mankind as a species, I first explore how pathogens have evolved throughout prehistory and how they affected the development of mankind up to the first occurrence of the Athenian plague. Secondly, I discuss how Athenian culture, such as the cultural reason for the increased population density of Athens during the outbreak, contributed to the scale of devastation caused by the plague and how Athenian culture was temporarily transformed by the plague. Finally, I examine how several environmental factors affected this particular occurrence of the plague, such as the dense human and animal populations of Athens, the migration of peoples during the Peloponnesian War, and the climate of Athens. Studying environmental and biological factors in the plague’s level of devastation is an interdisciplinary approach that provides a more complete discussion of how the plague occurred than previously published. Big history is not necessarily meant to provide new information about an event specifically, but rather creates a better understanding of the entire picture of an event and its historical significance. Studying environmental factors in the spread of disease, as well as how infectious disease evolved as the lifestyles of humans transformed, provides a unique and all-encompassing perspective of the Athenian plague. This thesis includes a supplementary website. Visual representations of the evidence will be very beneficial for readers when considering the geographic and chronological span of my 6 project. The website includes a short documentary and interactive timeline, which provide an overview of the general ideas that big history has been founded upon. An interactive map that illustrates the location and age of infectious disease victims from prehistory is also included in a subpage of the website. It includes information regarding the age, ethnic identification, and cause of death of the individuals that are being represented. My site can be accessed at http://www.csusmhistory.org/faulk006/. When studying ancient history, scholars are constantly challenged by the extremely limited number of available primary sources. By utilizing the ideas, timeline, and existing publications in the field of big history, I have access to a large amount of material that has never before been applied to ancient Greek history; material that is applicable to studying the Athenian plague in terms of geography, ecology, environmental history, and world history. Simply, my main argument is that in studying the history of the universe, planet earth, and life on earth, and the historical, biological, and environmental trends that span these histories, I provide an original perspective of the Athenian plague and its causes. In my study of the plague I set out to answer the following questions: What biological and ecological factors contributed to how the plague came to and spread through Athens? What environmental factors contributed to the scale of devastation caused by the plague from 430 B.C.E.-426 B.C.E.? Did the geographic location and climate of Athens affect how the plague occurred and resolved? How did environmental and biological factors interact with political, cultural, and social factors to contribute to the extent and severity of the plague? According to the writings of Thucydides, invading Spartan forces that had been exposed to the disease (which I argue was typhoid fever) during military campaigns on the African continent introduced the infection to the Athenian Empire. The Mediterranean climate in Athens, the well water supply, and dense population within the city 7 walls are a few environmental factors that contributed to the severity of the outbreak. Pericles’ decision to move the countrymen of Athens within the city walls during the Peloponnesian War created optimum conditions for the transmission of the disease, contributing to the extremely high mortality rate of Athenian citizens. The likelihood of imminent death transformed the behavior of Athenians, as there was wide disregard for lawfulness and traditional morality. As it intervenes into the historiographies of big history and environmental history, my thesis contributes to existing cultural history discussions of the Athenian plague. Big history is a considerably new field of history, the first publications appearing in the 1970s and the term “big history” being coined in the 1990s. The field has thus far been dominated by astrophysicists and geologists, giving it a strong scientific foundation. However, historians have taken great interest in investigating the relationship between humans and what we consider “nature” in an attempt to find answers to the elementary questions of human life: “How did we get here?” and, “Why are we here?” Big historians have managed to organize all of history into a more manageable structure for study and have established the timeline of threshold moments. Despite its incredible scale, big history has proven valuable in studying specific elements of Earth’s development and events in human history, e.g. Jonathan Markley’s big history of grass. 2 Markley creates a history of grass species, specifically the dominant and invasive ones of North and South America, spanning approximately one thousand years, and his article serves as a model for my application of big history themes as I study the Athenian plague. My thesis contributes to the environmental history discussion of infectious disease as I join historians such as David Christian, Alfred Crosby, and Harold Morowitz in studying how 2 Markley, Jonathan, “A Practical Compromise to Teaching World History: Thematic Bridges, Standards, and Technology.” World History Connected 6, no. 3 (2009). http://worldhistoryconnected.press.illinois.edu/6.3/markley.html. 8 the ecosystems of earth developed and why life exists on earth as it does today. As a leading environmental historian, Alfred Crosby provides a global perspective of the biological evolution of flora and fauna species on earth, and how certain species evolved superior defenses to pathogens which allowed them to dominate large regions of land masses in his book Ecological Imperialism: The Biological Expansion of Europe, 900-1900. Jonathan Markley followed the Crosbian model in his article “A Practical Compromise to Teaching World History: Thematic Bridges, Standards, and Technology,” as he creates a history of grass species, specifically dominant and invasive grass species of the North and South American continents, spanning approximately one thousand years. These two publications will serve as models for my thesis. Both environmental history and big history are interdisciplinary fields are founded upon evidence provided by the studies of experts in several scientific fields, such as physicist Isaac Asimov and astrophysicist Stephen Hawking. I have found several publications by these scientists especially relevant to this thesis. Isaac Asimov’s Beginnings: The Story of Origins of Mankind, Life, the Earth, the Universe and Chronology of the World: the History of the World from the Big Bang to Modern Times examine the formation of the universe, our solar system, Earth, and humans throughout all of time. They help to provide a scientific framework for the timeline big history follows and the trends that span all of history. Asimov’s publications are more popularized and accessible for scholars with knowledge of astrophysics, and include several diagrams that help the reader visualize the complexities of the universe. Stephen Hawking’s A Brief History of Time examines the history of the universe, but the language and theories are less accessible to an unprofessional scientist. However, his discussion of the beginning of life is very influential and relevant to my examination of how pathogens are spread among mammals. To supplement these environmental and scientific publications, I will also 9 examine publications in biology and disease journals in order to provide information for my readers about the physiology of pathogens (bacteria and viruses) and how they spread. Two biological publications that I find relevant to my thesis are: an article in the PNAS: Proceedings of the National Academy of Sciences of the United States of America journal 3 regarding the effects of climate on plague bacterium and the outbreak severity, and an Ecological Applications article which examines the spread of plague in mammal communities. 4 This thesis briefly discusses the cultural causes and effects of the plague on Athenian society as it contributes to current debates among cultural historians. Athenian religious and medicinal practices played an undeniably paramount role in how the plague infected Athens, and the death rate greatly affected cultural and social standards in the city-state for the duration of the outbreak. For example, traditional gender roles were ignored; inheritance practices were performed according to necessity despite traditional social norms, and economic behavior, such as spending and investments, changed drastically as death became more and more likely for citizens. The only existing primary source that discusses the Athenian plague is Thucydides’ History of the Peloponnesian War. Thucydides was an Athenian general who lived from approximately 460 B.C.E. to 395 B.C.E. who wrote about his experiences of the Peloponnesian War and Athenian plague beginning when he was a young man. He himself writes about being afflicted with the plague and surviving. Thucydides provides an extremely vivid and considerably impartial depiction of the events he describes. Several classical historians of the 3 Ari, Tamara Ben, Chang, Kung-Sik, Fang, Xiye, Qiyong Liu, Stenseth, Nils Chr., Stige, Leif Chr., Shuchun Wang, Xu, Lei, and Zhang, Zhibin, "Nonlinear effect of climate on plague during the third pandemic in China." PNAS: Proceedings of the National Academy of Sciences of the United States of America 1073, no. 10 (June 2011). http://www.pnas.org/content/early/2011/06/02/1019486108.short. 4 Antolin, Michael F., Laurel M. Hartley, Robin M. Reich, Lisa T. Savage, and Paul Stapp, "Climate, soils, and connectivity predict plague epizootics in black-tailed prairie dogs (Cynomys ludovicianus)." Ecological Applications 21, no. 8 (2011): 2933-43: Although this article discusses plague in black-tailed prairie dog communities, its analysis of the spread of plague bacterium among mammals who live in close proximity could be relevant to studies of plague outbreaks within human communities. The methods of pathogen transfer and the physiology of the bacterium are similar among mammal species. 10 twentieth and twenty-first centuries have written about Thucydides and his account. Donald Kagan’s book The Peloponnesian War offers a more historically complete analysis of the three decades of the war while quoting the ancient text many times. In his article “Thucydidean Chronology Anterior to the Peloponnesian War" Allen West creates a well-organized historical timeline of the Peloponnesian war, which will greatly assist me in mapping the plague outbreak. Other historians who have taken an interdisciplinary approach to the Athenian plague are J.C.F. Poole and A.J. Holladay, who in their article “Thucydides and the Plague of Athens" discuss the possible diseases that could have been the Athenian plague. In his book The Ecology of the Ancient Greek World, Robert Sallares provides a cultural examination of the Athenian plague with some applications of evolutionary theory. The greatest contribution of this thesis is to the field of big history. Beginning in the 1980s, as environmental degradation became a topic of international debate, historians began to study history on a broader scale than before as they wrote about the 14 billion years of our universe’s existence. This allowed historians to study how our world came to exist in its modern state and the role humans have played in its considerably recent history. In the early twenty-first century, climate change also became a controversial topic of scientific debate, emphasizing how humans have intervened in the natural order of our planet. Several historians have emerged as leading scholars in the field of big history. David Christian, who began his career as a Russian historian, essentially founded this young field with his article “The Case for ‘Big History’” in 1991, establishing the importance of studying the history of the universe in order to better understand events in human history. He later published Maps of Time: An Introduction to Big History, This Fleeting World: A Short History of Humanity, and several journal articles that have been essential contributions to his growing field of study. Craig Benjamin, Cynthia Stokes 11 Brown, and Fred Spier have also published several monographs and articles regarding more specific historical and scientific topics in the scope of big history such as gender studies, Asian history, economic history, and geological studies. While big history is a quickly growing and evolving field, no big historians have yet studied infectious disease in the scope of big history; this creates a gap that my thesis will fill. One cannot study and fully understand disease in human history without examining the entire history of disease which begins more than four billion years ago. 12 Chapter 1: Plague in Prehistory While there is a large amount of existing literature about the Athenian plague, very few historians examine the biology of infectious microbes, climactic factors in disease outbreaks, or evidence of prehistoric disease in their research. By taking this interdisciplinary approach and studying occurrences of disease over a large span of time, it is possible to identify how infectious microbes likely appeared in the universe and how they have changed throughout earth’s history on the cellular level. In studying evidence of outbreaks over the four billion years of life’s existence on earth, it becomes clear that human behavior in recent history (10,000 BCE to present) has greatly affected the evolution of microbes as well as the severity of disease outbreaks. The Athenian plague is a quintessential case study as evidence of this phenomenon and is a paramount point in the history of infectious disease as it is the earliest recorded outbreak that is considered a plague based upon the devastation that occurred. Utilizing biological research techniques such as DNA technology allows me to form a hypothesis on what bacterium caused the Athenian plague, which can then be applied in determining likely causes of the plague and how it was transmitted within the walls of ancient Athens. Studying disease transmission in prehistoric human and livestock remains and comparing the remains to those of Athenian plague victims in terms of death tolls, burial practices, and attempts at treatment illustrates how plague outbreaks in modern civilizations differed from prehistoric outbreaks. If one does not study disease from its first appearance in life, one cannot completely understand the causes and effects of outbreaks in human history including the Athenian plague. The many historians who have studied infectious disease know that it has threatened human populations since the beginning of human civilization more than twelve thousand years ago, but scientists understand infection as a process that has occurred since the first eukaryotic 13 cells appeared in the universe. The first cells are theorized to have formed over twelve billion years ago, but there is currently only evidence to support that cells came into existence on planet earth approximately four billion years ago, identified by big historians as Threshold Moment 5. 5 The first occurrence of cellular interactions is believed to have been a parasitic relationship amongst two, single cells, but not as we consider infection today. Charles Greenblatt defines the modern concept of infection as “one life form within another doing its host damage,” 6 but the earliest cellular interactions likely resulted in positive, negative, and neutral effects on the host organism. 7 These early occurrences were considered “prion diseases,” or a relationship where a protein catalyzes a conformational change in a normal protein, but this change was not necessarily negative. 8 After the Big Bang, the universe continuously expanded and cooled which allowed for elemental molecules and early life forms to become increasingly complex. As organisms in the universe became more complex from the first self-replicating organisms of life’s existence, the effects of infectious microorganisms included more possibilities between beneficial, benign, and detrimental and in varying degrees. Infectious microorganisms could affect a single organelle of a cell, and as organisms became larger and more complex, the many cells of a larger organ system. As earth’s atmosphere developed, it created a gaseous, warm environment which allowed for life to flourish on the planet. Organisms adapted to the varying environments that occurred over nearly four billion years, but the tropical climate that developed in the equatorial regions of the planet in particular allowed for unrestricted growth and sustenance of parasitic microorganisms. Larger host organisms were more abundant in these regions, and the warm, 5 Greenblatt, Charles, and Mark Spigelman, eds, Emerging Pathogens: Archaeology, Ecology, & Evolution of Infectious Disease. New York: Oxford University Press, 2003, 4-5. 6 Greenblatt, 6. 7 Ibid. 8 Greenblatt, 7. 14 humid climate allowed for more efficient transmission of microorganisms among larger species, 9 especially hominid species after their appearance approximately twenty million years ago. 10 With each Ice Age, 11 hominids were forced to adapt to the colder climate or migrate to warmer regions of the planet; these climactic changes led to the evolution of some parasitic microbes, resulting in more resilient species of pathogens. Those species that did not evolve and adapt died out completely. 12 The microorganisms that were best able to survive depended upon vector transmission (the most effective method of transmission among organisms), medium-sized hosts (moderately sized organisms had higher chances of survival in challenging environments due to their mobility and moderate food consumption), and durability in characteristics that allowed them to survive during rare mass extinctions. 13 This process of natural selection through evolution among infectious microbes isolated those species most able to evolve quickly, making them more resilient against mammal immunities and later medicinal treatments. This increasing virulence among microbes contributed to the lethality of later disease outbreaks that would devastate modern civilizations, such as the Athenian plague. Cyclical changes in climate greatly influenced the evolution of parasitic microbes on earth for over four billion years, and especially as species became more complex, living in small groups or solitarily dispersed over large regions with the most favorable environments. The dispersal of the human population across the planet in small, nomadic groups limited the frequency of contact between different populations, therefore limiting disease transmission and the destruction of life caused by infectious diseases. Approximately twelve thousand years ago 9 Greenblatt, 7. Greenblatt, 8. 11 Ice Ages have occurred on planet earth approximately every forty thousand years in regular years until very recently; Crosby, Alfred W. Ecological Imperialism: The Biological Expansion of Europe, 900-1900. New York: Cambridge University Press, 1986. 12 Greenblatt, 10. 13 Ibid. 10 15 there was a major shift in how the homo sapien species lived; there was a gradual transition from living in small, nomadic groups to living in one central location in larger populations. This transition, or Threshold Moment 7, was extremely beneficial for modern human species, allowing humans to climb to the top of the food chain. Humans domesticated a variety of vegetable and animal species, providing a constant food supply to support larger populations and a more nutritionally complete diet; a more balanced diet improved human health and produced stronger, more resilient individuals. Living in larger groups provided humans with security and protection from attacks by predatory animals and other human groups. The domestication of food sources and security provided by this sedentary lifestyle allowed humans more leisure time to develop superior tools, weaponry, and structures and to progress intellectually. Improvements in human health and intellect posed many threats to the parasitic microbes that existed on earth before human civilization. With an improved diet, safer food and water sources, and a better understanding of human illness and natural remedies, humans gradually became less susceptible to pathogens forcing microorganisms to evolve and become more virulent in order to infect human hosts. 14 The domestication of animal species, specifically livestock, meant that humans spent their lives in closer proximity to animals than ever before in history; this continual contact between humans and livestock allowed for microorganisms that had only infected livestock species historically to be transmitted to humans. Several plagues throughout recorded history are believed to have originated among livestock or rodent species which then transmitted the infection to humans due to their living in close proximity. Evidence of these transmissions is found by studying the remains of prehistoric disease victims; anthropologists and paleoepidemiologists are able to evaluate outbreaks of infectious diseases by studying the skeletal remains of humans and livestock. Bone material from skeletal 14 Greenblatt, 10. 16 remains must be radiocarbon dated to determine the age of the remains; radiocarbon dating does this by examining the decay of carbon-14 in ancient tissue according to the isotope’s half-life. When DNA material can be obtained from skeletal remains, scientists are sometimes able to identify specific bacteria that are present; one genus of bacteria that has been identified as a cause of several infectious diseases such as tuberculosis and leprosy is mycobacterium. 15 Before DNA technology was developed, anthropologists performed physical examinations on skeletal remains and identified signs of infection; finding ancient DNA material that has been preserved well enough to be studied is rare, and the physical examination and disease identification skills developed before DNA technology remain extremely useful. It is this technology that has allowed anthropologists to determine that the Athenian plague was typhoid fever, though this continues to be a topic of debate among experts. Although modern antibiotics and vaccines have nearly eliminated the deadly effects of disease that caused devastation in antiquity, the examination of the physical symptoms of disease-stricken individuals in modernity has allowed paleoepidemiologists to identify specific diseases in ancient human remains. In his monograph co-written with Charlotte Roberts The Archaeology of Disease, Keith Manchester discusses the challenges in finding skeletal remains that clearly exhibit skeletal damage from infection: “If we consider the infections from which we all suffer today, it is apparent that the vast majority affect the soft tissues of the body… Even without treatment, most of these infections resolve within a short time, …or in more sinister infections, the death of the 15 Spigelman, Donoghue 17 individual occurs fairly rapidly and long before the infective process will have spread to the bones.” 16 As human civilizations became more sophisticated and population densities rose, infectious microbes became more virulent, causing death more quickly in victims. This accelerated process of infection destroyed soft tissue in various ways, but did not allow the infection to reach bone tissue before the victim perished. While ancient skeletal remains are rarely well preserved due to environmental conditions, the factor of less bone damage in later remains makes it even more difficult for disease to be identified as a cause of death. Paleoepidemiologists have developed methods of identifying signs of infection in skeletal remains despite environmental damage. Paleoepidemiologists are able to determine which bacterium infected an individual according to skeletal evidence of specific symptoms. Inflammatory bone lesions, or the inflammation of bone cells, are a characteristic of several infectious diseases, and can help scientists identify from which infectious disease the victim suffered according to their location and appearance in skeletal remains. Inflammatory bone lesions are caused by long-standing, chronic infection, and do not appear “when infection resolves considerably quickly through recovery or death.” 17 When a victim recovers quickly or perishes quickly from disease, the infection does not reach the bone tissue and only affects the soft tissues, therefore leaving no evidence of the infection on the skeleton. If bone lesions are present, paleoepidemiologists are able to determine what type of infection affected the individual. “By and large, these infective bone lesions of antiquity were created by bacterial and not viral infection, since these latter were more rapidly resolved or fatal, and did not lead to the chronic invasive process as did bacteria.” 18 16 Manchester, Keith, and Charlotte Roberts, The Archaeology of Disease. Ithaca: Cornell University Press, 1995, 125. 17 18 Manchester & Roberts, 125. Ibid. 18 The location and formation of bone lesions indicates which specific bacterium caused the infection, or in other words, the disease from which the individual suffered. 19 For example, leprosy causes deformation in the extremities and inflammation of the joints or of the entire skeleton depending upon the severity of the infection. 20 Again DNA analysis is the most accurate determination of what bacterium are present in remains, but DNA material rarely survives from antiquity. Osteomyelitis is the term used by paleoepidemiologists to identify particular signs of infection on bone tissue: pitting or irregularities of the bone surface or cavity formation caused by pus-containing abscesses. 21 Signs of bone reparation or regrowth, evident in the presence of osteoblasts (woven, less-organized microstructure of new bone tissue), likely indicates that the individual perished during the infection process because the bone tissue did not have sufficient time to fully repair the abscessed damage. Another symptom indicative of death during the infection process is signs of infection in other parts of the body where the bacteria have been carried by the bloodstream, and the abscessed infection has spread. While secondary infection in the organs is very common with severe bacterial infections, it is not present in skeletal remains after the soft tissue has decomposed. However, the throat, ears, sinuses, and chest are areas of the body where secondary infection does damage bone tissue, and can be identified in modernity. 22 The tibia and femur are also areas of the body where secondary infection occurs quickly due to the abundant blood stream supply in these large bones, which carry bacterium in the blood stream to this area quickly. 23 19 Ibid. Ibid. 21 Manchester & Roberts, 126. 22 Manchester & Roberts, 127. 23 Manchester & Roberts, 129. 20 19 Changes in human lifestyle throughout history are also evident in skeletal remains. There is an abundance of remains exhibiting evidence of lower leg trauma and advanced infection in earlier agricultural societies due to accidents with equipment or animal attacks, but these infections are not what epidemiologists consider to be “infectious diseases.” The word “disease” in this phrase indicates a spread of bacterium from one creature to another, whether it be transmission between human beings or between humans and other animal species. As discussed by biologist John Lallo, who works primarily on the North American continent, there is evidence of increased occurrences of infectious diseases as humans began to live in more dense population groups approximately twelve thousand years ago; “It has been shown in an examination of early American populations that the frequency of bone-infective lesions increases with an increased population density.” 24 Lallo also identifies the likely cause of this increase as being “associated with an increasing population of increasing social and economic complexity there is an extension of trade networks.” 25 As human populations grew in these more complex social and economic centers around the world, individuals experienced more frequent encounters with individuals from other geographic regions, exposing them to pathogens that they may not have encountered, having been a nomadic group in earlier times. For example, war allowed for disease to be carried by armies from the African continent across the Mediterranean to the Athenian and Spartan Empires where individuals had never before encountered such microbes and therefore had developed no natural immunity. 26 Coinciding evidence of prehistoric disease outbreaks and changes in human lifestyles illustrates the role of human activities in the evolution of infectious microbes. Bacterium became more virulent at the same point in history when humans began living in denser populations, 24 Ibid. Ibid 26 Thucydides, History of the Peloponnesian War. New York: Penguin Group, 1954, 118. 25 20 providing them with securities that allowed them to become stronger against infection. However, the development of more complex economic and social structures among human civilizations also exposed large populations to diseases that they had not encountered historically and therefore had no natural immunity against. As human populations grew, changes in living conditions created an environment that served as an excellent host for infectious microbes and efficient transmission of infection, especially in equatorial regions such as Athens. 21 Chapter 2: The Athenian Plague Plague, in the context of this thesis, refers to an outbreak of disease which results in a great loss of life, and often has devastating effects on a culture and economy. The earliest written record of plague can be found in the book of Exodus of the King James Bible. According to scripture, God struck Egypt with ten “plagues,” but disease was present in only two of them. The “plague against livestock” is said to have killed a great number of livestock across Egypt, and the “plague of boils” caused boils on the skin of all of the people and livestock of Egypt; specific diseases have never been identified as the causes of these plagues. 27 There is physical evidence of infectious disease occurring in Egypt due to humans living in such close proximity to livestock in large economic centers, but not with such devastation as was caused by the Athenian plague. 28 Thucydides writes of the earliest plagues to his knowledge in History of the Peloponnesian War; in antiquity, it was believed that the first plagues originated in Ethiopia and spread through Egypt and Libya likely on trade routes or during military conquests. 29 Paleoepidemiologists have found evidence of infectious disease in human remains throughout the territories of ancient Egypt. Damage to the auditory ossicles and walls of the middle ear in Egyptian mummies serve as evidence of severe ear infections; there is also evidence of eardrum perforation procedures being performed to relieve pain for individuals suffering from severe ear 27 Exodus 9: 1-12. Filer, Joyce, Disease. Dallas: First University of Texas Press, 1996. 29 Thucydides, 118. 28 22 infections, identified by perforations in the eardrum with smooth, concise edges in the tympanic membrane caused by an instrument. 30 The low air humidity, frequency of sandstorms carrying sand particles in the wind, and unsterile water sources (oases or rivers often containing microbes that can cause infection when trapped in the middle ear) of ancient Egypt are factors recognized by modern physicians to increase the risk of ear infection. 31 Evidence of tuberculosis and pneumonia has been found in many Egyptian mummies manifested as lesions in the rib bones, suggesting prolonged and severe infection, and swelling of the joints. The mummy of Rameses V shows evidence of what is likely the smallpox infection; soft tissue is present in the wellpreserved remains, showing blisters on the skin and infection that has reached the bone tissue beneath the blisters. 32 All of these Egyptian remains exhibit symptoms of bacterial infections, or the damage of infectious diseases, supporting Thucydides’ claims of plagues predating the Athenian plague, but there is no physical evidence or written accounts of a plague that occurred before the Athenian plague that wreaked such devastation. It is currently estimated that the Athenian plague resulted in the deaths of one fourth to one third of the Athenian population; there was one outbreak in 429 BCE and a second in 427 BCE. It is estimated that three hundred and fifteen thousand Athenians lived within the city walls for long periods of time during the Peloponnesian War; the walls enclosed approximately three and a half square kilometers. 33 There is only one surviving account of the events surrounding the plague: the collection of historian and Athenian general Thucydides. Thucydides’ history ends abruptly in the twenty-first year of the twenty-seven year Peloponnesian War, spanning from 431 30 Cockburn, A, "Autopsy of an Egyptian Mummy." Science 187, no. 4182 (1975): 1156; See Appendix A. Ibid. 32 Zimmerman, M.R., "Examination of an Aleutian mummy." New York Academy of Medicine 47, no. 1 (1971): 133. 33 Murphy, Charles T., "Aristophanes, Athens and Attica." The Classical Journal 59, no. 7 (April 1964): 306-23. 31 23 BCE to 404 BCE. The Peloponnesian War was a conflict between the Peloponnesian League led by Sparta and the Delian League led by Athens. 34 The writings of Thucydides were organized by later historians into eight books and are considered a first-hand account and literary work; physical evidence is limited to confirm some of Thucydides’ accounts, but his writings are considered to be accurate by modern historians and anthropologists, making them extremely valuable as a rare account of an Athenian’s experiences during the war. Thucydides describes his goal in recording the war’s events as creating an accurate account of the Peloponnesian War so that posterity may learn and avoid repeating the events in order to save them from the near destruction that Athens and Sparta had suffered. 35 His writings are considerably unique from most fifth century Greek texts in that he does not discuss divine influence or intervention in human actions and conflicts; his efforts to present an objective account of historic events are evident. Thucydides first mentions the plague in Chapter I of the first book of his history as he describes extraordinary natural phenomena that began occurring in succession shortly after the Lacedaemonian invasion of Attica, beginning the second year of the Peloponnesian War; 36 he writes, “…there were earthquakes of unparalleled extent and violence; eclipses of the sun occurred with a frequency unrecorded in previous history; there were great droughts in sundry places and consequent famines, and that most calamitous and awfully fatal visitation, the plague.” 37 Chapter VII of Book II discusses the plague in great detail, much of which is drawn from Thucydides’ personal experience, since informs us that he himself contracted the disease but was able to survive it. The second year of the war began with the invasion of Attica by 34 Kagan, Donald, The Peloponnesian War. New York: Penguin Group, 2004. See Appendix B. Thucydides. 36 Thucydides, 16. 37 Ibid. 35 24 Archidamus, king of Sparta, and the plague struck soon after for the first time. According to Thucydides, “Not many days after their arrival in Attica the plague first began to show itself among the Athenians. It is said that it had broken out in many places previously in the neighborhood of Lemnos and elsewhere; but a pestilence of such extent and mortality was nowhere remembered.” 38 According to the writings of Hippocrates, an Athenian doctor who lived before the plague in Athens, Athenian doctors practiced methods of treating the disease in its early stages, such as cold baths and herbal remedies to reduce swelling. 39 Unfortunately, doctors were killed themselves early in the outbreak after visiting and treating the ill, which contributed to the final death toll and attests to the virulence of the disease; Thucydides does not specify which treatments were used by physicians to combat the outbreak but describes some methods used in attempts to relieve the symptoms, such as individuals bathing themselves in public fountains and drinking from the fountains to reduce their fevers. 40 Like medicinal practices, offerings of Athenians praying for the Gods to end the plague at the temples were also futile against the disease (this is Thucydides’ only mention of divinities). 41 It was rumored at the time that the plague originated in Ethiopia and spread through Egypt and Libya where trade brought the disease to Sparta and the Spartan forces carried the disease to Athens. However, in considering that the Spartans participated in very little trade outside of their own empire, it is unlikely that the Spartan forces would have carried the disease from the African continent. Also disputing this claim is the unlikelihood that the Spartan forces would not have experienced the death toll that Athens later experiences when they were exposed to the disease. There is no scientific evidence that Spartan peoples would have developed a 38 Thucydides, 118-119. 39 Hippocrates, "On Ancient Medicine." In Hippocrates on Ancient Medicine (Studies in Ancient Medicine), edited by Mark J. Schiefsky, Leiden: Brill Academic Publishers, 2005. 40 41 Thucydides, 118. Ibid. 25 natural immunity to any disease that Athenians would not have also developed. The true origin of the outbreak remains a mystery at this point. The first occurrence of the disease in Greece was in Piraeus, where there were claims that the Lacedaemonians had poisoned the water supply. 42 After contracting the disease himself and surviving, Thucydides describes the symptoms of the plague in great detail according to his own experience and events that he witnessed as a resident of Athens. In the first week, a plague victim experienced a high fever, red and inflamed eyes, and a bloody throat or tongue that expelled a “fetid odor.” 43 At the end of the first week sneezing, a heavy cough, and chest pain manifested; it was after this stage that some victims recovered, while others continued to suffer, knowing that death was imminent. In the second and third weeks of infection, vomiting and muscle spasms due to dehydration set in; the skin became hot to the touch, red, and small pustules or ulcers appeared all over the body. An unbearable “hotness” motivated victims to remove all of their clothing and submerge themselves in cold water, as some “plunged into the rain-tanks in their agonies of unquenchable thirst.” 44 In the third and fourth weeks of infection, victims experienced violent diarrhea and ulceration of the bowels. It was this stage that caused severe malnutrition and weakness, killing most victims. Many survivors lost fingers and toes or their eyes, and a small percentage experienced a complete loss of memory. 45 While the Athenians were unable to identify which disease was causing such devastation, I will later discuss how modern scientists have classified the plague. The first breakout of the plague lasted two years (430 BCE-428 BCE), and the second spanned one winter from 427 BCE to 426 BCE; when Athens was finally free of the disease, 42 Thucydides, 118-119. Thucydides, 119. 44 Thucydides, 120. 45 Ibid. 43 26 approximately one fourth of the Athens population had been killed and many others disfigured. 46 Due to the war, there had been an influx in city populations, especially Athens, as Greeks fled the country. 47 Pericles, the ruler of Athens during the Peloponnesian War, convinced Athenian countrymen to move their families and “moveable property” within the city walls to protect themselves from invading forces and to protect the city. His political motivation in moving citizens within the city was to conserve forces in order to reserve resources for the Athenian naval fleet. Pericles understood that Athens could not defeat the invading Spartan army in land battles and that Athens’ military strength lied with its naval fleet; Athens had “insufficient manpower to both man a fleet large enough to maintain the empire and fight the Peloponnesians on land.” 48 In his essay Thucydides, Pericles, and the Strategy of Defense, Josiah Ober offers a unique insight into Pericles’ motivation for relocating Athenian citizens: “If the Athenians were islanders they would be perfectly secure, therefore they should act as if there city were an island and abandon their land and homes in the countryside.” 49 By protecting the city of Athens and its harbor, Pericles was able to maintain a steady supply of resources to his citizens and his fleet. 50 Pericles was able to provide his citizens with food and military protection within the Athens walls, but the overcrowded living conditions of more than three hundred thousand people living within less than four square miles created favorable conditions for a severe outbreak of infectious disease. By continuing trade relations in the port city, Pericles unknowingly and continuously exposed his citizens to new sources of disease that originated in other regions. 46 Thucydides, 209. Thucydides, 122. 48 Ober, Josiah, The Athenian Revolution: Essays on Ancient Greek Democracy and Political Theory. Princeton: Princeton University Press, 1996, 74. 49 Ibid. 50 Ober, 76. 47 27 The crowding within the walls of Athens allowed for bacteria to be passed between individuals very efficiently in bodily fluids and improperly disposed waste, and the Mediterranean climate of Athens further promoted the growth of bacteria. When water wells were contaminated by individuals dumping waste into wells or through ground water contamination, thousands of people were infected. There was a shortage of housing in Athens, and so the lower class countrymen were forced to live in crowded “cabins” with no protection from the summer heat, making these individuals especially susceptible to infection. As people were infected and perished by the thousands, bodies piled up in the poor neighborhoods of the city and around the public fountains, as victims tried to get water and cool their feverish bodies. Many perished inside the temples where they lay praying to the gods for salvation from the disease. 51 Scavenger birds and animals left the dead bodies untouched, and as the number of dead increased rapidly, Athenians were forced to bury them in shallow mass graves with little regard for Greek burial tradition; there were simply too many bodies to perform traditional burial ceremonies. There were even instances of piles of bodies being set fire without any personal grave markers or ceremony. 52 Burial traditions were not the only Athenian morals abandoned during the plague; many characteristics of pre-plague Athenian culture evolved as the death toll rose. The growing mentality that death could be near at any time greatly affected how Athenians conducted their lives. People spent their money as quickly as possible and indulged in luxuries or activities that had not been deemed appropriate before the plague arrived. Lawlessness struck Athens, as “…no one expected to live to be brought to trial for his offenses, but each felt that a far severer sentence had been already passed upon them all and hung over their heads, and before this fell it was only 51 52 Ibid. Thucydides, 120, 123. 28 reasonable to enjoy life a little.” 53 Morality was no longer a concern to those violating civil laws or religious edict in their desperate indulgences “No fear of Gods or law of man deterred a criminal.” 54 The devastation of the plague even forced Athenian commanders to reconsider their military decisions against Sparta in the years of the outbreak. Losing so many able bodied men, “no less than four thousand four hundred heavy infantry in the ranks died of it and three hundred cavalry, besides a number of the multitude that was never ascertained,” to the disease forced the Athenian army to add Lesbos’ forces to their fleet, a move that had been avoided before the plague arrived. 55 In examining the cultural effects of the Athenian plague, it is clear that the shift of humans living in small, nomadic groups to large, densely populated economic, cultural, and military centers greatly intensified the devastation caused by infectious disease outbreaks, and the large geographic regions that were affected. The mass graves of the Athenian plague period were discovered in and near the modern city of Athens; the best preserved mass grave was excavated by Greek archaeologist Efi Baziotopoulou-Valavani in 1994 when it was discovered during the construction of a subway station. 56 It contained at least one hundred and fifty skeletons that were buried in a rushed and careless fashion with some traditional burial artifacts such as pots and oil flasks. 57 From the skeletal remains found in the mass grave, scientists were able to isolate DNA material that could identify the specific bacterium that caused the plague infection. Manolis Papagrigorakis of the University of Athens is the leading researcher in the Athenian plague DNA investigation; he has identified the DNA of typhoid fever bacterium (Salmonella Typhi) in dental pulp samples from the remains unearthed in the Athens mass graves; the remains were first carbon dated to confirm 53 Thucydides, 123. Thucydides, 122. 55 Thucydides, 209. 56 See Appendix C. 57 Axarlis, Nicos, Archaeology Archive. 1998. http://archive.archaeology.org/online/news/kerameikos.html. 54 29 that they were in fact from the plague era. 58 Despite some debate among scientists regarding the accuracy of their determination, Papagrigorakis has successfully supported his identification of Salmonella Typhi bacterium in the bone tissue of the ancient remains. 59 The usefulness of Thucydides’ description of the symptoms of the plague for identifying the disease that caused it has been a topic of debate among historians as the best resource for identifying the specific infectious disease. Since the publication of Papagrigorakis’ DNA results, many historians and modern epidemiologists have supported his findings based on modern diagnoses of typhoid fever. Extremely high fever, bloody nose, painful swelling in the abdomen, sores on the skin, diarrhea, intestinal ulcers and abscesses, and delirium are all currently recognized symptoms of typhoid fever, all of which are described by Thucydides. 60 Optimum environmental conditions and climate for the transmission of typhoid fever includes: improper disposal of feces which then contaminates the water supply (this often occurred in crowded, ancient cities), high temperatures that promote fly reproduction (flies often transmit bacteria from fecal matter to livestock or humans), and crowded living conditions where transmission between humans via bodily fluids would be extremely efficient. 61 All of these conditions existed in Athens during the first plague outbreak in the summer of 430 BCE, further supporting the theory that the Athenian plague was typhoid fever. 58 Baziotopoulou-Valavani, Effie, Manolis J. Papagrigorakis, Philippos N. Synodinos, and Christos Yapijakis, "DNA examination of ancient dental pulp incriminates typhoid fever as a probable cause of the Plague of Athens." International Journal of Infectious Diseases 1, no. 10 (2006): 206-14. 59 See Rambaut, Andrew, and Beth Shapiro, "No proof that typhoid caused the Plague of Athens (a reply to Papagrigorakis et al.)."International Journal of Infectious Diseases 1, no. 10 (2006): 334-40, and aziotopoulouValavani, Effie, Manolis J. Papagrigorakis, Philippos N. Synodinos, and Christos Yapijakis. " Insufficient phylogenetic analysis may not exclude candidacy of typhoid fever as a probable cause of the Plague of Athens (reply to Shapiro et al.)." International Journal of Infectious Diseases 1, no. 10 (2006): 335-41. 60 Centers for Disease Control and Prevention. CDC Health Information for International Travel 2014. New York: Oxford University Press; 2014. http://wwwnc.cdc.gov/travel/page/2014-yellow-book-about. 61 ibid 30 In Conclusion Examining the origins of infectious disease and environmental factors in how outbreaks have occurred throughout history gives historians a more complete understanding of how global changes in human lifestyle have affected the occurrence of plagues. The shift from humans living in small, nomadic groups to large, densely populated civilizations allowed for the domestication of vegetables and livestock, a generally more nutritious diet for prehistoric humans. Living in large civilizations also provided security and leisure time for residents. These improvements in quality of life and human health led to the evolution of some infectious bacterium, creating more virulent pathogens that were stronger against human immunities; these increasingly deadly microbes and increasingly dense human populations caused the level of devastation caused by disease outbreaks to intensify. With the preservation of Thucydides account, the Athenian plague is the earliest recorded plague that killed thousands in only four years and can be documented by physical evidence. Structuring my examination of the Athenian plague within the framework of the threshold moments of big history, combined with an interdisciplinary perspective has allowed me to contribute a new discussion of the plague to the existing scholarship on infectious disease and the ancient Athenian plague. 31 32 Appendix Appendix A A diagram of the human inner ear. Benitez, J.T. "Otopathology of Egyptian mummy Pum II: Final Report." The Journal of Laryngology & Otology. 33 Appendix B A map of the territories involved in the Peloponnesian War and the war strategies of the conflict. Meigs, Peveril. "Some Geographical Factors in the Peloponnesian War." Geographical Review. 34 Appendix C A photograph of a mass grave in Athens dating to the era of the Athenian plague. The grave was unearthed during the construction of a subway station. Holladay, A.J., and J.C.F. Poole. "Thucydides and the Plague of Athens." The Classical Quarterly. 35 Bibliography Primary Sources: Hippocrates, "On Ancient Medicine." In Hippocrates on Ancient Medicine (Studies in Ancient Medicine), edited by Mark J. Schiefsky, Leiden: Brill Academic Publishers, 2005. Thucydides. History of the Peloponnesian War. New York: Penguin Group, 1954. Secondary Sources: Andrewes, A., K.J. Dover, and A.W. Gomme. An Historical Commentary on Thucydides. 8th ed. Vol. 5. Oxford: Oxford University Press, 1980. Antolin, Michael F., Laurel M. Hartley, Robin M. Reich, Lisa T. Savage, and Paul Stapp. "Climate, soils, and connectivity predict plague epizootics in black-tailed prairie dogs (Cynomys ludovicianus)." Ecological Applications 21, no. 8 (2011): 2933-43. Ari, Tamara Ben, Chang, Kung-Sik, Fang, Xiye, Qiyong Liu, Stenseth, Nils Chr., Stige, Leif Chr., Shuchun Wang, Xu, Lei, and Zhang, Zhibin. "Nonlinear effect of climate on plague during the third pandemic in China." PNAS: Proceedings of the National Academy of Sciences of the United States of America 1073, no. 10 (June 2011). http://www.pnas.org/content/early/2011/06/02/1019486108.short. Asimov, Isaac. Asimov’s Chronology of the World: The History of the World From the Big Bang to Modern Times. New York: HarperCollins Publishers, 1991. Asimov, Isaac. Beginnings: The Story of Origins of Mankind, Life, the Earth, the Universe. 2nd ed. New York: Berkley Publishing, 1989. Aunger, Robert. “A Rigorous Periodization of ‘Big’ History.” Technological Forecasting and Social Change 74, no. 8 (2007): 1164-1178. Axarlis, Nicos. Archaeology Archive. 1998. http://archive.archaeology.org/online/news/kerameikos.html. Baziotopoulou-Valavani, Effie, Manolis J. Papagrigorakis, Philippos N. Synodinos, and Christos Yapijakis. "DNA examination of ancient dental pulp incriminates typhoid fever as a probable cause of the Plague of Athens." International Journal of Infectious Diseases 1, no. 10 (2006): 206-14. 36 Baziotopoulou-Valavani, Effie, Manolis J. Papagrigorakis, Philippos N. Synodinos, and Christos Yapijakis. " Insufficient phylogenetic analysis may not exclude candidacy of typhoid fever as a probable cause of the Plague of Athens (reply to Shapiro et al.)." International Journal of Infectious Diseases 1, no. 10 (2006): 335-41. Benitez, J.T. "Otopathology of Egyptian mummy Pum II: Final Report." The Journal of Laryngology & Otology 102, no. 6 (June 1988): 485-90. Centers for Disease Control and Prevention. CDC Health Information for International Travel 2014. New York: Oxford University Press; 2014. http://wwwnc.cdc.gov/travel/page/2014-yellow-book-about. Christian, David. Maps of Time: An Introduction to Big History. Berkeley: University of California Press, 2004. Christian, David. “The Case for ‘Big History.” Journal of World History 2, no. 2 (1991): 223238. Christian, David. This Fleeting World: A Short History of Humanity. Berkshire: Berkshire Publishing Group, 2007. Cockburn, A. "Autopsy of an Egyptian Mummy." Science 187, no. 4182 (1975): 1155-60. Crosby, Alfred W. Ecological Imperialism: The Biological Expansion of Europe, 900-1900. New York: Cambridge University Press, 1986. Douglas, Michele T., Rona M. Ikehara-Quebral, and Michael Pietrusewsky. "An Assessment of Health and Disease in the Prehistoric Inhabitants of the Mariana Islands." American Journal of Physical Anthropology 315, no. 14 (1994): 315-42. Filer, Joyce. Disease. Dallas: First University of Texas Press, 1996. Greenblatt, Charles, and Mark Spigelman, eds. Emerging Pathogens: Archaeology, Ecology, & Evolution of Infectious Disease. New York: Oxford University Press, 2003. Hawking, Stephen. A Brief History of Time. New York: Bantam Publishing, 1998. Holladay, A.J., and J.C.F. Poole. "Thucydides and the Plague of Athens." The Classical Quarterly 29, no. 2 (1979): 282-300. Hornblower, Simon. Thucydides. London: Duckworth Publishing, 1987. Hornblower, Simon. A Commentary on Thucydides. New York: Oxford University Press, 2010. Kagan, Donald. The Peloponnesian War. New York: Penguin Group, 2004. 37 Kutter, G. Siegfried. The Universe and Life: Origins and Evolution. Burlington: Jones and Bartlett Pub, 1987. Lloyd, Christopher. What on Earth Happened? The Complete Story of the Planet, Life, and People from the Big Bang to the Present Day. NewYork: Bloomsbury USA, 2008. Manchester, Keith, and Charlotte Roberts. The Archaeology of Disease. Ithaca: Cornell University Press, 1995. Markley, Jonathan. “A Practical Compromise to Teaching World History: Thematic Bridges, Standards, and Technology.” World History Connected 6, no. 3 (2009) http://worldhistoryconnected.press.illinois.edu/6.3/markley.html. Meigs, Peveril. "Some Geographical Factors in the Peloponnesian War." Geographical Review 51, no. 3 (July 1961): 370-80. http://www.jstor.org/stable/212783. Moddejonge, Alex, “The Biggest Story Ever Told: A Comprehensive Analysis of the Historiographic Origins of Big History, 500 BCE to 2010 CE.” California State University San Marcos. http://hdl.handle.net/10211.8/206 Morowitz, Harold J. The Emergence of Everything: How the World Became Complex. Oxford: Oxford University Press, 2002. Murphy, Charles T. "Aristophanes, Athens and Attica." The Classical Journal 59, no. 7 (April 1964): 306-23. Ober, Josiah. The Athenian Revolution: Essays on Ancient Greek Democracy and Political Theory. Princeton: Princeton University Press, 1996. Rambaut, Andrew, and Beth Shapiro. "No proof that typhoid caused the Plague of Athens (a reply to Papagrigorakis et al.)."International Journal of Infectious Diseases 1, no. 10 (2006): 334-40. Sallares, Robert. The Ecology of the Ancient Greek World. Ithaca: Cornell University Press, 1991. Smail, Daniel L. "Beyond the Longue Duree: Human History in Deep Time." Perspectives on History 50, no. 9 (December 2012): 59-60. Sommerstein, Alan H. Lysistrata and Other Plays. London: The Penguin Group, 2002. Spier, Fred. Big History and the Future of Humanity. Hoboken, NJ: Wiley-Blackwell, 2010. Spier, Fred. “Complexity in Big History.” Cliodynamics 2, no. 1 (2011): 146-166. 38 Stokes Brown, Cynthia. Big History: From the Big Bang to the Present. New York: The New Press, 2008. West, Allen B. "Thucydidean Chronology Anterior to the Peloponnesian War." Classical Philology 20, no. 3 (July 1925): 216-37. Zimmerman, M.R. "Examination of an Aleutian mummy." New York Academy of Medicine 47, no. 1 (1971): 80-103.