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The Plague of Caere (C. 535 Bce): Airborne Botulism?

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The Plague of Caere (C. 535 Bce): Airborne Botulism? Medical Research Archives 2015 Issue 3 THE PLAGUE OF CAERE (C. 535 BCE): AIRBORNE BOTULISM? 1Jean MacIntosh Turfa, Ph.D. 2Adrian Harrison, D.Phil.(cantab.) 1Mediterranean Section, The University of Pennsylvania Museum, 3260 South Street, Philadelphia, PA 19104-6324, (215) 573-6497, [email protected] 2IKVH, The Faculty of Health and Medical Sciences, Copenhagen University, Grønnegaardsvej 7, 1870 Frederiksberg C, Denmark, [email protected] ABSTRACT An unusual “plague” that occurred in late 6th-century BCE Italy, at Caere – modern day Cerveteri, located approximately 50-60 kilometres north-northwest of Rome, may have been a rare instance of airborne botulism following an atrocity on the Etruscan seashore, to judge from highly specific details furnished in the surviving account by the historian Herodotus. We have revisited the information available and compared the documented symptoms with likely causes. The hypothetical diagnosis we suggest is that of airborne botulism. In conclusion, an examination of the symptoms and possible modes of transmission in this unique event merits further consideration in the light of modern discoveries of terrorist activities and possible consequences of large-scale human disasters. Keywords: Botulism; Airborne infection; Etruscan; Plague Copyright © 2015, Knowledge Enterprises Incorporated. All rights reserved. 1 Medical Research Archives 2015 Issue 3 1. PRISONERS AND PLAGUES: Kadmeian victory for them, for they lost HISTORICAL ACCOUNT OF A forty of their ships, and the twenty that SUDDEN EPIDEMIC remained were unusable, as their rams had been twisted askew. Sailing back to Alalia, War was known in the ancient they picked up their children and wives world as a chief cause of sickness as well and as many belongings as they could fit as traumatic death, and modern examples into the ships and leaving Corsica sailed to still abound. A single event that occurred Rhegion [on the Straits of Messina]. during the 6th century BCE on the “The Carthaginians and Etruscans Tyrrhenian coast of Italy seems to have cast lots for the men [taken prisoner] from provoked a sudden and severe affliction the destroyed ships, for they were more among the population of the affluent numerous than those who escaped. Of the Etruscan city of Caere (modern Cerveteri, Etruscans, it was the Caeretans [called north of Rome). The only disease that fits Agyllaians after the Greek name for their the description recorded by the great city, Agylla] who brought them ashore, historian Herodotus is botulin intoxication and stoned them to death. Afterward, all – it appears that an atrocity committed by those approaching the area in which the the civilian citizens of Caere inadvertently dead Phokaians lay suffered a stroke or accomplished what modern terrorists have became twisted and paralyzed, sheep and attempted and failed to produce (for the draft animals just as much as men. The literary sources, some tangential, see Agus Caeretans sent a delegation to Delphi to 2000; Gras 2000). learn how to expiate the offense. And so In short, the so-called plague the Pythia [oracular priestess of Apollo] occurred after the Etruscans and their allies told them to do what the Agyllaians still do the Carthaginians had won (or survived) a today: they make a great sacrifice and hold huge naval battle with interlopers in the contests, both gymnastic and equestrian.” Sardinian Sea, a group of colonists from (Herodotus 1.166-167.2, translation JMT). East Greece (Phokaia in coastal Asia While the exact site of the battle in Minor) who had settled at Alalia (modern the Sardinian Sea cannot be precisely Aleria) in Corsica after escaping the known, the site of the atrocity and Persian conquest of their land. The epidemic is clearly the seashore and port Phokaian settlers, short of agricultural region serving the city of Caere (3-4 miles land, had turned to piracy, and probably inland). In the aftermath, the Greek had raided shipping and the coastal towns colonization movement was curtailed, as of Etruria and Punic Sardinia. In the words Alalia’s settlers removed themselves to of Herodotus of Halikarnassos (1.165- other Greek cities such as Marseille and 167.2) Elea/Velia. There is an extensive literature “...the Tyrrhenians [Etruscans] and on the battle and its ramifications, see: Carthaginians made a joint agreement Bernardini 2001; Colonna 1989 and 2000; against them, and sailed to attack them Gras 1997; Jehasse 1962 and Jehasse and with sixty ships each. The Phokaians also Jehasse 1973, 2001 and 2004. The move to manned their ships, sixty in number, and Rhegion (Reggio Calabria) implies their met the enemy in what is called the intent to continue in piracy, preying upon Sardinian Sea. They joined battle and the the traffic passing through the Straits of Phokaians won, but it was a sort of Messina. The effect on the Etruscan Copyright © 2015, Knowledge Enterprises Incorporated. All rights reserved. 2 Medical Research Archives 2015 Issue 3 captors of the Greek prisoners of war was closely enough to be stricken. to be even more profound. It is generally Herodotus says the captives were assumed that citizens walked out from the more numerous than the oarsmen who city of Caere to witness or participate in escaped with their mangled ships: since 40 the massacre. Greek ships were lost, if they were all The site of the stoning must have pentekonters (see Figure 1) – open long- been in the vicinity of the great sanctuaries ships carrying 50 oarsmen -- then as many of the port of Pyrgi, dedicated to Uni-Juno- as 2000 men could have been captured – Astarte and Śuri-Apollo. The area where although in battle undoubtedly scores or the bodies were left must have been close hundreds died, and the crews of naval enough to the main road and the port- vessels may not have been complete to towns, Pyrgi and Alsium, that people and begin with. But it would seem that flocks/herds could not simply avoid it in hundreds could have been taken prisoner their seasonal or daily activities – only to be stoned by as many Caeretans. otherwise no one would have approached A B Figure 1. An artist's version of an war ships. Pentekonters were very versatile early pentekonter. a fore-runner of the and had a long-range, so they could be bireme and trireme. Pentekonters emerged used for sea trade, piracy and warfare. at a time when there was no clear They had sails, but as their name suggests, distinction between merchant vessels and (Pentekonter - trans. fifty oared) these Copyright © 2015, Knowledge Enterprises Incorporated. All rights reserved. 3 Medical Research Archives 2015 Issue 3 vessels were rowed by fifty oarsmen, neurological symptoms in which victims arranged in two rows of twenty-five on “would suffer strokes and become twisted each side of the ship. You can clearly see and crippled” (Purvis 2009, 92). What sort the ram that was used to engage other of pathogens could have infected a vessels at the prow of the drawings (Upper passerby and fairly soon thereafter have (A): re-drawn (AH) after a depicted ship caused paralysis? A number of other on an 8th-century BCE bowl from Thebes serious diseases, like poliomyelitis, were shown in McGrail (2002) pg. 128; Lower present in the ancient environment and (B): re-drawn (AH) after a depicted ship on could have produced some of the an 8th-century BCE krater found at the symptoms (Aufderheide and Rodríguez- ancient cemetery of Dipylon, near the Martín 1998, 212), but the Herodotean set Dipylon Gate at Kerameikos (northwest of of symptoms, coupled with the apparently the Acropolis) in Athens, and acquired by airborne mode of delivery, precludes most the Louvre in 1884 - FR 513.2010). candidates (cf. Dembek et al. 2007, 126). Various poisons have severe effects but are 1. IDENTIFICATION OF THE DISEASE not aerosols (see, recently, Mayor 2010). Botulism and tetanus (which are not The account describes the local zoonotic) will cause paralysis or similar people and their livestock as stricken by a neurological problems, and tetanus toxin, very unusual infection or intoxication that also present in soil, is similar to botulism affected multiple species, “equally sheep, toxin, but its most striking symptom is draft animals and men” – which constitutes muscle spasm such as lockjaw: the internal evidence, if we believe Herodotus proprioception signals (feedback) from at all, that this is not a case of hysterical muscles to the central nervous system paralysis among guilt-stricken men, since become lost, and the motor cortex over- sheep and oxen would not have been compensates by contracting the muscles susceptible to suggestion. for prolonged periods of time. Further, the Ancient Italy was prone to a effects of tetanus toxin could only be number of zoonoses, such as cutaneous observed 7 to 21 days after infection with (rather than lethal) anthrax, and Brucellosis C. tetani, so in the minds of observers, any (as experienced by Napoleon and others connection with exposure to the corpses who drank unpasteurized goats-milk - See would be more tenuous (Reddy and Bleck Turfa 2012, 190, 193). The discovery of a 2009; Rossetto et al. 2011). Bronze Age Pompeii, in the site of Nola- Some diseases cause some subset, Croce del Papa, where, ca. 1800 BCE, but not all, of the symptoms recounted by Vesuvius covered a village, has revealed Herodotus. Only one fits the complete humans living in close proximity to their profile. One disease that fits some of the farm animals, and in conditions that were symptoms mentioned by Herodotus is GBS highly unsanitary according to modern - Guillain-Barré syndrome. This is a standards (see Turfa 2012, 156-158 with disease with many subtypes, one of which references. Prehistoric Nola-Croce del presents with acute motor axonal Papa: Mastrolorenzo et al.
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