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The health of the Roman emperor was important to 70 million people. The disease could destabilize the government. A sudden death could have sparked a civil war. It is not surprising that the emperor's health was often a closely guarded secret. Even consulting an astrologer about this was considered tantamount to treason. Historians, however, paid attention to the illnesses of emperors. And even when their accounts are too blurred or stylized for retrospective diagnosis, they provide valuable insight into the lives and deaths of emperors. The world in which the emperors lived was deadly dangerous. Due to the vast number of diseases and basic medical care, life expectancy at birth was 20 to 30 years. About half of all Romans did not live to be teenagers.
Very few people celebrated their 60th birthday. Skeletons found in Herculaneum, buried by Vesuvius in 79 AD, illustrate both the benefits and dangers of life in the empire. The inhabitants of Herculaneum were about the same height as modern Italians, indicating that most were well- nourished. About half of the skeletons studied, however, showed signs of enamel hypoplasia, likely caused by severe childhood illnesses. Arthritis was common in the skeletons of elderly victims. One man in his early 50s had almost no cartilage left in his knees. Dental health, on the other hand, was good. Although this could be due to the fluoride in the local water. Lead levels in some skeletons were elevated, but not dangerously so. As in
most places and times, wealth and health were interrelated. One skeleton from Herculaneum, named "Kermanich" by archaeologists, had bones stunted by childhood malnutrition and warped by hard labor throughout his life. Another skeleton, belonging to a middle- aged man, had hands not marked by the stress of physical labor, but arms and shoulders sculpted by regular exercise in the baths. This was obviously a representative of the leisure class. The vast majority of emperors came from privileged classes. As children, they were well- fed and spared the grueling physical labor endured by the poor. By the middle of the 3rd century, however, emperors spent most of their time in the least healthy place on the planet-the city of Rome.
The air was stifling with smoke. The streets were covered in filth. The baths were swamps teeming with bacteria. In September and October, when malaria was most prevalent, even the Senate left the city. Malaria exacerbated the effects of typhus, typhoid fever, tuberculosis, shigellosis, and a host of other pathogens that plagued the imperial capital. New diseases appeared periodically. Pliny the Elder reports that leprosy had recently arrived from Egypt, along with a mysterious facial infection known as lichen, which was transmitted through kissing. Epidemics swept through Rome every few years. The plague during Nero's reign claimed the lives of over 30,000 people in a matter of months. During the devastating Antonine
Plague, up to 2,000 deaths were recorded daily. In the catacombs of Marcellinus and Peter, archaeologists found halls filled with hundreds of bodies- apparently victims of the plague. Although the tops of the seven hills, where the wealthy usually lived, were considered healthier than other parts of the city, the emperors and their entourage were as vulnerable to Roman diseases as any plebeian. When emperors were not in Rome, they usually lived in military camps. These cramped forts were almost as hotbeds of disease as the capital. The Antonine Plague was spread throughout the empire primarily by soldiers.
Marcus Aurelius, who apparently died in the legionary camp at Vindobon, may have himself fallen victim to this plague. Long before his final illness, Marcus Aurelius was often ill. To cure his numerous ailments, he drank theriac-a potion that included opium, cinnamon, and viper meat among its 70 ingredients. Wolf Milk coffee, the sponsor of this video, has only one ingredient- high-quality coffee. Coffee from the supermarket sits on the shelf for months before you buy it. Wolf Milk, on the other hand, is freshly roasted every week. To ensure your coffee is always fresh, Wolf Milk offers a convenient monthly subscription that can be paused or
canceled at any time. In fact, right now you can save 20% by subscribing. No matter how you decide to buy Wolf Milk coffee, you can save an additional 5% with the promo code TOLD AND STONE. So follow the link below for some fresh coffee. Let's return to our topic. Against the backdrop of such a deadly environment, how healthy were the emperors and their families? Augustus lived to be 75, his wife Livia to 86, and his successor Tiberius to 77. Such longevity was exceptional. All of Augustus's intended heirs died young. Marcellus at 23, Gaius at 23, Lucius at 18, and Drusus at 29. Emperors fell victim to the same diseases as their subjects. Vespasian, for example, died of gastroenteritis.
Suetonius tells us that he was gradually weakened by bouts of diarrhea and died while trying to get out of bed, saying that an emperor should die standing up. Both Titus and Nerva probably fell victim to malaria. Adrian appears to have suffered from hereditary heart disease. Some of his portraits actually show Frank's symptom-a diagonal crease on the earlobe that is associated with cardiovascular disease. Valentinian died of a stroke while shouting at the barbarian ambassadors. Galerius apparently died of Fournier's gangrene, a rare bacterial infection affecting the genitals and abdomen.
Antoninus Pius died after eating too much Alpine cheese, likely from a severe case of bacterial food poisoning. Some emperors had chronic health problems. In the last years of his life, Septimius Severus was bedridden due to gout. He was forced to carry a litter throughout his final campaign against the Scottish lowland tribes. As a teenager, August was so sickly that his mother was afraid to let him leave the house. Later, he often felt cold, avoided baths, and wore four tunics under his toga in winter. His skin was covered in scaly patches and his bladder was full of stones. His left leg and thigh were weak. His teeth were rotten. During the Battle of Philippi, the future first emperor had to be carried to the front on a stretcher.
Two decades later, his condition had deteriorated to the point that everyone thought he was dying. It is believed that only the cold water treatment prescribed by the doctor Antoninus Muse saved his life. For the rest of his long reign, he had periods of declining health, which were accompanied by senatorial promises and the issuance of commemorative coins. Nick Summerton, a physician who wrote a book about the health of Roman emperors, suggests that Augustus suffered from a chronic lung disease, possibly asthma, which was particularly acute during certain periods. This may well be true. More broadly, Augustus' illnesses highlight the fact that Roman emperors faced the same basic health problems as everyone else in the ancient world. In fact,
because they typically lived in places with high population densities and poor sanitation, they were more likely to be exposed to infections than most of their subjects. Being king wasn't always good. Next April, you can join me in Tunis, where we will explore Carthage, Dougga, El Jem, and many other places. In June I'm going to Romania to see some of the most impressive and little-visited monuments of the Roman world. Finally, in October I am going to Greece in the footsteps of Alexander the Great. Learn more about these and other upcoming trips at the links in the description.
Leaky Aqueducts, Fighting Pigeons, and Mystery Cults, is now available in print and audio formats. Additional content, including the next episode of my epic review of HBO's Rome, can be found on Toldstone's Patreon. And finally, don't forget about my other channels: Toland Stone Footnotes and Scenic Routes to the Past. Thank you for watching.
