Book Review

Justinian's Flea: Plague, Empire, and the Birth of Europe

Plague and the End of Antiquity: The Pandemic of 541–750

N Engl J Med 2007; 357:1354-1355September 27, 2007

Article

Justinian's Flea: Plague, Empire, and the Birth of Europe
By William Rosen. 367 pp., illustrated. New York, Viking, 2007. $27.95. ISBN: 978-0-670-03855-8

Plague and the End of Antiquity: The Pandemic of 541–750
Edited by Lester K. Little. 360 pp. New York, Cambridge University Press, 2007. $75. ISBN: 978-0-521-84639-4

The interval between the 4th and the 8th centuries saw the decline of the Roman Empire, the rise of Christianity, the beginning of the Dark Ages in Western Europe, the spread of Islam, and the establishment of the Caliphate. These events echo through time to today, but few people are aware of an important link connecting all these events. The history of those times and that linkage is the subject of two recent books, Justinian's Flea and Plague and the End of Antiquity. Both books recount the tumultuous times at the end of antiquity in relation to the microbe that played such an important but generally underappreciated historical role. The two books are quite different. Justinian's Flea, an overview, is written by a single author, whereas Plague and the End of Antiquity is the work of 12 academics, each addressing a specific aspect of this first plague pandemic.

Justinian's Flea is William Rosen's first book. He is neither a scientist nor a historian but for more than 25 years was a senior executive at the publishing houses of Macmillan and Simon & Schuster. His book is a work of passion; one can only imagine the effort that went into the project. The result is a well-researched book that is also a pleasure to read. Rosen paints a picture of the 4th, 5th, and 6th centuries that allows the reader to appreciate a civilization in flux and to see how the once-united Roman Empire shattered for the final time, laying the foundation for the world we know today. Rosen tells of the breakup of an empire that at its height controlled territories from England to Iraq and from the Rhineland to North Africa, and he describes the attempt of Justinian I to reunite it. By the beginning of the 4th century, the population center and the richest part of the Roman Empire was not the Western Empire, which is now Western Europe, but the Eastern Empire. In 328 A.D., Constantine, the first Christian emperor of Rome, began the construction of Constantinople, his “Nova Roma.” Constantinople became the capital of the Roman Empire and remained a capital for over 1000 years.

Like dominos falling, a series of events that began in the latter part of the 4th century triggered the separation of the eastern and western portions of the Roman Empire. The Huns invaded Europe from the east and forced the Goths to flee across the Danube River into Roman territory in 376. The battle of Adrianople in 378 destroyed two thirds of the eastern Roman army and caused a definitive split of the east from the west. By the beginning of the 6th century, Justinian became emperor of the Eastern Roman Empire, and by 540, North Africa and most of Italy were under his control. But a new invader, Yersinia pestis, came to Egypt, and then to Constantinople in 542, and on to Western Europe and the Persian Empire. For the next two centuries, waves of plague struck throughout the Mediterranean, Western Europe, and the Middle East. The old Roman Empire and the Persian Empire were depopulated. Plague changed everything, and as it did again in the 14th century, it changed the course of history.

Rosen's knowledge of these events is remarkable. His explanations of the interaction of Y. pestis with the immune system and of bacterial pathogenesis provide insight into a killer that shaped history. By contrast, the book edited by Lester K. Little is based on his premise that “given the vast scope and interdisciplinary demands of the subject, the time is not yet ripe for a lone author to undertake a continuous and fully integrated narrative of this 210-year pandemic.” In keeping with this statement, Plague and the End of Antiquity is not an integrated narrative but a series of essays that address questions raised in the second essay, “Historians and Epidemics: Simple Questions, Complex Answers.” For students of history, these essays point out the controversies and uncertainties that surround the history of those turbulent times and even the cause of the plague itself. This approach gives the reader a greater appreciation of the role historians play in deciphering the past. After reading this book, I have a much better understanding of the academic view of this chaotic period and appreciate the difficulties inherent in studying it. As one would expect from academic writers, each of the topics is covered in depth, and considerably more details are supplied in specific areas than are supplied in Rosen's book. These details come from sources both inside and outside the territories of the old Roman Empire.

Of the various essays, I especially enjoyed the last two, which should have the most appeal to a medical audience. Robert Sallares's essay, “Ecology, Evolution, and Epidemiology of Plague,” blends molecular biology, climate, and vector biology with the historical record to make a convincing case for Y. pestis as the cause of so much death. Michael McCormick's essay, “Toward a Molecular History of the Justinianic Pandemic,” is a fascinating discussion of how modern molecular biology can be used to help historians decipher the past. It is clear that science will play an increasing role in historical studies in a variety of ways.

The two books have different aims — one a broad overview, and the other an in-depth review of discrete issues. Each book has achieved its goal. Although I understand that academic historians may rightfully think, like Little, that “the time is not yet ripe for a lone author to undertake a continuous and fully integrated narrative,” I do not fully agree with them. So much depends on the target readership. For most readers, Justinian's Flea is an excellent introduction to this subject, and I enthusiastically recommend it. However, it is clear that the events of the 4th through the 8th centuries are complex and veiled in the shadows of history. For those who want an in-depth discussion of discrete topics, I wholeheartedly recommend Plague and the End of Antiquity.

Raymond J. Dattwyler, M.D.
New York Medical College, Valhalla, NY 10595
raymond_dattwyler@nymc.edu