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i
Debt in the Ancient Mediterranean

and Near East
ii
iii
Debt in the
Ancient
Mediterranean and
Near East
Credit, Money, and
Social Obligation
z
Edited by
JOHN WEISWEILER
iv
Oxford University Press is a department of the University of Oxford. It furthers

the University’s objective of excellence in research, scholarship, and education
by publishing worldwide. Oxford is a registered trade mark of Oxford University
Press in the UK and certain other countries.
Published in the United States of America by Oxford University Press

198 Madison Avenue, New York, NY 10016, United States of America.
© Oxford University Press 2023
All rights reserved. No part of this publication may be reproduced, stored in

a retrieval system, or transmitted, in any form or by any means, without the
prior permission in writing of Oxford University Press, or as expressly permitted
by law, by license, or under terms agreed with the appropriate reproduction
rights organization. Inquiries concerning reproduction outside the scope of the
above should be sent to the Rights Department, Oxford University Press, at the
address above.
You must not circulate this work in any other form

and you must impose this same condition on any acquirer.
Library of Congress Cataloging-in-Publication Data

Names: Weisweiler, John, editor.
Title: Debt in the ancient Mediterranean and Near East : credit, money, and
social obligation / edited by John Weisweiler.
Description: New York, NY : Oxford University Press, [2023] |
Includes bibliographical references and index.
Identifiers: LCCN 2022018785 (print) | LCCN 2022018786 (ebook) |
ISBN 9780197647172 (hardback) | ISBN 9780197647196 (epub)
Subjects: LCSH: Debt—Mediterranean Area—History, | Credit—Mediterranean
Area—History, | Money—Mediterranean Area—History, | Debt—Middle
East—History. | Credit—Middle East—History, | Money—Middle
East—History,
Classification: LCC HG3701 .D3925 2022 (print) | LCC HG3701 (ebook) |
DDC 332.70956—dc23/eng/20220708
LC record available at https://lccn.loc.gov/2022018785
LC ebook record available at https://lccn.loc.gov/2022018786
DOI: 10.1093/oso/9780197647172.001.0001
1 3 5 7 9 8 6 4 2
Printed by Integrated Books International, United States of America

v
In memory of David Graeber (1961–2020)

vi
vi
Contents
Preface ix
List of Contributors xi
1. The Currency–Slavery–Warfare Complex: David Graeber and

the History of Value in Antiquity 1
John Weisweiler
2. Beyond Debt: Markets and Morality in First-Millennium

Bce Babylonia 18
Reinhard Pirngruber
3. Cosmic Debt in Greece and India 32

Richard Seaford
4. Private Debts in Classical Greece: Bond of Friendship,

Curse of Hatred? 46
Moritz Hinsch
5. Debt, Death, and Destruction in Ancient Rome 67

Lisa Eberle
6. The Poetics and Politics of Exchange in Roman Agronomy 84

Neville Morley
7. Monetization, Marketization, and State Formation:

The Later Roman Empire as an Axial-Age Economy 102
John Weisweiler
vi
viii Contents
8. Zoroastrian Materialism: Religion, Empire, and

Their Critics in Graeber’s Late Axial Age 120
Richard Payne
9. Debt, Debt Bondage, and the Early Islamic Economy 132

Michael Bonner
10. Debt’s Fourth Millennium Seen from Below:

How Papyri Modify the Picture 148
Arietta Papaconstantinou
11. After the Axial Age: Debt and Obligation in the

European Early Middle Ages 163
Alice Rio
12. Afterword 179

Keith Hart
Notes 189
Bibliography 223
Index 265
ix
Preface
In 2014 and 2016, I taught two undergraduate seminars on Greek and Roman
debt at the Seminar für Alte Geschichte of the University of Tübingen. This book
is inspired by the students who participated in these courses. The lively discus-
sions in the Zeitschriftenzimmer of the top floor of the Hegelbau, taking place
just as the Greek debt crisis reached its denouement, were a powerful reminder
of what is at stake in thinking about the interplay between credit and coercion in
world history.
Most of the chapters included in this volume were first presented at a work-
shop held in Schloss Hohentübingen in summer 2016. The stately surroundings
of the Fürstenzimmer provided an appropriate backdrop for discussing the roles
played by religion, state violence, and metal currencies in premodern Eurasia.
Although Michael Hudson, Michael Jursa, and Reinhard Wolters did not par-
ticipate in the project until the end, their observations and insights were crucial
in moving it forward. So was the learning and good humor of Cliff Ando, who
moderated the discussion. Finally, the manuscript greatly benefited from the
comments of two anonymous reviewers. I would like to thank all of them for
their contributions to this project.
It is a pleasure to acknowledge the generous financial support of the Fritz-
Thyssen-Stiftung for the workshop from which this book originates. The unbu-
reaucratic way in which this foundation awards and manages grant money is a
model for institutions of its kind—the opposite of the “box tickers” and “task
masters” who, according to David Graeber’s apposite characterization, dominate
so many organizations of higher education.
The delight about the appearance of this book is mixed with incalculable
sadness. Two key contributors to this project did not live to see its conclu-
sion. Michael Bonner’s acumen and generosity greatly enlivened the Tübingen
x
x Preface
workshop. His contribution to this volume will be among the last publications
of a scholar whose work has reconfigured our understanding of the early Islamic
economy. David Graeber’s learning and anarchic humor were a glorious spectacle
to behold. It is still difficult to grasp that his youthful mind is no longer with us.
This book is dedicated to his memory.
xi
List of Contributors
Michael Bonner, University of Michigan, Ann Arbor †

Lisa Eberle, University of Tübingen lisa.eberle@uni-tuebingen.de
Keith Hart, The Memory Bank [email protected]
Moritz Hinsch, Humboldt University of Berlin moritz.hinsch@hu-berlin.de
Neville Morley, University of Exeter [email protected]
Arietta Papaconstantinou, University of Reading a.s.papaconstantinou@read-
ing.ac.uk
Richard Payne, University of Chicago [email protected]
Reinhard Pirngruber, University of Vienna [email protected]
Alice Rio, King’s College, London [email protected]
Richard Seaford, University of Exeter [email protected]
John Weisweiler, St John’s College, Cambridge [email protected]
xi
1
The Currency–Slavery–Warfare
Complex
David Graeber and the History of
Value in Antiquity
John Weisweiler
In his Debt: The First 5,000 Years (2011), David Graeber develops a new grand
narrative of world history. Graeber argues that the roots of the current socio-
economic order are located not in early-modern Europe but in antiquity. From
the late Bronze Age onward, all across Eurasia, relationships of social obligation
were transformed into quantifiable and legally enforceable debts. Graeber sug-
gests that this transformation made possible new economic institutions, such as
IOUs, coinage, and debt-slavery. At the same time, it also led to the emergence of
new modes of thought, which have shaped Eurasian philosophical and religious
traditions ever since.
This volume explores the implications of Graeber’s work for the history of
the ancient Mediterranean and Near East (roughly 700 Bce to 700 CE). This
era, which Graeber dubs (following Karl Jaspers) the “Axial Age,” plays a central
role in his narrative.1 He suggests that the territorial states of this period had a
distinct political economy, marked by metal currencies, taxation, chattel slav-
ery, and impersonal markets. All across Eurasia, old credit systems began to be
replaced by new forms of coinage, and states and landowning elites accumulated
unprecedented amounts of wealth. New cosmologies and philosophical practices
enabled individuals to maintain a sense of autonomy and self-determination in
these dynamic market societies. At the same time, inequality soared. Warfare led
to the spread of chattel slavery, and debt enmeshed rural populations in webs of
John Weisweiler, The Currency–Slavery–Warfare Complex In: Debt in the Ancient Mediterranean
and Near East. Edited by: John Weisweiler, Oxford University Press. © Oxford University Press 2023.
DOI: 10.1093/oso/9780197647172.003.0001
2
2 Debt in t he Ancien t Medit err an ean an d N ear East
dependency and obligation. Adapting an expression coined by Geoffrey Ingham,

Graeber calls this synergistic relationship between coinage, markets, fiscally
intensive states and coercive labor practices the “currency–slavery–warfare com-
plex.”2 On his reading, this constellation of power unraveled at the end of antiq-
uity. After the highly monetized empires of antiquity had disintegrated, usury
was outlawed in most regions of western Eurasia, chattel slavery ended, and non-
market forms of exchange again became more important.3
The chapters assembled in this volume pursue two objectives. First, they test
the accuracy of this grand narrative of ancient history. Specialists assess how
well the interpretations advanced in Debt fit current understanding of the soci-
eties of the ancient Mediterranean and Near East. Does Graeber’s concept of a
“currency–slavery–warfare complex” shed new light on the political economy of
western Eurasia in this period? Second, this volume offers a history of ancient
credit systems which takes seriously the dual nature of debt as both a quantifiable
economic reality and an immeasurable social obligation. By exploring the diverse
ways in which social relationships were quantified in different ancient societies,
it tries out a method of writing the history of ancient systems of exchange that
departs from the currently dominant paradigm of neo-institutional economics.
Debt: The First 5,000 Years

When in 2011 David Graeber published his Debt: The First 5,000 Years, he was
professor of anthropology at Goldsmith’s College of the University of London.
But he spent his academic leave in his home city, New York. There he quickly
became one of the most influential voices of the Occupy Wall Street movement.
Graeber had long mixed activism with scholarship. In addition to writing three
influential works of ethnography and anthropological theory,4 he was an active
participant in the global justice movement and published a classic study of it,
Direct Action: An Ethnography.5 But none of his earlier books spoke as much
to the concerns of the moment as Debt: The First 5,000 Years. Although it was
published by a small independent press, it became an instant bestseller and has
been translated into seventeen languages. In retrospect, this success may seem
unsurprising. After all, Debt appeared at the height of the European debt crisis
and in a moment when the social effects of the 2007 credit crunch had led to an
upsurge of social protest across the globe. The book looked like the manifesto of
the movements that seemed to challenge the established order in the summer of
2011. This impression was reinforced by the fact that Graeber was one of the most
visible representatives of the protests in New York.
Yet this impression is misleading. Research for Debt had (of course) begun
years before the uprisings of 2011. Already in 2009, Graeber published a paper in
3
The Currency–Slavery–Warfare Complex 3
which he outlined the main contours of the argument that would later be elabo-
rated in his book.6 On closer inspection, it is also not clear whether Debt was
quite so obviously predestined to become a publishing success as it would later
appear. The book puts forward a complex and challenging argument. Although it
is written in accessible style, it is deeply versed in anthropological theory. Entire
chapters are taken up by technical arguments around the nature of money, defini-
tions of modes of exchange, or explorations of credit systems in remote societ-
ies or distant periods of history. In this sense, one may suspect that the popular
success of the book was more of a mirage than a reality. Like that other surprise
bestseller, Thomas Piketty’s Capital in the Twenty-First Century (2014), Graeber’s
Debt was probably more often cited than read from cover to cover. But for schol-
ars interested in the shape of premodern economies, the book repays attention. It
offers at least three insights that ancient historians may usefully incorporate into
their work.
First, Graeber challenges the narrative (prevalent since at least Adam Smith
and accepted as common sense in many quarters until today) according to which
world economic history can be written in terms of a development to ever more
efficient modes of exchange, from barter (allegedly prevalent in pre-monetized
societies) through coinage (developed in classical antiquity) to the complex
credit instruments employed in modern finance. Graeber shows that this story
is empirically wrong. In the opening chapter of the book, he demonstrates that
in reality the circulation of goods in most pre-monetized societies was deter-
mined by relationships of mutual obligation, not by exchanging fixed amounts
of one commodity against fixed amounts of another.7 The refutation of the myth
of barter was probably the most influential section of Debt. Though it was long
known among anthropologists that barter cannot have been the original form of
exchange, it was only in the wake of Graeber’s book that this conclusion began to
be widely accepted outside of specialist scholarship.8
Second, Graeber shows that exchanges based on reciprocity are not as natu-
ral or ubiquitous as common sense might lead us to believe and as social scien-
tists of different political persuasions since the nineteenth century have tended
to think. He observes that cash purchases, credit contracts, and barter resemble
each other in important ways. They are all based on an expectation that one party
will give something in return for what the other party has given, and will do so
in a precisely quantifiable way. Once the transaction is concluded, the relation-
ship between the two parties ends. Graeber distinguishes this reciprocal logic
from non-reciprocal forms of interaction. The latter fall into two subgroups. The
first (which he calls “baseline communism”) denotes interactions which operate
without an expectation of reciprocity, such as giving somebody a lighter, lend-
ing somebody a tool, or giving somebody directions. The second (which Graeber
4
calls “hierarchy”) comprises forms of exchange between non-equals, such as the

payment of protection money, euergetism, or gifts to a child. Though in some
of these cases obligations are claimed to be reciprocal, in practice they follow
the logic of precedent. Moreover, the relationship is constantly ongoing, rather
than being broken off. In all societies these non-reciprocal forms of interaction
are probably at least as widespread as market sales and other forms of reciprocal
exchange.9
Here is an important difference between Graeber and Karl Polanyi. In his
Great Transformation, Polanyi famously argues that market societies are products
of modernity. In order to highlight how radically different they are from what
went before, he emphasizes the wide gap that separated capitalism from earlier
systems of exchange in which the allocation of resources was chiefly determined
by networks of redistribution and reciprocity.10 Graeber challenges these views.
He observes that many forms of what Polanyi and others have called “reciprocity”
follow dynamics that in crucial regards resemble market mechanisms. Whether a
sale is conducted through the exchange of one commodity for another, through
a credit contract, or by handing over physical coins, what matters is that in all
those cases the value of the item is precisely calculated and that after the transac-
tion is conducted, neither the buyer nor the seller has (in principle) any further
obligations vis-à-vis each other. This perspective has interesting implications. By
emphasizing the similarities between different types of quantified exchange, he
cuts through the debate between “primitivist” and “modernist” conceptions of
ancient economy. On the one hand, Graeber’s insistence that the societies of the
ancient Mediterranean and Near East developed dynamic market economies
(even though they lacked the forms of rationality and technologies of exchange
ancient historians have long seen as preconditions for the emergence of such
economies) fits well with recent research which has decisively rejected “primitiv-
ist” views of the ancient economy. On the other hand, Graeber encourages us
to see the emergence of commodity markets not as a natural development (as is
sometimes the case in “modernist” scholarship) but to investigate for each society
the precise reasons why some fields of life came to be organized according to a
strictly economic logic.
Third, if it is recognized that commodity markets do not emerge naturally
or inevitably, this raises the question of why they played an ever more important
role in the societies of the ancient Mediterranean and Near East. The anthro-
pological evidence discussed by Graeber is a useful reminder that in small-scale
communities where people know each other reciprocal forms of exchange usually
play only a limited role; in these “human economies,” precise quantification of
mutual obligations is generally only necessary in the context of trade with outsid-
ers.11 Why then did in the ancient Mediterranean and Near East unquantifiable
5
moral obligations transform into precisely calculable debts? Graeber suggests

that the rise of territorial states which collected their taxes and paid their sol-
diers in metal currency played a crucial role: “By insisting that only their own
coins were acceptable as fees, fines, or taxes, governments were able to overwhelm
the innumerable social currencies that already existed in their hinterlands, and to
establish something like uniform national markets.”12 As will be seen in the final
section of this chapter, it is too simple to ascribe the spread of coinage to efforts to
finance mercenary armies and imperial warfare. Nevertheless, Graeber is correct
that state formation, monetization, and the expansion of markets are processes
that reinforce each other. They work hand in hand because they all operate by
subjecting new fields of life to a quantitative logic. By pointing to the crucial role
played by public institutions in promoting reciprocal exchange, he offers a useful
counterpoint to theories which see markets as the natural outgrowths of private
enterprise.
After Neo-Institutionalism
In seeking to understand ancient systems of exchange from the vantage point
of Graeber’s anthropological theory, this book departs from the now dominant
approach in economic history. Since the early 2000s, an outpouring of sophis-
ticated new work has applied the toolkit of new institutional economics (NIE)
to the societies of the ancient Mediterranean and Near East. The most influen-
tial exponent of this theory was the US economist Douglass North, who in 1995
received the prize in economic sciences of the Swedish Riksbank (often referred
to as the Nobel Prize in Economics). North ascribes differences in economic
performance of different societies to the efficacy of the institutions—a term that
encompasses both legal rules and informal understandings—that govern them. If
institutions are well designed, they facilitate the free exchange of information and
goods among economic actors. A positive feedback loop ensues; as trust among
market participants increases, production and exchange intensify. By contrast,
if institutions are inefficient, they create information and power asymmetries
between buyers and sellers. Market participants are forced to expend resources
to ascertain the quality of traded goods and to ensure the enforcement of con-
tracts; these “transactions costs” hinder exchange and economic growth.13 In the
view of North and his followers, these dynamics explain the divergent trajectory
of the economies of western Europe and North America since the Industrial
Revolution.14
As more recent scholarship has pointed out, there are problems with this
simple model of the relationship between institutions and economic growth.
By seeing markets and private property rights as the most efficient mechanisms
6
for allocating resources, North naturalizes the institutions of the liberal capital-
ist nation-states of his own time. Effectively, the economic order prevalent in
post–Cold War North America and western Europe becomes the transhistorical
measuring stick by which other economic systems are assessed. Such a teleologi-
cal view prevents understanding other periods and places on their own terms.15
NIE also does not provide much help for understanding the more recent evolu-
tion of the world economy. For instance, the recent rise of East Asia and espe-
cially China, where markets are more tightly regulated and public institutions
control a much larger share of national wealth than in contemporary Europe
and North America, sheds doubt on the view that low transaction costs and the
uncompromising defense of property rights play quite the central role in facilitat-
ing economic growth, as neo-institutional theory suggests.16 In retrospect, neo-
institutional economics is all too visibly the product of the triumphalist high
point of neoliberal globalization in the 1990s.17
It might thus be expected that the application of neo-institutional economics
to ancient history had unambiguously deleterious effects. However, this would be
a mistaken assessment. In a discipline concerned with the interpretation of source
materials that were produced in cultures that radically differ from our own, the
universalizing claims made by North and his followers were always unlikely to
be adopted in full. On the contrary, by providing a simple framework to make
sense of the relationship between institutions and economic performance in dif-
ferent societies, NIE had some beneficial effects on ancient economic history.
Two developments were especially welcome. First, neo-institutional economics
motivated ancient historians to enter into a dialogue with specialists in related
disciplines. Most importantly, Mediterranean and Near Eastern historians
began to collaborate more closely with each other. In a landmark collection, The
Ancient Economy: Evidence and Models, Joe Manning and Ian Morris exposed the
ways in which cooperation between specialist in Greek, Roman, Egyptian, and
Mesopotamian history might reconfigure each of those fields.18 More recently,
Michael Jursa has systematically applied the methods of quantitative history
honed in the Mediterranean to the much more densely documented regions of
ancient Mesopotamia.19
Second, the engagement with neo-institutional economics inspired a turn
toward quantification. It motivated ancient historians to harvest the wealth
of evidence provided by landscape surveys and archaeological excavations, in
order to trace rhythms of intensification and abatement in ancient economies.
The publications of the Oxford Roman Economy project have made an array of
new data sets available, which greatly refined our understanding of the ancient
economy.20 Walter Scheidel in various publications revealed the use of models
derived from other premodern societies for understanding the dynamics and
7
scale of the Roman economy.21 Alain Bresson, by combining neo-institutional

theory with a careful analysis of literary, epigraphic, and archaeological evidence,
expanded and refined our understanding of the Greek systems of exchange.22
Overall, the new focus on measuring the performance of the ancient economy
made possible a more rigorous comparison with other historical periods. Rather
than asking whether ancient economies were “modern” or “primitive,” scholars
began to explore the degree to which their performance resembled later systems of
production, consumption, and exchange. In the introduction to the Cambridge
Economic History of the Greco-Roman World, Ian Morris, Richard Saller, and
Walter Scheidel summarize the ways in which their interpretation of ancient
economic history expands on previous analyses: “It improves on substantivist
approaches by providing crude statistics of economic performance, but it also
goes beyond both sides in the old primitivist–modernist debate by developing
general theoretical models of ancient economic behavior and putting them in a
global, comparative context. It recognizes that classical antiquity saw one of the
strongest economic efflorescences in premodern history, but keeps this in per-
spective, refusing to confuse the ancient economy with the modern.”23
It should also be noted that the application of neo-institutional models
to ancient history did not produce the heavily ideological narrative readers of
Douglass North’s oeuvre might expect. To be sure, some celebrations of the effi-
cacy of ancient institutions and the dynamism of ancient market economies may
underplay the violence and inequality that sustained these systems.24 Yet overall,
the most influential work did not depict the development of ancient market soci-
eties as an unalloyed boon. For instance, Scheidel consistently emphasizes the
double-edged effects of the Roman economic miracle. While empire facilitated
an unprecedented expansion of exchange systems, it also escalated inequality
and had deleterious effects on human well-being.25 Similarly, Bresson and Jursa
are acutely sensitive to the predation and exploitation that made possible the
Greek and Near Eastern economic efflorescences, respectively.26 Overall then,
when ancient historians incorporated NIE into their own research, they did not
inevitably adopt the ideological standpoint and teleology that are implicit in the
founding texts of this theory—that market exchange and robust private property
rights, backed by the institutions of a liberal capitalist state, are the natural and
most efficient methods to allocate resources. On the contrary, by motivating a
turn toward quantification and a renewed effort to situate the Mediterranean and
Near East in a larger comparative context, scholarship inspired by NIE has added
insight and nuance to our understanding of ancient economies.
Nevertheless, it is unlikely that neo-institutionalism will maintain its role as
the dominant paradigm in the study of premodern economies for much longer.
Global warming, the financial crisis of 2007, and the coronavirus pandemic have
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About the fortieth day, had pain in the right eye, sight dull. It went
away.[671]
Case XI.—The wife of Dromeades having been delivered of a
female child, and all other matters going on properly, on the second
day after was seized with rigor and acute fever. Began to have pain
about the hypochondrium on the first day; had nausea and
incoherence, and for some hours afterwards had no sleep;
respiration rare, large, and suddenly interrupted. On the day
following that on which she had the rigor, alvine discharges proper;
urine thick, white, muddy, like urine which has been shaken after
standing for some time, until the sediment had fallen to the bottom;
it had no sediment; she did not sleep during the night. On the third
day, about noon, had a rigor, acute fever; urine the same; pain of
the hypochondria, nausea, an uncomfortable night, no sleep; a
coldish sweat all over, but heat quickly restored. On the fourth, slight
allevation of the symptoms about the hypochondria; heaviness of
the head, with pain; somewhat comatose; slight epistaxis, tongue
dry, thirst, urine thin and oily; slept a little, upon awaking was
somewhat comatose; slight coldness, slept during the night, was
delirious. On the morning of the sixth had a rigor, but soon
recovered her heat, sweated all over; extremities cold, was delirious,
respiration rare and large. Shortly afterwards spasms from the head
began, and she immediately expired.[672]
Case XII.—A man, in a heated state, took supper, and drank more
than enough; he vomited the whole during the night; acute fever,
pain of the right hypochondrium, a softish inflammation from the
inner part; passed an uncomfortable night; urine at the
commencement thick, red, but when allowed to stand, had no
sediment, tongue dry, and not very thirsty. On the fourth, acute
fever, pains all over. On the fifth, urine smooth, oily, and copious;
acute fever. On the sixth, in the evening, very incoherent, no sleep
during the night. On the seventh, all the symptoms exacerbated;
urine of the same characters; much talking, and he could not contain
himself; the bowels being stimulated, passed a watery discharge
with lumbrici: night equally painful. In the morning had a rigor;
acute fever, hot sweat, appeared to be free of fever; did not sleep
long; after the sleep a chill, ptyalism; in the evening, great
incoherence; after a little, vomited a small quantity of dark bilious
matters. On the ninth, coldness, much delirium, did not sleep. On
the tenth, pains in the limbs, all the symptoms exacerbated; he was
delirious. On the eleventh, he died.[673]
Case XIII.—A woman, who lodged on the Quay, being three
months gone with child, was seized with fever, and immediately
began to have pains in the loins. On the third day, pain of the head
and neck, extending to the clavicle, and right hand; she immediately
lost the power of speech; was paralyzed in the right hand, with
spasms, after the manner of paraplegia; was quite incoherent;
passed an uncomfortable night; did not sleep; disorder of the
bowels, attended with bilious, unmixed, and scanty stools. On the
fourth, recovered the use of her tongue; spasms of the same parts,
and general pains remained; swelling in the hypochondrium,
accompanied with pain; did not sleep, was quite incoherent; bowels
disordered, urine thin, and not of a good color. On the fifth, acute
fever; pain of the hypochondrium, quite incoherent; alvine
evacuations bilious; towards night had a sweat, and was freed from
the fever. On the sixth, recovered her reason; was every way
relieved; the pain remained about the left clavicle; was thirsty, urine
thin, had no sleep. On the seventh trembling, slight coma, some
incoherence, pains about the clavicle and left arm remained; in all
other respects was alleviated; quite coherent. For three days
remained free from fever. On the eleventh, had a relapse, with rigor
and fever. About the fourteenth day, vomited pretty abundantly
bilious and yellow matters, had a sweat, the fever went off, by
coming to a crisis.[674]
Case XIV.—Melidia, who lodged near the Temple of Juno, began
to feel a violent pain of the head, neck, and chest. She was
straightway seized with acute fever; a slight appearance of the
menses; continued pains of all these parts. On the sixth, was
affected with coma, nausea, and rigor; redness about the cheeks;
slight delirium. On the seventh, had a sweat; the fever intermitted,
the pains remained. A relapse; little sleep; urine throughout of a
good color, but thin; the alvine evacuations were thin, bilious, acrid,
very scanty, black, and fetid; a white, smooth sediment in the urine;
had a sweat, and experienced a perfect crisis on the eleventh day.
[675]
BOOK III.—OF THE EPIDEMICS.
THE ARGUMENT.
Though in the Argument prefixed to the First Book of the

Epidemics I have given a pretty full summary of the contents both of
that book and the third, I have still a few observations to make on
some important points, which were not sufficiently considered on
that occasion; and this I do the more readily, as it will afford me an
opportunity of noticing a subject on which M. Littré has bestowed
very extensive research. I allude to the origin of the Glandular
Plague. As I make it a rule, in giving these my annotations, not to
enter into any lengthy details, I shall now state, in a very succinct
manner, the result of my inquiries. The reader is referred, for a fuller
discussion of the subject, to the more ample disquisitions of M.
Littré.[676]
The opinion has been pretty generally maintained by modern
authorities, that the first description which we have of the glandular
plague of the East is that given by the historian Procopius, in the
sixth century; and the inference drawn therefrom is that the disease
was unknown until his time. This opinion is still held, to a certain
extent, by Hecker, Rosenbaum, Pariset, Nauman, and others of the
most distinguished scholars of the day, but it appears to be
untenable after the discovery of the “Fragment” of Ruffus, published
by Mai, Rome, 1831. As the passage is very important, I shall give a
translation of it in this place. It is as follows: “The buboes called
pestilential are most fatal and acute, especially those which are seen
occurring about Libya, Egypt, and Syria, and which are mentioned by
Dionysius Curtus. Dioscorides and Posidonius make much mention of
them in the plague which occurred in their time in Libya; they say it
was accompanied by acute fever, pain, and prostration of the whole
body, delirium, and the appearance of large and hard buboes, which
did not suppurate, not only in the accustomed parts, but also in the
groins and armpits.” The only thing which detracts from the value of
this paragraph is the difficulty of determining exactly who the
authorities are which are referred to in it. Of Dionysius Curtus
nothing is known; indeed it is more than probable, that there is
some mistake in this name. There are several medical authors of the
name of Dioscorides and Posidonius, and it is difficult to determine
to which of them reference is here made. Still, however, there seems
to be no reason for questioning the authenticity of the passage.
Ruffus, I may add, is generally admitted to have flourished in the
reign of Trajan.[677]
To this important document let me join an interesting extract
from Galen’s work “On Fevers.” Galen, treating professedly of
Pestilential Fevers, which he maintains are all connected with a
tendency to putridity, expresses himself as follows: “Moreover, as
Hippocrates says, all fevers from buboes are bad, with the exception
of ephemerals; although the bubo is also of the class of phlegmons.
And I agree in so far with what is said of putrefaction, for this is the
cause of the fever in inflammations, and not as Erasistratus
supposed.[678] But yet there are certain fevers from buboes of the
class of ephemerals, as certain others proclaim them to be; diseases
difficult to cure, which derive their origin from an inflammation, an
ulcer, an abscess, or some other such affection in a viscus. But the
ephemeral fevers from buboes differ from those connected with
putrefactions, either in a certain viscus, or in the hollow and very
large vessels, that in those from buboes, which always impart their
heat to the surrounding parts, the heat is communicated to the
heart, and the putrefactive fume does not reach it, but remains
circumscribed in the seat of the bubo, and the heat reaching the
heart solely by a change in the connecting parts, in like manner as in
those exposed to excessive heat and fatigue, the diffusion of the
heat takes place from the parts first warmed to the source of vitality;
but in a putrefaction about the viscera and large vessels, a fume, as
it were, from the putrefying humors reaches the cavities of the
heart, etc.”[679] From these two passages alone, without taking into
account several others of less importance, which might be gathered
from other medical authorities,[680] it must be quite obvious that the
glandular plague was known, at all events, in the second century of
the Christian era. Moreover it is equally clear, that Galen did not look
upon it as a new disease, but considered that it was noticed in the
works of Hippocrates. To my mind, then, there can be no doubt that
the pestilence which prevailed during the Peloponnesian war partook
of the nature of the glandular plague. What has tended to create
doubts on this subject, in the minds of many learned men, is the
omission of any distinct mention of buboes in the graphic description
of it given by Thucydides. But it should always be taken into account
that Thucydides was not a professional man, and therefore there is a
strong presumption that his acquaintance with the disease, even
although, as he states, he himself had experienced an attack of it,
must have been altogether of a general nature. Indeed Galen, both
in the treatise from which I have quoted above and in many other
parts of his works, does not hesitate to declare, that the historian
describes the disease as a common, that is to say, a non-
professional man, whereas Hippocrates gives its characters as a
physician. It is also to be borne in mind, that the description of it
given by Thucydides applies to it only at its outbreak in the city of
Athens, and it is a well-known characteristic of pestilential epidemics
that they change very much during their progress. This character of
them was well illustrated in the Plague of Aleppo, so admirably
described by Dr. Russel; for although the glandular form of the
disease prevailed in a large number of cases, a considerable
proportion of them were unaffected with buboes. Indeed it appears
to me to be too much the practice for the profession, as well as the
public, to imagine to themselves a certain type or ideal of every
disease, and when they do not recognize the exact characters which
they fancy it should present, they immediately set down such cases
as constituting an entirely different disease. This is an error that is
constantly committed, and one which I believe to be at the bottom
of the discordant opinions which prevail among professional men, on
the subject of the glandular plague. It would be well for the
physician to bear in mind how many varieties of symptoms the fever
designated as Typhus puts on,—some with the rash reckoned
peculiar to this fever, and some without it,—some with petechiæ,
and miliary eruptions, and others without them; and many other
complications of symptoms, which are sometimes present and
sometimes not.
With regard to the hypothesis lately advanced by Mr. Theod.
Krause,[681] and in so far countenanced by M. Littré, that the plague
of Athens was an epidemical variola, I must say that I can see no
probability in this supposition; for that a disease so strongly marked
as smallpox should have prevailed in ancient times, and yet not be
distinctly noticed by the Greek and Roman writers on medicine, I
cannot conceive, more especially when we call to recollection the
very accurate descriptions which they have left us of other
cutaneous diseases, by no means attended with symptoms of so
obvious a nature. Indeed it appears to me most wonderful, that such
an opinion should have been entertained by any person at all
acquainted with the Arabic writers on medicine, who described most
distinctly both the plague and the smallpox. Not to lose ourselves
amidst a host of authorities, I would refer the reader, in particular, to
Avicenna, iv., 1, 4, where the two diseases are treated of most
distinctly, so that I cannot entertain a doubt that the Arabian
physicians considered them to be essentially different.
In a considerable number of the cases reported in this book,
there are affixed to them in the original certain characters, the
interpretation of which the reader will find given in the translation. It
will be necessary, then, to give the reader some account of the
origin of these characters, regarding which our sole authority is
Galen, who, in his Commentaries on this book, enters on the
question in his usual elegant and attractive style. He admits that he
derived his information principally from Zeuxis, one of his
predecessors in the office of commenting upon the works of
Hippocrates. (See § 2, of the Preliminary Discourse.) It appears that
Ptolemy Philadelphus was so zealous in his search for books to adorn
his library, in Alexandria, that he gave instructions to the masters of
ships going on distant voyages to collect all the books they could
procure, and bring them back with them; that he ordered copies to
be taken of books brought to him in this way, and kept the originals,
but returned the copies, along with large sums of money, in certain
cases, to those who had lent them to him; and that the works so
obtained were preserved in a separate department of the library,
with the inscription, “The Books of the Ships.” Among these was
found a copy of the Third Book of the Epidemics, with the
inscription, “One of the Books of the Ships, according to the
redacteur Memnon of Sida.” Others say, that the term “redacteur”
was wanting, and that the book bore simply the inscription of
“Memnon;” and that the servants of the king inscribed the names of
all the seamen who had brought these books, when they were
installed on the shelves of the library. This, it would seem, was not
done immediately after their arrival in Alexandria, but that at first
they were collected together in certain houses. Memnon, the
librarian, then, is generally supposed to have surreptitiously
introduced the characters into one of the copies, in order that he
might raise himself into importance by interpreting them. But
whether or not this ruse was actually perpetrated by Memnon, the
general belief of the commentators was, that Hippocrates himself
had nothing to do with them. In fact, Zeno would appear to have
been the only commentator who held them to be genuine, and
ascribed the introduction of them to our author. The opinion thus
advanced by Zeno led him into a violent controversy with the two
Apollonii, namely, the Empiric and Biblas, who strenuously
maintained that the characters were an interpolation executed by
Memnon. This came to be the settled opinion of the commentators,
and among others of Galen, who, although he gives a key to the
interpretation of the characters, maintains, on all occasions, that
they are of no authority, and had in fact been forged by Memnon.
The following is the key which Galen gives to the interpretation
of the characters: α, signifies ἀποφθορὰν, abortion, or ἀπώλειαν,
loss; γ, signifies γονοειδὲς ὁυρον, urine resembling semen; δ,
punctuated below, thus, δ, signifies ἱδρῶτα, sweat, and διάρροιαν,
diarrhœa, and διαφόρησιν, perspiration, or in fact any other
evacuation which it is wished to express; ἐ, signifies ἐποχὴν,
retention, or ἒδραν, seat; ζ, signifies ζήτημα, the object of research;
θ, signifies θάνατον, death; ι, signifies ἱδρῶτα, sweat; κ, signifies
κρίσιν, crisis, or κοιλιακὴν διάθεσιν; μ, signifies μανίαν, madness, or
μήτραν, the womb; ν, signifies νεότητα, youth, or νέκρωσιν,
mortification; x, signifies ξανθὴν χολὴν, yellow bile, or ξένον τι καὶ
σπάνιον, something strange and rare, or ξυσμὸν, irritation, or
ξηρότητα, dryness; ο, signifies ὀδύνας, pains, or οὖρον, urine (but
some think that it is only when it has a ὐ above it that it signifies
urine); π signifies πλῆθος, abundance, or πτύελον, sputum, or πυρὸν
(πυρρὸν?), yellow, or πυρετὸν, fever, or πνεύμονος τάθος, affection
of the lungs; π, with a character ι in its middle or ),
signifies πυθανὸν, probable; ρ, signifies ῥύσιν, flux, or ρίγος, chill; φ,
signifies φρενῖτιν, phrensy; ς, signifies σπασμὸν, convulsion, or
στομαχοῦ ἢ στόματός κάκωσιν, illness of the stomach or mouth; τ,
signifies τόκον, accouchement; υ, signifies ὑγείαν, health, or
ὑποχόνδριον, hypochondrium; χ, signifies χολὴν, bile, or χολῶδες,
bilious; ψ, signifies ψύξιν, congealing; ω, signifies ὠμότητα, crudity.
See Galeni Opera, t. v., p. 412, ed. Basil.; and Littré’s Hippocrates, t.
iii., p. 33.
According to this key, the characters at the end of the first case
are thus explained by Galen: they are ΠΟΥΜΥ. Here, then,
signifies πιθανὸν, it is probable, Π, πλῆθος, that an abundance, ου,
οὔρων, of urine; Μ, on the 40th day; Υ, ὑγείαν, brought health. It is
more fully expressed thus by Galen: πιθανὸν ειναιδιὰ τὸ πλῆθος τῶν
ἐκριθέντων όυρων ἀυτὸ λυρθῆναι τό νοσημα καὶ ὑγιῆ γενέσθαι τὸν
ἄνθρωπον ἑν τῂ τεσσαρακοστῇ τῶν ἡμερῶν, that is to say, “it is
probable that, owing to the copious discharge of urine, the disease
was resolved, and the patient became well on the fortieth day.”
BOOK III.—OF THE EPIDEMICS.
Sec. I.
Case I.—Pythion, who lived by the Temple of the Earth, on the

first day, trembling commencing from his hands; acute fever,
delirium. On the second, all the symptoms were exacerbated. On the
third, the same. On the fourth alvine discharges scanty, unmixed,
and bilious. On the fifth, all the symptoms were exacerbated, the
tremors remained; little sleep, the bowels constipated. On the sixth
sputa mixed, reddish. On the seventh, mouth drawn aside. On the
eighth, all the symptoms were exacerbated; the tremblings were
again constant; urine, from the beginning to the eighth day, thin,
and devoid of color; substances floating in it, cloudy. On the tenth
he sweated; sputa somewhat digested, had a crisis; urine thinnish
about the crisis; but after the crisis, on the fortieth day, an abscess
about the anus, which passed off by a strangury.
Explanation of the characters. It is probable that the great
discharge of urine brought about the resolution of the disease, and
the cure of the patient on the fortieth day.[682]
Case II.—Hermocrates, who lived by the New Wall,[683] was
seized with fever. He began to have pain in the head and loins; an
empty distention of the hypochondrium; the tongue at first was
parched; deafness at the commencement; there was no sleep; not
very thirsty; urine thick and red, when allowed to stand it did not
subside; alvine discharge very dry, and not scanty. On the fifth, urine
thin, had substances floating in it which did not fall to the bottom;
[684] at night he was delirious. On the sixth, had jaundice;[685] all
the symptoms were exacerbated; had no recollection. On the
seventh, in an uncomfortable state; urine thin, as formerly; on the
following days the same. About the eleventh day, all the symptoms
appeared to be lightened. Coma set in; urine thicker, reddish, thin
substances below, had no sediment; by degrees he became
collected. On the fourteenth, fever gone; had no sweat; slept, quite
collected; urine of the same characters. About the seventeenth, had
a relapse, became hot. On the following days, acute fever, urine thin,
was delirious. Again, on the twentieth, had a crisis; free of fever;
had no sweat; no appetite through the whole time; was perfectly
collected; could not speak, tongue dry, without thirst; deep sleep.
About the twenty-fourth day he became heated; bowels loose, with
a thin, watery discharge; on the following days acute fever, tongue
parched. On the twenty-seventh he died. In this patient deafness
continued throughout;[686] the urine either thick and red, without
sediment, or thin, devoid of color, and having substances floating in
it; he could taste nothing.
Explanation of the characters. It is probable that it was the
suppression of the discharges from the bowels which occasioned
death on the twenty-seventh day.
Case III.—The man who was lodged in the Garden of Dealces:
[687] had heaviness of the head and pain in the right temple for a
considerable time, from some accidental cause, was seized with
fever, and took to bed. On the second, there was a trickling of pure
blood from the left nostril, but the alvine discharges were proper,
urine thin, mixed, having small substances floating in it, like coarse
barley meal, or semen. On the third, acute fever; stools black, thin,
frothy, a livid sediment in the dejections; slight coma; uneasiness at
the times he had to get up; sediment in the urine livid, and
somewhat viscid. On the fourth, slight vomiting of bilious, yellow
matters, and, after a short interval, of the color of verdigris; a few
drops of pure blood ran from the left nostril; stools the same; urine
the same; sweated about the head and clavicles; spleen enlarged,
pain of the thigh on the same side; loose swelling of the right
hypochondrium; at night had no sleep, slight delirium. On the sixth,
stools black, fatty, viscid, fetid; slept, more collected. On the
seventh, tongue dry, thirsty, did not sleep; was somewhat delirious;
urine thin, not of a good color. On the eighth, stools black, scanty,
and compact; slept, became collected; not very thirsty. On the ninth
had a rigor, acute fever, sweated, a chill, was delirious, strabismus of
the right eye, tongue dry, thirsty, without sleep.[688] On the tenth,
much the same. On the eleventh, became quite collected; free from
fever, slept, urine thin about the crisis. The two following days
without fever; it returned on the fourteenth, then immediately
insomnolency and complete delirium. On the fifteenth, urine muddy,
like that which has been shaken after the sediment has fallen to the
bottom; acute fever, quite delirious, did not sleep; knees and legs
painful; after a suppository, had alvine dejection of a black color. On
the sixteenth, urine thin, had a cloudy eneorema, was delirious. On
the seventeenth, in the morning, extremities cold, was covered up
with the bedclothes, acute fever, general sweat, felt relieved, more
collected; not free of fever, thirsty, vomited yellow bile, in small
quantities; formed fæces passed from the bowels, but soon
afterwards black, scanty, and thin; urine thin, not well colored. On
the eighteenth, not collected, comatose. On the nineteenth, in the
same state. On the twentieth, slept; quite collected, sweated, free
from fever, not thirsty, but the urine thin. On the twenty-first, slight
delirium; somewhat thirsty, pain of the hypochondrium, and
throbbing about the navel throughout. On the twenty-fourth,
sediment in the urine, quite collected. Twenty-seventh, pain of the
right hip joint; urine thin and bad, a sediment; all the other
symptoms milder. About the twenty-ninth, pain of the right eye;
urine thin. Fortieth, dejections pituitous, white, rather frequent;
sweated abundantly all over; had a complete crisis.[689]
Explanation of the characters. It is probable that, by means of
the stools, the urine, and the sweat, this patient was cured in forty
days.
Sec. II.
Case IV.—In Thasus, Philistes had headache of long continuance,

and sometimes was confined to bed, with a tendency to deep sleep;
having been seized with continual fevers from drinking, the pain was
exacerbated; during the night he, at first, became hot. On the first
day, he vomited some bilious matters, at first yellow, but afterwards
of a verdigris-green color, and in greater quantity; formed fæces
passed from the bowels; passed the night uncomfortably. On the
second, deafness, acute fever; retraction of the right
hypochondrium; urine thin, transparent, had some small substances
like semen floating in it; delirium ferox about mid-day. On the third,
in an uncomfortable state. On the fourth, convulsions; all the
symptoms exacerbated. On the fifth, early in the morning, died.
Explanation of the characters. It is probable that the death of the
patient on the fifth day is to be attributed to a phrenitis, with
unfavorable evacuations.[690]
Case V.—Charion, who was lodged at the house of Demænetus,
contracted a fever from drinking. Immediately he had a painful
heaviness of the head; did not sleep; bowels disordered, with thin
and somewhat bilious discharges. On the third day, acute fever;
trembling of the head, but especially of the lower lip; after a little
time a rigor, convulsions; he was quite delirious; passed the night
uncomfortably. On the fourth, quiet, slept little, talked incoherently.
On the fifth, in pain; all the symptoms exacerbated; delirium; passed
the night uncomfortably; did not sleep. On the sixth, in the same
state. On the seventh had a rigor, acute fever, sweated all over his
body; had a crisis. Throughout the alvine discharges were bilious,
scanty, and unmixed; urine thin, well colored, having cloudy
substances floating in it. About the eighth day, passed urine of a
better color, having a white scanty sediment; was collected, free
from fever for a season. On the ninth it relapsed. About the
fourteenth, acute fever. On the sixteenth, vomited pretty frequently
yellow, bilious matters. On the seventeenth had a rigor, acute fever,
sweated, free of fever; had a crisis; urine, after the relapse and the
crisis, well colored, having a sediment; neither was he delirious in
the relapse. On the eighteenth, became a little heated; some thirst,
urine thin, with cloudy substances floating in it; slight wandering in
his mind. About the nineteenth, free of fever, had a pain in his neck;
a sediment in the urine. Had a complete crisis on the twentieth.
Explanation of the characters. It is probable that the patient was
cured in twenty days, by the abundance of bilious stools and urine.
[691]
Case VI.—The daughter of Euryanax, a maid, was taken ill of

fever. She was free of thirst throughout, but had no relish for food.
Alvine discharges small, urine thin, scanty, not well colored. In the
beginning of the fever, had a pain about the nates. On the sixth day,
was free of fever, did not sweat, had a crisis; the complaint about
the nates came to a small suppuration, and burst at the crisis. After
the crisis, on the seventh day, had a rigor, became slightly heated,
sweated. On the eighth day after the rigor, had an inconsiderable
rigor; the extremities cold ever after. About the tenth day, after a
sweat which came on, she became delirious, and again immediately
afterwards was collected; these symptoms were said to have been
brought on by eating grapes. After an intermission of the twelfth
day, she again talked much incoherently; her bowels disordered with
bilious, scanty, unmixed, thin, acrid discharges; she required to get
frequently up. She died on the seventh day after the return of the
delirium. At the commencement of the disease she had pain in the
throat, and it was red throughout; uvula retracted, defluxions
abundant, thin, acrid; coughed, but had no concocted sputa; during
the whole time loathed all kinds of food, nor had the least desire of
anything; had no thirst, nor drank anything worth mentioning; was
silent, and never spoke a word; despondency; had no hopes of
herself. She had a congenital tendency to phthisis.[692]
Case VII.—The woman affected with quinsy, who lodged in the
house of Aristion: her complaint began in the tongue; speech
inarticulate; tongue red and parched. On the first day, felt chilly, and
afterwards became heated. On the third day, a rigor, acute fever; a
reddish and hard swelling on both sides of the neck and chest,
extremities cold and livid; respiration elevated; the drink returned by
the nose; she could not swallow; alvine and urinary discharges
suppressed. On the fourth, all the symptoms were exacerbated. On
the sixth she died of the quinsy.
Explanation of the characters. It is probable that the cause of
death on the sixth day was the suppression of the discharges.[693]
Case VIII.—The young man who was lodged by the Liars’ Market
was seized with fever from fatigue, labor, and running out of season.
On the first day, the bowels disordered, with bilious, thin, and
copious dejections; urine thin and blackish; had no sleep; was
thirsty. On the second all the symptoms were exacerbated;
dejections more copious and unseasonable; he had no sleep;
disorder of the intellect; slight sweat. On the third day, restless,
thirst, nausea, much tossing about, bewilderment, delirium;
extremities livid and cold; softish distention of the hypochrondrium
on both sides. On the fourth, did not sleep; still worse. On the
seventh he died. He was about twenty years of age.
Explanation of the characters. It is probable that the cause of his
death on the seventh day was the unseasonable practices mentioned
above. An acute affection.[694]
Case IX.—The woman who lodged at the house of Tisamenas had
a troublesome attack of iliac passion; much vomiting; could not keep
her drink; pains about the hypochondria, and pains also in the lower
part of the belly; constant tormina; not thirsty; became hot;
extremities cold throughout, with nausea and insomnolency; urine
scanty and thin; dejections undigested, thin, scanty. Nothing could
do her any good. She died.[695]
Case X.—A woman of those who lodged with Pantimides, from a
miscarriage, was taken ill of fever. On the first day, tongue dry,
thirst, nausea, insomnolency, belly disordered, with thin, copious,
undigested dejections. On the second day, had a rigor, acute fever;
alvine discharges copious; had no sleep. On the third, pains greater.
On the fourth, delirious. On the seventh she died. Belly throughout
loose, with copious, thin, undigested evacuations; urine scanty, thin.
An ardent fever.[696]
Case XI.—Another woman, after a miscarriage about the fifth
month, the wife of Ocetes, was seized with fever. At first had
sometimes coma and sometimes insomnolency; pain of the loins;
heaviness of the head. On the second, the bowels were disordered,
with scanty, thin, and at first unmixed dejections. On the third, more
copious, and worse; at night did not sleep. On the fourth was
delirious; frights, despondency; strabismus of the right eye; a faint
cold sweat about the head; extremities cold. On the fifth day, all the
symptoms were exacerbated; talked much incoherently, and again
immediately became collected; had no thirst; labored under
insomnolency; alvine dejections copious, and unseasonable
throughout; urine scanty, thin, darkish; extremities cold, somewhat
livid. On the sixth day, in the same state. On the seventh she died.
Phrenitis.[697]
Case XII.—A woman who lodged near the Liars’ Market, having
then brought forth a son in a first and difficult labor, was seized with
fever. Immediately on the commencement had thirst, nausea, and
cardialgia; tongue dry; bowels disordered, with thin and scanty
dejections; had no sleep. On the second, had slight rigor, acute
fever; a faint cold sweat about the head. On the third, painfully
affected; evacuations from the bowels undigested, thin, and copious.
On the fourth, had a rigor; all the symptoms exacerbated;
insomnolency. On the fifth, in a painful state. On the sixth, in the
same state; discharges from the bowels liquid and copious. On the
seventh, had a rigor, fever acute; much thirst; much tossing about;
towards evening a cold sweat over all; extremities cold; could no
longer be kept warm; and again at night had a rigor; extremities
could not be warmed; she did not sleep; was slightly delirious, and
again speedily collected. On the eighth, about mid-day, she became
warm, was thirsty, comatose, had nausea; vomited small quantities
of yellowish bile; restless at night, did not sleep; passed frequently
large quantities of urine without consciousness. On the ninth, all the
symptoms gave way; comatose, towards evening slight rigors; small
vomitings of bile. On the tenth, rigor; exacerbation of the fever, did
not sleep at all; in the morning passed much urine having a
sediment; extremities recovered their heat. On the eleventh,
vomited bile of a verdigris-green color; not long after had a rigor,
and again the extremities cold; towards evening a rigor, a cold
sweat, much vomiting; passed a painful night. On the twelfth, had
copious black and fetid vomitings; much hiccup, painful thirst. On
the thirteenth, vomitings black, fetid, and copious; rigor about mid-
day, loss of speech. On the fourteenth, some blood ran from her
nose, she died. In this case the bowels were loose throughout; with
rigors; her age about seventeen. An ardent fever.[698]
Section III.—Constitution 2.[699]
The year was southerly, rainy; no winds throughout.[700]

Droughts having prevailed during the previous seasons of the year,
the south winds towards the rising of Arcturus were attended with
much rain. Autumn gloomy and cloudy, with copious rains. Winter
southerly, damp, and soft. But long after the solstice, and near the
equinox, much winterly weather out of season; and when now close
to the equinox, northerly, and winterly weather for no long time. The
spring again southerly, calm, much rain throughout until the dog-
days. Summer fine and hot; great suffocating heats. The Etesian
winds blew small and irregular; again, about the season of Arcturus,
much rains with north winds. The year being southerly, damp, and
soft towards winter, all were healthy, except those affected with
phthisis, of whom we shall write afterwards.
3. Early in spring, along with the prevailing cold, there were
many cases of erysipelas, some from a manifest cause, and some
not.[701] They were of a malignant nature, and proved fatal to
many; many had sore-throat and loss of speech. There were many
cases of ardent fever, phrensy, aphthous affections of the mouth,
[702] tumors on the genital organs; of ophthalmia, anthrax,[703]
disorder of the bowels, anorexia, with thirst and without it; of
disordered urine, large in quantity, and bad in quality; of persons
affected with coma for a long time, and then falling into a state of
insomnolency. There were many cases of failure of crisis, and many
of unfavorable crisis; many of dropsy and of phthisis. Such were the
diseases then epidemic.[704] There were patients affected with every
one of the species which have been mentioned, and many died. The
symptoms in each of these cases were as follows:
4. In many cases erysipelas, from some obvious cause, such as
an accident, and sometimes from even a very small wound, broke
out all over the body, especially, in persons about sixty years of age,
about the head, if such an accident was neglected in the slightest
degree; and this happened in some who were under treatment;
great inflammation took place, and the erysipelas quickly spread all
over.[705] In the most of them the abscesses ended in suppurations,
and there were great fallings off (sloughing) of the flesh, tendons,
and bones; and the defluxion which seated in the part was not like
pus, but a sort of putrefaction, and the running was large and of
various characters. Those cases in which any of these things
happened about the head were accompanied with falling off of the
hairs of the head and chin, the bones were laid bare and separated,
and there were excessive runnings; and these symptoms happened
in fevers and without fevers. But these things were more formidable
in appearance than dangerous; for when the concoction in these
cases turned to a suppuration, most of them recovered; but when
the inflammation and erysipelas disappeared, and when no abscess
was formed, a great number of these died.[706] In like manner, the
same things happened to whatever part of the body the disease
wandered, for in many cases both forearm and arm dropped off; and
in those cases in which it fell upon the sides, the parts there, either
before or behind, got into a bad state; and in some cases the whole
femur and bones of the leg and whole foot were laid bare. But of all
such cases, the most formidable were those which took place about
the pubes and genital organs.[707] Such was the nature of these
cases when attended with sores, and proceeding from an external
cause; but the same things occurred in fevers, before fevers, and
after fevers. But those cases in which an abscess was formed, and
turned to a suppuration, or a seasonable diarrhœa or discharge of
good urine took place, were relieved thereby: but those cases in
which none of these symptoms occurred, but they disappeared
without a crisis, proved fatal. The greater number of these
erysipelatous cases took place in the spring, but were prolonged
through the summer and during autumn.
5. In certain cases there was much disorder, and tumors about
the fauces, and inflammations of the tongue, and abscesses about
the teeth. And many were attacked with impairment or loss of
speech;[708] at first, those in the commencement of phthisis, but
also persons in ardent fever and in phrenitis.
6. The cases of ardent fever and phrenitis occurred early in
spring after the cold set in, and great numbers were taken ill at that
time, and these cases were attended with acute and fatal symptoms.
The constitution of the ardent fevers which then occurred was as
follows: at the commencement they were affected with coma,
nausea, and rigors; fever not acute, not much thirst, nor delirium,
slight epistaxis,[709] the paroxysms for the most part on even days;
and, about the time of the paroxysms, forgetfulness, loss of strength
and of speech, the extremities, that is to say, the hands and feet, at
all times, but more especially about the time of the paroxysms, were
colder than natural; they slowly and imperfectly became warmed,
and again recovered their recollection and speech.[710] They were
constantly affected either with coma, in which they got no sleep, or
with insomnolency, attend with pains;[711] most had disorders of the
bowels, attended with undigested, thin, and copious evacuations;
urine copious, thin, having nothing critical nor favorable about it;
neither was there any other critical appearance in persons affected
thus; for neither was there any proper hemorrhage, nor any other of
the accustomed evacuations, to prove a crisis. They died, as it
happened, in an irregular manner, mostly about the crisis, but in
some instances after having lost their speech for a long time, and
having had copious sweats. These were the symptoms which
marked the fatal cases of ardent fever; similar symptoms occurred in
the phrenitic cases; but these were particularly free from thirst, and
none of these had wild delirium[712] as in other cases, but they died
oppressed by a bad tendency to sleep, and stupor.
7. But there were also other fevers, as will be described. Many
had their mouths affected with aphthous ulcerations. There were
also many defluxions about the genital parts, and ulcerations, boils
(phymata), externally and internally, about the groins.[713] Watery
ophthalmies of a chronic character, with pains; fungous excrescences
of the eyelids, externally and internally, called fici, which destroyed
the sight of many persons.[714] There were fungous growths, in
many other instances, on ulcers, especially on those seated on the
genital organs. There were many attacks of carbuncle (anthrax)
through the summer, and other affections, which are called “the
putrefaction” (seps); also large ecthymata,[715] and large tetters
(herpetes) in many instances.
8. And many and serious complaints attacked many persons in
the region of the belly. In the first place, tenesmus, accompanied
with pain, attacked many, but more especially children, and all who
had not attained to puberty; and the most of these died. There were
many cases of lientery and of dysentery; but these were not
attended with much pain.[716] The evacuations were bilious, and
fatty, and thin, and watery; in many instances the disease
terminated in this way, with and without fever; there were painful
tormina and volvuli of a malignant kind; copious evacuations of the
contents of the guts, and yet much remained behind; and the
passages did not carry off the pains, but yielded with difficulty to the
means administered; for in most cases purgings were hurtful to
those affected in this manner; many died speedily, but in many
others they held out longer. In a word, all died, both those who had
acute attacks and those who had chronic, most especially from
affections of the belly, for it was the belly which carried them all off.
9. All persons had an aversion to food in all the afore-mentioned
complaints to a degree such as I never met with before,[717] and
persons in these complaints most especially, and those recovering
from them, and in all other diseases of a mortal nature. Some were
troubled with thirst, and some not; and both in febrile complaints
and in others no one drank unseasonably or disobeyed injunctions.
10. The urine in many cases was not in proportion to the drink
administered, but greatly in excess; and the badness of the urine
voided was great, for it had not the proper thickness, nor
concoction, nor purged properly; for in many cases purgings by the
bladder indicate favorably, but in the greatest number they indicated
a melting of the body, disorder of the bowels, pains, and a want of
crisis.[718]
11. Persons laboring under phrenitis and causus were particularly
disposed to coma; but also in all other great diseases which occurred
along with fever. In the main, most cases were attended either by
heavy coma, or by short and light sleep.
12. And many other forms of fevers were then epidemic, of
tertian, of quartan, of nocturnal,[719] of continual, of chronic, of
erratic, of fevers attended with nausea, and of irregular fevers. All
these were attended with much disorder, for the bowels in most
cases were disordered, accompanied with rigors, sweats not of a
critical character, and with the state of the urine as described. In
most instances the disease was protracted, for neither did the
deposits which took place prove critical as in other cases; for in all
complaints and in all cases there was difficulty of crisis, want of
crisis, and protraction of the disease, but most especially in these. A
few had the crisis about the eightieth day, but in most instances it
(the disease?) left them irregularly. A few of them died of dropsy
without being confined to bed. And in many other diseases people
were troubled with swelling, but more especially in phthisical cases.
13. The greatest and most dangerous disease, and the one that
proved fatal to the greatest number, was the consumption.[720] With
many persons it commenced during the winter, and of these some
were confined to bed, and others bore up on foot; the most of those
died early in spring who were confined to bed; of the others, the
cough left not a single person, but it became milder through the
summer; during the autumn, all these were confined to bed, and
many of them died, but in the greater number of cases the disease
was long protracted. Most of these were suddenly attacked with
these diseases, having frequent rigors, often continual and acute
fevers; unseasonable, copious, and cold sweats throughout; great
coldness, from which they had great difficulty in being restored to
heat; the bowels variously constipated, and again immediately in a
loose state, but towards the termination in all cases with violent
looseness of the bowels; a determination downwards of all matters
collected about the lungs; urine excessive, and not good;
troublesome melting. The coughs throughout were frequent, and
sputa copious, digested, and liquid, but not brought up with much
pain; and even when they had some slight pain, in all cases the
purging of the matters about the lungs went on mildly. The fauces
were not very irritable, nor were they troubled with any saltish
humors; but there were viscid, white, liquid, frothy, and copious
defluxions from the head. But by far the greatest mischief attending
these and the other complaints, was the aversion to food, as has
been described. For neither had they any relish for drink along with
their food, but continued without thirst. There was heaviness of the
body, disposition to coma, in most cases swelling, which ended in
dropsy; they had rigors, and were delirious towards death.
14. The form of body peculiarly subject to phthisical complaints
was the smooth, the whitish, that resembling the lentil; the reddish,
the blue-eyed, the leucophlegmatic,[721] and that with the scapulæ
having the appearance of wings: and women in like manner,[722]
with regard to the melancholic and subsanguineous, phrenitic and
dysenteric affections principally attacked them. Tenesmus troubled
young persons of a phlegmatic temperament. Chronic diarrhœa,
acrid and viscid discharges from the bowels, attacked those who
were troubled with bitter bile.
15. To all those which have been described, the season of spring
was most inimical, and proved fatal to the greatest numbers: the
summer was the most favorable to them, and the fewest died then;
in autumn, and under the Pleiades, again there died great numbers.
It appears to me, according to the reason of things, that the coming
on of summer should have done good in these cases; for winter
coming on cures the diseases of summer, and summer coming on
removes the diseases of winter. And yet the summer in question was
not of itself well constituted, for it became suddenly hot, southerly,
and calm; but, notwithstanding, it proved beneficial by producing a
change on the other constitution.
16. I look upon it as being a great part of the art to be able to
judge properly of that which has been written. For he that knows
and makes a proper use of these things, would appear to me not
likely to commit any great mistake in the art. He ought to learn
accurately the constitution of every one of the seasons, and of the
diseases; whatever that is common in each constitution and disease
is good, and whatever is bad; whatever disease will be protracted
and end in death, and whatever will be protracted and end in
recovery; which disease of an acute nature will end in death, and
which in recovery. From these it is easy to know the order of the
critical days, and prognosticate from them accordingly. And to a
person who is skilled in these things, it is easy to know to whom,
when, and how aliment ought to be administered.[723]
Sec. 17. Sixteen Cases.[724]
Case I.—In Thasus, the Parian who lodged above the Temple of
Diana was seized with an acute fever, at first of a continual and
ardent type; thirsty, inclined to be comatose at first, and afterwards
troubled with insomnolency; bowels disordered at the beginning,
urine thin. On the sixth day, passed oily urine, was delirious. On the
seventh, all the symptoms were exacerbated; had no sleep, but the
urine of the same characters, and the understanding disordered;
alvine dejections bilious and fatty. On the eighth, a slight epistaxis;
small vomiting of verdigris-green matters; slept a little. On the ninth,
in the same state. On the tenth, all the symptoms gave way. On the
eleventh, he sweated, but not over the whole body; he became cold,
but immediately recovered his heat again. On the fourteenth, acute
fever; discharges bilious, thin, and copious; substances floating in
the urine; he became incoherent. On the seventeenth, in a painful
state, for he had no sleep, and the fever was more intense. On the
twentieth, sweated all over; apyrexia, dejections bilious; aversion to
food, comatose. On the twenty-fourth, had a relapse. On the thirty-
fourth, apyrexia; bowels not confined; and he again recovered his
heat. Fortieth, apyrexia, bowels confined for no long time, aversion
to food; had again slight symptoms of fever, and throughout in an
irregular form; apyrexia at times, and at others not; for if the fever
intermitted, and was alleviated for a little, it immediately relapsed
again; he used much and improper food; sleep bad; about the time
of the relapse he was delirious; passed thick urine at that time, but
troubled, and of bad characters; bowels at first confined, and again
loose; slight fevers of a continual type; discharges copious and thin.
On the hundred and twentieth day he died. In this patient the
bowels were constantly from the first either loose, with bilious,
liquid, and copious dejection, or constipated with hot and undigested
fæces; the urine throughout bad; for the most part coma, or
insomnolency with pain; continued aversion to food. Ardent fever.
Explanation of the characters. It is probable that the weakness
produced by the fever, the phrenitis, and affection of the
hypochondrium caused death on the hundred and twentieth day.
[725]
Case II.—In Thasus, the woman who lodged near the Cold Water,
on the third day after delivery of a daughter, the lochial discharge
not taking place, was seized with acute fever, accompanied with
rigors. But a considerable time before delivery she was feverish,
confined to bed, and loathed her food. After the rigor which took
place, continual and acute fevers, with rigors. On the eighth and
following days, was very incoherent, and immediately afterwards
became collected; bowels disordered, with copious, thin, watery, and
bilious stools; no thirst. On the eleventh was collected, but disposed
to coma; urine copious, thin, and black; no sleep. On the twentieth,
slight chills, and immediately afterwards was warm; slight
incoherence; no sleep; with regard to the bowels, in the same
condition; urine watery, and copious. On the twenty-seventh, free
from fever; bowels constipated; not long afterwards violent pain of
the right hip-joint for a considerable time; fevers afterwards
supervened; urine watery. On the fortieth, complaints about the hip-
joint better; continued coughs, with copious, watery sputa; bowels
constipated; aversion to food; urine the same; fever not leaving her
entirely, but having paroxysms in an irregular form, sometimes
present, sometimes not. On the sixtieth, the coughs left her without
a crisis, for no concoction of the sputa took place, nor any of the
usual abscesses; jaw on the right side convulsively retracted;
comatose, was again incoherent, and immediately became collected;
utter aversion to food; the jaw became relaxed; alvine discharges
small, and bilious; fever more acute, affected with rigors; on the
following days lost her speech, and again became collected, and
talked. On the eightieth she died. In this case the urine throughout
was black, thin, and watery; coma supervened; there was aversion
to food, despondency, and insomnolency; irritability, restlessness;
she was of a melancholic turn of mind.
Explanation of the characters. It is probable that the suppression
of the lochial discharge caused death on the eightieth day.[726]
Case III.—In Thasus, Pythion, who was lodged above the Temple
of Hercules, from labor, fatigue, and neglected diet, was seized with
strong rigor and acute fever; tongue dry, thirsty, and bilious; had no
sleep; urine darkish, eneorema floating on the top of the urine, did
not subside. On the second day, about noon, coldness of the
extremities, especially about the hands and head; loss of speech and
of articulation; breathing short for a considerable time; recovered his
heat; thirst; passed the night quietly; slight sweats about the head.
On the third, passed the day in a composed state; in the evening,
about sunset, slight chills; nausea, agitation; passed the night in a
painful state; had no sleep; small stools of compact fæces passed
from the bowels. On the fourth, in the morning, composed; about
noon all the symptoms became exacerbated; coldness, loss of
speech, and of articulation; became worse; recovered his heat after
a time; passed black urine, having substances floating in it; the night
quiet; slept. On the fifth, seemed to be lightened, but a painful
weight about the belly; thirsty, passed the night in a painful state.
On the sixth, in the morning, in a quiet state; in the evening the
pains greater; had a paroxysm; in the evening the bowels properly
opened by a small clyster; slept at night. On the seventh, during the
day, in a state of nausea, somewhat disturbed; passed urine of the
appearance of oil; at night, much agitation, was incoherent, did not
sleep. On the eighth, in the morning, slept a little; but immediately
coldness, loss of speech, respiration small and weak; but in the
evening recovered his heat again; was delirious, but towards day
was somewhat lightened; stools small, bilious, and unmixed. On the
ninth, affected with coma, and with nausea when roused; not very
thirsty; about sunset he became restless and incoherent; passed a
bad night. On the tenth, in the morning, had become speechless;
great coldness; acute fever; much perspiration; he died. His
sufferings were on the even days.
Explanation of the characters. It is probable that the excessive
sweats caused death on the tenth day.[727]
Case IV.—The patient affected with phrenitis, having taken to bed
on the first day, vomited largely of verdigris-green and thin matters;
fever, accompanied with rigors, copious and continued sweats all
over; heaviness of the head and neck, with pain; urine thin,
substances floating in the urine small, scattered, did not subside;
had copious dejections from the bowels; very delirious; no sleep. On
the second, in the morning, loss of speech; acute fever; he sweated,
fever did not leave him; palpitations over the whole body, at night,
convulsions. On the third, all the symptoms exacerbated; he died.
Explanation of the characters. It is probable that the sweats and
convulsions caused death.[728]
Case V.—In Larissa, a man, who was bald, suddenly was seized
with pain in the right thigh; none of the things which were
administered did him any good. On the first day, fever acute, of the
ardent type, not agitated, but the pains persisted. On the second,
the pains in the thigh abated, but the fever increased; somewhat
tossed about; did not sleep; extremities cold; passed a large
quantity of urine, not of a good character. On the third, the pain of
the thigh ceased; derangement of the intellect, confusion, and much
tossing about. On the fourth, about noon, he died. An acute disease.
[729]
Case VI.—In Abdera, Pericles was seized with a fever of the

acute, continual type, with pain; much thirst, nausea, could not
retain his drink; somewhat swelled about the spleen, with heaviness
of the head. On the first day, had hemorrhage from the left nostril,
but still the fever became more violent; passed much muddy, white
urine, which when allowed to stand did not subside. On the second
day, all the symptoms were exacerbated, yet the urine was thick,
and more inclined to have a sediment; the nausea less; he slept. On
the third, fever was milder; abundance of urine, which was
concocted, and had a copious sediment; passed a quiet night. On
the fourth, had a copious and warm sweat all over about noon; was
free of fever, had a crisis, no relapse. An acute affection.[730]
Case VII.—In Abdera, the young woman who was lodged in the
Sacred Walk was seized with an ardent fever. She was thirsty, and
could not sleep; had menstruation for the first time. On the sixth,
much nausea, flushing, was chilly, and tossed about. On the
seventh, in the same state; urine thin, but of a good color; no
disturbance about the bowels. On the eighth, deafness, acute fever,
insomnolency, nausea, rigors, became collected; urine the same. On
the ninth, in the same state, and also on the following days; thus
the deafness persisted. On the fourteenth, disorder of the intellect;
the fever abated. On the seventeenth, a copious hemorrhage from
the nose; the deafness slightly better; and on the following days,
nausea, deafness, and incoherence. On the twentieth, pain of the
feet; deafness and delirium left her; a small hemorrhage from the
nose; sweat, apyrexia. On the twenty-fourth, the fever returned,
deafness again; pain of the feet remained; incoherence. On the
twenty-seventh, had a copious sweat, apyrexia; the deafness left
her; the pain of her feet partly remained; in other respects had a
complete crisis.
Explanation of the characters. It is probable that the restoration
of health on the twentieth day was the result of the evacuation of
urine.[731]
Case VIII.—In Abdera, Anaxion, who was lodged near the
Thracian Gates, was seized with an acute fever; continued pain of
the right side; dry cough, without expectoration during the first
days, thirst, insomnolency; urine well colored, copious, and thin. On
the sixth, delirious; no relief from the warm applications. On the
seventh, in a painful state, for the fever increased, while the pains
did not abate, and the cough was troublesome, and attended with
dyspnœa. On the eighth, I opened a vein at the elbow, and much
blood, of a proper character, flowed; the pains were abated, but the
dry coughs continued. On the eleventh, the fever diminished; slight
sweats about the head; coughs, with more liquid sputa; he was
relieved. On the twentieth, sweat, apyrexia; but after the crisis he
was thirsty, and the expectorations were not good. On the twenty-
seventh the fever relapsed; he coughed, and brought up much
concocted sputa: sediment in the urine copious and white; he
became free of thirst, and the respiration was good. On the thirty-
fourth, sweated all over, apyrexia, general crisis.
Explanation of the characters. It is probable that the evacuation
of the sputa brought about the recovery on the thirty-fourth day.
[732]
Case IX.—In Abdera, Heropythus, while still on foot, had pain in

the head, and not long afterwards he took to bed; he lived near the
High Street. Was seized with acute fever of the ardent type;
vomitings at first of much bilious matter; thirst; great restlessness;
urine thin, black, substances sometimes floating high in it, and
sometimes not; passed the night in a painful state; paroxysms of the
fever diversified, and for the most part irregular. About the
fourteenth day, deafness; the fever increased; urine the same. On
the twentieth and following days, much delirium. On the thirtieth,
copious hemorrhage from the nose, and became more collected;
deafness continued, but less; the fever diminished; on the following
days, frequent hemorrhages, at short intervals. About the sixtieth,
the hemorrhages ceased, but violent pain of the hip-joint, and
increase of fever. Not long afterwards, pains of all the inferior parts;
it then became a rule, that either the fever and deafness increased,
or, if these abated and were lightened, the pains of the inferior parts
were increased. About the eightieth day, all the complaints gave
way, without leaving any behind; for the urine was of a good color,
and had a copious sediment, while the delirium became less. About
the hundredth day, disorder of the bowels, with copious and bilious
evacuations, and these continued for a considerable time, and again
assumed the dysenteric form with pain; but relief of all the other
complaints. On the whole, the fevers went off, and the deafness
ceased. On the hundred and twentieth day, had a complete crisis.
Ardent fever.
Explanation of the characters. It is probable that the bilious
discharge brought about the recovery on the hundred and twentieth
day.[733]
Case X.—In Abdera, Nicodemus was seized with fever from
venery and drinking. At the commencement he was troubled with
nausea and cardialgia; thirsty, tongue was parched; urine thin and
dark. On the second day, the fever exacerbated; he was troubled
with rigors and nausea; had no sleep; vomited yellow bile; urine the
same; passed a quiet night, and slept. On the third, a general
remission; amelioration; but about sunset felt again somewhat
uncomfortable; passed an uneasy night. On the fourth, rigor, much
fever, general pains; urine thin, with substances floating in it; again
a quiet night. On the fifth, all the symptoms remained, but there was
an amelioration. On the sixth, some general pains; substances
floating in the urine; very incoherent. On the seventh, better. On the
eighth, all the other symptoms abated. On the tenth, and following
days, there were pains, but all less; in this case throughout, the
paroxysms and pains were greater on the even days. On the
twentieth, the urine white and thick, but when allowed to stand had
no sediment; much sweat; seemed to be free from fever; but again
in the evening he became hot, with the same pains, rigor, thirst,
slightly incoherent. On the twenty-fourth, urine copious, white, with
an abundant sediment; a copious and warm sweat all over;
apyrexia; the fever came to its crisis.
Explanation of the characters. It is probable that the cure was
owing to the bilious evacuations and the sweats.[734]
Case XI.—In Thasus, a woman, of a melancholic turn of mind,
from some accidental cause of sorrow, while still going about,
became affected with loss of sleep, aversion to food, and had thirst
and nausea. She lived near the Pylades, upon the Plain. On the first,
at the commencement of night, frights, much talking; despondency,
slight fever; in the morning, frequent spasms, and when they
ceased, she was incoherent and talked obscurely; pains frequent,
great, and continued. On the second, in the same state; had no
sleep; fever more acute. On the third, the spasms left her; but
coma, and disposition to sleep, and again awake, started up, and
could not contain herself; much incoherence; acute fever; on that
night a copious sweat all over; apyrexia, slept, quite collected; had a
crisis. About the third day, the urine black, thin, substances floating
in it generally round, did not fall to the bottom; about the crisis a
copious menstruation.[735]
Case XII.—In Larissa,[736] a young unmarried woman was seized
with a fever of the acute and ardent type; insomnolency, thirst;
tongue sooty and dry; urine of a good color, but thin. On the second,
in an uneasy state, did not sleep. On the third, alvine discharges
copious, watery, and greenish, and on the following days passed
such with relief. On the fourth, passed a small quantity of thin urine,
having substances floating towards its surface, which did not
subside; was delirious towards night. On the sixth, a great
hemorrhage from the nose; a chill, with a copious and hot sweat all
over; apyrexia, had a crisis. In the fever, and when it had passed the

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Ancient Near East: A Captivating Guide to Ancient

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The Oxford History of the Ancient Near East: Age of

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Debt in the Ancient Mediterranean

Oxford University Press is a department of the University of Oxford. It furthers

Published in the United States of America by Oxford University Press

© Oxford University Press 2023

All rights reserved. No part of this publication may be reproduced, stored in

You must not circulate this work in any other form

Library of Congress Cataloging-in-Publication Data

Printed by Integrated Books International, United States of America

In memory of David Graeber (1961–​2020)

1. The Currency–​Slavery–​Warfare Complex: David Graeber and

2. Beyond Debt: Markets and Morality in First-​Millennium

3. Cosmic Debt in Greece and India  32

4. Private Debts in Classical Greece: Bond of Friendship,

5. Debt, Death, and Destruction in Ancient Rome  67

6. The Poetics and Politics of Exchange in Roman Agronomy  84

7. Monetization, Marketization, and State Formation:

8. Zoroastrian Materialism: Religion, Empire, and

9. Debt, Debt Bondage, and the Early Islamic Economy 132

10. Debt’s Fourth Millennium Seen from Below:

11. After the Axial Age: Debt and Obligation in the

12. Afterword  179

Michael Bonner, University of Michigan, Ann Arbor †

2 Debt in t he Ancien t Medit err an ean an d N ear East

dependency and obligation. Adapting an expression coined by Geoffrey Ingham,

Debt: The First 5,000 Years

The Currency–Slavery–Warfare Complex 3

4 Debt in t he Ancien t Medit err an ean an d N ear East

calls “hierarchy”) comprises forms of exchange between non-​equals, such as the

The Currency–Slavery–Warfare Complex 5

moral obligations transform into precisely calculable debts? Graeber suggests

6 Debt in t he Ancien t Medit err an ean an d N ear East

The Currency–Slavery–Warfare Complex 7

scale of the Roman economy.21 Alain Bresson, by combining neo-​institutional

Though in the Argument prefixed to the First Book of the

Case I.—Pythion, who lived by the Temple of the Earth, on the

Case IV.—In Thasus, Philistes had headache of long continuance,

Case VI.—The daughter of Euryanax, a maid, was taken ill of

Section III.—Constitution 2.[699]

The year was southerly, rainy; no winds throughout.[700]

Sec. 17. Sixteen Cases.[724]

Case VI.—In Abdera, Pericles was seized with a fever of the

Case IX.—In Abdera, Heropythus, while still on foot, had pain in

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In memory of David Graeber (1961–2020)

1. The Currency–Slavery–Warfare Complex: David Graeber and

2. Beyond Debt: Markets and Morality in First-Millennium

3. Cosmic Debt in Greece and India 32

5. Debt, Death, and Destruction in Ancient Rome 67

6. The Poetics and Politics of Exchange in Roman Agronomy 84

8. Zoroastrian Materialism: Religion, Empire, and

9. Debt, Debt Bondage, and the Early Islamic Economy 132

10. Debt’s Fourth Millennium Seen from Below:

11. After the Axial Age: Debt and Obligation in the

12. Afterword 179

The Currency–Slavery–Warfare Complex 3

calls “hierarchy”) comprises forms of exchange between non-equals, such as the

The Currency–Slavery–Warfare Complex 5

The Currency–Slavery–Warfare Complex 7

scale of the Roman economy.21 Alain Bresson, by combining neo-institutional