[The great plague of Athens 430 BC].

The plague of Athens in 430-426 BC has puzzled scholars and doctors for generations as to the aetiology of this deadly disease that had profound influence on the outcome of the Great Peloponnesian War (431-404 BC). Like several thousand soldiers and civilians, Pericles succumbed to the plague in 429. The main opponent to Athens was Sparta. Sparta had a formidable land based army, whereas Athens dominated at sea. Pericles' strategy was to shelter the whole of Attica's population within the protecting walls of Athens and Piraeus and the long walls connecting the two cities, while the Spartans ravaged Attica during the summer months. The result was a tremendous overcrowding in the two cities. The number of inhabitants rose from 145,000 to more than half a million. Therefore optimal conditions for the outbreak of an epidemic of any contagious disease were present. The Athenian general and historian Thucydides (455-396 BC), though not a medical man himself, has provided us with a very clear and precise description of the disease, which he himself contracted but survived. A huge number of modern aetiologies has been proposed, but none has so far been able to match Thucydides' clinical picture in all details. Presumably the disease has changed so much during the past 2400 years as not to be recognisable any more or it has totally disappeared.