but the worst strains killed thousands. Chinese physicians ap-
parently deduced that infl uenza could be transmitted through
the air, though this knowledge had little practical use in an-
cient times. Along with magic spells and potions, however,
doctors devised treatments that included sensible measures,
such as having patients rest and drink water.
Th e smallpox virus developed somewhere in Asia. Re-
lated to the cowpox virus, it seems to be a mutation of cowpox
that became capable of infecting human beings. Th us some
archaeologists suspect that it developed either in central Asia
among nomadic cattle herders or in India, where cattle oft en
roamed freely among people. Traders along the ancient land
route known as the Silk Road may have carried smallpox east-
ward. In 162 c.e. a disease that was probably smallpox killed
over 30 percent of the population of northwestern China.
During epidemics the Chinese oft en left people unbur-
ied, fearing that handling the dead could transmit the dis-
ease. Sometimes government authorities ordered the burying
of the dead, but some physicians argued that burning the
corpses would destroy the disease that killed them, prevent-
ing its transmission. During severe epidemics bodies lay
where they had died, in fi elds and on roads. In 162 c.e. they
would have lain everywhere in the northwest China, unmis-
takable evidence that the emperor had lost his mandate from
heaven.
A faith healer named Zhang Jiao formed a Daoist sect
popularly known as the Yellow Turbans because of their
headdress. In 162 c.e. Zhang advocated the overthrow of
the imperial government. By 184 c.e., when the Yellow River
fl ooded and killed many people, followed by deaths from epi-
demic disease, the Yellow Turbans had followers in most of
China, and they rebelled, seizing control of much of north-
ern and eastern China. Zhang and other leaders were killed,
and their armies were eventually defeated, but the Han gov-
ernment never fully recovered; the revolt led to the political
chaos that eventually ended the Han Dynasty in 220 c.e.
In India physicians tried to learn when epidemics were
most likely to occur and searched for ways to prevent them.
For smallpox Indians took dried scabs of the disease from
people who were recovering from it and scraped them into
the skins of uninfected people—an early eff ort at inoculation.
About 1 percent of inoculated people caught the disease, but
since smallpox could virtually wipe out entire towns and rural
areas, the rate of infection from inoculations seemed small.
Cholera, a deadly water-borne bacterial disease, was a
common affl iction in ancient India. Cities were customarily
surrounded by moats into which human waste was dumped.
City dwellers took their drinking water and cooking water
from these moats as well as from nearby rivers or streams
that were oft en quite polluted. Although Indian physicians
believed that cholera was caused by pollution, it was appar-
ently beyond their abilities to persuade people to fi nd their
water elsewhere, stop dumping human waste into the water
supply, or discontinue building moats to help protect their
cities from attack.
Annual fl ooding caused by monsoons was known to pre-
cede epidemics of cholera. Even so, the month of harvests,
Margali, was considered to be the month that ruled epidem-
ics. Shiva was the god of the month of Margali, and Indians
prayed and made off erings to him in the hope that he would
prevent epidemics. When epidemics occurred, Indians usu-
ally recited magical incantations and used charms to aid the
sick and asked magicians to cast spells and mix magical po-
tions for the affl icted.
Indians, however, had also long exhibited a practical streak
in their treatment of epidemics, with medicine becoming an
important profession before 500 b.c.e. Th ere were several clas-
sifi cations of physicians. Two of them, general practitioners and
a group that would in modern times be described as toxicolo-
gists (doctors who study and treat the eff ects of poisons) and
epidemiologists (doctors who study the spread and control of
epidemic diseases), oft en dealt with epidemics. Some epidemic
diseases, such as tuberculosis, were considered incurable, and
the physicians tried to ease patients’ suff ering with mixtures
that included opiates similar to morphine. Cholera was clas-
sifi ed as a “fever” disease, and the “epidemiologists” linked it
to pollution of air and water. Th ey treated it with opiates to
ease the terrible pain but also with the root of a plant known
today as serpentwood or Indian snakeroot. Nowadays the root
is used to treat high blood pressure, but it also reduces fever;
ancient Indian physicians used it to lower the fever of cholera.
It was hardly a perfect treatment, but it gave patients a chance
to survive the worst stages of the disease.EUROPE
BY CARYN E. NEUMANN
Infectious diseases devastated human populations in ancient
Europe, especially in later times as people began to cluster
together in settlements and then towns. Epidemics and pan-
demics of such diseases claimed more lives than all wars and
natural disasters taken together. Infectious diseases have
probably been the primary agent of natural selection over the
past centuries, eliminating human hosts who were more sus-
ceptible to them and sparing those who were more resistant.
Prehistoric Europeans who lived in hunter-gatherer soci-
eties were probably relatively free from the eff ects of epidemic
diseases. Th e small size of these groups, their remoteness
from one another, and their frequent movement would have
made it diffi cult for airborne or crowd diseases, such as tu-
berculosis, infl uenza, and diphtheria, to become established.
Diseases of the digestive tract may not have spread as rapidly
as in more concentrated populations either, even though san-
itation was not particularly good. When an infectious disease
struck, it probably worked its way through the population
and then vanished. Certain diseases, however, can fl ourish
and be transmitted readily even among small and scattered
hunter-gatherer populations. Measles and smallpox, for ex-
ample, could occur in lethal epidemic outbreaks. In general,
however, people in prehistoric Europe were more likely to die824 pandemics and epidemics: Europe