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In the II book of The Peloponnesian War, Thucydides described a disease which raged in Athens in 430 b. C. Many modern scholars, physicians and philologists, have analyzed the text in an attempt to give a name to the disease. A prerequisite for these studies is that Thucydides is a trustworthy writer, an author who rigorously studied facts and rationally interpreted them, never invoking supernatural causes or divine interferences (I,20-21). The aim of Tucydides, who was himself affected by such a disease (II,48), was to describe accurately the illness, so that if it would breaks out again, other could recognize it (II, 48).
The disease is carefully described in the chapter 49 of the II book. Patients suddenly had violent sensations of heat (thermai) in the head, and redness (erythemata) and burning (phlogosis) in the eyes. The throat and tongue were blood-red (haimatodes), emitting a disgusting (atopos) and malodorous (dysodes) breath. Subsequently, these symptoms developed into sneezing (ptarmos), hoarsness (branchos) and violent coughing (bex). When the illness affected the cardias (kardia), evacuations of bile (chole), empty retching (lynx kene) and violent spasms (spasmos) occurred. The body was neither unduly hot, neither yellowish, but flushed and livid, with an efflorescence of small blisters (or pustules) (phlyktaina) and sores (helkos). The internal heat was so intense, that patients could not endure clothes and linens and a looked for cold water for the great thirst (dipsa) which possessed them. Moreover, there was a inability (aporia) to rest and sleepnessless (agrypnia). The majority succumbed on the seventh or nineth day; If they survived, the illness would descend to the bowel (koilia), where would provoke severe ulcers (helkosis) and violent diarrhoea (diarrhoia). The illnes included also seizures of the extremities and genitals (aidoia). Many survived with loss of these or of eyes and presented loss of memory (lethe).
Hypotheses on Thucydides' disease are numerous, including viral and bacteric diseases, toxic diseases, or combinations of these. Tle list of proposed sideases includes smallpox, typhus, plague, typhoid fever, measles, scarlet fever, ergotism, glanders, leptospirosis, tularaemia, influenza complicated by toxic shock syndrome, Rift Valley fever, Lassa fever. However, despite of the great number of studies, Thucydides' disease has not been yet identified. In their interesting paper, Poole and Holladay concluded that "Thucydides' description does not exactly correspond to any disease of the present day". It is difficult to say why the account of the most objective among Greek historians remains enigmatic. An hypothesis may be that, collecting a great number (23) of signs and symptoms, Thucydides could not select them, because he was not a physician. The result was a clinical picture marred by symptoms of other different concomitant diseases. A Thucydides' sentence seems to support such a hypothesis: "if anyone did contract some other disease, it usually evolved into this one".

(from C. Urso, L'enigma del morbo di Tucidide, Pathologica 90, 826-836, 1998; C. Urso, The different originality of Homer and Thucydides, Am J Dermatopathol 23, 274-275, 2001)

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