The Middle East: 429–418 BCE

Stability, Revolts, and Imperial Administration

Under Artaxerxes I and subsequently Darius II (Ochus), the Persian Empire experiences a period marked by internal stability interspersed with localized rebellions, especially in peripheral satrapies. Artaxerxes I dies peacefully in 424 BCE after a notably long reign, succeeded by his son, Darius II, whose rule immediately faces internal unrest and challenges to imperial authority.

Darius II works diligently to reestablish control over revolting territories, including regions such as Asia Minor, where ambitious satraps attempt to assert greater autonomy from central Persian oversight. His reign is characterized by persistent efforts to re-centralize power, maintain imperial cohesion, and stabilize frontier provinces.

Despite these ongoing administrative and military challenges, the Persian Empire remains intact, functioning through its established satrapal system, with the court at Susa continuing as a cultural and political hub. The empire's core provinces enjoy relative prosperity, benefiting from the enduring Persian administrative structure, robust trade networks, and cultural integration fostered over previous generations.

Near East (429–418 BCE): Nehemiah’s Reforms and Cultural Consolidation

Between 429 and 418 BCE, significant religious and social reforms shape the community of Jerusalem, highlighting the growing importance of cultural identity among the Judahites, now increasingly recognized as Jews. Nehemiah, a prominent leader who had previously directed the reconstruction of Jerusalem’s walls, undertakes a second influential visit to the city during this era.

Nehemiah emphasizes strict observance of the Sabbath, seeking to strengthen and consolidate Jewish religious identity and practice. He notably condemns intermarriage between Jews and their neighbors, particularly criticizing marriages with the Ashdodites. Through these stringent measures, Nehemiah actively encourages Jews to maintain cultural and religious separation from surrounding peoples, ensuring the preservation and integrity of Jewish traditions and identity.

These reforms not only underscore Nehemiah's pivotal role in shaping Jewish communal and religious life but also reinforce a sense of collective identity essential for the resilience and continuity of the Jewish community amid external pressures and influences.

Nehemiah strengthens his fellow Jews' observance of the Sabbath on a second visit to Jerusalem, condemning the Jews of his time for intermarrying with the Ashdodites.

He ends the custom of Jewish men marrying foreign-born wives, helping to keep the Judaeans separate from their non-Jewish neighbors (Nehemiah 13).

Hippocrates will teach and practice medicine throughout his life, traveling at least as far as Thessaly, Thrace, and the Sea of Marmara.

Several different accounts of his death exist.

He dies, probably in Larissa, at the age of eighty-three, eighty-five, or ninety, though some say he lived to be well over one hundred.

Ancient Greek schools of medicine are split (into the Knidian and Koan) on how to deal with disease.

The Knidian school of medicine focuses on diagnosis.

Medicine at the time of Hippocrates knows almost nothing of human anatomy and physiology because of the Greek taboo forbidding the dissection of humans.

The Knidian school consequently fails to distinguish when one disease caused many possible series of symptoms.

The Hippocratic school or Koan school achieves greater success by applying general diagnoses and passive treatments.

Its focus is on patient care and prognosis, not diagnosis.

It can effectively treat diseases and allows for a great development in clinical practice.

Hippocrates is credited with being the first person to believe that diseases are caused naturally, not because of superstition and gods.

Hippocrates is credited by the disciples of Pythagoras of allying philosophy and medicine.

He separates the discipline of medicine from religion, believing and arguing that disease was not a punishment inflicted by the gods but rather the product of environmental factors, diet, and living habits.

Indeed there is not a single mention of a mystical illness in the entirety of the Hippocratic Corpus.

However, Hippocrates does work with many convictions that are based on what is today now known to be incorrect anatomy and physiology, such as Humorism.

Historians agree that Hippocrates was born around the year 460 BCE on the Greek island of Kos; other biographical information, however, is likely to be untrue.

Soranus of Ephesus, a seconnd-century Greek physician, will be Hippocrates' first biographer and the source of most personal information about him.

Later biographies are in the Suda of the tenth century, and in the works of John Tzetzes, Aristotle's "Politics", which date from the 4fourth century BCE.

Soranus will write that Hippocrates' father was Heraclides, a physician, and his mother was Praxitela, daughter of Tizane.

The two sons of Hippocrates, Thessalus and Draco, and his son-in-law, Polybus, were his students.

According to Galen, a later physician, Polybus was Hippocrates' true successor, while Thessalus and Draco each had a son named Hippocrates (Hippocrates III and IV).

Soranus said that Hippocrates learned medicine from his father and grandfather (Hippocrates I), and studied other subjects with Democritus and Gorgias.

Hippocrates was probably trained at the asklepieion of Kos, and took lessons from the Thracian physician Herodicus of Selymbria. Plato mentions Hippocrates in two of his dialogues: in Protagoras, Plato describes Hippocrates as "Hippocrates of Kos, the Asclepiad";  while in Phaedrus, Plato suggests that "Hippocrates the Asclepiad" thought that a complete knowledge of the nature of the body was necessary for medicine.

Sparta and its allies, with the exception of Corinth, are almost exclusively land based powers, able to summon large land armies that are very nearly unbeatable.

In the face of a combined campaign on land from Sparta and its allies beginning in 431 BCE, the Athenians, under the direction of Pericles, have pursued a policy of retreat within the city walls of Athens, relying on Athenian maritime supremacy for supply while the superior Athenian navy harasses Spartan troop movements.

Unfortunately, the strategy also results in massive migration from the Attic countryside into an already highly-populated city, generating overpopulation and resource shortage

Due to the close quarters and poor hygiene exhibited at this time, Athens has become a breeding ground for disease and many citizens die, including Pericles, his wife, and his sons Paralus and Xanthippus.

In the history of epidemics, the 'Plague' of Athens is remarkable for the one-sidedness of the affliction as well as for its influence on the ultimate outcome of the war.

Euripides (Hippolytus, Andromache, Hecuba, Heracles, The Suppliant Women) and Sophocles (Oedipus Rex, Electra, The Trachinian Women) write tragedies and patriotic plays; Aristophanes pens satiric comedies (The Acharnians, The Wasps, The Clouds).

Historians will long try to identify the disease behind the Plague of Athens.

The disease will traditionally be considered an outbreak of the bubonic plague in its many forms, but reconsideration of the reported symptoms and epidemiology will lead scholars to advance alternative explanations.

These include typhus, smallpox, measles, and toxic shock syndrome.

Based upon striking descriptive similarities with recent outbreaks in Africa, as well as the fact that the Athenian plague itself apparently came from Africa (as Thucydides recorded), Ebola or a related viral hemorrhagic fever will be considered.

Given the possibility that profiles of a known disease may have morphed over time or the plague was caused by a disease that no longer exists, the exact nature of the Athenian plague may never be known.

In addition, crowding caused by the influx of refugees into the city had led to inadequate food and water supplies and a probable proportionate increase in insects, lice, rats, and waste.

These conditions would have encouraged more than one epidemic disease during the outbreak.

However, advancing scientific technologies may reveal new clues.