¹⁵ Celsus, de medicina 1.2.1: at imbecillis, quo in numero magna pars urbanorum. Mudry (1997) discussed this text.
¹⁶ Cassius Dio 73.14.3–4 also mentions this epidemic.
¹⁷ Herodian 1.12.1: sunvbh d† ka≥ kat’ ƒke∏no kairoı loim*dh nÎson katasce∏n t¶n ∞Ital≤an: m3lista d† tÏ p3qoß ƒn t∫
f»sei ka≥ toŸß pantacÎqen Ëpodecomvn7, poll& tv tiß fqor¤ ƒgvneto Ëpozug≤wn ‹ma ka≥
ånqr*pwn. (At that time an epidemic disease spread over Italy. Its effects were particularly bad in the city of Rome, which naturally had a large population and attracted immigrants from all quarters. There were many deaths of both animals and men.).
¹⁸ Olympiodorus ap. Photius, bibliotheca, ed. Henry (1959), i. 175.
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Rome’s role as the centre of Christianity. Carcaterra noted that as recently as after the First World War immigration from southern Italy to the expanding city of Rome assisted the diffusion of malaria in the Agro Romano.¹⁹ It was no different in antiquity. In a previous brief discussion of migration to Rome, Sallares described ancient Rome as a population sink, using a concept drawn from studies of animal populations, in which a rough maintenance of overall population size by migrations from areas of excess fertility to areas of excess mortality is a frequent observation. Recently Morley has also discussed this theme, in more detail.²⁰
The presence of endemic malaria in at least some districts of the city of Rome in antiquity would have created extremely high mortality rates in an urban population of perhaps 750,000 to 1,000,000
people. Imperial Rome was a population sink of enormous dimen-sions. It soaked up the bulk of the natural increase of the rest of Italy (healthy places like Tifernum), as Morley argued.²¹ It is impossible to define the vital rates of the population of the city of Rome in detail, given the scarcity of evidence, and of course it would be impossible to generalize even if suitable quantitative data were available; some parts of the city were undoubtedly healthier than others. It is probably not wise to take Ulpian’s life-table as seriously as Frier did.²² Nevertheless, just for the sake of argument, let us consider it for a minute. Duncan-Jones, reconsidering Frier’s extremely complicated calculations, suggested that since Frier’s ¹⁹ Carcaterra (1998: 566).
²⁰ On Rome as a population sink see Sallares (1991: 88–9); Morley (1996: 33–54).
²¹ Morley (1996: 49).
²² Frier (1982) has made the most detailed study of Ulpian’s life-table ( Digest 35.2.68).
However, his analysis suffers from unjustifiable a priori assumptions. At the very end of his article (p. 251 n. 84), he recorded that one of the Michigan demographers had pointed out to him that his Proposed Model is closer to Coale–Demeny Model South than to Model West, which he chose to use. Frier rejected this because the lower levels of Model South appeared to him to be ‘rather unrealistic especially as to the relationship between child and adult mortality’. This problem requires empirical study commencing with knowledge about causes of death, not a priori assumption. It has been shown here that there is now available a considerable corpus of empirical evidence which supports the existence in populations affected by malaria of patterns of child–adult mortality even more divergent from Model West than Model South, which Frier rejected. Parkin (1992: 83–4) rightly criticized Frier for assuming a constant relationship between child and adult mortality. However, since Parkin too failed to pay any attention to the question of the causes of death, he did not make any significant progress beyond Frier’s position. Research on the demography of female orphans in Rome in the seventeenth and eighteenth centuries yielded mortality rates approximating to ‘low survival rates of the “southern” model’, but the empirically attested rates fit different levels of the southern model at different ages (Sonnino (1994: 108)).
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curve runs parallel to but well below the curve of Coale–Demeny Model South Level 1 (the lowest level), it indicates a life expectancy at birth well below 20. What sort of factors could possibly produce such extremely high mortality levels? Ulpian’s life-table, if it has any value at all for demographic purposes, can only be a crude estimate of the mortality produced by malaria within the city of Rome. The comparative data from early modern European populations show that the adult mortality caused by malaria runs off the lower end of the scale provided by the model life-tables used by demographers. Duncan-Jones also suggested that the population of Ulpian’s life-table was a servile population. If freedmen and their descendants were a significant component of the population of the city of Rome, as epigraphic evidence indicates, then saying that Ulpian’s life-table represents the demography of a servile population and saying that it represents the demography of the population of the city of Rome itself ( not the population of the entire Roman world) may amount to much the same thing.²³
There is no doubt whatsoever that people in antiquity were in fact fully aware, in an elementary fashion, of the existence of the enormous regional variations in mortality rates that are discussed above. Otherwise, why should Pliny the Younger have pointed out to his correspondent Domitius Apollinaris that Tifernum was much healthier than the coast of Tuscany? What was Varro talking about when he mentioned the reckoning with death, ratio cum orco, in pestilential localities? These passages from ancient authors directly parallel similar but more detailed texts from later periods, for example Doni’s writings in the seventeenth century. Doni singled out Faesulae in Tuscany and Stabiae in Campania, as well as Spoleto in Umbria, mentioned earlier (Ch. 4. 2 above), as examples of towns where the average duration of life was very long.
Conversely, he mentioned Ferrara and the Po delta, the Pontine region, and Ostia as places where life was short on average. However, for Doni the worst place of all was Aquileia, where everyone died young. There is a very striking contrast here with the situation in antiquity, when Aquileia was regarded by Vitruvius as exceptionally healthy for a town situated in a marshy area, but the prin-
²³ Duncan-Jones (1990: 96–101). He also (p. 104) noted the possibility of a ‘range of variation’. In the discussion appended to Etienne (1973), J. Dupâquier was one notable professional demographer who expressed the view that it is likely that there were different demographic patterns in different parts of the Roman Empire.
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ciple was the same. Short average life span was very highly correlated with the presence of endemic malaria in the seventeenth century just as it was in antiquity.²⁴
Mary Dobson noted that in early modern England the parishes that were perceived by contemporary observers as very unhealthy corresponded very closely to the parishes with excess mortality caused by P. vivax malaria, as revealed by her demographic research.²⁵ North noted that the inhabitants of the Roman Campagna in the nineteenth century had a very fine perception of degrees of (un)healthiness within their environments:
If we were to start from almost any of the gates of Rome, and follow the main road for a few miles, carefully examining the character of the land on either side, and inquiring of such inhabitants as we might find, their opinion of the healthiness or otherwise of their immediate neighbourhood, we should be greatly struck by the apparent precision with which they would indicate varying degrees of infection, within exceedingly limited areas.²⁶
Long and bitter experience enabled the inhabitants of regions where malaria was endemic to build up a considerable stock of knowledge regarding its distribution, even though its aetiology was not understood. A passage of Xenophon, advising generals to choose healthy locations for army camps, shows clearly that this was already happening by the fourth century in Greece. Similar advice appears in later authors.²⁷
This stock of knowledge allowed people to engage in a variety of forms of avoidance behaviour to minimize the risk of infection. The greater secur
ity of living above ground-floor level is one example, which has already been mentioned (Ch. 4. 3 above). Another method was to completely avoid perilous areas during the dangerous time of the year, in summer and autumn, as much of the population of the city of Rome did in the twelfth century , according ²⁴ Doni (1667: 129–30).
²⁵ Dobson (1997: 123–5).
²⁶ North (1896: 108).
²⁷ Xenophon, cyropaedia 1.6.16, ed. Gemoll: ka≥ g¤r lvgonteß oÛd†n pa»ontai oÈ £nqrwpoi per≤ te t0n noshr0n cwr≤wn ka≥ per≥ t0n Ëgiein0n: m3rtureß d† safe∏ß ‰katvroiß aÛt0n par≤stantai t3 te s*mata ka≥ t¤ cr*mata (For men do not stop speaking about pestilential and healthy places, since their bodies and their complexions are clear witnesses of both.); Vegetius, epitoma rei militaris 3.2.2, ed. Önnerfors: locis, ne in pestilenti regione iuxta morbosas paludes . . . milites commorentur (soldiers should not camp in a pestilential region near unhealthy marshes).
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to Otto of Freising (Ch. 8 above). In Grosseto in 1840 no less than 43% of the people who were registered as permanently resident in the town left their homes during the summer to stay and work in Scansano, a town which was only twenty-nine kilometres south-east of Grosseto, but, significantly, situated at an altitude of 500
metres above sea level.The annual estatatura (exodus) from Grosseto had been instituted by 1333 by the government of Siena, which ruled Grosseto at the time and decreed that government officials should leave Grosseto in July and August each year to avoid malaria. It was only abolished as recently as 1897, by which time the increasing use of quinine and widespread bonifications were having a significant impact on malaria in the region.²⁸ It is very striking that mortality in Grosseto was so high even with such a large proportion of the permanent population practising avoidance behaviour. Malaria was also endemic in Grosseto among migrant workers who only spent the summer there.
It was also possible to take avoidance measures at certain times of the day and night. In the nineteenth century Romans frequently made excursions to Fiumicino (now the site of Rome’s airport, near Ostia), whose small resident population was 100% infected with malaria, during the day to have a seaside meal, but they returned to Rome before nightfall and did not sleep there. Sambon noted that at Ostia in 1900 ‘in July and August the Anopheles used to appear very punctually a few minutes after sunset and disappear again a few minutes after sunrise’.²⁹ De Tournon, without any understanding of the aetiology of malaria, advised visitors to Rome itself to avoid in dangerous parts of the city the evening strolls which are such a prominent feature of everyday life in so many Mediterranean towns (with the effect of avoiding mosquitoes).³⁰ Tommasi-Crudeli noted that in Rome in the nineteenth century: in some parts of the city the inhabitants, during the hot weather, remain indoors after sunset, because experience has taught them that during the first hour of the evening there is a risk of infection, but later on they emerge from their houses³¹
²⁸ Del Panta (1989: 29–31); Celuzza (1993: 151); Santi (1996: 150); Bueti and Corti (1998).
²⁹ Blewitt (1843: 528); Sambon (1901 a: 199).
³⁰ De Tournon (1831: i. 216): [sc. during the dangerous season] sur toutes choses, il faut éviter, pendant la soirée, les promenades, soit dans la campagne, soit dans les parties désertes de la ville.
³¹ Tommasi-Crudeli (1892: 80); Wrigley (2000: 219) quoted Berlioz’ observation that Romans disappeared from their promenade on the Pincio ‘like a cloud of gnats’ (a doubly appropriate metaphor) at seven o’clock in the evening, cf. Blewitt (1843: 165).
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37. The site of the Circus Maximus at Rome, where chariot races were held. It is situated in a lowlying area between the Aventine and Palatine hills where there was a risk of malaria infection in the past.
Knight had earlier also noted this advice which was given by Roman doctors, adding the comment that ‘it would not be prudent to sleep with an open window’.³² Female Anopheles mosquitoes generally bite at night, commonly in the period leading up to mid-night. As recently as 1893, Filippo Pacelli noted the custom of shut-ting windows in the district on the left bank of the Tiber, near Isola Tiberina, to avoid malarial fevers.³³ Conversely, Lapi noted that in some areas of the city people kept the windows open all the time and remained healthy, but this is merely stating the obvious, namely that malaria did not occur everywhere.³⁴ Lancisi had also recommended keeping windows and doors closed. Evidently not everyone took all the precautions. In the fourth century Ammianus Marcellinus wrote that poor Romans set off at dawn for the Circus Maximus to watch the chariot races, but neglect of essential precautions helps to explain why malaria was common in imperial Rome.³⁵ Nevertheless in antiquity as well the accumulation of ³² Knight (1805: 3).
³³ Carcaterra (1998: 560): per schivare le febbri malariche, si è costretti a chiudere le finestre un’ora prima dell’Ave-Maria.
³⁴ Lapi (1749: 81).
³⁵ Ammianus Marcellinus 28.4.31.
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empirical knowledge would have permitted the practice of avoidance behaviour, to try to minimize the known risks, as Herodotus shows when he describes sleeping in towers in Egypt to avoid mosquitoes (Ch. 4. 3 above). Apparently a hieroglyphic text from a temple at Denderah in Egypt advised people not to go outside their houses after the sunset in the weeks following the Nile flood.³⁶
This ancient Egyptian text recalls the statement of Athenaios that people in the Greek colony of Sybaris who wanted to avoid dying young must not see either the setting or the rising sun.³⁷ Tommasi-Crudeli, followed by W. H. S. Jones, interpreted this text as a reference to malaria in southern Italy.³⁸ This remains a possibility, since Lancisi recommended staying indoors until sunrise to avoid malaria, although the text of Athenaios could equally well simply be a reference to the legendary life of luxury enjoyed by the citizens of Sybaris.
Regardless of the correct interpretation of this text, it was indeed well known in antiquity that the average duration of life was much lower in marshy areas where malaria was endemic than in mountainous areas (like Tifernum) where it did not occur at all. The following question in the pseudo-Aristotelian Problems proves it beyond doubt:
Why do men grow old slowly in places with fresh and pure air, while those in hollow and marshy places grow old rapidly?³⁹
As a comparison, the early modern tradition about Ninfa, which was abandoned because of malaria in the seventeenth century, should be recalled:
The modern legend that an evil spirit waits in ambush for passing young adults, to make them at once grow old miserably, is a personification of the wickedness of the air, which makes the youthfulness of those who breath its exhalations decay.⁴⁰
³⁶ Capasso (1985: 304) quoted this Italian translation of the Egyptian text: non uscire di casa dopo il tramonto del sole nelle settimane che seguono l’ingrossamento del Nilo.
³⁷ Athenaios 12.520a: tÏn boulÎmenon ƒn Sub3rei m¶ prÏ mo≤raß åpoqane∏n oÇte duÎmenon oÇte ån≤sconta tÏn ~lion Ør$n de∏.
³⁸ Dunbabin (1948: 80, 216–17) emphasized the scarcity of documentary evidence with regard to the possibility of malaria in Sybaris in the archaic period.
³⁹ [Aristotle,] Problems 14.7.909b: Di¤ t≤ oÈ m†n ƒn to∏ß eÛpnÎoiß tÎpoiß bradvwß ghr3skousin, oÈ d† ƒn to∏ß ko≤loiß ka≥ ‰l*desi tacvwß.
⁴⁰ Tomassetti (1910: ii. 394): la leggenda odierna che una fata malignamente sta in agguato dei giovani che passano per farli subito miseramente invecchiare è una personificazione della malignità dell’aria, che fa intristire la giovinezza di chi ne contrae l’effluvio. See also Hadermann-Misguich (1986: 23–46, esp.
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The prevailing view among ancient historians is to assume a fairly low life expectancy at birth across the whole of Roman Italy. Lo Cascio, following Hopkins, is a typic
al example of the traditional view:
Life-expectancy at birth cannot have been higher than, say, 25 for males . . . life-expectancy at birth for females must not have been higher than 25
and is likely to have been a bit lower . . . [this is] the assumption that we are entitled to make.⁴¹
The reality of Roman Italy was more subtle, more complicated, and more interesting than this bland uniformity. There were some extremely unhealthy localities,with a life expectancy at birth hover-ing around 20, in some cases no more than a few kilometres away from other localities, where life expectancy at birth may have been as high as 40 or 50.⁴² As was noted at the beginning of this book, the Italian demographers del Panta and Rettaroli found that the population of Grosseto, ravaged by malaria in the nineteenth century, did not have an age-structure corresponding to any of the main types described in the standard sets of model life-tables and based on data from modern European populations. The closest parallels instead come from African populations. African population structures in central Italy as recently as the middle of the nineteenth century ? African population structures in central Italy in antiquity? This will come as a tremendous shock to those historians who are accustomed to rely upon sets of model life-tables derived from modern European populations in their research on classical antiquity. A major flaw of the bulk of research carried out into the demography of the Roman Empire over the last thirty years has been the failure to realize that the standard sets of model life-tables do not encompass the entire universe of possibilities. In fact, they 43–5 on malaria). She noted that the eighteenth-century historian Pietro Pantanelli stated that no one in the region survived past the age of forty.
Malaria and Rome: A History of Malaria in Ancient Italy Page 39
