The classical writers of ancient Rome, such as Pliny, Seneca, Cicero, Horace, Ovid, and Celsus, all reference mosquito-borne diseases. The most thorough accounts were written by the acclaimed physician, avid author, and surgeon to the gladiators, Galen, during the second century CE. His explanation of human physiology, although adhering to Hippocratic traditions, was a more nuanced and sophisticated interpretation. He left a detailed depiction of the various types of malaria fever, elaborating on the observations and deductions of Hippocrates. Galen recognized the distant and primitive origins of malaria, noting that he could fill three volumes with what had been previously written about the disease. “We no longer need the word of Hippocrates or anyone else as witness that there is such a fever,” he wrote, “since it is right in our sight every day, and especially in Rome.” Galen also candidly recorded a second mosquito-borne disease, logging definitively for the first time the unmistakable physical symptoms of filariasis, or elephantiasis.
Galen emphasized that health was related to habits, including diet, exercise, natural surroundings, and living conditions. He understood that the heart pumped blood through arteries and veins, and he practiced bloodletting as a practical cure for most diseases, including malaria. Another popular Roman malaria remedy was to wear a piece of papyrus or amulet inscribed with the powerful incantation “abracadabra.” While the origin of the word is unclear, it appears to be borrowed from the Aramaic, meaning “I will create what I speak,” essentially summoning a cure.* The Romans also prayed to the fever goddess, Febris, for malarial respite in three specifically detailed temples on the healthful hilltops surrounding the city. The cult of Febris, which had a substantial number of adherents, attests to the expanse and impact malaria had on Rome and its larger imperial breadth.
As Roman legions and merchants swarmed across Europe, so, too, did malaria. The vast empire connecting Africa to northern Europe brought an unprecedented exchange of ideas, innovation, academia, and pestilence. As a direct result of Roman expansion, malaria’s grip now extended as far north as Denmark and Scotland. Malaria was an ever-present and chronic partner to Roman expansion. While the mosquito assured Roman ascendancy over the Carthaginians, a century and a half later she also played a role in the demise of the democratic Roman Republic and the rise of the emperor era beginning with Julius Caesar.
Following a string of victories in Gaul, Julius Caesar turned his army south in 50 BCE to confront the Senate, who had given his military and political rival Pompey dictatorial powers as the emergency consul. The Senate also voted to strip Caesar of his command and disband his personally loyal army. Refusing to bow to these demands, Caesar crossed the frontier boundary of Italy at the Rubicon River and purportedly uttered his immortal phrase “The die is cast.” There was no turning back. His army, however, was riddled with malaria, as was he, and was in no shape to fight. Caesar had a lifelong battle with the disease. Shakespeare wrote, “He had a fever when he was in Spain, And when the fit was on him, I did mark How he did shake: ’tis true this god did shake.” Had Pompey, whose army was vastly larger, met Caesar on the field of battle instead of fleeing, Caesar’s gamble in rolling the dice at the Rubicon would have ended in malarial, and martial, disaster.
As it turned out, Pompey was eventually defeated in a series of battles with Caesar’s reinforced and healthy legions. Seeking asylum in Egypt, Pompey was assassinated by an agent of the Egyptian pharaoh Ptolemy XIII. Upon being presented with Pompey’s head, a disgusted Caesar and his lover Cleopatra, who was also the sister of Ptolemy, deposed the pharaoh and placed Cleopatra on the throne of Egypt. In the wake of Julius Caesar’s assassination during the 44 BCE Ides of March, a string of dictators guiding the Roman Empire all had malarial bouts, with a handful succumbing to the disease, including Vespasian, Titus, and Hadrian. Caesar’s heir, Octavian (Augustus), and his successor, Tiberius, both had recurrent malarial episodes, courtesy of the mosquitoes of the Pontine Marshes.
Ironically, prior to his twenty-three murderous stab wounds, Caesar had prepared an ambitious project aimed at draining the Pontine Marshes of the Campagna to increase agricultural productivity. The early-second-century Greek-Roman biographer Plutarch mentions that Caesar “designed to draw off the water from the marshes . . . and to make them solid ground, which would employ many thousands of men in the cultivation.” If successful, this initiative would have inadvertently led to a momentous reduction in mosquito populations, overturning the events that followed, altering the historical arc of the Roman age. This alternative history expired with Julius Caesar. The ambitious scheme of reclaiming the Pontine Marshes, contemplated by Napoleon as well, would ultimately be realized 2,000 years later by another Italian dictator, Benito Mussolini.
While the malarious Campagna protected Rome from her enemies, malaria also dampened Rome’s marauding armies. Similar to bacteria or viruses, malaria strains differ by region. Roman legionaries, administrators, and accompanying traders were unaccustomed and thus not acclimated or “seasoned” to foreign malaria parasites in distant lands. During the Germanic campaigns in the early first century CE, the Germans consistently forced the superior Roman legions to fight and camp among bogs and marshes, where malaria and filthy drinking water drastically reduced their combat effectiveness. Given that swamp-bred miasma was thought to cause sickness, this German tactic has the hallmark indicators of deliberate biological warfare. When General Germanicus Caesar passed through Teutoburg Forest, he reported that he found tangled masses of Roman skeletons, horses, and mutilated corpses rotting in the “sodden marshland and ditches.” Adrienne Mayor, when writing about biological and chemical warfare in the ancient world, posits that “the German manipulation of the Roman legions . . . was most likely a biological stratagem.” In keeping with the miasma theory, this was a weaponization of the marshes and not a premeditated biological use of the true assassins, the snubbed and marginalized mosquitoes themselves. The Battle of Teutoburg Forest in 9 CE, where the entire Roman force of three legions and auxiliaries was annihilated, is regarded as Rome’s greatest military defeat. This disaster, coupled with indefatigable malaria, forced Rome to abandon its intentions east of the Rhine River. By the fifth century, these independent warring peoples of central and eastern Europe would eventually contribute to the fall of the Roman Empire.
The Roman attempt to subdue Scotland, known to them as Caledonia, was also thwarted by a local strain of malaria that killed half of the 80,000-man imperial force. Roman retreat behind the protection of Hadrian’s Wall, begun in 122 CE, allowed for the preservation of independent Scottish peoples. In the Middle East, as in Scotland, malaria prevented Rome from securing a concrete foothold. The exotic forms of malaria feasted on new Roman arrivals to northern Europe or the Middle East until these trespassers were either seasoned or dead.
While the mosquito foiled Roman armies fighting on the front lines and fields of the far reaches of empire, on the home front she progressively turned her poison arrows inward on Rome itself. For Rome, she served as both a savior and, eventually, a killer, proving, as she often does, to be a fickle, fly-by-night ally. As a stalwart defender, the mosquito continued to patrol the Pontine Marshes protecting Rome from foreign invaders, but she also slowly began to consume those she sheltered and quartered. Malarious mosquitoes gradually gnawed at the foundations of the Roman Empire and drained the life from its subjects. Through their own advancements in engineering and agriculture, the Romans helped to convert the mosquito from friend to foe and choreographed the denouement of their own downfall.
Ironically, the Roman penchant for gardens, cisterns, fountains, baths, and ponds, in combination with the complex system of aqueducts, frequent natural floods, and a coinciding period of global warming, all provided a haven for mosquito propagation, turning the elements of urban beautification into death traps.* As the city grew from a population of 200,000 to over a million in the last two centuries BCE, rapid deforestation and cultivation increased, fostering furt
her mosquito ecologies on the rural fringes of the city, including the Pontine Marshes. “The Romans did not just modify landscapes; they imposed their will upon them. . . . Human encroachments on new environments is a dangerous game,” emphasizes Kyle Harper. “In the Roman Empire, the revenge exacted by nature was grim. The prime agent of reprisal was malaria. Spread by mosquito bite, malaria was an albatross on Roman civilization . . . and made the eternal city a malarial bog. Malaria was a vicious killer in town and country, anywhere the Anopheles mosquito could thrive.” Italy’s malarial reputation was so well documented that outsiders referred to the disease simply as “Roman Fever.” This disparaging moniker was merited and duly deserved.
The city of Rome was continuously imperiled and consumed by overwhelming malaria epidemics. In the aftermath of the “Great Fire of Rome,” under Emperor Nero a hurricane tore through the Campagna in 65 CE, churning up moisture and mosquitoes, sparking a malaria epidemic that left upwards of 30,000 people dead. The mosquito was now attacking Rome itself. According to Tacitus, a Roman senator and historian, “the houses were filled with lifeless forms, and the streets with funerals.” Again, in 79 CE, after the eruption of Mount Vesuvius, which petrified Pompeii, malaria ripped through Rome and the Italian countryside, forcing farmers to abandon their fields and villages, most notably in the Campagna. Tacitus witnessed refugees and commoners “with no regard even for their lives, a large proportion camped in the unhealthy districts of the Vatican, which resulted in many deaths.” This massive area of bountiful farmland on Rome’s doorstep, encompassing the Campagna and its Pontine Marshes, was left fallow until Il Duce Benito Mussolini’s reclamation and relocation project prior to the outbreak of the Second World War.
In the wake of these natural disasters, the dearth of agriculture in the immediate vicinity of Rome allowed the marshes to expand, intensifying endemic malaria while also putting a dire strain on the food production required for the city’s rising population. This chronic malarial snowball effect was a direct catalyst for the decline and fall of the Roman Empire. Society and its economic, agricultural, and political appendages cannot prosper, let alone maintain the status quo, when habitual malaria creates a merry-go-round of labor-draining illness. Roman society was hampered in all directions, with fewer than half of infants surviving childhood. Life expectancy for those who beat the odds was a dismal twenty to twenty-five years. The etching on the gravestone of Veturia, the wife of a centurion, relates the life of an average Roman: “Here I lie, having lived for twenty-seven years. I was married to the same man for sixteen years and bore six children, five of whom died before I did.” Compounding the insidious presence of malaria was a series of catastrophic plagues that paralyzed the Roman Empire and hampered the progress of political and social life.
Livy, the Roman historian writing at the turn of the millennium, lists at least eleven distinct epidemics during the reign of the republic. Two now infamous plagues tore at the heart of the empire. The first, lasting from 165 to 189 CE, was brought by troops returning from the failed mosquito-ravaged campaigns in Mesopotamia. The Antonine Plague or the Plague of Galen, given his firsthand account, spread through the empire like wildfire. It first struck Rome, before spreading throughout Italy and causing large-scale depopulation and hordes of nomadic refugees and itinerant migrants. It took the life of Emperors Lucius Verus and Marcus Aurelius, whose family name, Antoninus, became associated with the outbreak. The disease then headed north as far as the Rhine, west to the shores of the Atlantic Ocean, and in the east, eventually reached India and China. At its peak, contemporary records reveal a death rate of 2,000 per day in Rome alone. Roman archives and the writings of Galen indicate a mortality rate of 25%, with an extrapolated death toll across the empire as high as five million. The severity suggests that it was a pathogen previously unknown to Europe. While Galen gives us symptomatic descriptions, they are uncharacteristically vague. While the true cause remains a mystery, the top candidate is smallpox, with measles as a distant runner-up.
The second epidemic, known as the Plague of Cyprian, originated in Ethiopia and then spread across North Africa and the eastern portion of the empire to Europe as far north as Scotland between 249 and 266 CE. Its name commemorates Saint Cyprian, the Catholic bishop of Carthage, who left an eyewitness interpretation of the misery, documenting a mortality rate of 25–30% and a daily death count in Rome nearing 5,000. Among them were the emperors Hostilian and Claudius Gothicus. The number of total deaths is not known, but estimates again reach as high as five to six million or one-third of the entire empire. Epidemiologists have proposed that both the Antonine and Cyprian Plagues were the first zoonotic transfers of smallpox and measles from their animal hosts to humans. Others view the first epidemic as one, or both, of these diseases. They ascribe the second, the Plague of Cyprian, to a mosquito-borne hemorrhagic fever similar to yellow fever or to a hemorrhagic virus akin to the dreaded Ebola (which is not transmitted by mosquitoes).
The lasting imprint of these plagues, in concert with universal malaria, was irreparable. The Roman Empire was an imploding superpower and could not be salvaged. Widespread manpower shortages for both agricultural labor and the Roman legions severely weakened Rome’s hold on the surviving populations, cowering while the vast empire crumbled and collapsed around them. In addition to mass death, or because of it, this “Crisis of the Third Century” also witnessed widespread rioting, civil war, assassinations of emperors and politicians by rogue military commanders, and the rampant and sadistic persecution of Christian scapegoats. This unchecked hedonistic violence was compounded by economic depression, earthquakes and natural disasters, and the pressures of persistent incursions from relocated ethnicities within the empire and belligerents from beyond its borders during the “Era of Migrations” beginning around 350 CE. General Anopheles intervened as a lifesaving stopgap measure by humiliating a successive line of invaders, though only to prolong the inevitable outcome she was also simultaneously orchestrating—the fall of the Roman Empire.
Amid this upheaval during the Era of Migrations, a series of foreign aggressors, like the Gauls and Carthaginians before them, set their crosshairs directly on a weakened Rome, which by now was no longer the capital of a homogenous Roman Empire. Due to its strategic military and commercial location, in 330, Emperor Constantine moved the capital from Rome to Constantinople (Istanbul). The realignment and destabilization of empire continued under Emperor Theodosius, who made Nicene Christianity the official state faith in 380, before apportioning the empire between his two sons in 395, creating an enduring divide between East and West. This cleave reduced the military and economic clout of both halves. Constantinople remained the capital of the eastern portion until the collapse of the Byzantines at the hands of the Islamic Ottomans in 1453. In the Western Empire, due to unremitting malaria, Rome was replaced by a series of capitals, but the Eternal City retained its paramount position as the spiritual, cultural, and economic center of empire. It also remained the prize for pillaging raiders.
The first to strike at Rome were the Germanic Visigoths led by King Alaric. In 408, his “barbarians” swept south through Italy and laid siege to the city of roughly one million people on three separate occasions. Starvation and disease slowly eroded the Roman will to fight. When a Roman envoy asked what would be left for the besieged citizens of Rome, Alaric sardonically quipped, “Their lives.” Zosimus, a Roman scribe tracking the events, woefully wrote, “all that remained of the Roman valor and intrepidity was totally extinguished.” In 410, Alaric laid siege to the city for a third and final time. There would be no negotiations, quarter, or immunity. Once inside the city gates, his forces embarked on and reveled in three days of destruction and death. The citizens of Rome were robbed, raped, killed, and sold into slavery. Satisfied with their pillage and plunder, the Visigoths quit the city and headed south, subjecting the Campagna, Calabria, and Capua to the same fate, leaving a trail of wreckage in their wake. Rome’s agricultural outpu
t, which was already unstable, was dealt another setback. Although intending to return to Rome, by this time Alaric’s forces were ruined by malaria. The mighty King Alaric himself, the first to sack Rome in nearly 800 years, succumbed to malaria in the fall of 410. The mosquito had shielded Rome once again.
With his death, the mosquito-chased Visigoths consolidated their loot and retired north, establishing a kingdom in southwestern Gaul in 418. The locals flattered their new rulers, and as legend has it, the displaced Celtic nobility allowed the Visigoth leaders to win at the game of backgammon to curry their favor. In Star Wars vernacular, they always, and wisely, “let the Wookiee win.” These new tenants of Gaul, however, would help defend the Western Empire from its next challenger—Attila and his plundering Huns.
The adroit, quick-striking Huns were skilled horsemen who terrified European populations with their fearsome tattooed arms, faces carved with patterned scars, and elongated skulls from having been bound between boards as infants. Originating in eastern Ukraine and the northern Caucasus, the Huns initiated their prolonged invasion of eastern Europe around 370, quickly reaching the Hungarian Danube River. By the late fourth century, as their raids intensified, a worried Constantinople began paying the Huns to spare the Eastern Roman Empire. With tribute payment arriving from the timorous east, a bold and ambitious new leader, Attila, projected his power westward over the Austrian Alps. It was only a matter of time before his skilled cavalry would attack Rome.
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