Malaria and Rome: A History of Malaria in Ancient Italy (2 page)
Read Malaria and Rome: A History of Malaria in Ancient Italy Online
Authors: Robert Sallares
Tags: #ISBN-13: 9780199248506, #Oxford University Press, #USA, #History
I wish to thank Mario Coluzzi and Claudio Finistauri for their hospitality when I visited the Istituto di Parassitologia in La Sapienza University, Rome, and Lugnano in Teverina. I also wish to thank xii
Hilary O’Shea and the staff of Oxford University Press and Jane Wheare. Last but not least, financial support from the Leverhulme Trust was invaluable.
Obviously I am solely responsible for the views expressed and for any faults that remain. All the translations of Latin, Greek, and Italian texts are my own translations. I benefited enormously from the resources of the John Rylands Library in Manchester and the Wellcome Library for the History and Understanding of Medicine in London, as it is now called. One important work exploited in this book was accidentally discovered, while looking for something else, gathering dust on a shelf in the Rylands Library. It did not look as if anyone had read it for a hundred years. I hope this book will enjoy a better fate.
R. S.
C O N T E N T S
List of figures, maps, and tables
3. Evolution and prehistory of malaria
4. The ecology of malaria in Italy
Agricultural change and deforestation
Direct and indirect approaches to the demography of
Interactions of malaria with other diseases
Comparative demography of malaria in Italy and
11. Geographical contrasts and demographic variation
All photographs were taken by the author except where stated otherwise in the captions to the illustrations.
1. Mussolini’s inscription at Sabaudia.
5
2. Ospedale di San Giovanni.
17
3.
Anopheles labranchiae.
45
4
.
Fontana di Trevi.
46
5
. Artemisia absinthium.
47
6. The Virgin of Fevers in the Sacristy of St. Peter’s in the Vatican in Rome.
51
7. Plan of modern Sezze.
56
8. View of Norma in the distance from Sermoneta.
58
9. View of Ninfa from Norma.
59
10. Ruins of the Roman villa of Poggio Gramignano,
near Lugnano in Teverina.
66
11. PCR products amplified from the Lugnano bones.
67
12. The coastal forest of the Parco Naturale della Maremma.
73
13
.
The entrance to the Cloaca Maxima.
76
14.
Anopheles sacharovi.
84
15. A traditional peasant hut in the Pontine region.
94
16. The Val di Chiana and Lago Trasimeno.
99
17. The Monti Cimini.
104
18. The northern slopes of Monte Circeo.
107
19. A view of Sermoneta.
120
20. Centro culturale polivalente in Pontinia.
170
21. View of the Lago di Sabaudia.
171
22. The ilex-oak forest of Monte Circeo.
172
23. The Pontine plain viewed from Sermoneta.
175
24. The southern end of the Pontine plain.
184
25. Ruins of the Roman colony of Graviscae.
194
26. The modem
saline
of Graviscae.
195
27. Wetland in the Parco Naturale della Maremma.
199
28. Cardinal Lugo orders the use of cinchona bark.
203
29. Monte Testaccio.
208
Illustrations
xv
30. Via della Reginella.
210
31. The Colosseum.
213
32. Ospedale di Santo Spirito.
216
33. The Roman Forum.
217
34. The monument of Leopold II in Grosseto (front and
side views).
232–3
35. Luigi Torelli’s
Carta della malaria dell’Italia.
237
36. The angel of death striking a door during the plague of Rome.
274
37. The Circus Maximus.
281
F I G U R E S , M A P S , A N D T A B L E S
M
1. Italy
6
2. Umbria and northern Lazio
65
3. Ravenna and Emilia-Romagna
80
4. Southern Lazio
169
5. The Maremma and Valdichiana
193
6. The city of Rome
207
7. Salpi and Apulia
263
F
1. Evolutionary relationships of selected
Plasmodium species
24
T
1. Some of the species in the genus
Plasmodium
8
2. Palaearctic mosquito species in the
Anopheles maculipennis complex
44
3. Probability of death at various ages
160
4. Probability of death at various ages
161
5. Number of deaths per person-years
162
6. Number of deaths per person-years (m(x) )
163
7. Number of people aged 20+ who die between ages
x and y
164
8. Distribution of lakes within the city of Rome
215
9. Baptisms and deaths in early modern Rome
275
Keith Hopkins moved the study of the demography of the ancient Roman world into a new era with his demonstration that ‘ages at death derived from Roman tombstones cannot be used to estimate expectation of life at birth or at subsequent ages’.¹ He suggested that the life expectancy at birth of the Roman population lay between 20 and 30 and advocated that life-tables derived from data from modern populations should be used as models for the age-structure of the Roman population in antiquity. Since then, the use of these model life-tables has enjoyed a considerable degree of popularity among ancient historians. Indeed it has become the current orthodoxy, almost an article of faith in certain quarters.
Hopkins himself was careful to add an important qualification, in terms of a requirement for further research, at the end of his article: ‘Our attention . . . should . . . be directed . . . to a more general assessment of the applicability of these model life tables and to an analysis of the determinants of mortality, both in Rome in particular, and in general.’² Unfortunately he never followed up his own recommendation. The bulk of subsequent research has also failed signally in this respect. Yet an analysis of the causes of death is absolutely essential if we are ever to move beyond attempting to describe
mortality in antiquity towards
explaining
and
understanding
it.
The message of this book is simply that in order to understand the demography of the ancient Roman world, it is necessary to pay much more attention to medical history than has been done in the bulk of research carried out so far into Roman demography.
Karl Julius Beloch, the pioneer of Roman demography, did not confine himself to antiquity. He intensively investigated Italian population history in more recent periods to provide a comparative foundation for his analysis of the scanty evidence from antiquity.
A large proportion of the output of Roman historians over the last ¹ Hopkins (1966: 246).
² Hopkins (1966: 264).
2
thirty years or so has failed to follow his example. Yet there is a wealth of evidence there, waiting to be exploited, which provides food for thought. The starting-point of the argument here is an extremely interesting recent discussion, by two leading Italian historical demographers, del Panta and Rettaroli, of an earlier study by one of them (del Panta) of the demography of Grosseto in the last century.³ They observed that the age-structure of the population of Grosseto in the 1840s does not match closely any of the Coale and Demeny life-tables, the set of model life-tables for the age-structures of human populations most widely employed by demographers, which are so popular with some ancient historians.
Nor did the age-structure of the population of Grosseto match any of the other available sets of model life-tables based on data for modern European populations. However, the demography of Grosseto in the last century does resemble something else that is completely different. What it resembles more than anything else, as they pointed out, is the demography of certain parts of Africa today where malaria is endemic.⁴ Of course the demographic patterns are not, and never could have been, precisely identical, because of numerous profound differences in the environment between central Italy and tropical Africa.
Nevertheless the degree of similarity in the demographic patterns between Grosseto and tropical Africa is striking. Malaria has an awesome power as a determinant of demographic patterns. It is estimated to have caused about a million deaths in Africa in 1995, and it also has far-reaching indirect effects, as will be seen later.⁵ In addition, it had the ability in the past to overcome the ecological barriers between tropical Africa and the Mediterranean world and so bring its power as a determinant of human demographic patterns to the ancient Mediterranean world, but this has been ignored by most Roman historians interested in ancient demography.⁶
³ Del Panta and Rettaroli (1994: 201–3); del Panta (1989).
⁴ Root (1999) discussed the relationship between differences in the intensity of malaria transmission and differences in spatial mortality patterns in various parts of Africa.
⁵ Snow
et al
. (1999).
⁶ A few historians have noted malaria as a possible contributing factor to mortality in antiquity. For example, J. C. Russell (1985: 88–9, 228, 234) rightly associated malaria with extremely high adult mortality, but regarded tuberculosis as more important. His suggestion that the ‘Antonine plague’ in the second century was
P. falciparum
malaria is exceedingly improbable (it was almost certainly smallpox). Similarly the suggestion (Karlen (1996: 69–70); Cartwright and Biddiss (2000: 9–10) ), that the epidemic which struck Rome (Cassius Dio 66.23.5; Suetonius,
Divus Titus
8.3–4) after the eruption of Vesuvius in 79 was
the first
3
The crux of the matter, as a problem in demography, is the relationship between infant mortality and adult mortality. This balance is affected by the differing effects of malaria on different age groups.
These effects of malaria on different age groups depend, in turn, on its transmission rate. In general, European populations in the past where malaria was endemic had higher levels of adult mortality relative to infant and child mortality than otherwise similar populations unaffected by malaria, as well as much higher total mortality.
The overall effect of malaria in terms of increasing mortality has indeed long been known, at least in principle (and, as will be seen later, the essence of the matter was also known in antiquity). Angelo Celli, one of the pioneers of the important Italian school of malariology, wrote at the end of the nineteenth century as follows: ‘the average life of the worker in malarious places is shorter, and the infant mortality higher, than in healthy places’.⁷ However, at that time modern historical demography based on such techniques as family reconstitution had not yet developed. It is only more recently that it has become possible to appreciate in quantitative terms the sheer scale of the phenomenon. Del Panta and Rettaroli compared the demography of Grosseto in the last century with the demography of Treppio, an Appennine community located northeast of Pistoia which was not affected by malaria. The population of Treppio had a life expectancy at birth of 37, but the population of Grosseto had a life expectancy at birth of only 20, with corresponding substantial differences in the age distribution of mortality in the two populations. The effect of the presence of malaria was to nearly halve life expectancy at birth (see Ch. 5. 4 below for further discussion).
Given such enormous effects, it is not surprising that Italian historians, scientists, and politicians devoted a great deal of attention to malaria so long as it continued to be a major public health problem in Italy. As Bonelli put it, ‘malaria was for centuries . . .
appearance
of
P. falciparum
malaria in Rome, has nothing to recommend it, even if the emperor Vespasian himself did die from malaria in that year at Aquae Cutiliae in the Sabine region (Cassius Dio 66.17.1: nos&saß . . . pureto∏ß (he became ill with fevers); Suetonius,
Divus Ves-pasianus
24.1). Scobie (1986: 422) mentioned malaria alongside gastro-intestinal diseases; Morley (1996: 43) also mentioned malaria; Salmon (1992) is rather more detailed. Nevertheless its importance has in the main not been appreciated by historians interested in ancient demography. A. Wear (1995: 226), writing about the early modern period, asserted that ‘the falciparum form of malaria did not exist in Europe’, an extraordinary error.