Malaria and Rome: A History of Malaria in Ancient Italy (3 page)

⁷ Celli (1900: 18).

4

one of the determining factors of the demographic and socio-economic evolution of a large part of the Italian peninsula’.⁸ Celli compiled a bibliography containing no less than 354 items on malaria in the Roman Campagna, up to the end of the last century.⁹ Interest continued to be strong in the first half of the twentieth century. However, the level of interest has waned since the final eradication of malaria from Italy after the Second World War. The last cases of native malaria in Italy were recorded in 1962. A re-organization of research in Rome led to the demise of the principal journal in the field, the
Rivista di Malariologia
, in 1967. This decrease in interest is reflected in the length of the bibliography, compiled by the eminent medical historian Mirko Grmek, of studies written in the twentieth century devoted to malaria in antiquity, only 113

items.¹⁰ This, in turn, is an example of the truism that historiography reflects contemporary interests. However, it is very important for modern historians to remember that so long as it was present, malaria was felt to be an enormous problem in Italy. The Pontine Marshes, one of the principal havens of malaria in central Italy, during the last two millennia attracted the attention of such major historical figures as Julius Caesar, Napoleon, and Mussolini, besides countless others of less note. Julius Caesar, who suffered from a quartan fever in his youth, conceived a scheme to drain the Pontine Marshes and make the area fit for agriculture, but it had not commenced at the time of his death.¹¹ Napoleon is reported to have been displeased when he learned that the French Empire contained a very large marsh. His efforts did not make any progress either, although the investigations of his prefect of Rome, M. le Comte De Tournon, constitute a fundamental source for the state of Lazio before modernization.¹² Mussolini finally succeeded where all his predecessors had failed for over two thousand years, and completely drained the Pontine Marshes, as part of his policy ⁸ Bonelli (1966: 659): ‘
la malaria fu per secoli . . . uno dei fattori determinanti della evoluzione demografica ed economico-sociale di una vasta parte della penisola italiana
’.

⁹ Celli (1900: 256–75).

¹⁰ Grmek (1994).

¹¹ Suetonius
DJ
1.2:
morbo quartanae adgravante
(seriously ill with a quartan fever) and 44.3: siccare Pomptinas paludes
(to drain the Pontine marches); Cicero,
Philippics
5.7:
ille paludes siccare voluit
(he wanted to drain the marshes); Plutarch,
Caesar
58.9, ed. Ziegler: t¤ m†n 1lh t¤ per≥

Pwment∏non ka≥ Sht≤an ƒktrvyaß ped≤on åpode∏xai polla∏ß ƒnergÏn ånqr*pwn muri3si (he wished to turn the marshes around Pomentinum and Setia into a plain which could be cultivated by many thousands of men).

¹² Celli (1900: 102); De Tournon (1831).

1 Mussolini’s inscription at Sabaudia, commemorating the eradication of malaria from the Pontine Marshes and the foundation of the new town of Sabaudia in 1934.

of internal colonization in Italy.¹³ In doing so, he altered the environment in a way that makes it difficult to imagine now what it was like in the past. The justification for another lengthy discussion of malaria, in spite of the volume of literature on the subject, is that there is nothing recent which combines a comprehensive assessment of the ancient sources for malaria in Italy with the latest results in historical demography and the latest advances in medical research and the scientific understanding of malaria. This book is devoted to reassessing the history and ecology of malaria in western central Italy in antiquity, and in particular its demographic consequences.

¹³ Collari (1949); Desowitz (1992: 210–11).

N

Milan

Venice

Ferrara

F R A N C E

B O S N I A A N D

Genoa

H E R Z E G O V I N A

Ravenna

Pistoia

Pisa

Florence

Ancona

Livorno

TUSCANY

A d r i a t i c S e a

Perugia

GrossetoUMBRIA

Terni

MAREMMA

Pescara

Rome

CORSICA

LAZIO

Pontine

APULIA

Marshes

Capua

CAMP

Bari

Brundisium

Naples

ANIA Tarentum

SARDINIA

Paestum

A L B A N I A

Metapontum

T y r r h e n i a n

Sybaris

Cagliari

S e a

Paola

SILA

Croton

M

Palermo

e

CALABRIA

d

S I C I L Y

i

Akragas

t

(Agrigento)

Syracuse

Carthage

Camarina

e

r r a

T U N I S I A

n

e

a

n

S

e

a

Map 1. Italy

2

Types of malaria

There are about 200 species of malaria, eukaryotic parasitic protozoa that belong to the suborder
Haemosporina
, order
Eucoccidiida
, subclass
Coccidia
, class
Sporozoea
of the phylum
Apicomplexa
.¹ New species are indeed still being discovered; yet another instance which illustrates the incompleteness of our current knowledge of biodiversity.² Most of these species of malaria infect other primates, rodents, bats, reptiles, and birds. Avian species of malaria have a much wider geographical distribution than malaria parasites of terrestrial animals (except the human species transported by man around the world) because of the mobility of birds. The avian species of malaria are abundant at the heart of the geographical area under study here, in the Roman Campagna. Since research in molecular evolution indicates that the malaria parasites are a very ancient group of organisms that originated at least two hundred million years ago, and birds are now widely believed to be descendants of dinosaurs, it is quite likely that dinosaurs also suffered from malaria. Malaria is not solely a problem for humans. Indeed it can sometimes cause severe problems for other animals as well. For example, the role of the introduction of avian species of malaria to Hawaii in the extinction of species of birds indigenous to that country has been a subject of debate in conservation biology.³

However, the focus of this book will be on human malaria.

The word ‘malaria’ originally signified ‘bad air’ (
mal’aria
) in Italian. This name was derived from the theory of the miasmatic nature of the disease which prevailed until Laveran’s discovery of malarial parasites in human blood in 1880 (see Ch. 4. 1 below).

Gilberto Corbellini and Lorenza Merzagora found that the first attested use of the term
mal aere
was by Marco Cornaro in a book entitled
Scritture della laguna
, which was published in Venice in 1440.

The earliest Italian publication to use the word
malaria
without the ¹ For the Greek and Latin origins of these names see Scarborough (1992: 37, 111).

² Kreier and Baker (1987). Perkins (2000) is a recent report of the discovery of a new species of Plasmodium.

³ Cann and Douglas (1999).

8

Types of malaria

Table 1. Some of the species in the genus
Plasmodium Species

Host

Periodicity

P. vivax

Humans

Tertian

P. schwetzi

Chimpanzees

Tertian

P. pitheci

Orang-utans

Quartan?

P. hylobati

Gibbons

Quartan?

P. eylesi

Gibbons

Tertian

P. jefferyi

Gibbons

Tertian

P. cynomolgi

Monkeys

Tertian

P. ovale

Humans

Tertian

P. simium

Monkeys

Tertian

P. fieldi

Monkeys

Tertian

P. simiovale

Monkeys

Tertian

P. gonderi

Monkeys

Tertian

P. malariae

Humans

Quartan

P. inui

Monkeys

Quartan

P. brasilianum

Monkeys

Quartan

P. knowlesi

Monkeys

Quotidian

P. coatneyi

Monkeys

Tertian

P. fragile

Monkeys

Tertian

P. falciparum

Humans

Tertian

P. reichenowi

Chimpanzees

Tertian

P. berghei

Rodents

Quotidian ?

P. chabaudi

Rodents

Quotidian ?

P. girardi

Lemurs

Quartan

P. sandoshami

Colugo

Quartan

P. traguli

Mouse deer

?

P. bubalis

Water buffalo

Quartan

P. atheruri

Porcupines

Quotidian

P. voltaicum

Bats

?

P. relictum

Birds

36 hourly

P. subpraecox

Owls

Quotidian

P. cathemerium

Birds

Quotidian

P. matutinum

Birds

Quotidian

P. giovannolai

Birds

Quotidian

P. gallinaceum

Birds

36 hourly

P. circumflexum

Birds

Tertian

P. lophurae

Birds

Quotidian

P. pinottii

Birds

Quotidian

P. rouxi

Birds

Quotidian

P. elongatum

Birds

Quotidian

P. floridense

Lizards

?

P. mexicanum

Lizards

?

P. wenyoni

Snakes

?

Source
: Garnham (1966). There are numerous other species infecting mammals, birds and reptiles belonging to other genera which are closely related to
Plasmodium
but differ from it in that they are transmitted by vectors other than mosquitoes and in that schizogony does not occur in erythrocytes.

Types of malaria

9

apostrophe that indicated its original meaning was Francesco Puccinotti’s book
Storia delle febbri intermittenti di Roma
, published in Naples in 1838, although Guido Baccelli’s book
La malaria di Roma
, published just two years before Laveran’s discoveries, was the first work to apply it to the disease.⁴ The word
malaria
was introduced into English literature by Horace Walpole in 1740. He made his exit from Rome just before the annual epidemic of
P. falciparum
malaria started. The English traveller did not expect to be able to get a Christian burial if he died from malaria in Catholic Rome!

You will wonder, my dear Hal, to find me on the road from Rome: why, intend I did to stay for a new popedom, but the old eminences are cross and obstinate, and will not choose one, the Holy Ghost does not know when. There is a horrid thing called the malaria, that comes to Rome every summer, and kills one, and I did not care for being killed so far from Christian burial.⁵

Today there are known to be four species of human malaria belonging to the genus
Plasmodium
:
P. falciparum
(malignant tertian), P. vivax
(benign tertian),
P. malariae
(quartan), and
P. ovale
.
P. ovale
, a fairly mild type of malaria, was not endemic in Mediterranean countries. Consequently only the first three species will be considered here.⁶ Their common names, such as tertian and quartan fever, are no longer used in modern medical literature, but of course are found in historical sources. All three species generate a variety of clinical symptoms and syndromes, many of which can also be produced by other diseases.⁷ Malaria can easily mimic typhoid fever, hepatitis A, or influenza, for example. It is above all ⁴ Corbellini and Merzagora (1998: 53–4). Baccelli’s work was reprinted in
Monografia (1881).

⁵
Letters of Horace Walpole
, ed. C. D. Yonge (1889), i. 20, ‘to the Hon. H.S. Conway’, 5 July 1740.

⁶ Garnham (1966: 217) recorded an isolated case of
P. ovale
malaria in Epirus in Greece.

Qari
et al
. (1993) identified a new human malaria parasite morphologically similar to
P. vivax
, but with the same circumsporozoite protein as the monkey parasite
P. simiovale
, which they termed ‘
P. vivax
-like’. Since it occurs in Papua New Guinea (besides Indonesia, Madagascar, and Brazil), where there are no monkeys, it appears to be established now in human populations, although it doubtless arose as a zoonosis, cf. Escalante
et al
. (1995). Since there is no evidence for its occurrence in Mediterranean countries it is not relevant for current purposes. Other species of malaria which typically infect primates other than man may occasionally cause zoonoses in humans (Fiennes (1967: 70–5) ).