Malaria and Rome: A History of Malaria in Ancient Italy (50 page)

As was noted earlier, Celli advocated ‘the theory that . . . periods of prosperity coincided with periods of attenuation in the severity of the malarial fever’.⁵⁵ He knew that many Roman villas were constructed in the Roman Campagna, above all in the period from Augustus to the Antonines, and thought that the economic prosperity indicated by these villas could only be explained on the assumption that malaria, which was certainly present, was less virulent at that time. Celli proposed a cycle of fluctuations of virulence of
P. falciparum
malaria in the Roman Campagna throughout history. The idea was accepted by other leading Italian malariologists, such as Missiroli for example, and by medical historians like Bercé and North. It has in fact never been subsequently seriously re-examined.⁵⁶ Yet the whole theory is quite weak. Of course Celli, writing at the end of the last century, had no direct scientific evidence for fluctuations in the virulence of
P. falciparum
, and there is little available today; as was observed in Chapter 3 above, current scientific research into parasite evolution and epidemiology suggests that extreme virulence is adaptive for
P. falciparum
. Moreover the modern populations of regions with endemic malaria in the past tend to have high frequencies of human genetic mutations which give some resistance to malaria (see Ch. 5. 3 above, and the discussion of Ravenna in Ch. 4. 2 above). This implies intense pressure by severe malaria as an agent of natural selection on ⁵⁴ F. Giordano,
Condizione topografiche e fisice
. . ., in
Monografia
(1881: lxiii):
dove è prossima e forte la causa di malattia e di morte, non si perita volentieri il lavoratore
.

⁵⁵ Celli (1933: 109).

⁵⁶ North (1896: 86); Missiroli (1938: 5–6); Bercé (1989); Hofmann (1956: cols. 1203–6) on Celli’s theory of cycles of malaria as applied to antiquity.

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human populations in Italy in the past and contradicts Celli’s theory of mild malaria.⁵⁷

Celli’s evidence was entirely indirect, basically the remains of villas in the Early Empire (and churches in the Late Empire) as signs of prosperity. A typical example is Cicero’s villa at Astura on the coast of southern Latium, a beautiful location. However, it must be noted that Virgil hinted that the marshes of Astura were unhealthy.⁵⁸ Moreover, according to his letters, Cicero stayed in his villa at Astura principally in the spring—the season of the year when transmission of malaria ceased or was very low. After the end of the Republic most of the villas on the coasts of Etruria and Latium eventually became the emperor’s property and probably rarely saw their owner. Domitian’s villa by the side of the Lago di Paola in the Pontine Marshes has left very imposing archaeological remains which have recently been restored. However, it appears to have been a single-phase site which was neglected after Domitian’s death. The letter of Pliny the Younger quoted earlier (Ch. 8 above) about the villa of Regulus on the Tiber confirms that some Roman villas were located in areas which were known to be unhealthy.

Moreover Celli did not consider who built these villas, or ask who were the people who formed the labour force working out of these villas afterwards. He did not consider the importance of the fact that these villas had a labour force made up of slaves. He did not pay any attention, as a possible parallel, to the slave societies of the western hemisphere, where plantation owners were quite happy to make big profits by employing large numbers of slaves with a low life expectancy in very unhealthy environments.⁵⁹ He did not pay ⁵⁷ In using this line of argument it is necessary to take account of human population movements and migrations. The modern populations of some of the regions of Italy which formerly had endemic malaria have moved there recently from other areas. For example, the modern population of the new towns of the Pontine plain is largely descended from colonists sent there from the north of Italy by Mussolini in the 1930s (Gaspari 1985). Under such circumstances it would obviously be foolish to use the genetics of the modern population of this region to attempt to shed light on ancient malaria. Similar considerations apply to the population of the city of Rome itself, which has been a magnet for migrants not just in modern times but throughout history (see Ch. 11 below).

⁵⁸ Cicero,
Letters to Atticus
, 257, ed. Shackleton-Bailey (1965–70) (written on 14 March 45

) described Astura as a
locus amoenus
(a pleasant place) (unlike the Pontine Marshes); Virgil, Aeneid 7.801.

⁵⁹ Giglioli (1972) studied the large reductions in mortality following the eradication of malaria from the sugar plantations of Guyana. For comparative evidence from North America see also J. F. Smith (1985: 7, 136–7); Joyner (1984: 35–7, 70); Savitt (1978: 17–35); Merrens and Terry (1984); Dubisch (1985); Duffy (1988); Dobson (1989); Dusinberre (1996); Rutman and Rutman (1997).

258

Roman Campagna

enough attention to the fact, accepted by all historians writing about the Roman Campagna from Ashby to Brunt, that there were very few significant towns or villages in Latium populated by free people during the Roman Empire. Free people had a choice of where to live, but slaves did not have any choice. The verdict of free people is much more significant in assessing the problem of the desirability of living in Latium. Above all, Celli, surprising as it may seem in a work of medical history, did not pay enough attention to one crucial category of literary evidence from antiquity, namely the evidence provided by the medical writers. It is worth quoting one paragraph from the English translation of Celli’s book to illustrate the problem:

The best description of the character of the different forms of fever is given by Galenus; he . . . describes vividly the . . . aestivo-autumnal fevers again recurrent in our days and which in those days were called ‘Emitritea fevers’, and were widely spread in Rome in summer and in autumn. The heavy occurrence of jaundice and dropsy could be daily observed, symptoms undoubtedly produced by malaria. This disease was widely spread at a time when we know from many signs and proofs [sc. villas, etc.] that the pest was diminishing in virulence.⁶⁰

The massive problem with this line of argument is that Galen does not say anything whatsoever about the pest diminishing in virulence! On the contrary, Galen explicitly described the semitertian fevers, which were so common in Rome, as extremely dangerous (kindunodvstatoß), as has already been seen (Ch. 8 above).

Moreover the symptoms of jaundice and dropsy noted by Celli himself indicate a severe disease. The direct testimony of Galen with regard to the virulence of the disease is much more significant than the extremely indirect evidence of villas which were largely populated by slaves. Celli’s argument for an attenuation of the severity of malaria during the Roman Empire, as a cyclical down-turn after the ravages which he argued it caused during the Late Republic, is very weak. There is no space to examine here in detail the possibility of fluctuations in the virulence of malaria in the Roman Campagna during more recent periods of history. That would require another book, which would have to be based on extensive research in archives and libraries in Italy, but the weak-

⁶⁰ Celli (1933: 47, 111–17).

Roman Campagna

259

ness of Celli’s arguments about antiquity suggests that the enterprise would be worth undertaking.

There is only space here to note that some of the evidence presented by Celli himself for later periods contradicts his own theory in exactly the same way that Galen contradicted it in antiquity. For example, Celli argued, again on the basis of construction work (analogous to the villas of antiquity), that another period of attenuation of the severity of malaria occurred from the mid-fourteenth to the seventeenth century . However, he noted that the leading seventeenth-century historian of the city of Rome, Father Alexander Donatus, observed that the villas of that period were built in hilly locations precisely because the lowlands were unhealthy: The reason is to be sought in the unhealthy and noxious wildness of the air. For the opinion of the doctor Alexander Petronius, expressed in notable works, is confirmed by experience, with everyone’s agreement: the summer residences of the citizens in the vineyards around the city are unhealthy, and are not far away from the danger of ill-health. Consequently very few villas can be counted not only on the land along the Tiber, but even on the land around the city, despite the presence of so many noblemen and the abundance of wealth. The villas are located instead a little further away, on the ridges of Tibur, Tusculum, and Mt.

Albanus.⁶¹

Donatus’ evidence undermines Celli’s own theory. It is very reveal-ing to compare Donatus’ account with the archaeological evidence for the distribution of ancient Roman villas around Praeneste, for example, as described by Andreussi:

All these villas arose either on the flat summits of hills separated by deep ravines, or on the southern slopes of the same hills, with a good aspect and view.⁶²

The similarity to the situation described by Donatus in the seventeenth century is obvious.⁶³ It is likely that Donatus was right, ⁶¹ Donatus (1694: bk iii. ch. 21, p. 272):
Causa rejicienda est in aëris intemperiem insalubrem, et gravem. Nam quod Alexander Petronius Medicus insignis typis evulgavit, omnium assensu, et experientia com-probatur; insalubres esse Civibus circum Urbem aestivas in vineis stationes, nec procul a periculo valetudinis abesse. Itaque non modo secundum Tiberim, sed etiam in agro suburbano, in tanta Principum et divitiarum copia, paucissimae numerantur Villae, quae paulo remotiora Tiburis, Tusculi et Albae juga insederunt
.

⁶² Andreussi in Giardina and Schiavone (1981), i. 351:
tutte queste ville sorgevano o sulle sommità piatte di colli separati da profondi burroni, o sui pendii meridionali dei colli stessi, con buona esposizione e vista
.

⁶³ Note also the comments of Thomas and Wilson (1994: 173) on the location of Roman 260

Roman Campagna

and the lowlands were always very unhealthy (from at least
c
.200 

onwards) because of malaria. Equally, there were always some healthy locations available for villas, especially on the slopes and summits of hills, during both the time of the Roman Empire and all subsequent periods. Humans continuously made efforts to reclaim the lowlands, for example the
domuscultae
of Pope Zacharias (

742-752), but they were always beaten back by malaria until modern times.⁶⁴ In so far as there were any periodic variations in the distribution and/or frequency (transmission rate) of malaria, these are much more likely to have been caused by local environmental change affecting the breeding habitats of mosquitoes, a question which Celli did not consider at all. The modern areas of anophelism without malaria were probably created by the modernization of Italian agriculture with the integration of arable farming and animal husbandry (replacing traditional transhumance) in a way that favoured zoophilic over anthropophilic species of Anopheles mosquito. There seems to be little evidence in fact that any of the regions of anophelism without malaria considered by Fantini actually existed before the nineteenth century. Pisa, for example, has already been considered. Its territory was unhealthy during the Renaissance period. Similarly the Val di Chiana, where Hackett performed some of his famous studies, and other areas of anophelism without malaria in Tuscany in the late nineteenth century such as Fucécchio and Altopáscio, were extremely unhealthy in the eyes of late medieval and Renaissance historians.

Herlihy and Klapisch-Zuber, for example, described these areas as ‘fever-ridden sinks’.⁶⁵ The vicinity of the southern end of the Val di Chiana continued to suffer from malaria into the nineteenth century, since Cesare Massari, a doctor from Perugia who pub-villas. On the Via Praenestina east of Rome at Ponte di Nona a mid-to late Republican healing sanctuary was excavated. Many terracotta votive offerings were found. Wells (1985) interpreted the large number of terracotta heads found at this site as connected with cerebral malaria. Grmek and Gourevitch (1998: 347–8) described Wells’s analysis as an example of ‘overinterpretation’. It is certainly true that there are many other possible causes of pain in the head besides cerebral malaria. Consequently no individual terracotta head can be conclusively associated with malaria. However, given the sanctuary’s geographical location, it is likely that some of the votive offerings were the result of malarial infections, although there is no way of knowing which ones.

⁶⁴ Tomassetti (1910: i. 110–12) on the
domuscultae
, which he described as a
villaggio sparso
, wrote as follows:
la durata di esse fu di circa trecento anni; la decadenza ne fu rapida e l’abbandono fu assai dannoso
.

⁶⁵ Fantini (1994); Herlihy and Klapisch-Zuber (1985: 34).

Roman Campagna

261

lished a history of that town’s experiences of epidemic disease in 1838, recorded the establishment of a hospital in about 1816 at Corciano specifically to handle cases of malaria among the inhabitants of the region of Lake Trasimene.⁶⁶ This proves that the region’s status as an area of anophelism without malaria was a modern development. Besides the drainage scheme that was mentioned earlier, it is also likely that increasing usage of quinine in the hospital during the nineteenth century played a significant role in the defeat of malaria in that region.

⁶⁶ Massari (1838: 144–5):
Nè deve sotto silenzio passarsi il provvedimento preso in quel tempo di stabilire uno Spedale nella terra di Corciano, distante sei miglia al ponente di Perugia, per la via di Toscana, a racchiudimento di tutte que’ febbricitanti i quale dalle vicinanze del Trasimeno, per le cattive arie d’estate ed autunno, entravano ammorbati tra noi. E là dovevano essere medicati que’ laghegiani, cui la continua o la intermittente paludosa febbre avesse colto
.

10

Apulia

Although the focus of this book is on western central Italy, Latium and Etruria, it must not be forgotten that much of southern Italy was also severely affected by malaria, as Alcuin commented in  801 upon hearing of the intentions of the army of the Frankish king Pipin: