Malaria and Rome: A History of Malaria in Ancient Italy (53 page)

274

Geographical contrasts

36. The angel of

death striking a

door during the

plague of Rome in

1656. Engraving by

Levasseur after

J. Delaunay. The

Wellcome Library,

London.

Geographical contrasts

275

Table 9. Baptisms and deaths (per 1000) in Rome from 1621 to 1824

Period

Baptisms

Deaths

1621–9

26.9

38.3

1630–9

30.4

29.0

1640–9

29.7

33.8

1650–5

27.9

31.8

1656–7

26.0

69.3

1658–9

30.8

28.1

1660-9

32.8

24.5

1670–9

30.1

25.6

1680–9

30.0

23.9

1690–9

30.9

24.0

1702–9

27.7

29.7

1710–19

26.0

39.3

1720–9

27.1

38.7

1730–9

28.3

41.1

1740–9

29.4

42.6

1750–9

32.3

39.9

1760–9

31.4

46.5

1770–9

32.6

38.3

1780–9

32.0

46.0

1790–9

33.1

44.9

1800–9

32.8

50.3

1810–19

30.8

37.6

1820–4

33.1

37.4

Source
: Schiavoni and Sonnino (1982: 102, table II).

own when it was small. Such a capability of course helps to explain where the manpower for colonization came from in the early stages of Roman history in antiquity. At the same time the early modern data also make it clear that as the urban population grew, a deficit of births relative to deaths became inevitable, and inevitable at a population-size level far below the size of the population of the city of Rome during the time of the Roman Empire.

The availability of data from Rome itself in the early modern period means that there is in fact no need at all for historians to rely on the example of London; the data from Rome itself are much more pertinent. Delumeau studied the census of 1526–7 in Rome.

Extrapolating from a sample of about 4,000 people for which evidence is available, he reached the conclusion that out of Rome’s population of about 55,000 at that time, only 16% were actually of local origin. No less than 64% of the population of Rome in 276

Geographical contrasts

1526 originated from other parts of Italy (principally Tuscany—encouraged by the presence in Rome at the time of popes born in Florence—and Milan), while as much as 20% of the population came from outside Italy (mainly from Spain, France, and Ger-many).¹⁴

There is no reason for thinking that ancient Rome was any healthier than early modern Rome. Celsus observed that
urbani
, the inhabitants of towns, were particularly liable to ill health.¹⁵ Indeed the situation in ancient Rome was probably significantly worse than the situation in early modern Rome, since the population was larger and denser during the time of the Roman Empire, and Galen’s information about the frequency of
P. falciparum
malaria in Rome in the second century  must also be taken into account.

The evidence of Herodian (commenting on the epidemic of  189, probably smallpox¹⁶) confirms that massive immigration to the city of Rome was occurring in Galen’s own time.¹⁷ Even as late as after the capture of Rome by Alaric in  410, it appears that the city was still attracting immigrants, according to Olympiodorus.¹⁸ It was noted in Chapter 5. 4 above that visitors from northern Europe contracted malaria in Rome and took the parasites back home with them. However, it is also very important to observe that continuous immigration to Rome would by itself have intensified malaria in and around the city because undoubtedly some of the immigrants would have come from other areas of endemic malaria (e.g. in southern Italy), already be infected, and so bring new malarial parasites to the city in their bloodstreams. The city of Rome both exported and imported diseases, a role facilitated first in antiquity by increased human mobility following the unification of the Mediterranean countries and a large part of Europe under the Roman Empire, and secondly in subsequent historical periods by ¹⁴ Delumeau (1957: i. 197–220); Black (1789: 17) recognized in the eighteenth century that the birth rate was lower than the death rate in Rome; Sori (1984: 554–9).

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.

Geographical contrasts

277

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)).

278

Geographical contrasts

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.

Geographical contrasts

279

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 security 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).

280

Geographical contrasts

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