Malaria and Rome: A History of Malaria in Ancient Italy by Robert Sallares (beach read .TXT) 📕

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Corneto (Tarquinia) near the coast the maximum number of cases did not occur until November in some years.⁴⁸ Marchiafava noted that even shepherds, who brought their flocks of sheep down from the mountains to graze in the Roman Campagna as part of the traditional pattern of transhumance at the end of the autumn, were still very vulnerable to infection with P. falciparum malaria at that time. Similarly there were a significant number of new cases in November at Grosseto during the epidemic of 1910. This is possible because A. labranchiae continues to be active in houses during the winter.⁴⁹ The seasonal mortality peak, which as will be shown later was indeed primarily caused by malaria, as Scheidel argued, was such a striking phenomenon that it was even noticed in antiquity.

The author of the pseudo-Aristotelian Problems stated that the number of deaths was much higher in the hundred days after the summer and the winter solstices, and the autumn was less healthy than the spring.⁵⁰ The seasonality of disease patterns in Mediterranean countries in antiquity, which was shaped above all else by malaria, had a long history of discussion in ancient medical writers stretching back to the Hippocratic Aphorisms.⁵¹

Pliny the Elder followed the agronomists on the dangers of farming in unhealthy districts, recommending that villas should not be placed near marshes or next to rivers.⁵² He added the following intriguing comment:

The healthiness of a locality is not always revealed by the complexion of the inhabitants, since those who are accustomed to such conditions can continue working even in pestilential areas.⁵³

⁴⁸ Celli (1900: 148–56). Aitken (1873) presented the following statistics for deaths directly from pernicious intermittent fevers in the city of Rome in 1872: 52 from January 1 to March 24, 39 from March 25 to June 16, 199 from July 15 to October 6, and 109 from October 7 to December 29. Rey and Sormani (1881) analysed mortality from malaria and other diseases in Rome on a weekly basis for the years 1874–6. Dobson (1997: 203–20) discussed seasonal patterns in the English marshlands.

⁴⁹ Marchiafava (1931: 52); Bellincioni (1934: 203), quoting G. Memmi’s observations at Grosseto in 1910; Herlihy (1958: 48–53) and Cipolla (1992: 79, 90 n. 6) on Pisa. Corradi (1865: i. 455–6) described malaria at Pisa in October–November  1530.

⁵⁰ [Aristotle] Problems 1.26–7.862b: åpoqn&skousi m3lista.

⁵¹ For references to the Aphorisms see Sallares (1991: 467 n. 381).

⁵² Pliny, NH 18.7.33: convenit neque iuxta paludes ponendam esse neque adverso amne, quamquam Homerus omnino e flumine semper antelucanas auras insalubres verissime tradidit. It is interesting that he interpreted the Homeric line ( Odyssey 5.469) as referring to the unhealthiness of rivers.

⁵³ Pliny, NH 18.6.27: salubritas loci non semper incolarum colore detegitur, quoniam adsueti etiam in pestilentibus durant.

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Celli interpreted this statement and various kinds of proxy data (discussed in Ch. 9 below) as evidence that malaria was milder in Pliny’s time than it was in certain other periods, in support of his cyclical theory of malaria in the Roman Campagna. There is in fact no reason for supposing that P. falciparum has ever displayed anything other than extreme virulence throughout its lengthy evolutionary history, as was suggested in Chapter 3 above following the latest scientific research.There was little detailed understanding of either inherited or acquired immunity to malaria in Celli’s time.

Either or both of these types of immunity (discussed in Chs. 4. 2 and 5. 3 below) provide a better explanation for Pliny’s statement than Celli’s inference that P. falciparum malaria was milder then.⁵⁴

Malaria was as active in central Italy in late antiquity as it was in the late Republic and early Empire. According to his own account Sidonius Apollinaris was infected while travelling through Umbria, next to ‘the pestilential region of Tuscany’, along the Via Flaminia from Ravenna to Rome in  467. (‘I entered and left immediately the other towns along the Flaminian road, moving forward with Picenum on the left and Umbria on the right; in Umbria either the Atabulus wind from Calabria or the pestilential region of Tuscany infected my body as I breathed in the air saturated with poison which caused alternate fevers and chills. Meanwhile fever and thirst devastated the inside of my body, my heart and marrow.’)⁵⁵

This suggests that the disease had already matched by then its distribution in the early modern period, when Doni (an important figure in the historiography of malaria who will be formally introduced in Ch. 8 below) noted in the seventeenth century that the section of the Via Flaminia closest to Rome was unhealthy. Some parts of Umbria were certainly very healthy, for example Spoleto, which was singled out by Doni in this respect. Nevertheless other sources confirm the active presence of malaria in some regions of Umbria, for example around Narni where seasonal migrant farm ⁵⁴ Celli (1933: 42). G. Brasacchio, quoted by Arlacchi (1983: 179), described the physical appearance of the inhabitants of the Crotonese as follows: ‘the pallor characteristic of malaria is hidden beneath the deep brown skin burnt by the summer suns, which give to the face a curious olive colour’. This also provides a reasonable explanation for the problem that concerned Celli. Mabeza et al. (1998) argued that intense pallor is associated with an increased risk of death in childhood malaria.

⁵⁵ Sidonius Apollinaris, Letter to Heronius 1.5.8: hinc cetera Flaminiae oppida statim ut ingrediebar egressus laevo Picentes, dextro Umbros latere transmisi; ubi mihi seu Calaber Atabulus seu pestilens regio Tuscorum spiritu aeris venenatis flatibus inebriato et modo calores alternante, modo frigora vaporatum corpus infecit. Interea febris sitisque penitissimum cordis medullarumque secretum depopulabantur.

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