Malaria and Rome: A History of Malaria in Ancient Italy
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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
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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).
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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:
I have heard that you are about to go to devastate the land of Beneventum. Ensure that you have maximum knowledge of the danger awaiting you there because of the pestilential air of that land.¹
The Samnite and later Roman city of Beneventum occupied a plateau (135 metres above sea level) between two rivers, the Sabato and the Calore. The site of the city itself was healthy, as Eustachius emphasized in his account of the air of Beneventum published in 1608. He acknowledged that some diseases entered the city at the time of the rising of the dog-star and the Etesian winds and noted that some patterns of autumn weather could produce ‘bad air’ at Beneventum. Nevertheless he maintained that the respiratory diseases of winter were more important than summer diseases at Beneventum (see Ch. 5. 2 above for the relationship between the two) and that the inhabitants of the city as a whole were healthy.
However, river valleys always had potential as far as malaria was concerned. Some parts of the region had a reputation for malaria throughout the medieval and early modern periods. Doni noted that there were unhealthy localities near Beneventum and Telesia in Samnium in the seventeenth century. More recently the distribution of malaria extended from Campania across the provinces of Benevento and Campobasso towards the Adriatic coast.² Con-
¹ Alcuin, Epistolae, 224, ed. Duemmler (1895), Monumenta Germaniae Historica. Epistolae, iv.
367: Audivi vos ituros esse ad vastandam Beneventanam patriam. Scis optime, quale periculum ibi imminet tibi propter pestilentem illius terrae aerem.
² Doni (1667: 87); Eustachius (1608: 56–7, 89). North (1896: 24, 100). The early medieval life of St. Barbatus, Bishop of Beneventum, identified fevers with paganism and sin: peccatorum febribus (fevers of sinners) ( vita Sancti Barbati Episcopi Beneventani, iii, ed. Waitz (1878), Monumenta Germaniae Historica. Scriptores Rerum Langobardicarum, ii. 557–8).
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Lago di
Lesina
Lago di
Vieste
Varano
Teanum
P RO M O N TO R I O
Apulum
D E L G A RG A N O
A d r i a t i c
Manfredonia
TAVO L I E R E
S e a
Lucera
Arpi
Foggia
SALINE
Margherita di Savoia
Salpi
Herdonia
Trinitapoli
Cannae
A P U L I A Cerignola
Andria
Canosa di Puglia
Ascoli Satriano
Lavello
Melfi
N
Map 7. Salpi and Apulia
sequently we may need to look no further to explain the significance to the Romans of Beneventum’s original name which was transcribed into Latin as Maleventum (‘bad wind’), the name changed by the Romans to the more auspicious Beneventum (‘good wind’) when they founded a colony there in 268 .³ The demography of malaria was widely distributed in the southern half of Italy as well as in western central Italy. Doni noted that acute ³ Livy 9.27.14; Pliny, NH 3.11.105; Velleius Paterculus, 1.14.7; Procopius, BG 1.15.4–7
attributed its original name to a stormy wind from Dalmatia which blew over the area.
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Apulia
fevers caused thousands of deaths in Apulia and Campania in 1607, a very hot, dry year.⁴
There is definitely evidence that this was already the situation in classical times. The marsh of Salpi ( Salpina palus) in Apulia, close to Old Salpi (or Salapia) on the gulf
of Manfredonia on the Adriatic coast of Italy, was notorious for malaria.⁵ During the Second Punic War Hannibal decided that Salpi, which he held for six years, was a good place in which to spend the winter, because of the lush pastures for his cavalry. Hannibal was too smart to spend the summer in an area subject to intense malaria if he could avoid it.⁶ The landscape changes which affected the vicinity of the old town, as described by Delano Smith, were typical of those undergone by coastal habitats which were being seized by malaria.⁷
The Lago di Marana adjoining the old town at Torretta dei Monaci was a small shallow lagoon originally connected to the much larger Lago Salpi on its southern side. Lago Salpi was a large lake running parallel to the sea but separated from it by a narrow strip of land, like the Lago di Paola and the other lakes along the Tyrrhenian coast next to the Pontine Marshes. To the north of Salpi lay Lago Salso, a large lake which was drained under Mussolini in the 1930s. The presence of these large lakes suggests that at least some parts of Apulia were wetter during the Iron Age than they are today. Some palaeobotanical research has reached this conclusion for Arpi, which was linked to Salpi by a waterway.⁸ The Lago di Marana next to Old Salpi was cut off from Lago Salpi by alluviation caused by intensive farming and gradually turned into marshes.
Once the marshes were cut off from the sea they were generally filled with fresh water, but their history created slightly brackish conditions. The whole region, from Manfredonia in the north to Margherita di Savoia in the south, is responsible for about three-quarters of modern Italy’s total salt production. Inevitably it was highly attractive for those species of mosquito which transmit malaria and are tolerant of brackish conditions. Di Biase pointed out that evidence for salt production in the area goes back to Roman times, as shown by the name Salinis given to Salpi in the ⁴ Doni (1667: 177–8).
⁵ Lucan, de bello civili 377 mentioned the Salpina palus, as did Vibius Sequester (see Ch. 6
above).
⁶ Livy 24.20.15, cf. 26.38.6–14 and Valerius Maximus 3.8. ext.1, on Hannibal.
⁷ Delano Smith (1978: 82–91, 154–7, 165–9).
⁸ Sanpaolo (1995: 85–7) on the palaeobotany of Arpi.
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Roman itineraries.This is yet another illustration of the fact that the areas infested by malaria were frequently areas of great economic importance. The historical geography of the entire region recalls Vitruvius’ comments, with reference to the Pontine Marshes, about the unhealthiness of coastal marshes which were or became isolated from the sea. Vitruvius explicitly states that Old Salpi, a once prosperous Daunian city located in a grain-exporting region, according to Strabo, was abandoned because it was unhealthy.
The landscape changes described by Delano Smith, a geographer, are extremely important for understanding the creation of suitable breeding habitats for Anopheles mosquitoes leading to intense malaria:⁹
The town of Old Salpi in Apulia . . . had been established in places like that [sc. stagnant marshes cut off from the sea], as a result of which the inhabitants were ill every year, until they eventually approached M.
Hostilius with a request in public and persuaded him to search for and choose a suitable place for the transfer of their fortified town. He did not delay, but immediately after making very shrewd investigations he bought some land in a healthy location near the sea and asked the Senate and Roman people for permission to transfer the town . . . he cut a channel to link a lake to the sea and made a harbour from the lake for the town. Consequently the people of Salpi now live in a healthy place six kilometres from the old town.¹⁰
Vitruvius states that the inhabitants were moved at their own request by M. Hostilius (whose identity is uncertain) to a healthier location on a small hill (il Monte) about six kilometres away from the old town, beyond the usual flight range of mosquitoes. This was a triumph for Roman town planning in the face of malaria, but it also shows malaria directly altering human settlement patterns. It is a very good illustration of how localized endemic malaria can be.
This episode cannot be closely dated, but archaeological evidence ⁹ Delano-Smith argued that Old Salpi was abandoned because of the silting up of a canal leading to the sea which had been used for grain exports. Strabo 6.3.9.283–4C described Salapia as the seaport of Argyrippa, but only mentioned exports from Sipontum, not from Salapia. He regarded Argyrippa as less important than Canusium in his own time.
¹⁰ Vitruvius 1.4.12: in Apulia oppidum Salpia vetus . . . in eiusmodi locis fuerat conlocatum, ex quo incolae quotannis aegrotando laborantes aliquando pervenerunt ad M. Hostilium ab eoque publice petentes impetraverunt, ut his idoneum locum ad moenia transferenda conquireret elegeretque. Tunc is moratus non est, sed statim rationibus doctissime quaesitis secundum mare mercatus est possessionem loco salubri ab senatuque populoque R. petit, ut liceret transferre oppidum . . . lacum aperuit in mare et portum e lacu municipio perfecit.
Itaque nunc Salpini quattuor milia passus progressi ab oppido veteri habitant in salubri loco.
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Apulia
suggests that habitation continued at Old Salpi into the second century . Gabba suggested that the refoundation of Salpi occurred after the Social War in 89 and should be interpreted as one small aspect of the integration of the Italians into the Roman state after that conflict.¹¹ Nevertheless the area remained notorious, since Cicero accused Rullus of wishing to lead Roman veterans into the pestilential territory of Salpi.¹² Di Biase proposed the alternative interpretation that the foundation of Roman Salpi should be dated to the Augustan period. Salpi was one of the districts chosen for the Gracchan land distributions in the second century . The choice of such unfavourable localities (cf. Graviscae) shows how difficult it was to find suitable land for distribution.¹³
The new Roman town of Salpi flourished and continued to thrive into the late medieval period, but in time the mosquitoes caught up with it and the new town was eventually abandoned in turn in the seventeenth century, after which modern Manfredonia became the most important town in the region. Malaria was certainly one of the reasons for this second abandonment ( pace di Biase), since the records of the Dogana of Foggia speak of bad air there in 1603.¹⁴ Given the existence of foci of intense malaria such as Salpi, it is not surprising that Julius Caesar’s army, coming from Gaul, was severely affected by the severe autumn in Apulia, in the same way, perhaps, that the Gauls themselves besieging Rome in c.386 were affected (see Ch. 8 above):
The noxious autumn in Apulia and around Brundisium brought ill health to the whole army, which had come from the very healthy regions of Gaul and Spain.¹⁵
The problems of Caesar’s army recall the misfortunes of the army assembled for the First Crusade when it moved from Rome to southern Italy. Similarly Cicero wrote a couple of letters at ¹¹ Gabba (1983); for other literature on Salpi see Marin (1970), Mazzei (1984) and Volpe (1990).
¹² Cicero, de lege agraria 2.27.71, ed. Marck (1983) in Salpinorum pestilentiae finibus Rullo duce collocari.
¹³ Liber Coloniarum, i. 210 and ii. 261, ed. Lachmann (1967), in Die Schriften der Römischen Feldmesser.
¹⁴ Delano Smith (1978: 168, 174): ci parla di aria cattiva; Di Biase (1985: 37–50).
¹⁵ Julius Caesar, BC 3.2: gravis autumnus in Apulia circumque Brundisium ex saluberrimis Galliae et Hispaniae regionibus omnem exercitum valetudine temptaverat.
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Brundisium to Atticus, significantly in August–September 47 , in which he clearly mentioned its unhealthiness ( loci gravitas).¹⁶
Malaria was certainly one of the reasons for Apulia being the least densely populated part of Italy, as described by Cicero. Extensive cereal cultivation occupied a large area of land and the whole region had a reputation for grain production and exports both in antiquity and in subsequent periods. Olive cultivation and viticulture were also widespread in Apulia. Nevertheless it is clear that transhumant animal husbandry began to
operate on a large scale in the Tavoliere after the unification of Italy by the Romans just as it did in the coastal regions of Latium (see Ch. 9 above). Varro mentioned the annual migration of the animals from Apulia to the mountains of Samnium for the summer. The documentary evidence for transhumance has been supplemented by archaeological research recently at Tiati (Teanum Apulum).¹⁷
Falleroni described the epidemic of malaria during the First World War, in 1915–16, around modern Trinitapoli in the vicinity of ancient Salpi. Many of the malarial infections were acquired by agricultural labourers during the harvest, a common pattern observed all over the world (see Ch. 2 above). Although the élite always had the option of flight to safe areas, it would have been virtually impossible for peasants in antiquity to avoid malaria in areas where it was endemic. However, direct mortality from malaria at Trinitapoli was concentrated among children; over two-thirds of the dead were young children. The epidemic coincided with an explosion in mosquito population size. Falleroni reckoned that cave di prestito (pits) were important breeding sites for mosquitoes during this epidemic. He noted that the large-scale transhumance for which Apulia was famous offered no protection at all against ¹⁶ William of Malmesbury Gesta Regum Anglorum, 4 .545, ed. Hardy (1840): pars pro intemperie soli morbo defecit (part of the army perished from disease because of the unhealthy climate).
Elsewhere (4.572) William, commenting upon the bravery and heroism of the Crusaders, put the risk of their dying from bad air on the same level as their risk of being killed by the Saracens: ubi vel pestifero afflarentur aere vel Saracenica occiderentur rabie. In most military campaigns throughout history more soldiers died from disease than were killed by the enemy.