Malaria and Rome: A History of Malaria in Ancient Italy

M A L A R I A A N D R O M E
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Malaria and Rome
A history of malaria in ancient Italy
R O B E R T S A L L A R E S
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© Robert Sallares 2002
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First published 2002
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P R E F A C E
A detailed knowledge of medical history is essential for understanding mortality patterns in past populations. Medical history in this context does not mean the history of ideas about causes of death, but the history of diseases themselves. It is a very demanding and difficult subject because it requires a multiplicity of different skills. It is necessary to possess the traditional skills in source criticism and analysis of conventional historians, as well as the ability to read texts in foreign or dead languages. However, there is another equally important dimension to it. It also requires a very solid foundation of knowledge about medicine and various branches of the natural sciences. Our knowledge and understanding of the malaria parasite Plasmodium falciparum is poised to increase exponentially as a result of the project to sequence its genome. Chromosomes 2 and 3 have already been completely sequenced, and it is likely that the complete DNA sequences of the other dozen chromosomes will have been obtained by the time that this book reaches the book-shops. At the beginning of the new millennium the history of diseases stands on the threshold of a revolution; a revolution created by the application of these new techniques of molecular biology to human skeletal remains excavated on archaeological sites. This revolution will eventually transform our understanding of the evolution, history, and distribution of diseases in prehistory and antiquity. I am engaged in such research, although very little is said about it in this book. Nevertheless the ultimate challenge must be to integrate the data yielded by different approaches, and there is still much to be learned from a comprehensive examination of the ancient documentary and literary sources for malaria, upon which this book concentrates. Very few people have the time and leisure and, dare one say it, the ability to master all the skills that are required by medical historians. The outstanding example of how it should be done is of course the late Mirko Drazen Grmek (obituary in Duffin (2000)). However, he was quite exceptional. There are many historians who are experts in the history of ideas about medicine, but know little or no science. Conversely, there are numerous viii


Preface
doctors and scientists who know little or no history. This problem applies to the medical history of all ages, including the medieval and early modern periods, but it is particularly serious as far as classical antiquity is concerned, because of the way in which ancient historians are trained.
Disease and demography have generally been studied quite separately by classicists. There are few exceptions to this trend.
Grmek (1983: 135–77) did include a chapter on palaeodemography in his marvellous book on diseases in the ancient Greek world.
He concentrated on the evidence for life expectancy provided by ancient bones, a very thorny subject, but said little about the mortality and morbidity levels and epidemiology of even the most important infectious diseases, such as malaria and tuberculosis.
The leading figures in research into Roman demography have paid virtually no attention at all to diseases, the major determinants of mortality patterns. Conclusions about the mortality patterns of ancient populations reached by historians who ignore the determinants of mortality patterns can only be pure description, at best. Nothing is being explained. In reality population history is embedded in a much larger ecological context. It cannot be understood without considering this wider context. Demonstrating this in relation to ancient history is the principal objective of this book.
Mary Dobson’s (1997) magnum opus on malaria in early modern England provides an admirable model of how it should be done.
She showed that the homogeneity of human populations, which is generally taken for granted by ancient historians, is basically a phenomenon of the twentieth century and the later stages of the nineteenth century . It cannot be taken for granted when studying earlier periods of history. The homogeneity of modern populations is a recent historical development, which was brought about by various specific means, for example the vaccination of entire populations against specific diseases (such as smallpox), and the provision of pure water supplies to whole populations (eliminating waterborne diseases). The development of universal health care services, for instance when the Italian government made the antimalarial