Malaria and Rome: A History of Malaria in Ancient Italy

drug quinine available to the entire Italian population free of charge at the beginning of the twentieth century, also played a major role, as well as general improvements in nutrition and the standard of living. Even so, there are still significant differences in mortality patterns between different regions and different social

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classes in modern European populations. In Britain at the time of writing life expectancy for males varies between 68 and 78 years, and for females between 75 and 83, in different parts of the country.
No modern population is entirely homogeneous. It is clear that the populations of early modern Europe were much less homogeneous. In fact, regional diversity prevailed. Yet the homogeneity of populations in antiquity is an assumption built into virtually all published modern literature on ancient Roman demography.
There is no evidence at all for this supposed population homogeneity in antiquity. The assumption is the result of a particular method of analysis, namely the brandishing of life tables not derived from evidence for ancient populations as schematic models supposedly applicable to the entire Roman Empire. In contrast, this book is a regional case study demonstrating that the regional diversity of demographic patterns now known to have been the norm in early modern Europe was also the norm in antiquity. It argues that actual demographic conditions were strictly dependent on often very highly localized ecological circumstances, particularly the precise configuration of the local ecological community of diseases or pathocoenosis (to use Grmek’s concept), which was in turn inextricably linked to other variables (e.g. climate, physical geography, hydrology, population density, the history of the distribution of disease vectors, etc.). In central and southern Italy in antiquity malaria was the single most important component of the pathocoenosis. The aim of this book is to focus attention on the effects of malaria on population structure, rather than population size.
In the course of this book frequent references are made to comparative material from later periods of Italian history. However, this book is most certainly not intended to be a comprehensive account of the history of malaria in medieval and early modern Italy. Obviously that would require another book or series of books, given the large volume of source material that is available.
The intention here is rather to use later material selectively to explicate the generally fragmentary ancient sources. For example, when Cicero describes the course of an infection of quartan fever in Atticus, how typical was the case of Atticus? It is unique in ancient Latin literature for its chronological detail, but statistical analysis is impossible with a sample of one. It is only by considering more abundant evidence from later periods that we can see that his case history was an absolutely typical example of the chronology of x


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cases of quartan fever in Italy in the past; undoubtedly there were countless other cases like it in antiquity (see Ch. 5. 2 below). It is exceedingly easy for ancient historians who are not specialists in medical matters to grossly underestimate how much material is in fact available. The Italian National Archive Office is currently undertaking a major project to publish all the documentation in its possession relating to malaria in Italy. Fantini and Muzzioli (1987) compiled a long catalogue of the numerous archives in the city of Rome containing documents relevant to the study of malaria in Italy, while in 1998 the journal Medicina nei Secoli : Arte e Scienza (10/3) published a long series of articles on the archival sources for malaria in Italy.
Traditionally ancient history ended with the downfall of the last Roman emperor in  476, with the implication of a sharp break between the ancient and medieval eras, although it is arguable that this date had no real significance. As far as the city of Rome is concerned, the Gothic wars described by Procopius in the sixth century  did the worst damage to Rome itself. The old civic institutions such as the Roman Senate seem to have disappeared by the time of the reign of Pope Gregory the Great ( 590–604).
Some specialists in late antiquity speak of the transformation of the Roman world and extend the chronological span of antiquity forwards into the sixth or seventh centuries , reverting towards Henri Pirenne’s (1937) opinion that the break between the ancient and the mediaeval worlds occurred in the time of Charlemagne in the eighth century, rather than in the fifth century. However, this position still leaves a dividing line between, on the one hand, ancient Roman history, and, on the other hand, later Italian history. The argument of this book is that the divide between ancient history and later periods is a barrier to understanding, at least as far as the topic of this book is concerned. It has prevented ancient historians from using the much more abundant and detailed later evidence to make sense of the fragmentary ancient sources.
A C K N O W L E D G E M E N T S
This book was largely written during a very fruitful period of collaborative research with Walter Scheidel. Indeed it would probably never have been written at all without him. Our original intention was to integrate my research with Walter’s research into a much larger volume comparing the effects of diseases on demographic patterns in different parts of the Roman world, but it became clear that our combined manuscript was too long for a single book. Consequently the original manuscript was broken up into pieces for separate publication. However, Walter’s forthcoming book Death on the Nile: disease and the demography of Roman Egypt should be read as a complement to this book. It demonstrates convincingly that regional variation in mortality patterns was as normal in Egypt during the time of the Roman Empire as it was in Italy, as is argued here. His book considerably extends the critical discussion in Chapters 5 and 11 here of the irrelevance to ancient populations of model life-tables based on data from modern populations. It also contains