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interesting pages on malaria in Roman Egypt, where the disease flourished in environments very different from those described here, illustrating its adaptability.

Mario Coluzzi, Gilberto Corbellini, Tim Cornell, Peter

Garnsey, Mirko Grmek, and John Scarborough all read previous versions of the text. Carmine Ampolo made helpful comments at a conference in Parma. Mary Dobson provided a photocopy of an important article that was difficult to obtain. Peter Attema and Franco Ravelli supplied copies of some of their own work. Mario Coluzzi, Clem Ramsdale, and Graham White provided information about mosquitoes. James Oeppen and Richard Smith gave advice on one technical detail about life-tables. The comments of the anonymous referees were very helpful. Susan Gomzi, Abigail Bouwman, and Cia Anderung worked alongside me on the bones from Lugnano in Teverina, which were provided by David Soren.

I wish to thank Mario Coluzzi and Claudio Finistauri for their hospitality when I visited the Istituto di Parassitologia in La Sapienza University, Rome, and Lugnano in Teverina. I also wish to thank xii

Acknowledgements

Hilary O’Shea and the staff of Oxford University Press and Jane Wheare. Last but not least, financial support from the Leverhulme Trust was invaluable.

Obviously I am solely responsible for the views expressed and for any faults that remain. All the translations of Latin, Greek, and Italian texts are my own translations. I benefited enormously from the resources of the John Rylands Library in Manchester and the Wellcome Library for the History and Understanding of Medicine in London, as it is now called. One important work exploited in this book was accidentally discovered, while looking for something else, gathering dust on a shelf in the Rylands Library. It did not look as if anyone had read it for a hundred years. I hope this book will enjoy a better fate.

R. S.

C O N T E N T S

List of illustrations

xiv

List of figures, maps, and tables

xvi

1. Introduction

1

2. Types of malaria

7

3. Evolution and prehistory of malaria

23

4. The ecology of malaria in Italy

43

Malaria and mosquitoes

43

Malarial environments

55

Malaria in Sardinia

90

Malaria, roads, and housing

93

Climatic change

101

Agricultural change and deforestation

103

5. The demography of malaria

115

Direct and indirect approaches to the demography of

malaria

115

Interactions of malaria with other diseases

123

Malaria and nutrition

140

Comparative demography of malaria in Italy and

England

151

6. The Pontine Marshes

168

7. Tuscany

192

8. The city of Rome

201

9. The Roman Campagna

235

10. Apulia

262

11. Geographical contrasts and demographic variation

269

References

287

Glossary

329

Index

331

I L L U S T R A T I O N S

All photographs were taken by the author except where stated otherwise in the captions to the illustrations.

1. Mussolini’s inscription at Sabaudia.

5

2. Ospedale di San Giovanni.

17

3. Anopheles labranchiae.

45

4 . Fontana di Trevi.

46

5 . Artemisia absinthium.

47

6. The Virgin of Fevers in the Sacristy of St. Peter’s in the Vatican in Rome.

51

7. Plan of modern Sezze.

56

8. View of Norma in the distance from Sermoneta.

58

9. View of Ninfa from Norma.

59

10. Ruins of the Roman villa of Poggio Gramignano,

near Lugnano in Teverina.

66

11. PCR products amplified from the Lugnano bones.

67

12. The coastal forest of the Parco Naturale della Maremma.

73

13 . The entrance to the Cloaca Maxima.

76

14. Anopheles sacharovi.

84

15. A traditional peasant hut in the Pontine region.

94

16. The Val di Chiana and Lago Trasimeno.

99

17. The Monti Cimini.

104

18. The northern slopes of Monte Circeo.

107

19. A view of Sermoneta.

120

20. Centro culturale polivalente in Pontinia.

170

21. View of the Lago di Sabaudia.

171

22. The ilex-oak forest of Monte Circeo.

172

23. The Pontine plain viewed from Sermoneta.

175

24. The southern end of the Pontine plain.

184

25. Ruins of the Roman colony of Graviscae.

194

26. The modem saline of Graviscae.

195

27. Wetland in the Parco Naturale della Maremma.

199

28. Cardinal Lugo orders the use of cinchona bark.

203

29. Monte Testaccio.

208

Illustrations

xv

30. Via della Reginella.

210

31. The Colosseum.

213

32. Ospedale di Santo Spirito.

216

33. The Roman Forum.

217

34. The monument of Leopold II in Grosseto (front and

side views).

232–3

35. Luigi Torelli’s Carta della malaria dell’Italia.

237

36. The angel of death striking a door during the plague of Rome.

274

37. The Circus Maximus.

281

F I G U R E S , M A P S , A N D T A B L E S

M 

1. Italy

6

2. Umbria and northern Lazio

65

3. Ravenna and Emilia-Romagna

80

4. Southern Lazio

169

5. The Maremma and Valdichiana

193

6. The city of Rome

207

7. Salpi and Apulia

263

F 

1. Evolutionary relationships of selected Plasmodium species

24

T 

1. Some of the species in the genus Plasmodium

8

2. Palaearctic mosquito species in the Anopheles maculipennis complex

44

3. Probability of death at various ages

160

4. Probability of death at various ages

161

5. Number of deaths per person-years

162

6. Number of deaths per person-years (m(x) )

163

7. Number of people aged 20+ who die between ages

x and y

164

8. Distribution of lakes within the city of Rome

215

9. Baptisms and deaths in early modern Rome

275

1

Introduction

Keith Hopkins moved the study of the demography of the ancient Roman world into a new era with his demonstration that ‘ages at death derived from Roman tombstones cannot be used to estimate expectation of life at birth or at subsequent ages’.¹ He suggested that the life expectancy at birth of the Roman population lay between 20 and 30 and advocated that life-tables derived from data from modern populations should be used as models for the age-structure of the Roman population in antiquity. Since then, the use of these model life-tables has enjoyed a considerable degree of popularity among ancient historians. Indeed it has become the current orthodoxy, almost an article of faith in certain quarters.

Hopkins himself was careful to add an important qualification, in terms of a requirement for further research, at the end of his article: ‘Our attention . . . should . . . be directed . . . to a more general assessment of the applicability of these model life tables and to an analysis of the determinants of mortality, both in Rome in particular, and in general.’² Unfortunately he never followed up his own recommendation. The bulk of subsequent research has also failed signally in this respect. Yet an analysis of the causes of death is absolutely essential if we are ever to move beyond attempting to describe mortality in antiquity towards explaining and understanding it.

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