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eam ponas; hieme enim fiet vehementer frigida et aestate non salubris (If you have to build a villa next to a river, make sure that it does not face the river, since it will be very cold in winter and unhealthy in summer.).

³¹ Celli (1900: 84, 132). Tommasi-Crudeli (1892: 131) and North (1896: 103) recorded that it was not uncommon for a woman of Sezze (their idleness was proverbial) to have had three [ cont. on p. 57]

56

Ecology of malaria

7. Plan of modern Sezze (ancient Setia).

Ecology of malaria

57

river valleys in the early modern period. For example, the Tiber was affected for a large part of its course, as were many other rivers in Lazio such as the Aniene, Arrone, Galera, Marta, Sacco and Timone. Tibullus’ recommendation, quoted above, that the vicinity of rivers and streams in Etruria should be avoided in the summer, should be recalled. It suggests that river valleys were as unhealthy in the first century  as in the early modern period.

Varro and Vitruvius also recommended building a villa on elevated ground, not in a hollow.³² This was a frequent and again well-founded recommendation in antiquity, since mosquitoes, which are weak fliers, dislike flying upwards and dislike windy locations.

Antyllus, writing in the second century , summarized the prevailing view in antiquity as follows: Localities situated at high altitude are the healthiest places, since the air is not static, but is scattered around and continuously driven away by the winds. Airy places are suitable for all afflictions of the chest and head and all the faculties.³³

Procopius stated that the air on Mt. Vesuvius was very light and extremely healthy. Consequently patients with tuberculosis were sent there to recuperate.³⁴ At least such patients would have avoided the synergistic interactions of tuberculosis with malaria (see Ch. 5. 2 below). Celli noted that the town of Norma, situated on a hill 433 metres above sea level overlooking the Pontine Marshes, was free from malaria in the nineteenth century, while the vicinity of Ninfa (described by Gregorovius as ‘the little medieval Pompeii’), located at the foot of the same hill, was intensely malarious, the cause of its abandonment between  1675 and 1680.³⁵ In husbands, who had all died from malaria, by the time she reached the age of thirty. This was the inverse to the situation described in the English marshlands by Dobson (1997), where men who had been brought up in the marshes married women moving into the marshlands from other areas, who died rapidly. [Aristotle] Problems 1.21.862a described marshes as unhealthy.

³² Varro, RR 1.12.3; Vitruvius 1.4.1.

³³ Antyllus per≥ tÎpwn ka≥ t0n ƒn aÛto∏ß åvrwn in Stobaios, florilegium 101.18, ed.

Wachsmuth and Hense: oÈ Ëyhlo≥ t0n tÎpwn ËgieinÎtatoi, toı åvroß ƒn aÛto∏ß oÛ mvnontoß åll¤ ka≥ periceomvnou ka≥ ËpÏ t*n ånvmwn sunec†ß åpwqoumvnou: eÛpnoo≤ te d¶ ka≥ diaqvs-esi p3saiß ƒpit&deioi ta∏ß per≥ q*raka ka≥ kefal∫ peponqu≤6 ka≥ to∏ß ajsqhthr≤oiß p$sin.

Nutton (2000 b) discussed the ancient tradition of meteorological medicine.

³⁴ Procopius, BG 2.4.30, ed. Haury (1905).

³⁵ Celli (1900: 85); Pratesi and Tassi (1977: 140–1) described the area of Ninfa, as did Tomassetti (1910: ii. 393–406, esp. 399–400 for the date of Ninfa’s abandonment). Tomassetti thought that Ninfa was healthy in antiquity, but there is no positive evidence for this.

58

Ecology of malaria

8. View of Norma

in the distance from

Sermoneta. Situated

on top of a hill overlooking the Pontine

plain, modern

Norma and the

ancient Roman

colony of Norba

(450 metres above

sea level), which lies

beyond it, did not

have endemic

malaria, since

mosquitoes are

weak fliers.

9. View of Ninfa

from Norma.

Situated at the foot

of the hill below

Norma, in the

Ecology of malaria

Pontine plain, Ninfa

suffered from intense

malaria as a result of

which the settlement

was eventually completely abandoned

in the seventeenth

century. Today the

ruins of the settlement are part of a

botanical park and

wildlife reserve

administered by the

Fondazione Caetani

and the World

59

Wildlife Fund.

60

Ecology of malaria

general malaria was not found above 500 metres in Italy. Consequently it was not found in the higher parts of the Colli Laziali, Monti Lepini, Monti Simbruini, and Ciociaria in Lazio. In the eighteenth century population growth occurred in these more mountainous areas, while the lowland populations stagnated or declined, and the bulk of the population was concentrated in the more mountainous regions. However, in southern Etruria there are not many localities whose altitude exceeds 500 metres.³⁶ Malaria creates differential demography according to altitude. Nevertheless it is important to bear in mind that people who live at altitude but descend to work will still be vulnerable to infection in their working environment, as we have already seen in relation to Sezze.

North observed that those inhabitants of Rocca Massima, situated at an altitude of over 700 metres, who went to work on the plain below frequently became infected with malaria. In general, upland areas were much healthier than lowland areas in the past in central and northern Europe, as various studies have shown. However, in the more mountainous parts of central Italy, where peasants often lived in housing which was inadequate for the winter, the winter cold could cause some adverse demographic effects. A comparison of Treppio, located 700 metres above sea level, with Casalguidi found that infant mortality in the first year of life was higher in Treppio for that segment of each cohort born during the winter months. To understand the ancient preference for elevated locations, it is essential to remember that it is only when the comparison is with lowland populations affected by endemic malaria that upland regions in central Italy in the past had an overwhelming advantage in terms of health. It is only in comparison with the intense malaria of Grosseto that Treppio appears extremely healthy.³⁷

There is also a famous passage in Varro on the causes of disease in swamps:

Care must also be taken in marshy areas . . . because certain small animals ³⁶ Rendeli (1993: 121–2).

³⁷ Breschi and Livi-Bacci (1986) on Treppio and Casalguidi; on the effects of altitude on malaria in Italy see Bonelli (1966: 678–81); North (1896: 98–105); F. Giordano Condizioni topografiche e fisiche in Monografia

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