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and no danger is to be apprehended where fires are kept up by any considerable number of houses. For this reason the cottagers of the Campagna usually leave their dwellings during summer, and sleep, either at Rome under the porticoes of the palaces and public edifices, or in the towns nearest to their little possessions. If they persist in remaining too long they get agues; and the greatest number of patients in the Roman hospitals, for the months of July, August, and September, consists of peasants from the circumiacent fields . . . During this month [sc. September], and the two preceding it, noone can be compelled to change his dwelling; as there is a law to that effect, for the purpose of preventing the pernicious consequences supposed to ensue, from the necessity of leaving a well-inhabited part of the town for one less salubrious.²⁴

Many later authors followed Doni’s approach to medical geography. Léon Colin produced a map of the frequency of malaria among the French troops stationed in various quarters of Rome in ²³ Lapi (1749: 11–16).

²⁴ Knight (1805: 4).

City of Rome

213

31. The Colosseum lay in a valley between the Esquiline, Palatine, and Caelian hills in Rome. Such lowlying localities were favourable to malaria in the past.

1864.²⁵ Celli cited the work of the doctor Maggiorani, who as recently as 1870 ‘considered not only the valleys of Rome, such as the Forum, the Colosseum, the Prati di Castello and the villa Borghese, to be centres from which arose pestiferous exhalations, but also declared that the populated hills of Rome were not immune from fever’. Celli also drew attention to a map of malaria in Rome in 1884 produced by two doctors, Lanzi and Torrigiani, who listed ‘even the quarters of Trastevere, Pincio, Viminale, Esquilin, Celio, Testaccio, Palatine’ as malarious.²⁶ This all too brief survey of literature on the medical geography of the city of ²⁵ A. Gabelli, Prefazione in Monografia (1881: l–li); North (1896: 238–42); Colin (1870: 88–9); Marchiafava and Bignami (1894: 23–7) on Colin’s classification of the malarial fevers which he observed in Rome. Beauchamp (1988: 258) made the observation that malaria is spreading today in developing countries which are experiencing rapid urbanization.

²⁶ Celli (1933: 167); Pinto (1882: 19–24) also described the healthy and unhealthy parts of Rome.

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City of Rome

Rome proves that numerous parts of the city were affected by malaria in the fairly recent past. If we return to reconsider the already quoted text of Cicero, de republica, on the healthy location of Rome, it becomes evident that Cicero, in spite of his attack on Rullus for wanting to settle army veterans in the pestilential territory of Salpi in Apulia (see Ch. 10 below), was really no more interested in the health of the masses than he was in any other aspects of their wel-fare. When he described Rome as healthy, he was only thinking of the hilltop districts where the aristocracy lived, and ignored the lowlying areas where many poor Romans lived and worked.²⁷

This conclusion, at least, should not surprise historians with more conventional interests in political history.

To evaluate Cicero’s statement, it also must be remembered that owing to sediment deposition in the intervening valleys by Tiber floods and deliberate infills in both antiquity and modern times, the hills of Rome were more impressive as hills in the early stages of Roman history than they are today.²⁸ The Esquiline, the highest of the seven hills of Rome, is only 65 metres above sea level, although the Janiculum (usually not counted among the seven hills) reaches 82 metres above sea level. Baccelli categorized the unhealthy lowland areas as having a topsoil which was always damp, though not actually waterlogged, with evaporation from the surface, overlying a stratum of impermeable cappellaccio, with substantial run-off of water from the hills of Rome, in other words a geology resembling that in areas of the Campagna Romana where cuniculi were constructed in antiquity.²⁹ In the early eighteenth century Lancisi had already noticed a correlation between certain types of soil and unhealthy locations. Scobie pointed out that the streets of ancient Rome were wet owing to the overflow from fountains and public water basins. This probably also created breeding sites for mosquitoes right inside the city. Moreover it is easy to underestimate the number of lakes inside the city. The lake which Nero constructed for his Golden House ( Domus Aurea) should not be allowed to dis-tract attention from all the other numerous bodies of water within the limits of the city, including for example the Velabrum, which was still navigated by boat at the end of the first century , and ²⁷ Galen noted that at Pergamum in Asia Minor the rich lived on the hill (Nutton (2000 b: 70) ).

²⁸ Ammerman (2000).

²⁹ Baccelli (1881: 156–7).

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Table 8. Distribution of lakes within the city of Rome

Region

Name of region

Number

number

of lakes

1

Porta Capena

81

2

Caeleomontium

65

3

Isis et Serapis

65

4

Templum Pacis

71

5

Exquiliae

74

6

Altosemita

73

7

Via Lata

76

8

Forum Romanum Magnum

120

9

Circus Flaminius

120

10

Palatium

90

11

Circus Maximus

20

12

Piscina Publica

80

13

Aventinus

89

14

Transtiberim

180

Source: Curiosum urbis Romae regionum, xiiii. Libellus de regionibus urbis Romae, ed. Nordh (1949). There are minor discrepancies in the figures between the Curiosum and the other list, the Notitia, and the repetition of certain figures may also raise some doubts about the accuracy of the data, but there is no doubt about the overall impression.

the lacus Caprae in the Campus Martius.³⁰ According to late antique catalogues of the features of the fourteen regions of the city of Rome, there were no less than 1,204 lakes within the city.

Hirsch in his monumental pioneering book on disease epidemiology was correct to state that ‘the Campagna di Roma . . . together with the city of Rome, forms one of the chief seats of the disease’, although it was on its way out of the city by then. By the end of the nineteenth century it was thought that infection no longer occurred within the walls of Rome itself, although numerous cases were still brought to hospitals in the city, such

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