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the Second World War. It attempted to induce American soldiers in Italy to believe that getting infected with malaria was desirable in order to be invalided out of military service and so avoid death in battle.

⁵⁹ Tacitus, Hist. 2.93: Postremo ne salutis quidem cura infamibus Vaticani locis magna pars tetendit, unde crebrae in vulgus mortes; et adiacente Tiberi Germanorum Gallorumque obnoxia morbis corpora fluminis aviditas et aestus impatientia labefecit. Alexander Donatus (1694: iii.21, p. 274) in the seventeenth century believed that the ‘Vatican district’ included the Ianiculum in Tacitus’ eyes.

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whole casks of wine. Others say that by chance he had been allotted that section of the walls where the current of the Tiber in the morning exhales deadly mists, which were the cause of death of all but ten of his own soldiers. He himself lost his hair and nails and recovered with difficulty.

Nevertheless in truth it is agreed that, whatever the reason, he was never free from the inconvenience of a continuous but slow fever until, having heard of the crusade to Jerusalem, he vowed that he would go there if God graciously bestowed good health upon him . . . the story is that the king’s old fever revived because he was unaccustomed to leisure.⁶⁰

In the following century Bishop Otto of Freising gave a detailed description of the first destruction by malaria at Rome of an army belonging to Frederick Barbarossa in  1155.

For the unhealthy climate and the heat at that time, especially around the city, had more power to hurt our men than the weapons of the Romans . . . the rising of the sparkling Dog Star at the morbid foot of Orion was imminent, and all the air in the vicinity became dense with misty vapours arising from the neighbouring swamps and caverns and the ruined places around the city, air that was pestilential and lethal for mortals to breathe.

The citizens in the city, accustomed to take refuge in the mountains at that time of the year, and the soldiers in the camp, who were not accustomed to such bad air, were both afflicted with this disease . . . As innumerable men developed very severe illnesses as a result of this corruption of the air, the prince, although chagrined and unwilling, was forced to transfer the tents of the camp to the neighbouring mountains to gratify his own men .

. . but as the rage of the Dog Star upon the army grew even hotter, and there were hardly any men left who were not debilitated by the seething heat and the bad air, and as many soldiers had also been injured and some killed during the storming of cities, castles, and towns, he was forced, not without feeling bitter about it, to go back across the Alps again.⁶¹

⁶⁰ William of Malmesbury, gesta regum Anglorum, iv.373, ed. T. D. Hardy (1840), pp. 573–5: Ad oppugnandam Romam profectus, eam partem muri quae vigiliis suis observabatur primus prorumperet, magnam fenestram irrupturis aperiens. Ita potissimum sudans, et praefervidis venis suspiriosus, cellarium subterraneum, quod forte se discursanti obtulerat, ingressus est: ibi, cum nimio vini haustu intemperantiam sitis placasset, febrim quartanam iniit. Dicunt alii venenato Falerno infectum; quod soleant Romani, et illius terrae homines, totis infundere toxica tonnis. Alii, ei partem illam moenium sorte obtigisse ubi Tiberis influens mane saevas exhalat nebulas, quarum pernicie omnes milites eius praeter decem interiise; ipsum, amissis crinibus et unguibus, dubie convaluisse. Veruntamen, quodlibet horum fuerit, constat eum nunquam continuae sed lentae febris incommodo vacasse; donec, audita fama viae Ierosolymitanae, illuc se iturum vovit si Deus propitius ei salutem largiretur . . . fama est regem otii desuetudine febrim antiquam nactam fuisse.

⁶¹ Ottonis et Rahewini gesta Friderici I. Imperatoris, ii.33–4, 37, ed. de Simson (1912): plus enim nostros intemperies caeli estusque illo in tempore maxime circa Urbem inmoderatior quam Romanorum ledere poterant arma . . . iam tempus imminebat, quo Canis ad morbidum pedem Orionis micans exurgere deberet, e vicinis stagnis cavernosisque ac ruinosis circa Urbem locis tristibus erumpentibus et exhalantibus nebulis totus vicinus crassatur aer, ad hauriendum mortalibus letifer ac pestifer. Urgebatur hoc incommodo in Urbe civis, 228

City of Rome

Otto clearly describes the custom of Rome’s inhabitants of fleeing the city for the mountains each summer, during the dog-days, in the medieval period.⁶² This was also a custom in antiquity, at least for the élite, as Pliny the Younger, when he went to Tifernum Tiberinum, and Horace, when he went to his farm in the Sabine territory, prove.⁶³ Celsus recommended flight from the scene of pestilence. Since he specifies that his recommendations particularly apply to pestilences brought on by the south wind and to travel in unhealthy regions and during the unhealthy season of the year, it is clear that in this case at least the word pestilentia does include malaria.⁶⁴

The extant ancient sources are less detailed than the medieval ones, but there is no reason for supposing that the situation with regard to the unhealthiness of the Tiber valley was fundamentally different in antiquity. Martial clearly described the conditions that created mosquito breeding sites in the Tiber valley. He stated that Ladon’s property near the Tiber was frequently flooded, turning the fields into a lake in winter. As the year progressed the fields near the river would gradually dry out, creating breeding sites for mosquitoes.⁶⁵ One of the letters of Pliny the Younger confirms that the banks of the Tiber were unhealthy in the first century , even though his uncle had said that there were more villas lining the Tiber than all the other rivers of the world.⁶⁶ The letter describes the activities of Regulus who, among numerous other faults, hoc tempore ad montana consuetus fugere, in castris miles, tanto desuetus aeris intemperie . . . Verum innumeris hac caeli corruptione in morbos gravissimos incidentibus, princeps dolens ac nolens suisque tantum morem gerens ad vicina montana transferre cogitur tabernacula…Verum excandescente amplius in exercitum Canis rabie vixque aliquibus residuis,

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