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Book Review
| Malaria and Rome: A History of Malaria in Ancient Italy. By Robert Sallares. New York, N.Y.: Oxford University Press, 2002. xv + 341 pp. Illustrations, maps, notes, bibliography, index. Cloth $75.00.
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| Robert Sallares believes that "the history of diseases stands on the threshold of a revolution; a revolution created by the application of ... new techniques of molecular biology to human skeletal remains excavated on archaeological sites" (p. vii). Although such methods are only beginning to inform the topic of this book, malaria and ancient Rome, the author's insistence upon using multiple disciplines to write the history of disease makes this work a model for disease historiography. Sallares does not flinch from the complex sciences of genetics or parasitology, while he is equally at home in deciphering the Greek and Latin of ancient sources. The result is a convincing demonstration that falciparum malaria was a major determinant of health, prosperity, and settlement patterns in the ancient Roman world. |
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Early in the book Sallares refutes prior arguments offered against this hypothesis. First he draws on recent analyses of DNA sequences to demonstrate that falciparum malaria is an old disease in humans, one that probably dates to the point when the earliest hominids separated from their nearest relatives, the chimpanzees. This in turn refutes the second claim, that falciparum malaria requires large populations for its persistence, since it managed to evolve in the small communities of early humans. Sallares likewise deals with studies based on the presence of appropriate Anopheles vectors and strains of plasmodia by recourse to relevant scientific information, much of it of recent vintage. |
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Sallares argues that demographers have been misled in trying to apply modern population tables to ancient Rome because they have not realized that modern sub-Saharan Africa, not modern Europe, provides the relevant model. The Roman population struggled to survive under heavy burdens of malaria, tuberculosis, and other infectious diseases. Further, it makes no sense to apply averages of, for example, life expectancy to Italy as a whole when geographic variation created wide variance in health experiences. Malaria could generate a life expectancy of only twenty or twenty-five years among valley folk, while a few miles away on a windswept mountainside the people lived twice as long. This fact was not lost on ancient observers; in the most heavily malarious areas only slave labor could be forced to harvest crops from the fertile soil. |
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As Rome grew, the demand for agricultural products led to deforestation and accompanying ponds created by run-off that were ripe for Anopheles reproduction. Malaria worked in synergy with other pathogens to increase mortality even when malaria itself was not directly blamed. The malarial parasite lowered birthrates as well by infesting the placenta and causing stillbirths, or sapping fetal nutrition so that low birth weight infants were more susceptible to other diseases. Sallares does not go so far as to intimate that malaria caused the fall of Rome. But he does show that it rendered large fertile areas near Rome uninhabitable by free men, which both reduced available calories and created the demand for large-scale slave labor with consequent revolts and instability. The author leaves no room for doubt that malaria was a major determinant of life, and death, in ancient Rome. |
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Margaret Humphreys, M.D., Ph.D., teaches medical history at Duke University. She edits the Journal of the History of Medicine, and is the author of books on malaria and yellow fever. |
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