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works of Gervase of Canterbury, ed. Stubbs (1879) i.: The chronicle of the reigns of Stephen, Henry II and Richard I, 42: Horrida enim pestilentia ex ardore aestatis nimio, et diversis aeris pas-sionibus quae post festum Sancti Johannis Baptistae emerserunt, Romanum adeo vastavit populum et maxime peregrinos, ut non nulla milia cleri et populi spiritus exhalerent. Ex hac pestilentia detestanda cardinales quidem Cantuariensis ecclesiae patroni extincti sunt, et ex sociis prioris monachi quinque et plurimi servientes.

Caeteri omnes adversa valitudine adeo detenti sunt, ut nec unus alteri vel aquam frigidam valeret propinare.

Prior autem Honorius iam fere praemortuus, beneficio episcopi Hostiensis in montana Velletrensis provinciae absportatus est, ut ibidem liberiori refectus aere respiraret. Sed illa corrupti aeris detestanda infectio, iam ipsius occupans vitalia, ad extrema perductum XIIo Kalendas Novembris compulit exspirare . . . Alii vero monachi, qui mense Julio mortui sunt, in diversis ecclesiis sepulti quiescunt.

¹³⁴ Brentano (1974: 50, 89). For the history of medieval pilgrimage to Rome and malaria see Birch (2000: esp. 56–8), citing numerous sources, e.g. Peter the Venerable, abbot of Cluny, Letter 118, in The Letters of Peter the Venerable, ed. Constable (1967) ( = Harvard Historical Studies, 78) i. 311: mortem ipsam, quam Romanus aer nostratibus celeriter inferre solet (death itself, which the Roman air is accustomed to bring rapidly to our colleagues). Peter suffered from malaria himself and made several other references to the unhealthiness of the Roman air in his letters written in the twelfth century (Constable, (1967) ii. 247–51).

160

Demography of malaria

likely that P. vivax malaria in Britain was regularly replenished and refuelled directly from Rome during the Roman and medieval periods, in exactly the same way that during the First World War the return of infected British soldiers from Greece led to a resurg-ence of malaria in the English marshlands. Rome exported diseases.

Dobson’s demographic data from the Kent and Essex marshlands can be directly compared to the data from Grosseto studied by del Panta to illustrate the profound deviations in the age-structure of mortality produced by malaria. Del Panta compared the population of Grosseto to Coale and Demeny Model South Level 2 (for males) because of the similarity in infant mortality in the first year of life.¹³⁵ He pointed out that adult mortality, especially in the age-group 20–50, was much higher in Grosseto relative to the (high) level of infant mortality than the model life-tables predict ( Table 3).

Table 3. Probability of death (qx) at various ages (in %) Interval

Grosseto

Treppio

South 2

South 1

East 1

1q0

31.7

19.6

31.1

33.6

50.5

5q1

34.0

16.5

31.6

34.7

24.7

50q20

60.0

26.5

43.1

46.0

46.3

e 0

20.0

37.0

22.3

19.9

1 7.4

The data in Table 3 show that the effect of malaria on the population of Grosseto was to produce a much higher level of adult mortality between the ages of 20 and 50 than even the ‘worst’

model life-tables used by demographers (and Coale and Demeny Model East Level 1 is a theoretical construct). In plain language, conditions in Grosseto were so bad that adult mortality went right off the bottom end of the scale generally used by demographers.

This is the full magnitude of Varro’s ‘reckoning with death’, ratio cum orco (see Ch. 9 below). Historians who have attempted to minimize the role of malaria in Italian history have completely failed to appreciate the magnitude of the ‘reckoning with death’. Del Panta, a leading Italian historical demographer, stated that numerous places in Italy, especially in the Mezzogiorno, had demographic patterns similar to those of Grosseto.¹³⁶ One example from the ¹³⁵ Del Panta (1989: 22).

¹³⁶ Del Panta (1989: 23).

Demography of malaria

161

Mezzogiorno is the territory of the Crotonese. Arlacchi described the excess adult mortality: [sc. in the early twentieth century] ‘for every 100 deaths in the Crotonese 15 befell persons between the ages of 20 and 40, compared to 7 to 8 for Calabria and 6 to 7 for Italy as a whole’.¹³⁷ According to Bonelli 12.3% of all deaths in the Crotonese in 1882 were directly attributed to malaria. This was substantially less than the direct mortality from malaria at Grosseto in the same year. Nevertheless Arlacchi’s description shows that malaria had severe effects on the entire population of the Crotonese. This once again demonstrates that the overall effects of malaria stretch far beyond the proportion of deaths directly attributed to it. In the nineteenth century the crude death rate reached 60 per 1,000, while as recently as 1890 life expectancy at birth in the Crotonese was no higher than 20. It is likely that this was the fate of the once prosperous populations of the great coastal cities of Magna Graecia, such as Croton and Metapontum, during the Hellenistic and Roman periods following the spread of malaria.¹³⁸

Table 4. Probability of death (qx) at various ages (in %) Interval

Treppio

South 8

South 9

(Females)

(Males)

1q0

19.6

18.5

19.0

5q1

16.5

18.5

16.2

50q20

26.5

26.5

27.0

e 0

37.0

37.5

38.5

Incidentally, the data for the age distribution of mortality of the population of Treppio, the Appennine community located at high altitude to which del Panta compared Grosseto, are very similar to model life-tables with similar levels of life expectancy at birth ( Table 4). This shows that at the very same time when some Italian populations had severely atypical age-structures as a result of ¹³⁷ Arlacchi (1983: 182).

¹³⁸ Arlacchi (1983: 176–83) on the Crotonese; Bonelli (1966: 662 n. 5). On malaria in Calabria see also Douglas (1955: 293–300), a perceptive account by a traveller who realized that the physical environment has changed substantially over the last two thousand years and appreciated the importance of these changes in relation to malaria. He reached the following conclusion: ‘Malaria is the key to a correct understanding of the landscape; it explains the inhabitants, their mode of life, their habits, their history’ (p. 300). Levi (1945: 156–7) described the effects of malaria in Lucania. Genovese (1924: 56–126) described the distribution of malaria in Calabria in recent times.

162

Demography of malaria

malaria, other populations in Italy not affected by malaria had quite normal patterns.

The population of Grosseto had three distinctive features: (1) much lower life expectancy at birth; (2) much higher overall mortality; (3) an unusual and distorted age-specific distribution of mortality. The third feature merits

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