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to help to justify the choice of Rome as the capital of the recently unified Italian state. Baccelli had the task of arguing that Rome was healthier than its reputation for bad air, especially among English writers and travellers, suggested. His task was in fact fairly easy by then. Extensive drainage schemes, filling in and paving over of lowlying areas, and substantial construction work all over the city, leading to the conquest of the lower land from the hills (the inverse of the movement in the sixteenth century described by Delumeau), were indeed well on the way by then to eliminating malaria from the city of Rome. Indeed the situation improved so drastically that Mendini was able to describe Rome as now the healthiest of the large Italian cities, in his hygienic guide to Rome to which Baccelli contributed a preface.¹⁴ Nevertheless Baccelli still had extensive information available about the situation before the modernization of Rome commenced: We find that on the right bank of the Tiber the centre of the Leonine city can be said to be immune to fevers; on the other hand more or less unhealthy are the side streets, Porta Angelica, the Vatican hill; the Janiculum and the entire area from the Janiculum to Porta Portese is unhealthy. On the left bank of the Tiber the unhealthiness of the vicinity of Monte Testaccio, of Porta and Via Ostiense and of Porta San Sebastiano is well known; the same may be said of the lowlying plain between the Caelian and Palatine hills, of the Aurelian wall, of Porta Metronia, of Via Ferratella until the Lateran hill and of the surroundings of Santa Croce in Jerusalem. Other more elevated localities, even if they cannot be regarded as completely immune to fevers, are sufficiently more healthy.¹⁵

¹⁴ Pesci (1971: 596–7); Mendini (1897: 83–100).

¹⁵ Baccelli (1881: 156): Troviamo che sulla destra del Tevere la città Leonina, nel suo centro, può dirsi immune dalle febbri; più o meno malsane sono invece le vie laterali, Porta Angelica, il Monte Vaticano; malsani sono il Gianicolo e tutto quel tratto che si estende dal Gianicolo fino a Porta Portese. Sulla sinistra del Tevere è nota l’insalubrità delle adiacenze di Monte Testaccio, di Porta e via Ostiense e di Porta San Sebastiano; così pure dicasi del basso piano compreso tra il Celio e il Palatino, del recinto Aureliano, di Porta Metronia, di via Ferratella fino al colle Laterano e dei dintorni di Santa Croce in Gerusalemme. Altri punti più elevati, se non possono dirsi immuni, sono assai più salubri.

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VIA CASSIA

Riv

River Tiber

er Aniene

Villa

Borghese

TIBURTINA

Vatican

VIA

City

Quirinal

Ospedale

Viminal

Santo Spirito

Ghetto

Capitoline

Esquiline

Janiculum

Forum

Colosseum

VIA

Isola

Palatine

P

OSPEDALE DI

R

Tiberina

E

SAN GIOVANNI

NES

VIA AURELIA

Circus

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CAELIAN

IN

TRASTEVERE

Maximus

A

HILL

Aventine

Baths of

MONTE

Caracalla

TESTACCIO

Riv

er Tiber

VIA

TUSCOLAN

A

VIA APPIA

VIA OSTIENSE

Map 6. The city of Rome

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City of Rome

29. The vicinity of Monte Testaccio was one district of the city of Rome that was dangerous with regard to malaria in the past. The hill is about 45

metres above sea level and is composed entirely of broken pots, which had been thrown away from the port facilities of ancient Rome on the River Tiber nearby. It is now overgrown with vegetation.

Information is also given on districts that had been afflicted by malaria before the construction work mentioned above, for example Piazza Barberini, Via Quattro Fontane, San Nicola da Tolentino, Via Urbana, and the vicinity of the Baths of Diocletian.

The drainage of the lake at the entrance of the Villa Borghese eliminated malaria from that particular district. Celli wrote that ‘it was sufficient in those days only to ride in the evening through the Villa Borghese in order to catch the fever’.¹⁶ Other writers also gave detailed accounts of the medical geography of the city of Rome with reference to malaria. One of the earliest such works was the pioneering book on the medical geography of malaria in the Roman Campagna written by Giovanni Baptista Doni, who has already been mentioned several times in passing, de restituenda salubritate Agri Romani, published in Florence in 1667. Doni began by observing that various countries were noted for particular diseases.

He gave as one example the ‘sweating sickness’ in England, a ¹⁶ Celli (1933: 131), referring to the first half of the nineteenth century.

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phenomenon of that period which has puzzled medical historians ever since. The causative pathogen might have been a hantavirus, according to the most recent research. Doni explicitly compared the Ager Romanus as a whole to southern Sardinia, and then concentrated on malaria in the city of Rome. He reckoned that the most heavily built-up areas of the city were healthier, also buildings facing north and east, and the districts further away from the Tiber, while areas close to the Tiber, and buildings facing south and west, and buildings in lowlying locations, particularly in the valleys, were more dangerous.¹⁷

He singled out the areas of the Campus Martius, between the Aventine and the Palatine hills, and the area between the Tiber and the Aventine as particularly dangerous (although the summit of the Aventine hill itself was healthy), as well as the area of the Ostian Gate, although the Leonine region was the worst of all.

Doni had no difficulty recognizing the continuous and semitertian fevers described by Asclepiades and Galen (quoted below) as the cause of the problems in his own time.¹⁸ The view expressed by Doni, Donatus, and later writers such as Lancisi, de Tournon, Colin, and North that a dense human population reduces the frequency of malaria is an instance of a correlation that does not necessarily indicate causation.¹⁹ Of relevance here is the standard view in statistics that the fact that two sets of data are correlated does not prove that one of them is causing the other.

Since most people in the early modern period chose, if possible, to live in relatively healthy areas, most areas of dense habitation ¹⁷ Doni (1667: 8–9): Quaecunque loca crebris aedificiis ambiuntur, atque editiora sunt, et in Septentrio-nem, atque Orientem spectant, et longius a Tiberi absunt, salubriora: vice versa quae seiuncta sunt, et remota a frequentioribus tectis, situque sunt humili, ac maxime in

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