Rome at that time may have been an exciting city in which to live, but it was hardly a healthy place, though it was not until 1631 that it suffered the beginnings of the plague epidemic that would eventually kill nearly half its citizens. In an entry written at the end of December 1624, Gigli was full of apologies. ‘I, Giacinto, have not been able to make daily descriptions of life as I would have liked, for I have been sick for a long time, with grave and lingering maladies, as a result of which there are many things I have not seen and others I have not noted. But, with God’s pleasure, I am now well and healthy, and I hope in the Holy Year of 1625 that I will be able to make diligent note of things as they occur unlike those I have missed this year.’
Medicine had barely advanced over the centuries, and it is easy to forget how small a proportion of Europe’s adult population would have been healthy at any one time. Stomach disorders of one kind or another were chronic, both among the rich, whose diet was poorly balanced, and among the poor, who found it hard to find sufficient food for themselves and their children. When they did, it was often rotten. Recurring outbursts of bacterial stomach infections resulted in dysentery, which often killed the old and the very young. Tuberculosis was rife, and for women childbirth was always very dangerous. Both sexes suffered from rotting teeth, while suppurating ulcers, eczema, scabs, running sores and other skin diseases were very common and sometimes lasted for years.
Gigli was constantly preoccupied with matters of health, his own and that of his family. And the malady he wrote about most often was the Roman or marsh fever, which we now know as malaria. ‘It returns every year in the summertime,’ he says, ‘and no one can feel himself to be safe from it.’
Rome then was the most malarious city on earth. Hundreds of people died of the disease every summer, while hundreds more were left so weak they were unable to walk, and became prey instead to the slightest infection. The rise and fall of the Tiber, which often broke its banks and flooded the plain of the Campagna, left pools of stagnant water through the countryside which provided the ideal breeding ground for the Anopheles mosquito that spread the disease. The views of those observers, such as the first-century BC Roman writer Marcus Terrentius Varro, who thought the miasma might be alive, full of what he called animaletti, ‘minute animals [that are] invisible to the eye, breed there [in swamps] and, borne by the air, reach inside of the body by way of the mouth and nose, and cause disease’, were regarded as extremely bizarre. Most Romans in Varro’s time knew only enough to recognise the intermittent fever and shivering that visited them every year.
Giacinto Gigli had a particular reason to know about the fever. His only grandchild, Maria Cecilia Hortenzia Gigli, died of it at the age of fifteen. One day she complained of an aching head and stiff limbs. Rivulets of sweat ran down her forehead, dampening the sheets. Yet just a few hours later her mother was piling on the covers in an effort to keep the child warm. At seven o’clock in the evening, just three days after falling ill, she passed away.
Gigli was deeply affected by his granddaughter’s death, and he must have fretted greatly at her decline, against which he would have had no cure other than the herbs and amulets left over from medieval times. His diary entry that day is unusually terse, and comes suddenly after a description of a great fire that destroyed the Santa Caterina de’Funari monastery. Numb with grief, he writes only that: ‘She was fifteen years, five months and three days, and her beauty, her virtue and her goodness will be eternally remembered.’
The most important hospital in Rome at the time was the Santo Spirito, which had been built between the Tiber and the walls of the Vatican and which Gigli could see from his study windows. The Santo Spirito trained many of Europe’s finest doctors, but for most of the city’s population the cost of visiting a professional doctor was beyond their means. They preferred, in any case, to consult the herbalists and sellers of secret potions whom they had known all their lives. Many medieval cures had involved patients and physicians trying to expel their diseases by transferring them to other objects. Peasants in a number of European countries would bring a sheep into the bedroom of a fever patient, in the hope of displacing the ailment from human to beast. One cure that was still popular in the seventeenth century involved a sweet apple and an incantation to the three kings who followed the star to Bethlehem. ‘Cut the apple into three parts,’ advised the prescription. ‘In the first part, write the words Ave Gaspari. In the second write Ave Balthasar and in the third write Ave Melchior. Then eat each segment early on three consecutive mornings, accompanied by three “Our Fathers” and three “Hail Marys” as an offering to the Holy Trinity.’
Another prescription, from a well-known sixteenth-century Roman healer named Tralliano, was supposed to be especially good against the most common fevers, called tertian and quartan because they resurged with worrying regularity, either every three days or every four. Tertian and quartan fevers were almost certainly malaria, and Tralliano’s cure was the same for both: ‘Take a ripe peach and remove the pip. Put the pip into an orange and tie it around the neck of the patient. He will be healed expertum et verum.’
Another was more complicated. ‘Write the following words on a piece of paper,’ it advised.
Abracolam …
Abracolai …
Abracola …
Abracol …
Abraco …
Abraco …
Abraco …
Abra …
Abr …
Ab …
A …
At the end, add the phrase, ‘Consumatum est.’ Then have the paper tied to the neck of the patient by a young virgin using a long piece of string and reciting at the same time three ‘Our Fathers’ and three ‘Hail Marys’ in honour of the Holy Trinity.
Gigli and his fellow Romans thought they knew only too well whence spread the fever that killed his granddaughter and was as permanent a feature of the city as the smell of incense or the gentle scent of summer apricots. From the swamps and stagnating ponds of the disoccupato, it was believed, rose dark mists laden with fever. In Rome, went a saying, if you did not catch the fever from the aria, you caught it from the mal’aria. Bad air.
The word malaria, or mal’aria as it was always written until recently, was unknown in English until the writer Horace Walpole introduced it. In July 1740, while on a visit to the Holy City, he wrote to his friend H.S. Conway, ‘There is a horrid thing called the mal’aria that comes to Rome every summer and kills one.’ For more than a century afterwards, though, mal’aria was not taken to mean a disease so much as a noxious gas which rose from swamps or rotting carcases and vegetation, and which caused a group of ailments variously known as intermittent fever, bilious fever, congestive fever, swamp fever or ague.
Whichever of these was really malaria, the Romans had known for centuries about the miasma. From the disoccupato it invaded the city and forced the citizens to take to the hills every year during the worst of the summer heat, leaving the city abandoned; abandoned, that is, by those who could afford to leave. The rest stayed behind, entrusting their health to the Almighty and to the concoctions of the healers whose numbers always grew larger in summer.
Malaria had probably existed in Rome since late antiquity. Chronicles of the imperial Roman army talk of soldiers suffering from constantly recurring fever, chills, sweating and weakness, and many historians believe that one of the main causes of the collapse of the Roman Empire may well have been the prevalence of malaria around the shores of the Mediterranean Sea. In 2001, British and American scientists found malarial DNA in the bones of an infant skeleton that had been unearthed in a fifth-century villa at Lugano, near Rome.
No one is quite certain why, but malaria seems to have receded during the early Middle Ages, only to reappear with even