Fiammetta Rocco - The Miraculous Fever-Tree - Malaria, Medicine and the Cure that Changed the World

In turn observant, witty and fastidious to the point of pernicketiness, Gigli became Rome’s most wonderful portraitist. At the start of the seventeenth century, the city had a population of about 115,000. It was a tenth of the size of its imperial predecessor, smaller by far than Paris or London—smaller even than Naples – but it was growing after the ravages of the previous century, when it had been sacked and later flooded, before being visited by the plague and then cast into ruin during the papal schism. With the return of the papacy, diplomats, bankers, doctors, artisans, traders, horsemen and financiers jostled in the capital for any part of the papal chancery’s swelling business.

Most of these people lived and worked, as Gigli himself did, in the occupato , the dense gathering of taverns and tenement houses separated by narrow cobbled streets that nestled in the crook of the arm of the Tiber where it curved in an ‘S’ shape, first west and then south-east. Inevitably they were almost all connected, one way or another, with the Church establishment. The three most important routes into the city converged on the Ponte Sant’ Angelo, just south of the Vatican, bringing travellers who were always hungry for news and for business directly into the heart of the city. Over it rose the bell towers of nearly 350 churches. The tallest among them were the great basilicas that kept watch over the tombs of the apostles. Then there were the churches that guarded the sacred reliquaries of the saints, and occasionally, some believed, even fragments of the True Cross. Lower still were the chapels of the patrician families and the oratories of the guilds. From every sacred spire and belfry the city trumpeted its patronage of the holy. In brick and stone, every street, every façade, every arch and roof and alleyway proclaimed its thousand years as a Christian symbol.

All that lay within the occupato.

Beyond the occupato , though, lay the disoccupato. And that was another story altogether.

To the east of the city, starting at the Capitol, to the south and to the north ranged a barely inhabited wasteland ‘set with ruins, where green snakes, black toads and winged dragons hid, whose breath poisoned the air as did the stench of rotting bodies’, as an eyewitness to the epidemic that killed half of the newly crowned Holy Roman Emperor Frederick Barbarossa’s army had described it in July 1155.

Encircling the town proper and extending out to the Aurelian walls, the disoccupato had barely changed in five hundred years. The loose patchwork of fields and vineyards was set with small houses, sheds and straw huts, tiny churches, gardens, groves and ancient ruins such as the Baths of Constantine and the Temple of Serapis. Much of it was only ever used for a few weeks each year. Dry in midwinter or at the height of a rainless summer, the disoccupato needed just the first downpour of spring to transform it into a swampy marsh, its muddy roads and ditches becoming pools of stagnant water that turned first green and then brown in the summer heat.

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.’