At the end of the eighteenth century, Edward Gibbon began his History of the Decline and Fall of the Roman Empire by observing that the empire’s inhabitants in the years 98-180 CE were reaping the benefits of the peace and prosperity initiated by the emperor Augustus, ‘‘a happy period of more than fourscore years.’’ Gibbon’s assertion that these inhabitants ‘‘enjoyed and abused the advantages of wealth and luxury’’ is reminiscent of Celsus’ view that townspeople were more sickly than country-folk because of their sedentary lifestyle and improper diet, both of which sprang from the omnipresent luxuries then available (Med. 1.2). The average citizen of Rome and those inhabiting urban centers throughout the empire certainly lived more varied and more interesting lives than those in centuries past. Traditions of euergetism flourished, and the emperors, as well as local elites, undertook many individuals projects that enhanced the quality of daily life (Gleason, this volume). In addition to entertainments, spectacles and doles of food stuffs, public libraries and parks, and magnificent buildings, there were aqueducts bringing water to fountains, bathing establishments, and public latrines; drainage projects attempted to clean sewers and clear unhealthy swamps; expanded harbor facilities ensured supplies of basic foods; cemeteries, crematoria, and professions associated with disposing of the dead were deliberately confined to the areas outside the walls (Bodel 2000; Patterson 2000). Public doctors, along with teachers and professors, were at times hired by individual communities, especially in the cities of the eastern provinces; emperors awarded these learned professions immunities from some tax burdens, yet they also strictly limited the numbers so benefited (Parsons 1976: 438-46). Still, it remains unclear the extent to which those labeled public physicians were concerned about the entire community, since the concept of public health did not exist in the ancient world. Policies designed to ameliorate an urban population’s health would come into being only with the Enlightenment of the eighteenth century (Nutton 2000: 71). The environmental factors classified as salubrious in the Hippocratic treatise ‘‘Airs, Waters, Places,’’ were adhered to and repeated by Roman authors: it was best to build in a locality that received the benefits of air and waters that were clear, bright, and light. Such advice was useful largely for those intending to locate a city or a villa on virgin territory, while those who lived in an unhealthy location with brackish water and stifling winds that brought bad air had either to fortify their bodies as best they could, or move elsewhere. If many sickened at once, the winds were faulted for bringing insalubrious conditions. The etiologies proffered for the diseases that killed in medical and lay writers of the Roman period more often centered on the capacity of the individual’s body to withstand assaults from malfunctions within the body than on the pernicious effects of one’s surroundings. Celsus frequently advised the sick to visit the baths without a thought for how this might compromise the health of other bathers (Fagan 1999: 179-88). There can be no question but that infective agents, such as worms, amoebas, bacteria, and viruses, lurked everywhere in Rome and other ancient cities, but they went unseen and unsuspected. It was the filth and squalor omnipresent in the crowded neighborhoods where dwelt the urban poor that those who would preserve their own health must avoid (Scheidel 2003). The wealthy did so in all seasons, building their urban houses on the hills of Rome and deserting the city altogether for country villas when the air ofsummer turned oppressive. Slaves and the poor had no choice but to remain where circumstances placed them; whether those who found themselves in slavery or poverty in the countryside found life less short and less nasty than that of their urban counterparts is uncertain.
Demographers who study the ancient Mediterranean work with admittedly jejune evidence that is sometimes a bit more full for the populations of the Roman Empire, especially that of Roman Egypt. Average life expectancy at birth was most likely between 22 and 25 years, and the level of infant mortality was high, with perhaps nearly half the babies born dying before their fifth birthday (Bagnall and Frier 1994: 103-10; Bagnall, Frier and Rutherford 1997: 100). Children who survived to their tenth birthday had on average a life expectancy of some 36 to 38 additional years, taking the surviving female past menopause and the male to nearly age 50. Life span among Romans was apparently similar to our own, yet only a little over one percent of the Roman population reached their eightieth birthday, and people were dying at all ages (Bagnall and Frier 1994: 81-103; Frier 2000b). Good genes were perhaps less essential to longevity than good nourishment in infancy and early childhood, and avoidance not merely of injuries that penetrated the skin and brought pernicious infections, but also of the potentially lethal diseases that antibiotics and other synthe-cized medications now cure.
World History
