Roman Fever

David Soren​ of the University of Arizona was excavating the remains of a villa just outside Lugnano in Umbria in 1992 when he uncovered a fifth-century mass grave: 47 small skeletons had been interred in layers, some pressed into large amphorae. A number of them were newborn babies. The deepest layer held only a corpse or two, but the higher levels were increasingly populated. Christianity was nominally the religion of the declining Roman Empire, but rites of witchcraft had been used on this site to guard against the resurrection of the dead. Ravens’ claws were scattered about; young dogs had been dismembered. A stone had been pushed into the open mouth of one child to impede its bite; the bones of a toddler’s legs were weighted with rocks to prevent the body emerging from the soil. The bones of the children were found to be pitted and spongy, almost certainly as a result of the malaria endemic to the Tiber valley. Its cause and the means of infection would not be identified for another 1300 years.

In Rome, at around the time of the burials, Sidonius Apollinaris recorded that he had ‘been suffocating by breathing the air which is imbibed in poisoned gasps and which alternates between sweats and chills’. Attila the Hun met with the pope and then withdrew rapidly from the city. It’s possible he was told that a fatal sickness had set in. Dread of the disease could cause a parent to desecrate the body of a child or an army to retreat: it was an atavistic fear then, and remains so now, despite its locus moving from pestilential waters, or the ‘bad air’ which gives the disease its name, to the bite of an infected anopheles mosquito. In 2009, at a conference in California, Bill Gates released a swarm of mosquitoes into the audience. ‘There is no reason,’ he said, ‘only poorer people should be infected.’ The delegates risked nothing more than a bite, but Gates – a prodigious funder of anti-malarial charities – was exploiting our instinctive fear of the mosquito: the approaching whine, the hungry proboscis, the possibility of disease.

Accounts of an illness like the one endured by Apollinaris have been found throughout the four thousand years of recorded history: the cycle of malarial fever is as distinctive as a signature. Its various names in English evoke its symptoms and its connection to place – as well as the ague, it has been known as swamp fever, marsh fever, intermittent fever and camp fever. It was once endemic in England – Pepys frequently laments that an acquaintance is sick with the ague – until an increase in livestock offered mosquitoes a less skittish source of sustenance than humans, and the fens were drained. Malaria is by no means the most contagious of diseases – it cannot be acquired from a sneeze like the plague, and does not, like syphilis, visit the sins of fathers on their children. But it holds a peculiar fascination because it is both an ancient and a modern scourge. Mosquitoes preserved in amber from the Palaeocene have been found to host the parasite: it is older than man, but remains resistant to eradication; vaccines are not all that effective, and half the world’s population remains at risk of infection.

As Jessica Howell’s scrupulous, fascinating and occasionally maddening book attests, the history of malaria is entwined with the history of empire. Population movement, war and the infrastructure of industry all contributed to the flourishing of the disease. Wherever pools of water stagnate – in the ruts left by carriage wheels or in the newly dug foundations of a building – the mosquito will thrive. Malarial disease, whether obliquely or explicitly described, is a common feature of 19th-century fiction, offering – together with tuberculosis, smallpox and scarlet fever – a ripe opportunity for the depiction of physical suffering, and a device for moving a plot briskly on. Howell examines the presence of malaria in the work of Dickens and Henry James, concentrating on Martin Chuzzlewit (1844) and Daisy Miller (1878). Both books were written before Ronald Ross proved, in 1897, that the malaria parasite was transmitted by the female mosquito’s bite rather than by miasma; each depicts the disease, known at the time as ‘Roman fever’, as intrinsic to foreign – and therefore often dubious, if not actually immoral – landscapes.

For Dickens, Chuzzlewit’s disastrous visit to America shows the dismal effects of industrialism in general, and New World industrialism in particular. It was not a novel calculated to endear itself to an American readership, which had already earned Dickens’s wrath by showing an appetite for pirated copies of his novels. Voyaging upriver to the settlement of Eden – a name less ironic than sarcastic – Chuzzlewit and his companions move ‘through weary days and melancholy nights: beneath the burning sun, and in the mist and vapour of the evening: on, until return appeared impossible, and restoration to their home a miserable dream’. His fellow passengers are ‘as flat, as dull, and stagnant, as the vegetation that oppressed their eyes’. Arriving at Eden, he finds ‘a flat morass, bestrewn with fallen timber; a marsh on which the good growth of the earth seemed to have been wrecked and cast away, that from its decomposing ashes vile and ugly things might rise’. The air, as one settler observes with some satisfaction, is ‘deadly poison’, and soon, as Howell says, ‘malaria arrives as punishment for Martin’s wilful ambition and short-sightedness.’ She suggests that ‘Dickens depicted America as ruinous due, perhaps, to his sense that it posed both personal and national economic threats.’ This suggestion is characteristic of a book which infers the motives – generally ignoble ones – of the authors under discussion. The death of the author has occurred, in this case both literally and theoretically, and Howell can divine whatever motive and meaning she pleases.

Was Dickens spiteful about the American national character because of its publishers’ practices? Was that ‘flat morass’, as Howell says, ‘metonymic for the larger American environment’, or simply an opportunity for Dickens to display his place-writing, inspired by his own river expeditions in America in 1842 (which he had not enjoyed, and which had left him ill and exhausted)? To read this book as a novelist is to mutter that sometimes one is thinking merely of constructing an entertaining chapter or two, but the study of literature could hardly survive on such thin gruel.

The tendency to see every sentence as a commentary on empire reaches its height when Howell turns to Ross’s work. Here the book offers particular pleasures: there are reproductions of Ross’s notebooks, in which he sketches the malarial parasite in the stomach of the mosquito, and records one patient’s fever cycles. Howell also quotes from his memoirs, in which he describes his efforts on a particularly ‘cloudy, dull, hot day’ and mentions that the Indian humidity required him to change the condenser on his microscope. Here, Howell says, Ross is portraying the foreign environment as ‘sabotaging his efforts by negatively affecting the physical mechanisms of experimentation’. There was indeed an element of ‘nationalist enterprise’ in the efforts of Ross and others to solve the problem of malaria, not least since the disease was a barrier to successful colonisation, but warm damp air will condense on a cool glass lens whether or not you are an agent of empire.

James responded to the malarial air of Italy, according to Howell, with ‘a kind of sensory and aesthetic dilation’. Not for him Dickensian descriptions of miserable dwellings sinking into the morass, or portrayals of sickness as just punishment for poor decisions: to him malaria is part of a semi-erotic experience in which the combination of classical ruins, peeling Renaissance frescoes and pestilential air induce a feverish pleasure all the more delightful because it may be fatal. In Italian Hours, his 1909 collection of travel writing, James recalls a villa fallen into ruin, ‘walls tattered and befouled breast-high, dampness and decay striking in on your heart … these heavenly frescoes, mouldering there in their airy artistry! It’s poignant; it provokes tears; it tells so of the waste of effort.’ When he detects the signs of malaria it is with a swoon: he sees ‘a handsome, pale, fever-tainted fellow’ whose pallor does nothing to mitigate his beauty; later, a poor boy ‘shaking with an ague’ is a ‘melancholy presence’ seeming to ‘point to the moral of forsaken nave and choir’. These fevers and agues derived from roughly the same source as the sickness that killed the children interred outside Lugnano.

The seductive quality of those ruined landscapes, with the shadow of Roman fever lying beneath every cracked pediment and toppled Doric column, was felt to be of particular danger to women, susceptible to chest colds and male lust alike. Ruskin wrote of Italy that ‘there is set forth for the delight of English women … a mass of disguised sensualism and feverish vanity – impotent, pestilent, prurient, scented with venomous elixir.’ Howell points out that in Daisy Miller James ‘subverts not only the idea that an artist should reject the influence of unhealthy environments, but specifically that a woman should’. When Daisy meets an Italian suitor at the Colosseum (an edifice which caused Dickens, an irascible tourist, to exclaim: ‘GOD be thanked: a ruin!’), she shows a reckless disregard for her health and her reputation; she is ‘a sentimental tourist of the urban pestiferous picturesque’.

Later, in a fascinating – if occasionally fanciful – section on H. Rider Haggard’s King Solomon’s Mines, Howell claims that novel sets a supposed ‘white vigour’ against the ‘yellowed, parchment-like corpses’ of Africans. The yellowing of the skin – characteristic of malarial cachexia, a severe wasting stage of the disease – is repeatedly invoked by Haggard, and Howell suggests that his representation of bodies conquered by disease ‘facilitates their rhetorical conquest by the narrative of British imperial progress’. She makes much of the word ‘parchment’ as used to describe the malarial complexion, reminding us that it is strongly associated with maps: does Haggard’s simile risk ‘granting textural and cultural longevity’ to England’s ‘political competitors’? I’m inclined to think not; but it’s an interesting digression. Elsewhere, the association of the mosquito’s bite with the Gothic – not least in Bram Stoker’s Dracula – is examined. As Howell points out, the identification of the mosquito as the vector of infection gave rise to a fresh set of cultural anxieties: ‘mosquito bites became linked imaginatively with other forms of epidermal breaching, including transfusion.’ The notion of foreign blood entering English veins and inducing states of foreign delirium was disquieting – as if a parasitic disease might compromise national character as much as biological function.

Depictions of malaria became linked with gender after it was realised that the female mosquito was more deadly than the male. Venturing out after dusk, her proboscis lubricious with saliva to aid penetration, she requires blood not for sustenance but for the production of eggs. Inevitably, the mosquito became connected with ideas of dangerous female agency. ‘The female mosquito is most emphatically a shrieking suffragette,’ a contributor to the San Francisco Chronicle wrote in 1915. ‘She alone conducts the business affairs of the domestic ménage, rears the family and does her own foraging. Her male consort is a poor, hen-pecked animal.’ In 1942 a public information poster intended for servicemen warned against the malaria mosquito: it shows a sultry specimen draped on a bed, with wings resembling a pair of large transparent blue buttocks, and a good deal of eyeliner.

Howell is at her best in exploring the way the experience of malarial fever inflected the work of Olive Schreiner, whose novel The Story of an African Farm was published in 1883. Schreiner was a formidable woman, but as her prodigious correspondence makes clear, she suffered from many ailments, including chronic malaria and asthma. Howell notes that ‘limited options for effective treatment for [asthma] during her lifetime often led key male figures, including her doctors and husband, to treat her illness as psychosomatic.’ ‘When I die you can have a post-mortem and open my brain,’ Schreiner wrote to her friend Havelock Ellis, ‘and then you’ll see how I’ve suffered.’ Her depictions of malaria – in particular the half-conscious, half-dreaming state induced by a high fever – are unmoored from ‘ancient associations of divine retribution’. Rather there is an almost mystic depiction of illness in which mind and body are intimately linked: ‘I do not want to think I have been ill. It is thinking and thinking of things that make them real.’ When, in The Story of an African Farm, Lyndall takes her final breath, ‘the dying eyes on the pillow looked into the dying eyes in the glass … only, the wonderful yearning light was in the eyes still. The body was dead now, but the soul, clear and unclouded, looked forth.’

Howell’s book does not offer any particular aesthetic pleasures. Elegance and clarity of style is neither attempted nor achieved. This is an academic monograph, and its intended audience is the authors of previous monographs, and the authors of future monographs being prepared in response. In a sense it isn’t about malaria or 19th-century fiction: it is about itself, and about the process of scrutiny and analysis which comprises academic study. But Howell makes a case for the urgency of her work, and for the relevance of colonial studies. ‘Through the close study of 19th-century fictions of malaria,’ she writes, ‘one may become more aware of the colonial legacies inherent in contemporary narratives of illness remission’ – an important task, since ‘for a large portion of the world’s population, malaria continues to be … a devastating part of life.’