Death and Disease in Ancient Rome

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Death and Disease in Ancient Rome

Postby Ty N. » 19 Feb 2015 05:46

Gigante, Linda. “Death and Disease in Ancient Rome.” Innominate Society. n.p. n.d. Web. 5 October 2013.

When we think of ancient Rome, we imagine an imperial capital with impressive marble structures and luxurious dwellings. Indeed, at the height of the empire (around 150 CE) Rome was the largest city in the Mediterranean, with a population estimated at one million. Its metropolitan center was filled with awe-inspiring buildings, which proclaimed the power and glory of the Empire; the Coliseum, the Roman Forum, the public baths, and the monumental markets built by Trajan. Rome’s wealthiest residents lived in richly appointed homes located in the finest neighborhoods that commanded impressive views of the Tiber River. What we tend not to consider is the fact that this privileged lifestyle was enjoyed by only about 5% of Rome’s population, with the remaining 95% living in poverty.

Roman society was rigidly stratified, with slaves and freed slaves at the bottom of the social hierarchy. It is impossible to determine the number of slaves and urban poor living in Rome at any given time, but it must have been enormous. For these residents, life was anything but luxurious. Their neighborhoods were cramped, squalid and dangerous. Instead of single-family dwellings (domus), the urban poor lived in high-rise (3-5 story) apartment buildings (insulae) which were at best equipped with communal latrines and water fountains. It is estimated that in the early Empire apartment buildings in Rome outnumbered single-family dwellings by a ratio of 26:1. Because of overcrowding, poor sanitation, and generally poor nutrition, diseases were rampant among Rome’s urban masses whose lifespan was consequently very short.

My goal is to reconstruct for you a picture of the quality of life of working-class Romans at the height of the Empire (between 100 and 200 CE). I will briefly discuss diet, general health and life expectancy, as well as the various diseases to which the general population apparently succumbed. I will also consider the burial rituals practiced by the Romans and the funerary monuments which they provided for their loved ones. By conclusion, I will discuss the Roman funerary monuments in the Speed Museum and explain the research project, which is currently underway to publish them.


The diet of an average Roman consisted of cereals, olives, wine, as well as fruits and legumes such as chickpeas and lentils. Fish was a luxury and rarely eaten, and the primary source of meat came from pigs. Cereals in the forms of bread and porridge were staples of a Roman’s diet, as the monthly state distribution of free grain to the urban poor attests. The poor, mothers and young children were probably undernourished and because the babies of well-to-do mothers were normally given to wet-nurses and hence denied colostrums, they were particularly vulnerable. Food was transported into the city on wagons from suburban farms and market gardens, and on barges from Rome’s port city of Ostia; it was then distributed to markets throughout the city. For example, the Cattle Market (Forum Boarium) was located at the foot of the Capitoline Hill and near the Tiber River. Since the cleanliness of these urban markets was likely marginal at best; food contamination was likely a major problem, exacerbated by the Cattle Market's proximity to the Tiber, which flooded frequently.


While the public sewers in Rome were maintained by the state, private drains were the responsibility of property owners. In fact, very few dwellings in the imperial capital were directly connected to either street drains or the public water supply. Kitchens were normally located near the households’ latrines, which were little more than cesspits which had to be cleaned out by hand. An apartment building may have had a latrine and fountain on the ground floor for its many residents. It was customary for those living in apartments on the upper floors to empty their chamber pots out their windows. Since there was no official street cleaning service in Rome, the congested neighborhoods were malodorous and plagued with flies and dogs.

Aqueducts channeled thousands of gallons of fresh water into Rome each day, supplying hundreds of public water basins and baths throughout the city. For a nominal fee the average Romans could refresh himself or herself at a large imperial bath building (thermae) like the Baths of Caracalla or a small privately owned neighborhood establishment (balnea). The Romans associated the baths with hygiene and health, for statues of Asclepius (the god of healing) and his daughter Hygeia (Good Health) were a popular form of decoration in the baths. Spending time at the baths was an integral part of a Roman’s daily ritual, with women visiting the baths in the morning and men in the afternoon. What is not commonly known is that the sick and the healthy often bathed together, for doctors regularly recommended that their patients visit the baths for their therapeutic value. The ill apparently preferred to visit the baths at midday or at night when the general public did not frequent them. The Romans did not have disinfectant and, while the evidence is scant, it is likely the bathing pools (which did not have circulating water) were only periodically emptied and cleaned. The picture that emerges is that Roman baths were not necessarily pristine and hygienic places.

It was customary for a latrine to be incorporated into a public bath building or to be adjacent to one. On average, public latrines (forica) could accommodate between 10 and 20 people at a time, affording no privacy to its patrons. Water running through a channel beneath the seats removed the waste, and toilet sponges were available for the patrons’ use; these reusable sponges were a breeding ground for bacteria.


While the people of Rome are known to have suffered from plagues, the real killers were infectious diseases such as malaria, tuberculosis, typhoid fever, and certain digestive ailments such as gastroenteritis. Studies suggest that the period from July to October was marked by high mortality, with about 30,000 residents dying each year. Roman authors refer to these months as ‘sickly’ and urged their fellow Romans to flee the city for the healthy climate of the country. Comparatively speaking, there was low mortality from November to February, except for the elderly who were particularly vulnerable to diseases during the winter months. The most deadly diseases to which Rome’s population routinely succumbed were affected by temperature; in particular, the most lethal form of malaria, which had a long incubation period and high temperature requirement, and did not reach its peak frequency until autumn. The high death rate from July to October could also have been due to other diseases (e.g. tuberculosis, typhoid) which were rendered lethal from a general weakness of the body due to previous malarial attacks.

Death and Burial:

The evidence suggests that there was no distinction in mortality rates between men and women, but it is likely that in epidemics women under the age of 40 experienced higher mortality than men. This would have been due to women’s harder work regimes and poorer diets compared to their male counterparts, as well as the dangers associated with childbirth. On average, the life expectancy at birth of women was between 20 and 30 years, and that of men a bit higher. Of course, slaves likely had a shorter life expectancy. While there are no precise figures regarding infant mortality, it appears that children in the first 10 years of life ran a very high risk of death. It is estimated that more than 50% of all children in this age group suffered from malarial infection.

Virtually all burials took place outside Rome’s city limits, a custom that was likely derived from concerns about the health of the urban environment. Along the major roads leading into and out of the city (like the via Appia) there were cemeteries with the tombs of Rome’s wealthiest families most prominent. In contrast, the bodies of the poorest Romans were anonymously buried in large open public pits (puticuli), like those outside the Esquiline Gate. While the Romans practiced cremation and burial simultaneously, cremation was the preferred method and crematories were safely situated on the periphery of the city, adjacent to the cemeteries.

The ceremony of the funeral and the size of the tomb reflected the family’s social stature and financial resources. Hiring a large number of female mourners (praeficae) to attend the lying in state in the home (collocatio) and to walk in the procession to the tomb (exsequiae) was a clear sign of a family’s prominence. At the other end of the social spectrum were slaves and urban poor where often dumped on the outskirts of town and transported to the communal burial pits by public undertakers (libitinarii). According to the Romans’ sensibility, anonymity in death was the worst fate, for it was remembrance of the deceased which secured immortality.

For the vast majority of Rome’s population, there was cremation burial in communal tombs (columbarium). A columbarium was normally a subterranean structure whose walls were carved with rows of niches for ash urns (cinerariaa). Beneath each niche a stone epitaph identifying the deceased was nailed to the wall. Ancient sources indicate the most expensive burial niches were those at or near ground level and the cheapest were least accessible and least visible to visitors.

The Ballard-Thurston Collection:

One of the most important collections of non-elite funerary monuments taken from columbaria in Rome was donated to the Speed Museum in 1929 by Rogers Clark Ballard-Thurston of Louisville. In December 1911 he along with his brother, sister-in-law and friend, traveled to Italy to purchase antiquities. While in Rome, they made the acquaintance of an Italian agent who took them to the newly completed Carmelite Church and monastery of Santa Teresa in the northern region of the city, near the ancient via Salaria. Ballard-Thurston purchased hundreds of funerary artifacts (ash urns, offering vessels, lamps and epitaphs) removed from columbaria, which were discovered at the site in the late 1890’s, at the time of the church’s construction. Twenty-eight crates of Roman antiquities were shipped to New York in February 1912 and transported by rail to Louisville. Following Ballard-Thurston’s donation to the Speed in 1929, a few objects were displayed, with small exhibitions mounted in 1932 and 1940. While some pieces were exhibited in the Speed’s antiquities gallery over the years, most remained in their original shipping crates for more than five decades.

In 1985, when the Speed was being remodeled and an addition was being built, I was notified that in a corner of the main building’s basement there were more than 20 wooden crates containing antiquities. The crates were moved to the attic of the museum and, with the assistance of U of L students, they were emptied of their contents. We found more than 60 terracotta ash urns (ollae) with assorted lids; 70 intact and fragmentary terracotta lamps; a variety of terracotta offering vessels, including about 100 unguent bottles; 12 marble ash urns and 2 children’s sarcophagi; and more than 150 epitaphs, many of them in pieces. Intrigued by the prospect of ‘rediscovering’ this collection, I set out to learn as much as possible about its provenance. Documents in the Registrar’s office at the museum and photographs taken by Ballard-Thurston in 1911 and 1912 document important details about the purchase and the site in Rome from which the artifacts came. My research in Rome and at various museums in the US revealed that the monuments in the Speed constitute the largest American collection of Roman funerary artifacts with a documented provenance.

Not surprisingly, the epitaphs in the Ballard-Thurston Collection indicate that most of the men and women buried in the via Salaria tombs were of slave or freed status; there are also several epitaphs identifying children and young adults. The inscriptions typically give the name, age, social status, and occasionally the occupation of the deceased, as well as the name of the loved ones who paid for the memorial. Among the more interesting epitaphs are those of L. Livineius Eutactus, a painter, and Blastus, who was probably the slave overseer of an estate (vilicus). There are also epitaphs identifying a nurse (mamma) and soldiers in the Praetorian Guard.

Linda Gigante
Associate Professor of History
University of Louisville
Ty N.
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Re: Death and Disease in Ancient Rome

Postby Monzambano » 23 Feb 2015 09:04

Interesting article.
"Innominate Society"? Cute name.
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