Communication and Cholera Morbus: measures and fears in 19th Century Italy in the face of an unknown evil. Medical ignorance and ideological paradigms unchanged over time.

Abstract

Abstract: The arrival of Cholera Morbus in Europe and Italy elicited a prompt institutional reaction. Starting in 1831, preventive measures characteristic of the plagues of the "Ancien Régime" were reactivated. The new disease triggered several instinctive and irrational reactions in the population, which resulted in the most diverse fears: fear of death, of doctors, of food, isolation, and abuse of food and alcohol. Ignorance of the origin of the disease, its etiology and modes of transmission meant that containment measures and treatment were often inefficacious. When patients recovered from the disease, this was due more to their living conditions and underlying state of health than to medical treatment, which was still limited to bloodletting, purgatives, and natural remedies (as emerges from the data from 1835 in the archives of the Genoese hospitals). As revealed by the pamphlets distributed around 1830, the disease was attributed to dietary disorders, personal and domestic hygiene, damp environments, menial occupations, and exposure to cold.The medical theories of the time were still closely bound to the "miasmatic-humoral paradigm", as the discoveries of Filippo Pacini, (1812-1883), John Snow (1813-1858) and Heinrich Hermann Robert Koch (1843-1910) had not yet been made. As for preventive measures at the institutional level, "contagionist" theories prevailed, which meant that sanitary cordons were reintroduced, safety measures (e.g. quarantine on people and goods) were implemented and great attention was placed on cleansing and disinfecting streets and public places.

Background: For centuries, Cholera Morbus was endemic to the territory of Bengal; only with the revolution in transport, starting from 1817, did the disease first spread beyond India [1], replacing the plague as the "scourge of urban populations" [2]. Cholera was localized in Asia until 1817, when a first pandemic spread from India to other regions of the world. Endemic in Asia, (in the delta of the Ganges-India), it remained enclosed to that geographical area until the beginning of the 1800s. It first emerged from the Sundarbans Forest where the bacterium Vibrio cholerae had perhaps been mutating for millennia.It afterwards moved to the Mediterranean and Europe as new commerce routes were opened up between East and West and in the 1830s, Western Europe was faced with this totally new and unknown evil [3], which appeared in Italy in 1835.