Epidemics and treatments in Milan over the centuries

How the city reacted to seven centuries of epidemics

Del governo della peste, e delle maniere di guardarsene (…), In Brescia, Rizzardi (1721) by Lodovico Antonio Muratori,Ca’ Granda – Ospedale Maggiore Policlinico

The famous "black plague" of 1348 that depopulated Europe was almost not noticed in Milan, thanks to the drastic measures adopted and the health laws that were applied thereafter.

In the first half of the fifteenth century a Health Office was also created, to be activated in emergencies. However, throughout the Middle Ages and the modern age the plagues were numerous and continuous, recurring cyclically.

San Giobbe e san Rocco (1506-1516 c.a) by Pittore lombardoCa’ Granda – Ospedale Maggiore Policlinico

The recurring epidemics were faced by invoking the saints: the Milanese Saint Sebastian martyr and, from the fifteenth century, Saint Roch.
Therapeutic talismans were also used: the archive of the Ospedale Maggiore conserves three.

miscellanea 40Ca’ Granda – Ospedale Maggiore Policlinico

One in the vernacular suggests that "if it was a person who currently has the pestiffy condition, say this prayer over evil: “God destroys you and finally you strep and scatter you from this place and from all the other loci of the living men eradicates you”

Icilio Calzolari, Il Lazzaretto, stampa all’albumina, 1881Ca’ Granda – Ospedale Maggiore Policlinico

The main defense against infectious forms was the infected isolation. Since 1087, the "unhealthy" hospital of San Lazzaro, known as the "Roman arch" for leprosy patients, had been in operation, welcoming those who came from the Via Emilia outside the city walls.

Resti del lazzaretto di Milano (1939 c.a.) by Giannino GrossiCa’ Granda – Ospedale Maggiore Policlinico

The need for separation during the plague, however, did not have an adequate response until the construction of the Lazzaretto in 1488: an immense construction of almost 400 meters on each side, with 280 rooms and a central area that could house temporary structures. 

Alessandro Manzoni gives us a vivid description of it in chapter 28 of the Promessi sposi.

Ave gratia plena, L’Ospedale Maggiore di Milano; prefazione di M. Della Porta, Roma, Ed. Mediterranea (1934) by Giacomo Carlo Bascapè,Ca’ Granda – Ospedale Maggiore Policlinico

During the so-called "San Carlo" plague of 1576, and again in 1630, the alternative to the Lazaretto was absentia: that is, segregation in the house (with the risk of dying of hunger rather than disease).

Incisione per I Promessi sposi, e Storia della Colonna infame, di Alessandro Manzoni, Milano: Guglielmini e Redaelli (1840) by Francesco GoninCa’ Granda – Ospedale Maggiore Policlinico

Ignorance attributed the spread of the infection to phantom "smearers", as described by Manzoni in the History of the infamous column.

Registro dei giustiziati (…) (1472)Ca’ Granda – Ospedale Maggiore Policlinico

The Register of those executed assisted by the brotherhood of San Giovanni decollato, also kept in the hospital archive, contains numerous other names of unhappy people, cruelly killed for a non-existent crime, in addition to Gian Giacomo Mora and Guglielmo Piazza.

Istruzioni per impedire la diffusione e per procurare l’estinzione delle malattie epidemiche e contagiose… (1814)Ca’ Granda – Ospedale Maggiore Policlinico

If the modern age is plagued by syphilis, smallpox, petechial typhus and cholera, Milan is one of the most modern cities in Europe, even in terms of treatment.

Osservazioni sopra alcuni innesti di vajuolo di Giovammaria Bicetti de’ Buttinoni da Trevi in Ghiaradadda, (...) con l’aggiunta di varie lettere d’uomini illustri, e un’ode dell’ab. Parini su lo stesso argomento. In Milano : appresso Giuseppe Galeazzi, 1765Ca’ Granda – Ospedale Maggiore Policlinico

Smallpox

Edward Jenner disclosed his revolutionary discovery in 1798: the use of smallpox in cattle (precisely "vaccine") made it possible to immunize themself against the human form, without running the risks associated with the practice of "smallpoxing", also supported by Giuseppe Parini in he hears The graft of smallpox (1765).

Risultati di osservazioni e sperienze sull’inoculazione del vajuolo vaccino instituite nello Spedal Maggiore di Milano dalla Commissione medico-chirurgica superiormente delegata a questo oggetto, Milano : Veladini (1802)Ca’ Granda – Ospedale Maggiore Policlinico

Immediately the doctors of the Ospedale Maggiore Alessandro Giuseppe Giannini and Luigi Sacco, verify and experiment the Jennerian method, and the Cisalpine Republic instructs a Medical-Surgical Commission to validate the results

doctors Giacomo Locatelli, Giovanni Battista Bertololi; Giovanni Battista Monteggia and Giovanni Battista Palletta.

Memoria sul vaccino, unico mezzo per estirpare radicalmente il vajuolo umano, diretta ai governi che amano la properità delle loro nazioni, Milano, Destefanis (1803) by Luigi SaccoCa’ Granda – Ospedale Maggiore Policlinico

Luigi Sacco

In particular Luigi Sacco (1769-1836) is recognized as the promoter of smallpox vaccination in Lombardy, spreading its knowledge and application on a large scale in every way and arriving in 1809 to have vaccinated one and a half million inhabitants.

Monumento a Luigi Sacco (1858) by Giovanni PandianiCa’ Granda – Ospedale Maggiore Policlinico

A commemorative monument, the work of Giovanni Pandiani (1858), depicts Luigi Sacco in the act of vaccinating a baby, taking the substance directly from the cow's breast.

In the background you can recognize the pious house of the exposed and pregnant women of Santa Caterina alla Ruote and the enclosure of the Guastalla garden, overlooking the hospital.

Magnani, Spiegazione delle preparazioni vaccine (…).Ca’ Granda – Ospedale Maggiore Policlinico

The medical director Pietro Moscati has wax models made to promote vaccination: a cow's breast, two horse's legs and the arms of a girl, and sends specimens throughout the Cisalpine Republic

Penne per vaccinazione Penne per vaccinazione (prima metà del Novecento)Ca’ Granda – Ospedale Maggiore Policlinico

Smallpox was officially declared worldwide eradicated in 1979.

Il padiglione “Annetta e Carolina Bosisio” (1927)Ca’ Granda – Ospedale Maggiore Policlinico

Rabies

The year following Louis Pasteur's discovery of the rabies vaccine, the "Committee for the assistance of bitten by hydrophobic animals" was set up at the Ospedale Maggiore in 1886, which initially financed the trip to Paris for the sick. 


To then create, in 1889, the Antirabic Institute, a vaccine production and inoculation center, under the guidance of dr. Remo Segré.

L’Istituto Sieroterapico Milanese (1919)Ca’ Granda – Ospedale Maggiore Policlinico

Milanese Serotherapy Institut

In 1894, the Milanese Serotherapy Institute was created by the bacteriologist Serafino Belfanti, a center for scientific research and production of vaccines, first of all the anti-diphtheria serum, and then against tetanus, smallpox, up to serum against snake venom.

Veduta dell’ospedale per contagiosiCa’ Granda – Ospedale Maggiore Policlinico

Municipal Lazzaretto

In 1896 the Municipality of Milan inaugurated the "Municipal Lazzaretto" or the infectious hospital in Dergano, named after Agostino Bassi.

Tabella con l'andamento dei ricoveri ospedalieri da "Gli Istituti ospitalieri di Milano" dal 1914 al 1921. (1914/1921) by Enrico RonzaniCa’ Granda – Ospedale Maggiore Policlinico

Spanish Influencia

When the "Spanish" influencia of 1918 appeared, the Ospedale Maggiore was mostly occupied by wounded soldiers of the Great War; a special department had to be created in piazza F.lli Bandiera to accommodate the numerous patients affected by the virus.

Il sanatorio di Garbagnate Milanese (1924)Ca’ Granda – Ospedale Maggiore Policlinico

Pulmonary tuberculosis

Pulmonary tuberculosis, which killed 46,000 in Milan between 1850 and 1900, was one of the scourges of the industrial age.

Degenti a GarbagnateCa’ Granda – Ospedale Maggiore Policlinico

This was remedied with the construction of the Garbagnate Sanatorium, designed by the Municipality of Milan in 1911, and inaugurated in 1923; management was initially entrusted to the Ospedale Maggiore, which managed it until 1949. 

Apprecchio per pneumotorace artificiale (prima metà sec. XX)Ca’ Granda – Ospedale Maggiore Policlinico

The invention of the artificial pneumothorax for the treatment of the disease, in 1888, is due to Professor Carlo Forlanini, who was also head physician at the Polyclinic.

Monumento a Giovanni Battista Monteggia (1815 c.a) by Camillo PacettiCa’ Granda – Ospedale Maggiore Policlinico

Polio

Giovanni Battista Monteggia, famous doctor of the Ospedale Maggiore, author of the eight volumes of the Surgical Institutions, is the first to correctly describe infantile paralysis or poliomyelitis in 1813 as "paralysis and atrophy".
The disease, contagious and viral, triggered real epidemics with thousands of cases in Europe and the United States between the nineteenth and twentieth centuries; with the paradox of spreading in conjunction with the improvement of hygienic conditions.

Augusto Giovanardi (1904-2005)Ca’ Granda – Ospedale Maggiore Policlinico

In 1958 a polio epidemic spread in Italy, with over 8,000 cases; in that year Albert Sabin developed the oral vaccine that bears his name, and which he will find in prof. Augusto Giovanardi (director of the Institute of Hygiene of the University of Milan) the greatest promoter, with countless clinical studies that proved its effectiveness.

Mass vaccination totally eradicated the disease in Europe.

Nuovo reparto di Malattie Infettive (2020)Ca’ Granda – Ospedale Maggiore Policlinico

Milan - Nowadays

The IRCCS Ca'Granda Ospedale Maggiore Policlinico Foundation now has a new department with 14 beds entirely dedicated to the research and treatment of infectious diseases: not only Covid-19, but also AIDS, antibiotic resistance, vaccine testing, severe sepsis , and more generally to do scientific research and teaching on the management of infectious emergencies at a global level.

In Policlinico di Milano the Hepatology Unit boasts the largest number of hepatitis C treated cases, a disease with almost no cure until a few years ago, and more than 2,200 patients recovered definitively in the last 3 years thanks to the new drugs antivirals, available since 2014.

Credits: Story

Paolo M. Galimberti 
All cultural items reproduced belong to the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano
 

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The story featured may in some cases have been created by an independent third party and may not always represent the views of the institutions, listed below, who have supplied the content.
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