Giuseppe Brotzu: war on malaria in Sardinia

(To Enzo Cantarano)

Often the most fought wars are not those that take place on a battlefield, but those, unknown to most, aimed at triumphing an idea or an intuition or a search or a discovery that can bring advantages and solutions to vital problems. not just of a people or a state, but of the whole world.

We have seen Vincenzo Tiberio and Aldo Castellani, Doctors and Military, struggling with similar "fights", but they were not, of course, the only ones to fight on the field of health ...

Giuseppe Brotzu (Cagliari, 1895-1976), he graduated in medicine, maintaining family traditions, at the Royal University of Cagliari in 1919. He was exempted from military service precisely because, equipped only with his professional competence, he immediately fought the battle against a disease that was then devastating: malaria. As a graduate, in fact, he was given the direction of the antimalarial outpatients of Cagliari. After the Hygiene and Didactics studies, first in Siena and then in Bologna, in the 1933, he returned to Cagliari and took over the management of the City Hygiene Institute. He was dean of the Faculty of Medicine (1935-36) and then rector (1936-1943). After leaving teaching in the 1965 for age limits, he continued to attend the Institute of Hygiene up to over eighty years. In 1945, after years of study and research, he came to the discovery of cephalosporins.

Alongside his academic career, he joined that policy: regional councilor for hygiene and health (1949 - 1955), president of the Region (1955 -1958) and mayor of Cagliari (1960-1969).

Constantly committed to social issues, he played a decisive role in the Rockefeller Foundation's campaign for the eradication of malaria from Sardinia. "The commitment in the fight against the most ancient and insidious disease in the history of Sardinia - malaria - spans the entire span of the scientific, academic and political-institutional life of Giuseppe Brotzu."The 8 of 1976 died in Cagliari. The most important health facility in Cagliari and Sardinia is dedicated to him.

Brotzu, from 1920, began his research in the microbiological field with a careful observation of the waters of the port of Cagliari, heavily polluted by urban sewers, in which however many young people did the bath every day without the occurrence of single episodes or epidemics at least of infections like typhus or paratyphus.

It was hypothesized that, since there were very poor health conditions but very few cases of infections, the Sardinians, and in particular the inhabitants of Cagliari, enjoyed an immunological strangeness. If this for many scholars represented an inexplicable fact, but in fact now well established, for Brotzu it was a clear proof of the presence, in those waters, of an immunizing agent. In fact, it showed that in the city there was an endemic tinge, but in a mild form, known as "eberthian infection", without the emergence of epidemics as happened in similar situations in Italy. Brotzu and collaborator Spanedda, "scholars of research even in wartime", began to collect samples of water from the eastern area of ​​the commercial Gulf of Cagliari, called"on Siccu ", looking for "bacterial antagonisms ". Initially Brotzu thought that the environmental conditions were so unfavorable for the bacteria to inhibit their pathogenic characteristics.

The microorganisms contained in the samples taken, were "sown on common soil and made to develop at room temperature... At full development the colonies of many germs had been isolated and each of them had been tested for antagonistic power " towards different bacteria responsible for infections. "Following this very simple technique it was possible to study hundreds of germs and choose among them the micete that since the first isolations showed itself endowed with particular and strong inhibitory activities ". In particular, the 20 July 1945 Brotzu and his collaborator Spanedda could admire "the colony (of a fungus of the genus Cephalosporinium) ocher color with pink hue that inhibited several microorganisms including salmonella typhi."In the same year, the" Brotzu micetina "was isolated that the professor and his collaborator personally tested to test its effectiveness, or toxicity.

At the beginning of 1947 Brotzu treated severely ill patients with typhus who recovered. "The general condition of a patient is generally affected by a considerable improvement (...) already after the first two or three inoculations the material taken was bacteriologically sterile".

Brotzu forwarded requests to the various Ministries and Bodies concerned to have funds and equipment, but, as often happens in countries where "the time dedicated to work is taken away from his career", he was completely ignored. At the request of Sir Howard Florey of the University of Oxford, the researcher who had produced the Penicillin re-discovered by Alexander Fleming after the intuitions of our Vincenzo Tiberio (v.articolo), Brotzu sent his own culture of the antibiotic microorganism he identified. Between the 1951 and 1961 different substances with antibiotic activity were isolated and purified; among these the cephalosporin C, which became the progenitor of a new generation of antibiotics. The patent of the active ingredient, unbeknownst to Brotzu, was sold to two very important pharmaceutical industries that obtained enormous profits with it. The scientific paternity of the antibiotic was recognized to the scientist of Cagliari by the international scientific community only in the seventies!

No less was his civil commitment in the difficult post-war years and reconstruction, when he was entrusted with the duties of regional health superintendent and president of the gathered hospitals of Cagliari. Brotzu, even before the large-scale use of DDT had spread, tried to counteract the two-thousand-year scourge of malaria, "cintimate of the silence of the tomb that has oppressed the island for so many centuries " and "gagging that hinders evolution ". "Among all the problems, one has had a fundamental importance in the history of Sardinia: malaria. Those who are not Sardinian and not well aware of the history of our people, will not be able to understand the state of mind and our sensitivity to the problem of malaria which has oppressed, debilitated, bent the Sardinian people for over 2000 years and impressed on them stigmata that perhaps, only in a few generations, can be erased ... Keeping the danger of malaria away from our island is therefore the first task to be faced ... It is necessary to remember that without health there is no wealth and well-being in a people".

Brotzu became a member of the High Commissioner for Hygiene and Health and was able to follow closely the first steps of the Sardinian Project, the great natural experiment that had as its objective the eradication of malaria in Sardinia. He was also a member of the Regional Anti-Anophelic Fight Agency in Sardinia and collaborated with the Rockefeller Foundation for the success of a "Plan of Rebirth" supported by the excellent results achieved in the USA and in other countries.

Once malaria was defeated, in the early fifties, by Councilor for Hygiene and Health, Brotzu supported the establishment of the regional antimalarial and anti-insects Center to consolidate the results obtained through small and medium reclamation. "Combattè" also for the construction of hospitals, polyclinics, hygienic slaughterhouses, aqueducts for the supply of drinking water, residential areas also suitable for opposing social illnesses, rehabilitation works and environmental protection.



  • Abraham, EP  The Cephalosporin C Groupin  Quarterly Reviews n. 21, 1967

  • Baldry P, The Battle Against Bacteria: A Fresh Look: a History of Man's Fight Against Bacterial Disease with Special Reference to the Development of Antibacterial Drugs, Ed. CUP Archive, 1976

  • Bo G :, G. Brotzu and the discovery of cephalosporinsin  Clin Microbiol Infect, 6, 3 pp. 6-9

  • Brotzu G, Observations and research on endemic tifica in Cagliari, in Modern Hygiene, XVI 1923

  • Brotzu G, Malaria in the history of Sardinia, in "Mediterranea", n ° 8, 1934, pag. 19

  • Brotzu G, Research on a new antibiotic, Cagliari, 1948 pag. 3

  • Cantarano E, Carini L. History of Medicine and Health Care for Health Professions, Universitalia, 2013, pag. 175.

  • Cornaglia, G To the memory of an angelin  Clinical microbiology and infection, European Society of Clinical Microbiology and Infectious Diseases, Ed. Decker Europe, 1995

  • Of Plan L. (edited by), For Giuseppe Brotzu , Edizioni Della Torre, Cagliari, 1998

  • Greenwood D. Antimicrobial Drugs: Chronicle of a twentieth century medical triumph, Ed. Oxford University Press, 2008

  • Landau R, Achilladelis B, Scriabine A, Pharmaceutical Innovation: Revolutionizing Human Health, Ed. Chemical Heritage Foundation, 1999

  • Paracchini R. The lord of the Cefalosporine. History of a discovery. Demos, Cagliari, 1992.

(photo: web)