The doctors, institutions and health organization, under the reign (1734 - 1861) of the Bourbon Two Sicilies, represent, as in every era, the faithful mirror of society, its turmoil, the cultural and economic travails that occurred under the Dynasty.
Poverty, famine, epidemics are closely related to the turbulent social events that prepared the French Revolution, the Carbonari Movement, the Neapolitan Republic, the Restoration, etc.
The Bourbons ruled in a relatively fruitful period for medical knowledge: in reality from empiricism and observation passed, on the threshold of modernity, to medicine as a profession, whose beginning, by convention, is fixed at the beginning of the nineteenth century. In fact at the beginning of the eighteenth century the dispute between the learned, self-referential, dogmatic and conservative university institutions opened up across Europe, refactuates to a pseudo-democratic-galenic static science and factions of empiricals, barbers, and fairies who practiced medical acts.
In the Neapolitan dialect, a greater tendency towards moderation in the medical exercise undoubtedly led to minor tensions between these categories, but, above all, the experimental intelligence of doctors of the stamp of Marco Aurelio Severino or Cotugno refacented to the true Hippocratic message, avoided regrettable episodes between the categories exercising themedical ars.
Gabriele Tedeschi, Enrico Granata, Antonio Cardarelli, Domenico Capozzi, Domenico Cirillo and many other illustrious physicians were, at the same time, extremely talented and acute teachers.
The medical - dental college based in the proto-hospital of the Kingdom - the Incurables - is the clinical expression of the observatio et ratio which were the cornerstones of the Neapolitan medical school.
In the eighteenth century the first welfare institutions were hospices for poor rejected and abandoned. Palazzo Fuga, better known as the Reale Albergo dei Poveri, built in Naples, in the 1749, by the will of Charles III of Bourbon, represents the dream of the Enlightenment utopia that wants to gather the poor, the indigent, outside the real city. A similar but less known institution was founded in Palermo already in the 1746.
Only in the nineteenth century did we arrive at the birth of specialized medicine and of the hospital understood as a place of care according to the modern meaning.
There are undoubtedly various paths that offer themselves to the historian's expert eyes and that offer speculative insights into the understanding of the relationship between the ruling house and medical institutions.
Mutatis mutandis, similar considerations, extended and integrated with those deriving from further interpretative cues, provide, in key terms umint, even today, open information with a view to medical intelligence. We will develop this topic in another of our contributions.
But let's see, now, what can be the most significant and useful approaches for us:
1) historical route: recording in the annals of the historical archive of the number of doctors, of the conducts, of the admissions in relation to the different periods.
2) path of university education: study of the institutions that conferred the title of Doctor of Medicine, duration of studies and compulsory medical subjects in teaching. The university statute resumes in broad terms that of Spanish university teaching with references in particular to the curriculum of training in Salamanca.
3) path of charity and charitable foundations which represent, as elsewhere, the first brick on which hospital structures and establishments are built.
4) path of relations between health institutions autonomous or semi-autonomous for economic financing and administrative-managerial positions. All health and care facilities after the French decade were directly under the Ministry of the Interior. This is to exercise control over the medical class considered by governments to be turbulent and prone to dangerous innovations for the attention of social problems.
5) economic aspect of remuneration represents another useful starting point for historical speculation.
Often the doctor exercised "tax-free", merely paying taxes at the time of granting the exercise. The same medical behaviors were in fact transmissible from father to son or between spouses.
6) relationship between health in the capital and health organization territorial present in the various districts of the Kingdom.
7) chronological succession of epidemics: they provide very useful information on the "system" of Health in the Kingdom.
8) path of the excellent patients and illustrious patients reported in the historical chronicles of the time.
9) very interesting path of the hospital assistance network traceable also in the toponymy and in the city cartography. The Bourbon hospitals represent the 80% of the existing assistance network in today's Naples.
10) Kingdom health primates:
First world institution of a Commission, the Council of Poisons, for the safe management of industrial waste. Issue of hygienic laws for health and environmental prevention, laws on separate waste collection and on street cleaning, laws on the protection of archaeological heritage. Mortuary police regulations.
Establishment of the first Chair of Pediatrics, of the "Marine Hospice" for thalassotherapy of rickets and tuberculosis. First description of the disease then known as scleroderma (Prof. Carlo Curzio). Edition of the first practical manual of "BLS". Foundation of the first Central Homoeopathic Pharmacy Special (Dr. R. Rubini)
First pension system with deductions of 2% on salaries (today over 40%).
Anti-saber vaccination (dr. Gatti), Assistance to abandoned children widely distributed in the single Municipalities, San Leucio Law Code (first allocation of public housing in Italy, nursery schools, sick pay, free health care for the sick, assistance to the elderly widows, precise working hours). First National Psychiatric Hospital in Palermo in Santa Teresa ai Porrazzi. First Chair of Psychotherapy in Palermo (Prof. Giovanni Linguiti). First quarantine health laws to prevent contagion to Nisida. Anti-tuberculosis Prophylaxis Interventions throughout the Kingdom territory. First botanical garden for phytomedicine in Palermo. First psychiatric hospital with attached Chair of Psychiatry (Reale Morotrofio di Aversa). First psychiatric magazine (prof. Biagio Miraglio). Introduction in Italy of homeopathy medicine (Dr. F. Romano) and first Homeopathic Clinic (Hospital of the Trinity in Naples and Homeopathic Hospital of the Cesaria). Foundation of the first Italian institute for deaf-mutes. Statistically very significant is the fact that in the Kingdom of the Two Sicilies, with the same birth rate, the lowest percentage of infant mortality in Italy was observed. The Kingdom also had the highest percentage of doctors per inhabitant of Italy. First Italian Chair of Obstetrics and Surgical Observations.
All this, and more, characterized the socio-health and welfare policy of a dynasty that was ostracized and demonized for exclusively defamatory purposes and that fell only because of an ideal, unfortunately utopian and anachronistic, as often happens with higher aspirations, of independence, economic and political, from an unbridled and amoral liberalism, of Anglo-Saxon inspiration, whose harmful effects are still evident today! Then? "Was it true glory? Posterity will judge"!
Luisa Carini, Federico Bizzarri, Enzo Cantarano
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Forte N, Journey into the lost memory of the Kingdom of the Two Sicilies - the facts and the fattarielli, Ischia (NA), Edizioni Imagaenaria, 2007
Olive G, A kingdom that has been great. The denied history of the Bourbons of Naples and Sicily, Mondadori 2012
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