Sabine Kalff

Researcher’s profile


Changing Airs and Waters – Court Physicians and Their Impact on Health Policy in Late 16th Century Italy, Francesco Alessandri and Marsilio Cagnati
Although Francesco Alessandri, personal physician of the duke of Savoy, was primarily concerned with the healthcare of the individual body of his aristocratic employer, in his plague tract Trattato della peste et febri pestilenti, tradotto di latino in volgare (Turin, 1586), he displayed a strong interest in medical matters that affected the community as a
whole. In the context of plague policies he put forward a multitude of political measures that were aimed at the Sabaudian collective of individual bodies. Alessandri’s advices for medical policy, the Ordini et avvertimenti per gl’officiali et altri per tempo di Peste, stretched over 36 pages of the treatise that had slightly more than 200 pages. It was one of the earliest plague tracts that devoted an entire section on plague policy, thus treating epidemics essentially as a political issue. Alessandri’s concern for public health could be a result from his close relationship to the duke of Savoy, whom he served as “consigliere e medico“, but as the physician was a member of the Sabaudian health board during the epidemic of 1585, also practical experience with public health during plague might have been a factor. However, both obligations were interrelated, since the health board was not independent of governmental influence. But Alessandri was not only concerned with public health measures against epidemics but also pondered over other sanitary aspects that affected the community as a whole. Right in the beginning of his tract, he considered miasmatic causes for the outbreak of epidemics, such as astral and meteorogical causes and had no doubt that celestial motion generally influenced the atmosphere which brought about changes in the human bodies, mostly for the worse.

Although the idea of astral causation of epidemics was anything but new, miasmatic
conditions were seldomly supposed to be subject to human change.
The notion that they could easily be shaped by sanitary regulations was at least adopted by Marsilio Cagnati, personal physician to several cardinals of the Roman papal court. Obviously, Cagnati’s medical service in the political sphere stimulated the physician to broaden his perspective on questions of health preservation considerably, as he wrote entire treatises on the miasmatic conditions of Rome, in which he also put forward proposals to modify them. In De Tiberis inundatione medica disputatio (1599), he discussed the possible interrelation between the occurrence of floods of the Tiber and epidemics and provided the reader with an exhaustive chronology of floods and epidemics. Cagnati’s concern for flood control and the quality of the Roman air (De romani aeris salubritate, 1599) showed well that the physician was not inclined to limit his competence to individual healthcare, although medical care for individuals and for the Roman population in general remained closely related. This becomes obvious in Cagnati’s medical instructions for a cardinal how to survive the unhealthy miasmatic conditions of the forthcoming conclave.
Also in the case of Cagnati, the physician’s concern for public health policy did not result necessarily immediately from his experience as a courtier, as Cagnati was an eminent figure in the Roman medical sphere in various ways. He not only taught medicine regularly at La Sapienza, but also worked for several years as Roman protomedico. In this maily legal function he supervised pharmacy and regulated medical practice.

My paper will therefore address the question to what extent Alessandri’s and Cagnati’s
considerable interest in medicating not only individuals, but rather the whole society may be regarded as a result from their position at court and the hence resulting affinity to the sphere of governmental power. As both physicians were not only courtiers, but were further practically involved in early modern public health policies, their professional experience shall be compared in order to single out different factors which may have attributed to the physician’s inclination to extend their medical competences to the population as a whole.

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