L'Italo-Americano

www.italoamericano.org 10 THURSDAY, APRIL 15, 2021 L'Italo-Americano I n t h e p a s t t w e l v e m o n t h s , w e ' v e a l l b e c o m e s a d l y acquainted with the idea of contact tra- cing: used very successfully in the management of the pandemic in countries like South Korea and Israel, it hasn't been as efficient here in Italy, where a dedicated app, Immuni, has been lar- gely considered a failure on all fronts. This is pretty strange to say, if you think that the idea itself of contact tracing a s a w a y t o c o n t r o l t h e spread of infectious diseases comes from Italy. We need to go back to the 16th cen- tury and the times of the "great pox," most commonly k n o w n a s s y p h i l i s . B a c k then, the illness was very lit- tle known: it was new and there was no mention about a n y t h i n g e v e n r e m o t e l y similar to it in traditional medical texts of the times, which were based mostly on classical and Arabic treati- s e s . I n t h o s e y e a r s , t h e U n i v e r s i t y o f P a d u a , i n V e n e t o , w a s t h e h u b o f medical research in Europe and it's not surprising it was there, thanks to the work of a n a t o m i s t G a b r i e l e Falloppio, that the first epidemiological studies on syphilis were carried out. Falloppio and his team had an important intuition: that to fight the new illness, it was not only necessary to learn about other similar p a t h o l o g i e s a n d t h e w a y they behaved, but also to understand how syphilis got to Europe and how it spread around. Interestingly, their basic texts to trace the deve- lopment and diffusion of the disease were Christopher Columbus' travel jour- nals. T h a n k s t o t h e d e t a i l e d account Columbus left of his trip back from America to Europe, Falloppio was able to track how syphilis had reached the Old Continent with Columbus' crew, and the first hospital cases recor- ded in Barcelona. The illness then spread through Europe via King Ferdinand II's army a n d e v e n m o r e v i a K i n g Charles VIII's mercenary soldiers, employed for great part of the winter of 1495 for t h e s i e g e o f N a p l e s . A first flare up of the illness came during these months, with an even more signifi- cant rise in infections when C h a r l e s V I I I ' s a r m y w a s dismantled and mercenaries returned to their countries. S o m e t i m e s l a t e r , i n t h e 1530s, another Paduan phy- s i c i a n , B e r n a r d i n o Tomitano understood how syphilis spread from Europe towards the East via Venice and its many commercial connections. Falloppio and Tomitano's work is important because it o p e n e d u p t h e w a y t o further research in the field, but it is to another, much less famous and renowned d o c t o r w e o w e t h e r e a l discovery of the importance of contact tracing. It was 1 5 7 6 w h e n A n d r e a Gratiolo, a village doctor from Desenzano del Garda, had to deal with a deadly outbreak of bubonic plague in town. People believed it w a s a w o m a n , w h o h a d r e c e n t l y t r a v e l e d f r o m T r e n t o , w h o b r o u g h t t h e disease to Desenzano, but Gratiolo was not convinced. Today, we known the plague is transmitted by infected rats and fleas through their bites but, in those years, it wasn't clear yet. Gratiolo, however, had a hunch and sensed the woman was not responsible for the outbreak. I n a c l e a r e x a m p l e o f "modern" contact tracing, he i n v e s t i g a t e d t h e w a y t h e woman traveled from Trento to Padua and discovered she had spent most of the trip in close proximity with another w o m a n w h o , o n c e h o m e , had gone back to her daily routines and habits, inclu- ding sleeping in the same bed with her husband and her children. Neither the woman, nor her family had contracted the plague, which was proof for Gratiolo that the outbreak did not origi- nate the way most people believed. Gratiolo wasn't the only doctor to go against main- stream medicine in those years, as many other practi- tioners had already begun to question a commonly accep- t e d s e t o f b e l i e f s a b o u t spreading and contagion, including the idea that pla- gue was caused by miasmas c o m i n g f r o m s w a m p y , unhealthy land, star align- ments, bad nutrition and, l a s t b u t n o t l e a s t , t h a t i t was, as all infectious disea- ses, a punishment sent by God to Mankind for its sins. W i t h o u r m o d e r n m i n d s , p e r h a p s , w e c a n ' t f u l l y understand the magnitude of Gratiolo's idea: illness wasn't a form of divine puni- shment for a sinful mistake, but the natural consequence of scientifically proven — or provable— factors. The validity of Falloppio and Gratiolo's theories and i d e a s w e r e e m b r a c e d i n E u r o p e q u i t e q u i c k l y , o r p e r h a p s e v e n d e v e l o p e d independently through the continent, as we have docu- m e n t s f r o m N u r e m b e r g , G e r m a n y — o f u n c e r t a i n date, but likely compiled between the 16th and the 18th century — where it is proven that hospital patients were asked questions to find out how and where they may have contracted an illness. I n t h e p a s t t w e l v e months, the careful and ade- quate use of contact tracing has helped the world limi- ting the already immense losses caused by Covid-19. Perhaps it never occurred to us that something we consi- der so simple and so auto- matic has a long history of discovery and observation behind. Nor that it is to be counted among the many gift Italy has given to the world. This article is based on a piece by Samuel Cohn and M o n a O ' B r i e n , o f t h e U n i v e r s i t y o f G l a s g o w , p u b l i s h e d o n T h e Conversation. A copper engraving of Doctor Schnabel, known as Dr. Beak, a plague doctor in 17th century Rome. He probably used contact tracing, too (Photo: Wikicommons/Public Domain) LIFE PEOPLE PLACES HERITAGE GIULIA FRANCESCHINI Italian medicine and the history of contact tracing

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