Academic journal article Population

Pellagra in Late Nineteenth Century Italy: Effects of a Deficiency Disease

Academic journal article Population

Pellagra in Late Nineteenth Century Italy: Effects of a Deficiency Disease

Article excerpt

The main purpose of this study is to identify why the disease known as pellagra, endemic in Italy in the late nineteenth century, was strongly selective by place of residence, occupational category, age and sex. Pellagra is a vitamin deficiency disease caused by a diet consisting almost exclusively of maize (corn), and was particularly severe among farming families in Veneto and Lombardy from the late eighteenth century to the interwar period. To better understand the social "preferences" of pellagra, this study adopts several analytic perspectives - epidemiology, history, history of medicine, gender studies and social history - thereby bringing to light the connections between the cultural, social and epidemiological factors that led to this selection, a selection that was not without demographic consequences.

In addition to medical and literary sources, two types of data were used to measure the main demographic effects of this nutritional deficiency, the first being the results of health and agricultural surveys conducted by Italy's Ministry of the Interior and Ministry of Agriculture from 1879 to 1900. These surveys covered all Italian regions affected by the disease and were designed to estimate the incidence of pellagra in terms of morbidity and mortality, and to describe the living conditions of the farming population. The purpose of the first survey, launched on 1 September 1879 by the agriculture department (part of the Interior Ministry at the time), was to "study the pellagrosi [the Italian term for pellagra sufferers] and the condition of the farming classes" (Annali d'Agricoltura, 1880; Interior Ministry archives). The second survey, conducted in response to a proposal by the parliamentary deputy Stefano Jacini, concerned the situation of the peasantry throughout Italy, focusing on the presence of pellagrosi in the affected territories (Jacini survey, 1882). In 1890, a survey on the health conditions of "persons who work the land" that included a section on pellagra was organized by Agostino Bertani, followed ten years later by another national survey that also covered the measures taken to combat the disease (Inchiesta sulla pellagra nel Regno, 1900). All these studies, despite their obvious utility, are hard to exploit because of severe underestimation. A person in the early stages of pellagra can easily conceal the disease, and many "ashamed" pellagrosi,(1) whose numbers are difficult to estimate, did not declare their condition to the health authorities when counts were organized for fear of losing their employment or their home, or of being driven offthe land they leased.

The second set of information analysed for this study comprises the data series from Italy's Statistics Institute (ISTAT) produced from the time of Italian unification (1861). They relate to censuses (taken every 10 years from 1861 to the present, but excluding the years 1891 and 1941 when the censuses were cancelled) and population change.(2) The method used at the time was to collect data from municipalities and transmit them to Rome for aggregation. Data are generally available for provincial capitals (in some cases for municipalities) and by region. Mortality statistics are compromised by the fact that declaring all causes of death did not become obligatory until quite late in the nineteenth century. Whereas provincial capitals were subject to this constraint from 1881, it was not until 1888 that the rule was applied to all Italian municipalities, urban and rural. Since pellagra was much more likely to affect the rural world and small urban centres, pre-1888 statistics are not reliable and must be used with caution. Furthermore, even when cause of death was indicated, pellagra mortality was usually underestimated: these deaths were often registered under another cause, notably suicide.

The present article deliberately leaves aside some aspects of the disease, such as prevention methods or treatment of pellagrosi, focusing instead on the social and demographic impact of this serious vitamin deficiency disease that ravaged the three regions of Veneto, Lombardy and Emilia in the last decades of the nineteenth century. …

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