Naples in the Time of Cholera, 1884-1911 (review)

This is a scholarly, well-written book with an arresting story to tell about how profoundly and yet how differently two cholera epidemics affected the city of Naples in 1884, and again in l910–11. Snowden begins with a horrific account of living conditions in Naples in the latter nineteenth century. It was a crowded, impoverished city, the largest in Italy. When it was deprived of its role as regional capital in 1861, taxes flowed northward, leaving Neapolitans to scrape a living by all sorts of marginal activities—some legal, others outside the law. Public health was miserable, and the physicians of Naples, which “enjoyed a prestigious position as one of the foremost medical centers of the nation,” served only the rich and so remained “virtual strangers in the community” (pp. 52, 53).

The next two chapters describe how cholera spread into Italy from southern France, concentrating its ravages in the slums of Naples. By comparison with older epidemics, the losses were not very great. But panic was widespread, and the city’s efforts to cope with the disease by using high-handed police methods to deliver infected persons to special cholera hospitals aroused intense resistance. The popular distrust was not groundless. Naples’ learned physicians could not cure cholera and experimented recklessly with painful and futile therapies. They also disagreed among themselves, old-fashioned miasma confronting Koch’s brand-new (l883) germ theory. The city’s poor concluded that the cholera was a diabolical plot for getting rid of them by poisoning, and viewed the high-and-mighty physicians as their appointed executioners. As a result, “on several occasions as the epidemic reached the height of its fury, the tensions of the city unleashed full scale insurrections” (p. 147).

The next chapter explains how private charity, combined with the intervention of King Umberto in concert with the archbishop of Naples (who repeatedly toured hospital cholera wards together), did something to heal the body politic. Moreover, inspection of the city’s slums convinced the king and his prime minister that the protection of the national health required that Naples be rebuilt along the lines recently pioneered in Paris by Baron Haussmann. But, as the following chapter explains, though the national government did make considerable amounts of money available, the contractor who undertook the scheme soon went bankrupt, leaving the plan uncompleted. As a result, when cholera returned to Italy in 1910 the epidemic again homed in on Naples. This time, however, public reaction was completely different: rich and poor agreed that it would be disastrous to admit in public that Naples was again infected with so dreaded a disease. The resulting secrecy effectually diverted attention from the epidemic. Snowden criticizes the authorities for their deception and rather lamely describes their policy as “part of a larger process by which the Liberal state slowly succumbed to a terminal illness that ended with Mussolini’s March on Rome in 1922” (p. 359). Yet the upshot could just as well be interpreted as a devious success story for the regime.

Throughout the book Snowden interweaves political and social history with medical, ecclesiastical, and intellectual history in thoroughly admirable fashion. The human drama of events and the role of key individuals also shine forth convincingly. This, in short, is a truly excellent study of a neglected aspect of Europe’s complex collision with cholera.