Morti improvvise: Medicina e religione nel Settecento (review)

Sudden death endangered the soul as well as the body, which risked burial in unconsecrated ground. An “epidemic” of sudden deaths in Rome between 1705 and 1706 sparked widespread fear, and Pope Clement XI ordered a public inquest based on autopsies of the deceased. Maria Pia Donato takes this “epidemic” and the responses it provoked as the focal point of a stimulating assessment of the relationship between medicine and religion in early-eighteenth-century Rome. If this geographical frame is narrow, Donato’s use of the methods of social and cultural history permits a wide-ranging exploration of the public health, medical, and religious dimensions of sudden death. Rather than write another history of mentalities, in the vein of many seminal studies of death, she aims to highlight the role of medicine in society.

The first section of the volume investigates how the pope turned to physicians for advice in the early years of the eighteenth century, seeking a medical perspective on a public health matter that was not plague for the first time and subsequently requesting opinions on burials and cemeteries and other epidemic crises. Alongside the Collegio medico and protomedico, the archiatra segreto (papal physician) played an intriguing role. In 1707 this figure, Giovanni Maria Lancisi, published De subitaneis mortibus, a work that drew heavily on his involvement in the public inquest and associated autopsies. While Donato’s analysis indicates the temporal preoccupations of the papacy, it is still more revealing about medical authority. Lancisi’s own authority derived from his connection to the sacred person of the pope, and Donato discusses how he and others sought to distinguish themselves in the medical marketplace by their attempts to explain sudden death.

The book’s second section delves into sudden death as a topic of contemporary medical interest, probing the intersections between physiological theory, pathological anatomy, and clinical practice. Through a detailed examination of Lancisi’s 1707 publication, Donato connects his work to mechanical philosophy and corpuscularism and explains why it was well received by the Church. Donato makes a subtle contribution to historiographical debates about change and continuity in medicine between the seventeenth and nineteenth centuries by comparing Lancisi’s work with that of other physicians, teasing out connections between their writings and clinical activity, and highlighting the scientific repercussions of the extent to which each was able to undertake autopsies.

Developments in ethical and religious approaches to sudden death are among Donato’s most important findings. One ethical question was whether the doctor should heed the maxim “first, do no harm” or try everything even in desperate cases. Lancisi suggested that intervention was always worthwhile, which Donato identifies as the beginnings of interest in reanimation, while still emphasizing that Lancisi was primarily motivated by a wish to obtain enough time for the administration of the sacraments. A second ethical issue was whether doctors should give a prognosis of death. A middle ground in which the doctor convinced the patient to confess without pronouncing a death sentence shifted in the eighteenth century to an inclination to remain silent, which Donato considers a subtle form of the medicalization of death and of the increased power of the doctor. In the religious sphere, preachers emphasized true contrition and correct sacramental observance as ways in which Catholics could guard against the dangers of sudden death. The canonization in 1712 of Andrea Avellino, who had died of apoplexy while celebrating mass, provided an intercessor and protector against sudden death and a religious counterpart to the papally instigated medical investigation.

Donato’s overall argument that attitudes to death changed before the later eighteenth century is broadly persuasive. The medicalization of death—a central theme of this study—is delicately balanced with appropriate recognition of a continuing place for religion. This reader’s single regret is that—despite the existence of relevant archival material in, for instance, Milan—so little is said about attitudes to sudden death beyond Rome. How unique and how innovative were attitudes and...