(1839Ã¢Â€Â“1910) Medical history in Japan - Wellcome Trust

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Luigi Sacco, ceroplastic andearly smallpox vaccinationin ItalyFeature: The use of media in early vaccination campaignsFabio Zampieri, Alberto Zanatta and Maurizio Rippa BonatiA plate published by Sacco on spurious and real vaccine.“Tables should be preparedwith well coloured drawingsor, even better, two armsmade by wax, one withpustules of real vaccine,another with spuriousand anomalous pustules.Those representationsshould be multiplied andsent to every chief town.”Luigi Sacco (1803)Luigi Sacco (1769–1863), whohas been referred to as the‘Italian Jenner’ and the ‘apostleof vaccination’, was the protagonistof the first vaccination campaign inNorthern Italy. In September 1800, twoyears after the discovery of Jenner’svaccination, Sacco identified thepus vaccine in a group of cows nearVarese; as a result, the governmentof the Cisalpine Republic appointedSacco executive chief of vaccinationin 1801. Sacco’s vaccine was used allover Italy – and in Eastern Europeand Asia – after this date. Sacco wasactive until the 1820s, and he headedthe vaccination campaign throughthree different Northern Italiangovernments between 1801 and 1809:the Cisalpine Republic, the ItalianRepublic and the Kingdom of Italy.In 1803 Sacco published amonograph about vaccination.This explained the creation anduse of iconographical and waxmodels in Italian smallpox controlefforts “to fix the attention of thepopulation, and, particularly, ofphysicians, surgeons and midwifes,and to avoid the danger of reachingdoubtful or misleading results.”In 1809 Sacco published his majorwork, The Treatise of Vaccination withObservations on Grease and Sheep-pox.2 | Wellcome HISTORY
He published those “well coloureddrawings” in this book with thegoal of “speaking better to the eyesof…readers” – these included fourwonderful coloured plates aboutpustules in cow, horse, sheep andhuman vaccine (real and spurious).The plate about the pustules in thenipples of the cow represented thespontaneous and the pustules inducedby inoculation. The plate about horse‘grease’ aimed to help readers todistinguish this disease from othersimilar eruptions in horses’ hooves. Theplate dedicated to sheep-pox, a diseasein sheep similar to ‘rogna’ (scabies)or ‘stizza’, highlighted the peculiarfact that it particularly affected thesnout. Finally, the plate about humans(left) was probably the most detailedpicture of the time of real and spuriouspustules. It depicted two arms. Thefirst, on the top, showed the evolutionof real vaccine from the beginninguntil the cicatrisation of the pustule;the second, at the bottom, representedtwo different series of pustules. Theseries above showed the evolution of‘spurious malignant vaccine’, whereasthe other represented the evolutionof the ‘spurious benignant vaccine’.We have found a series ofanatomical waxes that correspondexactly to the images available inSacco’s treatise in some north Italianhospitals and medical museums. Wehave discovered models in the archiveof the Ospedale Maggiore in Milan(where Sacco started his medicalcarrier), in Bologna’s ‘Cattaneo’sMuseum of Anatomical Waxes’, inPavia’s ‘Museum for the Historyof the University’ and ‘Museum ofPathological Anatomy’, and in Padua’s‘Museum of Pathological Anatomy’. Inthe Museum of Pathological Anatomyof Padua, we found the completeseries of four models. Each containsthe following legend: “Explanation ofthe vaccinal preparation contained inthe three tables executed under thedirection of Mr. Pietro Moscati, StateCounsellor Consultant, Dignitary ofthe Order of Iron Crown, GeneralDirector of the Public Education”.Pietro Moscati was one of themajor figures of political life during thesecond Cisalpine Republic (1800–1802),the Italian Republic (1802–1805) andthe Kingdom of Italy (1805–1814).Named State Counsellor, Senatorof the Kingdom, General Directorof Public Education and Presidentof the Magistrate of Health (from1805 to 1810), it is easy to understandwhy Moscati created the vaccinationwax models based on Sacco’s plates.Moscati was General Director ofPublic Education and President ofthe Magistrate of Health from 1805to 1810, the period in which Saccowas active and published his books.Moscati had an undoubted interest invaccination because he was the firstpractitioner of the older method ofvariolation in Milan; in addition, heprobably wrote an anonymous reviewof the Latin translation of Jenner’sInquiry published in Vienna in 1799.A letter from the Prefect of the ‘Brenta’, attestingthe receipt of a case from Milan for the Universityof Padua. Old Archive of the Centre for the History ofPadua UniversityAn 1809 etching by Sacco depicting a cow’s udderwith pustules. Wellcome LibraryBut what about the relationshipbetween Moscati and Sacco? Can weregard Sacco as a direct inspiration forthis project? After all, Sacco started hismedical career at the Maggiore Hospitalof Milan, where he became Moscati’s“friend” and “scholar”. Moscati carriedout the first official variolation in theMilan charitable institution (‘Ospizio’)of Santa Caterina della Ruota in 1761,and Sacco practised the first official actof vaccination in 1801. Moreover, whenSacco was named General Director ofVaccination in 1801 by the CisalpineRepublic, Moscati was ExecutiveDirector of the government, so we cansay that the presence of Moscati wasessential to Sacco’s nomination. Wecan, therefore, safely infer that Saccoinspired the creation of wax models.In the Old Archive of the Universityof Padua, we have found a documentthat attests the precise date on whichthe wax models arrived in Paduafrom Milan. The document consistsof two letters sent by the Prefect ofthe Department of ‘Brenta’ (generaladministration) of the Regionof Padua to the Regent of PaduaUniversity. One of the letters notesthat the Prefect received a case on28 October 1807 from the GeneralDirector of Public Education in Milan,and the descriptions provided inthe letters clearly correspond to themodels still conserved in the PaduaMuseum of Pathological Anatomy.The date of receipt mentioned in thiscorrespondence, 28 October 1807, isvery interesting – it is a period whenSacco was active, but it is before thepublication of the Treatise on Vaccine(1809), where Sacco published the“well coloured” plates, and after thepublication of the Memory of Vaccine(1803), in which Sacco highlightedthe importance of creating platesand wax models. This means thatthe creation and dissemination ofthe vaccination wax models werean important part of advertisingthe release of Sacco’s treatise.Sacco’s intention was not justto communicate with thinkers – hewas also particularly interested ininteracting with observers. His purposewas to show the specificity of poxpustules in cows, horses, sheep andhumans in order to permit everybodyto recognise them. This specificity washighlighted through the representationof the structure and colour ofpustules as they evolved over time.At a time without photography andtelevision, there was no better meansof representation and public healtheducation than the use of ceroplasticsto create models, a technique alreadywidely used for teaching anatomyand pathological anatomy.Fabio Zampieri and Alberto Zanatta are Researchersand Maurizio Rippa Bonati is a Professor in the Sectionof Medical Humanities, part of the Department ofMedico-Diagnostic Sciences and Special Therapies, atthe University of Padua Medical School.Winter 2011 | 3
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(1839Ã¢Â€Â“1910) Medical history in Japan - Wellcome Trust

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