- Email: [email protected]
Bernardino Ramazzini lies in Padua
CORRESPONDENCE
planned therapeutic manoeuvre instigated by me or by a colleague. My intention in reporting this patient’s clinical course was simply to relate an unusual occurrence. I did not condone the actions of the students; I reported what I saw, and not what I did. Kirk asks what the students have learned from the experience. This encounter made the students confront the inappropriateness of their actions and recognise the importance of integrity and honesty in the practice of medicine. I hope that any other students who read my case report will learn from it and so avoid similar inappropriate conduct. The treatment of hysterical conversion reaction is known.2 The case I reported does not offer a new treatment approach, but gives an interesting insight into the disease because of the therapeutic power of suggestion. I simply described the approach of the medical students as an observer, and was not involved with the patient’s treatment as Kirk falsely claims. Alper Sevinc Gaziantep University, School of Medicine, Department of Internal Medicine, Sahinbey Medical Center, Gaziantep, TR-27310, Turkey (e-mail: [email protected]) 1 2
Kirk EP. Treatment by deception is bad medicine. Lancet 2003; 362: 668. Sevinc A. Surgical treatment of a hysterical conversion reaction. Lancet 2003; 361: 2162.
Bernardino Ramazzini lies in Padua Sir—The most accurate sources of the time indicate that Bernardino Ramazzini (1633–1714; figure), founder of occupational medicine, died in Padua, Italy, and was buried in an unmarked tomb in the church of Beata Elena Enselmini, site of the present-day oratory of San Francesco di Sales. However, an investigation undertaken in 1914 failed to identify his remains.1 To resolve any confusion, we exhumed the body for further analysis and did a careful review of written records. Famous author of De morbis artificum diatriba,2 a treatise on workers’ diseases, Bernardino Ramazzini was born in Carpi in 1633. He gained a degree in Philosophy and Medicine in 1659. During his work as district medical officer for Canino and Marta, in the duchy of Castro, he noted the miserable working conditions of local farmers, who were afflicted mainly with the scourge of malaria, which he himself contracted. This experience along with others drew Ramazzini’s attention to the diseases of
1680
the working class, and led him to We noted numerous inconsistencies confront the matter in a systematic with respect to the report written in 1914 way. He died in 1714, the first when we opened the tomb on professor of practical medicine of the June 5, 2002. Contrary to the University of Padua.3 affirmations of Maggiora, who claimed Written records4,5 agree on the to have “suitably recomposed the location of his burial. Yet in 1914, discovered remains” and “closed the when for the bicentennial of the underground tomb by resealing it death of Ramazzini, Arnaldo with its stone cover” we found no Maggiora, professor of public trace of either the casket or the health at the University of garments, excluding a few Padua, was asked to make a fragments of wood and a few positive identification of the scraps of fabric. Moreover, remains in the tomb, his the buried remains, investigation proved fruitless. mixed haphazardly The professor noted that, and hidden in “in the church of part by earth, San Francesco di Sales clearly belonged an inscription regarding to four different Bernardino Ramazzini did individuals; three men not exist”1 (making reference and a child aged about to the commemorative head3 years. Two of the stone that, according skeletons were of old to the paperwork,4,5 one people. of Ramazzini’s nephews Among the remains, had had inscribed and however, we found a installed). Maggiora cranial segment of a therefore proceeded, on Bernardino Ramazzini man of advanced age July 13, 1914, to open (1633–1714) “with a rather wide, tall the only tomb in the and voluminous head”, building, inside which, besides a which might reasonably have belonged fragment of occipital bone and two to Ramazzini who died aged 81 years. metallic buttons dating back to the 17th When we carbon dated the specimen century, he found a wooden casket we found it to be 255 years old (give or containing a corpse in a decent state of take 35 years), placing it in a period conservation; the teeth still complete, compatible with the date of the death of robust shapeless adipocere masses— Bernardino Ramazzini. indicating good nutritional state—a The results of our research, the three-cornered cap on the head, and a privileged location of a resting place black stole with white border around the inside a convent—of nuns for whom we shoulders decorated with a Greek cross know Ramazzini to have been the on each hem, led to the conclusion that doctor—the discrepancies between the the body was that of a priest, aged 60 report of 1914 and our findings, and years or younger.1 the age of the remains (compatible with The professor therefore concluded that of Ramazzini and rare for someone that the corpse could not be that of living in that period) all lend support to Ramazzini, “who at eighty years could the hypothesis that, the great physician have hardly maintained such a robust from Carpi does indeed rest in Padua. and barely worn dentition and whose V Terribile Wiel Marin, C Bellinati, M Panetto, *G Zanchin lean body certainly could not have produced such quantities of Via Tolomei 22, 35100 Padova, Italy (VTWM); Via Andrea Memmo 49, 35122 Padova, Italy (CB); adipocere”,1 and identified the corpse Via Vallivo 1, 35043 Monselice, Padova, Italy instead as that of Abbot Peruzzo— (MP); *Via Loreto 15, 35142 Padova, Italy (GZ) namely, Giambattista Peruzzo of the (e-mail: [email protected]) minor convent order, who in 1832 1 Maggiora A. In ricordanza del II centenario helped Giovanna Francesca Gesuati to della morte di Bernardino Ramazzini purchase in order to institute a College (5 novembre 1714–1914). Modena: Società the church of Beata Elena and the tipografica modensese antica tipografia Soliani, 1918. convent annex. In 1852, Bishop 2 Ramazzini B. De morbis artificum diatriba. Monsignor Manfredini consecrated and Mutinae: Typis Antonii Capponi, 1700 dedicated the church to San Francesco (1st edn); Padova: Per Jo: Baptistam di Sales. On that occasion, according to Conzattum, 1713 (2nd edn). the research of Maggiora, the oratory 3 Di Pietro P. Bernardino Ramazzini: Biografia e bibliografia. Parma: Casa Edtitrico Mattioli, was restored; the tomb was opened to 1997. allow the work of reinforcing the church 4 Papadopoli NC. Historia Gymnasii Patavini. and part of the bones contained within it Venetiis: Apud Sebastianum Coleti, 1726. removed, providing reason to believe 5 Ramazzini B. Opera omnia medica et that the remains of Bernardino physiologica. Londini: Apud Paulum et Isaacum Vaillant, 1739. Ramazzini had been lost.
THE LANCET • Vol 362 • November 15, 2003 • www.thelancet.com
For personal use. Only reproduce with permission from The Lancet.
planned therapeutic manoeuvre instigated by me or by a colleague. My intention in reporting this patient’s clinical course was simply to relate an unusual occurrence. I did not condone the actions of the students; I reported what I saw, and not what I did. Kirk asks what the students have learned from the experience. This encounter made the students confront the inappropriateness of their actions and recognise the importance of integrity and honesty in the practice of medicine. I hope that any other students who read my case report will learn from it and so avoid similar inappropriate conduct. The treatment of hysterical conversion reaction is known.2 The case I reported does not offer a new treatment approach, but gives an interesting insight into the disease because of the therapeutic power of suggestion. I simply described the approach of the medical students as an observer, and was not involved with the patient’s treatment as Kirk falsely claims. Alper Sevinc Gaziantep University, School of Medicine, Department of Internal Medicine, Sahinbey Medical Center, Gaziantep, TR-27310, Turkey (e-mail: [email protected]) 1 2
Kirk EP. Treatment by deception is bad medicine. Lancet 2003; 362: 668. Sevinc A. Surgical treatment of a hysterical conversion reaction. Lancet 2003; 361: 2162.
Bernardino Ramazzini lies in Padua Sir—The most accurate sources of the time indicate that Bernardino Ramazzini (1633–1714; figure), founder of occupational medicine, died in Padua, Italy, and was buried in an unmarked tomb in the church of Beata Elena Enselmini, site of the present-day oratory of San Francesco di Sales. However, an investigation undertaken in 1914 failed to identify his remains.1 To resolve any confusion, we exhumed the body for further analysis and did a careful review of written records. Famous author of De morbis artificum diatriba,2 a treatise on workers’ diseases, Bernardino Ramazzini was born in Carpi in 1633. He gained a degree in Philosophy and Medicine in 1659. During his work as district medical officer for Canino and Marta, in the duchy of Castro, he noted the miserable working conditions of local farmers, who were afflicted mainly with the scourge of malaria, which he himself contracted. This experience along with others drew Ramazzini’s attention to the diseases of
1680
the working class, and led him to We noted numerous inconsistencies confront the matter in a systematic with respect to the report written in 1914 way. He died in 1714, the first when we opened the tomb on professor of practical medicine of the June 5, 2002. Contrary to the University of Padua.3 affirmations of Maggiora, who claimed Written records4,5 agree on the to have “suitably recomposed the location of his burial. Yet in 1914, discovered remains” and “closed the when for the bicentennial of the underground tomb by resealing it death of Ramazzini, Arnaldo with its stone cover” we found no Maggiora, professor of public trace of either the casket or the health at the University of garments, excluding a few Padua, was asked to make a fragments of wood and a few positive identification of the scraps of fabric. Moreover, remains in the tomb, his the buried remains, investigation proved fruitless. mixed haphazardly The professor noted that, and hidden in “in the church of part by earth, San Francesco di Sales clearly belonged an inscription regarding to four different Bernardino Ramazzini did individuals; three men not exist”1 (making reference and a child aged about to the commemorative head3 years. Two of the stone that, according skeletons were of old to the paperwork,4,5 one people. of Ramazzini’s nephews Among the remains, had had inscribed and however, we found a installed). Maggiora cranial segment of a therefore proceeded, on Bernardino Ramazzini man of advanced age July 13, 1914, to open (1633–1714) “with a rather wide, tall the only tomb in the and voluminous head”, building, inside which, besides a which might reasonably have belonged fragment of occipital bone and two to Ramazzini who died aged 81 years. metallic buttons dating back to the 17th When we carbon dated the specimen century, he found a wooden casket we found it to be 255 years old (give or containing a corpse in a decent state of take 35 years), placing it in a period conservation; the teeth still complete, compatible with the date of the death of robust shapeless adipocere masses— Bernardino Ramazzini. indicating good nutritional state—a The results of our research, the three-cornered cap on the head, and a privileged location of a resting place black stole with white border around the inside a convent—of nuns for whom we shoulders decorated with a Greek cross know Ramazzini to have been the on each hem, led to the conclusion that doctor—the discrepancies between the the body was that of a priest, aged 60 report of 1914 and our findings, and years or younger.1 the age of the remains (compatible with The professor therefore concluded that of Ramazzini and rare for someone that the corpse could not be that of living in that period) all lend support to Ramazzini, “who at eighty years could the hypothesis that, the great physician have hardly maintained such a robust from Carpi does indeed rest in Padua. and barely worn dentition and whose V Terribile Wiel Marin, C Bellinati, M Panetto, *G Zanchin lean body certainly could not have produced such quantities of Via Tolomei 22, 35100 Padova, Italy (VTWM); Via Andrea Memmo 49, 35122 Padova, Italy (CB); adipocere”,1 and identified the corpse Via Vallivo 1, 35043 Monselice, Padova, Italy instead as that of Abbot Peruzzo— (MP); *Via Loreto 15, 35142 Padova, Italy (GZ) namely, Giambattista Peruzzo of the (e-mail: [email protected]) minor convent order, who in 1832 1 Maggiora A. In ricordanza del II centenario helped Giovanna Francesca Gesuati to della morte di Bernardino Ramazzini purchase in order to institute a College (5 novembre 1714–1914). Modena: Società the church of Beata Elena and the tipografica modensese antica tipografia Soliani, 1918. convent annex. In 1852, Bishop 2 Ramazzini B. De morbis artificum diatriba. Monsignor Manfredini consecrated and Mutinae: Typis Antonii Capponi, 1700 dedicated the church to San Francesco (1st edn); Padova: Per Jo: Baptistam di Sales. On that occasion, according to Conzattum, 1713 (2nd edn). the research of Maggiora, the oratory 3 Di Pietro P. Bernardino Ramazzini: Biografia e bibliografia. Parma: Casa Edtitrico Mattioli, was restored; the tomb was opened to 1997. allow the work of reinforcing the church 4 Papadopoli NC. Historia Gymnasii Patavini. and part of the bones contained within it Venetiis: Apud Sebastianum Coleti, 1726. removed, providing reason to believe 5 Ramazzini B. Opera omnia medica et that the remains of Bernardino physiologica. Londini: Apud Paulum et Isaacum Vaillant, 1739. Ramazzini had been lost.
THE LANCET • Vol 362 • November 15, 2003 • www.thelancet.com
For personal use. Only reproduce with permission from The Lancet.