Pestilence, Sacred Trees And A Glass of Tonic Water

Dec5

I have a soft spot for tonic water. Maybe because it’s the only soda beverage with a taste I never fully understood, impossible to describe: an ambiguous aroma, a strange contrast between that pinch of sugar and a sour vein that makes your palate dry.
Every now and then, during summer evenings, I happen to take a sip on my balcony while I watch the Alban Hills, where the Roman Castles cling to a long-dead volcano. And as I bring the glass to my lips, I can’t help thinking about how strange history of mankind can be.

Kings, wars, crusades, invasions, revolutions and so on. What is the most powerful cause for change? What agent produced the most dramatic long-term modification of human society?
The answer is: epidemics.
According to some historians, no other element has had such a profound impact on our culture, so much so that without the Plague, social and scientific progress as we know it might not have been possible (I wrote about this some time ago). With each stroke of epidemic, the survivors were left less numerous and much richer, so the arts and sciences could develop and flourish; but the plague also changed the history of medicine and its methods.

“Plague” is actually a very generic word, just like “disease”: it was used throughout history to define different kinds of epidemic. Among these, one of the most ancient and probably the worst that ever hit mankind, was malaria.

It is believed that malaria killed more people than all other causes of death put together throughout the entire human history.
In spite of an impressive reduction of the disease burden in the last decade, the World Health Organization estimates that as many as 300 million people are infected by the disease every year. That’s about the size of the entire US population. Of those who fall sick, more than 400,000 die every year, mostly children: malaria claims the life of one child every two minutes.

Malaria takes its name from the Italian words “mala aria”, the bad air one could breathe in the marshes and swamps that surrounded the city of Rome. It was believed that the filthy, smelly air was the cause of the ague. (Giovanni Maria Lancisi suggested in 1712 that mosquitoes might have something to do with the epidemic, but only at the end of the Nineteenth century Sir Ronald Ross, an English Nobel-awarded gentleman, proved that malaria is transmitted by the Anopheles mosquito.)

Back in Medieval Rome, every summer brought back the scourge, and people died by the hundreds. The plague hit indistinctively: it killed aristocrats, warriors, peasants, cardinals, even Popes. As Goffredo da Viterbo wrote in 1167, “When unable to defend herself by the sword, Rome could defend herself by means of the fever”.

Malaria was widespread throughout Europe, Asia, and Africa. Yet, no one knew exactly what it was, nor did they know how to treat it. There was no cure, no remedy.

Well, this is the part that really blows my mind. I cannot shake the feeling that someone was playing a bad joke on us humans. Because, actually, there was a remedy. But the mocking Gods had placed it in a land which had never been attained by malaria. Worse: it was in a land that no one had discovered yet.

As Europe continued to be ravaged by the terrible marsh fevers, the solution was lying hidden in the jungles of Peru.

Enter the Jesuits.
Their first mission in Peru was founded in 1609. Jesuits could not perform medicine: the instructions left by the founder of the order, St Ignatius of Loyola, forbade his followers to become doctors, for they should only focus on the souls of men. Despite being expressly forbidden to practice medicine, Jesuit priests often turned their attention to the study of herbs and plants. Father Agustino Salumbrino was a Jesuit, and a pharmacist. He was among the firsts missionaries in Peru, and he lived in the College of San Pablo in Lima, putting his knowledge of pharmacy to good use as he built what would become the best and biggest pharmacy in the whole New World. Jesuits wanted to convert the natives to Catholicism, but understood that it couldn’t be done by means of force: first they needed to understand the indios and their culture. The native healers, of course, knew all sorts of plant remedies, and the priests took good notice of all this knowledge, picking never-before-seen plants and herbs, recording and detailing their effects.
That’s when they noted that the Indians who lived in the Andes sometimes drank infusions of a particular bark to stop from shivering. The Jesuits made the connection: maybe that bark could be effective in the treatment of marsh fevers.

By the early 1630s Father Salumbrino (possibly with the help of another Jesuit, Bernabé Cobo) decided to send a small bundle of this dried bark back to Rome, to see if it could help with malaria.
In Rome, at the time, there was another extraordinary character: Cardinal Juan De Lugo, director of the pharmacy of the Hospital Santo Spirito. He was the one responsible for turning the pharmacy from an artisan studio to something approaching an industrial production line: under his direction, the apothecary resembled nothing that had gone before it, either in scale or vision. Thousands of jars and bottles. shelves filled with recipes for preparations of medicines, prescriptions for their use and descriptions of illnesses and symptoms. De Lugo would cure the poor, distributing free medicine. When the Peruvian bark arrived in Rome, De Lugo understood its potential and decided to publicize the medicine as much as he could: this was the first remedy that actually worked against the fever.

Peru handing Science a cinchona branch (XVII C. etching).

The bark of the cinchona tree contains 4 different alkaloids that act against the malaria parasite, the most important of which is quinine. Quinine’s secret is that it calms the fever and shivering but also kills the parasite that causes malaria, so it can be used both as a cure and a preventive treatment.

But not everyone was happy with the arrival of this new, miraculous bark powder.

First of all, it had been discovered by Jesuits. Therefore, all Protestants immediately refused to take the medicine. They just could not accept that the cure for the most ancient and deadly of diseases came from their religious rivals. So, in Holland, Germany and England pretty much everybody rejected the cure.
Secondly, the bark was awfully bitter. “We knew it, those Jesuits are trying to poison us!”

But maybe the most violent refusal came from the world of medicine itself.
This might not come as a surprise, once you know how doctors treated malaria before quinine. Many medieval cures involved transferring the disease onto animals or objects: a sheep was brought into the bedroom of a fever patient, and holy chants were recited to displace the ailment from the human to the beast. One cure that was still popular in the seventeenth century involved a sweet apple and an incantation to the three kings who followed the star to Bethlehem: “Cut the apple into three parts. In the first part, write the words Ave Gaspari. In the second write Ave Balthasar, in the third Ave Melchior. Then eat each segment early on three consecutive mornings, and recite three Our Fathers and three Hail Marys”.

Even after the Middle Ages, the medical orthodoxy still blindly believed in Galen‘s teachings. Traditionalists who wanted to preserve the ancient doctrine of Galenic medicine at any cost felt the cinchona bark would overturn their view of the human body – and it was actually going to. According to Galen, fever was a bile-caused disorder: it was not a symptom but a disease in itself. A patient with a high fever was said to be suffering from “fermentation” of the blood. When fermented, blood behaved a little like boiling milk, producing a thick residue that to be got rid of before the patient could recover. For this reason the preferred treatments for fever were bleeding, purging, or both.
But Peruvian bark seemed to be curing the fever without producing any residue. How could it be possible?

The years passed, and the success of the cure came from those who tried it: no one knew why, but it worked. In time, cinchona bark would change the way doctors approached diseases: it would provide one of decisive blows against Galen’s doctrine, and open the door to modern medicine.

A big breakthrough for the acceptance of Jesuits Bark came from a guy named Robert Tabor. Talbor was not a doctor: he had no proper training, he was just a quack. But he managed to become quite famous and fashionable, and when summoned to cure Charles II of England of malaria, he used a secret remedy which he had been experimenting with. It worked, and of course it turned out to be the Jesuits powder, mixed with wine. Charles appointed Talbor as his personal physician much to the fury of the English medical establishment and sent him over to France where he proceeded to cure the King’s son too. Without really realizing it, Talbor had discovered the right way to administrate cinchona bark: the most potent mixtures were made by dissolving the powder into wine — not water — as the cinchona alkaloids were highly soluble in alcohol.

By the end of the 18th century, nearly three hundred ships were arriving in Spanish ports from the Americas every year — almost one each day. One out of three came from Peru, none of which ever failed to carry cinchona bark.

Caventou & Pelletier.

And in 1820, quinine was officially born: two scientists, Pelletier and Caventou, succeeded in isolating the chemical quinine and worked out how to extract the alkaloid from the wood. They named their drug from the original Inca word for the cinchona tree bark, quina or quina-quina, which means “bark of barks” or “holy bark”.

Many other battles were fought for quinine, lives were risked and lost. In the 1840s and 1850s British soldiers and colonials in India were using more than 700 tons of bark every year, but the Spanish had the monopoly on quinine. English and Dutch explorers began to smuggle seeds, and it was the Dutch who finally succeded in establishing plantations in Java, soon controlling the world’s supplies.

During WWII the Japanese occupied Java, and once more men wnt to war over tree bark extract; but fortunately this time a synthetic version of quinine was developed, and for the first time pharmaceutical companies were able to produce the drugs without the need for big plantations.

Troops based in the Colonies all consumed anti-fever, quinine-based pharmaceuticals, like for instance Warburg’s Tincture. This led to the creation, through the addition of soda, of several QuinineTonic Waters; in 1870 Schweppe’s “Indian Tonic Water” was commercialized, based on the famous carbonated mineral water invented around 1790 by Swiss watchmaker Jacob Schweppe. Indian Tonic Water was specifically aimed at British colonials who started each day with a strong dose of bitter quinine sulphate. It contained citric acid, to dissolve the quinine, and a touch of sugar.

So here I am, now, looking at the Alban Hills. The place where I live is precisely where the dreaded ancient swamps once began; the deadly “bad air” originated from these very lands.
Of course, malaria was eradicated in the 1950s throughout the Italian peninsula. Yet every time I pour myself a glass of tonic water, and taste its bitter quinine flavor, I can’t help thinking about the strange history of mankind — in which a holy tree from across the ocean might prove more valuable than all the kings, wars and crusades in the world.

Most of the info in this post are taken from Fiammetta Rocco, The Miraculous Fever-Tree. Malaria, medicine and the cure that changed the world (2003 Harper-Collins).

The Abominable Vice

Nov16

Among the bibliographic curiosities I have been collecting for years, there is also a little book entitled L’amico discreto. It’s the 1862 Italian translation of The silent friend (1847) by R. e L. Perry; aside from 100 beautiful anatomical plates, the book also shows a priceless subtitle: Observations on Onanism and Its Baneful Results, Including Mental and Sexual Incapacity and Impotence.

Just by skimming through the table of contents, it’s clear how masturbation was indicated as the main cause for a wide array of conditions: from indigestion to “hypoconriac melancholy”, from deafness to “bending of the penis”, from emaciated complexion to the inability to walk, in a climax of ever more terrible symptoms preparing the way for the ultimate, inevitable outcome — death.
One page after the other, the reader learns why onanism is to be blamed for such illnesses, specifically because it provokes an

excitement of the nervous system [which] by stimulating the organs to transient vigour, brings, ere middle life succeeds the summer of manhood, all the sensible infirmities and foibles of age; producing in its impetuous current, such an assemblage of morbid irritation, that even on trivial occasions its excitement is of a high and inflammable character, and its endurance beyond the power of reason to sustain.

But this is just the beginning: the worst damage is on the mind and soul, because this state of constant nervous stimulation

places the individual in a state of anxiety and misery for the remainder of his existence, — a kind of contingency, which it is difficult for language adequately to describe; he vegetates, but lives not: […] leading the excited deviating mind into a fertile field of seductive error — into a gradual and fatal degradation of manhood — into a pernicious, disgraceful, and ultimately almost involuntary application of those inherent rights which nature wisely instituted for the preservation of her species […] in defiance of culture, moral feeling, moral obligation, and religious impressions: thus the man, who, at the advent of youth and genius was endowed with gaiety and sociality, becomes, ere twenty-five summers have shed their lustre on him, a misanthrope, and a nadir-point of discontent! What moral region does that man live in? […] Is it nothing to light the gloomy torch that guides, by slow and melancholy steps to the sepulchre of manhood, in the gay and fascinating spring-time of youth and ardent desire; when the brilliant fire of passion, genius, and sentiment, ought to electrify the whole frame?

This being a physiology and anatomy essay, today its embellishments, its evocative language (closer to second-rate poetry than to science) seem oddly out of place — and we can smile upon reading its absurd theories; yet The Silent Friend is just one of many Nineteeth Century texts demonizing masturbation, all pretty popular since 1712, when an anonymous priest published a volume called Onania, followed in 1760 by L’Onanisme by Swiss doctor Samuel-Auguste Tissot, which had rapidly become a best-seller of its time.
Now, if physicians reacted in such a harsh way against male masturbation, you can guess their stance on female auto-eroticism.

Here, the repulsion for an act which was already considered aberrant, was joined by all those ancestral fears regarding female sexuality. From the ancient vagina dentata (here is an old post about it) to Plato’s description of the uterus (hystera) as an aggressive animale roaming through the woman’s abdomen, going through theological precepts in Biblical-Christian tradition, medicine inherited a somber, essentially misogynistic vision: female sexuality, a true repressed collective unconscious, was perceived as dangerous and ungovernable.
Another text in my library is the female analogue of Tissot’s Onania: written by J.D.T. de Bienville, La Ninfomania ovvero il Furore Uterino (“Nymphomania, or The Uterine Fury”) was originally published in France in 1771.
I’m pasting here a couple of passages, which show a very similar style in respect to the previous quotes:

We see some perverted young girls, who have conducted a voluptuous life over a long period of time, suddenly fall prey to this disease; and this happens when forced retirement is keeping them from those occasions which facilitated their guilty and fatal inclination. […] All of them, after they are conquered by such malady, occupy themselves with the same force and energy with those objects which light in their passion the infernal flame of lewd pleasure […], they indulge in reading lewd Novels, that begin by bending their heart to soft feelings, and end up inspiring the most depraved and gross incontinence. […] Those women who, after taking a few steps in this horrible labyrinth, miss the strength to come back, are drawn almost imperceptibly to excesses, which after corrupting and damaging their good name, deprive them of their own life.

The book goes on to describe the hallucinatory state in which the nymphomaniacs fall, frantically hurling at men (by nature all chaste and pure, it seems), and barely leaving them “the time to escape their hands“.
Of course, this an Eighteenth Century text. But things did not improve in the following century: during the Nineteenth Century, actually, the ill-concealed desire to repress female sexuality found one of its cruelest incarnations, the so-called “extirpation”.

This euphemism was used to indicate the practice of clitoridectomy, the surgical removal of the clitoris.
Everybody kows that female genital mutilations continue to be a reality in many countries, and they have been the focus of several international campaigns to abandon the practice.
It seems hard to believe that, far from being solely a tribal tradition, it became widespread in Europe and in the United States within the frame of modern Western medicine.
Clitoridectomy, a simple yet brutal operation, was based on the idea that female masturbation led to hysteria, lesbianism and nymphomania. The perfect circular reasoning behind this theory was the following: in mental institutions, insane female patients were often caught masturbating, therefore masturbation had to be the cause of their lunacy.

One of the most fervent promoters of extirpation was Dr. Isaac Baker Brown, English gynaecologist and obstetrical surgeon.
In 1858 he opened a clinic on Notting Hill, ad his therapies became so successful that Baker Brown resigned from Guy’s Hospital to work privately full time. By means of clitoridectomy, he was able to cure (if we are to trust his own words) several kinds of madness, epilepsy, catalepsy and hysteria in his patients: in 1866 he published a nice little book on the subject, which was praised by the Times because Brown “brought insanity within the scope of surgical treatment“. In his book, Brown reported 48 cases of female masturbation, the heinous effects on the patients’ health, and the miraculous result of clitoridectomy in curing the symptoms.

We don’t know for sure how many women ended up under the enthusiastic doctor’s knife.
Brown would have probably carried on with his mutilation work, if he hadn’t made the mistake of setting up a publicity campaign to advertise his clinic. Even then, self-promotion was considered ethically wrong for a physician, so on April 29, 1866, the British Medical Journal published a heavy j’accuse against the doctor. The Lancet followed shortly after, then even the Times proved to have changed position and asked if the surgical treatment of illness was legal at all. Brown ended up being investigated by the Lunacy Commission, which dealt with the patients’ welfare in asylums, and in panic he denied he ever carried out clitoridectomies on his mentally ill patients.

But it was too late.
Even the Royal College of Surgeons turned away from him, and a meeting decided (with 194 approving votes against 38 opposite votes) his removal from the Obstetric Society of London.
R. Youngson and I. Schott, in A Brief History of Bad Medicine (Robinson, 2012), highlight the paradox of this story:

The extraordinary thing was that Baker Brown was disgraced, not because he practised clitoridectomy for ridiculuous indications, but because, out of greed, he had offended against professional ethics. No one ever suggested that there was anything wrong with clitoridectomy, as such. Many years were to pass before this operation was condemned by the medical profession.

And many more, until eventually masturbation could be freed from medical criminalization and moral prejudice: at the beginning of the Twentieth Century doctors still recommended the use of constrictive laces and gears, straight-jackets, up to shock treatments like cauterization or electroconvulsive therapy.

1903 patent to prevent erections and nocturnal pollutions through the use of spikes, electric shocks and an alarm bell.

Within this dreadful galaxy of old anti-masturbation devices, there’s one looking quite harmless and even healthy: corn flakes, which were invented by famous Dr. Kellogg as an adjuvant diet against the temptations of onanism. And yet, whenever cereals didn’t do the trick, Kellogg advised that young boys’ foreskins should be sewn with wire; as for young girls, he recommended burning the clitoris with phenol, which he considered

an excellent means of allaying the abnormal excitement, and preventing the recurrence of the practice in those whose will-power has become so weakened that the patient is unable to exercise entire self-control.
The worse cases among young women are those in which the disease has advanced so far that erotic thoughts are attended by the same voluptuous sensations that accompany the practice. The author has met many cases of this sort in young women, who acknowledged that the sexual orgasm was thus produced, often several times daily. The application of carbolic acid in the manner described is also useful in these cases in allaying the abnormal excitement, which is a frequent provocation of the practice of this form of mental masturbation.

(J. H. Kellogg, Plain Facts for Old And Young, 1888)

It was not until the Kinsey Reports (1948-1953) that masturbation was eventually legitimized as a natural and healthy part of sexuality.
All in all, as Woody Allen put it, it’s just “sex with someone you love“.

On the “fantastic physiology” of the uterus, there is a splendid article (in Italian language) here. Wikipedia has also a page on the history of masturbation. I also recommend Orgasm and the West. A History of Pleasure from the Sixteenth Century to the Present, by R. Muchembled.

Se bella vuoi apparire…

Dec14

Questo nostro caduco et fragil bene
ch’è vento et ombra et à nome beltate
(Francesco Petrarca, Canzoniere, Canto 350)

Oggi essere belli è diventato un dovere.
Forse però è troppo facile prendersela con il martellamento promozionale, che ripropone all’infinito sensuali e perfette nudità occhieggianti dai cartelloni pubblicitari, dalle riviste, dai cataloghi; facile criticare il degrado dei tempi quando perfino le moderne donne politiche parlano delle capatine dall’estetista come di un imperativo etico o ideologico; facile anche scagliarsi contro la superficialità dilagante, nel sentir parlare sempre più spesso di seni, glutei ed altri parti anatomiche che si debbono per forza “ringiovanire”, a meno di non voler sfigurare. Facile, insomma, associare la rincorsa alla pelle più tonica, alle sopracciglia meglio disegnate o all’ultima miracolosa crema antirughe ad una crisi di valori.

Ma è davvero soltanto la nostra epoca ad essere così ossessionata dall’eterna giovinezza e dalla bellezza a tutti i costi?

La cosmesi è in realtà vecchia quanto l’uomo, ed in ogni periodo storico sono sorti estremismi e fissazioni estetiche, così come qualsiasi epoca ha visto propagarsi le cure anti-età più bizzarre, spesso poco più di fugaci mode d’una stagione.
È dunque divertente e illuminante gettare uno sguardo ai trattamenti che erano all’ultimo grido nella prima metà del secolo scorso: pur di apparire giovani e belle, anche le nostre nonne o bisnonne erano pronte a sottoporsi ai tormenti più surreali.

Partiamo da Max Factor Sr., nome leggendario, vero e proprio innovatore che, grazie al suo lavoro per le prime grandi star del cinema, fu in grado di costruire un impero. A lui si deve lo sviluppo dell’industria cosmetica, oltre che il termine “make-up”. Gli si deve anche la straordinaria maschera con cubetti di plastica per il ghiaccio che vedete qui sotto: pensata originariamente per dare rinfresco alle attrici accaldate dalle luci del set, senza rovinare il trucco, questa invenzione ben presto divenne però celebre tra i festaioli di Hollywood per tutt’altro motivo… guadagnandosi il nomignolo di Hangover Heaven (“paradiso del doposbornia”).

Sempre Max Factor è l’artefice dell’infame beauty micrometer, inquietante apparecchio che avrebbe dovuto identificare le parti del viso di una persona che necessitavano d’essere ridotte o aumentate dal trucco. Stranamente, questo incrocio fra uno strumento di tortura e un craniometro frenologico non ebbe mai lo sperato successo.

Similmente minacciosi ci appaiono oggi i primi caschi per la permanente, che modellavano i capelli ricciolo per ricciolo.

Per eliminare lentiggini e punti neri, negli anni ’30 si poteva ricorrere ad una macchina aspiratrice, le cui coppette di vetro erano collegate tramite tubi di gomma ad una pompa a vuoto.

L’alternativa era quella di congelare le lentiggini mediante applicazioni di anidride carbonica. Gli occhi della “paziente” erano protetti da gommini a tenuta stagna, le narici venivano tappate e per non inalare il gas nocivo era necessario respirare attraverso un tubo tenuto in bocca.
Non molto confortevole – e nemmeno efficace, a quanto si racconta.

Un altro metodo per ottenere una pelle sempre giovane e perfetta consisteva nello stimolare la circolazione sanguigna tramite una maschera che scaldasse il viso: lanciato nel 1940, questo caschetto si accendeva una volta attaccato alla presa elettrica.

Una bella camminata in montagna, si sa, è sempre salutare e tonificante. Ecco quindi apparire negli anni ’40 una macchina che, abbassando la pressione atmosferica attorno alla testa per simulare le condizioni d’alta quota, prometteva una carnagione rosata e florida.

Cosa c’è di più grazioso di due belle fossette agli angoli della bocca? Nel 1936 una certa Isabella Gilbert di Rochester, New York, brevettò questo apparecchio, da indossare ogni notte per crearle artificialmente: sfortunatamente, sembra che il dolore causato dalle molle fosse troppo intenso anche per le più fanatiche fra le aspiranti fotomodelle.

In soccorso delle pelli troppo sensibili, ecco due invenzioni degli anni ’40: gli occhiali da sole con proteggi-naso, e il “cappuccio a prova di lentiggini” (evidentemente, le efelidi erano nemiche giurate della bellezza).

Dalla stessa epoca proviene questa poltrona massaggiante per gambe sempre splendide.
E, immaginiamo, anche perfettamente depilate.

Questa carrellata di vecchie fotografie mostra come l’ossessione per l’aspetto fisico non sia certo una novità; d’altronde, la ricerca e la valorizzazione della bellezza estetica sono fra le caratteristiche più antiche della civiltà occidentale, a partire dalla kalokagathia greca. Oggi ci si spinge ancora oltre, quello odierno è un corpo fluido, flessibile, manipolabile e rimodellabile in un infinito lavoro di ricerca e di perfezione. L’unico ostacolo che si ritrova davanti è sempre lo stesso: l’antico, intollerabile e acerrimo nemico d’ogni avvenenza – il tempo.
La lotta per sconfiggere i segni che il tempo lascia sul corpo è senza quartiere, anche se l’esito della battaglia, purtroppo o per fortuna, è scontato. Ma demordere non è una peculiarità umana: e se pure qualcuno di questi trattamenti estetici d’altri tempi ci può far sorridere, non sono certo più ingenui o fantasiosi delle mode che nascono e muoiono anche oggi. Perché essere belli è diventato un dovere… ma rimane pur sempre un’illusione, fragile e a suo modo necessaria.

Psichiatra di frontiera

Nov24

Il gruppo musicale The Avalanches è originario di Melbourne, in Australia, ed è una band elettronica che fa un pesante uso di campionamenti da vecchi vinili dimenticati. Le loro canzoni sono dei collage di piccoli pezzi tratti da migliaia di 33 giri trovati nei mercatini dell’usato e poco noti al grande pubblico.

Il loro brano Frontier Psychiatrist, divenuto un hit discografico dieci anni fa, è stato “tradotto” in un video weirdissimo e totalmente delirante che è una gioia per gli occhi. Protagonista della canzone è un ragazzo che “ha bisogno di essere curato”. La sua follia dà occasione a uno show senza freni e completamente assurdo scandito dalla frase dello psichiatra che lo ha in cura: “That boy needs therapy!”. Ma ne ha veramente bisogno?

Nani, indiani, batteriste ultrasettantenni, fantasmi, mariachi, deretani di cavalli colpiti dalla bacchetta magica di una fata, pappagalli parlanti… chi più ne ha, più ne metta. Un grosso spettacolo del deviante, dell’assurdo, del nonsense senza barriere. Proprio come lo psichiatra “di frontiera” del titolo che, rigidamente risoluto a ridurre alla normalità il suo paziente, si ritrova perso nell’universo delirante dei casi-limite più fantasiosi, bloccato in un limbo in cui tutto è possibile; la follia è veramente una malattia o forse può in certi casi portare gioia e spregiudicatezza nella nostra vita?

[youtube=http://www.youtube.com/watch?v=qLrnkK2YEcE]

Lobotomia transorbitale

Jan20

Una delle pratiche mediche più discusse della storia, ormai completamente abbandonata, è la lobotomia. Eppure questa tecnica chirurgica ha goduto di un grande successo e diffusione fino a tempi relativamente recenti.

La lobotomia è una procedura neurochirurgica che consiste nel tagliare le connessioni della corteccia prefrontale, la parte anteriore dei lobi frontali del cervello. Introdotta nel 1935, ebbe un’inaspettata fortuna per più di vent’anni. Veniva utilizzata per ridare la pace agli animi tormentati, agli schizofrenici incurabili, e agli psicotici all’ultimo stadio.

Le prime tecniche prevedevano l’apertura del cranio per effettuare la lobotomia, ma questo rendeva la terapia economicamente irraggiungibile per molte fasce di popolazione; fu così che il dottor Freeman, nel 1945, mise a punto con l’aiuto del suo collega Watts una tecnica che prevedeva l’uso di lunghi strumenti ispirati ai punteruoli rompighiaccio (ice pick lobotomy). Questa nuova tecnica poteva essere svolta come una terapia da ambulatorio, senza bisogno di sale operatorie e grandi dispendi. L’idea del dottore era che la lobotomia avrebbe risolto praticamente tutti i mali psicologici moderni.

Nella lobotomia transorbitale così come la praticava Freeman, al soggetto veniva sollevata la palpebra superiore dell’occhio; il punteruolo (chiamato orbitoclast) veniva martellato fino a rompere il sottile strato osseo sopra l’occhio, e inserito dunque nel cervello. E qui cominciava il vero show di Freeman: con movimenti sicuri e decisi, muoveva i punteruoli avanti e indietro, e lateralmente, al fine di distaccare i lobi frontali dal talamo. Nel 1948 Freeman impreziosì la procedura, aggiungendo il “taglio profondo frontale”, un movimento del punteruolo direttamente dentro al lobo, un taglio che metteva talmente sotto pressione lo strumento chirurgico che talvolta si spezzava, rimanendo all’interno. Freeman era conscio dell’aspetto spettacolare delle sue operazioni, che spesso praticava in pubblico. Era arrivato a esibire una tale maestria da riuscire a operare i suoi punteruoli con una mano sola. Nel 1947 Watts, il collega assieme al quale aveva sviluppato la tecnica, si distaccò da Freeman, disgustato dalla piega che aveva preso una pratica chirurgica che auspicava più seria.

Già tra il 1940 e il 1944 erano state operate 684 lobotomie solo negli Stati Uniti; grazie alla promozione evangelica che Freeman fece della cura, i numeri impennarono verso la fine del decennio. I danni collaterali della lobotomia erano spesso evidenti: i pazienti molte volte rimanevano in stato semi-vegetativo, o mostravano evidenti problemi di linguaggio – non di rado rimanevano disabili per tutta la vita. Certamente la lobotomia era efficace per facilitare la cura dei pazienti più violenti: all’epoca, inoltre, i farmaci per malattie di tipo psichiatrico erano ancora agli albori. Per mettere maggiormente questa pratica nel contesto di quegli anni, bisogna ricordare che non si trattava dell’unica terapia radicale e invasiva in voga nella prima metà del XX secolo: elettroshock, shock da insulina, terapia malarica, coma indotto da barbiturici, shock cardiaci… i medici, all’epoca, non ci andavano certo per il sottile.

Si stima che negli Stati Uniti siano state lobotomizzate più di 40.000 persone, 17.000 in Gran Bretagna, 9.300 nei paesi Scandinavi. Nel 1950 l’URSS vietò la pratica, bollandola come contraria ai diritti umanitari, perché “trasforma un malato di mente in un idiota”. Negli anni ’70 la lobotomia lentamente cessò di essere utilizzata, anche se alcuni casi si segnalano fino agli anni ’80. Fra i più famosi lobotomizzati, ricordiamo Rosemary Kennedy (sorella di John), che si sottopose all’intervento a 23 anni e rimase per sempre ritardata, e la sorella di Tennessee Williams, Rose, la cui sorte sembra abbia ispirato diversi motivi ricorrenti nell’opera del drammaturgo americano.

Sanguisughe medicinali

Jan2

Uno dei rimedi più antichi della medicina galenica sta tornando in auge, complici anche le star di Hollywood. Parliamo delle sanguisughe, o mignatte, utilizzate per scopi terapeutici o cosmetici.

Appartenenti alla sottoclasse Hirudinea, le sanguisughe sono degli anellidi che vivono normalmente nelle paludi. La loro bocca è una sorta di ventosa con la quale si attaccano alla pelle dei vertebrati, incidendola con le loro mascelle dentellate. Riescono così a incamerare notevoli quantità di sangue, gonfiando il loro corpo elastico: una volta sazie si staccano dall’ospite, e possono restare senza mangiare per diversi mesi, addirittura fino a un anno.

Le sanguisughe (hirudo medicinalis) sono state usate in medicina per millenni. Secondo alcuni perfino il serpente della verga di Esculapio rappresenterebbe in realtà una sanguisuga. Eppure nell’ultimo secolo questo rimedio antichissimo è stato confutato e abbandonato dalla medicina ufficiale, parallelamente alla tecnica del salasso.

Per fortuna (delle sanguisughe) la medicina alternativa e, talvolta, anche quella tradizionale ritornano di tanto in tanto al buon vecchio parassita ematofago: la bocca delle sanguisughe secerne un potente anticoagulante, per permettere alla ferita di sanguinare a lungo, e un forte anestetico. Il morso delle sanguisughe non è infatti doloroso. Alcuni lo paragonano alla puntura di una zanzara, altri non se ne accorgono nemmeno. Per l’applicazione si utilizzano sanguisughe “affamate” per mesi, e tenute in acqua dolce fresca; da due a dieci esemplari vengono posizionati sulla parte del corpo che deve essere curata. In questo modo si cerca di sfruttare le qualità antinfiammatorie, anticoagulanti e spasmolitiche delle sostanze rilasciate dalla sanguisuga.

Qualche tempo fa anche la diva hollywoodiana Demi Moore ha dichiarato che il segreto della sua bellezza sta nell’utilizzo regolare di sanguisughe. “Quando sono sazie – ha raccontato – si staccano e rotolano via come ubriachi al bar”.

Oltre alla medicina alternativa, la naturopatia o l’ayurveda, la sanguisuga ha però alcuni seri utilizzi ancora oggi in ambito medico: viene utilizzata in chirurgia plastica e ricostruttiva per scongiurare il rischio di cheratosi.

Non solo: un team di ricercatori guidato dal prof. David Pritchard, dell’Università di Nottingham, ha studiato a lungo gli effetti del particolare anestetico rilasciato dalle sanguisughe sul corpo umano, giungendo a una sorprendente conclusione.
Si è scoperto che la sostanza iniettata dalle sanguisughe per non far provare dolore alle prede è in grado di diminuire sensibilmente le risposte immunitarie del nostro organismo. Ciò significa che malattie autoimmuni, causate da un’eccessiva e sproporzionata reazione immunitaria, come la sclerosi multipla, la febbre da fieno e patologie asmatiche potrebbero essere trattate con successo con le sanguisughe.

Che si prospetti un loro ritorno, in grande stile?