Historical Background

The introduction of maize in Italy must have seemed like a positive agricultural development, with its prodigious yields and its ability to feed so many, but it had some very negative long-term implications. One of the most significant of these was the spread of the deadly disease pellagra.

What is pellagra?

Native Americans, the original New World cultivators of maize, used a lime treatment to prepare the grain for consumption. As we understand the process today, this made the B-vitamin niacin in the maize nutritionally available. However, the benefits of this traditional method were not understood by Europeans when they began cultivating and consuming maize, so they did not import the process; instead, they treatied maize as a cereal, to be dried and milled into flour. This meant that when the crop became a staple in northern Italy, niacin deficiency became increasingly common. The wasting disease that resulted from this deficiency was termed pelle agra, in reference to the severe dermatitis that could be observed on sufferers (pelle = skin; agra = rough). But this was only the first stage of a debilitating and potentially fatal disease.

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Giuseppe Mentessi (Ferrara, 1857 - 1931)

From the middle of the eighteenth century, pellagra developed out of maize subsistence, maize being the cheapest and most filling food available to the poor of northeastern Italy. Even contemporaries understood it as a disease of poverty: il mal della miseria. By 1880 there were an estimated 100,000 victims of the disease. Sufferers of pellagra  -- pellagrins -- could experience a succession of different symptoms, from skin lesions and peeling, to chronic diarrhoea, extreme lethargy and dizziness; but in the long-term some of the most significant effects were on mental health. The disease would cause confusion and eventual insanity, referred to as pellagrous mania.

Soup kitchens were set up in affected areas, but this did little to alleviate the suffering of pellagrins and their families. For those driven mad by the disease, the only real relief came when they were sent to the provincial insane asylums. In the Veneto, serious cases would be sent to either the San Servolo asylum (men) or the San Clemente asylum (women). These were located on two adjacent islands in the Venetian lagoon, within sight of St Mark's Square. The extensive records from these asylums are an invaluable primary source of data that the 'Rough Skin' project will collate and transform into a published database. The data will enable the project to answer questions about the way mental illness was categorised over the period, how treatments changed, and to understand the social origins and experiences of pellagrins.

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