Fiammetta Rocco - The Miraculous Fever-Tree - Malaria, Medicine and the Cure that Changed the World

Immediately, Ludovisi ordered the bell of the Sistine Chapel to be rung. Borghese was carried there wrapped in blankets, and Barberini’s election took place at once. When the votes were counted, he fell on his knees to pray. Rising, he announced that he accepted the conclave’s choice, and would take the name Urban VIII. The fire in the stove of the Sistine Chapel was lit with grass only. From its chimney rose a plume of white smoke. ‘ Habemus papam ,’ Gigli wrote in his diary.

The name Urban, many believed, was for Urbi et Orbi – ‘For the city and for the world’ – the motto of the city of Rome over which Barberini, as Pope, would soon preside as both temporal and spiritual leader.

But the Holy City was about to demonstrate that it had powers of its own. ‘As soon as they left the conclave,’ wrote Giacinto Gigli, ‘nearly all the cardinals fell ill and many were on the point of death. Even Pope Urban himself was among the sick.’

By the beginning of August, less than a month after Pope Gregory’s death, the summer epidemic of malaria was spreading all over the city. Hundreds of people lay sick in the Santo Spirito hospital, by the Vatican. On 16 August a papal avviso reported that forty of the cardinals’ attendants had died of the fever. One of the cardinals had already succumbed. On 19 August it was the turn of Cardinal Serra, one of those who had arrived just as the conclave doors were closing. Four days later Cardinal Sauli, who had been a possible candidate for the papacy, also died of the fever. By mid-September four more cardinals were dead, making a total of six, more than a tenth of those who had assembled for the conclave.

Outside the Vatican, the priests who said mass in the small churches on the lower reaches of the Tiber, and the lay members of the city’s many confraternities who worked so diligently among the poor, died in even greater numbers.

The new Pope too could not throw off his illness. Racked with fever, alternately hot and then shivering with cold, he could feel his spleen hard and swollen by the malaria. His coronation was delayed by nearly eight weeks. Even then, he had barely recovered. At the end of his coronation day Urban’s head ached. His neck was stiff, and for many weeks afterwards, one of his courtiers wrote, he could not bear the weight of the coveted papal tiara upon his head. Giulio Mancini, the senior doctor at the Santo Spirito hospital, was summoned to attend him. The new pontiff took to his bed. For nearly two months he did not leave it. Not until early in November, when the temperature had fallen and the summer fever died down, would Pope Urban be strong enough to undertake the ceremony of the possesso , when he would ride across Rome in a procession that saw him symbolically take possession of the Holy City. There were many who had feared that the new Pope would never be well enough to rise from his bed at all. But Urban would confound them all.

The newly-elected Pope was an educated man; yet although the early days of his pontificate were distinguished by a flourishing of the arts and the sciences, he was also deeply conservative, and in time that aspect of his character would prevail. Despite his championing of artists like Bernini and Boromini, his rule over the Roman Catholic Church would be known more for how it shackled its subjects than for how it liberated them through progress. Urban VIII imprisoned Galileo. He waged war across Europe for years at a time, financing his soldiering by imposing such high taxes on the city that he became known as Papa Gabella , the Tax Pope. Yet, having been educated by the Jesuits at the Collegio Romano, he also supported the quest for scientific knowledge and education that they were promoting; indeed, on the very day of his election, 6 August 1623, he issued the bulls of canonisation that made saints of Ignatius Loyola and Francis Xavier, the two men who had founded the Society of Jesus a century earlier. The Jesuits believed in educating first, converting later. Pope Urban became a great patron of Catholic missions abroad, and well before the middle of the seventeenth century there were Jesuit missions as far afield as China and South America.

A year after his coronation, Urban paid an official visit to the Santo Spirito hospital to confer a papal blessing upon Giulio Mancini and the other doctors who had helped save his life when he was sick with malaria.

From its earliest history, the order of the Confraternity of Santo Spirito had a special link with the Vatican. It was the conduit through which the Pope directed nearly all his charitable giving, and Giulio Mancini would remain Urban’s personal physician throughout his reign. One of its surgeons became a specialist at dissecting and embalming. It was he who would be assigned the delicate task of embalming the Pope when he died in 1642.

The Ospedale Santo Spirito in Sassia, to give it its proper name, had the official task of caring for poor pilgrims who flocked to the city in Holy Years. An earlier Pope had built a hospice there for sick paupers after he had a dream in which an angel showed him the bodies of Rome’s unwanted babies dredged up from the Tiber in fishing nets. As many as fifty wetnurses were employed in the hospital at any one time, each being able to suckle two or three babies.

The hospital Pope Urban visited could accommodate the wounded and the fevered in 150 beds, and as many as four hundred during the summer epidemics of malaria. Twice a day each doctor, accompanied by his assistant and the assistant apothecarist, would visit one of the four wards, each of which normally held about forty patients. He inspected and palpated the patients and questioned them about their symptoms. He would scrutinise their blood, which after every bloodletting was kept in a special niche by the bed, and he would prescribe treatments.

Although a special ward was reserved for the nobility, and some of the hospital’s doctors also treated the cardinals and bishops who resided within the Vatican – as well as the Pope – the Santo Spirito was primarily intended to serve the poor. Most of the patients would have been artisans – blacksmiths, tailors, horsemen, bakers and butchers – but there were also many beggars who were cared for by lay nurses. Johannes Faber, a German physician who studied at the hospital, recalled that in 1600, when he began his five-year training, more than twelve thousand people received shelter, food and treatment from the Santo Spirito, as well as medication from the apothecary which had been established on the ground floor.

Under Pope Urban, the apothecary of Santo Spirito would become one of the greatest centres for dispensing medicine in Europe. It was here that quinine, in the form of dried cinchona bark, would be given to the malaria patients in the city for the first time. In 1630 the Pope named a Spanish archbishop, Juan de Lugo, a Jesuit lawyer and university professor, as director of the apothecary. Elevated to the purple in 1642, Cardinal de Lugo would become responsible for turning the pharmacy from an artisanal studio to something approaching an industrial production line.

Like an apothecary that was being built at the same time by another Jesuit across the seas in Lima, Peru, de Lugo’s Roman medicine house resembled nothing that had gone before it, either in scale or in vision. By the time Archbishop de Lugo took charge of the apothecary of the Santo Spirito hospital, its shelves were filled with recipes for preparations of medicines, prescriptions for their use and descriptions of illnesses and symptoms treated by different physicians. Spread on long tables were all the instruments of preparation: pestles, mortars, presses, beakers, alembics, boilers, distillating tubes, glass containers and ceramic jars. Neatly labelled in thousands of jars and bottles were botanical and chemical ingredients. Camillo Fanucci, one of the hospital’s Jesuit apothecaries, wrote in his Treatise on all the Pious Works of the Holy City of Rome : ‘I resolve to tell Monsignor Teseao Aldobrando, commendatore of this hospital, that after looking over the hospital accounts, every year we distribute more than fifty thousand syrups, ten thousand medicines and twenty-five thousand other medicines. And thus, it is obvious to anyone that no expense is spared in this hospital in the care of the sick.’