iM THE SERPENT OF AESCULAPIUS, THE CONFRATERNITY OF SS. COSMAS AND DAMIAN AND THE BISHOP OF MALTA A Medico-ecclesiastical Controversy 0.f1859

PAUL CASSAR S.B.St.J., M.D., B.Sc., D.P.M., F.R.Hist.S.

Hon. Fellow of the ROyQJl University of Malta

In the Middle Ages it was the usage doctors and surgeons being entrusted with for artisans engaged in a particular craft the application of leeches, the extraction of or art to combine together to form confra­ teeth and bloodletting. ternities and corporations under the aegis The confraternity of SS. Cosmas and of the church. The former were associations Damian held its religious functions at thE' aiming at fostering religious piety among church of St. Francis of the Minor Conven­ their members and assisting them when tuals in Kingsway, Valletta, where it had sick or unemployed; the corporations were an altar, still in existence, dedicated to the guilds concerned with the promotion of a two brother saints. The altar piece is from high standard of worksmanship among the brush of Filippo Paldini (1544-1614?) their craftsmen, the proper training of (Cassar, 1972). apprentices and the protection of the eco­ nomic interests of their members. The saints' feast day was commemor­ In Malta these associations emerged ated with great pomp and solemnity on the into prominence in the early seventeenth 27th September. A notable feature of this century. The confraternities (called also celebration was the procession from\ the sodalities and consodalities) and corpora­ Conventual Church of St. John to the tions bore the name of the tutelary saint church of St. Frands already mentioned of their craft; thus the carpenters formed and in which the Grand Master of the the confraternity of st. J oseph, the jewellers Order of st. John with the Chaplains of that of St. Relen and the shoemakers that of Obedience and the members of the confra­ st. Crispin. Their meeting place was usually ternity, in their distinctive tunics, took part the sacristy or oratory of the church where (Cassar, 1965b; Suppliche 1741-61). It is on their patron saint was venerated (Cassar, record that these functions were already in 1965a). existence in 1644. The medical practitioners and sur­ We are unaware of the other activities geons of Malta were organised in a confra­ of this confraternity until we reach the ternity named after the protective saints of years 1720 and 1754 when the barbers the profession Saints Cosmas and Damian. asked the Gand Master of the Order of St. This confraternity, founded on the 10th John to allow them to form their own October 1635, was also known as the brotherhood independently of the medical universitas barbitonsorum (Cagliola, 1644), practitioners. We catch a further glimpse the reason being that the physicians and of the confraternity of SS. Cosmas and surgeons shared the membership of this Damian on the 3rd June 1797 when ,by a association with the barbers as, in those government decree of this date the barbers days, the latter were ancillary assistants to were completely separated from the physi- 157 cians and surgeons and authorised to form Pace Forno took over th3 administration of their own corporation under the name of the diocese (1857-75), he gave the same St. Ludovicus of France (Cassar, 1965b; order to the Minor Conventuals and the Suppliche 1741-61). rector of the confraternity through the We again lose sight of the confra­ Vicar General but he, too, was ignored. ternity of SS. Cosmas and Damian for the The confraternity of painters, under next fifty years when we read of a funeral the patronage of St. Luke, also possessed service held by its members for the repose an altar in the same church. They too had of the soul of Dr. Luigi Gravagna on the decided to rebuild their altar dedicated to 29th March 1849 at St. Francis Church this saint. "Encouraged by the disobedience Il Piortafoglio maltese, 1849). By this time (of the doctors)" they adorned it with the oQThfratemity was know as the pia "sculptures of the square, the compass, the societd medico-chirrurgicGi-farmaceutica. In hammer and other symbols of the arts; but 1856 and 1857 the feast of the two saints as in Malta these (tools) are recognised as was celebrated on the 27th September with masonic signs many were scandalised and High Mass and a panegyric in which the Lh:> press criticised" the new designs. preacher exhorted the congregation to Arr:hbishop Pace Forno again repeated imitate the virtues of the two martyrs. The his instructions to the Minor Conventuals attendance in 1856 was, however, poor as t.o have these "inconveniences" removed less than a dozen medical men were pre­ hut "everything was in vain". sent. The expenses of the ceremonies were On the 31st August 1859 the Minister defrayed out of funds collected from m~m­ Gp-ueral of the Friars of St. Francis, Fra bers of the profession but it was being Salvatore Cali' of Catania, Master of Arts found difficult to obtain the money as som? and of Sacred Theology and Adviser to the declined to contribute, others made pro­ Sacred Congregation of the Index. came to mises which they never fulfilled while a Malta to visit the convents and churches of few agreed to pay only after much cajoling his Order and to hold a Chapter General. (L'ordine, 1856 & 1&57). It appears that the Bishop Pace Forno took the occasion to call religious celebrations were not held in the the attention of the Minister General to the following years. dispute about the two altars. During his visit Towards the end of 1859 we come 1:0 the church of St. Francis, Fra S. Cali', across a record of a few letters exchanged having seen the "equivocal emblems of the between the confraternity and the Minor fine arts" adorning the altar of st. Luke Conventuals. The topic which gave rise to and the "symbols of Aesculapius" decorat­ this correspondence was the altar of the ing the altar of Saints Cosmas and Damian, confraternity in St. Francis Church. Some concurred with the Bishop that they were time in the first half of the ninetef!nth out of place. century the altar was rebuilt in the form of On his d?-parture from the Island on "a sepulchral urn flanked by two large tlhe lOth September (L'ordine, 1859), he trunks or rods of Aesculapius entwined by gave orders to the Father Guardian to per­ serpents and serving as columns to support suade the owners of the altar of St. Luke the altar slab". These trunks and serpents to take away the emblems of the fine arts were meant to symbolise the medical and and to induce tbe confraternity of Saints allied professions but in the view of the Cosmas and Damian to "remove' from sight Archbishop Bishop Mgr. Publio Maria thos~ entwined s~rpents representing Sant (1779-1864) they were pagan symbols medicine and reminiscent of a pagan so that one could not say whether "the altar myth . . . , it being inappropriate to have was Christian or pagan or a mixture of both. emblems of paganism in Catholic The people who had remarked on this churches" . inappropriateness were scandalised". For It appears that the Father Guardian, this reason the archbishop requested thp. Fra Giuseppe Bonaventura Farrugia, had removal of the "pagan" emblems but his no difficulty in convincing the confraternity order was ignored. of painters, who were in charge of the altar As soon as his successor Fr. Gaetano at st. Luke, to take away their emblems. 158

In fact "they obeyed" and no such symbols ~ommitted by anyone against the altar can be seen to-day surrounding the altar of Y/ill have unpleasant consequences. St. Luke. In the case of the brotherhood of I am, with all due respect, Saints Cosmas and Damian, the medical Dr. Cal. Parnis." fraternit.y adopted a different attitude and reacted quite strongly. It is not known what was the decision The Father Guardian duly informed reached by the general meeting of ,the the med:cal confraternity of the instruc­ Society. It is certain, however, that the tions he had received from his Minister emblems were not removed. The Bishop, General. He wrote thus to Dr. Calcidonio therefore, through the Chancellor of the Parnis, the procurator of the confraternity Episcopal Grand Court sent this letter to on the 28th S-=ptember 1859 (translated the Father Provincial of the Minor Con­ from Italian):- ventuals, Fr. Michele Scl).embri, on th:~ "ID accordance with the written 15th October 1859 (translated):- ord:rs given me by the Rev. Minister General I have to ask you, as Pro­ "Very Rev. Fr. Provincial, curator of the Venerable Consodality His Excellency Rev. Mgr. Arch­ of Saints Cosmas and Damian, to take bishop Bishop of Malta was informed steps to take away and remove from at the commencement of his adminis­ sight within eight days those entwined tration (of the dioces2;) that in the serpents, symbolising medicine and church of St. Francis of Valletta there recalling a pagan usage, which are was an Clltar with two large staffs of qui.te improper and intolerable in C1 Aesculapius. In view of the fact that sacred place. these are wholly pagan symbols and, I await a written reply to this therefore, inappropriate in the house letter as I am responsible towards th3 of God and more so, in an altar on Head of the Order for the execution which the bloodless' sacrifice (of the of his c~mmands. In the meantime I Mass) is celebrated, he has already sign myself with all due esteem, twice suggested both to the religious th::l most humble and obedient community and to the confraternity, servant, which cJilims to own the altar, to have them removed. Fra Gius. Bonaventura Farrug"a, His directions repeatedly ex­ Father Guardian." pressed in the most explicit manner have remained unh«:>eded. Meanwhib the Very Rev. Fr. Salvatore Cali', Dr. Parnis repUed_ the next day in the Minister General, during his recent following terms (translation):- visit to the convent of the Order, has ordered the removal of the said pagan "Very Rev. Father, emblems from that altar. Since not In answer to your letter of even this mandate has been obeyed, yesterday, I have to inform you that it His Excellency, in his capacity as is not within my power to remove any Diocesan and as Apostolic Delegate, one of the emblems existing in our commands that from to-day until the altar of Saints Cosmas and Damian as said staffs of Aesculapius are remond, the said altar is the property of th3 the said altar of Saints Cosmas and medical corps. I have, however, com­ Damian is being interdicted so that municated the contents of your letter no one is allowed to celebrate Holy to the President of the Society who Mass (thereon). has }instructed me to call a general Your most humble and obedient meeting to which pertains the duty servant, to deliberate on the matter. Sac. Emmanuele Corsoni, In my capacity as procurator I Chancellor of the Episcopal solemnly affirm that any aggressive act Grand Court." 159

The reply of the confraternity was influence gradually waned; or else resolute. They did not write to the Arch· were, from the very beginning adoptea bishop but they addressed the following by the Christians, although they had letter to the Fr. Provincial on the 19th been previously used by pagans, a~ October, that is four days after the declara­ they represented id.eas common to tion of interdiction of their altar (transla­ both Christians and pagans. tion):- In the particular instance of the entwined serpC'llts, which are the cause "Very Re\>. Father, of such fear to Your Paternal In answer to your esteemed lettei Reverence, we have to add that they of th~ 28th September addressed to were placed on the altar belonging tf> one of us, we have been directed to this noble corporation as insignia of inform you, as deputies of the Medico­ the medical profession twenty-foUl chirurgical-pharmaceutical Corpora­ years ago with -the full knowledge and tion under the title of Saints Cosmas after Cl serious and mature considera· and Damian, that the coiled serpents tion of the ecclesiastical authority as to which you refer are the symbols of we shall prove if and when the the medical profession and as such occasion arises. For this reason the quite suitable as an emblem of this medical corporation which we repn:· corporation. In fact this emblem was sent does not consider it decorous and adopted at the very inception of the incumbent on them to adhere to the corporation following the example of request made by Your Paternal similar corporations elsewhere and Reverence. especially in the capital of the Moreover, as the medical corpora­ Catholic World. tion ig the possessor of the altar of The coats-of-arms of families and Saints Cosmas and Damian and as of corporations are to be seen, with­ ownership is safeguarded by the out any incongruity, in all the churches sanctity of the law and the authority of the diocese; and in some instances of our Queen, we deem it our duty to quite independently of the object inform Your Paternal Reverence and represented. To avoid drawing up a anyone else whom it may concern long list of examples, it is sufficient to that the medical corporation, in order call the attention of Your Paternal to ensure the inviolability of its rights Reverence to the insigna adopted by on the said altar, will not allow anyone the Cathedral Chapter which appears to lay his hands on it and will take on the silver frontal that adorns, on 1!;\gal steps against anyone who the most solemn feast days, the main 2tt.empts to do so. altar of the church of Malta. Here the Most humble and devoted servants, serpent, or rather the viper, is seen Cav. Gaetano La FerIa, curled round the sword and sur, Dr. Paolo Grillet mounted by that form of crown with which the pagans decorated their At this point the correspondence gods. Furthermore, does not the cl)mes to an end and we have to search bishop himself carry a serpent coiled ~lsewhere for a clue as to how the dispute round his pastoral staff? Besides if all was resolved. It is convenient, therefore, the objects which recall pagan rites and at this stage to pause in our search and usages were to be eliminated from our c.ast a glance at the corpus delicti and at churches - this being the reason on the personalities involved in the case. which Your Paternal Reverence The caduceus or staff or rod with one seems to base your request - our cult or two serpents entwined round it appeared will be deprived of its outward and as an attribute of the healing Greek god imposing majesty since many, not Aesculapius after the sixth to the fifth cen­ to say almost all, of its features were tury B.C. As a pagan deity of medicine, derived from the pagan rite as it~ Aesculapius aroused the antagonism of 160 Christians in the second century A.D. In later years the Christians adopted when h~ was regarded by the early the brass serpent as an image of Christ. Th~ Fathers of the Church as an evil spirit and bronze, which withstands the ravages o~: even identified with Sata"!l himself~ Inspite time, signified His Divinity: the serpent of this hostility, however, the concept of symbolissd His Humanity; and the pole Aesculpaius as a beneficent div:ne physi­ stood for the wood of the cross on which cian survived in the Christian guise of He was crucified for the salvation of the miraculous healing saints. Prominent world (Th~ Messenger of St. Anthony, among thes~ were the physicians Saints 1969), Cosmas and Damian who l:ke Aesculapius In sixteenth century Germany silver effected cures during incubation i.e. by m2dals were struck depicting the brass appearing to the patients in their dreams, serpent on the obvers~ and a crucified connselling them, prescribing remedies or Christ on the reverse s~de. They were healing them by the laying on of hands as worn as a protection against the plague was practised in the Asklepian temples at (Schouten, 1967c). Epidauros, Pcrgamum and Cos. The rod and serpent motif was Aesculapius with his traditional sym­ accepted within a Christian context by bol of the rod and serpent re-emerged in 1762 when it was incorporated in a painting the sixteenth century in Christian Europe of Sa:nts Cosmas and Damian by ,Johnn during the humanist culture of the Renais­ Anwand2r for the Maria Himmelfahrt sance when the visual arts ceased to be th(~ Kirche in Dilligen-on-the-Danube (Schoe­ handmaids of religion and attained an t.:n, 1967d). independent existence and expression. These remarks regarding the place of Since then the rod and serpent have the serpent in pagan and Christian thinking become the symbol of the medical and show how well read were Drs. La Ferla and pharmaceutical professions (Schouten, Grillet about the role of serpent symbolism 1967a). in ancient times. Their reference to the In Malta it was adopted as an emblem crowned serpent or viper coiled round of the Societa medica 'd'inconaggiamento the sword is an allusion to the coat-of-arms on its foundation in 1837. The serpent and of the Cathedral Chapter of Malta. This rod are emblazoned over the white and red device is derived from St. Paul's shaking shield of Malta (Statuti, 1843) and form the viper into the fire on landing on the part of the design by Nioola Zammit of the Island of Malta after his sbip'Nreck (Luke, diploma of membership of the society (Ms. Acts, 28,3). The crown symbolises the glory 491). of martyrdom and the sword the instru­ In mythology the serpent symbolises ment by which the apostle was put to rejuvenation, an idea derived from the death. This emblem is displayed on the top periodical shedding of its skin and the of the steeples of the Cathedral Church at formation of a new one, The rod represents Mdina and on the facades of farmhouses the renewal of vegetative life; hence both and other buildings belonging to th~ stand for the indestructibility of life and, Chapter of the Cathedral. by analogy, for recovery from illness and Some of the protagonists - Fr. M. for restoration to health (Schouten, 1967b: Schembri, Fr. G. Bonaventura Farrugia Geddes, 1945), and the Rev. Em. Corsoni - who were Among the Hebrews the serpent stood dragged into the controversy only in view for salvation. When the Israelites com­ of their official positions in the ecclesiastical plained about their food, while wandering hierarchy, have eluded all my attempts to in the desert round Sinai, God punished get to grips with them as personalities. them by sending fiery serpents, many dy. Mgr. Fra Gaetano Pace Forno, the son ing of bites from these animals. When the of the lawyer Dr. Fco.. Pace, was born in Israelites repented the Lord told Moses to Gozo on the 5th June 1809. His mother be­ make a brazen serpent and mount it on a longed tot the family of the barons Forno of pole so that whoever was bitten would Palermo. He joined the Augustinian Friars recover by looking at it (Numbers, 21:4). eventually becoming the Father Provincial 161 in 1847. In the following year he founded ing labour (Laferla, 1855). He stressed the the school which is still run by his Order. need of studying the natural history of the In 1857 he was appointed coadjutor to Mgr. Maltese Islands (1838-39) and proposed the Archbishop Publio M. Sant and when the compilation of a series of biographies of latter resigned in December of the same Maltese medical men (Sboria societa year, Fra Gaetano Pace Forno assumed the medica, 1845a; Ms. 1404). direction of the diocese. He became bishop In 1844 he went to the R~gency of of Malta on th~ 31st May 1858. Tunis to deal with a "contagious illness" His tenure of office was marked by a that spread among the troops of His Excel­ few episodes of friction with the British lency Ahmed Bey who honoured him with authorities who governed the Maltes9 a decoration as a reward for his successful Islands in those days. The first clash efforts. In 1853 he drew the attention of the occurred on the very day of his installation British Consul General at Tunis to the as bishop when the commander of the Bri­ plight of the Maltese settlers in that tish troops in Malta refused to fire the ar­ Regency and interceded with him to pro­ tillery salute that in the past had been tect them from the Mussulmans without accorded to the bishop of Malta on his charging them the prescribed fee. He was installation. In 1860 he was at variance with back in Malta in 1854. In 1856 he was the Governor when an Italian operatic elected a member of the Council of Gover­ company made some uncomplimentary ment (Ricorsi e lettere 1854; The M2Ita allusions to the temporal power of the Pope Government Gazette, 1856). He belonged although the Governor had ordered the to various foreign medical ass-ociatiollS company to withdraw the play in question. among which the Societe Royale de In the following year he was again at log­ Medecine de Marseille (1835), the Societd gerheads with the Governor when some fmnopatica italiana (1862), the PhYSICtJ­ roofing stones were removed from the Medical Society of Moscow (1862) and the vaults in st. John's Co-Cathedral to ascer­ Accademia medico-chirurgica di GeniQlVa tain whether certain structural alterations (1857). He died on the 30th August 1865 at could be carried out in a nearby cellar. A sixty-three years of age at Siggiewi (The far more serious discord arose in 1865 Malta Observer, 19(5). concerning the question of the validity of The Grillet family was established in marriages between Catholics and Protes­ Malta in 1645 when the Frenchman Stefano tants whicb lasted for many years before Grillet (or Grigliet) married Margerita a final solution was reached (Laferla, Cannolo at Birgu. By the end of the cen­ 1938). tury the Grillets had become a "medical" Very little is known about Dr. Ca1ce­ family there being a surgeon Sebastiano donio Parnis. The son of a doctor, he and his son, a physician, also named S8bas­ studied belles lettres at Pis a before he tiano, who lived in Valletta in the first two turned to his medical education at Malta. decades of the eighteenth century (Libr. He had a very short professional career Ad. 53). Dr. PaoIo Grillet studied medicine dying at thirty-s:x years of age on the 18th and surgery at the University of Pisa where August 1864. He is buried In the Carmelite he qualified in 1845. He appears as a mem­ Church at Valletta having been the Rector ber of the Societa medica d'incomggia­ of the Confraternity of Our Lady of Mount mento on the 16th June 1846 when he took Carmel (L'arte, 1864; L'ordine, 1864). part in a discussion on purpura haemorr lha­ Dr. Gaetano La Ferla, born on the 16th gica. His name occurs again in the proceed­ April 1802, qualified in medicine and sur­ ings of this society in 1848 in connection gery in 1825. He was a founder member of with a debate on hydrophobia and with a the Societa medica d'incoraggiamento proposal for plans for the preparation of a when this association was set up in 1837 standard nomenclature of diseases to (Guida, 1855; Pronostku malti, 1960; L'arte, oibv?:atet the confuSion caused by doctors 1865). He wrote a monograph on the use of who referred to different diseases by the asafoetida resin in the prevention of foetal same name and to the same diseases death in cases of inertia of the uterus dur- by d~fferent names. In 1849 he was 162 elected a member of a commission set up more so (in a country) under the influence by the society to study measures for a port of a Protestant government" (Le. the Bri­ medical service at a time when cholera had tish Government). The Sacra Congregazione appeared in various Mediterranean pons concluded its letter by inviting the Arch­ (Stona societa medica, 1845b). bishop to inform Rome what was "the real During the Crimean War (1854-56) he reason that gave rise to the interdiction of went to the Crimea where he dedicated the altar." himself to military surgery. On his return Archbishop Pace Forno replied on to Malta he served "with zeal and self-abne­ the 11th February. As his arguments and gation" in the cholera epidemics of 1865, observations throw a revealing light on 67 and 1887. He spent the last years of his the complex pattern of social and religious life as District Medical Officer of Valletta, life in Malta in the mid-eighteen-fifties it Quarantine Medical Officer and Visiting is worth reproducing extracts from his Physician to the Lazzaretto. In recognition letter at some length. After giving an ac­ of his services to the Italian community in count of the events leading to the interdic­ Malta he was created Cavaliere dell'Ordine tion, he remarks that if the serpents and della Corona d'Italia in January 1890. He abacus "were sculptures within a shield, died on the 29th July 1890 (La rivista one may allow them outside the altar pro­ medica. 1890), per on the pilasters at the sides of the altar As already stated. after the letter of as is the custom with coats-of-arms of noble the 19th October 1859 over the signatures families; they cannot, however, be permit­ of Drs. La FerIa and Grillet. the archives ted as they actually are and as an integral of the Minor Conventuals at Valletta dis­ - or rather a principal - feature of the close no further information on the sub­ slab itself on which the I',amaculate Lamb ject (Fiorini, 1973). Efforts to track and is sacrificed. Such strictness would not locate the registers of the confraternity seem necessary abroad; but it is not so in have given no clues as to their whereabouts Malta where we live in the midst of a but a search in the archives of the Archie­ thousand critics and especially among Pro­ piscopal Curia has revealed further docu­ testants who grasp every opportunity to mentation from which we learn that the accuse us of idolatrous rites. It is neces­ crisis had deepened and reached a climax sary for the Societa medico-chirur:giCa when the issue was referred to Rome whose deputies, to justify their disregard. through a memorial submitted by the of my order and that of the Father Friars. General, stated that . . . . if the Catholic In a letter of the 23rd January 1860 Church were to do away with its pagan the Sacra Congregazione dei Vescovi e (rites) nothing wilL be left. Such is the COll­ Reg,olari at Rome informed Archbishop cept of the church held by these men ... Pace Forno that it had learned that the some of whom, as is publicly known, do doctors had opposed the removal of the ser­ not believe in the Christian religion." pents on the ground that these animals The doctors, however, were not the were not meant to recall pagan rites but to only persons to earn the strictures of the symbolise the medical profession. The doc­ Archbishop; in fact he openly expressed tors claimed the right of setting up their his disapproval of the conduct of the Minor heraldic emblem in any place that belonged Conventuals (Sammut, 1860) who, on the to them. It had also been brought to the pretext of being regular priests and of their knowledge of the Sacra Congregazione that church being outside the jurisdiction of the the Minor Conventuals had been advised Archbishop, "do and allow everything to be to sue tl1em in a lay Court of Law to induce done without his sanction". He alSo them to remove the serpents in question deplored the fact that one of the friars had and that, as the Friars were reluctant to do insulted him and his officials not only in so, the Archbishop had reacted by inter­ public but also in church and that the friars dicting the altar. The Sacra. Congregazione endeavoured to have the interdiction did not consider it "prudent to i~itiate revoked by the Sacra Congregazione to be court proceedings in a lay tribunal much in a position to "boast that they had 163 shamed the bishop of the diocese". many occasions and, it must be truly said, As to the involvement of a lay tribunal that due to the integrity and independence in the dispute, commented the Archbishop, of the judiciary we never had any reason there would be no need to take this step ';it to complain". The friars themselves, con­ the friars had been prudent enough. Having cluded the Archbishop, had felt no qualms lmown since some time that those emblems on a past occasion to sue their own superior were not suitable in a Christian altar they in the Police Courts. should have endeavoured, with good mall­ While the Archbishop had no anxieties ners, to make the members of the sodaHy, about the administration of justice in the among whom there is no lack of reasonable Island, he was quite alarmed at the alleged (men), understand the whole question. But inroads of freemasonry among his flock." the friars did not care about the remarks "It is well known", he observed, "that in of the public neither about the Malta the numb2r of (masonic) sects has remonstrations of the bishops nor the increased considerably and that many Mal­ latter's orders. It was only when they tsse have joined them; if we go on like this, were prohibited from celebrating Mass ou we will one day see on our altars the image the altar that they began to stir. But what of a head of a sect and, under the pretext did they do? They irritated the member!'; of exemption or of ius patronatus, one of the sodality. It is well known that one of would have to tolerate this abomination. the friars, who is eager to have the inter­ Most Eminent Fathers, Malta is an excep­ diction revoked, has been insulting them In tional country. One must be on one's guard the streets saying that they neglect to ful­ to resist profanation; otherwise there is the fil their paschal duties and even threaten­ risk of losing the purity of the Catholic cult ing to break the rods with his own hands. and also of every religion" (Pace Fomo, In the end. when the friars. with their lack 1860). of prudence , had rendered any agreement The Archbishop's preoccupation about impossible they came to ask what they the diffusion of freemasonry in Malta should do. They were told to have recours':) was not altogether unjustified; indeed a to the law courts. What else, under the prominent freemason, writing in 1880, circumstances, could one do? Either remain stated that there was probably no part of with the altar mterdicted or else take steps the world where freemasonry had so to remove those emblems through court greatly prospered during the nineteenth action. This was a necessary consequence. It century as in Malta. As early as 1815 the every time that anyone refused to obey an Bishop of Malta had remonstrated with the order that order were to be rescinded, then Governor, Sir Thom~s Maitland. against tho. all the laws of the world would have to be weekly meetings of free masons in Valletta. abolished" . In 1843 he publicly condemned all secret Regarding the reluctance of the Sacra societies and especially freemasonry Congregazione to start court proceedings, (Broadley, 1880). he hastened to assure them that they had The dispute between the doctors and been very badly informed about the lav the Archbishop caused no furore in the judicature of the Island. "In Malta', he press in spite of its unusual nature but it says, "the tribunals ... are independent of was summarily referred to in a jocular vein the executive administration in fact they by the Fa,antropo maltese. In its issue of deal with law suits even against the govern­ the 31st January 1860 this paper repre­ ment itself . . . and the judges are so up­ sented Saints Cosmas and Damian nursing right that they deliver judgments even a grudge against the Maltese first because against the gover:;:nlent when the latter is their altar had been interdicted and at fault. Besides, the judges are all secondly because none of the medical men Catholics ... and before reaching a deci­ - Drs. Gaetano La Ferla, Felice Grech, sion they would ask for the opinion of Francesco Adami, Luigi Calleja and Nicola theologians and of experts on the Catholic Mamo - who had presented themselves as rite. Both my predecessors and myself candidates for the Council of Government have had recourse to these tribunals on had been elected (ll portafoglio, 1860'=t.~ 164 In fact the Council resulted formed of six and gave their approval for two shields lawyers and two business men (Filantropo with the symbols of Aesculapius to be fixed maltese, 1860). But the dawning of the year to the pilasters on each side -of the altar "in 1860 was of great concern not only to Saints conformity with the design" forwarded to Cosmas and Damian but also to Bishop them. These gilded emblems of Aesculapius Pace Forno. Grave events, triggered by the have survived and to this day they grace the Risorgimento in neighbouring Italy were altar of Saints Cormas and Damian in the seriously upsetting his peace of mind: no Church of the Minor Conventuals. less, in fact, than the "impiety" of those The serpent coiled round the abacus is who were struggling to destroy the tem­ picked out in bold and gilded relief on a poral power of the Holy See to further their shield which is framed by branches of ideal of a united Italy. Faced with this laurel (Laurus nobilis) which, like the rod "sorrowful and tragic" crisis the Arch­ and serpent has asklepian associations bishop directed all his energies to exhort­ for the god of healing is sometimes figured ing his Maltese flock to pray for, and to crowned with laurel while in the past an show their solidarity with. the Pope ethereal oil was obtained from the leaves (L'indipendente, 1860). He showed his pre­ and fruits of this shrub and used as a oooupati:on in a pastoral letter issued at medicament. the beginning of Februa,ry 1860 (Il porta­ From 1860 onwards the emblems of foglio, 1860b). Compared with this threat Aesculapius no longer called forth the to the Head of the Catholio Churoh, the dis­ wrath of the Maltese ecclesiastical authori­ pute about the "soulptured emblems of ties; so much so that henceforth the rod and Aesou~apius, which sinoe years had serpent were incorporated in the ornamen­ adorned" the altar of Saints Cosmas and tation of memorial inscriptions on the Damian was a trivial matter indeed. In faot marble tombstones of physicians and sur­ the inte~dktion was withdrawn, the lifting geons buried in our churches. Random of the !ban being amrounoed in a looal paper examples are those of Dr. Antonio Mifsud on :the 9,th February 1860 (Il messaggie'r'e, (1883) and Dr. Daniel F. Chetcuti (1895) at 1860). the Rotunda Church at Mosta and of Dr. The campaign against the incorpora­ Giuseppe Rocco Peralta (1896) at the Parish tion of "pagan allegorical insignas" in Church of Balzan. sacred art, however, did not slacken. The The subsequent fate of the various editor of the "politico-religious" new~­ personalities involved in the controversy paper L'ordine while referring to certan can be told in a few words. Mgr. Fr. Gaetano mosaic gravestones in our churches, Pace Forno died at Naples on the 22nd deplored the "horrible profanation" by July 1874 (11 portafoglio maltese, 1874). He SCUlptors, painters and other artists who had lived long enough to witness the had dared to represent sacred objects with dreaded fall of Rome in 1870 when, on the mythological symbols (L'ordine, 1860a). 20th September, the Italian army under The rift between the Archbishop and General Cadorna breached Porta Pia and the confraternity was eventually healed entered the city bringing to an end the apparently after the emblems of the rods temporal power of the Pope. and serpents supporting the altar slab were Of the three medical protagonists - removed; in fact the present altar of the Drs. Parnis, La FerIa and Grillet - the two saints conforms to the conventional first two preceded the Archbishop to the pattern of other altars in our churches. We grave; the third one was laid to rest in have not succeeded in tracking down a pic­ 1890. torial record of the lost altar and we wonder The pia societd of Saints Cosmas and what were its artistic merits. But not every­ Darnian faded into obscurity. It did not thing was lost. In a letter of the 30th Sep­ figure in a list of eighteen confraternities tember 1860, the Sacra Congregazione that contributed with other constituted expressed their satisfaction at the "conclu­ bodies to a fund of fifty-four thousand sion of the conciliation" between the Arch­ francs which was sent to Pope Pius IX by bishop and the Societd medico-chirurgica the Maltese Diocese as a sign of solidarity 165

when his temporal power was threatened by References the armed forces of the Italian Risorgmento in 1860 (L'ordine, 1860b). From now on we BROADLEY, A.M. (1880). The History of Free­ lose trace. of the confraternity which has masonry in the District of Malta, London, disappeared without as yet giving us a hint pp. 1, 15, 24 & 34. as to how and when its extinction came CAGLIOLA, Ph. (1644). Almae siciliensis pro­ about. In fact nothing has been found in the vinciae Ordinis Minorum ConventuaUum S. way of its records. Francisci, Venice, p. 121. CASSAR, P. (1965a). Medical History of Malta, Comment London, p. 485. CASSAR, P. (1965b). ibidem, p. 486. This excursion into a byway of Maltese CASSAR, P. (1972). The Cult and Iconography of medical history shows how the religious SS. Cosmas and Damian in the Maltese Islands, factor has moulded the pattern of the Melita Historica, 1972, 6, 3l. social, political, artistic and intellectual life FUantropo maUese (1860), 31st January, p. l. of Malta in the past. Any deviation from FIORINI, B., (1973). personal communication. the orthodox religious framework - even GEDDES, A., (1945). Creation and the Blessing as late as the mid-nineteenth century­ or the Curse Upon Fruitfulness, Man, 1945, called forth the intransigent opposition of Nov.-Dec., p. 123. the Maltese ecclesiastical hierarchy who Guida di MaUa (Muscat) (1855), p. 23. suspected implications of the most danger­ n messaggiere popolare (1860), 9th February, p. 3. ous kind even in the universal and harm­ n portafogUo maUese (1849), 29th March, p. 4918. less emblem of a professional association. Ibidem (1860a), 1st February, p. 3 & 4th February, Indeed they saw the disrupting enemy in p.3. all shapes and on every front not only in Ibidem (1860b), 15th February, p. 3. the artistic manifestations of classical Ibidem (1874) 28th July, p. 2. culture and in the flow of foreign influences LAFERLA, A.V., (1938). British Malta, Vol. I, among the laity, but even within their own Malta, pp. 229, 271 & 244. ranks. LAFERLA, G., (1855). Sun'uso deUa gomma The episode, however, has its redeem­ resina d'asafoetida adoperata per prevenire ing aspects; for by their stand our past col­ la morte del feto neUe gravidanze morbose leagues brought into sharp relief their cor­ agravate da inerzia deU'utero, Malta. porate sense of honour and set us an Uarte. (1864)" 22nd August, p. 4. example of courageous resistance against Ibidem (1865), 7th September, p. 6. what they felt to be the unreasonable Libr. Ad. 53, n.p. Royal Malta Library. demands of others. Although their efforts Uindipendente (1860), 11th February, p. 3 & 18th were not completely successful we cannot February, p. 4. but look with pride on the resolute manner La rivista medica, (1890), 31st July, p. 8. with which they met the challenge and on Uordine (1856), 3rd October, p. 4797. their dignified endeavours to save from Ibidem (1857), 2nd October, p. 5006. oblivion a unique landmark of our Ibidem (1859), 2nd September, p. 164; 9th Sep- medical heritage. tember, p. 167 & 16th September, p. 172. Ibidem (1860a), 29th June, p. 4. Acknowledgements Ibidem (1860b), 18th May, p. 3. Ibidem (1864), 12th August, p. 4. I am deeply grateful to His Grace the Ms. 491, n.p. Royal Malta Library. Archbishop for allowing me access to the Ms. 1404, n.p. Royal Malta Library. Archiepiscopal Archives and to Rev. Fr. B. Pace Forno, G., (1860). Correspondence. Archie­ Fiorini O.F.M. Conv., for indicating and piscopal Curia, Valletta. helping me to use sources in the archives Pronostku malti (1960), Malta, p. 6l. of the Minor Conventuals at Valletta and Ricorsi e lettere del Dr. G. La Ferla e di Sir E. also to Rev. Fr. A. Bonnici of the same Stuart Baynes, (1854), Malta. Order for other assistance. SAMMUT, A., (1860). Un fatto notabUe, Malta. 166

SCHOUTEN, J., (1967a). The Rod and Serpent of Ibidem (1845b), pp. 85, 101, 190, 202, 242 & 257. Asklepios, Amsterdam, p. 87, 88 & 227. Suppliche (1741,61), Vo1. 7 Part 2, fo1. 786, Archie­ Ibidem (1967b), pp. 194, 201 & 224. piscopal Curia, Valletta. Ibidem (1967c), p. 98. The MaLta Government Gazette (1856), 29th Ibidem (1967d), p. 204. August, p. 271. Statuto della societa medica d'incoraggiamento The Malta Observer (1865), 11th September, p. 2. (1843), Malta, frontispiece. The Messenger 9f St. Anthony (1969), September Storia della societa medica d'incoraggiamento Number, p. 15. (1845a), pp. xxiii, xxiv, xxvi, xxvii, xxxiii, & xxxviii.

A NOTE ON THE ECONOMICS OF MEDICAL PRACTICE IN EIGHTEENTH CENTURY MALTA

PAUL CASSAR S.B.SU., M.D., B.Sc., D.P.M., F.R.Hist.S

Hon. Fellow of the Roya:! University of Ma!.ta

The medical man is traditionally three hitherto unpublished manuscript regarded as being dedicated to the relief of volumes bearing the title Minutario dell' human suffering and motivated by a senti­ audienza (Arch. 675, 676 & 677). mental compassion for the needy sick. The applicants are of all kinds - gold­ Because of this dignified calling he is held smiths, tailors, coalsellers, manufacturers in high esteem by the community which he of gloves and stockings, notaries and even serves. This image of the doctor's apostol­ the compgnia dei comici (theatrical com­ ate, however, tends to blur the fact that pany) which sought payment for the hiring there is also an economics of medicine of boxes at the Manoel Theatre. Among since a practitioner adopts the medical pro­ this motley band of creditors figure our fession as a career and, therefore, expects ancestral colleagues - the physicians and to make a rewarding livelihood from :it. surgeons - and their auxiliaries i.e. the This paper deals with this facet of the prac­ aromatario (pharmacist), the maestro di tice of medicine in Malta in so far as the fisica (physic master), the pnattico (assistant financial aspects of the care and treatment surgeon), the barberotto (barber-surgeon) of opulent and highly placed members of and the cQJvasangue (phlebotomist or the Order of St. John during part of the bleeder). eighteenth century were concerned. Except in occasional instances, tile' When a knight died his creditors requests for payment are written in a uni­ applied to obtain their due from his spaglia form stereotyped manner Here are two Le. the effects existing at the time of his typical speciments (translated from the demise. Their names for the second half of original Italian): "Dr. Carlo Perdon the eighteenth century are recorded in demands to be paid from the spoglio of the