Introduction

The relationship between spirituality, religion and medicine has been recognized since antiquity in human communities living in different geographic areas of the world. Despite large differences in their history, society and economy, cultures from North and South America, The Far East and The Middle East, Africa and The Mediterranean area, shared a common belief that spirituality and religion played an important role in the healing of diseases. Afterwards, above all in Eastern cultures, spiritual and religious components have always been believed to be important factors in maintaining health. Instead, in Western cultures, above all after the Renaissance and the Late Enlightenment, spiritual and religious dimensions have diverged from medicine [1].

Nowadays, bio-medical research around the world, enriched by the contribution of other disciplines such as psychology and anthropology, shows growing interest in the relationship between spirituality, religion and health [2, 3]. In recent years, scientific literature highlighted that spirituality/religiosity can improve recovery from illnesses such as cancer [4], mental disorders [5], cardiovascular diseases, rheumatoid arthritis and head injuries [6].

At the same time it has developed an interesting debate on the definition of spirituality and religiosity. Some authors use the terms spirituality and religiosity as synonyms asserting that the two concepts have common matrix in rites and rituals and so cannot be separated. Others assert that spirituality is associated with finding meaning and purpose in life, transcendence beyond the physical body, and/or experiencing a sense of connectedness with self, others, nature, and/or a power greater than oneself. While, religiosity is associated with human expression of the rites and rituals of a particular faith tradition [7].

Moreover, spirituality/religiosity and culture are inextricably woven together [8]. The rituals, symbols and myths tied to religion can be interpreted as ways of making sense of the world [9]. According to Tarakeshwar, Stanton and Pargament [10], some people who believe in a sacred power view the world through the lens of mythic vocabularies and regulate their lives according to the models and injunctions set forth in their religious traditions.

For all the reasons set out above, cultural competency has become a fashionable term for clinicians too. The clinician can empathize with the lived experience of the patient’s illness, and try to understand the illness as the patient understands, feels, perceives and responds to it. But the large claims about the value of cultural competence for the art of professional care-giving around the world are simply non supported by robust evaluation research showing that systematic attention to culture really improves clinically service. Culture is often made synonymous with ethnicity, nationality and language, so patients of a certain ethnicity are assumed to have a core set of beliefs about illness owing to fixed ethnic traits [11]. Anthropologists, for example, have well documented these kinds of health-related beliefs for several of the ethnic groups in the United States [12]. Cultural differences, however, are not always accompanied by obvious markers such as language and ethnicity. There are people within our own modern society that adopt distinctive values, beliefs and rules for behaviour even if they have the same linguistic, ethnic, religious traits as their fellow-countrymen [13].

An example of this is represented by Italy, which is still today characterized by widespread affiliation to Catholicism (more than 80 % of the population), despite the increase in religious pluralism and undisputed secularization in the customs of population [14]. In Italy, however, to face the moment of illness part of the Italian population still carry out various manifestations of “unofficial” catholic religious expression [15, 16], so like trust in magician to heal (4 % of the population) [17].

The present work aims to unearth the religious remedies used by Italian folk medicine to heal diseases, between the late nineteenth century and the early to mid-twentieth century. The dual propose of this study is to explore how an historical anthropological perspective can provide a different lens through which to explain “unofficial” catholic religious remedies to heal diseases partly still performed in Italy and to interpret their symbolic representations and spiritual meanings.

Materials and methods

The study of religious remedies used by Italian folk medicine in order to treat diseases was based on a review of literature sources compiled between the late nineteenth century and the early to mid twentieth century.

The literature sources were identified from the online catalogue of the National Library Service of the Italian libraries network, by checking up the following key words: “folk medicine”, “usages and customs”, “folk traditions” and “folk remedies”. The methodology used has led to the consultation of ninety-seven sources (books and journal articles), compiled by anthropologists, physicians, ethnographers, folklorists, and scholars of local history between the late nineteenth century and the early to mid twentieth century.

In Italy, the beginning of this interval represents the period in which the study of folk traditions, including the collection of folk remedies for the cure of diseases, was created and dispersed with well-codified methodological bases [18]. While at the end of the 1950s there was the abandonment of the countryside to the cities so that, for the first time, the Italian population employed in industry exceeded that in agriculture [19]. This phenomenon contributed to the so-called “economic boom” and to the social and cultural transformation of Italy, which went from a predominantly agricultural society to a modern society [20].

Diseases and relative religious remedies used by Italian folk medicine for their care, have been grouped according to International Classification of Diseases (ICD, version 10) endorsed by World Health Organization [21].

Results

The sources consulted in this study highlighted a vastus corpus of religious remedies used to heal various diseases. These numerous sources showed how the interaction between religion and folk medicine has produced at the same time methods that have become part of official religious rites, like the cult of Saints, the use of Holy Water and Blessed Oil, and remedies that highlighted a strong influence between the Catholic religion, magic and pre-Christian practices.

The remedies have been divided into nine different categories: Saints, Pilgrimages, Holy Water/Blessed Oil, Blessings, Religious Objects (Table 1), Contact, Signs, Formulas and The Religious Calendar (Table 2).

Table 1 Invocation of Saints, Pilgrimages to sacred places, use of Holy Water/Blessed Oil, Blessings and Sacred Objects used to cure disease
Full size table
Table 2 Contact, signs, formulas and rituals used on certain days of the year to cure disease
Full size table

Therefore, because of the impossibility to explain every single remedy, are described, for every category, some remedies that largely favour the comprehension of their use in Italian Folk medicine.

Saints

To heal themselves from diseases, people entrusted The Holy Spirit, God, Jesus, Mary and the Saints with prayers or acts of devotion (Table 1). The Saint is invoked to heal a specific disease which was chosen because during its martyrdom they were inflicted in the same part of the body that the people have asked to heal [22]. Saint Valentino and Saint Donato, killed by decapitation, were considered the protectors of epileptics [23–26]; Saint Lorenzo, burnt alive, was considered the curer of burns [27–29]; Saint Apollonia to whom, during martyrdom, had her teeth extracted is prayed to by sufferers of toothache [23, 25, 27, 28, 30–33]; Saint Agata who had her breasts cut off, is prayed to by breast feeding mothers [23–25, 27, 28, 30], and so on. Another reason for the choice of the Saint was indicated by its name. The linguistic meaning of the name between the Saint and the disease, according to Italian folklore, was sufficient motivation to ask a Saint to heal a specific disease [34]. For example, Saint Liberata, whose name derives from Latin word “libero”, meaning to release, was invoked for the liberation from all diseases [29]. Similarly, Saint Lucia, from the Latin word “Lux”, meaning light, was considered the protector of the sufferers of eye diseases [25, 27–32, 35–37]. The special healing power was, after all, attributed based on what the Saint did during its life: Saint Biagio was invoked to heal throat ailments [25, 28–32] because he saved a child from suffocation; Saint Anna and Mary were invoked by pregnant mothers because they represent Motherhood [25, 29–32, 38] (Saint Anna being the mother of Mary and Mary being the mother of Jesus); while, Saint Cosma and Saint Damiano, that in their life were doctors, were invoked to heal all diseases [28].

Pilgrimages

Making a journey to a sacred place was, and still is, a widely used practice in Buddhism, Christianity, Hinduism and Islam. In the Catholic tradition it was thought the disease was a temporal punishment and that healing came from the remission of sin. The pilgrimage was undertaken to obtain plenary indulgence to resolve, hence, more the moral problem than the medical problem [39]. Moreover, very often, the place of pilgrimage was chosen based on “thaumaturgic capacity” of the saint to cure a particular disease, and for this reason, in Italy there was a true network of sacred sites with the function of a “surgery”. The practices put in action when the person arrived at the sacred sites weren’t only religious rites (Table 1). Very often the sufferers used a rite of passage: to cure epilepsy they undressed from their old clothes that they left in the church and wore new ones [24]. Another rite was to weigh the sufferer and offer to the saint the identical weight in grain [24]. To heal Insanity, Hernia and Rabies, the pilgrim had to exit from another door and not the one they entered in [28, 40].

Holy Water and Blessed Oil

Holy Water and Blessed Oil are among the Sacramentals “instituted for the sanctification of certain ministries of the Church, certain states of life, a great variety of circumstances in Christian life, and the use of many things helpful to man” [41]. In Table 1 are described the remedies used by Italian folk medicine that considered Holy Water and Blessed Oil to be potent symbols of rebirth, capable of eliminating sins and driving away evil, often indicated as the cause of the illness. Humectations of Holy Water were made to cure Stomatitis and Eye Ailments [28, 30, 38, 42, 43]. Holy Water was drunk to treat Rabies and was considered useful to treat Hyperhidrosis submerging the hands in the stoup [28]. Finally, Blessed Oil was wiped to heal Sore Throats and to cure Arthritis [30, 37].

Blessings

Even today, it is very common in the Roman Catholic Ritual to use various types of Blessings. Priests bless the sick, everyday objects, food, animals, homes, public buildings, etc. [44]. Italian folk medicine used blessings as therapy to heal many diseases (Table 1). For example, to bless the sick or the part of the body concerned, to cure Erysipelas, Typhus and to favour birth without complications [23, 32, 45]; eating blessed food was used to favour the secretion of maternal milk [30] and, even, to heal Sore Throats you needed to wear a blessed shirt [46].

Religious objects

A large range of objects, associated with healing saints, were used in Italian folk medicine: sacred images, Saint Vito’s rope, Saint Francesco’s stick, etc. Other objects, however, even if they weren’t associated with the saints, were used in its name in to fight certain illnesses (Table 1). The key of Saint Valentine or those of Saint Donato were put in the hand of an epileptic during paroxysm [23, 46, 47] giving the healing power of iron, which was capable of driving away the evil spirits in the sufferer [48]. Another example is the use of the Rose of Jericho, that in Italian folklore was known as the Rose of Mary or Saint Anna [27, 45, 47, 49]. This plant, common in North Africa, Asia Minor, the Middle East, represents the vital cycle that concludes at the start of the dry season, when it folds its branches in a compact spherical mass. In reality, when the rains start the plant rehydrates, the branches open and the growing cycle begins. This characteristic was interpreted by folklore as a magical event in as much as, once watered, was put near the expectant mother with the belief that it would open its branches this would in turn open the uterus ensuring a healthy and incident free birth [50].

Contact

Italian folk medicine recognised the power of thaumaturgic and all that came from contact with a sacred place or object (Table 2). For example, oil was used in a votive lamp to treat Stomachache [30]; you dragged your sides along the walls of a church to heal Kidney pains [38]; you carried the glass of a church lamp to avoid Abortion [37]; spread the grease of a church bell to cure Haemorrhoids [30]; for Toothache you needed to attach and ring a church bell using your teeth [30, 38]; you carried with you earth collected from a sacred place to combat a Fever [30].

Signs

Marking on the body of a sick person, was common practice for several illnesses and was done in different ways, sometimes praying or saying mysterious words (Table 2). For example, to heal Mumps, it was drawn directly on the affected part of the body, a cross or the sign of Solomon [23, 24, 51, 52], a symbol with its roots in paganism and in magical symbolism [53], or to write sacred words, for example Jesus, Joseph and Mary [24]. To heal malaria the sign of the cross was mimed on the spleen using the wedding ring or holding a knife or an axe in a clenched fist [28, 30]; to cure Headaches or Epistaxis, the signs were reproduced on the sufferer using a cross made of the stems of certain plants [23, 30, 32, 36, 38, 42, 45]; finally, you needed to trace three times using oil, the sign of the cross into the affected part of the body to treat Sciatica [31].

Formulas

Using the recital of certain formulas, often accompanied with massage, symbols on the body, the use of ritualistic objects and medicinal herbs or animal parts, religious folklore puts into use a ritual useful for healing (Table 2). The formulas that De Martino defined “historiole” [54] presented a largely homogenous form. The patient began by reciting an episode in the Saint or Jesus or Mary’s life, and finished by begging the disease to disappear.

Santa Lucia ‘n campa stavia, oru tagliava e argientu facia. Passa Gesù, Giuseppe e Maria, Chi hadi Lucia, chi lacrime jia? Và allu miu ortu e trovi zìpari e finocchi; Cu li lie piedi li chiantai, Cu le mie mani li zappuliai, Esci purvera, esci purata, Esci vena ‘nsanguinentata [55] (Saint Lucy was in a field, cutting gold and making silver. Jesus, Saint Joseph and Mary passed and asked her? What’s the matter? Why are you crying? Go to my orchard and find figs and fennels; I planted them with my feet, and I hoed them with my hands. Go away dust, go away puss, go away bleeding vein).

In other formulas, more simply the healer invited the illness to leave the sufferer in the name of God, Jesus, Mary, the Holy Spirit or in the name of a saint or even in the name of Christmas or Holy Week.

Sciuvidia santu/Venerdia santu/Sabatu santu/Pasca santa/Via li vermi/de sta panza [56] (Holy Thursday, Good Friday, Easter Saturday, Easter Sunday. Go away worms from this stomach).

Religious calendar

In Table 2, are described the remedies of Italian folk medicine used on certain days of the year dedicated to important Catholic festivals, like Christmas (25th of December), the day of Annunciation (25th of March), Easter (the Sunday following the first full moon after spring equinox), Ascension (40 days after Easter), Pentecost (50 days after Easter), the day of Holy Cross (celebrated on 3rd of May before the reform of the religious calendar in 1970), the day of Saint John the Baptist (24th of June) and that of Saint Lawrence (10th of August). The theory of Frazer suggested that Christianism has integrated, inside its rites many pagan rites that are celebrated based on agricultural and natural cycles. For example, Christmas and the feast day of the birth of Saint John the Baptist can be traced back to pagan festivals that celebrated the time of year in which the daylight began to progressively lengthen (winter solstice) and the period of maximum daylight (summer solstice) that represent the myth of death-rebirth of vegetation making nature fertile (man included) [57]. In this context we can interpret therapies used by folklore medicine for healing various diseases. During Christmas night, for example, people bathed in the sea to fight Skin diseases [55], water taken from public fountains was used to treat Milk Crust in children [58], spreading oil, fat or butter to heal Wounds, Bruises and Arthritis [31, 36]. Similarly during the night of Saint John, sufferers of Leprosy rolled in fields [59], collecting dew to heal Alopecia [23, 24, 30, 36], diving in the sea to cure Scabies [28], medicinal herbs were picked [23, 28, 30, 45, 49, 59–62] because, it was thought their healing virtues grew in these occasions. Finally, a remedy practiced on Annunciation, Easter Saturday, Saint John the Baptist, the Holy Cross to heal hernias in children, consisted of passing the sufferer three times across a split tree or in a circle created by a branch split in two for the occasion [37, 40, 55, 63–66].

Discussion

Disease represents for mankind one of the most critical and devastating moments in the human life cycle because of its turbulent effect on the individual, giving the sufferer a sense of helplessness, it limits the autonomy and puts in crisis the equilibrium of the whole family group of the sufferer [67].

Previous studies conducted on Italian folk medicine, between the end of XIX and the middle of XX century, to heal malaria [68] and epilepsy [48] have shown, together with a vast body of remedies based on the use of plants and animal parts, a large repertoire of religious practices. The sick entrusted God with prayers or acts of devotion, with the conviction that only God would be able to provide recovery from the above mentioned diseases. In the present work the enormous amount of data has made it necessary to interpret, from the key anthropological point of view in relatively few cases. However, they are considered by the authors to be sufficiently demonstrative of all the corpus of religious remedies used in Italian folk medicine to cure disease shown in Table 1 and Table 2.

To face the moment of crisis, tools were used to identify and symbolize the disease and to cure using coherent therapies based on their own cultural background, which means a set of views, beliefs, values, and attitudes towards life that is transmitted from generation to generation and may be expressed through customs, etiquette, taboos, or rituals [69].

This has determined inside Italian folk tradition a process of syncretism that has brought with it, other than the use of religious remedies that are a part of the landscape of the Catholic Church (begging for the intervention of the thaumaturgic saint, the use of Holy Water and Blessed Oil, pilgrimages and the use of sacred objects), also the use of practices that have come out of a process of contamination between the Catholic religion, the magic world and pre-Christian rituals. The rituals, for example, that call for the use of iron or metallic objects were put into use with the aim of driving away evil, considered as the cause of the disease; hence, passing a child, suffering of hernia, through a split in a tree, or abandoning in church the old clothes and wearing new ones to cure epilepsy, were considered symbols of re-birth which is the abandoning of the old life and acquisition of a new one, free from suffering.

It would be wrong to categorise religious remedies brought to light in this work in the group of the past superstitions. Religious remedies, used in Italian folk medicine between the 19th and the 20th century, form the historical bases of what many people currently perform in Italy, that is turning to prayer or participation in pilgrimages as well as the official medical system of diagnosis and treatment.

An example of engagement with healing prayer are Pentecostal churches [70] that have more of 300,000 Italian devotees [71]. Another excellent example is the cult of Padre Pio whose sanctuary in San Giovanni Rotondo receives million of pilgrims every year [72]. “Devotees of Padre Pio, for his Christ suffering and supernatural visions and stigmata, view the saint as an intimate and invisible friend. So the pilgrimage elicits a distinctive sense of “fellow-feeling”, a sympathetic recognition of another social organism’s humanity, a sense of unity in diversity. Pilgrimage fosters not only a religious experience with a liminal destination, but what Turner calls communitas. Communitas is more than merely sense of “community” – a term which itself is imbued with a geographical sense of common living within a social structure. Rather, occurring in the liminal phase of rituals wherein individuated statuses are suspended as individuals pass from one state to another, or from one structure to another, communitas is social anti-structure, a trascendence of social statuses that serve to order a social community” [73].

On the same basis, part of the Italian population still turns to healers, uses amulets, follows rituals and recites formulas and oaths to treat, for example, “malocchio” (evil eye) that is regarded for mostly physical diseases [15, 16, 74–76]. Moreover, “malocchio” ranks as one of the most searched words in Google Italia in 2014 [77].

Finally, many remedies of Italian folk medicine described in this work (i.e. candles, incense, minerals and Rose of Jerico) are also used by New Agers [50, 78].

There is nothing surprising about it, Garelli [14] in his work highlights that 43 % of Italian catholic population adhere to Catholicism for traditional and cultural reasons or they share its fundamental ideas even if they interpret them in autonomous and subjective way.

The question is if these remedies have had and continue to have a positive impact in facing disease and also if they have some importance from the anthropological point of view. Already, De Martino recognized magical and religious remedies of folk tradition of Southern Italy a protective-psychological value [54]. The authors believe that the vast corpus of religious remedies, highlighted in the present work, can be found inside current coping strategies that patients and relatives adopt to affront the crisis that has hit their personal identity and integrity, kick-starting inner energy that can contribute to the healing process. According to Droogers [79] syncretism seems to occur in an unreflective manner, as a “natural” or better cultural process. As a consequence, people who mix varied religious elements may not do so intentionally and would not necessarily defend or propagate their blended religious practices. Thus, syncretism often serves as a practical mean of solving existential problems.

The spiritual need that the sick shows adopting religious and magical practices, represents a symbolic framework, that works as a filter, mediates, containing the pain that constantly fills everyone’s life in remote ages even in the third millennium [80]. Considering these points, there is the need to add some other explanations more linked to the organic human functions. Many studies report that a silent prayer, meditation or the participation in religious celebration activate the parasympathetic function of the brain, suggesting moreover that these practices can lead to a more active immune response to the pathogenic agents [81, 82].

The theory of PNEI that all our feelings are experienced and psycho-neuro-endocrino-immunologically expressed in the body has been proposed since the late 20th century. Soma and psyche are two aspects of human life and there is a constant interplay between the two [83].

A more detailed analysis on the possible explanation of the functional meaning of suggestion evoked the activation of the limbic-hypotalamic axes, defined as “the locus of information transduction from the neural encoding of the languages of the mind (thoughts, sensations) into the messenger molecules” [84]. It is well known in fact that this system represents a functional connection between the sympathetic control centres (cardiovascular, respiratory, etc.) and the entire endocrine system, with subsequent ability to also influence immune activity [85]. On this ground it is reasonable to hypothesize that the satisfaction of spiritual needs in a stressful condition might support the recovery from individual sufferance via the releasing of neuromodulators (i.e. Interleukins) and hormones (Adreno Corticotropic Hormon, Prolactin, etc.) that have been proved to help in the healing process [22].

Conclusions

The studies concerning the impact of secular forms of spirituality regarding disease, are important currently because they offer to health-workers a key to understanding, from an anthropological and a psychological point of view, which could help to understand, interpret and satisfy the growing need for spirituality the sufferer, deeply rooted in their culture and traditions.

Research such as this, moreover, can give important information about which model of therapeutic belief impacts on modern society and which elements could be integrated into a holistic approach to disease that considers the patients not just as “having symptoms”, as a clinical case but also as an individual that carries a baggage of needs, suffering, hopes and desires.