Interlude: Patient Voices

Abstract

In this ‘Interlude’ between Parts I and II of the book, we reproduce a few verbatim excerpts from the thousands of clinical files of patients diagnosed with forms of pellagrous insanity at the Venetian insane asylums of San Servolo (men) and San Clemente (women) during the latter half of the nineteenth century. They are as close as we can come to the patients’ own harrowing experience of the illness, though of course as mediated by asylum doctors.

The following excerpts are taken from the thousands of clinical files of patients diagnosed with forms of pellagrous insanity at the Venetian insane asylums of San Servolo (men) and San Clemente (women) during the latter half of the nineteenth century. They are as close as we can come to the patients’ own harrowing experience of the illness, though of course as mediated by asylum doctors. (Archivio della Fondazione di San Servolo, Venice, Sezione sanitaria: tabelle nosologiche-cartelle cliniche).

He says that he has been in hospital for only fifteen days but that he was also admitted last year for six months because of a convulsive illness and pellagra, and at present he says that he is subject to heart palpitations, dizziness, he occasionally loses his sight suddenly seeing only darkness, he hears a constant buzzing in his ears, he is hungry but doesn’t enjoy eating, he sleeps little and always troubled, and he feels as if he is in a fire, and he pleads with us to cure him. As the cause of all these afflictions he blames the excessive labours which he had to do, which went beyond his strength, in order to support his family. He feels a weight in his stomach, he says, which oppresses his heart. He says he needs to walk a lot because if he stays in bed all his afflictions get worse. He asks us to give him plenty to eat because he understands it’s all down to weakness. … He willingly undergoes his treatment out of the desire, he says, to recover soon and return to the bosom of his family.

Luigi Pinello , 50-year-old married peasant, admitted to San Servolo in 1867.

Asked how, at home, she could have tried to attack those dear to her and try to harm her daughter, she answers, weeping, that a voice she found almost irresistible called to her from inside the well and that another internal voice, which seemed to come from her chest, coaxing her to kill her daughter. Because of that she tried in every way to get away from it so as not to commit that horrible crime, and she never went to the well to avoid being forced to throw herself in. She adds that she finds it impossible to believe that such ideas could occur to her since she loves her life and her dear daughter so much.

Luigia Ballotta , 41-year-old mother of six, admitted to San Clemente for the second time, 1877.

He claims that he was beside himself because of the poverty in which he lived, and that he would go here and there begging, perhaps sometimes too forcefully, so that he became troublesome, but which he had to do because of the hunger he suffered. He claims to have suffered from pellagra several times, the signs of which are presently evident. He has a burning, an internal dryness, for which he would drink all day long. He says he is happy to be in this hospital. He speaks calmly and reasonably, but always finishing his utterances with the poverty in which he finds himself, with not being able to help his family, and he becomes melancholy and tearful.

Domenico Bonosiol , 40-year-old married peasant, admitted to San Servolo in 1857.

He says he is so melancholic and does not know the reason why, but that he feels in himself something extra-natural which keeps him in that state. … The pellagra on his hands is quite evident.

Santo Francescetto , 35-year-old unmarried peasant, admitted to San Servolo in 1857.

An individual of melancholic temperament, robust, who without having displayed previous symptoms of mania set fire to his farmhouse. … He begins by declaring that the fire was ordained to him by God, that He sent St Paul to him expressly with the command. … After a month’s hospital stay [at San Servolo], the apyretic cutaneous desquamation appeared on the skin of his chest, head and hands which did not take long to recognise as pellagra. … His mental faculties became increasingly disordered, showing ideas of excessive religion, hallucinating visions of angels and saints who came to him at night and with whom he would converse out loud, always answering our questions with disconnected and totally incoherent words, leaving no doubt as to the nature of his mania.

Giovann Domenico Della Bianca , 61-year-old married peasant, admitted to San Servolo in 1857.

He is a young man of sound constitution but very disordered in his ideas, complaining of having always been tormented as a youth and of being mistreated by everyone. Whilst speaking he gets excited and converses with audaciousness, with arrogance, he is bad-mannered, insolent and impious, he starts to blaspheme and threaten, all his conversation refers to abuses and he doesn’t say what led up to them, he realises he was raving and beside himself but because of witches, and that his own mother is a witch and that he can’t look at her without horror. He recounts how he took fright when he saw the soldiers pass through his town, believing that this too was sent to torment him. … [Several months later] He participates willingly in the interrogations, confessing that he recognises he was a rascal, but because of his illness. He says, I understand that I was ill and that I couldn’t help it, and when people scolded me I felt my blood boil and had to do something to spite them.

Giordano Aldrigo , 20-year-old unmarried peasant, admitted to San Servolo in 1867.

The patient is continuously prey to a delirium of damnation accompanied by illusions and hallucinations. She believes she is damned because of her very grave sins, is no longer worthy to call on God’s help, she believes she will never be able to die and to be forever damned in life. She claims to be possessed by the Devil, she feels him in her womb and she has to eat more than usual in order to feed him; when she goes without eating for any longer than usual the Devil torments her, and she is forced to take in food in order to keep him quiet. She continuously thinks that she is destined to die in the asylum and then all of a sudden she believes she won’t ever die. However, she has made no further attempts at suicide, is normally calm and she works.

Regina Davin , 41-year-old married housewife and mother of five, admitted to San Clemente in 1881.

She believes she has committed enormous sins and that every action of hers is a sin. … She would rather not eat for fear of committing some sin.

Luigia Romagnol , 25-year-old artisan’s wife, admitted to San Clemente in 1881.

He says that for ten years, he has suffered from pellagrous erythema and confesses to having had an upset of the mind in the form of agitation due to the poverty in which he found himself whilst still with his family. He doesn’t remember having suicidal tendencies but impulses to strike his wife because she actually sought his help which he could not give.

Pietro Azzolini admitted to San Servolo in 1887, at the same time as his wife Rosa Davì (below) was admitted to San Clemente (Fig. 5.1).

Fig. 5.1

Portraits of Rosa Davì and Pietro Azzolini from their patient files. San Servolo Servizi Metropolitani di Venezia

She gives a full account of her family’s condition and the history of her illness. She says that she has continuously suffered from weakness as well as hunger. She felt like there was a fire in her head and she was forced to wander throughout the house without finding ease. … [Several months later] With the change to her dietary regime her physical improvement began, alongside that of her intellectual faculties. The news that her husband has been released from San Servolo, where he was institutionalised, contributed to her improvement.

Rosa Davì , 35-year-old married peasant and mother of one, admitted to San Clemente in 1887. Her husband, Pietro Azzolini (above), was admitted to San Servolo at the same time.

She confessed to us that she weeps from the desire to see her dear ones again, but that at the same time, from her own experience at home, that she is constantly tormented by a fixation on suicide, insistent at every moment. Asked whether this idea originates inside her because of domestic displeasures, she replies negatively. She tells us that she is overcome by an unease, which she cannot explain, which she cannot say where it comes from, and that this sense unknown to her torments her and gives rise to an irresistible delirium to throw herself into water in order to free herself of it. This impulse is stronger in her than her love as mother and wife, she feels it and trembles continuously from the fear of being pushed against her will to abandon forever the children and husband so dear to her.

Luigia Boccato , married mother of four, admitted to San Clemente in 1877.

At the moment of the examination, she was very calm, coherent and reasoned like a healthy person. She explained all that she feels when she is overcome by frenzy. She says that she hears voices that insult her and don’t leave her in peace, and for this reason she gets upset, curses and screams.

Marianna Puppo , 34-year-old married peasant, admitted to San Clemente in 1887 after she tried to burn down her house and no longer recognised her children.

Dear son,

Despite your bad news, I dare to send you this letter … Listen, I’m very well in both body and mind … So don’t worry that I’ll cause trouble to your family or that I’ll be a burden, rather I hope to be a help because I feel quite strong. And regarding the trip, this month the prices are so low that it won’t cost you much. Indeed if you are willing to take me in, the people from the town will certainly come to collect me at their expense, as they have done to some of my fellow inmates who have been released. So I ask you to do me this favour.

Your most affectionate mother.

Maria Scandolaro , 47-year-old widowed peasant, admitted to San Clemente in 1881 and writing to her stepson in 1887. The letter and envelope are still in her file, so perhaps were never sent.

She does not wish to return home, because of the bleak prospect of dire poverty.

Marianna Termini , 49-year-old widow and mother of one, admitted to San Clemente in 1886.