PRACTICE OF ANTIVARIOLIC VACCINATION IN THE PROVINCES OF THE PONTIFICAL STATE IN THE 19th CENTURY REMARKS ON THE SUPPOSED VACCINAL PROHIBITION OF LEON XII This work is the result of the meeting of a historian (Yves-Marie Rercé), specialist in the beginnings of vaccination practices, particularly in Italy, and a doctor (Jean-Claude Otteni), interested in a ban on vaccination against "smallpox" that Leo XII promulgated in 1829. The prohibition was formulated as follows: "Those who submit to vaccination against smallpox cease to be children of God. Smallpox is a punishment from God and vaccination is a challenge to Heaven (' )". He is currently often cited as an example of the Roman Catholic Magisterium's reticence and even opposition to medical innovations. However, the reality of the ban does not seem to be documented by credible sources. Donald Keefe, S.J., published in 1986 in a newsletter of limited distribution (12). It concludes that the ban is not a reality but a rumor. We have taken up the problem of the reality of the ban, considering in turn the historical data on smallpox vaccination in Italy in the 19th century, especially in the provinces of the Papal State, the quotations of an alleged vaccine ban in contemporary publications, the search for sources of this rumor and the hypotheses that can be formed about the origin of the supposed ban. (1) The earliest chronological mention of this claim can be found in the article by H. F a b r e , La position de l'Eglise face au planning familial, in L'Idée libre, 9 (1964). For a critical study, read with profit D. K e e f e s.j., A guest for a guotation, in Fellowship of Catholic Scholars Newsletter, 9 (1986). (2) D. K e e f e s.j., A guest... [see n. 1], P R A T I C E O F A N T IV A R IO L I C A L V A C C I N A T I O N 449 A n tiv a r io liq u e v a c c i n a t i o n i n 1 9 9 9 i n I t a l a n d t h e p r o v i n c e s o f t h e p o n t i c a l state We know that in 1796 an English physician, Edward Jenner, developed a method of preventing variola contagion. He imagined grafting under the human skin a little pus of a benign disease of cows, called coro pox. This process, using a cow's humour, was called vaccination. It was soon to replace the inoculation of attenuated variol pus, or variolization, which for several decades had been recommended by physicians as a protection against the deadly smallpox. Indeed, the careless application of variolization could be rightly considered responsible for epidemic outbreaks. Vaccinia, on the other hand, seemed to be in a different mood, incapable of communicating true smallpox. The first trials confirmed Jenner's hopes and during the year 1800 all the great physicians of Europe wanted to learn about this wonderful empirical practice. Italy was one of the first regions where the "vaccine fluid" was introduced, transmitted from arm to arm, in incessant human chains. Jenner's strains first arrived in Sicily, carried by the English doctors on board Nelson's ships (Joseph Marshall gave the first vaccination in Paierme on March 14, 1801). From Paierme, the vaccine was carried to Naples by Michele Troja, and then to Rome where it was probably administered during the summer of 1801. Two other chains were drawn in the North. One, provided by doctors accompanying the advance of the French armies, reached Genoa (doctor Onofrio Scassi, spring 1801). Another one, coming from Vienna, went to Venetia and Emilia (demonstrations of Luigi Sacco in Bologna in July 1801). Rome and the provinces of the ecclesiastical state thus benefited from several material sources of fluid and from several medical initiatives (3). (3) The material for this article comes from my book: Y.-M. B e r c é , Le chaudron et la lancette. Croyances populaires et médecine préventive, 1798-1830, Paris, 1984. This is a history of the practices and ideology of vaccination at its beginnings, with a particular focus on Italy. For the whole of the 19th and 20th centuries, and for a more detailed account of the French case, see P. D a r m o n , La longue traque de la variole. Les pionniers de la médecine préventive, Paris, 1986. 450 Y -M . B E R C E - J . - C . O T T E N I The notable families, whose previous generations had already welcomed the variola inoculation, readily adhered to this less dangerous innovation. They immediately became the advocates of a medical intervention that most of the scholars of that time considered as a wonderful proof of the progress of science. In Rome, as everywhere else, the public authorities first applied the measure to the foundling hospices, certainly for charitable reasons or, more brutally, because these groups of children offered subjects for experimentation. Indeed, the intervention of parents did not hinder the medical initiative, and last but not least, they were going to constitute, because of the constant contribution of abandoned infants, real human reservoirs of vaccine always available. It was in the Hospital of the Holy Spirit in the Borgo Santo Spirito, between the banks of the Tiber and the Vatican, that the pontifical authority had established the vaccination center in 1802. This hospice received about 800 newborns each year. There operated renowned doctors such as Dr. De Alessandris, who had previously been a fervent propagator of variola inoculation, Domenico Moricchini, a Neapolitan chemist (1773-1836) and the young Alessandro Flajani (4). For several decades inoculation had been accepted in Rome, but it remained neglected or refused in most popular families. The justification for preventive intervention from the point of view of Christian morality had already been worked out and was therefore no longer necessary. It should be noted that prevention did not deviate from the ancient medical doctrine either, since according to tradition one of the daughters of Aesculapius was Hygie, reputed to preserve health. The approval of vaccination in Rome is illustrated by the work of Alessandro Flajani (5). He was the son of Giuseppe Flajani, (1739-1808) archiatrist to Pius VI and first surgeon of the Hospital of the Holy Spirit. Alessandro Flajani made a trip to Rome in 1805 to see the country.(4) In 1795, Dr. De Alessandris published a plea for inoculation in Rome. It is now admitted that although the occasional danger of variolization is certain, its practice had already been able to reduce variola mortality locally, cf. J.-P. B ardet and J. D upaquier , Histoire des populations de l'Europe, Paris, 1998, t. 2, p. 92 (contribution by P. B ourdelais ). (5) A. F lajani, Saggio filosofico intorno agli stabilimenti scientifici in Europa appartenenti alla medicina, Roma, 1807. P R A T I C E O F T H E A N T IV A R I O L I C A L V A C C E I N A T I O N 451 investigation of the health policies underway in Berlin, Vienna, London, and Paris. In the account he published on his return to Rome, he included a chapter on vaccination, the acceptance of which he gave as undisputed. His book was dedicated to Pius VII, whose personal attention to public health he praised. According to the rules of censorship, the book was judged to be in conformity with the Catholic religion, faith and morals; on June 16, 1807, it received the approvals of Fr. Oliveri, Dominican, professor at the Archiginnasio of Rome, and of the professor of medicine Francisco Petraglia, both of whom were commissioned by the administration of the ecclesiastical state in matters of bookstore police. The imprimatur was granted accordingly by Fr. Pani, Dominican, master of the Apostolic Palace. It is thus certain that from the beginning of its circulation in learned Europe vaccination was very officially admitted by the Church in moral theology and that it was practiced publicly in the great Roman hospital. When, in 1809, the Roman territory was annexed to the French Empire, the three physicians already in charge in Rome and some others were appointed advisors of a Vaccination Committee (decree of August 11, 1809) in charge of controlling the vaccination of newborns in the provinces of Lazio and Umbria, which had become the imperial departments of Rome (capital Rome) and Trasimeno (capital Perugia). The French officials, lovers of statistics, left flattering accounts. In 1812, a peaceful year when Napoleon's power was at its maximum, the ratio of the number of vaccinations to the number of births was, for example, 34% in the department of Trasimeno; this result corresponds approximately to the Italian averages of the time (6). In January 1814, the French evacuated central Italy, replaced by the troops of Murat, king of Naples. In the northern provinces of the Church State, Emilia and Romagna, it was the Austrian army that assumed power. Pope Pius VII returned to Rome on May 24, 1814, but it was only a year later, in May 1815, that the papal administration recovered its northern territories. (6) Y.-M. B ercé, The Cauldron... [see n. 4], pp. 317-320, complete statistics of the imperial Italian departments in 1811 and 1812. 452 Y -M . B E R C E - J . - C . O T T E N I Whatever the de facto powers were, at the moment they maintained exactly the same institutional structures and the previous modes of management. Only the titles changed completely; what had been imperial became pontifical; legates or apostolic delegates replaced the prefects as heads of local health commissions; the use of French was suppressed in public acts, but most of the notables, dignitaries, magistrates, and administrative agents remained unchanged, with very little purging or prosecution of the beneficiaries of the vanished imperial regime. Vaccination operations, less numerous because of the military events in 1813 and 1814, resumed their full scope at the end of 1815. However, after 20 years of vaccination practice, scholarly opinion throughout Europe was concerned about various contradictions. If the inoculated fluid was "attenuated" or "degenerated and bastardized" by the constant communication of the same vaccine strains, transferred thousands of times, did it not lose its effectiveness? This would explain the accidents, impossible to conceal, of real cases of smallpox striking vaccinated subjects. These scandalous cases were called "varioloid", i.e. they were assumed to be the result of another eruptive infection with similar symptoms, unless it was a new and more virulent species of smallpox from Asia (7). It was only in the following decade that the hypothesis of a revaccination of the same subject in adolescence was considered here and there (Bavaria, Denmark, Prussian army, etc.). In any case, it was thought that it was urgently necessary to renew the vigor of the vaccine fluid and the most obvious suggestion was to find cases of pimples in herds of cattle. Jenner himself was said to have supplied the National Vaccine Establishment (established in London in 1808 by the Royal Jennerian Society, itself founded in 1803) with new strains in 1813 and 1817. In fact, this cow fever, which had been thought to be commonplace in 1798, was then found to be very rare (it seems that this is not always the case; in 1974, more than 13% of the cows that passed through the slaughterhouses of the United Kingdom were found to be infected). (7) Examination of the smallpox epidemic that occurred in Piedmont in the winter of 182930 by G. S t r a m b io , in Giornale analitico di medicina, Milano, (1830), pp. 104129. P R A T I C E O F T H E A N T IV A R IO L I C V A C C I N A T I O N 453 Southern England (8) had had the pimple). However, in herds in Campania, doctors from the faculty of Naples had been able to successfully take samples. One of them, a student of Michele Troja, Gennaro Galbiati (1776-1844), had already devised another procedure in 1803, the return to the cow, i.e. the transmission of the humanized vaccine to a heifer and the subsequent collection of the fluid from the pustules that appeared on the animal. This practice will be developed in the 1860s, because it provided an effective vaccine, an easy source to renew and finally because it avoided the lamentable cases of syphilitic contamination by imprudent vaccinations. The Neapolitan school of vaccination was therefore a pioneer in this field of research. It was in this context of questioning and reform of the public medical institutions (the so-called "health police") that the Roman doctors devised a new regulation for the entire ecclesiastical state, promulgated by edict of the Secretary of State Consalvi in 1821. A Council of Vaccination was founded, composed of professors of medicine from the Universities of Rome and Bologna. It was responsible for all the doctors hired by the municipalities (the practice of municipal doctors, medici di condotta, was a very old Italian custom, widespread since the 14th century), who could not be admitted without having demonstrated their competence in vaccination. For the procurement of the vaccine and for the safety of the operations, specific original solutions were adopted. The orphanages and foundlings' hospices were formally assigned the functions of fluid depots and vaccination centers. The recommended procedure was the direct transmission from arm to arm, instead of sending vials or crusts. This choice guaranteed a more successful transfer, but it implied the transportation of vaccinated children from town to town. The gonfaloniers of the communes (the equivalent of the mayor) had to ensure the travel and lodging of the vaccinator and the vaccinifiers. These municipal magistrates had to organize twice a year, in spring and autumn, a general vaccination of newborns. They had to see to the declaration of smallpox cases and to the isolation of contagious people. Finally, the variola inoculation, still practiced here and there, was forbidden. He (8) D. Baxby, Jenner's smallpox vaccine. The riddle of vaccinia virus and its origin, London, 1981. 454 Y -M . B E R C E - J . - C . O T T E N I There was no official law of obligation, but no newborn should escape vaccination (9). It should be noted that at that time, the only laws of total obligation, more or less applied, concerned Bavaria (1807), Denmark (1810), Sweden (1816 (101)) and, in Switzerland, only the canton of Aargau (1818). According to common moral conceptions, it was considered that it was not the role of the political authorities to replace the natural guardianship of the fathers of the family. In this perspective, England did not know the obligation until 1853 and abolished it at the end of the 19th century, Prussia instituted it in 1874, unitary Italy in 1888 and France in 1902. In central Italy, as elsewhere, the obstacles - almost insurmountable at the time - to a more generalized vaccination coverage were popular fatalism, the difficulty of access to remote villages, the dirtiness of some miserable neighborhoods (in Rome, the streets near the river, at the foot of the Capitol and the Aventine, especially the ghetto), and the endemic infirmities in certain cantons (ringworm, scabies, psoric diseases, etc.). With a view to reducing these pockets of misery, the charity offices, presided over by the Chaplain of Leo XII, had been strengthened according to the terms of a bull of June 18, 1824; they were theoretically to be subjected to annual controls (" ). That same year, 1824, the course of medical studies, like other university authorities, was the object of the bull Quod divina sapientia (Leo XII, 28 August 1824). According to the model of collegial government of the Church, systematized by Sixtus V, their tutelage fell to a Cardinal Congregation called Studies (12). Two so-called primary universities, Rome and Bologna, had a monopoly on the awarding of the doctorate, obtained after four years of study. The network of so-called secondary universities included (9) The pontifical regulation of 1821 was published in the Biblioteca vaccinica, Napoli, (1822), p.78-93, with a laudatory commentary by Vincenzo Miglietta. (10) P. S k o l d , The two faces of smallpox. A disease and its prevention in 18th and I 9P century, Umea, 1996. (11) For the history of the pontificate of Leo XII, see R. C o l a p ie t r a , La Chiesa fra Lamennais e Metternich. Il pontificato di Leone X I I , Brescia, 1963. Ph. B o u t r y , Souverain et pontife. Recherches prosopographiques sur la curie romaine d l'âge de la Restauration, 1814-1846, Roma, Ecole française de Rome, 2003. (12) A. G e m e l l i and S. V is m a r a , La riforma degli studi universitari negli Stati pontifici, Roma, 1933. P R A T I C E O F T H E A N T IV A R I O L I C A L V A C C I N A T I O N 455 traditionally Ferrara, Perugia, Camerino and temporarily Fermo. The University of Macerata was added in 1824 and that of Urbino in 1826. They trained full surgeons in three years and "minor surgery" graduates in two years (phlebotomy, obstetrics, dentistry). The practice of vaccinations was generally assigned to this type of personnel. In the 1830s, the University of Rome had about 600 students, including about 20 physicians and 60 paramedics. The University of Bologna, which was more renowned, had 500 students, of whom about 150 were future doctors. The doctors of Bologna, because of their geographical proximity and their attention to foreign developments, especially those of Vienna, had often also followed the teachings of the famous universities of Padua or Pavia. Many attended the Società medica chirurgica (founded in 1802, re-founded in 1823), which was in contact with other European learned societies; some of its members, such as Giacomo Tommasini or Maurizio Bufalini, two practitioners opposed in doctrine, acquired an international reputation (13). Because of their age-old experiences, the authorities of the various Italian states paid constant attention to epidemic dangers. Thus, the arrival of cholera in Rome on November 27, 1830, led to the centralization of measures and the granting of exceptional powers to a Congregazione di sanità, according to the Roman custom of instituting provisional Congregations to deal with serious and sudden situations (14). The 1821 vaccination regulations were later supplemented by a strengthening of the provincial and communal sanitary commissions (September 1836), and finally by a special law on vaccination (December 1841). In any case, it does not seem that there was an excess of variola mortality in Rome during the decades 1820, 1830 and beyond. A survey conducted by a French physician, Hippolyte Combes, in 1838 was very favorable about Italian health policies in general. According to his account, (13) A. G a l l a s s i , La società medica chirurgica di Bologna nel periodo risorgimentale, in Rivista di storia della medicina, (1961), pp. 3-28; W. V a l l ie r i , Il funzionamento degli ospedali di Bologna nel periodo risorgimentale, ibid, pp. 68-72. (14) A.L. B o n e l l a , A. P o m p e o and M.I. V e n z o , Roma fra la Restaurazione e l'elezione di Pio IX , Amministrazione, economia, società e cultura, Roma, Archivio di Stato di Roma, 1997. See especially the article by A.L. B o n e l l a , In attesa del colera. Istituzioni pontificie e politica sanitaria, pp. 221-248. 456 Y -M . B E R C E - J . - C . O T T E N I the ecclesiastical state was no exception and had a rate of medicalization comparable to the rest of the peninsula (15). In short, throughout the 19th century, the ecclesiastical state had a hygienic policy similar to that of other sovereignties. There is no evidence that the populations of central and southern Italy suffered higher variola mortality than elsewhere, nor is this reported in the Italian medical press. Moreover, it is very significant that the native physicians, although often resolutely critical of the pope's temporal authority (there were, for example, 80 paramedics or doctors among the 1829 people compromised in the revolutionary unrest of 1831), did not question the pontifical sanitary measures. As early as the 1750s, Catholic theologians, confronted with the approaches of a new preventive medicine, had legitimized the practices of inoculators. Similarly, the beginnings of Jennerian propaganda were immediately welcomed by the ecclesiastical authorities. The bishops readily responded to the requests of the public authorities when, from 1804 on, they were asked to support vaccination campaigns for children in French territories. The rare prelates who were reluctant only invoked their incompetence. In any case, the hypothesis of a contradiction between the divine will and human efforts at prevention, the version of a human hindrance to the designs of Providence, if it had ever been formulated, no longer belonged to religious logic; it was expressed in Catholic Europe at that time only as an example of an inadmissible argument (16). All the more curious and extravagant therefore appears a recurrent assertion which attributes to Pope Leo XII an alleged moral condemnation of vaccination. At the beginning of 1829, a few weeks before his death (February 10), he would have wanted to prohibit it. This claim, made in publications and lectures, has become, thanks to broadcasts on Internet sites, an additional argument in the traditional black legend of Catholicism. (15) H. C o m b e s , De la médecine en France et en Italie, Paris, 1842. (16) Y.-M.B ercé, Le clergé et la diffusion de la vaccination, in Revue d'Histoire de l'Église de France, 69 (1983), p. 87-106. P R A T I C E O F V A C C I N A T I O N A N T IV A R IO L I C A L 457 C ita tio n s o f a v a c c in a l s u p p o s e o f L e o n X II in c o n te m p o r a t i o n a l p u b lic a tio n s Their formulation of the prohibition, given at the beginning of this article, is almost always the same. The prohibition, of provocative brevity, is repeated as it is, without further documentation. The unusual and scandalous aspect of the statement, its polemical power, its total absence of proof, its presentation outside of scholarly historiography, without any scruples about references, give the circulation of this version the specific character of a rumor. Indeed, the authors who put forward this supposed ban either simply quote each other, or do not give any quotation at all. Neither the one nor the other refers to a public act or to any text of the time. They do not follow a historical research approach and completely ignore the Italian, French or other bibliography on the fields concerned, i.e. the particular historiographies of medicine, central Italy and the papacy. Three categories of citations can be distinguished. We give a list below. This list is certainly incomplete, since neither the title nor the summary of a publication always suggests the presence of the ban. The first category includes "chain" publications, in which the authors cite each other one after the other. Donald Keefe's work (17), we have been able to reconstruct an ascending genealogy covering more than 20 years. The sixth and seemingly final link in this genealogy is a 1986 text by Daniel Maguire, professor of moral theology at Marquette Catholic University in Milwaukee. An advocate of the right to contraception, abortion and same-sex marriage, he gave a lecture in Albany to a thousand Planned Parenthood officials in which he cited Leo XII's prohibition in his advocacy of birth control. This apparent ban on a major medical advance caused a scandal in the audience. The American press seized on it, thus ensuring a wide diffusion of the ban. It should be noted that the Albany Times-Union newspaper falsely attributed it to Leo XIII, which may explain why the error was repeated on certain Internet sites. Daniel Maguire, informed by (17) D. K e e f e s .j ., A quest for a quotation [see n. 3]. 458 Y -M . B E R C E - J . - C . O T T E N I Fr. Donald Keefe of the dubious reality of the ban, does not cite it again in his subsequent publications. The fifth link, on which Daniel Maguire relies, is a work by Fr. Richard McCormick SJ, published in 1984 (1S). He cites the ban as an example of the Magisterium's authoritarianism, "condemning a technique without taking the time to verify the validity of its decision. The fourth link on which Fr. McCormick relies is a publication by Canon Louis Janssens, professor emeritus of moral theology at the Catholic University of Louvain, published in 1980 (1819). In his work on the ethical questions posed by artificial insemination, he cites the prohibition as evidence of a premature judgment of the Magisterium that would prove to be erroneous. Its publication, in English, made the interdict known internationally. The third link, cited by Louis Janssens, is a work published in 1968 by Fr. (20). In his article on plastic, reconstructive and aesthetic surgery, he develops the Church's past resistance to human acts that modify nature, especially the body, using the example of the ban on vaccination. The second link, cited by Fr. Abel Jeannière, is Dr. Pierre Simon, gynecologist-obstetrician, Grand Master of the Grande Loge de France, President of the Collège Médical du Planning Familial and Vice-President of the Mouvement Français pour le Planning Familial, who mentions the ban in 1966 (21). The first link, on which Pierre Simon bases himself, is his colleague and friend, Dr. Henri Fabre, gynecologist-obstetrician, founding member of the 1st French Family Planning Center, created in Grenoble in 1961, and member of Freemasonry. In a lecture given at the Congress of the National Federation of Freemasons (18) R. A. McCormick s.j., Health and Medicine in the Catholic Tradition. Tradition in Transition, New York, 1984, p. 17. (19) L. J anssens, Artificial insemination: ethical considerations, in Louvain Studies, 8 (1980/1981), p. 11. (20) A. J eannière s.j., Corps malléable, in Cahiers Laennec, 28 (1968), p. 94; Id., Pour une sexualité humaine, in Projet, n° 30 (1968), p. 1235. In this work, the author gives his source of the prohibition quoted in his previous article. (21) P. Simon, Le contrôle des naissances. Histoire - Philosophie - Morale, Paris, 1966, p. 164. P R A T I C E O F A N T IV A R IO L V A C C I N A T I O N 459 Thinkers, in Dijon in 1964, he cites the ban (22). To explain the absence of a source, he advances the hypothesis that the Church "redacted" the texts mentioning Leo XII's interdict. It is interesting to note that the beginning of this chain was initiated by two Freemasons, continued by three ecclesiastics and apparently closed by a Catholic moralist theologian. A priori it is mainly from this chain of authors that the ban has been and continues to be drawn by others, with the consequence that none of the publications referring to it has a credible basis. In a second category of works, we have gathered contemporary French publications that mention the ban, but give no source. Thus, in 1950, Georges Cogniot, a communist senator and editor of the newspaper YHumanité, in his work on religion and science, cites the ban as evidence of the "fanaticism" of the Church (2324). In 1991, Jean Mathieu-Rosay, in his Veritable History of the Popes, wrote: "Just as astounding (by which he meant the prohibition of the translation of the Bible into the vernacular languages by the Biblical Societies) was that of the anti-smallpox vaccination that the wise Consalvi had introduced. An invention of the devil, it was contrary to the laws of nature! Even the immediate recrudescence of the plague did not make him change his decision". If Leo XII had issued his ban in 1829, he would certainly not have been able to see its effects before his death on February 10 of the same year. In 1991, Georges Minois, in his book on the Church and science, imagines two successive vaccine bans: the first during the restoration of the government of Pius VII, the second by Leo XII concerning the "diabolical vaccine, whose action is contrary to nature (25)". The first of these assertions is (22) H. F a b r e , The Position... [see n. 1], p. 2. (23) G. Cogniot, La religion et la science, Paris, 1960, p. 29. (24) J. Mathieu -R osay, La véritable histoire des papes. Du royaume des deux aux royaumes terrestres, Paris, 1991, p. 302-303. A Jesuit, the author left the Order and broke with the Church "because of the abuse of power by Rome and its blindness to the problems of today". cf. J. Mathieu-R osay, Pour Dieu contre l'Eglise. La révolte d'un prêtre, Paris, 1993. (25) G. Minois, Leglise et la science. History of a misunderstanding. T. 2. de Galilée à Jean-Paul II, Paris, 1991, p. 186. 460 Y -M . B E R C E - J . - C . O T T E N I of an inaccurate interpretation of the purely formal changes that occurred in 1815. It should be remembered that Napoleonic legislation strongly encouraged vaccination, but did not make it compulsory, which in the spirit of the time would have seemed abusive. In 1997, Claude Allègre, a geochemist and Minister of National Education from 1997 to 2000, cited the ban on vaccinations three times in his book on the tensions between science and religion: as proof of the Church's reticence towards medicine; because, according to Allègre, "God made nature with epidemics... and it is not up to man to rectify creation"; and, finally, as a reaction of the Church to the benefits introduced by Napoleon and the French (26). Pierre Grelot, an exegete, underlines the anti-clericalism of the work and the recourse to second or third hand sources for its argumentation (2728). In 2005, Marc Andronikov, a doctor of Orthodox faith, describes the prohibition of Leo XII as "nonsense" (2S). A third category of quotations, without reference, mentioning a vaccine ban, are available on many Internet sites. They can be obtained by using the search engine with the words "Leo XII - Vaccination". There are considerable fabrications: for example, on the site "Heretics, Atheists, Nationalists" w w w .lemanlake.com/ english, one can read: "1829. The Church against medicine. Declaration of Pope Leo XIII (sic): quotation of the ban, followed by : "In the same way, in the past, when the plague was ravaging, the Church promulgated edicts that forbade the destruction of rats, since they were considered, as propagators of the epidemic, as the realizers of the divine will. Rabbi Harold Schulweis, in his Rosh Ha-Channah sermon in 2002, also attributes to Leo XII a hypothetical ban on the use of condoms in 1826, used to combat syphilis (the "great pox"), because it would be against God's judgment (29). (26) C. A l l è g r e , Dieu face d la science, Paris, 1997, p. 149-151, 231. (27) P. G r e l o t , La science face à la foi. Lettre ouverte à Monsieur Claude Allègre, Paris, 1998, p. 65, 73. (28) M. A n d r o n ik o f , J. D a u x o is , Médecin aux urgences, Monaco, 2005, p. 159. (29) H. S c h u l w e i s , Sgnagogue & Hospital: a tale of two sanctuaries, Rosh Hashana 2002, www.vbs.org/rabbi/hshulw/synagog bot.htm. N.B.: in 1826, the condom was obtained from sheep caecum and preserved in liquid medium. A N T IV A R I O L I C A L V A C C I N A T I O N P R A C T I C E 461 In the end, all of these publications resort to the so-called forbidden to "add fuel to the fire" of their authors in order to prove a claim and/or denigrate the papacy. Too happy to have found it, they did not consider it useful to verify its veracity. For the purposes of this work, the search for a credible source was necessary. R e c h a i r c h o f s o u r c e s t o t h e r u m e u r o n The biographers and contemporaries of Leo XII make no mention of a ban. This is particularly true of the knight Artaut, the first biographer of Leo XII (30), and of Massimo d'Azeglio (31). The latter has great admiration for Jenner, "a man who has saved God knows how many millions of his fellow men from death... The day will come when Jenner will be rated higher than Napoleon". It is likely that if Leo XII had promulgated a ban on vaccination, Azeglio, who was well informed about the pope's doings, would have mentioned it in his Memoirs on life in Rome during the first half of the 19th century. Likewise, recognized scholars of 19th century popes do not mention Leo XII's ban. This is true of Raffaele Colapietra (32) and Philippe Routry (33). The first writes: "After Consalvi, vaccination continued under Leo XII, who did not ask for it to be stopped, contrary to what a certain tradition claims. Finally, research into the ban in treatises on ecclesiastical history has also remained negative (34). (30) A. F. Chevalier Artaut d e Montor, Histoire du pape Léon X I I , Paris, 1843, t. 2. (31) M. d'AzEGLio, Mes Souvenirs, Paris, 1876, t. 1, pp. 149 and 151. (32) R. Colapietra, La Chiesa fra Lamennais e Metternich [see n. 12], p. 118-120. (33) Ph. B outry, Léon X I I , in P. L evillain (ed.), Dictionnaire historique de la papauté, Paris, 2003, p. 1031-1035; Id., Souverain et pontife [see n.12]. (34) E. M. Crookshank, History and pathology of vaccination, vol. 2. Selected Essays, London, 1889; F. K. N ielsen , Geschichte des Papstthums im neuzehnten Jahrhundert (1876), Gotha, 1880, p. 285-327; M. B rosch, Geschichte des Kirchenstaates, t. 2, Gotha, 1880-82, p. 308. K. A. von H ase, Kirchengeschichte, Leipzig, 1900, pp. 598-599. J. J. W alsh, The popes and science, the history of the 462 Y -M . B E R C E - J . - C . O T T E N I The origin of the incrimination of Leo XII is undoubtedly due to the strong personality of Cardinal Della Genga, who became pope in 1823. His uncompromising piety, alien to the tumult of the world, quickly alienated liberal opinion; his austere spirituality made him the target of criticism and mockery. Indeed, the powers of the Holy Alliance were not indulgent towards the pontifical temporal power. They had hesitated for a long time to give back to the pope the provinces known as the Legations, Bologna and Ferrara. England, Prussia and Russia shared the anti-Catholic prejudices. In Austria, many notables professed the state anti-clericalism of Josephism. Thus, the English travelers visiting the peninsula and even many diplomats established in Rome peddled anecdotes and reservations about the severity of this pontiff. The obscurantism of the Church, the inertia of the pontifical government, the ridiculous superstitions of Italian piety, the laziness and dirtiness of the southerners were commonplaces in the travellers' accounts. The cause had long been heard. The notion of the Church's opposition to preventive sanitary measures was already present in letter XI of Voltaire's Lettres philosophiques published in 1734 (35). Roederer, the young prefect of Trasimeno, took it up again in 1809, stating without hesitation that inoculation and then vaccination had been forbidden by the Pope. Lady Morgan, in her Voyage d'Italie, written in 1819, made a theorem out of it: "In crossing the Apennines, each step takes away papal relations to science during the middle ages and down to our own time, 1912; J. S c h m id l in , Papstgeschichte der neuesten Zeit. T. 1. Papsttum und Päpste im Zeitalter der Restauration (1800-1846), München, 1933. French translation: Histoire des papes de l'épogue contemporaine, t.l: La Papauté et les Papes de la Restauration, Léon X I I (1823-1829), Lyon-Paris, 1940; J. L e f l o n , La crise révolutionnaire (1789-1846), le Pontificat de Léon X I I , in A. F l i c h e , V . M a r t i n (dir.), Histoire de l'Eglise depuis les origines jusgu'd nos jours, Paris, 1951, vol. 20, pp. 379-408; I d . , Leo X I I , in Centre Interdisciplinaire des Facultés catholiques de Lille (dir.), Catholicisme, vol. 7, Paris, 1975, pp. 328-331; I d ., Histoire de l'Eglise depuis les origines jusgu'd nos jours, Paris, 1984; R. A u b e r t , J. B e c k m a n n , P. C o r is h , R. L il l , Handbuch der Kirchengeschichte, Freiburg, 1985, p. 117-121; J.N.D. K e l l y , The Oxford Dictionnarg of Popes, Oxford, 1986, Dictionnaire des papes, Belgique, 1994, p. 636-639; A.- M. M o u l in (ed.), L'Aventure de la vaccination, Paris, 1996. G. M o n s a g r a t i , Leone X I I , in M. S im o n e t t i (ed.), Enciclopedia dei P api, Roma, 2000, t. 3, p 529-539; T.F. Ca s e y , Leo X I I , Pope, in C a t h o l ic U n iv e r s i t y O f A m e r ic a , New catholic encgclopedia (1914), Detroit, 2003, t. 8, p 489-490. (35) V o l t a ir e , Lettres philosophigues, (1734), Letter XI. P R A T I C E O F T H E A N T IV A R I O L I C V A C C I N A T I O N 463 of the light of science. The same languor that a gentle and soporific despotism extends over the other branches of science also reigns over the medical art (36). She tells us that in Florence the priests ordered babies to be swaddled and condemned their freedom of movement as an innovation and, she continues, "an English lady of very high rank who lives in Florence told me that she had tried in vain to get her child's nurse to have her child vaccinated at the same time as her infant: she constantly refused, saying, according to her confessor, that it was fleeing before the face of God. Vaccination is considered as Jacobin and revolutionary by all the supporters of the old regime". One recognizes the terms of the reasoning lent to the supposed bull of Leo XII. Certainly, Della Genga had a worried look at the political novelties that were shaking the old continent. He could have joked about it, it is true that the logic of the vaccination lent to laughter and the English caricatures had pleasantly put in scene bovine metamorphoses that would have threatened the new vaccinated. It is necessary to place in this register a reflection lent to the cardinal Della Genga, who in August 1823 would have said, according to the count Apponyi, Austrian diplomat (37): "Un innesto va bene, ma quest'innesto bestiale (38)...". Lady Morgan also reports a joke uttered by the old king of Sardinia Victor-Emmanuel I, who mocked the young people of today, incapable since they were vaccinated to dance until the early morning, as it was done in his time. The English diarist, far removed from the humor of her nation, instead of (36) Lady S.O. M o r g a n , L'Italie, French translation, Paris, 1821, 4 vols. (37) The joke of the cardinal Della Genga, reported by the count Apponyi to Metternich, is quoted by J. S c h m id l in , Papstgeschichte der neuesten Zeit, 1933, t. 1, p.369. French translation: Histoire des papes, Paris, 1940. (38) "A graft, that passes, but this bestial graft...". The term "graft" recalls that of "insertion" used by Voltaire to designate scarification with the introduction of variol pus. The term "bestial" can be interpreted as "which is like the beast" or as designating deviant behavior. It is probably the first meaning that applies. Like many people of the time, Della Genga feared, or pretended to fear, the consequences of applying an animal product to humans and the risk of what some refer to as "minotaurization. 464 Y -M . B E R C E - J . - C . O T T E N I see a word for laughter attributed the comment to the reactionary obsession of the victims of the revolutions (39). Thus, long before Della Genga ascended the throne, the arguments for his discrediting were ready. The severe piety of Leo XII, his undertakings of administrative reforms, his confrontation with subversive activities predisposed him to play, in a recomposed history, this provocative role, to receive this posthumous disguise. In fact, in the institutional logic of the ecclesiastical state, it was impossible for the Pontiff to be willing and able to make a drastic and sudden intervention on a temporal matter that would have required the advice of the medical professors of the Universities for the scientific aspects and of the Sacra Consulta and the management bodies of the sanitary policy for the practical directives. The formation of the legend remains to be discovered. To assume that the assertion originated immediately after the death of Leo XII and probably in the writings of English travelers seems reasonable, but documentary evidence is lacking. C o n c lu sio n The recent fortune of Leo XII's supposed vaccine ban belongs to the cultural history of our time. Let us admit that its appearance, after the death of Leo XII, remains enigmatic. Then, the polemical survival of this institutional incident, true or supposed, is part of a permanent hostility towards Catholicism whose diachronic stability is noteworthy. Some episodes are missing; the true origin of the anecdote, its repetitions, its transmissions remain to be completed. At least, this attempt at genealogical reconstitution illustrates a little the compartmentalization of intellectual channels, the ideological indifference to the demands of history and the space of abstraction, where received ideas and the disguises of the past live and are transmitted. Yves-Marie B ercé 121 avenue Philippe Auguste F - 75011 P a ris Jean-Claude 6 Boulevard Ohmacht F - 67000 S tra sbo u r g (39) Lady S.O. M o r g a n , Italy [see n. 36]. Otten i P R A T I C E O F T H E A N T IV A R I O L I C A L V A C C I N A T I O N 465 Summary - "Those who submit to smallpox vaccination cease to be children of God. Smallpox is a punishment from God and vaccination is a challenge to Heaven. This ban on the practice of smallpox vaccination in the Papal States, attributed to Leo XII in 1829, is often cited, especially in the field of bioethics, to show the persistent and unjustified hostility of the Roman Catholic Magisterium towards certain biomedical innovations. In fact, the citations of the ban are not referenced by a credible source: the authors quote each other without verifying what they are saying. This unsubstantiated claim continues to be presented as fact and the ban has become a reality that is no longer questioned. This work, centered on the problem of the citation of the ban, considers successively the historical data on smallpox vaccination in 19th century Italy, in particular in the provinces of the Papal State, the citations of an alleged vaccine ban in contemporary publications, the search for the sources of this rumor and the hypothesis that can be formed about the origin of the supposed ban. He concludes that this anecdote of a ban is very similar to a malicious rumor currently being spread by Internet sites. The probable origin of this rumor could be a negative joke about vaccination made by Cardinal Della Genga before he became Leo XII. In the end, it is arbitrary to establish a connection between this alleged ban and recent negative opinions of the Magisterium in the field of bioethics. Summary. - Whoever aUows himself to be vaccinated ceases to be a child of God. Smallpox is a judgement from God: thus vaccination is an affront to Heaven ". This ban on smallpox vaccination in the papal States, attributed to Pope Leo XII in 1829, is often quoted, especially in the field of bioethics, to demonstrate the persistent and unjustified reluctance of the Roman Catholic Magisterium to accept certain biomedical innovations. However no evidence supporting the attribution of this quotation is provided: authors give mutual citations without further verification. A groundless attribution continues to be presented as a true fact and the ban has become an unquestioned reality. This article aims to explore the problem of the ban's attribution and considers successively the historical data on smallpox vaccination in the papal States and in Italy during the 19th century, the quotations of the supposed papal ban in contemporary publications, the search for the sources and the hypothesis of the origin of the rumour. It is concluded that the ban is not a reality but a malevolent rumour, mainly maintained today on Internet web-sites. The probable origin of the rumour is a negative comment on vaccination by cardinal Della Genga before he became Leo XII. Finaby, it is not justifiable to accept a link between this supposed edict and certain condemnations by the contemporary Roman Catholic Magisterium in the field of bioethics. Summary. - " Whoever undergoes vaccination ceases to be a child of God. Smallpox is a judgment of God: vaccination is a challenge from Heaven ". This ban on smallpox vaccination in the Vatican States, attributed to Pope Leo XII in 1829, is often cited, especially in the field of bioethics, to describe the Roman Catholic Magisterium's persistent and unjustified opposition to certain bio 466 Y -M . B E R C E - J . - C . O T T E N I To show medical advances. However, no evidence is provided that this citation exists. Different authors quote each other without further proof. An unsubstantiated attribution is presented as fact and the ban has become a reality that is no longer questioned. This paper aims to examine the problem of the citation by successively providing an overview of the historical data of smallpox vaccination in the Vatican States and in Italy in the 19th century, analyzing the contemporary publications dealing with the papal ban, searching for sources of the rumor and investigating the hypothesis of its origin. It is concluded that the ban is not a reality but a malicious rumor that nowadays is mainly spread on Internet sites. The possible origin of the rumor is a negative comment of Cardinal Deila Genga on vaccination, before he became Pope Leo XII. Finally, it is not justified to establish a link between a hypothetical edict of Leo XII and certain disapprovals by the contemporary Roman Catholic Magisterium in the field of bioethics.