Tuberculosis in Siena: evolution of the disease and its treatment, from the Unification of Italy to the 1930s.

Abstract

Between the end of the nineteenth century and the first half of the twentieth century, the city of Siena experienced elevated tuberculosis-related morbidity and mortality, to the point that on January 1, 1929 the newspaper La Nazione wrote that "Siena ranks second in the official Tuberculosis (TB) incidence rate". The author presents statistical data relating to a time span ranging from 1898 to 1935, interpreting them in light of social and sanitary conditions found in the city. The result is an exhaustive picture of the most important actions implemented at city level to prevent tuberculosis and to assist and treat the sick, such as: the creation of seaside hospices conceived by Carlo Livi for children suffering from scrofula, as well as centers committed to the prevention of childhood poverty and malnutrition; the realization of activities in the green areas of the ramparts of the Fortress, upon recommendation by the great hygienist Achille Sclavo; the establishment of a Preventorium on the premises of the Monastery of Santa Maria Maddalena to accommodate children from families that included pulmonary tuberculosis patients, and countless activities carried out by the Anti-TB Dispensary. Of particular interest is the identification of the main cause of high TB incidence in the unhealthy houses located in some areas of Siena's district, which, in 1930 engendered a lively debate hinging upon the notion of building restoration.