The 1800s: a time of famine and cholera. How we were after Garibaldi, Cavour and the Thousand

What a time, the nineteenth century. We read history, and so here come the insurrections, and 1848; and the Risorgimento, and Cavour and Mazzini and Garibaldi and the Thousand; and the Unification of Italy, and Porta Pia and the Church; and the plebiscites and the capitals of Italy, right up to Rome in 1870: a string of events and dates from which the everyday lives of ordinary people vanish, overwhelmed. Who teaches us about that life? What do we know of it? There were no statistics; the number of deaths was unknown: how many, and from what ailments and diseases. Everything was estimated in broad terms—very broadly, if anything. The first decade of Italian unification saw the first statistics of any real reliability. When the infant mortality rate was first measured, in 1863, there were 232 deaths in the first year of life for every 1,000 births. Today, there are 2.5 deaths in the first year of life per 1,000 live births – practically a hundred times fewer. This alone should be enough to give us a sense of what we would find if we delved a little deeper into those times, which in many ways seem fabulous but which, given the conditions in Italy and for Italians, are – give or take a decimal place – best described as disastrous.

Following unification, as soon as the Kingdom of Italy had stabilised, a period began during which, quite rightly, one need seemed to take precedence over all others: the need to gain a better understanding, at least in certain fundamental respects, of the situation of the country and its inhabitants – those Italians who, it was said, still had to be ‘made’, now that Italy itself had been ‘made’. It was not as though it took all that much effort even just to imagine what Italy was like at the time, or the state it was in: one need only look at the densely packed chronology of the spread of epidemic waves, amongst which cholera stood out – an epidemic and contagious disease that, perhaps more than any other, revealed the wretched sanitary and hygienic conditions of environments, dwellings and people. Cholera arrived in Italy in 1835 from France, having been endemic since time immemorial in the region between the Ganges and the Brahmaputra; following British military and commercial movements in the region, it crossed the borders and spread inexorably in every direction. In Italy, it raged in the following series of epidemics: 1835–37; 1849; 1854–55; 1865–67; 1873; 1893, each claiming over 100,000 lives. Thereafter, it continued to flare up, albeit with less severity and fewer deaths, into the 20th century.

Sanitary conditions in municipalities and built-up areas; water supply systems and monitoring of water potability; the extent and quality of the sewerage network: the cholera vibrio, generally transmitted through the ingestion of contaminated water and other substances, with its spread and mortality rate, told the story – seamlessly from one decade to the next – of an Italy in which everything, starting with those three fundamentals, was deficient, lacking, defective, dangerous. Essentially nothing functioned as it should have, and nothing could be relied upon. Given these circumstances, the Italian population adapted accordingly.

Against this backdrop of palpable unease, there can be little doubt that, at least in broad terms, those at the helm of post-unification Italy envisaged that reality. But it is one thing to imagine, another to know, and yet another to possess knowledge grounded in extensive and objective documentation – documentation which, until then, was far from being not only acquired but even conceived. It was precisely in the realization that documentation was needed upon which to base reasoning and on the basis of which to attempt to devise remedial measures for Italy at that time that the first qualitative leap of post-unification Italy was measured. Two major nationwide inquiries shed a powerful light on post-unification Italy. Let us begin with the first.

Established in 1877 during the government of Agostino Depretis, a leading figure of the Historical Left, and chaired from 1881 by Stefano Jacini, an enlightened conservative, the Parliamentary Committee for the ‘Agrarian Enquiry and on the Conditions of the Agricultural Class’, better known as the ‘Jacini Agrarian Enquiry’, published between 1883 and 1886 a substantial body of documentation that drew considerable criticism of the Enquiry. Members of parliament from the radical left would have preferred a detailed survey of the material living conditions of peasants, whilst the Inquiry seemed to devolve too much into a study – however thorough – of the technical and structural situation of Italian agriculture. Indeed, as early as the ‘Preface to the Proceedings of the Inquiry’, Jacini himself commented bitterly: “No other country in Western Europe has such a large proportion of unproductive land: approximately 5,600,000 hectares out of a total area of 29,600,000; and of the remaining 24 million hectares, the term ‘productive land’ is, for at least half of it, more of a figure of speech than a reality.” He continued: “The average wheat yield is 11 hectolitres per hectare in Italy, whilst it amounts to 32 hectolitres per hectare in England, 22 in the Netherlands, 20 in Belgium, 15 in France and 23 in the German Empire – all countries towards which, to a greater or lesser extent, the sun is equally stingy. Italy, with a population amounting to three-quarters of that of France and an area comprising more than half that of France, produces three billion worth of agricultural produce annually, whilst that nation produces 12 billion”. To conclude: “In short, whichever way we look at it, agricultural Italy presents itself as a chronically and terminally ill patient, in an extreme condition; to save it from this would require a miracle of energy, diligence and wisdom on the part of all Italians – a miracle more desirable than it is possible.”

“Chronically ill and suffering from cancer, in an extreme condition, from which it would take a miracle to save her”. What more – and what even more radical – should Stefano Jacini have written to avoid being accused, as he was repeatedly, of being overly timid in his judgement?

All these factors contribute to the bleak picture that emerges from the investigation: outdated farming methods; rigid agricultural contracts laden with restrictions placed on tenant farmers; the burden of taxation; and the poverty and consequent physical frailty of the peasants. If one then considers that Italy at that time depended largely on agriculture, that industry accounted for a meagre 20 per cent of gross domestic product and employed a similar proportion of the working population, and that the first modest industrial boom of the years 1881–87 coincided with the worsening of the agricultural crisis—during which production, expressed in 1938 lire, from 28.3 to 25.9 million, it is clear that a state of almost universal poverty engulfed the countryside—and with it, Italy itself. A state of poverty that encompasses everything and spares nothing: from food to clothing, from housing to health.

The farmer’s soup from the Como area contains “rice and pulses of the poorest quality, old and spoiled pulses, unwashed vegetables, a little oil or lard” and, together with “undercooked, damp and rancid maize bread”, constitutes the meagre meal of those who work from morning to night in the fields of the “fittabile”.

From the north to the centre, in Umbria the staple diet of the peasants consists of pulses and maize; meat is consumed sparingly, ‘vinello’ is a rarity, and wine is practically unknown. In households, maize flour is made more palatable by baking it into flatbreads seasoned with salt. “In better-off households, both in the morning and in the evening, they add a dish of beans or broad beans to these flatbreads (…) but generally, more often than not, in the morning they eat only the maize flatbread.”

From the centre to the south. Every day, on behalf of the landowner, the foreman gives the Apulian farm labourers “a blackish, flat loaf weighing one kilogramme, known as pan tozzo”. The farmers nibble at the pan tozzo during their short break at ten o’clock, and in the evening, after the steward has boiled a large pot of water with a little salt and a few drops of oil, they treat themselves to ‘l’acqua-sale’ – that is to say, a soup made from the leftover pan tozzo from breakfast and water seasoned in that way.

The appearance of meat on the dining tables of farming families and others who, whilst not farmers, were nonetheless poor (that is to say, the vast majority of families living even in urban centres) used to mark the rhythm of special or exceptional occasions: from the major religious festivals of Easter and Christmas to the baptism and confirmation of children, from weddings to funerals.

In Italy at that time, the average Italian consumed one kilo of meat (including beef, pork, lamb, goat and horse meat) per month. But the disparities were enormous. While conditions were already somewhat better for working-class families, peasant households often slipped from bread and polenta, pulses and potatoes, chestnuts and (rare) fruit, all the way down to acorns, barley and millet – animal feed whose inclusion in the human diet distinguished the very poorest families from those who were merely poor. Eggs, milk and cheese were part of the ‘luxury’ foods that only the more ‘well-off’ families could afford. Fish appeared only sporadically on the tables of the wealthy, since, with its thousands upon thousands of kilometres of coastline, Italy was anything but a nation of fishermen. Consequently, nutrients (proteins, fats) and calories were, at that time, not only scarce but almost exclusively of plant origin.

And yet, to feed themselves as they did – poorly, if not worse – farming families spent up to 90 per cent of their income on such meagre food, whilst the average Italian spent two-thirds of their income on food.

Low in meat and protein, low in fat, monotonous and of poor quality, the diet of Italians right up to the turn of the 20th century seems to have been designed specifically to weaken the body’s resistance rather than strengthen it. It is no coincidence that medical examinations of conscripts from that period recorded, amongst those born between 1843 and 1856, a remarkably high percentage of those exempted from military service for reasons essentially stemming from the scarcity and poor quality of their diet. In fact, 40 per cent of those examined were rejected on grounds such as chest deficiency, frailty, excessive thinness and what was then termed ‘deficiency of stature’. Given that, to be accepted into the army, one had to be at least one metre 56 centimetres tall, 12.1 per cent of conscripts were rejected for failing to meet this threshold. Among those born in 1854—who therefore reached the age of military service around the mid-1870s to 1880s—the average height stood at one metre 62 centimetres, placing Italians among the shorter populations of the Mediterranean region, which in turn differed significantly in average height from continental and northern Europe.

Short in stature, frail in build, weak and hungry, Italians have a history of illness that is both extensive and varied; this is not solely the result of a diet which, rather than acting as a shield against such illnesses, facilitated their attack on bodies that were already congenitally weakened. We have mentioned cholera. The nineteenth century in Italy was the century of cholera. But it was also the century of malaria, so typically Italian: foul, unhealthy, marshy air, infested with mosquitoes that transmit the disease’s pathogen – air that descends from the valleys and the Po delta down to the Tuscan Maremma, spreads to the outskirts of Rome, and extends along the coastal areas. It was also the century of tuberculosis, a disease that would plague the population well into the post-war periods following the world wars.

There were a great many births in the nineteenth century – 36–37 births per 1,000 inhabitants each year – a figure not even comparable to the mere 6 of today. Of course there were many births, because even more people died. At a time when social security and insurance for old age – for ageing parents – essentially relied on their children, having just two children was not enough to ensure that at least one would reach adulthood; three were needed. The Jacini Agricultural Inquiry had assessed the state of agriculture and the diet of peasants, but had barely touched upon the sanitary conditions of the municipalities and dwellings of the time, another major factor, alongside diet, in the state of deprivation experienced by Italians in the period following unification, which would persist well beyond the nineteenth century, would also characterise Italians in the first two decades of the twentieth century, and which Fascism would essentially fail to eradicate.

And finally, the cavalry rides to the rescue. Not in the guise of Istat, which would not appear for another half-century, but in the form of the Directorate-General for Statistics, which, hot on the heels of – if not quite at the same time as – the Jacini Agricultural Enquiry, published in 1885 the “Risultati dell’inchiesta sulle condizioni igieniche e sanitarie nei Comuni del Regno”. The document is enough to make one shudder, recalling an era that, in reality, has never truly passed.

In his book "I pidocchi e il granduca", Carlo Maria Cipolla, an economist with a delightfully dark sense of humour and a leading scholar on the impact of epidemics on Italian society in the 16th and 17th centuries, recounts the 1621 epidemic of petechial typhus in the city of Florence. He elaborates on the role of the ‘votapozzi’—that is, those who, for a fee, were responsible for emptying the cesspits of homes. As there were no sewerage systems, the ‘votapozzi’ would recycle the ‘solid matter’ – which was good for making fertiliser for the fields – to local farmers, and unceremoniously discharge the ‘soft matter’, commonly known as ‘acquastrone’, into the Arno. However, the ‘poor and wretched souls who cannot scrape together enough to live on’, unable to afford the cost of emptying their cesspits, allowed them to overflow, ‘resigning themselves to living amidst these stench’. Was it any wonder, then, that typhus was rife?

But two centuries and sixty-four years have passed since the Inquiry into the Hygiene and Sanitary Conditions of the Municipalities of the Kingdom reached its conclusion. And, on the subject of sewers, here is the picture: “Throughout the Kingdom, there are 541 municipalities in which the streets are wholly or partly equipped with sewers, which also serve to carry away waste; 1,313 municipalities in which the underground pipes serve exclusively to collect rainwater or water from domestic use or from fountains; and 6,404 municipalities that lack any sewerage system whatsoever. The total population of the first category of municipalities is 5,523,614 inhabitants; that of the second is 8,055,291; and that of the third is 14,580,205”.

If we consider that, in the second category, ‘underground pipes’ are used solely for water drainage, the percentage of Italian citizens who can say they are served by a sewerage system does not exceed 20 per cent; whilst more than one in two Italians have not the faintest idea what a sewer is. In the first category, however, ‘there are only 97 municipalities (population 1,545,611) which claim to have a sewerage system extending to all or most of their streets’, meaning that, by rough calculation, no more than one in ten Italians in the 1880s had access to a sewerage system barely worthy of the name. Nine-tenths of Italians were still grappling with the – by no means minor – problem of disposing of human waste, which, two and a half centuries earlier, the Florentine cesspit-emptiers had, with shrewd business acumen, classified as ‘solid matter’ and ‘liquid waste’. This trade of the cesspit emptiers must not have experienced any decline whatsoever, given that: ‘383 municipalities remove excrement from the built-up area, making use of sewers and, to a lesser extent, other removal systems; 98 make use of odourless systems; 622 remove it using barrels or containers that are more or less poorly sealed; 5,870 by means of tubs or baskets – that is, containers that are almost always open; and finally, in 797 municipalities, excrement is deposited in the streets and left to the winds, the rain and the pigs to clear them of these constant sources of infection”.

However, the issue of waste disposal was, so to speak, a problem that arose ‘afterwards’, because the problem of ‘before’ – the primary problem, to stick with this line of argument – was still that of the provision of sanitary facilities in homes. And in this regard, the vocabulary itself is telling: these facilities are defined by the presence or absence of ‘latrines’. And here is the picture: “Only 908 municipalities, with a combined population of 4,220,481, reported that all homes are equipped with a latrine; in 2,428 municipalities (population 10,734,145), the majority of homes do not have latrines; and finally, in 1,286 municipalities (population 2,762,081), latrines were absent from almost all homes. This latter situation is found particularly in the municipalities of southern Italy and the islands, and in many municipalities in the Veneto region”.

Based on these figures, it is not far from the truth to estimate that 60 per cent of Italians did not have even a – mercifully unspecified – ‘latrine’ in their homes.

The Report by the Directorate-General for Statistics continues to present, as if they were the stages of a painful ordeal it is forced to endure against its will, the figures of a sanitary disaster that all too often leads to descriptions of subhuman conditions. Consider these passages from the Report: “In 966 municipalities, farmers are in the habit of spending their winter evenings in the stables, and in 4,701 municipalities they are in the habit of spending not only their evenings but also their nights there, breathing the same damp air, laden with noxious miasmas, to the serious detriment of their health. In southern Italy, pigs, donkeys or other domestic animals are often kept under shelter at night in the very same room where the family lives (…) There are also 1,124 municipalities which reported that some dwellings, particularly those isolated in the countryside, have hearths without a chimney or flue, so that the smoke fills the entire room and escapes through the door, windows or a hole in the roof”.

Particular attention should be paid to the figure of 4,701 municipalities – that is, 57 per cent of Italian municipalities – where farmers spend not only their evenings but also their nights in barns, alongside the animals. It goes without saying what the hygiene conditions are like, and what the implications for their health are.

However, it is worth noting that during the years of the two major surveys we have mentioned: (a) one in two Italians died within the first 5–6 years of life; (b) those who survived the high mortality rate of early childhood could expect an average lifespan of 55–56 years; (c) whilst, overall, the average lifespan or life expectancy of Italians at birth, and therefore without distinguishing between the years of childhood and those that followed, rose from 34 years in the decade 1870–1880 to 37 in the decade 1881–1890.

However, despite the significant increase in life expectancy from 34 to 37 years, even in the period 1881–1890 Italy continued to lag far behind the more developed countries, where the demographic transition towards lower birth rates and, above all, lower mortality rates had already begun in the early nineteenth century, if not as early as the last two decades of the eighteenth century, whereas in Italy it was not until the second decade following unification – 1881–1890 – that the first serious signs of a slowdown in mortality rates became apparent, leading to the first significant increase in the average life expectancy of Italians. In fact, life expectancy at birth of 37 years at the start of the 1881–1890 decade still placed Italy at the bottom of the table in terms of expected lifespan, incomparable not only to that of countries such as Sweden, Norway and Denmark (50 years), the forerunners of the demographic transition, but also compared to that of England and Belgium (45 years), the Netherlands and Switzerland (44 years), and France (43 years): the latter being the closest, yet still 6 years – almost 20 per cent – higher than our life expectancy.

Speaking in entirely general terms, Italy is clearly lagging behind in terms of civilisation, a fact that the results of the two major surveys of the 1980s both reflect and explain. A lag in the Industrial Revolution, a lag in the modernisation of agricultural structures and relationships, a lag in improving the disastrous conditions of local authorities and living standards – particularly amongst the rural masses and in the South – a lag in political life (in the 1882 elections, just over two million citizens were eligible to vote) and socio-cultural life (in the 1881 census, the illiterate accounted for over 60 per cent of the population aged over 6), and finally a lag in the process of the country’s actual unification, which has, it is fair to say, dragged on right up to the present day.

A civilisational lag that ultimately manifests itself in the persistence in Italy of high mortality rates, which are struggling to fall steadily and decisively due to the persistence of two characteristics of Italian mortality, both stemming from a natural demographic regime that will take us some time to modernise: the extremely high infant mortality rate and the abnormally high proportion of deaths caused by infectious and contagious diseases. The two major investigations of the 1880s were not into the mortality of Italians, but into fundamental aspects of Italians’ lives. And yet, it is precisely the lives of the Italians that these surveys helped to reveal and illustrate which speak volumes about the actions and measures that should have been pursued – measures that the ruling classes at all levels in post-unification Italy should have pursued – if the intention was to bridge that civilisational gap and overcome the unacceptable misery of Italians’ lives at that time.