The Aetiological Turn (The Nineteenth Century)

Abstract

AbstractBeginning in the 1830s, medical investigators began to think of organic disorders as having single causes that were both universal and necessary. For this to be possible required a radical shift in the way doctors defined diseases: from symptoms to causes. The so-called aetiological approach to disease meant that every case of the disease had the same cause. This, in turn, meant that any prophylactic or therapeutic measures directed at that cause, which were effective in one case, would be effective in every case. The crux of the matter now shifted to identifying a disease’s causation, beyond dispute. And when it came to pellagra, this was precisely the problem. By the middle of the nineteenth century, all the medical actors involved agreed on the close link between pellagra and maize consumption. What they disagreed on was the exact causal nature of that link, propounding two divergent, indeed mutually exclusive, explanatory models. How the cultural dominance of one explanatory model, at the expense of another, came about; what it tells us about the nature of Italian medical science in the second half of the nineteenth century; and what its dominance meant for sufferers, is the subject of this chapter.