Quinine prophylaxis in the early 20th century in malaria -affected Bologna

The authors outline public health and environmental conditions in Italy at the end of the 19th century and the attempts made at improvement in this field. Details of health investigations carried out within the framework of the emerging State Railways are given, together with information on studies in the health and social sectors. Such investigations showed a constant connection between wetlands, malaria, and social and economic decline. Far from improving public health, political and economic policies to consolidate the nation had compounded the existing critical situation and led to a deterioration of public health and living conditions of those who, like seasonal labourers, shepherds and fishermen, lived in malarial areas. With the laws passed from 1878 onwards and especially those at the beginning of the 20th century, attempts were made - with little success - to reverse the trend with a series of palliative measures. By contrast, outside the city gates of Bologna, where malaria epidemics had occurred between 1899 and 1901, wetland drainage, treatment of the sick and prophylaxis of healthy subjects, through the provision of quinine, achieved good results. The authors attribute such success to the fact that the population of Bologna had not become inured to the "malarial climate" which made people passive and abulic, and thus collaborated with the local administration by supporting drainage measures. The area of Bologna affected by the epidemic experienced little environmental deterioration, thereby few well-targeted measures sufficed to eradicate the epidemic.