A family threatened by influenza is prepared for a large scale bloodletting. Coloured etching, 18--.
- [between 1800 and 1899]
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The surgeon (seated near the centre, with a black jacket and a plum-coloured waistcoat) who has been called in to let blood is addressing the physician (standing wearing a dark blue coat on the left), asking him "Doctor, how much blood?". The doctor replies, absurdly, "Eight units (ròtola) for the whole family: divide yourselves up!". Ròtola are a unit of weight used in Naples, Palermo and Genoa before the introduction of decimal measures, equivalent to between 0.79 and 0.89 kg or in Malta 0.19 kg (Grande dizionario della lingua italiana, Turin 1970-, vol. XVII, p. 137). Death is pictured on a black backdrop behind the bedbound woman; it is flanked by two paintings of nudes beside the bed. The words "son morto" (I'm dead) escape from the mouth of the brown coated man at the far right
Comment: In traditional Western medicine diseases are classified according to their symptoms. One important symptom was fever: there were many kinds of fever, and the one which included the symptoms of what was later called in English influenza was epidemic catarrhal fever. In catarrhal fever, the body was struggling to get rid of excessive fluid (catarrh) and heat (fever, febris). The body could be helped to do this by bloodletting, because reducing an excess of hot and wet blood in the body would reduce the internal heat and fluid. English people started to use the word influenza instead of epidemic catarrhal fever after an epidemic of the disease came to England from Italy in 1743, and English people began to use the Italian colloquial word. This print shows an Italian family of which at least three generations living in the same household are all suffering from influenza or catarrhal fever. The surgeon (seated near the centre, with a black jacket and a plum-coloured waistcoat) who has been called in to let blood is addressing the physician (standing wearing a dark blue coat on the left), asking him "Doctor, how much blood?". In this humorous print, the doctor is a careless practitioner, because he replies, absurdly, "Eight units for the whole family: divide yourselves up!". A more careful physician would have prescribed more blood for the young and fit adults, and less blood for children and the aged, instead of just giving a total for the family as a whole. There are some practitioners who are careful and precise (even when it does not matter) and some who prescribe carelessly (even when it does matter). The fact that much of health care delivery is a matter of individual personality is one reason why historians have placed little value on the idea of unqualified "progress" in medicine