Casanova's Guide to Medicine

18th Century Medical Practice

Lisetta Lovett

• Publisher: Pen & Sword History
• Year: 2021
• ISBN:
  9781526779229
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Forget the stereotype! Giacomo Casanova's (1725-1798) reputation as libertine has sadly eclipsed his talents as scholar, linguist, prolific writer and manqué doctor. Fortunately for us, he wrote his memoirs at the end of his life on the advice of his doctor to control his propensity to depression. Although these often have been harvested for information on political, cultural and social aspects of his time, the insights they give about medical practice and the lived experiences of illness have been largely neglected. This book addresses this deficiency through exploring in detail what Casanova wrote on a variety of conditions that include venereal disease and female complaints, duelling injuries, suicide, skin complaints and stroke and even piles. These descriptions provide alternately grim and amusing insights about public health measures, the doctor-patient relationship, medical etiquette and the dominant medical theories of the era. To help the reader understand the historical significance of the medical subjects covered, the author integrates throughout the book an extensive historical context drawn from contemporary sources of information and current history of medicine literature

Chapter 1

Understanding Casanova, His Memoirs and their Historical Context

‘There are few more delightful books in the world’

Havelock Ellis, Affirmations (1898)

‘He did not live to write, but wrote because he had lived, and when he could live no longer’

Arthur Symons, ‘Casanova at Dux’;

Preface in Memoirs of Casanova (1902)

Say the name ‘Casanova’ now, and most people conjure up the image of a libertine or womanizer. One reason for this is that even though he was not as promiscuous as many of his contemporaries, he chose to describe his amorous exploits in great detail and by good fortune his writings survive. It is certainly true that Giacomo Casanova was easily captivated by women, taking great delight in courting those whom he found beautiful and intelligent. But unlike many of his male peers, he respected women and frequently earned their long-term respect. He was sensitive to a society where double standards prevailed in regard to male and female sexual activity, and compassionate, to the point of risking his own reputation through helping women who had been – or might be – compromised by exploitative, philandering men.

This is not to say that he was an angel. Nor would some of his behaviour meet the moral standards of today. But it is a mistake to judge from a temporal distance of over 250 years. In order to evaluate fairly, we have to put him in his social context. Casanova lived during the height of the Enlightenment, subscribing to the ideals of his era such as individualism, the power of Reason, the pursuit of happiness, personal liberty and sexual licence. His life is full of episodes that reflect these beliefs. We know about them because he chose to write with candour about both his amorous encounters and other escapades. He readily acknowledges that some of these do not reflect well on his character, but rarely makes excuses for himself or justifies any of his deeds, good or bad. At times he reflected whether to burn his Memoirs, simply because they were such an honest account, but then argued that dishonesty would defeat their purpose, namely to provide him with occupation and a vicarious enjoyment through reminiscence. Dwelling on old memories enabled him to stave off the depression that afflicted him in a bleak, lonely old age beset with irritations. By writing for ten to twelve hours a day he could ‘hinder black melancholy from devouring his poor existence, or sending him out of his mind’.1 Since his most pleasant memories were of his love affairs, he lingers on these in a way that reveals his pleasure in the game of courting and the subtle teasing dynamic that preceded the sexual act. By allowing the curtain to drop early on his descriptions of these encounters, he avoids explicit detail, thereby leaving something to the reader’s imagination.

Casanova’s amorous adventures today eclipse all his other achievements, which is a pity, since he was a prolific writer of scholarly texts that include forty-two books and plays, philosophical and satirical treatises, operatic libretti, poetry, writings on canon law, geometry and calendars, a translation of Homer’s Iliad into Italian and five volumes of a science-fiction novel. These achievements are only given passing reference in the Memoirs. Had he written more about the process of writing these intellectual works, it is likely that the Memoirs would not have been so culturally informative or entertaining. However, many of Casanova’s contemporaries did seem to appreciate him, recognizing him as a serious scholar, a gifted linguist (he spoke French, Greek and Latin as well as some German, Russian and English) and a great raconteur who was well travelled and well connected with many of the courts of Europe. One contemporary, Count Max de Lamberg, described him as ‘a man of letters, a man of profound knowledge’,1 and continued a correspondence with him for twenty-five years. The Prince of Ligne wrote that ‘Casanova has a mind without an equal, from which each word is extraordinary and each thought a book.’2 A Berne magistrate, in a letter of introduction in 1760 to an academic in Roche, described him as worthy of acquaintance, a curiosity and enigma who was very knowledgeable and interested in natural history, chemistry and the cabbala.3 During his life he was seen as a celebrity, a status that Casanova liked to fuel, and did so successfully on the back of his exciting escape from I Piombi (The Leads), a notorious Venetian prison where he had been imprisoned for eighteen months in 1754. Some were aware that he was a Freemason. Many, like the magistrate, regarded him with some curiosity and caution, given his reputation for gambling and involvement in the cabbala (see Endnote 1). He was a polymath with a range of talents and occupations, who had co-invented the highly successful state lottery in France, staged theatrical events to the delight of various European courts and discoursed seriously with most of the leading intellectuals of his time. These included Voltaire at Ferney, with whom he fell out, Rousseau at Montmorency, Fontanelle, D’Alembert and Crébillon in Paris and Benjamin Franklin in London. Despite all these achievements, most contemporary popular films have preferred to reduce him to the cartoonesque figure of the thoroughly immoral womanizer and neglected his scholarship.

Amongst Casanova’s many claims to scholarship was a knowledge of medicine. As a teenager, he had wanted to study medicine at Padua but was not allowed to by his mother and his guardian, the Abbé Grimani, who both insisted he become an ecclesiastical lawyer. However, his interest in medicine continued throughout his life. He took many opportunities to discourse with physicians who were up to date on such matters and writes about these encounters in his Memoirs. There is evidence that he was familiar with the medical works of Professor Boerhaave of Leiden (1668–1738),4 one of the most respected physicians and medical teachers in early eighteenth-century Europe. He was clearly impressed because he often referred with approval to physicians who had been pupils of the famous professor. Casanova’s descriptions of symptoms and treatments suggest that he was an informed observer of his own health and that of others. His comments reveal an understanding of ancient Greek medical theory, although limited familiarity with newer medical paradigms. He provides insights on how a wide range of conditions were understood, managed and experienced, as well as the relationship between patients and their health advisors. On occasions Casanova used his medical knowledge to advise others, but never as a formally hired practitioner, rather as a friend. He was anxious not to be seen as a quack, but at times found that his advice was more readily followed when pretending it arose from interpretations of the cabbala.

Thanks to Casanova’s interest in medicine and his own medical complaints, the Memoirs provide a rich source of information on a variety of illnesses. One of the most feared was the pox (syphilis), which is the subject of the following chapter. Casanova describes at length his personal experiences of this disease, as well as those of numerous friends and acquaintances. He writes not only about the symptoms but also about the treatments employed, including the ‘Great Cure’, mercury. In doing so, he vents his anger at the quacks that prescribed incompetently and thereby caused significant suffering and even death. His descriptions provide a testimony to the tragic lived effects and stigma experienced by the victims of venereal disease during his era.

The subject of women’s health issues arises repeatedly in the Memoirs. This is hardly surprising given Casanova’s interest in women, but one reason he knows so much on subjects such as contraception, the risks of childbirth and methods of procuring abortion is because women trusted and confided in him. The chapter devoted to this subject begins on a light note with the presentation of green sickness, first described by Hippocrates in about the fourth century BCE, and its cure, namely marriage, or at least loss of virginity. The episodes described illustrate the challenges women faced living in a world of gendered double standards.

Given that the previous two chapters are largely about sexual medicine and obstetrics, chapter four digresses from the strict confines of medical practice to explore sexual behaviours and attitudes. Masturbation, homosexuality, paedophilia and adultery are common topics in the Memoirs, which present the reader with numerous tableaus. These reveal the contested social, political, religious and legal responses of the era. The themes of gender inequality and double standards commonly arise, where philanderers enjoyed respect but fallen women were stigmatized and often sunk into terrifying poverty. This chapter puts the episodes described in an historical context and offers a revised version of Casanova’s behaviour. He emerges as a man quite sensitive to the injustices women faced and someone who often supported women who had become the victims of less moral men. However, he was also a product of his time, which means that many today would judge his behaviour as morally reprehensible.

Chapter five returns to medical subjects by focusing on the serious health concern of infectious diseases. Throughout the Memoirs there are repeated references to smallpox, tuberculosis, plague, malaria and influenza, and their effect on Casanova’s friends and acquaintances. Although in the eighteenth century there existed the notion of contagion – the ability of disease to spread from one person to another – there was no consensus on how this occurred. The proof of the existence of invisible organic particles – germs – was not to occur until near the end of the nineteenth century. Ancient Greek and Galenic ideas, which held that bad air – miasma – led to epidemics, still dominated eighteenth-century understanding. This bad air was thought to arise from unburied corpses, marshes, stagnant water or foul-smelling vapours from the earth’s depths. Whether a person succumbed or not depended on hereditary factors and, most importantly, his or her attention to lifestyle, known as the non-naturals, which included diet, exercise and sleep. The experiences of the Black Death and influenza in the proximate previous centuries had led to the observation that the best way to escape an epidemic was through avoidance of contact with infected persons and goods. This realization led to public health measures such as isolation, quarantine and fumigation. Quarantine was an experience that Casanova frequently experienced, particularly given that he lived in his first three decades in the Venetian Republic, where public health measures became a model for the rest of Europe.

Chapters six and seven describe a range of acute and chronic conditions – some fatal, others trivial – taken from the Memoirs. All these conditions and their treatment are put into historical context through reference to the state of contemporaneous medical understanding. Chapter six includes apoplexy (stroke), the falling sickness (epilepsy), fevers and gout. Chapter seven describes the social isolation, physical pain and personal distress experienced by many of the people whom Casanova encountered who suffered with a skin complaint. Social responses varied from revulsion to making scratching an attractive habit, as was the case in Bologna, where the ‘Bolognese itch’ was ubiquitous. Social distaste was the more common reaction and led some sufferers to withdraw entirely from society. Chapter seven also considers the impact of disorders of the gut. Despite improvements in anatomical and physiological understanding, the process of digestion was the source of robust debate between those championing very different medical paradigms. Nevertheless, one view that has its origins in ancient Greek medicine remained. This was the belief that an intimate connection or sympathy existed between the gut and brain by virtue of neuronal pathways. Nervous theory became a fashionable diagnosis, not just of gut complaints but a whole range of symptoms. By the end of the eighteenth century, suffering with a nervous disorder was regarded as the hallmark of the refined and sensitive upper classes.

Chapter eight picks up the theme of nervous theory by examining episodes of suicide, melancholy and ‘frenzied madness’ described in the Memoirs. Like many of his scholarly contemporaries, Casanova held quite ambivalent views about the rights and wrongs of suicide, even though he had made serious suicidal plans whilst living in London. This chapter explores contemporary views and describes episodes in the Memoirs of suicide and the reactions of the public to its occurrence. Melancholia affected Casanova on several occasions, particularly in his old age. The way in which this condition was understood and its relationship with the notion of temperament are also examined. The chapter closes with a look at what we would now call addictive behaviours, such as gambling and drinking, the fate of women who were deemed mad and Casanova’s comments on madness in the monarchy.

Chapter nine moves onto a completely different medical area, that of injuries arising from duelling, accidental injuries and surgical interventions. Casanova’s experiences of gangrene and avoidance of amputation from a duelling injury are described at length. This leads us into a consideration of contemporary medical knowledge and practice with regard to serious injury. Carriage accidents and horse-riding injuries were common, and those in the Memoirs highlight the role of the bonesetters and their relationship with the surgeons. After describing an interesting attempt at a cataract operation, we turn to the misery of piles, with which Casanova suffered recurrently during his life following his imprisonment in The Leads.

Casanova’s encounters with his various health advisors were often fraught. Chapter ten describes some of these episodes in detail and illustrates how tensions arose between licensed or trained practitioners and the unlicensed charlatan or empiric. A recurring question is the extent to which doctors practised ethically in the eighteenth century. Encounters are described that reveal medical attitudes towards confidentiality, telling patients the truth (particularly to the terminally ill patient) and consent to undertake procedures. Casanova was on occasions the recipient of some good medical care, which he describes with gratitude. He also admired a number of doctors, who are described in this chapter.

Chapter eleven focuses on Casanova’s use of remedies such as sneezing powders, smelling salts and ‘taking the waters’ in one of the many European spa towns. These towns, thanks to their natural springs, became increasingly popular in the eighteenth century. Casanova was one of many visitors, often more attracted by the opportunities for sexual liaisons and gambling than the therapeutic benefits of the waters!

In order not to impede the narrative, up to this point the book does not give much detail about medical theories present in the eighteenth century, how they evolved and why ancient medical theories continued their influence for so long. Chapter twelve provides this background for the interested reader. It is followed by a brief chapter summarizing what Casanova’s Memoirs tell us about the health concerns of ordinary people and lay understanding about medical conditions and their treatment.

Some acquaintance with major political, social-cultural and philosophical developments of the Enlightenment era is helpful to appreciate medical practice and progress in the eighteenth century. These developments also facilitate an understanding of the world in which Casanova lived, as well as the attitudes and behaviour of his many friends and acquaintances who came from a diversity of backgrounds. What follows is a broad-brush sketch of the changing European map and political stage, and then a description of the rise of the public sphere, which allowed people to congregate and exchange ideas more freely. There were many reasons for this change, including royal enlightened patronage, improved travel and the rise and popularity of printing and newspapers. There were also many factors that facilitated the Enlightenment project, most significantly the philosophical currents that challenged the authority of the Church and were responsible for the radical philosophical ideas of the seventeenth and eighteenth centuries. An acquaintance with these is crucial to understanding how they influenced scholars to shift their approach to exploring how the natural world, including the human body, worked. This shift in mindset led to what we now regard as the scientific method, which was to have significant implications for the understanding and development of medicine.

The Memoirs covers forty-nine years of the mid-eighteenth century, from 1725–74. During this time the world political stage changed due to several wars, the most significant of which was the quasi-global Seven Years’ War (1756–63), which encompassed South Asia, Canada and the West Indies. This war led to a repositioning of the great European powers, with Britain becoming a dominant colonial power while France and Austria both experienced loss of prestige and considerable debts. The war also led to the rise of two new Eastern powers: Russia and Prussia. None of these five powers escaped post-war economic penalties, although the extent varied. France’s foreign debts were particularly high; Russia and Prussia emerged without bad debt, but strained domestic resources. All were keen to preserve European peace in the war’s immediate aftermath in order to aid domestic recovery, though it was a more complex task to negotiate amongst five rather than three great powers. One eventual victim of the Seven Years’ War was to be Poland, which was partitioned soon after a further war between Austria, Prussia and Russia and then totally seized by them so that by 1795 it no longer existed as a separate country. The Ottoman Empire did not do too well either. This was partly due to the emergence of Russia and its expansionism under the rule of Catherine II. Although the Ottomans declared war on Russia in 1768, Russia made significant territorial gains in south-eastern Europe. It followed up this victory with absorption of Crimea in 1783 and then, having made a treaty with Austria, embarked on another war against the Ottomans (1787–92), with Austrian military support, in which Russia acquired more land. Whilst this was happening, the French revolutionary decade began in 1789, a circumstance that appalled Casanova despite his periodic resentments towards the nobility.

The Seven Years’ War does not seem to have inhibited Casanova from his travels, since during those years he visited France, H...

Table of contents

• Cover
• Dedication
• Title
• Contents
• Acknowledgements
• Chapter 1: Understanding Casanova, his Memoirs and their historical context
• Chapter 2: Casanova and the Pox
• Chapter 3: Women’s Health Concerns
• Chapter 4: Sexual Practices and Taboos
• Chapter 5: Diseases That Spread
• Chapter 6: Apoplexy, Fever, Falling Sickness and Gout
• Chapter 7: The ‘Itch’, Intemperance and Indigestion
• Chapter 8: Suicide, Temperament and ‘Frenzied Madness’
• Chapter 9: Duelling, Accidents and Surgical Interventions
• Chapter 10: Medical Ethics and Etiquette: Casanova’s relationships with Doctors and Quacks
• Chapter 11: Casanova’s Cures: Spas, Smelling Salts and Sneezing Powders
• Chapter 12: How medical Theories Survived and Changed from Ancient Greece to the Enlightenment
• Chapter 13: What the Memoirs tell us about Medical Practice in Casanova’s World
• Epilogue
• Appendix: Modern-day descriptions of Syphilis and Gonorrhoea
• References, Endnotes and Bibliography
• Plates