Jonathan Yardley

In the 1890s, a wet nurse contracted syphilis from a baby -- and sued.

AMALIA'S TALE

An Impoverished Peasant Woman, an Ambitious Attorney, and a Fight for Justice

By David I. Kertzer

Houghton Mifflin. 237 pp. $24

Difficult though it may be to imagine from the vantage point of 2008, little more than a century ago Europe was still under the thumb of syphilis. In Bologna, the northern Italian city that is the focus of David Kertzer's study of one especially dramatic case, "soldiers . . . were a common source of women's infections, as were other men who visited prostitutes and passed the disease on to their lovers," but that was only the beginning. Throughout Italy, cities sponsored homes for foundlings, which "for centuries . . . had taken in hundreds of thousands of babies abandoned by their parents at birth." Pasteurization had not been invented, so cow's milk was unsafe. To feed the babies, the homes hired poor women from the countryside to breast-feed them. Many of these babies had been born with syphilis, which they passed on to the women. Kertzer writes:

"That syphilis could be transmitted through wet-nursing had been known practically from the time that the disease first appeared in Europe, and it was mentioned in a Latin medical text of 1498. The constant contact of the babies' mouths with their nurses' nipples put the women at extreme risk. As the nineteenth-century French syphilologist Alfred Fournier put it, 'Nothing is so dangerous to its surroundings as a syphilitic infant.' With syphilis so widespread -- it is estimated that 10 percent of all the men in Europe's cities had the disease -- foundling home directors were desperate. . . . Making the problem worse, these women often caused wider contagion in their isolated hometowns. . . . At a public health conference in 1875, a public health doctor from St. Petersburg, Russia, reported that in one peasant community in his district, eight women who had served as wet nurses in the city's foundling home returned to their own homes with syphilis and ended up infecting sixty people."

One woman who found herself caught in this trap was Amalia Bagnacavalli, who "lived in a little hamlet called Oreglia, part of the larger mountain town of Vergato, whose hamlets lay scattered across a vast area" not far from Bologna. She was 23 years old, married to a man several years her senior, with a one-year-old daughter. In 1890, with her family sorely impoverished, she rode the train to Bologna and then walked to "an institution known as the Bastardini, the home of the 'little bastards.' " She applied for work as a wet nurse, was subjected to a medical examination and found free of syphilis, then presented with a "scrawny, whimpering infant" who had around her neck a medallion identifying her as Paola Olivelli.

Not until she boarded the train back to Vergato did Amalia look really closely at the baby: "What she saw made her shudder. The baby's body was malformed, her chest strangely twisted. And something else was wrong. At the foundling home Amalia had noticed that Paola's eyes seemed suspiciously filmy. Now that she got to look more closely, Amalia realized that the baby was blind." Back at home, the baby cried constantly and "would barely suckle at Amalia's breast." Soon, "not only wasn't Paola eating, but her nose was constantly running and, more worrisome still, began to emit a strange yellow fluid that ran down her lip" and her "breath had a pungent smell."

So Amalia took Paola to Carlo Dalmonte, Vergato's town doctor, who had seen all too many cases of syphilis among babies brought from the Bologna foundling home, the women who suckled them, the children and husbands and lovers of these women. He "told the frightened Amalia never to nurse the baby again, and he made her promise to take Paola back to the foundling home without delay." She did so the following day. Soon a "strange sore" appeared near her left nipple. She returned to Dalmonte, who wrote a medical certificate saying he had detected an initial syphiloma on her breast. He also stated the cause -- Amalia "had been given syphilis by the foundling Paola Olivelli" -- and he "urged her to get a lawyer and sue."

This was almost unheard of. Amalia was poor, ignorant and utterly powerless. The foundling home was a charitable undertaking of Bologna's rich, educated and powerful, in particular "its president, Count Francesco Isolani, one of Bologna's leading noblemen." But, as Kertzer is at pains to document, in the late 19th century, Italy was in the midst of profound political and social change. The old order of balkanized city states and an almighty Vatican had been replaced by the Risorgimento, a movement for the country's political unification. By 1871, Rome fell to the army of an Italy united for the first time and became the capital, while "the defeated pope, Pius IX, retreated to his Vatican palaces as a self-styled prisoner." Reform was in the air, and workers and peasants began to clamor for their rights:

"The tale of Amalia Bagnacavalli is the story of people living amid this historic upheaval. Her story can scarcely be imagined any earlier in Italian history. It would have been inconceivable that an illiterate peasant woman could take legal action against one of Bologna's foremost aristocrats and one of the major urban institutions of her time -- the Bologna foundling home. For all this to take place, a host of major changes had to appear. There had to be an established legal system that would allow such a suit to be filed and pursued. There would have to be a crusading lawyer who, motivated by a new ideology and social ambitions unleashed by the loosening of aristocratic control, would champion her cause. And there would have to be a change in legal philosophy in the courts, with lowly workers seen as having certain basic rights."

From Amalia's point of view, the crucial figure was Augusto Barbieri, a 28-year-old lawyer who saw himself -- and was seen by his peers -- as part of "an enlightened elite whose mission was to transform Italy into a modern country." A "man of strong convictions, he liked to see himself as a champion of more scientific government, a protector of the poor. But he was also deeply ambitious." His young practice had yet to take off, and he seems to have realized at once that taking on Count Isolani -- better yet, beating Count Isolani -- would make him a public figure, attracting more clients to his office and perhaps giving a push to the political aspirations he nurtured.

Between the time Amalia came to his office and the final resolution of the case, a full decade passed. Amalia's little girl died from syphilis, her husband Luigi contracted the disease, other children with whom she became pregnant died at, or soon after, birth. Her "life had become a tale of woe." She had absolutely no understanding of all the legal maneuvering that surrounded her, and she had little more than a pittance to live on. She persisted in the vague hope, encouraged by Barbieri, that a pot of gold lay at the end of this strange rainbow, but she was far too innocent to have any real idea what it would be or what it would mean to her.

As it evolved over the years, Amalia's case pitted her and Barbieri against "the entire medical establishment of Bologna." After one particularly disheartening setback, Barbieri seemed to have "nothing but his own righteous anger and his long-suffering client." Although he had told her that he would not collect his fee until a final judgment had been rendered in his favor, he took out loans to pay witnesses and other expenses.

The case was a roller coaster. There were victories, defeats, appeals and, in the end, a negotiated settlement with the foundling home that left Amalia virtually as penniless as she had been when it all started. She and Luigi received 22,500 lire -- a stupefying sum for anyone of their class -- but had to turn it all over to Barbieri to settle their debts. "How," Kertzer asks, "did Amalia and Luigi react to this news? Did they use the rich palette of profanity their mountain dialect provided to denounce their erstwhile defender? Did they remind him of all the assurances he had given them over the years, how many times he had told them that they should trust him completely?"

We can't know, for Barbieri did not record this in his otherwise voluminous records. But what we do know, as Kertzer says at the end, "is that back then, as today, when the world of the rich collides with that of the poor, it is rarely the rich who suffer."

Kertzer, a respected anthropologist and scholar of Italian history who is provost of Brown University, practices in Amalia's Tale what he calls "serious history for a general audience," and he places narrative ahead of footnote-by-footnote documentation. As he admits, this may well disturb some in academia who are chained to apparatus, but it will please the general reader who seeks a glimpse into a part of the past about which we know virtually nothing. Kertzer is correct to say that now, with "HIV-positive mothers" passing AIDS to infants, Amalia's story has continuing pertinence. He has told that story well. *

Jonathan Yardley's e-mail address is yardleyj@washpost.com.