Forget the stereotype! Most people on hearing the name Casanova immediately think of a libertine and debauched figure, tropes pedalled by numerous films, (of which the 1976 Fellini version was particularly vicious), television series, plays, books and even music from the early 20th century. What would a man like that have to say about the serious subjects of illness and medical practice? ‘Is it all about venereal disease?’ was a common question from acquaintances during the six years or so that I was researching my book.

Whilst it is true that Casanova was captivated by women and that he suffered with venereal disease several times in his life, his legacy is much more important than these reductive facts. He was a scholar, prolific writer, linguist, mathematician and philosopher, whose Memoirs have given researchers rich pickings on social, political and cultural aspects of his times. However, insights about medical practice and the lived experience of disease have been somewhat neglected, which is why I wrote this book. In doing so I grew to feel more sympathetic to the man even though I am a product of 1970s’ feminism. In particular, I realised that important lesson, which is not to judge the behaviour of past eras by our current moral standards. This book is not about Casanova, which is why I have not focused on character judgements. Rather, this is a book about disease and medical practice in the 18th century, an era when contagious diseases were a frequent challenge to normal life. Although plague was less rampant than in previous centuries it was still much feared as were smallpox, tuberculosis, typhoid and even influenza. The exact mechanisms of spread and how to treat them were both unknown. Life was a lottery, a situation that in a corona virus world, we can all probably understand better.

Casanova wrote on a number of conditions apart from the pox that range from dueling injuries to piles, skin complaints to stroke, cataract operations to gout; this last remains as painful now as was the case then. 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, I have integrated throughout the book an extensive historical context drawn from contemporary sources of information and current history of medicine literature. I have also tried to make the book as jargon free as possible, taking care to explain medical terms when they arise because I wanted the book to appeal to a non -medical readership. It was my hope that readers would find these medical subjects animated and memorable thanks to encountering them through the prism of Casanova’s stories.

Image from the Wellcome Collection of Images CCBY

Casanova’s interest in medicine started as a teenager. He had wanted to study the subject at university in Padua, but his guardian, the Abbé Grimaldi and his mother would not hear of it. Instead he was directed to study ecclesiastical law and become a cleric. However, he maintained an interest throughout his life, kept himself informed and at times gave medical advice. Like most of contemporary society, he felt obliged to take an interest in his own health because ancient Greek medical theory, which still dominated medical understanding, stressed the importance of taking responsibility for one’s health through attention to life style, or regimen.

Whilst a librarian in Dux in the last years of his life, Casanova’s doctor recommended that he write his Memoirs to control his black melancholy. It is thanks to this advice that we have his memoirs. They consist of 3800 folio pages organised into twelve bundles that start with his birth and continue to 1774, when they abruptly end because of his death in 1798 aged 72 years. The story of how the manuscript was preserved, edited and published subsequently is almost as colourful as Casanova’s life.

The lived experience of disease and medical understanding and practice in the 18th century may not seem to be of any relevance to us now. After all we have come a long way from the ubiquitous practice of bloodletting or purging patients. But on closer examination many of the episodes that Casanova describes relating to himself or others contain resonances. For example, avoidance of quarantine through foiling the Venetian cordon sanitaire, established to stop the spread of plague; support but also significant suspicion about inoculation for smallpox; the distress and stigma of having an itchy skin condition; the shame of suicide; the dangers of childbirth; patient ambivalence about their doctors’ advice; the absence of medical understanding about either the cause or mechanism of disease and therefore how to treat it. Of course medical science is so much more sophisticated today but the last year has illustrated that humanity can be as confused and vulnerable in the face of a disease as it was then. Medical hubris both from practitioners and a public that thinks medicine can treat everything has taken a tumble.

I have always been interested in history. As a medical student I persuaded my Medical School, then called Guy’s Hospital, to allow me to take a year off in order to study, amongst other things, a diploma course on history of medicine, run by the Worshipful Society of Apothecaries. A busy NHS career followed as eventually a consultant psychiatrist and a few years later I also took up an academic post in the medical school at Keele Univesity. There was little time to pursue my early interest although amongst the many psychiatric papers I published there were forays into history of psychiatry. One was a paper on Thomas Bakewell, who ran a small asylum on ‘moral therapy’ lines during the first decades of the 19th century. As a medical educationalist, I introduced into the undergraduate curriculum opportunities for medical students to undertake a project in a range of humanities subjects; many chose to do history, supervised by me or my colleague, an academic historian called Alannah Tomkins. Together we published a textbook on history of medicine with bite -sized chapters, designed to be easily accessible to busy medical tutors who wanted to introduce a historical perspective into their teaching1. Retirement has allowed me to pursue a second career as a medical historian. My interest in Casanova started whilst I was in Malawi on a volunteer psychiatric teaching programme shortly after I retired. The long, free evenings allowed me to read all of Casanova’s twelve volumes on my kindle, and thus the seed of an idea for a book was planted.

If you would like a foretaste of the book please go to my website.

1. Lovett L and Tomkins A. 2013.Medical History Education for Health Practitioners. Radcliffe publishing. London, New York

Casanova’s Guide to Medicine is available to preorder here.