Achille Sclavo (1861–1930) and His Innovative Contributions to Italian Preventive Medicine and Healthcare Policy

The second half of the nineteenth century saw the development of new medical "specialties", which, like the idea of constitutional disease, had a profound influence on medical practice. Against this lively "backdrop", Edoardo Maragliano played a central role in medicine's "renaissance" in Italy. Having graduated in medicine in 1870 at the University of Naples, he worked as an assistant in the University Medical Clinic. After beginning his academic career as professor of pathology at the Faculty of Medicine in Genoa in 1877, he became full professor of internal medicine in 1881. While he studied all fields of internal medicine, his research focused mainly on tuberculosis.His experiments in the medical clinic enabled Maragliano to announce the possibility of immunization against Mycobacterium tuberculosis. Although criticized for using an inactivated vaccine, Maragliano continued to advocate vaccination with any type of vaccine.In the Senate of the Kingdom of Italy, Maragliano actively debated social, economic and sanitary questions, without neglecting his duties as a physician and professor. As an officer during the First World War, he organized military health services and taught medicine at the Military University of Padua.In 1924, Maragliano created the first Italian specialty school in the study of tuberculosis, which provided physicians with specific training in the diagnosis, therapy and prevention of the disease. His scientific zeal and his vision of modern medicine prompted the introduction of new specializations, such as radiology and, especially, pneumology, which led to the creation of one of Europe's most renowned medical schools.

Poverty, high population density and unhealthy dwellings in Siena's historic district accounted for the spread of tuberculosis in its various forms between the mid-nineteenth century and the first three decades of the twentieth century. In this paper, the author relies on statistical data relating to a time span between 1898 and 1935 to discuss the high incidence of scrofula, or tuberculosis of the lymphatic glands, among Siena's infant population.The result is a description of the most important actions implemented at city level to prevent tuberculosis and to assist and treat sick children: stays in seaside hospices promoted by Carlo Livi in order prevent and treat poor and malnourished children, the establishment of a Preventorium to accommodate children from families that included members infected with pulmonary tuberculosis, the realization of activities in the green areas of the Fortress on advice of Achille Sclavo. Furthermore, the author recalls the work of great hygienist Sclavo to raise awareness of the hygienic practices among Siena's population, which was fundamental in the prevention of epidemic diseases such as tuberculosis.