A Journal of the University of Malta Medical School
Grand Master Perellos: rheumatic fever and syphilis
Malta Medical Journal, 2008: 3; 45
It is not given to everyone to have his maladies made the subject-matter of a published book. Not so Grand Master Perellos (1697 1720) who lived to see a 104-page volume about his recalcitrant fevers printed in his lifetime.1 It all started with a letter written on February 15, 1708, by Malta's protomedico (Chief Government Medical Officer) Dr Arcangelo Grech2 at the instance of the Grand Master, addressed to the most eminent physician in Sicily, indirectly asking for guidance about the defiant fevers the Grand Master had fallen victim to. The letter, I believe, bears translation and reproduction. `His Serene Highness Prince of this island of Malta, aged 71 years (but actually 74) di corpo pricocolo (small in stature?) on the anniversary in which his most joyful election was being celebrated on the seventh of this month, with a great number of knights and vassals gathered in the Palace to extend their congratulations, had felt extremely hot flushes and having left, was shaken by great shivers of cold. On the following day he was assailed by acute pains, first in the heel and later in the knees and right shoulder, for a whole day, with orrore (either stiffening or trembling) all over his back and high temperature, which persists to this day the ninth day of his infirmity this being of the type, though without the obvious symptoms, of double tertian continuous fever, and a general fatigue, with very clear and colourless urine. `And, because of the obstacle of high fever (fervore di orgasmo febrile) it was not thought proper at any time to administer any medication, except for one blood letting, in so far as his age and constitution allowed, hoping to procure some metastasis in some noble part, apart from the deposit of internodes. I omit any reference to what is usually done to correct the overabundance of acid exuded, through the appropriate remedies well known to the doctor to whom this brief summary of his medical history is addressed with profound reverence. From Malta, Arcangelo Grech'.3 Don Juan de Acuna, Spanish Governor of Messina and Fra Andrea di Giovanni, the Order's commander in that city, twisted Dr Bottone's arm to proceed to Malta to undertake treatment of the distressed Grand Master. Bottone says he was persuaded to go though many obstacles stood in his way, not least his old age and habitual infirmities, the harsh winter season and the state of war which encouraged pirates and enemies to run loose in the canal of Sicily. When Perellos's letter reached Bottone, the doctor was 67 years old, having been born in Lentini on October 6, 1641. He had been suffering from an extremely painful gout since at least 1692, and was universally recognised as the foremost physician in Sicily. Educated by the Jesuits in Latin and philosophy and in medicine by the university of Palermo under the renowned anatomist Marcello Malpighi, he graduated c. 1665. His reputation spread rapidly, being appointed physician to the Archbishop of Messina Simone Caraffa and subsequently to the Spanish Viceroys Villafranca (1674), Castel Rodrigo (1677) and Santo Strefano (1679).
Grandmaster, syphilis, rheumatic fever, history
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