Jewish anatomic pathologists in the time of Italian Racial Laws.

The persecutions of the Jews that began with legislation introduced by Italy's fascist government in the year 1938 ("Leggi Razziali" i.e. "Racial Laws") also affected the sphere of anatomic pathology, coming to bear on Italian physicians belonging to the Jewish communities of several cities and universities. The damage caused by the discrimination against them and their removal from their jobs penetrated a public health world that had hitherto been based on a climate of tolerance and integration. Here we recall some emblematic figures involved in those troubled times in Italy's history.

Introduction

Glancing through the list of Jewish physicians who enrolled in the Italian Army during the First World War [1], we can find the names of some of the best-known anatomic pathologists of the time, including the Venetian Giuseppe Jona (1866-1943), Salomone Enrico Franco (1881-1950) from Trieste, and Pio Foà (1848-1923) from Turin. Jona and Franco both had an active role in the Great War (Jona was a medicolegal consultant in army hospitals behind the lines; Franco enlisted as a volunteer, earning a medal while fighting on the front line). Foà was already an elderly professor at the time (though he was still working), so his involvement in WWI was only symbolic. As a Senator of the Kingdom, he was part of the committee in Piedmont that granted honors to Italian soldiers serving in France under the command of General Albricci in the last part of the war. Pio Foà has already been the object of a recent article in Pathologica [2] that outlines his point of view on the great Spanish flu pandemic of 1918.

The professional and human experiences of Jona, Franco and Foà are just three of many examples of how the participation of Italy’s Jewish communities in the social and cultural life of the country was important during the first three decades of the 20th century (Pio Foà had also volunteered to serve during Italy’s Third War of Independence). These Jewish communities were numerically limited, their total numbers peaking at around 50,000 individuals, but these people were almost all city-dwellers of medium-to-high social and cultural standing [3].

In the 20 years of fascist rule, there were both fascists and antifascists among the Jews. Some had already joined the party before 1922, while others had taken a critical stance from the start: at least 10% of the authors contributing to the socialist periodical Critica Sociale (founded by Filippo Turati and other intellectuals adhering to Benedetto Croce’s antifascist manifesto in 1925) were Jews [3]. As Michele Sarfatti wrote [3], “In a nutshell, we could say that Italian Jews were as fascist as other Italians, and more antifascist than other Italians”. To give an idea of the degree of integration of Italy’s Jewish communities during the years of fascist rule, it is worth noting that: with very rare exceptions [4], no Jews ever occupied important political positions in Italy’s national fascist party; on the other hand, their scientific contribution was such that the mid-1920s saw the mathematician Vito Volterra serving as president of the country’s two most prestigious scientific institutions (the Accademia dei Lincei and the National Research Council, the CNR).

Limiting our attention here to relations between academic medicine and fascism, among the names of the many physicians who signed the manifesto of fascist intellectuals promoted by Giovanni Gentile in 1925 [5] – which included the phthisiologist and senator Eugenio Morelli [6], and the psychiatrist Enrico Morselli – we can also find two future victims of the racial laws: the surgeon Mario Donati and the anatomic pathologist Carlo Foà (Pio Foà’s son). Gentile’s manifesto was also signed by Arturo Donaggio, a highly-respected neuroanatomist and neuropsychiatrist [7], and by the endocrinologist and ‘biotypologist’ Nicola Pende. Thirteen years later (July 1938), Donaggio and Pende were also among the promoters of a manifesto on race; and the role of the latter (a physician and also a senator by then) in its preparation prompted a great deal of controversy after the war [7].

Another notable indicator of how the climate was changing at the time is the well-known obligation imposed on all university professors in 1931 to swear an oath of allegiance to the fascist regime. Among the dozen or so “infidels” who refused to do so, there were just two physicians, the medicolegal doctor Mario Carrara (Cesare Lombroso’s son-in-law) and the surgeon Bartolo Nigrisoli [7].

During the so-called “years of consent”, more and more people opposing the regime paid the price with exile or imprisonment, and there were numerous Jews among them. One of the best-known cases concerns the anatomist and embryologist Giuseppe Levi (father of the writer Natalia Ginzburg). Levi was arrested in March 1934, accused of complicity with his son Mario who was caught trying to bring material containing antifascist propaganda into Italy from Switzerland. Mario Levi succeeded in making a daring escape to Switzerland, ultimately swimming to the Swiss side of Lake Lugano, but in Turin’s Jewish community (where the regime believed the operation had been conceived) there was much stopping and searching, and many arrests were made. A less well-known story concerns the role that Ramon y Cajal had in getting Giuseppe Levi released from prison. The Spanish histologist’s enormous respect for Italian science dated back to the time of his scientific competition with Camillo Golgi [8]. Details of the trouble that Cajal went to in his efforts to obtain his Italian anatomist colleague’s release have emerged only recently [9]: he wrote to the Spanish embassy in Italy, justifying his plea for Levi’s release on the grounds of the doctor’s international scientific standing.

After the publication of the manifesto on race on 14 July 1938, and especially after the announcement of legislative measures against the Jews in September (decrees countersigned by the King of Italy and approved by Parliament), the conditions in which many Jewish physicians lived and worked changed forever. With racial laws now in force, those Jews who had previously been professionally active and socially involved in the country were dismissed from their jobs in hospitals and universities. Nearly 900 professorships in a variety of faculties suddenly became vacant. They were promptly filled, with considerable satisfaction, by colleagues who generally – barring very rare exceptions (Fig. 1) – felt no need to express their disagreement with the Jewish professors’ removal in any meaningful practical way [10]. The newspapers carried comments like “Italian medicine can do without this harmful graft” [11], and the professional orders of physicians cancelled Jewish doctors’ memberships. They could continue to practice their profession, but only for Jewish patients.

Figure 1.

The writer Massimo Bontempelli (Como, 1878 - Rome, 1960) refused to take the place of Attilio Momigliano, who had been expelled from the University of Florence on racial grounds.

On being a Jewish pathologist after 1938

Giuseppe Jona (1866-1943) (Fig. 2) worked for 40 years at Venice’s City Hospital, where he directed the pathological anatomy unit for a long time. While there, he also spent time teaching, and training young physicians on clinical medicine and autopsy. He was a pathologist and a much-appreciated bacteriologist, who combined his expertise in anatomic pathology with an interest in internal clinical medicine. He was a Venetian by birth, and very fond of his city (he was president of the Ateneo Veneto cultural institution) and attentive to its needs. He founded a medical office where he cared for the less wealthy free of charge, earning himself the nickname of the “poor people’s doctor”. Among his many schemes, he promoted a circulating library to disseminate culture among the lower classes, he founded the anatomical museum, and he supported the establishment of a sanatorium on the coast for treating patients with tuberculosis. Venice remembers him with a wing named after him at the City Hospital, which is now called the Hospital of Sts John and Paul [12].

Figure 2.

The anatomic pathologist Giuseppe Jona (Venice, 1866 - Venice, 1943).

After he retired, and the racial laws had come into force, he was invited to become president of the lagoon’s Jewish community. Jona was not religious and did not attend the synagogue, but he accepted the appointment as a way to emphasize his roots in a very difficult moment. During the war years, he defended the Jews of Venice against anti-Semitic aggressions as best he could. In 1941, after yet another violent attack on the Jews in the local press, Jona went to see the director of the daily “Il Gazzettino”. He said, “I’m not so naïve as to ask for these articles to be withdrawn or rectified. My request is much more straightforward: in future, I would ask you to use more restraint in your campaign of persecution. You are well aware that we are a defenceless target. We cannot react with violence because that would trigger a massacre. We cannot respond through legal channels because nobody would listen. So people can stab us daily with atrocious insults, safe in the knowledge of their impunity. But I have not come to appeal for generosity or equity. As I said before, I ask for just one thing: that you use more restraint in future, for the sake of your own self-respect” [13].

A week after 8 September 1943, when the early signs of deportations from Italy intensified, Jona rewrote his will. He had no wife or children. He left his money to the most deserving nurses, and to the poorest patients. He donated a sum of money so that two young physicians chosen by the hospital’s heads of department could complete their specialization courses, and he made a gift of his sizable library to the City Hospital (more than 1600 books, including many old and valuable volumes) [13]. When the Germans came and ordered him to hand over the lists of the residents of the Jewish community of which he was president, he told them to come back the next day. During the night he burned the lists and then committed suicide [14]. The Nazi-Fascists spread the word that Jona had killed himself out of cowardice, but the physician knew how the Gestapo operated. Burning the lists of the members of the Jewish community delayed the round-ups, enabling many of Venice’s Jews to escape to safety. According to the historian De Felice, it was only through Jona’s action that the devastating effects of the subsequent brutal raids on Venice’s ghetto could be somewhat contained [14]. When news broke of his death, the authorities forbade any public ceremony, but on the day of his funeral his colleagues came together for a minute’s silence in the hospital courtyard, and the gondoliers who Jona had treated free of charge held a silent procession in his honor along the canals [15].

Among the young anatomic pathologists who worked with Giuseppe Jona was one Ettore Ravenna (1876-1963). Born in Ferrara, he soon found an academic position in Modena. When the racial laws came into force in 1938, the university’s chancellor had questionnaires distributed in which lecturers had to state their “racial position”. Ettore Ravenna, who had been full professor of anatomic pathology since 1911, did not hesitate to declare himself of Jewish race, and he lost his job. His assistant Elio Levi, a volunteer at the Pathological Anatomy Institute was also sacked [16], as the chancellor was not one for fine distinctions. This meant that, following the “racial protection measures in fascist schools” issued by Royal Decree in September 1938, Ettore Ravenna found himself back in his home city, teaching at a small Jewish school in Ferrara alongside other university professors. The school was attended by dozens of Jewish pupils expelled from Italian state institutions, from nursery-school children to high-school students. In those dark times, these young people had the great good fortune of having for teachers scholars of the caliber of Ettore Ravenna, Matilde and Giorgio Bassani, the chemist and agronomist Ciro Ravenna (who had been a head of faculty in Pisa, and who died in Auschwitz in 1944), and other important names in the cultural world. As one of them wrote, “We taught and studied there with enthusiasm and determination, as if to challenge the degradation and racial discrimination, and our shared fate bonded pupils and teachers together in a spirit of solidarity” [17].

Another of Giuseppe Jona’s pupils was Salomone Enrico Franco (1881-1950), who graduated in Padua, and left Venice to become an assistant professor at universities in Cagliari and Rome. He later moved to Portugal, but when WWI broke out (by which time he was head of Pathological Anatomy in Lisbon) he went to the front, enlisting as a lieutenant in the Italian army. We can find several of his works relating to the spheres of oncology and bacteriology in Virchow’s and Pathologica [18-23]. Franco became an international expert on visceral leishmaniasis, and was also very interested in hematology, working with Adolfo Ferrata. He returned to Italy in 1924 and, for a couple of years, he took Jona’s place as head of Pathological Anatomy at the City Hospital in Venice. During the same period, he also taught anatomy at Venice’s Fine Arts Academy (in those days anatomic pathologists could also be called on to assist aspiring painters and sculptors).

Franco followed the typical academic route, first at the University of Sassari, then in Bari at the newborn Royal University named after Benito Mussolini, and finally becoming full professor in Pisa in 1937. In 1938, on the death of his predecessor Antonio Cesaris Demel – who had long been director of Pathologica – Franco wrote an article that reconstructed part of the genealogy of Italian pathological anatomy starting from Pio Foà [24].

Then came the racial laws. In one of his letters of that year, Franco wrote: “I was professor of a pure discipline, pathological anatomy, in Italian universities, and I was earning only a modest salary; so, as I have no assets of my own, we shall soon find ourselves in wretched conditions (…). It thus becomes essential for me to find a paid appointment somewhere in the world as soon as possible” [25].

On 17 October 1938, Franco was removed from his post. He said goodbye to the general pathologist Cesare Sacerdotti, his maestro since his time in Cagliari (who was retiring that same month, consequently sparing himself the humiliation of being dismissed), and set sail on his own from Brindisi, heading for the future state of Israel. He became director of the Institute of Pathological Anatomy at Hadassah Medical Center and at the Jewish University [26]. He retained his links with Italy, however, from where he ordered textbooks and publications, as mentioned in a lengthy obituary published in Pathologica [27]. He died in Jerusalem in 1950.

The story of Carlo Foà (1880-1971), who was only part pathologist, was rather different. Son of the illustrious anatomic pathologist Pio Foà, he studied medicine in Turin and specialized at the Sorbonne and in Leipzig. He soon became professor of Physiology, first in Messina, then in Parma and Padua, and finally (in 1924) at the University of Milan, which had been established that same year thanks to the obstinate commitment of Luigi Mangiagalli. Foà was a well-established scholar in the fields of endocrinology and neurophysiology [7]. He had often been awarded prizes and was a member of the Accademia dei Lincei. He was a convinced supporter of fascism, and among those who signed Gentile’s manifesto of fascist intellectuals in 1925. In 1938 he converted to Catholicism and was baptized in a last-ditch attempt to escape the racial laws [3]. He was nonetheless a victim of the fascist purges, as the legal definition of Jew adopted by Mussolini’s government gave the regime a degree of freedom in its interpretation [3].

Foà left Italy and moved to Brazil, where he became professor of Experimental Pathological Anatomy at the University of Sao Paulo. He returned to Italy after its liberation and was given a professorship in Physiology. His career moved forward, and he was reinstated in the Accademia dei Lincei, but only for a few months. Because of his fascist past, he was definitively ousted the next year by a commission presided over by Benedetto Croce, on which Giuseppe Levi also sat [28]. This same commission also judged Tullio Terni, who had likewise been dismissed from the University in Padua for reasons of race in 1938. The epilogue to his story was far more tragic, however. Terni was an anatomist who had been a brilliant pupil of Levi’s. He was expelled from the Accademia dei Lincei for having supported the fascists in the past, and a few months later he took his own life [29].

Together with Carlo Foà, another scholar expelled from the University of Milan was Alberto Ascoli, (1877-1957) who had become an anatomic pathologist at the Faculty of Veterinary Medicine after showing his worth as an immunologist. He emigrated to the United States, where he taught at several universities. He was only able to return to a job in Italy in 1947, by which time he was 70 years old [30].

The human and professional story of Raffaele Lattes (1910-2003) belongs to more recent times (Fig. 3). He was born in Turin and grew up in an intellectual environment in which many were destined to become famous names (at high school he was a pupil of Augusto Monti’s, and Massimo Mila and Norberto Bobbio were among his classmates, and at university he had Giuseppe Levi as his professor of Anatomy). Lattes began his professional life as a surgeon. Once again, the racial laws changed the course of his life. In an interview for Pathologica [31] he said, “We could initially only perform surgical procedures on Jews. Then things began to get worse. I lost my post at the university and in 1940 I was obliged to make a hasty escape from Italy”. He left with his wife (a Jew born in Berlin), and started working as a surgeon again in a small hospital in New York, but he soon switched to a post as an anatomic pathologist. His meeting with Arthur Purdy Stout had changed his outlook and, from 1943 until he retired, Lattes remained a pathologist at Columbia University. He became head of department after Stout and, like his predecessor, he was one of the most influential surgical pathologists of his generation. Cecilia M. Fenoglio wrote, “Since surgical pathology represents a marriage between the fields of surgery and pathology, Dr. Lattes is uniquely qualified to practice this speciality” [32]. Up until two decades ago, it was not unusual to hear a group of Italian pathologists say, “We are all Lattes’s children”. After his wife’s death, Lattes returned to Italy, and he died in Turin in 2003. The colleague Marcello Filotico wrote a nice piece in his memory [33].

Figure 3.

The surgical pathologist Raffaele Lattes (Turin, 1910 -Turin, 2003).

Conclusions

When Italian fascism took a racist antisemitic turn, also the country’s pathological anatomy domain paid a heavy price in lost careers and broken lives. Here we have mentioned just a few cases as examples of the more generalized expulsion of Jews from the society to which they belonged. These physicians saw themselves essentially as Italian, coming as they did from a solid process (during the 19th and the first decades of the 20th centuries) of “moral and material assimilation, and this took shape in a profound attachment to Italy, its destiny and its state”, as the historian Renzo De Felice wrote [12]. Within a handful of years, however, they came to be seen as a “harmful graft” that needed to be snapped off. If they managed to escape the Holocaust, they went on to become profitably engrafted on societies more free than the Italian one they left behind.

Acknowledgements

We thank Roberto Dina for his careful reading of the manuscript.