During the unification of Italy, and despite the Italian government was reluctant to launch a military campaign against the Pope, Giuseppe Garibaldi crossed the Strait of Messina (with help from the British Royal Navy) in August 1862, and marched north to reach Rome. Unwilling to risk war with France, whose army protected the Pope, the Italian government hastily dispatched troops to stop his advance, and the two armies came face to face on in the Aspromonte Mountains in Calabria.
Garibaldi could not bring himself to shoot at fellow Italians and ordered a cease-fire. In the ensuing confusion he received three gunshot wounds, only one of which gave cause for concern. A bullet had penetrated the right ankle a little above and in front of the medial malleolus and, despite the efforts of the attending surgeon, Enrico Albanese, it could not be found.
Garibaldi was taken to Spezia, in Liguria, where he was imprisoned on a charge of treason. Two days later he was examined by Professor Porta of Pavia in the presence of Professors Rizzoli (Bologna) and Zanetti (Florence) and the surgeons Prandina (Chiavari), Negri (Genoa) and Ripari (Turin). With one exception, all were of the opinion that the ball was no longer lodged in the ankle.
The detection of a bullet was particularly difficult before the discovery of X-rays (it would be another 30 years before radiology was available to medicine).
Delicate questions of medical etiquette arose against the backdrop of nationalistic interests, as physicians from four countries (Italy, Russia, Britain, and France) became involved.
Supporters of Garibaldi’s ideals in England formed a committee, and Professor Richard Partridge of King’s College proceed to Spezia. After he examined the wound, he assured that “the bullet did not enter the joint nor effect a lodgment elsewhere.
But there were certain Italian practitioners who still maintain that the bullet was in Garibaldi’s foot. Meanwhile, Garibaldi’s wound did not improve and a Viennese surgeon said that the wound was very serious and amputation might be inevitable.
Garibaldi’s condition showed no improvement and his attendants decided to invite Auguste Nélaton, Professor of Surgery in Paris, to give his advice.
Nelaton, having introduced an ordinary stilet into the wound, was convinced that the bullet was still there, and advised against amputation.
Three days later, Partridge again arrived in Spezia, and accompanied by Nicolai Pirogoff, Professor of Surgery in Moscow, again saw Garibaldi. He was convinced by this second examination that the bullet was still in the ankle.
Nélaton had not convinced his Italian colleagues and on his return to Paris immediately applied himself to finding some means of proving that the bullet was still in the ankle. His solution was achieved by the construction of a probe with an unglazed porcelain head. Mere rubbing of the instrument against lead was sufficient to mark the porcelain. When Professor Zannetti received the probes from Paris, however, he was able to prove that Nelaton’s diagnosis was correct. On November 22nd, Zannetti successfully removed the bullet.
Nelaton’s reputation was greatly enhanced by this incident, just as that of Partridge was correspondingly diminished. After this initial success, Nelaton’s porcelain-headed probes were made in great numbers and were used for more than fifty years afterwards. They were considered essentials part of the equipment of military or naval surgeons until well on into the twentieth century, though it is doubtful whether they were ever used again for the purpose for which they were designed, especially after the introduction of X-rays.
Alfredo E. Buzzi