The research undertaken clarifies many aspects of the disease called Saint Anthony's Fire. At the same time though, it also raises issues that were not addressed by a historiography rooted in interpretative criteria from the eighteenth and nineteenth century.

With regard to the lexical question, which is fundamentally important as the lexicon reflects the way in which the disease was perceived, although the universally widespread affirmation that Saint Anthony's Fire is a synonym for ignis sacer corresponding to ergotism is not totally wrong, a careful examination of past sources reveals that it is frequently inaccurate. To start with, I have not found any accounts of epidemics described as Saint Anthony's Fire in medieval sources. When the term appears in medical, hagiographical, legal or literary texts, it refers almost exclusively to individual cases of gangrene of varying aetiology such as the form stemming from frostbite or, more commonly, an ‘infection’ resulting from a wound (I use the term infection in its modern sense, well aware that a similar concept did not exist at the time). We can certainly imagine that the term was also employed to describe gangrene developing from ergotism, but it is impossible to make this distinction as the disease was unknown at the time.

The connection between ergotism and Saint Anthony's Fire was only established in the eighteenth century after the latter had been equated to ignis sacer, a term widely used from the eleventh century onwards to describe epidemics of the burning disease. Ergot poisoning can be recognised in these, although a degree of caution needs to be adopted. As we have seen, however, besides the fact that ignis sacer sometimes simply referred to gangrene of any aetiology, the two terms were not used as synonyms in all sources. Indeed, a difference emerges between medical and non-medical texts, as the former sources maintained the original meaning of ignis sacer first used in antiquity and late antiquity, namely a skin complaint. This pustular disease is not comparable to gangrene or ergotism but rather erysipelas. However, as the latter term was attributed with multiple meanings from antiquity onwards, care needs to be taken when drawing comparisons with the present-day disease.

In terms of the required research methodology, the disease known as Saint Anthony's Fire presents an exemplary case. The importance of Alessandra Foscati's study lies precisely in her duly adopted approach.

This is a textbook case as it forces the historian of medicine and society tout court to constantly rethink the lexicographic and historiographical framework. Numerous challenges must be faced when undertaking a meticulous and thorough historical reconstruction, which must incorporate factors such as medical lexicography, the geography of medieval and early modern Europe and historiography. These three disciplines frequently come into play in the complex history of Saint Anthony's Fire both in the Middle Ages and the early modern period and beyond.

Faced with such intricate circumstances, the historian has to proceed with extreme caution. By implementing a strategy in some way comparable to detective work, the methods adopted must consistently manage to separate myths, legends and historiographical prejudices and beliefs from the clear, incontrovertible and dependable elements that emerge from the exhaustive examination of sources.

In this way, Alessandra Foscati has managed to highlight that the term Saint Anthony's Fire is never used in reference to an epidemic in sources from the Middle Ages and the early modern period. In fact, it is only employed in medical, hagiographical, legal or literary texts to allude to individual cases of gangrene of varying aetiology, perhaps deriving from frostbite or more frequently an ‘infection’ following a wound. These findings are truly important, firstly because they are the result of a comprehensive and astute rereading of the available sources and secondly as they prompt a rethink of the entire medical and social history of Saint Anthony's Fire from the Middle Ages onwards, always taking account of the aforementioned interweaving of lexicography, geography and historiography.

In terms of lexicography, Alessandra Foscati carefully analyses the semantic and semiological evolution of the term Holy Fire (ignis sacer), for which the reader will be grateful. In addition to examining both medical and non-medical sources, the author assesses the influence of ancient sources on medieval and early modern authors.

A Brief Preface on the Antonine Order

The term Saint Anthony's Fire derives from the thaumaturgical cult that developed around the presumed remains of St Anthony the Abbot, or the Great, an Egyptian saint from the third or fourth century, originating in the south of present-day France in around the eleventh century. Anthony was portrayed as the father of monasticism by all the medieval Churches following the circulation of the first biography about him, Life of Anthony, written in Greek by Athanasius (295c-373), Bishop of Alexandria. The author explains that on his deathbed the saint asked to be buried in a secret place, with the burial arranged by two of his closest and most loyal disciples who would not reveal the exact location to anyone else. Nevertheless, in the early Middle Ages various chronicles and most martyrologies in the West started to suggest that the saint's body had been transferred from an unknown location in the Egyptian desert to the Basilica of St John the Baptist in Alexandria at the time of Justinian (sixth century). This probably led to the creation of subsequent legends about the inventio and translatio (‘discovery’ and ‘translation’) of his body, firstly to Constantinople and then to the Dauphiné in the South of France. Being one of the most important Christian saints and given the value always attributed to saintly relics, it is no surprise that his remains were highly coveted.

The bibliography on Saint Anthony's Fire is extensive and there has long been a historiographical consensus on the precise profile of the disease: it is the medieval name for ergotism, a disease caused by the ingestion of ergot, a fungus that parasitizes rye, which was widely used in breadmaking in the Middle Ages. Carlo Ginzburg writes:

Similar explanations of ergotism and Saint Anthony's Fire can be found in most books on medieval studies. In his work on disease in Europe, Jean-Noël Biraben writes:

Medieval Epidemics of the Burning Disease as Told by Historians in the Sixteenth and Seventeenth Century

The historians that focused on Saint Anthony's Fire and ergotism from the nineteenth century onwards (in historiographical terms the two diseases tend to be considered as one and the same) drafted precise timelines for the occurrence of epidemics throughout history, starting in the early Middle Ages. They considered medieval sources and sometimes also works by early-modern authors, who had in turn retransmitted medieval accounts. The interpretation of these sources from two different periods somewhat inevitably led to inaccuracies. Firstly, it is not always possible to trace the original narrative source used by sixteenth and seventeenth-century historical authors who retranscribed descriptions of medieval epidemics that occurred at a regional or national level. Secondly, even when the source is known, the more recent version is not always an exact transcription of the medieval text, often taking shape as a summary padded out with arbitrary additions. Thirdly, there are changes in the medical lexicon as a result of interpreting the disease with different nosographic references from those used by the medieval authors. The dating of events is also revised in some cases.

The Frenchman Jean Bouchet serves as a prime example of the way in which medieval sources were interpreted by historians in the early modern period. In his sixteenth-century Annales d’Aquitaine, written in French, he focuses extensively on the Life of St Hilary and its accounts of miracles during his lifetime and post mortem.

Ignis Sacer (‘Holy Fire’) in the Ancient World

The different diseases that afflicted France in the 10th, 11th, 12th, 13th and 16th centuries which were variously called sacred fire, burning disease, hell fire and Saint Anthony's disease owe their origin to the use of rye ergot.

Taken from the 1771 Traité du Siegle ergoté by Read, a French physician at the Faculty of Medicine in Montpellier (‘Mr. Read, Docteur en Médecine de la Faculté de Montpellier’), this statement is a perfect synopsis of eighteenth-century medical thinking regarding cases of ergotism in previous centuries, a perspective that influenced subsequent medical literature and historiographical output. Discovered approximately a century beforehand, the disease caused by the ingestion of ergot became the focus of numerous medical and scientific treatises abounding with theories about its nature. At the same time, it was concluded that all conditions defined as Saint Anthony's disease or fire in medieval sources, or indeed ignis sacer (feu sacré in Read's text) and ‘mal des ardents’ on French soil should be interpreted as cases of ergotism.

These sources now need to be reread in the light of a philologically correct modern interpretation to understand whether it was accurate to link occurrences of Saint Anthony's fire to epidemics featuring ergotism and to establish when the expression was first used in the central period of the Middle Ages.

Chapter Three analyses the ‘theoretical’ connections that many physical-psychical scientists made between ‘physics and psychics’.It analyses general physical arguments against philosophical materialism and other ‘stumbling blocks’ to the idea of mind and spirit in the cosmos; vague analogies between physical and psychical effects; and more radical physical theories and explanations of telepathy and other psychical phenomena.The chapter highlights the extrordinary creativity of physical scientists in applying their concepts, ideas and theories to psychical puzzles.It also examines the criticism that many physicsts levelled against such psychical uses of physics and argues that while leading physical-psychical scientists accepted many of the problems with physical theories of largely non-physical phenomena, they never completely abandoned the idea that some kind of physical theory would ultimately help render psychical effects more intelligible.