Saint Joseph Moscati (1880-1927)

The life of Giuseppe Moscati spans only forty-six years, yet it cuts straight through the history of Naples and Italy: a studious youth in a family of magistrates, a medical and scientific career of the very first rank, three disasters faced on the front line, and an interior life of austere exactingness, kept secret until his death.

Birth in Benevento and settlement in Naples

Giuseppe Moscati was born on 25 July 1880 in Benevento, Campania, seventh of the nine children of Francesco Moscati, a respected magistrate, and Rosa De Luca dei Marchesi di Roseto, of noble birth^[1]. The family left Benevento for Ancona in 1881, following the father's professional appointments, before settling permanently in Naples in 1884^[2]. It was in this city, then the second intellectual and medical capital of unified Italy, that Giuseppe grew up and spent most of his life.

He completed his elementary schooling in 1889, then entered the Vittorio Emanuele II lyceum in Naples, where in 1897 he earned his secondary-school diploma with honours^[3]. Among his teachers was the seismologist and volcanologist Giuseppe Mercalli, whose rigorous scientific teaching left a lasting mark on his intellectual formation^[4] — an encounter which history would load with irony, since Moscati himself would face a major volcanic eruption a few years later.

The choice of medicine

Giuseppe enrolled at the faculty of medicine of the University of Naples two months before the sudden death of his own father^[5]. There he studied under eminent masters, notably Giulio Albini in experimental physiology and Pasquale Castellino in clinical medicine^[6]. According to the most constant biographical tradition, this choice of studies was not a mere career plan: Moscati said he had chosen medicine out of "compassion for the suffering"^[7], and the horse-riding accident which left his elder brother Alberto disabled some time before his death, in June 1904, is said to have strengthened this vocation as a healer^[8].

On 4 August 1903, he earned his degree in medicine and surgery with a thesis on hepatic ureogenesis (the formation of urea by the liver), defended with highest honours^[9][10]. A few months later, he came first in the competitive examination for assistant physician at the Santa Maria del Popolo hospital, better known by its popular name of the hospital of the Incurables, where in 1903–1904 he began a hospital career which would never leave him until his death^[11].

Rise at the Hospital of the Incurables

Between 1906 and 1911, Moscati was a voluntary assistant in physiology at the University of Naples, before becoming an ordinary assistant at the institute of physiological chemistry in 1908^[12]. At the hospital, he climbed the ladder methodically — ordinary assistant physician, then ward director — until becoming, in 1919, head physician (primario) of the Incurables, where he then directed the departments of pathological anatomy and tuberculosis as well as the wards reserved for soldiers^[13][14]. His university career progressed in parallel: libera docenza (the Italian post-doctoral qualification authorising university teaching) in physiological chemistry in 1911, supply teaching in physiology and physiological chemistry during the war (1916–1920), ordinary professorship in clinical chemistry in 1919, then libera docenza in general clinical medicine in 1922^[15].

Researcher on glycogen and nephritis

Between 1906 and 1911, almost all his scientific publications concerned the chemical reactions of glycogen and other substances in the human body, an early specialisation in biochemistry which earned him recognition in Italian and international medical journals^[16]. His research in nephrology, distinguishing several types of nephritis, counts among his contributions most cited by his colleagues of the time^[17]. In 1911, the year of the Neapolitan cholera epidemic, he attended the international congress of physiology in Vienna and became a member of the Royal Academy of Surgical Medicine^[18].

Pioneer of insulin therapy in Italy

The scientific fact most often remembered of his career is his role as a pioneer of insulin therapy in Italy. Discovered in Toronto by Frederick Banting and Charles Best in early 1922 — the 1923 Nobel Prize in Medicine would reward Banting and John Macleod for this discovery (Best, left out of the award, received from Banting half of the prize money) — insulin then remained an experimental treatment very difficult to obtain in Europe^[19]. Moscati was among the very first Italian physicians to procure it and administer it to his diabetic patients, determining the correct therapeutic dosage himself, a contribution hailed by his European peers^[20]. On 18 July 1923, he was invited to the international congress of physiology in Edinburgh^[21].

"It is not science, but charity, that has transformed the world." — Giuseppe Moscati, famous saying^[22]

The saying continues in its full form: very few men have passed into history for their science, but all can remain imperishable, symbols of the eternity of life — in which death is but a stage, a metamorphosis towards a higher ascent — if they devote themselves to good^[23]. This remark, from a researcher recognised in his own lifetime, is not a renunciation of science: it is the exact hierarchy Moscati lived by, placing charity at the summit of all that his intelligence had enabled him to acquire.

Renouncing the university career

At the outbreak of the First World War, Moscati could have favoured a more prestigious academic career, far from daily contact with the poorest sick. In 1917, while his university titles opened up prospects of advancement to him, he gave up a chair and full-time university teaching to continue his hospital work and stay close to the sick, in particular the wounded streaming in from the front^[24]. Between lecturing from a chair and directly serving the poor, he systematically chose the second — a choice consistent with his whole life, in which the most prestigious office was never preferred to closeness with the patient^[25].

Evacuating the Torre del Greco hospital

In April 1906, Vesuvius erupted with unusual violence: lava flows directly threatened the town of Torre del Greco, at the foot of the volcano, where there stood a hospital full of patients unable to move on their own. Moscati, then a young physician, went there and directed the complete evacuation of the building, patient after patient, until the last one was brought to safety — barely a moment, according to the most widespread account, before the roof collapsed entirely under the weight of the ashes and the structure gave way^[26]. In his own report on the event, Moscati never mentioned his personal role, attributing all the credit to the collective devotion of the hospital staff^[27] — a trait of modesty which would remain constant throughout his public life.

The Naples cholera epidemic (1911)

In 1911, a cholera epidemic struck Naples. The government called on Moscati's expertise, and he was requisitioned by the health inspectorate for public-health checks and epidemiological research^[28]. He collected field data methodically and presented a detailed report on the urban rehabilitation works needed to curb the disease, part of which was actually implemented by the municipal authorities^[29]. This same year 1911 also marked, on the academic plane, his libera docenza in physiological chemistry and his admission to the Royal Academy of Surgical Medicine^[30] — the man of science and the man of the field then advancing at the same pace.

Serving the wounded of the Great War

At the outbreak of the First World War, Moscati applied for voluntary military service, but his request was turned down: the authorities judged him more useful as a hospital physician, charged with assisting and spiritually comforting the wounded returning from the front^[31]. He supervised the military wards of the Hospital of the Incurables and, according to the most common biographical estimates, treated there more than three thousand wounded and sick soldiers in the course of the conflict^[32]. This wartime period coincided, in 1914, with a major personal turning point: his mother's death and his vow of chastity, discussed below.

"Let those who can put something in, let those in need take"

In the waiting room of his private practice, where he received rich patients as well as destitute ones, Moscati displayed a notice which settled, in its own way, the question of fees:

"Let those who can put something in, let those in need take." — notice displayed in the practice of Giuseppe Moscati, Naples^[33]

It was no empty formula: Moscati never charged the poor, often gave them free of charge the medicines he prescribed, and it was not uncommon for a patient to find, slipped into the bottle brought back home, a fifty-lire note to cover the family's living expenses^[34]. He personally visited the poorest districts of Naples, climbed the stairs of insanitary tenements, and sometimes walked home for want of having kept enough to pay for the tram, after giving everything to a patient^[35].

When a healed patient complimented him or attributed the credit for a cure to him, Moscati systematically refused any personal recognition and simply replied:

"It is the Lord." — Giuseppe Moscati, usual reply to his patients' compliments^[36]

This humility echoes that of other great figures of 20th-century lay holiness, such as Saint Pier Giorgio Frassati, whose charity towards the poor of Turin likewise remained unknown to his own circle until his death.

The vow of chastity to Our Lady of Good Counsel

Moscati never married and lived as a consecrated lay celibate. In 1914, the year his mother died, he made a vow of chastity before an image of Our Lady of Good Counsel, venerated in the church of the Sacramentine Sisters in Naples^[37]. This vow, discreet and never publicly presented as an ascetic feat, follows the same logic as the rest of his life: to give without reserve, keeping no private life for himself which would have competed with his total availability to the sick.

The "Eucharistic cure": healing soul and body together

The most singular trait of Moscati's medicine is no doubt his way of combining, on a single prescription, pharmaceutical remedies and sacraments. He has remained in Neapolitan memory for having, on several occasions, written on his prescription pad a genuine Eucharistic prescription:

"Eucharistic cure: one Communion a day for seven days." — prescription attributed to Giuseppe Moscati on a medical prescription^[38]

According to biographical tradition, the patient concerned followed this prescription to the letter and was found healed on the eighth day^[39]. For Moscati, confession and the Eucharist were not pious extras outside his art: he regarded them as genuine therapeutic instruments which, acting first on the soul, also had an effect on the healing of the body^[40]. This vision belongs to the great Catholic tradition of the Eucharist as a remedy for body and soul, food of eternal life long before being a mere moral support.

His daily devotion was ordered with the same rigour as his medical practice: Mass and Communion every morning, often serving the priest at the altar himself, a rosary carried at all times, a particular devotion to Our Lady of the Rosary of Pompeii and to Saint Thérèse of the Child Jesus^[41]. He regarded his medical profession itself as a form of lay priesthood, exercised in the service of souls as much as of bodies^[42].

The crucifix in the dissection room

As director of the Incurables' department of pathological anatomy, Moscati had placed, high up, a crucifix overlooking the entire room where autopsies were performed. A Latin inscription accompanied it, taken from the prophet Hosea:

"O death, I will be thy death" (Hosea 13:14).

This biblical word, which Moscati had engraved above the dissection tables, sums up his whole way of looking at death: not as the absolute enemy against which medicine would dash itself without hope, but as an adversary already vanquished by the risen Christ^[43]. On another wall of the same room, he had inscribed a formula in the same spirit, recalling that this place where the dead are dissected can also, through the most rigorous scientific study, serve life^[44].

On 12 April 1927, Moscati followed exactly the rhythm of his ordinary days. He attended morning Mass, received Communion there — as on every day of his adult life — then spent the morning at the Hospital of the Incurables with his patients^[45]. Back home, he devoted himself to his private consultations until about three o'clock in the afternoon^[46]. Feeling tired then, he sat down in an armchair in his practice — and died shortly afterwards, with no apparent agony, at forty-six^[47]. Nothing in this last day distinguished the physician from an ordinary working day: it is this radical normality of his end which would then strike his biographers, mirroring the secrecy in which his charity had kept itself all his life.

Recognition of heroic virtues

After a canonical process conducted over several decades, the Congregation for the Causes of Saints promulgated, on 10 May 1973, the decree recognising the heroic virtues of Giuseppe Moscati, who then received the title of Venerable^[48]. The cause had been formally introduced in Rome as early as 6 March 1949^[49], after long diocesan inquiry work carried out by the Curia of Naples.

The three healings attributed to his intercession

Three healings judged medically inexplicable marked the official recognition of Moscati's holiness: two for the beatification, a third for the canonisation.

This table summarises the three cases retained by the Church, each investigated with the usual medical and canonical rigour of canonisation trials: medical experts consulted, clinical files examined, known natural explanations ruled out before any official recognition of the miraculous character^[53].

Beatification by Paul VI

On the basis of the healings of Costantino Nazzaro and Raffaele Perrotta, Pope Paul VI beatified Giuseppe Moscati on 16 November 1975, in Saint Peter's Square^[54]. In his homily, the pope drew the portrait of a resolutely modern saint, lay and learned:

"He was a layman who made his life a mission lived with Gospel authenticity." — Paul VI, beatification homily, 16 November 1975^[55]

"He was a physician who made his profession a training ground of the apostolate, a mission of charity." — Paul VI, beatification homily, 16 November 1975^[56]

Paul VI stressed the harmony between science and faith which characterised Moscati's whole person, and that "tireless, hidden, heroic flowering of charity" which made Professor Moscati's reputation long before his death^[57]. The pope also noted the sobriety of this existence: spending one's whole life for others, doing good to the poor, healing bodies — until death surprised him in the very midst of his visits to his beloved sick^[58].

The second miracle and canonisation by John Paul II

The miracle retained for the canonisation was the healing of Giuseppe Montefusco, a twenty-year-old young man suffering from acute myeloblastic leukaemia in 1978 and healed in 1979 after a novena of prayers addressed to Moscati^[59]. The canonisation took place on 25 October 1987, in Saint Peter's Square, before some one hundred thousand faithful, sixty years after the saint's death^[60]. In his homily, John Paul II took up and extended the portrait drawn twelve years earlier by Paul VI:

"Moscati saw Christ himself in the sick man, who, in his weakness, in his misery..." — Saint John Paul II, canonisation homily, 25 October 1987^[61]

"...the human warmth with which Moscati solicitously visited the sick, especially the poorest and most abandoned..." — Saint John Paul II, canonisation homily, 25 October 1987^[62]

The pope also underlined the new saint's professional integrity — "an upright man and a consistent Christian, he did not hesitate to denounce abuses"^[63] — and recalled that Moscati found in his constant relationship with God the light needed to understand his vocation as a physician more deeply^[64]. John Paul II finally presented Moscati as "a concrete realisation of the ideal of the lay Christian"^[65] — the very formula which sums up the whole apologetic stake of this canonisation: to show that a great scientist recognised by his peers can be, in the same movement, a saint in the most exacting sense of the word.

The relics and the silent witness of 1943

Since 1930, the body of Giuseppe Moscati has rested in the church of the Gesù Nuovo in Naples; in 1977, his remains were placed in a bronze urn, at the centre of a chapel dedicated to him^[66]. An object kept in this same church tells, in its own way, of the protection of which this shrine was the object: on 4 August 1943, in the midst of war, an incendiary bomb fell on the Gesù Nuovo during an air raid, ricocheted off the left transept and broke open without exploding before the altar of Saint Francis Xavier, while the neighbouring church of Santa Chiara was destroyed by the bombing and later rebuilt^[67]. The device, rendered inert, is today displayed in the rooms adjoining the Moscati chapel, as a silent memorial of the war and a reminder of peace^[68].

Giuseppe Moscati holds, in the history of 20th-century saints, a particular place: that of a researcher recognised by his peers, publishing in the international scientific journals of his time, and at the same time a man of daily prayer and heroic charity towards the poorest. His holiness is not exercised in spite of his science, but literally through it: each diagnosis, each prescription becomes the occasion of a concrete act of charity, never dissociated from the spiritual life of the patient he treats. In 1923, this already renowned physician travelled to Lourdes, where he registered as a physician at the Medical Bureau^[69] — a gesture which says everything about his way of holding science and faith together: coming not as a wonder-worker but as a fellow physician, to observe and serve where the Church verifies with rigour what she never affirms lightly.

He thus joins, in contemporary Catholic memory, other great figures of lay holiness exercised at the heart of a demanding profession: Saint Gianna Beretta Molla, herself a physician, who died giving life to her child rather than interrupt her pregnancy; Saint Pier Giorgio Frassati, a young layman of Turin with a charity towards the poor just as discreet; or again Saint Josemaría Escrivá, apostle of the sanctification of ordinary work. Each, in his or her own way, embodies the conviction that holiness does not require leaving the world, but transforming it from within through charity — a patronage which Moscati today explicitly exercises for physicians, biochemistry researchers and all those who practise a demanding scientific profession without giving up their interior life.

• Saint Pier Giorgio Frassati — another great figure of lay holiness and hidden charity towards the poor, a contemporary of Moscati.
• Saint Gianna Beretta Molla — herself a canonised physician, a model of holiness in the medical profession.
• Saint Josemaría Escrivá — apostle of the sanctification of work and secular professions.
• Saint John Paul II — the pope who canonised Moscati on 25 October 1987.
• The Eucharist and Eucharistic adoration — the spiritual source of his "Eucharistic cure".