Ab actu ad posse valet illatio? Epidemiological inferences from ex-voto

Background An ex-voto is a votive offering to a saint or to a divinity, most frequently Virgin Mary, given in gratitude for surviving an illness or a serious accident. This practice still popular finds its highest expression from the Middle Ages and in the Catholic and Orthodox culture. We researched votive paintings that allow you to collect information on the type of accident, on the period and on the socio-economic status of the person who commissioned. The aim of this work is to create a database about accidents and illnesses from the past (from the 17th to the 20th century), to be used as an instrument of socio-cultural and epidemiological research, obtaining data since there were no previous studies in literature and nor such a database. Methods We have currently collected 3852 votive paintings (sample number 3852) personally photographed in sanctuaries, churches and museums or from other sources in all the Italian territory (38.34% North, 29.28% Centre, 32.38% South), categorized on the period, applicant (economic status, gender, age) and type of accident. For data input, managing and analysis was used SPSS 19.0. Results The collected ex-voto were concerning: diseases (30.56%), road accidents (27.94%), domestic or outdoor accidents (11.99%), work accidents (5.17%), other conditions, such as navigation accidents, war accidents, accidents with explosives and personal attacks (24.34%). We report just a few of all the findings: the steady growth of traffic accidents, from 22% in the 18th century, rising to 33% in the 19th century to 39% in the 20th century. Since 1800 the highest number of accidents occurred with carts (80%), while the horse was a more secure means of transport (20%). Over time there was a reduction in low-income population of work accidents from 90% to 72%; domestic accidents were related in 45% of cases to children, of whom 69% low-income and 31% medium/high income; ecc. Conclusions A database of votive offerings seems to be a useful tool to investigate accidents and illnesses which occurred in the past, something that is an almost unique resource for both epidemiologists and social sciences scholars. The intention is to expand in the space-time our source data and open up exciting and interesting perspectives of comparison between past and present.