Da la scheggia rotta usciva insieme parole e sangue: an unusual case of bleeding and the metaphor of a clinical trial

In the Canto XIII of the Inferno, in the forest of suicides, Dante and Virgil encounter a damned soul who, though not revealing his name, is easily identifiable as Pier delle Vigne, a notary and right-hand man of the emperor Frederick II in Palermo. Among other achievements, Pier delle Vigne signed the Constitutions of Melfi and, in 1224, the founding act of the University of Naples. Later, due to court intrigues, he fell out of favor with the emperor and committed suicide. The suicides in Hell have lost their bodies, transformed into trees or bushes (“men we were, and now we are stumps”). The report of Dante, Virgil and Pier delle Vigne’s encounter follows a sequence that, more than 700 years earlier, mirrors the general path of modern scientific research, in particular of clinical trials: from the observation of an unusual episode of bleeding (a tree that speaks and from which words and blood flow together), to the formulation of a hypothesis, from the mentor-student relationship to the experiment without informed consent, from empathy with the patient to the definition of autoimmunity and inflammation, and finally to the publication of the case.