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In this gripping narrative study, Bagnato shows how the modern quest for sanitation shaped Italy’s urban and rural landscapes, propelling major transformations from the draining of the wetlands around Venice, to demolitions and replanning in Naples, to the expulsion of the inhabitants of ancient Matera. He argues that current north–south inequalities are founded on spurious medical narratives, and focuses on the real impact on the people caught in their ministrations.