Copyright © The Malta Historical Society, 2005.
Source: Melita Historica [The Malta Historical Society]. 6(1972)1(25-49)
[p.25] The Cult and Iconography of Saints Cosmas and Damian in the Maltese Islands(*)
Apart from St. Luke, Saints Cosmas and Damian are the earliest Christians to have been medical men. They were twin brothers born in Aegea (Arabia) in the 3rd century A.D. They practised medicine in Cilicia (Asia Minor) where they gained renown for their successful treatments, their holiness and their generosity; in fact, it is said, they accepted no fees for their professional work.
They suffered martyrdom for their Christian faith during the reign of Emperor Diocletian on September 27th. The year is uncertain being variously given between 283 A.D. and 303 A.D. 
From Syria (Cyrus), where they were buried, their cult reached Constantinople in the 4th century and subsequently spread to Italy, Germany, France and Spain. Some of their remains were transferred to Rome and Venice.  Their names were introduced in the Canon of the Mass about the 6th century.
Since early times Saints Cosmas and Damian have been regarded, together with St. Luke, as the patron saints of physicians, surgeons and pharmacists. They have also been the object of popular veneration in various parts of the world. Great painters have, since the time of Fra Angelico (Giovanni da Fiesole 1387-1455), portrayed the two saints in various guises. 
In the Maltese Islands the veneration of the two saints found expression in the erection of a church in Gozo, the dedication of several altars in various churches, the foundation of a hospital, the naming of hospital [p.26] wards, the production of paintings and statues, the veneration of relics and the formulation of prayers.
These aspects of their cult will be considered in order of their chronological appearance.
1364 Church near Rabat, Gozo
From the Island of Gozo comes the earliest evidence of their cult amongst us. A church was dedicated to the two brother saints in the area of tal-’Ħ’amimiet and Gelmus Hill “about half a mile from Rabat, the suburb of the Citadel of Gran Castello.” It stood on the left hand side of the road that leads from Rabat to Ta’ Pinu. 
It was one of the “most ancient churches in the Island” being already in existence in 1364. It was rebuilt several times in subsequent years. Mgr. Pietro Duzina does not mention it in the records of his apostolic visit to Gozo in 1575 but there is an allusion to it in the documents of a pastoral visit of Bishop Don Baldassare Cagliares of 1615 where it is stated that the church possessed a small residence for the sexton. 
In 1623 a certain Sebastiano Grima from Gozo made arrangements for the celebration of a low mass every Saturday.  When Bishop Lorenzo Astiria visited the church in 1673 he found that the altar was cared for by Paul Madiona; that a light was kept burning in a pewter sanctuary lamp suspended in front of the altar; that the Mass founded by Sebastiano Grima was still being said every Saturday; and that there was an atrium in front of the main door surrounded by a wall along its sides.  By 1679 the feast of the two saints was being celebrated on the initiative of the surgeons with first vespers and High Mass. A lamp was lighted “on the customary days,” the expense being defrayed from the offerings of the devotees of the saints. 
When seen by Bishop Paul Alpheran in September 1744, the church was described as being “moderately large” and of a rectangular plan with two doors. The main entrance faced the east, and the other door, the north. The altarpiece showed the Immaculate Conception in the upper part and the two saints in the lower half. 
The church was still standing, with its own small cemetery, in 1746 when the surrounding countryside had become known as the district of [p.27] Saint Cosmas. It also appears in a list of the churches and chapels existing in Gozo in 1780 but had disappeared by 1866. 
1538 Altar at the Church of the Annunciation at Birgu
The original church of the Annunciation at Birgu had been in existence prior to 1528 when it was first taken over by the Dominican Friars.  According to a description of 1575 this church had sixteen altars one of which was dedicated to Saints Cosmas and Damian. This altar had been founded in 1538 by a certain Paul Fiteni alias Barmo whose heirs had bequeathed some property at Zabbar from the revenue of which a Mass was celebrated. 
The church was rebuilt in the first half of the seventeenth century. A side chapel in honour of St. Nicholas was erected in 1641 by Dr. Nicholas Cilia who since the 10th June 1634 had held the post of Protomedicus or Chief Government Medical Officer of the Island and was eventually buried in the same church.  In this side-chapel, Dr. Cilla had placed a small painting or sottoquadro of the two saints which though “devoid of any artistic merit” was of a “very ancient date” and had been held in great veneration by his forbears.  In a document of 1680 the side-chapel is referred to as that of Saints Cosmas and Damian and St. Agatha. 
In later years the altar-piece of St. Nicholas was substituted by a new one representing the Madonna in Glory while the sottoquadro of Saints Cosmas and Damian was removed from the side-chapel to the Priory of the Dominican Friars attached to the church. It was preserved in the Priory Museum with other artistic objects until the Second World War where it perished when the Priory and the church were destroyed by air bombardment (1941-42). The Priory and the church have since been reconstructed (1952-60) but there is now no trace of the cult and iconography of Saints Cosmas and Damian. 
[p.28] 1575 Altar at the Church of the Assumption at Bir Miftu’ħ, Gudja.
In 1436 the Church of the Assumption of the Virgin Mary of Bir Miftuħ (now part of Gudja) was the Parish Church of the village.
It was rebuilt in 1512 and when seen by Mgr. Pietro Duzina in February 1575 it possessed, besides other altars, one dedicated to Saints Cosmas and Damian situated on the right hand side of the entrance. Although this altar had no revenues, a Mass was said and vespers were chanted on the feast day of the two saints “thanks to the devotion of the people.” 
The altar was still standing at the time of the pastoral visit of Mgr. Ascanio Libertano in November 1585 but there is no mention of it in the records of the visits of Bishop Fra Tommaso Cargallo of 1594 and of Bishop Don Baldassare Cagliares of 1615. The latter refers only to the main altar and that of the Holy Rosary, on the right, and of the Assumption on the left side of the church.  Presumably, therefore, the altar of Saints Cosmas and Damian was demolished between 1585 and 1594.
The church underwent structural alterations in 1768 and again in 1830. By 1866 only the main altar remained. It still contains traces of an old fresco showing several saints but their figures are in such a bad state of preservation that they cannot be identified. 
The present Parish Church of Gudja which replaced that of Bir Miftuħ as Parish Church in 1655 has no paintings or other objects associated with the cult of the two saints.
1594 Altar at the Parish Church of St. Philip at Zebbug (Malta)
The first church of this village was built sometime before 1446, but the earliest reference to an altar of Saints Cosmas and Damian occurs in an account of the pastoral visit of Bishop Tommaso Gargallo on the 19th June 1594. This bishop records that there was an altar “on the left side” of the church dedicated to the Assumption and Saints Cosmas and Damian.  This altar is also mentioned by Bishop Don Baldassare Cagliares in 1615; Cagliares, however, places it on “the right side” and adds that it was cared for by the “Pace family.”
The present church dates from 1623. There is no reference to the altar [p.29] of the two saints in Bishop Lorenzo Astiria’s records of his visit to this church in 1672 and in a document of 1680 describing the various churches of Malta and Gozo in that year. 
None of the altars in this church are now dedicated to Saints Cosmas and Damian. The old altar-piece of 1594 cannot now be traced. 
1594 Altar at the old Parish Church of St. Catherine at Zurrieq
An earlier chapel stood on the site now occupied by the Parish Church of this village. This chapel had been raised to a parish in 1436 and was rebuild in 1448. When visited by Bishop Tommaso Gargallo on the 26th June 1594, this chapel had an altar dedicated to Saints Cosmas and Damian. 
The present Parish Church, which replaced the earlier chapel, was erected between 1634 and 1656.  It appears that the cult of the two saints declined at this period as there is no further mention of them after 1656. No vestiges of it remain today in this village. 
1594 St. John’s Co-Cathedral of Valletta
The Co-Cathedral of St. John possesses a few relics of the two saints, i.e. “a bone of St. Cosmas” and two fragments of the “arm of St. Damian.” They were preserved with many others in two reliquaries above the altar in the Chapel of the Holy Relics or Chapel of St. Charles Borromeo at the far end of the left aisle of the church.  The nucleus of this collection was formed in the Holy Land by the Knights of St. John of Jerusalem. It was later enlarged by additions during the Knights’ peregrinations in Rhodes and Malta.
On the 4th October 1594, the bones of Saints Cosmas and Damian were among the relics that were carried in the procession through the streets of Valletta in thanksgiving for the cessation of the plague of 1592-93. 
By 1644, on the occasion of the feast of the two saints on the 27th [p.30] September, the sacred relics were taken processionally to the church of St. Francis in Kingsway from the Co-Cathedral in the company of the clergy, the Knights of St. John and members of the confraternity of barbers.  This religious ceremony, in which “the master barbers and surgeons in their tunics” took part, was still being held in 1733. The Franciscan Friars (Minor Conventuals) also participated in the procession both during its way to their church and on its return to St. John’s Co-Cathedral. 
1598 Altar at the Church of St. Mary and Jesus of the Minor Observants of St. Francis at Rabat, Malta
There is a chapel with an altar in honour of Saints Cosmas and Damian which dates as far back as the close of the sixteenth century when the original church was erected. This chapel and its altar, placed on the left hand side as you enter the church, were built at the expense of Michael and his wife Francia Feriolo Falsone.
In 1598 a certain Joseph Cassar bequeathed the sum of two scudi to be paid yearly by his heirs, the Confraternity of the Holy Rosary of the Dominican Friars of Rabat, for the celebration of First Vespers and High Mass on the saints’ feast day. 
The chapel was rebuilt in 1699 and rededicated to the Holy Crucifix by Candida, Baroness of Cicciano, and her sister Maria Feriolo Testaferrata, descendants of the Feriolo Falsone family. A plaque with a Latin inscription affixed to one of the walls of the chapel records these events.
Saints Cosmas and Damian are represented separately, each on a rectangular canvas panel, flanking a large Crucifix over the altar. The panel on the left shows St. Cosmas and the one on the right depicts St. Damian. The name of each saint appears in large letters at the bottom of the panel. As the state of preservation of the paintings is rather poor, the details of the figures of the saints cannot be made out clearly. The panels are unsigned and undated but they are probably of Sicilian origin of the seventeenth century. 
[p.31] 1612 Altar at the Church of St. Francis of the Minor Conventuals ’Kingsway, Valletta
This altar is on your left immediately you enter the church.
The altar-piece is by Filippo Paladini (1544-1614?) and dated 1612. A Maltese painter, writing in 1881, remarked that this picture had suffered so much from restoration that it was “almost entirely recoloured.”  The painting was restored in 1966 by the National Museum, Valletta and in May-September 1967 was displayed at the Exhibition of the works of Filippo Paladini held at the Palazzo dei Normanni in Palermo, Sicily.
Filippo Paladini was born in Florence about 1544. After being imprisoned for assault in 1586, he came to Malta. He was in the Island in 1589 working for the Grand Master of the Order of St. John, Hugues de Loubenx de Verdalle. By 1601 he had gone to Sicily where most of his paintings are to be seen. It has been surmised that he was back in Malta in 1611 when he may have seen the works of the painter Michelangelo Merisi da Caravaggio (Bergamo) (1560-1609) and been commissioned to execute the altar-piece of Saints Cosmas and Damian which he painted in Sicily in the following year. Another painting of medical interest from his brush in Malta is that of Saints Paul, Roque and Sebastian at St. Lawrence Church at Birgu. He died in Sicily in 1614. (?)
It has been stated that the scene in the Malta altar-piece represents the miraculous substitution of a diseased leg by a healthy one on the patient in the foreground.  According to legend the saints amputated a white man’s leg while he slept and replaced it by that of a black Ethiopian (or Moor). The saints, in the act of attaching the black leg to the sleeping man, are depicted in the painting by Fra Angelico (circa 1438) in the Museo di San Marco, Florence; in that of the sixteenth century Spaniard Fernando del Rincon where the corpse of the black donor is shown in the foreground; in a miniature painting ascribed to Andrea Mantegna (15th century) where the amputated leg is seen on the floor  ; and in a work by Alonso de Sedano (active 1496) in Burgos Cathedral. 
In the Malta canvas neither the black leg nor the amputation and transplant are shown. The patient is sitting (almost squatting) on the floor in the foreground and has a bandage round his head. It is of interest to note that on a shelf by the side of one of the saints (the surgeon [p.32] Cosmas?) there is the triploide - an instrument employed for the elevation of depressed fragments of bone from the vault of the skull. 
In this church the sodality or confraternity or guild of barbers, physicians and surgeons (Universitas barbitonsorum) was founded on the 10th October 1635. The altar was being used by the sodality in 1644 though a writer on church history states that it was donated to the sodaliy in 1647.  The meetings of the confraternity were probably held in the sacristy as was then the custom with other guilds. 
The confraternity was still active in March 1849 when some of its members held a funeral service for the repose of the soul of Dr. Luigi Gravagna who died on the 17th of the month.  In September-October 1859 the guild clashed with the Bishop of Malta as a result of the latter’s insistence on the removal of the “pagan” symbols of the serpent and abacus that are still to be seen on each side of the altar. The feast of the two saints, however, continued to be celebrated at St. Francis church and the day kept as a holiday by physicians and surgeons until 1865 if not even later. 
As recently as 1915 the religious ceremonies were still being held in this church by “the (medical) family of Malta” with High Mass sung at the altar of the two saints. 
1615 Altar at the old Parish Church of the Nativity of Our Lady at Naxxar
Naxxar, with its church dedicated to the Nativity of Our Lady, was raised to the status of a parish in 1436. When visited by Bishop Baldassare Cagliares on the 6th December 1615, the old Parish Church had an altar on the right hand side with a painting showing St. Lawrence and Saints Cosmas and Damian. 
The original church was replaced by the present one between 1616 and 1630.  There is now no trace of an altar commemorating the two saints or of their past cult in this church. 
[p.33] 1615 Altar at the Parish Church of St. Lawrence at Birgu
The Parish Church of St. Lawrence traces its origin as a chapel to 1090. It underwent various structural modifications during the sixteenth century when for a time it functioned as the Conventual Church of the Order of St. John (1530-71).
In the records of the pastoral visit of Mgr. Ascanio Libertano of 1585 there is no mention of an altar dedicated to Saints Cosmas and Damian but an altar had been set up by 1615 when it was seen by Bishop Don Baldassare Cagliares. A mass was celebrated from revenues left by a certain Philip Ehimes (?).
The altar was subsequently rebuilt and when Bishop Lorenzo Astiria saw it in 1671 it was made of stone and “had everything that was necessary for the sacrifice of the mass.” The altar was still in existence in 1680. 
The church was rebuilt between 1681 and 1697. It seems that the altar of the two saints was not set up again. In fact it is not mentioned in a list of altars existing in the church on the 20th January 1715 but the feast of Saints Cosmas and Damian was being celebrated at the main altar with First and Second Vespers, a High Mass and three low masses. It was organised by the physicians, surgeons and barbers of the city of Birgu. 
The altarpiece of the two saints was hung “on the left side of the church” in 1715. In later years it was transferred to the Vestry of the church where it survived until 1941 when it was lost at the time that the Chapter Hall and Vestry were hit and destroyed by air bombardment during the Second World War. It has been stated that the painting was a work by Filippo Paladini (1544-1614?) “a replica of which may be seen at St. Francis Church, Kingsway, Valletta.” 
1655 Church of the Assumption and of Saints Cosmas and Damian at Gargur
The cult of Saints Cosmas and Damian at Gargur dates since at least 1655 and is associated with a small church, known as Ta Bernarda. [p.34] Originally erected in the fifteenth century, it was rebuilt in 1655 at the expense of a certain Luca Mifsud. 
There is only one altar. The painting above it portrays the Madonna, in the top centre, being borne to heaven by angels and, in the bottom part, it shows the apostles gazing perplexedly at the empty tomb from which the Holy Virgin has risen. In the middle part of the canvas, on each side of the Madonna, there is a saint with uplifted arms and supported on a cloud. He is accompanied by an angel holding the palm of martyrdom. The angel on the right side (of the viewer) also carries a chalice-like receptacle containing a number of small round objects (pills?). Although there are no definite symbolic signs by which these two saints can be said to be Saints Cosmas and Damian, an old village tradition unhesitatingly identifies them with the “doctors of Christ - Cosmas and Damian” (It-tobba ta’Kristu — Kosma w Damian). Confirmatory evidence is provided by the fact that on the 7th September 1720, the Rev. John Dominic Mifsud left a bequest for the celebration of High Mass and First Vespers on the feast day of the two saints on the 27th September. These religious functions were still being held, in fulfilment of this bequest, at the church of Ta Bernarda, up to 1944 when the edifice fell into disuse and was utilised as a store for the street decorations of the festa of the patron saint of the village, St. Barholomew. The High Mass, however, is still sung every year at the main altar of the Parish Church of Gargur. 
1673 Altar at the Parish Church of St. Leonard at Kirkop
This church formed part of the parish of Bir Miftuħ until 1592 when it was raised to a Parish in its own right. Bishop Lorenzo Astiria records the existence of an altar and picture of Saints Cosmas and Damian in 1673. 
The edifice was enlarged in 1706.  Bishop Paul Alpheran paid a visit to the church in 1744 but makes no reference to the altar of the two saints  ; so, presumably, the altar was removed during the structural alterations of 1706. In fact there is to-day no memory of the cult and of the whereabouts of the altarpiece of Saints Cosmas and Damian. 
[p.35] 1698 Painting at St. John Co-Cathedral at Valletta
Several wards of the Holy Infirmary of Valletta, founded by the Order of St. John of Jerusalem in 1575, had an altar raised in honour of a saint. Similar arrangements existed abroad; for instance in the Hostel Royal des Invalides of Paris in 1683 where wards were named after saints such as a ward of St. Cosme for the treatment of wounded men. 
In the Valletta Holy Infirmary there was a ward for the wounded with an altar dedicated to Saints Cosmas and Damian, the altarpiece being from the brush of the Calabrese painter Mattia Preti (1613-99).
Mattia Preti was born in Taverna (Calabria) in 1613. He studied in Rome, Venice and Antwerp. He was admitted into the Order of St. John while in Rome in 1642. He subsequently came to Malta where he lived for thirty-eight years embellishing many of our churches with his works. His masterpiece is the painted ceiling of St. John Conventual Church (now Co-Cathedral) where he is buried. He died at eighty-six years of age in 1699.
The altar-piece of Saints Cosmas and Damian shows the two brothers with almost identical facial features, bearded and barefooted. They are in the act of ministering to the sick. The saint on the left of the viewer wears a red tunic and holds a small jar in his left hand. His right hand is touching the shoulder of an elderly man who is stretched on his back in a canopied bed with his left upper limb hanging limply down to the floor. The other saint is garbed in a dark tunic and red mantel. His right hand is grasping the right wrist of a kneeling woman as if feeling her pulse. His left hand is held out in an imploring gesture and his gaze is turned upwards towards two cherubs, each holding the palm of martyrdom, in the left upper corner of the canvas. The left lower corner of the picture bears the coat-of-arms of the French Grand Prior of the Conventual Church Fra Pietro Viani or Viany, Chaplain of the Langue of Provence. He was elected to this post in 1667 and died in 1700. 
In the traditional representations of the two saints, Cosmas stands for the physician or surgeon and is generally placed on the left of the viewer  ; Damian is the apothecary or pharmacist and carries some symbol of his profession such as a pharmacy jar or ointment box. In Mattia’s [p.36] picture, the traditional position of the figures is reversed as the one on the left is obviously the pharmacist with his jar (Damian) and the one on the right is undoubtedly the physician (Cosmas) judging from the fact that he is feeling the pulse of the kneeling patient. The close resemblance of the saints’ facial features stems from the tradition that they were twins.
In 1699 Grand Master Ramon Perellos y Roccafull applied to the Holy See for an indulgence brief (breve d’indulgenza) for the altar of Saints Cosmas and Damian at the Holy Infirmary. His request was granted but only for a period of seven years. When this time lapsed, the Grand Master submitted a plea for its extension. 
The feast of the two saints was celebrated annually at the Holy Infirmary with great pomp. A diarist, writing in 1733, records that the ward of the wounded was cleared of the patients for the occasion and adorned with tapestry. The Prior of the Church of St. John said mass to the accompaniment of music. Relics of the twin saints were exposed to public veneration and a Plenary Indulgence was imparted. The ceremony was attended not only by a large congregation but also by the Grand Master himself. 
Thirty years later an eyewitness wrote that on the 27th September 1764 the feast of the two saints was celebrated at the Holy Infirmary with much solemnity and with “unusual great pomp. The hall, as far as the stairs, was richly decorated. There was music and singing. His Eminence the Grand Master (Emanuel) Pinto, who had not attended this function for the last twenty years, was present. The (religious) celebrations were conducted by Monsignor the Prior of the (Conventual) Church. A great number of Knights and Balis attended and were served by (surgeon Michel’Angelo) Grima and the Infirmarian with abundant drinks of chocolate and cakes (pan di Spagna). A luncheon was given by the Infirmarian to which were invited a number of knights and the physicians and surgeons. There was frequent firing of petards and in the evening there were fireworks which lasted for an hour and, may be, more.” The feast was held at the expense of surgeon Michel’Angelo Grima who had been the last member to join the hospital staff, the custom being for the physicians and surgeons of the hospital to take it in turn to meet the cost of the celebrations. 
During the eighteenth century the painting was removed from the Ward of the Wounded as it was being damaged by the exhalations from [p.37] the infirmary and, after cleaning, was transferred to the atrium of the sacristy of St. John Conventual Church in 1739. It was later taken to the main sacristy itself where it still hangs. 
A smaller copy of Mattia’s canvas was substituted for the original painting in the Ward for the Wounded. Probably this is the same picture which was later transferred to one of the medical wards of the Central Hospital at Floriana when this institution was opened in 1850. The Central Hospital was eventually closed and the medical wards were moved to the newly erected St. Luke Hospital at Gwardamanġa in 1954. The copy of Mattia’s work was taken to the Chapel of the new hospital but in 1970 it was transferred to the Main Hall of the Department of Health at Valletta.
1698 (after) Painting in the Church of Madonna tal-Providenza at Siggiewi
This baroque church, built between 1750 and 1753, rises on the site of an earlier one. The portico was added in 1815-16.
Over the door leading to the sacristy, on the epistle side of the main altar, there is a small painting of Saints Cosmas and Damian. It is a copy of Mattia Preti’s work in the vestry of St. John Co-Cathedral, Valletta, already mentioned. It bears a coat-of-arms but owing to the bad state of the painting the features of this crest cannot be made out. Presumably this picture was painted afer 1698, the date borne on Preti’s work.
It was commissioned by a devotee of the saints but neither his name nor the date are recorded. 
1715 Altar at the Parish Church of the Immaculate Conception at Bormla
Saints Cosmas and Damian are portrayed in a painting by the Maltese artist Francesco Zahra (1680-1765) placed over the altar dedicated to St. Catherine of Alexandria. It is at the far end of the church on the right hand side of the nave as one faces the main altar. The two saints are depicted with Our Lady, St. Catherine and St. Louis.
The painting must have been commissioned about 1715 as on the [p.38] 17th January of that year a certain Joseph Fiteni bequeathed in his last will and testament a plot of land (clausura) at Qrendi called Ta Betti the rent of which was to be used for the celebration of a number of masses on the feast day of the two saints. These masses, however, are no longer said. 
1729 Ward at St. John the Baptist Hospital (Victoria Hospital) at Victoria (Rabat), Gozo
The Hospital of St. John the Baptist was founded in 1719 but was not built until 1729. Only men were admitted.
The sick were treated in two wards each with an altar at one end. One ward was dedicated to the Immaculate Conception, St. John the Baptist and St. Anthony of Padua; the other was named in honour of Saints Cosmas and Damian. Grand Master Antonio Manoel de Vilhena founded a number of masses to be said on the occasion of the feasts of these saints and of the Holy Virgin. 
The two altarpieces are now in the office of the Medical Superintendent of Victoria Hospital. Both are dated 1728 and bear the crest of Grand Master Antonio Manoel de Vilhena. The painting of Saints Cosmas and Damian shows the saints, one of them holding a book and the other an object which cannot be identified, while a man with a bandaged head sits on the floor. An angel carrying the palm of martyrdom is figured at the top of the pictures. 
1744 (earlier) Altar in the Chapel of Holy Spirit (Santo Spirito) Hospital at Rabat, Malta.
The chapel of the erstwhile Santo Spirito Hospital was built in 1688 on the designs of the Maltese architect Lorenzo Gafa. It had three altars, the one on the left of the visitor commemorating Saints Cosmas and Damian.
This altar was erected on the initiative and at the expense of the physicians and surgeons of the hospital who were also responsible for the celebrations of the religious festivities on the saint’s feast-day.
[p.39] Bishop Paul Alpheran, who visited the hospital on the 15th May 1744, recorded that the altar had been set up “a few years earlier.” 
A mass was founded by Dr. Salvatore Bernard (1724-1806) and was still being said on the 27th September of each year until 1816. 
When the hospital was closed down in 1967, the canvas was removed for restoration to the National Museum, Valletta, where it is still preserved. The saint on the left side of the viewer wears a grey tunic and a light brown mantle or coak; he holds a palm-leaf in his left hand and a partly opened book in his right. The other saint, in a green tunic and light grey mantle, holds a palm leaf and a closed book in his right hand while his left is hidden under his robes. In the background there is the facade of a church of a classical style of architecture. The foreground is occupied by a cherub holding a pharmacy jar in one hand and pointing with the other to the saint on his left. Below the cherub is the following inscription:-
SS COSMAE ET DAMIANI INTERCESSIO NOS PROTEGAT
The painting is unsigned and undated. It may possibly be the work of a south Italian artist about 1700. The head of the saint on the left side of the viewer appears to have been inspired by that of St. John in Patmo. As a work of art it is rather mediocre. 
1749 Altar at the Church of Our Saviour at Attard
The Church of Our Saviour or of the Transfiguration was erected in 1500 and rebuilt in 1614. In 1615 Bishop Baldassare Cagliares paid a pastoral visit to the village of Attard but left no record of the contents of this church. 
In 1744 Bishop Paul Alpheran found the church in ruins but stated that a certain Santo Fiteni offered to provide funds for its restoration.  When it was completed in 1750, it had three altars, one of which was dedicated to Saints Cosmas and Damian. On the 24th December 1749, Santo Fiteni left the sum of three scudi a year, derived from property near Zabbar, for the celebration of the saints’ feast with First Vespers and High Mass.
[p.40] The church and the altarpiece of the two saints were destroyed during the Second World War by a direct hit during an air bombardment on the 22nd April 1942. 
1751 Hospital for Women at Victoria (Rabat), Gozo
A hospital for poor sick women was founded in 1454  by a certain Francesco Bonnici in the Citadel of Gozo. It had only two rooms.
Monsignor Pietro Duzina visited the place in 1575 and described it as consisting of a few dwellings near the gate of the Citadel but it was not admitting patients as it possessed neither beds nor cultras. It was originally dedicated to St. Julian, the Confessor, but by the eighteenth century (1751) it was known as the Hospital of Saints Cosmas and Damian.  At this period it housed twelve persons and was administered by the bishop. The edifice was restored in 1732 and again in later years. 
On the 25th September 1744 it was visited by Bishop Paul Alpheran. It consisted of an oblong hall for eight patients. On the left hand side, near its entrance, there was a stone altar dedicated to Saints Cosmas and Damian who were portrayed on canvas surrounded by a wooden frame.
Mass was said on Sundays. Religious ceremonies were held on the 27th September thanks to a bequest of the Prior Melchior Alpheran who also contributed from his own purse for the restoration of the hospital in 1732. 
The hospital survived until 1838 when the patients were moved to the Hospital of St. John the Baptist now called Victoria Hospital.
In 1865 the building was enlarged and converted into a seminary for the Gozitan Diocese. 
The altarpiece was taken to the Cathedral of the Assumption in the Citadel of Victoria (Rabat). It is now in an ante-room on the way to the Oratory of the Cathedral. It is by an unknown painter and measures about six feet six inches by five feet two inches.  It is undated. The canvas shows the two saints with books and medical instruments, one on each side of the Immaculate Conception who is portrayed on a higher plane. [p.41] A small church appears behind the saint on the right hand side of the viewer. In the central background is a low one storey building with three fountains. Is this painting the same one that was originally in the Church of Saints Cosmas and Damian at Tal Hammimiet?
The devotion towards the two saints is still alive and candles are lit on their altar in thanksgiving for favours received. 
Painting at the Church of Our Lady of Sorrows at Żebbuġ, Malta
This small church was founded in 1725 by the physician and pharmacist Dr. Baldassare Debono whose marble tombstone, in the centre of the floor, records his death on the 28th December 1746 at the age of eighty years.
Dr. B. Debono had made a reputation for the efficacy of his medicaments and chemical preparations. His portrait hangs in the vestry attached to the church.
The church contains only one altar dedicated to Our Lady of Sorrows but on the wall, on the left hand side of the viewer, there is a painting of an oval shape representing Saints Cosmas and Damian wearing a dark tunic and red mantle. The saint on the left of the painting is holding the wrist of an old man sitting on the floor in the foreground; the other saint appears to be medicating the head of an infant held in his mother’s lap. He holds a roundish receptacle in his left hand. No date or name of the painter can be seen.  Presumably the painting was commissioned between 1725 and 1746.
Stone statues at the Friary of the Minor Observants of St. Francis at Valletta
Two stone statues of the two saints flank the interior of the portal of the convent as you step inside the entrance hall from the St. Ursola Street approach. They are placed on stone pedestals, the one on the left being St. Damian and the one on the right St. Cosmas. Their respective names are engraved on the bases of the statues.
They are almost lifelike in size, their youthful countenances being turned upwards in an ecstatic attitude. Their hands are missing from the wrists except the left one of St. Damian in which the saint holds an [p.42] oblong receptacle divided into shallow compartments.
The statues are traditionally reputed by the friars to be “very old” but no information could be obtained as to their approximate date, their association with the convent, their original location or connexion with the possible existence of a guild or confraternity of physicians and pharmacists. 
The belief in the baneful influences of the evil eye was - and still is - widespread in the Maltese Islands. Illness, in men and animals, was sometimes ascribed to the harmful effects of the evil eye and one folk remedy against sickness thus caused consisted in fumigating or smoking the diseased creature with the burnt leaves of the olive tree that had been blessed during the church ceremonies held on Palm Sunday. During the fumigation the following invocation or exorcism was recited:-
F’ġieħ San Kusman u San Damjan
’K hawn xi għħajn toħroġ minn hawn,
Min fuq kulsivolja ta bniedem
U kulsivolja t’annimal;
Kienu tobba ta’ Kristu,
Ikunu tobba tar-ruħ tagħna.
(In the name of Saints Cosmas and Damian/ if there is (an evil) eye let it get out/ Let it depart from any man/ or any animal./ They were the doctors of Christ/ may they be the doctors of our soul). 
From Nadur, Gozo, comes another invocation with some variation in the ritual of smoking in the sense that pieces of candles (xema tat-tnibri) were added to the burning olive leaves. The smoking was repeated, after making the sign of the cross, on three successive days and accompanied by the recitation of three Pater poster, Hail Mary, and Gloria. In the meanwhile the smoke was wafted on to the sick animal or human being. In Gozo there are still people who carry out this ritual every Thursday evening. The words of the invocation are:-
li rawk, F’ġieħ San Pitru u San Pawl ta’ Ruma,
Dawk l-ghajnejn li ferħu bik, Jekk inhi għajn toħroġ il barra,
Tinżel il Madonna mis-sema Jekk inhi ferħa terġa lura.
F’ġieħ San Kosmu u San Damian,
Jiena nbaħħrek, San Mikiel u San Rafel,
Inbaħħrek biex jgħaddilek, F’ġieħ il qaddisin kollha
Inbaħħrek biż-żebbuġ imbierek. Biex jitolbu għalina. 
(Those eyes that saw you/ Those eyes that welcomed you/ May the Madonna descend from Heaven/ to heal you./ I smoke you/ I smoke you to cure you/ I smoke you with the blessed olive (leaves)./ In the name of St. Peter and St. Paul of Rome/ if you are an (evil) eye get out/ if you are (some kind of) joy come back./ In the name of St. Cosmas and St. Damian,/ St. Michael and St. Raphael,/ In the name of all the saints/ may they pray for us).
Until about thirty years ago, elderly men and women from Senglea recited a Pater poster, in honour of “Saints Cosmas and Damian the doctors of Christ,” with other prayers said before going to bed at night. 
In a militia list of some eighty different male Christian names of 1419-20, those of Saints Cosmas and Damian do not appear at all.  However, Mgr. Pietro Duzina, the Apostolic Delegate to Malta in 1575, records that among other saints’ names Maltese children were given those of Saints Cosmas and Damian. These names are far from being common to-day but there are still some families in which the names of Cosmas and Damian are passed on from one generation to a successive one; so much so that one family at Żebbuġ (Malta) is known as Ta Kosma.  Cosmas occurs also at Floriana, the bearer being from Zejtun (1972), at Zabbar and at Valletta. There is at least one Damian at Birkirkara. 
These names are current also at Kercem, Xewkija and Nadur (Gozo) where the father takes the name of Cosmas and the son that of Damian and so on as one generation follows another; or where a grandfather is a Cosmas and two grandsons are respectively Cosmas and Damian.
[p.44] Images in private houses
The author possesses a framed representation of the two saints worked out in embroidery on white satin. It once belonged to Dr. Gaspare Camilleri who was Medical Superintendent of Santo Spirito Hospital in the first decade of this century. It is very likely that it was embroidered by the Sisters of Charity who were on the nursing staff of that hospital.
A colleague has a print of the two saints that was given to him by his father on qualifying as a doctor in 1928. 
The author has seen coloured prints of the two saints hanging in bedrooms in village houses. They measure about three by two feet and are probably of Italian origin. They could still be bought from furniture dealers. 
Until three years ago a family at Kercem, Gozo, had a reliquary (Qwadru tar-reliqwi) containing some fifteen relics of various saints among which a few tiny fragments of bones of Saints Cosmas up to about 1939. The saints are shown holding a palm leaf in one hand and an ointment square box with partitions and spatula in the other. It was destroyed when the house was flooded by a heavy down-pour of rain during a storm that hit the Island of Gozo.
Some six years ago an elderly woman from Valletta had an “ulcer” in one of her legs which proved resistant to medical treatment. The surgeon. recommended amputation as he feared that it might “poison her blood.” She made a novena to the two saints of whom she had a picture at home. At the end of the novena she removed the bandage from her leg and found that the “ulcer” had healed completely. 
The greater part of the paintings portraying Saints Cosmas and Damian in Malta and Gozo are the unsophisticated works of anonymous painters. There are, however, two exceptions. Both these canvases are of high artistic merit being from the brush of such masters as Mattia Preti and Filippo Paladini respectively. While most of the anonymous paintings depict the saints in a full-face conventional style, Preti’s and Paladini’s show the thaumaturges in more natural poses and in the company of the sick to whom they are ministering. Patients are likewise present in two other pictures of unknown authorship, i.e. the altarpiece at St. John the Baptist Hospital (Victoria Hospital), at Gozo, and the painting at the [p.45] church of Our Lady of Sorrows at Zebbug, Malta, where one of the saints appears to be medicating the head of an infant held in his mother’s lap.
The pharmaceutical and medical objects which appear in the various paintings and sculptures include the book, symbol of learning and science, the pharmacy jar and the ointment box, denoting the art of pharmacy, and the triploide. The representation of this surgical instrument, used in elevating fragments of bone from the factured vault of the skull, rivets our attention because this instrument has not been seen depicted, so far, in association with Saints Cosmas and Damian.
One of the characteristic and recurring features of the iconography of the two saints is their portrayal with Our Lady who appears under various guises such as the Assumption, the Immaculate Conception and the Madonna with the Infant Jesus. This association in art of Saints Cosmas and Damian with the Madonna is not unique to Malta. Indeed the two brother saints have been figured with Our Lady in Italian Iconography from at least the 15th century to as recently as 1940. 
Sometimes other saints are combined with the two thaumaturges besides the Madonna. At least three instances of such pictorial combinations are known — an altarpiece that existed in 1615 at the old parish church of Naxxar where Saints Cosmas and Damian figured with St. Lawrence; a second canvas, which is still extant, at the church of the Assumption at Gargur (ta’ Bernarda) which also shows some apostles grouped round the empty tomb of the risen Madonna; and a third altar-piece in the parish church of Bormla portraying them with St. Catherine, St. Louis and the Madonna.
From the earliest Christian times the intercession of saints was solicited by the sick to obtain recovery from illness. Among the saints whose aid was invoked when health was impaired were Saints Cosmas and Damian.
There is evidence that their cult had already emerged in the Maltese Islands by 1364. Those were the days when disease was regarded as a punishment from God for private sins committed by the patient and for a general dissolute way of life of the community. As the aetiology and pathology of disease became gradually understood by the 18th century and as remedial measures against sickness became more rational and efficacious in the following century, less reliance was placed on the religious element in the fight against illness.
[p.46] From its beginning in the 14th century, the cult of Saints Cosmas and Damian in the Maltese Islands reached a peak in the 16th and 17th centuries.
Most of the Masses and other religious functions celebrated at the altars of the two saints were financed by bequests from private individuals but at least two altar paintings are associated with highly placed officials in the hierarchy of the Order of St. John of Jerusalem. These are the canvas by Mattia Preti which displays the coat-of-arms of the Grand Prior Pietro Viani or Viany, and the altarpiece at Victoria Hospital, Gozo, which bears the crest of Grand Master Antonio Manoel de Vilhena.
The cult of the two saints was also fostered by the guild of barbers, physicians and surgeons that had been founded on the 10th October 1635 and held its religious functions at the altar of St. Cosmas and Damian at the Church of St. Francis in Kingsway, Valletta. This guild came to an end some time after 1859.
The physicians and surgeons of the Hospital of the Holy Spirit (Santo Spirito) at Rabat, Malta, had raised an altar to the brother saints in the hospital chapel “a few years” before 1744 and continued to hold religious ceremonies until 1816.
The medical and surgical staff of the Holy Infirmary, at Valletta, held similar celebrations on the feast day of Saints Cosmas and Damian, in the ward dedicated to these saints, certainly until 1764 and probably even later.
The surgeons of Gozo celebrated the feast of the two saints, at the church dedicated to them near Rabat, in the late 17th century (1679).
The popularity of the devotion towards Saints Cosmas and Damian was waning towards the mid-18th century but was still active among medical men in 1816. It is also recorded that after the lapse of a century members of the medical profession were still holding religious functions on the feast day of their patron saints as late as 1915. To-day only a few vestiges of the veneration of Saints Cosmas and Damian can be traced.
The story of the decline of the cult of the two thaumaturges is not an unfamiliar phenomenon. Popular devotion to saints protectors of health tends to fade away with advances in treatment and with progress in preventive medicine. We have witnessed, for instance, the disappearance of a once widespread devotion towards saints regarded in the past as protectors against disease such as St. Sebastian and St. Roche against plague; St. Anthony the Abbot against egotism (St. Anthony’s Fire) and St. Valentine against epilepsy. However, in spite of the loss of their popularity among the inhabitants of the Maltese Islands, Saints Cosmas and Damian have left in their passing a deep mark on our artistic and cultural history. It is hoped that what has survived the destructive forces of time [p.47] and violent events and the changes in devotional trends will be saved from oblivion and neglect for the contemplation and enlightenment of present and future generations of medical men.
Summary of chronology
1364 Church of Saints Cosmas and Damian in existence near Rabat, Gozo. Still standing in 1780.
1538 Altar at Church of the Annunciation of the Dominican Friars at Birgu. No longer extant in 1641 but the sottoquadro of the two saints survived until 1941-42.
1575 Altar at the Church of the Assumption of Bir Miftuħ near Gudja. Removed between 1585 and 1594.
1594 Altar at the Parish Church of St. Philip, Zebbug, Malta. No longer extant between 1623 and 1672.
1594 Altar at the Parish Church of St. Catherine, Zurrieq. Ceased to exist between 1634 and 1656.
1594 Reliquary containing bones of Saints Cosmas and Damian was carried processionally in Valletta in thanksgiving for the cessation of the plague of 1592-3.
1598 Altar at the Church of Saint Mary and Jesus of the Minor Observants of St. Francis, Rabat, Malta. The altar was rededicated to the Holy Crucifix in 1699 but panels of the two saints are still extant.
1612 Altar at the Church of St. Francis of the Minor Conventuals, Valletta. Religious ceremonies recorded as taking place in 1915. Altar and painting still extant.
1615 Altar at the old Parish Church of the Nativity of Our Lady, Naxxar. No longer extant between 1616 and 1630.
1615 Altar at Parish Church of St. Lawrence, Birgu. No longer extant between 1681 and 1697 but the feast of the two saints was still being celebrated at the Main Altar of the church in 1715. The altarpiece survived until 1941.
1644 Sacred relics of Saints Cosmas and Damian were carried in procession at Valletta on the occasion of the feast of the saints on the 27th September. This feast was still being held in 1733.
1655 Church dedicated to the Assumption and to Saints Cosmas and Damian at Gargur. The church fell into disuse in 1944 but the feast of the two saints is still being celebrated at the Main Altar of the Parish Church of St. Bartholomew, Gargur.
1673 Altar at the Church of St. Leonard, Kirkop. Ceased to exist between 1706 and 1744.
1698 Altar and painting at the Holy Infirmary at Valletta. Feast day of the brother saints was celebrated as late as 1764 and possibly [p.48] later (but not after 1798). The altarpiece is now at the Co-Cathedral of St. John, Valletta. A copy of it is at the Department of Health, Valletta.
1698 Painting at the Church of the Madonna tal Providenza, Siġġiewi. Still extant.
1715 Altar at the Parish Church of the Immaculate Conception, Bormla. Still extant.
1729 Altar in a ward at St. John the Baptist Hospital, Victoria, Gozo. Only the painting is still extant.
1744 Altar at the Chapel of the Hospital of the Holy Spirit (Santo Spirito Hospital), Rabat, Malta. The feast of the two saints was still being celebrated in 1816. The hospital was closed down in 1967. The altarpiece is now at the National Museum, Valletta.
1744 Altar at the Hospital for Women at Victoria, Gozo. The hospital was closed down in 1838. The altarpiece is now at the Cathedral of the Assumption, in the Citadel, Gozo.
1749 Altar at the Church of Our Saviour, Attard. Destroyed by air-bombardment in 1942.
1764 Feast of the two saints celebrated at the Holy Infirmary, Valletta.
1816 Feast celebrated at the Hospital of the Holy Spirit (Santo Spirito Hospital).
1915 Religious celebrations held at the altar of Saints Cosmas and Damian at St. Francis Church, Valletta.
1970 The feast of the saints still celebrated on the 27th September at the Main Altar of the Parish Church of St. Bartholomew at Gargur.
1. Two panels showing Saints Cosmas and Damian separately. Church of St. Mary and Jesus of the Minor Observants of St. Francis, Rabat, Malta.
2. Altarpiece by Filippo Paladini. Church of the Minor Conventua1s of St. Francis, Valletta.
3. Altarpiece showing the Assumption with Apostles and Saints Cosmas and Damian. Church of the Assumption (ta’ Bernarda), Gargur.
4. Altarpainting by Mattia Preti, previously at the Holy Infirmary. St. John Co-Cathedral, Valletta.
5. Copy of the above painting, previously at Holy Infirmary, Central Hospital and St. Luke Hospital Chapel. Department of Health, Valletta.
6. Painting at the Church of the Madonna tal Providenza Siggiewi.
7. Altarpiece showing Our Lady, St. Catherine, St. Louis and Saints Cosmas and Damian. Parish Church of the Immaculate Conception, Bormla.
8. Altarpiece of the two saints. Victoria Hospital, Gozo.
9. Altarpainting of Saints Cosmas and Damian, previously at the Hospital of the Holy Spirit, Rabat (Malta) now at the National Museum, Valletta.
10. Painting at the Church of Our Lady of Sorrows, Zebbug.
11. Altarpiece at the Cathedral of the Assumption, Gozo.
1. Statue of St. Cosmas and statue of St. Damian. Convent of the Minor Observants of St. Francis, Valletta.
1. Folk prayers and invocations.
2. Naming of children after Saints Cosmas and Damian at baptism.
3. Images of the two saints in private houses.
4. Celebration of Mass on the Saints feast day at the Main Altar of Parish Church of St. Bartholomew, Gargur.
5. Bone relics of the saints in reliquary in the Chapel of St. Charles Borromeo, St. John Co-Cathedral, Valletta.
- O -
1605 Altar at the old Parish Church of the Assumption at Mosta
The first reference to the cult of Saints Cosmas and Damian at Mosta occurs in 1605 when a certain Jacobus Vella made a bequest for the celebration of masses on the feast day of the two saints at this church. It is very likely that an altar in honour of Saints Cosmas and Damian existed at this period. There is no doubt that such an altar — dedicated to the Assumption of the Virgin Mary and to Saints Cosmas and Damian — had been erected by 1615. In fact Bishop Don Baldassare Cagliares records that at the time of his pastoral visit to this church on the 6th December of that year this altar was on the right hand side of the main one and that masses were said on the feasts of the Assumption and of the two saints out of a bequest by Angelo Grixti.
By 1673, St Anne had replaced the Assumption in the altarpiece but Saints Cosmas and Damian continued to figure in the canvas as stated in the entry of the pastoral visit to the church on the 31st May 1744.
The old parish church of Mosta was demolished in 1860 and substituted by the present edifice which contains no evidence of the cult of the two saints (Ms. 181, Pastoralia, Tom. II, fol. 121 & 280t; Ms. 190, Pastoralia, fol. 143, Cathedral Archives, Mdina).
* This paper was awarded the British Medical Association (Malta Branch) prize in the Medical Essay Competition for 1970.
 Winkelmann, J.P. — Catholic Pharmacy, no place of publication, 1966, p. 43. Hoever, H. — Lives of the Saints, New York, 1955, p. 378.
 Julien, P. — Du Finistère à la Macedonie par Courtrai, in Revue d’histoire de la pharmacie, Tome XVII, No. 187, Decembre 1965, p. 481. La Pharmacie Française, No. 370e annee, Octobre 1966, p. 13. Gondoni, G. & Longhi, R. — The Lives of Saints Cosmas and Damian as Depicted by Fra Angelico, in Rassegna medica, No. 1, Vol. XXV, 1958, no pagination. Winkelmann, J.P., op. cit., p. 43.
 Winkelmann, J.P., op. cit., p. 44.
 Ms. 422, fol. 415, (RML) Royal Malta Library, Valletta. Cassar, P. Gozo. Personal communication, 17th February 1968.
 Ms. 180, no pagination, Cathedral Archives, Mdina.
 Ms. 422, fol. 415, RML.
 Ms. 181, fol. 266, Cathedral Archives, Mdina.
 Ms. 422, fol. 415, RML.
 Ms. 190, Visitatio Alpheran, fol. 218, Cathedral Archives, Mdina.
 Ms. 145, fol. 285 & fol. 382, RML. Abela, G. & Ciantar, G.A. — Malta illustrata, Malta, 1780, Vol. 3, p. 341. Ferris, A. — Descrizione storica delle chiese di Malta e Gozo, Malta, 1866, p. 693.
 Vella, A.P. — Storja tal knisja tal Lunzjata tal Birgu, Malta, 1965, p. 6.
 Ms. 643, fol. 243, RML. Ms. 422, fol. 62, RML. Ms. Visita di Mons. Duzina, fol. 141 Cathedral Archives, Mdina. This ms. has Bianco instead of Barmo.
 Cassar, P. — Medical History of Malta, London, 1965, p. 466.
 Archivum Conventus Victoriosae, Vol. S, fols. 781-2. I am indebted to Prof. A.P. Vella O.P., S.Th.M., B.Litt., (Oxon) for this source.
 Ms. 180, no pagination, Cathedral Archives, Mdina.
 Vella, A.P., op. cit., pp. 14, 20 & 31-41. Prof. A.P. Vella, personal communication, 2nd July 1968.
 Ms. 182, fol., 228, Cathedral Archives, Mdina. Ms. 643, fol. 173, RML.
 Ms. 181, fols. 31t, 40t & 93t, Cathedral Archives, Mdina.
 Ferris, A., op. cit., p. 353. Galea, J. — Storja tal Knisja ta Santa Marija ta Bir Miftu’ħ, Malta, 1946, pp. 22 & 33. Attard, E. Rev., Personal communication, 3rd October 1967.
 Ms. 181, Pastoralia, Tomo II, fol., 37t Cathedral Archives, Mdina.
 Ms. 180, no pagination, Cathedral Archives, Mdina. Ms. 181, fols. 108 & 242t, Cathedral Archives, Mdina.
 Cachia, L. Very Rev. Parish Priest, Zebbug. Personal Communication (verbal) 30th December 1968.
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 Ferris, A. op. cit., p. 383.
 Dalli, J., Personal communication (verbal), 24th July 1970.
 Ferris, A., Il maggior tempio di S. Giovanni Battista in Malta, Malta, 1900, p. 35. Ferris, A., Descrizione storica delle chiese di Malta e Gozo Malta, 1866, p. 140.
 Parisi, P. — Aggiunta agli avvertimenti sopra la peste, Palermo, 1603, p. 16.
 Cagliola, Ph., Almae siciliensis provinciae Ordinis Minorum Conventualium S. Francisci, Venetia, 1644, p. 121.
 Ms. 142 E, fol. 309, RML. Ms. 235, fol. 136 & fol. 160, RML.
 Ferris, A., Descrizione etc., p. 121. Cuschieri, A. Rev., Personal communication 23rd November 1968; Mintoff, D. Rev., Personal communication 10th January 1969.
 Cauchi, J. LL.D., Curator of Fine Arts, National Museum, Valletta. Personal communication, 20th February 1969.
 Calleja, G., —The Works of Art in the Churches of Malta, Malta, 1881, p. 53.
 Catalogo Mostra di Filippo Paladini, Palermo, 1967, pp. 25, 33, 65 & 67.
 Guthrie, D., — A History of Medicine, Edinburgh, 1947, Plate xviii.
 Matthews, L.G., “SS. Cosmas and Damian Patron Saints of Medicine and Pharmacy, Their Cult in England,” in Medical History, Vol. XII, No. 3, 1968, p. 284.
 Cassar, P. — Medical History of Malta, London, 1965, p. 485.
 Cagliola, Ph., op. cit., p. 121. Ferris, A., Descrizione etc. p. 226.
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 Il Portafoglio Maltese, supplimento No. 568, 26th March 1849, p. 4918.
 Companion to Muir’s Almanack of 1857, Malta, no date, p. 40. Muir’s Almanack and Directory for 1865, Malta, no date, p. 18.
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 Ferris, A., Descrizione etc., p. 478.
 Libro delle fondazioni del Rev. Don Giovanni Domenico Mifsud (1642-1722) Archives of Gargur Parish Church. I am indebted to the Rev. K. Vella and to Dr. C. Delucca M.D. for this source and for personal communications of 5th August 1969.
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 Vella, A. Very Rev. Parish Priest, Kirkop. Verbal communication 23rd September 1970.
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 Benassi, E. — I Santi Cosma e Damiano in una tela di G. B. Tinti in Gazzetta sanitaria, Settembre, 1953, p. 514.
 Archives 1467, no pagination, Letter of Grand Master to his Ambassador Sacchetti at Rome, 21st January and 31st March 1706, RML. I am indebted to Prof. W. Ganado B.Sc., M.D., F.R.C.P. (Lond) for this source.
 Ms. 142 E, fol. 309, RML.
 Ms. 14, fol. 371, RML.
 Scicluna, H.P. — The Church of St. John in Valletta, Rome, 1955, pp. 150 & 207.
 Ferris, A., Descrizione etc., p. 407. Deguara, A. Very Rev. Parish Priest, Siġġiewi. Personal communication, 28th November 1968. I am indebted to the Rev. Annetto Depasquale of the Pastoral Research Services, Valletta, for drawing my attention to this painting.
 Ferris, A., — Descrizione etc., p. 298. Mifsud Bonnici, R. — Dizzjunarju Bio-Bibljografiku Nazzjonali, Malta, 1960-68, p. 549. Mis. 191, fols. 359t & 360, Cathedral Archives, Mdina. Cassar, J. Rev. Can. Archpriest, Bormla. Personal Communication, 12th July 1968. Cilia, V., Very Rev. Can., Bormla. Personal communications of 4th December 1969 & 2nd January 1970.
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 Information obtained from the sexton on 18th September 1969.
 Ferris, A. Descrizione etc., p. 423. He gives the date of foundation as 1740 but an inscription beneath the portrait of Dr. Debono records the year of foundation as 1725. Ciappara, S. — Storia del Zebbuġ e sua parrocchia, Malta, 1882, p. 44.
 Mintoff, D. Rev. Personal communication 19th November 1968.
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 Demartino, C. (Senglea). Personal communication 30th June 1970.
 Wettinger, G. “The Militia List of 1419-20,” Melita Historica, Vol. 5, No. 2, 1969, p. 80.
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 Galea, J. Personal communication 7th October 1971.
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