Expelling the Plague

Expelling the Plague: The Health Office and the Implementation of Quarantine in Dubrovnik, 1377-1533

Zlata Blažina Tomić
Vesna Blažina
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  • Book Info
    Expelling the Plague
    Book Description:

    A vibrant city-state on the Adriatic sea, Dubrovnik, also known as Ragusa, was a hub for the international trade between Europe and the Ottoman Empire. As a result, the city suffered frequent outbreaks of plague. Through a comprehensive analysis of these epidemics in Dubrovnik, Expelling the Plague explores the increasingly sophisticated plague control regulations that were adopted by the city and implemented by its health officials. In 1377, Dubrovnik became the first city in the world to develop and implement quarantine legislation, and in 1390 it established the earliest recorded permanent Health Office. The city’s preoccupation with plague control and the powers granted to its Health Office led to a rich archival record chronicling the city’s experience of plague, its attempts to safeguard public health, and the social effects of its practices of quarantine, prosecution, and punishment. These sources form the foundation of the authors' analysis, in particular the manuscript Libro deli Signori Chazamorbi, 1500-30, a rare health record of the 1526-27 calamitous plague epidemic. Teeming with real people across the spectrum, including gravediggers, laundresses, and plague survivors, it contains the testimonies collected during trial proceedings conducted by health officials against violators of public health regulations. Outlining the contributions of Dubrovnik in conceiving and establishing early public health measures in Europe, Expelling the Plague reveals how health concerns of the past greatly resemble contemporary anxieties about battling epidemics such as SARS, avian flu, and the Ebola virus.

    eISBN: 978-0-7735-9711-2
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-viii)
  2. Table of Contents
    (pp. ix-x)
  3. Figures and Tables
    (pp. xi-xiv)
  4. A Note on Names
    (pp. xv-xvi)
  5. A Note on the Pronunciation of Croatian Names
    (pp. xvii-xviii)
  6. A Note on Money, Weights, Measures, and Prices
    (pp. xix-xx)
  7. Acknowledgments
    (pp. xxi-2)
    Zlata Blažina Tomić and Vesna Blažina
  8. Introduction
    (pp. 3-7)

    This is a study of the origins and early history of plague control measures in the Croatian city of Dubrovnik from 1377 to 1533. The inspiration for this study was drawn from the work of Mirko Dražen Grmek, who established that Dubrovnik, also known as Ragusa, was the first city-state in the world to develop the concept of quarantine legislation as early as 1377.¹

    Zlata Blažina Tomiæ began her research with the hypothesis that, over time, Ragusan patricians must have continued to refine and ameliorate their plague control measures. The archival sources retrieved in the State Archives of Dubrovnik confirmed...

  9. 1 History of Dubrovnik
    (pp. 8-41)

    Dubrovnik, also called Ragusa in the past, was an aristocratic city-state that wielded enormous power in the Mediterranean. Flourishing maritime and caravan trade, as well as shipbuilding and shipping, contributed to its incredible wealth (see Figure 1.1). In his workOpis slavnoga grada Dubrovnika / Situs aedificiorum, politiae et laudabilium consuetudinum inclitae civitatis Ragusii(Description of the illustrious city of Dubrovnik), written in 1440, Diversis, an educated eyewitness and reliable chronicler, reports on the rapid development and the economic prosperity of this bustling city.¹ During the years that Diversis spent in Dubrovnik, the whole city was an enormous construction site...

  10. 2 The Plague Phenomenon and Plague Epidemics in Dubrovnik
    (pp. 42-67)

    Plague pandemics are ranked as the worst catastrophes to ever strike humanity. They appeared cyclically over many centuries and claimed millions of lives in Asia, the Middle East, the Mediterranean, and Europe. The appearance of plague had wide-ranging political, social, and economic consequences. Many historians consider that the first plague pandemic in the sixth century brought about the end of late antiquity.¹ Mirko Dražen Grmek argues that plague mortality may have left a demographic void in Dalmatia that was filled by the Slavs.² The second plague pandemic, later named the Black Death, was particularly virulent.³ Between 1347 and 1350, it...

  11. 3 Health Culture: Pharmacies, Hospitals, Physicians, and Surgeons
    (pp. 68-104)

    In Dubrovnik, various institutions provided health care. Monasteries and their pharmacies offered it in the name of Christian solidarity. Religious confraternities also played a minor role but most of the health care was financed and organized by the government. The state established and funded the hospital. It also hired and paid for medical men who took care of all the citizens without any extra pay. Throughout its history, Dubrovnik was known for the state promotion of health care for all citizens.¹ This chapter discusses various sources of health care but it focuses on physicians and surgeons employed in Dubrovnik between...

  12. 4 Founding and Development of the Health Office, 1390–1482
    (pp. 105-137)

    This chapter examines the development of plague control measures from 1377 to 1482. The chronological evolution of the plague legislation reveals that, gradually, during each new plague epidemic, more complex regulations, dealing with a large variety of issues, were promulgated. Thus, each plague outbreak represented a new milestone in fighting the epidemics and every time strict and more repressive measures were adopted. The 1390 addition of plague control officials to enforce and implement the quarantine legislation promulgated in 1377 constitutes the most important development in this period. Another milestone was reached in 1397 when the regulation, which prescribes the elections...

  13. 5 Control of Arrivals in Dubrovnik, 1500—1530
    (pp. 138-161)

    The sixteenth century was a troubled time in the Adriatic region. Since the Ottomans conquered Constantinople in 1453, their intention was to occupy all of Italy as a steppingstone to the rest of Europe. With this in mind, after having occupied the Balkans, the Ottomans invaded the easternmost Italian city of Otranto in 1480 and continued to deprive the Venetians of their possessions in the Aegean. At the same time, the Venetian maritime empire was threatened by the discovery of the New World and by the Portuguese finding a route to the Far East around the Cape of Good Hope.¹...

  14. 6 The Disastrous Plague Epidemic of 1526–27
    (pp. 162-182)

    Donato Muzi, a physician from Venice, was in his first year of service in Dubrovnik when he was called to examine a young female patrician who had high fever. He lingered at her bedside and suddenly noticed right in front of his eyes two buboes typical of plague developing on her body. He fled quickly, persuaded that his patient was doomed. Honouring his professional duty, before returning home, Muzi informed the Ragusan authorities about his diagnosis of plague. Soon he noticed the same symptoms on himself. He had high fever, a headache, and buboes in the femoral area of his...

  15. 7 Plague Survivors as Plague Workers
    (pp. 183-197)

    When the surviving councillors returned to Dubrovnik on 16 June 1527, the special plague control measures prescribed by the Senate were still in force. Armed squads of patricians and commoners still kept guard in the city. For each office, the Senate instituted a schedule of calls of duty by a draw. According to the number of members in each Council, each quorum was divided into four groups. Each group was on call for one week and, during that time, all the members of that group had to remain in the city, day and night. Considering the extraordinary conditions under which...

  16. 8 The Health Officials and the Patricians
    (pp. 198-212)

    Suspected plague carriers and plague sufferers quite understandably feared being sent by force to a quarantine compound – an isolated and very uncomfortable place – where they would share their destiny with the dying and the rare lucky individuals who had survived plague. They all faced this prospect with apprehension, knowing that it would mean being separated from their loved ones and taken away from their homes where they could at least expect some security, protection, and care. As we discovered in the previous chapter, plague control measures were not applied equally to citizens of all social classes. Patricians, wealthy commoners, members...

  17. 9 Concealing Symptoms of Plague, Importing Suspicious Goods, and Other Offences
    (pp. 213-228)

    The most common breaches of plague control measures were concealment of the symptoms of plague as they occurred amongst family or household members and failure to disclose the disease until death ensued. Although seemingly harmless, these offences resulted in the continued spreading of the disease. Such cases appeared from the very beginning of the 1527 epidemic. The health officials deserve credit for observing this phenomenon early and for trying to put a stop to it. Judging by the number of cases that were revealed and processed, it is clear that it was a matter of serious concern for the authorities....

  18. Conclusion
    (pp. 229-238)

    In 1377, the aristocratic city-state of Dubrovnik, situated on the Dalmatian Adriatic coast of present-day Croatia, became the first government in the world to formulate, develop, and apply the concept of quarantine. This legislation, which proposes a novel approach to plague, including the concepts of incubation and healthy carriers, demonstrates that the Ragusan Major Council believed that plague was a communicable disease. It was predicated on the idea that the government was justified in controlling the space and the movement of the few in the interest of the common good.

    In 1390, Dubrovnik established the earliest recorded Health Office, an...

  19. APPENDIX A The State Archives of Dubrovnik
    (pp. 241-245)
  20. APPENDIX B Diversis on the Import and Export Trade in Dubrovnik
    (pp. 246-247)
  21. APPENDIX C The Testament of Angelo de Leticia
    (pp. 248-254)
  22. [Illustrations]
    (pp. 255-260)
  23. Notes
    (pp. 261-316)
  24. References
    (pp. 317-346)
  25. Index
    (pp. 347-362)