Intro
Welcome to another episode of death and suffering.
Last time we mostly talked about what the plague is, and what people of the time thought the plague was. This time we’ll talk about what the Venetians did, based on their knowledge and beliefs of the plague.
Links
Transcript
The plague arrived in Venice in 1347 or 1348, by ship from the east. Over the following couple of years it killed tens of thousands, in a city of maybe a hundred thousand.
As often with the Middle Ages, details are lacking, but we can be quite certain that the Venetians did everything imaginable and unimaginable to stop it. Whatever they did, it failed. They found no functioning cure or remedy for the plague. In fact, no such cure or remedy would be found before the discovery of antibiotics in the 1900s.
What the Republic of Venice did do, was what it almost always did when faced with a crisis.
The Maggior Consiglio — the Greater Council which was the sovereign body of the republic — or the Pregadi — the Venetian Senate elected by the Greater Council — met, debated, cast their ballots, and elected three esteemed noblemen to lead the response to the emergency.
They were titled provvisori alla Sanità — superintendents of health.
This was very much standard procedure for the Republic of Venice. Faced with a crisis, the nobility met, discussed what to do, took a decision, and then delegated authority to a small group of sages to enact what had been decided. Such a group often consisted of three noblemen, but it could be any number. They often served for a term of twelve months, but that too could be any suitable period.
The power delegated was usually both executive, legislative and judicial because that division of power, which we take for granted, is an idea much younger than the Republic of Venice.
If, at the end of the term, the problem wasn’t solved, another group of noblemen would take over.
If the problem persisted for a long time, such provisional, short-term appointments could grow into permanent — and sometimes long-lived — institutions of the republic.
The three sages chosen in 1348 would over time become the venerable Magistrato alla Sanità — a kind of ministry for public health — formally instituted in 1485, but in reality it had existed in a provisional form for much of the preceding century.
What exactly did the first three Superintendents of Health do?
We don’t know for sure.
They were in the middle of a major disaster, and they probably had other things on their mind, than leaving a paper trail for posterity.
We can, however, be fairly sure that their main concerns were to dispose of the dead, limit the spread of the disease and maintain the social and political order.
The importance of burying the dead was not just a matter of tradition, decency and religion. It was an all-important matter of protection against the disease.
If the many dead weren’t buried quickly, the corpses would decompose, and start to smell. This would, in their world-view, cause disease by itself. The smelling, rotting cadavers would produce new miasma, and therefore more contagion. Not burying the dead immediately would make the crisis much worse.
The sheer number of dead to be buried made this an essential task for the survival of the city.
Still based on the concept of miasma, they likely had large bonfires lit in the campi of the city, to fill the houses and alleyways with smoke with a pleasant smell, as a means of removing the miasma.
None of this had any discernable effect on the course of the epidemic. The plague burned through the city, until it could find no new victims to infect. The epidemic only ended when it ran out of victims.
As the numbers of daily deaths started to dwindle, the survivors must have started to hope that it was over.
From hundreds of dead each day, it became tens of dead, and then single digits.
It was over. They had made it.
And they had no reason not to believe it was over.
We know in hindsight that it would last another three centuries and a bit, but there was no way the people back then could know that.
Successive waves
The plague returned in 1361. And the whole nightmare repeated.
The republic appointed three new Provveditori alla Sanità, who tried their best to ensure the dead were disposed of, bonfires lit, and the social order maintained as much as possible.
But then the plague returned in 1371, and again in 1374 for good disorder.
It was not going away, but then, maybe it was?
Fifteen years passed without another disaster, but in 1390 the plague came back anyway.
It wasn’t over. Would it ever be?
Meanwhile, the population was down to half of what it had been before the plague. Fields were left untilled, workshops stood empty, ships couldn’t depart lacking sufficient crew.
Society was coming apart at the seams, and the economy was grinding to a halt.
Lockdown or not
When rumours arrived in Venice in the year 1400, that there was a plague outbreak in the Republic of Ragusa down the Adriatic Sea (that’s modern-day Dubrovnik), the Maggior Consiglio decided to ban all ships from Ragusa to Venice.
Until then, all effort had gone into managing and alleviating the inevitable outbreaks.
The decision of 1400 is the first case of Venice trying actively to avoid the arrival of the plague, rather than just trying to manage it once it had arrived.
It is all the more important because the Venetians had realised that the plague arrived on the same ships which formed the basis of their wealth.
The dilemma was to stop the ships to avoid the contagion, but suffer the economic consequences, or let the ships travel freely, and risk the plague destroying their society.
It is not unlike the discussions we had around Covid. Do we stop the flights to block the disease, accepting the subsequent economic damage, or do we let people travel, so business can continue as usual, only to see people die in droves?
Money or people?
In any case, the ban on ships from Ragusa didn’t work. The plague arrived anyway, and Venice suffered yet another bloodletting, which it could hardly afford.
The early lessons
From all this, it appears that the Venetians learned a few lessons during the first half century of the plague.
Firstly, they realised that the plague was not going away by itself. Whatever they did, it kept coming back. There was no easy win.
Secondly, there was no cure or remedy, not at the individual level, nor at a societal level. If a person got the plague, there was little anybody could do to help. If the plague entered a populous city, there was little anybody could do to stop it from spreading.
Thirdly, the plague spared no-one. Noble birth or wealth was of no help in front the plague. In 1382, newly elected doge Michele Morosini died of the plague, just a few months after his election. Later, in 1438, doge Francesco Foscari lost four sons to the plague.
Lastly, the demographic collapse — the halving of the population in half a century — had made the crisis existential. If the plague kept coming back with the same frequency and with the same severity, Venetian society wouldn’t survive.
Something had to be done.
The first lazzaretto
Venice, however, got a bit of a respite.
It wasn’t until 1423 — almost a quarter of a century, that is, a generation later — that the plague returned to the city.
Three sages were appointed, as always, and the nightwatchmen of the city were instructed to report the number of deaths in each sestiere each night.
Later that same year, the Venetian Senate decided to create a hospital for the plague stricken.
Now, we associate the word ‘hospital’ with cures and treatment, but the origin of the word is different. It was a place which offered hospitality to a specific group.
Venice was full of hospitals for all sorts of people: homeless women, single mothers, for the infirm, those with disabilities who couldn’t work, and so on. They were, in short, charities to help the needy.
Given the nature of the plague, the choice of location logically fell on an island.
In most Italian languages, an island is isola, and being confined to an island was isolamento. The word ‘isolation’ literally means being confined to an island.
As an aside, the word ‘insulation’ has the same origin, but here from the Latin word for island, which is insula.
The island the Venetian Senate chose for the hospital, housed a small monastery dedicated to St Mary of Nazareth — Santa Maria di Nazareth — which was also the name of the island.
That’s a rather long name — L’isola di Santa Maria di Nazareth — and people back then were no less lazy than we are, so the name was often shortened to just Nazaretum.
The island is located about 3km south-east of Venice, close to the Lido, and adjacent to the island of St Lazarus — which today is called San Lazzaro degli Armeni.
That island also had a hospital — a leper colony.
The similar functions of the two islands led to name mix-ups, and within a short time, Nazaretum regularly became Lazaretum, which is the origin of the word lazzaretto and ‘lazaret’.
What did the Venetian Senate hope to achieve here?
They wanted the sick removed from the city.
After at least seven epidemics over seven decades — and countless deaths — there was little doubt the contagion spread from person to person. Hence, isolation of the sick on an island.
Initially, however, the place was rather small.
Many of the documents from the early years of the Lazzaretto are still in the archives. From these, we find that the first priore — manager — was a physician named Anzolo, who received 120 ducats annually for his work. From this amount, he had to pay two women for cooking and cleaning, and a boatman.
He was also given twelve beds, with feathers and bed linen, and cauldrons, pots, tripods and buckets for cooking and cleaning, along with all the necessary utensils, and a new boat, complete with mast, sail and oars.
From these humble beginnings in 1423, grew a sanitary facility, which would operate for over three centuries, and revolutionise how states and cities handled the plague.
The citizens of Venice started donating and bequeathing money to the hospital, just like they did with the other charities in the city, and half a century later, in the 1470s and 1480s, documents mention hundreds of patients on the island.
More lessons
Isolating the visibly sick had a positive effect, as it obviously reduced the spread of the contagion.
It wasn’t sufficient to stop the plague, though.
However, having many of the infected in the same place, and being able to talk to the survivors — and half or more of the plague stricken survived — led to more knowledge about the disease.
The Venetians realised that persons could transmit the disease in a period before they became visibly sick.
This is — as we know very well — the incubation period of the infection, which for yersinia pestis is between two and seven days.
They also realised that the plague could spread through objects.
People, who used the clothes of the diseased, or slept in their bed, but without any direct contact with the infected persons, could get the disease anyway.
Such behaviour might seem odd or negligent for us, but their world was different from ours.
The industrial revolution made fabric very cheap, and consequently, we all have wardrobes worthy of a pre-industrial king or queen.
Before the industrial revolution, fabric, clothes and bed linen were all entirely hand-made, and they were therefore much more expensive. It wasn’t unusual that a person’s clothes were the most valuable thing they possessed.
Therefore, when a person died, their clothes and bed linen were often sold or reused.
That apparently healthy persons could spread the disease, and that objects could too, were, at the time, new discoveries.
They showed the limits of just having a hospital for the visibly sick, and they made the problem of containing the contagion much more difficult.
Quarantine
The Venetians knew very well the contagion mostly arrived with the ships.
A typical merchant ship of the period, a carrack or a galleon, easily had a crew of fifty, and could carry up to a hundred tonnes of cargo.
Any ship with the plague on board, or simply from a known infected harbour, was suspect, even if there were nobody sick on board when it arrived in the lagoon.
The persons would have to be kept separate from the rest of the population, until it was seen that they didn’t get sick.
Likewise, the entire cargo of the ship was suspect too,
The suspect persons, and the suspect cargo, couldn’t go to the Lazzaretto because then they would get sick.
A second island was needed, not for the sick, but for quarantining the persons and the merchandise, which was suspect of carrying the contagion.
The Lazzaretto Nuovo
The search for that second island started in 1456, when three noblemen were charged with finding a suitable place.
When another wave of the plague arrived in 1468, the process was accelerated, and the choice fell on a small island, just inside the lagoon, on a major canal behind the Lido di Sant’Erasmo.
The location was chosen because it would be easy to divert ships entering the lagoon at San Nicolò.
The island didn’t really have a name, and it just appears in early documents as the Vigna Murada — a walled vineyard — which belonged to the monks of San Giorgio Maggiore. The only residents were the few monks who tended to the vines. It already had a walled enclosure, and a few rooms.
The denomination soon changed to Lazzaretto Nuovo, and the first Lazzaretto got the addition Vecchio to distinguish the two. These are still the names of the two islands today.
While hospitals on islands for the sick weren’t a novelty in the 1400s, a permanent state run quarantine station was. The Lazzaretto Nuovo was where the systematic quarantining of persons and goods, using permanent structures, was organised for the first time.
From the rather simple structure inherited from the monks, the Lazzaretto Nuovo grew over the next century, and it became an essential part of the protection of Venice from the plague.
Just like with the Lazzaretto Vecchio, the early period of the Lazzaretto Nuovo was quite fluid and dynamic. The Venetians didn’t have anywhere to look to see how to do things, so they had to figure it out themselves.
Over time, however, it developed an articulated structure.
A walled enclosure of some two hundred metres by two hundred metres, internally subdivided by tall walls without doors or windows, into nine or ten separate compartments.
Each compartment, called a contumacia (which means isolation), had one entrance towards the outside. There was no internal communication between the compartments, and there were no windows towards the outside.
The compartments on three sides, six or seven of them, forming a horse-shoe, had rooms in two storeys along the external walls, some half-roofs along the internal walls, access to water and to a place for people’s bodily needs.
These were compartments for people in quarantine.
Three larger compartments, mostly in the middle of the island, were destined for goods. They only had sleeping quarters for the dozen or so workers employed for the cleansing of the merchandise.
The suspect ships, without crew and with the cargo unloaded, were kept at anchor in the canals around the island.
The quarantine period was never specified. Generally, the documents only state that nobody could leave the islands without the permission of the magistrates. In practice, periods of some thirty, forty, fifty days were common, and at times even longer.
The common average came out around forty-ish, which in Venetian (and Italian) is a quarantina. Hence, the term quarantine.
This word was, however, never used within the Magistrato alla Salute or in the lazzaretti. The term used there was always contumacia — isolation.
The quarantine period for goods seems to have been around two months, during which the merchandise went through a series of treatments to eliminate any miasma present.
Such treatments included washing in cold, hot or salty water, exposure to the sun and the winds, soaking in vinegar, and treatment with ashes, depending on the nature of the merchandise.
Soon, detailed protocols were devised regulating and formalising the cleansing process for each type of goods.
The Magistrato alla Salute
The Republic of Venice usually, when there was an urgent task to see to, appointed a small group of noblemen for it. There were no fixed rules, but very often there were three, appointed for a term of one year, but both the size of the college and the period they served, could vary.
When the plague struck the first time in 1348, this was what the republic did. Three noblemen were given one year to do what was necessary to handle the crisis.
As long as the immediate crisis lasted, three such magistrates were appointed each year.
When the crisis ended, the appointments simply weren’t renewed any more.
It was a dynamic and agile system, which served the Venetian republic well for many centuries.
When the Venetians realised that the plague kept returning, that the crisis was never really over, focus changed to prevention. The appointments became more regular, each year, as they had to keep their guard up, even if there was no immediate danger.
With the creation of the first Lazzaretto there were also questions of budget, accounting, payroll, maintenance, and checks and balances on spending and operation. With a permanent structure came permanent bureaucracy.
The second lazzaretto added to this administrative burden.
However, it was only in 1478, that the Pregadi (the Senate) created a provisional Magistrato alla Sanità as a substitute for the ad hoc appointments of magistrates, which at that time had been going on for a century.
This state office was formalised as a permanent part of the republic in 1485, the same year the doge Giovanni Mocenigo succumbed to the plague. His wife, Taddea Michiel, had died of the disease six years earlier.
The plague spared no-one.
The primary task of the Magistrato alla Sanità was prevention — to avoid that the male contagioso — the contagious evil — entered the city of Venice.
All their experience showed, that if the plague entered the city — and all that was needed was one infected individual — there was nothing they could do, and tens of thousands would die.
Efficient prevention requires good information.
One of the main tasks of the Magistrato alla Sanità was therefore to keep track of where there were outbreaks of the plague, so ships from those harbours could be prevented from coming to Venice, or intercepted and taken to the Lazzaretto Nuovo.
A network of informants, placed in all the main harbours in the Mediterranean, regularly reported back to the magistrates in Venice, so they could keep track of the danger.
It became a sanitary intelligence gathering service.
It worked
More lazzaretti were created, further away from Venice, to intercept and block the contagion before it could arrive in the lagoon. All the major cities on the mainland had a lazzaretto built outside the city walls, and many others were established in harbours and on islands under Venetian control, further south in the Adriatic Sea.
While the lazzaretti on the Venetian mainland were often permanent structures, like the two lazzaretti in the lagoon, the facilities in the overseas dominions were usually more ad hoc, put up and taken down as need arose and waned.
In some cases, like on the island of Corfu, the quarantine area was not on land, but at sea. A bay close to the harbour area served as porto di contumacia — isolation harbour — where suspect ships were kept apart from the others, until they were deemed safe.
This multipronged system worked.
The combination of systematically isolating the sick, quarantining the suspect, and keeping track of the plague before it arrived in Venice, proved an efficient way of controlling the plague.
Now, the plague never disappeared.
What the Venetians succeeded in doing, wasn’t to eliminate the plague. What they did achieve, was to mostly govern the plague.
The contagion circulated in all of Europe and in all the Mediterranean, and there were regularly cases around, also occasionally in the city, but the Venetians managed to avoid major outbreaks in the densely populated city.
The weak side
There was a weakness to the protective system the Venetians had created.
It was almost entirely focused on avoiding and intercepting any contagion arriving by sea.
This was where the plague mostly came from in the late 1300s and early 1400s, but as the disease became endemic in all of Europe, cases could just as well arrive from the mainland, as from the sea.
In terms of stopping the plague from arriving by sea, the lazzaretti and the Magistrato alla Sanità were very successful.
Once all the parts of the system were in place in the late 1400s, there were no further epidemics in Venice, arriving by ship from the east.
In fact, while the plague was endemic in the late 1300s with a major epidemic roughly every decade, during the 1400s they gradually became rarer.
During the 1500s, there was only one major epidemic in Venice, and it arrived from the mainland.
In the 1600s too, there was only one uncontrollable outbreak, and that too arrived from the mainland.
For all the 1700s, Venice was spared.
This is a remarkable success story in the fight against a disease, which the people of the time didn’t understand, and against which they had no remedies, and yet they managed to create working defences.
Next episode
The next episode will be about the 1500s, 1600s and 1700s.
We’ll talk more about how the lazzaretti actually worked, about the two remaining major outbreaks of 1575 to 1577 in Venice, and 1630 in Verona and Venice, about how the plague waned in the 1700s, and the Lazzaretto Nuovissimo and the last cases of plague in 1793, shortly before the fall of the Republic.
Time permitting, or in an additional episode, I’ll also cover the later development of the three lazzaretto islands, and we still have to prosecute the case against the mythical plague doctor.
There’s still some road to cover before this ordeal is over.
Leave a Reply