Nearly 700 years ago, overwhelmed doctors and health officials battling a devastating epidemic of bubonic plague in medieval Italy had no idea of viruses or bacteria, but they understood enough about the black plague. to implement some of the world’s first anti-contagion measures.
From 1348, shortly after the arrival of the plague in cities like Venice and Milan, the municipal authorities implemented emergency public health measures which foreshadowed the best current practices of social distancing and surface disinfection .
“They knew you had to be very careful with the goods traded, as the disease could spread to objects and surfaces, and that you were doing your best to limit interpersonal contact,” says Jane Stevens Crawshaw, a lecturer in modern European history at the University of Oxford Brookes.
Italian fresco of the 14th century plague, taken from the Stories of Saint Nicholas of Tolentino.
DeAgostini / Getty Images
The first quarantine
The Adriatic port city of Ragusa (modern Dubrovnik) was the first to adopt legislation requiring mandatory quarantine of all commercial ships and caravans in order to screen for infections.
The ordinance, which miraculously survived in the Dubrovnik archives, states that on July 27, 1377, the Grand City Council passed a law “which states that those who come from plague-infested areas must not enter [Ragusa] or its neighborhood, unless they spend a month on the islet of Mrkan or in the town of Cavtat, for disinfection purposes. “
Mrkan was an uninhabited rocky island south of the city and Cavtat was located at the end of the caravan route used by land traders en route to Ragusa, writes Zlata Blazina Tomic in Expel the plague: the health office and the implementation of quarantine in Dubrovnik, 1377-1533.
Tomic says that some medical historians consider the Ragusa quarantine edict to be one of the greatest achievements of medieval medicine. By ordering the isolation of healthy sailors and traders for 30 days, Ragusan officials have shown remarkable understanding of the incubation periods. The new arrivals may not have had symptoms of the plague, but they would be detained long enough to determine if they were actually free from the disease.
Middle Ages. & nbsp; A slow-growing bacterial disease that causes sores and deformities, leprosy was considered a punishment from God who ran in families. & nbsp;
“data-full-height =” 1594 “data-full-src =” https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcxNDE0NTQyNzEyMypr -1150947013.jpg “data-full-width =” 2000 “data-image-id =” ci0260fc9f700027ee “data-image-slug =” 11-Century-Leprosy-GettyImages-1150947013 “data-public-id =” MTcxNDE0NTQyNzE3Mjk4MzU1 “data -source-name = “From Agostini / Getty Images” data-title = “Leprosy, 11th Century” /> Social distancing and quarantine were used in medieval times to fight against the black plague
Learn more: & nbsp;When London faced a pandemic – and a devastating fire& nbsp;
“data-full-height =” 1417 “data-full-src =” https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTYyMjk2ODg3MTA0MjUpgMxxx -width = “2000” data-image-id = “ci0240982900002579” data-image-slug = “GettyImages-51241529” data-public-id = “MTYyMjk2ODg3MTA0MjUxMjU3” data-source-name = “Hulton Archive / Getty Images” data- title = “The Great Plague in London, 1665” /> cholera Pandemics Over the next 150 years, this wave of small intestine infection started in Russia, where one million people died. Spread in fecal-infected water and food, the bacteria was transmitted to British soldiers who brought it to India where millions more died. & Nbsp;
“data-full-height =” 1312 “data-full-src =” https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcxNDE0NTQyNzE8M815-348. jpg “data-full-width =” 1535 “data-image-id =” ci0260fc9e700027ee “data-image-slug =” 1817-Cholera-GettyImages-959158348 “data-public-id =” MTcxNDE0NTQyNzE3Mjk4Njcw “source-name =” Photo 12 / Universal Images Group / Getty Images “data-title =” Choléra, 1817 “/> The Russian flu of 1889: the deadly pandemic that few Americans have taken seriously
“data-full-height =” 1200 “data-full-src =” https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcxMzQ0MjM5NDcxMcc mapj.pg -full-width = “1766” data-image-id = “ci0260bcadb00026b3” data-image-slug = “Russian flu map” data-public-id = “MTcxMzQ0MjM5NDcxMzcxOTU1” data-source-name = “National Library of Medicine “data-title =” Russian flu, 1889 “/> 1918 flu was first observed in Europe, the United States and parts of Asia before spreading worldwide. At the time, there was no effective drug or vaccine to treat this killer flu strain. & Nbsp;
“data-full-height =” 1080 “data-full-src =” https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcwNDE4NjYzNTUwMTY8 flu -32images .jpg “data-full-width =” 1920 “data-image-id =” ci025d72df3000271c “data-image-slug =” 1918-Spanish-Flu-GettyImages-520830329 “data-public-id =” MTcwNDE4NjYzNTUwMTY2NzE4 “data-source -name = “Universal History Archive / Universal Images Group / Getty Images” data-title = “Spanish Flu, 1918” /> How the 1957 flu pandemic was stopped early on its way
“data-full-height =” 1920 “data-full-src =” https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcxMjA2MzAzOTEyMz4377 Images “data-full-width =” 1486 “data-image-id =” ci02603f3a300026b3 “data-image-slug =” Flu-Virus-GettyImages-500437723 “data-public-id =” MTcxMjA2MzAzOTEyMzA2MzU1 “data source-name =” Ed Clark / The LIFE Picture Collection / Getty Images “data-title =” Asiatic flu, 1957 “/> AIDS destroys a person’s immune system, resulting in the possible death of diseases that the body would usually fight. & nbsp; AIDS was first observed in American gay communities, but it is believed to have developed from a West African chimpanzee virus in the 1920s. & Nbsp; Treatments have been developed to slow the progression of the disease, but 35 million people have died of AIDS since its discovery
The 30-day period stipulated in the quarantine order of 1377 was known in Italian trentino, but Stevens Crawshaw said that doctors and civil servants also had the power to impose shorter or longer stays. The English word “quarantine” is a direct descendant of quarantino, the Italian word for a period of 40 days.
Why 40 days? Health officials may have prescribed 40 days because this number had great symbolic and religious significance for medieval Christians. When God flooded the Earth, it rained for 40 days and 40 nights, and Jesus fasted in the desert for 40 days.
Stevens Crawshaw says that even before the plague arrived, the biblical notion of a 40-day cleansing period had transposed into health practices. After delivery, for example, a new mother had to rest for 40 days.
Even with the new quarantine law, Ragusa continued to be hard hit by outbreaks of aftershocks in 1391 and 1397. As a maritime city that survived the trade, it would have been impossible to completely isolate Ragusa disease without draining the economy.
But even if the quarantine measures did not fully protect the Ragusans from the disease, Stevens Crawshaw believes that the laws may have served another purpose: to restore order.
“There are risks with any kind of epidemic of social breakdown, generalized panic or complacency, which can be just as dangerous,” says Stevens Crawshaw. “There are many emotions that must be recognized and anticipated and which were part of public health policy 600 years ago as much as today.”
The plague of Florence in the 14th century, as described by Giovanni Boccaccio.
Bettmann Archives / Getty Images
Ragusa also built the first plague hospital
Quarantine was not the only tool in Europe’s current battle against the plague, which would periodically ravage the continent until the 17th century. Ragusa was also the first city to set up a temporary plague hospital on another island called Mljet. This new type of publicly funded treatment center would soon become known throughout Europe as lazaretto.
Stevens Crawshaw, who has written a book on plague hospitals, says the name lazaretto is a corruption of the word Nazaretto, nickname of the lagoon island on which Venice built its first permanent plague hospital, Santa Maria di Nazareth.
the lazaretto fulfilled two functions: medical treatment center and quarantine center. It was a means of caring compassionately for new arrivals and local citizens who fell ill with the plague while keeping them isolated from the healthy. AT lazaretto, plague-infected patients would receive fresh food, clean bedding and other health-promoting treatments, all paid for by the state.
“This is a fairly remarkable public health structure in which the government has to invest huge sums of money,” says Stevens Crawshaw. “Whether or not there is a plague in Venice, these hospitals are permanently staffed, ready and waiting for ships that might be suspected of carrying an infectious disease.”