Quarantine

Of all the means by which in modern times the infection of that dangerous malady, the plague, has been so much guarded against, that according to general opinion, unless the Deity render all precaution useless, it can never again become common in Europe, the most excellent and the most effectual is, without doubt, the establishment of quarantine 1124. Had not history been more employed in transmitting to posterity the crimes of princes, and particularly the greatest of them, destructive wars, than in recording the introduction of such institutions as contribute to the convenience, peace, health and happiness of mankind, the origin of this beneficial regulation would be less obscure than it is at present. At any rate, I have never yet been so fortunate as to obtain a satisfactory account of it; but though I am well-aware that I am neither acquainted with all the sources from which it is to be drawn, nor have examined all those which are known to me, I will venture to lay before my readers what information I have been able to collect on the subject, assuring them at the same time, that it will afford me great pleasure if my attempt should induce others fond of historical research to enlarge it.

The opinion that the plague was brought to Europe from the East, is, as far as I am able to judge, so fully confirmed, that it cannot be any longer doubted; though it is certainly true, that every nation endeavours to trace the origin of infectious disorders to other people. The Turks think that the plague came to them from Egypt; the inhabitants of that country imagine that they received it from Ethiopia; and perhaps the Ethiopians do not believe that this dreadful scourge originated among them 1125. As the plague however has always been conveyed to us from the East, and has first, and most frequently, broken out in those parts of Europe which approach nearest to the Levant, both in their physical and political situation, those I mean which border on Turkey, and carry on with it the most extensive trade, we may with the more probability conjecture that these countries first established quarantine, the most powerful means of preventing that evil. If further search be made in regard to this idea, we shall be inclined to ascribe that service to the Venetians, a people who, when the plague began to be less common, not only carried on the greatest trade in the Levant, but had the misfortune to become always nearer neighbours to the victorious Turks. It is also probable that the Hungarians and Transylvanians soon followed their example in this approved precaution, as the Turks continued to approach them; and this agrees perfectly with everything I have read in history.

In the first centuries of the Christian æra, it does not seem to have been known that infection could be communicated by clothing and other things used by infected persons. The Christians all considered the plague as a divine punishment, or predestinated event, which it was as impossible to avoid as an earthquake; and the physicians ascribed the spreading of it to corrupted air, which could not be purified by human art. The Christians therefore gave themselves up, like the Turks at present, to an inactive and obstinate resignation in the will of God, and hoped by fasting and prayer to hasten the end of their misfortune.

But after the plague in the fourteenth century, which continued longer than any other, and extended over the greater part of Europe, the survivors found that it was possible to guard against or prevent infection; and governments then began to order establishments of all kinds to be formed against it. The oldest of which mention has yet been found in history, are those in Lombardy and Milan of the years 1374, 1383 and 1399 1126.

In the first-mentioned year the Visconte Bernabo made regulations, the object of which was to guard against the spreading of the plague by intercourse and mixing with those who were infected; and with that view it was ordered, that those afflicted with this disease should be removed from the city, and allowed either to die or to recover in the open air. Those who acted otherwise were to suffer capital punishment, and their property was to be confiscated. But twenty-five years after it was strictly commanded that the clothes and things used by those who had the plague should be purified with great care: and in 1383 it was forbidden under severe punishment to suffer any infected person to enter the country. These means, however imperfect, must have been attended with utility, because they were again employed during a new danger of the same kind in the fifteenth century.

Brownrigg, an Englishman, who wrote a book on the means of preventing the plague, says, that quarantine was first established by the Venetians in the year 1484 1127 , but like his learned countryman Mead, who assigns the same year, without adducing any proofs 1128. I imagined that I should find some more certain information respecting this point in Le Bret's History of the Republic of Venice; but as that historian does not mention, as the title professes, the original sources from which he derived his materials, his work is less worthy of credit. He tells us however that the grand council in 1348, chose three prudent persons, whom they ordered to investigate the best means for preserving health, and to lay the result of their inquiry before the council. The plague which broke out afterwards in 1478, rendered it necessary that some permanent means should be thought of, and on that account a peculiar magistracy consisting of three noblemen, with the title of sopra la sanità, was instituted in 1485. As these were not able to stop the progress of the disease, the painful office was imposed upon them, in 1504, of imprisoning people against whom complaints might be lodged, and even of putting them to death; and in 1585 it was declared, that from the sentence of these judges there should be no appeal. Their principal business was to inspect the lazarettos erected in certain places at some distance from the city, and in which it was required that all persons and merchandize coming from suspected parts should continue a stated time fixed by the laws. The captain of every ship was obliged also to show there the bill of health which he had brought along with him.

As Le Bret produces no proof that quarantine was established by the Venetians so early as he says, I cannot help suspecting that he is mistaken respecting the year (1348), and conjecture that it ought to be 1448, or perhaps 1484. I have not been able however to resolve my doubt; for, in examining different Italian writers, I find that various years are given 1129. The institution of the council of health (sopra la sanità) is mentioned by Bembo; but I cannot discover from him to what year he alludes 1130. His countryman Lancellotti, who undoubtedly must have understood him well, makes it to be 1491 1131. Caspar Contarenus, who died in 1542, in the sixtieth year of his age, mentions no particular period, and only says that the institution had been formed not long before his time 1132. The islands on which the pest-houses were erected, were called il Lazaretto vecchio  and il Lazaretto nuovo. In the elegant description of Venice, ornamented with abundance of plates, below mentioned, it is remarked that the pest-house on the former island was built in 1423, and that on the latter in 1468 1133. The same account is given in the newest and best Topography of Venice 1134.

The Venetians are entitled to the merit of having improved the establishments formed to prevent infection; and that their example was followed in other countries is generally admitted. But the year in which quarantine was first ordered by them to be performed is uncertain. Muratori 1135 , following Lorenzo Candio, gives the year 1484, and Howard 1136  says that the college of health was instituted in 1448.

Brownrigg affirms that letters of health, in which he confides more than in quarantine, were first written in 1665 by the consuls of the different commercial nations, but they are much older, for Zegata 1137  asserts that they were first established in 1527, when the plague again made its appearance in Europe.

This much is certain, that all these means against infection, which, though far from being perfect, have secured Europe from this misfortune, were not invented or proposed by physicians, but ordered by the police, contrary to their theory. The latter seem to have known, at an early period, the most dangerous causes of infection, and to have formed at a very great expense precautionary means, the observance of which was enforced under pain of the severest punishment.

Why the space of forty days was chosen as a proof I do not know. It arose no doubt from the doctrine of the physicians in regard to the critical days of many diseases. The fortieth day seems to have been considered as the last or extreme of all the critical days; on which subject many physicians appear to have entertained various astrological conceits 1138. On the Turkish frontiers this period was reduced under the emperor Joseph II. to twenty days 1139.

[With respect to the quarantine establishments in this country, M c  Culloch observes that they are exceedingly defective. Even in the Thames there is not a lazaretto where a ship from a suspected place may discharge her cargo and refit; so that she is detained, frequently at an enormous expense, during the whole period of quarantine, while if she have perishable goods on board, they may be very materially injured. The complaints as to the oppressiveness of quarantine regulations are almost wholly occasioned by the want of proper facilities for its performance. Were these afforded, the burdens it imposes would be rendered comparatively light.

The existing quarantine regulations are embodied in the act 6 George IV. c. 78, and the different orders in council issued under its authority. These orders specify what vessels are liable to perform quarantine, the places at which it is to be performed, and the various formalities and regulations to be complied with.]

Footnotes

1124  [This opinion is not generally admitted by the most experienced medical men in this country. It is a disputed point whether the plague is even  contagious; and the mass of evidence is in favour of its being so occasionally, but that the plague is usually not propagated in this manner. The disappearance of this pest from our own and most other countries of Europe is undoubtedly owing to the much greater attention paid to drainage, ventilation, and the prevention of the accumulation of filth in the streets, &c. When the peculiar atmospheric conditions upon which its diffusion depends are present, quarantine has proved insufficient to prevent its propagation.]

1125  The oldest plague of which we find any account in history, that so fully described by Thucydides, book ii., was expressly said to have come from Egypt. Evagrius in his Histor. Ecclesiast. iv. 29, and Procopius De Bello Persico, ii. 22, affirm also that the dreadful plague in the time of the emperor Justinian was likewise brought from Egypt. It is worthy of remark, that on both these occasions, the plague was traced even still further than Egypt; for Thucydides and the writers above-quoted say that the infection first broke out in Ethiopia, and spread thence into Egypt and other countries.

1126  They may be found in Muratori Scriptores Rerum Italic. tom. xvi. p. 560, and xviii. p. 82, thence copied into Chenot, p. 147. See also Boccacio, Decamer. Amst. 1679, p. 2.

1127  [“The Venetians seem to have been the first who established quarantine in their dominions about the year 1484, soon after the Turks became their neighbours in Europe; the constant intercourse which they maintained with those powerful neighbours, either in war or by commerce, rendering it necessary for them to take this and other precautions against the introduction of this contagion into their country.”]

1128  De Peste, in Mead's Opera Medica.

1129  Everything said by Le Bret on this subject may be found equally full in D. C. Tentori, Saggio sulla Storia Civile, &c., della Republica di Venezia. Ven. 1786, 8vo, t. vi. p. 391. As Sandi in his Principi di Storia Civile della Republica di Venezia, 9 vols. 4to, 1755–1769, gives the same account, lib. viii. cap. 8. art. 4, they must have both got their information from the same source.

1130  Historia Vinitiana. Vinegia, 1552, 4to, lib. i. p. 10.

1131  L'Hoggidi, overo il mondo non peggiore, ne più calamitoso del passato. Ven. 1627, 8vo, p. 610.

1132  De Republica Venetorum, lib. iv.

1133  Thesaurus Antiquitatum Italiæ, v. 2, p. 241.

1134  Topografia Veneta, overo Descrizione della Stato Veneto. Venezia, 1786, 8vo, iv. p. 263.

1135  Lib. i. cap. 11, p. 65.

1136  Account of the principal Lazarettos, Lond. 1789, 4to, p. 12.

1137  Cronica di Verona, in Verona, 1747, 4to, iii. p. 93.

1138  See G. W. Wedelii exercitatio de quadragesima medica, in his Centuria Exercitationum Medico-philologicarum. Jenæ, 1701, 4to, decas iv. p. 16. Wedel mentions various diseases in which Hippocrates determines the fortieth day to be critical. Compare Rieger in Hippocratis Aphoris. Hag. Com. 1767, 8vo, i. p. 221.

1139  Martini Lange Rudimenta Doctrinæ de Peste. Offenbachii 1791, 8vo. See Gottingische Anzeigen von gelehrt. Sachen, 1791, p. 1799.