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Golden Age of Piracy Maritime Quarantine For Plague, Page 9

Quarantine at the Mediterranean Lazarettos: Letters

Letters and other papers including money were considered potential vehicles for infection, so they also had to be treated before being released by Mediterranean lazarettos. Surgeon Samuel Sharp,
Letter Disinfected at Marseille Lazaretto (1741)
discussing the lazaretto in Venice in 1765, mentioned that if he visited a person who was serving quarantine and they were "to have handed over a news-paper to me, and we had been detected in the action, I must inevitably have performed quarantine in the Lazaretto"¹. Doctor Charles Savona-Ventura says that in the effort to combat the plague, "[p]ostal disinfection was practised in all the major European ports."²

When ships brought letters for those in a city, they were not even to be handled by the guardian who was assigned to the ship. John Howard explains that while visiting the lazaretto at Malta in the late 18th century, a "letter brought by a ship just arrived from Turkey, was, I saw, received with a pair of iron tongs"³. The 1695 Messina lazaretto instructions also order the use of long iron tongs⁴. French historian Daniel Panzac explains that "the papers of the ship and the mail brought by the ship are taken with the help of long tongs and dipped in a bucket of vinegar in Malta, Genoa and Marseilles or placed in a split shaft and treated with sulfur in Venice and Trieste."⁵ The instructions for the lazaretto at Trafine, across the estuary from Lisbon, Portugal similarly explain that the bills of lading were to be "first purified it, which he [the guardian] will do using a long reed, or rod open at the tip, and the letters, passports, and other papers will be put therein, and bathed in vinegar, and then smoked in a brazier with good fire which will wipe out contagion, without which treatment he will receive no paper of any kind from suspect parts."⁶

Howard explains that all letters were taken to a "room designated in Lazzaretto for this purpose, without touching them,
A Brazier, From Pierre Dionis, Cours d'Operations, Table xxxvi (1708)
using all precaution"⁷. Here they were to be either perfumed, bathed in scented smoke and/or vinegar. Medical historian Paul Cassar explains, "Arrangements for this procedure were already in existence in Malta by 1678 when letters were 'smoked' or 'perfumed' after being slit in a few places to allow the free entry of the fumes inside them."⁸ In Malta, "quarantine regulations issued by the Order of St. John in 1720 mention that Dispatches brought in by ships are not to be received unless they are first perfumed. The packet and letters are to be unpacked, disinfected by a double perfume, and left exposed to the action of the latter for twenty-four hours."⁹ Howard provides an even more detailed description of the process at Malta while he was touring the lazaretto. A case containing a letter was "dipped in vinegar, and then put into a case, and laid for about a quarter of an hour on wire grates, under which straw and Perfumes had been burnt: after which the case was opened, and the letter taken out by one of the directors of the office. And this is the usual method of receiving letters here."¹⁰

George Sandys (1621)
Other locations practised similar letter disinfection. Discussing his encounter with quarantine at the lazaretto in Zankythos, Greece in the early 17th century, George Sandys explained, "They will not suffer a Letter to be delivered, if sealed with thread, before it be opened and ayred."¹¹ William Biddolph visited Zante around the same time. He said that when letters were brought to merchants there "the Guardia[n] wil open them & aire them at the fire before he wil deliver them. But if the letter be sowed (or if there bee any thread about them) they must not be delivered untill they that brought them have Prattick."¹² (Letters were sown shut to prevent others from reading them. The presence of the infectible thread apparently changed the status of the letter to suspect, requiring it to undergo full quarantine.) Howard explains that letters received at Venice were treated similarly. There, the eldest guardian was "to receive, open, and perfume, or smoke, all letters that come by ships from suspected parts; and all captains, sailors or passengers, are strictly prohibited from keeping letters on board, or sending them ashore without this requisite formality at the health-office: they are afterwards sealed again, and distributed according to their directions."¹³

Even letters written by people serving quarantine were treated this way.
Man Delivering Letter, From Massager Boiteux, Almanac Cover (18th c.)
Howard says, that such letters "must be fumigated in the usual way by the guardian who superintends the [quarantine] apartment, then reached to the prior by means of a cane, or other stick split in the end for that purpose, and by him sometimes perfumed and sent away."¹⁴ The Messina lazaretto instructions explain that when letters were written by those in the lazaretto, "the Custodian will take the open, unfolded letters delivered, and after perfuming them in the above room, he will have the people close, and seal them" and then would have them delivered to the intended recipient.¹⁵

Attitudes about the opening and treatment of mail coming into a city varied. Dr. Sharp, who visited the Venice lazaretto in 1765, said "There is not the least connivance ever practised; all letters, to whomsoever directed, are first opened by the officers, and then smoaked before they are delivered."¹⁶ Jean-Jacques Rousseau, quarantined at Genoa, Italy in 1741, rather sourly commented, "I managed to send a letter saturated with vinegar, perfumed, and half-burnt" to the French ambassador, in an effort to have his quarantine reduced.¹⁷ Biddolph was even more suspicious of the letter-opening, complaining that it was done "under pretence of avoiding sicknesse: but they have a further meaning therein, viz. partly to get money and bribes; and partly to bee acquainted with the businesse of all commers, and what commodities they bring."¹⁸

¹ Samuel Sharp, Letters from Italy, 1766, p. 12; ² Charles Savona-Ventura, Knight Hospitaller Medicine in Malta [1530-1789], 2015, p. 49; ³ John Howard, An Account of the Principal Lazarettos In Europe, 1791, p. 8; ⁴ Instruzzioni e gouerno del lazzaretto di Messina per la scala franca,  1695, p. 19; ⁵ Daniel Panzac, Quarantines et Lazarets, 1986, p. 37 - interpreted by the author; ⁶ Eduardo Freire de Oliveira & Câmara Municipal de Lisboa, Elementos para a historia do municipio de Lisboa, Tomo X, 1899, p. 423, interpreted by the author; ⁷ Instruzzioni e gouerno del lazzaretto di Messina, p. 19; ⁸ Paul Cassar, A Tour of the Lazzaretto Buildings (Malta), 2004, p. 374; ⁹Savona-Ventura, p. 49-50; ¹⁰ Howard, p. 8; ¹¹ George Sandys, A relation of a iourney begun an dom 1610, 1652, p. 5; ¹² William Biddolph, The trauels of certaine Englishmen…, 1609, p. 6; ¹³ Howard, p. 17; ¹⁴ Howard, p. 15; ¹⁵ Instruzzioni e gouerno del lazzaretto di Messina..., p. 19; ¹⁶ Sharp, p. 12; ¹⁷ Jean Jacques Rousseau, The Confessions of Jean Jacques Rousseau, Citizen of Geneva, Part the Second, Volume 1, 1790, p. 46; ¹⁸ Biddolph, p. 6

Quarantine at Mediterranean Lazarettos - Doctors

Medical historian Carlo Cipolla says that Italian lazarettos had medical professionals on hand to treat those serving quarantine. and examine potential plague victims.¹ The lazarettos medical staff were "usually young physicians and surgeons with no established practices of their own. Their availability was closely linked to the creation of local medical colleges and surgical guilds in the greater urban centers."² These are actually the same type of surgeons who were volunteered to serve on ships. Because working in a lazaretto put the doctor at risk for infection, doctors with
Artist: William Hogarth
A Satiric Take on Physicians Arguing About Treatment,
From A Harlot's Progress, Plate 5, (1732)
established clientele typically had little interest in serving in such a dangerous and socially unacceptable capacity.

The largest Italian lazarettos had both surgeons and physicians on staff. Medical historian Guenter Risse says the Venice lazarettos had one or two physicians and three servants.³ Smaller lazarettos typically employed only a surgeon or two. "In the lazaretto at San Miniato in Florence, early in November 1630 there were two physicians and nine surgeons in addition to lay personnel of 134 people and 5 friars… Among others a female surgeon – Margarita di Giovanni Lombardi – was added to the staff to take care of female patients."⁴

Convincing physicians to serve in lazarettos was a challenge. Cipolla explains that

physicians, being people of high social standing and good economic condition, resisted [serving in lazarettos] more than others. ...In Rome during the plague of 1656-7 ‘high fees and special prizes were not enough to induce doctors to go and tend people in the pest-houses and they had to be compelled to do so by public authority.’ The physicians suggested that the patients ought to be cured at a distance, with the barber-surgeon of the lazaretto shouting out of the windows ‘the quality, sex, condition of the patient and the stage of the illness’. From a safe distance the doctor would shout back the cure.⁵

The difference in status of a physician and a doctor is clear in this passage. It is likely that even the physicians found in a lazaretto had little, if any, direct contact with the patients, instead leaving the surgeons to work with patients. Most of the physician's work was theoretical - diagnosing diseases and prescribing medicines based on the conclusions drawn from their diagnoses - while most of the surgeon's work was practical - performing operations, bloodletting or other physical tasks. As Cipolla explains, "physicians and surgeons came from and belonged to quite different social classes and in those days the value attributed to human life largely depended on class and social status."⁶ Yet, like sea surgeons, many lazaretto surgeons were knowledgeable enough to perform much of the physician's work. At small lazarettos where there was no physician on staff, the surgeon would have had to handle most, if not all, of the physician duties, contacting physicians outside the lazaretto when he was unsure how to handle a particular case.

Doctors in a lazaretto had two basic responsibilities: looking for signs of patients contracting bubonic plague and taking care of people who experienced these or any other health problems while serving quarantine. Both were important, although the first was of more interest to those in charge of the lazaretto.
Artist: John Dunstall - A Plague Hospital, From a Broadsheet (1665)
As Risse notes, "Medical professionals willing to work in lazarettos or visit the sick in their homes were primarily hired for their diagnostic skills."⁷ The whole point of serving quarantine was to be sure no signs of the illness they were trying to prevent occurred.

This is not to detract from the second responsibility - taking care of the health of those serving quarantine. As lazarettos were established at ports and kept open to deal with maritime traffic, hospitals were sometimes included as part of the structure to handle such health problems. Medical historian Charles Savona-Ventura says that beginning some time after 1681 in Malta, "a section of the Lazaretto, referred to as the Infermia, was formally set apart for the treatment of sick or injured individuals. This was under the jurisdiction of the barber surgeon and Assistant Physician."⁸ A surgeon would have performed most of the operations with the oversight of a physician. Speaking of the Venice lazaretto, John Howard explained that surgeons and physicians there "are consulted by the board in cases relating to their respective professions; they are also obliged in contagious emergencies to shut themselves up in the lazaretto to take care of the sick."⁹

Artist: Rembrandt
The Anatomy Lesson of Dr. Nicholaes Tulp (163`)
The 1695 Messina, Italy regulations mention both responsibilities while still making clear which of them was the most important. Physicians were sent to the lazaretto "to protect the public health with their recognition [of the plague], as also, so that the sick do not remain deprived of those remedies, & assitance as it is necessary"¹⁰. What is not clear from the Messina instructions is that either physicians or surgeons were resident in the lazaretto. The instructions say that when someone fell ill in the lazaretto during quarantine, a written description was to be given to the Custodian who would then make arrangements for a doctor to attend the ill. This was also true for those serving their quarantines on their ships.

The 1716 Marseille lazaretto rules specified that patients who arrived with the plague or contracted it while in quarantine were "to be treated by a surgeon that the Bureau of Health provides to him, the one already on board of their Ship being preferred... [and patients in quarantine also] will be visited once a day by the Surgeon of the Office, to provide the necessary remedies"¹¹. This does not suggest that a surgeon was posted in the lazaretto, one was only provided if the ship either did not have or could not provide a surgeon. Howard's 1789 map of the Lazaretto d'Arenc does not include quarters for medical men.

As already mentioned, medical professionals serving the lazaretto performed post-mortem examinations. John Howard says that at the Venice Lazaretto, "the bodies of those who die without any previous malady, are accurately examined by the Physician and surgeon immediately belonging to the office"¹². As when dealing with the sick, it is likely that the surgeons, not the physicians, performed the physical labor of the autopsy while the physician oversaw the process.

¹ Carlo M. Cipolla, Cristofano and the Plague, 1973, p. 25; ² Guenter B Risse, Seventeenth-Century Pest Houses or Lazarettos, Jan. 1999, p. 33; ³ Risse, p. 26; ⁴ Cipolla, p. 25; ⁵ Cipolla, p. 25-6; ⁶ Cipolla, p. 26; ⁷ Risse, p. 34; ⁸ John Howard, An Account of the Principal Lazarettos In Europe, 1791, p. 13; ⁹ Charles Savona-Ventura, Knight Hospitaller Medicine in Malta [1530-1789], 2015, p. 48-9; ¹⁰ Instruzzioni e gouerno del lazzaretto di Messina per la scala franca, 1695, p. 28 - Interpreted by the Author; ¹¹ Daniel Panzac, "Appendix 1: INSTRUCTION POUR LES INTENDANTS DE LA SANTE SUR LES USAGES & COUTUMES DU BUREAU", Quarantines et Lazarets, 1986, p. 135 - translated by the author; ¹² Howard, p. 13

Quarantine at Mediterranean Lazarettos - Cheating

Despite all the regulations that existed , cheating on the quarantine rules appears to have been rampant during the golden age of piracy. Scottish surgeon and naturalist Patrick Russell felt that this was due to the actions
Artist: Reinier Nooms - A Small Dutch Merchant Fluyt (late 17th century)
of men on "smaller vessels; of adventurers unacquainted with the customs of the country, who, under the necessity of making the most advantage of a voyage, which they probably never will repeat, consider every redaction or impediment to their despatch as an unreasonable or tyrannical exertion of the magistrate."¹ Russel goes on to note that the vessel's captains "are often strangers, bred in other service; not aware of the dangerous consequence of infractions, they are less vigilant in preventing them: and, not being dependent on the Company, they are less under control of a Consul, whose recommendation or disapprobation becomes a matter of little importance to their future prospects of service "²

Modern historian John Booker put the blame for cheating on the men in charge of the quarantine regulations. He explains that in 1662 and 1663, "[t]he Spanish, wishing to harass England, claimed there was plague at Tangier where they English were trading. Because of this, English ships were denied pratique in Spain, and then at Toulon [France]. Charles feared that the same might happen, disastrously, at ports like Leghorn [Livorno] and Genoa, and the Venetian ambassador was asked to persuade Italian rulers that Tangier was perfectly healthy."³ Writing in December of 1663,
Artist: John Hayls - Samuel Pepys (1666)
Samuel Pepys, Clerk of Acts to the Navy Board, said that pratique "is a thing that is now-a-days made use of only as a cheat, for a man may buy a bill of health for a piece of eight, and my enemy may agree with the Intendent of the Sante [Health] for ten pieces of eight or so; that he shall not give me a bill of health, and so spoil me in my design, whatever it be."⁴

Although Pepys had no direct personal experience of how things were done at sea, he was not alone in this view. After talking with some merchant sailors at Livorno in 1681, sailor Samuel Atkins of 4th rate frigate HMS Crown wrote a diatribe against the whims of pratique in his journal which is not much different in tone from that of Pepys.

They [merchant sailors] complaine of ye hardship put upon them for want of prattick [pratique], which they have for some parts of their lading, and are denyed it for others, and are at a great loss in their despatches, for want of being ashore to looke after their owne business with ye merchants, who 'tis agreed generally are assisting to keep them from it for their owne advantage. The whole businesse of the prattick seemes very ridiculous; and [the officials'] manner of conferring with you, allowing you some liberties in which there is equall or more danger of giving infection, (where it is,) and denying you others very strictly wherein there is apparently less. But it is a custom so long settled among, and of such advantage to these people, as 'twill be great indiscretion in them to part with it while they can keep it. For what is commonly said of other nations having greater priviledge in this matter than ours, appears a mistake, ffor that the French and Dutch (of whome here are now severall ships without it), are denyed it in the same manner wee [the navy] are, when the circumstances between us are alike.⁵

Artist: William Hogarth
Bribery, From An Election Entertainment (c. 1755)
Graft of the officials overseeing quarantine was specifically prohibited in Italy. According to the 1695 Instruzzioni e gouerno del lazzaretto di Messina, those caught participating in such activities or trading with vessels were to be fired, put in jail and fined.⁶ Writing about his time in a lazaretto in the late 18th century, John Howard explained that the prior at the Venice lazaretto "is strictly enjoined not to exact money, or any other consideration whatever from the passengers, by Way of recompense for his trouble or attendance, nor ought he even, (according to the laws) to accept of presents from passengers who perform quarantine, or from merchants whose goods are under his inspection"⁷. In addition, "He must neither buy nor sell, nor make bargains or contracts with passengers or others within the lazaretto, nor permit others to do so; neither are contracts of any kind, purchases or sales, nor even powers of attorney or other notorial acts allowed there, without express leave from the board; otherwise they are null and void."⁸

In addition to the lazaretto management, the guardians and porters who were in charge of overseeing the passengers and goods in quarantine were 'expressly forbidden' to accept any gift from those whom they attended, even if such things were given freely to them. The penalty for being caught accepting gifts was loss of their job, prohibition from taking any other job at the lazaretto and three years in jail.⁹ Howard explains that the guards and porters "are under the eye of the prior, and in cases of collusion or wilful neglect, they are punished severely and sometimes capitally."¹⁰

This doesn't mean that the lazaretto staff didn't receive money from those in quarantine. Howard says that, despite the rules in place, the prior "and his assistants expect a gratuity."¹¹ He also mentions that his guard "was very
Artist: Willem van de Velde the Younger (circa 1658)
cross till I made him an extra-allowance of a sequin [a gold Venetian coin] a week for provisions."¹² This was not limited to Italy. While at anchor in the harbor at Cadiz, Spain, Jean-Baptiste Labat matter-of-factly explains that when an official came up to their boat,

he saw that all looked in perfect health he said that he would hurry them up and we gave him a few reals [Spanish pieces of eight] to help him remember. Immediately after him came another officer to forbid us to trade or sell anything under pain of confiscation, and left four men in little boats to prevent us smuggling. Two of these spies moored their boats to our anchor chains, but they were made to move off and murmured against our lack of hospitality. We soon found means, however, to make them tractable, and each one received his price.¹³

For quarantine to be effective, the people under quarantine had to be isolated from those outside. This was not always appreciated by the locals. Writing of a journey taken in 1610, sailor George Sandys describes something that happened at the
Artist: Jan Peeter Verdussen
Merry Company Having a Picnic (early 18th)
Valetta lazaretto on Malta which he found so extraordinary that he thought he was imagining it at first. While waiting for his guard to bring him food, a small local boat (felucca) pulled up to the isthmus.

Out of which there stept two old women; the one made mee doubt whether she were so or no, she drew her face into so many forms, and with such antick gestures stared upon me. These two did spread a Turkie carpet [Turkish rug] on the rock, and on that a table-cloth, which they furnished with variety of the choysest viands. Another arrived; which set a Gallant [man] ashore with his two Amorosaes [attentive women], attired like Nymphs, with Lutes in their hands, full of disport and sorcery. For little would they suffer him to eat, but what he received with his mouth from their fingers. Sometimes the one would play on the lute, whilest the other sang, and laid his head in her lap; their false eyes looking upon him, as if their hearts were troubled with passions. The attending Hags had no small part in the Comedy, administring matter of mirth with their ridiculous moppings. Who indeed (as I after heard) were their mothers, born in Greece, and by them brought hither to trade amongst the unmarryed fraternity. At length the French Captain (for such he [the gallant] was, and of much regard) came and intreated mee to take a part of their banquet, which my stomach perswaded me to accept of. Hee willed them to make much of the Forestier, but they were not to be taught entertainment; and grew so familiar, as was not much to his liking. But both hee and they, in pity of my hard lodging, did offer to bring me into the City by night (an offence, that if known, is punished by death,) and back again in the morning.¹⁴

Such contact was expressly prohibited by the rules of quarantine. The 1695 Messina regulations even prohibited people from planting gardens or fishing near the lazaretto, "to avoid the danger caused by proximity to,
Artist: Antonio Visentini
Fishing Off Isola del Lazzaretto Nuovo, (1777) working and conversing with the people who are in Lazaretto."¹⁵ These rules were still in place when Howard served his quarantine in the latter half of the 18th century in Venice. Howard explains that the prior of the lazaretto "suffers no fishing boats, nor other small craft to come within a certain distance of the lazaretto, nor any communication between those in quarantine, and such boats."¹⁶

Locals occasionally ignored even the most stringent rules, sometimes to their detriment. Daniel Panzac sites judicial rulings against people who failed to observe the law about fishing and visiting the lazaretto in Marseilles during the golden age of piracy. "On December 4, 1699, Lebret, steward of Provence, ordered '... laying charges on fishermen who placed nets by the lazaretto and quarantine buildings incurring a two hundred pound fine...'"¹⁷. An order of August 22, 1726 prosecuted "several boatmen of the city of Marseilles who trespassed with their boats to the vicinity of the infirmaries or lazaret of the said city, where they bring people of all sexes and all ages to bathe or to swim and gather shells."¹⁸ The sailors were fined three hundred pounds and their boats were seized and burned for violating the rules.

Artist: Joos van Craesbeeck- Young Man Writing (1650)
One of the most blatant examples of a ship cheating on quarantine from this period comes from the journal of sea surgeon James Yonge. He was sailing on the 150 ton merchant ship Robert Bonaventure, which came into port in Genoa, Italy in the winter of 1664. Yonge explains that

we had no bill of health to certify the place not having the pest whence we came. Wherefore I set my wits and drew up one, as from a Governor of Newfoundland, and signed myself as Secretary. The seal was dominic plaster, hanging to a label, stampt between two leaves with the broad end of a leaden weight with some rude marks in it which were hid by the leaves. This passed for current, and prattick [pratique] admitted, we lay there at the mole [breakwater] as vessels do at the kay in Plymouth, one cable astern to the shore, another at an anchor in the haven.¹⁹

More interesting than the idea that a surgeon would stoop to such measures is that the officials at the Genoese lazaretto would not have immediately seen right through this obvious tactic.

¹ Patrick Russell, A Treatise on the Plague, Vol. 2, 179, p. 342; ² Russell, p. 342-3; ³ John Booker, Maritime Quarantine: The British Experience c. 1650 -1900, 2007, p. 12-3; ⁴ Samuel Pepys, Diary, Monday, 14 December 1663; ⁵ Samuel Atkins, "A Sailor's Journal", Colburn's United Service Magazine, Part 1, 1854, p. 206; ⁶ Instruzzioni e gouerno del lazzaretto di Messina per la scala franca, 1695, p.11 - translated by the author; ⁷ John Howard, An Account of the Principal Lazarettos In Europe, Vol. 2, 1791, p. 15-6; ⁸ Howard, p. 14; ⁹ Instruzzioni e gouerno del lazzaretto di Messina.., 1695, p. 24-5; ¹⁰ Howard, p. 16-7; ¹¹ Howard, p. 14; ¹² Howard, p. 17; ¹³ Pere Jean-Baptiste Labat, The Memoirs of Pére Labat 1693-1705, 1970, p. 261; ¹⁴ George Sandys, A relation of a journey begun an dom 1610, 1652, p. 177-8; ¹⁵ Instruzzioni e gouerno del lazzaretto di Messina.., 1695, p. 13; ¹⁶ Howard, p. 14; ^17,18 Daniel Panzac, Quarantines et Lazarets, 1986, p. 37 - interpreted by the author; ¹⁹ James Yonge, The Journal of James Yonge [1647-1721] Plymouth Surgeon, 1965, p. 70

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