Plague Hospitals

Public Health for the City in Early Modern Venice

Jane L. Stevens Crawshaw

• Publisher: Routledge
• Year: 2016
• Print ISBN:
  9780754669586
• eBook ISBN:
  9781317080282
• Topic: Medicina
• Subtopic: Storia mondiale

Developed throughout early modern Europe, lazaretti, or plague hospitals, took on a central role in early modern responses to epidemic disease, in particular the prevention and treatment of plague. The lazaretti served as isolation hospitals, quarantine centres, convalescent homes, cemeteries, and depots for the disinfection or destruction of infected goods. The first permanent example of this institution was established in Venice in 1423 and between the fifteenth and eighteenth centuries tens of thousands of patients passed through the doors. Founded on lagoon islands, the lazaretti tell us about the relationship between the city and its natural environment. The plague hospitals also illustrate the way in which medical structures in Venice intersected with those of piety and poor relief and provided a model for public health which was influential across Europe. This is the first detailed study of how these plague hospitals functioned, where they were situated, who worked there, what it was like to stay there, and how many people survived. Comparisons are made between the Venetian lazaretti and similar institutions in Padua, Verona and other Italian and European cities. Centred on the sixteenth and seventeenth centuries, during which time there were both serious plague outbreaks in Europe and periods of relative calm, the book explores what the lazaretti can tell us about early modern medicine and society and makes a significant contribution to both Venetian history and our understanding of public health in early modern Europe, engaging with ideas of infection and isolation, charity and cure, dirt, disease and death.

Chapter 1
‘From a distance it looks like a castle’: First Impressions and Architectural Design

The striking environment of the Venetian lagoon, with its marshes and sandbanks, presents an ever-changing picture of land interweaving with water. The lagoon breaks the landmass into separate islands of varying sizes. The largest of these islands have supported significant populations during their histories. In the medieval and early modern periods, some of these larger islands were administered in the same way as the principal cities of the terraferma, illustrating a degree of political independence from Venice. The smaller lagoon islands were often used by the religious orders, although a number of these sites were abandoned during the medieval period, because of the poor quality of the air and issues of indiscipline within the communities.¹ Two of these smaller islands were adapted for use as Venice’s plague hospitals during the fifteenth century. The site of the lazaretto vecchio lies just off the Lido, one of the protective islands which shelters Venice from the sea, approximately three kilometres from the city. The second island, which housed the lazaretto nuovo, lies three kilometres northeast of Venice, separated by a small channel of water from Sant’Erasmo, the island known as the garden of Venice. In this chapter, we will consider the views of these lazaretti islands, from city and beyond. First, the view of the lazaretti as important religious and civic institutions will be described. Second, the impression made on visitors, as recorded by contemporaries in literary and visual sources will be illustrated, including the notable views of the sites as Hell and Purgatory, and, as extensions of Venice in times of health, as Paradise.² Third, the protective nature of the architecture at the lazaretti will be explored using the contemporary metaphor of the castle. In the final sections, the architecture of the hospitals will be described in more detail, including both the structure and decoration of plague hospitals within and beyond Venice. Each of these sections illustrates that the Venetian lazaretti can fruitfully be compared with other contemporary institutions in terms of the use of space within the city and the nature of the isolation employed within the sites.

Religious associations, ideas and language infuse contemporary accounts of the lazaretti, from the earliest examples. Discussions of Venice’s first plague hospital, the lazaretto vecchio, refer to the role of St Bernardino of Siena in determining the location and foundation of the site. St Bernardino, visiting Venice in 1422, preached for a year and it is said that he had such success that the Doge of the city promised him two wishes. Having served in the plague hospital in Siena during the epidemic of 1400, St Bernardino wished that the Venetian authorities should establish a plague hospital on an island of the Venetian lagoon and he stressed the need for a spacious and remote location.³ In a wider Italian context, it is not unusual to see the involvement of a prominent religious figure with the lazaretti, although the Venetian lazaretti were in the hands of the political authorities and were never staffed by religious orders. In Milan, St Carlo Borromeo worked within the lazaretto during the terrible outbreak of plague of 1575–77 – sometimes known as the plague of St Carlo.⁴ Various contemporary writings described Borromeo’s work as that of the model for a perfect pastor during outbreaks of epidemic disease and in this, service within the lazaretti was prominent.⁵ His worked bridged spiritual and physical care. He was renowned for distributing clothing and food. In the image of his ministry [Plate 2], we see the connections between piety and medicine: even the putti, in the top left, are put to work perfuming and purifying the air.

In some places during the late sixteenth and seventeenth centuries, the context of plague was talked of in the light of the Catholic Reformation and epidemics were said to provide an opportunity for the humble giving and receiving of charity, for developing an attitude of compassion and, where necessary, for acts of submission and conversion to Christianity. Plague, for example as Thomas Worcester has shown, was described by the Jesuit Etienne Binet [1569–1639] as a time when many were saved because it was ‘blessed by God’. This meant it was not only an opportunity for the conversion of souls but a time ripe for the making of saints and martyrs, although the latter was the cause of some debate.⁶ Binet highlighted that illness and the necessary medical response created opportunities for effective spiritual care. He particularly praised the example set by Carlo Borromeo in the care of the sick in Milan between 1575 and 1577.⁷ Binet begins his treatise by asking whether the plague brings more ill than good and concludes that, without the plague, there would be less devotion and fewer saints.⁸

The lazaretto in Genoa was thought to have a clear charitable and religious purpose, tailor-made for the purposes of the Catholic Reformation in the written description by Father Antero Maria da San Bonaventura, the Rector at the hospital for the outbreak of 1656.⁹ Father Antero recorded the ‘scandalous’ behaviour of some patients within the lazaretto, who ate meat on a Friday and Saturday and did not go to Mass or act with any reverence towards the Mass. One example of such patients was four Dutch sailors.¹⁰ All of these sailors were said to have converted in the lazaretto and become very devout. Father Antero wrote that they converted during their period of sickness and praised God that they were healed. Here, religious and physical healing went hand-in-hand. The healing of these sailors was said to have been particularly extraordinary (and all the more obviously miraculous) because it happened at the beginning of July, when few in the plague hospital survived. Father Antero described his own reaction to their conversion as one of recognition that he had witnessed ‘a great miracle, similar to that which I read about in the report from Japan by PP Giesuiti, of five blind persons, who were baptised and all had their vision restored’. Here, the concurrent healing of soul and body is emphasised by the restoration of sight in both the religious and physical sense, making use of a common metaphor for conversion. Elsewhere in his text, Father Antero also employed the metaphors of slavery and freedom and disease and cure. The Italian lazaretti were seen to fulfil both a general religious and specific Catholic-Reformation function, making the involvement of religious figures appropriate.

Conversion was also a feature of lazaretti elsewhere in Europe. In Malaga, Mary Elizabeth Perry has recorded the case of a slave girl, Fatima, who is said to have converted to Christianity in the plague hospital.¹¹ Fatima was said to have been given the baptismal name Ana, recovered from her illness and left the hospital. She was then said to return to her Muslim faith and deny that her baptism had taken place. When pressed during an investigation by the Inquisition, Fatima eventually acknowledged the baptism but explained it by saying that she had been ‘crazy and without sanity and without judgement’. This is a shrewd defence by someone who had recovered from the plague, since madness was widely acknowledged to be a common characteristic of the plague sick. The cleric who had carried out the baptism also spoke directly to this aspect of conversions amongst the plague sick, saying, ‘that since the said Moor [Fatima] continued to ask for baptism and since she was not frenetic but in her sound mind and it was for her remedy and salvation, he had baptized her’. One of the specific features of plague hospitals was their locations on the outskirts of cities – whether beyond city walls on the mainland or on islands close to ports. This allowed them to be used by city authorities to protect populations from perceived threats – whether that was the Protestants for the Atlantic-facing Genoese or the Muslim slaves of Malaga. The sites offered the opportunity to prevent the importation of heresy and immorality as well as epidemic disease.

The religious function and potential of plague hospitals enhanced their importance for cities. The civic purposes of hospitals were explored in John Henderson’s 2006 monograph, in which he established Florence as the home of ‘The Renaissance Hospital’. Henderson’s work has described the aim of medieval and early modern hospitals as that of ‘healing the body and healing the soul’ in equal measure.¹² He cites a contemporary who describes Florence’s hospitals as, ‘beautiful and capacious … adapted and organised to receive any sick or healthy person who is wretched and needs to be received for whatever reason’. Florence, however, cannot claim the invention of the Renaissance plague hospital: the same contemporary goes on to say ‘except those who are sick from plague’. At the point of writing, early Renaissance Florence lacked a lazaretto and instead made a ‘third class’ response to plague, using temporary sites during periods of emergency. Henderson writes that the use of these temporary sites ‘should not be confused with the general tenor of attitudes that underlay society’s mechanisms to deal with the poor’. The consensus of historians has been that temporary lazaretti cannot be aligned with the broader context of developing ideas on poor relief, which is why so much attention has been paid to the introduction of permanent Health Boards, particularly in Italy.¹³ Where permanent lazaretti were established, however, the decision was informed by ideas about charity and welfare. Indeed, Henderson’s work reflects this: in 1479, when the decision was taken to set up a permanent plague hospital, it was said to be ‘couched in terms of Christian charity to show the world that the city’s door of charity was as open as in other parts of the world’ and justified on the grounds that ‘the greater the danger to those who look after the sick and the more these people are abandoned by everybody, the greater the merit in the eyes of God to whomever receives them and provides for their needs’.¹⁴

In discussions of the origins of the Venetian lazaretti, there is dispute as to where the original charitable impulse lay. The role of St Bernardino of Siena has already been discussed. In his study of Doge Francesco Foscari [1373–1457], Denis Romano gives the responsibility for the hospital’s proposal to Foscari himself and uses it as an illustration of the Doge’s paternal care for the community. In a way that is characteristic of Venetian history, the credit for the foundation of the lazaretto is given to the figure who represented the Republic. Regardless of the point of origin, Venetian authors came to associate the lazaretti with particularly Venetian virtues: piety, longevity, stability and prosperity. The hospitals were written into the long tradition of panegyric writing, in which Venice was described as an earthly Paradise. During the Renaissance, the mould was created for the genre of ‘praise of city’ writing, which shaped the amorphous myth of Venice.¹⁵ Once formed, the myth was brought out for use on special occasions through the early modern period. According to the myth, the beauty and calm of the natural environment permeated the social and political structures of the city. This close connection between the nature of the environment and the nature of the place, however, became problematic in times of plague because explanations of disease causation were so closely linked to physical enviro...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Dedication
• Contents
• List of Illustrations and Plates
• List of Abbreviations
• Acknowledgements
• Introduction
• 1 ‘From a distance it looks like a castle’: First Impressions and Architectural Design
• 2 The Sick-Poor
• 3 ‘Abandon hope, all you who enter here’: Experiences of Staff and the Patients’ Daily Routine
• 4 Syrups and Secrets: Treating the Plague
• 5 Dying in the Lazaretti
• 6 Returning to the City
• Conclusion
• Epilogue
• Bibliography
• Index