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Paradise, Purgatory and Hell

December 15, 2010

Experiences of the early modern plague hospital – by Jane Stevens Crawshaw

During outbreaks of plague, early modern Europeans faced mortality levels that we struggle to comprehend today. In order to describe their experiences of epidemics, people used the most vivid and apocalyptic vocabulary they knew, drawing comparisons with Biblical plagues and adopting religious rites and periods of purification in response to the disease.

Reading early modern plague writings reminds us that experiences of illness in the past were not the same as in the present and that responses to disease were shaped significantly by the context in which they were developed in terms of both time and place. This is true of public health policies in general and of the early modern plague hospital in particular, which makes these institutions a fascinating focus for a social history of public health. My project reveals the rich and varied history of these hospitals, which were significant parts of the political and economic as well as the social and medical structures of early modern towns and cities.

Saint Roch attending plague victims in a lazaretto. Oil painting by Giacomo Robusti. Wellcome Library

Among the various and notable studies of plague, it is rare to find extensive discussion of the victims; the sources are difficult and the terrifying statistics have often been left to speak for themselves. My project adopts a new approach in the study of plague, making an institutional study of the lazaretto, a type of plague hospital first founded in Ragusa (Dubrovnik) on a temporary basis in the 14th century and set up permanently for the first time in Venice in 1423. These institutions were subsequently founded across centuries and across the world, yet they have received little serious study by historians. A return to the archives of northern Italy allows us to rethink traditional characterisations of early modern public health as misplaced and ineffectual, and illuminates the experiences of a cross-section of society as they endured periods of plague and quarantine.

Of the three contemporary descriptions of plague cited in the title of this piece, the most surprising to modern eyes is surely that of Paradise. Much of what has been written about early modern plague hospitals has focused upon the hellish nature of conditions. A number of contemporaries described the purpose and potential of the hospitals, however, in idyllic terms. Patients had no need to work on the islands and their care o was largely paid for by governments, which provided food and wine as well as clothing and medical treatments. Some contemporaries suggested that the days of patients in isolation could be structured by religious rites and the general atmosphere could be one of prayer and praise. During the Counter-reformation, the potential for these hospitals to heal the body and the soul, inspiring compassion and sometimes enabling conversion to Catholicism, was particularly emphasised, making the metaphor of Paradise an attractive one.

Contemporaries were familiar with the idea that the soul could be cleansed in Purgatory just as the body could be cleansed using purges as part of the medical pluralist system of care. Purgatory was used to describe the institutions reserved for those suspected of infection but who had not yet shown signs of the disease, along with their possessions. In Venice this hospital was known as the lazaretto nuovo. Beyond epidemics, these hospitals would have catered for merchants, whose valuable merchandise was disinfected using elements of the natural world such as air, sunshine, water and sand. A stay in quarantine was recorded as tolerable, if tedious. During epidemics in Venice much was done to minimise the sense of abandonment on the lagoon island of the lazaretto nuovo – including allowing visitors to the sites.

Hell is an understandable image for the plague hospital – institutions that, when placed under strain during the worst early modern epidemics, were said to have clouds of choking smoke billowing out from the fires that burned corpses and infected goods. Contemporaries described the choking smell of vomit, just one of the horrible effects of the plague, and patients induced to madness, who would run and scream through the sites or hurl themselves out of windows, leading the authorities to strap them to their beds. Despite the best efforts of the authorities, plague hospitals, like wider cities, were transformed by the monstrous plague when it hit on an epidemic scale.

Plague hospitals were developed in Europe across three centuries and during that time were felt to be the best way to prevent and respond to the plague, despite controversies regarding their structure and administration. The nature of the lazaretti varied depending on whether they were used for the sick or the suspected and whether a city was infected. During epidemics, experiences varied too: the hospitals were used to treat rich and poor, young and old, men and women, and played host to episodes of birth and marriage as well as death. My study of these sites – their location, architecture, decoration and administration – illustrates that, whether resembling Paradise, Purgatory or Hell, they have much to reveal about early modern disease and society.

Dr Jane Stevens Crawshaw is Lecturer in Early Modern European History, Oxford Brookes University.

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