Quarantine and History

Quadraginta. Quaranta giorni. Forty days. A Biblical number, first used for medical reasons in Venice in 1377, or at least the law and enforcement of it dates to 1377. Forty days in the wilderness, forty years in the wilderness, forty days of fasting and prayer, forty days of rest to assure others that no impurity in the form of disease afflicted a traveler. The practice goes back much farther, but the current name stems from Venetian Italian. The Torah mentions the need to separate those afflicted with leprosy (or feared to have it) from others until either they recovered, or it became apparent that they were indeed ill and thus ritually impure until they succumbed to the disease (or were healed and repeated the process, then were purified and returned to the community.)

People knew from observation that large groups of people traveling together often carried disease, especially armies. “Disease follows the army” was a proverb for a reason, due to the poor sanitation, poor hygiene, and rapacious nature of armies passing through various lands. Dysentery and other “dirty water” diseases were common, and later small pox as well. (Note, we’re talking about non-venereal diseases here.) Readers of the first four Colplatschki books will remember how obsessed Elizabeth von Sarmas was with boiling water or at the very least filtering it through layers of cloth and then adding wine (or another form of alcohol.) Those of her men who followed those orders tended not to get “the flux.”

It became apparent in Europe that isolating people for a period of observation not only worked for leprosy but also for the Black Death. Renaissance trading ports had a lazaretto, named for St. Lazarus the Beggar, which later served as a hospital for leprosy patients. It was outside the city walls. Over time the area near the lazaretto came to be a place of general quarantine for merchants and sailors, if suspicion existed that they and their goods might be carrying plague or other diseases.

The Habsburg Empire managed to escape major outbreaks of the Black Death and a few other infectious diseases in the 1700s by establishing a hard medical border. Traders had to stop for a set period of time if they came in from the south (Ottoman Empire). Their goods were categorized as being more or less likely to carry whatever it was that harbored plague, and the merchants were fed and housed at government expense until it became obvious if they were well or ill, and until the risk of plague transmission from their goods had ended.

Sailing brought its own risks of disease, especially plague, yellow fever, smallpox, and later cholera. A ship that had sickness on board was supposed to fly a yellow flag*, meaning “disease present” and was not supposed to dock until a medical examiner had cleared the vessel. As you can imagine, this procedure wasn’t always followed. This is why sorting out the ill from the healthy was such an important function at US immigration ports, especially after the 1860s and the “second wave” of immigration to the country. Quarantines and special hospitals also came back into use in Europe and the US in the late 1800s as cholera reared up again, most infamously in Hamburg, Germany.

Extended precautionary medical confinement is still used in many places for livestock and pets, in order to prevent rabid or otherwise sick critters from entering. People going to animal shows in the US have to show proof at various state borders that their animals have been vaccinated for certain things, or are certified free of certain infectious ailments.

Notice, in all cases, the goal is to keep the ill or possibly ill out of the general population. This was far, far easier than trying to keep the healthy confined away from the potentially sick. It also makes more medical sense in a world where people had some sense of disease transmission, but weren’t 100% certain of the details. Malaria was, indeed, found in places with “bad air” and “miasmas.” So too was yellow fever. That the miasmas were a sign and not the cause of the problem didn’t fit the understanding of the times. (Think about the outbreak of fever an’ ague in Little House on the Prairie. Everyone agreed that it came from the lowlands. Ma thought it had gotten into the watermelons because of where they grew. That the mosquitoes spread the ailment didn’t make sense, given what people knew.)

Today we have germ theory, and a much better idea of how various types of diseases spread. However, if you think about how the Wuhan fever has been considered and discussed, our society and mentalité are not as modern as we like to think. It’s an invisible killer that lurks in the very air, haunting public places, and attacking everyone. It hides and we cannot find it, cannot know who might harbor it, or where it abides. It comes with strangers and outsiders, who are to be regarded warily, lest something leap from them onto us, killing at random and laying waste to millions. The elite flee to rural retreats, hiding from the common folk and telling tales to entertain themselves. Plague doctors attend to the ill, and neighborhoods and communities are left to fend for themselves.

No wonder sales of The Decameron and De Foe’s Diary of a Plague Year have soared.

*A local city government asked people to hang yellow flags and yellow ribbons in honor of medical personnel. I missed the announcement, and wondered if the house with the yellow flag meant that someone had been diagnosed with Wuhan fever and the flag was a warning. Oops!

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