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Studying an extraordinarily rich set of documents in the city of Dubrovnik, Croatia
Zlata Blažina Tomić and her daughter Vesna Blažina, with their important book
The Health Office and the Implementation of Quarantine in Dubrovnik, 1377-1533.
Expelling the Plague
The Health Office and the Implementation of Quarantine in Dubrovnik, 1377-1533
By Zlata Blazina Tomic and Vesna Blazina
A ground-breaking study about plague control measures in medieval and early modern Croatia.
A vibrant city-state on the Adriatic sea, Dubrovnik, also known as Ragusa, was a hub for the international trade between Europe and the Ottoman Empire. As a result, the city suffered frequent outbreaks of plague. Through a comprehensive analysis of these epidemics in Dubrovnik, Expelling the Plague explores the increasingly sophisticated plague control regulations that were adopted by the city and implemented by its health officials.
In 1377, Dubrovnik became the first city in the world to develop and implement quarantine legislation, and in 1390 it established the earliest recorded permanent Health Office. The city’s preoccupation with plague control and the powers granted to its Health Office led to a rich archival record chronicling the city’s experience of plague, its attempts to safeguard public health, and the social effects of its practices of quarantine, prosecution, and punishment. These sources form the foundation of the authors' analysis, in particular the manuscript Libro deli Signori Chazamorbi, 1500-30, a rare health record of the 1526-27 calamitous plague epidemic. Teeming with real people across the spectrum, including gravediggers, laundresses, and plague survivors, it contains the testimonies collected during trial proceedings conducted by health officials against violators of public health regulations.
Outlining the contributions of Dubrovnik in conceiving and establishing early public health measures in Europe, Expelling the Plague reveals how health concerns of the past greatly resemble contemporary anxieties about battling epidemics such as SARS, avian flu, and the Ebola virus.
Figures and Tables • xi
A Note on Names • xv
A Note on the Pronunciation of Croatian Names • xvii
A Note on Money,Weights, Measures, and Prices • xix
Acknowledgments • xxi
Introduction • 3
1 History of Dubrovnik • 8
2 The Plague Phenomenon and Plague Epidemics in Dubrovnik • 42
3 Health Culture: Pharmacies, Hospitals, Physicians, and Surgeons • 68
4 Founding and Development of the Health Office, 1390-1482 • 105
5 Control of Arrivals in Dubrovnik, 1500-1530 • 138
6 The Disastrous Plague Epidemic of 1526-27 • 162
7 Plague Survivors as PlagueWorkers • 183
8 The Health Officials and the Patricians • 198
9 Concealing Symptoms of Plague, Importing Suspicious Goods, and Other Offences • 213
Conclusion • 229
Appendices
The State Archives of Dubrovnik • 241
Diversis on the Import and Export Trade in Dubrovnik • 246
The Testament of Angelo de Leticia • 248
Notes • 261
References • 317
Index • 347
Zlata Blažina Tomić is a medical historian who worked at McGill University’s Osler Library.
Vesna Blažina is a translator and librarian who worked at the Université de Montréal.
“This major study of sixteenth-century responses to plague makes significant use of primary sources not available elsewhere. Outlining the history and development of plague legislation, and looking in detail at its application, it teems with real people: officials desperate to keep plague out of the city, physicians, barbers, priests, and gravediggers coping with the diseased and dying, and humble victims of the disease.”
David Gentilcore, University of Leicester “Studying an extraordinarily rich set of documents in Dubrovnik, the authors bring scholarly attention to an early public health office dedicated to surveillance and containment of plague epidemics. Social and medical historians will find this work very valuable.” Ann G. Carmichael, Indiana University
Source www.mqup.ca
| Many thanks to Professor Ante Padjen, McGill University, Canada, for drawing our attention to these books. Zlata Blažina Tomić with her book Kacamorti i kuga (Kacamorti and the Plague)
Lovorka Čoralić: Prikaz knjige
Zlata Blažina Tomić,
Kacamorti i kuga: utemeljenje i razvoj zdravstvene službe u Dubrovniku,
Zavod za povijesne znanosti HAZU u Dubrovniku, Posebna izdanja Monografije, knj. 27, Zagreb-Dubrovnik 2007, 295 str.
Zbornik Odsjeka povij. znan. Zavoda povij. druš. znan. HAZU, 27 (2009): 396-398.
Knjiga pod gornjim naslovom novo je djelo u seriji Monografije, u izdanju iznimno produktivnog Zavoda za povijesne znanosti HAZU u Dubrovniku. Djelo je nastalo kao rezultat autoričina višegodišnjeg proučavanja problematike povijesti javnog zdravstva u srednjevjekovnom i renesanskom Dubrovniku. Riječ je o problematici koja, iako prevažna za povijest zdravstva na širem području Jadrana i Sredozemlja nije do sada monografski bila obrađena.
Rad na ovom istraživanju autorica je zasnovala na podrobnom uvidu u djela strane historiografije koja obrađuju kugu na području Zapadne Europe u srednjem i ranom novom vijeku (npr. Anna Campbell Montgomery, Robert Pollitzer, Jean Noël Biraben, John Norris, Michael W. Dols, i dr.), a u kontekstu cjelovitijeg sagledavanja političke i društvene povijesti Dubrovnika u navedenom razdoblju uporabljena su djela domaćih istraživača. Kada je riječ o izvornoj arhivskoj građi, uporabljeno je više fondova pohranjenih u Državnom arhivu u Dubrovniku (fondovi Acta Consilii Maioris, Acta Consilii Rogatorum, Diversa Cancellariae, Diversa Notariae, Libro deli Signori Chazamorbi, Testamenta de Notaria i dr.)
Knjiga započinje predgovorom (9-11 ) i uvodom (11-15) u kojem autorica razlaže motivaciju za izradbu ove monografije te sažeto i pregledno ukazuje na postojeća saznanja domaće i strane historiografije o povijesti javnog zdravstva u doba kužnih pošasti. Slijede cjeline koje nas pomno uvode u problematiku kužnih pohara. U poglavlju “Kužne zaraze kroz stoljeća“ (17-31), autorica ukratko obrazlaže povijest pandemije kuge (“Justinijanova kuga“ u 6. st.; druga pandemija kuge ili “Crna smrt“ u 14. st., treća pandemija u Kini kraj 19. st.) Tragom dosadašnjih spoznaja o etiologiji i patologiji kuge (na osnovi rezultata medicinskih i bakterioloških istraživanja) ovdje se, za čitatelja slabije upućenog u povijest medicine, donose korisna znanstvena saznanja o medicinskom aspektu srednjevjekovnih oblika kuge te se ukazuje na zemljopisno podrijetlo i nastanak te pohare. Slijedi osvrt na “Pojam zaraze u starom i srednjem vijeku“ (33-43), ponajprije s obzirom na antičke i srednjovjekovne teorije o zarazama i zaraznim bolestima, kao i s obzirom na poimanje kuge na Bliskom istoku.
Cjelina “Medicinska profesija i kužne zaraze“ sadrži pregledan osvrt na status liječničke profesije u Dubrovačkoj Republici (u usporedbi sa situacijom u gradovima duž Apeninskog poluotoka), način upošljavanja liječnika (fizika i kirurga), liječničke plaće, obveze i dužnosti pri obavljanju svoje prakse (posebice u godinama haranja kuge), kao i na primjere djelovanja dubrovačkih liječnika u susjednim državama. U ovom poglavlju se donosi (50-55) vrlo koristan pregled liječnika i kirurga u Dubrovniku od 1301. do 1550. godine (navodi se ime liječnika, plaća, godine službovanja i staž).
Tri su zapažena liječnika djelatna u Dubrovniku u 16. stoljeću predmet zanimanja autorice u poglavlju “Liječnici u Dubrovniku: Donato Muzi, Mariano Santo i Ivan Mednić“ (69-80). Prvi od njih , Mlečanin Donato Muzi (oko 1490 do oko 1554 ), djelovao je u Dubrovniku od 1526. godine, a autor je vrlo zanimljivog spisa o Galenu i osvrta na liječnička iskustva stečena u Dubrovniku (objavljeno 1547). Iz Barlete je zavičajem bio Mariano Santo, osoba lutalačke naravi, često u sukobu s drugim dubrovačkim liječnicima i krurzima. Kao kirurg posebno se zanimao za primjenu metode litotomije, pa je u djelu Libellus aureus de lapide e vesica per incisionem extrahenda (1522.) opisao kako je izumio novu metodu vađenja kamenaca iz mokraćnog mjehura (methodus Mariana ili sectio Mariana). Godine 1526. u Dubrovnik je za liječnika zaduženog za oboljele od kuge (medicus pestis) primljen Ivan Mednić iz Kotora, a kao izvor za proučavanje statusa liječnika i primjene liječničke prakse u uvjetima epidemije posebno nam je zanimljiva njegova molba za primanje u državnu službu upućena dubrovačkom Senatu.
Kacamorti ili protukužni zdravstveni službenici, njihov osnutak i ustroj u kasnom srednjem vijeku i početkom novog ranog vijeka jedno je od središnjih i najvažnijih problematskih pitanja koja autorica obrađuje u navedenoj monografiji (“Utemeljenje i razvoj zdravstvene službe kacamorata u 14. i 15. stoljeću,“ 81-111). Podrobno se ukazuje na uredbu koju je Veliko vijeće donijelo 27. srpnja 1377. godine i koja je poznata kao prva karantenska uredba u svijetu (izvornik je sačuvan u Liber viridis, knjiga nadopuna uredaba dubrovačkog statuta iz 1272. godine). Kao grad posebno izložen naletima kuge (zbog učestalih dolazaka trgovaca i putnika iz zaraženih krajeva), Dubrovnik je u godinama pohare brojnim zakonskim mjerama, sustavno i promišljeno djelovao u sprječavanju širenja zaraze unutar gradskih zidina. Stoga je u žarištu autoričina razmatranja djelovanje protukužne službe i kacamorata, a posebno se iscrpno razmatra primjenjivanje izvanrednih mjera, ovlasti protukužnih službenika, nastojanja da se uspostavi nadzor nad kretanjem građana i stranaca i na kopnu i na moru, uređenje karantene na cavtatskim grebenima Mrkan i Bobara i dr. Autorica zaključuje upravo na osnovi znamenite uredbe iz 1377. godine (kao i na osnovi drugih kasnije nastalih i provedenih uredbi), da “koliko nam je do sad poznato, ni jedan grad u Sjevernoj Italiji, koja je, po mišljenju mnogih, predvodila u protuepidemijskim mjerama u Europi i služila kao primjer ostalima, nije posjedovao stalnu javnu zdravstvenu službu takve prirode koncem 14. stoljeća, nego istom pola stoljeća kasnije, moguće i pod utjecajem dubrovačkih iskustava“ (111).
Nova pogubna pohara kuge nastupila je početkom prosinca 1526. godine i smirila se u studenom sljedeće godine. Njezino širenje i ugrožavanje Dubrovnika predmet je podrobne analize u poglavlju “Protuepidemijske mjere zdravstvene službe od 1500 do 1526. godine“ (113-147), a kao glavni izvor uporabljena je Libro deli Signori Chazamorbi, knjiga u koju su zdravstveni službenici upisivali dolaske s kopna i mora, zajedno s robom koju su dopremali u Dubrovnik, te pri dolasku jamčili (pod prijetnjom zatvora) da nijesu prispjeli iz krajeva koji su zaraženi (tablica dolazaka putnika u Dubrovnik prema mjestu polaska za razdoblje od 1500. do 1530. godine objavljuje se na str. 142-144).
Slijedi poglavlje “Pogubna epidemija kuge 1527. godine“ (147-161). O pohari koja je tada ugrozila dubrovačko stanovništvo svjedoče i kroničarske bilješke Anonima, Nikole Ranjine i Serafina Razzija. Tada je, prema procjenama povjesničara demografije, usprkos svim provedenim mjerama, smrtno stradala četvrtina ukupnoga žiteljstva. Na to se poglavlje izravno tematski nastavlja cjelina u kojoj autorica (također na osnovi upisa u Libro deli Signori Chazamorbi) raščlanjuje “Kažnjavanje prekršitelja zdravstvenih uredaba od 16. lipnja 1527. do 16 lipnja 1528. godine“ (163-176).
O službi kacamorata zorno posvjedočuju sudski procesi vođeni na njihovu inicijativu u godinama pohare (poglavlje “Sudski procesi zdravstvene službe od 27. lipnja 1527. do 23. svibnja 1529.“, 177-191), ali i problemi i teškoće s kojima su se redovito susretali (“Prikrivanje simptoma kuge i uvoza zaražene robe“, 193-201). Na kraju, završno poglavlje knjige (“Zdravstveni službenici i Crkva“, 203-222) osvrt je na ponašanje dubrovačkog klera u okolnostima haranja kuge (navode se sudski procesi u kojima se kao akteri spominju svećenici, redovnice i redovnici) te na opći utjecaj Katoličke crkve na društvena i vjerska zbivanja u Gradu, (gradnja zavjetnih crkava i kapela, sveci-zaštitnici od kuge, oporučne odredbe dubrovačkih građana i dr).
Na kraju knjige sadržani su zaključak (223-229), prilozi (kronološki pregled epidemija kuge i protukužnih mjera u Dubrovniku, oporuka Anđela de Leticije iz 1348. godine, 231-243), popis uporabljenih vrela i literature (245-262), sažetci na stranim jezicima (263-268) te kazala imena, zemljopisnog nazivlja i pojmova (269 do 289).
Monografija Zlate Blažina Tomić zaokružen je i sustavan pregled ustroja, razvoja i djelovanja zdravstvene službe u Dubrovniku u doba haranja kužnih epidemija. Knjiga je pomno pisana i odaje vrsno poznavanje povijesti medicine, ali i onodobnih društvenih, političkih i vjerskih prilika u Dubrovniku. U radu je uporabljena brojna raznovrsna literatura (ponajprije djela strane historiografije koja se bave poviješću kužnih epidemija) te izvorno gradivo koje posvjedočuje o društvenom ozračju u Gradu u vrijeme “izvanrednog stanja“ uzrokovanog širenjem kužne pohare. Karantenska uredba iz 1377. godine, niz zakonskih odredbi i ustroj zdravstvene službe u godinama i desetljećima što ih je - na globalnoj razini - obilježila pandemija neslućenih razmjera, pokazali su svu snagu, promišljenost i sposobnost Dubrovačke Republike i njezine vlasti da se odupre i najpogubnijim opasnostima. U tom je smislu, po inovativnosti i organiziranosti, Dubrovnik prednjačio većim i bogatijim europskim metropolama. Time su, zaključuje autorica (229), “Dubrovačka Republika i Hrvatska svojim civilizacijskim i kulturnim dostignućima postale pretečama i uzorima javnim zdravstvenim službama u Europi.“
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Lovorka Čoralić: Review of the book
Zlata Blažina Tomić,
Kacamorti and Plague: founding and development of health office in Dubrovnik
Zavod za povijesne znanosti HAZU u Dubrovniku, Posebna izdanja Monografije, knj. 27, Zagreb-Dubrovnik 2007, 295 str.
Zbornik Odsjeka povij. znan. Zavoda povij. druš. znan. HAZU, 27 (2009): 396-398.
The above title is the latest work in the series “Monographs” of the exceptionally productive Dubrovnik Institute for the Historical Sciences of the Croatian Academy of Arts and Sciences. This work is a result of the author’s multi-year research in public health of medieval and Renaissance Dubrovnik. Although it deals with a subject matter of utmost importance for the larger Adriatic and Mediterranean area, this is the first monograph about this topic.
The author is totally familiar with the western European plague literature of the medieval and early modern period. She quotes for ex. Anna Campbell Montgomery, Robert Pollitzer, Jean Noël Biraben, John Norris, Michael W. Dols and others. Croatian authors are cited in the exploration of the political and social history of Dubrovnik during the same period. The author has also examined many collections of manuscript sources from the State Archives of Dubrovnik (for ex. Acta Consilii Maioris, Acta Consilii Rogatorum, Diversa Cancellariae, Diversa Notariae, Libro deli Signori Chazamorbi, Reformationes, Testamenta de Notaria and others.)
The book begins with a Foreword (9-10) and an Introduction (11-15) in which the author explains the motives for writing this monograph. Succinctly and in a well laid out manner, she surveys the Croatian and foreign historiography concerning public health during plague outbreaks. In the following chapters the topic of plague epidemics is methodically introduced. The chapter “Plague Epidemics through the Ages” (17-31) examines the history of plague pandemics (Justinian’s plague in the 6th century, the second pandemic or the “Black Death” in the 14th century and the third pandemic at the end of the 19th century which started in China). Based on the medical and bacteriological research, the aetiology and the pathology of plague are explored. For a reader not familiar with the history of medicine, useful data about the medical aspects of medieval plague are revealed and the geographical origin of plague is discussed. In the chapter “Contagion Theories in Antiquity and the Middle Ages” (33-43), theories of communicable diseases and the concept of plague in the Middle East are reviewed.
The chapter “Medical Profession and the Plague” (45-67) explores the status of the medical profession in the Ragusan Republic in comparison with the cities on the Apennine Peninsula. It includes the hiring of medical men, both - physicians and surgeons, their salaries, their duties and obligations, especially in plague years, as well as examples of Ragusan physicians serving abroad. This chapter contains an especially useful table of physicians and surgeons in Dubrovnik from 1301 to 1550 (p. 50-55) in which the names, salaries and years of service of medical men are quoted.
The careers of three notable physicians serving in Dubrovnik in the 16th century are revealed in the chapter “Physicians Serving in Dubrovnik: Donato Muzi, Mariano Santo and Ivan Mednić” (69-80). The Venetian Donato Muzi (ca 1490-ca 1554), who served in Dubrovnik since 1526, is the author of an interesting document about Galen. He also described his medical experience in Dubrovnik and published it in 1547. Mariano Santo from Barletta was a peripatetic soul who was often in conflict with Ragusan physicians and surgeons. Interested in performing lithotomies, in his work Libellus aureus de lapide e vesica per incisionem extrahendo (1522), he describes his new method of removing bladder stones (methodus Mariana or sectio Mariana). In 1526, Ivan Mednić from Kotor was hired as a plague doctor in Dubrovnik. His job application addressed to the Ragusan Senate is of particular interest for the study of the status of medical men during plague outbreaks.
“Founding and Development of the Health Office in the 14th and 15th Centuries” (81-111) represents one of the core topics investigated in this book. The regulation promulgated by the Ragusan Major Council on 27 July 1377, known as the first quarantine legislation in the world, is closely scrutinized. The original text is preserved in the Liber viridis, the book of legislative supplements of the 1272 Ragusan Statute. Due to merchants who arrived from plague infected areas, Dubrovnik was a city particularly susceptible to plague breakouts but with numerous legislative measures enacted systematically and deliberately, it did everything it could to prevent plague. The activities of the Health Officials therefore represent the central interest of the author. Their authority, the implementation of extraordinary plague measures, the control of the movement of citizens and foreigners, on land and sea, the establishment of quarantine compounds on the islets of Mrkan and Bobara near Cavtat, etc. are discussed in great detail. Basing her judgment on the quarantine regulation of 1377 and those promulgated later, the author concludes that “as far as we know, the cities in northern Italy, as recognized precursors of public health measures in Europe, had not established their Health Offices at the end of the 14th century, but only much later, possibly under the influence of the Ragusan experience” (111).
A disastrous plague epidemic struck Dubrovnik at the beginning of December 1526 and lasted for a whole year. Its spread and threat to Dubrovnik is analyzed in the chapter “Plague Control Measures of the Health Office from 1500 to 1526” (113-147). The book Libro deli Signori Chazamorbi in which the Health Officials registered the arrivals of travellers and goods by land and sea, who under the threat of fines and imprisonment had to vouch that they had not arrived from plague infected areas, served as the main source for this chapter (Table of Travellers’ Arrivals According to the Place of Departure, 1500-1530, is available on p. 142-144).
The following chapter deals with the “Disastrous Plague Epidemic of 1527” (147-161). The Anonymous chronicler as well as Nikola Ranjina and Serafino Razzi report on that calamitous epidemic, which, according to the demographic historians, in spite of the implementation of plague control measures, claimed one fourth of the population of the Ragusan Republic. The chapter “Punishment of Persons Who Contravened Public Health Regulations from 16 June 1527 to 16 June 1528” (163-176) is also based on the Libro deli Signori Chazamorbi.
The trials that the Health Officials conducted in plague years (“Trials of the Health Office from 27 June 1527 to 23 May 1529”, p. 177-191) but also the problems and the difficulties that they encountered (“Concealing the Symptoms of Plague and the Importing of Plague Infected Goods, p. 193-201) vividly describe their activities. The last chapter (“Health Officials and the Church,” p. 203-222) probes the behaviour of the Ragusan clergy during plague epidemics. Trials, in which priests, monks and nuns appeared as violators of plague control measures, are analyzed. It also surveys the influence of the Church on the construction of votive churches and chapels against the plague, the reverence of protector saints against the plague, the bequests of Ragusan testators, etc.
At the end of the book, we find the Conclusion (223-229), the Appendices (chronological survey of plague epidemics and plague control measures in Dubrovnik, the testament of Angelo de Leticia of 1348, p. 231-243), the list of manuscript sources and the bibliography (245-262), summaries in foreign languages (263-268) and the name, geographical name and subject indexes (269-289).
The monograph of Zlata Blažina Tomić is a well-rounded and systematic investigation of the founding, development and activities of the Health Officials in Dubrovnik at the time of plague epidemics. This carefully written book reveals an erudite expert of the history of medicine and also of the social, political and religious circumstances in Dubrovnik of that period. This work has a diversified bibliography, consisting first of all of world literature dealing with plague outbreaks, but also of original manuscript sources which bear witness to the social conditions during “extraordinary circumstances” in the plague infected city. The quarantine legislation of 1377, and a whole series of regulations that followed, the establishment of the Health Office in the years marked by plague upsurges, demonstrate all the power, foresight and ability of the Ragusan Republic and its authorities to withstand the most hazardous perils. As far as its ability to innovate and organize is concerned, Dubrovnik preceded bigger and wealthier European capitals. Thus, concludes the author, “the Ragusan Republic and Croatia with their advanced social organization and cultural achievements became precursors of public health offices in Europe” (229).
| Translated from the Croatian language by Vesna Blažina
Zlata Blažina Tomić
Zlata Blažina Tomić received her B.A. in History and Latin from the University of Zagreb (1967). From 1970 to 1991 she worked as a bibliographer at the Osler Library of the History of Medicine at McGill University in Montreal. Her master’s thesis (McGill 1981) dealt with public health measures in Dubrovnik from the 13th to the 15th centuries. Her Ph.D. from the University of Zagreb (2001), based on archival material that has never been studied before, focused primarily on the role of the Health Officials and the health regulations promulgated by the Dubrovnik government in fighting plague in the early 16th century.
She is the recipient of the research grant of the Hannah Institute for the History of Medicine, now AMS (Toronto) and the History of Medicine Project of the Croatian Academy of Arts and Sciences (Zagreb). Since 1990, she is a research associate at McGill University and the Institute for the History of Medicine of the Croatian Academy of Arts and Sciences. She has participated in numerous international conferences in Canada, Croatia, Russia, Turkey and the U.S.A.
Her book Kacamorti i kuga: utemeljenje i razvoj zdravstvene službe u Dubrovniku (The Signori Cazamorti and the Plague: founding and development of the Health Office in Dubrovnik) was published by the Institute for the Historical Sciences of the Croatian Academy of Arts and Sciences (Zagreb, Dubrovnik) in 2007.
Expelling the Plague: The Health Office and the Implementation of Quarantine in Dubrovnik, 1377-1533, co-authored with Vesna Blažina, published by McGill-Queen’s University Press in 2015 is a completely revised and substantially expanded version of the Croatian edition Kacamorti i kuga.
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Vesna Blažina
Vesna Blažina earned her B.A. in English and French Literatures at Sir George Williams University (now Concordia) in Montreal, Quebec, Canada (1970). She received her Master’s in Library and Information Science at the Université de Montréal (1975). She spent her whole professional career managing various libraries (Biology, Botany, Chemistry, Aménagement, Bibliotheque des lettres et sciences humaines) at the Université de Montréal. In 1990, she joined AMCA Quebec and was elected its president in 1995. During the war years (1991-1995), she contributed to the advancement of Croatian-Canadian relations and the presentation of Croatian culture in Canada. She also wrote for Gaudeamus, the newsletter of AMCA societies of North America and worked as a translator and interpreter. Lately, with her mother Dr. Zlata Blažina Tomić, a medical historian, she has been working on medieval and early modern Latin texts held at the State Archives of Dubrovnik, Croatia that relate to the plague control regulations and other early public health measures implemented by the Ragusan Republic (1358-1808). The monograph of the mother-daughter team Expelling the Plague: The Health Office and the Implementation of Quarantine in Dubrovnik, 1377-1533 was recently published by McGill-Queen’s University Press in Montreal (2015).
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