The plague ravaged major cities and provincial towns in northern and central Italy from 1629 to 1631, killing over 45,000 people in Venice and wiping out more than half the population of cities like Parma and Verona. But strikingly, some communities have been spared.
In fact, the city of Ferrara, in northern Italy, managed to prevent even a single death from the plague after the year 1576, even when neighboring communities were devastated. How did they do it? Records suggest that border controls, sanitary laws, and personal hygiene were essential to the city’s success.
From the catastrophic arrival of the black plague in 1347, Italian cities gradually began to take proactive public health measures to isolate the sick, quarantine potential carriers and restrict travel from affected regions, explains John Henderson, professor of Italian Renaissance history at Birbeck, University of London, and author of Florence Under Siege: Surviving the plague in a modern city.
Over the next three centuries, epidemics of plague occurred regularly in the densely populated cities of Italy, provoking increasingly coordinated and sophisticated responses. While Henderson says that the same general package of anti-plague measures has been taken in the cities of Italy, the city of Ferrara, which has about 30,000 residents, offers a fascinating success story.
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Border control, sanitation and hygiene
A team of researchers from the University of Ferrara delved into municipal archives and historical manuscripts to discover a Renaissance approach to “integrated disease management”. They attribute Ferrara’s remarkable success to a combination of strict border surveillance, aggressive public sanitation, and rigorous personal hygiene regimes that harnessed the natural antimicrobial properties of herbs, oils, and even scorpion and snake venom. .
Ferrara is a picturesque fortified town situated along a branch of the Po river halfway between Padua and Bologna, both seriously affected by the plague in 1630. Site classified as World Heritage by UNESCO, Ferrara stands out for having some of the first paved roads in 1375 and a sewage system since 1425.
From the 15th century, says Henderson, the big Italian cities like Venice and Florence remained in constant communication with the small cities like Ferrara to follow the propagation of new epidemics of plague. The information was used to set threat levels and coordinate public health responses.
In Ferrara, the highest level of threat meant closing all but two of the city gates and setting up permanent surveillance teams made up of wealthy noblemen, municipal officials, doctors and apothecaries. Anyone arriving at the gates of the city had to carry identity papers called Fedi (“Evidence”) to ensure that they had arrived from a plague-free area. Then they would be screened for any signs of illness.
Plague hospitals outside the city walls
In the city, the same level of vigilance was used to identify suspected cases of infection and to move individuals into one of the two lazaretti or plague hospitals outside the city walls of Ferrara. Similar hospitals in Florence treated more than 10,000 patients during the plague of 1630-1631, all paid for by the state. Henderson says doctors have long believed that the plague was caused by “corrupt air”, which could be released underground during earthquakes. Corruption has also been caused by “putrefaction”, decaying matter and other dirty garbage in cities and countryside.
In 1546, the Italian doctor Girolamo Fracastoro published an influential text on the contagion in which he pushed this theory a little further. “He developed an idea called ‘disease seeds,'” says Henderson. “This is how he envisioned the spread of the disease from one person to another. These disease seeds had a sticky quality that could also adhere to clothing and objects. “
Public sanitation campaigns in cities like Ferrara were born out of a long tradition of medieval and health legislation, reinforced by theories of the contagion of Fracastoro. The streets were swept with garbage and rid of “dirty” animals like dogs, cats and chickens (no mention of rats). The lime powder has spread generously over any surface that may have been in contact with an infected person.
Inside the homes, residents tried a multitude of measures to disinfect objects and surfaces. Any damaged or cracked furniture was removed and burned. Valuables and money were heated near a fire and perfumes were sprayed throughout the house for 15 days. Clothes and other textiles were hung in the sun, beaten and sprayed with perfumes.
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Antimicrobial body balm
For personal hygiene, the citizens of Ferrara turned to several popular natural remedies prescribed to protect themselves from the plague. But they took one above the others: a medicinal oil called Composito. By law, a supply Composito was to be stored in a locked box in the wall of the municipal palace and distributed only in case of plague.
The secret recipe of Composito was concocted by the Spanish doctor Pedro Castagno, who wrote the influential of Ferrara “Reggimento contra la plague(“Diet against the plague”), in which he described how to apply the fatty balm on the body.
“Before getting up in the morning, after lighting a fragrant wood fire (juniper, bay leaf and vine shoots), warm the clothes and especially the shirt, first rub the region of the heart, near the fire to facilitate the absorption of the balm, then the throat, ”wrote Castagno. “[Afterwards], wash hands and face with acqua chiara (clean water) mixed with wine or vinegar of roses, with which sometimes the whole body must be cleaned, using a sponge. “
Venom added to medicine
Castagno never disclosed the ingredients used in manufacturing Composito, but by examining the records of the materials ordered by Castagno, the researchers determined that the balm contained myrrh and Crocus sativus, both known for their antibacterial properties, as well as the venom of scorpions and vipers.
In fact, the recipe for Composito was no different from the anti-plague schemes used in other parts of Italy, in particular “Oil of Scorpions” and an ancient ointment called Theriac, also made from viper venom.
“The choice to use venom is that only real poison could fight the plague poison,” says Henderson.
Centuries later, it is difficult to confirm that the specific combination of public health measures in Ferrara was the secret of its success. Most Italian cities have also applied the same rules and regimes to combat the plague. The difference, says Henderson, may have to do with the level of application of Ferrara.