Expelling the Plague: The Health Office and the Implementation of Quarantine in Dubrovnik, 1377–1533 by Zlata Blažina Tomič, Vesna Blažina (review)

Expelling the Plague is an overdue corrective to the study of plague control in late medieval and early modern Europe—a field still dominated by Italy and principally the city-states of Florence, Milan, Turin, and Venice, despite recent works on Seville and cities in Germany. Since studies by Richard Palmer and Carlo Cipolla from the late 1970s, Italy has been pictured as the pioneer in developing quarantine procedures, lazzaretti, border controls, health passports, information networks to track plague, and draconian measures to ensure isolation of suspected individuals and goods. To be sure, historians of early modern Italian plague have mentioned Ragusa in passing and its “trentina” of 1377. Since 1911, medical historians have recognized it as the first plague quarantine,¹ which barred persons from infected regions entering Dubrovnik and isolated them on the island of St. Mark and town of Cavtat. But as regards plague and health care, little further is heard of Ragusa post-1377.

Steeped in archival sources and informed by a wide reading of the European plague historiography, Tomič and Blažina’s study continues Ragusa’s remarkable story of epidemic control to its last plague in 1533. In 1390 it formed the first health office, and in 1397 led the way again, establishing the first permanent health office with regular elections of patricians (Cazamorti), who appointed commoners as assistants to guard city gates, hired gravediggers, cleaners, and plague doctors, and established courts to try violators of plague ordinances. With successive plagues (1397, 1415, 1426, 1437, 1457, 1482, and its most devastating one of 1526–27), Ragusa’s patrician councils extended plague controls and imposed stiffer penalties. In 1397 corporeal punishment and torture were added to fines. In 1415, the health office acquired an armed boat to patrol Dubrovnik’s coastline against the entry of goods and persons from infected regions. In 1457, the Cazamorti employed two commoners to patrol the city twice daily to search for the sick and keep detailed records of them. In 1482 the health office began tracing plague contacts and even the goods they handled and from where these originated. During that plague the first violator of a plague ordinance was executed.

Expelling the Plague is not just an administrative survey of plague legislation and implementation. Rather, it argues cogently that the increasing sophistication of these controls made a difference to the city’s protection. Plagues at Ragusa became shorter and reduced in scale, and the gaps between outbreaks widened from one every seven to ten years, common in Europe as late as the seventeenth century, to no plagues in forty-four years between 1482 and 1526 in Ragusa. Despite Dubrovnik’s dependence on commerce with Italy, its system of surveillance successfully prevented the widespread Italian plague of 1502 from entering its gates. Most markedly, the city was the first major commercial city to rid itself of plague during the Second Pandemic, and this was achieved a century before Milan, Venice, and Florence and 130 years before Rome, Genoa, Naples, and their environs.

This important work, however, is riddled by one contradiction. The authors rightly praise Ragusa’s plague controls based on contemporaries’ observations that their plague was a “communicable” disease (pp. 161, 229, 234), transmitted person to person and through goods. Yet, without qualification, Tomič and Blažina present the disease (regardless of its pathogen or possible strain of Yersinia pestis) as dependent on the complex and generally noncommunicable transmission from rats to fleas to people. Their book is filled with passages about rats that supposedly crawled through ships’ hulls and fleas that infested victims’ hats (pp. 42, 43, 162, 166, 179, 190, 205); yet not a single cited document mentions a flea or rat. More important, by the early twentieth century scientists and afflicted communities...