Dr. Jane Stevens Crawshaw (5:09)

Thank you so much. Thank you for the invitation. I'm delighted to be here.

Professor Susannah Lipscomb (5:12)

Dr. Stephen Scrawshaw. I suppose we should start by thinking about the nature of Venice as a place, and what about it made it so susceptible to plague.

Dr. Jane Stevens Crawshaw (5:23)

Venice at this period is one of the largest cities in Europe, so it has a really high population density. So we. We estimate that it had about 170,000 people in the second half of the 16th century. And it was a really cosmopolitan population. So in addition to quite a high level of permanent residence, it was described in this period as a hotel for the people of the world. So there are visitors, there are traders, merchants, and so on passing through the city. So I suppose it's the High level of population density and also the transient nature of some of those visitors. You mentioned earlier in your introduction, the distinctive environment that Venice has and the fact that it's constructed in the middle of the sea is felt at the time to affect the quality of the air. And so if you had asked someone in the 16th century why Venice was predisposed to higher levels of plague, they would have said, well, it's maritime, it's a port. This is exactly where we know the risk of plague is higher, where you have higher levels of moisture in the air, it's therefore more prone to corruption. And it's the transient level of the population. You know, lots of people from all parts of the world mixing together as part of this kind of vibrant mercantile trade economy.

Professor Susannah Lipscomb (6:46)

And yet, given this preponderance for plague and disease in this area, it is strange that you point out in your work that before you started working on it, plague hospitals had received little sustained attention from historians working on Venice or beyond. Why do you think that was so?

Dr. Jane Stevens Crawshaw (7:08)

I think it's probably partly to do with where they were located. So we were talking a moment ago about Venice's distinctive environment. So the urban centre is comprised of these small islands come to be linked by individual bridges, and then there's a sort of circle of islands surrounding that central concentration. And these hospitals that were set up were located on these slightly more peripheral islands. And what's true of the Lazaretti is also partly true of the history of these broader islands too. They were neither in the centre of Venice and therefore absolutely prominent within Venetian histories, nor belonging to territories beyond. They were much more on that kind of border zone. And that's precisely why they were located on these islands. They were intended to provide a kind of zone of protection really for the city, particularly for the trading vessels that were coming in from places across the globe. Vessels would be directed to these islands before they were allowed to then progress with their materials and their crews into Venice itself. And I think that meant that they were not central in terms of visibility in the kind of urban centre. There's been much more attention paid to the writings of medical doctors as well. And that sort of higher level case built around the ideas about plague than people's experiences. That's partly to do with the challenges that there are around the sources that people left behind, which are quite fragmentary. And I think it's more recent work that started to look at the material culture of plague, the burial sites that survive, an interest in what we can learn from buildings. This has all helped to sort of come together to create a context within which the hospitals came, you know, more sort of central to the story of plague in Venice.

Professor Susannah Lipscomb (9:05)

And can we start out by thinking about the ways in which the lazaretti were different from other European plague hospitals? I mean, I'm assuming that there are other European plague hospitals to start with, so perhaps we can establish that. First of all.

Dr. Jane Stevens Crawshaw (9:22)

Yes. No, there are. I mean, Venice establishes some of the earliest. So 1423 is when we get the first of these Venetian hospitals. It's known as the old lazzaretto. And about 30 years later, the Venetian authorities decide that they should have a second to provide more of a kind of comprehensive system for dealing with the plague, so that you could have one space within which you treated the sick and one space within which you observed those that may have come into contact with infection, but it's not yet clear, or those who are convalescing after a period of treatment. So we get this development of the system and absolutely, we see these hospitals established elsewhere in Europe too. It takes time. Not every everywhere in Europe sets up hospitals, as the Venetians did, on a permanent basis. It's actually much more common for the authorities to earmark a space that they know could be utilised if a city was affected by plague. And this might be a site for a religious community. Generally, what the authorities were looking for were large spaces that were fairly well connected to urban centres, so good transport links, often with access to high quality water supply. But crucially, they were looking for space. You needed large sites in which you could accommodate populations of the sick, but also, as you referred to in your introduction, the goods that these individuals had, so that there was space to disinfect materials, objects, as well as to treat people. And what the authorities also tried to do was to have a number of kind of services for the sick on site, so there might be a space for the preparation of medication. There were often laundries and kitchens. And so on the whole site, the institution required quite a lot of space. And so that's why in a number of other places, those were set up on more of a temporary basis and could be requisitioned when they were needed. But they do eventually come to be established across Europe, sometimes located slightly more centrally within towns and, as I say, more commonly located on the outskirts. And a kind of final option that the authorities could utilise was to set up wooden structures. You might build a temporary structure, utilise it for the duration of a plague outbreak and then burn it at the end to Ensure that that was a kind of measure of disinfection that was used by public health officials in some instances.

Professor Susannah Lipscomb (11:50)

And you've said authorities throughout that. We're talking in Venice about civic authority as opposed to religious institutions. How unusual was that?

Dr. Jane Stevens Crawshaw (12:01)

So in terms of Italy in this time, it certainly wasn't unusual to have a health office as part of the government. So in the 15th century, we see set up and these offices had quite broad areas of responsibility. They would make sure, in theory, that the streets were cleaned and things like the quality of foodstuffs being provided in the city was high. They might also take on the oversight of groups within the population that were seen to potentially pose a risk to the health of the urban community. So sometimes they are responsible for the oversight of the sex trade. So the development of a health office is not particularly unusual in an Italian context. In facing up to the threat or the experience of epidemic disease, it's really sensible to think about the state and the established church working hand in hand. That was certainly the intention in this period. The ultimate cause of epidemic disease, certainly through the 16th century, was generally seen to be the wrath of the Christian God in Europe. 1 16th century writer in Venice compares plague to a storm and says, in the same way that you can't see the dying down of a storm without an abating of the winds, so for an outbreak of plague, you won't see a dying down of the impact without the kind of abating of the wrath of God. And that moral basis for epidemic disease meant that state and church tended to work hand in hand across Europe. The church was fundamental to the running of charitable institutions, and the church structures were also fundamental to communication structures in early modern Europe. So if you wanted, as a government official, to get a piece of legislation out, recognised and adhered to quickly, one of the strategies you would often use was that of the pulpit and the parish officials. So I think in terms of that understanding of the cause of disease, as well as the way in which communication worked, in an early modern context, it made sense for church and state to work together. And that's true in Venice too. So the hospitals that are set up on these islands of the Venetian lagoon have chapels and they have chaplains appointed to serve in them with assistants, and they would have been responsible for providing that spiritual care. But you're absolutely right to say that in Venice, these hospitals are overseen ultimately by the state, they're funded by the state and they're largely staffed by individuals who were appointed by the government health office. So there is something Distinct about the Venetian response in that it's this publicly funded permanent structure that is overseen by, directly by the government from a really early stage to say, early 15th century.

Professor Susannah Lipscomb (15:04)

And why and when was it that 40 days was chosen to be the period of time for which someone was quarantined?

Dr. Jane Stevens Crawshaw (15:12)

Yeah, I mean, I think it is very much, as you said, it's a reflection of that intersection between the medical and the religious in understanding epidemic disease and does come back to the purpose of public health care in this period, which was that form of purification. And it is a. A biblical period that you see repeated as a time through which that atonement for sin would be carried out. It had also been applied to other medical contexts like the lying in after childbirth for women was associated with that need to purify the female body. And that was established as a 40 day period in practice. And so that's where our term quarantine comes from, that quaranta in Italian, that 40 day period in practice. Because in the running of this system, there is a recognition that it needs to be practical as well as effective. There are other periods that are applied to particular groups or particular materials over time. So initially there is absolutely this system of using a 40 day period. But with experience, officials come to see that there are contexts within which you can reduce that partly in order to make the system as cost effective as possible, because these public health measures were phenomenally expensive, where they observe that you can reduce the period and still have, they feel the same degree of positive impact. So those ideas about symbolism are central to understanding the purpose of quarantine. But the practice of it does come to be adapted to experience and circumstances.

Professor Susannah Lipscomb (17:00)

What did a lazaretti look like?

Dr. Jane Stevens Crawshaw (17:02)

Well, it depends a little bit on where you were in Europe, but in Venice it would have looked a little bit like a religious convent or monastery. It had reasonably high walls as you approached it from the water, but you would have been able to see some sort of bell tower and central chapel. So that idea that these were spaces within which the care of your soul was as important as the care of your body was important, you would have been aware of large areas of open space. So quite a lot of the structure was left without building in order to allow for that free flow of air. The Venetian structures allowed for space for both people and goods. And actually these islands were a little bit more compartmentalized than we see elsewhere in Europe. So the idea was that you would have been placed in a particular area and you probably, unless you were an official, wouldn't necessarily have had that overarching sense of the rest of the island. You would have been placed in a particular part of the hospital and that small corner would have been the bit that you experienced during your period of quarantine. And it was probably pretty full of other people and other people's goods in the nearby warehouses. Elsewhere in Europe, some of these buildings become quite grand, particularly when they're purpose built. Sometimes you get a beautiful central chapel with a rectangular hospital structure surrounding it, so that the idea would have been that from patients rooms they could have looked upon the chapel and also have seen a service of the mass. There would have been wells for the provision of water. But as I say, I think the buildings themselves had that central notion of open space in practice that was often taken up with, as I say, other people. When these hospitals became overcrowded and the movement of materials and staff, and what.

Professor Susannah Lipscomb (19:02)

Was the contemporary response to them?

Dr. Jane Stevens Crawshaw (19:04)

It can be difficult to know. We get the odd reference in the records of the Venetian Health office, where you have officials talking to the administrators who are responsible for trying to organize the transportation of people out from their homes. And every so often you come across references that talk about treating people kindly, trying to understand the emotions that they might be feeling in being taken out to these islands. And you certainly come across the occasional reference to people resisting the journey out to these islands. But we do know that tens of thousands of people were moved out to these islands in Venice during the worst of the outbreak. So we have 1 in 1575-7 which is particularly severe. And as I say, the. The population sizes, patient population sizes, are really very significant. So in the vast majority of cases, people do go out to the islands, they would often be taken out in groups, family groups or groups that their neighbours would be taken out altogether. Quite how people spent their time is difficult to piece together. And we have very few records from people who carried out quarantine of how they responded to it. Sometimes these hospitals do have graffiti on the walls of rooms in which patients stayed. But the vast majority of the graffiti that survives was actually made by officials rather than by patients. So we have things like tally marks on the walls, which instinctively, as a historian, you think is that someone counting down their days, you know, they know they've got 40, where have we got to? But we think in practice, actually that was more to do with the administration of quarantine, the sort of practical concerns about whose goods are whose. How long has that pile of bedsheets been in that corner of the warehouse, These sorts of things that actually the tallies may also have been to do with game playing on behalf of the officials, not the patients. And in Venice there are a reasonable number of graffiti marks that are actually merchants marks. So again, we have this huge warehouse in one of these Venetian hospitals called the Tezzo Grande and the Wal covered in graffiti. But most of that is about. So this is so and so's pile of merchandise using the graffiti marks that you can see in other government documents. So it's one of the most challenging parts of working on these hospitals is to try to get to grips with how people would have experienced them and how they responded to them. We know that they were sites in which there were some medical cures, for example, tried out on the patients. And one of the things I would love to have been able to piece together about these sites is not just what was the intention of the authorities in allowing these cures to be tried out, but, you know, how did people respond to that sense that a new person might arrive with their so far yet unproven cure to try out on the individuals in these spaces? It's really intriguing. Were difficult to piece together from the sources that we have. But I think what does survive is a series of accounts written after the plague in which we hear about much more, a much more general sense of emotions in times of epidemic disease. And they tend to be things like an understandable sense of fear, a sense of being astounded by the speed with which the disease took hold in households and in neighborhoods. So people leave accounts that remark on the fact that you may well have seen a neighbour alive and well one day, and the next, you know, you hear that they have died as a result of the disease. So there's something about the suddenness of the plague that astounds people. And they also write about the impact on the streets of their city. So you mentioned at the beginning Venice is this trading center. It's bustling and cosmopolitan. And you get these descriptions of the streets of Venice. The principal shopping street is described by John Evelyn in 17th century as being one of the most delicious streets in the world, full of spices and beautiful cloths from across the globe. And suddenly these streets are empty. And people remark on the fact that there are so few people walking and walking so important in Venice because of the lagoon environment. So you either travel by boat or you travel on foot. And that these streets that are not being walked in this time of place start to become, you know, overgrown. You can see vegetation growing on them and so on. So it's the suddenness with which the city is transformed that you feel most keenly when you read some of the accounts of Venice in times of plague, People's experiences at the hospital are far less well documented. Unfortunately, yes.

Professor Susannah Lipscomb (24:07)

That sense that plague was so destabilizing is something perhaps we can now resonate with having gone through COVID 19 and remembering seeing those empty streets. We were very lucky, though, because although in that early phase many people died, it wasn't something that happened in 24 hours in that, you know, terrible, speedy death that plague brought, which must have been completely bewildering for contemporaries.

Dr. Jane Stevens Crawshaw (24:45)

I think that's right. And one of the things, and we've talked about the fact that these hospitals in Venice were set up in the 15th century. They're permanent, therefore they're in use for a long period of time. But when we get through to some of these experiences of plague in the 16th century, what is really distinct is the intensity of these outbreaks, and that's a change. So plague affects cities in Italy probably estimated every sort of seven to eight years through the 15th century. When we get to the second half of the 16th century, suddenly these epidemics become less frequent, but the levels of mortality are much higher. So in the 1575 plate that I mentioned, mentioned earlier, just under 50,000 people died out of a population of about 170,000. So the level of mortality is really very frightening. And people at the time are frightened by it because they haven't seen the disease affect their cities and their populations like this. So plagueis is familiar, but it is being experienced in a really very distinction way. And that trying to understand something that you thought you knew, that's presenting itself in an entirely distinct way is challenging. And you can feel that in the writings of people at the time that they're trying to reconcile why it is that it's being experienced in this new way and much more intense way.

Professor Susannah Lipscomb (26:12)

It's hard to get your head around that, isn't it? That's one in every three or every four people. It's extraordinary.

Dr. Jane Stevens Crawshaw (26:18)

The levels are astonishing. And I think, particularly in a city like Venice, where they knew their level of preparedness was high. This was not a city that had left public health to chance. So they had had their public health systems in place for 150 years, give or take, by the time the plague of 1575 affects the city. And so there is a sense that they've invested an enormous amount. They have expertise, they have systems that are ready to go, and the experience of the disease is still very intense. And severe. And so that's a different challenge for governments to grapple with. And I mean, at the time, you do see, there are debates about when you should introduce, when do you decide that you are going to declare that an epidemic is in place? As you know, it's interesting to look at those factors about when you start an epidemic as well as when you declare it to be at an end. And that matters, the declaration of the epidemic matters, because that's when you really mobilise the public health systems properly. And In Venice in 1575, there is a well known episode whereby physicians come from Padua. And Padua was part of Venetian territory. It had a renowned university, very well respected medical faculty, and the physicians said the disease that was affecting Venice in the summer of 1575 was not plague. And as a result all of those measures are not put in place at that early point. The same a similar thing happens in Padua where after the event they say, you know, we did, we put the right measures in place, but not at the right time. And I think that debate about you may well have systems that you can call upon and this accumulated expertise in dealing with public health, but actually, when do you declare an epidemic that really matters and people realise that it really matters? And even by, you know, late 17th century, you get medical officials looking back over the centuries and saying, you know, there have been times in Venice's history where the disease hasn't been diagnosed effectively. And as a result, this public health knowledge and these systems that we have in place that we know we can use haven't been put into place early enough. So it's not just having the measures, it's the timing at which you implement them. And the debate around what happens in 1575 partly coalesces around this timing of the introduction of public health measures. In trying to answer the question, why is the city so badly affected by an epidemic in this time, particularly when it's known as a place with this high level of expertise in public health.

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Professor Susannah Lipscomb (31:28)

So say an epidemic had been declared. What was the process that was followed when people got the plague in Venice?

Dr. Jane Stevens Crawshaw (31:35)

Yes, so it comes back to one of your earlier questions about the relationship between church and state. So this is where we really see the unit of the parish come to the fore. So what would have happened is the household heir would have been responsible for reporting that sickness to their local parish official and at times that would be the parish priest. Then we do get male residents appointed at this parish level as the disease progresses so that you get a couple of people that you could call upon. Those officials are then responsible for collating this information about which households are infected and reporting that daily to the central government office. So the health office and that health office starts to compile statistics on a large scale about infection. Which households are infected, where deaths have occurred. If they're concerned about a death being played, then they could send out the doctor, the health office doctor, in order to talk to anyone, householders and family members, about how symptoms came on and sort of activities, behaviours leading up to that moment of mortality. And the government starts to also post statistics on a weekly basis so that individuals get some information about what's happening in their city through an outbreak. So once the health office has been notified of an infection, ultimately it's in the hands of the officials to decide whether or not that you. It gets closed up as a home or whether or not the residents get taken out to the plague hospital islands. And in Venice, what tends to happen is people are moved out to the islands for their initial period of treatment and care. They could be on these hospital islands for a really extended period. If they spend 40 days in one of the islands being treated and then have a period of convalescence on the second island, then they would be returned into the city, but their household would be closed up for a further period of quarantine. So you could spend, you know, months in different stages of quarantine, and through that time, parish and government officials are responsible for monitoring symptoms, assessing levels of need. So certainly in the hospitals that would be. Are there any particular medical treatments that are required back in the household that would be to do with food supply and making sure that people had the necessary provisions when they weren't allowed to leave the boundaries of their home. So there's a whole kind of apparatus that's called to the fore. You know, really bureaucratic exercise around communication at every level, you know, parish, district and citywide. And the islands are being. The officials on the island are also in constant contact with the health office. So there are letter books that go back between the doctors on these islands, and we know that the officials overseeing the island hospitals are also writing letters. So it's a constant flow of information about levels of need, levels of infection and also levels of mortality and how.

Professor Susannah Lipscomb (34:52)

Compliant were people, these patients were the punishments if they disobeyed quarantine?

Dr. Jane Stevens Crawshaw (34:59)

There were because. And that's one of the interesting things, I think, about the development of quarantine is, as a public health measure. You're essentially saying, you know, the government has the right to inhibit the liberty of an individual and their movements and their ability to earn a wage for the benefit of the collective good. And it does pose all sorts of very genuine economic and social problems for households. They're principally through that inability to earn a wage during A time of quarantine. But we also know that there were people who felt that their homes were boarded up unnecessarily, who continued to try to socialize with neighbors during times of plague for all sorts of different reasons. I mean, the contemporary sources talk about a kind of state of mind that says things are really, really very difficult, so you should just seize the day and you should try to live life to the full, because levels of mortality are incredibly high. Other times, it might have been boredom that prompted that desire to not to follow the rules. And undoubtedly, there were efforts made to try to send out a signal that compliance was important. And interestingly, historians like Julia Calvi, who have worked on criminal records in times of plague, have said, actually the levels of prosecution of cases in practice shows that there was some degree of understanding, leniency, perhaps things were not pursued to the degree that they might have been. But the idea is to convince people that they need to comply. If they didn't, they weren't always prosecuted to the full measure of the law. But there is absolutely a recognition that trying to carry out the public health measures that are in place on the scale, you know, citywide, when you're trying to deal with a level of crisis that is represented by epidemics, you require compliance. And the number of officials within a government office in the 16th century is really quite low. And of course, they try to increase their staff, but they're still massively outnumbered. So you really do need the population to be compliant for this to stand any chance of working. I think that, as with a lot of records that survive, you don't always get, as a historian, that access to what happened when things went wrong. As I say, you know, in some cities, you do have criminal records. You can see that people are. If they've tried to steal objects, absolutely. That is something that government officials followed up on. But at times, I suspect the picture that comes through from the records that survive is a much more sanitized version of the history of public health. And there's much that is hidden. And Venice is particularly prone to this. This was a republic. It was very proud. The sense was that it was a stable city. It was a wealthy, successful city. The story that they tended not to tell was one of the resistance and social upheaval and so on. So we can imagine that there was much more of this everyday resistance than the records really allow us to piece together.

Professor Susannah Lipscomb (38:27)

Let's think about the people who worked at Lazzaretti, who was running it, for a start.

Dr. Jane Stevens Crawshaw (38:35)

So in Venice, they were called the priority of the hospital, and this would generally be someone who was of the kind of middling classes in Venice. This was actually the post of being the head of the plague hospital doesn't sound like an enormously enticing role, but actually it was one that brought a high degree of job security. So it was one that people applied for. And particular families seem to have, have been gifted this role in return for loyal service to the Venetian state, and then to have looked to have passed it on down the generations. It came with a house with quite a pretty garden in the Venetian lagoon and, as I say, a reliable salary. And most of the time would have been a fairly bureaucratic role, dealing with the quarantine of a few vessels coming into Venice at a time. Certainly some complexities over the cleaning of goods from a particular trading vessel and handling the cruise and so on, but on a reasonably small scale. That was the sort of everyday life of the lazaretti. Obviously, if you happened to be the prior in charge of these hospitals when an epidemic hit Venice, all of a sudden, and with that kind of suddenness that we were talking about earlier, the nature of your role would have been transformed almost unimaginably with the kind of intense level of need within these hospitals. But that wasn't the history of these institutions across many of the years of their operation. These were short periods, but very, very intensely experienced. So it was, yeah, priors in charge of the hospital structures. Sometimes it would be a married couple who were appointed, although the sort of office holder was in the kind of patriarchal 16th century way, the office holder would be referred to in terms of the male head of hospital. But it was important to have a woman appointed alongside them, either their wife or someone who would have oversight of the female population on the hospitals in times of need. So there was an important role for women within the structures, but just a little bit more hidden in the documentation that survives.

Professor Susannah Lipscomb (40:54)

You note that there was a 15th century scandal that led to, to this kind of segregation by gender. Can you tell me about that?

Dr. Jane Stevens Crawshaw (41:02)

Yeah. So I think this is one of the interesting things about charting the development of these hospitals, is that there's some degree of experimentation that comes out in terms of how you should structure these hospitals to really try to give, you know, patients the best chance, but also the community the best chance at the protection that they were intended to provide. And so at one point, the Venetian authorities experiment with using one island for male patient and one island for female patients. And in the early years of the 15th century, some degree of some Quite high degree of responsibility actually was given to the female head of hospital. But as you say, there is a scandal in Venice. That means that the authorities, you know, start to really emphasize the need to have an overarching male appointee in place. This is at a time when in Europe, Europe more generally, there's a sense that some of the opportunities that have been there for women to earn money in their own rights start to contract and what's been called a masculinisation of work is taking place. And so what happens in the Venetian hospitals does broadly fit in with that pattern. But I think you're absolutely right to say that the particular events in Venice are the kind of spark, but that is part of a slightly broader shift anyway, I think where you see across a number of charitable institutions, this need for male, clearly identified male oversight starts to become much more common.

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Professor Susannah Lipscomb (43:55)

And what about ordinary people working in a lazaretti? It doesn't seem like it would necessarily have been an attractive role. Quite hazardous conditions. So who was it who was employed?

Dr. Jane Stevens Crawshaw (44:08)

So I think again it was. It's a bit like what we were saying with the priors when these islands were being used for visitors and for the support of that mercantile trade economy for these vessels. I mean actually conditions on the islands would not have been particularly difficult and so you could have been one of the cleaners on the island and you would have taken your boat ride back and forth to the island each day. You wouldn't have needed to be resident on the islands, you would have carried out your shift disinfecting goods and could have earned a fairly reliable wage. The same if you were someone who was cleaning or providing the bread cooking in these hospitals and so on. When it becomes really difficult to staff these hospitals at the level that's needed is during these epidemics, when the cities themselves are affected, and in those periods, the government starts to try all sorts of different measures to try to make sure that they have enough people on their staff. That's both for these hospitals, but also for the operation of this bureaucracy around public health within the city as well, there are certain roles that I think were particularly difficult to staff. One that interested me was that of the body clearer, where, with the high levels of mortality, it is necessary to have individuals who will remove the bodies of those who have died, whether it's in the city or in a hospital. During a plague epidemic, that is one of the roles that governments find it particularly difficult to maintain what they consider to be a kind of optimal, safe level of staffing. And so they start to offer incentives, financial incentives. They do also try to improve the quality of clothing that they give to the people who are carrying out these roles. So they give them gloves that are waxed on the outside with the idea that that would be a material that the kind of. Of particles of plague, as they're thought of, would be less likely to stick to. And so that would reduce levels of infection. The same with over garments, they try to provide more of that and they also provide some medical treatments to those who are carrying out these roles, again giving them a sort of preservative against the plague. So they do recognise that this is a job that is difficult to. That is seen to carry a high level of risk. And at one point, they also do offer those who have been convicted of a crime within the city up to a particular level of seriousness. So it's for more minor misdemeanors, not for the most serious crimes in the city, but they do offer individuals an opportunity to essentially atone for their crime by taking on a period of service in a public health role, like body clearing. So it is difficult. It's partly difficult because there is a level of turnover in these roles, but it's mainly challenging because of the high level of need in these epidemics.

Professor Susannah Lipscomb (47:11)

Yes, I can imagine turnover might have been a problem. You mentioned there some of the things that were used as preventatives or thought to be preventatives at the time. Were there traditional cures?

Dr. Jane Stevens Crawshaw (47:25)

There were.

Professor Susannah Lipscomb (47:26)

There were the things that they believed could treat plague.

Dr. Jane Stevens Crawshaw (47:28)

Yes. And so we have doctors throughout the centuries writing plague tracts from the end of the 15th century, publishing plague tracts, and often these would include cures as well as preservatives against the plague. We also have, in an Italian context, where governments throughout this period have looked to encourage a degree of innovation by offering patents across a whole suite of areas of economic and technological activity. So these could be for innovations in cloth weaving or dredging machines and so on. What the Venetian government does at an early point is to offer a system of patenting and invention. And there comes to be a sort of form of this applied to public health, whereby you could approach the health office and tell them about the cure that you had in your possession, and. And if they accepted that your cure was beneficial, you could receive actually quite generous financial payment. And the people who offer these are quite wide ranging, and sometimes they're health office doctors who may well have proven their cure over a few years of service, but also they're offered by, generally men, but across the social spectrum and from a whole host of different backgrounds, you didn't have to be a doctor in order to offer one of these cures. And as I mentioned earlier, during some of the worst of the epidemics, the government does offer the opportunity for some of these individuals to prove their cure by going out to these island hospitals and administering it to patients and seeing whether or not it's effective. And if it's effective, then they may well be purchased by the state. And some of the most successful of these do come to be printed so that they would have circulated in a kind of cheap print, single sheet form around the city, so that whether you were in one of the public hospitals or not, you had access to the information about the sorts of cures that were felt to be beneficial.

Professor Susannah Lipscomb (49:29)

How many survived a trip to the lazaretti?

Dr. Jane Stevens Crawshaw (49:33)

So it's difficult to say, but people did come back. And I think for Venice, during the worst of the epidemics, something like 70% of the people who went to the islands were probably died on the islands. And that would have been a mixture of people who were already diagnosed with the plague and those who were being observed in. In quarantine. But outside of that epidemic period, a very, very high proportion of the people came back from the lazaretti. You know, it would have been seen as just part of a kind of necessary stage of the trading economy that you would carry out your obligatory period in quarantine. But the vast majority of people who went into the hospitals in Those sorts of contexts would have expected to carry on with their journeys and carry out their. Their sort of periods of contact in the city as they had planned. But during an epidemic, levels of mortality were very high in the hospitals. And as I say, that would have been a mixture of people who had already been showing symptoms within the city, so people who we know were sick. So, yes, high levels of mortality on these islands, which prompted, you know, a challenge around the administration of these sites. And I was emphasizing that space was really important, but. But they were never designed to accommodate the numbers of people that were sent during the worst of these epidemics. So the systems undoubtedly became completely overwhelmed and dealing with that level of mortality came to be hugely challenging. And I think account for some of those observations that you referred to in your introduction, where the hospitals are described as hellish. Undoubtedly, the conditions in the worst of these epidemics must have been truly awful to behold.

Professor Susannah Lipscomb (51:16)

Tell me a bit more about some of those conditions.

Dr. Jane Stevens Crawshaw (51:19)

It wasn't unusual in an early modern hospital to have to share a bed with another patient. I mean, it wasn't unusual in an early modern home to share a bed. We do have accounts of people being, you know, three or four to a bed in these hospitals. Some of the symptoms of plague are distressing to observe. I mentioned earlier that the disease comes on very suddenly. It was often associated with a high fever and delirium. And so there are accounts of, you know, shouts and screams in the hospitals, patients being distressed. We know that the staffing levels were not where they would have been in that those structures were stretched unimaginably. And so there would not have been a sufficient number of serving staff, nurses, doctors to deal with the number of patients that were there. So although the hospitals were set up with that intention of providing good quality care, clean environments, good quality food, medication and so on during the. And the epidemics are not. Are not experienced in a sort of linear or uniform way. But during the worst of the epidemics, that just the levels of overcrowding must have meant that conditions were very, very distressing to behold. I think, and I mentioned earlier, that people would have traveled out with other members of their household, with their neighbours. So the way that transportation was organized was generally parish by parish, so they would have taken out groups. So you may well have been surrounded by. By some people that you knew very well, that you had, you know, lived and worked alongside for many years, as well as a whole host of strangers. But I think there's something about the way that the hospitals were organized. The idea was that you were out, you were transported out with others that you knew. And so you would, you know, to some extent that would have brought a degree of comfort, but it also must have been very, very distressing to see those that you, you knew very well in these incredibly difficult conditions.

Professor Susannah Lipscomb (53:26)

What were the practices when someone died during a plague?

Dr. Jane Stevens Crawshaw (53:30)

So if it happened in the city, then one of these body clearers that I mentioned earlier would be sent by the health office to remove that individual. In most cases, then the rest of that household unit would be sent out to the plague hospitals. And these same body clearers would be responsible for cleaning the space of the home. So that might mean removing a number of the objects and materials. Sometimes those would be cleaned, sometimes they would be burnt. It involved making sure that the floors were well swept. And there were also measures used to clean the walls of buildings. So that often employed a solution, was high in vinegar content. And sometimes not normally in a home, but in more of an institutional setting, it would involve whitewashing, because there was a sort of belief in that significance of colour, that by painting something white, it would repel disease, whereas that colour, black, was seen to sort of absorb more of the sort of material of infection and pollution. So there was a sort of practical and partly symbolic purpose to whitewashing. And sometimes, depending on the number of households that have been affected, you might well get the burning of aromatic herbs and woods either within particular home or sometimes in the street, if there was an effort being made to sort of purify, cleanse the air in a particular area. And then the individuals who have been sent out to the plague hospitals would be obviously observed initially, unless they were showing signs of infection themselves. And after a period of time when they were believed to be free of the suspicion of infection, they would be allowed to return to their homes, but their homes would be fundamentally transformed, you know, with a number of the objects, materials no longer there, perhaps looking very different with this process of cleaning that had gone on that couldn't always be done carefully or thoroughly. And so, you know, plenty of records survive that talk about the impact on buildings of plague. Just the wear and tear, the destruction of materials, the way in which to return to a city where quarantine's been carried out and some of these measures have been put in place, meant that you were returning to a place that was at once familiar and also fundamentally different.

Professor Susannah Lipscomb (55:59)

That's absolutely fascinating. So, as we come towards an end, could you tell me whether the model of the lazaretti, this Venetian sort of pioneering solution to the Plague, did it just remain unique to Venice, or did anywhere else attempt to copy it?

Dr. Jane Stevens Crawshaw (56:18)

The idea of having a site for quarantine is something that had been used in other ports beforehand. So Ragusa Put, which is Monde, Dubrovnik, for example, had a space. It's not used in the same kind of permanent way. But Venice isn't the first, and it certainly isn't the last to make use of these spaces for quarantine. In many of the cities and we think probably towns and villages, although it's much harder to trace when you get down to the sort of records of smaller communities, did have a space that would be used in order for people to be taken from their homes in times of plague, to be theoretically cared for and treated before they would be returned. So we see plague hospitals set up, certainly in a European context, throughout the Iberian Peninsula, France, the Holy Roman Empire in England, in Scotland, we know that these institutions were common. They're also set up in early modern Scandinavia. So that basic premise of having a central site to which people could be taken, in which care would be provided, in which people could be observed before they were returned, was a very, very common model for dealing with this challenge problem of plague in early modern Europe.

Professor Susannah Lipscomb (57:32)

Well, thank you so much. It's been fascinating to drill down into this detail of one important city in Europe and how it dealt with something that was surprisingly common, you know, so frequent and so devastating. And yet, despite the way that that was so destabilizing and upsetting for people, people, there was this established system of managing it. And it's a really good reminder that we often patronize our early modern forebears, but actually they were developing really elaborate, sensitive systems to trying to manage the circumstances in which they found themselves.

Dr. Jane Stevens Crawshaw (58:18)

Yeah, I think you're absolutely right. And it just reminds us of some of those complexities of you can have a system there in principle, and it's often to do with the practice. You know, the timing with which you put a measure into place, the timing with which you declare an epidemic. Those can be the things that make a difference. But when you look back at the early modern period, there was this recognition. It was important to be prepared for managing the risk and the impact of an outbreak of epidemic disease. And I think that didn't mean that experiences were easy. In many cases, they remained very challenging. But I think it's an important recognition, as you say, that part of the state's responsibility was to ensure that the community was well prepared for outbreaks of epidemic disease in Europe.

Professor Susannah Lipscomb (59:05)

Thank you so much. For joining us on the podcast Dr. Jay and Stephen Croshaw. It's been lovely to talk to you.

Dr. Jane Stevens Crawshaw (59:13)

Thank you for having me.

Professor Susannah Lipscomb (59:16)

Thank you for listening to this episode of Not Just the Tudors From History Hit. Thank you also to my researcher Max Wintool, my producer Rob Weinberg, and to Amy Haddow, who edited this episode. We are always eager to hear from you, including receiving your brilliant ideas for subjects we can cover. So do drop us a line and not just the tudorsistoryhit.com and I look forward to joining you again for another episode. Next time on Not Just the Tutors From History Hit.

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