Contagion Theory and Contagion Practice in Fifteenth-Century Milan
Author(s): Ann G. Carmichael
Source: Renaissance Quarterly, Vol. 44, No. 2 (Summer, 1991), pp. 213-256
Published by: The University of Chicago Press on behalf of the Renaissance Society of
America
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Contagion Theory and Contagion Practice
in Fifteenth-Century Milan*
by ANN G. CARMICHAEL
WW HEN USED TO UNDERSTAND AND COMBAT the spread of bubonic
plague, "contagion" is not a very helpful term. Plague is ecologically a complex disease transmitted from rodents to humans via
fleas, and human-to-human passage of the disease is uncommon.
Moreover, humans do not form lasting immunity to plague and
cannot maintain the microorganism in human populations in the
absence of infected rodents and their fleas. There can be no "Typhoid Mary" figure in the passage of plague. Nevertheless, popular
histories of late medieval and Renaissance Europe, as well as specialized histories of medicine and of public health, champion the
emergence of contagion theories and practices based on the acceptance of contagion ideas, as the progressive edge of European defenses against recurrent plague.
While contagion theories do not adequately account for the actual biological occurrences of plague in humans, the evidence that
surrounded the earliest production and elaboration of such ideas can
tell us much about the social context in which they first appeared.
What observers found important and what explanatory models
they accepted at all stages of the diagnostic process is as revealing
of early modern experience during epidemics as is discussion of
what actually happened to cause illness and/ or death from the mod-
ern medical point of view. In "seeing through" (the literal meaning of"diagnosis") an ill person's observable "signs" and reportable symptoms, medical and lay witnesses to sickness and death attach meanings reflected, in part, in the naming of a disease, a
"cause," or a particularly disturbing event or sequence of events.
*All manuscript materials are drawn from Milan, Archivio di Stato, and I am most
grateful to the staff archivists who helped me in locating these materials. This paper
was originally presented at a conference on the History of Disease sponsored by the
Francis Wood Institute at the College of Physicians of Philadelphia, March, 1988. I am
grateful for the comments and suggestions of Ellen Dwyer, Arthur Field, Helen Nader,
James C. Riley, Charles Rosenberg, Steven Stowe, and especially Katherine Park for
guiding my revisions of the original paper. This research was supported by the Na-
tional Endowment for the Humanities, #RH2o835-87.
'On the standards of diagnosis see Ballester; Lockwood; and Siraisi.
1 213
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214
RENAISSANCE QUARTERLY
In this way, social historians of medicine would argue, a d
"socially constructed."
The diagnosis of plague, for example, involved a process
tinguishing some illnesses and deaths as cases of plague wh
ferentiating these from non-plague cases. Some part of th
relevant criteria were obviously medical, some epidemiol
leading a diagnostician to say that a case was one of plague
some important criterion was fulfilled and could be verified
one observing the evidence. Of course, to agree on the nam
agnosis observers had to share the same assumptions abou
could be concluded from that evidence. A larger meaning
cial construction of disease" might make far greater claim
shall here as to how the assumptions (e.g., theories) were
upon and what kinds of evidence were allowed or discoun
this more limited study, I shall examine the relations dr
tween evidence and assumptions in the diagnostic process
scribe how differently-oriented persons in authority wrestle
different experiential data that they gathered by managing,
day, the spread of plague in a city. Many struggled to link th
perience to the concepts invoked by their use of the
diagnostic category, "contagion," which had different m
for different diagnosticians.
I describe the course of a relatively minor plague, that o
in a relatively large urban center, Renaissance Milan. Most
elaborate discussions about plague contagion and public hea
trols based on that assumption postdate the mid-fifteenth cen
so I am also describing a relatively early point in the polit
intellectual debates about contagion-based plague control.
the Milanese were wrestling with the formulations of co
theories and concepts generations before others did, I sha
sarily have to preface description of the 1468 plague with
of Milanese practices and attitudes to plague before this time
this groundwork is laid, I shall provide a detailed description
ideas and assumptions of medical witnesses, public health
ities, and the ruling elite during this particular plague.
Death by itself had become a meaningful social event to
sance Italians, who first began to keep records of mortality d
the late fourteenth century.2 For the Milanese, the assign
'See Carmichael, 1986; and Cipolla, 1972.
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CONTAGION THEORY AND CONTAGION PRACTICE 215
medical cause to death registrations was obligatory aft
fifteenth century. All individuals over the age of two
all years, whether or not plague occurred, had to be assig
for death, as the records surviving after 1452 amply test
rich data that Milanese records provide suggest that it
to debate whether medical men or public health authoriti
cepted the notion of contagion. The story to follow illust
there were two divergent traditions of evidence, argumen
tion governing the behaviors of these two different
groups. How a physician could believe that the disease
vidual patient was contagious depended upon acceptanc
different view of plague experience from that guiding
ficers. Reflecting parts of the society's overall commitme
tagion principles during plague, the Milanese evidenc
that the variant experiential data supporting these sep
tions in contagion theory and practice permitted general
authorities, in this case the duke of Milan, to vacillate bet
physicians' and the health officials' differing solutions to
agement of plague.
Public Health Practices in Milan, 1350-1468
Very little is known about the Black Death and the second p
epidemic in Milan other than the fact that Milan, as an inland
may have escaped infection until 1360. In 1374, however, t
wave of plague to hit urban Italians, Duke Bernabo Viscon
mulgated a version of the earliest quarantine laws ever ma
centrating on the restriction of movement from plague-s
territories into the ducato, the lands controlled by the duke o
lan. 3
In I399-1400, his successor, Giangaleazzo Visconti, an exceptionally able military leader and administrator, took such an active
personal interest in plague control that records of procedures at the
parish level can still be gleaned from his dispatches and general cor-
respondence. Probably not all of the epidemic controls and strategies for crisis management were novel to Giangaleazzo's admin-
istration, but the core program evident sixty years later had
3For the legislation see the Chronicon Regiense, 82; Corradi, 1:224-25; and Grmek,
40-42.
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RENAISSANCE QUARTERLY
216
certainly been established by this early date.4 The duke interv
in three specific ways. First, he demanded notification con
all illnesses and deaths in the city, in the process setting up a
anism for regulating part of the practice of medicine in the c
All illnesses were to be reported to the appropriate parish elde
ziano), either by the physician caring for the patient or by th
of household. The parish elder then notified either the officia
bollette or the duke's hand-picked commissar. The specific
cation procedures and the regularization of this process were
established by 1438 and were repeated practically verbatim
the tumultuous years of the Ambrosian Republic (1447-145
oligarchy formed after the death of Filippo Maria Visconti
legitimate heir. Political revolutions did not change this re
process, which had been extended to normal as well as to e
years during this half-century.
Second, Giangaleazzo intervened in the creation of an officia
sition, the commissario, overseeing all health regulations
duchy as well as in the city of Milan. Scattered evidence
smaller Lombard cities during the first half of the fifteenth c
suggests that the scheme of confirming the causes of both ill
and deaths was extended throughout Milanese territory and th
crisis years a second tier of administrators personally respons
the duke sifted through all the information in order to coo
defenses throughout the territory. Thus the commissioner'
probably originated as a temporary solution to epidemics
missioners were appointed in 1419 and 1424, and again dur
brief-lived Ambrosian Republic.
Third, Giangaleazzo interfered in the use of hospitals an
pital resources, regulating how the commune would co
emergency personnel, possessions, housing, and sustenanc
those touched by plague. Ecclesiastics could be fined for b
anyone whose family was not provided a burial license, t
product of the reporting and registration process developed
tail. Religious houses were conscripted for the housing of
who might otherwise die of famine because access to resour
4On Giangaleazzo's plague controls see Bottero, 1942, 17-28; Pasi Testa
and esp. the thorough summary by Albini, 84-101. In general, see Cipolla,
17, for comparison of Milanese legislation with that of other north Italian st
sOther aspects of the regulation of medical practice are treated in Bottero,
Belloni.
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CONTAGION THEORY AND CONTAGION PRACTICE 217
severely limited during the crisis. Other houses o
erties controlled by the Church could be assigned c
covering from plague (not everyone who got plagu
the overflow patient population normally absorbed
hospitals. Thus, at least from the time of Gianga
care for the poor and care for the plague-stricken w
concerns of the state, a state that asserted its right
claims of private individuals and religious institution
need to combat plague demanded.6
These premises of public health control still op
century later, but little real change had occurred.
thorough study of the topic teases out the details of
eral sanitary legislation and practices, finding the
change administrators' gradual acceptance of in-ho
during plague times. Giangaleazzo's approach to pl
volved strict segregation of healthy from infected, p
burden on officials to remove from the city all in
nosed with plague, and to create houses of recovery t
pede the re-introduction of plague. Firmly believ
spread by contact, Giangaleazzo was aware that b
in the house with the ill person and those who had
tact with the household were tainted and should be
the general community. Early in the century, adm
perately tried to keep up with the construction of te
or cabins away from the city or the assignation of m
pital properties for quartering these people, in add
in providing for those who might perish without sta
bini concludes that by mid-century the necessity
contacts in their own houses became both a polit
nomic necessity, even though health officials, app
tagionist models, could argue that the procedure w
plague in the city. Plague would surely spread to
the household, multiplying the sources for new ca
was not both lengthy and rigidly enforced.
6Albini, 63-78, esp. 68. I argued that plague and poverty wer
during the early fifteenth century, but for an altogether different r
perience during plagues fueled this administrative conclusion; s
Albini's book, unavailable to me when I wrote my study of Floren
a rich discussion of the late medieval notions of poverty as well a
linked their perceptions to specific plague controls.
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218
RENAISSANCE QUARTERLY
Plague entered Milan in 1449, despite the Ambrosian Rep
best efforts to follow every detail of traditional sanitary proc
gaining the full cooperation of Milan's College of Medicine
as benefiting from the contemporary reform of hospitals so t
full resources of these wealthy institutions could be directed
trolling the problems of poverty and famine. Ironically, th
villa Giangaleazzo had used as a refuge from plague in 1400
propriated first as a shelter for the mendicant, desperate poo
lected from the streets of Milan, and then for the city's first
shift lazzaretto (pest house).7 In 1450, Francesco Sforza, a b
mercenary soldier equally successful later as an administrator,
possession of Milan from the Ambrosian Republic. His vict
aided in part by marriage to Filippo Maria's daughter,
Maria, and in part by the coexistence of this devastating pl
the city, eclipsing the resources of the republic. Sforza made
ical capital of the population's weariness with war, plague
famine, but he did very little to change reporting and isolatio
tices in the middle of the epidemic. He did receive notification
sonally, probably daily, of the deaths and new suspicious i
in the city, though few of these bulletins now survive. By 14
plague was receding, the bulletins that had so long been re
of parish elders, physicians, surgeons, barbers, and herbali
porting deaths in the city by date, age, sex, cause, parish, a
tifier of cause-of-death, were written into the first surv
Necrologi or death registers.
The basic outlines were the same as in 1400, but it is worth
marizing the status of public health surveillance with the adv
Sforza rule in Milan. First was death reporting, where by
heads of household were to report in writing both illnes
deaths to their parish's elder. If an individual was under the c
a physician belonging to the prestigious College of Medic
were university-trained physicians and surgeons), the ph
could by-pass this step on behalf of the family. Barbers had t
the permission of a collegiate physician before attending a
tient; all surgeons, herbalists, and barbers had to call in a coll
physician if a patient remained in their care more than three
There were predictable exceptions to these rules: infants an
7Albini provides full texts of the relevant legislation during the 1447-50 pe
details of the use of Cusago first as poor house, then pest house, see Decio
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CONTAGION THEORY AND CONTAGION PRACTICE
219
young children or, in some cases, accident
whether by the judgment of the general p
by an elder's testimony. The elders were o
report of these illnesses and deaths to the of
conservation of health" or the "health comm
Milan." The older officiali delle bollette, had
duties, one (the older, original function) gov
of all visitors to the city, lodged in privat
one governing the other aspects of health su
the time of Giangaleazzo. In other cities o
neighboring territories, the sanitary office
officiali delle bollette, but by mid-centur
called "officali deputati a la conservatione de
super sanitate servanda in urbe Mediolani"
sanitatis. "X
Because Milan had a population of aroun
it was large enough that the position of com
functions and, to some extent, general hea
the duchy. Here the overlapping jurisdict
management problems, such that the duk
about plague in Milan, or plague in Pavia,
mona, for example, either from the depu
from a more general governing agency, su
to the duke (Consiglio secreto). Since it wa
second half of the fifteenth century where c
plague should first be directed, correspon
come from the Secret Counsel, usually co
state such as peace treaties and war; from
vants such as his secretary, general infor
from the health deputies; from the commis
boards of health or officiali delle bollette; o
sicians. For example, there were at least thr
death report in normal years: one from th
record in the Necrologi, and one in a daily
duke. During the year I shall discuss below,
ried to the duke from the deputies, the h
Secret Counsel, but the permanent death reg
Thus on some days, three bulletins reached t
'Albini, 9off., gives information for Milan and the
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RENAISSANCE QUARTERLY
220
pearance of one agency or individual checking up on anothe
rare, however, that the duke would have been informed ab
events directly by a physician. For the most part, the p
seem to be peripheral to the main process of public health
that is, they were not the decision-makers. The extent to w
put from particular physicians may have been crucial to ch
public health practices is important, and a question to whic
return shortly.
Some changes in public health practices accompanied Sf
in Milan, however much they built on older traditions.
Sforza's relationship to the process of plague and general h
veillance, insisting that he be fully informed of the m
health in the city at all times, recalled something of th
control exercised by Giangaleazzo Visconti. Francesco Sfo
wise appears to have been concerned most with the reform
pitals and the aggregation of their extensive properties in
ation of a central receiving and acute care hospital, th
Ca'Grande or Ospedale Maggiore. Sforza dedicated the g
and inaugurated the building of the hospital in 1456.9 H
have left other details of health control to his secretary
monetta, and to his personal physicians, especially Ben
Norcia.
Francesco Sforza died in 1466, leaving the government of Mi
in the hands of his wife, Bianca Maria Visconti, and Galeazzo Mari
Sforza, his oldest son. Mother and son shared controls for just
couple of years, her voice usually the stronger, until three sim
taneous processes effectively placed young Galeazzo Maria in fu
uncompromising control. First, he completed negotiations fo
politically superb marriage to Bona of Savoy, bringing Genoa i
Milanese control. Though only in her early forties, Bianca Mar
failed to keep ahead of chronic illness. And finally, plague reac
Milan. In 1467, plague, common to all the cities and territories
southern Italy, crossed the river boundaries patrolled by the duke
men. In 1468, it reappeared in the city. Because Galeazzo Mar
planned his wedding celebrations to include a triumphant tour
his domain, beginning in Genoa and ending in Milan, his perso
involvement in plague surveillance and control was much keen
9Spinelli.
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CONTAGION THEORY AND CONTAGION PRACTICE 221
than his father's ever had been. o All levels of Milanese administra-
tion ultimately had to contend with his understanding of the causes
of plague, his preferences for exercising controls, and ultimately,
his anger at their failures. But there was enough of a political vacuum created after the death ofFrancesco Sforza that the young duke
had to craft his own understanding of the role physicians and health
officers should play. Galeazzo Maria Sforza's correspondence with
officials betrays his attempt to "micromanage" the epidemic from
a safe distance, inserting his orders and ideas into the process of
plague control almost as much as did his great-great-grandfather,
Giangaleazzo Visconti. Both officials and advisors were quick to inform the duke what his opinions about plague control should be.
Galeazzo Maria's own anxieties about the wedding plans as well as
his political need to assume unchallenged control of Milan and the
duchy may account for his unprecedented involvement in the medical and public health details of an unfolding epidemic.
Medical Traditions in Milan, 1350-1468
Milanese physicians had an ambivalent relationship to th
"contagion" in medical theory, even though the College
sicians had since 1396 made plague-related exceptions to its r
collegians should attend the funerals of others in the college
league died with a "contagious or pestilential malady," his
did not have to go to the interment or carry the bier. I Give
unwillingness to touch plague, the physicians as a group m
been reluctant to perform any kind of postmortem verificat
a person died of plague. College physicians did perform au
presumably in the study of human anatomy, for the statute
the college and the city of Milan in 1396 allude to the yea
vision of a corpse and a place for dissection. 12 The physi
not, however, express unqualified support for a contagion
of plague, nor did they make recommendations similar
public health officials urged. The reasons for their reluct
'Corradi, 5, 244-46.
"Bottero, 1943, 104.
'2See ibid., 105; and Belloni, 671-72. One year a male corpse would be provided
by the podesta of Milan, the next a female corpse. The large hospital Brolo was the typical location for dissection. One of the anatomists, Iacopo da Firenze, served as the surgeon to the Sanita in the 1450s plague. Toward the end of the century autopsies were
performed with such regularity at the Ospedale Maggiore that they had to be regulated
by the directors. See Spinelli, 112.
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RENAISSANCE QUARTERLY
lodged in the ways in which a diagnosis was made when a p
trained in Galenic medical theory was confronted with
uous clinical history or ambivalent "signs" on the body
person.
The following, tortured description of what seems to me a
straightforward case of plague will help to illustrate the clinical
problem with contagion theory in the fifteenth century. Here the
principal physician to the Sanita, Giovanni Catelano, reported a
suspicious case on 20 May 1468:
Gotardo de' Magi, thirty-five years old, fell ill on Tuesday about the hour
of mass, with an aposteme in his left groin, about which case I am doubtful
and perplexed. There is that which accuses and that which excuses. First
the short time period accuses. But his horseback riding excuses because he
was unaccustomed to it and because an aposteme can arise this way. He
has a son who Monday was bitten by a rabid dog, . . . which caused the
father to seize and to weaken considerably, either in compassion for the son
or possibly by contagion of rabies [contagione rabiey], for rabies is among
the contagious [diseases]. Tuesday evening he returned home [after killing
and burning the dog] with this weakness, nausea and aposteme which have
persisted until now (i.e., for three days). But I could be persuaded that the
aposteme might be caused by the rabies venom more than by pestilential
fever. For rabies is of a cold and dry, melancholic humor, and its respective
venom more detrimental to the spleen than to the heart. [Here follows a
description of what kind of material Catelano and other doctors think
might be inside this swelling.] The urine is laudable, but he has become
alienated [stuporous] over the past night, and has been vomiting bitter acids. Since this appears to alleviate his suffering I shall visit him and think
over the case.'3
Aside from the fact that the physician has chosen to take the patient's story seriously, this account shows how Catelano was simultaneously wrestling with the different causative physiological processes that could explain an acute bubonic swelling and with the
nosological dimensions of contagious and noncontagious diseases.
In other words, Catelano's interest in whether or not rabies belonged among diseases classified as "contagious" may have been
linked to here-unrehearsed debates about whether plague should
also be categorized as contagious. But deciding what caused Gotardo's aposteme involved a different sort of evaluation, one reviewing all the possible ways in which apostemes could appear. In
this initial case report, Catelano suggests that Gotardo could have
'3Milan, Archivio di Stato, Miscellalea storica brfizesca (hereafter, MS), 2, 1no. 41.
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CONTAGION THEORY AND CONTAGION PRACTICE 223
acquired the swelling traumatically, while at the sam
was weakened with the absorption of rabies pois
the aposteme and absorption of the poison toget
tardo's fever, nausea, vomiting, naturally so beca
the spleen, was compromised. From our point of
this particular rabies story cannot possibly accou
bubo or the malaise. While it is possible that the
agnostic dilemma lay with the credence the physi
patient's story, it is necessary first to examine t
Catelano presented.
The reason humans died from any acute diseas
plained by means of sudden humoral imbalances,
of as a putrefactive process. Plague was normally
ulent putrefaction of the humors, killing rapidly
suffocated. 4 The body's attempt to deal with th
sulted in the bubo or the skin reaction, literally
sonous putrefactive by-products from the body. It
records use to describe signs seen: butato, "thrown
teenth century, physicians would turn to examine t
process independently of the specific disease nee
and would begin to ask what caused the putrefactio
air that in turn caused deaths from plague. s In o
would focus on the ultimate, inciting causes. But
century, the physician could look at a bubo and
dents" of a physiological process of infection, lit
derive from the first insult to the body, the exter
of a hidden disruption of normal body functioning
these external manifestations as diseases in themsel
lowing other clinical courses than that seen with
do's case, Catelano thought it possible that the ap
erated exteriorly, initiating a local putrefaction,
medially as the rabies poison debilitated its victi
Melissa P. Chase's superb study of Montpellier
tive between 1348 and 1450 clearly distinguishe
concern with whether they were seeing contagio
witnessing pestilential fever manifested by the "acc
'4See Singer; Castiglioni; Sudhoff; and Chase.
'SSee Palmer, 1978; Nutton; and Palmer, 198I.
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RENAISSANCE QUARTERLY
224
apostemes. 6 What made the former contagious was the
they contained, an important point to which I shall shortly r
On the possibility ofnoncontagious apostemes, much the s
tinctions are made by Milanese diagnosticians as in Montpe
it is not surprising to find detailed differentiation from p
apostemata or swellings that were believed to have originated
wise. Three examples from 1468:
[une 6, a thirty-year-old man], reseen after death: found to have
teme behind the left ear, but already mature, emitting pus mixe
blood, which is believed to have come by way of a crisis of the illne
finally took him after twenty-two days; not worrisome, according
elano.
Bertola de' Rigoni, twenty-two years, . . was seen while alive and
found to have swelling or aposteme in his left side, toward the front, that
was said to have been caused by a severe blow by a piece of wood, which
[explanation] I trust to a degree. I was shown the place, which had a certain
lividness and a little excoriation, and the urine was good and abundant, but
unexpectedly he died after twelve hours. I returned to see the body. Another large swelling over the groin was found in addition to the other. He
died Saturday, that is, yesterday [une 6] at twenty-two hours. By thejudg-
ment of Catelano.
[August 5] Emanuel, servant of lord Ubleto da Fisco, twenty-five-
years-old [died] from a bubo [dragonzello] in the right groin, because of an
ulceration of the propoltius[?] due to an ill-considered application of constrictive medicines. The putrid matter turned back inward to the interior
and this caused a continuous, proportional tertian fever, not suspicious in
thejudgment of Maestro Stefano da Trivulio and Dionysio de' Ceruti, surgeon. '7
Earlier reference to rabies is rather more difficult for us to un-
derstand because we live a post-Pasteurian world that recognizes
rabies virus has an incubation period of at least two to eight weeks.
i6But Chase has us understand "accidents" by the term "symptoms," which has
had a long and varied medical history and may mislead many readers. Symptoms currently are considered to be the subjective expression of illness by the patient, specifically
what causes suffering to an individual. See Foucault, 90-94 on the early modern medical
usage of "symptom"; and King, 73-89, for what "symptom" means today.
'7MS, i, passim, by date. The last example, however, is found in Sforzesco, Carteggio interno, 883, 5 August 1468: "Emanuel famulus domini Ubleti de Fliso, annorum
xxv, [decessit] a dragonzello in inguine dextro propter ulceratione propoltii ex indebita
applicatione medicinarum constrictivarum. Reversa est materia putreda ad intra. Et sic
causa est febris tertiana continua proportionalis, sine suspectu, iudicio M.ri Stephani
de Trivulio et Dionysii de Cerutis, cirugici." It is quite possible that this man had a
plague bubo lanced, treated with poultices and constricting unguents. Surviving the
first disease, he succumbed to secondary infection of the lesion.
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CONTAGION THEORY AND CONTAGION PRACTICE 225
But according to medieval tradition, rabies was clas
short list of "contagious" diseases, diseases that cou
only through contact with someone (possibly an an
of contagions was short: phthisis, ophthalmia, anth
"sacred fire" (either ergotism or erysipelas, or both
bies, and leprosy. 8 What made a disease categoriza
gious related more to notions of the disease's transm
the specificity of the individual disease phenomena
measles and smallpox, indeed most of the "exanthe
bearing diseases, reflected signs of inward processes
the body surface. The modern concepts of disease s
example, that the measles rash is identical in each and
who suffers it, was first most clearly stated by Thom
in the I68os. As early as the I 540s, Girolamo Fracas
the idea of a "precisely similar corruption," which
the idea of specificity. '9 Before this time, Galenic em
determinative influence of an individual's unique h
sition governed most clinical thinking. Instead, me
naissance contagious diseases fit better into explanat
ing. It is in the treatises on poisons, in fact, that ra
discussed, and poisons were a medical topic of longs
est to the Visconti lords of Milan.20 Thus it is interest
subgroup of physicians, not under the control of
Medicine, did have a strong tradition with regard to t
tagion in plague. These were the ducal physicians,
time of Bernabo Visconti presented plague treatises
quently seen as the earliest sustained commitment
principle. Cardone de' Spanzoti was the first of the
his De preservatione a pestilencia to the Visconti in 136
advises the usual flight from turbid, humid airs, recti
'8Grnek, 25ff., provides a different list of the traditional contagio
ton, esp. 15-I6 for the rabies example, with the Galenic texts cited.
devoted a chapter to rabies as a contagious disease, following sugges
Aristotle, Galen, and popular tradition. Guainero wrote that rabies c
quickly after infection; see Thorndike, 4: 226. Temkin provides yet
diseases commllonly assumed to be contagious during this period.
I'Winslow.
2°Thorndike, 3: 525-45. Thorndike, 4: 217, explicitly links the literature of contagions and the literature of poisons.
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RENAISSANCE QUARTERLY
226
air by burning woods and herbs if flight is not possible, all b
the "morbo pestilenziale e contagioso."21
The most famous of all fourteenth-century plague tra
surely one of the two most often reprinted later, was Pietro
da Tossignano's Consilium pro peste evitanda, dedicated to Gia
azzo Visconti in I398. Tossignano has the most definite n
about contagion theory of any physician before the sixtee
tury.22 He argues that "it is safer to move to a region where
has never been an epidemic than where pestilence has reig
six months back, since the 'reliquiae' will remain and, act
a ferment, will infect those who come into the locality."
speaks both of contagious houses and the poisonous con
apostemes. Tossignano is justly famous because he was w
address both the public health dimensions of plague contr
the clinical treatment of individual plague cases.
This was not true of collegiate physicians. For example,
Guainero became one of the most prominent of Milanese
cians during the early fifteenth century, dedicating his trea
plague and poisons to Filippo Maria Visconti. Guainero ta
Pavia for a major portion of his long career in Milan
1448), and counted two of the Visconti court physicians am
preceptors.23 Delivering his treatise in both longer and ab
forms sometime before 1440, Guainero was possibly tryin
cure Visconti patronage. Guainero was predominantly a c
and clinical teacher, and his plague treatise, while claimin
drawn from standard, long-known medieval sources, is a
quite different from comparable literature of the day. He
the work by acknowledging that "some say plague is a con
disease" transmitted in touching, even though much of th
sion, following tradition, maintains that plague is generated
corruption of the air.24 Guainero, however, does not venture
'Panebianco. See also Belloni, 61 3. Two other physicians to this generati
conti wrote plague treatises: Giovanni Dondi and Maino de Maineri. The l
probably the son of Visconti physician, Pietro Maineri. See Castiglioni; and P
Zitelli.
-2See Singer, 187-89; and Mazzini.
:3Thorndike, 4: 2 5-3 I, 674-77. Luchino Bellocchio and Giovanni Franc
were personal physicians of Filippo Maria Visconti, as were Petrus de Mo
and Stephanus de Burgo, to whom Guainero refers on other occasions. See al
-4Guainero, f. i68v: "Dicitur et aliter pestis contagium a contangendo
tetigerit popuit vel quod ex unius contactu ad alios se facilinie transfert. Et id
tertio ethimnologiarurn pestilentia inquit est contagiumn quoddumn unumn com
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CONTAGION THEORY AND CONTAGION PRACTICE 227
cussion of public health measures for the control of
ring the matter to appropriate communal authorities.2
ingness to dictate public policy seems to differentiate
university-trained collegiate physicians from ducal
allowed such a refuge.
Strikingly different are the policy recommendat
physicians who advised the Visconti and Sforza
plague. The last of these, in the period before 1468,
Reguardati da Norcia, who became the personal
Francesco Sforza when the latter was still a militar
With Sforza's rise to power, Reguardati was called u
the duke about plague controls, which Sforza passed
Secret Counsel. 26 In 145 I, Benedetto was concerned
the health conditions of the city, specifically the am
he also proposed an interesting solution to the tra
plague controls presented. He suggested the equivale
zone, or portion of road between Milan and Pavia,
might be safely exchanged: a solution to quarantine
commercial goods that would become common a ce
A member of the Secret Counsel in 1464, Benedetto
further direct experience with managing plague. Bu
tant to the events of 1468, letters from Reguardati to
Maria Sforza in 1467 reveal his significant intermed
May, 1467, he reassured the duke that all the iden
plague had been imported, that is, they resulted from
plague outside Milan. He urged the duke to protec
avoiding all contact and conversation with anyone w
places where plague reigned and to interpose human
he had to deal with anyone who could have had
plague. 28 Ten days later, in a letter concerned with m
ad alios celerime transit." Interestingly, Guainero is aware of Isid
contagion in the Etymologies (7th century A.D.); Nutton, 20-21,
naissance authors overlooked Isidore.
2'Guainero, f. 70ov: "Et illo modo per viam contagii plures civitates ac ville fuerun
infecte. Qua de re reipublice gubernatores conversationem locabitantium infecta su
debent inhibere immo solum eius sive de propinquo locutionem."
26The letter, with others is printed in Deffenu, 140.
27Ibid., 21-22.
28Ibid., 159-60, prints the letter. Benedetto does not use the word "quarantine,
but the advice does seem similar to his solution to the Milan-Pavia commerce of 145
"ve dignate havere reguardo alla vostra persona et a quelli che ve stanno dappresso ch
ne voi ne loro non habbiano praticha ne conversatione con persone che vengano da loc
suspetti, et spaciare le facende per mezo de interposite persone."
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RENAISSANCE QUARTERLY
228
and business matters, Benedetto remarked that he knew M
been relatively plague-free, until he got "the list of the offic
the Sanita at 22 hours today." It is interesting, of course, t
ulate that individuals among the physicians to the dukes,
just this one, intercepted the lists of the deaths and illnesses o
city, filtering the information that went on to the duke. Ben
also mentions his devotion to the contagion model: "[thes
do not surprise us or cause anxiety, because we clearly see t
occur through contagion." Thus the city could be purified e
Reguardati wrote very traditional health advice and conf
with colleagues at Pavia on medical matters. He subscribed
astrological medicine especially favored at the university a
all of which suggests that his connections with the health
trates stimulated his open subscription to, even innovation
ing, contagion practices (not theory).30 Until young G
Maria came to power at age twenty-four, the dukes of Mil
have been comfortable with physician intermediaries. Ga
Maria was delivered and raised by Maestro Benedetto, w
scribed himself as "more nurse than physician" to the heir, an
duke was clearly torn by Benedetto's supplications to ret
Tuscany, a long-cherished desire, and his own mother's d
that the dearly beloved physician remain in her service.3
upon Bianca Maria's death in October, 1468, could Ben
leave, severing one sure link between university physicia
duke, and health magistrates.
Negotiating the Diagnosis of Plague
However sophisticated the observations of plague infecti
death from plague revealed in many of the physicians' record
absence of a theoretical defense of the transmission of dis
'9Sforzesco, CartceVio interno, 880, 18 May 1467: "Per lo dio gratia doi di p
Milano non e suto ne morto ne Infecto alcuno de peste. mal al presente ad hore
me venuta la lista del officiale della sanita che nel borgo de porta Comasina ch
stallo di piu fameghe ne sonno infirmate de pestilentia dove nelli di passati n'er
tre. Questo non ce da maraveglia ne grande affanno perche vedemo manife
essere per contagione. La quale per la gratia de dio se spera che legierment
purificare."
3°On1 Benedetto see also Cotton.
3'Letters of these negotiations among the duke, Benedetto, and the duchess appear
in Sforzesco, Cartcggio intcnro, 883, 15 February 146x (with a second letter this day from
the duchess to Cicco Simonetta to urge the duke further), and in other letters reprinted
in Deffenu.
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CONTAGION THEORY AND CONTAGION PRACTICE 229
contagion hindered direct discussion of the pr
with public health officials. While those tryin
spread of an epidemic understood the problem of
as one linked to Hippocratic notions about how
be transmitted from one person to another, p
the problem at the level of distinguishing wh
fact infected with the plague poison or putre
cians regarded the means of conveying the diseas
to another largely irrelevant to pressing diagnos
issues. Contagion was not the starting point f
unless one began by accepting that diseases, li
dividual entities entering human bodies. Thus lvh
was ultimately to become more important to phy
understanding of contagion than how disease cou
for Galenic and Hippocratic theory seemed to
for both successes and failures to transmit disease from infected to
healthy individuals.
Frequently, plague had to be the conclusion even though no clinical evidence could affirm the diagnosis, thus challenging and widening the physicians' basis for making a diagnosis. Clinically, phys-
iologically, plague was known by two very different sets of
descriptive evidence. Most of all, it was a profound imbalance of
the humors that accelerated putrefaction around the most vital of
all organs, the heart. In order to apprehend that process externally,
physicians had to rely on outward "signs" and discrete changes in
the patient's urine. On the other hand, plague was suspected if a
person progressed from health to death in less than five days, or if
he or she died in a place where other plague deaths had occurred.
Here classical theory had no framework for translating epidemiological information into clinical sign or symptom. An epidemic disease, since the time of Hippocrates, was an epidemic because it had
a cause common to the entire population affected, such as corruption of the ambient air, or through contaminated food, or through
astrological changes impinging upon the terrestrial world. The intersection between clinical information and epidemiological information was as difficult then as it often is for laymen today.32
32Many nonspecialists today trying to understand infectious diseases accept strongly
deterministic versions of the germ theory of disease and reject statistical models of cau-
sation. In fact, many things we consider to be discrete diseases fail to satisfy Koch's
postulates for proving the causal relationship. See Evans.
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RENAISSANCE QUARTERLY
230
"Plague" in practical, emergency conditions could en
far more than the texts allowed. But even had the narrowe
diagnosis carried greater weight, positive plague "signs
"black measles," "red (or black or violet) signs," "plagu
(even the expectation that these would appear), any acut
any "carbone," "pestilential fever" (an acute, high, cont
ver), "malignant pustules," anthrax-any one of which
cur alone or in combination with a bubone, glandula, drago
other aposteme. In such circumstances, it was difficul
plague as a discrete disease, unique in its clinical appea
Because the doctors were diagnosing more with an ey
cess, to the pathophysiology of plague rather than the
plague as a thing foreign to a body, passable from one t
their best efforts to comply with the health officials tend
dermine contagionist efforts. "Today we have two cases
uties wrote, "through which, according to thejudgment
below, we are doubtful and perplexed." With that, Ma
repeated the language of Catelano the day before (the
above): "And for clarification we diligently consulted
cians deputized to oversee this, who through that which
been able to understand and know by the script of this
neither absolve these cases entirely nor condemn them
the cases involved the female servant of a doctor-this time the
prestigious collegian Maestro Francesco de' Medici da Sereg
She was twenty-five-years-old and had an aposteme in the right a
illa. The case was arguable because she had several times before
difficulty (malo) in that spot, the part could have remained de
itated and "could have easily generated that aposteme, not, h
ever, pestiferous." The case report does admit that whatever
cause of the swelling, the woman's urine was "confused," poss
meaning cloudy, and she was in pain "from her head all the
to her feet on this same side." On the other hand, surgeon Dionys
equivocated, the fever was not intense. Perhaps Dionysio
swayed by the logic of the great physician, whose home woul
sealed if he could not persuade the young surgeon the case was re
ly more complex, but the Sanita also had to believe the story in o
der to support their subsequent actions.34 In another case
33MS, 2, no. 44.
34Francesco de' Medici da Seregnio matriculated in the College of Medicine 31 M
1454; see Bottero, 1943, 1i. Before his college appointment he taught surgery in
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CONTAGION THEORY AND CONTAGION PRACTICE 231
twenty-three-year-old woman with a "pestiferous
char, would have been a clear case of a plague pustule,
appeared on the left breast-not typical of plague.
uties decided to let the physicians wait for surer sign
worsened, it would be plague. If not, not.35
Believing in contagion as the magistrates did, ver
occurring in a confirmed, infected house, or at the la
the cabins, were ever considered anything but plag
cases awaited the surest medical "signs." Rapid succe
in a household helped to speed diagnosis and actio
May 1468] we do not have any new case except a w
Catharina, the wife of Tomaso da Pergamo, who die
der suspicion; she became ill yesterday and tonight wi
the deputized place."36 By the same measure, recov
diagnosis of non-plague. Arguing, as usual, that t
cising extreme caution, the deputies wrote the duk
they exported everyone in Giovanni Bono's house t
despite the fact that the house was large enough that
been separated from neighbors effectively. But "we
certain that the case was truly suspect, there being at
in this house another sick person who recovered."
every time there was a reprieve in the death coun
new cases, the deputies were willing to take advant
sicians' ambiguity in diagnosis: "Things are going
God's grace, and we hope they continue to improv
sicians are beginning to change their sentence and
now hold the firm opinion that no excessive news
cause now some tertian fevers have begun to appea
not convert into suspicious illness, from which
hope."38 Fuller discussion of the events of 1468 he
short-lived Studium of Milan; see la Cava. Dionysio appears in th
in the late 1460s, but is both a foreigner and a surgeon, never join
died in 1504, at the age of 80; see Motta, 256.
3sMS, 2, no. 44: "Pur per piu secureza havemo deliberato che ques
et secundo sara il caso si guovernaremlo. Domani per il nleglioramn
ramento che fara la fantescha de dicto M.o Francescho se intendera chiaramente si sara
sospecto o nonl."
36Ibid., no. 46.
37Ibid., no. 50.
38Ibid. (27 May).
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232
RENAISSANCE QUARTERLY
how physicians and health magistrates were called to de
separate traditions of contagion theory and contagion p
Galeazzo Maria Sforza
and the Path of Plague
In 1468, physicians, health officials, legislators, the duke, and his
personal staff were all involved in the process of identifying and
outlining what conditions presented a threat to the state. Effectively
the Milanese public authorities delimited the parameters of contagion practices before physicians could explore and articulate the
ways in which contagion theory posed serious challenges to
Hippocratic/Galenic physiology, for the physicians were most
concerned with understanding how contagious disease could undermine body defenses. Then as now, clinical data did not neatly
address epidemiological questions, though the debate was not seen
in these terms. Most of the numerical data about this epidemic must
be gleaned from letters, because no bound registers of the Sanita's
Necrologi now survive. 39 But the Sforza dukes retained so much
of their personal correspondence, among which many notices of
death and illness reports during 1468, from both the deputies of
health and the Secret Counsel, that we can reconstruct how the pro-
cess of diagnosing plague was negotiated and argued, the practice
behind an emerging theory of contagion.
It was probably inevitable that plague would reach Milan, for all
the major cities of Italy from Rome northward were stricken between 1464 and 1467.40 The deputies of health repeatedly warned
the duke that additional funds would be necessary in posting guards
at the gates, rivers, and major thoroughfares flanking the duchy.
Early in March 1468, a few plague cases were identified inside Milan, most of them associated with one large household.41 After a
few satellite cases appeared in late March, there was a period of
calm: "for twelve days now, by the grace of God, no case of plague
has followed [the cases in March]," the Secret Counsel wrote to the
3'A fire on New Years' Eve, 1502, destroyed much of the building in which the
health officials worked, probably accounting for the numerous lacunae in the late
fifteenth-century series of registers. The scribe notes this in the 1503 register, and the
text is published by Motta, 244. Zanetti further describes the Necrologi series.
4°Corradi, I, 4, and 5, ad ann1iiir)1.
4The earliest surviving notices come from late March but consistently refer to
plague cases among one large household, the Lampugnani, e.g., MS, 2, no. 2, 25 March
1468.
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CONTAGION THEORY AND CONTAGION PRACTICE 233
duke on April 6.42 But later the same day the counse
that a thirteen-year-old boy died "not withou
plague," and they immediately contacted the depu
mation. The deputies of health in turn dispatched
collegiate physician Giovanni Catelano, who had e
rience diagnosing plague during the 1450-52 epid
reported that he was in agreement with another co
Maestro Marco da Roma, that the signs surround
warranted caution. Although the boy's urine gave n
of plague, and he died after an eleven-day illness, the
ing was a new finding when they inspected the c
thought that perhaps the boy had arisen too soon a
illness and this was a recurrence resulting in an ap
bated further by rainy weather. Nonetheless, Ca
that the course of illness could be attributed to a
to contagion."43 Marco's report (via the deputies' le
swelling in the right groin, a continuous fever for e
blood-tinged urine that could not rule out the fever
The Secret Counsel decided to impose cautions des
cians'judgments, giving the household the option o
der house arrest or going to their villa. They were to
and not have any dealings with others.44 Officiall
judged a plague death even though the medical evid
ocal. The duke's magistrates superficially accept
judgments about early plague cases but separately
plague controls should be applied whether or not thes
dividuals actually died of plague. In taking the doc
with a grain of administrative salt, the deputies and
were also assuring the duke that their view of the si
for the city than the physicians' more tedious ana
Ten days went by without another worrisome death
ficials were clearly unsettled. The next official pla
April, an eighteen-year-old girl who had been ill for
attributed to her living next to the house of the firs
March. The physicians almost certainly agreed that sh
because they reported a bubo in the left groin an
events" (accidentibus). In this case no other potentiall
42Sforzesco, Carteggio interno, 883, by date.
43MS, 2, no. 3, 6 April 1468.
44MS, I, no. I36.
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RENAISSANCE QUARTERLY
234
tail was offered. We can infer from surviving correspondence
the duke was informed when this girl first fell ill, for H
Marchese,45 the health commissioner himself, wrote to the du
April 17 that he had gone to visit another member of this hou
because the duke so ordered him. The ill man that he saw was then
exiled from the city, to go to his villa or to one of the designated
plague houses, along with three siblings. Hector assured the duke
that if this man disobeyed in any way he would be punished "in a
manner that would provide an example to others. "46 Another death
on April 23 called forth plague controls because an immediate
neighbor of this six-year-old girl had died a few days before. As in
an earlier case, she showed no convincing signs of plague infection,
but the girl had an enlarged inguinal gland. Though Catelano found
the urine "good," provisions were made. Catelano was not willing
to judge this case plague on the basis of a "glandula" alone, because
urinalysis was a crucial factor for him, but as the physician appointed to the Sanita he acquiesced to the demand for precautions.47
By late April the Secret Counsel and the deputies of health had
translated their worries into a set of provisions, bracing themselves
for massive evacuation of the city even as they offered up an explanation to the duke of the origin of the illnesses and deaths iden-
tified. One neighborhood around the Cinque Vie (Five Points or
Five Streets)48 was seen to account for almost every new case of
confirmed plague. The original cases in early March had occurred
in the parish of St. Pietro della Vigna (see map), and all the satellite
cases of March and early April occurred in this or a contiguous par-
ish. The first mention of Five Points occurs, however, in a letter
of 27 April from the Secret Counsel, noting a new case in a man
named Maestro Legutero. At this point two different shelters in the
countryside were set up to receive healthy suspects, and San Gregorio was designated to receive the ill.49 All the guards on passes,
45Most proper names in the Sforza archives appear in Latin, and I have translated
them to Italian. Hector Marchese is the exception: because he always signs his name
"Hector," even when writing in Italian, I have preserved this form.
46MS, , no. . This story is appended to a normal death report and begins, "o visto
quanto me scrivi la excellentia Vostra circha il fato di Ambrosio, nepote di Symone
Mantegatio. .. ," thus alluding to a letter from the duke to Hector.
47MS, I, no. 292.
48A nineteenth-century photograph of the area is provided by Branduani, 72-73.
49MS, 2, no. 6, 27 April. One of the purposes of this letter seems to be shifting the
blame for plague away from administrative error to the argument that plague was everywhere in Italy, especially in the principal cities with which Milan traded. See Albini,
101.
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CONTAGION THEORY AND CONTAGIO)N PRACTICE
235
Santa Maria al Circolo
MAP OF MILAN WITH FIFTEENTH-CENTURY PARISHES
roads, and rivers were put on full alert, much like closing the barn
door after the horse has escaped!
The surviving letters from the end of April and first week of May
reflect only the tip of the iceberg of a growing panic in the city.
Conducting business normally became less possible as the circle of
contacts of plague cases and plague houses widened. For example,
one of the members of the Secret Counsel failed to show up for
work. The duke, somehow informed of his absence, immediately
demanded that his salary be withheld. On 2 May the deputies wrote
to explain that the man's daughter had entered the house of a priest
who subsequently died of plague; thus the councilor had voluntarily absented himself from the city for a few days.5s Within a week's
time the city would empty of its better citizens, including the duke's
mother and her extensive entourage, bound for her dower city of
Cremona.5s Galeazzo Maria's wedding was set for midsummer,
and wealthy Milanese would normally have housed dignitaries attending the wedding, so the exodus was a matter of utmost concern
SOMS, 2, no. 9.
S'For a good discussion of flight from cities during plagues, see Mazzi.
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RENAISSANCE QUARTERLY
236
to all officials. If those who fled were to return, they would s
how have to be persuaded that plague was not a threat to th
the city. If the plague indeed spread by personal contagion,
than by mere proximity to infected houses, this kind of socia
sure could be relieved if plague could be diagnosed early e
to remove the sources of contagion before other individua
inadvertently exposed. And so the process of diagnosis was to
under scrutiny during the month of May.
On the first day of the month came a report of the mortal
of a twenty-five-year-old female servant of Lord Scaramu
conti, who, together with his large household, was lodged
Castello Sforza as the duke's guest. Catelano was sent to det
the cause of the servant's illness. Although he viewed the p
urine and admitted that it was cloudy or "turbulent," a cau
worry, his report does not indicate clearly whether he actually
Caterina. Instead he could have made his diagnosis through
terview, or case history, taken from members of the hous
She had a swelling in the groin area but supposedly was deb
by fasting ("ex defectu necessarii regiminis pro vita") and may
received treatment, specifically inducing sweating and open
lesion in order to evacuate the noxious material causing her
("putabam eam ex toto evadere per copiosum sudorem e
tionem illius eminentie in coxa. ")52 Whatever procedure wa
it didn't resolve the problem, for Caterina was close to deat
haps the cloudiness of urine was a further sign of the concent
of putrid matter in the body.
Surely the ambiguity in this report reflects some measure o
political delicacy of a plague diagnosis inside a household pr
by the duke. All would have to be evacuated or confined to
ters. A second case this same day had placed an entire family u
sanitary interdict because the man had a carbone or pustule in t
eral part of his left eyelid. Though this man's urine was judge
suspicious and his death occurred after a seven-day illness
mally outside the range considered indicative of plague, "
valde est," Catelano reported. It is possible that the diagn
plague in this case had little political consequence, so the di
between the physicians' diagnosis and the deputies' decision
be ignored. But a plague physician as experienced as Catelan
52MS, i, no. 307.
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CONTAGION THEORY AND CONTAGION PRACTICE
237
not governed easily by the politically or so
days later, May 3, the servant Caterina died
swelling reappearing in the groin. "I do no
this other than plague," Catelano reported.
Also on May 3 the duke's deputies wrote th
old boy who lived near the Five Points had m
tato el signo de infection") that could not be
plague. Here the victim, not yet dead, was o
and his father, a citadino and notary for the c
known to the duke. "But by the father and by
sumed that this case proceeded from the hou
Laghuti" (probably the same as Legutero not
The deputies' next letter, May 4, noted the b
the wife of Guido de la Croce, a builder, claim
ready informed the duke about both cases, as p
they assumed these two and a girl who just
quired plague in the Five Points. Finally, 5 M
cleric associated with the church of S. Pietr
a high fever and vomiting: "This new case is p
ceeded because this cleric conversed with a p
of the church of S. Maria Pedone, who had pra
house of Petro Crispo near the Five Points."
out of the city, and the deputies grimly no
have to supplement S. Gregorio as places for
first of these three cases had glandular or b
idence of plague.
Thus carefully noting the precise chain of in
every case of plague, the deputies' letters in ea
that careful case tracing and aggressive sepa
from the potentially infected would prote
more than three people died each day of plag
from contagion, taken in that neighborhood
S3Ibid., no. 225, 5 May 1468: "Questa matina siamlo avi
sato al Clerico del preyto de la Clesia de S.to Petro al ort
de etade circa anni xvi asalto el vomito cumn la febre gr
mandato el Catelano quale per il suojudicio lo mete suspec
sume sia proceduto per havere havuto esso clerico convers
tonio beneficiale de la Clesia de S.ta Maria pedone el quale
Crespo infect. vicina ale Cinquevie. Havemno ordinato de m
fuora de questa prefata vra. Citate."
54MS, 2, no. 12.
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238
RENAISSANCE QUARTERLY
other places," the Health Magistrates argued, "there is present
stain [of plague] whatsoever." Interestingly, the duke didn't se
information so optimistically. He answered the bulletins
. . we understand from what you wrote in your [letter] yesterday
the progress plague makes and of those who are ill, and we are m
pleased with this. It appears to us that you have not applied every
and good provision. Thus we wish and charge you to summon the
College of Medicine before you along with Maestro Benedetto da N
and all the court physicians, and even all the gentlemen (zettil
elected to [stand guard] at the gates. And all of you together shou
sider and deliberate upon all of the best provisions for remedying
plague. We want to hear by this evening what you have arranged c
ing this. It truly surprises us that you always assert that you need
to make provisions, etc., for you have not given us information a
sums needed to make these provisions. We will make all disbursem
they appear necessary to us.55
The deputies were clearly in a difficult position, having to
each step in order to receive money to operate and dealing
duke who suspected that they were not performing thei
honestly.
From their own perspective the deputies could argue that they
were being cautious to a fault (in fact they were later faulted in just
this regard). Even in the cases where the sick person's urine did not
yet reveal plague to the physicians and where no external mark or
signs had yet appeared on the individual's skin, the families were
cautiously isolated or exiled. Insofar as they regarded medical coun-
sel crucial to the outcome of plague control and believed plague to
be spread by contagion, the duke and the deputies agreed in early
sSforzesco, CartcLqgio ilitcrno, 884, 5 May 1468: "havemo Inteso quanto ne scriveti
per la vra. dil di de heri del progresso fa la peste et de quelli sono morti, del che ne
havemo preso dispiacere assay, parendone che per niente non se gli habii ad mandare
de ogni remedio et bona provisione. Et impero voleimo et cosi vi commiettiamo che
voy debbiati havere tutto el collegio di medici da vuy et cosi Maestro Benedicto da Nors[i]a. Insieme con tutti li altri medici de la corte et Item tutti li zentilhomini ellecta per
le porte et tutti Insieme debbiati pensare et deliberare tutte quelle bone provisioni che
siano remediatorie ad la peste. In modo che questa sera nel mo[do] zonzere li possiamo
Intendere quella deliberatione gli haveriti facta. Ben ne maravegliamo di facti vostri che
vuy sempre allegati che se havesti dinari provediesti, etc. Et dal altro canto non ne avisati che summia gli bisognaria siche avisatine de li dinari bisognariano ad fare queste
provisione perche stipendolo faremo poy quello ne parrera essere el bisogno. Abiate[grasso]." At the same time Galeazzo Maria summioned the lawyers and judges to a
debate, charging them to deliberate the terms of the peace treaty he was negotiating
in Rome. It is interesting that this well-educated young duke appeared to value professional advice highly.
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CONTAGION THEORY AND CONTAGI(N PRACTICE 239
May. The deputies of necessity had to listen to phy
tions on individual patient cases and trust to some deg
diagnoses. The duke, instead, could view all failures
plague as failures in applying prescriptive epidemi
not as data questioning the epidemiological model
Galeazzo Maria never lost his suspicion of the dep
and dedication to thorough plague control, as later
show. But for the deputies, the problem in May b
dealing with the medical information that reached
ferent sets of doubts could confound their simple c
that plague spread by human-to-human contact: ca
side the geographical boundaries the deputies acce
obscuring the medical boundaries used to find a de
due to plague. Uncontested plague cases usually, b
consisted of the sudden appearance of a bubo in the g
or death after only four or five days' illness. Thus, in
fend their actions before a skeptical duke, the dep
Counsel had to shift the blame for procedure failu
sicians' inability to give clear guidance, or to the n
tions of private citizens who evaded public health
other option before them, of course, was a serious
the contagion model on which all their practices were
the deputies entertained this possibility that plague w
by person-to-person contacts: "But if plague has p
other influences, as from intemperance of the air, it
sary that the charity and grace of God work [wit
heard loud murmurings about us and worry that
complaints will reach your Excellency's ears. . . . W
to displease nor to injure any living soul. We only
your orders and that which we know will be to the
this city."s6 But because doctors were at least parti
to the notion of contagion as cause of new plague case
belief in the efficacy of contagion practices would ha
56MS, 2, no. 19, 8 May 1468: "Se questi casi procedano da cont
v. S. che se gli fara bona provisione in modo la Cita se adiutara: M
sero da altro influxo, o per intemperie de aere, bisognieria che la m
de dio se operasse. Nuy Intendemo se fano de grande murmuratione
molti verrano a le orechie de v. Ex.tia a fare li rechiami et volerne sindicare dicenmo
cossi, che nuy siamo qui per non fare dispiacere ne iniuria ad persona che viva. Solo
atendiamo a fare quanto ne ha imposto V.S. et quello cognosceremo essere bene et salute de questa Citate."
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240
RENAISSANCE QUARTERLY
uties in an even more precarious position. Hence the d
moved more committedly to document the contagious
plague.
The extent of the inquisitorial investigation by the health offic-
ers, done to document the contact transmission of plague, can be
illustrated by a longish example. Giovanni Catelano reported a new
case of plague on the morning of 7 May. Antonio da Robio, a
nineteen-year-old youth who worked in the barber shop of Giovanni Pietro de' Mori, fell ill with a high fever, no "signs" yet apparent. The shop in Piazza della Corte was across from the window
of the Maestri dell'Intrate (customs officials), where a few cases had
occurred. 7 This discovery was a relief to the deputies because it ex-
plained a case that otherwise demanded a very cautious, measured
report. Young Antonio actually lived elsewhere in the city, across
from the house of a Baldesare Capra (near the church of S. Sim-
plicianino; see map). "Until now," they admitted, "we couldn't
find out where he had acquired the disease," and they suspected that
he had bled or had otherwise come into contact with an infected
person. Despite their best efforts they had not been able previously
to trace the path of plague from person-to-person. 8 The area ne
the barbershop was clearly infected: Lucia, the fourteen-year-o
daughter of a certain Giulielmo di Teoldo, died there this day. C
elano or his superiorsjudged this a case of plague even though Lucia
showed no external sign whatsoever, merely because she had go
into the Cinque Vie and talked with people who subsequently fe
ill with plague. Yet a third plague death was explained by caref
investigation of her itinerary, allowing the deputies to conclu
that the Cinque Vie was still the principal focus of plague infection
in the city. Contagion was reaffirmed along with the geographic
57Ibid., no. I5, 7 May 1468. The health officers and customs officials were trad
tionally adversaries during plague times, the latter often trying to postpone declarat
of plague because it would reduce income and commerce to the city. In the view
health officers, the delays put the community at further risk. See Albini, 97.
58Presumably the deputies were informed of this new case on the day they wrot
which makes the "until now [fin qui]" statement problematic. The next day (MS,
no. I6) they wrote that the barber [Antonio?] "ha butato fora el signale" but that "s
far [fin qui]" they had not traced the origin of the case. The text is otherwise ambi
uous. No report of Baldasare's illness (if he was ill), or his death (if he died) survives
If he was not ill, Baldasare could be related to this case merely to secure the location
or perhaps because he was socially important. The other case reported this day, in t
letter, mentions the immediate neighbors of the infected, Count Giovanni Bonrome
and banker Marco da Galara (MS, 2, no. I5).
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CONTAGION THEORY AND CONTAGION PRACTICE 241
concentration: "only one new case appeared today [
we believe was produced by contagion, because it o
infected district. "59
The deputies' letters cheerfully affirm the wisdom
cedures, revealing to the duke the actions that they h
immediate past, how the evidence confirmed their
tagion model, and ending with assurance that they
to do everything possible to arrest the progress of
as they reported "evidence" for contagion buried
which action had already been taken, they had bee
from the duke evidence that didn't immediately fi
expectations. Cases that eventually became expl
ported at length. In all of this, it is not clear whethe
were deceiving the duke or themselves. Physicians
agnosis with which they all had to contend becam
portant information, and, as we shall see, the health
Hector Marchese, claimed that it was at just this ti
worry about the process of medical diagnostics. Beg
May, Hector began to send the duke yet another co
death and illness report, so that the duke received
nearly identical bulletins each day! At this point t
began to send separate reports of new cases, distinct
reports.
Responding to the rather dramatic increase in the n
ficial plague cases reported, the mass exodus began
At this time two little girls fell sick with plague, dau
Cristoforo da Cazeniga, who lived in the district of
cellina, the neighborhood of S. Pietro della Vigna,
Maria al Circo. They lived near enough to houses in
March that no worry presented (see map). And two
previously infected houses. But Hector and Catelan
case to explain. The parish elder in S. Maria Pedone
woman who was interrogated unsuccessfully. N
Marchese and Catelano find no evidence of the path
the woman died during the questioning, redoubling
that plague was the cause. A personal advisor to th
the health deputies' message in a way unburdened of
ory: "things are not without danger now that [the
59Ibid., no. 28.
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242
RENAISSANCE QUARTERLY
in so many different places. . . . Most of all you must protect
self."6o It was a message Galeazzo Maria related to his mot
early June, begging her not to stay in Cremona, where pla
haved the same capricious way.6' It was also a message tha
tioned the spread of plague by contagion alone. But at thi
Galeazzo Maria was preoccupied with his ambassadors' negot
a peace treaty in Rome and with upcoming wedding plans,
personal secretaries and servants concentrated more on the
lems created by flight from the city.62
Missing links in the chain of infection were a type of pr
Hector Marchese and the health magistrates had to explain
sively to the duke, for the latter would conclude that officials
simply not diligent enough. In turn they tended to fault th
sicians who could not seem to diagnose plague early enough
course for implementation of appropriate precautions. Fr
physicians' perspective, it was sometimes difficult to diag
plague even after a person died. For example, at just the time p
was greatest, on I6 May, Constantina, the five-year-old dau
of Maestro Iacopo da Firenze, died with "many malignant w
and abdominal swelling and pain, after a six-day illness."
was both a surgeon and an anatomist, and he had worked with
lano in the great plague of I45 as official physicians to the
Thus he, too, had extensive experience diagnosing and tre
plague. His daughter died of an illness common among youn
dren. But on 31 May, Ambrogio, twenty-year-old servant
copo, fell ill with pestilential fever, a bubo in the right axi
with a profuse nosebleed, according to the judgment of Ia
himself and Maestro Dionysio de' Cerruti, another surgeon
case was unavoidably listed among the new "suspicious" case
day, even though the deputies made an exception and allow
60Ibid., no. 21, from Giovanni Giapano to the duke: "non me pare siano senz
icolo vedendola [peste] saltare in tanti diversi lochi. E pero fidelmente ricordo
prima el conservare la persona da la quale depende la universale salute, non
questa sua patria ma de tuta Italia."
6'Ibid., no. 354.
62Ibid., no. 22, Francesco Maletesta, io May, worries that citizens fleeing fr
lan to other cities in the ducato will bring plague with them; ibid., no. 21, J
Giapanus warns the duke that he should consider envoys from Milan, as well a
plague spots, dangerous, and that it is important for the duke to preserve
health, "da la quale depende la universale salute non solo de questa sua patr
tuta Italia"; ibid., no. 29, Giovanni Simonetta tells the duke 5 May that none
"poveraglia" remain in Milan.
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CONTAGION THEORY AND CONTAGION PRACTICE 243
household to remain in their quarters, while they whisk
of the other suspects. Catelano added to the repor
amazed that the urines are laudable in this case; I expe
the appearance of a rash [morbilorum, or measles]."63
Infections occurring in the houses of physician
evoked some of the flexible rhetoric in plague diagnosti
istrates' own criteria often overruled the physician's.
a servant of Maestro Girolamo da Lode, longtime me
college, on I8 May was ill with an "aposteme" in his
and had "spasmotic tetanus with parafrensy."64 The
death's door, and the deputies doubted that this could
any way other than plague, for another boy in the h
recently died. "For greater security I [probably Hect
the house closed up, and that which he [probably Gir
to hide by alleging that these are not suspicious [cases
clearly seen. This is not a new case because he [the serva
taminated, as your Excellency can see."65 The duke's
formant, Giovanni Giapano, spelled out the path of co
ing the earlier death fifteen days before as a plague
though he [the physician] denies it" and because the phy
to visit his father at the hospice "il Seraxino," near the
physician was ordered to stay in his house and had done
through one whole day, "even though he has tried [to es
times . . . saying that this is not a suspicious case."
enlarged upon the duke's theme of mendacity among
cials, asserting that Maestro Girolamo had not declare
in his household, concealing it for several days. Pers
ably by Giapano, that the physician's motives were m
'3MS, I, no. 364.
'4MS,, , no. 36, Deputies to duke: "Antonius famulus Mri. Hyro
[14 years old], infirmatur cuIm aposteme in coxa destra et spasmo t
frenesia, moriturus iam iam." Hieronymus de Casetis de Laude [Lod
in the College of Medicine 12 November 1432; see Bottero, 112. Bian
formed of the servant's death as well; see Sforzesco, Cartcggio interno, 88
Giovanni da Petrasancta to Bianca Maria. Giovanni avoids the word "
ferring "contaminatio."
5Ibid.: "Per magiore secureza l'ho fecemo serrare in casa et cuossi
cultare con allegare non fuosse sospecto hora si se apertamente dim
non e caso novo per essere luy contaminato in quelo Inodo puo vede
ria."
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RENAISSANCE QUARTERLY
244
deputies said that they had decided to send Hieronymo
tire family to S. Gregorio, the lazaretto, "where he can ten
others."66
The Boundaries of Contagion Practices
By late May Galeazzo Maria began to question the rationale for
the contagion practices that health officers defended. The response
of an old, faithful servant of Galeazzo Maria's father and grandfa-
ther may have been prompted by the duke's growing concern: "I
don't recall ever seeing such ordinances [during the time of] your
uncle, Filippo Maria," Antonio Canobio wrote to Galeazzo Maria
on 25 May, but there were more recent precedents.67 By earlyJune,
the duke began to question both the model of contagion and, again,
the honesty of his deputized officials. After a rash of cases that the
deputies likened to a flame,68 Galeazzo Maria had ordered a full in-
quiry into the causes of plague, summoning (from a safe distance)
the opinions of the physicians in the College of Medicine, from his
deputies and Secret Counsel, and from Hector Marchese himself. 69
Two things worried the duke: was not the plague contagious? and,
if it was, why was the trail lost in May? The college responded with
a consilium taking into account Milan's relation to astral events that
spring but blaming the excessively humid fall and early winter for
the appearance of acute fevers, though without any explanation
why transmission of the disease progressed steadily through the
spring. Hector Marchese, aware of the medical opinion, also an''Ibid., no. 38, 19 May 1468. This story becomes still more complex. On May 25
(no. 47) the Deputies wrote that on the ninth of May a boy (ragazo) of Magister Hyeronimo went to the hospice of the Sarayno near the castello, and "we, as is our custom,
saw that all those in the household were promptly [statiim] taken to Sancto Gregorio,
and thus it was done." This isn't quite true. They next say that there were "other pensioners" in this house who remained separated from the infected, so, cautiously, they
were quarantined in the house so that they could not get out. For fifteen days they were
hale and hardy [sani et salvi]. Nevertheless, two little girls died the previous night (May
24), so all the rest of the household were shipped off to S. Gregorio. The deputies were
offering the best possible interpretation of their actions.
67E.g. Ibid., no. 48. That exemplar no longer survives with the letter, nor have I
been able to locate Galeazzo Maria's letter specifying the procedures that troubled him.
6'Ibid., no. 57, I June 1468.
6'He demanded the opinion of the College of Medicine in early May, but the convocation probably did not take place untilJune. The undated consilium appears in MS,
I, no. 26, titled "Responsio Collegii Phisicorum et eius apparere super interrogatione
facta per Illustrissimum principem vestrum circa processum pestis Initiantis ad multum
susceptura [sic] sit incrementumn dicitur ut infra."
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CONTAGION THEORY AND CONTA(ION PRACTICE 245
swered the duke's request of 2 June, acknowledgin
with his own strict adherence to contagionism:
During the first wave, about the fourteenth of March, in
following house by house from those of Lampugnano, I r
time to time about the process and concluded it must be by
plague spread]. This was until the third of May, when th
Scaramuzia Visconti was infected. From there it proceede
houses and parishes, and I lost the path of contagion. And s
your question, I went around with Catelano and other ph
college, visiting the houses with them so that I could unde
happening. I wanted to know why so many [cases] were see
on the day that they first became ill, but the physicians,
nizing their illnesses, held the [news] two or three days
the case one of plague. The answer I had from Catelano and
that in the beginning they didn't know, and couldn't kno
looked only at the urine: they had neither visited nor to
nor do they visit or touch them. Thus some had evidence
for which, in a short time, the urine later changed and sh
be pestilential, and then they had to change their notificat
we [at the office of the Sanita] went to visit the ill person
truth about who was plague-stricken. Now as to the cause
agree that we should doubt the influence of some planet or
excellency, even until today I do not lack either the convic
that, God willing, [our approach will work].7"
Marchese then cited his experiences with plague in
in the previous year, expressing faith in the effic
plague procedures, if applied diligently. During la
the other health magistrates had increasingly shift
70MS, 2, no. 70; "mediante dal primo asalto fece a di xiiij di Marz
attine6 [?] et sucesive in casa di quili da Lampugnano et proceden
tempo In tempo, ho miso la mente trovava et Intendeva il process
per fino al tertio giorno di mazo, quale fece lo asalto in Casa dil
viceconte, poy procedendo in diversi loci et parochie ho perso la stra
Et io como quello voleva intendere piu inante me sono astretto pi
Catellano et con alcuni altri medici collegiati digando io verso di l
Intendere procedese questo, perche molte case quale erano nele
prascripti medici non havevano Inteso le loro malatie et teneveno n
giorni uno amalato possa ala fine si ritrovar pestiferi. La risposta ch
tellano et da loro e questa: che neli principii loro non cognosene
gnosere sopra le urine perche che non visitaneno ne tochaveno n
visitano, dicono havere ante nele mane alcuni di alcune febre che
se cambianeno le urine et monstraveno subiugale et pestifere et li re
di lo officio donde havemo che visita et chi tocha ad dicernere la
concoreno et dubitano non sia Influentia di alcuni pianeti. ..."
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RENAISSANCE QUARTERLY
246
physicians' tardy diagnoses, further emphasizing the duke'
ous conviction that the contagion model best fit the facts.
EarlyJune brought a reprieve in the number of new plague
as it usually did in Milanese plagues.72 Galeazzo Maria cou
seen these events as a measure of the success of public health
vention had not his adherence to contagion practices begun
ver. As he had predicted, his mother became ill in fleeing Mil
Cremona. She wrote 30 May to praise his powers of divinat
sponding on 2 June, the Duke argued that his deduction t
would become ill was only logical due to the rigors of the
trip. As to his prediction that Cremona would soon have
Galeazzo Maria explained: "it seems to me almost impossib
you would not carry it there," bringing such a huge retin
he avoided altogether the delicate issue of contagion, whic
implicate some member of her household. Galeazzo Maria r
letters from her doctors that she was improving but cautione
to be especially careful, "because your every illness is my i
In other words, this was a period in which Galeazzo Maria
pendent upon what the good doctors could do, and a time in
he was abandoning hope for a wedding in Milan.
Over the summer, the medical authorities vacillated as m
did the duke on the verdict of contagion. When a burst of ne
confounded all efforts at diagnosis and control, the doctor
cluded that the hot, humid weather and bad astrologic
meant plague could not be extinguished. By i July, with a
break in the succession of new cases, the deputies took ho
"these physicians are beginning to say what they didn't say b
that the plague has been due more to contagion than to cor
of the air. "73 The deputies, for their part, held fast to the con
7'E.g., Saturday, 28 May, MS, I, no. 359, from Hector: "Ambrogio dei
aged 40, fell ill on Tuesday about the 20th hour, with fever and severe heada
In fact, Tuesday about the same hour a carbone appeared on his right neck
chin; and he was in a house contiguous [with a plague house]. [Now dead] w
measles, the judgment of Catelano. And today is the notification." MS, 2, no.
same day, the deputies list the new cases, repeating that the victims were infe
day and Tuesday, "but we were not told."
72Albini, 166-67. The peak months of mortality in normal years (from 14
were the hot summer months of July and August, the lowest monthly mo
June. Aggregating plague and other epidemic years. the June nadir is even m
nounced.
73See MS, 2, no. 103 (17 June); and ibid., no. 148 (i July). Both letters are from
Giovanni Simonoetta. The operative part of the latter text reads: "et spera che la cosa
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CONTAGION THEORY AND CONTAGION PRACTICE 247
"theory," even when having to acknowledge seve
difficulties. When Catelano's servant fell ill with plag
gust, the deputies decided that they could not do wit
informed the duke that they simply could not adh
control in this case. Catelano would set out early i
and return late each night, as he always did, thou
change his garments often, use discretion, touch
spend much time with any one person during this
antine. 74
When he began to doubt that contagion alone
plague, the social consequences of contagion practi
tolerable to the duke. Apparently Galeazzo Maria
Catelano and Marchese were to blame for excesses,
deputies begged him to do nothing rash:
We respond, both to clarify things to Your Excellency a
[anxieties]. First, about the plague: that Catelano and Hec
houses that are really not suspected, because of some hop
is unlike them, there could be none better than these tw
anyone to blame it should be us, not Catelano and Hector
silent we could do an enormous injustice .... We must
lency that all the cases occurring so far have been denoun
know with certainty that Catelano has faithfully discharg
but one of those judged "suspect" have turned out to be
any dubious case, they have returned two and three times
[the plague] passara bene maxime perche questi medici dicono altra
vano prima: et che el male e stato pii tosto per contagione che p
de aiere [sic]."
74MS, 1, no. 2, 6 August 1468.
754June 1468, MS, i, no. i: "Et primo a la peste, che il Catellan
spesse fiate sarrare le case non sospecte, per aviditate del guadagno
questo in loro: ne niuno puo meglio attestare questa cosa de nuy
Et nuy intendendolo mal voluntiera il comportaressino che loro ne
cio facessero cosa alcuna mancho del debito suo. Et quando si rit
vero, ne reputariamo che ogni defecto et manchamento fuosse in n
tellano et de Hector, che tacendo consentisimo ad cuosi enorme
fuossimo si pocho diligenti che non intendesimo li excessi suoy. M
si neti et si immaculati in questa cosa, che non li cade reprehension
fanno uno yota senza nostra deliberatione. Avisando v[ostra] S[ig
occorsi fin a hora denuntiati qua a nuy: comprendimo chiarame
ha facto fidelmente l'offitio suo, pero tutti quelli Iudicii n'ha dati
ungtlem li hanno trovati esser veri. Et quando gli accadera un caso
due volte et tre ad visitarlo et sempre n'ha [?] chiarito de la verita
ponevamo che de nostro mandamento fuossero sarrate ne de cio
intrometuto-perche non specta a luy."
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248
RENAISSANCE QUARTERLY
The deputies, not Catelano, then sealed the houses, and f
tional security, the deputies quarantined all those who had
dealings at all with the plague victim, operating with the
of two other well-respected physicians in the college, m
taught at Pavia and were known to the duke.76 They deem
defense of Marchese and Catelano "extremely useful and nece
for without them we would have enormous difficulty findin
equals. Neither in capability nor in experience could there
so suited to this job."
One of the problems surrounding the spread of plague
could scarcely be attributed to procedure failures by the
health authorities. Plague-free cities in the duchy would have
travel from Milan, and thus compromise the whole structure
but the very wealthiest citizens seeking a safe refuge. The du
in effect admitted privately that Cremona was infected by t
tourage of the duchess. Pavia was still safe, but travel fro
would have to stop.77 Cicco Simonetta, the duke's secretar
ized how much more severe the restrictions had to become in order
to arrest a contagious plague. On 3 June he advised the Secret
Counsel: "Because at Cremona and in Parma, the plague has recently appeared in several different houses, we remind you, and
want you, to renew all [the precautions taken] at the gates, bridges,
passes, and other necessary posts, such that those from these cities,
or any other infected places, cannot come to Milan, nor those from
Milan with other suspected or unsuspected. Because [doing so]
would be like extinguishing a fire one place while throwing dry
wood on another."78 The Secret Counsel compiled but urged the
duke to adjust the regulations so that trade was not completely
stopped: "About the infection of Parma and Cremona, we also have
heard that some contagion has appeared, but not very much." Banning these places entirely, they argued, would be very damaging
to the customs duties, and it would rapidly extend to the entire
duchy. There should be something less restrictive than the ban.
"Nevertheless, we will certainly not accept anyone from these
places who does not possess a pass from their officials certifying
that [he] is healthy and free from all suspicion." They would write
the duchess that passes would be a necessity, either from the officiali
76'See below, n. 83.
77MS, 2, no. 66.
7XIbid., no. 65.
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CONTAGION THEORY AND CONTAGION PRACTICE 249
delle bolette or from her, and if conditions worsen
travel and trade would cease. 79 Effectively the cou
ucating the young duke about the economic lim
control.
Another kind of problem that could not be bla
the deputies was the popular unrest growing amo
in Milan. The duke's personal servant, Giovan
sessed rumors of the duke's lack of charity and
from malcontents "who have nothing to lose."
overly arrogant, imperious individuals among t
there was more to fear from occult plague spreader
until now a few who have had plague in their house
of the fact and didn't recognize the disease until th
that they went around the city without any respec
... but then some fled, leaving houses abando
thought the latter action should be punished sev
mended irrevocable seizure of their household g
Still other problems plague caused could not b
deputies' shortcomings. Galeazzo Maria must ha
even if the plague were brought under full control
citizens would not return in time to host and
guests.8' Nonetheless, he did assign properties b
Misericordia to a cavalier from Calabria. The de
mind him that they felt bound to the conditions
will donating the property for aiding the poor
moved in people, horses, and cattle, upsetting the d
siderably. Here the duke had to give in, for, withou
ous places and lay confraternities managing the dai
all plague controls would fail.82
By August the wedding had past, with only to
in Milan. To retain physicians other than Catela
79Ibid., no. 355, 4 June. The letter to the duchess, dated the s
no. 68. The Consilio Secreto also promised to notify all the appr
decisions. In ibid., no. 74, June 6, Bianca Maria replied that she
with the new, moderate restrictions.
8°Ibid., no. 67. Symonetta may have been alluding to the case
see ibid., nos. 57, 59, and 97.
8'Sforzesco, Carteggio interno, 884, i6 June, Giovanni Giapa
8ZMS, 2, no. 143. The duke instructed the Consilio Secreto to
in suitable quarters, and they assigned possessions of the confrat
82.
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RENAISSANCE QUARTERLY
250
dedicated doctors to the Sanita, Galeazzo Maria would hav
begged or ordered collegiate physicians to stay, much as
threaten guards and provincial officials who tried to abando
posts. Even inJune, the college physicians who reconfirmed
agnoses of the deputized physicians found excuses to leave.
where the duke could not assert his personal will, such
in lateJune, posed considerable threats to the best executed
visions. The servant sent to Novara was dedicated and well in-
formed how to exercise plague controls, but he had to advise
duke that "this city is surrounded by many plague-infected l
And I have real doubts about this city because of the negligence
avarice of these citizens. Never in my life have I seen greedier m
they make little or no provisions for the city and every day the
further infected . .. they make my soul cringe in my body!"
The Epidemic of 1468 in Wider Perspective
From all the surviving notices it appears that this plague in M
was relatively minor: never were there large numbers of deaths,
had been the case elsewhere in the I460s. The notices are inc
plete, but during April through July no month lacks the entrie
more than three days. During those months, May and July w
the worst periods, with totals of a mere I 50 deaths (from all ca
per month. The plagues of 1450 and 1483 were the two lethal
in Milan's history during the late fifteenth century.85 Nearly al
the physicians active in making the diagnoses of cause of dea
1468 were alive well into the I470s. The relatively slow progre
of new cases allowed the health officials both the time and the in-
centive to explore the operational limits of contagion theory. Admitting any other theory than the contagion model implied the
charge that the duke and his men were not acting with Christian
'3Sforzesco, Carteggio interno, 884, 23 June. Maestro Symone da Mazenta and Maestro Matteo da Busti, deputized by the College of Medicine to serve as backups, left
the city. Both asked to be excused from further duties in the city.
X4MS, 2, no. 147 ("me fanno crepare l'anima nel corpo").
X'Albini, I62, finds a total of 648 deaths this year (I count only 623), but the records
ofJanuary-March are largely missing, and many other gaps exist late in the year. By
contrast, the surviving, incomplete records of I451, for only three months at the end
of a plague, include 2,515 names; in 1483, 4,179 names are recorded, and in 1485, the
year after the great plague (no records of it survive), partial registrations number 8,598
deaths.
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CONTAGION THEORY AND CONTAGION PRACTICE 251
charity in a tragedy that was either inevitable, ecol
trologically, or simply an unknowable aspect of G
trust of the officials' motives could breed dissension a
litical disaster. Full and early knowledge of pla
brought the risk of contaminating the men responsib
the diagnosis, just one of the practical medical co
managing the epidemic while adhering to the conta
These extraordinarily rich letters allow us to explore
basis for making the original diagnosis of plague, at le
reaucratic level, and they present a distinctive imp
epidemiological reasoning in the face of an epidem
driven inquiry is more elaborate and self-conscious
ing with accelerating death rates, and the resulting co
provides detail quite unusual this early in state plag
for another century would the health boards of ot
comprehensive daily record of their deliberations.
Just as the process of plague control in 1468 involve
gotiated agreements between health officials, phys
"central government" --the duke and his servants
three groups could be seen to have approached the
certain legacies toward what "contagion" meant w
plague. Much of this has been discussed above, but
that the duke was willing to side with the physicians
officials and Secret Counsel who claimed to be fol
structions to the letter. One letter hints the duke's irritation with
the College of Physicians in Pavia, but it may have concerned issues
other than plague. 6 Even as the plague receded, Sforza was far an-
grier at the deputies and Hector than at any physician. September
2 he wrote to Hector personally: "At a little church called S. Biaso
... a young boy was found dead this morning, who just yesterday
was said to have been moving about. And because he could have
died from suspicious causes the captain here ordered that he not be
buried without being seen. We want you to send someone experienced to do this right away, who should then relate his findings
to whomever our captain sends. I am warning you [Avisandote] that
at Pillastrello, which is just overlooking this road and across from
the church, there will be someone watching and informing [us]
86Sforzesco, Cartce~Qio inlterno, 883, 7 August 1468. Galeazzo Maria didn't like their
talking about him or criticizing his actions.
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252
RENAISSANCE QUARTERLY
about everything. "7 And again late December the depu
respond to Galeazzo Maria's wrath:
Today we have a letter from your Excellency, which we have
all too well. Your Lordship judges that the last occurring cases
duced through conversations of people and touching goods
houses, not well cleaned and scoured, and that they cannot hav
from some other fault [culpa] or contagion. We advise your Exc
this cannot have happened in this way, for all of the houses a
places, except the very last one which was on the i6th of this m
Porta Nova, were fully cleaned and purified. Nothing has trans
out great diligence, consideration and care, the effects of whic
onstrated by those returning from S. Gregorio and even thos
mained in their own houses, which were afterwards cleaned. By
of merciful God, not one house has shown any peril or illness
through our fault nor our oversight that the last cases have oc
Of course it was no one's fault that plague did not faithfu
like a contagious disease, because it is not normally
from person-to-person. A rat- and flea-borne disease,
produce contagious plague pneumonia, contagious becau
borne droplets the patient coughs out are highly infec
usually occurs, however, after the victim becomes severely
the initial infection. Similarly, opening or lancing a bu
erate organisms, passing the disease by touch. But in m
plague epidemics the appearance of contagion is accide
Health officials in Milan were certainly empowered in
forcement of contagion practices, aided by strong, su
dukes in a way "republican," or rather oligarchical, gov
elsewhere in northern Italy would not permit, because of
ages to trade and to their strategies for flight from the cit
form of personal defense. But in 1468, Galeazzo Maria
wedged his own daily controls between the physician
health officers' views of plague. In these negotiations
magistrates obviously felt that they had to account and d
ery decision, small or large. They articulated their positio
fully, whether or not anything they did changed the
plague in the city.
In 1476, the next time plague threatened Milan, Gale
was assassinated, but the same deputies in charge in 146
X7Sforzesco, Cartcggio inter,o, 885, 2 September 1468.
'XMS, 2, no. 209, 21 December.
'9See Carmichael, I986, 5-9.
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CONTAGION THEORY AND CONTAGION PRACTICE 253
virtually where they had left off, now extending the
aggressive plague defenses to the ducato cities. A mon
murder, Giovanni da Pietrasanta, commissioner o
health defense (Hector Marchese was still commissione
of Milan), wrote to the duke that the few identified
had been brought under control. Since they were not
city, Giovanni and Hector left for the town of Ch
with others as we deem necessary," in order to snuff
of plague. "And we want you to understand that
order everything necessary to eradicate this veno
otherwise, we will never be secure; unless, as I have s
and cruel venom is extirpated to the tips of the roots
extensive inquisitions about contacts, and burning all
longings of those diagnosed with plague.90 With G
death the health magistrates became the vessels of tr
ing contagion practices, in a way that the physicians,
the physical management of cities and towns durin
never be.
Individual physicians, such as Giovanni Catelano, who were
willing to stay and serve the plague-stricken, may well have explored the practical challenges contagion models offered in diagnosing disease. 9 But most physicians of the late fifteenth and early
sixteenth centuries would have to explore these concepts devoid of
intimate contact with plague.
Richard Palmer brilliantly argues that the health magistrates, es-
pecially when they carried out a role of public health surveillance
and administration in years between the major plagues, were the
ultimate source of innovation in contagion practices in Renaissance
9°See MS i, no. 10, 27 November 1476. A letter from Giovanni Nicol6 dei Berezonzii (ibid., no. I I) confirms the extensive destruction of property with the outbreak
of Pavian cases of plague.
9'One of the most striking examples I have found is that of Catelano, in the midst
of the great 1485 epidemic, arguing to both the health officials and whoever among
the duke's (now Ludovico il Moro) staff read the notices that pleurisy was a specific
disease and it was contagious. MS, 4, no. 739, contains one of these entries, reading
"Reynaldus de Pergamo, 47 years old from the parish of (San) Eufemie, fell ill about
Friday with true pleurisy on the left side." Catelano judged the case to threaten contagion ("et periculosa de contagii") because his wife and one of his daughters died in
the previous days of the very same cause, "such that I judge these pleurisies should be
considered another epidemic just as pestilence" ("dixi huius pleureses altera epidimia
atque pestilentia considerabitur"). The deputies merely labeled this a probable plague
death, coming as it did from a suspected house.
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254
RENAISSANCE QUARTERLY
Venice.92 Prior to establishing a permanent health office
I49os, the Venetian magistrates consciously borrowed Mi
methods during crisis interventions. The plague controls
rated during 1468 in Milan and reiterated in the I470s w
served and copied by Venetians. From Milan they could
strong and sure voice, unequivocating as they articulated t
effective means of plague control, a voice unbroken by the
of later Sforza dukes.
The Milanese practices during epidemics would lead eventually
to the most brutal-if in some sense logical-expression of an unqualified contagion theory: prosecution, persecution and execution
of the untori or plague spreaders in the 1630 plague. Late in the sixteenth century, after the most severe plague ever to hit Milan, the
plague of Saint Carlo Borromeo in 1576, Milanese physicians
linked their commitment to contagion theory to the possibility that
plague could be carried in the form of unguents and salves, spread
on the doorways, walls of the city, benches of the churches, and
elsewhere, to facilitate the spread of plague.93 By 1630 the Milanese,
virtually alone among northern Italians, were prepared to identify
and prosecute those who transmitted the plague maliciously. It was
a bitter consequence of a politically privileged contagion theory in
the search for effective plague control.
Much has been made, by myself and many others, of the behavior of true plague in the early modern cities. Are plagues of this pe-
riod dominated by the lethal action of Yersinia pestis in a human
population, or do the economic disruption, the chaos, and poor
personal and public hygiene push the death rates far higher than a
killer microbe could unaided? Did plague change over time, becoming a more (or less) brutal disease than that seen in twentiethcentury experience? Were these plagues actually contagious? If eye-
witnesses insist that the identified cases of plague evidenced
contagion, is there any reason we should doubt that precious testimony? In this exposition of the reasoning processes at work, at
92Palmer, 1978. This masterful dissertation has unfortunately never been published,
though it is cited repeatedly in most recent works devoted to the topic of plague in Renaissance Italy. I am very grateful to Palmer for permitting me to see this dissertation
and for discussing these issues of contagion theory in the fifteenth century, for the ideas
he provides were the most crucial to this study. Portions of the thesis are published
in Palmer, I986 and 1979.
931On the plague of I630 and contagion theory and practices that led to the persecution of Itiori, see Preto; Nicolini; and Canosa.
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CONTAGION THEORY AND CONTAGION PRACTICE 255
the clinical and epidemiological levels, by conscien
trators and dedicated physicians, I have suggested tha
and a "no" could be given to all of these questions
mate, reductionist sense the microorganism Yersin
in the fifteenth century as it does today, and it cause
and death. But the disease of plague, the associated
agnosis and defense, and the contagion theory to gove
were all socially constructed responses to some deaths
idemics, not necessarily to Yersinia infection.
INDIANA UNIVERSITY
Bibliography
Albini, Giuliana. Guerra,fame,
Cipolla,peste:
Carlo. "I libri
Crisi
dei morti."
di In Lefonti
mortalita e sistema sanitario nella
Lombardia
della demografia
storica in Italia, ed. idem,
vol. I, pt. 2, 851-952. Rome, 1972.
tardomedioevale. Bologna, 1982.
Ballester, Luis Garcia. "Galen as a Medical
. Public Health and the Medical Profession in the Renaissance. New York, 1976.
Practitioner: Problems in Diagnosis." In
Gale,n: Problemts and Prospects, ed. Vivian
Chronicon Regiense. In Rerum Italicarumt
Nutton, 13-46. London, 1981.
Scriptores, ed. L. A. Muratori, vol. 18. Milan, 1730.
Belloni, Luigi. "La medicina a Milano fino al
Seicento." In Storia di Milano, vol. 8, 597- Corradi, Alfonso. Atnali delle epidemiie occorse
695. Milan, 1955.
in Italia dalle primte memorie fino al 1850,
Bottero, Aldo. "La peste in Milano nel 13991400 e l'opera di Gian Galeazzo Visconti."
vol. I, 224-25. Rpt. Bologna, 1973.
Cotton, Jiuliana Hill. "Benedetto Re-
Atti e nmemorie dell'Accademia di Storia
guardati of Nursia (1398-1469)." Medical
History 13 (1969): 175-89.
. "I pih antichi statuti del Collegio deiDecio, Carlo. La peste in Milano nell' ainno
dell'Arte Sanitaria 8, ser. 2 (1942): 17-28.
Medici di Milano." Archivio storico lotm-
1451 e ilprino lazzaretto a Cusago: Appunti
bardo 70 (1943): 72-112.
storici e note inedite tratte dagli archivi milanese. Milan, 1900.
Branduani, Cesarino. C'era una volta Milano.
Deffenu, Gonardo. Benedetto Reguardati,
Milan, 1968.
medico e diplomatico di Francesco Sforza. MiCanosa, Romano. Tempo di peste: nagistrati
ed untori nel 1630 a Milano. Rome, 1985.
lan, 1955.
Evans, Alfred. "Causation and Disease: The
Carmichael, Ann G. Plague and the Poor in ReHenle-Koch Postulates Revisited." Yale
naissance Florence. New York, 1986.
Castiglioni, Arturo. "I libri italiani della pestilenza." In idem, II volto di Ippocrate: Istorie di medici e mtedicina d'altri tempi, 147-67.
Milan, 1925.
Chase, Melissa P. "Fevers, Poisons, and
Journal of Biology and Medicine 49 (1976):
I75-95.
Foucault, Michel. The Birth of the Clini
trans. A. M. Sheridan Smith. New York
1975.
Apostemes: Authority and Experience inFracastoro, Girolamo. De Contagione et ConMontpellier Plague Treatises." In Science tagiosis Morbis, trans. and ed. W. C.
and Technology in Medieval Society, ed. Wright. New York, 1930.
Pamela O. Long, 153-69. New York, Grmek, Mirko. "Le concept d'infection dans
I985.
l'antiquit6 et au Moyen Age: Les anci-
This content downloaded from 204.187.23.196 on Sat, 20 Aug 2016 17:49:33 UTC
All use subject to http://about.jstor.org/terms
RENAISSANCE QUARTERLY
256
ennes mnsures sociales contre les maladies
Fortune." Medical History 25 (1981): 385410.
contagieuses et la fondation de la premiere
quarantine a Dubrovnik." RAD Jugo- . "Sanita pubblica e pestilenza: La po-
litica veneziana nel Friuli all'inizio dell'eslavenske Akademi,je Z,nanosti i Unj!etnosti,
no. 384 (1980): 40-42.
poca moderna." In Sanitd e societd: FriuliVenezia Giulia, secoli XVI-XX, ed. A.
Guainero, Antonio. Opera Om,aia. Pavia,
1488.
Pastore and P. Sorcinelli, 32-60. Udine,
King, Lester. Medical Thinikintg: A Historical
Preface. Princeton, 1982.
1986.
La Cava, A. Francesco. "Le scuole medico-
diche sulla peste e il contesto veneziano."
In Venezia e la peste, 1348-1797, 2 1-70.
Venice, 1979.
chirurgiche dell'Ospedale Maggiore di
Milano." Ospedale Maggiore 44 (1956):
and Andreina Zitelli. "Le teorie me-
Pasi Testa, Antonia. "Alle origini dell'Uffi157-74.
cio di Sanita nel Ducato di Milano e PrinLemay, Helen Rodnite. "Anthonius Guain-
erius and Medieval Gynecology." Incipato di Pavia." Archivio storico lombardo
W'Home, of the Medieval World, ed. Julius 102 (1976): 376-86.
Kirshner and Suzanne F. Wemple,
Panebianco, Domenico. "'De preservatione
317-36. Oxford, Eng., 1985.
a pestilencia' di Cardone de Spanzotis da
Lockwood, Dean. Ugo Beizi: Medieval Phi-Milano, del 1360." Arcltivio storico loimlosopher and Physicia,i, 1376-1439. Chi-bardo 102 (1976): 347-54.
cago, 1951.
Preto, Paolo. Epidemia, paunra e politica
Mazzi, Maria Serena. "La peste a Firenze nel
inell'Italia moderna. Bari, 1987.
Quattrocento." In Strntt,arefantiliari epide-
Singer, Dorothea Waley. "Some Plague
mitie c nmigrazioni inell'Italia medievale, ed. R.
Tractates (Fourteenth and Fifteenth Cen-
Comba, G. Piccini, and G. Pinto, 91-115.
Naples, 1984.
turies)." Proceedings of the Royal Society of
Mazzini, Giuseppe. Vita e opera di Maestro Pietro da Tossig)nano. Rome, 1926.
Medicine 9, pt. 2 (1916): 187-89.
Siraisi, Nancy. Taddeo Alderotti and His Pupils. Princeton, 1981.
Motta, Emilio. "Morti in Milano dal 1452 al
Spinelli, Salvatorc. La Ca' Grande. Milan,
1552." Arclhivio storico lonmbardo 18 (1891):
241-86.
1958.
Sudhoff, Karl. "Pestschriften aus dem ersten
Nicolini, Fausto. "La peste del 1629-32." In
15o Jahren nach der Epidemie des
Storia di Milanio, vol. 10, 499-557. Milan,
schwarzen Tod 1348." Sndltoffs Archiv 17
(1925): 264-91.
Temkin, Owsei. "An Historical Analysis of
Explanation of Contagion and Infection
the Concept of Infection." In idem, The
1955.
Nutton, Vivian. "The Seeds of Disease: An
froml the Greeks to the Renaissance."
Double Face ofJaniiis, 456-71. Baltimore,
Medical History 27 (1983): 1-34.
1977.
Palmer, Richard J. "L'azione della RepubThorndike, Lynn. A History ofMagic and Exblica di Venezia nel controllo della peste:perimiental Science. 8 vols. New York,
Lo sviluppo della politica governativa. " In 1923-58.
Ve'ezia e la peste, 1348/1797, ed. Orazio
Winslow, Charles-Edward Amory. The
Pugliese, 103-11o. Venice, 1979.
Coinqiest of Epidemiic Disease: A Clapter ii
. "The Control of Plague in Venice the History of Ideas. New York, 1967.
Zanetti, Dante E. "La morte a Milano nei
and N. Italy, 1348-1600oo." Ph.D. Diss.,
University of Kent at Canterbury, 1978. secoli XVI-XVIII: Appunti per una
- . "Nicol6 Massa, His Family and His ricerca." Rivista storica italiania 88 (1976):
803-51.
This content downloaded from 204.187.23.196 on Sat, 20 Aug 2016 17:49:33 UTC
All use subject to http://about.jstor.org/terms