Abstract
Reviewed by: Gordan Ravančić, Croatian Institute of History (Zagreb), Croatia
Various diseases are the constant companions of mankind. Moreover, one could even state that each epoch of human history has its own characteristic epidemic disease that significantly determined the economic and social development of human societies. Thus, although modern medicine has defeated almost all seriously dangerous communicable diseases we even today encounter numerous problems with AIDS, hepatitis and, in some cases, certain variants of influenza. Similarly, people in ancient Greece or Rome had serious problems with typhoid epidemics, smallpox and malaria. By the same token, the Middle Ages were marked by leprosy and plague, while people in the early modern period had to struggle with some ‘new’ diseases like typhus and later – after discovery of the Americas – syphilis. In the same way, the industrial age also had its own ‘new’ disease, and this was tuberculosis. All in all, we could certainly agree that throughout history mankind has had to struggle with various epidemics, and thus much of the contemporary knowledge and crafts were engaged in conquering diseases.
Thinking about history in this way, one could say that this book by Z. Blažina Tomić and V. Blažina deals with an important aspect of our historical development, since the focus and topic of this study is the organized struggle against plague epidemics. Basically, as the title suggests, the book presents a case study of Dubrovnik’s efforts regarding the prevention of plague epidemics during the late Middle Ages and early modern period. Moreover, throughout the book the authors maintain and emphasize the important role of Dubrovnik in the process of the invention of quarantine. This fact was already established some decades ago by Mirko Dražen Grmek, but unfortunately it is still not widely known and accepted within the scholarly community.
The book is divided into nine chapters, supplemented with three appendices and a number of figures, among which one should note three maps and four tables that help the reader to follow and better understand the main text. All the statements and conclusions are augmented by citation of relevant scholarly literature and primary sources, which is supplemented with a long list of references (317–46). In the first three introductory chapters the authors attempt to reveal the chief political, economic and social development processes of pre-modern Dubrovnik. All the information delivered suggests that medieval Dubrovnik’s authorities gained significant control over all aspects of public life, including public health and care for the sick. Moreover, in contrast to some Italian (and Dalmatian) cities Dubrovnik’s hospitals were not financed by the local confraternities but public state money (70), and health care was basically free for each citizen and often for foreign visitors, too. Consequently, the entire third chapter is dedicated to the physicians and their role in the public health organization. Additionally, the authors emphasize that the physicians hired by the Dubrovnik authorities sometimes acted as special ambassadors of Dubrovnik, especially to the hinterland under the Ottoman rule (94–9). This was of grave importance since – as the authors suggest throughout the entire study – Dubrovnik’s economy deeply depended on trade between the Balkans (at that time under Ottoman rule) and the Mediterranean.
Still, during the plague epidemics all the contemporary medical knowledge of the hired physicians often was not of much use. Moreover, as the authors quote from various primary sources, in case of plague physicians usually fled from Dubrovnik. Still, on the basis of daily commerce and travel experience, Dubrovnik’s authorities had already in 1377 introduced the first anti-plague measures, which, later – in the 1390s – were transformed into the first Public Health Office in the pre-modern West (a comparative table of similar offices in other European cities is available at page 134).
The following chapters (‘Founding and Development of the Health Office, Control of Arrivals in Dubrovnik’ and ‘The Disastrous Plague Epidemic of 1526–27’) form the main part of the book, in which the authors have described and analysed the foundation and functions of Dubrovnik’s Health Office. The primary source of information for these chapters – besides the acts of the Dubrovnik authorities – was the Libro deli Signori Chazamorbi, a unique source consisting of lists of arrivals in Dubrovnik and the anti-plague activities of Dubrovnik’s health officials in the period between 1501 and 1530. Namely, according to contemporary laws and orders, during the epidemics state health officials were empowered to prosecute anyone who would not obey strict anti-epidemic regulations. The authors systematically follow and analyse all available sources comparing Dubrovnik cases with the situation in other contemporary northern Italian cities. This analysis has demonstrated that the Dubrovnik authorities and the Health Office were ahead their time regarding the execution and efficiency of the anti-plague measures. This can be additionally proven by the fact that the major plague epidemics which devastated Italy in the 1570s and 1630s somehow omitted Dubrovnik (181–2), and this was undoubtedly result of the efficient work of the Health Office.
In the closing three chapters (‘Plague Survivors as Plague Workers’, ‘The Health Officials and the Patricians’, and ‘Concealing Symptoms of Plague, Importing Suspicious Goods and Other Offences’) the authors try to reveal the consequences and effects of anti-plague measures to Dubrovnik’s economy, social development and daily life in general (though these topics are partly explored in the previous chapters, too). At the end of this volume the reader can find rather interesting Appendices consisting of three parts.
Though this book is an extended version of a book published in Croatian in 2007 by the Croatian Academy of Sciences and Arts, and written only by Zlata Blažina Tomić, it is a great deal more than an elaborated translation of the Croatian version. Namely, in this English edition the authors have examined the topic of an anti-plague legislative and public health organization in a more comprehensive way, showing to what extent plague epidemics and the struggle against them have determined the economic and social development of pre-modern Dubrovnik, which – because of its unique geographic and political position – became a forebear and innovator in the history of medical practice and public health organization in the pre-modern West.