QUARANTINE FOR PLAGUE IN DURING the sixteenth and seventeenth centuries

By JOHN RITCHIE, M.B., Ch.B., M.R.C.P.E., D.Ph.

During the sixteenth and, at least, the earlier part of the seventeenth century, the bulk of Scottish overseas trade was with France, Flanders and the Baltic States.1 These countries, in common with the rest of Europe, were subject to periodic outbreaks of plague, and the protection ?f our seaports against the introduction of infection was a matter of constant concern to the Scottish authorities. This was no easy task. Scotland was a small country, poor and sparsely populated. War with her more powerful neighbour, diversified by domestic quarrels, absorbed much of her energy, and when both these means of self- expression were lacking bitter religious controversy was usually available to replace them. Even in times of relative peace the ordinary law was administered with difficulty in many parts of the kingdom ; to enforce the special and generally onerous enactments necessary for the control of plague was often practically impossible. Yet some sort of defensive mechanism had to be devised, and it may be of some mterest to discuss one of the methods designed to control the ravages ?f a devastating epidemic disease at a time when accurate knowledge of its etiology and method of spread was non-existent. The responsibility rested primarily on the Privy Council of Scotland which was, in effect, the central health authority of the period, but the actual administration of its orders was normally the duty of the town councils of the seaports, to whom powers were generally delegated and by whom they were sometimes assumed. For extra-burghal districts and for small burghs, whose councils might lack the resources and the authority necessary to enforce the quarantine regulations, commissioners Were often appointed, with powers to enlist citizens and to use any force necessary to ensure that the law was obeyed. In an age when the speed with which administration functioned depended largely on the rate at which a messenger could ride, it was fortunate that the majority of the Scottish ports, and, in particular, Leith, the largest among them, were within fairly easy reach of the capital. Along the shores of the of Forth and the adjacent coast from the eastern extremity of to Eyemouth, close to the English border, lay a number of towns with harbours large enough to accommodate the small trading vessels of the period. All these were sufficiently near to permit of news about the arrival of suspected vessels reaching the Privy Council fairly quickly except, mdeed, from Eyemouth which, according to Thomas Tucker who Read to the Scottish Society of the History of Medicine on 18th June 1948

691 , 692 JOHN RITCHIE

" made a survey of the Scottish ports in 1656, gave occasion of much deceipt "?at least in the matter of landing contraband cargoes, the question with which he was specially concerned. It was fortunate also that there are in the Forth?as at Venice and Marseilles, two of the first European ports to establish quarantine?a number of islands to which ships could be sent for detention and disinfection. seems to have been that most frequently used ; , Inchgarvie and Cramond Inch were also utilised. On one occasion at least a ship was ordered to go into quarantine at the May. There was also a station on the mainland at Newhaven, sometimes used for the final disinfection of people who had been employed in cleansing infected ships, sometimes for isolating travellers who could not conveniently be sent to the islands. Occasionally ships went through their quarantine at their port of arrival, if the authorities thought that might be done with safety. It would, of course, be wrong to suggest that any regular and permanent service was established. It was not until much later that the provision of machinery for prevention of disease, to be maintained even though there were no obvious or immediate threat to the public health, was recognised as a duty of the State. The regulations and orders regarding plague that were made from time to time during the fifteenth, sixteenth and seventeenth centuries were operative only during the outbreak that evoked them. When the crisis had passed, they, along with the protective measures that they had authorised, fell into abeyance. As soon as the next epidemic seemed imminent the service had to be improvised afresh. But if no sanitary code was created a useful tradition of service was evolved, as the authorities came to recognise the steps that, according to the ideas of the time, should be taken. It was often impossible to ensure that these steps were taken effectively, but that was due to the inadequacy of the administrative machinery available. The earlier regulations, admittedly, do not seem specially useful. In 1538, when trade with England was stopped on account of an outbreak of plague on the borders, letters were sent to all seaports on the north and south shores of the Forth directing that no Englishman coming by sea was to be admitted.2 This appears to have been an attempt to impose a complete barrier to traffic rather than a quarantine service. A less absolute prohibition was prescribed in 1555 on ships from Bordeaux and other French ports where plague was epidemic. The arrival of those vessels was reported to the magistrates of Edinburgh and they were then examined by town's officers. If there were no sick on board, no history of sickness or deaths during the voyage and no other suspicious circumstances the cargo might be landed, but only on condition that its owners agreed that if disease resulted they should 3 be put to death and their goods confiscated ! The idea that epidemics might be prevented by threatening death to those who might be supposed to have spread the infection bulks pretty largely in early QUARANTINE FOR PLAGUE IN SCOTLAND 693 public health legislation. Fortunately, it was not long before more efficient and less barbarous methods were devised. Those varied in detail from time to time, but in broad outline remained pretty stable. When it became known that plague had broken out in any of the ports frequented by Scottish merchantmen Proclamation was made at the market cross of Edinburgh, the pier and shore of Leith, and other places concerned, forbidding shipmasters from the suspected places to set any passengers or goods ashore until they had reported to the local authority who had to make a thorough examination and decide whether those on board were and had been free from all infection or suspicion of sickness." The state of the plague at the port the ship sailed from and the nature of her cargo were also investigated. If all were satisfactory crew and passengers Were allowed to come ashore and land their goods. If, on the other hand, there were grounds for alarm?as, for mstance, when a ship from an infected place reported sickness or deaths during her voyage?severe restrictions were imposed. Attempts to land were punishable by death. Ship, passengers and cargo underwent a very thorough process of disinfection, and an order of the Privy Council, dated 23rd September 1564, gives a good idea of how this Was carried out. The cargoes of the ships concerned on this occasion consisted of lint, pitch, tar, iron, timber and barrels of potash, and, ?f course, the personal effects of passengers and crew. The order provides that:? " because maist danger appearis to be amang the lynt, that the same be loissit and housit in St Colm's Inche, oppynit, handillit and cassin furth to the wynd every uther fair day quhill the feist of Martimes nixtocum be sic visitouris and clengearis as sail be appointit and depute thairto be the Provost, Baillies and Counsall of the burgh of Edinburgh upoun the expensis of the marchantis, awneris of the saidis guidis. And as conserning the uther Guidis pik, tar, irne, tymmer, that the samyn be clengit be owirflowing of the sey, at ane or twa tydis, the barrellis of asse to be singit with hadder set on fyre and that the schippis be borit and the sey watter to haif interes into thame to the owirloft, and all the partis within to be weschin and clengit; and sic like that the marinaris and utheris that sail losse and handill the guidis abone written be clengit and kepit apart be thameselffis for ane tyme at the discretioun of the saidis visitouris, and license to be requirit, had and obtenit of the saidis Provest, Baillies and Counsall before thai presume to resort opinlie or quietlie amangis oure Soverane Ladies fre liegis." 4 " The instruction that the lint should be opened, handled and cast " forth to the wind refers to a process intended to serve both as a means of disinfection and a test of its efficacy. It must be remembered that the contagion of plague was believed to be a venomous quality in the air which penetrated and adhered to materials to an extent depending on their porosity and their liability to putrefaction. The VOL. LV. NO. II 2X2 694 JOHN RITCHIE destruction of this atmospheric poison or its replacement by clean air was the object of disinfection, or?to use an old word perhaps more appropriate in this connection?" expurgation." Dry and moist heat were used, fumigation with a variety of odoriferous substances was recommended, but free ventilation was regarded as of high importance, and was the method of choice when dealing with infected textiles. It entailed opening up bags and bales, unfolding, shaking, beating and generally handling the contents for a number of days. It was supposed " to be most effective in winter when the goods could be exposed to aire of frost." The principle had been approved by medical writers on plague?Marsilius Ficinus, Mercurialis, Diemerbroeck and many others?and it was still one of the chief means of dealing with infected goods in the great lazaretto of Venice at the end of the eighteenth century.5 It was assumed that if the goods were really dangerous this would be demonstrated by some of the handlers developing plague. Hence " " the process is sometimes referred to as taking the sey (the assay " or trial) of the geir." Frequently the owners and their families had to do the handling themselves, the idea, no doubt, being that if anyone were to contract the disease it should, in justice, be the owner of the infected fomites. The other methods of disinfection mentioned in the order? immersion in sea water for several tides, or singeing with burning " " heather?are examples of the cleinging by fyre and wattir often mentioned in official documents of the time. (Incidentally, flaming walls with burning heather was the approved method of disinfecting houses. It occasionally resulted in the house being set on fire?indeed, the whole town of Kelso was destroyed in this way in 1645.) Clothing was boiled or heated in a kiln. What could not be dealt with in any other way was scrubbed, sometimes, it seems, with a good deal more vigour than discretion ! The most drastic method of disinfection was that applied to the " " ships themselves. They were bored and scuttled in tidal waters till their upper decks were awash?an effective method, no doubt, of destroying infected rats and fleas. After the ships had been raised again they were thoroughly cleaned. Finally all who had taken part in those various operations were isolated for a period that apparently might be varied at the discretion of the authorities. The story of one unfortunate ship's company gives a fair idea of how the system worked. About the middle of September 1580 the William, owned and commanded by John Downey, arrived in the Forth from Dantzig.6 There had been several deaths on board during the voyage. She was ordered to Inchcolm where her company? seventeen sailors and fifteen passengers?were to remain on pain of " death, till they were clengit of the said seikness." The authorities of all seaport towns were warned that if any of the William's people tried to land, or had landed already, they must be arrested along with QUARANTINE FOR PLAGUE IN SCOTLAND 695 those who had received them?" thair houssis to be closit up and thameselvis to be execute incontinent to the deid." In fact, the authorities, as often happened, were content with a much lighter penalty than the law prescribed. A man named James Henry, with several companions, did succeed in leaving the William and arrived instead in Edinburgh. They were arrested there, but the magistrates, " " ?f hanging them incontinent as they were authorised to do, merely isolated them in their lodging. It is to be regretted that they showed no under proper appreciation of this leniency. Baillie William Little, whose supervision they had been placed, received so much insolence and abuse from them that as soon as their quarantine was over they there Were summoned to appear before the indignant town council, to ask pardon of God and the baillie, and to admit that, so far as the latter was concerned, they had slandered him. In addition, they were fined ,?3 apiece.7 (Baillie Little, by the way, was quite an important Public man who became Provost of Edinburgh a few years later. What is perhaps of greater interest to us is that he was the brother and executor of Mr Clement Little, whose bequest of books to the town formed the nucleus of the University Library.) " " In the meantime a number of clengeris had been sent to Inchcolm. Those were officers, both men and women, who were employed for various sanitary duties during outbreaks of plague, but mainly, as their name implies, for disinfecting persons and goods. Though employed by the municipality they had to be paid by the People requiring their services, an arrangement which, however com- mendable from the town council's point of view, would undoubtedly evoke vociferous protests from the modern rate payer ! On this occasion relatives of some of the people who had already died at Inchcolm did Protest, but without avail. To complicate matters, news came from Flanders that the plague " " Was vehement there, and on the 3rd October the Wynden arrived on and from Bruges, an infected town. She had some soldiers board also three pregnant women. They were isolated at Newhaven Probably the authorities had to recognise that huts on Inchcolm at the beginning of winter were not suitable accommodation for expectant mothers. The soldiers were allowed the same privilege, but other Passengers apparently had to find surety for ? 100 apiece if they wished to be quarantined there. " " At the same time a fly-boat arrived from Dantzig. Evidence is of the care with which the authorities were making their enquiries the fact that they discovered that she had on board three chests, with some other baggage and clothing, that had been transferred to her from the William. In view of that vessel's subsequent history the it to Newhaven owners of this gear were given the choice of taking and handling it there for 1 5 days, or sending it to be dealt with by the clengeris at Inchcolm?" and gif thai will nocht be content thairwith 8 the said guidis and kystis to be brynt and destroyit." Eventually, 696 JOHN RITCHIE

" however, the owner of one of the kysts," was allowed to send it to " " his home in Peebles to be handled there, but only on condition that he left the key in Edinburgh. It was to be restored to him when he produced a certificate that his chest had arrived at Peebles and was under supervision by the magistrates of that town. An entry in the Privy Council's register dated 22nd November indicates that things were going badly with the survivors of the William. They had now been confined on Inchcolm for nine weeks, Downey the skipper and a number of others were dead, the ship was leaking and likely to deteriorate badly, and the owners were at law with the merchants to whom the cargo belonged. The Town Council of Edinburgh were instructed to enquire into all the circumstances and " thereafter to tak sic order thairanent as thai sail think masist meet." But it was not until the middle of January, when the William's quarantine had lasted 115 days, that the last of the surviving sailors and passengers were released, the maistrates having decided that the danger of infection was over?" prayset be God "?a pious exclamation doubtless echoed by all concerned ! 9 The Council sometimes managed to get information about suspected ships before they arrived at Scots ports. In 1625 the plague was specially severe in London and other parts of England and a rumour reached Edinburgh that an infected ship had caused an outbreak at Holy Island, on the coast of Northumberland, and at Berwick on Tweed. Instead of asking the English authorities for confirmation of this the Council wrote to the Laird of Ayton in Berwickshire? " being ane gentleman of honour and credite who in our opinion is most able to gif unto us a true light and information of all the particulars concurring in this business." He was asked to report whence the ship came and what cargo she had brought, how long she stayed at Holy Island and where she went afterwards, what merchants traded with her, whether infection had been reported on either side of the border, and, finally anything else he might think of interest.10 The laird's reply is not available, but he seems to have investigated the matter thoroughly, as the Privy Council were fully informed about the suspected vessel when she appeared in the Forth shortly after. She had arrived at Holy Island from an infected port, but her captain had concealed that fact. When plague broke out and detection became imminent he fled to Norway. The Scots authorities were presumably not specially interested in his behaviour south of the border, and his misdemeanours would probably have been overlooked if he had been able to produce evidence of the good health of his crew since leaving Holy Isle. Being unable to do this he was ordered to leave the Forth at once and warned that if he or any of his crew attempted to land or to put goods ashore anywhere in Scotland they would be hanged.11 The long detention to which suspected ships were liable, the close confinement of passengers and crew in roughly improvised accommoda- tion, often on barren islands devoid of all amenities, the expense, the QUARANTINE FOR PLAGUE IN SCOTLAND 697

loss of market and the deterioration of goods that were the inevitable result of the quarantine system naturally resulted in many attempts to evade the regulations. A minute of the Privy Council dated " Ist August 1625 refers to a daylie and frequent arryval of shippis and barkis from London." These, if not prevented, landed goods and passengers If resisted sent them ashore by boat " openly. they at obscure pairtis and burnis alongis the coast "?" the skippers pretending misknowledge of the saidis proclamations." The Council re-enacted their previous regulations, and, as evidence that they were ]n earnest, gave orders, when a ship from London came into Prestonpans a fortnight later, that an armed guard should be set over her, and that any of her people attempted to land they should be killed at once 12 with shoittis of muskettis or haquebuttis or by pikis and halbertis." Attempts to disobey or evade the quarantine regulations were not confined to recalcitrant shipmasters : the magistrates of the coast towns also occasionally proved untrustworthy and disobedient. A ftagrant case occurred in 1625 when David Robertson, a skipper of Leith, arrived from Dantzig with cases of plague aboard his ship. He was instructed to discharge his cargo at Inchcolm, where it would be dealt with, and then take the ship to Inverkeithing to be temporarily scuttled in the harbour there.13 The baillies of Inverkeithing, however, oppoised thameselffis be force and violence against the lying of the Said ship in thair harborie," and, along with a local magnate who had encouraged them, were summoned before the Privy Council to answer for their misconduct?an experience which, three years later, was shared by the civic fathers of most of the Fifeshire seaports, all of " whom were charged with having been most remise and negligent ]n the execution and careful advertance to that whiche was given thame in charge." 14 A case of some interest was that of the ship Good Fortune which, during 1627 arrived at Leith from London with a history of sickness and deaths during her voyage. After a good deal of ordering and counter ordering she was eventually quarantined at Alloa, where she had gone to take in a cargo of coals. The special feature in her case is that after twenty-three days detention she was released after a medical " examination of her crew. Laurence Cokeburn, chirurgion in Edin- burgh," who certified her free from infection reported that he visited the haill companie of the same, and speciallie one of the companie 15 that had a byle upon him, whom he found sound and weele." This Js probably the first record of a medical man acting as port medical officer in Scotland. Cockeburn was the son-in-law of James Henrysoun, who is sometimes described as the first medical officer of health of Edinburgh. It is possible that on this occasion he may have been deputising for his father-in-law. Towards the end of 1635 plague broke out seriously in the Nether- tands, and a small epidemic at Cramond was ascribed to infection brought by Dutch ships. The usual regulations were put into force, 698 JOHN RITCHIE and amongst the shipmen who immediately got into trouble was a captain called William Moodie. The charge against him was, that having come from the Low Countries " ?where he knew that the contagious sickness of the pest was most violent, he verie unchristianelie, after he came in this firth, sett ashoare at Werdie one callit Lyll, who wes sicke for the time within the said ship and his sickenesse knowen to the haill equippage." Moodie protested his innocence but was convicted on the evidence of his own crew. He was imprisoned and kept in the stocks for a month, and then given the choice of returning to Holland or remaining in gaol. His decision is not recorded, but it must be allowed that he got off fairly easily.16 In fact, it is remarkable that, so far as can be ascertained, the extreme penalties threatened against those who disobeyed the ordinances concerning quarantine were never enforced. The mild, almost paternal, chastisement inflicted on these maritime transgressors is in strong contrast to that sometimes meeted out to ordinary citizens, as, for example, during the epidemic of 1530, when the magistrates of Edinburgh hanged a man, drowned two women and banished or branded more than a dozen other persons, mostly for failing to notify cases of plague. By the middle of the seventeenth century plague had disappeared from Scotland, but the risk of its re-introduction from less fortunate " " countries still worried the authorities. In 1661 the Black Plague " was raging at Dantzig, and some infection referred to as the new " white plague was spreading in Holland.17 Once more quarantine was imposed on all ships reaching Scottish ports. But it seems that by this time the advisability of refraining from unnecessary interference with trade was becoming a little better recognised. Some distinction seems to have been drawn between cargoes that were thought specially likely to spread infection and those that were innocuous. Some consideration was given to the length of time a vessel had been at sea, " " and frequent references to the ordinary tryall of fourtie days suggest that quarantine no longer implied an indefinite period of incarceration. Nevertheless, it continued to be oppressive enough and attempts at evasion naturally continued. In 1664 reports about the epidemic in Holland became so alarming that it was decided to stop the Dutch trade entirely. Very drastic regulations were made, but unfortunately their administration had to " be left to a large number of authorities, ?magistratts of burghes, shireffs of shires, stewarts of stewartries, baylies of regalities, justices 18 of peace, barrones and heritours." Overlapping and confusion were inevitable, and ample opportunities for evasion were available to intelligent and unprincipled mariners. Some Dutch ships for example, defied the authorities at Bo'ness, and the Duke of Hamilton's agent was empowered to burn them if they did not put to sea at once. They did so, but one, at least, slipped back and attempted to take in a cargo QUARANTINE FOR PLAGUE IN SCOTLAND 699 of to burn her coal. This was stopped by the agent getting sanction wherever he could catch her above Queensferry, unless she left im- mediately?which, apparently, she did. not be But a complete ban on the movements of shipping could enforced. Scots shipmasters, faced by the prospect of remaining tied UP in Dutch harbours till seized for debt, often preferred to take the risk of running for home, and the Privy Council had to recognise that the policy of threatening to hang mariners and burn their ships had the its limitations. The regulations were relaxed in several cases, Council apparently dealing with each on its merits. But some got pretty severe treatment. David Thomson, for example, obediently remained in Holland till his ship was on the point of being seized. He then set sail for Scotland, but, caught in a winter storm, was driven right round Britain. On 10th November he reports that he and his " since." company are by God's mercy arryved at Greinok fyftein dayes All on board are in good health, but they are forbidden to come ashore. Their ship is damaged, they are in hazard of their lives, and they crave the Council's permission to land with their goods. It is now forty-five days since they left Holland. The ship had a mixed cargo, parts of which may have been considered dangerous, and it was possibly for this reason that the Council insisted on the crew being isolated at Greenock for the customary forty days?at their own expense, of course?and directed that any of the goods that could not be properly disinfected must he burned.19 The Great Plague of London broke out in the following year. All trade between London and Scotland was interdicted, and the authorites hastened to make preparation for the epidemic that might be expected if the infection spread northward. But nothing untoward happened. when Not until October did any suspicion of sea-borne infection arise, usual three ships were sent to Inchkeith to be detained there for the forty days. They were released in due course, the authorities being was free of convinced that there was no danger of infection. London the plague by the end of the following year ; within a few more years and disease had ceased to be a serious problem in Western Europe, than with the disappearance of a menace that had lasted for more three centuries the record of the Scots quarantine service comes to an end. In It is difficult to say how far it served its purpose. conception from it was sound enough. We are not justified in demanding any based on activity of preventive medicine more than that it shall be best means the best medical knowledge of the age, and that the available shall be used for the practical application of that knowledge. authorites So regarded, the preventive measures devised by the civil on which Were, for the most part, quite reasonable. The doctrines of the they were based were those held by all the orthodox physicians and that disease time?that infection was caused by an aerial poison, 700 JOHN RITCHIE acquired thereby might be spread by contagion. We have discarded " both the theory of infectious miasmata and that of contingent contagion," but it is well to remember that they survived, as funda- mental tenets of epidemiology, till well into the nineteenth century. In light of those beliefs the lengthy quarantine imposed and the methods of disinfection used were logical enough. It is, perhaps, not irrelevant to point out that when, a few years ago, it seemed possible that we ourselves might be exposed to an aerial poison with qualities rather similar to those of the hypothetical plague venom?I mean mustard gas?we proposed to use methods of decontamination that would have appeared quite obvious and perfectly familiar to anyone who had had experience in dealing with plague four hundred years ago. The real weakness lay less in the theory than in its practical application. Lack of any permanent machinery for dealing with epidemics, the number of small local authorites attempting, within restricted areas, to carry out duties for which they had inadequate resources and little enthusiasm, and, not least, the primitive means of transport and communication?services on which efficient administra- tion largely depends?all militated against success. Several outbreaks of plague in Scotland?in particular that which lasted from 1584 till 1588?were attributed, at the time, to infection from overseas, but no evidence is now available for determining whether the attribution was justified. It may well be that endemic centres in this country in which the plague was always smouldering were a more pressing danger. Nor is it possible to say how far the quarantine regulations I have outlined afforded a real protection. It is easy to point out that maritime quarantine has never been an absolute safe- guard, that it must entail much hardship and dislocation of trade, and that the present system of medical inspection and supervision gives much better results. But that system has become practicable only because we now possess the very facilities which in former days were conspicuously absent?a permanent administrative machine with close communication and co-operation between its units. Lacking this, our forefathers did their best with what they had. Whether the protection they improvised was of real value or not its story may have some interest as dealing with one phase in the evolution of our health service, and as showing how men, with limited knowledge but with courage and public spirit, faced the recurring menace of one of the most terrible epidemic diseases.

REFERENCES

1 Mackintosh, J. (1892), History of Civilisation, 2, 286. 2 PlTCAIRN, Criminal Trials, 1, 294. 3 Ext. Rec. Burgh of Edi?iburgh, 1528-1557, p. 227. 4 Reg. Privy Co. Scot., 1st Series, 1, 280. 5 Howard, J. (1798), Account of the Principal Lazarettos in Europe. QUARANTINE FOR PLAGUE IN SCOTLAND 701

Reg. Privy Co. Scot., 1st Series, 3, 313. Ext. Rec. Burgh of Edinburgh, 1573~ 1589? P- !79- Ibid., p. 178. Ibid., p. 556. Reg. Privy Co. Scot., 1st Series, 13, 688. Ibid., 2nd Series, 1, 30. Ibid., p. 116. Ibid., pp. 99-218 passim. Reg. Privy Co. Scot., 2nd Series, 3, 380. Ibid., 2nd Series, 1, 484-501 passim. Ibid., 2nd Series, 6, 119, 126. Ibid., 3rd Series, 1, 83. Ibid., p. 561. Ibid., p. 623.