Revista de Historia Interdisciplinaria, xxxviii:2 (Otoño, 2007), 177–205.
HOUSEHOLDS AND PLAGUE
Samuel K. Cohn, Jr., and Guido Alfani
Households and Plague in Early Modern Italy The
past decade has seen the debate about the Black Death and its suc-
cessive waves edging away from social and cultural history toward
questions of biology and epidemiology: Was the Black Death
Yersinia pestis? Does it make sense to claim that the three pandem-
ics that swept across Europe from Justinian’s time to the twentieth
century all had the same pathogen? From studies of ancient dna
extracted from dental pulp in medieval and early modern corpses
to epidemiological modeling, the lines of debate have become
rigid—for and against the Black Death as being the same as the
slow-moving rodent disease that entered Hong Kong in 1894,
spread to India, and touched (but failed to decimate) several major
seaports in temperate zones at the opening of the twentieth cen-
tury. Despite striking differences in the epidemiological character
of the Black Death and the bubonic plague of the so-called third
pandemic, no consensus has emerged as to whether these earlier
plagues were Yersinia pestis; nor does any look likely to appear in
the near future.1
Samuel K. Cohn, Jr., is Professor of Medieval History, University of Glasgow. He is the au-
thor of Lust for Liberty: The Politics of Social Revolt in Medieval Europe, 1200–1425 (Cambridge,
Masa., 2006); Popular Protest in Late Medieval Europe: Italia, Francia, and Flanders (Manchester,
REINO UNIDO, 2004).
Guido Alfani is Assistant Professor of Economic History, Bocconi University, Milan.
He is the author of Padri, padrini, patroni: La parentela spirituale nella storia (Venice, 2007); “Les
réseaux de marrainage en Italie du Nord du XVe au XVIIe siècle: Coutumes, evolution,
parcours individuals,” Histoire, Economie et Société, IV (2006), 17–44.
This article was made possible through a Royal Society of Edinburgh exchange, cual
brought Dr. Alfani to Glasgow to work with Professor Cohn.
© 2007 por el Instituto de Tecnología de Massachusetts y The Journal of Interdisciplinary
Historia, Cª.
1 Recent contributions to the debate include Susan Scott and Christopher J. Duncan, Biol-
ogy of Plagues: Evidence from Historical Populations (Nueva York, 2001), 128–129; ídem, Return of
the Black Death: The World’s Greatest Serial Killer (Chichester, 2004), 140–144; Cohn, El
Black Death Transformed: Disease and Culture in Early Renaissance Europe (Londres, 2002);
George Christakos et al., Interdisciplinary Public Health Reasoning and Epidemic Modelling: El
Case of Black Death (Berlina, 2005); y, especially, two conferences, “The Plague Confer-
ence,” November 9–12, 2005, CEES/DNVA, Oslo, Norway, and “Workshop: The Identity
of Plague," Abril 5, 2006, Wellcome Trust Centre for the History of Medicine, Universidad
College London. For the plagues of 542 a 750, see Lester Little (ed.), Plague and the End of
Antigüedad: The Pandemic of 541–750 (Nueva York, 2007); Peregrine Horden, “Mediterranean
Plague in the Age of Justinian,” in Michael Maas (ed.), The Cambridge Companion to the Age of
Justinian (Nueva York, 2005), 134–160.
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178 | SAMUEL K. COHN, JR., AND GU I DO ALFANI
Sin embargo, new questions about the character of late medi-
eval and early modern plagues can be posed without establishing
deªnitively what its pathogen may have been. This article investi-
gates several extraordinary sources for Milan and Nonantola in
northern Italy from the mid-ªfteenth to the seventeenth century.
They provide the opportunity for the kind of combined demo-
graphic and epidemiological research about plague that is not pos-
sible for early medieval plagues, or their repeated waves into the
mid-ªfteenth century. Analysis of these later sources shows house-
hold-composition patterns during and between plague deaths that
permit a closer look at plague transmission and more informed
speculation about its periods of latency, incubation, and infec-
tiousness. The upshot is the discovery of something about early
modern European plagues that most likely was also true about the
earlier Black Death: Victims of plague within the same households
died within a remarkably short time of one another, most of them
on the same day. No other disease now known to medicine pro-
gresses with such a pattern.2
milan’s books of the dead To detect whether “true plague”
(vera pestis) was within its walls, poised to erupt into a deadly epi-
demic, physicians of the Milanese health board (ufªciale di sanità)
began registering deaths and diagnosing their causes during the last
year of the plague of 1449–1452. Initially called “necrologi,” these
Libri dei morti (books of the dead) continued with few lacunae until
1755. Though not the ªrst attempts to register a city’s deaths (como
opposed to burials), they are almost unique in that regard, al menos
until the civil registers of the nineteenth century, given that uni-
versity-trained physicians—not parish priests, other clerics, o
gravediggers—evaluated the corpses, gathered the reports of
symptoms, and pronounced the cause of death. Zanetti and
Carmichael have constructed elaborate nosologies of diseases from
these records, but such were not the concerns of the health board.
Bastante, throughout the ªfteenth and sixteenth centuries, doctors
used this evidence to distinguish true plague from other fevers and
ailments. Their dichotomous judgments—suspected or not sus-
pected of plague—had grave consequences not only for the vic-
2 Cohn principally collected and analyzed the Milanese data and Alfani
Nonantola.
those for
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HOUSEH OLDS AND PLAGUE | 179
tims’ families but also for policy, commerce, and the movement of
people and goods. Además, houses in which a family member
or co-resident was judged to have died from plague (peste) eran
usually marked as domus infecta, or boarded up (domus clausa). El
families were compelled to reside beyond the city walls
en
lazzaretti—makeshift camps with special huts (campane) for those
con, or “suspected” of, plague.3
Deaths diagnosed not to have been caused by plague (sine
contagio, sine aliquali contagione, absque signo pestiªco) generally re-
ceived less attention about signs, symptoms, and course of illness.
Often the cause of death went completely unlabeled. Plague cases,
sin embargo, no matter how lowly the victim’s status, regularly com-
prised paragraph-long entries. After identifying the victim’s parish,
household, name, edad, and occasionally profession, the death bol-
lettino (later to be copied into the Libri dei morti) recorded the dis-
ease’s progress from initial symptoms—continuous fever, cabeza-
aches, vomiting, pains in various parts of the body, sometimes
where buboes might later appear, deep sleep, dazed eyes, milky
urine, loose bowels, loss of appetite, y más. When examining
the plague corpse, doctors added further descriptions of signs that
usually appeared late in the disease, such as buboes, carbunculi, drag-
onzoli, tumors (often accompanied by black or purple spots—
morbilis nigris or violaceis, and occasionally rubeis), recording their
number and location on the body. Sometimes later symptoms, como
with a white and spiky tongue, were also described. These reports
and accompanying letters show consultation among the health-
board physicians, even debates, about whether a victim had died
3 For the distinction been plague and “vera pestis,” see, por ejemplo, a case of June 25, 1468,
Miscellanea Storica, No. 1, fasc. No. 1, carte 407, Archivio di Stato di Milano (hereinafter
asm). For a detailed survey of the lacunae in this series, see Giuliana Albini, Guerra, fame, peste:
crisi di mortalità e sistema sanitario nella Lombardia tardomedioevale (Bologna, 1982). For other
books of the dead, see Carlo Cipolla, “I Libri dei morti,” Le fonti della demograªa storico in italia
(Roma, 1972), II, 851–866. Similar records with physicians’ evaluations survive for Mantua
but are not nearly as well preserved, especially for plague years. For previous analyses of the
Milanese records, see Ann Carmichael, “Contagion Theory and Contagion Practice in Fif-
teenth-Century Milan,” Renaissance Quarterly, XLIV (1991), 213–256; ídem, “Epidemics and
State Medicine in Fifteenth-Century Milan,” in Roger French, Jon Arrizabalaga, y andres
Cunningham (editores.), Medicine from the Black Death to the French Disease (Aldershot, 1998), 221–
247; Dante E. Zanetti, “La morte a Milano nei secoli XVI–XVIII: Appunti per una ricerca,"
Rivista Storica Italiana, 88 (1976), 804–852; Albini, Guerra, fame, peste; Franco Saba,
“Una parrocchia milanese agli inizi del XVII secolo: S. Lorenzo Maggiore, Materiali per una
storia demograªca,” Nuova Rivista Storica, LIX (1975), 413–414.
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180 | SAMUEL K. COHN, JR., AND GU I DO ALFANI
of plague, especially when a death had occurred too quickly for
skin disorders to form. Such casi dubiosi allow historians to follow
doctors’ reasoning and understand operationally their deªnition of
plague.
Although the symptoms of continuous fever, headaches, y
vomiting were labeled as “pestilential accidents,” they were
insufªcient for doctors to diagnose plague as the cause of death.
Nor was the formation of a bubo or tumor in the groin, thigh, o
under the armpits sufªcient proof. Such swellings could accom-
pany illnesses that physicians declared as “without suspicion.” The
single most common reason for judging a dubious case as plague
was the swiftness of death (propter celeritatem). Cases of plague were
not so patently obvious to laymen or doctors from the onset of
sickness as historians and present-day scientists usually assume; af-
ter all, many diseases began with fevers.
Physicians recorded the duration of illness, sometimes calcu-
lated to the hour, to make their diagnoses. Judging from the dura-
tion of other diseases with strikingly different symptoms, the doc-
tors’ reasoning appears perspicacious and consistent. Other than
death from wounds, horriªc falls, and other accidents, few deaths,
if any, were as sudden as those from plague. Por el contrario, those
who died from the second most dreaded epidemic in this period—
syphilis, or the French pustules (ex pustulis gallicarum) as the Mila-
nese called it—suffered periods of illness so long (egritudine longa)
that the physicians rarely knew, or bothered to count, the weeks
or months of suffering before death. In a Milanese epidemic of
1477 that killed 782 from July 1 to December 31 and that modern
scholars have attributed to typhus, the victims died after thirteen
days on average, and less than 2 percent died within a week. El
modal time of illness of plague victims during the Milanese epi-
demics of 1452, 1468, 1483, 1502, y 1523, sin embargo, was consis-
tently two days, and the median was less than three. Del 1,683
people who died of plague, solo 53 (3 por ciento) endured their ill-
ness for more than a week before death (ver tabla 1).4
4 For the epidemic of 1477, see Fondo popolazione, parte antica, asm (hereinafter
Popolazione), norte. 75 (unfortunately the records for the ªrst half of the year are missing.) El
duration of plague illnesses may have been even slightly shorter than these ªgures indicate.
Physicians reported the number of days of illness before death or the day of the week when
the patient ªrst became ill. If the latter, this study calculated the interval as including both the
start day and the day of death, even if a physician noted that a victim became ill at night and
died the next morning.
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HOUSEH OLDS AND PLAGUE | 181
Mesa 1 Plague Deaths in Milan, 1452, 1468, 1483, 1502, y 1523, by Dura-
tion of Illness
No
info
1st
día
2nd
día
3rd
día
4th
día
5th
día
6th
día
7th
día
8th
día
9th
day >
597
46
301
287
229
82
54
29
14
5
39
These records allow a precision for evaluating the plague that
is impossible either with early modern parish records or with ear-
lier burial records collected citywide in towns such as Florence
and Arezzo during the late fourteenth or ªfteenth centuries. Primero
de todo, these other records do not usually indicate whether a death
during an epidemic was attributable to plague; después de todo, individuals
continued to die from other ailments, which may well have
intensiªed during periods of plague. Unlike parish registers, el
Milanese documents recorded the date of death, not of burial,
which could be delayed especially in times of crisis when corpses
mounted, cemeteries ªlled, and gravediggers were in short supply.
The Milanese records also provide a second date, not found in
these other death records—the moment when the ªrst signs or
symptoms of illness appeared, before buboes, morbilli, or other skin
disorders had been able to form.5
family reconstitution and the detection of diseases This
study is not the ªrst to use techniques and evidence of family re-
constitution to elucidate characteristics of early modern plague.
Scott and Duncan used them to analyze parish burial records from
Penrith and Eyam for evidence about the plague’s transmission
and to differentiate it from late nineteenth- and early twentieth-
century bubonic plague (Yersinia pestis). They maintain that the
efªciency with which the late medieval and early modern plagues
(which they call “haemorrhagic plague”) were able to spread was
due to their long periods of incubation and infection, before any
signs became apparent. Como consecuencia, people who carried the
plague could travel, mix with others, and infect them by stealth
5 The Aretine books of the dead begin in the 1370s and the Florentine in 1385. On quanti-
tative evidence of the delays between death and burials in plague time, see Roger Schoªeld,
“The Last Visitation of Plague in Sweden: The Case of Bräkne-Hoby in 1710–11” Economic
History Review (próximo).
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182 | SAMUEL K. COHN, JR., AND GU I DO ALFANI
before they could be ostracized by neighbors or kin. According to
Scott and Duncan, the disease was latent during the ªrst ten to
twelve days; for the next twenty to twenty-two days, infection
was active but without signs; and after or during the ªnal ªve days
of infectivity, the victims died. The interval from infection to
death extended to an average of thirty-seven days. Por eso, ellos son-
gue, Venice adopted quarantine, or forty days of isolation, en 1422,
and other states across Europe followed.6
Scott and Duncan assume that once the ªrst signs of plague
illness appeared, people in early modern communities would have
easily and immediately recognized the disease and avoided the car-
rier at all costs. But as numerous sixteenth-century plague tracts
reveal, one of the most pressing problems for physicians was dis-
tinguishing between pestilential fevers and true plague. The Mila-
nese death books illustrate that plague diagnosis was not always
obvious; it often had to await postmortem evaluations, cuando
plague signs might appear for the ªrst time. A menudo, the fact that an
ill person had died within a week was the ªrst clue that plague had
been the cause.7
Aside from these considerations, how do Scott and Duncan
measure these intervals of latency, incubation, and infectivity with
such precision, given that such periods until the ªrst appearance of
sure signs of plague would have been invisible to contemporaries
and left unrecorded by them? How do they determine that invisi-
ble moment of ªrst infection? They claim, “By working through
the data for a large number of households derived by family recon-
stitution from parish registers, it is possible to derive estimates of
the latent, infectious and incubation periods for haemorrhagic
plague.” Yet, they fail to explain how they “derive” these invisible
periods unsuspected by contemporaries from registers that provide
only the dates of burials. Nor do they reveal how such periods can
be determined from reconstituting the deaths of family members
(who may or may not have lived together). De hecho, their charts
fail even to indicate clearly the one fact registered in the parish
6 Despite use of the term quarantine, governments often found far shorter periods of isola-
tion to be effective. The plague of 1576/77 in Milan established eight- and then ten-day peri-
probabilidades; physicians such as Cesare Rincio commented on the effectiveness of these shorter
measures in containing the plague. See A. Francesco La Cava, La peste di S. carlo: Nota
storico—Mediche sulla peste del 1576 (Milan, 1945), 55, 116–117.
7
Scott and Duncan, Biology of Plagues, 128–129; ídem, Return of the Black Death, 140–144.
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HOUSEH OLDS AND PLAGUE | 183
burials—the date of burial and presumably of death. But their as-
sumption seems to be that the longer was the grace period be-
tween successive plague deaths within a household, the longer was
the period of incubation.8
Instead of data from a large number of households, Scott and
Duncan’s Biology of Plagues lists 9 households from the 242 eso
they reconstituted from the parish records of Penrith during the
plague of 1597/98. Their later Return of the Black Death supplies
only three of the same nine households from the same plague. El
number of clear cases in Eyam is even smaller. The authors give
little hint of the reasons for relying on such a highly selective and
pequeña muestra, except that the “early stages [of plague] . . . are much
more informative than are the confusing events in mid-summer
[1598 at Penrith] when the infection spread with devastating ra-
pidity.” But they do not explain why this peak period, cual estafa-
stitutes over 96 percent of their data, should remain unexamined.
Nor does measuring the one interval that is readily apparent from
the family reconstitutions of deaths—the interval between succes-
sive deaths within a household or family—become more difªcult
with later stages of plague. True, the infections between house-
holds might become more complex, but these cross-household in-
fections are highly speculative at the best of times, since they are
based entirely on the moment of burial and the presumed location
of houses. Did the intervals between the deaths of family members
change with different phases of a plague, from when it smouldered
in late winter to periods of peak mortality, usually during the sum-
mer?9
Además, the evidence for the presumable point of infec-
ción, which is crucial to Scott and Duncan’s analysis, does not
come from contemporary observations recorded in parish burial
records but from anecdotal sources, of which they have only
two—one from Penrith, the other from Eyam. Eyam’s, además,
derives from a story written 177 years after the plague. Both stories
record the entry of a stranger to town, who later died of plague. En
Penrith, his death came twenty-two days after his arrival; in Eyam,
it came ªfteen days later. Such stories, sin embargo, do not rule out
the spread of plague by other avenues, such as the arrival of goods
Ídem, Biology of Plagues, 24. The dates of burial for the three cases are clearer in Return of
8
the Plague than in the earlier, more abstruse, Biology of Plagues.
9
Ídem, Biology of Plagues, 128.
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184 | SAMUEL K. COHN, JR., AND GU I DO ALFANI
(as contemporaries at Eyam and other observers during the Black
Death period as well as during eighteenth-century plagues sus-
pectado) o, more plausibly, the coming and going of transients
who happened not to settle in these market towns and thus were
not registered in their parish records.10
Similarmente, in examining subsequent deaths and intervals be-
tween deaths in households, Scott and Duncan do not account for
the possibility of new sources of infection from outside the family.
Can all deaths within a family or household be traced to a primary,
secondary, or tertiary infection within that household or family, como
though once infected, these households became sealed units iso-
lated from the larger community? As we shall see, certain large
households during the early modern plagues in northern Italy
show several clusters of deaths, sometimes separated by as many as
two or three months. Should we assume that these later infections,
unlike the vast majority of the others, derived from earlier family
members who harbored the plague for long periods without
showing any signs of illness?
Finalmente, Scott and Duncan presume that long periods of incu-
bation and infectivity were the necessary preconditions for any
disease spreading rapidly and effectively during the early modern
período. Brieºy, they mention the Great Flu of 1918, maintaining
that its rapid and global transmission depended on the invention of
steam power and the mass movements of troops, which would
have been impossible before the twentieth century. The history
of inºuenza, sin embargo, fails to substantiate these claims. Well be-
fore the harnessing of steam and the railway, as early as the mid-
thirteenth century, chroniclers described respiratory diseases ac-
companied by fever, headache, coughs, and runny noses racing
across European regions in late autumn, invierno, and early spring.
At least six such visitations have been noted for the fourteenth
siglo, four for the ªfteenth century, nine for the sixteenth cen-
tury, twelve for seventeenth century, and sixteen for the eigh-
teenth century. En 1510, 1557, 1580, 1732, 1782, y 1837, estos
types of disease spread from Asia through Russia and Turkey to
the countries of Western Europe and across the Atlantic Ocean to
10
Scott and Duncan follow the story of William Wood, History and Antiquities of Eyam,
written in 1842. On the problems of the Eyam sources and its legends, see Patrick Wallis, “A
Dreadful Heritage: Interpreting Epidemic Disease at Eyam, 1666–2000,” History Workshop
Diario, LXI (2006), 31–56.
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HOUSEH OLDS AND PLAGUE | 185
America. En 1826, a prominent physician in Philadelphia reported
a ºu pandemic in North America that affected “a whole region in
the space of a week, nay, a whole continent as large as North
America, together with all the West Indies, in the course of a few
weeks.”11
Hirsch, a physician writing at the very moment when steam
and mass motorized transport were transforming global communi-
catión, observed that inºuenza “has not spread more quickly in
our own times, with their multiplied and perfected ways and
means of communication, than in former decades or centuries.” In
hecho, epidemiologists today recognize that the extent and speed of
an inºuenza epidemic depend on the virulence of the virus and
the balance between immune and susceptible populations as
mucho, if not more, than on a region’s transportation infrastruc-
tura. Además, they have discovered that the short time between
primary and secondary cases (not a long time, as Scott and Duncan
theorize) was critical for the rapid and devastating transmission of
el 1918 pandemic.12
By arguing that the plague had a long period of infection be-
fore any signs became apparent, Scott and Duncan undercut one
of their own conclusions about plague that is solidly based on their
parish records and corroborated by other plagues across Europe
from the late Middle Ages to the eighteenth century—the house-
hold or family clustering of plague deaths. They ªnd that 485
plague deaths occurred within 242 nuclear families in Penrith,
slightly more than two deaths per family. This ªgure compares fa-
11 Thomas Bevill Peacock, On the Inºuenza or Epidemic Catarrhal Fever of 1847–8 (Londres,
1848), iii; C.W. Potter, “A History of Inºuenza,” Journal of Applied Microbiology, XCI (2001),
572–579; Gerald F. Pyle, The Diffusion of Inºuenza: Patterns and Paradigms (Totowa, 1986), 23–
25; Alfred W. Crosby, Jr., Epidemic and Peace, 1918 (Westport, 1976); ídem, “Inºuenza: En el
Grip of the Grippe,” 148–153, in Kenneth F. Kiple (ed.), Plague, Pox & Pestilence (Londres,
1997). The physician in Philadelphia (“Dr. Jones”) was cited by August Hirsch (trans. Charles
Creighton), Handbook of Geographical and Historical Pathology. I. Acute Infective Diseases (Lon-
don, 1883), 36, from the Philadelphia Journal of Medicine and Physical Science, IV (1826), 5. Cer-
tainly, further research could add to these lists. Por ejemplo, a physician from Macerata in the
Italian Marches observed an epidemic of “very contagious coughing” in 1562 that spread
through Macerata, Perugia, Roma, Nápoles, Venice, Padua, Milan, Bologna, and many other
parts of Europe (Marino Massucci, La preseruatione dalla pestilenza, con molte materie appertinenti
a’ l’arte di medicina [Macerata, 1577], 43). In the following year, Giovanni Filippo Ingrassia, a
Sicilian physician, reported a “epidemial catarro” that spread through Sicily, killing mostly the
poor in two or three days (Informatione del Pestifero et contagioso Morbo [Palermo, 1576], 60).
12 Hirsch, Handbook., I, 36; Pyle, Diffusion of Inºuenza, 2; C. Mills, j. Robins, y M.
Lipstich, “Transmissibility of 1918 Pandemic Inºuenza," Naturaleza, CDXXXII (2004), 904–906.
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186 | SAMUEL K. COHN, JR., AND GU I DO ALFANI
vorably with late ªfteenth- and early sixteenth-century plagues in
Lombardy, although the household clustering was even stronger
allá. For the plague of 1468, Milan’s health board recorded 1,880
plague deaths between February 4 and September 21, occurring in
654 houses (domus infecte)—2.88 deaths per household. Para el
same plague in Parma, 1,810 died within 543 “infected homes,” at
una tasa de 3.33 plague deaths per household. Ever since the Black
Death of 1348, contemporaries have seen this household cluster-
ing as a key characteristic of true plague and proof that the disease
was transmitted from person to person.
For diseases that are much less contagious, such as Yersinia
pestis (even with primary and secondary cases of pneumonic
plague), household clustering is much lower. At Sydney in 1900,
Yersinia pestis struck 276 households, but only in ten did more than
one person become infected. If the victims of early modern
plagues were able to interact for thirty days or more with fellow
villagers or townsmen, why would their deaths have clustered so
strongly within households? Would plague not have resembled
other diseases, which have long incubation periods and tend not to
cluster in households?13
family reconstitution: comparison with the evidence from
early modern penrith The average interval between deaths in
Scott and Duncan’s three afºicted Penrith households with clear
dates of burial in Return of the Plague is 15.6 días. The interval in
the ªrst household ( j. Railton) is forty-two days, of the second
household (A. Railton) two days, and of the third household
(Hewer) thirteen days. When the intervals for Scott and Duncan’s
seven other households affected by the same plague in Biology
of Plagues are included—the Hewers’ nine days, the Haskews’
13 Miscellanea storica, No. 2; Miscellanea storica, No. 1, nos. 485–486, asm; Albini, Guerra,
fame, peste, 31. Similar rates of household clustering are found for the late medieval plagues.
See Cohn, Black Death Transformed, 117–121, 134, 235; Carmichael, Plague and the Poor in Re-
naissance Florence (Nueva York, 1986), 24, 80. For the sixteenth-century plagues, see the obser-
vations of the Cesare Rincio, Milan’s head physician during the plague of 1576, cited in La
Cava, La peste di S. carlo, 55. On the household clustering of Yersinia pestis, ver J. Ashburton
Thompson, “On the Epidemiology of the Plague,” Journal of Hygiene, VI (1906), 540. The In-
dian plague commission also found comparable percentages for villages and the City of Bom-
bay during epidemics from 1903 a 1906. See The Etiology and Epidemology of Plague: A
Summary of the Work of the Plague Commission (Calcutta, 1908), 64–67.
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HOUSEH OLDS AND PLAGUE | 187
three days, the Watsons’ and the Cookes’ zero days, the Walkers’
twenty-ªve days, and the Blysees’ seven days—the average falls to
10.1. The inner household clusters are narrower still.14
Do these results show signiªcantly longer intervals than cases
of Yersina pestis in the rare instances when it appears to have been
transmitted from person to person? A study of the bubonic plague
in the village of Nawra in Nepal between September 6 and No-
noviembre 5, 1967, is the only one available to explore in detail the
transmission of the plague at the household level. The number of
cases is limited, but the intervals between household deaths in this
setting are longer than Scott and Duncan can ªnd for the early
modern plague, thus allowing for longer periods of incubation and
infectiousness. In one of the Nepalese households, the interval
spanned from September 24 to November 5—forty-three days—
longer than any case supplied by Scott and Duncan. The intervals
in the other three households at Nara ranged from twenty-three
days to ªve days, an average of 16.2, six days longer than the inter-
val Scott and Duncan discovered for late sixteenth-century plague
in Cumbria. Todavía, despite these longer intervals—as well as more
modern forms of communication, transport, and commerce—the
plague of Nawra did not spread quickly from one village to the
next. Además, the bubonic plague found in Nawra was a rare
form of interhuman plague, a mixture of pulmonary and tonsillar
plague, in which the human ectoparasite may have been Pulex
irritans. This variety killed faster and spread more quickly than the
more usual rat-ºea vector variety of Yersinia pestis.15
the evidence from the milanese plagues The empirical data
from the early modern plagues in Milan present a vastly different
picture of plague transmission than Scott and Duncan’s for “haem-
orrhagic plague” in general. For one thing, the Milanese data can
supply more examples of households with multiple deaths. En efecto,
the number of the death records for Milan—one of the largest cit-
Scott and Duncan, Biology of Plagues, 129.
14
15 F. Marc Laforce et al., “Clinical and Epidemiological Observations on an Outbreak of
Plague in Nepal,” Bulletin of WHO, XLV (1971), 693–706. The failure of the infection to
spread beyond the village of Nawra did not result from the intervention of medicine. Physi-
cians and other plague workers from Tehran reached Nawra a month after the plague had
erupted and had almost run its course.
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188 | SAMUEL K. COHN, JR., AND GU I DO ALFANI
ies in Western Europe, with a population that ranged from 60,000
after the mid-ªfteenth-century plague to more than 120,000 en
the eve of the plague of 1523—poses problems for household and
family reconstitution. Todavía, even without family reconstitution, el
day-to-day tally of plague deaths in Milan reveals a remarkable
household clustering. The proportion of such household deaths
can be crudely estimated from physicians’ identiªcations of plague
cases coming from previously “infected” households (domus infecta
or clausa). More surprisingly, around one-quarter of all deaths
caused by plague were ones that occurred within households on
exactly the same day, as evident in the chronological listings of
plague deaths.16
The Milanese Libri dei morti began on July 21, 1452, durante
the last months of the plague of 1449–1452, the ªrst major Italian
pandemic since 1400. In this ªnal phase of plague, 185 people died
in Milan; 74, almost 40 percent of them, came from “infected” or
“suspected” houses. The proportion, sin embargo, may well have
been larger. Not only did physicians fail to label many cases as new
or from infected houses; thirty-six plague victims also died ad lo-
cum montanee, a special plague camp of provisional huts built be-
yond the city walls. The physicians speciªed that twenty of these
victims had come from infected households. Nothing, sin embargo,
was said about the rest of them. But why else would they have
been brought there? If these sixteen unlabeled cases are added
to the infected households, the proportion rises to half of the
plague victims, a ªgure not unlike that seen for other plagues,
when the health board tallied summaries of plague victims by
household.17
16 For these population estimates of Milan, see Albini, Guerra, fame, peste, 28–29; Beatrice
Besta, “La popolazione di Milano nel periodo della dominazione spagnola,” in Atti del
Congresso Internazionale per gli studi sulla popolazione (Roma, 1933), I, 593; Domenico Sella,
“Premesse demograªche ai censimenti austriaci,” Storia di Milano, XII (Milan, 1955), 459–
478; Stefano D’Amico, “Poveri e gruppi marginali nella società milanese cinque-seicentesca,"
in Danilo Zardin (ed.), La città e i poveri: Milano e le terre lombarde dal Rinascimento all’età spagnola
(Milan, 1995), 273.
17 According to the records of the Ospedale Maggiore, this plague reached its peak in April
1451. See Cesare Decio, La peste in Milano nell’anno 1451 e il primo lazzaretto a Cusago: appunti
storici e note inedite tratte dagli archivi milanesi (Milan, 1900); Albini, Guerra, fame, peste, 121.
From the end of September 1451 to the end of December 1452, acerca de 4,000 died within the
urban parishes of Milan, 64.8% of them from plague. Bolletini or slips of paper survive for the
period between September 28 and October 24, 1451 (Carteggio Sforzesco, norte. 657); they re-
cord the daily death tolls, totaling 1,694 in October alone. See Albini, Guerra, fame, peste, 127.
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HOUSEH OLDS AND PLAGUE | 189
Milan’s next plague struck sixteen years later in 1468. El
Libri dei morti, sin embargo, do not survive for this plague, a pesar de
the physicians’ bolletini scattered throughout other archival collec-
tions give some indication of what they must have contained.
These small paper slips, later copied into the now lost volumes of
the dead, also point to a signiªcant number of household plague
fatalities. Those who died of plague within infected households or
who died on the same day of plague with other household victims
en 1468 comprise 43 percent of the plague deaths, similar to the
proportion in 1452. Pero, de nuevo, the actual clustering was probably
más alto; many slips failed to mention whether a case was new or
from an infected home. Además, sixty-six family members or
their domestic servants (in two cases) died of plague on the same
día, constituting one-quarter of all deaths registered in the
bolletini. In another three cases, deaths on the same day were de-
scribed as coming from “contiguous households.” These people
may have been next-door neighbors, or living in stalli within large
compounds, which were common for the poorest sections of six-
teenth-century Milan. Además, in two cases, three household
members died of plague on the same day: In one of them, a thirty-
year-old woman, a ªve year-old boy, and a four year-old girl,
none of whom appear to have been related, died of plague on
Julio 5. Por eso, the daily interval separating the deaths in these sev-
enty-two household plague deaths was zero.18
The health board’s records provide a far more detailed ac-
count of the period from the ªrst signs of illness to death than do
the parish burial registers. Although later documents from the Libri
Unlike the bolletini that the health board issued after 1452, these initial ones did not examine
corpses or diagnose causes of death. There were no plague cases from December to at least
Enero. See the chronicle references to this plague across Italy in Alfonso Corradi, Annali delle
epidemie occorse in Italia dalle prime memorie ªno al 1850 (Bologna, 1865–1869), I, 282–289; IV,
145–162. For epidemics of early modern Italy, see Lorenzo Del Panta, Le epidemie nella storia
secoli XVI–XIX (Turin, 1986). The data from Milan come from
demograªca italiana:
Popolazione, norte. 73. Bernabò Visconti’s castle once stood where the special plague camp was
located; the hospital of the Filarete took its place later.
18 Miscellanea storica, norte. 1, asm. These facts come principally from two fascioli, norte. 2—
“Elenchi morti auctor Hector de Marchesi, Januarii–Decembre 1468”—and n. 6—“Elenchi
mortis sine auctore 1468 March and April.” In “Contagion Theory” and “Epidemics and
State Medicine,” Carmichael elaborated on the careers of
two physicians—Giovanni
Catelano and Hectore Marchesi—whose diagnoses ªll these records. For the examples given,
see Miscellanea storica, norte. 1, carte, No. 180, asm. D’Amico, Le contrade e la città: Sistema
produttivo e spazio urbano a Milano fra Cinque e Seicento (Milan, 1994), 149–150.
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190 | SAMUEL K. COHN, JR., AND GU I DO ALFANI
dei morti recorded the duration of illness more consistently than
they did in 1468, these earlier records are suggestive. Physicians
recorded the duration of illness for two cases of same-day/same-
household plague deaths. In both, the onset of ªrst symptoms—
headaches and continuous fever (which could have been most any
enfermedad)—also started on the same day. In one household, ellos
arose three days before death and in the other, on the day of death.
In this instance, the physicians were particularly precise: One sister
died within eighteen hours from the ªrst appearance of fever; el
second sister died in sixteen hours, before any buboes or other
skin disorders had time to form.19
The next plague struck ªfteen years later, after almost the
same amount of time as that separating the previous two. Its in-
ception was mild. Between the ªrst recorded case of plague on
Marzo 12, a junio 8, 1483, only twenty-seven plague cases were
diagnosed. But by the autumn of 1484, this plague had become
one of the most devastating of the ªfteenth century. Unfortu-
nately, the records are sketchy and scattered throughout the health
board’s bollettini in four different archival registers, along with a
smattering of records in the Libri dei morti for 1483 and more com-
plete ones for 1485. But even during its initially mild phase, el
household clustering of plague deaths is noteworthy. Nine of the
twenty-seven cases arose in infected households, and another four
were multiple household deaths that occurred on the same day.20
En 1503, plague struck Milan again, though only 190 plague
deaths were recorded, constituting less than 6 percent of that year’s
mortality (3,172). Sin embargo, starting in 1503, the health board no
longer rigorously reported the deaths of plague victims who had
been moved to the makeshift huts or to its Lazzaretto. Only six are
described as having been taken from their homes and placed in
huts, now called in loco sanitatis. Sin embargo, 58 del 190 plague
deaths came from infected homes, a clustering of at least 31 por-
cent.21
19 Solo 88 de 265, one-third of the records for this year, recorded the duration (Miscellanea
storica, norte. 1, carte nos. 167, 149 [asm]).
20 Popolazione, nn. 76, 77; Albini, Guerra, fame, peste, 163–165, 179–180; Sella, “Premesse
demograªche,” 459–461; Miscellania storica, nos. 1–4, asm. In none of these records did the
physicians specify the duration of illness. Since completing this article, Cohn has coded all of
the plague deaths for 1483 y 1485 found in the Milanese archival registers of Popolazione,
parte antica. These results do not alter the conclusions drawn herein and will be evaluated in a
later monograph.
21 The ªgures come from G. Ferrario, Statistica medico-economica di Milano dal secolo XV ªno
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HOUSEH OLDS AND PLAGUE | 191
milan’s plague of 1523 The fullest record of plague deaths for
any epidemic recorded in the Milanese Libri dei morti is that of
1523. By some chroniclers’ estimates, this may have been Milan’s
worst plague since the ªfteenth century, con 40 por ciento de la
population succumbing to it. The death records for the city, cómo-
alguna vez, do not reveal this level of severity. With greater care than in
any previous plague year, the physicians on the health board re-
corded 1,013 plague deaths from January 4 to September 17, 1523,
in a separate ªlza. This ªgure, sin embargo, amounted to less
than one-third of Milan’s normal annual mortality during the ªrst
half of the sixteenth century and only one-fourth of that year’s
deaths.22
Contra Carmichael, these plague records do not decline in at-
tention to detail compared to the ones kept by such physicians as
Hector Marchesi and Giovanni Catelani, who died at the end of
the ªfteenth century. The physicians on this health board de-
scribed plague symptoms and signs more fully and more consis-
tently than any of their predecessors, recording the duration of ill-
ness before death as well as demarcating various moments in the
brief course of the disease before sudden death, when certain
symptoms or signs arose. Often buboes, tumors, pustules, glandule,
and the like appeared only after death, in postmortem examina-
ciones. Unlike in earlier outbreaks of plague, when physicians re-
ported the duration of illness in only one-quarter of the cases (173
de 670), el 1523 records speciªed them in more than 90 por ciento
(913 de 1,013 casos). The detailed records of 1523, además,
ai nostril giorni (Milano, 1838), 374, who copied them directly from summaries made in 1791.
According to Albini, Guerra, fame, peste, 158, sin embargo, they contain errors, but she does not
further explicate or correct them. Saba, “Una parrocchia milanese,” 414–415, sin embargo, ªnds
a close correspondence between the 1791 summary ªgures and his counts from the surviving
Libri dei morti, from1607 to 1640.
22 These impressions come from contemporary and later chroniclers, who estimated plague
deaths from 50,000 a 160,000. See La Cava, La peste di S. carlo, 28; Gasparo Bugati, Historia
universale . . . dal principio del mondo ªno all’anno MDLXIX (Ferrara, 1571), 770–771, who esti-
mated that more than 100,000 died within the city walls of Milan within four months alone in
1523, leaving the city “dishabitata, incolta, & selvaggia.” The plague, además, continued
en 1524. The combined city death toll for both years, sin embargo, was only 10,567, y el
plague deaths in 1523 comprised only 20% of the total deaths (at least until mid-September,
when the plague was in decline). Fewer deaths were tallied for 1524. No one has yet distin-
guished plague deaths from others for this year, but contrary to the reports of the chroniclers,
the summer months show low levels of mortality compared with 1523 or other plague years.
Por el contrario, 1522—not a plague year—experienced higher city mortalities than either 1523 o
1524. Ferrario, “Statistica medica di Milano,” 374–375, tallies 5,288 deaths in 1523 y 3,962
before October.
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192 | SAMUEL K. COHN, JR., AND GU I DO ALFANI
identiªed plague victims by more than their parishes, adding the
street or locale of their houses and supplying the names of their
landlords. This precision may well be helpful to later studies that
attempt to chart the plague’s spread. El 1523 records also offer
extensive information about victims’ households, and not just that
of their families. They even go so far as to report those without
any apparent relation who lived in the same cell, habitación, or apart-
mento (in eodem stallo) as another victim who died on the same
day.23
With the inclusion of this detail, el 1523 plague registered
284 households in which either a victim died in an infected house-
hold or two or more household members died of plague on the
same day. At least 28 percent of the households had multiple cases.
Sin embargo, indications of infected or “locked” households ap-
pear understated in this plague year. By far the largest component
of these multiple cases comes instead from evidence of same-
the coincidence of
household/same-day deaths. Además,
household plague deaths within twenty-four hours may have been
even higher. Whether a particular scribe’s marginal note about a
previous plague death—ut supra—referred to the household or
only to the parish is often difªcult to tell. Consistently and conser-
vatively, this study interprets it to mean the same parish only.
The records for the epidemic of 1523 allow a more precise
calculation of the intervals between the appearance of illness and
death of household members dying on the same day than the re-
cords for any earlier plague. Of the eighty-eight households satis-
fying this criterion only ªve fail to supply the duration of illnesses.
The amount of time between notice of the ªrst symptoms of
household victims dying on the same day shows a pattern similar
to their death dates: Pequeño, if any, time separated the onset of their
respective symptoms—that
the formation of buboes and
morbilli—when physicians, amigos, or family may have realized
that they were plague victims. As with the date of death, most of
these household members showed their initial symptoms on the
same day (ªfty-ªve of eighty-two households) (see Tables 2
y 3).
es,
A pesar de, in most cases, no more than two people died of
plague within a household on the same day (seventy-one house-
23 Carmichael, “Epidemics and State Medicine,” 237–240.
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HOUSEH OLDS AND PLAGUE | 193
Mesa 2 Duration of Plague Illness before Death for Plague Victims, Varios
Años
No
info
1
día
2
días
3
días
4
días
5
días
6
días
7
days >
145
223
14
115
100
14
0
4
1
1
40
11
1
8
1
11
280
88
10
8
0
14
255
63
10
15
8
32
164
39
4
5
0
3
70
15
5
2
1
0
46
7
1
1
2
5
21
4
11
0
0
8
37
6
1452
1468
1483
1503
1523
Multiple Deaths
en 1523
Mesa 3
Intervals between First Signs of Illness of Households Members Dy-
ing on the Same Day, 1523
no info
0 día
1 día
2 días
3 días
4 días 8 días
15 días
5
32
23
15
7
3
1
1
sostiene), three died on the same day in ten households, four died on
the same day in one household, and ªve in another. On July 17 en
the parish of San Calimero just outside the city walls (foris) near the
porta Romana, Angolina de Buªneo, age ªfty, died at home with
three daughters, Caterina, Paognina, and Margerita, and an unre-
lated woman, Elizabeth, the wife of Francesco de Patuliis, quien es-
sided in the same apartment (in eodem stallo).24
family and household reconstitution: four milanese par-
ishes during the plague of 1485 Given that one-quarter of the
plague victims died within the same households on the same day,
did other household members die later of plague, over extended
periods? And could such later deaths lend credence to Scott and
Duncan’s contention that intervals between deaths in households
were long and that plague could be infectious for as long as a
month before showing any distinctive signs? To test for subse-
quent fatal attacks, we reconstituted household plague deaths in
24 Popolazione, n.p., Julio 17, 1523. Although Margherita is identiªed as a daughter of
Angolina, she is listed as ªfty years old. Either she was the household head’s sister, or the
scribe wrote down the wrong age.
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194 | SAMUEL K. COHN, JR., AND GU I DO ALFANI
1523 from four of Milan’s most populous and most impoverished
parishes—San Lorenzo, San Protasio, San Simpliciano, and Santo
Stefano. All of them except for San Simpliciano had communities
within and beyond the city walls (intus et foris). Of Milan’s sixty or
more parishes, these four alone accounted for 430 plague deaths in
1523 (42 por ciento). Characteristically, plague victims came from
the poorest families. Only two of the 1,013 victims in 1523 bore a
title—a friar and a parish priest—and not a single victim was a no-
bleman. In an age when family names had become diffused
throughout northern Italian urban and rural populations, solo 15
percent of these victims (75 de 1,430) possessed a family name.25
This paucity of identiªcation for such impoverished victims
may appear not to bode well for reconstituting subsequent house-
hold deaths. Sin embargo, the plague victims appear to have been
mostly recent emigrants to the city. Más que 61 percent of them
were identiªed by a place name, y solo 13 percent of them had
neither a place nor a family name. Además, these victims were
not from major cities or even minor ones but from a myriad of
small villages and towns within Milan’s hinterland—Arzate, Cas-
sata, Corbetto, Glusiano, Oltolina, Carnago, etc.. The identiªers
were highly speciªc, usually appearing only once or twice, y
none more than ªve times.
In this sample of parishes, the percentage of household plague
deaths occurring on the same day nearly matched that of total
plague deaths in 1523 (25 percent compared to 24 por ciento). Más tarde
plague deaths within these households, además, were extremely
rare. Only seventeen victims in nine households can be added to
the household plague deaths, an increase of only 13.6 por ciento (ver
Mesa 4). The household reconstitutions indicate that a staggering
86 percent of the multiple plague deaths within households oc-
curred on the same day. Además, the onset of illness also
struck on the same day (ªfty-two cases) or on the following day
25 For San Lorenzo, see Saba, “Una parrocchia milanese.” Carlo Borromeo’s reforms in
1567 divided the territory of the parish outside the city walls into three new parishes. Ver
D’Amico, Le contrade e la città, 54, 146–147, for the social and economic character of these
communities. In the plague of 1576/77, these neighborhoods (especially San Simpliciano)
were the ªrst and worst hit (La Cava, La peste di S. carlo, 51). For a map of Milan’s sixty par-
pescados, see D’Amico, Le contrade e la città, 18–19; for percentages of family names, Antonio
Molho, Marriage Alliance in Late Medieval Florence (NewYork, 1994), 281; Cohn, The Laboring
Classes in Renaissance Florence (Nueva York, 1980), 23–24, 43–44.
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Mesa 4 Reconstituted Deaths, Plague of 1523
name
parish
death date
Asta ªlia Leonardi de Cribellis
Lucia ªlia Leonardi de Cribellis
Interval between deaths: 53 días
Petrus de Bregnio
Domenica de Bregnio
Interval between deaths: 165 días
Zaninis de Oltolina
Caterina ªlia Zaninis de Oltolina
Domenico de Oltolina [possibly]
Interval between deaths: 4 days and
possibly 157 días
Johanna ªlia Leonardi de Bustio
Francesca uxor Leonari de Bustio
Leonardo de Bustio
Interval between deaths: 12 y
0 días
Ambroxius Iacobi de Corbecta,
Abiatus Iacobi de Corbecta
Battista Ambroxii de Corbecta
Interval between deaths: 0 y
83 días
Baldasarus de Carnago
Arcangela de Carnago
Interval between deaths: 2 días
Lucia uxor Stephani de Roxate
Antonius-Augustinus ªlius Ambroxii
de Caxate
Interval between deaths: 14 días
Caterina famula Magistri Iacobi
Barbitonsoris
Caterina uxor Johannis-Iacobi
Barbitonsoris
Interval between deaths: 2 días
Domenicus Muzani de Cusonio
Lucia uxor Domenici Muzani
Caterina, famula Domenici Muzani
Interval between deaths: 15 y
16 días
S. Stefano “intus”
S. Stefano “intus”
8 Feb.
2 Abril
S. Protasio “intus”
S. Protasio “intus”
20 Feb.
12 Julio
S. Simpliciano
S. Simpliciano
S. Simpliciano
1 Marzo
5 Marzo
9 Agosto
S. Protasio “intus”
S. Protasio “intus”
S. Protasio “intus”
4 Abril
16 Abril
16 Abril
S. Lorenzo “foris”
S. Lorenzo “foris”
S. Lorenzo “foris”
15 Junio
15 Junio
7 Septiembre
S. Lorenzo “foris”
S. Lorenzo “foris”
11 Julio
13 Julio
S. Lorenzo “foris”
S. Lorenzo “foris”
13 Julio
27 Julio
S. Lorenzo “foris”
5 Agosto
S. Lorenzo “foris”
7 Agosto
S. Lorenzo “foris”
S. Lorenzo “foris”
S. Lorenzo “foris”
13 Agosto
27 Agosto
13 Septiembre
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196 | SAMUEL K. COHN, JR., AND GU I DO ALFANI
(thirty-six cases), comprising 74 percent of the recorded cases
(119).
This apparent rarity of later plague deaths within households
may have been due, en parte, to the difªculties of household recon-
stitution, but the tendency to ªnd matches from ambiguous
identiªers also may have slightly overstated the numbers. Más-
encima, physicians occasionally identiªed unrelated victims who died
in the same household on the same day with the marginal note, en
eodem stallo. No such indicators, sin embargo, exist for those who died
later in households. Todavía, these unrelated household members con-
stituted only a small portion of same-day deaths (9 de 245 deaths,
3.7 por ciento).
The unusually rich data for the 1523 plague enable the link-
age of later inter-household deaths of those who bore no signs of
kinship. A search of the owners of houses where victims resided
increases the multiple household plague deaths, sin embargo, by only
uno, and that case is questionable. On July 13, Lucia, wife of
Stefano from Roxate, died while residing in a house owned by
Giovanni-Ambrogio de Caxate in San Lorenzo outside the walls.
Two weeks later, on July 27, Antonio-Agostino, son of this
Ambrogio, also died of plague in what may have been the same
house; its owner was Ambrogio of the same parish outside the
walls. The physicians did not label the case, sin embargo, as originat-
ing from an infected or closed house. The sporadic absence of
such tags may signal oversight on the part of physicians, pero
Ambrogio may have owned more than one house in San Lorenzo
“foris.”26
A change in the registration of plague deaths may account for
an underestimation of later household plague deaths. Infected
people sent to the Lazzaretti, or the huts for quarantine, do not
seem to have been recorded among the plague deaths in 1523. Todavía
such a change would probably not account for the absence of a
large portion of successive plague deaths. Primero, el 1523 records
continued to document those dying in previously infected house-
sostiene, some closed (domus clausa) and others possibly left more
abierto (domus infecta). Segundo, those carted ad locum montanee for
quarantine during the plague of 1452, or in loco sanitatis during the
26 According to the Stato d’anime of 1610, solo 44 del 1,251 people in San Lorenzo
Maggiore owned their houses (Saba, “Una parrocchia milanese," 437).
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HOUSEH OLDS AND PLAGUE | 197
plague of 1503, did not constitute a large proportion of the plague
victims. Del 187 plague deaths registered in 1452 solo 16 (menos
than 9 por ciento) died ad locum montanee, and in 1503, solo 6, o 3
por ciento, died while in the sanitary zones. Only during the ªrst
seven months of the 1485 plague, before it escalated, did those
transported to the Lazzaretto represent a high proportion of the
plague dead. Quarantine primarily took place in the home, dentro
the city walls.27
households and death in milan’s lazzaretto during the
plague of 1485 Was the plague of 1523, with its high portion of
household members dying on the same day, anomalous? Did the
absence of subsequent household plague deaths result from prob-
lems intrinsic to household reconstitution? As already noted, el
surviving bollettini of 1468 report the same proportion of house-
hold plague victims dying on the same day as in 1523 (25 por ciento).
El 1485 record, sin embargo, provides an even more deªnitive an-
swer to the question; this register is organized not only by time but
also by household. Physicians listed those sent to the Lazzaretto of
San Gregorio from January 1 a julio 25 by household and in a sep-
arate column noted if and when they died. The number of dead at
the Lazzaretto was 262, most of them presumably from plague (Alabama-
though unlike in the other entries, the causes of death were not
mentioned).28
Most surprisingly, the Lazzaretto does not appear from this
evidence to have been the ineluctable death trap that it is often
portrayed to be (most vividly in Alessandro Manzoni’s I Promessi
sposi [1842]). The survival rate (dos tercios, o 517 de 779) was re-
markably high, especially if everyone interned there had already
been afºicted with plague, as Albini assumes. As the architecture
and reports from the plague of 1576/77 make clear, the enclosed
27 According to the records of 1468 y 1483, no plague victims died in special sanitary or
quarantine zones, even though the Lazzaretto of San Gregorio and a place called the Barone
were in operation during the plague of 1468, and most likely in 1483 también. See Albini,
Guerra, fame, peste, 30. The percentage of plague deaths in the Lazzaretto during the ªrst seven
months of the plague of 1485 appears higher than for other plagues charted in the Libri dei
morti—262 deaths. On quarantine enforcement, see the ordinances and descriptions for the
plague of 1576/57 in Ascanio Centorio de’Hortensij, I cinque libri degli avvertimenti, ordini, gride
et editti . . . della Peste de anni MDLXXVI & LXXVII (Venice, 1579).
28 Albini, Guerra, fame, peste, 183, reports around 250 deaths, but her ªgures show 256. Ella
has also either miscounted or rounded down the total number admitted to San Gregorio dur-
ing this period to 760; it was actually 765.
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198 | SAMUEL K. COHN, JR., AND GU I DO ALFANI
were well fed and cared for. But did all of the interned show visi-
ble signs of plague afºiction or carry the disease when admitted?
The age structure of inmates suggests that entire households, no
just the members with plague, had to relocate. Solo 13 (0.077 por-
centavo) del 1,683 people who died of plague (as coded thus far
de 1452 a 1523) were older than seventy years old, and not a
single plague victim was older than eighty. Por el contrario, at San
Gregorio, eight were older than seventy (3 por ciento), and half of
them were older than eighty.29
The average family size of those admitted to San Gregorio
also suggests that families entered as a whole. One family num-
bered twelve, y 42 de 271 (más que 15 por ciento) possessed ªve
or more members. By the end of the sixteenth century, when stati
d’anime records ªrst appear, allowing family size to be calculated
for Milan, the ªgures are similar to those found for Florence and
other Tuscan towns in 1427. De término medio, families numbered 4.5
miembros, and after plagues as few as 3.5. This average, sin embargo,
was steeply graded by class—elites possessing the largest families
and the poor, the smallest. The families at San Gregorio reºect the
typical proªle of plague victims—poor people, recent immigrants,
and individuals in search of work: 65 del 271 “families” were
comprised of one person, and family size on average was 2.87—
not unlike that of Florence’s poor families in 1427 or of the Mila-
nese parish of S. Lorenzo “foris” in 1610, cuando 634 de 1,251
29 Albini’s tallies are different (507 de 765), but the proportion is about the same—66.27%.
On the conditions of the Lazzaretto, see La Cava, La peste di S. carlo, 175, 190. According to
Giacomo Filippo Besta, an ofªcer during Milanese plague of 1576, in Vera Narratione del
successo della peste (Milano, 1578), 18v., those at San Gregorio were divided into three
groups—the infected, the suspected, and the recovering. The lists from 1485, sin embargo, sug-
gest that entire families were brought to the Lazzaretto at the same time. Lethality rates were
much higher at Lazzaretti in Tuscan cities (Florencia, Pistoia, Prato, and Empoli) durante el
plague of 1630/31. In Florence they were just under 70%, but even there it is not clear
whether only those showing clear signs of plague or other “suspected” family members were
also interned. See John Henderson, ‘“La schifezza, madre della corruzione’: Peste e società
nella Firenze della prima età moderna, 1630–1631,” Medicina & Storia, II (2001), 49. For six-
teenth-century indictments of
frightful conditions in Lazzaretti, see Lorenzo Condivi,
Medicina ªloscoªca contra la peste: Di Lorenzo Condio dalla Ripa Transone (Lyon, 1581), 178r:
Giovan’ Andrea Bellicochi, Avvertimenti di tutto ciò che in publico da Signori & in Privato da
ciascuno, si debbe far nel tempo della peste (Verona, 1577), 411v–412v (folios from the Vatican
copy); Heronimo Donzellini, Discorso Nobilissimo e dottissimo preservative et curative della pesta
(Venice, 1576), 311v–312r (Vatican copy); ídem, Discorso de Annibale Raimondo versonese ne
quale chiaramente si conosce la viva et vera cagione, che ha generate le ªere infermità, che tanto hanno
molestato l’anno 1575 & tanto il 76 acerbamente molestano il Popolo de l’invittissima Città di Venetia
(Padua, 1576), 392v and 393v (Vatican copy).
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HOUSEH OLDS AND PLAGUE | 199
households (not families) possessed less than four members. If the
loners are subtracted from the San Gregorio families, they num-
bered 3.47 on average.30
Had the residents of the Lazzaretto all been infected with
plague, research would expect to discover a greater than average
household clustering of plague victims, but this clustering was
considerably less than that found for the total population of Milan
or Parma during the plague of 1468. At San Gregorio, 262 gente
en 156 familias, o 1.68 per household (only half as many as at
Parma during the plague of 1468), died.31
More striking still are the differences in the duration of plague
illness between San Gregorio’s inmates and victims recorded for
other plague years, including 1485—that is, if we assume that all of
those admitted to the Lazzaretto already showed signs of plague.
Instead of dying within two to three days after the ªrst signs of ill-
ness, and even less time after buboes or other pustules had formed,
giving doctors reasonable grounds for suspecting plague, those
who died in the Lazzaretto lasted 11.76 days on average from the
day of admission to death. Además, although only 5 por ciento
of those with plague (58 de 1,086) endured the disease for more
than a week, almost half of those dying at San Gregorio (111 de
245) survived as long from their admission, and seventeen lasted
for more than a month.
These patterns strongly suggest that the Milanese health board
carted away complete households whenever a plague death or ill-
ness was discovered within them. Such a policy would have been
consistent with their larger policy of locking up entire homes
within the city. De este modo, the Lazzaretto data would understate the
number of household members who died on the same day, desde
27 del 262 (10.3 por ciento) victims arrived dead at the Lazzaretto
or died on the day that they arrived—that is, on the day when at
least one other household member had probably died,
de este modo
prompting the board’s action. These prior deaths, sin embargo, son
not recorded in the San Gregorio list (ver tabla 5).
Despite this probable underestimation, the clustering at San
Gregorio in 1485 shows a striking similarity to that in the city as a
30 For Florence and other Tuscan cities, see D’Amico, Le contrade e la città, 58–60; Daniel
Herlihy and Christine Klapisch-Zuber, Les Toscans et leurs familles: Une étude du catasto ºorentin
de 1427 (París, 1978), 472–479. Saba, “Una parrocchia milanese," 441.
31 Popolazione, No. 77, notario público.
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200 | SAMUEL K. COHN, JR., AND GU I DO ALFANI
Mesa 5
Intervals between Deaths within Households: The Lazzaretto of San
Gregorio, 1485
0
30
1 día 2 días 3 días 4 días 5 días 6 días 7 días 8 días 9 días
7
5
5
1
5
3
4
2
4
10
días
13
días
14
días
15
días
17
días
19
días
20
días
21
días
29
días
34
días
2
2
3
2
1
2
1
2
2
1
51
días
76
días
1
1
whole during the plague of 1523. In both instances, nearly one-
quarter of all plague deaths occurred in the same household on the
same day (60 de 262, o 23 percent of the plague deaths, comparado
con 24 percent for the general population in 1523 y 25 por ciento
for the four large parishes in that year). The overwhelming modal
interval of plague deaths within households for Milan’s total popu-
lation in 1523 and San Gregorio’s in 1485 era 0 (thirty pairs), y
the next most frequent interval was a single day (seven pairs).
Forty-seven (o 94 deaths, 55 por ciento) occurred within three days,
y 120 o 70 percent within a week. Después, the intervals be-
tween plague deaths extend to as long as seventy-six days. Is the
conclusion that this tiny minority represents a normal long incu-
bation period for plague, as Scott and Duncan assumed from their
datos, warranted? Might these few have caught the disease later
from outside the household, or might they have had an unusual
resistance to the disease that ultimately failed to save them?32
nonantola and the plague of 1630 Even though the Mila-
nese registers contain different ways of listing plague deaths for
each of the six years, could Milan’s remarkable household cluster-
ing have depended on some inherent peculiarity of the city or its
records?
32 On the problems of enforcing strict household isolation, see Centorio de’Hortensij,
I cinque libri, 12, 77–78; La Cava, La peste di S. carlo, 113–134.
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HOUSEH OLDS AND PLAGUE | 201
Nonantola, an agricultural/rural town, not at all like or near
Milan, possesses a remarkable series of registers, which are entirely
different from those in Milan. Nonantola’s baptismal, marriage,
and burials records (with almost 20,000 vital events from 1560 a
1650), in combination with its salt-tax records—the Boccatico del
Sale, which recorded all of Nonantola’s residents grouped by
hearths, including servants—enable the reconstitution of not just
families but also households. De este modo, it can convey crucial informa-
tion about the victims of the plague of 1630, which inºicted the
highest mortality on many regions of Italy since the Black Death.
Not even the San Gregorio register, which divided the Lazzar-
etto’s inmates into families and later added death dates, can claim
to duplicate the household structures of nucleated families so ac-
curately. This assemblage of Nonantola’s records represents, by far,
the most comprehensive attempt to study a plague through family
reconstitution. A later study will explore more thoroughly this
rich documentation; for now, it serves to control for the conclu-
sions drawn from late ªfteenth- and early sixteenth-century
Milan.33
On the eve of the plague in 1629, Nonantola counted 3,439
residents living in 626 different households. Between June 9, 1630,
when the priest of San Michele wrote “qui comincia il contaggio
(here begins the plague)” in the burial register, and December 31,
760 died in Nonantola, a twenty-ªve-fold increase in deaths rela-
tive to normal years. Only rarely did these parish registers report
the cause of death, but the vast majority of these burials must have
resulted from plague. Because burials of infants younger than four
were never recorded, the total number of deaths during the plague
year was certainly higher, but the jump in mortality for this year
would probably have been much the same. To evaluate the popu-
lation decline at Nonantola, children under four have been sub-
tracted from the Boccatico, along with those dying between the
Boccatico’s redaction and the beginning of the plague in June.
33 Except for the presence of an important Benedictine Abbey and of vast common lands,
Nonantola’s social and economic structure was typical of rural towns in early modern Italy.
Alfani, “Battesimi, sepolture, matrimoni a Nonantola: dinamiche demograªche e strategie
sociali (secoli XVI–XVII),” Proceedings of the Congress “La Partecipanza agraria di Nonantola: le
radici del futuro,” Nonantola, 2004 (próximo). All relevant sources are in S. Michele: Regis-
ters of Baptisms, Burials, Marriages, Nonantola. Although those younger than ªve or older
than sixty were not liable for the salt tax, they were listed in the Boccatico nevertheless (Ruolo
di popolazione—Boccatico, 1629, Archivio comunale di Nonantola).
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202 | SAMUEL K. COHN, JR., AND GU I DO ALFANI
Mesa 6
Intervals between Deaths within Households in Nonantola, 1630
0
46
1 día 2 días 3 días 4 días 5 días 6 días 7 días 8 días 9 días
35
28
23
9
16
15
9
15
6
10
días
11
días
12
días
13
días
14
días
15
días
16
días
17
días
18
días
19
días
10
9
10
11
4
4
7
5
5
5
20
días
21
días
22
días
23
días
24
días
25
días
26
días
27
días
28
días
29
días
5
3
3
4
3
1
2
3
0
3
30
días
31–40
días
41–50
días
51–60
días
61–70
días
71–80
días
81–90
días
91–100
días
101–110
días
>110
días
1
11
6
5
4
5
3
0
1
2
With these adjustments, Nonantola’s population would have been
3,042 living in 623 households at the plague’s start. Por eso, the ªrst
seven months of plague felled 25 percent of the population.34
Because of homonymy among Nonantola’s most common
surnames (Zoboli, Vaccari, and Piccinini), some record linkages
may not be justiªable. Como resultado, 23.7 percent of the burials (180
out of 760) cannot at present be linked to households in the
Boccatico. These burials, sin embargo, rarely concerned households
with more than a single death; their absence does not seriously al-
ter the intervals between plague deaths. But if better information
about families emerges later to link more deaths to households, el
intervals between plague deaths in Table 6 would become even
shorter.
The reconstitutions of deaths at Nonantola show patterns
similar to the ones observed at Milan for the plagues from 1452 a
1523. Like Milan’s, Nonantola’s modal interval of plague deaths
34 The average annual number of deaths from 1624 a 1628 was thirty-two. See G. METRO.
Sperandini, “La peste del 1630 a Nonantola,” Nonantola e la Bassa Modenese: Studi in onore di
Mons. Francesco Gavioli, Quaderni della Bassa Modenese, XI (1997), 231–247. After December
1630, the plague disappeared. In March 1361, a few cases reappeared, but the plague never re-
gained its former momentum.
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HOUSEH OLDS AND PLAGUE | 203
era 0 (13.65 percent of cases), followed by intervals of one, two,
and three days, the deaths declining thereafter progressively. Alabama-
though the proportion of household plague deaths occurring on
the same day was lower in Nonantola than in Milan, the propor-
tion of those who died within three days after a previous house-
hold death was higher at Nonantola—40 percent of the multiple
household deaths as compared to 34.7 percent at San Gregorio in
1485, the highest for any of the Milanese plagues examined thus
far. Por eso, this different place at a different time according to dif-
ferent sources corroborates the pattern of earlier plagues seen in
Milan. Plague infection and death struck quickly in households,
whether urban or rural, clustered within households and in rapid
succession.
After intervals longer than a week, the string of subsequent
household deaths in Nonantola tended to be slightly more pro-
tracted–20 percent of them occurring between three and nine
días, otro 20 percent between nine and nineteen days, y 10
percent thirty-two days or more after the last household death.
The longest interval was 118 días. These longer gaps might have
been a consequence of Nonantola’s sizable households. On aver-
edad, each included 5.74 miembros; Milan’s poor families consisted
of fewer than three. The differences might also have derived from
differing social networks, communal forms of living, or contin-
gencies attendant on isolating the plague stricken in a rural versus
an urban setting. But despite these minor variations, the two
plague settings were remarkably similar.
Rather than long periods of incubation reºected by long intervals
between successive household deaths (as Scott and Duncan argue),
the modal interval of household plague deaths and the speed at
which death followed the ªrst signs of illness suggest that the
transmission of early modern plagues was similar to that of a deadly
inºuenza. As in the case of inºuenza, a short incubation period of
a day or two for the plague would not have impeded transmission.
En cambio, a short incubation period allowed these two diseases to
spread as quickly as any known infectious disease, with the possi-
ble exception of food poisoning, since pre-industrial times.
Long before the railway, steam power, or the transport of
troops overseas during World War I, the spread of inºuenza was so
rapid that contemporaries attributed it to the wind or other clima-
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204 | SAMUEL K. COHN, JR., AND GU I DO ALFANI
tic condition rather than by human contagion. The early modern
plagues were even more extraordinary; no other known disease
causes such a high percentage of deaths within individual house-
holds on the same day. This new ªnding for early modern plagues
was probably the same for the Black Death and its successive
strikes to the mid-ªfteenth century but cannot be shown without
such records as Milan’s Libri dei morti or Nonantola’s combination
of parish and tax records.35
The early modern plagues were not inºuenza. Not only does
inºuenza fail to show tumors, pustules, and the like; the seasons of
the two diseases also differ radically, being near mirror opposites.
The early modern plagues generally struck in summer, and inºu-
enza most often from January to March. More important, the early
modern plagues from 1452 a 1523 (at least in Milan) do not show
a vital trait common to the earlier plagues from 1348 a 1400.
Despite their high contagion and rapid spread within households
and across cities and regions, the later plagues no longer pre-
sented the pneumonic traits or respiratory symptoms that chroni-
clers and physicians attributed to the early ones—coughs and the
spitting or vomiting of blood. In the voluminous Milanese death
books studied for this article, which contain far more detail on
plague signs and symptoms than is available in any of the earlier
plague accounts, not a single physician’s report alluded to coughs
(catarrah) or the vomiting of blood. The closest description to any
respiratory ailment associated with plague was a bloody nose
(efºuere sanguinis enaribus), but even this symptom is found in only
eight plague cases (0.05 por ciento). En cambio, vomiting, stomach ail-
mentos, and effusions suggest that by the mid-ªfteenth century, el
35 When inºuenza reached virgin soil, such as the Faroe Islands, Calle. Kilda, and Greenland,
in the nineteenth century, the mortality rates may have been as high. Descriptions of the ºu’s
rapid transmission in these isolated places resemble that of the Black Death in 1348. Ver
Hirsch, Handbook of Geographical and Historical Pathology, I, 37, who reports that as soon as the
Danish ships arrived, the natives died “suddenly and without prelude.” From hundreds of dis-
eases described in Gordon Cook and Alimuddin Zumla (editores.), Manson’s Tropical Diseases
(Londres, 2003; origen. pub. 1898), none parallels the devastation of the early modern plague,
during which one-quarter of deaths occurred within households on the same day. In a private
correspondencia, Hajo Grundmann of the Medical School of Groningen, a microbiologist and
epidemiologist who has worked in tropical and subtropical regions, maintains that he is un-
aware of any present-day disease with this characteristic. Only certain forms of food poison-
En g, the incubation periods of which can be as short as four hours, spread more rapidly than
inºuenza.
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HOUSEH OLDS AND PLAGUE | 205
intestinal tract had become the plague’s principal means of diffu-
sion.36
Despite the absence of sneezing, coughing, and other symp-
toms characteristic of respiratory transmission, sin embargo, the early
modern plagues continued to spread with remarkable alacrity and
deadly contagion. Although the detailed records of the early mod-
ern period now allow historians to trace family and household pat-
terns of illness with greater precision than any records from the
late Middle Ages, scientists and historians still cannot conªdently
attribute the plague to any modern disease with a known patho-
generación. Sin embargo, these later sources add a valuable characteristic
to the proªle of a disease that periodically decimated European
cities and regions across four centuries.
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36 The Libri dei morti provide speciªc quantitative evidence of the distribution of symptoms
and skin disorders for the plague. Similarmente, in long and detailed lists of plague symptoms, six-
teenth-century physicians recorded stomach pains, effusions, and vomiting of meals, pero
rarely mentioned coughs or any other respiratory symptoms. When they did—as with Andrea
Gallo Tridentino, Fascis de Peste, Peripneumonia pestitentiali cum sputo sanguinis, ªbre pestilentiali
ac de quibusdam symptomatibus, in quinque daciolos digestus (Brixiae, 1566), 37v–38r—their refer-
ences are to the Black Death of 1348.
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