Marseilles Case Study

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Case Study: Plague at Marseilles 1720

Plague at Marseilles, 1720: Courtesy of the National Library of Medicine.

Letter written from Marseilles on 1 January 1721 and printed in The Great Bill of Mortality or, The late dreadful Plague at Marseilles (Bristol, 1721).

This account of the advent and course of plague at Marseilles in 1720 highlights the full impact of plague on this prosperous city, the most important port of France. It likewise echoes many of the elements known from plague epidemics elsewhere in Europe in the medieval and early modern period:

• The arrival of the infection from outside (via a port).
• The role of cloth merchandise.
• The characteristics buboes, the most famous symptom of the plague.
• The subsequent social breakdown and the class-related nature of mortality: the rich could take the age-old advice ‘cito, longe, tarde’: to ‘flee, stay away for long and be slow in returning’, leaving the poor behind to cope with illness, unemployment and famine.

The account also highlights the tardiness of the authorities in dealing with the plague, for what exacerbated the Marseilles plague of 1720, the last great plague of western Europe, were the initial lax quarantine arrangements and the delay in effecting a cordon sanitaire around the city. By the time the civic authorities tried to impose a cordon on 1 August at least 10,000 had already fled, bring with them not only their goods but also the illness into the surrounding countryside.

There is, however, an element of 20:20 hindsight in the account. For though the officials sought medical diagnosis of the infectious disease in their midst, doctors at Marseilles were by no means unanimous in declaring that what they were dealing with was plague. Dr Sicard was the first to diagnose the disease as the fearsome plague but others, such as Dr Bauzon, disagreed, arguing that it was yet another fever. As Francois Chicoyneau, perhaps the most famous commentator on the Marseilles plague, explained in his reports from Marseilles, reports collected by Edward Worth, there were a host of symptoms and a time factor involved in their appearance. Not all plague victims bore the characteristic buboes.

Delayed diagnosis may have been one factor, but the city authorities may also have been loath to close their merchant hub because they were well aware that they had insufficient food stocks to keep the city going if cut off from their hinterland. Aware that seven sailors on the Grand St Antoine had died on route, they arranged for crew members to be kept in isolation at the island of Jarros when the ship arrived at Marseilles on 25 May 1720, but the sailors had already established contacts in Marseilles and it was the porters of the contraband cloth and the workers dealing with it that were the first to fall ill at the end of June, more than a month after the ship had docked. July, August and September, the hottest months and therefore the most propitious for the spread of bubonic plague, which was climatically determined, saw the deaths rise to incredible heights: the inability to clear the dead in turn exacerbated the conditions for the living, already weakened by lack of food. Of the initial population of 90,000 some 39,334 people died.

Undoubtedly the spread into the countryside was due to the delay in setting up a cordon – one which was only instituted on 1 August. It was a reactive gesture, for as Biraben (1968) has demonstrated, by that date the plague had already spread as far as Aix and Apt. By 2 October it was at Avignon, and steadily making its way through Provence and the Languedoc. Using official bills of mortality from the area, Biraben states that by August 1722 there were 94,184 recorded cases of plague in Provence alone. His study has demonstrated not only the extent of the mortality but also its modality: not all of Provence was affected, but only those towns that lay along trade routes. Evidently at this stage of the plague, the chief agency was human, for transmission by a wild rodent population would have led to a far different picture emerging.

Bubonic or pneumonic?

Scott and Duncan, Biology of Plagues (CUP, 2001), p. 338.

As Scott and Duncan point out, the incubation period at Marseilles was relatively short, a characteristic of bubonic, rather than haemorrhagic plague which has a lengthier incubation period. The presence of the buboes, the characteristic signs of bubonic plague would also suggest that the Marseilles plague was the last great bubonic plague in Europe. This is corroborated by the presence of DNA sequences specific for Yersinia pestis in the dental pulp of plague victims buried at Marseilles in 1722 and may also, perhaps, be corroborated by the second wave of infection following the 40 day quarantine period (as Scott and Duncan point out, quarantine only affected humans, not rats!). However, the high death rate suggests that pneumonic plague may also have played a role in Marseilles.

Once the central government became aware of this alarming death-rate they were forthcoming with aid. They not only prevented the plague from reaching other areas of France but also sent money and physicians to Marseilles and the surrounding afflicted areas. One of these physicians was François Chicoyneau (1672-1752).

François Chicoyneau

Portrait of Francois Chicoyneau: Courtesy of the National Library of Medicine.

It is not surprising that the focus on Edward Worth’s collection was on the 1720 plague of Marseilles: it was the last great European plague, it was the greatest plague of his own lifetime and, finally, it was the cause of an explosion of plague literature both in France and England. Worth’s library holds no less than five tracts written by François Chicoyneau who had been sent to Marseilles after the civic authorities there had appealed to the Regent for assistance. Chicoyneau and his colleague, Verny, both members of the prestigious medical faculty of the University of Montpellier, verified on 17 August that the disease was indeed the plague and set to helping plague victims at Marseilles. Chicoyneau certainly made a name for himself and was well respected because he had spent so much time studying the plague as it ran its course at Marseilles. As a result of his endeavours he was appointed premier physician to Louis XV and Chancellor of the University of Montpellier

Chicoyneau’s tracts were all written in French, indicating that they not only had an intended medical audience but also a lay audience who might, especially in times of plague, be left to care for the sick themselves. His publications were not, it must be said, at the cutting edge of plague analysis. He had, for example, a very different view of the nature of plague, than his English counterpart Richard Mead, whose seminal work on plague, written in reaction to the outbreak at Marseilles, was likewise collected by Worth. Where Mead had advocated strict government imposition of a cordon sanitaire, Chicoyneau was furiously opposed to what he saw as an unnecessary infringement of civil liberties. In Chicoyneau’s view, the cause of the disease was pestilential air, so a cordon made little sense: indeed, he viewed the social and economic effects of a cordon as contributing to the rise of fatalities – not minimising the spread of the disease by limiting movement. Interestingly, Chicoyneau placed far for emphasis on the psychological aspect of plague: the battle against the disease, in his view, lay not in an imaginary line in the countryside, aimed at keeping the illness at bay, but in the very minds of the afflicted. Whether Worth agreed with Chicoyneau is difficult to say: he was certainly interested in his works and collected a number of medical tracts connected to the University of Montpellier.

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