14 • The Great PlagueHôpital Saint Louis was part of an evolving grand scheme of specialized
hospitals called the General Hospital. At Poitiers and probably some other
provincial cities, civic officials added to the usual pesthouse a recovery center
for those who had survived the illness.^34 But many places in northern Europe
chose the least expensive expedient, erecting a small, makeshift facility at the
start of an epidemic and letting it fall into disrepair after the plague ended.
Such a primitive hospital could not have housed many persons nor been of
much comfort to its overcrowded inmates. Even the most expensively main-
tained lazarettos in Italy often failed their patients. The hospital at Venice
was likened in 1576 to the Inferno in Dante’sDivine Comedy,with its patients
running through the wards amid the stench and groans, shrieking with the
voices of the Damned.^35
English cities lagged behind both northern and southern Europe in pro-
viding facilities for the infected poor. English pesthouses, where they existed,
were often a small cluster of huts capable of handling no more than a few
dozen inmates. The vast majority of the infected poor were shut up in their
own homes along with healthy relatives, servants, and nurses until forty days
had elapsed since the household’s last plague fatality. England was also much
slower than continental states in creating a national health body and munic-
ipal boards to oversee plague control. The Italian city-states established per-
manent public health bodies within a century of the Black Death. The rest of
continental Europe moved gradually in the same direction, with physicians
and surgeons working under the direction of lay officers and boards. The
English state and its cities started from scratch each time plague broke out.
In other respects the English nation had gone just about as far as other
countries in fighting plague. England had a set of Plague Orders for the cap-
ital and another for the rest of the kingdom. The quarantine of ships coming
from infected foreign ports and their cargo and passengers was the nation’s
first line of defense, and placing guards at a city’s gates a second, more des-
perate gesture. Sanitation measures were haphazard, as were many on the
Continent, and none seemed to stem the pestilential flow.^36 England did not
take a census, as did some places on the Continent, but London began track-
ing plague deaths in printed weekly Bills of Mortality in the early sixteenth
century, almost immediately after Milan and Venice. This told officials and
householders where the infection had been spreading. Although English cit-
ies and towns did not have the extensive control over the surrounding coun-
tryside that Florence exercised during epidemics,^37 they made far better use
of the institution that was closest to the people—the neighborhood parish.
In Italian cities, civic hospitals and private confraternities carried the burden