LAZZARETTO (HOSPITAL). — With the spread of plagues in the second half of the 14th century, the isolation of patients suffering from contagious diseases began, so that they would not transmit their illnesses to others.
Venice was the first to establish a hospital for contagious diseases; in 1493, in fact, the Signoria removed the island of Santa Maria di Nazareth from the Hermits of the Order of St. Augustine, where those friars had built a monastery and a church, upon which an existing hospital for pilgrims stood, transforming it into a hospital for contagious diseases. The name “lazzaretto” given to it seems to derive from a mispronunciation of *Nazarethium* or from its proximity to the Island of San Lazzaro; the term later passed to all such institutions. Subsequent decrees in 1448 and 1476 confirmed the institution, which was maintained administratively through the revenues of the salt office and private donations, until the moral duty of bequeathing legacies to the lazzaretto became widely accepted. Soon, such establishments multiplied in Italian cities. In 1488, Milan built its own, with notable improvements in internal layout, surrounded by a moat eight braccia wide.
Lazzarettos were constructed at a distance from inhabited areas—not too close to avoid contagion, nor too far to ensure easy access for patients. Care was taken not to orient them toward westerly winds, which were considered harmful due to their foul and putrid nature, thought to spread epidemics.
As a means of isolation, they were built in elevated locations and on islands, with a preference for isolation created by water; thus, wide moats were dug when other means were not possible. In Rome, for example, in 1656, Cardinal Gastaldi built the lazzaretto on the Tiber Island. Patients, as far as crowding allowed, were housed in well-ventilated rooms; but during epidemics, porticoes and auxiliary huts served as shelters. A chapel for divine offices was placed at the center. The air was purified with fumigations inside the rooms, pouring strongly aromatic substances onto burning coals; the belongings of the deceased were incinerated.
The construction of lazzarettos was also necessary in port cities to defend against the importation of contagious diseases. These quarantine sites, after improvements made through years of experience, were each composed of four two-story buildings spaced at appropriate intervals. The first housed the superior staff: inspector, commissioner, physicians, surgeons, apothecary, priest, and officials; the second contained offices and the chapel; the third, where quarantine was enforced, housed the infirmary for suspected patients and warehouses for goods from infected places. These first three buildings were spaced at least forty feet apart. The fourth was to be at least two hundred feet from the others; it housed those clearly afflicted by the disease and stored goods from ships that had had sick passengers aboard. Guards patrolled the courtyards where convalescents could walk, ensuring no violations occurred. In a secluded and distant location was the mortuary chamber.