Barcelona 1821

Mazet dans une rue de Barcelone, lithographie de Jacques Arago, 1821, Wellcome coll.The 1821 yellow fever outbreak in Barcelona made clear the political dimensions of public health legislation.

This epidemic owes its fame to its political exploitation by the French monarchy which isolated then invaded Spain, thus putting an end to the Trienio Liberal set in place by the 1820 revolution. The amalgam of epidemic contagion with revolutionary contagion is striking. And yet, the opportunistic misuse of the handling of the epidemic should not obscure the long-term elaboration of public health measures in France and in Spain alike, driven by the prevalence of yellow fever since the beginning of the century.

Yellow fever transmission by the Aedes mosquito would not be discovered before the end of the 19th century; in the meantime, its propagation beyond its Caribbean endemic zone, and as far as the United States and Spain, fuelled the debate between the advocates of its introduction through contagion and those arguing an environmentally induced local production. From a medical viewpoint, those theories actually complemented each other, but they underscored disputes around the usefulness of quarantine and sanitary cordons, resented for their economic and political costs at a time when epidemics drove governments to set in place sanitary regulations towards centralising and harmonising measures hitherto too punctual or disparate.

The Barcelona epidemic epitomises the politicization of this medical and healthcare issue. The first cases were reported in the port at the end of July, but the city, deserted by some of its officials and population, would not be isolated by a sanitary cordon before September. In France, the government imposed at the end of September its own cordon by closing the Pyrenean border even as a medical mission set off from Paris. Published in the press, their correspondence, along with young André Mazet’s death, alerted French opinion to the epidemic’s toll estimated at 20,000 deaths. Theirs however was not a humanitarian but a scientific mission whose contagionist verdict retroactively offered a scientific justification for sealing the border.

The government had not waited for the mission’s report to set forth its new healthcare law, which broadened the Marseille Intendance quarantine system born of the plague. The law, being drafted after the reappearance of the plague and yellow fever in Spain in 1819 and 1820, was voted by the Upper Chamber in 1821, but the sanitary and political context was different when it came under the scrutiny of the Lower Chamber in 1822. The epidemic had petered out in December as civil war broke out in Spain and, in France, a new, ultraroyalist government seized upon a “circumstance that allowed political proscription, under the garb of sanitary prohibition” to reinforce the cordon while secretly supporting Spanish absolutist guerrillas. The cordon thus became a mere pretext in liberal eyes, and though the law was passed on 3 March 1822, its implementation was a travesty. Sanitary measures were lifted in September when the disease did not return, but the troops stayed put in an observatory capacity, only to convert, in 1823, into an expeditionary corps that, sanctioned by the Congress of Verona, invaded Spain in order to reinstate King Ferdinand VII’s absolute monarchy.

With the overthrow of the Trienio Liberal, the French expedition also pronounced the demise of the health code the Spanish representatives had attempted in vain to consolidate in line with earlier attempts under the Cortes of Cadiz. In 1822, the yellow fever epidemic monopolised the Cortes’ activity. The public health committee received many Spanish and foreign papers and deemed the matter “of the highest political order” for it would make it possible to protect the population while avoiding the abuses and costs of quarantine. However, the health code it proposed was rejected as its measures were deemed draconian. The physician and liberal representative Mateo Seoane, the project’s architect, embodied this contradiction: he rejected contagion and the tyrannical measures it implied but had to accept, failing indisputable scientific evidence to the contrary, to align with foreign legislation.

The deployment of these laws is a reminder that neither medical theory nor political regimes can alone explain the origin of the divergence in public health policies adopted by diverse nations in the 19th century. The former may depend on the latter’s position in relation to the epidemic flows’ trajectory, their commercial interests, or considerations of neighbouring legislation, or even of the administrative inertia of their pre-existing structures. Even thoug the contagion debate was not settled after the Barcelona yellow fever, or even the 1830s cholera pandemics, the handling of these diseases would have a lasting effect on 19th and 20th centuries public health policies.

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Read the paper in french : Barcelone 1821