This print titled "The Plague in Barcelona in 1821" depicts the city in the the grips of the 1821 yellow fever epidemic. Lithograph by N.E. Maurin, Public domain, courtesy of the Wellcome Collection.
The 1821 yellow fever outbreak in Barcelona wasn’t the first epidemic that the city had experienced—like other major European cities, it suffered outbreaks of the Black Plague during the Middle Ages, as well as epidemics of tertian fever, dengue fever, cholera, smallpox, rabies and other illnesses during the subsequent centuries—but this one had a particular effect on public health legislation in both France and Spain. The frequency of these types of outbreaks and the severity of this one in particular led both the Spanish and French government to establish a series of uniform, centralized health regulations designed to improve their respective countries’ ability to minimize the spread of contagious disease.
The 1821 yellow fever epidemic is said to owe its notoriety both to this fact and to its exploitation for political purposes by the French monarchy as part of a policy to isolate Spain, which it invaded in 1823, effectively putting an end to the liberal government and helping to restore the system of absolute monarchy. The epidemic took place during a period known as the Trienio Liberal: three years of liberal rule in Spain in which the Spanish Constitution of 1812 was revived and a number of social and political reforms took place.
An Epidemic of Epidemics
During this period in history, yellow fever and its symptoms were already quite well-known, especially in port cities like Barcelona, which had survived a major outbreak in 1803. Amidst yet another deadly wave of the disease, debates raged in the medical community. Was the sickness a result of person-to-person contact or some kind of environmental factor?
In spite of efforts to control its spread, cases of the fever continued to crop up even in healthy people putting distance between themselves and the sick. The mosquito as a transmitter of the disease had not yet been considered, so the question remained as to whether or not yellow fever was a communicable disease, or the byproduct of something else. This resulted in heated arguments concerning the effectiveness of quarantines and sanitary regulations. Enforcing these measures cost the local government both time and money, and frustrated its citizens, which could cost the rulers even more politically.
One of the possible causes of yellow fever was thought to be contamination of Barcelona’s drinking water; pollution experts were sent to examine the Rec Comtal canal, which had been the city’s main water supply since the 10th century. Waste from the city’s factories and slaughterhouses was commonly dumped into it, potentially providing a breeding ground for any number of illnesses.
André Mazet tending people suffering from yellow fever in the streets of Barcelona. Lithograph by Langlumé after J. Arago, 1821, Public domain, courtesy of Wellcome Collection.
The 1821 Outbreak
The 1821 outbreak is thought to have started with the arrival of a ship from Cuba, which was a Spanish province at the time. The ship was called El Gran Turco, and had sailed from Havana with a stopover in Malaga along the way. When it arrived in Barcelona on June 29th, 1821, a group of local shipyard workers were tasked with caulking the inside of its hull; some of them contracted yellow fever while making these repairs, and soon their family and friends fell ill as well. The first concentration of cases were found in the Barceloneta neighborhood, near the shipyard.
At first, doctors weren’t sure whether their patients were sick with yellow fever or with tuberculosis, but the black vomit that accompanied most of the cases made it clear that it was the former. The first deaths from yellow fever in Barcelona in 1821 were officially reported in July, but the city was relatively deserted at the time, as many of its residents had already fled out of fear of contagion. It wasn't until September that the area was put under quarantine.
However, the quarantine wasn’t effective—healthy people continued to get sick—so a stricter health cordon was imposed around the entire city in October; nobody could get in or out of Barcelona. Nobody poor, that is. Wealthier families and individuals were often able to leave by bribing officials. Local politicians were amongst the first to leave; they installed a temporary Catalan capital in the town of Esparraguerra, near Montserrat, while Barcelona was on lockdown.
The residents who were unable to escape the limits of the cordon grew increasingly upset, until the government finally agreed to let people leave the walled city and set up makeshift barracks housing and tents in the mountains of Collserola and on Montjuïc.
In November, the cold killed the mosquitos and the epidemic stopped, but not before it had spread to Tarragona and Palma de Mallorca. The grateful citizens of Barcelona organized a procession in honor of Our Lady of Mercy (La Virgen de la Mercé) in thanks for her supposedly saving the city from the illness; the celebration became an annual event, though instead of celebrating in December, as they did in 1821, the celebration now takes place on the 24th of September, the feast day of La Mercé, who is the co-patron saint of the city along with Santa Eulàlia.
Official numbers put the final death toll of the 1821 Barcelona epidemic at around 20,000 people, which was one-sixth of the city’s population at the time. There is a monument to the victims in the Cemetery of Poblenou.
France: Politics and Health Controls
The French closed their border with Spain around the same time as the initial quarantines were announced, stationing an estimated 15,000 soldiers in the Pyrenees to control the border; they also sent a medical team of doctors and nuns from Paris, ostensibly to explore the causes of the epidemic. In the end, the Paris team’s scientific conclusions were used as retroactive justification for having closed the border.
The France-Spain border remained closed even after the epidemic was over, and these same soldiers were later used to invade Spain, as French King Louis XVIII feared a more dangerous contagion than the fever: that the Spanish political liberalism of the Trienio Liberal would spill into France, causing the people to rise up against the monarchy.
The French invasion was sanctioned by the Congress of Verona, one of a series of international congresses between European powers after the Napoleonic Wars; the troops helped reestablish Spanish King Ferdinand VII’s absolute monarchy with the support of King Louis XVIII and their collective allies.
New Health Codes for France and (Eventually) for Spain
After observing the devastation that this and other previous epidemics had wreaked on the populations of France and Spain, both countries felt the need to put new prevention measures in place. In France, the new laws expanded the scope of the Intendance Sanitaire de Marseille quarantine system that had been developed in 1640 to control the spread of the bubonic plague.
In Spain, the health code that the former liberal government had tried and failed to consolidate under the Cortes de Cádiz—a body of over 700 delegates that was supposed to represent the interests of the entire Spanish empire, including the Iberian Peninsula as well as provinces overseas—was rejected. The code, designed by Dr. Mateo Seoane, was an attempt to copy foreign health code legislation, but it was deemed too restrictive by King Ferdinand.
However, Ferdinand and his successors would establish a centralized health code in Spain. The Ministerio de Fomento was established by Royal Decree in 1832 and public health was described as being within the scope of its responsibilities. The Junta Suprema de Sanidad, which had been established in 1720, was also given more specific control over public health, though members of the government and the medical community would continue to argue over which regulations were necessary and/or effective for the next decade or so.
In 1845, new constitutional text was adopted that spelled out the need for a new Spanish health code, which was in turn overhauled again between 1847 and 1855 under Queen Isabella II. However, Barcelona still wasn’t safe from future outbreaks of this and other diseases. Yet another serious outbreak of yellow fever took place in 1870; it was also thought to have been caused by the arrival of a ship from Cuba.