Le Infezioni in Medicina, n. 1, 157-159, 2021

INFECTIONS IN THE HISTORY OF MEDICINE

The Greek physician and politician Ioannis Kapodistrias (1776-1831) and the plague of 1828 in Greece

Gregory Tsoucalas1, Spyros N. Michaleas2, Marianna Karamanou2,3

1History of Medicine, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece;

2Department of History of Medicine and Medical Deontology, Medical School, University of Crete, Greece;

3Institute of Humanities in Medicine, School of Medicine and Biology, University of Lausanne, Lausanne, Switzerland

SummaRY

Count Ioannis Antonios Kapodistrias was an important political figure of the 19th century. He was a pioneer in the fight against epidemics and used his medical experience in Italy to protect Greeks from the 1828 plague. As a renowned diplomat and leader, Kapodistrias helped forge the federal state structure of Switzerland and formed the first organized administrative state in the Hellenic peninsula.

Keywords: Hydra, quarantine, social distancing, Italy, Greece.

Corresponding author

Spyros N. Michaleas

E-mail: sp.michaleas@gmail.com

INTRODUCTION

Count Ioannis Antonios Kapodistrias (1776-1831), known as Giovanni Capodistria in Italian, was an important political figure of the 19th century. Born in Corfu to an established and respected family of Catholics, Kapodistrias was educated at the medical school of the University of Padua in Italy. He was a distinguished member of the local Republic and served in several capacities, including secretary of the Septinsular Republic (Italian: Repubblica Settinsulare). As diplomat of the Russian government to Switzerland, he helped free the country from French dominance imposed by Napoleon. Kapodistrias also served as governor of the newly formed Hellenic state from 1828 to 1832 [1].

Kapodistrias was a pioneer in the fight against infectious epidemics and invested heavily in public health regardless of ecclesiastical misgivings, political disputes, or public opinion. As governor, he used his medical expertise and experience in Italy to protect Greeks from the 1828 plague. The Kapodistrias family had close connections with Italians from the quarter of the Walls (de la contrada delle mura) in the Istria Cape (Capo d’Istria) and Venice. Italy had experienced multiple waves of the plague epidemic and understood the importance of quarantine and sanitation. They isolated the infected in Lazaretos and implemented procedures for the purgation of merchandise, mandating that all goods had to be stored in designated areas to be cleansed [2]. Venetians, who were among the first to use isolation tactics, built garrisons on the Greek Ionian Islands to control population movement, according to archives kept by Venetian health inspectors (provveditori alla sanità) [3].

Unfortunately, Greece was unable to avoid the political instability in the surrounding areas [1]. In April 1828, the Egyptian captive army brought “the plague of the poor” to the city of Methone in Messenia, Peloponnese, Greece. Sickness soon devastated the Egyptian army of Ibrahim (1789–1848), killing 20 to 30 soldiers per day and forcing Ibrahim to isolate himself on a ship. The epidemic soon reached the island of Hydra in the Saronic Gulf. Kapodistrias sensed the imminent danger and sent instructions to the Greek politician Spyridon Kalogeropoulos (1790-1864) to implement any necessary method to confront the outbreak. Like Kapodistrias, Kalogeropoulos was born in Corfu and had studied medicine in Italy. Kalogeropoulos soon took drastic measures: all dead were to be buried by an enlisted group of grave diggers, their clothes were to be burnt, and all establishments were to be disinfected. He also enacted a 50-day quarantine for all those who were asymptomatic but who had had contact with the ill. He soon scaled up these efforts by ordering everyone to isolate themselves at home and all enterprises to cease their activities. Churches were closed, and only a few commercial shops continued to provide for the islanders. All ships had to be disinfected and their crews examined. Arab populations were deported due to a fear that the Arabs had brought the infection. The government’s resolve proved strong. On August 20, 1828, a decree (article 285: paragraph 3) officially forbade all travel to and from areas with known infections [4].

Although the inhabitants of Hydra complied with these instructions, outbreaks increased and soon spread to the surrounding islands of Spetses, Poros, and Salamis, the cities of Chalkida, Megara, and Kalavryta, and the region of Argolida. The epidemic became a pandemic. Kapodistrias made the hard decision to enforce a stricter quarantine. All islands and the coast were immediately declared non-movement zones for 40 days. No person or commodity was to be transferred. All infected were to be isolated in wooden huts as far from the inhabitant areas as possible. Intense personal hygiene was suggested.

Kapodistrias’ brother Viaros (1774-1842) was a member of the administrative body for the Army and Navy and head of the Secret Police. Viaros was sent to Hydra to observe the quarantine and ensure compliance. The Swiss physician and one of the founders of the Greek Committee in Geneva, Louis-André Gosse (1791-1873), was commissioned to Poros. Gosse had studied medicine in Paris and had relevant experience in Italy, Austria, Germany, Holland, and England. The Greek politician Ioannis Kolettis (1773-1847), who had studied medicine in Pisa, was sent to Spetses. Specialized teams were deployed to infected areas to identify and report new cases. This combination of social order and medical expertise worked. Cases began to decrease, and the plague was eradicated within a year of its initial outbreak [4, 5].

During an inspection of his government’s measures, Kapodistrias was asked if he was scared of the plague. He cynically answered that the only “plague” he was concerned about were the demogerontes, the elder lords and nobility serving in local government. He was right to fear them, particularly Petrobeis Mavromichalis (1765-1848), whose son Georgios and brother Constantinos killed Kapodistrias just outside the church of Saint Spyridon in Nafplio, Greece, as he was accompanied by policemen [6, 7]. Kapodistrias, a faithful Christian, died in front of the church he cherished, a church he had previously closed to protect civilians from the plague [1, 7].

Ioannis Kapodistrias’ legacy is that of a political mastermind. He helped create the federal state structure of Switzerland and formed the first organized administrative state in the Hellenic peninsula. During the 1828 plague epidemic, Kapodistrias implemented several legislative orders to enforce social distancing, self-isolation, travel limitations, prohibition of large gatherings, community-wide containment, disinfection, personal hygiene, and case detection. In doing so, transmission of the plague was prevented and eventually halted. These extreme measures helped the democracy survive. Indeed, such actions are part of an essential methodology in today’s fight against the coronavirus SARS-Cov-2 [8]. Kapodistrias escaped a fatal plague of illness only to be murdered by a “plague” of politics. As an esteemed international diplomat and physician, Kapodistrias spent his life fighting for the prosperity of his fellow Greeks.

Conflict of interest

The authors have no conflict of interests to disclose.

Funding

No funding sources need to be credited.

REFERENCES

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