Situated on the main channels of commercial intercourse through the Mediterranean Sea, the Maltese authorities soon adapted quarantine measure to protect their community. During the late Middle Ages (at least by 1458), quarantine control was in the hands of public officials appointed by and answerable to the Mdina Municipality. Ships suspected of harboring infection were directed to Marsamxett Harbour. Attempts to contain the infection included the burning of cargo, isolating the crew and submersing the ship. When in 1523, the ship owners refused to comply with the instructions, the municipality was compelled to set fire to the ship. During this epidemic, cases of plague broke out at Birgu and attempts were undertaken to cordon off and isolate the town from the rest of the Island with special guards[3]. With the arrival of the Knights Hospitaller of St. John of Jerusalem to the Islands in 1530, quarantine enforcement fell under their control. It has been suggested that the Knights first adopted a forty-day quarantine after their establishment on the island of Rhodes in 1306. During their stay in Rhodes the Knights developed a very comprehensive code of laws to safeguard the health of the community. These laws promulgated during the Grandmastership of Fra E. D'Amboyse (1503-1512) included detailed regulations regarding quarantine control and the notification of infectious disease. These regulations were subsequently introduced in Malta. A Health Commission composed of two knights responsible for quarantine control was set up. This formed part of the Complete Council of the Order[4]. No ship was allowed to disembark passengers, crew or goods before being granted pratique by the port sanitary authorities. Harsh punishments, including the death penalty, were meted out to anyone who infringed the regulations. All the merchandise had to be brought ashore for disinfection, while the passengers and crew had to be depurated. The isolation of persons suspected of harboring infection was carried out at the Lazaretto. The first lazaretto was set up at Rinella Bay, but subsequently was transferred to the foreshore beneath Kordin Heights and later to the Valletta wharf. A permanent lazaretto was built on Manoel Island in 1643 by Grandmaster Jean Paul Lascaris, though the islet had been previously used on a number of occasions as a temporary lazaretto. The quarantine regulations were maintained under British rule and were only relaxed in conformity to international recommendations in the mid-twentieth century[5].

Disinfection of ships' cargo extended to mail since paper was considered a potential vehicle of contagion. The Order of St. John set up a postal or courier service in 1571 to provide communications with various governments and with the Order's possessions in Europe. Postal disinfection was practised in all the major European ports. A letter addressed to Toulouse signed by Grand Master Pinto in 1748 has been slited to facilitate disinfection. Arrangements for carrying out the disinfection of letters were in existence in Malta in 1678. The method employed at this time has not been specifically identified, but the process used in Malta was probably similar to that used at Marseilles and elsewhere. Evidence of these procedures has been described in eighteenth century manuscripts. A set of quarantine regulations issued by the Order of St. John in 1720 mentions that Dispatches brought in by ships are not to be received unless they are first perfumed. The packets and letters are to be unpacked, disinfected by a double perfume, and left exposed to the action of the latter for twenty-four hours. It is only after undergoing this process that letters are to be delivered. A further document of 1749 states that Letters brought by ships with a clean bill of health but hailing from suspected places are to be incised by a scalpel to ascertain that they contain no susceptible goods such as objects of wool, silk, and thread and to ensure that the perfume penetrates inside them. The letters are then placed in the perfuming stove. Two examples of correspondence and literature dealing with plague infection dated to about 1744 held in the National Library of Malta [NLM: Archives 6464] have evidence of slitting and fumigation[6]. The procedure in use at the Quarantine Station at Valletta was detailed by the French traveler J. Houel in 1787 and the Englishman J. Howard in 1789. The letters were seized with a pair of pincers and struck with two blows from a chisel so that they were cut in two places from one side to another. They were then dipped in vinegar and after were placed over a grill inside a stove and fumigated for a quarter to half hour over burning straw and aromatic herbs[7].

The quarantine measures regarding postal items continued to be practised throughout the nineteenth and early part of the twentieth century. After taking over the administration of the Islands, the British authorities established a packet agency at Valletta to handle external mail. The Island Post Office was inaugurated in 1806. In May 1819, a new tariff of charges for letters fumigated at the Quarantine Office was appended to the newly published Tariff of Postage for the Island Post Office[8]. Paper was considered a possible cause of contagion. Thus during the 1813 plague epidemic, many public documents were probably destroyed, while wood was used as a writing medium for receipts, legal documents and letters. A fumigating mixture to disinfect paper was offered for sale at cost price[9]. The fumigating mixture in first half of the century was composed of common salt, manganese and an aqueous solution of sulphuric acid. To facilitate penetration and easy circulation of the fumes among the papers, wooden wedges were introduced in the incised slits. Specially constructed cupboards and implements were provided for carrying out the fumigation. The practice of slitting of letters became generally infrequent after 1845 but was still in use until 1866. In Malta, disinfection of letters came to an end towards the 1880s[10].

External fumigation of parcels persisted until very much later, particularly in times of possible importation of infection. Until October 1906, the Customs Department was responsible for the Quarantine Establishment. After that date, quarantine matters became the responsibility of the Public Health Department. During that year five hundred and sixty parcels of luggage from infected ports were disinfected at the Lazaretto disinfector, and a few small parcels were disinfected at the Custom House disinfector. A quantity of goods of different kinds was also disinfected by means of corrosive sublimate solutions or sulphurs vapours. New Quarantine Regulations based on the 1903 Paris Convention and excluding postal items from disinfection came into force in August 1908. These regulations stated that Parcels excepted, nothing in these Regulations shall render liable to detention, disinfection or destruction, any article being part of any mails conveyed under the authority of the Postal Administration of any Government or shall prejudicially affect in any case the due delivery of any such mail to the Post Office. During that year only 48 bags of mail were disinfected by sulphur fumes. During the Cholera epidemic of 1911, the quarantine staff disinfected 855 parcels, while 44 parcels were returned to the place of origin or destroyed at the owners' request. In 1920, 598 pieces of luggage, parcels, etc were disinfected externally. As late as 1929 correspondence from Tunis was disinfected when plague was raging in that country[11].

Fumigated postal items during the nineteenth century were marked by special seals or postmarks. These markings indicating disinfections were first used in 1813 in France. Red wax seals were first used in Malta during the period 1816-1844. The earliest known used around 1816 at the back of folded letters was composed of an oval single-line 25x23mm imprint with the words SANITA DI MALTA. The seal was changed around 1825 when the Crown and Royal Cipher G.R. were included with the words QUARANTINE OFFICE, MALTA. Three varieties of this seal are described. During the period 1825-1844, the seal was changed to a 25x21mm oval horizontal heavy line frame incorporating the Crown and Royal Cipher G.R. with the inscription OPENED AND RESEALED/LAZZARETTO OF MALTA. Two varieties are described, one used in 1839. Postmarks or cachets were apparently introduced in 1830. They continued to be used until 1911. The earliest known used probably for administrative purposes in 1830-31 is a fancy horizontal oval 35x15mm with LAZARETTO/MALTA across the center. This was apparently replaced in 1837 by a handstamp consisting of a double oval 26x22mm black cachet with the inscription PURIFiE AU LAZARET and MALTA across the center. Varieties of this handstamp continued to be used until 1883. A simple handstamp reading PURIFIE AU LAZARET*MALTA was also in use during the same period. After 1887, varieties of dated/undated handstamps reading DISINFECTED/LAZARETTO MALTA were introduced. These continued to be used until 1911. The latest known consists of a single 32mm circle incorporating the words DISINFECTED. LAZARETTO-MALTA and the date across the center[12].

The routine fumigation of letters for public health reasons gave an excellent opportunity for the government to scrutinize the contents of letters. This led to protests from members of the diplomatic corps. In 1842, the United States Consul at Malta William Winthrop complained that American dispatched from China in passage to the United States through Malta were being opened for fumigation endangering the maintenance of the secrecy of diplomatic correspondence. He recommended that despatches from China were not to be subjected to fumigation unless an American official was present to ensure confidentiality. He also refers to the conviction of some Quarantine Department clerks who had taken money from letters that were opened by them for fumigation. These requests were not acceded to, though in 1844 Winthrop succeeded in persuading the Malta Board of Health to abolish quarantine on American vessels coming with a clean bill of health from Baltimore or from any port to the north of Maryland[13].

Philately is often useful to directly or indirectly identify various aspects of the political history of a country by identifying political figures or concepts on the period stamps. It can also give an insight to aspects of the social history of a country or region. The disinfection of postal items to prevent the introduction of infective disease to the Islands reflect an aspect of medical history and the preventive efforts of medical practitioners and administrators to combat forms of disease at a time when the medical armamentarium was limited and often ineffectual.

NOTES

2. N.M. Goodman: International Health Organizations and their work. Churchill Livingstone, Edinburgh, 1971, p.23-52

3. P. Cassar, 1964: op. cit. note 1 above, p.11-13, 164-165

4. N.M. Goodman: op. cit. note 8 above, p.31; P. Cassar, 1964: ibid, p.273; L. De Boisgelin: Ancient and Modern Malta, London, 1805, vol.1, p.275

5. P. Cassar, 1964: ibid, p.283-308

6. M. Carnevale-Mauzan: La purification des lettres en France et a` Malte. Gap, 1960, p.62; N.A. Cutajar: The history of the Maltese Postal Service. Heritage, 1977, 7:p.139; P. Cassar: Slitting of letters for disinfection in the eighteenth century in Malta. British Medical Journal, 14 January 1967, p.105-106

7. J. Houel: Voyage pittoresque des Isles de Sicile, di Lipari et de Malte. Paris, 1787, iv,p.91; J. Howard: An account of the principal Lazarettos in Europe. London, 1789, p.8

8. N.A. Cutajar: op. cit. note 6 above, 1978, 13:246-248, 1979, 21:401-403, 1981:818-820; J.A. Mackay: Malta. The story of Malta and her stamps. Philatelic Publ, London, 1966, p.59-61

9. P. Cassar: Documents written on wood during the plague of 1813 in Malta. British Medical Journal, 1961, 2:377; P. Cassar: A further document on wood relating to the plague of 1813-14. Scientia, 1961, 27:165; P. Cassar: The use of wood as a writing medium during the plague of Malta of 1813. Medical History, 1966 10:275-280; P. Cassar and A. Ganado: Two more documenrts of 1813 written on wood during the plague of Malta. Melita Historica, 1979, 7(4):356-362

10. Medical & Health Archives [MHA]: Minutes of the Board of Health, 14 March 1832 to 31 December 1856. In P. Cassar, op. cit. note 3 above, p.291; K.F. Mayer: Disinfected Mail. Gossip Printery, Kansas, 1962, p.282-283; P. Cassar: The early days of the Postal Services in Malta. Union Postale , 1964, 9:138a

11. Government Notice 165: Regulations made by His Excellency the Governor under the Fourth Sanitary Ordinance 1908. Malta Government Gazette, 28 August 1908, 5096:831; G. Caruana Scicluna: General Health Report for 1906-07. Reports on the Workings of Government Departments during the Financial Year 1906-07. Government Printing Office, Malta, 1908, J12; G. Caruana Scicluna: General Health Report for 1908-09. Reports on the Workings of Government Departments during the Financial Year 1908-09. Government Printing Office, Malta, 1910, J6-7, app.Z; G. Caruana Scicluna: General Health report for 1911-12. Reports on the Workings of Government Departments during the Financial Year 1911-12 . Government Printing Office, Malta, 1912, K55; A. Critien: Report on the Health of the Maltese Islands during 1920-21. Reports on the Workings of Government Departments during the Financial Year 1920-21. Government Printing Office, Malta, 1922, app.K; P. Cassar: op. cit. note 1 above, p.219

12. M. Carnevale-Mauzan: op. cit. note 6 above, p.54,70; J.A. Mackay: op. cit. note 8 above, p.58,60; The J.B. Catalogue of Malta Stamps & Postal History. Sliema Stamp Shop Publ, Malta, 1993, p.122-123

13. P. Cassar: Early relations between Malta and U.S.A. Midsea Books, Malta, 1976, p.32-33