The Great Plague of Marseille was the last of the significant European outbreaks of bubonic plague. Arriving in Marseille, France in 1720, the disease killed 100,000 people in the city and the surrounding provinces. However, Marseille recovered quickly from the plague outbreak. Economic activity took only a few years to recover, as trade expanded to the West Indies and Latin America. By 1765, the growing population was back at its pre-1720 level.
At the end of the plague of 1580, the people at Marseilles took dramatic measures to attempt to control the future spread of disease. The city council of Marseilles established a Sanitation board, whose members were to be drawn from the city council as well as the doctors of the city. The exact founding date of the board is unknown, but its existence is first mentioned in a 1622 text of the Parlement of Aix. The newly established sanitation board then made a series of recommendations for maintaining the health of the city.
The most major component of the sanitation board was to establish a bureaucracy for the maintaining of the health of Marseilles. In addition to protecting the city from exterior vulnerabilities, the sanitation board sought to build a public infrastructure. The first public hospital of Marseilles was also built during this time period, complete with a full-sized staff of doctors and nurses. Additionally, the sanitation board was responsible for the accreditation of local doctors. Citing the vast amount of misinformation that propagates during a plague, the sanitation board sought to at a minimum provide citizens with a list of doctors whom were believed to be credible.
The sanitation board was one of the first executive bodies formed by the city of Marseilles, and it was equipped with a full-time staff to adequately address the growing needs of the board's responsibilities.
The largest component of the health system of Marseilles was the three-tiered quarantine system. Members of the Sanitation board inspected all incoming ships and gave them one of three bills of health. The “bill of health” then determined the ship and its cargo's access to the city.
A delegation of members of the sanitation board was to greet every incoming ship. They were then to ask for the captain’s log, which recorded every city the ship had landed in, and to consult the sanitation board's master list of cities throughout the Mediterranean who had rumors of recent plague activity. The delegation also inspected all the cargo, crew and passengers looking for signs of possible disease. Should they see signs of disease, the ships were to be turned away from Marseilles docks. If there were no signs of disease, but the ship’s itinerary included a city with documented plague activity, then the ship was sent to the second tier of quarantine on islands outside of Marseilles harbor. The criteria for the lazarettos were ventilation (to drive off the miasma of disease), be near the sea to facilitate communication and pumping of water to clean, and must be isolated yet be easily accessible.
A clean bill of health was still heavily doubted and required a minimum of 18 days quarantine. During such a time, the crew would be held in one of the lazarettos that were constructed around the city. Which lazaretto one stayed at depended on one's bill of health. With a clean bill, one went to the largest quarantine site, which was equipped with stores and was large enough to accommodate many ships and crews at a time. If they believed there to be a possibility of plague, they were sent to the much more isolated quarantine site, which was built on an island off the coast of the Marseille harbor. The crew and passengers were to wait there for fifty to sixty days to see if they developed any sign of plague.
Once crews served their time, they were allowed into the city in order to sell their goods and enjoy themselves prior to departure.
This great outburst of plague was the last recurrence of a pandemic of bubonic plague, following the devastating episodes which began in the mid-fourteenth century with the European Black Death. In 1720, Yersinia pestis arrived at the port of Marseille from the Levant upon the merchant ship Grand-Saint-Antoine. The vessel had departed from Sidon in Lebanon, having previously called at Smyrna, Tripoli, and plague-ridden Cyprus. It first infected and killed a Turkish passenger, followed by several crew members and the ship's surgeon. The ship was refused entry to the port of Livorno and, on arrival at Marseille, was promptly placed under quarantine in the lazaret by the port authorities. Due largely to its monopoly on French trade with the Levant, this important port had a large stock of imported goods in warehouses and was actively expanding its trade with other areas of the Middle East and emerging markets in the New World. Powerful city merchants needed the silk and cotton cargo of the ship for the great medieval fair at Beaucaire and pressured authorities to lift the quarantine.
A few days later, the disease broke out in the city. Hospitals were quickly overwhelmed, and residents panicked, driving the sick from their homes and out of the city. Mass graves were dug but were quickly filled. Eventually the number of dead overcame city public health efforts, until thousands of corpses lay scattered and in piles around the city.
Attempts to stop the spread of plague included an Act of the Parlement of Aix that levied the death penalty for any communication between Marseille and the rest of Provence. To enforce this separation, a plague wall, the Mur de la Peste, was erected across the countryside. The wall was built of dry stone, 2 m high and 70 cm thick, with guard posts set back from the wall. Remains of the wall can still be seen in different parts of the Plateau de Vaucluse.
During a two-year period, 50,000 of Marseille's total population of 90,000 died, and an additional 50,000 people succumbed as the plague spread north, eventually reaching Aix-en-Provence, Arles, Apt and Toulon. Estimates indicate an overall death rate of between 25%-50% for the population in the larger area, with the city of Marseille at 40%, the area of Toulon at above 50%, and the area of Aix and Arles at 25%.
After the plague subsided, the royal government strengthened the plague defenses of the port, building the waterside Lazaret d'Arenc. A double line of fifteen-foot walls ringed the whitewashed compound, pierced on the waterside to permit the offloading of cargo from lighters, once merchantmen had passed inspection at an island further out in the harbour, where crews and cargoes were examined.
In 1998, an excavation of a mass grave of victims of the bubonic plague outbreak was conducted by scholars from the Université de la Méditerranée. The excavation provided an opportunity to study more than 200 skeletons from an area in the second arrondissement in Marseille, known as the Monastery of the Observance. In addition to modern laboratory testing, archival records were studied to determine the conditions and dates surrounding the use of this mass grave. This multidisciplinary approach revealed previously unknown facts and insights concerning the epidemic of 1722. The reconstruction of the skull of one body, a 15-year-old boy, revealed the first historical evidence of an autopsy dated to the spring of 1722. The anatomic techniques used appear to be identical to those described in a surgical book dating from 1708.