













































THE ORIGIN OF QUARANTINE


Global Partners in Education Journal – Special Edition   December 2015, Vol. 5, No. 2, pp. 24-31 
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THE ORIGIN OF QUARANTINE 
Wen Nie 

 
School of History and Civilization, Shaanxi Normal University 

 
Abstract 

 
Quarantine, a major breakthrough achieved by human beings in the battle 
with infectious diseases throughout history, is embedded in health practice 
and strictly related to plague ever since the 14th century. This term dates 
back to 1377, when the rector of the seaport of Ragusa officially issued a 
30-day isolation period for ships and 40 days for land travelers. During the 
next 100 years, similar laws were introduced in Italian and French ports and 
they gradually assimilated other connotations with respect to their original 
implementation. Through the measures taken by governments from 
infected regions and nations, we all know that the period for quarantine 
varies. Whereas the original 40 days is not without a basis, instead, it has 
a strong association with the medical theory of Hippocrates, the Lenten 
Season of the Judeo-Christian tradition, and the Philosophical month in 
ancient western alchemy. In the absence of a targeted vaccine and 
according to medical theory, traditional belief and alchemical practice, 
quarantine formed the standard system and was relied upon for the 40-day 
period as one of the most effective general preventive intervention, which 
influenced people for centuries.  

 
  Keywords: quarantine, Hippocrates, Lent, philosophical month  

 
Introduction 

 
The Ebola virus is a contagious virus with a long history. Recently (February 2014), there 
was an outbreak in West Africa which drew close attention from all over the world (Rajak, 
2015 and WHO, 2015). The vice president of Sierra Leone himself was faced with the 
fate of quarantine because one of his bodyguards was diagnosed with the Ebola virus 
and died days later (BBC News, 2015). This virus illustrates the relationship between man 
and disease. In the battle with infectious diseases throughout history, human beings have 
achieved a major breakthrough in four aspects: 1) the establishment of the quarantine 
system; 2) the discovery of pathogenic microorganisms; 3) the presence of specific 
medicine; and 4) the emergence of vaccine (Zhang, 2003). Quarantine, being of utmost 
significance, is embedded in health practices and is strictly related to the outbreak of the 

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plague, especially the black death which had a huge stimulus on the establishment of a 
permanent quarantine (Schepin, 1991).  

 
Historical Background of Quarantine 

 
The earliest record of quarantine can be traced back to 532 AD. During the Justinian 
plague period when one hundred million people around the world deceased, the eastern 
Roman emperor Justinian decreed that all people from areas contaminated with the 
plague who were trying to enter the city of Constantine, must be cleansed in special 
localities and then they would be awarded the health certificate (Schepin, 1991). As early 
as 1127 AD, the 40-day period of quarantine appeared in Venice in the outline of the first 
set of legislation about the plague (Schepin, 1991). These regulations required 
businessmen and travelers coming from the Levant (the eastern Mediterranean region) 
to stay in the House of St. Lazarus for 40 days before they were allowed to enter the city 
of Venice. In 1403, Venice established its first quarantine station (i.e., Lazaret quarantine 
station). In quarantine, the sick could get treatment and those from affected areas needed 
to be isolated for 40 days and in some cases, the quarantine period could be extended. 
Healthy people would be temporarily quarantined for 40 days although if any new cases 
appeared during the quarantine, there would be an additional 40 days of isolation 
(Schepin, 1991).  
 
Quarantine measures in preventing infectious disease were obviously a big step forward. 
These were the first attempts for preventing potential infectious diseases from spreading 
throughout the world and protecting local people from the infectious diseases carried by 
foreigners. According to previous research, quarantine was an ideal system because it 
included regulations, laws, personnel departments and finance supports, and it even had 
a legal impact (Schepin, 1991). During those days, people treated quarantine as the only 
reliable way to prevent the invasion of infectious disease with great conviction and this 
sort of belief was continued for hundreds of years. The term quarantine was derived from 
the Italian (quaranta giorni, Byrne, 2008) and the development of the thoughts about 
modern international quarantine originated from The First International Sanitary 
Conference (held on July 23th, 1851), which had the purpose of drafting an agreement to 
protect all human beings from the cholera epidemic which had mounted since the 1830s.  
 
Although isolation and quarantine are likely the oldest documented measures used to 
prevent infectious diseases, isolation differs from quarantine. The distinction was made 
by the CDC (Centers for Disease Control and Prevention) and was undoubtedly the most 
worthy of reference. This explanation was given by this authority which gradually was 
accepted by more scholars and reveals that isolation “is the measure taken to those who 
had specific infectious diseases and healthy people, to limit their actions, so as to prevent 
the spread of disease”; while quarantine inspection “is used for those who are exposed 

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to infection near the original, being vulnerable to infection, separate them and limit their 
action” (CDC, 2014). However, the concept of quarantine is changing constantly as 
mentioned in an essay written by Gensini (2004). Meanwhile, the Oxford English 
Dictionary also gives its definition which explains “Isolation means the act of separating 
somebody; Quarantine means a period of time when an animal of a person that has or 
may have a disease is kept away from others in order to prevent the disease from 
spreading” (Hornby, 2010). In sum, although quarantine is of limited value, it still can play 
a useful public health role in properly circumscribed situations.  
 
Concerning the origin of the forty-day quarantine period, some scholars feel that it was 
both related to the forty days of Lent which represents a form of spiritual purification and 
a result of medical observation (Kilwein, 1995). Some scholars are inclined to regard forty 
days as a sufficient period for preventing the spread of infectious diseases (Gordis, 1995). 
Others believed it was closely related to the idea of “critical days”, an idea deriving from 
ancient Greece that infectious diseases would continue to develop within 40 days (Wang, 
2013). Although scholars referred to some conjectures, they seldom made deeper 
explanations of any of them. This article would like continue to explain this question in 
three aspects (i.e., medical theory of Hippocrates, Lent and ancient western Alchemy), 
and attempts to gain some historical enlightenment from the discussion.   
 

Quarantine and the Medical theory of Hippocrates 
 
Hippocrates was one of the most famous physicians in ancient Greece (Daintith, 2009). 
He was born on the island of Thasos around 460 BC. Hippocrates was said to be born in 
a medical family with many generations of health practitioners, and the offspring of 
Asclepius, the medical god in Greece (Novelli, 2011 and Castiglioni, 2003). Hippocrates 
preceded Plato and Aristotle, the two great men of the most notable figures in ancient 
Greece, and out of respect he was regarded as “The Great Hippocrates”. Galen, the most 
famous physician in ancient Rome, treated Hippocrates as "The Medical Sage" 
(Hippocrates, 2007), and the medieval western world revered him as the "Father of 
Medicine" (Hippocrates, 2007). Owing to the efforts and theology made by him and his 
fellows, western medicine finally became a science and technology (Du, 2006).  
 
Hippocrates had two famous sayings: “Cause drowsiness is a harbinger of illness”, “In 
every house where I come, I will enter only for the good of my patients, keeping myself 
far from all intentional ill-doing and all seduction.” (quoted from Hippocrates Oath, 
Castiglioni, 2003). Thus, as the founder of western medicine, his interpretation of the 
diseases and the corresponding measures would no doubt have a significant impact on 
the behaviors of Europeans.  
 
Fortunately, we could find mounds of evidence which proved the significance of a forty-

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day period for disease in The Hippocratic Collection. In one chapter on epidemics, he 
mentioned that when summer arrives and until the autumn, all kinds of fevers will begin 
to attack residents in Thasos. These fevers were to last long since they were not very 
serious although they always seemed to affect the weaker to a greater degree than those 
who did not yet get the disease before (Hippocrates, 2007). Generally, Fen Li (分利), 
which is a term from Chinese medicine which uses drugs to make patients perspire 
significantly in order to improve their health (Zhang, 2014 and Zhong, 2003), appears on 
the twentieth day, yet most patients see the improvement on the fortieth day and some 
on the eightieth day. For example, Hippocrates recorded the condition of his patients, one 
of which was Antioch (son of Bruce in Crito) whose Fen Li first happened on the fortieth 
day and then proceeded to get well afterwards (Hippocrates, 2007). The great physician 
also mentioned that encephalitis could cause many residents to die during the period from 
around winter to the vernal equinox and it affects children and adults equally. What’s more, 
Fen Li appeared to some on the eleventh day, relapsed on the fortieth day, totally Fen Li 
began on the twelfth day. But, if the situation became worse, then the totally Fen Li 
appeared on the fortieth day (Hippocrates, 2007).  
 
The medical theory of Hippocrates dedicates the significance of the roles played by a 
forty days period in dealing with disease. It appears to be a turning point and situations 
improve if they will not get worse during the crucial forty days. When we put the status of 
Hippocrates and his effects on medieval society into consideration, it is not so difficult to 
deduce this conjecture: the vital forty days from the medical theory of Hippocrates directly 
influenced the origin of quarantine.  
 

Quarantine and the Lenten Season of Judeo-Chrisian tradition 
 
The Lenten Season was well-known not only in Judeo-Christian world, which generally 
lasts for forty days from Ash Wednesday (the first day of Lent) to Easter. Lent is a fasting 
season for Christians so that they can be well prepared for the coming confession (Strayer, 
1986). It derived from a biblical story of when the Spirit drove Jesus out into the wilderness 
where he spent forty days and where he was tempted by Satan. Jesus was with the wild 
animals and the angles were ministering to him (Mark 1:12) Jesus endured hunger for the 
sake of human beings and he lived in the wilderness for forty days resisting the temptation 
of Satan. Why did the Spirit put Jesus in the wild for forty days and not twenty days or 
eighty days? In my opinions, forty days was a symbol which is significant in the Christian 
world. Although Christian could not understand the mystery of the forty days, they 
believed that forty days was symbolic of the time period for rebirth which brought about 
change and hope.  
 
 
 

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Actually, the number forty in common in the Bible: 
• The Lord went to destroy human beings then said “I will send rain on the earth 

for forty days and forty nights, and every living thing that I have made I will 
blot out from the face of the ground.” (Genesis 7:4)  

• “the Lord’s anger was kindled against Israel, and he made them wander in the 
wilderness forty years, until all the generation that had done evil in the sight 
of the Lord was gone.” (Numbers 32:13)  

• “the people of Israel again did what was evil in the sight of the Lord, so the 
Lord gave them into the hand of the Philistines for forty years.” (Judges 13:1)  

• Following the will of God, “Jonah began to go into the city, going a day’s journey. 
And he called out, Yet forty days, and Nineveh shall be overthrown!” (Jonah 
3:4)  

• When Israel died in Egypt, physicians will usually spend forty days to embalm 
the remains, “Joseph commanded his servants the physicians to embalm his 
father. So the physicians embalmed Israel. Forty days were required for it, for 
that is how many are required for embalming.” (Genesis 50:2)  

• When it comes to test someone, forty days or years also play an important 
part, Moses stayed on the top of Mount Sinai for forty days and forty nights, 
(Exodus 34:28) he tried to make an agreement with the Lord for humans sake, 
“So I (Moses) lay prostate before the Lord for these forty days and forty 
nights, because the Lord had said he would destroy you.” (Deuteronomy 9:25)  

• “I myself stayed on the mountain, as at the first time, for forty days and forty 
nights, and the Lord listened to me that time also. The Lord was unwilling to 
destroy you.” (Deuteronomy 10:10)  

• What’s more, in Hebrews, there was a famous sentence, “your fathers put me 
to the test and saw my works for forty years.” (Hebrews 3:9)  

 
All of the references above were quoted from Bible and we see in Christianity that the 
Lord uses the number forty to destroy or remodel humans.  
 
These implications indicates that, in Christianity, the Lord would like to spend forty days 
and forty nights to destroy every living thing that he made in the world, and he was also 
going to punish a nation for forty years until the disappearance of the whole generation 
for their sins. When a test approaches, forty days or forty years seem to be the cost for 
survival. Without denying of the influence that the Bible has on the medieval European 
society, we have no reason to believe that Judeo-Christian tradition has no influence on 
the origin of quarantine.  
 
 

Quarantine and the Philosophical month in ancient western alchemy 
 

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Western alchemy originated around the first century BC which gradually declined after its 
peak during the Roman empire (Hopkins, 1918 and Leicester, 1982). However, alchemy 
was popular everywhere throughout western world in 9th-10th century AD. Furthermore, 
alchemy theory became an essential part of scholasticism when Arab countries had 
transformed it (Yang, 2003). During the period of transition, alchemy was always the 
guiding principle of natural science, which had a direct impact on the emergence of early 
modern chemistry (Legend, 2013).  
 
Distinguished from alchemy in ancient China, the ancient alchemy discussed here was 
not aimed at refining elixir but to increase in wealth by turning base metals such as 
coppers, irons and leads into precious metals. Throughout the origin of western and Arab 
alchemy, we found two origins of ancient alchemy: the philosophy of ancient Greece (or 
the natural philosophy) in 6~4 century BC and the ancient technology with astrology in 
Mesopotamia. The real alchemy actually derived from the combination of Greek 
philosophical thoughts and ancient Egypt’s chemical technology. (Yang, 2003) Some 
crucial ideas determined the alchemist's behavior. They believed that any substance 
could be converted to each other. As Aristotle once believed, everything was made of the 
original substance and the original material had two groups of contradictory features: cold 
and warm or dry and wet. The combination of the different original materials formed four 
basic elements: warm and dry materials produce fire, warm and wet materials produce 
gas, cold and dry material produce soil, and cold and wet materials produce water. And 
then the combination of the four elements could produce all things and the great variety 
of things lies in the different proportion of these four elements (Miao, 1991).  
 
More importantly, during the process of refining the gold, a period named philosophical 
month was applied to ensure that there was enough time for the gold to be refined, which 
was usually forty days. The ancient alchemists believed that the period of forty days was 
a complete circle for the transformation and generation of the materials. This is similar to 
the process used by Chinese alchemists when they refined elixir, they insisted that forty-
nine days could be sufficient for producing a fairy medicine. The forty days of the 
philosophical month for ancient alchemy was common during those centuries in which 
the forty days quarantine was utilized.  
 

Conclusion 
 
The author argues that the medical theory of Hippocrates, the Lenten Season of Judeo-
Christian tradition, and Philosophical month in ancient alchemy have a direct impact on 
the emergence of the forty days quarantine period. Although the reason is not always 
clear, future investigations into this issue are important. Besides, those descriptions lead 
us to another world. When facing a plague, many historians tend to delineate the degree 
of the terrible disaster, to discuss how much impact the plague had on the whole society 

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and people’s lives, as well as the fear and the eager to escape from it. However, we begin 
to think about the other side of human’s spirits through this quarantine phenomenon. More 
specifically, the forty days period evident from medical experiences, biblical records and 
alchemy practice indicates people then struggling with the plague tenaciously, and 
extending their strong will to survive.  
 
 

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