“192 
During the reign of the Czesars attempts 
were made to drain the Pontine Marshes, 
sanitary officials and physicians to the poor 
were appointed and homes for poor girls 
and orphans were established. In the 
meantime the true spirit of Christianity as- 
serted itself, and we read of the establish- 
ment of hospitals as early as the 4th cen- 
tury ; these were speedily followed by infant 
and orphan asylums and homes for the 
poor and incurables. During the Middle 
Ages sanitation received a decided check, 
ignorance and brutal prejudices appear to 
have been the ruling spirit, and for many 
reasons it was the most insanitary era in 
history. 
About this time most of the towns in 
Europe were built in a compact form, sur- 
rounded with walls; the streets were nar- 
row and often winding for defensive 
purposes, shutting out light and air from 
the houses. The accumulation of filth was 
simply frightful. Stables and houses were 
close neighbors, human filth was thrown on 
the streets or manure heap. A city ordi- 
nance of Muhlberg in 1367 prescribed that 
manure deposited by householders on the 
market space must not be allowed to re- 
main longer than 14 days. The dead were 
buried within the -churchyards. Sewers 
and aqueducts having been permitted to 
fall into disuse, the inhabitants were com- 
pelled to resort to wells with polluted 
subsoil water. All the conditions were 
favorable for the spread of infectious 
diseases, and in the 14th century the Ori- 
ental pest or bubonic plague carried off in 
Germany over a million victims. Venice 
lost 100,000 and Florence 50,000 of its in- 
habitants ; England lost one-half of its peo- 
ple, and London, then a city of 110,000 
residents, buried over 50,000 in one ceme- 
tery. According to conservative estimates 
the deaths from this plague in Europe 
amounted to from 25 to 30 million people. 
The majority of people regarded the plague 
SCIENCE. 
LN. S. Voz. VI. No. 152, 
.as the dispensation of God’s providence, 
an evidence of divine wrath, which they 
hoped to allay by all sorts of self-inflicted 
punishments, and the passion plays of 
Oberammergau and elsewhere originated 
about this time. Others accused the Jews 
of being the cause, and hundreds were 
burned at the stake until Pope Urban IV. 
placed them under his special protec- 
tion. The Faculty of Paris attributed 
the epidemic to the conjunction of planets 
on a certain day in 1345, and the Faculty of 
Leipzig, with equal gravity, asserted that it 
was connected with earthquakes, unseen 
waves of air, inundations, ete. Venice, 
alone of all Europe, took a sensible view of 
the matter, and for the first time in history, 
in 1348, appointed three guardians of public 
health, and the rules adopted later to iso- 
late infected houses and districts for forty 
days has given rise to the term quarantine 
(from quaranta giorni). 
We are told that this board rendered ex- 
cellent service in matters relating to public 
sanitation, the control of markets and the 
sale of unwholesome foods, etc., and also in- 
augurated a system of mortality reports with 
columns for the insertion of the cause of 
death, showing that they fully appreciated 
the importance of vital statistics in the 
study of the causes and prevention of dis- 
ease. This question is scarcely understood 
at the present day, and yet, as remarked by 
Dr. Billings, ‘‘when we wish to study the 
healthfulness of a city, whether itis getting 
better or worse, or judge correctly the effects 
of certain sanitary laws, we should not only 
know the number of deaths, but also the 
amount and character of the prevalent dis- 
eases, together with accurate information as 
to the number of population at different 
ages.” 
The repeated invasion of the Oriental 
pest appears to have everywhere compelled 
some sanitary efforts and an imperial decree 
in 1426 required the appointment of city 
