GEOGRAPHIC DISTRIBUTIO^' OF BUBONIC PLAGUE 101 



statistics of the epictemics which occurred during this and previous 

 centuries. Typhoid fever is another disease which no doubt con- 

 tributed largely to the general mortalit}'', but which was not recog- 

 nized as a distinct and specific infectious malady until the first quarter 

 of tlie present centur3^ We now know that this disease is endemic 

 in all parts of Europe and America, and that under certain circum- 

 stances it ma}' prevail as a fatal epidemic. While modern methods 

 of diagnosis have enabled us to recognize tyi)hoid fever, typhus fever, 

 relapsing fever, and bulionic plague as distinct diseases, it must be 

 remembered that up to the end of the fifteenth century no such dif- 

 ferentiation had been made, and the term " pest " Avas applied to any 

 fatal malad\' which jirevailed as an epidemic, and no doubt included 

 in some instances smallpox, which i)rior to the discover}^ of Jenner 

 contributed largely to the general mortalit}' of the ])opulation of 

 Europe. 



Bubonic plague continued to prevail in Europe in the sixteenth 

 century, and we have authentic accounts of a devastating pestilence 

 in China during this century, which was probably due to this disease. 

 The disease prevailed in London in 1563- '64, and for a time the mor- 

 tality exceeded 1,000 per week; later it prevailed in Edinburgh 

 (1568-'74) and in other parts of the British Islands. On the conti- 

 nent the greatest mortality occurred at Moscow in 1570. Over 200,000 

 people are said to have succumbed to the epidemic in this city and 

 its environs. The disease prevailed in different parts of France dur- 

 ing the century, and in 1572 caused a mortality of 50,000 in the city 

 of Lyons. A little later than this (1575) Europe again suffered from 

 a widespread epidemic, which appears to have been started by the 

 introduction of cases from Constantinople to seaports in Italy and by 

 extension from the same cit}'' through Austria and German}'. The 

 city of Venice is said to have lost 70,000 of its inhabitants during this 

 epidemic, and in Germany the city of Breslau suffered a most destruct- 

 ive epidemic. 



BuVjonic plague still prevailed in various parts of Europe at the end 

 of tlie sixteenth century, and early v.\ the seventeenth century (1603) 

 an epidemic occurred in London which caused the death of 38,000 of 

 the inhabitants. It continued to prevail in this city and in various 

 parts of England, and six years later caused a mortality of 11,785 in 

 the city of London. At the same time it prevailed to some extent in 

 Holland and in fiermany. During tiie year 1(503 a most disastrous 

 epidemic occurred in l^^gypt which is said to have caused a mortality 



