102 GEOGRAI'IIIC DISTRIBUTION OF BUBONIC BLAOUE 



of at least a iiiillion. After an interval of 10 or 15 j'ears, durin<)j which 

 there was a marked diminution in the number of cases and the ex- 

 tent of its distribution in European countries, it again obtained wide 

 l)revalence during the 3'ear 1620 and subsequently, es])ecially in Ger- 

 many, Holland, and England. The epidemic in the cit\^ of London 

 in 1(525 caused a mortalit}' of more tlian 35,000. In 1630 a severe 

 e})idemic occurred in Milan, and in 1636 London again suffered a 

 mortality of over 10,000, while the disease continued to claim nu- 

 merous victims in other ]>arts of P^ngland and on the continent. 

 Later in the century (1656) some of the Italian cities suffered devas- 

 tating epidemics. The mortalit.y in the cit}^ of Naples was in the 

 neighborhood of 300.000, in Genoa 60,000, in Rome 14,000. The 

 smaller mortality in tiie last-named city has been a8cril)e(l to the 

 sanitary measures instituted b}^ Cardinal Gastaldi. Up to his time 

 j)rayers, processionals, the firing of cannons, etc., had been the chief 

 reliance for the arrest of pestilence, with wliat success is shown by 

 the brief historical review thus far presented. But this enlightened 

 prelate inaugurated a method of combating the i)lague and other 

 infectious maladies which, with increasing knowledge and experience 

 in the use of scientific preventive measures, has given us the mastery 

 of these pestilential diseases, and has been the principal factor in the 

 extinction of bubonic plague from the civilized countries of .Europe. 

 But it was long after the time of Cardinal Gastaldi before sanitary 

 science was established upon a scientific basis and had acquired the 

 confidence of the educated classes. Indeed, the golden age of ])re- 

 ventive medicine has but recently had its dawn, and sanitarians at 

 the present day often encounter great difficulty in convincing legis- 

 lators and the public generally of the imiDortance of the measures 

 which have been proved to be adequate, when i)roperly carried out, 

 for the prevention of this and other infectious maladies. 



We have now arrived in our historical review at the period of the 

 " great plague of London." For some years this city had been almost 

 if not entirely free from the scourge, but in the spring of 1665 it again 

 appeared and within a few months caused a mortality of 68,596 in a 

 population estimated at 460,000. This, however, does not fairly repre- 

 sent the percentage of mortality an)ong those exposed, for a large 

 proportion of the population fled from the city to escape infection. 



Upon the continent the disease })revailed extensivelv, especially in 

 Austria, Hungary, and Germany. The epidemic in Vienna in 1679 

 caused a mortality of 76,000. In 1681 the city of Prague lost 83,000 



