From Publishers Weekly
The Mootes have written an extraordinary and insightful account of life in London during 1665, when nearly 100,000 people died of the plague. They detail the havoc unleashed upon the city and the efforts of the large number of people who stayed behind rather than fleeing. The Mootes apply their knowledge of history (Lloyd Moote) and microbiology (Dorothy Moote) to analyze the results of their original archival research, most notably the city's weekly "Bills of Mortality" and unpublished documents including publicly distributed pamphlets, personal correspondences, business ledgers and medical records. The story they tell is of two Londons, the working poor of the "alleys and cellars and tenements," and the rich, titled and merchant classes, and how they become "interdependent" during 1665. In a powerful narrative device, the authors often incorporate the words of real people, including Samuel Pepys, who continued risky business arrangements and a "wide range of exotic adventures"; Symon Patrick, the rector of metropolitan London's wealthiest congregation; and Nathaniel Hodges, a doctor who valiantly sought to find a cure for the disease in the face of popular healers selling self-proclaimed "wonder drugs," as well as outdated medical practices. The book also details how the Restoration government was woefully unprepared for dealing with the plague; an epilogue on the development of microbiology and antibiotic cures forcefully argues that modern society still needs to be better prepared for future infectious diseases.
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From The New England Journal of Medicine
Plague killed millions, quickly. It terrified communities, families, and individuals. Plague put enormous pressure on social cohesion and economic activities. Beginning at the time of the Black Death, from 1347 to 1352, plague repeatedly visited Europe's populations until it died down in the 18th century. At each visitation of the deadly disease to a particular area, some 20 percent of the population died -- less than the devastation of the Black Death (which killed one third to one half of the populace), but still a catastrophic event. In England there were successive "Great Plagues," the most famous being the last one, in 1665. (Figure) In this excellent book, husband and wife Lloyd and Dorothy Moote, a historian and a biologist, respectively, have brilliantly captured the human, medical, and political dimensions of the Great Plague in London and the surrounding areas. They have succeeded in combining meticulous historical research and scholarship with an account of the plague that is full of human interest. Using the letters, diaries, and manuscripts of the famous (Samuel Pepys) and the obscure (apothecary William Boghurst), the authors convey the all-consuming fear of plague. They show how individuals and families responded to the dilemma of staying or fleeing. Flight, rather than medical measures, had been the preferred option ever since the Middle Ages. But flight left property and goods open to theft. Moreover, the poor, who also figure large in the book, often could not flee. They usually had no savings, and at a time of plague many of them became unemployed and destitute. Flight into the countryside with no money often meant being harried away from farms and villages by country people who were anxious to avoid contagion, so the runaways faced starvation and a lonely death. The administrative structure of London just about held out. Parish clerks stayed at their posts and compiled the bills of mortality that week by week listed the number of deaths from plague. In April 1665, 2 deaths were recorded; by August, there were more than 7000 in one week. The government played down the importance of the early deaths. But as the numbers rose, the king and the court left London. The mayor remained, with some aldermen and parish officials. They organized and enforced the controversial quarantine of infected houses, whereby people who were well were imprisoned with the sick. The officials distributed money and food to the sickly poor; they also paid for doctors to attend the sick and forked over money for some of the cures for plague that were being touted. Many doctors fled the plague, often justifying their actions by pointing out that they were following their clients. Some stayed, and the nonconformists in religion gained a lot of credit by remaining and looking after the poor. The authors note that the contagion was explained by intertwined religious and medical ideas. Plague was God's punishment for the sins of the community. But he acted through natural means. A plague poison, the theory went, was spread from person to person by breathing and by putrid fumes from cesspits, rotten food, and other sources of putrefaction. This theory legitimized prayer, the quarantining of people, and the cleaning up of the environment. However, nostrums were eagerly sought, and fear created hope, which in many cases was to be disappointed. In the book's epilogue, the authors discuss plague in terms of modern science. As to the much-debated question of whether 17th-century plague was caused by Yersinia pestis, the agent of modern plague that is transmitted by the rat flea and the body louse, the authors incline cautiously to the affirmative but await definitive DNA testing of the dental pulp of plague victims from the 1600s and before. There is much else in this book, including a narrative that is structured by vivid demographic and geographic descriptions linking deaths and places and a masterly account of the near, yet not complete, fracturing of London's economy. Above all, the stories of individual people facing the terror of the unknown make this a unique and very human history of the Great Plague. The authors draw us into the lives of Londoners as they graphically depict how plague touched and altered the residents' lives. By the end of this extremely readable, lively, and informative account, which is underpinned by enormous historical scholarship that is lightly worn, we can imagine what would happen if a similar disaster hit again. Human nature is relatively unchanging. The reactions to something like plague when medicine remains helpless and the burial grounds overflow would be, I suspect, the same across time. Andrew Wear, Ph.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
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