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No longer is plague a serious public health problem in the Western world. But in previous eras the disease struck repeatedly with catastrophic force, and epidemics, besides inducing a high mortality, severely affected the economic and social life.
Dr. Shrewsbury presents a masterly account of the disease in England, paying attention chiefly to the period from the 14th through the 17th centuries. Scrupulous scholarship and excellent critical acumen characterize his work.
The author, emeritus professor of bacteriology at Birmingham, bases his presentation on the natural history of the disease, which depends on a complex interaction of the bacillus P pestis, the rat, certain species of fleas (particularly X cheopsis), and man. The flea carries the bacillus from the infected rat to man. But epidemics require that the fleas must parasitize the house rat, Rattus rattus, and that the infected rats must have invaded the communities in substantial numbers. The field
King LS. A History of Bubonic Plague in the British Isles. JAMA. 1970;212(5):885. doi:10.1001/jama.1970.03170180161037
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