Epidemics are on all our minds right now. Probably many of us could use a break from the relentless stream of statistics, percentages, and predictions related to Covid-19. Still, we thought a look at some statistics from an era when modern medicine had not yet been born might provide a little perspective. It was a need for historical perspective that, in fact, pushed Ellen Cotes to publish London's Dreadful Visitation, which collected all the “bills of mortality” printed in London during the Great Plague of 1665 (in which 100,000 people, or a quarter of the city’s population, perished). Lamenting the disappearance of the bills from the earlier "Great Plague" of forty years before ("the sight of them hath been much desired these times"), Cotes “resolved to communicate unto the Nation, these subsequent leaves” so that “Posterity may not any more be at such a loss”.

But what were these “bills of mortality”, and how did they come about? As early as 1592, London parish officials had instituted a system for keeping track of deaths in the city, trying to curb the spread of the plague by tracking it and quarantining victims and those who lived with them. Since it was not then legally required to report deaths to a central authority, the officials hired “searchers of the dead”, whose job it was to locate corpses, examine them, and determine cause of death. These “searchers” were not trained in any kind of medicine. Typically they were poor, illiterate, older women whose contact with the infected isolated them socially and often brought their lives to an early end. They were also, in one of the more gruesome examples of gig work offered by history, paid per body.

The causes of death reported by searchers were recorded by sextons and clerks on weekly bills of mortality — sheets sold like broadsides for a penny, meant to let citizens know where the disease had spread.

The bill of mortality featured above comes from a week in September 1665, when the epidemic was at its height. As you can see toward the bottom right-hand corner, a total of 7,165 people in 126 parishes were proclaimed to have died of “Plague” — a number most historians believe to be low, considering how many people (Quakers, Anabaptists, Jews, and the very poor, among others) were not taken into account by the recording Anglicans.

In addition to the alarming number of plague deaths, Londoners, of course, continued to die by other means, both familiar and strange.

Many familiar maladies hide behind the enigmatic naming. “Rising of the Lights”, dreamy though it sounds, was a seventeenth-century term for any death associated with respiratory trouble (“lights” being a word for lungs). “Griping in the guts” and “Stopping of the stomach” were similarly used for deaths accompanied by gastrointestinal complaints. "Spotted feaver" was most likely typhus or meningitis.

Many labels — such as "suddenly", "frighted", and "grief" — speak of the often approximate nature of assigning a cause (not carried out by medical professionals but rather the "searchers"). "Planet" referred to any illness thought to have been caused by the negative influence/position of one of the planets at the time (a similar astrological source lies behind the name Influenza, literally influence).

Other causes of death endemic to seventeenth-century England practically litter the bills. Tuberculosis, both in the form of “Consumption” and of “Kingsevil” (a tubercular swelling of the lymph glands which was thought to be curable by the touch of royalty), killed hundreds of people every month. “Surfeit”, meaning overindulgence in food or drink, could sometimes be interchangeable with “Gowt” (gout) or “Dropsie” (edema). And the toll childbearing took on both mother and infant is also painfully evident on the bill, with its entries for “Childbed”, “Infants”, “Stillborn”, “Abortive”, "Teeth" (babies who died while teething), and “Chrisomes” (a catch-all for children who died before they could talk). ※

Probably the entries that strike us most, because they set us telling a story in our minds, are those that read like captions in an Edward Gorey book: “Killed by a fall from Belfrey at Alhallowes the Great”, “Burnt in his Bed by a Candle at St. Giles Cripplegate”, or “Drowned in a Tub of Wash in a Brewhouse at St. Giles in the Fields”.

Three years before the Great Plague ravaged London and Cotes published her book, founder of statistical science John Graunt published his Natural and Political Observations Mentioned in a Following Index, and Made upon the Bills of Mortality (1662). In this pioneering work he analyses the statistics offered up by bills from previous decades – just the kind of useful work which Cotes wanted to (and did) facilitate with her compilation.

A useful overview, from 1908, of the history of the Bills of Mortality can be read here, and another from 1843, here. And from a more poetic response to such bills, see William Cowper's Stanzas on Mortality, a collection of his poems that were attached to the bills of mortality for the parish of Northampton from 1787–93.