From the earliest attempts to control epidemics in the Italian Ci ty States (often even then in the interests o f ruling families and groups and the commerce and interstate trade they controlled), there has been a tension between the refusal o f disease to recognize local, political and social boundaries and the desires o f men and women to pursue local or group interests. This tension has had a number o f consequences. O n the one hand, it probably led to the modern profession o f spying, w i th Florentine health spies looking for signs o f plague in Genoa. O n the other, i t has given rise to unparalleled co-operation, communication and mutual assistance as was the case in the seventeenth century when epidemic disease threatened to cross class and state boundaries (Cipolla, 1981).