"Bloom's skillfully crafted analysis provides a fascinating perspective on the nineteenth century's confused response to a terrifying malady, illuminating the psychological and scientific climate of the time. The great epidemic struck at a time when theories about the nature of yellow fever and other infectious diseases were in transition. Local health boards acted on the idea that a germ propagating on the ground was the cause of yellow fever, and sprinkled carbolic acid to disinfect threatened areas. The public fell back on time-honored expedients, burning straw and pine tar in the streets to purify the noxious atmosphere. Meanwhile, fatalists called for fasting and prayer." "Estimates of the epidemic's economic cost to the country ran as high as $200 million, an amount equal to nearly one-third of the nation's annual exports. The wide diffusion of the contagion and its broad economic impact meant that yellow fever was a national rather than regional concern, and spurred federal, state, and local governments to begin to overhaul and refine quarantine and sanitation policies. But until it was discovered that mosquitoes carry the virus, these governmental efforts would only amount to swinging at phantoms.".