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The aim of the essay is to clarify the demographic, social, and economic effects brought about by epidemics from mid-18th to mid-19th century, in an urban context. The case in question is that of Bosa, a port town in Northwestern Sardinia, surrounded by walls and divided by the river Temo, in which the waste of oil mills and the filthy waters of tanneries were poured. The inobservance of sanitary rules, together with the poor health conditions of the population (the town lacked aqueducts and drains) resulted in a series of epidemics such as those of tiphus in 1776 and 1816, of smallpox in 1829, and of cholera in 1855. On the basis of the numerous archive documents consulted (including the reports of health officers sent by the Protomedicato Generale di Sardegna) it was possible to identify on the one hand the defensive strategies planned by the sanitary institutions and the therapeutic interventions of the recognized medical doctors; on the other hand, the effects of the epidemics on the demographic, social and economic set-ups.