The menace of plague engendered great fear and anxiety in European cities in the early modern period. The response of Italy's city-states was looked to by contemporaries throughout the continent as the model framework by which to control plague. Florence was a city that had not experienced a severe epidemic for over a century before a devastating period of plague in the early 1630s. John Henderson presents a nuanced and in-depth account of the epidemic in 1630/31 and refreshingly argues for a more compassionate and flexible response from above than has traditionally been presented in the earlier historiography. Henderson also presses the importance of moving beyond positive views of Italy's response to plague and instead shifting the focus to the impact of plague policies on the communities where those policies were enacted. As such, he vividly, takes the reader down to the street-level experience where the human impact and response is put front and centre.

The book is divided into two broad sections. The first focuses on how the city and its hinterland environs coped with plague and the second takes a thematic approach in which the religious response, the experience of quarantine and the challenges of ensuring compliance with plague regulations are explored. Henderson draws on a rich corpus of documentation. This includes the official records and daily communications of the health board, or Sanità, in Florence. As Henderson explains, these records demonstrate the conditions in which people lived and died, the motivations of those breaking plague regulations and show the tragic desperation felt by people. The records of the Fraternity of the Misericordia and the official history of the epidemic, written by Francesco Rondinelli, are used to a similarly effective end. The public records are balanced with the use of eyewitness accounts, which adds an important human dimension to the narrative.

Henderson begins the story of the epidemic in the summer of 1630 when the health board sought to prevent the spread of plague from northern Italian cities (chapter 2). The early preventive efforts to control plague when it appeared in the outskirts of Florence and spread within the city are outlined in chapter 3. Henderson shows the proactive attempts by the authorities to survey the environmental conditions of the urban environment and houses of the poor. He sets this alongside the paradox of marginalization and charitable action which existed in the attitudes that were held toward the poor at the onset of the epidemic. In chapter 4, he seeks to assess whether this changed as the epidemic worsened and presents the public structures and medical response to control plague that was embedded through the epidemic as an effort to treat the city and what he terms the body of the poor.

The final chapter in the first section focuses on the impact of plague and plague regulations, primarily the rigorous implementation of quarantine. Henderson uses the large parish of St Lorenzo as a case-study. The geographical patterns of the epidemic are outlined for this parish during the first months of the epidemic in 1630. He concludes the chapter by drawing out the strategies adopted by the Sanità to manage the disposal of the vastly elevated numbers of dead. It is here that Henderson pushes the argument away from social control having been the motivation of the Sanità and grand duke, and argues for a greater acknowledgement of their charitable and Christian intentions. This is an important redirection of approaches to the impact and reaction of plague in the early modern period.

Henderson also pushes back against scholarly traditions where he argues against the conflict between church and state, and rather emphasizes their co-operation in the religious response to the epidemic (chapter 6). In presenting the idea of a compassionate response from above, Henderson effectively highlights the ecclesiastical authority's concern with providing for spiritual needs beyond the public processions they organized.

Henderson explores the realities of the great isolation hospitals or lazarettos that came to define an important element of the plague experience in Italy in the penultimate chapter. He once again challenges existing scholarship, specifically the perceptions of lazarettos as a means of social control, and instead emphasizes the moral and charitable dimension in the operation of these institutions. This is an important shift in the historical debate.

In the final chapter, Henderson turns his attention toward the poorer Florentines who were not quarantined in their houses or the lazaretto. He uses court records to give the poorer citizens of the city a voice and succeeds in providing a nuanced account of their experience of plague in the epidemic. Henderson draws a complex picture of non-compliance and the punitive response of authorities, but most strikingly shows the degree of flexibility that was exercised by judicial authorities toward those infracting plague regulations.

In a brief but effective epilogue, Henderson outlines the return of plague in 1632–33 and uses this as a reflection to measure the extent to which authorities had learned from the epidemic. It would have been interesting to see some comment toward outside perceptions of the city's response and any direct influence in other urban contexts beyond the epidemic. He concludes the book by reiterating the conflicting response of the elite. On one hand, the official policies and attitudes which presented negative views of the poor, and the other, the surprising levels of compassion evident in individual responses at the street level. Henderson leaves the reader with an important reminder that despite the pervasive compassion that he argues for, this should not devalue the fear that plague rendered and the terror that was the lived experience of the epidemic. Henderson succeeds in providing students, academics and general readers with a scholarly but accessible and innovative account of the impact and response to plague in the early modern city. This fresh and ground-breaking study will most certainly have an important influence on future studies of early modern plague in the urban context.