To all these difficulties the prevalence of the plague must be added. Since the century of the Black Death Europe had not so suffered from this scourge as in the sixteenth. It recurred intermittently, being especially violent in the years 1531, 1533, 1544, 1546, 1548, 1553, 1562-64, 1568, 1577-80.[835] No part of Europe was spared. France, England, Spain, the Low Countries, Germany, and Italy, all suffered. But certain portions of France suffered more than others, as Bas-Languedoc, Provence, the Lyonnais, Burgundy, Champagne, the Ile-de-France, and Normandy. The west and especially the southwest were relatively exempt. Apparently the disease followed the trades-routes along the river valleys, for Toulouse, Lyons, Châlons-sur-Saône, Macon, Châlons-sur-Marne, Langres, Bourges, La Charité, Orleans, Tours, Moulins, Sens, Melun, Dijon, Troyes, Château-Thierry, Soissons, Beauvais, Pontoise, Paris, Rouen, and the Norman ports suffered most.[836] As always, Italy was the immediate source of the epidemic, which was communicated from place to place by the movements of trade. Lyons paid dearly for its commercial pre-eminence, for the ravages of the plague were terrible there.[837] It was at its height when the court was there in July, 1564. The English ambassador, Smith, gives a fearful picture of the state of the city. Men died in the street before his lodgings. His servant who went daily for his provisions sometimes saw ten and twelve corpses, some naked, lying in the streets where they lay till “men clothed in yellow” removed them. A great many bodies were cast into the river, “because they will not be at the cost to make graves. This day,” he writes on July 12, “from break of day till ten o’clock there laid a man naked in the street, groaning and drawing his last breath, not yet dead. Round the town there are tents of the pestiferous, besides those which are shut up in their houses.”[838] Almost every third house was closed because of the plague. The city authorities vainly tried to combat the disease by providing that visits were to be made twice a day by those appointed; but as there were but five “master surgeons” in the whole city, medical attention must have been slight. Persons affected with the plague were to be removed to the hospital—the oldest and one of the best in Europe at that time. Corpses were to be buried at night and the clothes of the dead burned.[839] “About the Rhone men dare eat no fish nor fishers lay their engines and nets, because instead of fish they take up the pestiferous carcasses which are thrown in.” New sanitary regulations were made. All filth was to be cast into the river and not allowed to pollute the streets or the river banks. Fires of scented wood were kept burning between every ten houses in the street. Pigs and other animals were not allowed at large. Meat, fish, and vegetable stalls were to be inspected and all decayed provisions destroyed.[840]