On the morning of 6 July 1395, the city council of Valencia met in the council chamber. Plague had been in the city since March, and despite the council's best efforts, the death toll continued to rise. This morning, the councilmen authorized several new measures to combat the epidemic. They organized charitable donations "to placate divine anger," and a procession to the chapel of Our Lady of Mercy to "beseech divine mercy for the said plague." Immediately thereafter, they authorized funds for the removal of "dead dogs, cats, rats, and other dead things that people throw in the streets and squares, and which in these times of summer and epidemic give great corruption to the city." 1 Almost in one breath, the council addressed both the immediate, material source of the plague and the divine anger that was its ultimate cause. Both hygienic and ritual approaches to public health have received considerable attention in the last few decades, but rarely together. Scholars of medieval public health have established beyond doubt that medieval and early modern city governments were concerned about issues of hygiene and devised measures to limit the spread of disease. 2 They have also made clear that sacred and secular medicine were closely The author's deepest thanks to the many people who read, heard, and commented on successive drafts of this article, including