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When Milan was the capital of the west, it surpassed Rome in importance because the imperial court was there. Christianity was made the state religion of the empire with the Edict of Milan. Two fathers of the Catholic church worked in Milan.
D. Hawkins, The Black Death and the new London Cemeteries of 1348). London, as the country's largest city, had all the concomitant problems of overcrowding and poor sanitation. The Thames was a polluted mess and cesspits within the city were a constant source of contamination.