Disease has long been a central part of Neapolitan life, and has always shaped the relationship between the Neapolitans and their rulers and governors. Nowhere can this be seen more clearly than in one of the central leitmotifs of modern Neapolitan history, namely the repeated waves of cholera. Few cities have been so ravaged by this disease as Naples, as we have seen in the case of the horrible devastation in the seventeenth century. The image of a suffering Naples is a lot older than Italian unification. The city was dominated by foreign forces long before the Piedmontese sent Garibaldi to take control of the Kingdom of the Two Sicilies. By 1910–1911, health authorities knew how to deal with new outbreaks of the disease, but the return of cholera, even on a much smaller scale than in 1884, was a terrible blow to the governments in Naples and Rome.