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The native population of New England suffered from disease at two levels. The first was in the form of sudden onslaught by widespread, extremely lethal epidemics. Two of these, plague in 1617, and smallpox in 1633, caused up to 100 percent mortality in local areas and killed close to 7,000 Indians in the aggregate. The second was manifested in chronic maladies such as tuberculosis and dysentery. These debilitating ailments were effective in reducing the population steadily for nearly two centuries and greatly intensified the unfavorable demographic conditions created by warfare between whites and natives. A study of known mortality on the Islands of Martha’s Vineyard and Nantucket shows that the mean annual population decline referable to all types of disease amounted to approximately 1.5% of the existing population throughout the Colonial period.