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Hygiene in the Middle Ages

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Hygiene and Infectious Disease During the Middle Ages
Cayman Scott
Jacksonville University

| In the period known as the Renaissance, the transition of the Middle Ages to the modern world was taking place, showing diversity |
|in cultural and religious practices and philosophical and artistic impressions, including an emphasis in education. What coincides |
|during this era is the eventual change in belief system regarding hygiene and the thought process of infection causes, treatments and |
|preventive measures. |
|The relation of religion to disease process was widely accepted, as diseases manifested upon the body were believed to be derived from |
|sin. It was generally accepted to find the relief of ailments in disease through prayer, meditation, religious pilgrimage and |
|ritualistic practice. Many practicing physicians were priests or clerics and it was common to find hospitals treating illness to be on |
|the grounds of monasteries and churches. As the body was seen as part of a universal whole, the concept of atonement of sin to |
|eradicate one's health maladies was commonplace. The general belief of practitioners was that diseases were part of the original four |
|humors relating to specific body fluids, blood, phlegm, and black and yellow bile, coordinating with elemental properties of fire, |
|water, earth, and air. The generally accepted view was that all needed to be in balance for homeostasis and optimal health. An |
|imbalance in one's humor would be treated often by bloodletting, vomiting or sometimes induced sneezing (Sayre, 2012). Practitioners |
|and lay people alike were unaware of the impact of disease prevention and process, the benefits of a healthy diet or environmental |
|factors. The biggest culprit, and perhaps the easiest remedy is in hygienic practice, or lack thereof, in regards to preventive care |
|and in the treatment of disease (Faria, 2012). The general public of this era was quite superstitious and some people believed that bad|
|odors were what caused the onset of illness, although the means to eradicate the causes of these offensive agents were widely |
|overlooked. As a result, when the population grew, especially in more concentrated communities, so did the spread of these diseases |
|from animal or human hosts to one another. |
|The occurrence of the bubonic plague killed millions of people and nearly wiped out some cities entirely (Sayre, 2012). A great cause |
|for many illnesses spreading throughout Europe during the middle ages was due to the lack of adequate sanitation for growing cities, |
|basic medical knowledge and disease prevention. There was no running water, sewers were open to the streets and it was common to find |
|garbage strewn about. This proved to be a feeding source and breeding environment for rats carrying fleas, spreading from animal host |
|to human as they scurried from place to place. In London, there would be occasional gatherings and dumping of city garbage directly |
|into the Thames River, corrupting the water supply and spreading contaminated debris down to populated areas and harbors where ships |
|docked for trade activities. Because disease was believed to be a punishment directed from heaven, public-health and basic sanitation |
|practices were not seen as important (Faria, 2012). Although population control of these infected rats was never conducted, the |
|population eventually plummeted causing the vectors, the fleas, to seek out human hosts. The people that were infected were not kept in|
|quarantine from the general populous and it was common to find the dying within their homes, often with actively draining buboes, with |
|family present (Newman, 2012). |
|The outbreak and rate of transfer during the Black Death gave cause for people to look at the relationship between hygiene and health. |
|Basic dental practices consisting of cloths for cleaning along with herbal mixtures as antiseptics and deodorizers, and barrels for |
|infrequent bathing were rare, although they did exist (Knight, 2008). It was believed by some that the act of bathing actually allowed |
|for disease to spread through the open pores of the skin (Dowling, 2014). Larger buildings such as churches and castles had primitive |
|toilets, utilizing a chute system for the removal of waste. Often times this material would be led to the outdoors or surrounding moat |
|or water feature, with running water if it all possible. The problem lies with the breakdown of the waste and the lack of running water|
|throughout. Many towns people used communal wells and open water supplies that were easily tainted by continual dumping of human and |
|animal waste products. As the population grew, crowded, congested areas were the norm, further adding to sanitation issues and disease |
|risk (, n.d.). |
|People often lived in small, basic homes and it was common to bring livestock indoors at night to prevent theft (Newman, 2012). The use|
|of rush flooring was a large threat to basic hygiene. Fragrant herbs such as fennel, rose and lavender were tossed within the floor |
|covering to disguise any underlying odors. The odors that were being masked included human and animal waste, a variety of bodily fluids|
|and food products. As described by Erasmus concerning the floors, the unpleasant vapors were released when there was a change in the |
|weather. Because the emissions were so concentrated and as he states, "very detrimental to health", he felt the rushes should be |
|eliminated and the use of windows for aeration, or opened walls, should be utilized (Faria, 2002). In 1388 the English Parliament |
|issued orders to improve hygiene and sanitation practices in London, by disallowing the dumping of human and animal waste and garbage |
|into open areas and water supply. Refusal to follow this proclamation was to cost the offender 20 pounds, payable to the king. As noted|
|by Faria (2002), the streets were considered dumping grounds and often found both domestic and livestock animals roaming the public |
|streets, free to defecate. |
|Medical treatment in the middle ages was quite basic as true disease etiology was unknown. Treatment of those suffering from the plague|
|was by lancing the infected lymph nodes, buboes, and applying warm herbal compresses of butter, garlic, onions, lily root, and arsenic.|
|Treatments for illnesses from stomach pain, skin problems, headache and joint pain ranged from herbal pastes to elixirs to the |
|ingestion of herbs such as coriander, mint, licorice, and wormwood (Mc Leod, 2008). The wound care was done primarily with vinegar, |
|straight or mixed with myrrh. Early surgeons were often actually barbers or butchers. Any surgical intervention however necessary, was |
|risky for postoperative wound infection (Trueman, 2010). Sterilization was not a consideration as the knowledge and disease etiology, |
|spread, and control was unknown, and the thought of germs was not yet conceived. The common practices of releasing bodily fluids to |
|re-balance humors may have actually played a role in the spread of blood-borne pathogens or those contracted through droplet |
|contamination, as sanitation in the medical setting was sparse as well (Sayre, 2012). |
|Hygiene and proper sanitation during the Middle Ages in regards to overall health, are closely related. Many folk remedies involving |
|the use of herbs were helpful in the treatment of illness. However, the key to decreasing the spread of disease was then as it is now, |
|based on simple hygiene such as hand washing. As it was common for most people to wash their hands prior to eating, as cutlery tools |
|were limited, the spread of diseases transferred by direct content was probably greatly reduced. Forms of sanitation practice including|
|the elimination of rushes from floors, banning of human and animal waste dumping and the moving of waste away from towns and villages, |
|greatly cut down on the spread of communicable disease carried by people, livestock, opportunistic rodents and insects. |
| |
| |

Works cited: Sayre, H.M. (2012). The Humanities: Culture, Continuity & Change. Upper Saddle River, New Jersey: Prentice Hall. Faria, M. (2012). Medical History: Hygiene and Sanitation. Macon, Georgia: Hacienda Publishing, Inc. Mc Leod, J.A. (2008). In a Unicorns Garden. Crows Nest, New South Wales: Murdoch. Dobell, S. (1997). Down the Plughole: An Irreverent History of the Bath. Chicago, Illinois: IPG. Knight, E. (2008). History of Hygiene: Bathing, Teeth Cleaning, Toileting and Deodorizing. Retrieved from http:// Trueman, C. (2010). Health and Medicine in Medieval England. Retrieved from Newman, S. (2012). The Black Death. Retrieved from
Dowling, M. (2014). The Black Death. Mike Dowling. Retrieved from
Middle Ages Hygiene (n.d.). Retrieved from hygiene.htm


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