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 (lordsandladies.org, 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. |
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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:// www.historyundressed.com/2008/07. Trueman, C. (2010). Health and Medicine in Medieval England. Retrieved from http://www.historylearningsite.co.uk. Newman, S. (2012). The Black Death. Retrieved from http://www.thefinertimes.com/Middle-Ages.html
Dowling, M. (2014). The Black Death. Mike Dowling. Retrieved from http://www.mrdowling.com
Middle Ages Hygiene (n.d.). Retrieved from http://www.lordsandladies.org/middle-ages- hygiene.htm

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