C3 - Public Health in the Middle Ages

Question 1

What is public health?

Answer 1

The health and well-being of the population as a whole

Question 2

What was unhygienic about medieval towns?

Answer 2

As towns grew, systems could not keep up with the increased demand for water; rivers were often used to remove sewage and other waste. Towns were usually dirty with only a few paved streets; cesspits could overflow onto roads and into rivers. In poorer areas the streets stank and were often littered with toilet waste and household rubbish. Leather tanning used dangerous chemicals while meat butchers dumped the waste blood and guts into rivers.

Question 3

What was hygienic about medieval towns?

Answer 3

Medieval towns took water from springs, wells, or rivers. Some Roman systems survived and still worked well while towns like Exeter used new technology with pipes made of wood or lead. Most towns and some private houses had privies with cesspits to collect sewage; people left money in their wills to build public privies’ for the towns citizens. Medieval town councils passed laws encouraging people to keep the streets in front of their houses clean and tidy. Town councils and local craft guilds tried to encourage tradesmen to keep to certain areas and keep them clean.

Question 4

Why was is difficult to keep medieval towns clean?

Answer 4

• town populations grew and public health facilities couldn’t cope
• rivers were used for drinking water, for transport and to remove waste
• people had no knowledge of germs and their link to disease and infection. They thought that disease was spread by ‘bad air’, so they were keen to remove unpleasant smells

Question 5

What were some key parts of monasteries that made them have good public health?

Answer 5

Dormitory - monks washed their clothes regularly as well as their faces and feet
Lavatorium - pipes delivered local well water to wash basins, filters removed dirt
Privies - these toilets sometimes contained potties to collect urine (used for bleaching wool) and were emptied into pits, from which the waste was taken to be used as manure
River - waste water from toilets was often put into a river
Infirmary hall - a small hospital (mainly used herbal remedies)

Question 6

How did wealth help monasteries have good public health?

Answer 6

• they had money to spend on cleaner facilities
• many people gave money, valuables and lands in return for prayers to be said for them when they died
• monks made a lot of money from producing wool and used large areas of donated land to keep the sheep

Question 7

How did knowledge help improve public health in monasteries?

Answer 7

• monks could read and understand books in their library
• they learned the basic idea of separating clean water from the wastewater and wash places
• they understood the ancient Roman idea of a simple routine involving moderation in diet, sleep and exercise to balance the humours

Question 8

How did location help monasteries have good public health?

Answer 8

• isolation helped protect monks from epidemics (monasteries were usually far away from towns as the Christian Church believed lay people were sinful)
• Christian monasteries and abbeys were near to rivers; water was an important resource to supply mills, kitchens, bakeries and breweries

Question 9

How did rules help monasteries have good public health?

Answer 9

• the monks obeyed the abbot strictly
• they had simple lives that followed a routine
• they kept clean for God and had routines of cleanliness e.g. baths once a month

Question 10

How did the Black Death reach England?

Answer 10

It began in Asia and travelled rapidly along the trade routes to Western Europe. It reached Constantinople (in Turkey) in 1347 and it arrived in England in 1348.

Question 11

What were some symptoms of the bubonic plague?

Answer 11

• acral necrosis
• tongue goes black
• buboes (black swollen lumps) on lymph nodes
• fever
• vomiting

Question 12

What was the main symptom of the pneumonic plague?

Answer 12

Your breath would smell rotten as lungs would rot inside you

Question 13

How was the Black Death spread?

Answer 13

Bubonic - rats and fleas
Pneumonic - contact with a victim’s breath, through coughing or blood

Question 14

What were the believed causes of the Black Death at the time?

Answer 14

Position of stars and planets, bad air, wells poisoned by Jews, punishment from God

Question 15

What were the actual causes of the Black Death?

Answer 15

Bacteria Yersinia Pestis which grew in fleas’ stomachs. Fleas fed on rats’ blood, disease killed rats, fleas moved on to humans. Fleas passed the disease on to humans. Food shortages meant the poor were malnourished and more vulnerable to infection.

Question 16

Why did the Black Death spread so quickly?

Answer 16

• street cleaning was poor
• dirty streets encourages rats to breed
• unhygienic habits e.g. throwing out rubbish were common
• animals dug up quickly buried victims’ bodies
• laws about cleanliness were difficult to enforce
• quarantine was not effective on infected villages
• ignorance of germs and causes of disease was widespread

Question 17

What were some remedies for the Black Death?

Answer 17

Prayer, unusual remedies such as drinking mercury or shaving a chicken and strapping it to the buboes, moving away if they thought the plague was coming, avoiding contact with people who might be infected - some local councils tried to quarantine affected places.

Question 18

How many people died as a result of the Black Death?

Answer 18

It killed nearly half of Europe’s population, with at least 1.5 million people in Britain dead between 1348 and 1350.

Question 19

What were some impacts of the Black Death?

Answer 19

• whole villages were wiped out
• demands for higher wages contributed to the Peasants’ Revolt (1381) and the weakening of the feudal system
• damage to Catholic Church as experienced priests had died, others had run away
• it created food shortages, so the price of food went up, creating hardship for the poor
• landowners switched to sheep farming as this required fewer workers
• farm workers demanded higher wages and were less willing to be tied to the land and work for the feudal landlord

Question 20

When did the Black Death end?

Answer 20

By 1350, the Black Death subsided, but it never really died out in England. Further outbreaks of the plague occurred at intervals with varying degrees of deadliness (e.g. 38000 Londoners killed in an outbreak in 1603), and there was another big outbreak in the Great Plague of 1665.