Approaches to Public Health in Medieval Britain (OCR GCSE History B (Schools History Project)): Revision Note

Summary

Medieval towns were far less hygienic than medieval villages, and life expectancy was shorter for town dwellers. This was because larger populations created more sewage, which was not dealt with effectively. Local trades also caused pollution to both the streets and the water supplies. Attempts to improve public health were largely ineffective.

The public health in monasteries was much more effective due to a combination of better funding and better education.

Approaches to public health in towns

• Hygiene in medieval towns was much worse than in 21st-century England

  • This was due to a variety of reasons

Unhygienic features of Medieval towns

• There was no sewage system in medieval towns

• Human waste was either:

  • Placed into rivers and streams, which were also the water supply for the town

  • Thrown onto the streets

• Many people used communal, outdoor toilets called privies

• Attached to privies were cesspits to store waste

  • Cesspits often overflowed, spreading more waste onto the streets and into the water supply

• Local tradesmen disposed of their waste in rivers and streams

  • Leather tanning used dangerous chemicals, which ran into the water

  • Butchers and fishmongers dumped guts and blood into the water

Attempts to improve public health in medieval towns

• Local governments attempted to improve public health in Medieval towns

• People believed that miasma caused disease

• The actions of local governments aimed to remove bad smells in towns

• Local governments used a variety of methods to improve conditions including:

  • Fines

  • Laws

  • New jobs

Fines

• Local government fined people for dumping rubbish

  • In 1309, the fine for dumping rubbish in London was 40p (equivalent to £400 in 2021)

Laws

• It was against the law for butchers to work on the street

• In 1357, London banned people from placing waste in the River Thames

  • The punishment for breaking this law was imprisonment

New jobs

• Local governments created new roles to improve public health:

  • Gongfermers

    • Emptied cesspits before they overflowed

    • They sometimes just dumped the waste elsewhere in the town

  • Muck rakers

    • Swept the streets and removed the waste

Why were public health measures in medieval towns ineffective?

• Public health did not improve because the punishments were not enough to change the conditions in towns

  • When the local government introduced fines for dumping waste, people found other places to dispose of their waste

  • Laws were weakly applied due to a lack of law enforcement

• The government did not pay to supply clean water for towns

• Some councils, such as in Exeter, installed a system that piped clean water into the city

  • The approach varied from town to town

• People's beliefs about what made them ill were incorrect

  • Belief in miasmas caused people to cover up bad smells rather than remove the source of the smell

  • The Theory of the Four Humours did not acknowledge external factors that caused illness

  • Believing that God cause disease made people focus on prayer, rather than hygiene

Approaches to public health in monasteries

• Monasteries had better public health and were much more hygienic than medieval towns

Understanding of hygiene

• Monks were well-educated

  • They could read and write

  • They had access to a library of information

• Monks understood that waste should be separated

  • Monasteries had filters in their water system

  • Privies were emptied regularly

    • The waste was used as manure for growing crops

    • Sometimes, urine was collected to bleach wool

The monks' beliefs

• Monks cleaned themselves more regularly than most medieval people

  • Monks believed that they needed to be clean for God

  • They washed around once a month

Location of monasteries

• Monks had less contact with other people

  • This kept monks safe during times of epidemic

• Monasteries were usually built by streams, providing a clean water supply

Investment in monasteries

• Many people gave money to the Church

  • The Church could afford to invest money into making conditions good in monasteries

• Monasteries had hospitals, which provided care for the sick

  • Wealthy people invested in monasteries to keep this service available to those in need