Health and disease

Introduction

With the advantages of modern technology and science, humans now know more about health and disease than ever before. In Medieval Europe, however, people knew very little about important but simple things such as the importance of proper hygiene for good health. This chapter discusses the beliefs surrounding health and disease during the Middle Ages. It particularly focuses on the Black Death, which caused the death of between 25 and 35 million Europeans.

Understanding disease

Today there are medicines and antibiotics which have been scientifically proven to cure infectious diseases. Modern medicine has even seen the development of vaccines, which can make a person immune to particular diseases. In Medieval Europe, however, people did not understand how diseases were caused. Some people believed that sickness was a form of punishment from God for sinful behaviour. Others blamed illness on the misalignment of the planets and stars or the imbalance of fluids in the body. It was also a common belief amongst Medieval Europeans that bad odours were poisoned air which, if inhaled by a person, could cause them great sickness.

Since people knew very little about what caused disease, or how to treat it once they had contracted one, odd and often extreme preventative measures and cures were employed. Those who blamed bad smells for a sickness would burn candles or lemon leaves, or smell flowers and herbs. Herbs and beetles were also commonly used to make tea, medicines and ointments. Since the Roman Catholic Church (the Church) was such an influential part of everyday life, people often believed that if they made a pilgrimage to a holy shrine to pray to God, He would cure them of all ailments. Refer Image 1

There were few trained doctors during the Middle Ages and even fewer people who could afford to call on them. Many often relied on the advice of a 'wise woman,' who administered herbal cures. Even trained doctors, however, did not know how disease was spread. Some doctors would study a patient's urine, if they believed that his or her fluids were imbalanced. The diagnosis would often result in vomiting, sweating or bleeding to be induced. Doctors used leeches to suck what they believed was 'bad blood' from ill patients. Alternatively, they would cut a patient's vein or artery to let some blood drain from the patient. One problem was that surgeons often used dirty equipment to operate on a patient, increasing his or her risk of death through infection. While opium was used to attempt to anaesthetise a patient, he or she was still awake throughout surgery.

Health and hygiene

Considering the ignorant way in which diseases were treated in Medieval Europe, it is not surprising that there was a high rate of child mortality and a short life expectancy. Today, the average life expectancy in western Europe is around 80 years of age. In Medieval Europe, even the wealthy, who were able to enjoy a better diet and better living conditions, were lucky to live to 45 years of age. Many people did not even make it past childhood, with 200 children out of every 1000 dying within their first twelve months of life. Today, the child mortality rate for western Europe averages around five children out of every 1000 born.

In the Middle Ages, nobody realised that poor hygiene was the cause of the spread of disease. Peasants lived in rat- and flea-infested homes, only bathing a couple of times a year. While the wealthy were able to afford to bathe much more often than peasants, they were still exposed to dirty living conditions. Sewage and rubbish were often disposed of in the streets or in the rivers.

The Black Death

In 1347, a deadly disease known as the Black Death spread across Europe. The Black Death is thought to have been spread in Europe by Genoese soldiers (from Genoa in northern Italy) who had contracted the disease while fighting in Kaffa (city in Crimea, Ukraine). It is believed that a withering Mongolian Army, who may have contracted the disease in China, flung the infected dead bodies of Mongolian soldiers into Genoese settlements. Several ships of Genoese attempted to escape the disease by fleeing Kaffa and docking in the harbour of Messina on the Italian island of Sicily. It was too late for the Genoese, however. By the time the ships arrived in Messina the Genoese onboard were either fatally ill or already dead.

The Black Death, already in China since the 1320s, spread from Italy to France, Spain and the lower part of England. By 1349, the disease had expanded to the rest of England and Ireland, encompassing the entire British Isles by the following year. The Black Death also spread through Germany and Scandinavia, reaching Russia by 1351. Only Poland and parts of the Netherlands and Belgium were untouched by the deadly disease.Refer Image 2

While no one knew at the time, historians now believe that the Black Death was an outbreak of bubonic plague which was caused by a bacterial infection. The Black Death is thought to have been spread by infected fleas attached to rats which came to Europe in trading ships. Once a person was bitten by an infected flea, the bacteria rapidly multiplied in the bloodstream. Early symptoms included a fever and vomiting. Large, pus and blood filled, black lumps in the neck, armpit and groin usually followed. The later stages were usually marked by slurred speech and rapid heart beats. Infected people usually died between four and seven days after the initial symptoms appeared. Some people, however, lived for only 48 hours. Refer Image 3

Since no one understood how the Black Death was spread, people did not realise that improving their hygiene, to rid themselves of fleas and their homes of rats, would decrease their chances of infection. In an attempt to be spared, people were willing to try anything from giving up food to giving money to the Church or even whipping themselves in the hope that God would have mercy on them (known as flagellants). Doctors also treated the Black Death in accordance with the prevailing beliefs of the time. They relied on astrology, herbal ointment, sweet-smelling herbs and the practice of attaching leeches to patients.

The Black Death had a devastating effect on Medieval Europe. It is thought that in the first four years that the plague spread in Europe, between 25 and 30 million Europeans died from it. Refer animation