1. Medieval Public Health www.theeducationforum.co.uk

2. Fall of the Roman Empire The Roman Empire grew until it could no longer control its borders successfully. Barbarian tribes overran the western parts of the empire, and by AD 500 Europe consisted of many small, feuding tribal kingdoms. These kingdoms were often at war with each other. The Romans public health systems fell into disrepair and misuse Public health regressed

3. Wars Frequent wars in the Middle Ages meant that many of the Roman developments were lost Roman Building, health systems and libraries were destroyed. It was now dangerous to travel, so communications were limited, and there were far fewer opportunities for doctors to learn or train

4. Peasant Life Most people in medieval Europe worked the land as peasants Most peasants lived in single room ground floor wooden huts. Animals such as cows, pigs, and chickens lived close by behind a partition. In the evening and in winter animals would share the main living space with the humans. Rats were a major problem in medieval towns and villages, attracted to the filth and thatch of the roofs they bred quickly and spread epidemics like the Black Death in 1348. Peasant’s huts were badly lit and badly ventilated. Glass was expensive so windows scarce. Peasant’s homes contained an open fire for heat and cooking. Huts were smoky and polluted. Whole families shared one tiny room making infection spread quickly when it occurred. There were no proper toilets or sewerage disposal facilities in either the villages or the towns just cesspits built too close to wells and rivers. A peasant’s diet was restricted and unreliable. Black rye bread and weak soup and stew were staple foods. There was no way of preserving food other than by using salt. Malnutrition and starvation were commonplace.

5. Medieval Public Health In the absence of strong government, medieval villages and towns were filthy. Rubbish and human waste was just thrown into the streets and the streets were unpaved so impossible to keep clean. Rivers used for drinking water were also used for washing which spread disease. Cesspits were built too close to wells and rivers and were not built of stone so would just leak into the water supply. Government was not strong enough, rich enough or interested enough to impose proper hygiene and public health facilities on the people. Even if they wanted to it was impossible to keep unpaved streets clean.

6. Medicine and Public Health Regressed In addition to the terrible killer epidemics like the Black Death, diseases like St Anthony’s Fire causing ulcers and flesh rotting were commonly spread by the fungus found on mouldy bread. Other common diseases such as St Vitus Dance and Leprosy were linked to poor hygiene and public health. Life was short with a life expectancy of just thirty years. In the face of serious disease and epidemics that couldn’t be understood or cured people resorted to supernatural and religious explanations. The all powerful Roman Catholic Church was hostile to new ideas. The Church taught that all you needed to know about medicine had been discovered by the Ancient thinkers Hippocrates and Galen. People who disagreed were punished. Doctors were trained in Church approved Universities so tended never to question church teachings. Roman public health systems which had been funded and excellent fell into disrepair.

7. Conclusion A combination of factors caused medieval medicine and public health to regress – weak government, powerful religion, poor education and the damaging impact of war.