Medieval Hygiene: Practices Of The Middle Ages

We all know the Middle Ages weren't an enviable time to be alive, but do you really know what people's daily lives were like? When it came to staying fresh, their secrets might be best left in the dark.

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Laughing at medieval people is fun. It’s a bit like watching a reality television show so far removed from your reality (Jersey Shore Family Vacation, anyone?) that you can’t help but feel better about your own life because, damn, look at these poor fools still gyming, tanning, and laundering! Or, in the case of medieval people, slathering a well-known toxin all over their faces in the name of beauty. (Obviously, the toxin part wasn’t well-known at the time.) Looking at the hygiene and grooming practices of people living over half a millennium ago is a perfect distraction from your own miserable failures and existential quandaries, and everyone you’re making fun of is too far gone to care or defend themselves, so really, it’s a perfect setup. We wouldn’t try to take that away from you. But schadenfreude isn’t particularly informative, and if you’re at all interested in historical accuracy, you should try reading something besides that “Medieval People Were Nasty As Hell” clickbait. Sure, the Middle Ages was full of gross stuff, but so is New York City. Medieval people, given the circumstances, were doing the best they could. Sometimes their ideas worked out well for them, and sometimes they really did not.

1. Sewage Management

If you were to time travel back to a major medieval city, perhaps the first thing you’d notice would be the stench. Though a disorienting succession of food and foul odors would no doubt take your attention while walking the streets of any bustling metropolis today, things were a bit funkier back in the Middle Ages. The explanation was simple: poop. More specifically, poorly managed poop. Medieval London’s population of approximately 100,000 people produced about 5,000 kilograms (or 11,000 pounds) of human waste every day—approximately the weight of an adult Asian elephant (first link opens a PDF). Multiply that by the number of days in a year and you can see why medieval folks were quickly up to their knees. This wasn’t for lack of trying. It’s a common misconception that people of the Middle Ages were relieving themselves all over the place, but the reality is that they simply didn’t have the same quality of facilities available to them to get rid of their stuff. Though Roman London did have a sewer system that emptied into the River Thames and its connected streams, it fell into disuse by the medieval period. “Without anyone to flush the old tunnels and keep them clean, old London disregarded and soon forgot about its precious subterranean Roman legacy,” wrote cultural historian Craig Taylor in a comparison of waste management (PDF) in ancient Rome and medieval London. “Instead of having passageways, which were underneath the pavement and flowed into the rivers, sewers became open and public facilities were connected directly to the streams and rivers, making a long system of tunnels and pipes unnecessary.” The Roman model, while still not an A+ in sanitation, would have done a better job of sparing the senses because it more efficiently moved water in and out of the city. Medieval London’s approach, on the other hand, brings to mind one of those cartoon fiascos where someone keeps trying to plug a hole in a leaky boat only to have several more water spurts pop up in its place. As Taylor described:

In 1357 a proclamation was issued forbidding anyone to throw any sort of waste into the Thames or any other waterway under the penalty of imprisonment and severe punishment at the discretion of the mayor and aldermen. This was intended to force London citizens to put their waste into the carts and dung-boats meant to carry it outside the city. However, the result was that many dumped their waste elsewhere in the city. One such place was Tower Hill, which in 1371-72 was so tainted that those living nearby were disgusted by the odor of the dung and other filth. Citizens were then forbidden to dump their wastes there, which caused a renewed dumping into the Thames. Again an attempt was made to prevent people from dumping any kind of waste into the Thames as the King noted that the channel of the river had been narrowed so much that it caused a great hindrance to shipping.

See the vicious, smelly cycle? Another option for dumping waste was cesspits. “E. Sabine [Ernest L. Sabine, author of Latrines and Cesspools of Mediaeval London] believes that after digging up the dirt, taking away the earth, finding the lime, sand and other materials, the total cost for constructing the cesspit would have amounted to about four pounds,” wrote Taylor. This was at least twice the yearly wages of an unskilled laborer. Thus: “These cesspits, even though built for the convenience of all the tenants within a tenement, must have been seen as rather ostentatious utilities.” Still, cesspits were just another temporary solution to everybody’s endless digestive drain. Though, by law, they were to be constructed a certain distance from the property of others, they could still muck everything up. “Despite these regulations, cesspits were not designed to hold liquids and therefore leaked into the soil and nearby wells,” wrote Taylor. Plus, he said, “the smell emanating from it could still be very obnoxious.” This was a problem beyond just sensory dissatisfaction since people of the Middle Ages subscribed to the miasma theory (PDF), which held that disease spread through bad-smelling, poisonous vapors. So if your neighbor’s cesspit was making your kitchen smell like the local summer fair’s porta-potty, even though you weren’t thinking about bacteria, you understood that this needed to be fixed. You’d likely file a complaint, which might demand that they get their…stuff…together within the next forty days.

2. Bathroom Etiquette

Suboptimal as medieval disposal methods were, the idea that cleanliness or privacy in the bathroom realm were of no importance is simply wrong. “You wouldn’t be pooping outside and burying it like an animal,” medievalist Danièle Cybulskie tells HealthyWay. “You’d have a place to go.” “You were never that far from a place where you could,” she says. “In town, they would often have a public place to go to the washroom. Lazy people would probably just pee outside.”  Basically, medieval times were just like a typical St. Patrick’s Day parade.

Citizens of medieval London had private and public facilities available to them. There is evidence of at least 13 public latrines, though, as Sabine noted (PDF), “there must have been many more such public conveniences.” One was at London Bridge. “As early as 1358 there were already one hundred and thirty-eight shops on the bridge,” wrote Sabine. “Along with the customers frequenting the shops, businesses would have required the facilities of the privy.” The London Bridge facilities were large and possibly spread out to accommodate the shop-goers, business people, and citizens living nearby who would have used them. Of course, in instances where there were no public or private facilities available, people would be more likely to dump their waste in less regimented ways. For example, in 1421, during an investigation of one ward’s public housing it was “reported that all the little rents…were without privies, so that all the tenants threw their ordure and other horrible liquids before their doors, to the great nuisance of holy church and of passers-by,” wrote Sabine. Another possible reason for dumping waste in the streets was the danger of going out at night, suggested Taylor in his essay “The Disposal of Human Waste: A comparison between Ancient Rome and Medieval London.” He cited a case from 1290–91 when someone named John de Abyndon met his end while traveling from one of the common privies at London Wall. “At night, sleeping with a chamber pot full of human waste was not too pleasing to the olfactory senses,” Taylor wrote. “Rather than taking the risk of venturing out into the streets to empty the chamber pot, it was instead quickly deposited out the window.” (He added: “There is also the possibility that some tenants were just simply lazy!”) If you had a chamber pot, it likely meant that you were wealthy enough to have someone empty it for you. “Most people would go outside [to use their outhouse],” says Cybulskie. “Most people wouldn’t have a chamber pot.” An exception would be if you lived in the city and didn’t have your own bathroom in the yard. Even if you were dumping your dumps into the streets, “it wouldn’t necessarily sit there forever,” notes Cybulskie. Though it would smell, the contents would be poured into a gutter running down the street where it would later be washed away by rainwater. Inseparable from the issue of waste disposal was the concept of privacy. Evidence suggests that, even if it wasn’t uncommon, public urination wasn’t considered appropriate, not only for reasons of sanitation, but also—and perhaps especially—because of propriety. In 1307, Thomas Scott, groom of the prince, brought charges against a couple of Londoners for assaulting him, supposedly, because he was peeing on a side road. (They claimed to have told him that “it would be more decent to go to the common privies of the City to relieve himself,” after which Scott threatened them, so the assault was merely in self-defense. If you’ve ever had to wait in line for a women’s bathroom at a bar, Scott’s irritation makes a lot of sense.) The public was even less tolerant of public defecation, according to Carole Rawcliffe, author of Urban Bodies: Communal Health in Late Medieval English Towns and Cities. “A beggar child [struck] in 1339 by a cart when squatting in a London street (‘secreta nature faciendo sedentem’) is censoriously described in the record as little more than a savage,” she wrote. (People were also apparently very classist. Good to know that some things never change!) You may be surprised to learn that, once inside the privies, the quality of privacy probably wasn’t much worse—and was maybe better?—than that of your office bathroom (if your office is in America) where daily you try to hold onto some shred of decorum as you’re forced to poop within a couple feet of your coworkers. (Living is absurd and divine and grotesque; that’s just the mixed bag of humanity. Whatever! But seriously, why haven’t American offices gotten this one simple thing right?)

Though it wasn’t Rome, where, according to Taylor, “going to the toilet was not an aspect of life considered embarrassing or private,” medieval Londoners weren’t completely lacking in shame about their bathroom time, as evidenced by the dividing walls found in the privies of castle turrets and towers, monasteries, and cities. As further evidence, in 1333, records show that the tenant of a London tenement made a complaint about the removal of a party wall and roof that had been enclosing a common cesspit. With these removed, “the extremities of those sitting upon the seats [could] be seen, a thing which is abominable and altogether intolerable.”

3. Laundry

Unlike the fast fashion of today, where clothes are worn for a season before being discarded and sent to whatever landfill purgatory Forever 21 and its ilk go at the end of life, medieval threads were costly, whether in time or money, and expected to be worn for a long time. “Clothes were so expensive and highly regarded that even the queen’s exchequer accounts of Isabella, queen of Edward II, show that she had the worn-out hems of her gowns replaced, rather than pay for entirely new gowns,” wrote Toni Mount in The Medieval Housewife. Much like a nice pair of jeans that you wouldn’t want to break down by washing with every wear, medieval clothing would have only been cleaned on an as-needed basis. “One of the reasons that they layered up was that they could wash the clothes that were underneath, and they wouldn’t necessarily have to wash the fancy clothes that were on top,” says Cybulskie. “People were wearing linen next to their skin and they would wear wool overtop, or if they were able to afford it, velvet or silk. But linen was next to the skin because it was easy to weave and it was easy to wash.” When it came to these linen shirts, shifts, and undergarments, the more cleaning, the better. “Washing actually improved the fabric, bleaching and softening it the more it was washed,” wrote Mount. Overgarments, by contrast—and counterintuitively (to our modern ears)—were often stored near the toilets, at least for those rich enough to have garderobes, the latrines built in monasteries and castle walls. Why? Because of the smell. “They believed that moths hated the stink as much as people did and stayed away, thus their robes were guarded,” wrote Mount. “So they had even more reason for using lavender and rose petals before wearing their Sunday best to church.” (Garments made of fine fabric were kept nice by brushing, shaking and airing out, and storage among lavender, herbs, and dried rose petals.) Those who could afford it would send their laundry to be washed by career laundresses in the cities, says Cybulskie. This would include shirts, tunics, sheets, towels, and napkins. Cleaning agents included urine (at least they were resourceful?), used as a stain remover or to set dyes, and lye soap. (As you can imagine, laundry workers’ skin was not in great condition.)

Laundry water and drinking water were expected to remain unmixed, thankfully. According to Cybulskie, many legal documents reflect this rule. But laundry workers must have had to deal with a fair amount of jerks who insisted on breaking this rule. “There were separate places where you would have water that was just for laundry, so laundresses would get really angry if you watered your animals there,” she says, presumably because feces and urine would be involved with this pit stop. “And they would get really angry if tanners were washing their stuff off there,” because—and we’re just going out on a limb here—perhaps more feces and urine?

4. Medicine

For most people, the term “medieval medicine” doesn’t evoke many good images. Pre-germ-theory medical practices didn’t always miss the mark, though. “People were doing stuff like cautery. They were doing stuff like suturing. They knew you had to keep a wound clean. They knew you had to keep it dry,” says Cybulskie. “You didn’t necessarily need to know about the actual bacteria to know that if there’s dirt in it, it will fester and you will die. This was a time where people were on the battlefield a lot. Or day-to-day injuries, they could go bad really fast, because you didn’t have antibiotics.”

That doesn’t mean that they didn’t accidentally tap into antibiotic properties. “They used a few things that are really, I think, fascinating. One was honey. Honey is antibacterial; this has been shown today. So they would put honey on wounds and use it to clean them out. And it’s sticky, so it keeps stuff together,” says Cybulskie. “Also, they used to pack wounds with moss because moss is absorbent. They didn’t realize that some forms of moss will grow penicillin. So that worked.” Some of the recipes include ingredients you still might see floating around the internet today as possible homeopathic remedies, such as this one using betony and vervain, recounted in The Medieval Housewife:

For the migraine—take half a dishful of barley, one handful each of betony, vervain and other herbs good for the head and when they be well boiled together, take them up and wrap them in a cloth and lay them to the sick head and it shall be whole.

So, they got a surprising amount right, or nearly right, given the theoretical framework they were working with. Still, they got some things very, very wrong. For example, this deeply unsettling “cure:”

To cure gout. Boil a red-haired dog alive in oil until it falls apart. Then add worms, hog’s marrow and herbs. Apply the mixture to the affected parts. Or take a frog when neither sun nor moon is shining. Cut off its hind legs and wrap them in deer skin. Apply the right to the right and the left to the left foot of the gouty person and without doubt he will be healed.

Clearly, dogs and other pets were viewed a bit differently in the Middle Ages than they are by many today. If you consider the profound trauma of the Plague, which wiped out millions of people throughout the Middle Ages, it’s hard to blame people of the time for their more superstitious tendencies. That the smell of death was literally in the air was just another reason to employ the nosegay (meaning nose ornament), a small bunch of flowers that could be held up to the nose when passing through a particularly smelly area of town—or to offer some olfactory or emotional comfort in the face of death. “People did carry a nosegay to keep the smell off—to keep from smelling the bodies and stuff—but they also would put herbs in there that they thought would protect them,” says Cybulskie. “They were desperate to do anything that would save them.” This included “using plants in trying to keep the miasma—the vapors—away.” Their ideas about medicine were shaped by the humoral theory of the ancient Greeks, which focused on the “balancing” of black bile, yellow bile, blood, and phlegm in the body in order to achieve health. Closely tied to this theory was the treatment of bloodletting, which involved drawing blood from a person in an attempt to balance these body fluids, otherwise known as humors. One of the ways this was done was through the use of leeches, placed on the skin to suck away like little vampires. “In leeching, the physician attached an annelid worm of the species Hirudo medicinalis to the patient, probably on that part of the body most severely affected by the patient’s condition,” wrote historian Michael Livingston in “Misconceptions about Medieval Medicine: Humors, Leeches, Charms, and Prayers.” “These worms were called leeches because they were used extensively by Anglo-Saxon physicians. (The word for ‘doctor’ in Old English is læce). The worms would suck off a quantity of blood before falling off.” Interestingly, the use of leeches has stuck around in modern medicine, though not for balancing humors. “The leech can help reduce venous congestion and prevent tissue necrosis,” wrote Gerry Greenstone, MD, in the British Columbia Medical Journal. “In this way it can be used in the postoperative care of skin grafts and reimplanted fingers, ears, and toes.”

5. Makeup 

Given that a person living in the Middle Ages must have been hyper tuned in to the fragileness of their own existence, it’s a wonder that any of them mustered the effort to care at all about the vainer pursuits of life, like optimizing physical appearance. Then again, you can never underestimate the drive to reproduce—and as anyone who’s ever hooked up after a funeral can attest, the threat of death sometimes heightens that drive. Carpe diem and all that. “People did not like being gross, and they didn’t like being smelly,” says Cybulskie. “Part of that reason was because it’s unattractive….You know, there are books of manners that say, like, ‘You want to make sure you have nice-smelling breath,’ for example. Which is not something we would imagine they worried about because we figure they are used to being stinky—but they did. And they had recipes for deodorant as well. They had recipes for toothpaste, for shampoo, for makeup.” Indeed, if you take a look through The Trotula: A Medieval Compendium of Women’s Medicine, you’ll find recipes for [linkbuilder id=”6702″ text=”haircare”], hair removal, skin whitening and rosying, blemish, wrinkle, and freckle removal, exfoliation, lip softening, lip and gum dying, tooth whitening, and eliminating bad breath. (Though, Cybulskie points out, medieval folks had better teeth than those in the Tudor period, “because they hadn’t discovered the New World and so they didn’t really use sugar a lot.”) These recipes called for local ingredients like herbs and animal products; imported substances like frankincense, cloves, cinnamon, nutmeg, and galangal; and mineral substances including orpiment (a compound of arsenic), quicklime, quicksilver, sulfur, natron, and white lead. One recipe for a face-whitening “ointment” advises:

Take two ounces of the very best white lead, let them be ground; afterward let them be sifted through a cloth, and that which remains in the cloth, let it be thrown out. Let it be mixed in with rainwater and let it cook until the consumption of the water, which can be recognized when we will see it almost completely dried out. Then let it be cooled. And when it is dried out and cooled, let rose water be added, and again boil it until it becomes hard and thick, so that from it very small pills can be formed. And when you wish to be anointed, take one pill and liquefy it in the hand with water and then rub it well on the face, so that the face will be dried. Then let it be washed with pure water, and this [whitened look] will last for eight days. 

If rubbing lead all over your face seems like a bad idea, that’s because it is. Depending on the frequency with which this kind of toxic makeup was used, side effects might have included swelling and inflammation of the eyes, tooth enamel erosion, retexturing and blackening of the skin, and, eventually, death. That’s a pretty high price for beauty.

6. Bathing

One of the main reasons medieval citizens wanted to stay clean was the miasma theory. “They didn’t like being smelly because they were afraid that was going to make them sick,” says Cybulskie. “And they were right! But it was because of the germs that were floating around.” Unfortunately, not wanting to stink isn’t the same as not stinking. Though people in the Middle Ages desired cleanliness, it wasn’t always possible by the standards of today, given the practical hurdles. “If you went to the bathhouse, you were going to be sharing bathwater with other people. If you had a private bath, that meant heating up gallons and gallons of water and hauling it to a bathtub, and then getting rid of it later,” says Cybulskie. “Given the chance, would they have had a bath every day? Probably. But it was just not possible.” So were medieval people, on the whole, smellier than we are today? Sure. “But not as smelly as we think,” says Cybulskie. And, “it was probably less noticeable because you’d be used to it.” When they did bathe, it was quite the production. That’s because tub time was kind of a big deal. “The great numbers of different references to baths throughout the medieval sources show they obviously held a special place in medieval life socially, medically, and spiritually,” wrote historian Virginia Smith in Clean: A History of Personal Hygiene and Purity. She described, for example, fifteenth-century German bath etchings featuring luxe scenes like “the town bathhouse, with a long row of bathing couples eating a meal naked in bathtubs, often several to a tub, with other couples seen smiling in beds in the mid-distance.” Bathing as both spa treatment and party, complete with your friends, your honey, some pastries, and maybe even a bed? We don’t know about you, but that pretty much blows every bath we’ve ever had out of the water.

Anna Cherry
Anna Cherry is the staff writer for Multiply. She's lived in a few different places, written in more, and is now back in the state of her birth (Missouri).