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Medieval Hygiene

Medieval Hygiene


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People in the Middle Ages have acquired something of a bad reputation when it comes to cleanliness, especially the peasantry. However, despite the general lack of running water and other modern amenities, there were common expectations of personal hygiene such as regularly washing from a basin, especially the hands before and after eating which was regarded as good etiquette in a period when cutlery was still a rarity for most people. The better off had the possibility of more frequent baths and castles, manors, monasteries, and cities offered their residents better toilets with better drainage, and sometimes even had running water using the ancient combination of cisterns and gravity. Naturally, standards of hygiene varied over time and place, and even, of course, between individuals, just as today; what follows examines the general habits and expectations regarding hygiene in medieval Europe.

Water Supply

Water was available in villages from nearby springs, rivers, lakes, wells and cisterns. Indeed, most settlements had developed where they had precisely because of the proximity of a reliable water source. Castles might be situated for the same reason and were provided with additional water from masonry-lined wells sunk into their interior courtyards, sometimes accessible from within the castle keep for extra security when under attack. Of over 420 castles surveyed in the United Kingdom, 80% were provided with a well in their interiors and one quarter had two or more. The shaft of the well could be extremely deep: the one at Beeston Castle in England measures 124 m. Some castles, such as the one at Rochester in England, even had the possibility to draw up water from the well at every level of the keep using a system of buckets and ropes which ran inside the walls. Cisterns collected rainwater or natural ground seepage and sometimes a castle might have a system of lead, wooden or ceramic pipes which carried water from a cistern to other, lower parts of the castle like the keep or kitchens, as at Chester Castle in England. Another system of supplementary water collection was to have pipes on the roofing to drain rainwater into a cistern. Finally, settling tanks were sometimes employed to improve the quality of the water by allowing sediment to settle before the cleaner water was drained off. Many monasteries would also have had some or all of these features.

Canals, water conduits, wells & fountains provided (relatively) fresh water to the urban populace.

As towns grew in number and size across Europe from the 11th century CE onwards so hygiene became more and more of a daily challenge. Fortunately, many of the larger towns tended to be situated near rivers or coastlines in order to facilitate trade, so the supply of water and the disposal of waste was less problematic in these places. Canals, water conduits, wells and fountains provided (relatively) fresh water to the urban populace. These were maintained by town councils who also imposed sanitary measures on local businesses and the population in general. For example, there was often an obligation to clean the portion of the street directly in front of one's house or shop. Towns and cities might have public baths; Nuremberg, which seems to have been one of the cleanest towns in Europe thanks to its enlightened council, had 14 of them. Local authorities also undertook such emergency measures as removing the dead during times of plague.

Personal Hygiene

As running water was very rare, and considering it took such a physical effort to get one bucketful from a well or nearby water source, it is perhaps not surprising that taking a full bath every day was not a feasible option for most people. Indeed, with baths seen as a luxury given the cost of fuel to heat the water, monks, for example, were typically prohibited from taking more than two or three baths in a year. For those who had a bath, it most often took the form of a wooden half-barrel or tub. Even then it would not have been filled very much but most of the 'bathing' was done using a jug of heated water poured over the body rather than a full immersion. A lord might have a padded bath for extra comfort and he usually travelled with one, such was the uncertainty of finding the convenience on one's travels. The vast majority of people, though, would have made do with a quick swill using a basin of cold water. As 80% of the population did physically demanding jobs working the land it is likely that washing of some kind was done on a daily basis.

Medieval peasants have long been the butt of jokes regarding hygiene, which goes back to medieval clerical tracts which often described them as little more than brutish animals; however, it was common practice for just about everyone to wash the hands and face in the morning. An early wash was also desirable because fleas and lice were a common problem. Rarely-changed straw bedding was a particular paradise for vermin even if some preventative measures were taken such as mixing herbs and flowers like basil, chamomile, lavender and mint into the straw.

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Soap was sometimes used & hair was washed using an alkaline solution such as the one obtained from mixing lime & salt.

As most people ate meals without knives, forks or spoons, it was also a common convention to wash hands before and after eating. Soap was sometimes used and hair was washed using an alkaline solution such as the one obtained from mixing lime and salt. Teeth were cleaned using twigs (especially hazel) and small pieces of wool cloth. Shaving was either not done at all or once a week unless one was a monk, in which case one was shaved daily by a brother. As medieval mirrors were still not very large or clear, it was easier for most people to visit the local barber when required.

The ordinary peasant was probably more concerned with getting rid of the day's grime when they washed but for an aristocrat there were a few more details to be attended to in order to gain favour in polite society. Social occasions like meals, when one might get up close and personal to one's peers, warranted particular attention to hygiene and there were even rules of etiquette produced as helpful guides for the unimaginative diner, as here from the Les Countenance de Table:

…and let your fingers be clean, and your fingernails well-groomed.

Once a morsel has been touched, let it not be returned to the plate.

Do not touch your ears or nose with your bare hands.

Do not clean your teeth with a sharp iron while eating.

It is ordered by regulation that you should not put a dish to your mouth.

He who wishes to drink must first finish what is in his mouth.

And let his lips be wiped first.

Once the table is cleared, wash your hands, and have a drink.

(Singman, 154)

Monks had their own special areas for washing, including at Cluny Abbey in France which had a lavabo or large basin where hands were washed before meals. We know from records that they had towels, which were changed twice a week while the water was changed only once a week. The Great Hall of a castle or manor typically had a similar large basin for visitors to wash their hands.

In summary, then, it is safe to say that the common presentation in modern films and books of filthy medieval peasants who regarded washing as some form of torture is perhaps not quite accurate and people of all classes did keep themselves as clean as their circumstances permitted. Nevertheless, it is also true that when medieval Europeans, even those of the higher classes, made contact with other cultures such as the Byzantines or the Muslims during the Crusades, the Europeans often came off second best in the hygiene stakes.

Toilets

In villages or on manor estates the peasantry used a cesspit for their own waste, which might then be taken and spread on the fields as a fertiliser. In some cases a small hut provided some privacy and a wooden bench with a hole in it some comfort (as well as reducing the chances of falling into the cesspit). Chamber pots were used at night and then emptied into the cesspit. Without toilet paper, or really paper of any kind, people had to make do with a handful of hay, grass, straw or moss.

The toilets in a castle, also known as privies or latrines, were much the same as everywhere else although the waste was channelled down a hole into a cesspit at the foot of the castle walls or into the moat itself (an added defensive feature not much talked about in military history). Sometimes there were two toilets next to each other and these might empty into a channel which was regularly flushed with water from a diverted stream. The same arrangement was common to monasteries where toilets were clustered together. There were 45 such cubicles at Cluny Abbey which also boasted a bathhouse with twelve tubs. Castles might also have triangular-shaped urinals, especially in the tower of the circuit walls.

In towns, the well-off had their own privy in a back-yard or even in the house itself with a channel or chute to drain off waste into the yard. Where the poorer classes lived in greater concentrations households often shared a single outside toilet or a number of toilets with their waste leading to a communal cesspit. Lined with stone, the cesspits also received any other household rubbish and were regularly emptied by a professional labourer dedicated to that specific and unenviable job. There were regulations prohibiting the tipping of waste into the street but these were often ignored and a spell of heavy rain or, even worse, floods, could cause havoc with the town's sanitation system and contaminate the water supply. With towns also packed with horses and donkeys, and farm animals being transported elsewhere or to the butchers, the streets were usually filthy and this combined with the ever-present rats, mice and other vermin meant that urban centres became the ideal breeding grounds for disease.

Plague & Diseases

The Black Death, which peaked from 1347 to 1352 CE, was just one (albeit the deadliest) of many waves of plagues and diseases which hit medieval Europe. Carried by fleas on rats, the bubonic plague killed anywhere between 30% and 50% of the population wherever it took hold. The low standards of medieval hygiene certainly helped it along although there were other factors such as a complete lack of understanding of what caused it and the absence of effective quarantines. It is also important to note that many medieval locations such as Milan and Bohemia survived relatively unscathed, so it is not quite so simple to attribute the spread of plague solely to a lack of hygiene and proper sanitation.

Besides terrible plagues and epidemics that seemed to spring out of nowhere with alarming regularity, there were often equally deadly dangers lurking in everyday places. Poor food preparation and storage was a particular area of health risk. Epidemics of diarrhoea (ergotism), known in medieval times as Saint Anthony's Fire, were caused by eating rye that had been poisoned by fungi. Skin diseases were particularly prevalent, too, although they may have been caused just as much by poor diet as by uncleanliness.


Medieval Hygiene - History

Medieval Feminine Hygiene
* adult themes *

MENSTRUATION - PREMENSTRUAL TENSION - THE WANDERING WOMB - FEMININE HYGIENE PRODUCTS

Menstruation
Surprisingly, we do know a little about that certain time of the month thanks to medical treatices like those attributed to Trotula. An English copy from the early 15th century advises that:

Women have purgations from the time of twelve winters to the time of 50 winters, although some women have it longer, especially those with a high complexion who are well-nourished with hot meats and hot drinks and live very much in leisure.

Punishment from God
Some doctors called menstruation a sickness although it was generally agreed that it was a punishment from God upon women to pay for Eve's original sin in the Garden of Eden and was therefore deserved and not in any way in need of medical relief.

If a woman suffered with cramps or excessive flow, it was because God willed it. It was also seen as extremely significant that holy women were often found to not menstruate, thus substantiating the belief of regular women were sinners who deserved their lot.

In reality, the extremely frugal diets of very pious women were probably the underlying cause for the lack of menses. With a strict monastic diet and lack of proper nourishment, the body could not longer sustain a pregnancy or reproduce and the menses stopped. If a woman left the harsh religious life and returned to the secular world and diet, her menses would return.

Again, this was seen as an undisputed sign from God of the holiness of nuns and the worldliness of other women generally. Another possible reason for the lack of menses in holy women is that many wealthy women only turned to a life of religious contemplation very late in life and were possibly post-menopausal.

Either way, troubles associated with menstruation were seen to be something that was not in need of any medical intervention.

Medical beliefs
Those who were more medically minded believed that the menses bloodletting started at the head and traveled throughout the body collecting poisonous wastes and humors. This was because most medically minded doctors believed in the Theory of the Wandering Womb.

This particular theory was the cause for any number of female illnesses.

The theory of the wandering womb
Medical practitioners during the middle ages failed to agree on a rather unusual point connected to feminine complaints- whether the womb was stationary or whether it wandered around inside the body causing a variety of other ailments- including vomiting if it stopped at the heart, and loss of voice and an ashen complexion if it stopped at the liver.

The stress of a wandering womb was usually believed to be the cause of hysteria. Indeed the word hysterical translates loosely as madness of the womb. Even physicians who did not adhere to the theory of the wandering womb, agreed that hysteria was a solely female complaint and was probably caused by a lack of intercourse when uterine secretions built up and were not released, thereby causing the entire body to be poisoned.

Popular belief
There were a lot of what we consider today, to be ridiculous beliefs attached to medieval women and menstruation in the middle ages. One popular belief was that sex with a menstruating woman would kill or mutilate the semen and produce horribly deformed offspring or children with red hair or leprosy.

Just the gaze of an old woman who still had her periods was thought to be poisonous- the vapours being emitted from her eyes.

It was also believed by some that the touch of a menstruating woman would cause a plant to die- a belief which was probably not shared by landowners who required women to work alongside men in the garden and would not have wished to lose days of productivity each month. Pliny the Elder, in the first century, declared that the menstrual fluid was most potent-

Contact with it turns new wine sour, crops touched by it become barren, grafts die, seeds in gardens dry up, the fruit of the trees fall off, the bright surface of mirrors in which it is merely reflected is dimmed, the edge of steel and the gleam of ivory are dulled, hives of bees die, even bronze and iron are at once seized by rust, and a horrible smell fills the air to taste it drives dogs mad and infects their bites with incurable poison.

Pliny reported that the poisonous properties of menstruating women could be put to good use. If menstruating women go round the cornfield naked, it would act as a powerful insecticide, he wrote. Caterpillars, worms, beetles and other vermin were expected to be eliminated. During plagues of insects, Pliny had read, menstruating women had been instructed to walk around the fields with their clothes pulled up above their buttocks. He does not note whether this proved a successful remedy or not.


Premenstrual Tension
As with our modern society, premenstrual tension was not undiagnosed. Known as melancholia, very little effort was spent in seeking causes or cures as it was once again seen as God's natural design for the female and therefore not necessary of change. In spite of this, many herbal remedies were widely known and used.

The astringent leaves of Lady's Mantle, Alchemilla vulgaris, at left, were helpful with profuse menstruation.

Thyme, Thymus species, was used for 'women's complaints' and as an ointment for skin troubles.

Fresh leaves of Woodruff, Asperula odorata, (shown at right) made into tea and drunk was recommended for nausea.

Aldobrandino of Siena produced a work Regime du Corps which included advice on feminine hygiene, skincare and gynecology.

According to the 14th century manuscript, Tacuinum Sanitatis, fennel was particularly useful for menstruation. It also advises that acorns would prevent menstruation from occurring, but does not indicate how the acorns should be eaten. It goes on to say that this could be countered by having the acorns roasted with sugar.

Feminine hygiene products
There is very little information about what was used for a woman's monthly period written. Trotula mentions wads of cotton being used for the cleansing of the inner canals of the woman's vulva prior to sexual intercourse with her husband, but it is unlikely that a similar cotton wadding may have been used for a kind of medieval tampon as the belief in letting the menses flow and drain from the body prevailed. To plug up the flow of menstrual blood would be seen as both dangerous and injurious to the woman. Obviously, some device was necessary, so this leaves the alternate as a stuffed sanitary pad or napkin of some kind as a logical conclusion.

A pad of linen fabric seems possible, but when filled with linen wadding would make a pad which would be unlikely to launder well for reuse. The filling would probably not wash well and dry badly in the winters. Since the lower classes also menstruate, it seems that when considering a reusable, washable pad, this was not the answer. It seems that due to wool's water-dispelling qualities, it is also an unlikely stuffing for a sanitary pad.

In the middle ages, sphagnum moss, Sphagnum cymbifolium, shown at right, was used for toilet paper and was also believed by surgeons to have antiseptic properties.

It was also known by the name Blood Moss and was used during the crusades by physicians to stem blood flow in battle wounds. It was renown for its sponge-like absorbent qualities and ability to be rinsed out and reused. A Gaelic Chronicle of 1014 relates that the wounded in the battle of Clontarf stuffed their wounds with moss, and the Highlanders after Flodden tended to their bleeding wounds by filling them with bog moss.

It occurs to me that this might make an exceptionally good filling for a sanitary pad- absorbent, reusable, washable, almost instantly driable and freely available to both wealthy and the lower classes alike in almost all geographic locations. The benefit of antiseptic properties from a woman's poisonous menstrual blood would possibly be seen as an added bonus.

Although there is no concrete proof, it is entirely possible that medieval women used moss-stuffed napkins as sanitary pads. We know that moss is very like a very fine sponge. It easily and quickly absorbs liquid and retains it. Water can be squeezed out and the moss does not collapse and is ready for reuse. A pad of sphagnum moss would absorb the blood in lateral directions well as above and retain it until fully saturated.

In a forum discussion in January, 2006, Robin Netherton discusses an interesting find from a burial at Herjofsnes. It concerns a pad, possibly used for incontinence. It is made of sealskin, wool and has traces of moss in the filling. Her conclusions are:

When the body was laid in the grave there must have been lying on the back of os coccygis . a strip of sealskin to which was fastened a redbrown woolen cord to keep the sealskin in place, while in front on mons pubis it was also kept in place by a couple of woollen cords which probably passed up to a cord or belt about the hip-region, thus representing a kind of bandage passing from mons pubis between femora down before pudenda and anus and up between nates in the sacral region.

It shows that the possible use of a pad for both incontinence and other bodily fluids was known. Indeed, before the advent of the self-adhesive sanitary pad, napkins were similarly suspended, although from modern elasticised suspenders.

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Contents

Hygiene is a concept related to cleanliness, health and medicine. It is as well related to personal and professional care practices. In medicine and everyday life settings, hygiene practices are employed as preventive measures to reduce the incidence and spreading of disease. Hygiene is also the name of a branch of science that deals with the promotion and preservation of health.

Hygiene practices vary, and what is considered acceptable in one culture might not be acceptable in another.

In the manufacturing of food, pharmaceutical, cosmetic and other products, good hygiene is a critical component of quality assurance.

The terms cleanliness and hygiene are often used interchangeably, which can cause confusion. In general, hygiene refers to practices that prevent spread of disease-causing organisms. Cleaning processes (e.g., handwashing) remove infectious microbes as well as dirt and soil, and are thus often the means to achieve hygiene.

Other uses of the term appear in terms such as body hygiene, personal hygiene, sleep hygiene, mental hygiene, dental hygiene, and occupational hygiene, used in connection with public health.

Home hygiene overview Edit

Home hygiene pertains to the hygiene practices that prevent or minimize the spread of disease at home and other everyday settings such as social settings, public transport, the workplace, public places, etc.

Hygiene in a variety of settings plays an important role in preventing the spread of infectious diseases. [3] It includes procedures used in a variety of domestic situations such as hand hygiene, respiratory hygiene, food and water hygiene, general home hygiene (hygiene of environmental sites and surfaces), care of domestic animals, and home health care (the care of those who are at greater risk of infection).

At present, these components of hygiene tend to be regarded as separate issues, although based on the same underlying microbiological principles. Preventing the spread of diseases means breaking the chain of infection transmission. Simply put, if the chain of infection is broken, infection cannot spread. In response to the need for effective codes of hygiene in home and everyday life settings the International Scientific Forum on Home Hygiene has developed a risk-based approach based on Hazard Analysis Critical Control Point (HACCP), also referred to as "targeted hygiene." Targeted hygiene is based on identifying the routes of pathogen spread in the home and introducing hygiene practices at critical times to break the chain of infection. [ citation needed ]

The main sources of infection in the home are people (who are carriers or are infected), foods (particularly raw foods) and water, and pets and domestic animals. [4] Sites that accumulate stagnant water—such as sinks, toilets, waste pipes, cleaning tools, face cloths, etc. readily support microbial growth and can become secondary reservoirs of infection, though species are mostly those that threaten "at risk" groups. Pathogens (potentially infectious bacteria, viruses etc.—colloquially called "germs") are constantly shed from these sources via mucous membranes, feces, vomit, skin scales, etc. Thus, when circumstances combine, people are exposed, either directly or via food or water, and can develop an infection.

The main "highways" for the spread of pathogens in the home are the hands, hand and food contact surfaces, and cleaning cloths and utensils (e.g. fecal-oral route of transmission). Pathogens can also be spread via clothing and household linens, such as towels. Utilities such as toilets and wash basins, for example, were invented for dealing safely with human waste but still have risks associated with them. Safe disposal of human waste is a fundamental need poor sanitation is a primary cause of diarrhea disease in low income communities. Respiratory viruses and fungal spores are spread via the air.

Good home hygiene means engaging in hygiene practices at critical points to break the chain of infection. [4] Because the "infectious dose" for some pathogens can be very small (10-100 viable units or even less for some viruses), and infection can result from direct transfer of pathogens from surfaces via hands or food to the mouth, nasal mucous or the eye, 'hygienic cleaning' procedures should be sufficient to eliminate pathogens from critical surfaces.

Hygienic cleaning can be done through:

  • Mechanical removal (i.e., cleaning) using a soap or detergent. To be effective as a hygiene measure, this process must be followed by thorough rinsing under running water to remove pathogens from the surface.
  • Using a process or product that inactivates the pathogens in situ. Pathogen kill is achieved using a "micro-biocidal" product, i.e., a disinfectant or antibacterial product waterless hand sanitizer or by application of heat.
  • In some cases combined pathogen removal with kill is used, e.g., laundering of clothing and household linens such as towels and bed linen.

Hand washing Edit

Hand hygiene is defined as hand washing or washing hands and nails with soap and water or using a waterless hand sanitizer. Hand hygiene is central to preventing the spread of infectious diseases in home and everyday life settings. [5]

In situations where hand washing with soap is not an option (e.g., when in a public place with no access to wash facilities), a water less hand sanitizer such as an alcohol hand gel can be used. They can be used in addition to hand washing to minimize risks when caring for "at-risk" groups. To be effective, alcohol hand gels should contain not less than 60%v/v alcohol.

The WHO (World Health Organization) recommends hand washing with ash if soap is not available in critical situations, [6] schools without access to soap [7] and other difficult situations like post-emergencies where use of (clean) sand is recommended, too. [8] Use of ash is common in rural areas of developing countries and has in experiments been shown at least as effective as soap for removing pathogens. [9]

Respiratory hygiene Edit

Correct respiratory and hand hygiene when coughing and sneezing reduces the spread of pathogens particularly during the cold and flu season. [3]

  • Carry tissues and use them to catch coughs and sneezes, or sneeze into your elbow
  • Dispose of tissues as soon as possible

Food hygiene at home Edit

Food hygiene is concerned with the hygiene practices that prevent food poisoning. The five key principles of food hygiene, according to WHO, are: [10]

  1. Prevent contaminating food with mixing chemicals, spreading from people, and animals.
  2. Separate raw and cooked foods to prevent contaminating the cooked foods.
  3. Cook foods for the appropriate length of time and at the appropriate temperature to kill pathogens.
  4. Store food at the proper temperature.
  5. Use safe water and raw materials.

Hygiene in the kitchen Edit

Routine cleaning of (hand, food, drinking water) sites and surfaces (such as toilet seats and flush handles, door and tap handles, work surfaces, bath and basin surfaces) in the kitchen, bathroom and toilet reduces no of spread of pathogens. [11] The infection risk from flush toilets is not high, provided they are properly maintained, although some splashing and aerosol formation can occur during flushing, particularly when someone has diarrhea. Pathogens can survive in the scum or scale left behind on baths, showers, and washbasins after washing and bathing.

Hygiene in the bathroom Edit

Thorough cleaning is important in preventing the spread of fungal infections. Molds can live on wall and floor tiles and on shower curtains. Mold can be responsible for infections, cause allergic responses, deteriorate/damage surfaces, and cause unpleasant odors. Primary sites of fungal growth are inanimate surfaces, including carpets and soft furnishings. [12] Air-borne fungi are usually associated with damp conditions, poor ventilation, or closed air systems.

Laundry hygiene Edit

Laundry hygiene involves practices that prevent disease and its spread via soiled clothing and household linens such as towels. [13] Items most likely to be contaminated with pathogens are those that come into direct contact with the body, e.g., underwear, personal towels, facecloths, nappies. Cloths or other fabric items used during food preparation, or for cleaning the toilet or cleaning up material such as feces or vomit are a particular risk. [14]

Microbiological and epidemiological data indicates that clothing and household linens etc. are a risk factor for infection transmission in home and everyday life settings as well as institutional settings. The lack of quantitative data linking contaminated clothing to infection in the domestic setting makes it difficult to assess the extent of this risk. [13] [14] [15] It also indicates that risks from clothing and household linens are somewhat less than those associated with hands, hand contact and food contact surfaces, and cleaning cloths, but even so these risks needs to be managed through effective laundering practices. In the home, this routine should be carried out as part of a multibarrier approach to hygiene which includes hand, food, respiratory and other hygiene practices. [13] [14] [15]

Infectious diseases risks from contaminated clothing etc. can increase significantly under certain conditions, e.g., in healthcare situations in hospitals, care homes and the domestic setting where someone has diarrhoea, vomiting, or a skin or wound infection. It increases in circumstances where someone has reduced immunity to infection.

Hygiene measures, including laundry hygiene, are an important part of reducing spread of antibiotic resistant strains. [16] [17] In the community, otherwise healthy people can become persistent skin carriers of MRSA, or faecal carriers of enterobacteria strains which can carry multi-antibiotic resistance factors (e.g. NDM-1 or ESBL-producing strains). The risks are not apparent until, for example, they are admitted to hospital, when they can become "self infected" with their own resistant organisms following a surgical procedure. As persistent nasal, skin or bowel carriage in the healthy population spreads "silently" across the world, the risks from resistant strains in both hospitals and the community increases. [17] In particular the data indicates that clothing and household linens are a risk factor for spread of S. aureus (including MRSA and PVL-producing MRSA strains), and that effectiveness of laundry processes may be an important factor in defining the rate of community spread of these strains. [13] [18] Experience in the United States suggests that these strains are transmissible within families and in community settings such as prisons, schools and sport teams. Skin-to-skin contact (including unabraded skin) and indirect contact with contaminated objects such as towels, sheets and sports equipment seem to represent the mode of transmission. [13]

During laundering, temperature and detergent work to reduce microbial contamination levels on fabrics. Soil and microbes from fabrics are severed and suspended in the wash water. These are then "washed away" during the rinse and spin cycles. In addition to physical removal, micro-organisms can be killed by thermal inactivation which increases as the temperature is increased. Chemical inactivation of microbes by the surfactants and activated oxygen-based bleach used in detergents contributes to the hygiene effectiveness of laundering. Adding hypochlorite bleach in the washing process achieves inactivation of microbes. A number of other factors can contribute including drying and ironing.

Drying laundry on a line in direct sunlight is known to reduce pathogens. [19]

In 2013 the International Scientific Forum on Home Hygiene (IFH) reviewed some 30 studies of the hygiene effectiveness of laundering at temperatures ranging from room temperature to 70 °C, under varying conditions. [20] A key finding was the lack of standardization and control within studies, and the variability in test conditions between studies such as wash cycle time, number of rinses, etc. The consequent variability in the data (i.e., the reduction in contamination on fabrics) obtained, in turn makes it extremely difficult to propose guidelines for laundering with any confidence, based on currently available data. As a result, there is significant variability in the recommendations for hygienic laundering of clothing etc. given by different agencies. [21] [22]

Medical hygiene at home Edit

Medical hygiene pertains to the hygiene practices that prevents or minimizes disease and the spreading of disease in relation to administering medical care to those who are infected or who are more "at risk" of infection in the home. Across the world, governments are increasingly under pressure to fund the level of healthcare that people expect. Care of increasing numbers of patients in the community, including at home is one answer, but can be fatally undermined by inadequate infection control in the home. Increasingly, all of these "at-risk" groups are cared for at home by a carer who may be a household member who thus requires a good knowledge of hygiene. People with reduced immunity to infection, who are looked after at home, make up an increasing proportion of the population (currently up to 20%). [3] The largest proportion are the elderly who have co-morbidities, which reduce their immunity to infection. It also includes the very young, patients discharged from hospital, taking immuno-suppressive drugs or using invasive systems, etc. For patients discharged from hospital, or being treated at home special "medical hygiene" (see above) procedures may need to be performed for them e.g. catheter or dressing replacement, which puts them at higher risk of infection.

Antiseptics may be applied to cuts, wounds abrasions of the skin to prevent the entry of harmful bacteria that can cause sepsis. Day-to-day hygiene practices, other than special medical hygiene procedures [23] are no different for those at increased risk of infection than for other family members. The difference is that, if hygiene practices are not correctly carried out, the risk of infection is much greater.

Disinfectants and antibacterials in home hygiene Edit

Chemical disinfectants are products that kill pathogens. If the product is a disinfectant, the label on the product should say "disinfectant" or "kills" pathogens. Some commercial products, e.g. bleaches, even though they are technically disinfectants, say that they "kill pathogens" but are not actually labelled as "disinfectants". Not all disinfectants kill all types of pathogens. All disinfectants kill bacteria (called bactericidal). Some also kill fungi (fungicidal), bacterial spores (sporicidal) or viruses (virucidal).

An antibacterial product is a product that acts against bacteria in some unspecified way. Some products labelled "antibacterial" kill bacteria while others may contain a concentration of active ingredient that only prevent them multiplying. It is, therefore, important to check whether the product label states that it "kills" bacteria." An antibacterial is not necessarily anti-fungal or anti-viral unless this is stated on the label.

The term sanitizer has been used to define substances that both clean and disinfect. More recently this term has been applied to alcohol-based products that disinfect the hands (alcohol hand sanitizers). Alcohol hand sanitizers however are not considered to be effective on soiled hands.

The term biocide is a broad term for a substance that kills, inactivates or otherwise controls living organisms. It includes antiseptics and disinfectants, which combat micro-organisms, and pesticides.

Home hygiene in developing countries Edit

In developing countries, universal access to water and sanitation has been seen as the essential step in reducing the preventable infectious diseases burden, but it is now clear that this is best achieved by programs that integrate hygiene promotion with improvements in water quality and availability, and sanitation. This approach has been integrated into the Sustainable Development Goal Number 6 whose second target states: "By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations". [24] Due to their close linkages, water, sanitation, hygiene are together abbreviated and funded under the term WASH in development cooperation.

About 2 million people die every year due to diarrheal diseases, most of them are children less than 5 years of age. [25] The most affected are the populations in developing countries, living in extreme conditions of poverty, normally peri-urban dwellers or rural inhabitants. Providing access to sufficient quantities of safe water, the provision of facilities for a sanitary disposal of excreta, and introducing sound hygiene behaviors are of capital importance to reduce the burden of disease caused by these risk factors.

Research shows that, if widely practiced, hand washing with soap could reduce diarrhea by almost fifty percent [26] [27] [28] and respiratory infections by nearly twenty-five percent [29] [30] Hand washing with soap also reduces the incidence of skin diseases, [31] [32] eye infections like trachoma and intestinal worms, especially ascariasis and trichuriasis. [33]

Other hygiene practices, such as safe disposal of waste, surface hygiene, and care of domestic animals, are important in low income communities to break the chain of infection transmission. [34]

Cleaning of toilets and hand wash facilities is important to prevent odors and make them socially acceptable. Social acceptance is an important part of encouraging people to use toilets and wash their hands, in situations where open defecation is still seen as a possible alternative, e.g. in rural areas of some developing countries.

Household water treatment and safe storage Edit

Household water treatment and safe storage ensure drinking water is safe for consumption. These interventions are part of the approach of self-supply of water for households. [ citation needed ] Drinking water quality remains a significant problem in developing [35] and in developed countries [36] even in the European region it is estimated that 120 million people do not have access to safe drinking water. Point-of-use water quality interventions can reduce diarrheal disease in communities where water quality is poor or in emergency situations where there is a breakdown in water supply. [35] [36] [37] [38] Since water can become contaminated during storage at home (e.g. by contact with contaminated hands or using dirty storage vessels), safe storage of water in the home is important.

Methods for treatment of drinking water, [11] [38] include:

  1. Chemical disinfection using chlorine or iodine
  2. Boiling
  3. Filtration using ceramic filters
  4. Solar disinfection – Solar disinfection is an effective method, especially when no chemical disinfectants are available. [39]
  5. UV irradiation – community or household UV systems may be batch or flow-though. The lamps can be suspended above the water channel or submerged in the water flow.
  6. Combined flocculation/disinfection systems – available as sachets of powder that act by coagulating and flocculating sediments in water followed by release of chlorine.
  7. Multibarrier methods – Some systems use two or more of the above treatments in combination or in succession to optimize efficacy.

Regular activities Edit

Personal hygiene involves those practices performed by an individual to care for one's bodily health and wellbeing through cleanliness. Motivations for personal hygiene practice include reduction of personal illness, healing from personal illness, optimal health and sense of wellbeing, social acceptance and prevention of spread of illness to others. What is considered proper personal hygiene can be cultural-specific and may change over time.

Practices that are generally considered proper hygiene include showering or bathing regularly, washing hands regularly and especially before handling food, washing scalp hair, keeping hair short or removing hair, wearing clean clothing, brushing teeth, cutting finger nails, besides other practices. Some practices are gender-specific, such as by a woman during her menstruation. Toiletry bags hold body hygiene and toiletry supplies.

Anal hygiene is the practice that a person performs on the anal area of themselves after defecation. The anus and buttocks may be either washed with liquids or wiped with toilet paper or adding gel wipe to toilet tissue as an alternative to wet wipes or other solid materials in order to remove remnants of feces.

People tend to develop a routine for attending to their personal hygiene needs. Other personal hygienic practices would include covering one's mouth when coughing, disposal of soiled tissues appropriately, making sure toilets are clean, and making sure food handling areas are clean, besides other practices. Some cultures do not kiss or shake hands to reduce transmission of bacteria by contact.

Personal grooming extends personal hygiene as it pertains to the maintenance of a good personal and public appearance, which need not necessarily be hygienic. It may involve, for example, using deodorants or perfume, shaving, or combing, besides other practices.

Excessive body hygiene Edit

Excessive body hygiene is one example of obsessive compulsive disorder.

Excessive body hygiene and allergies Edit

The hygiene hypothesis was first formulated in 1989 by Strachan who observed that there was an inverse relationship between family size and development of atopic allergic disorders—the more children in a family, the less likely they were to develop these allergies. [40] From this, he hypothesized that a lack of exposure to "infections" in early childhood transmitted by contact with older siblings could be a cause of the rapid rise in atopic disorders over the last 30 to 40 years. Strachan further proposed that the reason why this exposure no longer occurs is not only because of the trend towards smaller families, but also "improved household amenities and higher standards of personal cleanliness".

Although there is substantial evidence that some microbial exposures in early childhood can in some way protect against allergies, there is no evidence that humans need exposure to harmful microbes (infection) or that it is necessary to suffer a clinical infection. [41] [42] [43] Nor is there evidence that hygiene measures such as hand washing, food hygiene etc. are linked to increased susceptibility to atopic disease. [33] [34] If this is the case, there is no conflict between the goals of preventing infection and minimizing allergies. A consensus is now developing among experts that the answer lies in more fundamental changes in lifestyle etc. that have led to decreased exposure to certain microbial or other species, such as helminths, that are important for development of immuno-regulatory mechanisms. [44] There is still much uncertainty as to which lifestyle factors are involved.

Although media coverage of the hygiene hypothesis has declined, a strong ‘collective mindset’ has become established that dirt is ‘healthy’ and hygiene somehow ‘unnatural’. This has caused concern among health professionals that everyday life hygiene behaviors, which are the foundation of public health, are being undermined. In response to the need for effective hygiene in home and everyday life settings, the International Scientific Forum on Home Hygiene has developed a "risk-based" or targeted approach to home hygiene that seeks to ensure that hygiene measures are focused on the places, and at the times most critical for infection transmission. [4] Whilst targeted hygiene was originally developed as an effective approach to hygiene practice, it also seeks, as far as possible, to sustain "normal" levels of exposure to the microbial flora of our environment to the extent that is important to build a balanced immune system.

Excessive body hygiene of internal ear canals Edit

Excessive cleaning of the ear canals can result in infection or irritation. The ear canals require less care than other parts of the body because they are sensitive and mostly self-cleaning that is, there is a slow and orderly migration of the skin lining the ear canal from the eardrum to the outer opening of the ear. Old earwax is constantly being transported from the deeper areas of the ear canal out to the opening where it usually dries, flakes, and falls out. [45] Attempts to clean the ear canals through the removal of earwax can push debris and foreign material into the ear that the natural movement of ear wax out of the ear would have removed.

Oral hygiene Edit

It is recommended that all healthy adults brush twice a day, [46] softly, [47] with the correct technique, replacing their toothbrush every few months (

3) or after a bout of illness. [48]

There are a number of common oral hygiene misconceptions. The National Health Service (NHS) of England recommends not rinsing the mouth with water after brushing — only to spit out excess toothpaste. They claim that this helps fluoride from toothpaste bond to teeth for its preventative effects against tooth decay. [49] It is also not recommended to brush immediately after drinking acidic substances, including sparkling water. [50] It is also recommended to floss once a day, [51] with a different piece of floss at each flossing session. The effectiveness of amorphous calcium phosphate products, such as Tooth Mousse, is in debate. [52] Visits to a dentist for a checkup every year at least are recommended. [53]

Sleep hygiene Edit

Sleep hygiene is the recommended behavioral and environmental practice that is intended to promote better quality sleep. [54] This recommendation was developed in the late 1970s as a method to help people with mild to moderate insomnia, but, as of 2014 [update] , the evidence for effectiveness of individual recommendations is "limited and inconclusive". [54] Clinicians assess the sleep hygiene of people who present with insomnia and other conditions, such as depression, and offer recommendations based on the assessment. Sleep hygiene recommendations include establishing a regular sleep schedule, using naps with care, not exercising physically or mentally too close to bedtime, limiting worry, limiting exposure to light in the hours before sleep, getting out of bed if sleep does not come, not using the bed for anything but sleep and avoiding alcohol as well as nicotine, caffeine, and other stimulants in the hours before bedtime and having a peaceful, comfortable and dark sleep environment.

Medical hygiene pertains to the hygiene practices related to the administration of medicine and medical care that prevents or minimizes the spread of disease.

Medical hygiene practices include:

    or quarantine of infectious persons or materials to prevent spread of infection. of instruments used in surgical procedures.
  • Use of protective clothing and barriers, such as masks, gowns, caps, eyewear and gloves.
  • Proper bandaging and dressing of injuries.
  • Safe disposal of medical waste.
  • Disinfection of reusables (i.e., linen, pads, uniforms).
  • Scrubbing up, handwashing, especially in an operating room, but in more general health-care settings as well, where diseases can be transmitted.
  • Ethanol-based sanitizers.

Most of these practices were developed in the 19th century and were well established by the mid-20th century. Some procedures (such as disposal of medical waste) were refined in response to late-20th century disease outbreaks, notably AIDS and Ebola.

Culinary hygiene pertains to the practices related to food management and cooking to prevent food contamination, prevent food poisoning and minimize the transmission of disease to other foods, humans or animals. Culinary hygiene practices specify safe ways to handle, store, prepare, serve, and eat food.

Personal service hygiene pertains to the practices related to the care and use of instruments used in the administration of personal care services to people:

Personal hygiene practices include:

  • Sterilization of instruments used by service providers including hairdressers, aestheticians, and other service providers.
  • Sterilization by autoclave of instruments used in body piercing and tattoo marking.
  • Cleaning hands.

Indian subcontinent Edit

The earliest written account of Elaborate codes of hygiene can be found in several Hindu texts, such as the Manusmriti and the Vishnu Purana. [55] Bathing is one of the five Nitya karmas (daily duties) in Hinduism, and not performing it leads to sin, according to some scriptures.

Ayurveda is a system of medicine developed in ancient times that is still practiced in India, mostly combined with conventional Western medicine. Contemporary Ayurveda stresses a sattvic diet and good digestion and excretion. Hygiene measures include oil pulling, and tongue scraping. Detoxification also plays an important role. [56]

Islamic world Edit

Islam stresses the importance of cleanliness and personal hygiene. [57] Islamic hygienical jurisprudence, which dates back to the 7th century, has a number of elaborate rules. Taharah (ritual purity) involves performing wudu (ablution) for the five daily salah (prayers), as well as regularly performing ghusl (bathing), which led to bathhouses being built across the Islamic world. [58] [59] Islamic toilet hygiene also requires washing with water after using the toilet, for purity and to minimize germs. [60]

In the Abbasid Caliphate (8th-13th centuries), its capital city of Baghdad (Iraq) had 65,000 baths, along with a sewer system. [61] Cities and towns of the medieval Islamic world had water supply systems powered by hydraulic technology that supplied drinking water along with much greater quantities of water for ritual washing, mainly in mosques and hammams (baths). Bathing establishments in various cities were rated by Arabic writers in travel guides. Medieval Islamic cities such as Baghdad, Córdoba (Islamic Spain), Fez (Morocco) and Fustat (Egypt) also had sophisticated waste disposal and sewage systems with interconnected networks of sewers. The city of Fustat also had multi-storey tenement buildings (with up to six floors) with flush toilets, which were connected to a water supply system, and flues on each floor carrying waste to underground channels. [62]

A basic form of contagion theory dates back to medicine in the medieval Islamic world, where it was proposed by Persian physician Ibn Sina (also known as Avicenna) in The Canon of Medicine (1025), the most authoritative medical textbook of the Middle Ages. He mentioned that people can transmit disease to others by breath, noted contagion with tuberculosis, and discussed the transmission of disease through water and dirt. [63] The concept of invisible contagion was eventually widely accepted by Islamic scholars. In the Ayyubid Sultanate, they referred to them as najasat ("impure substances"). The fiqh scholar Ibn al-Haj al-Abdari (c. 1250–1336), while discussing Islamic diet and hygiene, gave advice and warnings about how contagion can contaminate water, food, and garments, and could spread through the water supply. [64]

In the 9th century, Ziryab invented a type of deodorant to get rid of bad odors. [65] He also promoted morning and evening baths, and emphasized the maintenance of personal hygiene. Ziryab is thought to have invented a type of toothpaste, which he popularized throughout Islamic Iberia. [66] The exact ingredients of this toothpaste are not currently known, [67] but it was reported to have been both "functional and pleasant to taste." [66]

Europe Edit

Regular bathing was a hallmark of Roman civilization. [68] Elaborate baths were constructed in urban areas to serve the public, who typically demanded the infrastructure to maintain personal cleanliness. The complexes usually consisted of large, swimming pool-like baths, smaller cold and hot pools, saunas, and spa-like facilities where individuals could be depilated, oiled, and massaged. Water was constantly changed by an aqueduct-fed flow. Bathing outside of urban centers involved smaller, less elaborate bathing facilities, or simply the use of clean bodies of water. Roman cities also had large sewers, such as Rome's Cloaca Maxima, into which public and private latrines drained. Romans didn't have demand-flush toilets but did have some toilets with a continuous flow of water under them. The Romans used scented oils (mostly from Egypt), among other alternatives.

Christianity places an emphasis on hygiene. [69] Despite the denunciation of the mixed bathing style of Roman pools by early Christian clergy, as well as the pagan custom of women naked bathing in front of men, this did not stop the Church from urging its followers to go to public baths for bathing, [69] which contributed to hygiene and good health according to the Church Fathers, Clement of Alexandria and Tertullian. [70] [71] The Church built public bathing facilities that were separate for both sexes near monasteries and pilgrimage sites also, the popes situated baths within church basilicas and monasteries since the early Middle Ages. [70] Pope Gregory the Great urged his followers on value of bathing as a bodily need. [71] The use of water in many Christian countries is due in part to the Biblical toilet etiquette which encourages washing after all instances of defecation. [72] Bidet and bidet showers were used in regions where water was considered essential for anal cleansing. [72] [73]

Contrary to popular belief [74] and although some of the Early Christian leaders, such as Boniface I, [75] condemned bathing as unspiritual, [76] bathing and sanitation were not lost in Europe with the collapse of the Roman Empire. [77] [78] Public bathhouses were common in medivail Christendom larger towns and cities such as Constantinople, Paris, Regensburg, Rome and Naples. [79] [80]

Northern Europeans were not in the habit of bathing: in the ninth century Notker the Stammerer, a Frankish monk of St Gall, related a disapproving anecdote that attributed ill results of personal hygiene to an Italian fashion:

There was a certain deacon who followed the habits of the Italians in that he was perpetually trying to resist nature. He used to take baths, he had his head very closely shaved, he polished his skin, he cleaned his nail, he had his hair cut as short as if it were turned on a lathe, and he wore linen underclothes and a snow-white shirt.


30. If You Bathed Often, You Were Probably Rich

Contrary to popular belief, taking a bath was considered to be very important in the Middle Ages. After all, no one enjoys smelling their own stink. The Romans used communal bath houses, rather than cleaning themselves at home. The Vikings were bathing for both cleanliness and religion, while nuns and monks made bathing a part of their spiritual practice. For commoners, their options for bathing were limited to streams, rivers, lakes, or hot springs. This meant that they were always cleaning themselves in cold water, and it was really only available in spring and summer. In the winter months, people would have to go longer periods of time without taking a bath, because being out in the cold with a wet head could lead to hypothermia, pneumonia, and an early grave.


Hygiene in Medieval Cities

Poor hygiene and sanitation in medieval cities contributed to the spread of disease, especially the devastating plague years of the mid to late 14th Century in Europe. Although the Bubonic Plague was spread by fleas on black rats, living conditions in both urban and rural communities resulted in weakened immune systems. Population densities in emerging cities, which involved housing large numbers of people in small quarters and often including livestock under the same roof, merely helped to spread pestilence.

Medieval Cities Lacked Privacy and Encouraged the Spread of Disease

21st Century tourists walking the narrow streets of centuries’ old cities like Rothenburg ob der Tauber envision a romanticized past where mythical unicorns roamed the countryside and great Gothic edifices pointed to the heavens, celebrating the glory of Christianity. But in the crypt below St. Stephen’s Cathedral in Vienna, for example, visitors can peer through slats in the wall to see stacks of human skeletal remains, a visible testament of the recurring plague years.

Historian Philippe Contamine writes that, “…cities were mazes of twisting, tiny streets, impasses, and courts…” There were few private areas and wider streets, plazas, and city squares did not become universally common until the 15th Century. Communal ovens and wells spread diseases while waste disposal continued to be an urban problem well into the pre-modern era.

Waste Disposal and Urban Overcrowding in the Middle Ages

Almost everyone used privies or chamber pots, which were emptied into open sewers that typically fed into streams, creeks, or adjacent rivers, as in the case of London and the Thames. Cities also contained public latrines and outhouses. Waste from these vehicles fed into ditches that ultimately emptied into nearby bodies of water.

Urban dwellings were constructed as primitive tenements, the upper levels extending over the lower so as to block out sunlight onto the narrow passageways below. This led to severe overcrowding and an acute lack of privacy. In most cases, beds were considered a luxury. When sickness inflicted one or more members of the “household,” there was no possibility of isolation medical care was practically non-existent.

Poor Immune Systems in Medieval Populations Led to Disease Epidemics

The absence of personal hygiene and the prevalence of poor dietary habits weakened immune systems, making it impossible to physically combat disease when it struck. Most Europeans living in France, Spain, and Italy, for example, subsisted on porridge-type meals devoid of protein. Not until the 16th Century, with the Columbian Exchange and the diffusion of agricultural products like the potato from the Americas, would European life expectancy rise.

Displaced People and Rootless Youth in Medieval Towns and Cities

Italian historian Giulia Calvi, writing about the impact of Bubonic Plague in Italy, comments that, “…poor people attracted contagion and vice, serving as a sort of putrifying pimple where all sorts of diseases coagulated.”

In addition to the town dwellers, cities attracted the homeless, beggars, abandoned children, and students denied admittance to early universities. Wanderers, known as “vagabonds,” traveled from city to city.

In 1212 hundreds of children made their way to Southern France and Italy, compelled by charismatic leaders to participate in the European crusading mentality. This Children’s Crusade is still a mystery and historians like the late John Boswell question whether they were truly “abandoned,” but the phenomenon suggests a characteristic of medieval everyday life: many people, especially the youth, were prone to homelessness and living on the very edge of destitution.

Calvi’s link between poverty and “contagion” takes on greater meaning when viewed through the actions of, for example, rootless children making their way through towns and cities while pursuing a perceived noble and sacred cause.

Disease Epidemics Linked Historically to the Wrong Causes

Not until the scientific advances of the late 19th Century and early 20th Century would urban disease and epidemic outbreaks be blamed on poor sanitation, overcrowding, and dietary considerations. In the 1830s, for example, a severe cholera outbreak in American cities was blamed on Irish immigrants. As late as the 1890s, immigrant groups were blamed for disease epidemics, linked to ethnic considerations rather than environmental realities.

Lincoln Steffens’ Shame of the Cities, published in 1904, definitively explained the causes and effects of urban blight. These same reasons can be tied to the rise of European urban centers in the Middle Ages and how everyday living conditions contributed to on-going epidemics, notably the Bubonic Plague which reemerged in France well into the reign of the “Sun King,” Louis XIV in the late 17th Century.

Wars such as the Thirty Years’ War and attempts at early “urban renewal” beginning in the 15th Century replaced the narrow streets with wider avenues.

Napoleon Bonaparte and his French successors redesigned Paris, building sewer systems and eliminating the narrow medieval passages, albeit for political reasons: it was far more difficult to erect barricades across wide avenues. But the efforts indirectly affected urban sanitation.

It took European society centuries to transition from the unsanitary conditions of medieval towns and cities. The few remaining examples of walled towns with their picturesque passageways hardly bear witness to the noisy, stench-ridden cities of the Middle Ages, ripe for disease and premature death.


Medieval elites used handwashing as a shrewd ‘power play.’ Here’s how.

The before-meal wash was an important ritual for peasants and nobility alike—especially since people often ate with their hands.

No everyday task has taken on more importance this past year than handwashing. From the beginning of the pandemic, when the Centers for Disease Control and Prevention (CDC) advised “cleaning hands in a specific way,” lathering and scrubbing for 20 seconds has become a ritual, especially when returning home after a foray into the coronavirus-plagued world.

It’s the sort of ritual that medieval Europeans would recognize, although for them it was often a more social exercise than we are currently allowed. People living in the Middle Ages are commonly assumed to have had poor personal hygiene, but in truth many were well-practiced in cleanliness. Born of necessity, handwashing evolved into a highly choreographed demonstration of power and wealth. It was a “sign of civility,” says Amanda Mikolic, curatorial assistant for the Department of Medieval Art at the Cleveland Museum of Art in Ohio. (Discover how pandemics changed medieval burial practices.)

Kings and peasants alike washed up before and after meals. Most people ate with their hands—cutlery was rare and food was often consumed using stale bread called trenchers. Washing away the day’s grime was necessary and a sign of respect for whoever was feeding you. "Let your fingers be clean, and your fingernails well-groomed," commanded Les Contenances de Table, a 13th-century medieval text on table manners.

Medieval nobility and clergy took hand and face washing to new heights, with the rituals around monarchs being especially elaborate. Those who dined with a medieval European king were greeted by minstrels playing beautiful music on a harp or vielle (a medieval ancestor to the violin) and ushered into a lavatory with “luxurious basins … fresh white towels, and scented perfumed water,” according to Mikolic. Surrounded by servants, guests cleaned their hands, taking great care not to sully the pristine towels. Women would have washed their hands before they arrived, ensuring that “when they blotted their hands on these white cloths, not a speck of dirt or soil would be there—proving their virtuous, clean nature.”

Once everyone was seated in the great hall, the king would enter. The guests would stand and watch as the king then washed his own hands. Only after the king had finished would everyone else take their seats. It was “a power play to show who’s in charge,” says Mikolic, “as most everything in the entire program was.”

Strict guidelines governed how the nobles ate, some of which would likely meet with CDC approval. Les Contenances de Table, as translated by Jeffrey Singman and Jeffrey Forgeng in their book Daily life in Medieval Europe, lists a whole range of dining rules:

“Once a morsel has been touched, let it not be returned to the plate.

Do not touch your ears or nose with your bare hands.…

It is ordered by regulation that you should not put a dish to your mouth.

He who wishes to drink must first finish what is in his mouth.

And let his lips be wiped first.

Once the table is cleared, wash your hands, and have a drink.”

Elaborate rituals required ostentatious tools. Crusaders brought luxurious Aleppo soap made from olive and laurel oils to Europe. Soon enough, the French, Italians, Spanish, and eventually the English all started making their own version of Aleppo soap with local olive oils rather than the smelly animal fat of centuries past. Perhaps the most well-known of these European versions is Spain's Castile soap, which is still made and shipped around the world today.

Ornate vessels such as aquamaniles (pitchers) and lavabos (essentially a hanging bowl with spouts) were filled with the warm, scented water used during handwashing. In the wealthiest households, servants would pour the fragrant water onto the hands of those dining. These receptacles were so prized that Jeanne d’Évreux, queen of France and wife to Charles IV, included several aquamaniles among the precious table decorations in her will.

But eventually handwashing began to fall out of practice. Many scholars blame the fork, which wasn’t commonly used until the 18th century. “The whole ritual nature around handwashing starts to fade when tableware starts to become more prominent, when households start having tableware for guests,” says Mikolic, “and then when you can actually eat while still wearing gloves.” (Modern table manners began in the Renaissance.)

It’s too early to say which pandemic-era rituals will stick with us. But today, long after aquamaniles and lavabos have gone out of fashion, handwashing can still be a way to show off one’s wealth. From hand-painted vessel sinks to costly soaps made with essential oils to plush Egyptian cotton towels, we continue to create luxurious rituals around washing our hands. Whenever she uses scented soaps, Mikolic says she’s reminded of the scented water of the Middle Ages. “I always chuckle.”


I assure you, medieval people bathed.

I can’t believe I have to write this down right now, but my dear friends, medieval people bathed regularly.

Yes. I assure you. I am very serious. It is true.

In fact, medieval people loved a bath and can in many ways be considered a bathing culture, much in the way that say, Japan is now. Medieval people also very much valued being clean generally in an almost religious way.

This is not to say that getting clean was as easy for medieval people as it is for us now. But medieval people were very clever and had ways of getting around that.

So, say you are an average-ass medieval person. That means you are a peasant, because 85% of the population or so were peasants. This meant that you were working very hard doing manual labour in a field. How would you stay clean? Well you would probably wash daily at home. This usually involved filling an ewer with water, heating it and then poring it into a larger basin which allowed for ease of scrubbing, like so:

Detail from Geburt Mariens: Kunstwerk: Temperamalerei-Holz Einrichtung sakral Flügelaltar Meister des Schottenaltars Wien Dokumentation: 1469 1480

You might also have a special wooden bathing tub that would be brought near the fire, as and when needed, and filled for a more luxurious bath on occasion, like so:

The Hague, KB, 76 F 21 fol. 15r Mary in bath Fol. 15r miniature. (Thanks to joshthomps for the attribution!)

So that’s how you got around the hot water problem, just a lot of work.

Say that you couldn’t or didn’t have time to heat up water though, what then? Well people would just bathe in a local water source, like so:

Armarium Codicum Bibliophilorum, Cod. 111, 2 r.

So, fine, regular people figured out how to get wet, right? Well, the other thing that is important to note here (and I can’t believe I am saying this), when washing at home medieval people used soap. Yes. I am serious. They did.

In fact soap is a motherfucking medieval invention. Yes. It is. The Romans – whomst I don’t see a bunch of basics going around accusing of being filthy – did not, in fact have soap, in contrast. They usually washed using oil. Medieval people? Oh you better believe that they had soap.

It was first introduced from the East, like most good stuff was at the time, but it took off rather quickly. Your peasant ass would likely have been making soap at home, and books of secrets often included various recipes for soap, all of which can still be made today. The general ingredients were usually tallow, mutton or beef fat, some type of wood ash or another, potash, and soda.

However, soap could also be purchased. As early as the seventh century soap makers guilds began to spring up , trading it as a high value commodity. If you were fancy enough to be buying soap you could also get the good imported stuff initially from Aleppo, which was traded heavily and involved laurel oil rather than animal fat. After importing rather a lot of this to Castille, in the twelfth century the denizens there got to thinking that they could probably create a similar product using the local olive oil. Voila! Castille soap was born and also became a popular trade good.

Castille soap is still available. We stan a legend.

Even if you couldn’t get the good fancy soap, many people would scent the water that they bathed in, often with thyme or sage. People often used herbs not just for washing, but in deodorant as well. Yes. They had deodorant. It was often made of bay leaves, hyssop or sage. In fact, one of the more popular medieval deodorant recipes came from Dioscorides, a Greek physician active in the first century AD. His De Materia Medica was super popular throughout the medieval period and advised readers on how to make a deodorant using salvia and sage.

Medieval people also regularly washed both their hands and faces both before and after meals when in between baths because – stay with me here – they knew that dirt and grime could be hazardous to their health if ingested. Yes. They did. They really really did. In fact, the whole washing after eating thing was an explicit health concern, because as medieval medical writers such as Magninius Mediolanesis noted,

If any of the waste products of third digestion are left under the skin that were not resolved by exercise and massage, these will be resolved by the bath.[1]

Our girl Hildegard of Bingen even had a recipe for face cleanser because apparently she was a skin-care bitch. She advises that,

one whose face has hard and rough skin, made harsh from the wind, should cook barley in water and, having strained that water through a cloth, should bathe his face gently with the moderately warm water. The skin will become soft and smooth, and will have a beautiful color.[2]

So yes, medieval people, even regular old peasants were pretty clean types of people. In fact, they were so clean that for them bathing constituted a leisure activity. So the average person would likely wash daily at home, but once a week or so they would treat themselves to a bath at the communal bath house. That is where the party was at.

Medieval bathhouses were big fucking business. In Paris Bathhouse Keepers constituted a guild and there were a specific set of rules that they had to follow in order to make sure they remained in good standing. [3] To whit:

  1. Be it known that no man or woman may cry or have cried their baths until it is day, because of the dangers which can threaten those who rise at the cry to go to the baths.
  2. No man or woman of the aforesaid trade may maintain in their houses or baths either prostitutes of the day or night, or lepers, or vagabonds, or other infamous people of the night.
  3. No man or woman may heat up their baths on Sunday, or on a feast day which the commune of the city keeps.
    And every person should pay, for a steam-bath, two deniers and if he bathes, he should pay four deniers.
    And because at some times wood and coal are more expensive than at others, if anyone suffers, a suitable price shall be set by the provost of Paris, through the discussion of the good people of the aforesaid trade, according to the situation of the times.
    The male and female bathhouse-keepers have sworn and promised before us to uphold these things firmly and consistently, and not to go against them.
  4. Anyone who infringes any of the above regulations of the aforesaid trade must make amends with ten Parisian sous, of which six go to the king, and the other four go to the masters who oversee the trade, for their pains.
  5. The aforesaid trade shall have three good men of the trade, elected by us unanimously or by a majority, who shall swear before the provost of Paris or his representative that they will oversee the trade well and truly, and that they will make known to the provost of Paris or his representative all the infringements that they know of or discover, and the provost shall remove and change them as often as he wishes.

You, my gentle readers may have picked up on something here, and that is that our girls the sex workers be showing right TF up in the public baths. This meant that whether or not you admitted them made the difference between whether you were keeping a bathhouse or a brothel. Here in London, of course the Stews in Southwark were essentially brothels where you could also have a bath (and were largely owned by the Bishop of Winchester (as you do). Having said that, there were plenty of people who went to bathhouses just to go to bathhouses and by 1292 in Paris, there were at least 26 running that could give you just a bath.[4] Medieval people related to this very much as we do having a spa day, and medieval bathhouses often included steam baths along with big wooden tubs where you could sit down and enjoy a meal. In order to stand out from the crowd, the Parisian bathhouses would even employ criers to advertise themselves.[5]

And, I cannot stress this enough, this was just for regular ass people. Rich people? Oh, you better believe they were bathing, and often had dedicated rooms for washing unlike the poors. They also might go places simply to bathe, like Bath in England, or the thermal baths in Pozzuli in Campania, which was so famous it had a whole ass poem, De balneis Puteolanis written about it. They could also afford that nice soap and perfume and all that good stuff. In fact they were so into poncey baths that most medieval knighthood ceremonies involved having a scented bath.

The baths at Pozzuoli. Valencia, MS. 838 F 4v.

So OK, clearly, fucking clearly medieval people bathed and were clean and into it. So why am I telling you all of this? Well the idea that medieval people didn’t bathe is a persistent myth that some basics on twitter will come at me with at least once a week. Why is that?

Well part of it is a modern misunderstanding of the idea of bathing. It’s true that we have medieval sources which warn against “excessive” bathing. But here’s the thing, that wasn’t really about being clean, it was about hanging out naked in bathhouses with the opposite sex. They didn’t want you to not be clean, they wanted you to not be going down the bath house and getting your fuck on.

And yeah, some holy people didn’t bathe, notably saints who would forego bathing themselves but bathe sick or poor people.[6] But if you bring that up you are missing the point. Medieval people thought that bathing and being clean was really nice, so giving it up and living with your stank was a sign that you had given up on the corporeal world and only thought of heaven. It was holy because it was uncomfortable, like wearing a hair shirt, or eating vegan, and hitting your chest with rocks and sitting in the desert trying not to wank. You know, standard saint stuff. It is mentioned because it is uncommon and uncomfortable.

These things, while they make sense in context are often taken by people who have never learned a damn thing about the middle ages and read in the worst possible light. If you intrinsically believe (and it is a belief) that the medieval period is the Dark Ages, and very bad, then you read stuff like this and just assume people are gross and dirty, even if there’s no real evidence of that.

You know what else helps? Well, in the modern period sometimes people were gross. In both the sixteenth and eighteenth centuries, there were times when some doctors claimed that bathing was harmful. This was often linked to the idea that bathing with warm water would open the pores and allow contagion in. And here’s the thing about that – a lot of people just don’t know what the medieval period is, but they are pretty sure it is when stuff was gross. So if they hear about doctors telling you not to bathe they are like, “LOL medieval people were gross”, even if that is going down smack bang in the modern period.

Now on the one hand we can see this as a historical quibble. After all it’s not like I don’t have a history of getting big mad about someone incorrectly relating to the medieval period. But here’s the thing, allowing myths like this to perpetuate allows us to keep upholding harmful ideas about the medieval period that furthers our colonialist ideas about history, and simultaneously allows us to gloss over all the harmful and gross stuff that we as modern people do. If we always blame medieval people for everything difficult it allows us to deny their humanity and write off a thousand years of thinking and culture that still influences us now.

[1] Quoted in, Fabiola I.W.M. Van Dam, “Permeable Boundaries: Bodies, Bathing, and Fluxes”, in, Medicine and Space: Body, Surroundings and Borders in Antiquity and the Middle Ages,(Brill, 2011), p. 125.
[2] Hildegard von Bingen’s Physica: The Complete Translation of her Classic Work on Heath and Healing, IV Barley.
[3] Etienne de Boileu, Le Livre des Métiers, in, Emilie Amt, Women’s Lives in Medieval Europe: A Sourcebook, (London and New York: Routledge, 1993) p. 162.
[4] Quoted in, Fabiola I.W.M. Van Dam, “Permeable Boundaries: Bodies, Bathing, and Fluxes”, in, Medicine and Space: Body, Surroundings and Borders in Antiquity and the Middle Ages (Brill, 2011), p. 125
[4] Jean Riolan, Curieuses recherches sur les escholes en médecine de Paris et de Montpellier, nécessaires d’estres sceuës pour la consevation de la vie, par un ancien docteur en médecine de la faculté de Paris(Gaspar Meturas, 1651), p. 219.
[5] Georges Vigarello, Concepts of Cleanliness: Changing Attitudes in France Since the Middle Ages, (Cambridge University Press, 1752) p. 21-22.
[6] Katherine Ashenburg, Clean: An Unsanitised History of Washing (Farrar, Straus and Giroux, 2008), p. 62.

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Cleanliness and Sanitation in the Middle Ages

The Middle Ages are often seen as a time when there was little knowledge about health and sanitation. But, attempts were made to keep communities healthy.

People in the 21st century have access to a range of anti-bacterial and specialised cleaning products, for both body and home. In the Middle Ages, the options were more limited. The first references to soap in Europe were made in around the year 1000. Bristol was particularly well-known for the number of soap makers in the city during medieval times, proving that there was a demand for such a product, at least among those who could afford this luxury. Around 180 soap makers worked in the city in the sixteenth-century, making hard and soft Bristol soap mainly for sale to shops in London.

Soap-Making in the Middle Ages

Medieval soap was made from ash and lime mixed with oil and beer or mutton fat which was heated to a high temperature before being mixed with flour and made into the required shape. Soap makers often worked as butchers or chandlers, or had close associations with these, because of the close associations between the two trades, which both used animal fats extensively.

Cleanliness in Medieval Times

Personal cleanliness in medieval times was hampered by a lack of access to fresh water supplies and frequent problems with sewage disposal in medieval towns. During medieval times, it was widely believed that bad smells were the cause of disease and so if the smell could be combated, the threat of disease was lessened.

Town authorities across Europe made attempts to get rid of their rubbish and sewage, even if the link between waste and disease wasn’t fully understood. In the late thirteenth-century, the Great Conduit of London supplied the city with clean water and in other towns, rivers were often used to carry away waste, to the detriment of those downstream.

Another problem was the lack of separation between industrial and domestic living areas. Many industries such as butchery, dyeing and tanning were carried out in or alongside living accommodation, meaning that dirt and strong, foul smells were part of everyday life. Waste from these industries often made its way back into the local water supply, further endangering health.

The widespread practice of covering floors with a rush matting was another potential health hazard. Unless the floor covering was changed frequently (as in the wealthiest households), animal droppings and particles of food would rot within the rushes, spreading germs and disease.

Medieval people did wash, often in cold water, and many cleaned their teeth, with a cloth dipped into a solution of herbs or ash. Only in the wealthiest households did people have access to warm baths in wooden tubs. For everyone else, washing in a stream, river or bowl of cold water was the only available option.


The (not so) stinky Middle Ages: why medieval people were cleaner than we think

Did people in the Middle Ages take baths? Did they wash their clothes and hands – or have a general awareness of hygiene practices? If there’s one thing we think we know about our medieval ancestors, it’s that they were mud-spattered, lice-infested and smelt like rotting veg. Yet the reality appears to have been far less pungent. Here, Katherine Harvey digs the dirt on the medieval passion for cleanliness

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Published: March 3, 2020 at 11:08 am

In the film Monty Python and the Holy Grail (1975), two minor characters spot King Arthur. They know who he is because, as one of them points out: “He must be a king… he hasn’t got shit all over him.” The scene encapsulates an enduring belief about the Middle Ages: medieval people, and especially medieval peasants, were dirty and smelly.

This impression is bolstered by examples of real medieval people who rarely washed, such as Queen Isabella of Castile. She supposedly boasted that she had bathed only twice in her life: on the day she was born, and on the day she married Ferdinand of Aragon. And it is undoubtedly true that, like everyone who lived before domestic plumbing and electricity became the norm, medieval people would have struggled to abide by modern standards of hygiene, even if they had wanted to. Nevertheless, we should not assume that pre-modern people were indifferent to personal hygiene, because we know that many people – including Isabella’s own daughter – made significant efforts to keep clean. Juana of Castile bathed and washed her hair so often that her husband feared she would make herself ill.

Archduke Philip’s concerns for his wife were rooted in contemporary medical theory, which suggested that too much washing could weaken the body. But, on the other hand, it was widely acknowledged that regular washing was necessary for good health, because it cleaned visible dirt from the body. Washing also removed the invisible excretions, including sweat, which were believed to be the potentially harmful side-products of digestion. If the latter were not removed, they could cause health problems including skin conditions and parasitic infestations.

Consequently, both medical writings and advice literature were full of exhortations to good hygiene. Readers were instructed to wash their hands, face, mouth and head every morning, and to wash their hands throughout the day, particularly before meals.

Did medieval people take baths?

Contrary to popular belief, medieval doctors were enthusiastic about the benefits of bathing. They urged caution during epidemics, because heating the body opened the pores to disease, and because sickness spread easily in bath-houses. But they also thought that bathing could prevent and cure illness, and prescribed it for conditions ranging from bladder stones to melancholy. Nightly bathing or foot-washing was a popular late medieval cure for the common cold.

So, the benefits of good hygiene were well established, but did medieval people follow the medical advice? All the evidence suggests that rich people washed regularly, and spent a lot of money on making bathing a luxury experience – for example, by supplementing wood-ash soap with expensive scented oils. Although he had many faults, King John almost certainly didn’t smell. He travelled with a bath-tub, employed a bath-man, and once took 10 baths in six months. His descendants had even better facilities: in 1351, Edward III bought new taps for his Westminster bath chamber, which had both cold and hot running water.

The medieval hygiene guide

5 tips for combating grime in the Middle Ages

1) Clean with wine

“There are some women who have sweat that stinks beyond measure,” noted the 12th-century writer Trota of Salerno. She advised cleaning them with a cloth dipped in wine in which “there have been boiled leaves of bilberry, or the billberries themselves.”

2) Invest in a basin

Although medieval people didn’t bathe in the morning, they used an ewer and basin to wash their hands and face when they woke up. The same equipment was used for handwashing throughout the day.

3) Turn to urine

Our ancestors washed clothes and domestic linens in a tub, or in a river or a stream. And to ensure that their garments emerged thoroughly ‘clean’, they sometimes added stale urine or wood ash to the water.

4) Shave your hair…

One way to combat dirt was to shave or pluck unwanted hair. Then people were advised to prepare a mixture of ground needle seeds and vinegar, do some vigorous exercise to warm the body, and smear the mixture on the skin.

5) …or wash it

Doctors recommended washing hair – at least once every three weeks – with water and herbal preparations. Hair was combed daily, sometimes with special powders made from sweet-smelling ingredients such as rose petals.

Such luxury was limited to the grandest royal residences, but many households owned a large wooden tub, lined with cloth and sometimes covered by a canopy, which could be filled with hot water heated over the fire. Ownership of basins and ewers (large jugs) used for washing the hands and face extended to all but the poorest. Robert Oldham (d1350), a well-to-do Oxfordshire peasant, owned two basins and four ewers. Washing equipment made up a substantial portion of the possessions in his sparsely furnished home.

Not all washing was done at home, and town-dwellers could enjoy a trip to the public baths. Alexander of Neckham, who lived in Paris in the 1170s, complained that he was often woken in the morning by street cries of, “The baths are hot!” A few decades later, there were at least 32 public baths in the city.

During the summer, many people washed in rivers, lakes and ponds. Sadly, we know about such outdoor bathing practices mainly from coroners’ records, which include numerous cases of death by drowning. One evening in April 1269, 12-year-old John White “took off his clothes and entered a certain stream to bathe… he was drowned by misadventure”. The river Thames claimed the lives of several 14th-century bathers, among them Robert de Leyre, who “went to the wharf and entered the river to bathe. No one being present, he was by accident drowned.” Elsewhere, a 10-year-old boy drowned in a marketplace trough as he washed his hands and bowl after eating.

Medical advice suggested that, as well as washing their bodies, people should wash their hair – chiefly because it was a form of excrement, produced from the waste products of digestion (which rose as fumes to the uppermost part of the body). Consequently, hair should be washed at least once every three weeks this opened the pores in the head, releasing bad vapours from the body. Hair was cleaned with water, sometimes mixed with ash and herbs to make it shiny and sweet-smelling. Daily combing was also important, and was sometimes combined with the sprinkling of special powders (made from fragrant ingredients such as rose petals).

Medieval people were also well aware of the importance of good dental hygiene. They were advised to rinse their teeth with water on waking, to wash off any mucus that had built up overnight. Gilbert the Englishman, a 13th-century doctor, suggested rubbing teeth with powders made from herbs such as mint or marjoram, although he cautioned against using hot spices which would make teeth rot. He also advised patients “to dry the teeth after eating with a dry linen cloth… so that no food sticks to them, and there will be no putrid matter among the teeth to make them rotten.” According to Gerald of Wales, the Welsh were particularly enthusiastic teeth-cleaners: “They are constantly cleaning them with green hazel-shoots and then rubbing them with woollen cloths until they shine like ivory.”

Did people wash their clothes in the Middle Ages?

Of course, washing the body was only truly effective as a form of personal hygiene if it was combined with regular washing of clothing and bed-linen. At the very bottom of the social hierarchy, extreme poverty may have limited peasants’ ability to wash their clothes. In some 14th-century Burgundian villages, for example, it seems that many people literally owned only the clothes they stood up in. In this, sadly, the Burgundians were far from alone.

Gerald of Wales described how his poorer countrymen “keep on the same clothes [in bed] which they have worn all day, a thin cloak and a tunic, which is all they have to keep the cold out”.

However, there is ample evidence to suggest that most people owned at least a change of clothes, and that they washed them relatively frequently. Typically, this was women’s work: in the words of a popular late medieval verse: “A woman is a worthy thing/They do the wash and do the wring.”

Clothes could be washed in a tub, often with stale urine or wood ash added to the water, and trampled underfoot or beaten with a wooden bat until clean. But many women did their washing in rivers and streams, and larger rivers often had special jetties to facilitate this, such as ‘le levenderebrigge’ on the Thames. In fact, so great was the popular enthusiasm for washing that it sometimes caused complaints. In 1461, Coventry banned the washing of clothes at the town conduits, because it caused a public nuisance 20 years later, the prior of Coventry complained that “the people of this citie hurten the ffyshe in Swanneswel-Pole be the wasshyng ther”, but was reminded that the people had been allowed to wash there since time immemorial.

Like bathing, laundry could be dangerous: in 15th-century Paris, the nurses of the Hôtel Dieu “waded in the mud of the Seine quite frozen up to their knees” to wash their patients’ sheets. Around the same time, an English teenager died when, washing his socks in a pit one Friday after work, he fell in and drowned.

Read more about the history of medicine

How did people in the past treat illness, injury and disease? What medicines did they use?

Such enthusiasm for laundry, despite the practical difficulties and potential dangers, was surely linked to the well-known health risks associated with dirty clothes. Until the 17th century, people thought that parasites were produced by spontaneous generation – that is, they did not hatch from eggs, but formed from existing matter, including dirt on the skin and clothes. As the theologian and philosopher Albertus Magnus put it, the louse is “a vermin which is generated from the putrescence at the edge of a person’s pores or which is amassed from it as it is warmed by the person’s heat in the folds of his clothing”. Parasitic infestations probably were fairly common, especially among the very poor, but people did their best to avoid and treat them by using herbal remedies and practising good hygiene. Thomas Platter, a poor German student, described his efforts to rid himself of lice by picking them off his shirt, before washing it in the river Oder.

Only one section of medieval society actively embraced poor personal hygiene, including lice, as a way of life: the extremely pious. Queen Isabella’s avoidance of bathing should be understood within the context of this strong Christian tradition: it did not reflect social norms, but rather the efforts of an extremely devout woman not to overindulge her body. For medieval Christians, washing oneself could be seen as evidence of excessive worldliness. The Italian mystic Catherine of Siena often wept as she recalled how, as a teenager, she had been persuaded to wash her face and comb her hair more often, in order to attract suitors. Despite her confessor’s reassurances, she remained convinced that she had committed a mortal sin by obeying her mother’s wishes, rather than prioritising her faith.

A handful of saints went further still, and embraced filth as a form of asceticism – that is, a behaviour that caused suffering to the individual, and thus both demonstrated and deepened his or her commitment to God. Their approach to personal hygiene was not just negligent, but deliberately harmful. For example, St Margaret of Hungary refused to wash her hair so that she would be tormented by lice.

It has to be pointed out that dirt was not required of the devout. Indeed, monks and bishops were early adopters of running water (and associated washing and toilet facilities) in their residences. Nevertheless, even the most rich and powerful churchmen were prepared to get filthy for their faith, concealing their penitential garments (and the creatures that lived in them) under their splendid vestments. After Thomas Becket was murdered in his cathedral, the monks who prepared his body for burial discovered that his underclothes were “swarming… with minute fleas and lice”, which they interpreted as a form of martyrdom. During the canonisation inquiry for Thomas Cantilupe, bishop of Hereford (d1282), his servants reported that he never bathed, and his bedding and clothing contained whole handfuls of lice. When Cantilupe’s old clothes were given away to paupers, they had to be deloused: even those poor enough to need charity would turn down such dirty garments.

The bishop’s willingness to embrace such an unhygienic lifestyle was deeply impressive to medieval Christians because it was atypical, and because his contemporaries, including the very poor, found it as repulsive as we do. Most medieval people probably were dirty, and perhaps even smelly, by our standards – however hard you try, it must be nearly impossible to make a cold, muddy river work as well as a power shower and a washing machine. But only a tiny number of medieval people were truly filthy. Even fewer actually wanted to be dirty.

Katherine Harvey is a historian of medieval Europe based at Birkbeck, University of London. She will be discussing medieval hygiene on our podcast

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Hygiene in Medieval: Was it really that bad?

Accounts of medieval hygiene are wildly exaggerated. People did bathe, especially the upper classes who had servants to bring them hot water etc. Some palaces and castles had bathrooms. A queen would certainly have bathed quite often. Monasteries often had piped water and sewer systems.

The common people didn't bathe as often, but then this remained the case up until the 20th century. Most people didn't have indoor plumbing, so bathing was hard work. How often do you think you would bathe, if you had to fetch buckets of water from a well or fountain, heat them up over a fire, fill and empty the tub by hand? I doubt you would do all that every day. Most common people in medievalmtomes had work quite hard to have a bath. There is also some evidence thst people may have taken forms of "sponge baths" using pitchers of water and small towles, moistening and wiping themselves down. There are also references to people washing their heads. There are many references to people washing their feet. Toothpicks were used to remove food from between teeth, and health manuals ascised rinsing out the mouth with solutionsmof wine or vinegar and scrubbing the teeth with towels. People also chewed on mallows, reedy olants that grew in marshy areas and from which the substance "marshmallow" was originally derived. Soap was made domestically by combining potash from wood ashes with rendere animal fat (lard) and then allowing the mixture to cool and solidify. Those people who could afford it bought and used milder, olive-oil based soaps, made in Italy and Spain.

Many towns had public bath houses, which were very popular. For instance, Matilda, wife of Henry I, built the first publuc baths and public lavatories in London. Illustrations of public baths and bathing are found in many sources. These illustrations depict public baths as long halls with many large tubs or as shallow pools of varying sizes, either man-made or natural ones, bordered and finished with stone or tile. Sometimes pictured were the large furnaces that heated the water and produced steam for the saunas.

Clothes and bed linen were laundered, and in castles for instance professional laundresses were employed to do the washing. Linen, which was worn next to the skin, was washed as frequently as people could manage. Health manuals recommend sleeping on beds whose linens were changed and cleaned regularly and books on household management streszed that a wife's duties included keeping the bedding and her husband's clothing clean.

Medieval towns had wells to provide water, and sometimes public fountains which were kept supplied with spring water brought into the towns via conduits, or sometimes even transported in casks. Civic water mains were major feats of construction.

Latrines, both public and private, were often placed alongside or even spanning streams or rivers. The practice of building houses and businesses on bridges was motivated in part by the easy disposal of sewage and other garbage provided by the river flowing below. Attempts were made to stop people building latrines that emptied into rivers, but they always seemed to come back. Some residents did dump their sewage out of the window or into the gutter, but this could result in prosecution or a fine. A more sanitary and legal method of disposal was to use a cesspit. These pits, both large public ones and small private ones, were a common feature in medieval cities. Gongfermors were regularly used to dig outmpits that had filled up with sewage. Cesspit cleaning was often limited to the nighttime. Regulations of the city of London as early as 1189 specified that cesspits had to be at least five and a half feet inside the property line (stone lined pits could be built within two and a half feet of the property line). Public toilets were also a common feature of medieval cities. In cities that processed sheep fleeces into wool cloth, the public toilets served an additional function, the collection of urine for commercial use. Urine was collected and sold to wool processors, who used the urine to remove oil from the wool, an essential step in turning wool into good quality cloth.

The above information comes from Daily Life in the Middle Ages by Paul B. Newman


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