Public health improvements in 16th century Europe

Re: this article on leprosy

What would those be? This was way before the cholera / water souce connection was discovered.


Quarantine, possibly.

Leper asylums, which I guess is similar to hogarth’s quarantine reference.

How historically accurate is the “Valley of Stone” scene, from the movie Ben Hur?

Set in the time of Jesus, lepers (according to the movie) were banished to a remote cave in the wilderness. It was shown as being at the bottom of a cliff. It appeared that they were supplied with food using cranes from the top of the cliff.

Well, in the late 1600s population pressure started relieving in the larger cities by the colonies in the US forming, along with better nutrition being available [combination of food being shipped in from the country side and from the colonies] and a wider variety of foods from various colonies.

Nutrition has almost as much influence on health as sanitation - the healthier you are the better you withstand illness.

And with the colonies being opened, if you did not have a farm share due, you could move to a colony instead of a London or Liverpool slum.

I am a bit confused about what people thought caused disease-before the germ theory (Pasteur, ca. 1880), people believed that disease came from “miasmatic air” or “bad air/malaria”. So they knew that polluted water, garbage, sewage contributed to disease. The Romans knew this, and built sewers to carry waste away from cites. Why didn’t the “medical experts” of the time conclude that cleaning up cities would reduce disease? Bad smells were a sign of a disease-ridden environment. Why the disconnect? In the story of the “Mayflower”, I read that the British colonists had enough sense not to drink polluted water-tea or beer was healthier. So people knew that disease was spread by dirty water and air.

There were efforts to keep things relatively sanitary even in Medieval times. As you say, people had made the connection between disease and filth, and even aside from that, it was just as true then as now that no one particularly wants to draw water out of the same river used for waste disposal. So London, for example, had the Great Conduit as early as the 13th century so people could avoid drinking out of the Thames, and there were ordnances for trash disposal from an equally early period. The idea that pre-modern people happily wallowed in their own filth isn’t true.

But with limited technology, weak social institutions to enforce compliance and cities growing at an accelerating rate with little in the way of central planning, there was only so much they could do. Not unlike third-world cities today, its not that they don’t know poor sanitation is bad for them or like living next to their own sewage, its just that its hard to keep things clean with no resources, little political organization and and ever-growing number of people living in a small space.

You don’t need to know that cholera comes from water to know that dumping fecal matter and dead bodies in water might make it bad to drink.

One area of “disconnect” was in what you could see vs. what you couldn’t see. Nobody knew about micro-organisms. So, for example, if your hands were visibly filthy, and in particular you could see little vermin, then it was easy to guess that there was disease there.

But if your hands (or the water, or whatever) didn’t have visible organisms in them, it took a lot longer to figure that out. And, furthermore, people didn’t even know of the existence of microorganisms, let alone their connection to disease. There were all sorts of other strange notions of diseases and their causes kicking about. (Bad humors, vapors, evil spirits and demonic possession, witchcraft, . . . )

I think a major advance of the day, that turned a major corner in the concepts of health, was the improved development of the microscope by Anton van Leeuwenhoek in the 1650’s, which helped found the science of microbiology. (There was and still is a famous popular-science book Microbe Hunters by Paul de Kruif, 1926, that tells the story.)

You might look up George Sorocold as a pioneer of water supply.

Keeping medieval towns and cities was a problem because the administration was simply not up to it.

Few towns had the power to raise revenue on a scale that would pay for public works and waste collection, in most towns the responsibility for clearing up was often put into the hands of locals who were tasked with keeping a designated area ‘clean’ through local by laws. These were only rarely enforced since there was very little in the way of local officers to do it - again down to the lack of public officials due to lack of the means to pay them.