What was the highest level of sanitation/medicine plausible in Medieval Europe?

Discussion in 'Alternate History Discussion: Before 1900' started by Drunkrobot, May 12, 2019.

  1. Drunkrobot Well-Known Member

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    So let's talk shit.

    Most historians seem to agree that Europe in the Middle Ages, most particularly the period of the High Middle Ages from about 1000 CE to 1300 CE, was very far from the completely ignorant and plague-riddled mud farmers portrayed by Monty Python, but it would also be too much to say it had public sanitation and medicine comparable to today. Medicine was ultimately founded on the theory of humours and people commonly chucked their refuse out onto the open street. Infant and child mortality was at a level we would deem traumatically high.

    Taking the period of 1000 to 1300 into consideration (admitting, of course, that even this limited stretch of time saw monumental change such that the beginning of the period was drastically different from the end), what improvements to public health were eminently feasible with the technology and social structures of the age? What advances were achievable by physician blessed with exceptional genius, royal patronage, and a bit of luck? What obstacles were in the way for these advances to be implemented on a wider scale?
     
  2. Mongo Well-Known Member

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    I would say that the biggest single advance in terms of impact on life expectancy would be safe drinking water. A basic slow-sand water filter would be possible, and fairly inexpensive to operate. Its output, while far from modern standards, would be much safer (and more palatable) than unfiltered water.
     
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  3. Thoresby Well-Known Member

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    There was massive scope to improve sewage disposal, gong farmers had their place and a Cloaca Maxima equivalent dumping everything in the river would be wasteful, solid waste is useful fertiliser and liquid is useful for tanning and dying, but some sort of system to automatically get waste out of the city to where it can be processed is technically possible and would be extremely useful.
     
  4. Gannt the chartist Well-Known Member

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    Tea
     
  5. sloreck Grunt Bear

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    "medicine" would require a lot of PODs, part of the problem was the attitude of the church towards experimentation, anatomical study, disease as a punishment etc. Basically sanitation (sewers, not dumping waste in the street), better wells water filtration and so forth. Handwashing and better food sanitation, wounds being cleaned even soap and water or alcohol. Sanitation and other public health measures could do a great deal, require no significant theoretical advances, and would be relatively inexpensive.
     
  6. The Tai-Pan The Pagemaster/Plogmonger

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    Look at what China and Japan was doing.
     
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  7. Richard V Well-Known Member

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    Take it up a level with bank filtration. Add composting toilets. That’s about the best they can do AFAIK.
     
  8. Kaze Well-Known Member

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    One of the easiest methods would be the system in place within some of the major Song Dynasty cities prior to the Mongol invasion where there was a guild that would take the leavings within the local chamber pots for a price, they would haul it off, and distill it for fertilizer, and then sell for the use in local gardens and fields. The down-side of the guild would be also the problem of what the major Song Dynasty cities had - paying the guild, if on whim they decide to up the price or want their annual New Years "gift" (bribe) they might do one of several things if you do not pay up - firstly not pick up your camber pot even if you asked a hundred times, secondly they would come to your house in the middle of dinner time and toss your neighbor's camber pot into your window. For some mysterious reason the guild was never defied or brought to trial - I wonder why?
     
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  9. Jared Voldemort Jnr

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    Because no lawyer would take on such a shit case, and even if they filed something the judge would assume they were taking the piss.
     
  10. sloreck Grunt Bear

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    There is a problem with using human waste (AKA nightsoil) as fertilizer. Bacteria, viruses, and parasites that are in nightsoil are from humans and optimized/adapted for infecting humans. In order to use nightsoil you need to disinfect it. OTL there are many municipal sewage systems that do this (example "Milorganite" produced in Milwaukee, WI), however this is a relatively modern process well beyond any society in 1000 CE. Disease transmission from fields fertilized with human waste, as opposed to horse or cow manure, is much more problematic. Proper waste disposal, making clean(er) water available, public sanitation, handwashing, some basic wound cleaning, are pretty much as much as you can do at this time. Going much further than this requires the germ theory of disease (and antisepsis), basic chemistry/pharmacology, anatomy, and the scientific method - all of which were prdoucts of the period 1750-1900 (roughly).
     
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  11. Thoresby Well-Known Member

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    Something not dissimilar to that was happening in mediaeval Europe, it was known as gong farming. The problem with that was gong farmers collected waste from cesspits and the street which meant you had waste lying around for a while until the gong farmer came along. What you'd want is a system that combines Roman sewers for the hygiene benefits with medieval gong farming via the waste being transported out of city automatically by sewer to somewhere it can be processed.
     
  12. My Username is Inigo Montoya Virile Member

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    Would medieval Europe and the Muslim world be better off if the four humours theory had been lost after the Fall of the Roman Empire?
     
  13. marathag Kicked

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    Look at what the Romans had done.

    Those ruins were all around them
     
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  14. HB of CJ Well-Known Member

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    Mongo nailed it and thank you. Scientific Method. Dug wells. Sand filter shallow wells. Perhaps, (?) Standard type sanitary septic systems? Possibly. Again, soap. Hand washing. Daily bathing. Cleaner abodes. Cleaner towns and cities. Better diet if possible. Washing out open wounds with winter wine. Stopping institutional resistance to experimental scientific methods. This might be impossible. Catholic Church or just general organized religious resistance. Better homeopathic disease treatments. Now kidding a little. More cats.
     
  15. Thoresby Well-Known Member

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    Roman cities were healthier because of baths not because they had better sewage disposal, well done gong farming is better than pouring raw sewage into rivers.
     
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  16. marathag Kicked

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    Healthier from that, but do not underestimate clean drinking water, rather than polluted river and well waters.
     
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  17. Mongo Well-Known Member

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    I saw a chart once, showing yearly infectious disease mortality in the UK from the early 1800s to the year the chart was made, and with significant public sanitation and health events (water purification, sewage treatment, antibiotics, major vaccines, and so on) superimposed. By far the biggest reduction in mortality was due to the widespread introduction of safe drinking water (something like 80% to 90% of the TOTAL reduction in infectious disease mortality).
     
  18. sloreck Grunt Bear

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    @ mongo: Absolutely clean water, adequate sanitation (sewage/garbage), and protecting the food sources do the vast majority of the gains in public health. Vaccinations are the next step - really the only way to prevent many diseases, sanitation can help for some but for many only vaccination is truly effective. Typhoid, polio, cholera are water borne, plague comes from fleas off rats (primarily) so better sanitation cuts rats back. Measles, smallpox, and many others are airborne so "sanitation" really not a big influence.
     
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  19. piratedude Pirate Lord of the Great Lakes

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    A lot of good ideas guys, but there is more to the problem of city sanitation than just proper waste disposal (although that helps significantly).

    The cities of Medieval Europe were pupulated by animals as much as humans, kept by residents as well as brought in from the country for market. As long as you have dense populations of people living alongside animals like that there's going to be a not insignificant chance of disease transmission
     
  20. Thoresby Well-Known Member

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    Well the Roman way around that was the capital intensive method of aqueducts to bring in clean water from far away while they made the local river a polluted mess. It worked but it cost a hell of a lot. I think on balance the Roman approach of aqueducts plus sewers was better than the Medieval gong farming method but aqueducts plus gong farming would have been the ideal, especially if you could have widespread baths and a bathing culture.

    As for animals in cities there's no way around it. Either you slaughter close to the consumer or you have massive food spoilage issues while horses and oxen in cities are essential as a source of motive power.
     
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