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Bathing went out of fashion in Europe after the Black Death to such a degree that people thought bathing was unhealthy. What if this kind of fear of bathing struck those in Europe as early as the Antonine Plague of 165 AD? I'm sure there wouldn't be MASSIVE changes, but I'm sure there would be a different attitude to what constitutes "cleanliness" for the Romans and early European Kingdoms. I'm guessing the Romans would concentrate on different building projects too. For example, no Baths of Caracalla. Maybe the stereotype of High Middle Ages' people being filthy would actually be true in this TL?
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