All The Afflictions You Might Have If You Lived In A Medieval City

Life in the Middle Ages was dangerous. Whether living in a communal setting, fighting abroad, or simply tending a field, there were numerous challenges that could bring it all to an end. Life inside a castle or a monastery may have offered some protection, but you were just as exposed to horrible, contagious diseases as everyone else.

As they developed, medieval cities were particularly susceptible to afflictions resulting from a lack of hygiene, poor sanitation, and overcrowding. Such poor hygiene practices certainly contributed to the spread of the Black Plague. Many diseases that affected people during the medieval period were similar to those of the ancient world or continued on through the early modern period. Others have mysteriously reappeared today, hundreds of years later. Luckily, better understanding and medical technology have brought on cures, treatments, and preventatives that make them far less devastating.

With all of the potential risks to a person's health that existed in a medieval city, the Middle Ages may have been one of the most dangerous eras in history.

  • Leprosy
    Photo: James le Palmer / Wikimedia Commons / Public Domain

    Caused by the Mycobacterium leprae bacteria, leprosy is, arguably, as misunderstood today as it was during the Middle Ages. Now called Hansen's Disease, leprosy results in skin lesions and nerve damage that can impair a person's eyes and limbs. Leprosy develops slowly, and visible symptoms can take decades to manifest. 

    In medieval society, lepers were shunned and cast out of cities, towns, villages, and even the smallest of communities. Leper hospitals were established outside of town centers during the 12th century in France and the Low Countries. Facilities tasked to solely care for lepers were known as leprosaria (or leprosariums) and fell under the charitable auspices of the Church.

    Leprosy was common in both the Byzantine Empire and Western Europe from the 12th century forward, often transferred by pilgrims and Crusaders. Lepers were refused burial alongside non-lepers thanks to the Old Testament passage Leviticus 13:44-46:

    He is leprous, he is unclean. The priest shall pronounce him unclean; the disease is on his head. The person who has the leprous disease shall wear torn clothes and let the hair of his head be disheveled; and he shall cover his upper lip and cry out, “Unclean, unclean.” He shall remain unclean as long as he has the disease; he is unclean. He shall live alone; his dwelling shall be outside the camp.

    The social class of the leper dictated their overall reception, however. Alice the Leper, a lay sister from the Cistercian monastic order, remains the patron saint of the blind and the paralyzed after becoming both due to her leprosy. 

  • Bubonic Plague
    Photo: Pierart dou Tielt / Wikimedia Commons / Public Domain

    The Black Plague spread from Asia into Europe during the mid-14th century, resulting in millions of casualties in the process. No one was immune from the Black Plague, a general term for the three different types of plague caused by the Yersinia pestis bacteria. Most commonly spread by infected fleas carried on cargo ships, the plague could manifest in bubonic, pneumonic, and septicemic forms.

    The bubonic plague affected one's lymphatic system, causing swelling and discoloration of the areas around the lymph nodes - known as buboes. The pneumonic plague infiltrated the lungs, while the septicemic plague resulted when the bacteria entered an individual's bloodstream. The pneumonic was the most dangerous and infectious because it could be transmitted through airborne blood droplets. 

    According to 14th-century Italian poet Giovanni Boccaccio, the plague affected "men and women alike... at the beginning of the malady, certain swellings, either on the groin or under the armpits… waxed to the bigness of a common apple, others to the size of an egg, some more and some less, and these the vulgar named plague-boils.”

    Other symptoms included fever, vomiting, body aches, and, more than 50% of the time, loss of life. The Black Plague terrified everyone:

    One citizen avoided another, hardly any neighbour troubled about others, relatives never or hardly ever visited each other. Moreover, such terror was struck into the hearts of men and women by this calamity, that brother abandoned brother, and the uncle his nephew, and the sister her brother, and very often the wife her husband. What is even worse and nearly incredible is that fathers and mothers refused to see and tend their children, as if they had not been theirs.

    There were so many cadavers in many medieval towns and cities that they reportedly "[f]illed every corner... Although the cemeteries were full they were forced to dig huge trenches, where they buried the bodies by hundreds."

  • St. Anthony's Fire

    St. Anthony's Fire, caused by eating grains contaminated with the Claviceps purpurea fungus, is also known as ergotism. The ergot fungus grows on moldy grains and, once ingested, can cause redness, swelling, and gangrene. Rye was produced and consumed in large quantities by the poor and was especially susceptible to the ergot fungus, so the disease affected the lower classes in the greatest numbers.

    When one is first struck with St. Anthony's Fire, red spots appeared on the flesh. The initial burning soon becomes excruciating as limbs swell; people often hallucinate, with some in the past believing they were in a fight with the devil. Sometimes, people have convulsions, but as their extremities begin to rot, toes, fingers, ears, and even arms or legs can fall off. Based on an account of the St. Antony's Fire outbreak that struck southern France during the 10th century:

    The afflicted thronged to the churches and invoked the saints. The cries of those in pain and the shedding of burned-up limbs alike excited pity; the stench of rotten flesh was unbearable.

    In 944 CE, 40,000 people in France perished from St. Anthony's Fire, and monastic hospitals were built throughout Europe to treat victims.

  • Sweating Sickness
    Photo: Pieter Cornelis Dommersen / Wikimedia Commons / Public Domain

    Sweating Sickness

    Largely associated with England, "sweating sickness" appeared several times from 1485 to the late 16th century. In 1485 alone, sweating sickness took the lives of 15,000 people in London. After the initial onslaught of the disease, it faded until 1508 and reappeared again in 1517. The sweating sickness jumped to Continental Europe and struck Flanders, Germany, Sweden, and several other locations during the 1520s before it reemerged in England for the last time in 1551.

    The initial symptoms of the sweating sickness were "a sense of apprehension" followed by headaches, pain in one's back and shoulders, and nausea. This was followed by excessive sweating, delirium, and abdominal pain. The more severe symptoms lasted anywhere from 15 to 21 hours and accompanied extreme fatigue which could result in a coma or loss of life. 

    The sweating sickness mostly affected the upper class and could end the life of an adult in a matter of hours. During the outbreak of 1529, King Henry VIII so feared getting the disease that he "left in great haste, and went a dozen miles off" to hide from the affliction.

    Researchers have theorized that the sweating sickness was caused by typhus, influenza, botulism, or the hantavirus, but no definitive source of the disease has been found.

  • Tuberculosis
    Photo: Metaweb (FB) / Public domain

    Called the "white plague," "consumption," or "king's evil" during the Middle Ages, symptoms of tuberculosis include a fever and persistent coughing that can result in expressing white phlegm or blood. When the lymph nodes in one's neck become enlarged, the disease is also called scrofula

    Tuberculosis was believed to be contagious, but there were assertions that royalty could cure the disease with a simple touch. As early as the 11th century, King Edward the Confessor in England and Philip I in France conducted ceremonies to touch individuals suffering from scrofula. Those afflicted and touched received "touchpieces," or gold coin amulets, signifying the event. 

    Tuberculosis mostly afflicted poor town dwellers living in less than hygienic conditions.

  • Dysentery
    Photo: Guillaume de Boldensele / Wikimedia Commons / Public Domain


    Also known as "the flux," dysentery was endemic during the Middle Ages, common in medieval towns, cities, villages, monasteries, and among groups of soldiers. Dysentery results from bacteria or parasites in water or contaminated food and causes bloody diarrhea, fever, and dehydration.

    St. Martin, Bishop of Tours (d. 397 CE), described his own bout with the disease as so bad that he "completely gave up any hope of living."

    The cause of dysentery was generally unknown during the Middle Ages. During the 13th century, Arnau of Vilanova recounted the case of a youth who had "uncontrolled dysentery" and was asked by his physician where he got his food and water. The boy responded he got water from a stone cistern. The doctor advised him to stop drinking what he believed was "calcinated water" resulting from the stone and cement that lined the cistern. He supposedly quickly recovered after he stopped drinking the water.

    We know now that "calcinated water" was not the problem, but because the doctor inadvertently stopped him from drinking from a tainted water source, he did improve. In another instance, however, the disease was attributed incorrectly and the physician's advice had no effect on the patient; Vilanova mentioned an open roof allowed the wind to bring in dysentery.

    Generally, no one was safe, a fact 15th-century Italian polymath Girolamo Savonarola made clear when he observed that pestilential dysentery affected "not only in the same house but also in an entire locale, and with [the affliction] moving from a child of ten or fifteen to a sexagenarian." Savonarola himself came down with dysentery in 1495