Anyone who sees many feature films or Netflix series about the Middle Ages thinks that it was mainly a dirty mess back then. “That’s why I wanted to know if they really used to shit in the street and throw all their dirt out the window, as if life was in one big Monty Python movie, with those dirty faces and clunky clothes,” he says. René de Kam in his office in the center of Utrecht, with piles of books on his desk. He is a historian and curator at the Centraal Museum Utrecht. Based on his conclusions, he the exhibition The healthy city together, over a thousand years of health in Utrecht. It is the sequel to his previous exhibition The Walled City from two years ago, about the (military) security of the city.
And, is that cliché of those unhealthy Middle Ages a bit correct?
René de Kam: „Not at all. The lowest point in public health was in the nineteenth century. I think that story about all those dirty and unhealthy medieval people was invented in the nineteenth century, because they saw how bad it was, and thought: then it must have been even worse in the past. But that is not the case. Around the year 1000 people were about 6.5 cm taller than in 1700 or 1850. It was not until 1940 that people were again the same size as in the early Middle Ages.”
In the early Middle Ages, the health and quality of food is greatest
What has debunked that image of the dirty Middle Ages?
“Especially through bone research in old cemeteries. You can infer a lot about height and health from the length of thighs and the quality of teeth. A large overview was published about this a few years ago The Backbone of Europe, on health and mortality over the past two millennia. And that hit me like a bomb. Because these researchers, led by Richard Steckel, find the exact opposite of that cliché in all those thousands of bones and teeth – and they are certainly not the only ones. In the early Middle Ages, after the decline of the Roman Empire in the west, the health and quality of food is at its highest. That remains quite good, until the early modern period, from the sixteenth century. Then it goes down, until there is another turning point in the nineteenth century.
“It has become the common thread through the exhibition: everywhere you see the average length from the period of the room in question on the wall. In 800 the average man is 1.74 meters, in 1800 that has dropped to 1.66 meters, fascinating! You see the same picture everywhere in Europe.”
How can these developments be explained?
“Interestingly, there was a plague epidemic in the sixth century, which reduced the population, and so the survivors got off relatively well, with more land at their disposal. I personally think that the organization of society also has an influence: how much inequality is there? Inequality is bad for average health.
Everything was swept, you can see that in the city bills
“We once excavated a very ordinary settlement from the seventh century in Utrecht. When you see what they all ate! Very varied: all kinds of meat, vegetables, grain, sea fish. They had the space, clean air, clean water. Then you understand that they were healthy. After the year one thousand, more cities will be built, Utrecht had been around longer, but this city is also getting bigger and in 1122 it also receives city rights. And guess what? Those cities are also surprisingly good for the average health, because the guilds often sit in the city council there. This leads to a relatively equal society. The dark ages fall in the nineteenth century. That room in our exhibition is the darkest. Nice right?
“And those ancient cities were kept surprisingly clean because there was a deep belief that disease was caused by bad fumes. Miasmas, stench! That in itself is a misconception, but it turned out very well.”
Also read about René de Kam’s research into the Utrecht Cathedral (2014): Tallest tower in the main city
So the hatred of stench kept the medieval cities clean?
“Yes. The streets were very well paved. Hundreds of thousands of boulders have been purchased for this purpose in Utrecht. Everything was swept, you can see that in the city bills. You were also really not allowed to discharge anything on the canals. There were a lot of rules.
“And very important in the fight against stench was the system of cesspools near the houses, which was strictly controlled by the city authorities. Just like fire safety, someone from the board also came to look at it. Those cesspools were emptied once in a while and that went like manure on the land. That is why you can still find Utrecht gold rings here outside the city at Maartensdijk, which would have fallen into the cesspool at one time.”
In the Dutch cities, the builders of new houses think that cesspools are much too expensive
So why does things go wrong after the Middle Ages?
“Population growth and fewer rules. Especially the Dutch cities, such as Amsterdam, will grow enormously. Utrecht will then remain relatively out of the picture. And that growth leads to greater filth. Archaeologist Roos van Oosten wrote the book about this The city, the dirt and the cesspool† And her conclusion is that all kinds of good facilities from earlier times went overboard in order to be able to build quickly and cheaply in those growing cities. That was the end of the hygienic cesspool system!
“That system will remain in place for a fairly long time in the inland cities, because they do not grow as fast and they can use the manure well. But in the Dutch cities, the builders of new houses find the cesspools much too expensive. They are going to create simple gutters in which all that poo and pee will run straight into the canal. Only then do the canals become open sewers. In the growing cities, city councils condone all this. They have long been happy that houses are being built. The greater difference between rich and poor also plays a role: because ‘well, it’s only about poor people’. And then things quickly go wrong. In Utrecht, the cesspool will remain in use for longer, because the city does not grow between 1550 and 1830.”
So how did the healthy city get back on track?
“In the nineteenth century you see the cooperation that existed in the Middle Ages again, between the government, the citizens and the specialists. If they join forces, things can change. From the nineteenth century onwards – thanks to new insights – radical solutions have emerged. The smelly canals will be filled in, and water will be installed. And sewerage will finally be introduced, in Utrecht only in the twentieth century, because they really didn’t want to get rid of that manure system here.
“The city authorities are really going to take action again. And as a result, the average age expectancy at birth rose from 39 years in 1870 to 80 years in 1970.”