Medieval towns were unhealthy places. Public health was not high on the agenda of most town councils. Towns did not have sewage systems or supplies of fresh water, and probably smelled quite awful as garbage and human waste were thrown into the streets.
Houses were made of wattle and daub and overhung the streets, cutting out light and air. Rats, lice and fleas flourished in the rushes strewn over the clay floors of people's houses. It is hardly surprising that disease thrived in medieval towns.
The Shambles in York was once a street of butchers. Some houses still have hooks outside where meat was displayed.
Contrary to popular opinion, most medieval people realised the importance of personal hygiene.
However, cleanliness was a luxury few could afford. Most people washed in cold water unless they were rich and could afford to have it heated.
By the later Middle Ages there was a growing awareness of the importance of hygiene, and municipal authorities were spending money on trying to keep their cities clean.
Most monasteries were on the outskirts of towns or in the countryside, and they observed strict rules about cleanliness. They had fresh running water, 'lavers' (wash rooms), flush 'reredorters' (latrines) connected to sewers, clean towels and a compulsory bath four times a year.
Even small towns like Kenfig, in Wales, had public health regulations. Sanitation was obviously thought important. Dumping refuse inside the town or close to its walls was an offence and residents were told to clean the pavements in front of their houses.
Butchers were not allowed to slaughter animals in the street and were fined if they threw offal into the street. To keep the townspeople healthy, there were also strict rules about the quality of food sold by traders.
However, the biggest fines were reserved for those who disrupted business, eg 3 shillings (15p) for fighting or 5 shillings (25p) for playing tennis in the street, perhaps indicating that, for the corporation, there were more important things than public health.
The Government also took steps to try to improve public health and hygiene and issued a fine of £30, which was huge for this period. This law passed by parliament after the Black Death in England (1348-1350) shows its concern.
... so much dung and filth of the garbage and entrails be (are) cast and put into ditches, rivers, and other waters... that the air there is grown greatly corrupt and infected, and many maladies and other intolerable diseases do daily happen... all they who do cast and lay all such annoyances, dung, garbages, entrails, and other ordure, in ditches, rivers, waters, and other places aforesaid, shall …forfeit to our Lord the King the sum of 20 pounds.Law passed by parliament after the Black Death in England
However, in spite of the efforts listed above, there is no evidence of any real improvement in public health during the Middle Ages.
the air there is grown greatly corrupt and infected.