Of later diseases the name of influenza is Italian of the eighteenth century, but Dr. Creighton refers to several epidemics which may have been the same disease as those of 1173, 1427, 1510 and 1557. The ‘new disease’ of 1643 was either typhus or influenza.
Sanitation
Having considered the condition of medical practice at the hospitals and among private patients, and having also reviewed the particulars of some of the chief epidemics, we shall now be better able to understand the sanitary condition of mediæval London, and the means taken to keep it clean. There can be little doubt that strenuous attempts were made at different periods to improve its condition.
We may allow at once that old London was not a clean or healthy town, as we understand these words now, but there can be little doubt that it was in advance of most other towns.
Dr. Poore is rather severe in his estimate of the health of mediæval London; he considers the situation of the city fairly good from a sanitary point of view. It was not healthy, however, because of its marshy surroundings. Ague and dysentery were always present and very fatal. Scurvy was very prevalent before the introduction of the potato by Hawkins.[186]
William Clowes, the well-known Elizabethan surgeon of St. Bartholomew’s, was also surgeon to Christ’s Hospital, and in his day twenty or thirty children had the scurvy at a time in the latter house, a fact due to a diet largely composed of fish and other salted provisions, with a scanty allowance of vegetables.
‘There can be no doubt that down to the commencement of the present century London was a veritable fever-bed, the causes of death being largely malarial fever, spotted or typhus fever, plague, small-pox, measles, scarlet fever, and whooping cough, the two latter being comparatively recent introductions.’[187]
Another source of the unhealthiness of London is supposed by Dr. Poore to be due to a soil soaked with the filth of centuries, by which means the wells were probably infected.
Dr. Creighton takes a much more favourable view of the condition of London, and he writes: ‘Nuisances certainly existed in mediæval London, but it is equally certain that they were not tolerated without limit.’[188] It is also probable that the polluted condition of the soil inside and outside the houses has been greatly exaggerated.
There was overcrowding in some quarters of London, but in most parts there were gardens and plenty of fresh air. Many of the streets were used as markets, and they were mostly left in a very untidy state, but attempts were made to cleanse them.