Roman public health

        In the Middle Ages many Roman improvements were no longer used. The population ran into many difficulties. There were overcrowded towns as the population increased. There were several diseases going around, the most terrible being the Black Death in 1348 which killed thousands of people. One of the most distressing problems was the open sewers and as a result the population was vulnerable to the diseases. At that time only the rich could afford to see a doctor and there were less well equipped hospitals because of hardly any government help and basically no social organisation. People did whatever they wished such as building their houses wherever they wanted which reduced the space in the cities. Wells and cess pits were built too close together. Residents decided to throw rubbish and sewage on the streets and in rivers. Some corporations passed by-laws to reduce the garbage thrown into the streets but these were ineffective. Surprisingly nothing was done about this until a serious disease would break out in town, then the corporation would clean the streets and burn all the rubbish. In towns ordinary people found it difficult to get clean water, which was abundant in Roman times. However, monasteries were often rich and had their own piping system which provided them with clean water, such as Canterbury Cathedral. Towns were run by a group of rich men who decided how much sanitation to provide by raising money. They thought it wasn’t their business to get water and drains for the whole town. For these reasons, public health could not advance. Concerns about the terrible state of public health in towns only reached the government with the outbreak of the Black Death. Following the collapse of the Roman Empire in 500 AD when it split in two, there were the ‘dark ages’ where knowledge was lost and the progress in construction and engineering was forgotten.

        Public health actually regressed from Roman times to the Middle Ages for other reasons as well. In Roman times there was quite a small population yet by the Middle Ages, the population had grown rapidly. In the process, knowledge of diseases and medicine from the Romans was lost with the fall of their huge empire. Another reason why public health was so much better in Roman times is that the emperor cared very much about his large army and empire and sustained it hoping that it would last forever. Unfortunately in Medieval Times there was no army to sustain and the King did not really care about the poor.

Also he did not use the wealth to improve the social and economical situation of his country. In Roman times, very little of the population was actually poor. The Emperor really cared that the whole population was healthy so that he could recruit healthy soldiers. In Roman times, it was a social occasion to go the baths and keep clean. By Medieval times, as a lack of education and maybe indifference, people stopped trying to keep clean and just had a bath whenever they could. A big mistake was often made when people dug their cess pits near the wells and the water got infected. Also the streets were nearly like open sewers, which there were plenty of anyways. This was unlike Roman times where the sewage would be carried out of the city by water. With a little organisation and care from the government, however, this could have been prevented.                

        In Ancient Rome many aspects of social life were very well developed and organised. The Emperor cared for his people and their well being. All these, together with the progress in construction, engineering, science and medicine were also factors to assure good public health. On the other hand, in English towns during the Middle Ages, the government was not willing to take positive steps to keep the improvements from Ancient Rome or to develop a proper health system on its own. The lack of help from the King also left people to cope by themselves with diseases and the terrible state of the towns. Unfortunately, it will take a few centuries and a great deal of effort to bring the health system from the disastrous state in the Middle Ages up to a normal level in the 1800s.