Cleaner, Healthier, But With More Parasites
It was a puzzle.
Friars in medieval monasteries
lived far cleaner lives than the lay people outside.
The monastery latrines were isolated and kept clean.
Their gardens produced fresh vegetables.
Many monasteries had running water systems,
a luxury that even the nobility lacked.
The friars often outlived commoners due to superior health,
often due at least in part to their more nutritious diet.
But at the Augustinian friary in Cambridge
during the 12th through 14th centuries,
the friars were roughly twice as likely as the local citizens
to be plagued with roundworms and whipworms,
Why was this?
The friars' better hygiene may have led them to gardening practices
that greatly increased their risk of parasitic infection.
That's the conclusion of a 2022 paper in the
International Journal of Paleopathology.
Medieval English Sanitation
Sanitation in medieval Europe relied on the cesspit.
It was an extremely simple system, just a deep hole.
A wooden board might form a toilet seat over it.
Chamber pots would be emptied into it.
Kitchen waste might also be thrown into the cesspit.
Given that people lived alongside their livestock in small cottages,
animal feces would also have ended up in the cesspit.
requiring the difficult, dirty, and altogether unpleasant job
of digging it out.
But cesspits persisted into the early 20th century in Europe.
Ernest Hemingway wrote about the cesspit excavators of 1920s Paris in
A Moveable Feast.
Monasteries and friaries, however, commonly had running water systems
with which the residents could wash their hands.
The water and hygiene were requirements of their order's rule.
A typical system involved a raised cistern with water drawn from it by gravity.
"Cleanliness is next to godliness" is a much later saying,
possibly invented in 1788 by John Wesley, the co-founder of Methodism.
But the concept goes back to the Hebrew Bible's book of Leviticus,
which reached its present form when the Achaemenid Persian Empire
ruled Judea in 538–332 BCE.
The running water sometimes also served to flush waste out of the latrine block.
Here is an example of that at
which was founded in the 7th century CE.
The water channels in the foreground go down either side of what
was the latrine block at Glastonbury Abbey.
A row of toilet seats went down each long wall of the latrine,
and the water channels underneath washed the waste away.
Monks versus Friars?
A monk in a monastery leads a
contemplative life apart from the world under vows of poverty,
chastity, and obedience, and tends to remain living in one place.
A monk's life is cloistered asceticism.
The words are from the Greek
or monos, meaning "alone".
A friar in a friary also
lives in a community under a formal rule.
But friars interact much more with the outside world,
preaching and moving from place to place in service to society.
The Augustinian order of friars was founded in 1244
and their rule is based on the writings of Augustine of Hippo.
Cambridge and its Friary
The site of the city of Cambridge was occupied during the Bronze Age.
It became an important trading center when first the Romans and later
the Vikings ruled this part of Britain.
It continued to be a trading center into modern times.
Toilets of Higher Education
The University of Cambridge was founded in 1209.
It is now composed of 31 semi-autonomous colleges
and over 150 academic departments.
Today the university dominates the architecture of the city center.
Lots of gothic limestone.
A red British post box and one of the limestone buildings
of the University of Cambridge.
The Augustinian friary in Cambridge was a
studium generale, an international study house.
Clergy from across Britain and Europe would travel to Cambridge
to read manuscripts and meet other scholars.
The friary was founded in the 1280s and lasted until 1538,
when it and most other English monasteries were closed or destroyed
as part of King Henry VIII's break with the Roman Catholic Church.
The University of Cambridge began work in 2017 on a
renovation and expansion of a museum.
They soon realized that they were excavating in an old cemetery.
The university provided plenty of archaeologists and historians.
They found that the excavation had stumbled upon the friary's cemetery.
No everyone buried in an Augustinian friary's cemetery was
Wealthy people from the town could pay to be interred
in that more auspicious setting.
However, the friars were buried in their standard garb,
while the townspeople would be buried in a shroud.
The friars in their work-and-study clothes,
the townpeople wrapped in sheets.
The Augustinian rule specified that a friar wear a belt,
and the Augustinian belts of that period had metal buckles
with a distinctive design.
The clothing and shrouds were long gone,
but belt buckles found with some of the bodies showed
that this was the friary cemetery.
Then those buckles told the scientists who was a friar and
who was a well-to-do person from the town.
First = Plague of Justinian in 6th–7th centuries
Second = the Black Death in 14th century
Third = pandemic beginning in Yunnan, China in 1855
The nearby comparison cemetery was the parish cemetery
of the All Saints by the Castle church.
Everyone buried there was one of the local townspeople.
It was in use starting around 940–1150,
with the majority of the burials from the 12th through 14th centuries.
It was abandoned in 1365/6 after a drop in population caused by
early outbreaks of the Second Plague Pandemic.
The Black Death, the second bubonic plague pandemic,
first reached Europe and then England in 1348,
killing 40–60% of the population
and quickly leading to a halt in the campaigns of the Hundred Years' War.
A second wave returned to England in 1361–1362,
killing about 20% of the remaining population.
The parish was a socio-economic mixture
with a significant fraction of the population involved in agriculture.
Overall, the people living in the parish and buried in its cemetery
were probably poorer than those of Cambridge as a whole.
The study compared 19 Augustinian friars of the 13th to 16th century
with 25 townspeople of the 10th to 14th century buried at the parish cemetery.
The University of Cambridge's King's College Chapel
is one of the finest examples of
late Perpendicular Gothic English architecture.
It was built in stages by the succession of kings of England
from 1446 to 1515, including
Edward V (for two months),
We're looking across The Backs, grounds of several colleges of the
University of Cambridge facing the River Cam.
The Wormy Medieval Europeans
The Hanseatic League's parasites
Roman spread of parasites
Parasites on the sacred island of Delos
Parasites in Crusader castles
Medieval and early modern populations in northern Europe
had a variety of parasites.
Roundworm, whipworm, beef tapeworm, fish tapeworm,
and dysentery-causing protozoa
were generally common across northern Europe.
Some parasitic worms are contracted by the contamination of food and drink
Other parasites come from eating uncooked or undercooked meat and fish.
Intestinal helminths or worms seem to have been
quite common in medieval England even among the upper classes.
The King Richard III was killed in battle and buried in Leicester in 1485,
in a friary church that was demolished in 1538.
In 2012–2013 his body was
exhumed, studied, and reburied.
Roundworm eggs were found in and around the lower abdomen.
One study of 589 medieval burials from seven sites in three European countries
(Britain, Germany, Czech Republic) found that of those people:
9–45% had roundworm,
1.5–28% had whipworm,
0–10% had Taenia tapeworm, and
0–6% had fish tapeworm
Another study was limited just to England, looking at high and late medieval
burials in York, Ipswich, Christchurch, and Southampton.
It found a mean prevalence of 31% roundworm infection,
but much lower prevalence for other parasite species.
Ascaris lumbricoides or the "large roundworm"
is the most common parasitic worm in humans.
And they are large.
The males are 15–31 cm in length and 2–4 mm in diameter.
Females are even larger,
20–49 cm in length and 3–6 mm in diameter.
image originally from the U.S. Centers for Disease Control and Prevention.
This is a small one.
Wash your vegetables.
Adult roundworms and whipworms live in the host's intestines.
They have a lifespan of one to two years.
After mating, their eggs are passed in the host's feces.
Many eggs, a worm will lay up to 200,000 per day.
The eggs can remain fertile for months to years in good soil conditions.
When someone ingests worm eggs in contaminated food or water,
larvae hatch in the intestines.
Whipworms stay in the intestines and mature there,
but roundworms have a more complex life cycle as so many parasites do.
The juvenile worms make their way from the host's duodenum,
the first section of the small intestine,
into the circulatory system and
through the right side of the heart to the lungs.
They emerge from blood vessels into the lung's alveoli.
Then they crawl up the airways to the pharynx.
The host coughs them part of the way up, then swallows them and they
go back to the intestines to finish maturing.
And then they find a mate, produce eggs, and the cycle starts around again.
Parasites have fascinating life cycles.
They have been around for a long time.
Roundworm eggs have been found in human coprolites more than 24,000 years old.
And, roundworms are still a problem.
The U.S. Centers for Disease Control and Prevention
that 807 million to 1.2 billion people in the world are infected with
Restricted gateway leading into a college at the University of Cambridge.
The colleges are built around large courtyards
accessible only to students, faculty, and staff.
For a long time there was a "town versus gown" tension.
The tension was worsened when the colleges locked their facilities
and refused to help those affected by the plague.
During the Peasants' Revolt of 1381, townspeople attacked and looted
So What Did They Find In Cambridge?
The researchers looked for worm eggs where the buried people's lower
digestive tract would have been.
The worms themselves would have decayed away centuries ago,
but parasitic worm eggs have a tough outer case and would still be there.
Eight of the twenty-five townspeople (32%) had parasites,
which is very close to the study of other English locations
and within the range of the study of distributed European locations,
both cited above.
The townspeople in medieval Cambridge had worms,
but at the typical prevalence for that time and place.
All of them had roundworms only.
Eleven of the nineteen Augustinian friars (58%) had parasites,
roughly twice the prevalence of the townspeople living within a kilometer.
All of those had roundworms, and one friar also had whipworms.
The friars had much better hygiene, at least in some ways,
but they suffered from double the parasite load.
The researchers suspect that the friary may have used the friars' feces,
collected from the latrine, to fertilize their garden.
Also, they may have purchased waste from the townspeople.
On the positive side, the friary's garden provided much more nutritious
meals for the friars.
But on the negative side, it very likely was the source of worm eggs
that hatched within the friars.
The recent study is described in
Intestinal parasite infection in the Augustinian friars
and general population of medieval Cambridge, UK
by Tianyi Wang,
Jenna M. Dittmar,
Peter M. Jones,
and Piers D. Mitchell,
in International Journal of Paleopathology, 2022,
See it for the full details.
Punts are flat-bottomed boats originally built as cargo boats,
now used for pleasure trips by visitors to Cambridge.
What Did The Educated Friars And Skilled Physicians Think Of All This?
John Stockton, who died by 1361, practiced medicine in Cambridge.
He left a manuscript to Peterhouse college, where he was a fellow.
Academics now call it
It covers medicine and astrology
and was mostly written in Italy and England in the 13th century.
One of the texts included in that manuscript is the Practica brevis
of Johannes Platearius.
Within that, the second chapter of the section on illnesses of the intestines
is De lumbricis or "On Worms".
A modern English translation of that explains things:
Different shapes of worms are generated there
according to the varieties of the humour, phlegm.
Long round worms form from an excess of salt phlegm,
short round worms from sour phlegm,
while short and broad worms came from natural or sweet phlegm.
Bitter medicinal plants like aloe and wormwood kill these intestinal worms,
but they need to be disguised with honey or other sweet things.
Humour-based medical theory has been out of favor for some time,
as has the concept of spontaneous generation.
However, the medical professionals trained in that time and place
were aware of intestinal worms.
The "long round worms" are likely the too-common
Ascaris lumbricoides or large roundworm.
The "short round worms" might be Trichuris trichiura,
the 5-cm-long whipworm found in that one friar.
And, bitter plants like wormwood might drive out worms.
The colleges are not open to the public.
But the "town versus gown" conflicts have largely disappeared
with the enormous growth in the number of high-technology and biotechnology
firms, service providers, and other support firms,
with associated economic benefits for the residents.
1,500 new companies and up to 40,000 jobs were added between
1960 and 2010 in the Cambridge area.
The Augustinian friars in Cambridge may have had a copy of
a medical text compiled by Franciscan friars in 1416–1425.
Its entry for Vermes or worms contains some remedies
attributed to specific friars.
One wrote that bursa pastoris or shepherd's purse should be worn
on a long thread around the neck, as it will compel worms breeding in the
intestines or womb to drop out.
Another has a recipe for a mixture of herbs cooked in vinegar
and applied to the stomach as a plaster.
Yet another said, vaguely, that he had made a powder from moles
which could be mixed into a drink
that had good effect against intestinal worms.
As vague as it seems to have been, two prominent 15th century
Cambridge physicians swore by the Tabula Medicine.
Masters Lodge at 1 Trinity Lane in Cambridge,
dating from the late 14th century.
Trinity College is on the north side of the lane,
Gonville and Caius College is on the south.
Clare College and King's College are nearby.
Cleaning Things Up, Eventually
Pestilence kept breaking out through the 16th century.
Finally, in the early 1600s, clean water and associated improved
hygiene and health came to Cambridge.
Thomas Hobson built a water channel that came to be called Hobson's Conduit.
Hobson's Conduit brought fresh water from Nine Wells to the city center.
These visitors are being punted,
or poled in a punt,
through a waterway in Cambridge.
Who Is The Toilet Guru?