Diseases in the Middle Ages – Germany in the Middle Ages

Diseases in the Middle Ages - Germany in the Middle Ages

Diseases in the Middle Ages


In the 14th century, there were exceptionally large population decimations due to the large plague plagues, which were promoted by the breeding and transmission centers of densely populated cities and an extended mobility of the population. If one spoke of the plague in the Middle Ages, it meant not only the Asian bubonic plague, which broke over Europe only in the 14th century, but all sorts of infectious diseases, as well as typhus or anthrax. In addition to malaria, smallpox and dysentery, pulmonary tuberculosis, which is difficult to diagnose, was one of the main causes of death throughout the Middle Ages, apart from the plague. Not a few victims also demanded the leprosy and especially the rye-infested ergot, which triggered the so-called “holy fire”, against which one implored the help of the hermit Antony (hence the name “Antonius fire”).

Because of poor hygiene, diseases spread quickly in the Middle Ages. In the cities, there was no sewerage and it was swarming with rats. The water came from wells or springs that were easily contaminated. The medieval treatment of illnesses was characterized by faith, superstition and medical tradition. Illnesses were felt in the Middle Ages as the punishment of God or the work of the devil. On the basis of some “typical” medieval diseases, I will try to highlight the way people deal with the diseases.

Leprosy or leprosy


Leprosy or leprosy is one of the symptoms that causes the nerves to die, resulting in insensitivity to pain. If a leprosy sufferer is injured but does not feel the wound and leaves it untreated, the risk of getting life-threatening infections through the wound increases, such as: B. tetanus. But also heat or cold, the leprosy sufferer no longer feels so that he can burn himself or stay with inadequate clothing in the cold.

A second symptom is that the blood thickens, causing the veins and arteries to clog. Untreated, this disease ends fatally.

A common misconception is that various parts of the body fall off due to the disease “leprosy”. When a leper loses body parts, it is not caused by the disease leprosy itself, but by the infections that are not treated and lead to the death of the body part. Since the leprosy patient does not feel the infection, it can spread further and further until the body parts die off.

Leprosy in the Middle Ages

The leprosy sufferers’ resistance to pain was used by some of the warlords to fight leprosy animals into battle to intimidate the enemy, on the one hand by seemingly unfeeling beings, and on the other hand by the fear of being infected.

The infection of leprosy took place through intimate physical contact, through the so-called “droplet infection”. In Germany the leprosy came at the time of the crusades. This new Arab leprosy appeared with terrifying violence and for many it was a warning not to engage with Arabs and other Orientals.

On earlier grounds, there was a new reason for the Church to forbid Christians from being treated by Jewish or Saracen doctors; for they sought, the bishops said, only to destroy them, be it through sinful counsels or perishable poisons. Later, there were formal persecutions because the Jews were suspected of a secret plot with the lepers.

The leprosy doctors were helpless and recommended the most incredible funds. (Cum sibi sentiret leprae periculum imminere, de consilio medici virilia sibi fecit abscindi, ut posset a tam gravis infirmitatis vitio liberari; Innocent III ep. 151. “).

Lepers were treated harshly. They were living dead. The pastor read the sick-mass about those who had been touched, that the death-corpse was listening to their confession, heard their confession, gave them the sacrament, handed them their own clothes, gloves, a drinking vessel and a bag of bread, and led them into the emergency house outside the gates. They were not allowed to drink from any public well and had to give warning signs by rattling before they came close.

In the 15th century, leprosy subsided somewhat because people used to bathe more often.

The syphilis


Syphilis (or also Franzensenkrankheit) manifests itself by ulcers on mucous membranes and lymph nodes. In the advanced stage, organs, the skin and the central nervous system are also affected. If the onset of ulcers is superficial, ie on the skin and mucous membranes, you will see red, open or swollen changes in the diseased region.

The syphilis in the exit of the Middle Ages

Syphilis occurs only at the end of the Middle Ages and is also called “Franzosenkrankheit”. The name derives from the fact that according to the “Columbus theory” the causative agent of syphilis has been introduced by the Columbus’ voyages of discovery to Europe. From Spain, the causative agent of syphilis spread to France and from there to Germany. The Germans in the Middle Ages saw the disease first with their neighbors, the French, hence the name “French disease”.

The syphilis seemed to be worse than leprosy, it was hard to spot and difficult to treat. The transmission of the disease happened through sexual intercourse or the like. It is a venereal disease that poisoned the whole body. The army of Charles VIII of France infected himself in Naples with syphilis in 1495 and subsequently carried the disease throughout Europe.

“She spared neither high nor low, neither rich nor poor, and was bitterly worried about the untethered carnal lust. Most of the women’s shelters were taken in and the bath-houses disappeared because they were the main herd of infection, but without the people becoming more civilized. If they no longer had the opportunity to have sexual intercourse in the baths, morality sank much deeper because of various circumstances, until a long period of suffering brought man back to his senses. “(Grupp, G. Cultural History of the Middle Ages, Paderborn: 1925)

The Antonius fire

The Antonius fire is triggered by the ergot. The ergot is a dark fungus of cereals. When people eat ergot, or cereal-derived foods containing ergot, with the poisonous ingredients, the vessels contract and circulatory disorders occur in the heart, kidneys and limbs. The limbs are weak and pale and the pulse is barely noticeable. There are also reports of tingling on the skin and other sensory disturbances.

In the further course of the disease, due to the lack of blood, the extremities, such as fingers and toes, die off. Common side effects include vomiting, headache, diarrhea and delusions. The disease was often fatal.

The humans did not know that the disease was caused by the ergot fungus. That’s why washing, cleaning and drinking alcohol did not help. It was not until the 17th century that the connection with the holy fire (St. Anthony’s fire) and ergot was recognized and thus the frequency of the illness was reduced.

In the Middle Ages, the ergot came mostly through the rye to humans. In the 14th century, the Order of Antonites set itself the task of treating people suffering from Antony’s fire. “In the 15th century, the Antonites maintained around 370 hospitals throughout Europe, in which about 4,000 patients were treated.” (Http://de.wikipedia.org/wiki/Antoniusfeuer)


Typhoid fever is an infectious disease transmitted by bacteria. Transmission is through contaminated drinking water or contaminated food. In the course of the disease the sick person gets a fever, which is consistently high at up to 41 degrees for about 2 weeks. The sufferer has headache and body aches, fatigue and shivering. The pulse is slow, sometimes the patient becomes unconscious. Outwardly, typhoid fever manifests itself in small, bright red spots on the front of the body, especially on the abdomen.

In the further course you get terrible diarrhea alternating with constipation. The intestine is damaged and it can come to intestinal perforation. If you look at the hygienic conditions of the Middle Ages, it becomes clear that this disease lurked in many foods on humans. The disease was often fatal. However, if the disease was suppressed, it was usually immune to it for a lifetime.

The anthrax

The anthrax (or anthrax) is an infectious disease that usually affects cloven-hoofed animals. Inhalation of high doses of the anthrax pathogen can also infect humans. In the Middle Ages, the anthrax was used for “biological warfare” by catapulting animal carcasses that had died of anthrax with a catapult over the wall of a besieged city. So it was hoped the plague would spread throughout the city and destroy the population until the gates of the city were opened.

Anthrax is transmitted through the skin, air or food. Thus the anthrax splits into Hautmilzbrand, Lungenmilzbrand and Darmmilzbrand. While only about 15% of skin patients die from cutaneous anthrax, mortality from pulmonary anthrax and intestinal spasms is very high.

The malaria

The name “Malaria” comes from “bad air”. It used to be thought that the transmission of the disease came from bad air, especially from the vapors of swamps. In fact, malaria is transmitted by a mosquito, which occurred in the Middle Ages mainly in swamps. Only with the drainage of the swamps in the most recent time could the malaria in Germany be eradicated.

The symptoms of malaria include high fever, convulsions, chills and discomfort of the gastrointestinal tract. Especially children fell victim to malaria in the Middle Ages. In adults, she was not as deadly as often.

The smallpox

The smallpox or pox is a great plague in human history. Similar to the plague, smallpox in devastating epidemics caused countless deaths. In the 18th century, smallpox even caused the plague as the worst disease.

The course of the disease begins at the nose and throat area, where the poxviruses invade the mucous membranes. From there, they are flushed through the bloodstream throughout the body. There is fever and chills on. Then the well-known bubbles on the skin, and all over the body. The smallpox is not to be confused with the chickenpox.

Picture 107: A person suffering from smallpox lies in great pain on his sleeping place. He can barely move, stretch or kill. Many died of hunger. Of the few who survived, some lost an eye or became blind.
(Original file on Wikimedia Commons)

In the Middle Ages every 10th child died of smallpox, even before it reached the age of ten. Smallpox probably reached Europe in 165, when victorious Roman troops returned from Syria. From then spread the epidemic and raged for 24 years. A mass extinction over large tracts of land was the consequence. This mass extinction went down in history as the “Antonine plague”. From then on, the disease occurred again and again in Germany sporadically. From the 11th century, the Crusaders contributed significantly to the spread of smallpox and throughout Europe to the Middle East suffered from the smallpox that caused fear and terror among the people. In some areas, children did not really belong to the family until they were 10 years old, as their parents‘ fear of losing their smallpox child was too great.

The Ruhr

Dysentery (or dysentery) is the name given to a feverish illness accompanied by abdominal pain and frequent urge to bowel movements. However, in the dysentery the feces are retained in the upper part of the intestine and evacuated is only a slimy or bloody fluid. The Ruhr is usually transmitted via contaminated drinking water or flies that absorb the transmitter, for example, if they first put on feces and then sit down on food and unload it from where it then enters humans. Carriers of the Ruhr can be amoebae or bacteria. Accordingly, one also distinguishes between amoebic dysentery and bacterial dysentery:

1. Amoebic dysentery: The pathogens are amoebae, which multiply in the human colon by cell division.

2. Bacterial disorder: Pathogens are “Shigella. “As a highly resistant permanent form of the pathogen cysts can form and remain in this form in the colon – may cause for years without any signs of disease – and is also eliminated with the stool (” Minutaform “). The infected person is also the transmitter at the same time. The excreted permanent form can remain infectious in the outside world for months. “(Wikipedia). Particularly dangerous is the loss of water and electrolytes due to the frequent, accompanied by cramping bowel movements, which are excreted mostly mucus and / or blood. As a result, it can cause seizures, kidney failure, circulatory collapse or coma. Particularly often the Ruhr occurred – especially in the Middle Ages – at times of need. Because of the lack of food the immune system of humans was weakened, whereby the body could hardly defend itself against the invading pathogens themselves.

The plague

The most well-known illness which was spread in the Middle Ages was the plague, the black death (big pest epidemic: 1347-51 in Europe). As the cause of the plague was suspected in the Middle Ages as well as other diseases changes in the air, poisonous vapors and bad star constellations. The famous Parisian report of 1348 explained the occurrence of the disease by the fact that on March 20, 1345, the three upper planets met in the house of Aquarius to emit a particularly humid and dangerous exhalation that congealed in the lungs into a poisonous matter that should cause the plague.

Most people of the Middle Ages could not explain the occurrence of the plague. To overcome their fear, the blame was shifted to others. The anger of the population was directed against foreigners, cripples, beggars, Gypsies and against the Jews. The Jews were accused of poisoning the wells, and the Jews themselves became ill with the plague and also died, hardly a proof of their innocence. What are the doctors doing? They believed the cause was a poisoning of the air, and advised people to lock doors and windows or seek refuge on heights. Obscure advice made the rounds. For example, the windows should only be opened to the north, sleep at the time of day was forbidden, hard work frowned upon. Wet and humid climate and south wind were considered dangerous, the air over stagnant waters of all kinds.

Picture 108: The bubonic plague was one of the horrors of the medieval people. On the picture you can see two sick people, but it is more likely that the smallpox is pictured here – from the location and size of the bumps.
(Original file from: Wikimedia Commons)

The religion offered many people an explanation for the plague and other diseases. The body was a tool to serve man in the fulfillment of his godly everyday work. Being healthy was considered a sign of the grace of God and an indication that God was pleased with one. But if one was ill, it could either be understood as a test of God, or as a punishment for a wrong life. The “natural” diseases, such as the epidemics, which could also break in on “good” people were understood more as a test of God. Those who survived proved the good pleasure that God had with him. Leprosy, unlike leprosy, was seen as a disease whose behavior was caused by its own behavior. Leprosy was considered a disease that was transmitted through sexual intercourse and as a punishment of God. Also, the onset of symptoms (thickening of the skin, damage to the larynx and sensory disturbances) were associated with the bad climate and spoiled food.

Medieval Disease Theory

In the disease of the Middle Ages are humoral pathological, pneumatic and mechanistic elements. The basis was the juvenile pathology. As in ancient times, the four human juices – blood, phlegm, yellow bile (cholera) and black bile (melancholy) – dominated the metabolism. The condition of the health was dependent on the balance of the juices, or the primary qualities represented by them (moisture, cold, heat, dryness). The disease broke out only after a strong deviation from the normal conditions, whereby the juices changed either quantitatively or qualitatively. The cause of the illness was considered to be primarily a faulty lifestyle (for example, in relation to: food, sexual intercourse, poisoning, but also strong odors, etc.). The climate (temperature and humidity) was also one of the major causes of illness. For example, by inhaling spoiled, bad air that had too much moisture, the blood was heated and spoiled with heated rot. Poisoning by food was also a cause of disease in the Middle Ages. An example of poisoning by food would be the stinging fire of the Antonius, which was caused by a poisonous fungus that nestled in the rye’s ear. The people in the Middle Ages, however, did not recognize the cause of the disease.

Man has seven companions in life who plague him: hunger, thirst, cold, heat, fatigue, disease and death. Life in the Middle Ages was marked by illness. Death was omnipresent.


  • Unfortunately, the sources for this essay have been lost.

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