Podcast Summary: "How to stay healthy in the Middle Ages"

HistoryExtra Podcast
Host: Charlotte Vosper
Guest: Dr. Catherine Harvey
Date: April 2, 2026

Episode Overview

This episode explores how people in the medieval period understood health and endeavored to live healthily, challenging many common stereotypes. Dr. Catherine Harvey, historian and author of The Medieval Guide to Healthy Living, discusses the primary medical concepts, daily practices, and societal attitudes towards well-being, hygiene, diet, environment, mental health, and much more in medieval Europe.

Key Discussion Points & Insights

1. Medieval Understanding of the Body

(03:07)

• Medieval health was grounded in the humoral system — the belief that health depends on balancing four bodily fluids: blood, phlegm, black bile, and yellow bile.
• Each humour had qualities (hot, cold, wet, dry). Imbalance led to illness.
• Everyone had their own "complexion" or individual humoral makeup.
• Age, gender, and even geography affected one’s complexion:
  • Young people: hot and moist.
  • Older people: colder and drier.
  • Men: hot and dry; Women: cold and moist.

"The whole basis of medieval medicine is trying to keep those humours in balance and trying to rebalance them if you get ill." (Catherine Harvey, 03:07)

2. Medical Knowledge and its Spread

(04:25)

• Technical knowledge belonged to university-trained medical practitioners (Oxford, Paris, Bologna), monastic scholars, and court physicians.
• However, practical medical ideas diffused widely, even among untrained local practitioners.
• Case study: John Crophill, an Essex bailiff whose medical notes show rural and elite practices were similar.
• The Church disseminated medical analogies and advised clergy to consider humoral balances during confession.
• Increased literacy and access to books spread rudimentary health knowledge to urban craftspeople and artisans.
• "Regimens" (lay guides to health) became popular, focusing on the "non-naturals": air/environment, food/drink, exercise/rest, sleep, excretion, emotions.

3. The Non-Naturals: Environment & Hygiene

Healthy Environments

(08:11)

• Air quality was paramount; fresh, clean, well-ventilated spaces promoted health.
• Mountain air = good, but sea air = potentially unhealthy (too wet).
• Stagnant air/water, marshes, ditches, and pollution viewed as dangerous.
• Households aspired to clean, light spaces and valued gardens with greenery and water features.
• Medieval towns enforced regulations on waste disposal to avoid foul air.

“Your ideal home in the Middle Ages was very much somewhere it's well ventilated, it's light and airy, away from bad smells.” (Catherine Harvey, 08:11)

Cleanliness Stereotypes Debunked

(10:24)

• Contrary to the "filthy medieval" stereotype, people placed importance on personal and household hygiene.
• Archaeology finds evidence of swept floors; regular hand and face washing was common.
• Public health was considered a communal responsibility; cities employed cleaners and imposed rules on residents to keep streets clean.
• Waste disposal and latrine placement were regulated; public toilets existed.

4. Food and Drink in Medieval Health

(13:28)

• Foods classified by humoral qualities, not nutrients.
• Some foods we consider healthy (like raw fruit and fish) were viewed as risky due to being cold/moist; safer when cooked or paired with "balancing" sauces.
• Dietary advice was tailored to personal complexion, local foods, and—interesting to modern ears—social class. Elite diets were considered "delicate," while peasants' diets were "coarse."
• What people actually ate: Most peasants subsisted on bread, vegetables (like cabbage), and ale. Meat, cheese, and fish were variable by region and season.

"They were at least as obsessed by food and drink as we are, they had some quite different ideas … foods are labeled as hot and cold and wet and dry." (Catherine Harvey, 13:28)

5. Health Practices: Excretion and Bloodletting

(16:48)

• Practices far removed from our own included purging (induced vomiting or laxatives) and phlebotomy (bloodletting), intended to remove excess humours.
• Bloodletting was common, often performed by barbers or monastic staff, and even clergy and monks underwent regular bloodletting.
• Evidence suggests some laypeople bled themselves.

"They definitely used [phlebotomy] as a preventative strategy. To us, the idea that you might have yourself bled to stop yourself being ill feels like a bad idea, but they definitely thought it was a good way to make sure that your humours stayed in balance." (Catherine Harvey, 17:32)

6. Attitudes Toward Sex and Health

(22:22)

• Sex was seen as a healthy form of excretion—important in moderation.
• Celibacy, especially in clerics, was considered to risk illness due to unexpelled bodily "seed."
• Women, too, were thought at risk if not sexually active, as this would cause "suffocation of the womb."
• However, excessive sex was also seen as potentially harmful.

“It's a healthy thing in moderation as part of a healthy lifestyle ... They’re quite concerned that it can make you ill if you're not having sex.” (Catherine Harvey, 22:22)

7. Religion, Medicine, and Mental Health

(23:52)

• Medicine and spirituality were deeply entwined; both were part of prescriptions for well-being.
• Physicians might prescribe both potions and prayer.
• The body was seen as God's creation, and there was a spiritual duty to keep it healthy.
• Medieval people recognized a mind-body connection; emotions, joy, and stress were understood to affect physical well-being.
• Joy was thought to "moisten the body" and promote health; anger and melancholy (akin to depression) were considered harmful.

“They see things like going to church or confessing or having religious images in your house as things that are good for your soul. They're good for you spiritually, but they're also good for your mental and therefore your physical health. It all ties up.” (Catherine Harvey, 23:52)

8. Women's Health: Menstruation, Pregnancy, Menopause

(27:41)

• Church moral teachings sometimes condemned women’s bodies, but medical texts offered practical advice and remedies for menstrual, pregnancy, and menopause-related issues.
• Pregnant women were advised to rest, eat well, drink wine (anachronistically), exercise gently, and recover after childbirth.
• Menopause wasn’t discussed in modern terms, but its health implications (such as risk of breast cancer) were noted.

“From the medical texts, actually, we get a lot more practical stuff and a lot more sensible stuff ... remedies for menstrual problems, for painful periods, for having no periods, all of that sort of stuff.” (Catherine Harvey, 27:41)

9. Awareness of Cancer and Diseases

(29:54)

• Medieval concept of "cancer" encompassed a variety of sores and abscesses, though breast cancer was notably recognized.
• Surgery was rare and approached with caution.

10. Beyond Christian Europe: Global Parallels

(30:47)

• Medical ideas were shared across Christian, Jewish, and Muslim traditions (e.g., Avicenna’s texts).
• Hygiene and air quality were universal health concerns (e.g., Ibn Battuta’s travel accounts).

11. Did Good Health Advice Pay Off?

(32:15)

• Life expectancy was lower due to high infant mortality; surviving childhood meant one could live into old age (15% of some Italian town populations were over 60).
• Preventative medicine aimed at living longer, healthier lives—much as we hope today.
• Some pursued longevity through "eccentric" means (drinking young blood, gold, breast milk), but emphasis remained on balanced living and activity.

"All this preventative medicine very much shows that they didn’t [accept dying young]. They really did think that if you lived a healthy lifestyle, it could help you to live longer." (Catherine Harvey, 32:15)

12. Challenging Stereotypes & Modern Takeaways

(35:35)

• Harvey hopes her book helps listeners see medieval people as relatable: concerned about health, hygiene, and quality of life.
• Stereotypes that dismiss medieval people as ignorant and dirty obscure their active pursuit of good health.
• Some lessons—emphasis on prevention and moderation—are still relevant today.

“People in the Middle Ages were in a lot of ways quite like us and that they worried about their health and they tried to keep themselves healthy and they wanted to live long, healthy lives and that they were concerned about things like hygiene that we very much assume that they were not.” (Catherine Harvey, 35:35)

Notable Quotes & Memorable Moments

• On the humoral system:
  “Everybody has their own, what's called a complexion ... But broadly speaking, young people are hot and moist and you get colder and drier as you get older.” (Catherine Harvey, 03:07)

• On medieval hygiene:
  “I think that's one of the most unfair stereotypes about the Middle Ages ... they thought it was really important to be clean and they tried really hard to be clean.” (Catherine Harvey, 10:24)

• On joy as medicine:
  “Joy being happy is very much good for your health, and the things that make you happy are good for you ... you can die of too much joy, so you have to be a bit careful.” (Catherine Harvey, 25:18)

• On living long lives:
  “It's not unheard of for people in the Middle Ages to get into their 70s, 80s, even 90s ... they really did think that if you lived a healthy lifestyle, it could help you to live longer.” (Catherine Harvey, 32:15)

• On gold as a health tonic:
  “They also are very interested in the potential health benefits of gold, because gold's like the perfect element. It's perfectly balanced. And so they think that maybe if you eat or drink gold, that will help you to live longer.” (Catherine Harvey, 32:15)

• On correcting stereotypes:
  “Probably to be aware that maybe they didn't all die of black deaths because they were stupid is a good thing to be aware of.” (Catherine Harvey, 35:35)

Timestamps for Key Segments

• Understanding the Body/Humours: 03:07
• Spread of Medical Knowledge: 04:25
• Healthy Environment & Hygiene: 08:11–10:24
• Diet & Class: 13:28–15:59
• Bloodletting/Excretion: 16:48–19:09
• Sex & Health: 22:22–23:34
• Religion & Mental Health: 23:52–25:09
• Women's Health: 27:41–29:43
• Cancer & Disease: 29:54
• Global Connections: 30:47–31:58
• Life Expectancy: 32:15
• Stereotype Corrections & Modern Lessons: 35:35

Conclusion

This episode shines light on the surprisingly complex, proactive, and familiar ways that medieval people approached health and longevity. Their efforts to understand nutrition, hygiene, mental well-being, and even environmental impact demonstrate motivations and anxieties similar to our own. Dr. Catherine Harvey’s work dispels many myths, reminding us that medieval people weren’t simply ignorant sufferers of their era but were often thoughtful, preventative, and knowledgeable in their pursuit of a long and healthy life.