health problems in the ancient world

Since the fall of the Western Roman Empire, there have been three major bubonic plague epidemics, which afflicted large segments of the population in the continuous Eurasian landmass and North Africa. Death quickly followed the trade routes of the times. The death toll is almost incomprehensible. The Plague of Justinian (6th Century A.D.), the Black Death (14th Century A.D.), and the Bubonic Plague (1665-1666, which coincided with the Great Fire of London) caused an estimated 137 million dead in a world much more sparsely populated than it is today.

To make matters even worse, one must also remember that these pestilences assailed and ravaged mankind at a time when the average life span was short --- less than two decades during the Middle Ages. Survival to age five was a miracle not only because of endemic disease, dirt and filth, concomitant poor hygiene and sanitation, but also because of the primitive state of medical knowledge. Pestilential disease thrived under such conditions. Moreover, during the Middle Ages, bathing and cleanliness, even in the upper classes, was a rarity, being viewed as unhealthy as well as irreverent --- acts of vanity in the face of God.