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The disposal of human waste could be a major problem, especially in the city. In the country, cesspits were cleaned out during the winter, the waste being used to fertilize the fields. Cesspits in the city needed empty-ing more often—this was the work of professional
gong-farmers,
who were required to remove the waste at night to minimize the unpleasantness for
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Daily Life in Elizabethan England

town residents. The absence of an effective means of collecting sewage and removing it from the crowded city environment were major factors in the poor health conditions and high rate of urban disease and mortality.

Other kinds of biodegradable waste might be dumped on a dunghill

behind the house—the waste was allowed to decompose and could be

used as garden fertilizer. Nonbiodegradable waste might be buried or dumped in a river or into the privy—the Thames today is a gold mine for diggers looking for the detritus of Elizabethan daily life. There were strict city ordinances against fouling the streets, but—as with many Elizabethan laws—they were not always effective. Town officials called
scavagers
were responsible for clearing the streets of refuse once or twice a week—probably hiring laborers to do the actual collection. Both street and cesspit waste was carted to dumping areas, called
laystalls,
outside the town.

Some kinds of waste had resale value. Itinerant buyers walked the

streets calling for housewives to sell them old linen rags (used for paper), kitchen grease (usable for candles or lamps), or other refuse for which there was a secondary market.

Poor sanitation contributed to the breeding of vermin, a perennial problem in any Elizabethan home. Fleas, lice, and other insects were a constant pest, and housewives were expected to keep their homes as clean as possible to keep their populations in check. Mice and rats were also ubiquitous, and predators like foxes were the bane of a family’s poultry.

Most households kept at least one cat to control the rodent population.

Mousetraps were another means of addressing the problem, and in the cities there were also professional rat catchers, equivalents of the modern exterminator who used a variety of tools, including poisons, ferrets, and terriers, to deal with infestations of pests.

SICKNESS AND MEDICINE

Poor sanitation, vermin, and urban overcrowding contributed to a high level of disease and low life expectancies. Common diseases included smallpox, measles, tuberculosis (known as
consumption
), stones, and venereal diseases (especially syphilis). Diseases such as influenza and malaria were also present but hard to diagnose today based on Elizabethan descriptions, which tended to label both as
fever
or
ague.
Typhus and dysentery were a frequent problem in crowded and unsanitary living conditions; they were rife in jails and among soldiers and sailors. Among sailors, scurvy was also common, due to the lack of fresh food onboard ship, and it could also affect people ashore during the months when fresh fruits and vegetables were hard to come by. A less serious but very common ailment was toothache: tooth care was poor, and dentistry was much less developed than medicine.5 Mental illness was a well-recognized problem with minimal means of care: Bethlehem hospital in London specialized in the long-term care of the mentally ill, although for many of the residents the conditions were little better than a prison.

Material Culture

121

Diseases often came and went in cycles. At the beginning of Elizabeth’s reign there was an epidemic of New Ague, perhaps a form of influenza, lasting from 1557 to 1559, which may have carried off over 1/10 of the population. There was a serious outbreak of smallpox in 1562, which, surprisingly, struck the upper classes hardest of all: Elizabeth herself almost died of the disease.

The most dreaded disease of all was the plague, or bubonic plague, which had arrived in Europe during the 1300s. The disease was declin-ing in England relative to previous centuries, but outbreaks continued until the late 1600s (it is still found in some parts of the world today). The plague is carried by the flea
Xenopsylla cheopis,
which normally lives on rats. If plague-carrying fleas transfer to a human host, there is a possibility they will communicate the disease and cause an outbreak of bubonic plague, with a mortality rate of about 50 percent. If the plague enters a person’s pulmonary system, it can become pneumonic plague, an even more virulent and deadly form of the disease. Pneumonic plague can be transmitted directly from person to person, and its mortality rate is near 100 percent.

The plague was largely an urban phenomenon and struck most severely in the summer. Epidemics commonly came from the Netherlands to London, whence they might spread to other towns, although occurrences in any given town were often independent of each other. London was visited by the plague in 1563, 1578–79, 1582, 1592–93, and 1603. The worst epidemics in London were those of 1563 and 1603, which may have killed almost a quarter of the city’s residents; even worse was the outbreak in Norwich in 1578–79, which claimed nearly 30 percent of the town’s population. Children and the poor were especially at risk.

Medical Practitioners

The problem of disease was aggravated by the inability of medical science to treat or even understand it. The medical profession in Elizabethan England was largely shaped by structures inherited from the Middle Ages. At the top of the hierarchy of practitioners was the physician, a university-trained theorist who specialized in diagnosis and prescription of medicines. These medicines were prepared by the apothecary, who was considered a tradesman and well below the status of the physician, although he belonged to one of the most privileged and prestigious trade guilds in England. Also ranking below the physician was the surgeon, another tradesman, who specialized in what we would call operations.

Below the surgeon was the barber-surgeon, who performed similar procedures. Simple barbers also practiced basic forms of surgery, including teeth cleaning and dentistry.

In the latter part of Elizabeth’s reign, there may have been one licensed medical practitioner for every 400 people in London, far fewer in the rest of the country. However, the official licensing system did not always restrict
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Daily Life in Elizabethan England

A SURGEON DESCRIBES A SUCCESSFUL OPERATION

At the very beginning of this cure, I did shave or cut the hair away round about the wound, then with my finger I made further probation into the wound, and there I did manifestly feel a notable fraction or breach in the skull on the left side of his head upon the bone called
Os petrosum,
which . . .

was depressed upon the panicle
Dura mater.
And for that the fracture of the skull was greater in length than the wound in the flesh, for that cause, without detracting of time, I made incision, and so followed the fracture, until all the rift or cracked bone was wholly discovered. When I did see and behold the full length of the fracture or breach in the skull and had raised up the flesh, then for that I could not at that present time proceed any further in this business, because of the great flux of blood, and the rather for that he had lost a great quantity of blood before he was brought home to his lodging— all which being considered, I filled the wound with pledgets and runlets

[waddings] made of lint and very fine tow, wet in the whites of eggs being mixed with Galen’s powder. Then after, with good bolstering and rolling, he remained thus until the next day.

William Clowes,
A Proved Practice for All Young Chirurgians
(London: Thomas Cad-man, 1588), sig. P3r

the practice of medicine. Surgeons diagnosed illnesses and prescribed treatment for many who could not afford a physician or who lacked access to one. Outside of the formal medical hierarchy were the unlicensed practitioners, who typically practiced medicine only on a part-time basis. These included folk healers, midwives, and a fair number of outright quacks, as well as learned nonspecialists such as the mage-scientists John Dee and Simon Forman. Women also learned some basic home medicine as a part of their preparation for managing a household, and even an aristocratic lady might engage in charitable healing for her poorer neighbors. Indeed there was a substantial volume of medical literature coming from Elizabethan presses, providing households with voluminous advice on how to deal with a variety of medical situations.

If the structure of the medical profession was old-fashioned, its medical theories were even more so. By and large, there had been few major developments in medicine since the Middle Ages. Physiological theory was based on the ancient idea of the Four Humors, corresponding to the Four Elements, which were believed to make up all physical matter: Melancholy (cold and dry, like Earth), Blood (hot and moist, like Air), Phlegm (cold and moist, like Water), and Choler (hot and dry, like Fire). Physicians often attributed illness to an imbalance of these humors and treated it by prescribing foods and medicines whose properties were thought to be opposite to those of the excessive humor. Since the Galenic system identified correspondences between the humors, the zodiac, and the parts of
Material Culture
123

the body, one of the most common medical procedures was bloodletting: it was believed that draining some blood from the appropriate part of the body could also help restore balance to the humors. (See Table 9.1 for the system of correspondences.) Surgical practitioners may have been somewhat more effective, in part because the mechanics of the body were more readily understood than its chemistry, and many of the surgeons had experience in military service where they had ample opportunity to develop their skills by trial and error.

Surgeons like William Clowes were able to provide meaningful treatment for serious injuries like fractured skulls and recognized the importance of cleansing wounds with compounds that included ingredients like wine or salt (both of which we now know have antibacterial properties). Nonetheless, rates of postoperative infection were high in a world that had not yet developed the concept of sterilization.

In spite of disease and nutritional shortcomings, our modern notion that people back then were smaller is an exaggeration. Average heights from London grave finds dating to the Elizabethan period are 5’ 7½” for men, 5’ 2¼” for women—less than 2” below the 5’ 9” and 5’ 3¾” averages for Londoners today.

NOTES

1. For incomes and wages, see Sir John Harington,
Nugae Antiquae
(London: Vernor and Hood, 1804); William Harrison,
Description of England
[1587] (Ithaca, NY: Folger Shakespeare Library, 1968), bk. 2, chap. 5; Paul L. Hughes and James F. Larkin,
Tudor Royal Proclamations
(New Haven, CT: Yale University Press, 1964), 3.39–41; R. H. Tawney and Eileen Power,
Tudor Economic Documents
(London: Longmans, 1924); D. M. Palliser,
The Age of Elizabeth
(London and New York: Longman, 1992), 118; M. St. Clare Byrne,
Elizabethan Life in Town and Country
(London: Methuen, 1950), 115; Margaret Spufford,
Contrasting Communities
(Cambridge: Cambridge University Press, 1974), 52.

2. For prices, see Fynes Moryson,
An Itinerary
[1617], The English Experience 387 (Amsterdam and New York: Da Capo Press, Theatrum Orbis Terrarum, 1971), III.ii.62, III.iii.151; Harrison,
Description,
bk. 3, chap. 16; Hughes and Larkin,
Proclamations,
3.21, 39–41; James E. Thorold Rogers,
A History of Agriculture and Prices in
England
(Oxford: Clarendon Press, 1882); Percy Macquoid, “The Home,” in
Shakespeare’s England: An Account of the Life and Manners of His Age
(Oxford: Clarendon Press, 1916)
,
2.136–37, 141; Palliser,
Age of Elizabeth,
134; Marjorie Plant,
The English
Book Trade
(London: G. Allen and Unwin, 1939), 220, 241; Jo McMurtry,
Understanding Shakespeare’s England
(Hamden, CT: Archon, 1989), 73. The daily cost of food given in this table is based on the amount of money allowed to workers for their daily food according to the official rates. The price of standard-quality bread was fixed; only the weight changed. Note that some of these were the officially decreed prices; the real prices could be rather higher, depending on the state of the economy.

3. Palliser,
Age of Elizabeth,
129.

4. MacQuoid, “The Home,” 2.120–22.

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Daily Life in Elizabethan England

5. On medicine, see Margaret Pelling, “Medicine and Sanitation,” in
William Shakespeare: His World, His Works, His Influence. Vol. 1: His World,
ed. John F.

Andrews (New York: Scribner, 1985), 75–84; C. Webster,
Health, Medicine, and Mortality in Sixteenth-Century England
(Cambridge: Cambridge University Press, 1979); Alban H. G. Doran, “Medicine,” in
Shakespeare’s England. An Account of the Life and
Manners of His Age
(Oxford: Clarendon Press, 1916), 1.413–43.

 

6

Clothing and

Accoutrements

Of all aspects of Elizabethan culture, the most distinctive may well be its clothing. In a world of unprecedented physical and social mobility, clothing served as a crucial marker of status. The privileged classes used clothing to set them apart from ordinary people; the socially ambitious used it to help them stake a claim to status in the eyes of others. As fashion-conscious Elizabethans sought ever newer ways to stand out, clothing evolved a look that was elaborate, artificial, and striking. Moralists railed against the obsession with sumptuous apparel, rich accessories, and stylish coiffures. Government authorities issued decrees that regulated clothing, jewelry, and weaponry based on the wearer’s rank. Such efforts at control were doomed, and ultimately even the lower ranks of society adopted scaled-back versions of the modish styles favored by the upper classes.

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