Nec Divitiis, Nec Auro – death threatens the city of Ypres, 1623. Neither gold nor wealth can protect a person from death, a universal constant. Copper engraving by Daniel Meisner, courtesy of our partner in this research, the Yper Museum.

Classic quarantine

To many, the government-mandated quarantine measures of the last few months may have seemed unprecedented and unparalleled. Remaining indoors, staying distanced from friends, loved ones, and even strangers on the street, planning grocery shopping ahead of time like a military operation and being constantly aware of your surroundings was draining and definitely not what we’re used to.

The notion of these regulations as purely modern is, however, inaccurate. The same is true of the image often portrayed in popular culture of medieval Europe as a filthy hotbed of disease governed by superstition. In fact, medieval cities throughout Europe had many regulations regarding public hygiene that were strictly and regularly enforced with a view towards preserving the maiori sanitate hominum (the people’s greater health).

Bad breath

Medieval people were well aware of the connection between a lack of cleanliness and the spread of disease and acted accordingly. They operated under a concept now referred to as miasma theory, in which disease could be caused by or spread through foul or corrupted air. Though flawed, this concept did explain why rotten food could result in sickness, why sewage or industrial waste would cause disease and why breathing the same air as a sick person would cause the illness to spread.

Straf onhygiëne

Non-compliance of public hygiene regulations, created for the benefit of public health, would result in punishments such as heavy fines or even time in the pillory. Here a monk and nun are satirically depicted in the stocks. © British Library Board, Royal Ms. 10 E IV f. 187r.

Thus, many measures were taken to preserve the cleanliness of both public and private spaces in medieval towns and cities. The houses of sick people, especially in times of epidemics, were quarantined and sometimes even boarded up to ensure those who had come into contact with the afflicted could not infect others. Most famously, people suffering from leprosy were systematically segregated from the wider community, illustrating the fact that people in the Middle Ages were well aware of the beneficial effect isolation had in limiting the spread of disease. People seen to be breaking quarantine were sometimes brutally punished by the public, as we are seeing in a few places in the world today. Click on a headline to read the article:

Masters of medicine

Doctors and surgeons were staples of large urban centres and, despite popular beliefs, their techniques were not limited to the classic example of bloodletting. For example, the 14th century surgeon Jan Yperman wrote of remedies for fractures, wounds, scurvy, tinnitus and even the use of an oesophagus tube, a medical instrument used for artificial feeding.

A surgical manual from the last quarter of the 15th century, displaying illustrations of surgical instruments used at the time. Excerpt from ‘Cyrurgie’ by Meester Jan Yperman, Leiden University Libraries, MS. BPL 3094, f. 87v-88r.

As his name suggests, Jan Yperman came from the city of Ypres. As a cloth production centre renowned across Europe and especially popular with the Italian, French and English, Ypres attracted many people from across the continent. The city’s population is thought to have been around 30,000 in the thirteenth century, making it one of the largest cities in Europe at that time. As such, the city council financed Yperman to travel to Paris, then the most highly respected centre of learning in northern Europe, to study medicine and surgery in order to serve the community. Unfortunately, despite Ypres’ size and its role as a mercantile centre, little is known about the actual composition of the medieval population or the reasons why its prominence diminished over the subsequent centuries. The paucity of historical information is due to the near total destruction of Ypres and the surrounding area during the First World War, in which the city’s archives were lost.

Cloth hall Ypres

The Cloth Hall of Ypres was the largest purely commercial building in Europe at the time of its original construction in the 13th century. The building was reconstructed in the 20th century following its destruction during the First World War. Photograph taken by the author.

Archaeological aspects

The Vrije Universiteit Brussel has recently launched a new interdisciplinary research project, the Make-Up of the City, to provide an in-depth analysis of the inhabitants of Ypres through time. The project will run from 2019 to 2024.  It will supplement the limited historical information on medieval Ypres with archaeological data from the burial record. We will analyse the skeletal remains of over 1,200 individuals who lived and died between the 12th and 16th centuries, shedding light on the health, diets, and geographic origins of the city’s population.

Through demographic analyses of the population of Ypres, we will be able to find mortality spikes – which reflect times of crisis such as epidemics and widespread famine – and explain what caused each of these spikes.



” diseases such as the plague, tuberculosis, and leprosy are still in existence and quite prevalent in various areas around the world 



Additionally, our project will examine whether certain people are more susceptible to certain diseases than others and, if so, the reasons behind this phenomenon. It has been assumed that some people are more susceptible to disease due to either genetic predisposition or because of external factors such as age, sex, diet, living conditions and/or socioeconomic status. Currently, we are seeing similar discussions surrounding whether the impact and severity of COVID-19 is dependent on such factors as age, sex, health status, living conditions, and socioeconomic status. The study of past epidemics and the impact of disease over time is essential to inform ways to prevent future outbreaks and limit the number of people who are at-risk.


A researcher during the excavations in Ypres in 2018. © Monument Vandekerckhove

Bioarchaeology has thus far been essential to understand the origin of diseases and the ways in which a disease is transmitted. Archaeological populations are especially important to epidemiological research as it is difficult to obtain large samples of modern individuals who have suffered from such a wide range of diseases without extensive intervention from modern medical techniques such as antibiotics, radiation, and surgery. Although we are largely sheltered from such things in modern European contexts, diseases such as the plague, tuberculosis, and leprosy are still in existence and quite prevalent in various areas around the world. Projects such as the Make-Up of the City are therefore essential in studying the effects and spread of such diseases and hold tremendous potential in contributing to modern clinical understandings and treatments.

If you would like to learn more about the Make-Up of the City project, you can find us at