Home StoriesPart of Inside our collections

How to live well, the medieval way

Medieval recommendations on how to maintain health are surprisingly similar to the advice we hear today. The importance of sleep, exercise and a balanced diet can never be underestimated, as historian Dr Katherine Harvey reveals.

Words by Katherine Harvey

  • In pictures
A diagram showing in red the four qualities; in green the four elements; in sienna the four humours; and in blue, the four temperaments.
The four qualities, elements, humours and temperaments. Drawing, 19--.. Source: Wellcome Collection. Attribution 4.0 International (CC BY 4.0).
1 of 11

Medieval attitudes were shaped by the belief that the human body was composed of four humours: blood, phlegm, yellow bile and black bile. To stay healthy, you should adopt living conditions and behaviours to keep your humours in balance. Just like us, medieval people believed that lifestyle was the key to a long, healthy life.

A woodcut illustration of a man sitting at a desk. On the desk is an open book, on the wall above him are dividers; and at the window a moon and stars are visible.
Title page from the first print edition (Venice, 1480) of the Regimen Sanitatis Salernitanum, Arnaldus de Villanova. Source: Wikimedia Commons. CC0 1.0 Universal.
2 of 11

By the later Middle Ages, regimens were extremely popular throughout Europe. These books told the reader how to stay healthy, focusing on lifestyle factors such as diet, sleep, exercise and emotions. The wealthy commissioned personalised versions, which considered their individual bodies and lifestyles. For example, a bishop’s regimen would tell him how to avoid health problems linked to fasting and celibacy.

An illustrated manuscript with three panels, showing the biblical story of David and Bathsheba.
David's Lust, Adultery, Damage Control. Source: The Morgan Library and Museum.
3 of 11

Your environment was extremely important to your health. Houses and gardens should be situated so as to benefit from health-giving north and east winds, and it was considered unhealthy to live in a basement or on the ground floor. The belief that illness was spread through airborne vapours prompted concerns about ventilation, hygiene and the elimination of unpleasant smells.

An illustrated manuscript showing nine figures gathered around a dining table laden with food and dishes.
Sir Geoffrey Luttrell at table, Luttrell Psalter. Source: Wikimedia Commons. CC0 1.0 Universal.
4 of 11

Medieval people shared our belief in the power of a balanced diet, although they classified foods in humoral terms, as hot or cold, wet or dry. The best foods (such as chicken) were warm and moist, but some surprising things were considered unhealthy – like uncooked fruit. Overeating was also dangerous, because it produced humoral excesses that could cause disease. Alcohol could be health-giving if consumed in moderation.

A page with latin text and two illustrations: one of a woman washing a man's hair, and one of two large rodents fighting in front of a tree.
Ortus sanitatis, Johann Prüss. Source: Wellcome Collection. Attribution 4.0 International (CC BY 4.0).
5 of 11

Although we often assume that medieval people were dirty and smelly, good personal hygiene was actually extremely important. Regular washing and bathing of both body and clothes helped to remove potentially harmful residues (including sweat). This was important because parasites such as worms and lice were thought to spontaneously generate from such dirt.

A page from a book, showing an illustration of a male human form, contained within a diagram of the zodiac, overlaid with interconnecting red lines.
Wellcome Apocalypse. Source: Wellcome Collection. Attribution 4.0 International (CC BY 4.0).
6 of 11

Staying healthy meant expelling bodily waste products. This could mean via regular urination and bowel movements, but phlebotomy was another important form of preventative medicine too: many people were regularly bled. It was important to choose a skilled practitioner that knew who not to bleed (children and pregnant women, for example), and who would avoid astrologically inauspicious times.

An illustration of a couple embracing in a large wooden bed, half-covered by a red bedspread.
Coitus, Liber Tacuina sanitatis, Giovannino de' Grassi. Source: Wikimedia Commons. CC0 1.0 Universal.
7 of 11

It was widely believed that both sexes produced seed, which was expelled during intercourse. If this did not happen, it would accumulate inside the body, causing illness; it was even possible to die of celibacy. But too much sex was also unhealthy, especially for men, because it used up too much heat and moisture. So it was good to have regular sex with one’s spouse – but not too often!

Illustration of of a scene of two wrestlers being watched by groups of seated spectators, and one man holding aloft a pole with a cock on top.
Wrestling, Queen Mary Master. Source: British Library. CC0 1.0 Universal.
8 of 11

According to the French physician Bernard de Gordon, exercise was “one of the best things that can be imposed on the human body”. It improved digestion, opened the skin’s pores, and toned the limbs. Anything that caused sweating and increased breathing and pulse rates counted as exercise, but walking, running and riding were especially popular. Some people did gym-style activities, including rope climbing and lifting heavy rocks.

Image of a stained glass panel depicting a man and a woman in bed. They lie sleeping, with night caps on, in their bed which is covered with a deep blue brocaded bed spread. Behind them is a red curtain. On their bed is a small dog asleep. A table with a candlestick and candle is in the front left of the panel and a single pair of heeless shoes lie on the floor to the right.
Tobias and Sara on their Wedding Night. Source: Victoria and Albert Museum.
9 of 11

Sleep was important because it aided digestion and rested the senses. Sleep hygiene is not a modern invention: regimens usually advised sleeping for 8–12 hours a day and made detailed recommendations about beds and sleeping positions. For example, it was best to sleep first on the right side, then on the left, and then again on the right. Napping was prohibited.

An etched illustration of a woman on a chariot drawn by farm animals, holding a wreath and flowers in her hands, surrounded by people playing musical instruments.
Ceres on a chariot with children representing the months March, April and May, Antonio Tempesta.. Source: Wellcome Collection. Attribution 4.0 International (CC BY 4.0).
10 of 11

Contemporary concerns about mental health would have made sense to medieval people, who believed that the emotions could have a direct impact on physical health. For this reason, they worried about stress, and doctors emphasised the importance of relaxation. Music, good company and spending time outdoors could all form part of a healthy lifestyle, while arguments, noisy neighbours and too much work were best avoided.

A woodcut image, showing a man lying in bed surrounded by a priest and two women.
A priest gives a dying man his last rites. Source: Wellcome Collection. Attribution 4.0 International (CC BY 4.0).
11 of 11

For medieval people, the body and soul were intimately connected. This meant that religious practices such as going to Mass had a direct impact on both spiritual and physical wellbeing. During a serious illness, it was extremely important to confess one’s sins and to receive the last rites, which might relieve physical symptoms, and would certainly ensure that the soul was prepared for death.

About the author

Katherine Harvey

Dr Katherine Harvey is a medieval historian based at Birkbeck, University of London. She is the author of ‘The Fires of Lust: Sex in the Middle Ages’ (Reaktion, 2021), a Sunday Times Paperback of the Week. Her writing has appeared in publications including BBC History Magazine, History Today, The Sunday Times, The Times Literary Supplement, and The Atlantic.