Daily Life in the Old Regime333mulated in dung-heaps alongside peasant cottages. One
of the keenest observers of that age, the duke de Saint-
Simon, noted that even the royal apartments at Ver-
sailles opened out “over the privies and other dark and
evil smelling places.”
The great cities of Europe were filthy. Few had
more than rudimentary sewer systems. Gradually, en-
lightened monarchs realized that they must clean their
capitals, as King Charles III (Don Carlos) ordered for
Madrid in 1761. This Spanish decree required all
households to install piping on their property to carry
solid waste to a sewage pit, ordered the construction of
tiled channels in the streets to carry liquid wastes, and
committed the state to clean public places. Such public
policies significantly improved urban sanitation, but
they were partial steps, as the Spanish decree recog-
nized, “until such time as it be possible to construct the
underground sewage system.” The worst sanitation was
often found in public institutions. The standard French
army barracks of the eighteenth century had rooms
measuring sixteen feet by eighteen feet; each room ac-
commodated thirteen to fifteen soldiers, sharing four or
five beds and innumerable diseases. Prisons were
worse yet.
Another dangerous characteristic of Old Regime
housing was a lack of sufficient heat. During the eigh-
teenth century the climatic condition known as the Lit-
tle Ice Age persisted, with average temperatures a few
degrees lower than the twentieth century experienced.
Winters were longer and harder, summers and growing
seasons were shorter. Glaciers advanced in the north,
and timberlines receded on mountains. In European
homes, the heat provided by open fires was so inade-
quate that even nobles saw their inkwells and wine
freeze in severe weather. Among the urban poor, where
many families occupied unheated rooms in the base-
ment or attic, the chief source of warmth was body heat
generated by the entire family sleeping together. Some
town dwellers tried heating their garrets by burning
coal, charcoal, or peat in open braziers, without chim-
neys or ventilation, creating a grim duel between freez-
ing cold and poisonous air. Peasants found warmth by
bringing their livestock indoors and sleeping with the
animals, exacerbating the spread of disease.
In a world lacking a scientific explanation of epi-
demic disease, religious teaching exercised great influ-
ence over public health standards. Churches offered
solace to the afflicted, but they also offered another ex-
planation of disease: It was the scourge of God. This
theory of disease, like the miasma theory, contributed
to the inattention to public health. Many churches or-
ganized religious processions and ceremonies of expia-
tion in hopes of divine cures. Unfortunately, such pub-
lic assemblies often spread disease by bringing healthy
people into contact with the infected. Processions and
ceremonies also prevented effective measures because
they persuaded churches to oppose quarantines.
Churches were not alone; merchants in most towns
joined them in fighting quarantines.Medicine and the Biological Old Regime
Most Europeans during the Old Regime never received
medical attention from trained physicians. Few doctors
were found in rural areas. Peasants relied on folk medi-
cine, consulted unlicensed healers, or allowed illness to
run its course. Many town dwellers received their med-
ical advice from apothecaries (druggists). The proper-
tied classes could consult trained physicians, although
this was often a mixed blessing. Many medical doctors
were quacks, and even the educated often had minimal
training. The best medical training in Europe was found
at the University of Leiden in Holland, where Her-
mann Boerhaave pioneered clinical instruction at bed-
sides, and similar programs were created at the College
of Physicians in Edinburgh in 1681 and in Vienna in- Yet Jean-Paul Marat, one of the leaders of the
French Revolution, received a medical degree at Edin-
burgh after staying there for a few weeks during the
summer of 1774.
Medical science practiced curative medicine, fol-
lowing traditions that seem barbaric to later centuries.
The pharmacopeia of medicinal preparations still fa-
vored ingredients such as unicorn’s horn (ivory was usu-
ally used), crushed lice, incinerated toad, or ground
shoe leather. One cherished medication, highly praised
in the first edition of theEncyclopaedia Britannica(1771),
was usnea, the moss scraped from the scalp of prisoners
hung in irons. The medical profession also favored
treatments such as bleeding (the intentional drawing of
blood from a sick person) or purging the ill with emet-
ics and enemas. The argument for bleeding was derived
from the observation that if blood were drawn, the
body temperature dropped. Because fevers accompa-
nied most diseases, bleeding was employed to reduce
the fever. This treatment often hastened death. King
Louis XV of France was virtually bled to death by his
physicians in 1774, although officially he succumbed to
smallpox. As Baron von Leibnitz, a distinguished Ger-
man philosopher and scientist, observed, “[A] great
doctor kills more people than a great general.”
The treatment given to King Charles II of England
in 1685, as he died of an apparent embolism (a clot in