Today national health protection agencies around the world such as CDC in United States often issue health and personal hygiene guidelines during pandemics or epidemic or where a large population of a nation is under threat from a particular disease.

Do kingdoms (kings and their ministers, health officials) used to issue health related guidelines, warnings such as do's and don'ts to the public regularly or in times of epidemics etc. in the medieval period.

Although the question is not limited to it, but I am especially interested in medieval Europe and Britain.

I know heralds, pamphlets and posters were some of the mediums to address to mass public back then, so how such messages were transmitted to public?

So is there any record of any public health, personal hygiene guidelines issued by kingdoms, kings in medieval times, especially from Europe and Britain?

Note — The question is not mainly about medical guidelines(also called a clinical guideline, standard treatment guideline, or clinical practice guideline) but it will be a good supplement to answer about those as well.

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    You are assuming that any court official had any advice to give. For many such situations not even the Medical professionals had reliable answers. 1485-1551: Sweating sickness - Wikipedia, shows how gathered observations of medical professionals were exchanged. At that time governments really had no ministries responsible for health, trade, transport or housing. That basically started around the 18th/19th century. May 28, 2021 at 8:24
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    As a general rule, kingdoms don't issue guidelines. In a monarchy, the Monarch's will is the law, and very few Monarchs had useful opinions on medical issues. Furthermore I think this question is predicated on multiple false assumptions and would benefit from preliminary research; for example, "The modern age of guidelines began with a 1992 Institute of Medicine (IOM) report, "; while it is true that Hippocrates may have written a clinical guideline, he was not a king.
    – MCW
    May 28, 2021 at 9:57
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    Does this answer your question: How were the cities of Milan and Bruges spared by the Black Death? May 28, 2021 at 11:18
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    @MCW -BTW thanks for making title more interesting a nice edit. May 28, 2021 at 14:08
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    Instead of phrasing this as a narrow yes/no question (which might be invitign some downvoting), perhaps better phrased as "Did public-health-related guidelines exist in the middle age, and who issued them?"
    – smci
    May 30, 2021 at 0:52

4 Answers 4


Missum imperatori de pestilentia is one such guideline, written in 1371 for the emperor Charles IV for dissemination.

It was based on the Paris Plague Concilium Tractate of 1348 written by the faculty of medicine members for king Philip VI of France.

In contrast to what is emphasized on that wiki-page, it not only contained some 'scientific' explanations, but also guidelines for the healthy.

Since this founded a European tradition of thought for such occurrences, its basic recommendations are found in countless later Regimina sanitatis or Regimen pestilentiae.

One such pest-regiment is on WP as


A page from the "Pestregiment" (1482) by Hans Folz. Source: Renate Smollich, "Der Bisamapfel in Kunst und Wissenschaft". Deutscher Apotheker Verlag, Stuttgart 1983.
(LLC: This page mainly a didactic poem on the proper ingredients for a Bisamapfel/Pomander, a ~'scent-apple', used for it nice smells and the preventative and curative powers the ingrediente confer. Depending on the ingredients used, this was more than just 'aroma-therapy'.)

More of the details resembling modern 'guideline' or the most beloved by all non-'pharmaceutical as well grossly unscientific interventions' (NPI) can be read in summary

Don't get the contagion, avoid infected, avoid getting poisoned, by:

  1. get fresh and healthy air (including 'clean your air with pleasant smokes')
  2. painstakingly avoid places where the sick are
  3. use prophylactic medicines (herbs, to clean your insides)
  4. eat and drink healthy, that is: in moderation

Ein Kurtzer vnd nützlicher bericht wess sich die gesunden / vnd krancken in der ferlichen zeytt der pestilentz vorhalten sollen.
Durch Johansen Sigismunden Goerlitzer / der Ertzney. Doctorem ordinirt vnd gestellet. Anno M. D. Liij.

A direct descendent of the Paris tractate would also be found in — Karl Sudhoff: "Ein deutsches Pest-Regiment aus dem 14. Jahrhundert", Archiv für Geschichte der Medizin, vol 2, no 5, 1909, pp379–383. (That author was a collector of such 'regiments', a German version of Missum imperator pestilentiae is here.)

These guidelines and recommendations were copied and slowly expanded when republished as letters or short pamphlets. The Missum imperatori pestilentia adds basically these recommendations:

  1. get used to blood letting
  2. avoid plagued places and plagued people
  3. use smoke and fire to cleanse your sleeping room
  4. eat breakfast late and 'sour'
  5. avoid public bathes
  6. be happy and content
  7. do not talk about the black death
  8. take a herbal plague prophylactic (fresh rue), first thing in the morning, before leaving the bed room

Towards the end of that period the first printed medical text in German language was then of this exact genre:

— Heinrich Steinhöwel: "Büchlein der Ordnung der Pestilenz, mit Widmungsvorrede des Autors an die Bürgerschaft von Ulm", Ulm, 1473. (digitized)

Directed at the common man in that city, it consists of two parts. The first part explains what the illness is, and how to avoid and prevent it, the second part is then telling doctors and pharmacists how to treat actual illness.

Tacuinum Sanitatis aimed at a cultured lay audience, says that illnesses result from imbalance of: "sufficient food and drink in moderation, fresh air, alternations of activity and rest, alternations of sleep and wakefulness, secretions and excretions of humours, and finally the effects of states of mind."
It was an 11th century Arabic treatise whose translation into Latin was commissioned by King Manfred of Sicily.

The Regimen [Sanitatis Salernitanum] is believed to have been written in the 12th or 13th century, although some sources estimate this to have been as early as 1050. Even though the book bears the name of the famous medieval medical school, it is not certain if it originated there. According to tradition, the poem was written for the benefit of Robert Curthose.

The — Regimen sanitatis Salerni. This boke techyng al people to gouerne them in helthe, is translated out of the Latyne tonge in to englishe by Thomas Paynell. Whiche boke is as profitable [et] as nedefull to be had and redde as any can be to obserue corporall helthe. To the ryght excellent and honorable lorde Iohū Erle of Oxforde / and hygh chamberlayne of Englande Thomas Paynell gretynge. 1311 is a 1528 English translation of a 14th century Italian (Latin) text out of the Salerno school of medicine.

  • 2
    "use smoke and fire to cleanse your sleeping room" would probably kill lice, bedbugs, etc.
    – RonJohn
    May 30, 2021 at 4:58
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    @RonJohn Depends on dosage, but also bacteria and fungi. Actually that is a practice that persistet not only in eso-circles, but state of the art hospitals right to the beginning of the 20th century. As thyme goes by… May 30, 2021 at 9:12
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    Fascinating. Why did they write the pest-regiment as a rhyming poem?
    – Heinzi
    May 31, 2021 at 11:43
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    @Heinzi Superior style in general. But that's also an old category: la.wikipedia.org/wiki/Po%C3%ABsis_didactica Hinting at the very aim of this: also easy (& with increased memorability/retention & thus reliability) oral transmission. Plus: a thing at Salerno en.wikipedia.org/wiki/Gilles_de_Corbeil May 31, 2021 at 11:47
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    My german isn't what it was, neither has ever been my ability to interpret these glyphs well: But is this writ literally perscribing an apple (a day)?! How amusing indeed, if I read it correctly
    – Stian
    May 31, 2021 at 11:53

One famous source for life during medieval pandemic is the introduction of Boccaccio's Decamerone, which describes the Black Death in Florence in 1348:

And against this pestilence no human wisdom or foresight was of any avail; quantities of filth were removed from the city by officials charged with the task; the entry of any sick person into the city was prohibited; and many directives were issued concerning the maintenance of good health.

(emphasis mine)

If you count quarantine measures (in the sense that travellers cannot enter a port or city before waiting a number of days without getting sick), those were also imposed by local authorities. The word "quarantine" itself stems from the 15th century, but a "trentine" (30 days) was already practiced in the 14th century.


It was a little after the medieval period (though very British), but King James' A Counterblaste to Tobacco from 1604 is an oft-cited early example of public health guidance and one of the earliest texts to specifically identify specific health risks of smoking (emphasis mine below). It also identifies smoking as a poor social skill and alludes to its addictive nature. It also (very interestingly!) compares some possible medicinal value of tobacco with "abuse", foreshadowing the modern distinction between drug "use" and drug "abuse".

Have you not reason then to bee ashamed, and to forbeare this filthie noveltie, so basely grounded, so foolishly received and so grossely mistaken in the right use thereof? In your abuse thereof sinning against God, harming your selves both in persons and goods, and raking also thereby the markes and notes of vanitie upon you: by the custome thereof making your selves to be wondered at by all forraine civil Nations, and by all strangers that come among you, to be scorned and contemned. A custome lothsome to the eye, hatefull to the Nose, harmefull to the braine, dangerous to the Lungs, and in the blacke stinking fume thereof, neerest resembling the horrible Stigian smoke of the pit that is bottomelesse.

My "modernization" of the above (not really a translation since it was already in Modern English, but rephrased in a more 21st century manner):

You should be ashamed of yourselves and quit this filthy habit that you were foolish and stupid to get into. By abusing tobacco, you sin against God and harm both your health and your finances. You also look vain and foreigners stare at, scorn, and condemn you when they see you smoking. Smoking is bad for the eyes, nose, brain, and lungs, and looks like the smoke that rises from Hell.

While this document lacks the medical precision of more recent guidelines, it is a clear example of public health guidance of yesteryear - a document issued by a king, not as regulation, but as guidance to encourage healthy behavior in his subjects.

Also do read its 17th century depiction of drug addiction, still quite easy to understand today and also substantial documentary evidence that drug addiction was well-known hundreds of years ago:

And from this weaknesse it proceeds, that many in this kingdome have had such a continuall use of taking this uusavorie smoke, as now they are not able to forbeare the same, no more then an olde drunkard can abide to be long sober, without falling into an uncurable weaknesse and evill constitution: for their continuall custome hath made to them, habitum, alteram naturam: so to those that from their birth have bene continually nourished upon poison and things venemous, wholesome meates are onely poisonable.

My "modernization" of the above:

This weakness is evident in the fact that so many people in this kingdom have been smoking this unsavory substance for so long that they can't quit without getting sick, just like alcoholics can't quit drinking. Their constant smoking has turned their habit into their nature, just like those that have grown up consuming poison and venom find that healthy food is poisonous to them.

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    What a fascinating document! And what brilliant prose.
    – dbmag9
    May 29, 2021 at 8:50
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    Your uusavorie smoke must surely be an OCR error for unsavorie smoke where it got confused by the minims. I'm pretty sure I found several of those in the UT version when I did my own rather lighter edit here: preface, main, appendix.
    – tchrist
    May 29, 2021 at 19:53
  • I think "lothsome to the eye, hatefull to the Nose" means "loathsome/hateful for other people to see/smell" (i.e., "it's an eyesore and it stinks"), not "harmful to the smoker's eyes and nose".
    – user570286
    Nov 6, 2021 at 12:05

We've had some Covid 'guidance' that was mandatory, so I'll merge guidance/rules in this answer.

A useful trick was to make the 'guidance' a religious matter. Sidesteps all that personal judgment question about whether guidance should be followed or not. As the bible says, pork, camel and rock-badger are unclean meats.

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    I'm struggling to see an answer to the question here. Answers should only be used to answer the original question and not for comments, suggestions or discussions.
    – Steve Bird
    May 30, 2021 at 18:52
  • Did kings/kingdoms used to do it ... yes, sometimes by hiding it as religious proclamation
    – krtymon
    May 30, 2021 at 19:09
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    The bible predates medieval kingdoms...
    – PatrickT
    May 31, 2021 at 10:31
  • above all, don't forget to ignore what the majority of professionals are telling you, and cling to the 3 or 4 who say something different May 31, 2021 at 14:20
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    In addition to not being about medieval kingdoms, your example doesn't seem to be about physical health (rather than ritual cleanliness). The biblical instructions on how lepers should isolate would be closer, though that still wouldn't answer the question. May 31, 2021 at 16:11

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