As anyone with a cable connection or a sword of Valyrian steel can tell you, the new season of HBO’s “Game of Thrones” (9 p.m. Sundays) means lots of dragons, lots of heads lopped off and lots and lots of visits to brothels. And another 13 weeks of wondering how everyone in the 1400s stayed so healthy and strong.
I asked Elly Truitt, a medieval historian at Bryn Mawr College who specializes in science, medicine and technology, about health and health care in medieval Westeros.
Life expectancy depended wildly on what kind of person you were. And it also depended on when and where you were living. Because ... the 14th century ... saw the pandemic of the black death, which significantly changed the demographic of Europe. The black death was an infectious disease a widespread epidemic that started to hit Europe in 1348 and just kept coming in successive waves for the rest of the 14th century, and then for centuries after that.
The other thing is that people had fewer what we would consider now to be chronic illnesses, and the burden of disease was more infectious disease. So now our burden of disease is chronic diseases, like hypertension, high cholesterol, heart disease, Type 2 diabetes – at least in the United States. In the Middle Ages and, until the 19th century, the burden of disease was infectious diseases like the plague, or an influenza.
They didn’t have a model of disease based on a germ theory. Instead, the therapeutic framework, or at least the learned therapeutic theory, was based on “humoral theory,” going back to Hippocrates and then significantly expanded on by Galen.
So everybody has their own complexion, and kind of natural balance in which the four humors (black bile, blood, phlegm and yellow bile) are in the proper portions to one another. And disease is caused, according to humoral theory, when the humors get out of balance, and that causes essentially corruption of some kind. Some kind of noxious-like toxicity in the body.