The Middle Ages are a dangerous time, and you'll need stamina and good luck to survive. One monkish writer, who compiled the Annals of Bermondsey, reckons that famine is so common that starving people resort to eating dogs, cats, the dung of doves and their own children.

The really bad news is the Black Death, the culmination of a series of disasters which begin in the early 1300s, when England is struck by uncommonly bad weather. A little ice age is followed by severe floods, failed harvests and livestock plagues. Famine hits hard in 1315.

Diseases and healthcare

The most common causes of death are unclean water and bad hygiene, especially in the crowded, dirty towns. Diet is another factor. Fruit is reckoned to be bad for you, and a low intake of dairy produce makes it difficult to resist epidemics.

Average life expectancy is only 30. Of the children born to medieval kings, less than half survive into their 20s. At Winchester College, a public school for 70 boys from prosperous homes who are well looked after, 12 die during 1401 and 20 during 1431.

Hospitals are run by monasteries and convents but are generally reserved for the long-term sick, such as lepers. It is also usually necessary to be referred by someone such as a parish priest.

Medicine depends on a mixture of folklore and herbs. Blood-letting is the most popular surgical procedure. Doctors claim that it restores the proper balance of body fluids, but it often just weakens an already sick patient. A 15th-century poem says that opening the veins behind the ears can cure dizziness.

Shrines to the saints are places of pilgrimage for people with ailments. The shrine of Thomas Becket at Canterbury Cathedral is said to be responsible for curing a girl with crippled fingers and a boy with an intestinal worm half a cubit long (1 cubit = the length of a forearm).

Scrofula (swollen neck glands, possibly a form of tuberculosis) is also known as 'the king's evil' and is said to be cured by the king's touch. When a knight called Roger takes his 14-year-old child to see Henry II, the swellings subside.

Herbal remedies include wormwood, to purge the digestive system of worms; lungwort, to treat chest illnesses; lemon balm, for anything from colds to serious conditions; feverfew, for headaches and labour pains; and marjoram, for bruises.

Dental hygiene is unheard of. Rotten teeth can be yanked out at visits to the local market where tooth-pullers are available for business. Wealthy people clean their teeth for cosmetic rather than health reasons, using an abrasive powder made from crushed seashells. Cumin or coriander seeds and honey are used as breath-fresheners, but people smell pretty awful anyway.

Childbirth

Childbirth is a risky venture for both mother and baby. All manner of superstitions are called into play to ease labour.

By the early 1100s, St Anselm's girdle is being loaned out by Canterbury Cathedral as a relic to lay around pregnant women's abdomens to facilitate birth. Queens have access to what the Church believes is the Virgin Mary's belt. It is dispatched from Westminster to Gascony to assist Henry III's wife, Eleanor of Provence. Lesser mortals lay a parchment over their belly that bears a cross 1/15 the height of Jesus or a mark resembling the wound in his side, along with a written promise of a successful delivery.

If it looks as if the woman may die with the baby still inside her, the Church permits the midwife to slit open the womb to perform a Caesarean section.

Women use herbs and spices to inhibit or induce pregnancy. One woman writes to her sister recommending a herbal potion to help her become pregnant, but notes: 'It stinks so much that there have been husbands who have thrown it away.'

See also Sex and sleaze.

Black Death

Today, the plague is thought to have been caused by the bacillus Yersinia pestis carried in the guts of fleas living on diseased black rats. People catch it either because they are bitten by the fleas or because they inhale the bacillus from rats' droppings. It attacks the lymph nodes, lungs and blood. However, researchers investigating the spread of the disease have recently suggested that it might be transmitted from person to person, rather than requiring an insect or animal host.

The first signs of disease are 'buboes', swellings in the groin, armpits and neck. They are described by Welsh poet Leuan Gethin: 'Great is its seething like a burning cinder, a grievous thing of ashy colour ...' Other symptoms include coughing up blood, fever and blue-black blotches on the arms and legs.

Herbal remedies include wearing sachets of lavender and thyme. A strange concoction of marigold, treacle and egg is another suggestion. Doctors desperately suggest sleeping on your back or even inhaling toilet fumes but, in reality, they can do nothing – the plague is incurable.

Crowded towns such as Bristol, with open sewers and narrow streets full of animals, soon fall to the plague. Within a year, 45% of the town's population succumbs. A disproportionate number of the clergy are affected because they nurse the sick.

The plague is seen by religious leaders as a sign of displeasure from God. A monk writes: 'God is deaf nowadays and deigneth not to hear us/And prayers have no power the plague to stay.' The clergy counsel clean living as the answer to the evils of lechery and adultery, which have caused the epidemic.

Some scholars think the disease is the result of an unlucky planetary alignment. Others put it down to muck, sewage, offal and lust creating a global cloud of noxious vapour.

William Dene, a Rochester monk, writes: 'Alas, this mortality devoured such a multitude of both sexes that no one could be found to carry the bodies of the dead to burial, but men and women carried the bodies of their own little ones to church on their shoulders and threw them into mass graves.'

See also Plague, which describes the effects of the plague in 17th-century England.

Crime and punishment

In 1202, there are 430 reported crimes in the town of Lincoln, which include 114 murders and 45 rapes. Criminal activity is more prevalent in towns, where there is overcrowding and more opportunity to escape notice. Markets are a perfect place for thieves to operate, so watch your purse. Crime flourishes particularly in periods of civil war, of which there are many. Henry II, keen to keep his kingdom together, makes justice available to all free men – an early form of the common law. Juries of 12 hear cases at the king's courts that travel around the country. The poorest, though, who are not free, have to make do with justice from the lord of the manor, which is often swift and harsh.

In the late 1100s, suspected felons are put to trial by ordeal. One ordeal involves carrying a red-hot metal bar or removing a stone from boiling water. If your skin blisters, you are pronounced guilty. Depending on the seriousness of the offence, you might be put in the stocks (so people can yell abuse or throw rotten food), dragged along the ground by a horse, blinded or hanged.

Another ordeal involves being trussed up and lowered into a pool of consecrated water. If you float – that is, if the holy water doesn't accept your sinful body – you're judged guilty and might then have a foot chopped off. Poachers on the royal hunting grounds risk losing a hand.

Crime is not the preserve of the poor. At the end of the 1300s, Eustace Folville, a Leicestershire lord's son, is part of a gang which carries out rapes, murders and kidnappings to order for people in power.

At the Tower of London, Edward IV uses thumbscrews and the rack as means of torture. Traitors can look forward to being partially hanged, then disembowelled and castrated before having their heads cut off and stuck on a pole; after that, their limbs are dispatched to the places most affected by their actions. Horrible punishments are carried out in public as a deterrent.

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