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Not surprisingly, these filthy cities became a hotbed of disease. Death was at the center of life in the Middle Ages, and the high rate of mortality in overcrowded urban centers, especially that found in infants, posed problems for those tasked with dealing with the dead. Rot, poorly buried corpses, and a general lack of procedure all conspired to make dying very dangerous for all concerned.

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Open-air markets drew throngs of customers to an environment seriously lacking the most basic public health requirements. The floors of places like Billingsgate Market in London would be littered with garbage, rotting fish, fly-ridden entrails, and ever-present animal dung. Invariably, all produce was handled by unwashed hands.

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London, however, emerged as the center of European commerce and trade. Around 80,000 citizens were crammed inside the old Roman walls.

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Living conditions were basic, with few of the amenities we today would call essential.

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The age-old process of tanning—treating skins and hides of animals to produce leather—thrived in medieval Europe. But it was a disgusting and noxious trade involving the use of a dangerous alkaline lime mixture, urine, dog excrement, and even mashed animal brains to soak the skins. The odor, meanwhile, was simply nauseating.

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Few if any cities in the Middle Ages had any semblance of a functioning underground sewage system. Indeed, proper sanitation was for the most part a preserve of the rich.

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Helping to clear away this stinking putrid stockpile were individuals known as gong farmers, or gongfermors. Their thankless task was to dig out and remove human excrement from privies and cesspits. Even so, much of it still ended up in the river.

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During this era, diseases including diphtheria, measles, tuberculosis, leprosy, typhus, anthrax, and smallpox were rife. But nothing prepared the medieval European diaspora for what happened next.

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Medieval London was a maze of twisting streets and narrow lanes. Townhouses, most of them half-timbered, were equally constricted, and three or four stories tall.

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A population so tightly packed together would have stunk. Lice and fleas enjoyed a bonanza of blood.

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The Middle Ages or medieval period lasted approximately from the late 5th to the late 15th centuries. By the 10th century, the population of Europe had increased dramatically. And with this exponential growth, cities like Paris (pictured) saw a huge influx of people.

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Actually, quite often streets sufficed as repositories for human waste. Chamber pots were emptied on them and, worse perhaps, the entrails of slaughtered animals.

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Few people bothered to wash regularly, with even less having more than one set of clothes. In fact, the concept of personal hygiene didn't exist.

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For medieval Londoners, as with those living in Paris, Venice, and other European cities, the only source of water would have been a river. Besides its use as a washing and bathing facility, as well as a provision for drinking water, a river also afforded a convenient dumping ground for all sorts of mess. The water would have been absolutely foul.

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People began complaining of sudden high fever, chills, headaches, and weakness. Other symptoms included coughing, vomiting, and giddiness.

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Vast areas in cities such as London, Paris, and Cologne became burial grounds for the dead.

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Likewise, simply cooking over an open fire produced thick woodsmoke and ash, the fumes of which were funneled skywards to further blight the city skyline.

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Butchers sometimes did the job themselves, bypassing a slaughterhouse and dispatching a pig, goat, or sheep onsite. Animal parts that weren't needed or not sold were tossed into an already clogged gutter.

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Nasty bugs and microbes abounded to create "miasmas," a putrefied air that was invisible or sometimes identified as a mist.

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Instead, communal cesspits were provided for the deposit of human waste. Otherwise the river again served as a place where you could go and excrete straight into the water.

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It's estimated that in a medieval city with a population of 10,000, people typically produced 900,000 liters of excrement and nearly three million liters of urine annually. That's over and above the huge quantities of dung left by horses and livestock and which needed to be shoveled off streets on a daily basis.

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The function of smokehouses made matters worse. The widespread process of smoking meats in urban areas produced sickly, acrid fumes that tended to hang over rooftops for days on end.

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It wasn't uncommon to come across a bloated and decomposing corpse floating in the river. Dead dogs and cats also made up this deplorable detritus.

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Traditional trades such as that of the blacksmith compounded the already increasing problem of air pollution. Smithies spewed toxic gases from their forges.

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Europe's cities were overrun with rats. These rodents carried fleas, which in turn served as vectors for the bubonic plague.

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Soon, millions across Europe had succumbed to what became known as the Black Death.

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Streets littered with human feces and animal entrails, rivers awash with bloated corpses, putrefied air alive with deadly microbes, and the nauseating stench of death and decay. Welcome to your average medieval city. Urban life in the Middle Ages was unbelievably dirty and smelly. Overcrowding and a near-total lack of public services compounded an already unhealthy environment made worse by spreading disease. But why exactly was living in a city during this era such a horrendous and frankly dangerous experience?

Take a deep breath, tread carefully, and click through this foul and disgusting list of excuses.

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Medieval slaughterhouses were notorious for the dreadful mess left in the wake of butchering livestock. While blood and water with fur or hair could be rinsed away, heads and entrails were simply disposed of in the street.

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Stews of beef and mutton, and vegetables such as cabbage and leek, were for many the mainstay of the medieval diet. Supplying meat, however, contributed enormously to the unhealthy conditions experienced by the average citizen in the Middle Ages.

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In 1666, a devasting fire destroyed much of medieval London. Ironically, it took a disaster of this magnitude to drag the city out of the Middle Ages and make it a safer and cleaner place to live. And its rebirth served as a template for other cities across Europe.

Sources: ('The History of London') (University of California Press)

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The inability of medicine to deal with common injuries saw surgeons taking drastic measures to diagnose and treat even the simplest of maladies, often in contaminated surroundings.