What about the reality of the ‘‘good old days’’? In this chapter, we’ll review the health history of those days and demonstrate that health in times past may not have been as good as we imagine. Indeed, the image of health in the ‘‘good old days’’ is usually ignored, often idealized in historical representations in books, movies, and television. Because of this, many people imagine that generations in prior history were fortunate, experiencing little disease; clean air and water; and lots of good, wholesome food. With this comes a sense that hygiene and cleanliness practices in the ‘‘good old days’’ were sufficient and would be protective in our daily lives today. Since few of us experienced those days, we depend on historical records, which can be manipulated and misinterpreted. Moreover, many people have different perceptions about what constitutes a historical record. Many of our impressions about the past are based on images created in movies and historical novels, not on data. We identify with royal heroes, aristocratic heroines, dashing adventurers, dramatic events, and happy endings. But rarely do movies and novels describe the ugliness of smallpox, the pathos of infant diarrhea, and the rotting piles of waste. They hardly deal with the daily struggle and misery of the common people, nor the filth, disease, and suffering that they experienced. Let’s look at the historical record and see what those ‘‘good old days’’ were really like. . . FILTH AND WASTE We know that the ancient Romans developed sewers and public baths, the Greeks were concerned with physical beauty, clean skin, and healthy diets, and the Talmud (ca. 2,000 BC) promoted physical cleanliness as a prerequisite to physical and spiritual health. But Europe during the Middle Ages went a thousand years without a bath, and sanitation was as foreign as the toga! By the 19th century in Europe, the public sanitation practices and aims of ancient Greece and Rome had been lost. Europe during the Middle Ages went a thousand years without a bath! Some insights into the causes behind this development come from John Simon, who claimed that the sanitary practices of the Romans and Greeks were in direct conflict with the monastic and ascetic values of