Prescriptive allowances for infirmity in medieval England

Arrangements for sick leave among customary tenants who owed labor services on the manorial demesnes of medieval England have predominantly been studied from thirteenth-century custumals and surveys of a range of landlords. Historians have emphasized the variety of such arrangements in terms of how long tenants might be excused from their works, which could range from up to a fortnight through to a year and a day, with such allowances also varying from manor to manor on the same estate. As a result of this variation, Bennett concluded that “these wide limits are evidence enough that no very clear rule can be laid down.”Footnote ²¹ The Ely Coucher Book of 1249–50 provides an excellent example of the ways in which local arrangements differed between manors in medieval England while also showing that such variations had their limits. Thus, even on the manors of the bishops of Ely within the Cambridgeshire fenlands, there were different arrangements for when tenants who owed labor services fell ill. At Ely itself, for example, customary tenants were excused from performing their labor services when they were infirm for up to a fortnight during the busy harvest period but for a month during the rest of the year.Footnote ²² At Stratham, tenants were allowed a fortnight of leave if they had a long illness but were still expected to fulfill their ploughing service and harvest obligations throughout this time; if they were sick for a shorter period, then they were quit of all labor services during their illness.Footnote ²³ In contrast, Wisbech manor avoided any such quibbles by simply noting that if a tenant was ill “nevertheless he will do the labor services he owes.”Footnote ²⁴ Infirm tenants were not expected to provide these services themselves, but rather to find an appropriate substitute to take their place, such as a family member or even a hired laborer. As Paul Harvey noted, “we must not be misled by the custumal’s phraseology: “he shall work two days every week” normally means that the tenant has to provide someone to do the work, not that he need do it in person.”Footnote ²⁵

Arrangements not only differed from place to place but could also depend upon the length of illness and the size and tenure of land that the sick tenant held. At Colne and Somersham, for example, customary tenants of full lands were excused from their labor services for up to thirty days when ill, though they were expected to continue to perform their ploughing service and harvest boons regardless; cottagers were excused their labor services for ten days if ill; while a tenant holding a toft would not be “excused from his labor services by reason of any illness in the course of the year.”Footnote ²⁶ Nevertheless, despite such variations in arrangements—some of which could be quite drastic—some general patterns do emerge on the Ely estate. Sick tenants were normally excused for anywhere between a fortnight and a month, although they were often still required to fulfill their ploughing or harvest obligations.

Custumals from the Sussex manors of the bishops of Chichester from the thirteenth and fourteenth centuries reveal similar arrangements. At Selsey, for instance, a customary tenant would be quit of works for up to a month “but no more even though he is (still) sick,” and a cottar would only be excused from work for two weeks.Footnote ²⁷ In 1276, there was a similar situation recorded at Sidlesham and Aldingbourne, where customary tenants were allowed between a fortnight and a month of absence, while at Amberley and Rackham there was a qualifier relating to the severity of the illness, which stipulated that “whoever of the workmen is so sick that he is shriven and houselled shall be quit of the works of two weeks.”Footnote ²⁸ The Church had a series of such rites for sickness, which not only depended on the severity of a person’s illness but might also involve a priest visiting the infirm individual’s house, offering them the sacrament of anointing with holy oil and hearing their confession.Footnote ²⁹ Arrangements at Preston varied again: there was the usual illness allowance to tenants of a fortnight, but only outside of the harvest period; during the harvest, they were excused half of their works while sick.Footnote ³⁰ At Stretham in 1373–74, tenants were excused from their labor services for two weeks, but there was also a provision that “if he dies of that illness he shall be quit of his works for a month from the day he was houselled.”Footnote ³¹

Although much of the language of these provisions is uniform, some included detailed stipulations, such as those in the custumal of Slindon (Sussex), which belonged to the archbishops of Canterbury. In 1285, it was noted that if a tenant was “seriously ill he shall be quit of his month’s works and no more, although he has labored in illness for a whole year.”Footnote ³² A particularly full description of such arrangements survives in the survey of Hartest (Suffolk), belonging to the bishops of Ely, which in 1251 noted that:

The provisions described thus far relate to manors belonging to large and wealthy ecclesiastical lords. This is partly a result of the better survival of documentation for such landowners but also reflects the fact that such estates tended to require particularly heavy labor services. Nonetheless, equivalent arrangements can be found on the estates of their lay counterparts. For example, a survey of the estates of the Fitzalan earls of Arundel from 1301 notes that the cottars of Bourne (Sussex) could be excused from work for up to forty days when ill.Footnote ³⁴ An inquisition into the lands of Sir Robert de Beauchamp in 1251 stated that at Stoke-sub-Hamdon (Somerset) a sick customary tenant could be excused from his labor services for up to four weeks but “after the four weeks, he must work with the other men, whether well or sick, if the lord so will [sic].”Footnote ³⁵

Although there is considerable prescriptive evidence for sick leave arrangements, we should be cautious of assuming that all customary tenants in medieval England had such allowances. After all, lords did not specify how a tenant should perform their works, caring more that the obligation itself was satisfactorily fulfilled rather than how. Tenants might perform the works themselves, send a family member in their stead, or even hire someone to perform the service. In the many stipulations above that enforced ploughing and harvest services, lords can hardly have envisaged that a feverish tenant would drag themselves from their sickbed to perform a day of hard labor but rather that they would find a suitable replacement if they were too ill. The court at Writtle (Essex), for example, heard complaints in 1381 that instead of sending a man to perform their service as custom specified, tenants had substituted “a boy aged fourteen years” and a boy “who harvested badly.”Footnote ³⁶ Thus, although on many estates there are no mentions of absences for illness, this is presumably because tenants were expected to make alternative arrangements so as to fulfill their tenurial obligations.Footnote ³⁷ It is not that the surviving evidence explicitly denies this right to their tenants (as at Wisbech above), but simply that they make no mention of arrangements for excusing labor services when ill. Such silences in the evidence serve as a reminder that provisions for infirmity were not necessarily universal and that many tenants were probably faced with needing to provide a substitute to take their place on the lord’s demesne should they fall sick themselves. Some sick tenants may even have tried to continue working, as on the manor of Esher (Surrey) where Robert de Panymor “worked on the point of death … by order of the lord bishop for twelve days” around the Christmas of 1290/91.Footnote ³⁸

Another consideration to bear in mind is the differing extent of labor services due on each manor. After all, what might appear particularly “generous” leave arrangements on one manor may simply have been a recognition of the especially onerous exactions that existed there, with heavy labor services potentially requiring more extensive sick leave provision. This may help to explain the variations seen above in the sick leave entitlements, which were based upon the size and tenure of holdings. On some manors, tenants of virgate holdings of approximately 30 acres were excused from more of their labor services because they were more heavily burdened with such exactions than cottagers. However, these considerations do not explain all the varying practices outlined here. After all, tenants at Wisbech did not seemingly have a lighter burden of services than did their counterparts on neighboring manors, which would explain why they were not entitled to any reprieve when they fell ill.

Moreover, there is little evidence of the actual implementation of such sick-leave arrangements beyond occasional ad hoc references. Glimpses of infirmity can be caught where alternative arrangements were made in the absence of a worker, as in the cellarers’s rolls of Battle Abbey (Sussex) where, in 1420/21, in the absence of the ploughman who was sick for 84 days, a man was hired to drive the wagon and plough at a cost to the abbey of 14s.Footnote ³⁹ The same records show that Thomas Hoker was paid 20d for looking after the pigs in the absence of John Preest, who was infirm. Unfortunately, there is little evidence—even in the Ramsey Abbey material—of the direct hiring of one individual to replace the missed labor of an infirm worker. Such examples, however, serve as a timely reminder that sick leave arrangements could cost the lord if they were required to find a replacement. It is little wonder, then, that so many arrangements stipulated that infirm tenants still needed to fulfill their ploughing or harvest obligations, which were not only crucial tasks in the agricultural calendar but were also the most expensive forms of labor to replace.

Allowances for infirmity at Ramsey Abbey

Although practices varied between manors, there was a broad pattern of obligations and allowances for infirmity across medieval England, that is until we turn to the Huntingdonshire manors of Ramsey Abbey. An inquisition of 1251 noted that sick tenants at St. Ives would be excused from all works except for ploughing services during illness for up to the “end of a year and a day,” after which they were expected to resume their normal services.Footnote ⁴⁰ No other estate in medieval England seems to have had such an extended period of leave. The same inquisition reveals similar arrangements were in place at the abbey’s manors of Wistow, Houghton, and Hemingford.Footnote ⁴¹ At Holywell-cum-Needingworth and Abbots Ripton, the same practice was found, except that here it was stipulated that if the illness should fall during the harvest, tenants were only to be excused from half of their works.Footnote ⁴² Cottagers at Holywell-cum-Needingworth were also specifically given the same rights to leave as full virgaters, while at Abbots Ripton it was noted that tenants were not to be excused from work beyond the period of a year and a day, even if they were still infirm.Footnote ⁴³ At Warboys, Broughton, and Upwood, tenants were seemingly excused from all of their labor services throughout the period of their illness for up to a year and a day, with the 1251 inquisition noting that at Broughton if a tenant became ill, “his wife will stay at home to look after him,” while at Upwood it stipulated that “if any of them falls ill at any time, the lord abbot will substitute another in his place during the time of his illness.”Footnote ⁴⁴ Although it was a reality that the lord would have to make up the shortfall in labor in such cases, it is nonetheless surprising to see the monks so clearly assuming this obligation in their custumal. As can be seen in Figure 1, most of the above manors were in Huntingdonshire, not far from the Abbey itself, but three more far-flung manors in Bedfordshire deviated from these arrangements: at Cranfield, tenants were excused from their works for only fifteen days; at Shillington tenants were excused for fifteen days during the autumn but for three weeks the rest of the year; and at Barton tenants were excused for fifteen days if they were so ill they had taken the sacrament.Footnote ⁴⁵

Source: Map constructed by Tudor Skinner from: Addy Pope, GB Rivers, [Dataset]. University of Edinburgh, 2017; WFD Lake Water Bodies Cycle 1 © Environment Agency copyright and/or database right 2017. All rights reserved. Contains Ordnance Survey data © Crown copyright and database right 2008; NASA JPL, NASA Shuttle Radar Topography Mission Global 1 arc second, 2013. Sioux Falls, South Dakota, USA: NASA Land Processes Distributed Active Archive Center, https://doi.org/10.5067/MEaSUREs/SRTM/SRTMGL1.003

Figure 1. Map of the Ramsey Abbey manors containing evidence of illnesses.

Why Ramsey Abbey should differ from the seeming pattern of leave arrangements established elsewhere by offering infirm tenants up to a year and a day of relief from performing labor services remains unclear. Yet, the rarity of this material is precisely what offers unique insights into the history of infirmity and work in medieval England.

Ramsey Abbey manorial accounts

So far we have examined the prescriptive evidence, set out in custumals and manorial surveys, about how absences caused by infirmity should have been dealt with. Where the Ramsey Abbey evidence differs from that of other estates is that it allows us to see how the allowances for sickness were actually dealt with in practice. This can only be reconstructed from the “works” section contained within some manorial compoti (accounts) in which the reeve or bailiff accounted for the use of the labor services (the “works”) available to the lord.Footnote ⁴⁶ In most manorial accounts elsewhere, the works sections simply give the total number of labor services supposedly available for each category of service—such as winter, summer, autumn, and post-autumn works—and indicate the number of works owed per week on the lord’s demesne from each type of holding on the manor.Footnote ⁴⁷ The manorial accounts then detail how the works were actually expended during the year, including, for example, the total number used in agricultural tasks on the demesne. Such works accounts are thus normally concerned with how the labor services were discharged rather than with naming the individuals who did, or did not, perform them. As a result, even in the works accounts where deductions for illnesses are recorded, only overall totals of missed works are normally provided, and the absent workers remain anonymous.Footnote ⁴⁸

By contrast, the Ramsey Abbey works accounts routinely recorded absences caused by infirmity, detailing the names of ill tenants and including the length of their absences and the number of works they missed. We have not uncovered any examples of such a systematic recording practice of absences on other estates.Footnote ⁴⁹ It is possible that recording the names and absences of infirm tenants was unique to the Ramsey Abbey monks, who were especially bureaucratic in the management of their estate, and may have resulted from their extended provision for sick leave, which necessitated tracking ill tenants for up to a year and a day.Footnote ⁵⁰ An example of the detailed management of the Ramsey monks can be seen at their manor of Houghton-cum-Wyton, where Judith Bennett found that they effectively prohibited sales of real property among their tenantry, while they carefully monitored the labor services due from tenants and amerced all those guilty of work defaults. She concluded that “seigneurial authority was, in short, very much a reality in Houghton-cum-Wyton before the plague.”Footnote ⁵¹ Table 1 sets out the number of references to allowances for infirmity that have survived on the Ramsey estate from across the fourteenth and early fifteenth centuries.

Table 1. The number of works accounts with references to allowances for illness.Footnote ⁵² Source: Ramsey Abbey account rolls at the British Library and The National Archives

The surviving evidence of infirmity is thus not evenly distributed across the Ramsey Abbey manors. There are no references to illnesses at Burwell, Brancaster, Bythorn, Chatteris, King’s Ripton, Lawshall, Ramsey, or St Ives, though this is probably due to the lack of surviving works accounts for some of these manors. Conversely, Warboys has the most incidences of illnesses, in part because of the far higher survival rate of works accounts from the manor. Even here, the evidence is not spread evenly across the whole period. For example, the first reference to illness at Warboys is from 1336/37, but this simply states that many tenants were ill, with the earliest list of the infirmities of named individuals coming in 1342/43.Footnote ⁵³ The last reference to allowances for illness at Warboys is in 1407/08, after which labor services were almost entirely commuted. Weekly works were no longer performed after 1416, although there were a small number of tasks, such as harrowing and mowing, that were undertaken by a handful of tenants. While the Warboys manorial accounts continued to retain a works section, they no longer include any allowances for infirmities or feast days.Footnote ⁵⁴

Figure 2 sets out the chronological and geographical survival of the Ramsey Abbey evidence, revealing the fragmentary nature of this data. Multiple accounts survive for several years in the 1340s, unlike in most other decades, and so undue significance should not be placed in any subsequent peaks in the 1340s as this most often represents a larger sample size of evidence rather than, necessarily, any higher prevalence of infirmity or sick leave. Caution must also be taken when analyzing changes over time because the evidence is derived from multiple manors, each with its own population size, which cannot be accurately estimated over time. As a result, the actual prevalence of illness on these manors cannot be determined. This is further complicated by the fact that each manor had different tenurial obligations for its tenants, which evolved across the fourteenth century, with the leasing out of demesnes and the commutation of labor services into cash rents making it less likely that labor services would be enforced and thus that allowances in this regard would be required or recorded.Footnote ⁵⁵

Source: Ramsey Abbey account rolls at the British Library and The National Archives.

Figure 2. The chronological and geographical survival of manorial accounts, which include allowances for infirmity on the Ramsey Abbey estate.

As Table 1 and Figure 2 demonstrate, the manor of Warboys accounts for nearly half of the incidences of illness in our evidence. This is not just the product of a higher survival rate of its manorial accounts but is also caused by the survival of one particular works account, that of 1348/49, the year the Black Death struck England.Footnote ⁵⁶ Unfortunately, it is the only works account that survived for the Ramsey estate for this year. This disproportionately impacts our analysis, not least because it records a spike of twenty-two illnesses in just a thirteen-week period over the summer, which affects any analysis of the seasonality of sickness. The experience of the Black Death has the potential, therefore, to distort some of the analysis and so, where indicated, the accounting year of 1348/49 for Warboys has been excluded.Footnote ⁵⁷

A brief explanation of the system of demesne “works” is required before proceeding further into the evidence of tenant absences. Each manor had its own customary system of labor services, and so every variant cannot be described here, but Warboys serves as an example of the general tenurial obligations placed upon the abbey’s tenants.Footnote ⁵⁸ The “works” varied with the agricultural season and might involve tasks such as harrowing, ploughing, or weeding, and the custumals specified the length of time a tenant was obliged to work, such as between sunrise and sunset. As can be seen in Table 2, a tenant of a virgate holding owed three works per week in winter and summer, four in the post-autumn period, and five in the autumn.Footnote ⁵⁹ This higher burden of services in the busy harvest period may help to explain some of the seasonal patterns of absences noted below. Some lords in medieval England were willing to commute labor services. For example, on the bishop of Worcester’s estate, a third of labor services had been commuted to a cash rent by 1302.Footnote ⁶⁰ The patchy survival of the Ramsey manorial accounts make this process difficult to track on individual manors across the fourteenth century, but the monks did “sell” unused works back to their tenants, the implications of which are explored below. There were also some one-off works required of tenants, such as additional weeding known as “loveboon” weeding.Footnote ⁶¹ The burden of these works fell most heavily upon tenants of the larger holdings, full virgates, which at Warboys were 30 acres, down to the maltmen and akermen who held cotlands of half-virgate size, and then the mondaymen who held the smallest units of a croft and an acre.Footnote ⁶²

Table 2. Number of works owed by customary tenants at Warboys, 1342/43. Source: Add. Roll 39803, BL

Crucially, most customary tenants who owed labor services had a weekly obligation to work upon the lord’s demesne throughout the year, and so they should appear in the records if they fell ill and could not perform their services. The only difference here is that we might expect the records to include more virgaters who experienced short-term acute sicknesses at harvest time, when they owed five works per week, compared to the mondaymen who only performed their works on Mondays and whose illness during the rest of the week would therefore not feature in the manorial accounts. This also means that the long-term absence of a virgater had a disproportionally more significant impact on the loss of works to the monks than that of one of their neighbors on a smaller holding. For example, William de Hoghton, a virgater at Upwood, was ill for the whole autumn of 1342/43, as part of a longer-term absence, missing five weeks and two days, representing thirty-seven missed works, whereas his neighbor, Geoffrey Siwelle, who held a cotland of two acres, was absent for the same period but only missed eight works.Footnote ⁶⁴ The number of works missed does not always neatly correspond to Table 2, in part because each manor had slight variations in the tenants’s obligations and also because the calculations in the works accounts have sometimes already taken allowances for feast days into consideration. Tenants were not only excused from their labor services if they were ill, but they were also allowed time off on feast days, and this was sometimes factored into the calculation for missed works, especially for long-term absences (i.e., a tenant owing three works per week might have missed ten weeks but only be recorded as missing twenty-five works because the other five were feast days when they were not expected to work). Allowances for feast days during an individual’s illness were not systematically disaggregated in this way, and the number of feast days observed varied by manor and year.Footnote ⁶⁵ As a result, in the following analysis we have indicated the number of works missed because of sickness, alongside the length of such absences.

It is also important to note that despite the detailed information provided in these manorial accounts, they do not provide a general survey of sickness on these manors. Even within this exceptional source, the experience of most women, children, or, indeed, of men who did not owe labor services, cannot be observed. We should not, for instance, place any importance on the fact that most of the absentees are men since this reflects the gender bias of manorial land tenure and servile obligations rather than any sex-selectivity of illness in late medieval England.Footnote ⁶⁶ It should also be remembered that the following is not a study of physical recovery from illness but rather of when people were sufficiently recovered that they returned to performing their labor services. This is a potentially vital distinction because people may have been well enough that they were ambulatory but not so well that they felt able to return to hard physical labor. Indeed, there may even have been an added cultural dimension at work here since it has often been remarked by historians that customary labor services may have been “frequently resented as a mark of unfreedom and thus probably grudgingly performed.”Footnote ⁶⁷ If so, we should not expect tenants to have been overly eager to return to performing them, and the length of absences may reflect a certain foot-dragging on the part of some tenants.

The works accounts also do not go into any detail about the actual nature of the tenants’s infirmities. Most simply use the phrase egrota, which is a general term for sickness, and on occasion infirma, again a general term equivalent to our modern notion of infirmity. It is difficult to detect patterns in the variable usage of these terms, although when an illness continued over multiple seasons, it tended to be referred to as continued infirmity (infirma). Unfortunately, therefore, the underlying cause of the absence cannot be determined from the language of the manorial accounts, though it is likely that infirm tenants suffered from a range of viral and bacterial infections, respiratory infections, heart disease and strokes, or even accidental injuries and fractured bones.Footnote ⁶⁸ Most entries follow the general rubric of noting that a particular person was infirm, the length of their absence, and the number of works they had missed, as in the case of Matilda Russell who held a half-virgate at Knapwell in the winter of 1347/48, when she missed four weeks and seven works: “et Matilda Russell, semivirgati, egrota, per iiij septimanas, vij opera.” A handful of cases used more specific language. At Abbots Ripton, Amic’ Hythe was described as languid, perhaps indicating a weakness or fatigue, during her six-week absence in the winter of 1368/69: “et allocatione Amic’ Hythe, virgatari, languido per vj septimanas, xviij opera.”Footnote ⁶⁹ At Knapwell, Thomas Bovyel junior was excused from his sowing works in the winter of 1377/78 because he was described as impotent: “in allocatione operi Thomae Bouyel Junior, conducere per seminare quia impotens, lij opera.”Footnote ⁷⁰ At Holywell-cum-Needingworth, Richard Gray was excused for sixteen works due to an illness lasting eight weeks in the summer of 1371: “et in allocatione Ricardi Gray languentis ad mortem per viij septimanas xvj opera.”Footnote ⁷¹

At other times, the works accounts follow the rubric more commonly found on other estates by summarizing allowances for illness rather than specifying individual tenants, as on the manor of Elton in 1324/25: “item infirmis pro infirmitate xxxiiij.”Footnote ⁷² Such instances have been included in Table 1 as references to illness but they cannot be analyzed beyond this as they do not provide any further biographical details of the infirm. As a result, the absences may not always refer to sicknesses caused by specific diseases but could imply infirmity from a range of potential causes, such as malnutrition leading to extreme exhaustion and incapacity, or even to workplace accidents in which individuals may have been injured so seriously that they were unable to continue working. As noted in the custumals discussed above, infirmity as a reason for absence was supposed to be sufficiently serious that individuals could not perform their labor services. At Ramsey Abbey, the sick, particularly in the late fourteenth century, were referred to as “confessus et communicatus,” indicating that they had received confession and communion because of the severity of their infirmity.

Seasonality and length of sick-leave absences

What, then, can be said about the seasonality of infirmity on the manors of Ramsey Abbey? At first glance, Table 3 suggests that the incidences of infirmity at Warboys appear relatively evenly distributed across the seasons, except in the post-autumn period. However, as noted above, the Warboys evidence is distorted because of the inclusion of the twenty-two individuals who fell ill with plague during the summer of 1349. Once the accounting year of 1348/49 is excluded, there is an obvious seasonal pattern to sicknesses at Warboys and the other Ramsey manors, in which winter accounted for more infirmities than the other seasons. Yet, this is largely a product of the way that manorial accounts divided the year into seasons as much, if not more, than because of the prevalence of winter diseases. Medieval accounting seasons were not evenly distributed blocks of time.

Table 3. Seasonality of absences caused by illnesses on the Ramsey Abbey estate. Source: Ramsey Abbey account rolls at the British Library and The National Archives

Table 4 demonstrates the different lengths of each season for the manorial account of 1342/43 for Warboys.Footnote ⁷³ The exact length of accounting seasons varied by manor and year because seasons often started or ended on feast days, some of which were not fixed in the annual calendar.

Table 4. Length and timing of seasons in the manorial account of Warboys, 1342/43. Source: Add. Roll 39803, BL

The variations in the length of seasons on the Ramsey Abbey manors can be seen in Table 5. At Warboys, Abbots Ripton, Holywell-cum-Needingworth, Slepe, Upwood, and Wistow, winter ran from Michaelmas (29 September) to either Hockday (Tuesday of the second week after Easter) or Pentecost (seventh Sunday after Easter), while at Houghton it ran to St Trinity (Sunday after Pentecost) and at Broughton it ran all the way to the Nativity of John the Baptist (24 June). Despite variations, “winter” was thus always by far the longest season, covering a longer period than the other seasons combined. Summer then ran from Hockday, Pentecost or St Trinity to Gula Augusti (1 August), while at Broughton it was shorter, running from 24 June to 1 August. Cranfield, Elton, and Knapwell have been analyzed separately in Table 3 and have been excluded from Figure 3 because they combined these two seasons into one overlong season that ran for 43 weeks between 29 September and 1 August. Autumn and post-autumn were the same on most manors, running from 1 August to 8 September, and 8 September to 29 September respectively, though Cranfield and Knapwell combined these into a single eight-week season.

Source: Ramsey Abbey account rolls at the British Library and The National Archives

Figure 3. The seasonality of incidences of illness across the Ramsey Abbey manors.

Table 5. Variations in the length of seasons on the Ramsey Abbey manors. Source: Ramsey Abbey account rolls at the British Library and The National Archives

In other words, what Table 3 shows is that the autumn harvest period had a very high number of absences considering that it covered just five weeks in August and early September. Figure 3 presents this seasonality of absences across the fourteenth century, which clearly demonstrates the exceptional peak in summer absences of 1349. In some ways, this pattern contrasts with that found by Harvey in her study of the Westminster Abbey infirmary in which she found that “the infirmarer was, it appears, more likely to have empty beds in the autumn (September to November) or winter (December to February) than in spring.”Footnote ⁷⁴

There are many potential reasons that might explain this seasonal peak in autumn indicated by the records. One is that it is an accurate reflection of the seasonality of disease. However, it should also be remembered that these absences were not specifically related to disease but were allowances for infirmity more generally. It could, therefore, be the consequences of the demands of the harvest in medieval England, in which tenants, themselves at the edge of subsistence and overworked, simply could not keep up with the demands made upon them. After all, a virgater at Warboys was expected to provide five works per week and, although they could send family members or even employ someone to do the works in their place, this must have proven difficult for some households to fulfill. Exhaustion would have been a very real and life-threatening danger in medieval society, especially for older or malnourished tenants during a summer heatwave. With tiredness, accidents could also happen, and presumably at least some of the infirmities were the result of workplace accidents that incapacitated someone for weeks at a time.Footnote ⁷⁵ This autumn peak might also reflect the simple fact that most labor services were due during the harvest; it stands to reason that most absences would coincide when most works were themselves due, especially since some tenants on the manors might only have owed harvest works. This seasonal peak might also reflect the monitoring practices of the monks, who were presumably more eagle-eyed than at other times of the year given the importance of the harvest and the additional costs of finding replacement labor at the most in-demand time of the agricultural season.

Finally, however, the high frequency of autumnal infirmities apparent in the Ramsey manorial accounts might reflect the potential for sick-leave fraud. After all, the tenants’s priority was presumably to work on their own lands, getting in the harvest as the weather allowed, and there must have been a temptation to avoid working on the lord’s demesne if a potential excuse was available. Given the heavy demand for agricultural labor during the harvest, especially with the labor shortages caused by the Black Death, tenants may even have pretended to be ill so as to avoid fulfilling their labor services while hiring themselves out elsewhere. Certainly, contemporaries were aware of the possibility that people might feign infirmity. William Langland included the characters of idle wastrels in his allegorical poem, Piers Plowman, who “said they were blind/Or tried the old trick of pretending to be crippled,” claiming that they were “far too sick to sweat and to strain.”Footnote ⁷⁶ When threatened by Hunger, however, “The bed-ridden and blind were cured by the cartload,/And sprawling beggars sprang up quite sound.”Footnote ⁷⁷

There are examples that survive in the court rolls and manorial accounts of medieval England of individuals who appear to have been fined for falsely claiming infirmity. For instance, on the Glastonbury Abbey manor of Damerham (Hampshire), the whole halmote was amerced 2s because they presented one of the tenants, Henry, as infirm in 1373, when he presumably was found not to be.Footnote ⁷⁸ We have not uncovered any examples of such fraudulent practices on the Ramsey manors, and the monks were likely vigilant against such possibilities, especially as infirm tenants were supposed to have received the Sacrament if they were so ill that they could not work. Presumably manorial officials could work closely with parish priests in deciding who may have been feigning sickness.Footnote ⁷⁹ Yet, we should not discount the possibility that at least a few of the individuals who were absent during the harvest may not have been quite as sick as they may have claimed.Footnote ⁸⁰ It is also possible that tenants who claimed they were infirm but who were deemed not to be by the reeve may simply have been fined for refusing to work, as opposed to being fined explicitly for feigning illness. There are many examples in the Ramsey Abbey court rolls of individuals being cited for not coming to work on the demesne when called and it is entirely possible that a denied request for sick leave lies behind some of these entries. The seasonality of such refusals to work aligns with the examples of sick leave here, with J.A. Raftis noting that they “virtually never occurred during the winter and pre-harvest summer periods,” “but during the hard-pressed harvest season it could be otherwise.”Footnote ⁸¹

Overwhelmingly, as Table 6 shows, the most common length of absence due to infirmity was three or four weeks but, again, this is skewed by the recovery time from the Black Death over the summer of 1349. Once this is removed, there is a more even spread of absences, though most still came in at under a month. Although we have grouped periods of infirmity to the nearest week (in most cases, they already are within the accounts themselves), a potentially interesting example is the cluster of workers missing fifteen days, which was a stipulation of the maximum allowance on some of the Bedfordshire manors of Ramsey Abbey, and which has been included as a separate category.

Table 6. Length of absences caused by illness on the manors of Ramsey Abbey. Source: Ramsey Abbey account rolls at the British Library and The National Archives

There is a cluster of illnesses that lasted a week or less, and the diligence of the monks in recording even short-term sicknesses can be seen in the example of Richard Berenger. He held a quarter-virgate of land at Warboys and fell ill for just two days in the post-autumn period of 1343, missing half a work.Footnote ⁸² Other short infirmities include those of William Frebern, who held a croft at Knapwell, and who was ill for a week in the autumn of 1348, missing two works; Simon ad Porea, a half-virgater of Broughton, who was absent for a week in the winter of 1342/43, missing two works; and John Miles, a virgater from Upwood, who was absent for a week in the summer of 1356, missing three works.Footnote ⁸³ As far as we can ascertain, none of these sicknesses proved fatal, and each person presumably recovered and returned to perform their labor services after a short bout of illness. It is these kinds of acute illnesses, perhaps involving vomiting, diarrhea, or flu-like symptoms, which incapacitated individuals for a few days and which were presumably very common in medieval England, that have virtually escaped the historical record entirely.

By contrast, there were some individuals who had long-term, chronic, and presumably debilitating infirmities. For example, Richard Colleson, who held a virgate of land at Warboys, fell ill in the post-autumn period of 1347 for three weeks, missing twelve works.Footnote ⁸⁴ His sickness continued into the following winter (thirty-one weeks, eighty-seven works), summer (twelve weeks, thirty-four works), and autumn (five weeks, twenty-three works) of 1348.Footnote ⁸⁵ It is unclear whether Richard had recovered at this point or if he had simply run out of sick leave and had to continue fulfilling his tenurial obligations. Another long-term absentee was Thomas Elot, who held a half-virgate at Wistow and fell ill in the post-autumn period of 1391, missing three weeks and seven works.Footnote ⁸⁶ He was then ill for some of the next winter, though not the whole season, suggesting that he had returned to work at some point (missing twenty weeks, thirty works). This absence then seems to have continued into the summer (ten weeks, fifteen works), the autumn (five weeks, twenty-two-and-a-half works), and the post-autumn of 1392 (three weeks, four-and-a-half works), totaling forty-one weeks and seventy-nine works missed across two potential lengthy absences.Footnote ⁸⁷

Given that such long-term absentee workers could be excused dozens, if not hundreds, of works, the monks presumably had a system of monitoring potential abuse of the system. These manors were not large communities, and it would not have been difficult to check the veracity of someone’s illness at multiple points during a year-long absence. Unfortunately, because customary tenants were only entitled to up to a year and a day of absence, we cannot see what eventually happened to them: presumably, they were forced back into performing their labor services, ill or not, as some of the custumals suggest. If they were unable to continue working, some may have given up their holdings or entered into arrangements with others in the village to perform their labor dues, much akin to the contracts some tenants created in their old age, though the patchy survival of works accounts with corresponding court records make this difficult to verify.Footnote ⁸⁸

There were also individuals who suffered from repeated bouts of illness, as in the case of John Wodecok, whose story of multiple illnesses introduced this article.Footnote ⁸⁹ He was not alone in this. A good run of ten accounts with records of illnesses survives for Houghton between 1369/70 and 1395/6, which demonstrates the potential regularity of absences caused by infirmity in late medieval England. Of the twenty-two absences recorded, eight were of men who had a single absence, two who had two absences, two who had three absences, and one who had four absences.Footnote ⁹⁰ The potential for some customary tenants to have short but frequent infirmities is perhaps exemplified by Robert Payn, who held a virgate at Houghton. He was absent in the autumn of 1392/3 for three weeks, missing twelve works; then again in the winter of 1393/4 for three weeks, missing nine works; again, in the post-autumn of 1393/4 for a further three weeks, missing eleven works; and again, for an additional week in the autumn of 1395/6, when he missed four works.Footnote ⁹¹

On the manor of Warboys, out of the 107 incidences of illness, there were seventy-three separate individuals (and two entries of “many” ill people). Of these seventy-three people, fifty-four appeared only once, eleven appeared twice, three appeared three times, three four times, and one person on five occasions. Given the patchy survival of the works accounts, as laid out in Figure 2, there must have been far more repeated absences than can be traced in the extant material, especially on the other manors where only a handful of works accounts have survived. John, son of Geoffrey, appears ill in three separate accounts and provides a good example of both how tenants might have multiple absences due to illness and of the difficulties of tracing where one sickness ended and another began in the surviving accounts. John first appears in the winter of 1347/48, holding a virgate of land, when he was sick for fifteen days, for which he missed six works.Footnote ⁹² He was also ill for four weeks in the summer—possibly of the same illness if the previous absence was at the end of the winter period—and so missed a further twelve works. John was then ill in the summer of 1349, presumably suffering from plague during the Black Death, and so missed another four weeks and twelve works.Footnote ⁹³ His final two appearances come in 1349/50, when he was absent for three weeks and nine works in both the winter and summer seasons though, again, this may have been one continual illness across the seasons that lasted for six weeks.Footnote ⁹⁴ This example demonstrates some of the challenges in quantifying the number of repeated illnesses: was John sick on five occasions or, rather, were two of these continual illnesses that traversed the accounting periods of winter and summer? Although the works accounts give many details, they do not provide any clarity on when in the season a person fell ill.

Another example of a long-term absentee is Robert Albyn, who had repeated absences; in 1346/47, he held a virgate of land at Warboys, and he fell sick for a period of thirty-three weeks, missing a total of 115 works. The manorial account notes that he was continuously ill (egrota) in the winter, and in the summer he was excused due to his continued “infirmitate.”Footnote ⁹⁵ He recovered, as he later appears in 1353/54, when he fell ill for three weeks in winter and seven weeks in summer, again perhaps representing one continual illness or two shorter bouts of sickness, missing a total of thirty works.Footnote ⁹⁶ Nicholas Roger, who held a half-virgate at Broughton, fell ill three times in the same year, through the winter, summer, and autumn, but each absence was only for a short period of time and so was unlikely to represent one continual illness. In the winter, he was ill for three weeks and missed four works, and in the summer and the autumn he missed fifteen days and four works in each season.Footnote ⁹⁷ He may, therefore, have recovered sufficiently to return to work, only to relapse multiple times or, alternatively, he may have had multiple short bouts of separate illnesses.

The case of William de Hoghton is an example of someone who had a long-term illness but who may have tried to return to work partway through his infirmity. He initially fell ill at Upwood during the winter of 1342/3, missing four weeks and twelve works. William is then recorded as sick in the summer (twelve weeks and three days, twenty-nine works), autumn (five weeks and two days, thirty-seven works), and post-autumn (three weeks, eleven works), so it would appear to be one continuing infirmity. However, his summer allowance is not for the full season, and the account specifically notes that he was absent from 6 May. In other words, William was absent for some of the winter, potentially tried to return to work, but either relapsed or caught another illness and missed the rest of the accounting year.Footnote ⁹⁸ Henry Edward, who held a half-virgate at Warboys, is an example of someone who was repeatedly ill, suffering from a long-term chronic sickness, and who died afterwards. In the autumn of 1377, he missed three weeks and eleven works.Footnote ⁹⁹ He recovered from this relatively short illness but in 1394/95 he fell continuously ill in the winter (thirty-one weeks, forty-one-and-a-half works), the summer (twelve weeks, sixteen works), and the autumn (two weeks, five works), after which he died.Footnote ¹⁰⁰

Although the Ramsey Abbey material makes it clear that most of the individuals who were excused for illness in the works accounts went on to recover, some such as Henry Edward did die shortly afterwards. We cannot be sure that their illnesses were the cause of death; however, the manorial accounts clearly show that the two were associated in the minds of the scribe, who recorded their death duty heriot after their last allowance for illness. In total, we can identify thirteen out of the 229 incidences of illness that resulted in death. At Warboys, three individuals were recorded as having succumbed to their diseases: Geoffrey Bettis died after a four-week bout of illness in the winter of 1342/43, as did William Mold after a four-day illness in the winter of 1344/45, and John Wodecok died after repeated periods of sick leave and a three-week illness in the winter of 1347/48.Footnote ¹⁰¹ At Abbots Ripton, the accounting process can clearly be observed upon the death of the virgater, John Martyn after an illness lasting eighteen days in the autumn of 1343, during which he missed eight works. His widow, Margerie, was then excused from her labor services for thirty days as was customary, eight days of which continued in the remaining autumn season, accounting for five missed works, and twenty-two more days in the post-autumn season, representing a further eight works.Footnote ¹⁰² In each of the following examples, the surviving widow was given the same thirty days of relief from the labor services attached to the family’s land. At Holywell-cum-Needingworth, in the summer of 1403/4 John Hunne and Richard Reve each fell ill for six weeks, after which they both died.Footnote ¹⁰³ At Upwood, in the post-autumn period of 1342/3, Robert Crane was sick for two weeks, after which he died; in the winter of the subsequent year, John Pikeler was ill for twelve weeks, after which he also died.Footnote ¹⁰⁴

Although most tenants in the lists were men, as was noted above, this reflects the gender bias of manorial land tenure and servile obligations rather than any sex-selectivity of illnesses in late medieval England. In total, 131 men and nineteen women, with a further thirteen unidentified individuals, were absent because of infirmity. Widows appear intermittently within the manorial accounts as they were customarily allowed thirty days of relief from labor services after the death of their husbands, as in the above examples.Footnote ¹⁰⁵ In perhaps a variation of this practice, Agnes le Reve of Upwood was excused a single work twice in the winter of 1342/43 because of a death in her household, “et allocatione Agnes le Reve pro j mortuo in domus sua, j op.”Footnote ¹⁰⁶ This was clearly not the usual thirty-day allowance for the death of a husband, and may have represented some form of compassionate leave. Female absentees seem to follow the same broad patterns of absence as their male counterparts, but with one exception: there were no long-term absences, with the longest running to nine weeks. For example, at Knapwell, Matilda Russel was ill for four weeks, missing seven works; Annore Boykyn was absent for fifteen days, missing four works; and Margery Lucas was sick for three weeks, missing three works, all in the winter of 1347/48.Footnote ¹⁰⁷ At Broughton, Mariote Katelyne missed fifteen days and four works during the autumn, while at Upwood, Agnes le Reve, was ill for a week and a day, missing five works in the autumn of 1343.Footnote ¹⁰⁸ At Warboys, Agnes Mold, was sick for two weeks, missing four works in the post-autumn of 1347, and was ill again in the summer of 1349, presumably struck by plague, for nine weeks, missing a further twelve works.Footnote ¹⁰⁹

Despite being a small sample size, it is perhaps significant that no woman was recorded as having a longer infirmity than nine weeks, and even this was during the anomalous year of the Black Death. Although nineteen women were absent because of illness, the relatively short duration of their infirmities meant that female absences accounted for a total of just 144.5 missed works, less than that of a single long-term male absentee like Richard Colleson. No formal reason was given for this pattern, which could reflect the age-health profile of women likely to hold land and owe labor services, but it is possible that women suffering from longer-term infirmities were expected, or even encouraged, to find a substitute laborer or to pass on their holding to a male relative more readily than an infirm man may have been. Although some labor services specified that they were to be performed by a man, as could be the case for ploughing, women can be found engaged in nearly every agricultural activity in the medieval countryside.Footnote ¹¹⁰ As a result, female tenants had the same options available to them as their male neighbors when it came to fulfilling their labor services, i.e., to perform the works themselves or to substitute a family member or hired laborer in their stead.Footnote ¹¹¹

It is possible that so few female absences are recorded because some women may already have been hiring a substitute laborer to perform their services, and so their own infirmity would not interrupt the fulfilment of their dues. Yet, nowhere in the custumals or accounts does it suggest that a tenant hiring a substitute laborer would not be excused from their services, just the same as someone who normally performed them in person. In this case, presumably, the infirm tenant—male or female—simply stopped hiring the replacement laborer for the duration of their own illness. It is also perhaps significant that sixteen out of the nineteen female absences occurred before the Black Death, with only two happening afterwards (1350/51 and 1368/69, with another undated). We may, therefore, be seeing part of a broader trend in women’s landholding after the Black Death where, “faced with the choice of single women, or male relatives with lesser claims and migrant males arriving on their doorstep, lords and their stewards opted for the latter groups as a safer bet.”Footnote ¹¹²

Landholding and missed works due to infirmity

Given that the landholding sizes of absent tenants are recorded alongside the duration of illness and number of works missed, do any patterns emerge? Table 7 shows that tenants of the larger holdings were absent most frequently, especially those holding a half or full virgate. When briefly discussing this material, Raftis noted that “there is further evidence from Warboys that the problem of malnutrition in the medieval village cannot be too closely correlated with the size of tenement.”Footnote ¹¹³ He continued that “the incidence of illness was actually higher for larger property holders than for the smaller. It may be recalled from our information in the extent of the Hundred Rolls that the actual number of tenants on the small holdings, especially the mondaymanland, was quite large.” In other words, despite tenants on the smaller holdings—the mondaymen/crofters—being fairly numerous, it was tenants of the larger holdings—those holding virgates—who were most often recorded as falling ill.

Table 7. Frequency of landholding sizes of absent tenants on Ramsey Abbey manors.Footnote ¹¹⁴ Source: Ramsey Abbey account rolls at the British Library and The National Archives

There are many potential reasons for this. First, tenants on the larger holdings were more likely to be better nourished than their neighbors on smallholdings, and thus they may have been more likely to recover from a bout of illness.Footnote ¹¹⁵ Secondly, because virgaters owed a larger number of works, they may have been more likely to need a period of leave if they fell ill: covering five works per week during the harvest period must have pushed the resources of even wealthy peasant families to the maximum if the head of the household fell ill. Finally, because of this higher burden of labor services, the monks themselves may have been more assiduous in recording the absences of virgaters than smaller crofters because an absent virgater cost them more in missed works.

How much did excusing so many works cost the monks of Ramsey Abbey? There was usually a surplus of works owed by the customary tenants than were actually used on their estate, and so the loss of hundreds of works per year to infirmity was not necessarily detrimental to completing the agricultural tasks that needed to be done, especially if the absences were spread out across the year.Footnote ¹¹⁶ Given this surplus, it is unlikely that the monks would have felt the need to hire replacement labor for many of their infirm tenants who missed certain tasks in the year, such as weeding or carrying goods.Footnote ¹¹⁷ It is only more time-sensitive tasks, such as harvesting crops, that would have likely involved hiring additional labor.Footnote ¹¹⁸ Yet, the loss of even excess labor was still felt by the monks because they would often sell unused works back to the tenants—in effect, commuting the unused labor services into a monetary rent. Winter works were the least valuable and were sold at 0.5d per work; summer and post-autumn works were sold at 1d each; while in autumn during the harvest period, when labor was most in demand, works were sold at 1.5d each. A long-term absentee, like Richard Colleson, who missed twelve post-autumn works (12d), eighty-seven winter works (43.5d), thirty-four summer works (34d), and twenty-three autumn works (34.5d), thus accounted for the equivalent of 10s 4d if his missed works had been sold back to him instead of being excused during his year-long illness of 1347/48.Footnote ¹¹⁹

Such rates, however, were notoriously “sticky” because they were the amounts at which missed works were customarily sold back to tenants rather than how much it would cost to replace the infirm tenant. The costs could have been much higher if the monks decided to go to the open market and hire a laborer to carry out the missed tasks, with estimated day wages of around 1.5d per day in the decades before the Black Death, which doubled to around 3d per day afterwards.Footnote ¹²⁰ It is little wonder then that some lords, such as the bishops of Ely on their manor of Wisbech, put the financial burden entirely upon tenants and required them to fulfill their labor services even when they were ill. The combined effect of the sick leave policy of Ramsey Abbey on the number of works lost due to infirmity can be seen in Figure 4. As noted above, many of the peaks are caused by the survival of a greater number of works accounts in a particular year rather than by an outbreak of disease. For example, 1342/43 is unusual because works accounts for four manors survive—Warboys, Abbots Ripton, Upwood, and Broughton—and so the spike in this year is caused by a larger sample size of surviving evidence.Footnote ¹²¹

Figure 4. Total annual works allowed for infirmity on the Ramsey Abbey manors. Source: Ramsey Abbey account rolls at the British Library and The National Archives.

The large number of works lost at Warboys in 1348/49 was due to the Black Death, but the two peaks in the preceding years deserve explanation.Footnote ¹²² The significant numbers of works allowed because of infirmity in 1346/47 and 1347/48 were the result of several long-term and chronic illnesses, such as that of Richard Colleson above, that ran for entire seasons, if not the entire accounting year.Footnote ¹²³ The spike in illnesses at Warboys in 1394/95 is similarly largely accounted for by Henry Edward’s continued and long-term illness, as he alone missed sixty-two-and-a-half works out of the total 118.5 allowed in the accounting year.Footnote ¹²⁴ Long-term, chronic infirmity rather than large numbers of acute illnesses thus caused the most significant loss of labor services at Ramsey Abbey, except, of course, in 1348/49 when this pattern was inverted by plague. There is also an overall decline in absences recorded for infirmity after the heights of the 1340s, though this is partly the product of the survival of fewer works accounts per year in the later period.

This overall trend towards fewer absences caused by infirmity being recorded within the Ramsey Abbey manorial accounts as the fourteenth century progressed may have several underlying causes. It may reflect genuine improvements in the health of the workforce as living standards increased after the Black Death. As subsequent generations put the subsistence-related crises of the early fourteenth century behind them and enjoyed the combined benefits of more varied diets, better access to land, and higher real wages, workers may have fallen ill less frequently.Footnote ¹²⁵ However, any health benefits from improving living standards may have been offset by recurrent outbreaks of plague in the second half of the fourteenth century. Alternatively, a more significant cause for this overall decline in recorded absences may have been the changing economic landscape of the second half of the fourteenth century where labor services were increasingly commuted for cash rents and demesnes leased out.Footnote ¹²⁶ Labor services were less readily required or performed and so there was no longer a need to grant relief from fulfilling such obligations when tenants fell ill. Evidence about infirmities may therefore slowly disappear from the records as the fourteenth century progressed, not necessarily because people were healthier but rather because there was less need to grant such absences as a result of tenurial changes.Footnote ¹²⁷

This decline in labor services is widely considered to have been beneficial to villein tenants because they could now choose from a wide range of ways to earn an income to meet their largely monetary rents rather than working on the lord’s demesne, which could be heavily resented.Footnote ¹²⁸ Yet, this shift may have had a previously unrecognized outcome: it rendered many of the customary sick leave arrangements discussed in this article largely obsolete. Although some lords forgave the rents of particularly infirm or indigent tenants, we have not found the systematic practice—protected by custom—of lords giving tenants who owed monetary rents the equivalent of a year and a day reprieve from their rental obligations when they fell ill. Cash rents were expected to be paid irrespective of other considerations, such as the health of tenants. Customary obligations like weekly labor services may, therefore, have been a heavily resented feature of the medieval countryside but they also came with customary allowances that may have on occasion benefited villein tenants. The removal of such customary obligations thus came with the loss of any associated customary benefits like sick leave.