Cleanliness is a relatively new thing.  Even doctors didn't wash their hands after using the toilet and so people died from secondary infections.  It took a long time - several years - before it finally sunk in that washing and cleanliness in general helps prevent the spread of disease.  

Back in the middle ages and for a long time after, people beleived diseases were caused by bad smells, hence the nosegays that were popular in the days of open sewers.

French royalty - and others, no doubt - had vermin living in their elaborate wigs; most people had fleas, worms and rotten teeth.  Shall I go on, or are you losing your lunch yet?  ;)

Coppula eam se non posit acceptera jocularum.

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