Hygienic conditions in ancient Rome and modern London
By Lord Amulree
Medical History, Vol.17:3 (1973)
Introduction: Edwin Chadwick, acting on first principles only, outlined a programme for the improvement in the health of the public in the mid-nineteenth century – he claimed that: ‘the primary and most important measures, and at the same time the most practical, and within the recognised province of public administration, are drainage, the removal of all refuse from habitations, streets and roads and the improvement of supplies of water’. How was it that these principles, which were well known in the classical world, or even before, had been so completely lost sight of that they needed restating, as if they were a novel concept, by Chadwick?
The Romans fully appreciated the importance of a plentiful and wholesome supply of water, for domestic purposes, to the health of the community. Vitruvius writing in 27 B.C., says that: ‘without water neither the animal frame nor any virtue of food can originate, be maintained or provided. Hence great diligence and industry must be used in seeking and choosing springs to serve the health of man.’ For 441 years after the foundation of the city, Rome depended on water from the Tiber for drinking and other domestic purposes. In 312 B.C. Appius Claudius Crassus provided the city with water obtained from springs in the Alban hills and brought to consumers by means of an aqueduct. This move was in line with the teaching of Hippocrates that stagnant water should be refused in favour of spring water from the hills or of rain water. By the first century A.D. water was brought to Rome by means of nine aqueducts and was derived from relatively uncontaminated sources in the country. Vitruvius states that the health of sick persons will improve if they are: ‘removed from a pestilent to a healthy place and the water supply is from wholesome fountains…. Likewise if the water itself in the spring is limpid and transparent, and if wherever it comes or passes, neither moss nor reeds grow nor is the place defiled by any filth, but maintains a clean appearance, the water is indicated by these signs to be light and wholesome.’
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