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Modern humans Homo sapiens have dwelled on this earth for some years, most of that time as hunter-gatherers and gradually growing in number. Approximately 50 years ago modern man began to inhabit every corner of the world and people were constantly on the move. Occasionally people were troubled by pathogens transmitted by contaminated water, but the general aversion for water that tasted revolting, stank and that looked disgusting must have developed quite early during the biological and cultural evolution of humankind. Archaeological and written sources concerning water and sanitation can, however, only be found from relatively recent times.

Thus, in reconstructing the history of water and sanitation of this hunter-gatherer phase, we have to rely on the analogies of later societies. Modern anthropological studies and recorded mythologies of indigenous peoples play an important role in these analogies while observing primates and other more evolved mammals can also give us useful information. Some 10 years ago, when people adopted an agrarian way of life, mankind established permanent settlements. This new type of livelihood spread everywhere and the population began to expand faster than ever before.

Sedentary agricultural life made it possible to construct villages, cities and eventually states, all of which were highly dependent on water. This created a brand new relation between humans and water. In this world guaranteeing pure water for people became a prerequisite for successful urbanization and state formation. The earliest known permanent settlement, which can be classified as urban, is Jericho from — B. In Egypt there are traces of wells, and in Mesopotamia of stone rainwater channels, from B.

From the early Bronze Age city of Mohenjo-Daro, located in modern Pakistan, archaeologists have found hundreds of ancient wells, water pipes and toilets. The experience of humankind from the very beginning testifies to the importance and safety of groundwater as a water source, particularly springs and wells.

Women and families

The way in which water supply and sanitation was organized was essential for early agricultural societies. If wells and toilets were in good shape, health problems and environmental risks could be avoided. The realization of the importance of pure water for people is evident already from the myths of ancient cultures. Religious cleanliness and water were important in various ancient cults. The first known Greek philosophical thinkers and medical writers also recognized the importance of water for the public health.

A Brief History of Water and Health from Ancient Civilizations to Modern Times | IWA Publishing

The first urbanization in Europe occurred during antiquity B. The most urbanized areas were the Eastern Mediterranean, Egypt, North Africa modern Tunisia , the Apennine Peninsula modern Italy , and the southern part of the Iberian Peninsula, most of which were areas of quite modest rainfall. In this period the archaeological and written sources become richer, and consequently improve our possibilities to study the relationship between water and health of people. Alcmaeon of Croton floruit ca. Airs, Waters, Places. According to B. Vitruvius from the late first century, marshy areas must be avoided when the site of a city is chosen.

De Architectura. De Sanitate Tuenda. The quality of the water was examined by the senses: taste, smell, appearance and temperature. I,iv,9,10; VIII, iv,1,2.

Ancient History and Literature

Throughout antiquity tasty or tasteless, cool, odourless and colourless water was considered the best, and stagnant, marshy water was avoided. Because of the inadequacy of sources, it is practically impossible to evaluate the health of ancient populations and the role of water in it.

It is, however, quite safe to conclude that despite the impressive measures used to obtain pure potable water, urban centres had serious public health problems. The ancient Greek or Roman society did not have the interest or the means to deal adequately with matters of public health Nutton The Greeks and Romans used different methods to improve the quality of the water if it did not satisfy their quality requirements.

Research & Homework

From written sources and archaeological excavations, we know that using settling tanks, sieves, filters and the boiling of water were methods used during antiquity. At least boiling of water, which was widely recommended by the medical authors during antiquity, would have diminished the biological risks of poor quality water. Although the boiling of water might have been feasible from a hygienic point of view, it was ecologically and economically not feasible in extensive use since firewood and other combustibles would sooner or later have become a scarce resource around the Mediterranean.

The poor level of waste management, including wastewater, most probably involved a major risk for public health during antiquity. For instance, toilet hygiene must have been quite poor. The abundance of water that was conducted to the bath could also be used to flush a public toilet.

The Romans, however, lacked our toilet paper. They probably commonly used sponges or moss or something similar, which was moistened in the conduit in front of the seat and then used to rinse their bottoms. In public toilets facilities were common to all; they were cramped, without any privacy, and had no decent way to wash one's hands. The private toilets most likely usually lacked running water and they were commonly located near the kitchens. Water-borne infections must have been among the main causes of death. Dysentery and different kinds of diarrhoeas must have played havoc with the populations.

Although the ancient medical writers described different kinds of intestinal diseases, the retrospective diagnoses are difficult and the causative agents cannot be identified. Summer and early autumn, when water resources were meagre in the Mediterranean world, must have been a time when drinking water was easily contaminated, and intestinal diseases were rife as presented in several passages in the Hippocratic writings e. III, 11, 21, 22; Internal Affections. The mortality of children, especially recently weaned, must also have been high Prorrhetic II.

Furthermore, it should be kept in mind that the salubrity of the water supply must have differed markedly in accordance with the social status of people in the Roman towns. The rich had running water in their homes; the poor had to fetch their water from public fountains. The rich had their own baths and toilets, while the poor had to use public toilets and baths. A lot of the water in a Roman town was consumed in bath s connected to the aqueduct s Figure 1. Ideally shining marble walls and limpid water were considered a feature of a bath in Rome, the cleanliness of which was watched over by aediles Seneca.

Ad Lucilium epistulae morales. Baths were probably also beneficial for public health in towns where there was an abundance and rapid turnover of water. However, in towns where water was in short supply, cisterns had to be used and the turnover of water was slow, the role of baths was probably negative for public health. Water supply and sanitation for military needs was a primary concern of the authorities of an imperial power like the Roman Empire needing a strong military machine.

The Romans did know how to obtain adequate amounts of drinking water for their garrisons, cities and troops in the field and thus successfully planned their operations according to the availability of water.


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Army veterans were well accustomed to baths and to an ample water supply during their active service, and they may have been a quite important pressure group for building an aqueduct and bath in a town. The contamination of water by lead has been a topic in the discussions concerning the health of people in Roman times. Roman authors expressed doubts concerning the use of lead pipes and recommended the use of ceramic pipes Vitruvius. Opus Agriculturae. Yet, there are two reasons to believe that exposure through water was quite minimal, as pointed out by A.

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Trevor Hodge Hodge and Firstly, as a consequence of the quality of the water, a calcium carbonate coating separated the lead and the water in most cases. Secondly, because of the constant flow, the contact time of water in the pipe was too short for contamination by lead. The indirect public health effects of water might have been greater than the direct effects during antiquity. Agriculture depended on the proper amount of available water. Droughts and floods led to food shortages and famines.


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Food, people and pathogens moved most easily by water during antiquity. Maritime trade was especially vigorous around the Mediterranean in the period B. This meant that the Mediterranean world became more or less a common pool of infectious diseases McNeill , 78— Two important diseases caused by parasites were intimately connected with water and the ways water was managed during antiquity: namely malaria and schistosomiasis. The breeding of mosquitoes depended on water and mosquitoes spread malaria, which was a serious and widespread health problem around the Mediterranean during antiquity.

Malaria was well documented by Greek and Roman medical authors from the Hippocratic writings onwards. Schistosomiasis bilharzias has been for millennia a scourge in Egypt. The parasite blood-vessel inhabiting worms has an intricate relationship between the human host and a snail intermediate host. The type of agriculture irrigation, flooding of the Nile must have spread the disease.

Although the evidence from ancient Egyptian medical papyri remains hard to interpret, there is strong paleopathological evidence of schistosomiasis in human remains from ancient Egypt. Frontinus expressed clearly that a water system needed constant maintenance to function efficiently Frontinus — For instance, calcium carbonate incrustation that formed inside the conduits needed constant removal, otherwise the flow of water would eventually stop Hodge — In Italy aqueducts and baths seem to have been maintained even after other monumental buildings in the towns, with the exception of town walls and palaces, fell into disuse in late antiquity Ward-Perkins 31, In Antioch and other Near Eastern towns, at least part of the ancient water system was maintained into the Byzantine period and possibly up to the Era of Islam Kennedy Although there were continuities from antiquity to the Middle Ages, the water supply was more limited and the Christian water patronage replaced the classical one: it was a move from luxuria to necessitas Ward-Perkins After the fall of the Roman Empire, water supply and sewage systems experienced fundamental changes in Europe.

Medieval cities, castles and monasteries had their own wells, fountains or cisterns.