By Tim Lambert
Ancient Sewers
In the ancient world, public health was often surprisingly advanced. Stone Age farmers lived in a village at Skara Brae in the Orkney Islands about 3,000 BC. They built stone huts with drains under them, and some houses had cubicles over the drains. It’s thought they were inside toilets.
In the Indus Valley civilisation (c.2,600-1,900 BC), people built streets on a grid pattern, and they dug networks of sewers under them. The toilets were flushed with water.
On the island of Crete, the Minoan civilisation lasted from 2,000 to 1,600 BC. The Monoans also built sewers. The toilets were flushed with water.
The Romans also built sewers to collect rainwater and sewage. (They even had a goddess of sewers called Cloacina!). Rich people had their own toilets, but most people used public lavatories or they went in the street!
The Romans also built aqueducts to bring water into towns.
Medieval Sanitation
In the Middle Ages there were public lavatories in some towns. There was one over the River Fleet in London. In some towns, water was brought along pipes from higher elevations to public fountains. Many towns had public bathhouses where you could pay to have a bath. People could be fined for leaving garbage in the streets. In London, Men called rakers cleaned the streets.
In Europe in the Middle Ages, monasteries had good sanitation. Streams provided clean water. Dirty water was used to clean toilets, which were in a separate room. Monks also had a room called a laver where they washed their hands before meals.
At Portchester Castle in the 12th century monks built stone chutes leading to the sea. When the tide went in and out it would flush away the sewage.
Sanitation in the 18th Century
In the 18th century conditions in most towns improved (at least for the well-off). Bodies of men called Improvement Commissioners or Paving Commissioners were formed with powers to pave, clean, and light the streets (with oil lamps). However, despite some improvements, 18th-century towns would seem dirty and crowded to us.
In 1775 Alexander Cumming was granted a patent for a flushing lavatory. Joseph Bramah made a better design in 1778.
19th Century Sewers
However, flushing toilets were a luxury at first and did not become common till the late 19th century. Also popular in the 19th century were earth closets. An earth closet was a box of granulated clay over a pan. When you pulled a lever clay covered the contents of the pan. In rural areas, flushing lavatories did not replace earth closets until the early 20th century.
In the early 19th century working-class homes often did not have their own toilet and had to share one. Sometimes you had to queue to use it.
Even in the late 19th century inside toilets were a luxury. Working-class homes almost always had outside lavatories. About 1900 some houses were built for skilled workers inside toilets. However, it was decades before everyone had an inside toilet.
The first modern public lavatory, with flushing toilets, opened in London in 1852.
From the late 18th century the Industrial Revolution changed Britain. Some small market towns rapidly grew into industrial cities. They were dirty, overcrowded, and unhygienic. Not surprisingly, British towns suffered outbreaks of cholera in 1832, 1848 and 1866. However, conditions in towns gradually improved.
In 1859 work began on building a system of sewers for the whole of London but it was not completed until 1875. After that, deaths from infectious diseases fell drastically.
Other towns also built sewer networks. In 1865-70, the Portsmouth council built sewers. In 1875 a bylaw stated that any house within 100 feet of the main sewer must be connected to it. However, not all towns in Britain were so keen to build sewers. Many people in Chichester were reluctant to build a network of drains and sewers because of the expense. They were finally built in 1893-96.
In the 18th century, piped water supplies were available in many towns – for those who could afford them. Water was pumped along elm pipes. In the 19th century, local councils took over the water supply from private companies. Also gas made it much easier to heat water for washing. Bathrooms and running hot water made it much easier to keep clean.
Public health was transformed in Britain in the 19th century, and by its end, most people were healthier.
Last revised 2026