2.4 How hygienic were ancient cities?

Toilets were recognised as smelly, and, as you learned in Section 1.3 Finding a toilet, in private houses they would have been located next to the kitchen. In the communal toilets, the ‘sponge on a stick’ would spread disease and there were also no handwashing facilities. Baths, as you have just seen, were about more than keeping clean, and may also have spread disease. But what about the city more generally?

There was genuine concern in the ancient world about polluting the water supply. An inscription from Herculaneum, found on the wall of the water distribution point and dating from the period 60–70 CE, reads:

However, there was no central administration to control such pollution.

Scholars are still divided on whether running water and baths did anything for public health. Focusing on archaeology, you may be impressed by the water supply or the architecture, but if you concentrate on literary sources, which often present the city as a place of overcrowding with streets full of rubbish and danger, then you will get a very different picture. As a magnet for immigration and a centre of trade, the huge city of Rome was always playing host to new strains of disease. With a far greater density of population than the countryside, city dwellers would meet more people and thus more potential carriers of disease than their rural counterparts.

In a recent article in Parasitology, Piers Mitchell compared the pre-Roman and early medieval periods to see if there was any improvement between them. He found none, and suggested that the Roman public baths did nothing to reduce the various internal and external parasites which caused disease.

The Roman army may even have spread parasites across the empire, along with the sanitation which in theory could have improved people’s health. The recent discovery of what may be ‘sponge on a stick’ toilet wipes, found in a toilet at Xuanquanzhi on the Silk Road, which was used over 200 years from around 100 BCE onwards, found eggs of Chinese liver fluke, roundworm, whipworm and Taenia tapeworm, and may suggest that travellers from eastern and southern China brought their internal parasites along this important travel route which linked Europe to Asia. It is known that silk from Asia was used in medical practice in the Roman Empire, because Galen mentioned it alongside dried animal gut when stitching wounds.