Public health
The Romans copied many things from the Greeks and they did not develop new ideas about the
causes of disease. However their common-sense approach to medicine, and their great skills as
builders and engineers did lead them to make a major contribution to medical development - public
health.
They knew that large numbers of people could not live close together and be safe from disease
without three things: a pure water supply, clean streets, and efficient sewers.
Below you can find out about how the water supply was brought to Rome and other cities.
1) Water was collected from rivers and
springs. Vitruvius, a retired engineer in
the first century bc, tells us about the
trouble the Romans took only to use
sources of pure water: 'You must study
the soil. In clay and fine gravel, water will
be poor in quality and taste; in coarse
gravel it will be sweeter and purer; in
lava it will be plentiful and good. If the
spring is free-running and open, look at
the people who use it: if they are strong,
have fresh complexions and clear eyes,
then the water is good.'
2) It flowed along stone channels
about the size of a doorway. The
channels had stone walls, floor
and roof. Sometimes these were
under the ground but when
valleys had to be crossed they
were on bridges.
3) When the channels got close
to Rome they emerged from the
hills and were carried to the city
on a bridge on a long row of
stone arches. The Aqua Claudia
swept into the city on a bridge of
over a thousand arches (it was
10 km long and 25 metres high).
4) The water was cleaned by the use of settling basins and reservoirs
along the route. These allowed any dirt to sink to the bottom and leave
the water pure.
5) Once inside the city the water was piped underground to street
fountains, from which most people drew their water, and to the
public baths and lavatories. The rich and businesses paid a fee to
have their houses and workshops connected to the system. Their
connecting pipes would be limited to a certain size to make sure
they didn't take too much water. Some people stole water by
secretly connecting their houses to the pipes. In times of drought
the public fountains, baths and lavatories had priority over private
houses. This system provided 300 gallons of water a day for every
person in Rome. This is more than each of us uses today! By the
fourth century AD there were 1 352 public fountains and 144 public
lavatories.
The siting of towns
The starting point for the Romans was to build cities, towns, villas and army bases in healthy places.
Marcus Verro mentioned this when he wrote: 'When building a house place it where it is exposed to
health-giving winds. Care should be taken when there are swamps nearby because tiny creatures
breed there. These float rough the air and cause serious diseases.' Unfortunately Rome was built
near swamps. The Romans knew that malaria came from mosquitoes and swamps and tried to drain
the marshes. They were only partially successful and Rome suffered from several epidemics of
malaria.
Water supply
! Romans realised that clean and pure water was important. By th end of the first century ad they
had built nine aqueducts bringing water to Rome. These aqueducts were magnificent engineering
achievements and some of them still stand today.
A practical attitude to health.
The Romans did not know about germs and so they did not understand the real cause of disease.
However, they used their common sense and realised that dirt, sewage, bad water and marshes
were all connected to people becoming ill. The important thing is that the Romans then went and did
something about it!
You will remember that the Greeks took great trouble to keep clean and healthy, but only the rich
had the time to do this properly. You will also remember that Greek cities were described as having
poor water supplies. For the Greeks, keeping clean and healthy was a private thing that each person
did for themselves. For the Romans it was important that whole cities were kept clean and healthy. It
was the government's job to achieve this.
Public baths
The public baths were magnificent buildings and played an important part in the everyday life of Romans. People went to
the baths to stay clean, as a treatment for complaints like backache, and to meet friends or even to conduct business.
Some baths were huge and could take over 1,500 bathers at a time - one had over 3,000 rooms! There were warm baths,
cold baths and steam baths with professional masseurs on hand. Central heating was provided by hot air circulating beneath
the floor. There were also spectacular gardens with fountains and springs, and tree-lined promenades for walking. By fourth
century AD Rome had 11 public baths and 856 baths in private houses.
A day at the baths
■ Enter about 1 pm and pay. Have a game of tennis to get warmed up.
■
Enter the tepidarium, a moderately warm room, and sweat with your clothes on.
■
Undress in the apodyterium and get anointed with oil. It may be mixed with African sand if you are very dirty.
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Move into the calidarium or hot room and sweat, then into the laconicum, a spot over the furnace - very hot.
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Then have water poured over you, first warm, then tepid and finally cold.
■
You are then scraped with a strigil, a curved metal tool with a groove to collect all the dirt.
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Then you are sponged and re-anointed with oil.
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Finally you are plunged into the cold bath, the frigidarium.
■
At last you can meet with friends, sit around the baths and chat, and later go to dinner.
Lavatories and sewers
To keep Rome clean and healthy used water and sewage had to be got rid of. To do this the Romans built the
Cloaca Maxima, a complex system of sewers and conduits running under buildings and streets and emptying into
the River Tiber. Prisoners were used to clean out these sewers and they became a popular place for women to
leave unwanted babies!
The sewers were connected to the public baths and lavatories, and rich families paid to have their houses
connected. For those not connected to the sewers there were cesspits, or chamber pots, which could be emptied
through the window into the streets below. Both the cesspits and the streets were emptied of rubbish every night and
generally the streets of Rome were kept clean. Urine was useful for cleaning newly woven cloth. Fullers, keen to get
their hands on as much urine as possible, would put jars outside their workshops for the public to use.
Romans might spend hours chatting with their neighbours in public lavatories in the picture. Under the seat was a
trench with running water. In front of the seat was another trench containing running water. This was for cleaning
themselves. Buckets with sponges were provided. If you think this doesn't sound very attractive, remember that
London did not have public lavatories until 1851!
Other ways Rome was kept clean and healthy
At first the city of Rome grew haphazardly with crooked, narrow streets and crowded houses. However, after a fire
in ad 64 much of the city was rebuilt and the Romans took care to build straight broad streets and wide squares.
Officials were appointed to check food being sold for quality and freshness.
Burying the dead inside the city walls was banned and this made the much healthier method of cremation popular.
Elsewhere in the Empire
Wherever the Romans built towns, they built public baths and aqueducts. In Roman Britain most large towns like
Wroxeter were supplied with pure water by aqueducts. Stone sewers were built in towns like Colchester and York,
and every town would also have large public baths.