Diseases and Sanitation
(Click on thumbnails to enlarge image)
Even without an understanding of germs, many ancient civilizations had a good understanding of the need for careful sewage disposal, but this knowledge was lost or ignored in the Middle Ages in Europe. The result was terrible sanitary conditions, polluted waterways, and periodic outbreaks of disease.

One of the greatest advances of the modern era was the recognition that disease could be caused by pathogens, and that poor sanitary conditions were a prime culprit in the spread of disease. Sanitary engineers in the nineteenth century were in the forefront of the development of sanitary sewer systems that protected the public from epidemics of cholera and other water-borne illness.

A survey conducted by the British Medical Journal in 2007 asked a group of experts and doctors what they consider the greatest medical advance since 1840. The answer, beating out antibiotics and modern surgical methods, was sanitation.

See Tracking Down the Roots of Our Sanitary Sewers, Parts 1-5, for more information.


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See articles and poems for more information
John Snow Archive and Research Companion for literature, graphics and information about John Snow and the struggle to end cholera in London. Also see the UCLA John Snow webpage.

School of Civil Engineering (University of Leeds) history website for links and information about disease and sanitation.

Delivery of water and sanitation services to the poor in nineteenth century Britain.

www.victorianlondon.org for extensive information about Victorian London. There is a large section about Sewers and Sanitation under "Health and Hygiene," and materials can be found under "Diseases" (cholera and typhus) and by searching "sewer." A number of cartoons of the time lampoon the dangerous pollution of the River Thames and London drinking water. A huge thanks goes to Lee Jackson, the creator of the website, for this impressive collection of original materials.

The National Library of Medicine photo archives includes sanitation posters, Cholera Online, and many other topics.
Visit our Cholera page for information about the spread of cholera and John Snow's campaign to end cholera in London.
Collection of photos and graphics about cholera epidemics from the Life Photo Archive.
Plague and other epidemics
Collection of photos and graphics about plague in Europe from the Life Photo Archive
Photos and graphics about other epidemics from the Life Photo Archive
Deaths from typhoid in American and European cities before, during, and after the introduction of sewerage systems and water supplies, circa 1899.

Source: Cady Staley and Geo. S. Pierson, The Separate System of Sewerage, Its Theory and Construction, Third Edition (New York: D. Van Nostrand, Co., 1899), p. 32.
Medieval latrines and toiletst
See Toilets and Latrines for a view into the sanitary conditions in medieval castles.
Government sanitation campaigns
Horrible sanitation conditions led the United States and state governments to run campaigns to introduce well-built outhouses into rural areas as recently as the 1940s. As hard as it is to imagine now, outhouses were a hygienic alternative to cesspits and open sewers prevalent in rural (and even some urban) areas. View our collection of sanitation posters and photos from government campaigns.
See National Library of Medicine exhibit for a collection of sanitation posters from the US and local governments.
Otis Historical Archives National Museum of Health and Medicine - World War 2 sanitation poster.

Source: Creative Commons image under CC license
Otis Historical Archives National Museum of Health and Medicine - World War II sanitation poster.

Source: Creative Commons image under CC license
Diseases and sanitation in art
View our collection of posters, graphics and advertisements about diseases and sanitation. (Additional artwork can be found under individual disease sections, ie cholera, plague, etc.)
Disease prevention in sewers
Placing rat poison in sewers in Paris, France. Date unknown.

Source: Bruno de Ville d'Avray, Mairie de Paris / Direction de la protection de l'environnement, Section de l'assainissement de Paris; and Lucien Finel, previous Deputy to the Mayor of Paris (in charge of water and sanitation management).


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