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As the world finds itself engaged in a life-or-death battle against the coronavirus pandemic, the questions of hygiene and sanitary practices have come to the fore. In the new millennium, we pride ourselves on our superior knowledge, our unparalleled health systems, and the sophistication of our modern infrastructures.

Yet, if this virus has taught us anything, it’s that, as far as our civilization has come, we’re still vulnerable and there is still room for improvement. Nevertheless, when we compare our modern world to the sanitary conditions of the 18th century, we can see just how far we have come. And yet, we can also see how quickly sanitary practices that once seemed cutting-edge, state-of-the-art science turn out to be both foolhardy and dangerous.

Wasting Away

No question about it: living is a dirty business. Human beings produce massive amounts of waste each year. That’s just the cost of being alive. But when you consider how much waste a single person produces, and then multiply that by every single person living in a home, a town, or a city, you end up with literally tons of waste generated per city, per year.


If waste management continues to be a challenge in the 21st century, with all its technological innovation, just imagine how much more formidable the problem was in the 1700s.To be sure, less populated, more rural areas may have generated less waste, principally because there were fewer people and those who inhabited rural areas tended to be far thriftier, using their scant and precious resources to the fullest possible. Not surprisingly, though, in the cities, where resources were more abundant and accessible, waste was far more common.


Today, we have a range of advanced technologies and systems to help us deal with waste. For instance, we have resources dedicated exclusively to the safe storage and disposal of potentially hazardous waste, including medical waste and related biohazards.


In the 18th century, though, they weren’t so lucky. While rural environments certainly weren’t immune to the problem of waste management, it was the cities that really suffered.


Conditions in London were abysmal, and infectious diseases related to poor sanitation were rampant. Unfortunately, it wasn’t until the mid-1700s that London, then the world’s most powerful and technologically-advanced city, had its first underground sewer system and waste management facilities. 

Next to Godliness?

If cleanliness is next to godliness, then the lack of sanitation in the 18th century must have made living in the city feel like renting a summer home in Dante’s 9th circle of hell. Even as infectious diseases decimated entire communities, the lack of understanding of processes of bacterial growth and contagion only made matters worse.


Ironically, it was often the medical community that contributed to the massive death toll. Failure to properly sanitize medical instruments meant that infections quickly spread from one patient to another.


And treatment often only exacerbated the problem. Based on the theory of the bodily humours, 18th-century physicians thought that disease was the result of a loss of balance, the overabundance or underabundance of one of these four essential humours — blood, phlegm, yellow bile, and black bile.


Purging was considered the latest and greatest of medical science. And so the most learned physicians of the era sought to cure their patients through forced purging in order to restore their humoral balance. This most often meant either inducing vomiting or bleeding the patient. 

Plumbing the Depths

Even though London was paving the way, so to speak, toward the development of a modern sewage system by the mid-18th century, plumbing as we know it today was still pretty much non-existent. Yet, progress was being made, including in the larger cities of the fledgling United States.


By 1777, innovations had been made that are still used in today’s modern toilets. Likewise, in Boston, Philadelphia, and New York City, systems of aqueducts had been created to supply clean water to the city. This dramatically improved human hygiene and helped protect citizens against water-borne diseases. Firefighters were also able to tap into the water system, saving countless structures and untold lives.


Today’s plumbing and water systems, of course, have advanced significantly in these 300 years. And yet they’re not without their own challenges. Weirs, for example, are often used in modern water systems to damn bodies of water and control their flow, yet the systems are far from foolproof.


So, maybe, if there’s anything to learn from the 18th century, it’s that as technologically sophisticated as we think we are, we’re no different than our predecessors in at least one thing. Like them, we also don’t yet know what we don’t know!

The Takeaway

By any measure, sanitary conditions in the modern world have come far since the 18th century.  Lack of proper hygiene and sanitation claimed more lives than old age and accidents in the 1700s. And yet we can’t become too self-congratulatory, because some of the technologies we enjoy today began to emerge in the 18th century. The first clean water systems were developed in America’s first cities, while London had created its first underground sewage system and waste management facilities by the turn of the 19th century.