Roman toilets gave no clear health benefit, and Romanization actually spread parasites

Roman toilets gave no clear health benefit, and Romanization actually spread parasites
Photograph of Roman latrines from Lepcis Magna in Libya. Credit: Craig Taylor

The Romans are well known for introducing sanitation technology to Europe around 2,000 years ago, including public multi-seat latrines with washing facilities, sewerage systems, piped drinking water from aqueducts, and heated public baths for washing. Romans also developed laws designed to keep their towns free of excrement and rubbish.

However, new archaeological research has revealed that—for all their apparently hygienic innovations—intestinal such as whipworm, roundworm and Entamoeba histolytica dysentery did not decrease as expected in Roman times compared with the preceding Iron Age, they gradually increased.

The latest research was conducted by Dr Piers Mitchell from Cambridge's Archaeology and Anthropology Department and is published today in the journal Parasitology. The study is the first to use the archaeological evidence for parasites in Roman times to assess "the health consequences of conquering an empire".

Dr Piers Mitchell brought together evidence of parasites in ancient latrines, human burials and 'coprolites'—or fossilised faeces—as well as in combs and textiles from numerous Roman Period excavations across the Roman Empire.

Not only did certain intestinal parasites appear to increase in prevalence with the coming of the Romans, but Mitchell also found that, despite their famous culture of regular bathing, 'ectoparasites' such as lice and fleas were just as widespread among Romans as in Viking and medieval populations, where bathing was not widely practiced.

Roman toilets gave no clear health benefit, and Romanization actually spread parasites
Photograph of a Roman whipworm egg from Turkey. Credit: Piers Mitchell

Some excavations revealed evidence for special combs to strip lice from hair, and delousing may have been a daily routine for many people living across the Roman Empire

Piers Mitchell said: "Modern research has shown that toilets, clean drinking water and removing faeces from the streets all decrease risk of infectious disease and parasites. So we might expect the prevalence of faecal oral parasites such as whipworm and roundworm to drop in Roman times—yet we find a gradual increase. The question is why?"

One possibility Mitchell offers is that it may have actually been the warm communal waters of the bathhouses that helped spread the parasitic worms. Water was infrequently changed in some baths, and a scum would build on the surface from human dirt and cosmetics. "Clearly, not all Roman baths were as clean as they might have been," said Mitchell.

Another possible explanation raised in the study is the Roman use of human excrement as a crop fertilizer. While modern research has shown this does increase crop yields, unless the faeces are composted for many months before being added to the fields, it can result in the spread of parasite eggs that can survive in the grown plants.

"It is possible that sanitation laws requiring the removal of faeces from the streets actually led to reinfection of the population as the waste was often used to fertilise crops planted in farms surrounding the towns," said Mitchell.

The study found fish tapeworm eggs to be surprisingly widespread in the Roman Period compared to Bronze and Iron Age Europe. One possibility Mitchell suggests for the rise in fish tapeworm is the Roman love of a sauce called garum.

Made from pieces of fish, herbs, salt and flavourings, garum was used as both a culinary ingredient and a medicine. This sauce was not cooked, but allowed to ferment in the sun. Garum was traded right across the empire, and may have acted as the "vector" for fish tapeworm, says Mitchell.

"The manufacture of fish sauce and its trade across the empire in sealed jars would have allowed the spread of the fish tapeworm parasite from endemic areas of northern Europe to all people across the empire. This appears to be a good example of the negative health consequences of conquering an empire," he said.

The study shows a range of parasites infected people living in the Roman Empire, but did they try to treat these infections medically? While Mitchell says care must be taken when relating ancient texts to modern disease diagnoses, some researchers have suggested that intestinal worms described by Roman medical practitioner Galen (130AD - 210AD) may include roundworm, pinworm and a species of tapeworm.

Galen believed these parasites were formed from spontaneous generation in putrefied matter under the effect of heat. He recommended treatment through modified diet, bloodletting, and medicines believed to have a cooling and drying effect, in an effort to restore balance to the 'four humours': black bile, yellow bile, blood and phlegm.

Added Mitchell: "This latest research on the prevalence of ancient parasites suggests that Roman toilets, sewers and sanitation laws had no clear benefit to public health. The widespread nature of both intestinal parasites and ectoparasites such as lice also suggests that Roman public baths surprisingly gave no clear health benefit either."

"It seems likely that while Roman sanitation may not have made people any healthier, they would probably have smelt better."

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Jan 07, 2016
In much greater population density, as in Roman times, Iron Age hygiene would have led to far greater parasite problems.

It is the Roman system that kept parasite lower than it would otherwise have been.

Consider the frequent health problems even in 19th century London where life expectancy was increased from as low as 20 years in some regions through public health initiatives.

Jan 08, 2016
just goes to show how much intellectual common sense standards have fallen in the UK

Jan 08, 2016
The real blame for the spread of these diseases might be the communal "toilet brush" that was used in the Roman latrines. Multiple people would wipe their behinds after using the latrines with the same brush that wasn't cleaned.

Jan 08, 2016
Bathing not widespread in the middle ages? Only if you have the middle ages last from roughly 1450 to 1700. Nearly all clichés about medieval Europe actually refer to the 15th and 16th centuries, i.e. at the very end of the middle ages and the start of the early modern era.

As RobertKarlStonjek points out, rapid increase in population density (Roman-era urbanization) are a far more important contributor to disease and parasites. Also, do these archaeologists believe they can simply dismiss centuries of Roman written primary sources offhand?

Finally, how do these people believe they can compare the Iron Age to Roman times in terms of archaeological finds of dead people, since most of Iron Age Europe practices cremation virtually exclusively until Romanization?

What really bothers me in practitioners of ancient history and archaeology is that, unlike more 'modern' historians, many of them are still comfortable making sweeping statements on the basis of minimal evidence.

Jan 08, 2016
I vote for the "Toilet Brush". It has always creeped me out imagining a Roman passing a brush to another. A quick rinse in water is the best it gets between use. Who knows how many people handled it in a day. The sicker the city is the more its people use the toilet. This must have prolonged the length and severity of any outbreaks. I wonder if you were expected to rinse it before you passed it on or was this the receivers duty? I suspect, after selecting one from a pile, a plebeian would have rinsed it no matter how clean it looked.

Jan 09, 2016
It's likely microbial diseases were positively impacted by Roman practice, something not mentioned in the article. Microbes always took a higher toll on life than parasites. But eating poorly-cooked pork (as an example) can infect you with parasites, even if you are normally clean. I found the article to be in a line of articles by left-leaning anthropologists who systematically denigrate Western history while lauding non-Western cultures and their (modest for the most-part) achievements.

Jan 13, 2016
I find some conclusions drawn from the factual evidence (e.g. "more parasites found despite public toilets...") highly questionable (e.g. "Roman toilets contributing negatively to public health..."). If, for instance, people take in more parasites with their food harvested from the fields fertilized with human faeces gathered from the public toilets, then this does not reflect badly on the existence of public toilets as such and neither on their benefit to public health but rather on how unwittingly badly the waste from Roman toilets was disposed of. To understand the ridicule of this article's argument better consider in an analogy from modern times the claim the existence of IV syringes should have per se a bad effect on public health just because diseases can be spread through contaminated needles - therefore syringes worsen public health. Maybe we had better identify the weak link in the chain of Roman sanitary hygiene; and, no, I don't think for tape worm this was Sponge Bob BC.

Feb 24, 2016
The gutter running around the front of the toilets (see picture above) was always filled with running water that the brush was meant to be cleaned in, but this was obviously far from perfect.

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