The Romans had the best public health system in the world it was unmatched until about fifteen hundred years after the empire fell. The Romans were the first use a public health system on a large scale. The efficient Roman government ensured good public health because they needed a healthy population to recruit from for their advanced army that held the empire together. Public health measures would also re assure the roman citizens over their government which would reduce the chance of a revolt against the government also if they kept the public healthy then the senate and all the rich and powerful people would not catch as many diseases off the citizens.
The Romans had many advanced ideas that made public health possible. Their system of collecting taxes helped their economy, which would pay for many things needed for their public health.
The Romans had and needed engineering skills for quality design and building an organised work force to enforce provisions and the correct materials for making the facilities. The most important thing the Romans had done to make public health possible was the discovery of the connection between dirt and uncleanness to disease. They believed the Hippocratic idea that there a natural causes and cures to disease. Because of the connection between dirt and disease the Romans knew that they needed clean water and good drainage.
Sighting of Roman settlements
The Romans took great care over where they sited their settlements advice was given in books where and where not to place settlements for example:
(Country life book1, chapter 12)
When building a house or farm special care should be taken where to place it at the foot of a wooded hill where it is exposed health-giving winds. Care should be taken when there are swamps in the neighbourhood, because certain tiny creatures which cannot be seen by the eyes breed there. These float through the air and enter the body through the mouth and nose and cause serious diseases.
Advice was also given on water supplies such as to search for springs and how to test the water. One method was to look at the physique of the people living near the spring and if their bodies were strong, their complexions fresh, their legs sound and eyes clear then the water is clean. If they look unhealthy then the water is not clean. They also boiled the water and if there was no mud or sand left in the bottom of the cauldron then the water should be excellent. This helped the Romans build their forts and towns near good springs, rivers and wells. The sighting of a settlement was very important to keep their soldiers healthy that was the main reason for the advice.
The Romans built public baths to ensure that both rich and poor citizens were keeping clean. They had baths built wherever they settled. This was yet another original Greek idea the Romans adopted. The baths were usually open from 1pm to dusk and the entrance fee was low so poor people could afford it. The Romans believed that bathing was good for the sick and essential to keep healthy.
The Romans built Latrines like baths for the whole public, which was a first. They built public latrines in towns, military forts and at the baths. The Romans had about 144 latrines flushed by water. Richer citizens would install latrines in their home.
Drains and sewers
Due to the baths, latrines and other water facilities the Romans needed and good drainage system in their towns and forts.
The Roman sewers were amongst some of their greatest achievements. A large sewer built underground connected to several tunnels, which were connected to several rivers, took water to sweep away the sewage. The bottom and the side needed good structural integrity to be able to take a hammering.
In order to supply huge amounts of water to a place the Roman engineers designed and made conduits that were tunnels of brick as other methods such as pipes had faults over long distances. The engineers were presented with an other problem as they had to make the water flow along the conduits slow and even paced so they built them on a gentle slope all the way from the source to the destination. Difficulties were reached when hills or valleys had to be crossed so the Romans came up with…
These were arches of stonework, which looked like bridges, water travelled over them so pace was not gathered or lost due to the aqueduct compensating for height and ground. When hills could not be avoided engineers built tunnels through the hill. Air vents were made to prevent airlocks and to allow safe inspection and cleaning. To carry water across narrow gorges inverted siphons were made. The conduit was built in the shape of a flat-bottomed V. Water flowed down one side and was forced across and up the other side due to atmospheric pressure the opening on the later side had to be lower than the first side were water flowed down.
Concern for soldiers yet again lead to a health provision. These were mainly built on the frontiers of the empire. The hospitals were not one of Rome’s Great achievements except for their drainage and sanitation system, which made them a model for the future. Hygiene was essential if they wanted the soldiers to get back to battle quickly. The not so great things about the hospitals were the lack of professional doctors only the army commander had his personal surgeon. The doctors were just normal soldiers experienced in basic treatment.
Many of the features of the Roman Public health system have inspired today’s public health facilities. It was like many Roman ideas very advanced and set the standard for public health today. We are lucky that the Romans had conquered a vast empire or we may have been behind on health and hygiene today.