Urban areas require some methods for collection and disposal of sewage.
Therefore, the historical focus of sewage treatment was on conveyance of raw sewage to a natural body of water, such as a river or ocean, where it would be satisfactorily diluted and dissipated. Early human habitations were often built next to water sources. Rivers could double as a crude form of natural sewage disposal.
Higher population densities required more complex sewer collection and conveyance systems in order to maintain (somewhat) sanitary conditions in crowded cities. The ancient cities of Harappa and Mohenjo-daro of the Indus Valley civilization constructed complex networks of brick lined sewage drains from around 2600 BC and also had outdoor flush toilets connected to this network. These were the earliest artificial sewage systems. Ancient Minoan civilization had stone sewers that were periodically flushed with clean water.
Roman towns and garrisons in the United Kingdom between 46 BC and 400 CE had complex sewer networks sometimes constructed out of hollowed out Elm logs which were shaped so that they butted together with the down-stream pipe providing a socket for the upstream pipe.
A significant development was the construction of a network of sewers to collect waste water, which began from the Indus Valley civilization. In some cities, including Rome and Istanbul (Constantinople), networked ancient sewer systems continue to function today as collection systems for those cities' modernized sewer systems. Instead of flowing to a river or the sea, the pipes have been re-routed to modern sewer treatment facilities.
However, many cities had no sewers and relied on nearby rivers or occasional rain to wash away sewage. In some cities, waste water simply ran down the streets, which had stepping stones to keep pedestrians out of the muck, and eventually drained as runoff into the local watershed. This was enough in early cities with few occupants but the growth of cities quickly overpolluted streets and became a constant source of disease. Even as recently as the late 19th century sewerage systems in parts of the highly industrialised United Kingdom were so inadequate that water-borne diseases such as cholera and typhoid were still common. In Merthyr Tydfil, a large town in South Wales, most houses discharged their sewage to individual cess-pits which persistently overflowed causing the pavements to be awash with foul sewage.
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