When the activists responsible for the first modern public-health systems sought to convince their governments to invest in sanitary infrastructure, a favorite tactic was to point to the glorious aqueducts and sewers of ancient Rome.
In stark contrast with European governments of the first half of the 19th century, one writer stressed:
It seems to have been a rule with [the Romans], that from the time when the foundation of a city was laid, to that of the summit of its greatness, no structural operation, public or private, should be permitted to take a shape which might render it a harbour either for disease or crime; and it is to this vigilant forethought that, in the absence of other organising agencies discovered only in our later times, we may attribute the success with which that remarkable people preserved social order, throughout so dense and vast a mass of human beings as the inhabitants of the imperial city in the days of its greatness.
The argument that Rome’s success was a direct result of its commitment to public health popped up first in Victorian London, and almost immediately hopped the Atlantic to be repeated by American sanitarians. While recent paleopathological research into Roman feces suggests that aqueducts weren’t enough to spare Romans from playing host to various gastrointestinal parasites, the ancient capital’s infrastructure was still quite a bit more advanced than Victorian London’s. But it’s not clear that Romans owed their impressive hydraulic technology to some great concern for public health on the part of the government—or, at least not at first.