Author | M. Martínez EuklidiadasLondon has been at the forefront of innovation for hundreds of years. Christened with the name of Londinium by the Romans in AD 43, this enclave has never stopped being abuzz with activities and diseases. As a result, London was ravaged by epidemics. From cholera to industrial pollution or the plague, the city became resilient.Without the epidemics caused by hundreds of thousands of people overcrowding the city, we would not be able to read Shakespeare. Perhaps the Industrial Revolution would not have taken place in London and epidemiology would have emerged in a different city. London was able to learn from the infectious diseases that ravaged the city and it came out stronger.
From cholera to epidemiology
One million two hundred thousand people lived in the city. The Romans had introduced the cobbled streets two centuries earlier, but it was the 2nd century, and at the northern end of the Empire, hygiene practices were much more lenient than those inherited from Ancient Greece by the Romans. London did not have a sewerage system. Diseases were rife. It comes as no surprise that the city went through a series of flus, generalized pneumonias, a constant succession of smallpox, typhus, tuberculosis, polio and any other infectious diseases that one can imagine.Although the efforts to create a sewerage system greatly improved the quality of life of residents, the epidemics did not disappear. It was in 1854, when the young doctor, John Snow, came up with the idea of drawing a map of the people dying of cholera in a neighborhood. That experience identified the public water pump in Broad Street as the cause of the outbreak. Epidemiology had begun, a discipline that we owe so much to now during the coronavirus crisis that will define our cities.

Getting water to homes, the first great invention

The Great Plague, the Great Fire, the Great Smog, the Great Stink
London had been experiencing, together with its respective diseases, ‘small stinks’ since the Middle Ages when its minute and notably insufficient sewerage network was designed. But in 1858, the stink (miasma) was unbearable. During that period it was extremely hard to stomach the smell in London, the city that made holding handkerchiefs dipped in perfume to the nose popular to bear the rotting smell of its river.A river that was used as a giant sewer until well into the 19th century. It was normal to see the Thames full of rotting animal corpses, waste water and even dead bodies (clearly it was cheaper than a burial), but the stone pavements, if they existed, were not much cleaner.
London’s sewerage system: goodbye to the stench and infectious diseases?
Bazalgette’s solution was ingenious. He built major brick-lined sewerage systems totaling over 100 kilometers in length, plus around 2,000 kilometers of secondary pipelines. He visited the densest part of London to calculate the section, calculating the diameter needed to evacuate the waste water from the residents and then generously multiplied the diameter a number of times by two.
Florence Nightingale: infrastructure is not enough
1860 was a decade that saw unprecedented scientific advances. While thousands of men were laying the new pipes, another small army, this time made up of women, was looking after the sick in hospitals. And St. Thomas’ Hospital had an enormous impact thanks to the figure of Florence Nightingale.During her experiences as a nurse during the Crimean War in 1854, Florence discovered, learned and taught the importance of hygiene practices in nursing and medicine in general. The same year in which Snow discovered the cholera well using a map, Florence discovered that hygiene and ventilation greatly improved the health of sick patients.On her return, she introduced some key improvements in St. Thomas’, convincing the Royal Commission to improve ventilation in hospitals, adding drains or frequently cleaning surfaces. It was a resounding success, as we now know.The new Tideway project
