Improvement in plumbing systems was very slow.
Virtually no progress was made from the time of the Romans until the 19th century.
The relatively primitive sanitation facilities were inadequate for the large, crowded population centres that sprang up during the Industrial Revolution, and outbreaks of typhoid fever and dysentery were often spread by the consumption of water contaminated with human wastes.
Eventually these epidemics were curbed by the development of separate, underground water and sewage systems, which eliminated open sewage ditches.
In addition, plumbing fixtures were designed to handle potable water and water-borne wastes within buildings.

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