Summary: James Salzman’s book explores the fascinating and often dangerous history of water consumption, from ancient Rome to 18th-century New York. The book shows how premodern superstitions influenced the culture around drinking water, and the widespread contamination of drinking water in preindustrial cities. Salzman explains the historical mistrust of water, as people sought safer alternatives like beer and wine due to the perils of polluted water sources.


James Salzman’s Drinking Water: A History is a captivating book that has earned praise from notable thinkers such as Jared Diamond. While the book spends a great deal of time covering contemporary debates about drinking water (its regulation, provision, etc.), as well as recent history, it also provides some fascinating insights regarding drinking water during the preindustrial era.

The book reveals the many superstitions related to drinking water in the past. “Insanity was cured at St. Maelrubha’s Well on an island in Loch Maree, Scotland. Reportedly, the ‘patient’ was dragged behind a boat and rowed twice around the island, then plunged into the well and made to drink the water—all of which produced the cure. However, drinking from Borgie Well near Cambuslang, Scotland, produced insanity.” “Additional holy wells known for their gifts of fertility can be found on the Isle of Skye. One ensured the birth of twins, while another ensured the fertility of cattle.” And Scotland was hardly unique in this regard. “Ferrarelle in Italy, described by Pliny the Elder as ‘miraculous waters’ in his Natural History, was known to soothe digestive complaints. Évian-les-Bains near Switzerland was effective against skin diseases. Other spas’ waters were recommended for sufferers of arthritis, confusion, and an impressive range of ailments.”

Indeed, there was purportedly a healing well for almost every illness imaginable. “In a sort of hypochondriac’s fantasy, one can find wells that cure the full spectrum of maladies, from blindness and soreness of the eyes to rickets, lameness, whooping cough, leprosy, paralysis, and an assortment of other ailments.” The legendary healing properties of various wells were not entirely imagined, although they were often exaggerated. “As with many enduring legends, there is a kernel of truth here. Natural spring waters often have high mineral content that do provide therapeutic value.” There are many examples. “Modern medicine has demonstrated that natural salts can soothe the pains of arthritis. Sulfates and bicarbonates found in some spring waters are routinely used to treat gastrointestinal ailments. Calcium strengthens bones and teeth. And water containing naturally dissolved lithium, a drug long used to treat depression, may even be useful for those with mental health problems. Thanks to their dissolved minerals, some healing waters really do heal beyond the power of positive suggestion. . . . Because of their unique natural composition of salts and minerals, many spring waters became widely known for their curative powers. Specific waters were recommended for specific ailments.” That said, if a well became popular enough to draw a crowd in search of healing, swarms of diseased drinkers and bathers soon contaminated the water and canceled out any therapeutic qualities it might possess.

While some water sources “healed,” others killed. Ancient Rome is famed for its relatively advanced plumbing, but drinking water in the city would not meet modern standards. In ancient Rome, “as the city’s population grew, the water of the Tiber became increasingly polluted.” Moreover, many of the city’s inhabitants may have suffered from lead poisoning. “Indeed, the name for lead craftsmen was ‘plumbarii,’ the origin for our word ‘plumbers.’ Lead pipes were in common use both in aqueducts and street connections to houses. There is also clear evidence that Romans ingested large amounts of lead, more than enough to cause lead poisoning and perhaps some of the strange behavior so common among the emperors.” And the behavior was often bizarre indeed.

“Claudius slobbered when talking and suffered from tremors and inappropriate giggling. The brutal Caligula declared himself a god and appointed his horse a priest.” The famed Roman engineer Vitruvius observed, “water conducted through earthen pipes is much more healthy than that through lead; indeed that conveyed in lead must be injurious, because from it white lead [often used for facial cosmetics] is obtained, and this is said to be injurious to the human body. . . . Water should therefore on no account be conducted in leaden pipes if we are desirous that it should be wholesome.”

Sadly, Vitruvius’s words on the matter fell on deaf ears, and lead pipes remained in common use. Interestingly, lead pipes may not have been the main cause of lead poisoning in Rome. “The most likely culprit was the Romans’ diet. Sugar was not an ingredient in Rome. Instead cooks would boil down fermented grape juice, reducing it to a thick syrup known as sapa. . . . The sapa, unfortunately, was generally produced by boiling the mixture in lead pots or lead-lined copper kettles. Lead would leach into the acidic liquid, resulting in a sweet but poisonous elixir. Studies of sapa suggest that just one teaspoon of the syrup ingested once a day would have caused chronic lead poisoning over time. Modern analysis of lead in exhumed skeletons show much higher lead levels in the aristocrats than slaves, supporting the sapa theory since only the wealthy could afford a diet with sapa.”

Leaden pipes weren’t the only problem with the Roman water system. Because the Roman water system worked by gravity, it could never be turned off—the water was always running. The result was extreme wastefulness. Imagine if a household today kept its faucets running all day and night. “The daily water delivered to a Roman household has been estimated as the equivalent of a modern household’s use over two months.”

Poor drinking water quality remained a problem long after the Roman Empire. In 17th-century New York City, then called New Amsterdam, the earliest wells were “none too attractive. As Dr. Benjamin Bullivant described at the time, ‘[there are] many publique wells enclosed & Covered in ye Streetes . . . [which are] Nasty & unregarded.’” In the 18th century, the water was still “nasty.” “Peter Kalm, a Swedish botanist visiting New York in 1748, observed . . . that the well water was so terrible horses from out of town refused to drink it.” According to the Commercial Advertiser in 1798, Manhattan’s main well “is a shocking hole, where all impure things center together and engender the worst of unwholesome productions; foul with excrement, frogspawn, and reptiles, that delicate pump system is supplied. The water has grown worse manifestly within a few years. It is time to look out [for] some other supply, and discontinue with use of a water growing less and less wholesome every day . . . It is so bad . . . as to be very sickly and nauseating; and the larger the city grows the worse this evil will be.” When New York was hit by a yellow fever epidemic in 1795, “many blamed the disease on the city’s foul water and fouler streets.”

Benjamin Franklin observed that unless actions were taken to protect a city’s water, “the water of wells must gradually grow worse, and in time be unfit for use, as I find has happened in all old cities.” Initial actions taken to protect city water supplies were often private in nature. “Through the eighteenth and early nineteenth century, urban water projects were generally provided by private enterprise.” Initial efforts did not necessarily provide much improvement, however. In 1831, a letter in the New York Evening Journal described the state of the water supply this way: “I have no doubt that one cause of the numerous stomach affections so common in this city is the impure, I may say poisonous nature of the pernicious Manhattan water which thousands of us daily and constantly use. It is true the unpalatableness of this abominable fluid prevents almost every person from using it as a beverage at the table, but you will know that all the cooking of a very large portion of the community is done through the agency of this common nuisance. Our tea and coffee are made of it, our bread is mixed with it, and our meat and vegetables are boiled in it. Our linen happily escapes the contamination of its touch, ‘for no two things hold more antipathy’ than soap and this vile water.”

In 1832, the year after that letter was penned, New York experienced a devastating outbreak of cholera, a bacterial disease typically spread through contaminated water that killed with remarkable speed. “A victim could feel healthy in the morning and be dead by that evening, felled by painful cramps, vomiting and diarrhea.” The epidemic killed around 3,500 New Yorkers. In fact, even after industrialization, water remained unsafe until the advent of citywide chlorination. “Typhoid epidemics were still killing thousands of Americans in the 1920s, but by the 1950s, even individual cases of typhoid had become rare. It has been claimed that chlorination of drinking water saved more lives than any other technological advance in the history of public health.”

There is a common belief that prior to industrialization, water was pristine. This book quickly disabuses the reader of that notion. In the 17th century, the English naturalist Martin Lister warned visitors to Paris that the city’s water caused “looseness, and sometimes dysenteries.” In London, the situation was also lamentable. For water, “the poor relied on the unsanitary and foul-smelling Thames, and some merchants even tried to charge for that. In 1417, a city ordinance forbade owners of wharves and stairs on the Thames from charging for access to the river.” The river water, teeming with bacteria, was a frequent cause of illness and untimely death, even in the 18th century. “Much of the water was taken from the River Thames, the receiving body of the city’s sewers. Terrible cholera outbreaks were quite common but shrugged off as an unpleasant fact of urban living.” London’s water was filthy for the entirety of the pre-industrial age, as well as the early industrial era.

“For the most part, filth flowed out windows, down the streets, and into the same streams, rivers, and lakes where the city’s inhabitants drew their water. As a result, cities stank to high heaven. This state of affairs only became worse as cities grew in population through the Middle Ages. As late as 1854, journalist George Goodwin graphically described London as a ‘cesspool city. The entire excrementation of the Metropolis shall sooner or later be mingled in the stream of the river, there to be rolled backward and forward around the population.’ The Thames grew so polluted in an 1858 episode, dubbed ‘The Great Stink’ by the Times, that the overpowering stench forced Parliament to adjourn until the odors subsided.” The poor quality of the water was well known. “As Punch magazine explained in its description of the Great Exhibition in 1851, ‘Whoever can produce in London a glass of water fit to drink will contribute the best and most universally useful article in the whole exhibition.’”

“In many cultures, the most effective strategy to avoid unsafe drinking water has been to avoid water altogether.” Almost everyone with the means to drink something besides water did so. “The drink of choice in Egypt was beer, and in ancient Greece wine. It may not be surprising that one of the very first buildings constructed in Plymouth Plantation was a brewhouse.” Practically everywhere, people sought alternatives to unsafe water. “The fifth-century Hippocratic treatise ‘Airs, Waters, Places’ recommended adding wine to even the finest water. Beer was routinely added to water (called ‘small beer’) in the Middle Ages. Water was also commonly mixed with vinegar, ice, honey, parsley seed, and other spices. . . . After the discovery of the East Indies, mixing hot water with coffee and tea became popular” in the Western world as well.

Because anyone who could afford to avoid water did so, drinking water became associated with poverty and low status. For example, Salzman quotes a classical scholar saying that in ancient Rome, water was “the characteristic drink of the subaltern classes, the cheapest and most easily available drink, fit for children, slaves, and the women who had been forbidden from drinking wine very early on the Republic.” In fact, water was so despised throughout the preindustrial age that drinking it was sometimes considered a punishment. “In the time of Charlemagne, high-ranking military officers were punished for drunkenness by the humiliation of being forced to drink water. In the fifteenth century, Sir John Fortescue observed that the English ‘drink no water unless it be . . . for devotion.’ The sixteenth-century English doctor Williaim Bullein warned that ‘to drinks colde water is euyll [ evill]’ and causes melancholy. His contemporary Andrew Boorde claimed ‘water is not holsome soole by it self; for an Englysshe man . . . [because] water is colde, slowe, and slack of dygestyon.’” According to the hydrologist Francis Chappelle, in colonial America, among the Pilgrims of New England: “Drinking water—any water—was a sign of desperation, an admission of abject poverty, a last resort. Like all Europeans of the seventeenth century, the Pilgrims disliked, distrusted, and despised drinking water. Only truly poor people, who had absolutely no choice, drank water. There is one thing all Europeans agreed on: drinking water was bad—very bad—for your health.”

Given the state of drinking water at the time, they were right. The English physician William Bullein observed in the 16th century that “standing waters and water running neare unto cities and townes, or marish ground, wodes, & fennes be euer ful of corruption, because there is so much filthe in them of carions & rotten dunge, &c.”