In the cities of Sumer, the first simple toilets with drainage to sewage pits appear.
In cities such as Mohenjo-daro, houses are equipped with seating areas with drainage into an extensive sewer system.
In cities such as Mohenjo-daro and Harappa, houses are connected to an extensive network of brick-lined sewers and private toilets with running water.
In palaces and tomb temples along the Nile, wooden and limestone stools with collecting basins are used.
Urban planners improve the network of covered sewers and drainage channels in Harappa and surrounding cities.
The royal palace of Mari on the Euphrates gets separate bathing rooms with terracotta drainage pipes.
The Minoan palace of Knossos on Crete gets one of the earliest known flush toilets, with a system that used rainwater to flush away waste.
Rome builds an extensive sewer system, the Cloaca Maxima, and sets up public, communal latrines where citizens relieved themselves together.
On Crete the first Minoan urban centers arise with simple water pipes and drainage channels.
The Maya developed advanced sewer systems with stone drainage channels to carry off rainwater and wastewater, including in the city of Palenque.
The English courtier John Harington builds a flush toilet with a water reservoir and valve mechanism, which he calls 'Ajax', for the court of Queen Elizabeth I.
The Scottish inventor Alexander Cummings obtains a patent for an S-shaped water seal that keeps sewer gases out of the house.
An extreme heatwave makes the stench of untreated sewage in the Thames so overpowering that the British parliament takes crisis measures.
Physician John Snow traces a deadly cholera outbreak in London to a contaminated water pump, exposing the link between sanitation and the spread of disease.
Engineer Joseph Bazalgette completes a network of more than 2000 kilometres of underground sewers that carry London's wastewater far downstream from the city.
plumber and entrepreneur Thomas Crapper improves and markets flushing mechanisms for toilets, making sanitary fittings a common feature of the Victorian home
Following the example of London and Paris, cities such as New York, Tokyo and Buenos Aires build their own modern sewer systems to combat epidemics and improve public health.
By the end of the nineteenth century, engineers worldwide had embraced the link between sanitation and disease control. Cities invested heavily in underground infrastructure, water purification and separate drainage systems. The combination of sewers, flush toilets and clean drinking water is regarded by historians as one of the most important factors behind the dramatic rise in life expectancy in urban areas worldwide, often surpassing the impact of individual medical discoveries.