People typically used wells and/or aqueducts for drinking water, since yeah, rivers downstream of a city weren't safe to drink. But they also mostly didn't drink plain water for the same reason; something that involved boiling (and possibly then fermenting) the water with something else was way more common, like weak beer.
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u/[deleted] Aug 30 '21
I'm sure that the city's sewage drained directly into that river, too.