At MIT, "Sanitary Engineering", e.g. the designing of sewers, was a five year course. Not only did you have to know structural engineering, but also about soils and biochemistry. As late as 1970 the commode at a major crossroads of the world, the airport in oil-drenched Baku, Azerbaijan, was a hole in the ground.
An 1858 Punch cartoon depicting the Thames, not inaccurately, as a source of terrible diseases for Londoners. Credit: Hulton Archive/Getty Images