As the population expanded which put a lot of pressure on the old medieval streets and buildings. The Horsefair in central area of Kingston became slums with multiple families living in a single building.
There were no sewers or healthy water supplies to speak of and many of the drains were uncovered ditches (unbelievable!), these ran off into the Thames.
The Sewage from toilets or privies often drained into local cesspools,but these may well overflow polluting the surrounding area causing disease. Summer diarrhoea was common in the slums as were other deadly diseases including cholera which hit 1849, 1855 and again in 1866. Young children, the elderly or infirm could easily die which led to an outcry as the well to do clearly did not want to become infected as well.
There were two Kingston upon Thames Improvement Acts in 1855 and 1888 these started a long process of improving the public health of my birth place.