How did medieval cities get rid of waste?

Question

What I am trying to get to is that many video games have a sewers level. To my understanding, these aren't as realistic as we'd like to think (too big or sewerage wouldn't exist yet in the settings timeframe; you name it). I know of the idea of cesspits, but modern cesspits don't tend to be in cities, and are well regulated by laws.

If you were to think of a medieval (anything from 12th century to 15th century) city, with quite a high population; how did the major cities handle waste disposal? Did they use a cesspit? Because if so, I am already filled with a bunch of questions:

1. Where were the cesspits located? Were they located away from civilian life, or still within city boundaries?
2. How did the waste get into the pits; was there a primitive sewer system taking waste from latrines to the pits, or were there shared latrines at the location of the pits?
3. How were the pits emptied? Would they have multiple pits rotate use, and once one is full it gets emptied by hand to be used as fertilizer?

Basically, I can't picture what waste disposal and going to the toilet is like in those times... And I dislike the idea of giant tunnels called sewers where you can walk among the turds. Correct me if I am wrong, but that seems like a game design to me rather than an actual historical practice.

(ps. I do understand that they might not have entirely known what we'd consider best practices. There is a reason why we've had the Black Death and the like: people wouldn't have known what we know about hygiene.)

Answer 1

• You call it waste, they call it raw materials.
  Depending on the era, human and certainly animal feces were fertilizer. They would be collected and carried to the fields. Similar for some organic wastes. Urine would be used by some crafts, too. Rags get collected by papermakers.

• There were some sewers, just not so big.
  The thing about sewers in games is that they're big enough to fight a duel, not that they exist. Think of them as tunnels barely big enough for a single person to move.
  https://www.thescottishsun.co.uk/tech/4501395/mystery-tunnel-abbey-drain-paisley-abbey-drain-scottish/

• Open gutters.
  Not as nice and clean as an enclosed sewer, but they work after a fashion.

Answer 2

you could take the German town Freiburg as an inspiration. They had small canals on the sides of the streets in which they poured the grey water. they also used the water in them to stack fires.

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Sources:

• Archäologische Beobachtungen zu den Freiburger Altstadt-Straßen und zur Entstehung der „Bächle" (PDF, in German)

Answer 3

Trier is one example of a city which for a long time used the old Roman waste water system (ie sewer.) Trier is built at a slope with a fairly stable water resource upslope. That water was used to continuosly flush the sewer piping.