Before the mid 19th century, chair-like toilets had only been used by royalty and the disabled. But with the advent of indoor plumbing in the 1800's, the throne-like water closet was invented to give ordinary people the same "dignity" previously reserved for kings and queens. The plumber and cabinet maker who designed it had no knowledge of human physiology – and sincerely believed that they were improving people's lives.
The prevalences of bowel diseases (hemorrhoids, appendicitis, polyps, ulcerative colitis, irritable bowel syndrome, diverticular disease, and colon cancer) are similar in South African whites and in populations of prosperous western countries. Among rural South African blacks with a traditional life style, these diseases are very uncommon or almost unknown.