They used height difference between a water source and the fountain.
Tap water is generally in the 1-4 bar pressure range.
10 meters of height difference provides 1 bar of pressure and is enough for a fountain to shoot a meter or two upwards.
It was generally advantageous to keep the water elevated in the city wherever possible so it would naturally flow into houses e.t.c. The water came from springs in the mountains via aqueducts.
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