What Did Ancient Romans Do Without Toilet Paper?

No. Just that it could not produce them reliably with efficiency. Consider this from Friedman's book "Free to Choose":

First, the wood comes from a tree, "a cedar of straight grain that grows in Northern California and Oregon." To cut down the tree and cart the logs to the railroad siding requires "saws and trucks and rope and . . . countless other gear." Many persons and numberless skills are involved in their fabrication: in "the mining of ore, the making of steel and its refinement into saws, axes, motors; the growing of hemp and bringing it through all the stages to heavy and strong rope; the logging camps with their beds and mess halls, ... untold thousands of persons had a hand in every cup of coffee the loggers drink!" And so Mr. Read goes on to the bringing of the logs to the mill, the millwork involved in converting the logs to slats, and the transportation of the slats from California to Wilkes-Barre, where the particular pencil that tells the story was manufactured. And so far we have only the outside wood of the pencil. The "lead" center is not really lead at all. It starts as graphite mined in Ceylon. After many complicated processes it ends up as the lead in the center of the pencil. The bit of metal - the ferrule - near the top of the pencil is brass. "Think of all the persons," he says, "who mine zinc and copper and those who have the skills to make sheet brass from these products of nature." What we call the eraser is known in the trade as "the plug." It is thought to be rubber. But Mr. Read tells us the rubber is only for binding purposes. The erasing is actually done by "Factice," a rubberlike product made by reacting rape seed oil from the Dutch East Indies (now Indonesia) with sulfur chloride. After all of this, says the pencil, "Does anyone wish to challenge my earlier assertion that no single person on the face of this earth knows how to make me?" None of the thousands of persons involved in producing the pencil performed his task because he wanted a pencil. Some among them never saw a pencil and would not know what it is for. Each saw his work as a way to get the goods and services he wanted - goods and services we produced in order to get the pencil we wanted. Every time we go to the store and buy a pencil, we are exchanging a little bit of our services for the infinitesimal amount of services that each of the thousands contributed toward producing the pencil. It is even more astounding that the pencil was ever produced. No one sitting in a central office gave orders to these thousands of people. No military police enforced the orders that were not given. These people live in many lands, speak different languages, practice different religions, may even hate one another - yet none of these differences prevented them from cooperating to produce a pencil.

I have heard that the piss-collection industry still exists, but collecting the urine from portable toilets and extracting human urokinase from it, rather than using it for cleaners, glazes, and flavorings.

And, after searching for confirmation, here it is: http://www.toilets.com/Pharm/pharm_production.htm

It seems like the idea never truly died out.