Evolution of Personal Hygiene

A History of Hand-Washing, Clean Water, and Flush Toilets

Hand washing

In this day and age, physicians and patients alike turn to modern medical technology for combating all types of diseases and afflictions. The approach to the treatment of infectious diseases is no different, with many patients demanding prescriptions of antibiotics with the mildest of symptoms. Unfortunately, misuse of antibiotics has to lead to increased emergence of antibiotic-resistant strains of microbes, by which infection can have devastating and sometimes fatal consequences.

Prior to the discovery of microbial pathogens, many people believed that diseases resulted from evil spirits. However, scientific contributions during the 1800s by Louis Pasteur and Robert Koch proved that tiny microbes could cause fatal and deforming diseases such as tuberculosis and smallpox. But did you know that the dramatic decrease in infectious diseases between the discovery of microbial contribution and the discovery of antibiotics (a.k.a. “miracle drugs”) was attributed not to high-tech medical treatments, but rather, to changes in human behavior?

Three individuals, Ignaz Semmelweis, John Snow and Thomas Crapper, are attributed for initiating our daily lifestyle practices of hand washing, drinking clean water and toilet flushing.

History of Hand Washing: Ignaz Semmelweis

Imagine what life would be like if hand washing was optional among surgeons. Pretty scary, isn’t it? In developed countries, hand washing is heavily promoted for people of all ages and walks of life, but few people know the history of its beginnings.

In 1847 Hungarian-born physician Ignaz Semmelweis made striking observations which lead to the practice of hand washing in medical clinics. While working at an obstetrics clinic in Vienna, Dr. Semmelweis was disturbed by the fact that fatal childbed (or “puerperal”) fever occurred significantly more frequently in women who were assisted by medical students, compared with those who were assisted by midwives.

Through meticulous examination of clinical practices, he discovered that medical students who assisted in childbirth often did so after performing autopsies on patients who had died from sepsis (of bacterial origin). After instituting a strict policy of hand-washing with a chlorinated antiseptic solution, mortality rates dropped by 10- to 20-fold within 3 months, demonstrating that transfer of disease could be significantly reduced by this simple hygienic practice.

He could not convince his colleagues of the importance of his discovery. He was thought to have gone mad and died in an institution from sepsis from injuries he received there, much like many of the women he sought to protect.

Clean Drinking Water: John Snow and the Broad Street Pump

Can you imagine what your life would be like if your only source of drinking water was contaminated with diarrhea from people dying of cholera? Sounds pretty gross, doesn’t it?

In mid-19th century England, outbreaks of cholera (of bacterial origin) led to an epidemic of massive proportions, leaving tens of thousands of people dead and more ailing. At the time, people knew little about the microbial origins or spread of infectious diseases. Rather, they were convinced that the cholera disease was caused by poisonous gasses from sewers, open graves, and other places of decay.

John Snow was a medical doctor who observed that cholera appeared to be spread not through poisonous gasses, but from sewage-contaminated water. He noticed that most of the cholera-related deaths occurred near a pump on Broad Street, where residents of the area frequently stopped to drink water. Dr. Snow removed the pump handle, and almost instantaneously, the spread of the disease was contained. Although it took some time for the local government to believe his assertions and take action, Dr. Snow’s theories and findings represent major contributions both in the understanding of origins of infectious disease and in the disseminated use of clean drinking water.

The Modern Flush Toilet: Thomas Crapper

Remember the days of the outhouse? Or a hole in the ground, in some cases? It makes you more thankful for the modern flush toilet, doesn’t it?

Thomas Crapper, born in 1836 in Yorkshire, England, has been attributed as the inventor of the flush toilet. In reality, he did not invent the flush toilet but is believed to have made major contributions toward its development and distribution in modern society. By implementing a modern septic system that pumped soiled waters out of the cities, residents were less prone to catching diseases from microbes found in human feces. So whether or not Thomas Crapper the individual actually contributed toward the practice of toilet flushing is up for debate, but the flush toilet represents a major leap toward improving public health.

What’s the Take-Home Message?

Three individuals are attributed to these giant leaps in humankind, most of which we take for granted. The implementation of these daily practices occurred prior to the introduction of antibiotics and even before it was understood that diseases could be caused by microbes. What’s the take-home message? Changes in lifestyle are likely to make a huge difference when it comes to avoiding deadly infections.


Biography: Ignaz Philipp Semmelweis. July 30, 2008

Thomas Crapper: Myth and Reality. Plumbing & Mechanical 1993

Summers, Judith. ”Broad Street Pump Outbreak”. A History of London’s Most Colourful Neighborhood. Bloomsbury, London, 1989; pp. 113-117

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