Coronavirus: The evolution of hand-washing, explained by a historian – Vox.com

Are we all washing our hands several times a day? As the Covid-19 coronavirus pandemic spreads, we should all be washing our hands several times a day. Take a moment right now, go give your hands a scrub with some warm soapy water for 20 seconds, and then come back. Maybe spritz around some hand sanitizer if you dont have access to a sink. Put on a little hand lotion so your skin doesnt get too chapped.

Ready? Great.

Right now, all of us either are or should be very vigilant about washing our hands, but for much of human history, that wasnt the case. Hand-washing as a social responsibility is a fairly new concept.

To learn about how that concept developed and when and why it emerged, I called up Peter Ward, a professor of history at the University of British Columbia and the author of The Clean Body: A Modern History. Over the phone, we discussed the history of hygiene, when people started washing their hands, and why we usually wash our hands and it has a lot less to do with medicine, and a lot more to do with social acceptance, than you might think. Highlights from our conversation, which has been lightly edited for length and clarity, follow.

To start off, tell me a little bit about your book, The Clean Body. Whats the central argument?

The book is a history of personal hygiene in the West from the 17th century to the recent past. Its about how people have thought about their bodies and treated their bodies.

In the 17th century, people didnt have baths regularly. They thought that to be clean, it was enough to change their underwear and wash their underwear frequently.

The first person I mention in the book is Louis XIV of France, who had two baths in his adult lifetime. They were both for medicinal reasons. He had headaches and his doctors recommended baths. It didnt work to cure the headaches, so he lived another half century and never bathed again.

But he washed his hands once a day in scented water and his face every second day. And he changed his underclothes. That was it. That was the habit of middle and upper-class people in the Western world until the middle of the 19th century.

So what changed in the middle of the 19th century?

A lot changed then! It began in the upper reaches of Western society. People began to think about their bodies as something to be cared for, and that treatment as something to distinguish themselves from the lower classes, who didnt wash in the same way. By washing you were making a statement about what class you belonged to.

Then theres the technological side, like the development of new bathing equipment. And the architectural side, the beginning of the appearance of the bathroom first in the homes of the extremely wealthy, and then over the course of about a century, down to mass housing.

Theres lots of strands here. Some of them have to do with the history of plumbing, some of them have to do with the history of domestic architecture, the history of clothing, of class understanding. A lot of them have to do with the history of business and the advertising of soap, which became highly industrialized in the late 19th century. That had a huge educational impact on hygiene.

And when did people start to talk about hand-washing specifically?

Well, Louis washed his hands every day. The idea was there. Our current concern for hand-washing was a product of the germ theory era more than anything else. The idea that people should habitually wash their hands is not an idea that existed before the latter part of the 19th century.

Before then, people had no particular reason to wash their hands unless they were dirty or sticky or something of that sort. There was no epidemiological reason to wash until the germ theory emerged, which was another gradual process. It really didnt take root fundamentally until the 1880s, with the discoveries of Pasteur.

Theres this story I read that Ive always thought might be apocryphal of surgeons refusing to wash their hands during the beginning of the rise of germ theory, because a gentlemans hands are always clean, so on those grounds hand-washing was unnecessary. Is there any truth to that story?

Ive not heard that one, so its probably too good to be true. But at that point in time, surgeons and all attending physicians didnt have any clear reason to wash their hands as they moved from one patient to the next. This was an acute problem for physicians and any medical attendants who dealt with women delivering children. One of the leading causes of maternal mortality was childbed fever, which was circulated in maternity hall settings and passed from physicians to patients during the process.

Some of the earliest people who began to think more clearly about this began to think there might be a connection between hand-washing and the passage of disease. One of the first was an American, Oliver Wendall Holmes. He was a Boston poet and physician who wrote an article in the 1840s positing that there might be a connection between medical practitioners moving from patient to patient and womens post-birth deaths. But there was no theoretical basis for the idea to gain any broad acceptance. It more or less disappeared from sight until the 1880s.

It wasnt until Pasteur came along that people began to think about these microbiological elements, the unseen life of germs. Pasteur proved it. But even after Pasteur, it took a decade or even more, a generation, for his ideas to be accepted.

Why was there so much reluctance?

There were competing theories. We tend to think of Pasteur as this great genius who came to a universal truth, but he wasnt working in a vacuum. There were other people in his field working on the same problems and coming to different conclusions. He was one of many competitors, and not all his competitors fell away.

So what can we take away from that history? This long period where hand-washing wasnt considered important, and now all of a sudden its medically necessary?

Until very recently, most of our bathing practices had to do with our idea of ourselves as social beings. We want to go through our daily lives in a way that is agreeable to other people, and we assume probably correctly that one of the best ways of doing that is to be very, very clean. To look clean, to smell clean, to feel clean, to be clean. And a lot of that has to do with using the products that purport to make us clean. The commercialization of personal hygiene is driven by a different agenda than a medical one. Its primarily a social one.

Do you think thats changing now?

I think everybody is scared skinny at the moment. We all know that you must wash your hands many times a day right now, for 20 seconds, singing Happy Birthday to yourself twice. Theres going to be a degree of care at least in the short run thats driven by a medical agenda, but I think the underlying issues are going to be the same. From the 20th century on, the hygienic revolution of modern times has to do with the social imperatives of our communal lives more than anything else.

That takes the argument back to the 17th century: People appeared to be clean by wearing clean underwear that showed over their outer clothes through collars and cuffs. If you look at Dutch art, one of those marvelous Franz Hals portraits or really any other Dutch artist in the 17th century, youll see these people who are very somberly dressed. But they all have something white coming out over the tops of their outer garments: a collar, a cuff. There are often slashes in the outer garments that reveal white clothes next to the skin.

What these people were doing were displaying their cleanliness. They were differentiating themselves from the poor, who in some cases didnt wear a second layer of clothing and in other cases couldnt afford to wash their underclothes. It was a social statement of a different time, one of social differentiation rather than social inclusion. But right now, we clean ourselves to make a statement of social inclusion. Were making ourselves agreeable to each other.

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Coronavirus: The evolution of hand-washing, explained by a historian - Vox.com