Hand Washing – A Little History

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Hand washing has probably become the most talked about health hygiene practice in the last year. With COVID-19 affecting millions across the globe, hand washing as a primary prevention strategy has gained high importance.

The interesting fact is that hand hygiene is no new practice. We knew it all along. The medical faculty recognised it years ago. I even remember my mother asking me to wash my hands every time I touched anything dirty. During my junior doctor days, hand sanitisers were kept by the bedsides of patients to be used by health care staff between patients.

All this was done to prevent the spread of infection; infection that has already killed many globally, and I am not just talking about Coronavirus (see the list below of some disease that can be prevented by handwashing).

Here are some common diseases whose spread can be prevented by hand washing.

  1. Cholera

2. Coronavirus (COVID-19)

3. Common cold (influenza virus)

4. Pink eye or Madras Eye (conjunctivitis)

5. Hepatitis A

6. Staphylococcal infection (MRSA)

7. E Coli O157:H7 infection (causes severe diarrhoea)

8. Streptococcal throat infections

9. Norovirus infections

The History of Hand-washing

Handwashing as a sanitary practice dates to the 1800’s, when mothers and infants in the Western world started dying at a staggering rate (nearly 4 out of 10) following delivery due to a condition called ‘childbed fever’ or ‘puerperal fever’. It was caused by a bacterium called Group A and Group B Streptococcus, which exists even today.

hand washing to prevent corona

When this happened, people believed that disease was being brought into humans by invisible seeds or poisonous insects. However, the medical community had rejected this theory. The ‘germ theory’ remains the widely accepted one.

However, even prior to this, there existed other theories about how infection was entering humans. For many years, the ‘spirits evil theory’ suggested that all that happened with humans, good and bad, were related to evil spirits looming around us.

Over the years, theories changed and slowly an understanding of how infection spread gained clarity. In the mid-17th century, Anthonie Van Leeuwenhoek reported the presence of micro-organisms as a cause for disease.

But it was Ignaz Semmelweis, a physician, who was responsible for introducing and implementing hand washing as a method of infection prevention. It is the steps he introduced that was responsible for lowering the rate of puerperal fever. He was a part of the generation of doctors who actively participated not just in dispensing treatments, but also looking at medicine from a more scientific perspective through autopsies and microscopy.

Over the years, people began to revere doctors who participated in such research and attributed their dirty clothing to all the work they did during their autopsies. People looked upon dirtier doctors as being better doctors. Doctors would move from the autopsy room or surgical theatre to the maternity ward for their rounds, without changing their clothes or cleaning their hands.

The result?

Well, unsurprisingly, infections from the doctors clothing and hands spread from the corpses to mothers and infants. Doctors were the source of infection, said Ignaz Semmelweis; a theory that was rejected.

In fact, a couple of years before Dr Ignaz’s theories were put forward, Dr Oliver Wendell Holmes, another physician, also published research in a journal regarding the role of doctors in the spread of infection.

This was widely overlooked.

Dr Holmes suggested burning clothes after autopsies and cleaning instruments used for procedures. Dr Ignaz suggested washing hands thoroughly, a step that helped lower the rates of puerperal fever dramatically.

Sadly, his desire to control puerperal fever by handwashing, and a constant rejection by his medical peers of his theory, led Dr Ignaz to become obsessed with it.

One day, he was lured into a mental institution, where he was locked up in a dark room and beaten severely every day. He died 2 weeks later from a blood infection.

It was over 20 years later that the medical community recognised hand washing as a step toward prevention of disease spread.

While the above remains documented in history, I found in my research for this article papers that suggested that Prophet Muhammed advocated cleaning of the hands and feet, teeth brushing and proper ablution as a way to maintain hygiene years before the western world’s theories were revealed to the world.

A Few Things To Bear In Mind

I do not need to go through how to wash your hands the right way. I am sure the plethora of WhatsApp videos and YouTube videos explaining how it needs to be done has educated you.

But there are a few things you should know.

To keep your hands clean, keep your nails well-manicured and less than 0.5cm long.

Do not wear too many rings, as these can harbour bacteria in the gap between the rings and the skin (an area that is rarely cleaned).

If your hands are visibly dirty, it is better to use soap and water to wash off the dirt rather than a sanitiser, which only kills bacteria but will not take off the mud from your hands.

While this information is important for you, doctors should also observe measures to keep their hands clean in between the patients they see. Let us hope cleaner hands will rid our world of COVID-19 this year.

Dr Vivek Baliga B
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1 Comment

  1. Respected doctor I m 44 years of age I m not talking any medicine but my father got heart attack at age of 50 so can i take tab ecosprin 75 mg because of hereditary factor my blood investigation are normal TMT IS also normal please guide me THANX

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