The 180-Year Old Origins of Handwashing

By Da Young Kang


Graphic by Helena Kim

These days, we hear about washing hands every day. Surprisingly, however, the importance of washing hands was not established or publicly well known until the mid-19th century. Now that we know that washing your hands is our primary defense against diseases, this periodical will investigate how people discovered that handwashing is a life-saving action.


A Hungarian doctor named Ignaz Semmelweis was the first person who identified the importance of washing hands. At the hospital he worked in, there were two wards in the maternity wing: doctors ran one ward, and midwives ran the other. At the time, childbed fever, an infection of a woman’s reproductive organ, was a widespread disease that caused infected patients to die within ten days of delivery or miscarriage.


Semmelweis found that there was a higher rate of maternal mortality from childbed fever in the doctors’ ward compared to the midwives’ ward. Based on his published research from 1840 to 1846, the mortality rate in the doctors’ ward was 98.4 per 1,000 births, while the mortality rate was 36.2 deaths per 1,000 births in the midwives’ ward.


In his observation of both wards, Semmelweis noticed that the doctors and their students practiced autopsy before entering the maternity wing. Since germs had not yet been discovered at the time, Semmelweis was not aware of the unseen particles causing disease. Thus, he postulated that “morbid matter” from corpses was the cause of high childbed fever rates in the doctors’ ward. Following this conclusion, Semmelweis instructed the doctors to wash their hands with chlorinated lime before entering the maternity ward. This resulted in a decrease in maternal mortality in the doctors’ ward, and its death rate dropped to a level similar to that of the midwives’ ward.


At the time, however, his postulation was widely rejected simply because doctors did not appreciate being characterized as the cause of a deadly illness. Moreover, Semmelweis was a dogmatic man, so his arguments were largely ignored.


Thankfully, there were other people after Semmelweis who stressed the importance of washing hands. For example, Florence Nightingale, a British nurse, instructed other nurses to wash their hands frequently before attending to patients in the 1860s. Around the same time, a British surgeon by the name of Joseph Lister also supported widespread handwashing among surgeons and the practice of sterilizing surgical instruments.


Such history shows that the importance of handwashing is still a relatively recent concept. Nonetheless, the COVID-19 outbreak has made it a critical part of our daily lives.


The Centers for Disease Control and Prevention (CDC) encourages frequent handwashing with the following steps: First, you should wash your hands in running water and then apply soap. Lather your hands for 20 seconds and wash the back of your hands, between your fingers, and under your nails. The CDC recommends humming the “Happy Birthday” song twice while washing, as this takes around 20 seconds. After rinsing your hands with water again, dry them completely.


If you are using hand sanitizer, they must contain at least 60% alcohol. After applying hand sanitizer gel to your hands, dry your hands completely. However, hand sanitizers do not remove all germs, and are not effective when the hands are visibly greasy or dirty.


Remember to wash your hands whenever you enter and leave a public place, and whenever you touch your mask. To encourage your friends to wash their hands too, try entertaining them with a little story behind handwashing.


Graphic by Helena Kim


References

https://www.britannica.com/science/puerperal-fever

https://www.history.com/news/hand-washing-disease-infection

https://journals.sagepub.com/doi/10.1177/0141076813507844

https://globalhandwashing.org/about-handwashing/history-of-handwashing/#:~:text=Schoolchildren%20washing%20their%20hands%20before,the%20father%20of%20hand%20hygiene.&text=He%20noticed%20that%20doctors%20and,directly%20after%20performing%20an%20autopsy.

https://www.cdc.gov/handwashing/when-how-handwashing.html

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