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Why do you wash your hands after you go to the bathroom?
And did you know, the first physician who said doctors need to wash their hands was
put into an insane asylum?
So before we get started today, we want to thank Google for supporting PBS Digital Studios.
If someone walked out of the bathroom without washing their hands then tried to give you
a high five, I'm pretty sure you wouldn't be so eager to make physical contact; especially
in the middle of flu season.
But until relatively recently hand washing was something relegated primarily to religious
rituals and cultural ceremonies.
And the story of how we came to wash our hands as a central part of hygiene is a fascinating
exploration of how people can be threatened by new knowledge.
But to understand how we got to side eyeing people who don’t wash their hands in the
restroom, we first have to ask: What types of hand washing existed before
it became a form of germ control?
Well, it turns out that the expression in English of "washing your hands of something or someone"
to signify that you are removing yourself from a situation or absolving yourself of
responsibility for an outcome originates in The Bible.
In the New Testament Book of Matthew, Pilate pours water on his hands to symbolize that
he is innocent of a crime, which is where the popular idiom draws its roots from.
And as a ceremonial practice, hand washing plays an important role in Judaism, Islam,
and Sikhism.
For example in Islam, ritual cleansing of the body is essential before prayer.
Ablution known as wudu includes washing the hands, face, feet and other parts of the body
in preparation for spiritual ceremony.
And this occurs 5 times a day, outside of other hand washing and bathing routines.
So the hand washing here is connected to cleanliness and cleaning the body but also carries a larger
spiritual meaning.
And in Judaism, it is customary for people to wash their hands and say a blessing before
eating a meal that includes bread or matzo.
This is known as the netilat yadayim.
And it is also performed outside of handwashing that occurs to keep dirt away, because it
is related to a larger spiritual context.
Other forms of ritual hand washing can exist even after death.
Take for example Buddhism: before cremation, pouring water over the hands of a dead body
can be essential to a sign of forgiveness.
And during the New Year, a younger person washing the hands of an elder can also be a sign of
wishing them a long and healthy life.
So hand washing was clearly on the scene as religious metaphor before we connected it
to health.
But, that brings us to our next question: When did we connect hand washing to disease
prevention?
And who made that first connection?
Well according to Rebecca Davis at NPR, we owe that revelation to a Hungarian physician
named Dr. Ignaz Semmelweis, though at the time no one really believed him.
In 1846, this young obstetrician was interested in figuring out the connection between physicians
cleanliness and the spread of puerperal fever.
Also known as childbed fever.
But at this time, germ theory wasn’t commonly accepted as scientific fact.
So physicians often focused on many different (and primarily false) causes of diseases such
as bad spirits, misaligned humors, and individual disposition.
Despite this, Semmelweis and other physician scientists were interested in making connections
between anatomy and disease, and collecting data to prove patterns rather than asserting
that disease was entirely unique to the individual.
In particular, Semmelweis was invested in reducing deaths from puerperal fever.
So he studied two maternity wards: one staffed by male physicians and another staffed by
female midwives.
He noticed that mothers in the clinic staffed by physicians died more frequently from childbed
fever.
At first, he postulated that it was because the mothers in the doctors’ ward gave birth
on their backs and the mothers in the midwives’ ward gave birth on their sides.
But when he tried shifting the positions of the women in the physicians’ ward he saw
no change.
Then one of the pathologists he worked with died of puerperal fever after pricking his
finger performing an autopsy.
Which was kind of eye opening to him because he discovered that anyone exposed to the disease
could die and not just women who had given birth.
Semmelweis then theorized that the real difference was that physicians were performing autopsies
on patients who had died from the disease while the midwives were not.
And he thought that the physicians were transferring little pieces of corpse to women in child
birth, which was killing them as a result.
Although, not technically correct, it’s actually very impressive that he was able
to deduce this considering he didn't know what “germs" even were.
So Semmelweis made the interns in his clinic wash their hands and instruments with chlorinated
lime solutions.
As a result, fatal puerperal fever was reduced from an average of 10% to 1-2%.
So hooray for the hand washing Hungarian doctor!
Right?
Well, actually no.
Semmelweis’s contemporaries didn’t take kindly to his findings because they thought
1) he was a quack bigger than Donald Duck and 2) he was making it look like they were
responsible for killing their patients by passing on tiny bits of corpse during childbirth.
So he lost his job and was shunned by the medical community, even as he spent the rest
of his life trying to convert other doctors to scrub up with chlorine before touching
patients - which would have saved countless lives.
He wrote a series of increasingly scathing letters and in 1865, at age 47, he was committed
to a mental asylum because of his hand washing crusade (and a suspicion that he was losing
his mind either from some form of alzheimer's or syphilis).
And he died there only 14 days later at the age of 47, after being beaten by the guards.
But scientists such as French biologist Louis Pasteur eventually did develop theories around
bacteria control.
He found that heating up then cooling down foods (such as milk, wine, and beer) could
kill some of the creepy crawly bacteria that caused most spoilage and he later went on
to develop vaccines for anthrax and rabies by expanding this germ theory.
And Florence Nightingale also championed handwashing
in hospitals during the Crimean War to reduce the spread of infections.
But as for washing your hands after you go number one and number two, it wasn’t until
the 1980s that the CDC in the U.S. started to advertise regular campaigns to promote
hand washing after a rash of food borne outbreaks and healthcare related infections.
After that, they developed and promoted guidelines for proper hand hygiene.
So, how does it all add up?
While hand washing has been around for hundreds of years as part of different rituals, ceremonies,
and everyday hygiene.
It wasn't until the latter half of the 19th century that we started to think of it as
in the central form of keeping illness at bay.
And the first physician to start championing hand washing as a central part of disease
control was committed to an asylum and eventually beaten to death where he died of suspected
sepsis.
Which ironically, is a disease that hand washing and proper hygiene could have prevented.
Wow. History is kind of cruel.
Today the center for disease control and prevention, or the CDC, and world health organization,
advocate that all healthcare providers and patients should keep those hands clean in
order to prevent the spread of different illnesses.
And both institutions are invested in conducting research on how to spread awareness about
hand washing practices across cultural considerations.
But if you're feeling bad for Dr. Semmelweis’ sad demise there is a small footnote to add.
Just like Pasteur, whose name lives on in the word “pasteurization,” there is something
named after his lesser known contemporary.
The “Semmelweis reflex" or the “Semmelweis effect" is the term for rejecting new ideas,
knowledge, and findings simply because they don't conform to current norms.
So if history has a sense of humor it's very dark and extremely morbid.
So what do you think?
Want to add some other resources of the cultural uses of handwashing?
And do you know any other historical scientific ideas that resulted in the Semmelweis Effect?
I’d love to hear them so drop them below!
And before we go we want say thanks to Google for supporting PBS Digital Studios.
They’ve created a mobile app - Science Journal – that lets you take notes and measure scientific
phenomena such as light, sound, and motion.
You can find activity ideas and additional information on their website at g.co/ScienceJournalApp"
Make sure to drop all your scientifically accurate comments below and we'll see you
next week!
I really heart (sorry!) all of your comments and questions from last week on why the heart
symbol doesn’t look identical to a human heart.
One question that came up a few times was: isn’t the heart symbol drawn from two hearts
being sewn together?
Two hearts stitched together looks like the heart symbol and love is the joining of two
hearts.
So while this is a beautiful sentiment, it may not be historically accurate.
I haven’t found any evidence that the two hearts theory exists in the formation of the
symbol, even though it’s emerged as a rather popular meme, and according to Pinterest,
tattoo idea.
Also the symbol itself predates the anatomically correct drawings of the heart that are featured
in the online images.
So the timeline here doesn’t exactly add up.
But outside of providing the snappy lyrics of Stacey Q’s infectious “two of hearts”,
this urban legend and folk etymology is catchy and relatively harmless.
So always remember to check those sources and we’ll see you next week!