Handwashing- lessons from history

Photo by Nathan Dumlao on Unsplash

Do you wash your hands frequently? If not, you are putting yourself and the people around you at greater risk in these times of Covid-19. 

Everyone seems to recognize the importance of hand hygiene these days. But it wasn’t always like that. Some religions like Islam and Judaism have been practicing handwashing rituals for thousands of years. But the idea that sickness can be spread by our hands was only adopted for about 130 years ago.

A revisit to the history of handwashing

The father of handwashing is undoubtedly Dr. Ignaz Semmelweis. During his time as the Chief Resident at the Vienna General Hospital in 1846, the Hungarian physician was faced with high maternal deaths caused by childbed fever at the maternity ward run by doctors.

Marble statue of Ignaz Philipp Semmelweis
Credit: Wellcome Collection

Childbed fever was once a common cause of death for women. Women develop childbed fever due to an infection after childbirth. Interestingly, there was another maternity clinic at the same hospital where Dr. Semmelweis worked. This maternity ward was run by midwives and there were much fewer cases of childbed fever and lower mortality rate.

This observation baffled Dr. Semmelweis. After observing the activities of doctors and midwives, Dr. Semmelweis had a eureka moment. At the time, doctors working at the maternity ward would perform autopsies on the deceased and then carried on with their usual routine including delivering babies without washing their hands. Midwives on the other hand never performed autopsies or surgeries.

It was then Dr. Semmelweis hypothesized that microscopic infectious particles from the corpses transferred to the doctors’ hands during autopsies and subsequently transferred from doctors’ hands to women during childbirth. He instituted a policy that all medical staff was required to wash their hands with a chlorinated lime solution between medical procedures. As a result, the mortality rate of childbed fever dropped by 90%.

Sadly, despite his success, the father of handwashing met a tragic end. His hypothesis was rejected by the medical societies at the time. Blinded by egos, other physicians were offended and saw the hypothesis as an insult to their hygiene practices. His hypothesis also didn’t sit well with the upper- and middle- class families in Vienna as they viewed themselves as very clean people compared to the lower-class people. The notion that their hands could be unclean was absurd.

Dr. Semmelweis lost his job and was admitted into an asylum in 1865 after suffering years of dismissal. He passed away just 14 days later at the age of only 47.

As Dr. Semmelweis’s mental state slowly declined, in 1857, Louis Pasteur made a breakthrough with his invention of the pasteurization technique of treating milk and wine with high heat. Using Pasteur’s findings, Joseph Lister developed antiseptic techniques for wounds and promoted sterile surgery.

In the years to come, the concept of germs and antiseptic techniques became widely accepted. Their research contributed to the “germ theory of disease” and validated Dr. Semmelweis’s theory. Since then, the field of bacteriology flourished (back then scientists didn’t know that viruses existed. Hence, there was no distinction between the study of bacteria and viruses).

In 1876, Robert Koch discovered the anthrax bacillus. And started a new era for medical bacteriology. Florence Nightingale further revolutionized nursing, improved hospitals’ sanitary conditions and instilled the idea of household cleanliness. More and more diseases (cholera, tuberculosis, typhoid, smallpox) caused by bacteria and viruses were subsequently identified. Medical professionals began practicing antiseptic techniques. 

Dr. Semmelweis was a man ahead of his times but others’ egos got in the way of progress. He is now widely celebrated as the pioneer of antiseptic procedures. Almost 170 years later, we are taking hand hygiene more seriously than ever. 

Next time you wash your hands, remember Dr.Semmelweis and know that a seemingly simple handwash (at least 30 seconds with soap and water) can make a real difference. 

Credit: GoogleDoodles
Poster of Dr. Ignaz Semmelweis and proper handwash techniques.

About the Author

Ameline Lim, Ph.D.
Ameline Lim, Ph.D., is a research scientist and biologist. She received her PhD from the University of New South Wales at Sydney, Australia. She has broad interests in medicine, history of science, and behavioural science. She is particularly interested in science education and the public understanding of scientific research. Her blog 'Science with Amy' celebrates the pleasures of finding things out and general curiosity.