Hygiene Before Germ Theory

[Fudbucker]

I was reading a book about surgery in the 1700's, and I'm always dumbfounded when I read about how unsanitary surgeons were. Even if you didn't know about germ theory, wouldn't it just make sense not to get a bunch of crap into an open wound, to minimize the amount of foreign matter that goes in (e.g., washing hands, cleaning instruments before-hand)? Don't we have an instinctual dislike of filth? Wouldn't you want everything to be a clean as possible...just because?

 

[thaiboxerken]

Perhaps. But people also believe in angels, so.....

Also, there is a hypothesis that we have become too hygienic, resulting in weak immune systems.

 

[kid meatball]

Wasn't there also a pathological distrust of water for a very long time, prior to germ theory? Washing might have been seen as entirely counterproductive.

 

[geni]

I was reading a book about surgery in the 1700's, and I'm always dumbfounded when I read about how unsanitary surgeons were. Even if you didn't know about germ theory, wouldn't it just make sense not to get a bunch of crap into an open wound, to minimize the amount of foreign matter that goes in (e.g., washing hands, cleaning instruments before-hand)? Don't we have an instinctual dislike of filth? Wouldn't you want everything to be a clean as possible...just because?

Humans can get used to almost anything. You've also got to consider the shear level of effort involved in keeping everything clean prior the invention of modern cleaning products and the availibilty of running water.

 

[WhatRoughBeast]

Don't we have an instinctual dislike of filth? Wouldn't you want everything to be a clean as possible...just because?

Well, feces turn us off (after about the age of a few years, of course). Otherwise, no. Prior to the development of cheap hot water, bathing (in Europe and the US, at least) was very rare. Even as late as the turn of the 20th century, the Saturday Night Bath ritual was common. And as for earlier? Keep in mind that wigs for men, in part, allowed the head to be cropped very close to control lice. A letter has survived (sorry, no citation) from George Washington to a niece who was about to arrive in the city, advising her on etiquette, which includes the advice that the well-bred do not scratch their flea bites. Napolean's command to Josephine, "Home in three days. Do not wash." would seem to pertain.

Aldous Huxley, in an essay collection titled "Tomorrow and Tomorrow and Tomorrow", stated that Middle Ages Europeans had theological problems with the idea of cleanliness, since being clean in bed implied an approximation to immaculate conception, and that would never do.

 

[casebro]

Really stinky mates must have been a turn on.Because every must have been really stinky. But maybe the smell covered up the smell....

 

[Iamme]

I was reading a book about surgery in the 1700's, and I'm always dumbfounded when I read about how unsanitary surgeons were. Even if you didn't know about germ theory, wouldn't it just make sense not to get a bunch of crap into an open wound, to minimize the amount of foreign matter that goes in (e.g., washing hands, cleaning instruments before-hand)? Don't we have an instinctual dislike of filth? Wouldn't you want everything to be a clean as possible...just because?

And wouldnt you think even if you didnt know smoking causes lung cancer and break down of arterial walls...that repititiously breathing in concentrated smoke/particulate cant be all that good to do?...even from the standpoint of displacing oxygen that your cells need?

 

[Fudbucker]

Humans can get used to almost anything. You've also got to consider the shear level of effort involved in keeping everything clean prior the invention of modern cleaning products and the availibilty of running water.

I don't think in London, in the 1700's, surgeons were lacking for water to cleanse their instruments.

There is very little effort in at least rinsing your hands and the tools you'll be using. Maybe they wiped the blades on a cloth? But I never read about any sanitary measures they took. Surgery is always described as incredibly filthy.

 

[Fudbucker]

Well, feces turn us off (after about the age of a few years, of course). Otherwise, no. Prior to the development of cheap hot water, bathing (in Europe and the US, at least) was very rare. Even as late as the turn of the 20th century, the Saturday Night Bath ritual was common. And as for earlier? Keep in mind that wigs for men, in part, allowed the head to be cropped very close to control lice. A letter has survived (sorry, no citation) from George Washington to a niece who was about to arrive in the city, advising her on etiquette, which includes the advice that the well-bred do not scratch their flea bites. Napolean's command to Josephine, "Home in three days. Do not wash." would seem to pertain.

Aldous Huxley, in an essay collection titled "Tomorrow and Tomorrow and Tomorrow", stated that Middle Ages Europeans had theological problems with the idea of cleanliness, since being clean in bed implied an approximation to immaculate conception, and that would never do.

But doctors knew that foreign matter causes all sorts of problems when it gets in a wound. They would do too much surgery, in order to remove a bullet, when they were better off just leaving it in. Why then, would you use a dirty knife blade, or dirty finger?

I can't believe they didn't at least try to clean a little, prior to surgery, but then you look at the success of Lister's hand-washing experiment, and I guess they really were content to be filthy back then. It doesn't make any sense. Although, I was re-reading Lister's experiments, and there was a lot more going on than just washing hands.

Is it possible doctors in the middle ages tried to maintain as much cleanliness as possible, and books juts exaggerate how bad it was?

 

[Fudbucker]

And wouldnt you think even if you didnt know smoking causes lung cancer and break down of arterial walls...that repititiously breathing in concentrated smoke/particulate cant be all that good to do?...even from the standpoint of displacing oxygen that your cells need?

Actually, I would think that. Breathing in smoke naturally feels uncomfortable and just... not good for you. I don't smoke anyway, but I doubt that many people would, if cigarettes didn't have any nicotine in them.

Breathing in smoke is not a pleasant sensation, at least not for me. There better be something in the smoke!

 

[Lowpro]

But doctors knew that foreign matter causes all sorts of problems when it gets in a wound. They would do too much surgery, in order to remove a bullet, when they were better off just leaving it in. Why then, would you use a dirty knife blade, or dirty finger?

I can't believe they didn't at least try to clean a little, prior to surgery, but then you look at the success of Lister's hand-washing experiment, and I guess they really were content to be filthy back then. It doesn't make any sense. Although, I was re-reading Lister's experiments, and there was a lot more going on than just washing hands.

Is it possible doctors in the middle ages tried to maintain as much cleanliness as possible, and books juts exaggerate how bad it was?

If we're talking 1700's a la post Veserius I'd be inclined to think that most medical doctors were NOT necessarily surgeons. Earlier in medicine the practice of a PHYSICIAN and the practice of a surgeon (ever learned where the term barber comes from?) were not necessarily the same person though I'm sure at the end of the day it crossed up.

*edit for factual errors* Basically a physician and a surgeon may not be the same when it comes to field surgery XD

That's kind of how I remember learning about it. They all understood the concepts of transmissible disease and sanitation but I think part of the issue was pragmatism, idiopathic and iatrogenic problems, and the lifestyle of the patients that probably made the overall preconception of sanitation then to be poor. It probably wasn't as bad as we think but compared to today...it's pretty much appalling. I mean by then they probably knew what a fomite was but may not have understood the sanitation protocol that managed a post-op.

 

[Skeptic Ginger]

But doctors knew that foreign matter causes all sorts of problems when it gets in a wound.

When did they know this?

They would do too much surgery, in order to remove a bullet, when they were better off just leaving it in. Why then, would you use a dirty knife blade, or dirty finger?

I can't believe they didn't at least try to clean a little, prior to surgery, but then you look at the success of Lister's hand-washing experiment, and I guess they really were content to be filthy back then. It doesn't make any sense. Although, I was re-reading Lister's experiments, and there was a lot more going on than just washing hands.

Is it possible doctors in the middle ages tried to maintain as much cleanliness as possible, and books juts exaggerate how bad it was?

A bullet is large and visible. Microorganisms were small and invisible.

It wasn't until nurse midwives washing their hands was finally noticed to be saving lives by Dr Semmelweis that physicians figured out they needed to wash their hands.

Florence Nightingale also documented the benefit of cleaning wounds.

But men write history and the discovery of the benefit of cleaning wounds and washing hands wasn't recorded as a discovery of women nurses. Men took credit.

Now to be fair, Dr. Snow's careful epidemiological research of the cholera epidemic in 19th century London was key to the discovery of the germ theory.

 

[Sideroxylon]

Perhaps. But people also believe in angels, so.....

Also, there is a hypothesis that we have become too hygienic, resulting in weak immune systems.

Speak for your self.

 

[Katdai]

My understanding is that water was considered (probably rightly so, especially in densely populated areas such as London) more likely to be contaminated than not, leading to our lovely collection of alcoholic beverages. Transmissible diseases were either visible and physical, and therefore wiped away/physically removed via surgery, or invisible and airborne, for which there seemed to be no defense. What would water remove that wiping off would not? Would it make up for the chanciness of the water supply anyway? And to be effective, hot water and soap is necessary.

It wasn't that they were not concerned about sanitation, but that their idea of good sanitation differed greatly from ours. Just as ours will differ from future generations.

 

[Lowpro]

When did they know this?


A bullet is large and visible. Microorganisms were small and invisible.

It wasn't until nurse midwives washing their hands was finally noticed to be saving lives by Dr Semmelweis that physicians figured out they needed to wash their hands.

Florence Nightingale also documented the benefit of cleaning wounds.

But men write history and the discovery of the benefit of cleaning wounds and washing hands wasn't recorded as a discovery of women nurses. Men took credit.

Now to be fair, Dr. Snow's careful epidemiological research of the cholera epidemic in 19th century London was key to the discovery of the germ theory.

Eh only because it irks me. I think that honor would go to Pasteur. John Snow developed a system of population mapping the distribution of incidence which is the foundation of the field of epidemiology.

Again maybe it's worth reiterating but the idea of fomites and sanitation were documented by these times. What was not truly understood was the source of some diseases (microorganisms). Whether it was the miasma theory or spiritual may have been a lingering etiology of disease there was still a rudimentary understanding of cleaning and dressings wounds as well as sanitation in an operating space. It may have not been heavy-duty practice but it wasn't a matter of being oblivious to it either. Field surgery (IE. surgery that didn't happen in a hospital which was most everywhere then; physicians and surgeons were not all a localized lot and the ones that were tended to be near ports and universities) If a man was shot you fetched a doctor and that doctor had a bag... you get the picture.

 

[Skeptic Ginger]

My understanding is that water was considered (probably rightly so, especially in densely populated areas such as London) more likely to be contaminated than not,...

When?

The timeframe matters.

 

[Skeptic Ginger]

Eh only because it irks me. I think that honor would go to Pasteur. John Snow developed a system of population mapping the distribution of incidence which is the foundation of the field of epidemiology.

Didn't mean to shortchange Pasteur, however, Snow was first and probably contributed to Pasteur's discoveries.

http://en.wikipedia.org/wiki/1854_Broad_Street_cholera_outbreak#John_Snow_investigation

The germ theory was not created at this point (as Louis Pasteur would not create it until 1861), so Snow was unaware of the mechanism by which the disease was transmitted, but evidence led him to believe that it was not due to breathing foul air.

Again maybe it's worth reiterating but the idea of fomites and sanitation were documented by these times.

I ask again, by what time?

You're annoyed I shortchanged Pasteur, I'm annoyed you are short changing the nurse midwives who figured out hygiene long before the doctors of the day figured it out.

The fact the doctors delivering infants caused fatal puperial fever in women while the midwives had a lower fatality rate is well documented.

What was not truly understood was the source of some diseases (microorganisms). Whether it was the miasma theory or spiritual may have been a lingering etiology of disease there was still a rudimentary understanding of cleaning and dressings wounds as well as sanitation in an operating space. It may have not been heavy-duty practice but it wasn't a matter of being oblivious to it either. Field surgery (IE. surgery that didn't happen in a hospital which was most everywhere then; physicians and surgeons were not all a localized lot and the ones that were tended to be near ports and universities) If a man was shot you fetched a doctor and that doctor had a bag... you get the picture.

I beg to differ. If you think surgeons figured this out before the midwives that Semmelweis observed, by all means tell us this timeline.

The nurses figured it out, the doctors are credited by history. But I am willing to reconsider, just document the timeline.

 

[Sideroxylon]

The nurses figured it out, the doctors are credited by history. But I am willing to reconsider, just document the timeline.

Not, entirely true as I assume you became aware of this through someone else's research in medical history. Semmelweis is a great story though.

 

[Skeptic Ginger]

Not, entirely true as I assume you became aware of this through someone else's research in medical history. Semmelweis is a great story though.

What isn't true? What is your version, what is the timeline and by all means post a link or at least cite your source.

 

[fuelair]

Semmelweiss : http://semmelweis.org/about/dr-semmelweis-biography/