Foreword

The nostalgic image of the "good old days" is probably a fantasy when it comes to human health. Not only is it difficult to pinpoint a specific time frame when the "good old days" occurred, but in all probability, they never existed! Historical facts describe an endless struggle with devastating epidemics and unsanitary conditions leading to disease, particularly infant mortality and the early death of young adults. This situation prevailed in Western Europe and the U.S. until the beginning of the "health revolution" in the late 18th and early 19th centuries.

The "health revolution" brought about a fundamental upset of the status quo in these two regions and the dawning of an era in which disease is no longer inevitable and early death no longer an accepted fate. Since the 1850s, every decade has been marked by improvements in human survival and life expectancy. Western Europe and the U.S. are clearly better off today than in those imaginary "good old days."

The first 100 years of the health revolution can be credited to the control of infectious disease. A variety of medical, environmental, technical, and political innovations that were introduced as far back as 1850 interacted to gradually eliminate the sources or transmission routes of the "big killers." Some of these innovations were deliberate, some were accidental, some were well-documented, some were obscure, and some are still subjects of historical speculation and debate.

A substantial but overlooked component of the health revolution was a sociocultural transformation in personal hygiene and cleanliness. The quarter-century 1890 to 1915, in particular, was the beginning of a mass change in bathing, laundering, and domestic hygiene practice in the United States and England. These nonmedical, behavioral changes were probably a major factor in the control of significant morbidity and mortality.


“The ultimate conclusion is that the current status of cleanliness and the resulting health benefits in developed countries shouldn’t be taken for granted... Sanitary diligence is as pertinent to health today as it was a century ago.”


A basic hypothesis is that personal hygiene and domestic cleanliness -- including bathing, showering, laundering, dishwashing, and housecleaning -- played an essential but subtle and generally ignored role in the revolution. To support this hypothesis, this book examines records of soap production and consumption, bathing and hygiene habits, epidemiological data, and morbidity and mortality data from not only the United States and England, but also other areas of the world.

Today, the health revolution continues in the form of personal hygiene and household cleanliness -- two important disease-prevention strategies. This book includes an examination of the effectiveness of handwashing as well as household cleaning and disinfecting practices, today in removing and killing microbes.

The ultimate conclusion is that the current status of cleanliness and the resulting health benefits in developed countries shouldn't be taken for granted. They are only of relatively recent historical origin, are remarkably confined geographically, and require continuous nurturing and promotion.

There are improvements yet to be achieved in developed countries, and sanitary diligence is as pertinent to health today as it was a century ago. Furthermore, it is proposed that the health revolution and the sanitary revolution are still in progress. There are great strides -- including new cleanliness revolutions -- yet to be made in some regions of the world.