THE NEFF ZONE -- BY JIM NEFF

CADILLAC NEWS -- APRIL 18, 2020

“Stay calm and wash your hands” seems like an obvious message in these trying times. However, this simple task took a long time to be recognized as beneficial. Hand washing has traveled a somewhat grimy road to get to where we are today. 

Keeping hands clean has not always been a common practice. “The Middle Ages were disgustingly smelly and dirty.” The only reason hand washing happened at all was: “...to remove both external dirt and harmful bodily excretions.” 

Quite bluntly, the concern was with “dirt and bodily excrement.” The advice by  some doctors during the Renaissance was that “...hands must regularly be cleaned of superfluities, sweat and grime that nature often deposits in those places.” 

During the 1700s, there was more concern about hand washing among servants than there was among the aristocrats. This was mainly related to food handling. In 1745, author Jonathan Swift wrote “Directions to Servants.” In this he “specifically criticised domestic helpers who prepared salads with unwashed hands after handling meat or visiting the lavatory.” (https://www.historyextra.com/period/medieval/history-hand-washing-how-when-start-past-disease/)

As a sidelight note, realize that toilet paper (as we know it) was not produced much before 1857 and not widely available until the 1900s. But that's topic for another column perhaps. 

At any rate, the practice of hand washing changed course a bit in 1844. “An early proponent of hand washing was Ignaz Semmelweis, a Hungarian doctor who worked at the Vienna General Hospital. He wondered why mothers who delivered infants using midwives had a mortality rate only one-third as much as mothers who were assisted in delivery by doctors.  

Semmelweis started to look for any differences between the wards. “One difference was that in the doctors’ division, a priest regularly passed through and rang a bell as a last sacrament to the dying women. Semmelweis wondered if women were dying because of the psychological terror of hearing the bell. Semmelweis rerouted the priest, but it made no difference.”

Another theory was related to cadavers. “Semmelweis realized that, unlike the hospital’s midwives, doctors sometimes examined women in the maternity ward after performing autopsies. Semmelweis theorized that women in the doctors’ ward might also be dying because cadaveric matter from doctors’ hands.”

This was not the case, but Semmelweis was on the right track. “He started mandating that doctors wash their hands with chlorinated lime after autopsies. The maternal mortality rate in the doctors’ ward dropped to around the same level as the midwives’ ward.”

Semmelweis tried to convince other hospitals to adopt his policies, but many refused. “In any case, Semmelweis wasn’t the only doctor in the mid-19th century to realize medical professionals’ own hygiene might have some effect on their patients. Other proponents were the American doctor Oliver Wendell Holmes and the British nurse Florence Nightingale. Nightingale wrote: “Every nurse ought to be careful to wash her hands very frequently during the day.”

The importance of hand washing for medical professionals  really became common practice when scientists hit upon germ theory. “In particular, the British surgeon Joseph Lister drastically improved patient mortality by advocating that surgeons wash their hands and sterilize their instruments in between patients.” (https://www.history.com/news/hand-washing-disease-infection)

So, this all brings us to the current situation where the simple task of washing hands is at the least a way to protect us against COVID-19 and at the best a heroic action by doing something to protect our fellow man. 

This dovetails in with the Global Handwashing Partnership which “works to save children's lives and improve health by promoting handwashing with soap.”  This group's website states: “Handwashing with soap and other forms of hand hygiene have been gaining recognition as a cost-effective, essential tool for achieving good health and nutrition. Now that its effectiveness is no longer in question, the main focus is on how to make handwashing universal.” (https://globalhandwashing.org/)

This coming October 15 is Global Handwashing Day. Let's hope that by that date we can all raise our clean hands and give ourselves a round of applause. 

Jim Neff is a local columnist. Read Neff Zone columns online at CadillacNews.com and NeffZone.com/cadillacnews.