The Importance of Cleanliness | 18th Century Medicine


    About the author

    Edward St. Germain.
    Edward St. Germain

    Edward A. St. Germain created in 1996. He was an avid historian with a keen interest in the Revolutionary War and American culture and society in the 18th century. On this website, he created and collated a huge collection of articles, images, and other media pertaining to the American Revolution. Edward was also a Vietnam veteran, and his investigative skills led to a career as a private detective in later life.


      Editor’s note
      The following is a chapter from the book “Domestic Medicine” written by Dr. William Buchanan in 1785. It provides a fascinating insight into medical knowledge of the time, including the often haphazard and sometimes dangerous techniques used to treat certain injuries and illnesses in the 1700s. We have not edited this book chapter, and as a result it may contain old English spellings of certain words.


      THE want or cleanliness is a fault which admits of no excuse. Where water can be had for nothing, it is surely in the power of every person to be clean. The continual discharge from our bodies by perspiration renders frequent change of apparel necessary. Changing apparel greatly promotes the secretion from the skin, so necessary for health. When that matter which ought to be carried off by perspiration, is either retained in the body, or resorbed from dirty clothes, it must occasion diseases.

      DISEASES of the skin are chiefly owing to want of cleanliness. Mr. Pot, in his surgical observations, mentions a disease which he calls the chimney-sweepers cancer, as it is almost peculiar to that unhappy set of people. This he attributes to neglect of cleanliness, and with great justice. I am convinced, if that part of the body which is the seat of this cruel disease was kept clean by frequent washing, it would never happen. They may indeed be caught by infection, or brought on by poor living, unwholesome food, &c. but they will seldom continue long where cleanliness prevails. To the same cause must we impute the various kinds of vermin which infest the human body, houses, &c. These may always be banished by cleanliness alone, and wherever they abound we have reason to believe it is neglected.

      ONE common cause of putrid and malignant fevers is the want of cleanliness. These fevers commonly begin among the inhabitants of close dirty houses, who breathe unwholesome air, take little exercise, and wear dirty clothes. There the infection is generally hatched, which often spreads far and wide, to the destruction of many. Hence cleanliness may be considered as an object of public attention. It is not sufficient that I be clean myself, while the want of it in my neighbour affects my health as well as his. If dirty people cannot be removed as a common nuisance, they ought at least to be avoided as infectious. All who regard their health should keep at a distance even from their habitations.

      IN places where great numbers of people are collected, cleanliness becomes of the utmost importance. It is well known, that infectious diseases are communicated by tainted air. Every thing, therefore, which tends to pollute the air, or spread the infection, ought with the utmost care to be guarded against. For this reason, in great towns, no filth, of any kind, should be permitted to lie upon the streets. Nothing is more apt to convey infection than the excrements of the diseased.

      IN many great towns the streets are little better than dunghills, being frequently covered with ashes, dung, and nastiness of every kind. Even slaughterhouses, or killing shambles, are often to be seen in the very centre of great towns. The putrid blood, excrements, &c. with which these places are generally covered, cannot fail to taint the air, and render it unwholesome. How easily might this be prevented by active magistrates, who have it always in their power to make proper laws relative to things of this nature, and to enforce the observance of them!

      WE are sorry to say, that the importance of general cleanliness does not seem to be sufficiently understood by the magistrates of most great towns in Britain; though health, pleasure, and delicacy, all conspire to recommend an attention to it. Nothing can be more agreeable to the senses, more to the honour of the inhabitants, or more conducive to their health, than a clean town; nor can any thing impress a stranger with a more disrespectful idea of any people than its opposite. Whatever pretensions people may make to learning, politeness, or civilization, we will venture to affirm, that so long as they neglect cleanliness, they are in a state of barbarity. In ancient Rome the greatest men did not think cleanliness an object unworthy of their attention. Pliny says, the Cloacoe, or common sewers for the conveyance of filth and nastiness from the city, were the greatest of all the public works; and bestows higher encomiums upon Tarquinius, Agrippa, and others who made and improved them, than on those who achieved the greatest conquests. How truly great does the Emperor Trajan appear, when giving directions to Pliny his proconsul, concerning the making of a common sewer for the health and convenience of a conquered city?

      THE peasants in most countries seem to hold cleanliness in a sort of contempt. Were it not for the open situation of their houses, they would often feel the bad effects of this disposition. One seldom sees a farm-house without a dunghill before the door, and frequently the cattle and their masters lodge under the same roof. Peasants are likewise extremely careless with respect to change of apparel, keeping their houses, &c. clean. This is merely the effect of indolence and a dirty disposition. Habit may indeed render it less disagreeable to them, but no habit can ever make it salutary to wear dirty clothes, or breathe unwholesome air.

      AS many articles of diet come through the hands of peasants, every method should be taken to encourage and promote habits of cleanliness among them. This, for example, might be done by giving a small premium to the person who brings the cleanest and best article of any kind to market, as butter, cheese, &c. and by punishing severely those who bring it dirty. The same method sfhould be taken with butchers, bakers, brewers, all who are employed in preparing the necessaries of life.

      IN camps the strictest regard should be paid to cleanliness. By negligence in this matter, infectious diseases are often spread amongst a whole army; and frequently more die of these than by the sword. The Jews, during their encampments in the wilderness, received particular instructions with respect to cleanliness. Thou shalt have a place also without the camp, whither thou shalt go forth abroad: and thou shalt have a paddle upon thy weapon: and it shall be when thou shalt ease thyself abroad, thou shalt dig therewith, and shalt turn back, and cover that which cometh from thee, &c. Deuter. chap. xxiii. ver. 12, 13. The rules enjoined them ought to be observed by all in the like situation. Indeed the whole system of laws delivered to that people has a manifest tendency to promote cleanliness. Whoever considers the nature of their climate, the diseases to which they were liable, and their dirty disposition, will see the propriety of such laws.

      IT is remarkable, that, in most eastern countries, cleanliness makes a great part of their religion. The Mahometan, as well as the Jewish religion, enjoins various bathings, washings, and purifications. No doubt these might be designed to represent inward purity; but they were at the same time calculated for the preservation of health. However whimsical these washings may appear to some, few things would tend more to prevent diseases than a proper attention to many of them. Were every person, for example, after visiting the sick, handling a dead body, or touching any thing that might convey infection, to wash before he went into company, or sat down to meat, he would run less hazard either of catching the infection himself, or of communicating it to others.

      FREQUENT washing not only removes the filth and sordes which adhere to the skin, but likewise promotes the perspiration, braces the body, and enlivens the spirits. How refreshed, how cheerful and agreeable does one feel on being shaved, washed, and shifted; especially when these offices have been neglected longer than usual!

      THE eastern custom of washing the feet, though less necessary in this country, is nevertheless a very agreeable piece of cleanliness, and contributes greatly to the preservation of health. The sweat and dirt with which these parts are frequently covered, cannot fail to obstruct the perspiration. This piece of cleanliness would often prevent colds and fevers. Were people careful to bathe their feet and legs in lukewarm water at night, after being exposed to cold or wet through the day, they would seldom experience the ill effects which often proceed from these causes.

      A PROPER attention to cleanliness is no where more necessary than on shipboard. If epidemical distempers break out there, no one can be safe. The best way to prevent them, is to take care that the whole company be cleanly in their clothes, bedding, &c. When infectious diseases do break out, cleanliness is the most likely means to prevent their spreading: it is likewise necessary to prevent their returning afterwards, or being conveyed to other places. For this purpose, the clothes, bedding, &c. of the sick ought to be carefully washed, and fumigated with brimstone. Infection will lodge a long time in dirty clothes, and afterwards break out in the most terrible manner.

      IN places where great numbers of sick people are collected together, cleanliness ought to be most religiously observed. The very smell in such places is often sufficient to make one sick. It is easy to imagine what effect that is likely to have upon the diseased. In an hospital or infirmary, where cleanliness is neglected, a person in perfect health has a greater chance to become sick, than a sick person has to get well.

      FEW things are more unaccountable than that neglect, or rather dread of cleanliness, which appears among those who have the care of the sick; they think it almost criminal to suffer any thing that is clean to come near a person in a fever, or example, and would rather allow him to wallow in all manner of filth than change the least bit of his linen. If cleanliness be necessary for persons in health, it is certainly more so for the sick. Many diseases may be cured by cleanliness alone; most of them might be mitigated by it; and, where it is neglected, the slightest disorders are often changed into the most malignant. The same mistaken care which prompted people to prevent the least admission of fresh air to the sick, seems to have induced them to keep them dirty. Both these destructive prejudices will, we hope, be soon entirely eradicated,

      CLEANLINESS is certainly agreeable to our nature. We cannot help approving it in others, even though we should not practise it ourselves. It sooner attracts our regard than even finery itself, and often gains esteem where that fails. It is an ornament to the highest as well as the the lowest station, and cannot he dispensed with in either. Few virtues are of more importance to society than general cleanliness. It ought to be carefully cultivated every where; but, in populous cities, it should be almost revered. As it is impossible to be thoroughly clean without a sufficient quantity of water, we would earnestly recommend it to the magistrates of great towns to be particularly attentive to this article. Most great towns in Britain are so situated as to be easily supplied with water; and those persons who will not make a proper use of it, after it is brought to their hand, certainly deserve to be severely punished. The streets of great towns, where water can be had, ought to be washed every day. This is the only effectual method for keeping them thoroughly clean; and, upon trial, we are persuaded, it will be found the cheapest.

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