“Medicine has made enormous strides since [the early 19th century]. But better, more efficacious medicine -- the treatment of illness and repair of injury is only part of the story. Much of the increased life expectancy of these years has come from gains in prevention, cleaner living rather than better medicine. Clean water and expeditious waste removal, plus improvements in personal cleanliness, have made all the difference. For a long time the great killer was gastrointestinal infection, transmitted from wastes to hands to food to digestive tract; and this unseen but deadly enemy, ever present, was reinforced from time to time by epidemic microbes such as the vibrio of cholera.
The best avenue of transmission was the common privy, where contact with wastes was fostered by want of paper for cleaning and lack of washable underclothing. Who lives in unwashed woolens –and woolens do not wash well– will itch and scratch. So hands were dirty, and the great mistake was failure to wash before eating. This is why those religious groups that prescribed washing –the Jews, the Muslims– had lower disease and death rates; which did not always count to their advantage. People were easily persuaded that if fewer Jews died, it was because they had poisoned Christian wells.”
David S. Landes, The Wealth and Poverty of Nations (Norton, New York, 1998), p. xviii.
David S. Landes (1924-) is a professor emeritus of economics at Harvard University and retired professor of history at George Washington University. He is the author of Revolution in Time, The Unbound Prometheus, The Wealth and Poverty of Nations, and Dynasties. Professor Landes has received both praise for detailed retelling of economic history as well as scorn on charges of blatant Eurocentrism, He replies that an explanation for an economic miracle that happened originally only in Europe must of necessity be a Eurocentric analysis.
Needless to say, many deaths are preventable when you understand the underlying causes of diseases and disabilities caused by diseases. Simply washing your hands (and your food) makes a big difference for your life expectancy. The increasing concern for cleanliness in the past, for example, accounts for much of the rising life expectancy recorded over the past two centuries.
Even today the potential contribution of sensible living to longevity is tremendous. We know very well that smoking, the illicit use of drugs, drunkenness, promiscuity and homosexuality, and obesity all contribute to early death. If people simply took steps to avoid these causes of premature death, not only would we live longer, we wouldn’t need expensive and freedom-denying government-controlled health care to deal with the health problems caused by our own behavior and action.
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