From around the 1840s on, American architecture pattern books (books you could buy and build your house with the directions in it) included a little room that was called a “bath-room.” This mostly meant the rooms were destined to once have fixed plumbing. In most rural areas however, it took wel into the 1920s before the habit of bathing once a week in a tub in the kitchen, was over.
Especially after the Civil War, sanitation became a popular subject and the profession of sanitary engineer emerged. The earth-closet was developed in Britain, which was like a soil-composting system, and was at first thought healthier than water closets.
Colonel George E. Waring was a sanitary engineer and helped make the water closet system become popular in the US.
In London after 1860 a war against dirt was waged:
• the rising stench of the Thames prompted governments to develop new sewage systems to divert sewage away from the Thames, which became established in 1870, and thus allowed an increase in water supply to be feasible as water needs to be transported away as sewage. The benefits on the death rate were immediate: death rate per 1,000 dropping from 24 in 1870 to 19 by 1890’s.
• The rise of modern nursing in 1860’s using Nightingale’s creed of fresh air, soap & water, and light to remove dirt & “putrid exhalations”, with which she had reduced the death rate of hospitalised soldiers in the Crimean War from 42% to 2.2% in 4 months!
• From 1880, the war against dirt was further reinforced by the discovery of the germ theory which can be said to be the start of the new scientific era of medicine: Pasteur who had found that organisms caused putrefaction & silk-worm disease in the 1860’s, but pasteurisation of milk did not start until 1900 & saved incalculable infant lives.
• Lister develops antisepsis & then in 1887, aseptic technique for surgery resulting in the virtual disappearance of pyaemia, hospital gangrene & erysipelas from the surgical ward, allowing new surgical techniques to be developed without such a devastating infection rate. The practise of dressing wounds with cobwebs & cow dung were ceased & the need for cleanliness as a health issue rather than a class issue was reinforced.
• The discovery of the causal organisms of many diseases (mainly by Koch & colleagues 1876-1905): anthrax (1976), wound sepsis (1878), typhoid (1880), TB (1882), cholera (1883), diphtheria (1883), malta fever (1887), tetanus (1889), plague (1894), dysentery (1898), syphilis (1905).
• The discovery of antitoxins by von Behring, in the 1890’s, to treat tetanus & diphtheria