Microbes Were Discovered in the 1600s. Why It Take 200 Years For Doctors To Start Washing Their Hands?
May 8, 2025
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In this engaging conversation, Thomas Levenson, author of "So Very Small," uncovers the intriguing history of microbes and public health. He explains why it took over 200 years for the medical community to link germs to disease, despite their early discovery. Levenson highlights revolutionary figures like Edward Jenner and Florence Nightingale, whose innovations shifted public health from ignorance to action. He also touches on the antibiotic era, emphasizing the urgent need for responsible use as resistance grows, reminding us of the ongoing battle against infectious diseases.
The initial discovery of microbes in the late 16th century took centuries to link to disease due to prevailing human-centric beliefs.
Florence Nightingale and John Snow were instrumental in transforming medical practices through sanitation and the understanding of waterborne diseases.
The rise of antibiotic resistance highlights the critical need for responsible usage and ongoing research to combat evolving infectious diseases.
Deep dives
Discovery of the Microcosmos
The existence of microscopic life was first confirmed in the late 16th century when scientists observed tiny living organisms, referred to as animalcules. It would take centuries, however, for these discoveries to be meaningfully connected to disease causation. During the civil war in the 1860s, disease from infected wounds and pathogens like typhoid took a heavy toll on soldiers, emphasizing the need for improved understanding of sanitation and germ theory. Pioneers such as Florence Nightingale transformed medical practices by demonstrating that proper sanitation could drastically reduce mortality rates in hospitals.
Understanding Vaccination
The late 18th century witnessed the early practices of vaccination, especially through Edward Jenner's observations of dairy maids who showed immunity to smallpox after exposure to cowpox. Despite initial resistance, this empirical evidence laid the groundwork for modern vaccination practices. Influential figures like Cotton Mather promoted inoculation in Boston, though they faced significant backlash from the public. The progress made during this time highlighted the importance of cross-cultural knowledge in health practices, as successful inoculation methods were inspired by techniques from outside Western medicine.
Cholera and Public Health Innovations
In the 1850s, John Snow's mapping of cholera cases in London led to the groundbreaking discovery that the disease was waterborne rather than spread through the air, challenging long-standing miasma theories. His investigation into a contaminated water pump on Broad Street demonstrated the crucial link between sanitation and health outcomes, marking a pivotal moment in public health. Similarly, Florence Nightingale's focus on cleanliness and proper hospital management during the Crimean War significantly improved patient survival rates. These advancements collectively contributed to the evolution of public health practices and the emergence of germ theory.
The Role of Antibiotics in Warfare
World War II saw the introduction of antibiotics, such as penicillin, which drastically changed the landscape of military medicine by effectively treating infections, including those from sexually transmitted diseases among soldiers. The strategic use of these antibiotics bolstered troop readiness and significantly reduced the impact of disease on overall military effectiveness. Historical practices of quarantining and palliation were replaced with new medical solutions that quickly returned soldiers to duty. This advancement underscored the critical relationship between medical innovation and military success.
Challenges of Antibiotic Resistance
The emergence of antibiotic resistance has become a pressing public health issue, with microbes adapting to survive despite the presence of antibiotics, significantly diminishing the effectiveness of these drugs. Early awareness of resistance highlighted the need for careful prescribing and patient compliance to ensure that infections are fully eradicated. Addressing antibiotic resistance requires a multifaceted approach that includes stricter regulations on antibiotic usage in agriculture and healthcare, as well as ongoing research into new antimicrobial treatments. This ongoing battle against resistance illustrates the continuing evolution of infectious diseases and the necessity of vigilance in public health.
Scientists and enthusiastic amateurs first confirmed the existence of living things invisible to the human eye in the late sixteenth century. So why did it take two centuries to connect microbes to disease? As late as the Civil War in the 1860s, most soldiers who perished died not on the battlefield but of infected wounds, typhoid, and other diseases. Twenty years later, the outcome might have been different, following one of the most radical intellectual transformations in history: germ theory, the recognition that the tiniest forms of life have been humankind’s greatest killers. It was a discovery centuries in the making, and it transformed modern life and public health.
As today’s guest, Thomas Levenson (author of “So Very Small: How Humans Discovered the Microcosmos, Defeated Germs—and May Still Lose the War Against Infectious Disease”) reveals in this globe-spanning history, it has everything to do with how we see ourselves. For centuries, people in the West, believing themselves to hold dominion over nature, thought too much of humanity and too little of microbes to believe they could take us down. When nineteenth-century scientists finally made the connection, life-saving methods to control infections and contain outbreaks soon followed. The next big break came with the birth of the antibiotic era in the 1930s. And yet, less than a century later, the promise of the antibiotic revolution is already receding due to years of overuse. Is our self-confidence getting the better of us again?
So Very Small follows the thread of human ingenuity and hubris across centuries—along the way peering into microscopes, spelunking down sewers, visiting army hospitals, traipsing across sheep fields, and more—to show how we came to understand the microbial environment and how little we understand ourselves. Levenson traces how and why ideas are pursued, accepted, or ignored—and hence how human habits of mind can, so often, make it terribly hard to ask the right questions.
