More than two-thirds of Americans shower every day—though whether we should is an open question. Yet daily showers are a relatively recent development for human hygiene. Little more than a century ago, most people preferred an infrequent soak in a bathtub. The first showers, though a product of physicians, were not for hygienic purposes, according to a recent paper in History of Psychiatry, but for the treatment of insanity.
In the 18th century, insanity was thought to stem from a "violent heat" and inflammation in the brain, according to the paper's authors. Physicians knew that cold water could calm inflammation in joints, wounds, and elsewhere in the body, so the idea was that a shock of cold water on the head might have the same effect on an inflamed brain. It wasn't the water alone that doctors believed was therapeutic, however; fear, as much as the cold itself, was thought to impose order on a disordered brain.
To create that fear, doctors often doused patients with cold water unexpectedly to shock them, and the showers would continue "for as long as the patient could endure, thus creating in them the fear of death," according to the authors. Showers were believed to bend obstinate patients to the will of their doctors. For example, the authors cite the case of an unnamed married woman in the mid-18th century whose madness manifested as a desire to leave her husband.
Her doctor, one Patrick Blair, tied his patient blindfolded to a chair in a bathtub beneath an abandoned, 35-foot-tall water tower on three separate occasions. "All this put her in an unexpressable terror," Blair wrote of his treatment plan, "especially when the water was let down." During the last treatment, Blair dropped 15 tons of water on his patient over the course of 90 minutes. He considered the treatment a success, writing:
I threatned her with the fourth Tryal, took her out of bed, had her stript, blindfolded and ready to be put in the Chair when she being terrify’d with what she was to undergo she kneeld submissively that I would spare her and she would become a Loving obedient and dutifull Wife for ever thereafter. I granted her request provided she would go to bed that night with her husband, which she did with great cheerfulness.
In the 19th century, the criminal justice system, which was turning to the medical fields for solutions to criminality and phasing out corporal punishments for psychological ones, embraced cold-shower treatments, also known as hydropathy. "Alongside solitude, technologies such as the shower provided both physicians and prison administrators with a way to inflict 'unpleasantness' on the body without leaving the marks of the whip," the authors write.
But shower treatments were not without risks. Indeed, doctors argued that the benefits of shower treatments stemmed directly from those dangers: "That hydropathy can kill—and that it may kill—in the hands of the ignorant practitioner—is perfectly true," Dr. Joel Shew wrote in The Water Cure in 1844. "It would not be worth two straws if it could not. For that which, when abused, can do no harm, cannot be capable of much good when properly used."
But shower-related deaths in prisons and hospitals eventually turned both the public and medical professionals against the method. Still, showers did not disappear from either institution. "It was in prisons that the idea of using showers to wash skins emerged," says Stephanie Cox, a lecturer at Auckland University of Technology in New Zealand and lead author on the study. As prison populations and sentences increased in the mid-1800s, so too did concerns about the spread of disease among prisoners. "At the time prisoners were lucky to be bathed four times a year, if at all," Cox says.
The realization that disease might spread through skin contact was emerging, and warm water poured over the bodies of prisoners came to be seen as an efficient and economical way to promote health and hygiene. A French prison physician, Merry Delabost, created the first cell-like shower design that allowed guards to separate and monitor prisoners as they washed, and to serve large numbers of prisoners in a relatively short span of time.
"Very quickly the idea of using showers to reduce the spread of disease among populations caught on, with showers becoming part of public-health initiatives around the world," Cox says. "The hygiene discourse is what resulted in people installing showers in their homes."
Americans' obsession with showers was largely cultivated by the advertising industry, which capitalized on social anxieties about body odor and bad breath as more people began working together in the closer quarters of factories and offices.
Fear as a therapeutic tool may seem bizarre today, Cox says, "however, the cold shock shower treatment used by the psychiatrist didn’t fall out of favor because it didn't cure mania; it faded out as thinking shifted toward our current view of it as outdated and cruel."
"I wonder what treatments we use today that in 100 years will be considered cruel, barbaric, and ignorant," she says. "I also wonder if we will rediscover the 1800s understanding of the therapeutic effects of water."