The humble chore of washing clothes and linens is not conspicuously related to health issues. When these items become soiled, we whisk them into the washing machine, which whirls them around while pumping water through and through to clean them. Yet not long ago (from the viewpoint of history), most people had few clothes, and those they had were heavy, often worn in layers, and seldom washed from one year to the next. Leaving aside the incremental odor of clothes worn for long periods without washing, which might have felled a fainthearted modern but at least did no actual harm to contemporaries, the soiled clothes could harbor germs and parasites.
Until cotton fabric became available in the 1700s, most of the people in Europe and the European colonies never washed their clothes at all. The fabrics available for clothes and bedding were wool and linen, primarily wool. Wool, when washed, loses its shape, and hot water shrinks it. Cotton, on the other hand, is easily washed, tolerates hot water, and retains its size and shape.
Cotton's availability in bright colors and patterns, combined with its low cost and light weight, quickly made it popular. In hot weather, women's dresses and men's shirts were cotton. By the early 1800s, gentlemen were also wearing cotton underdrawers under their handsomely tailored wool breeches. Ladies wore cotton chemises under their corsets, and cotton petticoats (their young daughters were the first to wear the women's version of underdrawers, which later became universally accepted).
Soon, many of the garments in any family's wardrobe, and its sheets and towels, were made of cotton, which could be laundered often. Clean clothes and linens came to be a mark of social status, even of good character. The burden of keeping them clean fell on women, some of whom supported themselves and their families by “taking in washing.” In families without servants, one day a week was likely to be “wash day.” The work was onerous, entailing much scrubbing with harsh lye-containing soaps, as well as boiling the linens. Commercial laundries sprang up and thrived.
People were insensible of the sanitation benefits of cleanliness of clothing and linens when they initially adopted cotton fabrics and began to wash them, because conceptions of the causes of disease were primitive. As time went by, however, increasing evidence of the nature of transmission of infection reached individuals and medical establishments. Hospitals constructed their own laundry facilities to ensure fabric sanitation. The laundry remains an important, though generally unnoticed, part of the modern hospital.