Cleanliness is next to godliness, table manners, monetary exchange and a host of other human behaviours; how has it escaped the notice of anthropologists, ethnologists and historians for so long? One of Virginia Smith's many accomplishments in this excellent study is integrating the philosophies and practices central to the subject. Cleanliness is part of medical routines essential for the prevention of disease; it has an aesthetic foundation in the human love of order and beauty and the exercise of such on the body; and it has a moral dimension in perceptions of purity, that of the body in harmony with the soul. By explaining the contradictions inherent in these concepts, the author identifies why the very few previous publications on cleanliness have dealt with either theories of hygiene or related inventions, but not both. Practices enhancing beauty can endanger health; they encourage vanity and self-obsession, behaviours in conflict with moral purity, and scientific discoveries connecting health with hygiene are sometimes incompatible with religious beliefs. Because of these tensions, the history of cleanliness has not been a “positivist” progression of improvement, as Smith demonstrates, but characterized by periods of “regression”, when moral concerns take precedent over the aesthetic or the latter over the scientific.

This crucial theoretical basis is clearly laid out in the introduction, after which the author presents a very comprehensive narrative from animal grooming behaviour through to twenty-first-century environmental concerns. Cleanliness begins with biological processes at a cellular level and the instinctive revulsion of all primates for the rotten and excremental. In human society, technology comes to the aid of cleaning activities and influences a wide range of behaviours and artefacts; bathing, shaving, perfuming, hairdressing, laundering, housekeeping, food preparation, to list a few, all of which have a huge impact on domestic material culture, architecture and urban planning. Hygiene is closely linked to religious beliefs and practices: dietary restrictions, the sacred properties of water, beliefs and rituals relating to pollution and purity. The Greeks first made the conscious connection of cleanliness with health and absence of disease, placing the care of the body with diet, sleep and exercise in the regime of enhanced well-being. Such ideas and practices were inherited by the Romans and embraced by Galen as principles of western medicine in its attempts to understand and thereby control the inner workings of the body. However, the standards of hygiene achieved in the classical world did not last; with the fall of Rome went much of the technology necessary to maintain urban communal baths, Christian asceticism rejected the care of the body as detrimental to the soul, and medicine required several more centuries of scientific discoveries to make the microbiological link between dirt and disease.

Politics is the fourth factor in the history of cleanliness; as Smith explains, for centuries the means to be clean were available only to the wealthy. The concentration of dirt and frequency of epidemics in urban environments made the importance of public hygiene evident in antiquity, although, until the nineteenth century, this often involved nothing more technical than keeping the unwashed poor well out of sight and smell of the rich. Following John Snow's discovery of the cause of a cholera outbreak in London in the 1850s, the provision of clean water supplies and sewerage were established as modern public health essentials, reinforced by Louis Pasteur's concurrent discoveries in germ theory. Yet as Smith discusses, such “progress” has its detrimental side-effects, environmental and immunological.

Clean serves as an excellent introduction to the history of hygiene, body and soul, public and personal. Smith has expertly marshalled a vast amount of research on a wide variety of subjects from an equally impressive range of primary and secondary sources. Her findings are presented in a lucid and engaging style, with remarkable discipline given the breadth of the subject and the limits of the book's size. It is a shame that Oxford did not offer a more generous format; the topic really deserves the large, three-volume presentation of L'Univers Historique's new series, Histoire du corps. Nevertheless, Clean establishes a new domain in the study of human behaviour, providing an essential text for historians of medicine, architecture, and material culture; scholars and students of social history, anthropology, ethnology and cultural studies.