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National obsession with cleanliness bodes ill for health

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Shincho 45 (May) assembles a special issue of eight articles under the combined title, "Allergic Japan." Tokyo Medical and Dental University professor emeritus Koichiro Fujita leads off with a warning against people's growing propensity toward "keppeki-sho," translated variously as fastidiousness, fussiness over cleanliness or phobia of dirt.

"In the beginning," he writes, "living things were dirty and stank. Now there are even pills people can take to reduce their body odor." This obsession with "germ removal" and "disinfection" is driving out "good" bacteria that is always present on the body.

Fujita's conclusions come from direct observation: He spent a good number of years over the past five decades on visits to rural Indonesia, where public sanitation practices were close to nonexistent. Yet, he says, children in Kalimantan (Borneo) grow up free from such common maladies in Japan as atopic dermatitis, asthma and pollen allergies.

How can this be? While the outspoken Fujita's research has been published widely in foreign medical and scientific journals, he is regarded as a "kawari-mono" (oddball) in Japan.

The biggest changes, he says, date back to the postwar period, when U.S. occupation troops here frequently came down with parasites from eating raw vegetables. At that time, some 60% of Japan's population were found to harbor some type of parasite. By 1960, the figure had declined to 20% by 1965 less than 5%. Today it is believed to be below 0.2%.

Yet for their entire existence on the planet human beings have been surrounded by germs. Only within the past 20 years have humans begun to become so obsessive in their determination to eliminate germs from their environment.

Around the time of the "bubble economy" of the early 1990s, this creeping mysophobia became increasingly extreme, spawning such phenomena as people who found that sitting on the same taxi seat as the previous passenger was so repellent, they would first spread a disposable sheet before planting their own rump. Others would wear gloves to avoid touching a strap handle on a train. Some parents even demanded schools to revert to Japanese-style commodes because they don't want their children's backsides making contact "where someone else has been."

These practices have been contributing to the decline in people's natural immunity. And the most extreme example of all is to be found in bidet-type toilets.

"I suppose using them for washing once or twice a day is alright," Fujita writes, "but excessive washing kills the good bacteria present around the rectum, leaving it open to infections."

And once this occurs, use of toilet paper causes discomfort, making people even more dependent on warm-water wash, and creating a vicious circle.

For women, use of bidet-toilets may also kill beneficial bacteria in the vagina, leaving it more susceptible to infections. Fujita cites joint research by two obstetric hospitals that suspect 50 to 60% of premature births or miscarriages may have been due to infections brought on by overwashing.

Fujita notes that the volume of bacteria present in Japanese intestines has declined to only one third that of prewar levels. The volume of the stools they produce is also just one-half to one-third that of prewar times.

He cites three reasons for this: one is major changes in postwar dietary intake; second is the effect of free radicals (aka reactive oxygen) due to modern lifestyles; and third is stress.

The way to boost the numbers of bacteria present in the intestine and thereby raise one's resistance to infections is through greater consumption of dietary fiber. One should avoid stress. And to reduce the impact of free radicals, one should chew one's food well -- at least 30 seconds for each mouthful. When resting, he adds, it's important that people be "in contact with nature" to the greatest extent possible.

"If this overly fastidious society goes overboard, even though things appear clean on the surface, I think an internally dirty world will result," he writes. "A society where germs are all around us is not a dangerous one. Most of the germs around us have not changed for 10,000 years or more, and to there's no need for us to overreact to what is only 'slight badness.'"

"I don't expect that the Japanese are a race of fools," concludes Fujita. "Rather than letting themselves be made to dance to the tunes of the marketers of 'hygienic' and 'fastidious,' they need to dispassionately consider what being clean really is."

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excessive washing kills the good bacteria present around the rectum, leaving it open to infections

Ew.. gross!

-6 ( +0 / -6 )

@JonathanJo - I agree but it really has to be said.

8 ( +9 / -1 )

Whether I'm in Asia or the US, if I use a bidet wash for a few seconds, and then, wipe with toilet tissue, does that mean I'm still okay? :D

1 ( +2 / -1 )

"... he is regarded as a “kawari-mono” (oddball) in Japan."

And there just happens to be a huge "clean" industry in Japan that would stand to lose if anyone listened to him.

19 ( +19 / -0 )

If they are that clean, then why is it that so many men don't wash their hands when they use the toilet, even when they do Number #2!! Also, I think Japanese need to eat a lot more fiber as in cereal grains or healthy bacteria like yogurt. They just don't get enough or there isn't enough education about it.

11 ( +12 / -1 )

FINALLY!!! Japan wakes up to what the rest of the world has always known and what it had presumably forgotten...

5 ( +6 / -1 )

Finally, somebody takes over-cleanliness to the public. Americans have become obsessed with cleanliness but no where near as the Japanese. When I first came to Japan I wondered why so many people had allergies and skin problems like eczema. Just look at how serious people take being clean and you can see why.

By the way doctor, is there such thing as a Japanese "race"?

6 ( +6 / -0 )

By the way doctor, is there such thing as a Japanese "race"?

I suppose he used the word minzoku, rendered in dictionaries as people, race or nation, but also translated by some as ethnic group, or even tribe. In this case "nation" probably fits better.

3 ( +3 / -0 )

If there is a national obsession with cleanliness, why is there never any soap in subway toilet facilities?

Perform a bowel movement, use cheap, one-ply toilet paper, then let a trickle of water cascade on your fouled fingers for a second and get on the busiest mass transport system in the world.

Same with public parks. Run around with the kids for three hours, then have a picnic. Want to wash your hands before you eat? Just rub the grime around a little with some water. Then eat.

This is a classic example of Doublethink. We are a) obsessed with cleanliness and b) don't cover our mouths when we sneeze.

10 ( +13 / -4 )

@Ian

Perform a bowel movement, use cheap, one-ply toilet paper, then let a trickle of water cascade on your fouled fingers....

Doesn't sound like you're using that toilet paper very well.... ; )

9 ( +10 / -1 )

Ian Duncan,

Perform a bowel movement, use cheap, one-ply toilet paper

I think it's acceptable to pull 100cm or so of paper from the dispenser and wad it up.

Go on!

Live a little!

4 ( +7 / -3 )

This is nothing new, a British study two decades ago found that children who grew up on farms were half as likely to suffer from allergies and childhood illnesses as children who lived in "clean" city environments. It's also the reason that tourists often suffer from "Montezuma's revenge" when eating foods in less-developed countries. The bacteria common in not-so-clean foods is not necessarily a bad thing, it helps proper digestion. Having traveled a lot, and having enjoyed eating food in the different places I have visited, I find that the foods that "disagree" with my body the most are those in America and Japan (the lands of lawyers and cleanliness). My body much prefers foods from other places, even if my palate doesn't.

5 ( +5 / -0 )

Though I understand his point, I still like to wash my bum after a good poo. Keeps the undies stain free too.

Long live the washlet.

7 ( +8 / -1 )

@XianDC

Yes, I am.

Are you seriously lecturing the Japanese on eating habits? an American? The US has a 30% obesity rate while Japan has 3.2!!!! http://www.nationmaster.com/graph/hea_obe-health-obesity

http://www.foodnavigator-asia.com/Nutrition/Dietary-fiber-may-cut-Japanese-heart-disease-risk-study

Sorry, but we are not talking about General Foods, we are talking about daily Dietary soluble and Non-soluble fiber. Where the average American takes in 18 to 35 grams a day, the Average Japanese takes in 6.8 grams.

http://www.hsph.harvard.edu/nutritionsource/fiber-table/

Japan has a life expectancy of 82 yrs (#% in the world) while the US has 78.37 (#49)

Well, actually the Okinawans have the longest, but a lot of that is also due to genetics.

Japanese food is considered as one of the healthiest in the world, while no one would seriously think the same of American food - and you seriously lecture the Japanese on eating habits?!

That depends on who you ask and where you go. My father is a chef and he studied at Cordon Bleu in Los Angeles (the second most prestigious culinary school in the world) extremely difficult to graduate from, ask Anthony Bourdain. California created the Fusion cooking and while in part you are right on certain aspects of American Cuisine, California is one of the largest Vegan, organic community that caters to all cultures and nationalities. Yes, even Japanese have junk foods and lots of it. It depends on what works for you and helps you. For me, Japanese food is NOT the best for me. The food is all right, I am not THAT impressed. There are other foods that to me taste much better and are a lot healthier. Like beauty is subjective, what may be good for you doesn't mean its good for me or someone else. I don't care what anyone says, I care what helps my body and Japanese is not that kind of culinary.

Regarding fiber in the diet, the Japanese eat more veggies, beans, and including high fiber foods you'd never eat like seaweeds. In fact the Japanese diet is considered to be high fiber and thus a reason for low colon cancer.

http://onlinelibrary.wiley.com/store/10.1002/ijc.20030/asset/20030_ftp.pdf;jsessionid=7DAD1448119F35F8F2DD120B83106BC0.d03t03?v=1&t=hg4nffth&s=2ebe819e609b9dddd5c668fd278efe86dbe995cf

http://fightcolorectalcancer.org/dr_lenz/2009/05/why_is_red_meat_associated_with_colon_cancer_risk_newclues

I don't know what you are talking about, but that is not true. Colon cancer in Japan is on the rise, just brought out the recent stats. Sorry, Japanese don't enough wheats, too much bleached wheat, not enough heavy grains, barley or oats, NOT enough fruits, NOT just apples, oranges and bananas, not enough dried fruits.

Regarding healthy bacteria (like yogurt), there is enough natto, miso, and kimchi which are excellent substitutes for yogurt and maybe more suited for the Japanese who have a genetic propensity for lactose intolerance.

Natto doesn't even come close to the high percentage of healthy bacteria level that yogurt has. Yogurt has the highest levels of acidophilus (live bacteria cultures) that are essential for a healthy gut track. And again, you are generalizing that ALL Japanese have genetic propensity for being lactose intolerant and that is not always the case.

0 ( +0 / -0 )

@bertie

Yes, exactly! I am NOT saying American diet is better, I am specifically talking about FIBER, I am NOT putting down Japanese diet, I am just saying it is not the best for me, I have found out. As far as Asian diets, Korean food for MY personal health and overall feeling is better suited for MY body.

Moderator: You're on the wrong thread.

0 ( +0 / -0 )

Anyone have a link to the original article in Japanese? I would love to share this with my in-laws!

0 ( +0 / -0 )

Lol -If I had a dollar for every time I have seen an oyaji just walk out from a cubicle after doing no.2 without washing his hands here -all my money worries would be over. This particular national obsession is definately not uniform.

2 ( +3 / -1 )

Professor Fujita declines to mention the major cause of the major reduction in intestinal bacteria, the over prescription of antibiotics.

7 ( +7 / -0 )

papasmurfinjapan,

Long live the washlet.

Amen to that!

4 ( +4 / -0 )

Indeed, washlet is very convenient and I don't think you can go back to the old "plain" toilet after using washlet.

I am a little bit skeptical about this article, even though I can see its points. Yes, on the one hand excessive cleanliness might have bad results to health regarding illnesses such as skin diseases, allergies, etc. On the other hand, though, isn't one of the (many) reasons why Japan is first in the life expectancy list (while Indonesia mentioned in the article is below the world average)? Isn't this a contradiction?

3 ( +3 / -0 )

Japanese people not especially clean. Cold water in washing machines, no morning showers, spraying all that artificial spray over anything that smells instead of taking care of what's causing the problem. Tatami. There's a germ farm if I ever saw one. Now, they think they are very clean with their damn masks on all the time, their costant wiping and what have you but, as often here, nobody knows why they do it. They just do.

I think this "odd-ball" is absolutely right, though. Wash and scrub (all of you who have been to an onsen know what I mean) yourself too much and you are killing off necessary bacteria.

-3 ( +2 / -5 )

Knox Harrington,

Japanese people not especially clean.

I suppose it depends what your standards are.

When I was a kid in England, baths were once a week - and if we could find a way round it, we would.

Food that tastes of washing up liquid (detergent) because the dishes and plates haven't been rinsed. Mould, cobwebs, and just plain dirt.

Coming to Japan certainly raised my standards of cleanliness.

3 ( +4 / -1 )

When I was a kid in England, baths were once a week - and if we could find a way round it, we would.

Hi Bertie, I don't know your exact age, but according to my older Japanese friends and students, Japan wasn't so much different. Bathing daily is a relatively recent custom here. One of my students, a lovely lady in her seventies, told me that "bath day" was a big event in her village, because only one family had an actual bathtub, and when they were feeling generous they shared it with the rest of the neighborhood.

Don't forget that bathwater is shared by families (ew!) and that traditionally the youngest daughter-in-law in the house is the last to use it. According to my student, by the time she got to use it the water was milky-colored, and not especially clean at all.

As for dishwashing, I know people in my neighborhood who still don't have hot water in their kitchens. They do all their dishwashing with cold water and non-soapy detergent. They are scrupulous about rinsing, but only because they don't trust the quality of the detergent.

-1 ( +0 / -1 )

Japanese people not especially clean. Cold water in washing machines, no morning showers, spraying all that artificial spray over anything that smells instead of taking care of what's causing the problem. Tatami. There's a germ farm if I ever saw one. Now, they think they are very clean with their damn masks on all the time, their costant wiping and what have you but, as often here, nobody knows why they do it.

I cannot stand the idea of washing my undergarments in cold water, or washing them together with bath towels and dish drying towels, like so many Japanese people do. Since I came to Japan I wear disposable paper panties. It's probably not good for the environment, but it's better for my peace of mind. Also, a large number of Japanese households recycle their bathwater for laundry. Just think, four or five people have bathed in the water that you are about to use to launder your panties.

About tatami: according to my student, a retired architect, tatami is so attractive to insects that he refuses to have a tatami room in his home. Tatami is dirty. He said that this is pretty much common knowledge amongst architects in Japan.

As for the face masks, they are often re-used for days on end. My feeling is that masks aren't really used to keep germs out, so much as to keep people cut off from society. I can't really blame them.

-5 ( +1 / -7 )

Tessa,

I can't imagine getting through a sweltering hot and humid Tokyo summer without some form of bathing.

Sentos (public baths) have been in operation in one form or another for centuries.

I think your lovely seventies lady must have been the exception rather than the rule. Perhaps her village was in the mountains or in an area that didn't get so humid.

As far as I know there is a much longer tradition of bathing in Japan than in Europe. Queen Victoria thought that putting her naked body into a bath was disgusting. English houses didn't have baths until about 100 years ago and public baths dropped out of fashion with the Romans. That's why, apparently, perfume was invented, to hide the body odours.

Tatami comes from a time when women spent most of their waking hours doing housework. The mats were regularly put out to dry and cleaned daily with used tea leaves. These days, when many women continue to work after marriage, there simply isn't time for this. A light hoovering once a week is certainly not good enough.

The great thing about tatami is that it gave you an extra room. Put away the futon in the morning and your bedroom becomes a breakfast/lunch/dining/sitting room for the rest of the day. You couldn't do this on a concrete floor. However, I think there is a general trend away from tatami, for the reasons you mention and a move toward sleeping on beds rather than futon.

Living in Okinawa, we don't have tatami, or carpets (another attractive home for our six legged friends), and we rarely use the bath. A shower is more convenient.

But I still maintain that Japan is cleaner than the U.K.

Us blokes don't go as far as paper pants, though.

4 ( +4 / -0 )

What about people who don't wear underwear?

1 ( +1 / -0 )

Yet, he says, children in Kalimantan (Borneo) grow up free from such common maladies in Japan as atopic dermatitis, asthma and pollen allergies.

I don't suppose he compared infant mortality and childhood death rates between Borneo and Japan. I know that lower levels of sanitation tend to correlate positively with low incidence of allergies and certain chronic conditions in children, but the cost is usually higher mortality in the first year of life.

I think there's probably something to the idea that there can be too much cleanliness and endeavouring to kill all bacteria is a bad thing, but my worry is more from overuse of antibiotics than people running the washlet too long.

And to reduce the impact of free radicals, one should chew one’s food well—at least 30 seconds for each mouthful.

I'm going to say I have my doubts on this one.

2 ( +2 / -0 )

Tessa -

Don't forget that bathwater is shared by families (ew!) and that traditionally the youngest daughter-in-law in the house is the last to use it. According to my student, by the time she got to use it the water was milky-colored, and not especially clean at all.

I don't understand what the ew! is for. Everyone washes before getting in the tub, which means there is very little difference between first-in and last-in. (You are also appalled by onsens? Unable to enjoy sea-bathing because the water is shared with billions of sea creatures?) You can buy bath salts intended to make the water milky - nigori-yu is supposed to be good for you. I imagine your lovely seventies lady student was enjoying your ew! reaction and deliberately hamming it up, or a lot got lost in translation.

Is it your used undergarments in the same washing water as the hygienic bath towels/dish towels that you can't stand the idea of, or the used bath towels/dish towels in the same washing water as your delicate undergarments? From your aversion to using the bath water for laundry, I imagine it's the latter, but all the towels have on them is a bit of sweat and mebbe a bit of food...... The bath water doesn't get all that dirty from having four or five clean bodies sitting in it, and you know, Japanese washing machines (and detergents) are pretty good. You can set the programme to use bath water only for the initial wash or for the whole cycle, or use mains water for the final rinse, or a variety of other combinations. The stuff all comes out clean.

I also read sangetsu03's British report, or certainly something very similar. If you can't live on a farm, at least make sure your kids have access to animals (cats, dogs, guinea pigs, birds, any kind of pet that produces dander and pooh) and are actively involved in their care and cleaning.

2 ( +3 / -1 )

Everyone washes before getting in the tub, which means there is very little difference between first-in and last-in.

If that's the case, then why do women go last?

The bath water doesn't get all that dirty from having four or five clean bodies sitting in it.

I suppose you'll be advocating everyone sharing the same toothbrush, next.

0 ( +0 / -0 )

The great thing about tatami is that it gave you an extra room.

This argument doesn't hold water. The same thing can be done with a flooring room too, provided there is enough storage space.

Put away the futon in the morning and your bedroom becomes a breakfast/lunch/dining/sitting room for the rest of the day.

Ah, this was the bugbear with my architect student. He said that the fact that people insist on using their bedrooms as dining rooms is precisely what attracts the nasty insects in the first place. He strongly recommended that if people insist on regularly using a tatami room as a living room, then don't even spill so much as a drop of clean water on the mats, let alone crumbs of food.

Anyway, if tatami is so great, then why do most modern homes now only one tatami room, and flooring or even carpeting for the rest?

-3 ( +0 / -4 )

Everyone washes before getting in the tub, which means there is very little difference between first-in and last-in.

If that's the case, then why do women go last?

1 ( +3 / -2 )

Yeah, same bath water... I remember the first time I went to the wife's place with the whole fam in there before me. Didn't like it (still don't) but in I went because the option (no bath) was less appealing. Cleo, your comparison to onsen and the ocean (?) doesn't really hold up as onsen are far bigger than a bathtub as well as having cleaning systems.

-1 ( +0 / -1 )

Cleo, your comparison to onsen and the ocean (?) doesn't really hold up as onsen are far bigger than a bathtub as well as having cleaning systems.

Not to mention that people generally don't go to the ocean to clean their bodies. At least, I certainly don't.

0 ( +1 / -1 )

Tessa,

If that's the case, then why do women go last?

Why not?

They could go first if they wanted to, couldn't they?

Unless the bathroom police are watching!

0 ( +1 / -1 )

If that's the case, then why do women go last?

A hundred years ago, maybe, because in them days it was her job to empty the water out, wash everything down and get everything ready for tomorrow, including setting the fire. Today I don't know of any family that sticks to this outdated 'women last' rule, whether it's taking baths or eating or going to bed. (Why were women not supposed to go to bed before their husbands? Because the futon got dirtier? And why were women supposed to walk three paces behind? It was all about 'ore ga saki' status, nothing more.)

onsen are far bigger than a bathtub as well as having cleaning systems.

Not always they aren't, neither do they always have 'cleaning systems'. And they're used by a whole lot more people who are complete strangers and not family members even by marriage.

if tatami is so great, then why do most modern homes now only one tatami room, and flooring or even carpeting for the rest?

Because people have found that it's more comfy/easier on the knees/back to use tables and chairs and beds, and the furniture legs do terrible things to tatami. I don't think there's that much difference in the bugs that like to live in tatami and the bugs that like to inhabit carpets. Does your architect student also recommend that people either don't have carpet in the dining room or don't eat in the dining room? As a working woman, I find I don't really have the time to spend keeping either tatami or carpets clean, especially with critters covering everything with shed hair. Wooden floors are the most hygienic and easy to keep clean, but there's still something nice about relaxing on a clean tatami/carpet and I'm reluctant to give up either. And the balls of fluff in the corners of the rooms are a price I'm prepared to pay for having the critters close by. Any food that's dropped gets gobbled up toot sweet.

2 ( +2 / -0 )

I hope i dont get moderated off here, but here are a few simple facts; your toothbrush contains more bacteria than you rectum. your computer keyboard also contains more bacteria than your rectum. fact.

its all good for us, so dont be overclean.

0 ( +1 / -1 )

I'm with Cleo on the hard surface floors.

The other thing is that you can have too much bacteria that causes disease and death but then you can have too little as well. There's a growing body of evidence that indicates that the type of bacteria that inhabit a person is important for digestion and overall health. Get rid of the good bacteria and the bad ones can move in.

There's no way to get rid of this stuff. You have to live with it.

0 ( +0 / -0 )

Why would there be so many parasites from eating raw vegetables post WW2? From fertiilizer (night soil?) or something else? I could see getting parasites from fish or raw eggs, poor quality meat and similar, but why from veggies?

2 ( +2 / -0 )

Japan is way cleaner that most places but I can't help thinking that atopy (atopic syndrome), or hyperallergic skin rashes may be caused by over washing.

0 ( +0 / -0 )

I can't help thinking that atopy (atopic syndrome), or hyperallergic skin rashes may be caused by over washing.

I think a lot of it is down to the genes. Both I and my brother were born with an allergy to (among other things) sticking plasters, which I seem to have passed on to my son together with generally weak skin and a tendency to atopy. His sister, raised in the same environment and subjected to the same amount of/lack of washing, has skin that no germ or 'lurgy would ever dare invade.

1 ( +1 / -0 )

Just use "common sense" people! Yes, wash your hands carefully after going to the bathroom, but do not wash your "private parts" more than once or twice per day unless you have no choice. It also makes sense to wash your hands before eating, especially after touching things like door knobs and handles.

0 ( +1 / -1 )

"Cleanliness is next to godliness" and you may get to go and see whichever god you believe in before your time if you kill off all the "good bacteria"...

@Cleo :

toot sweet

Took me a couple of seconds to figure it out but I guess you mean "tout de suite" ?

0 ( +0 / -0 )

I can't help thinking that atopy (atopic syndrome), or hyperallergic skin rashes may be caused by over washing.

I used to think so, but a student who suffered from "atopi" was told by her doctor that it's more likely to be caused by air pollution. He strongly advised her to move out of the city.

here are a few simple facts; your toothbrush contains more bacteria than your rectum.

Without wishing to sound vulgar, I don't usually share either with other people. I don't care to share my bathwater, either, for the same reasons.

0 ( +0 / -0 )

@stuarto

I hope i dont get moderated off here, but here are a few simple facts; your toothbrush contains more bacteria than you rectum. your computer keyboard also contains more bacteria than your rectum. fact.

I don't doubt it. But I bet the bacteria on my toothbrush and keyboard are far more refined than the others.

It pays to be a bit of a snob when it comes to microbes ; )

0 ( +0 / -0 )

Took me a couple of seconds to figure it out but I guess you mean "tout de suite" ?

Hee hee, yes but the dog don't understand le Francais, he's bowlingual in English and Japanese.

0 ( +0 / -0 )

@Cleo

But surely you don't give him anything "toot sweet" do you ? (Not good for his teeth - nor the rest of his body...)

0 ( +0 / -0 )

Fighting - he gets to lick out the inside of the empty ice-cream cup after I've scraped out every last morsel - all of the smell, a bit of the taste, none of the sin. :-)

0 ( +0 / -0 )

The three 'cleanest' countries in Asia; Japan, Australia and New Zealand all have the highest high rates of atopi and asthma, compared to their 'dirtier' brethren.

0 ( +0 / -0 )

Bottom line - stop wiping after you do your business - it's bad for you.

0 ( +0 / -0 )

It is true that having an excessively clean environment will diminish the efficiency of the immune system as the immune system no longer has to work to fight off bacteria itself. When I visit Beijing I always get sick and particularly in the summer develop a cough, most likely due to the high air pollution, but my family and friends living their have no problems.

If we think about what this could mean in evolutionary terms it becomes a little troubling. Nature has this unique way of getting rid of things it perceives as unnecessary, so if we come to rely too much on man-made things like sanitary wipes and whatnot, making everything pristine and almost sterile, is it possible that one day certain humans will be born with very weak, or possibly even no immune system at all?

2 ( +3 / -1 )

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