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Nineteenth-century cities were crowded, polluted, and brim-full of tuberculosis. The combination of disease and dirty air led to enormous nasal issues—and the rise of the surprisingly large and influential handkerchief trade. Then came Kleenex and the rise of disposable hygiene. Join Virginia Postrel and Charles C. Mann as they explore the strange history of nose-blowing, tissues, and the modern culture of throwaway consumer products.
People have been blowing their noses as long as there have been people, but phlegm control did not become an industry until after the industrial revolution in the late 18th century.
Rising affluence, industrialization, and urbanization led to a global increase in polluted city air. Exacerbated by ubiquitous coal smoke, a host of respiratory diseases became constant presences in those cities, tuberculosis most prominent among them. Constant coughing, sneezing, and nasal discharge became ordinary features of city life.
Enter the handkerchief.
A remarkably sophisticated physical object, it became a cultural focus, a vital part of the middle- and upper-class wardrobe, and an icon of approved male behavior. Like so many other aspects of 19th-century society, the handkerchief-industrial complex died in the trenches of the First World War.
But technology developed for that same war gave rise to the complex web of creped, plied, and folded wood-pulp fibers known as tissue paper. Kleenex, introduced by Kimberly-Clark in 1924, was more than just a new method of cleaning your nose, it was a harbinger of a new age of disposability—for good and bad, the age we live in now.
Subjects discussed include:
- Charles’s Memorable Shaanxi Snot Shower
- The Handkerchief-Industrial Complex
- Dying Attractively from Tuberculosis
- Advertising Unmentionable Products (A Digression)
- Reliability of Ancient Disease Estimates
- Teddy Roosevelt’s Swag
- East Asian Social Norms, Nasal Division
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References, further reading, and credits:
Erasmus on nose-blowing: Desiderius, Erasmus. De Civilitate Morum Puerilium, 1530. (English translation)
Indigenous disgust with European handkerchiefs: Charles’s book, 1491: New Revelations of the Americas Before Columbus, 2005 (online excerpt with quote).
History and prevalence of tuberculosis: John Green, Everything Is Tuberculosis: The History and Persistence of Our Deadliest Infection, 2025.
Scholarly study of the same subject: Ilaria Barberis, et al., The history of tuberculosis: from the first historical records to the isolation of Koch’s bacillus. Journal of Preventive Medical Hygiene, 2017.
Fashionability of 19th-century TB: Imogen Clarke, Tuberculosis: A Fashionable Disease. Sciencemuseum.org, 2019.
The plague of female shoplifters: Elaine S. Abelson, When Ladies Go A-Thieving: Middle-Class Shoplifters in the Victorian Department Store, 1992.
Rheta Childe Doer at the handkerchief counter: Rheta Childe Doer, Christmas Behind the Counter. The Independent (NY), 1907.
Why, of course there is an illustrated history of the handkerchief: Helen Gustafson, Hanky Panky: An Intimate History of the Handkerchief, 2002.
The invaluable Business History Center on Kimberly-Clarke, Kotex, and Kleenex: Gary Hoover. Kimberly-Clark: From Commodities to Powerhouse Brands. American Business History Center, 2021.
Kotex and Kleenex: Thomas Heinrich and Bob Batchelor, Kotex, Kleenex, Huggies: Kimberly-Clark and the Consumer Revolution in American Business, 2004.
Boll weevil outbreak in US South: James C. Geisen, Boll Weevil Blues: Cotton, Myth, and Power in the American South, 2012.
The Hidden History of Bandanas, Virginia’s YouTube video