History of covering sneezes/Switch from hands to elbow?

[RSB]

Does anyone happen to know when people started covering with their elbows?

Also about how people reacted to covering with a hand before then? Like if someone in the 1920s sneezed into their palm and then shook hands with someone or touched a doorknob, was this something people would be grossed out by, the way many would today? Were handkerchiefs seen as the more sanitary option?

And by that measure, did people always cover with their hands prior to covering with an elbow? Was uncovered sneezing more acceptable at some point in the past? Is this a cultural/regional thing as well?

Thoughts/info appreciated!

As a side note, now I'm curious about what the earliest written or illustrated depiction of sneezing is...

[allergyboy2001]

The elbow thing is relatively recent, at least as a public health push - within the past 20 years. 

Handkerchief use has been seen as a polite thing by upper/middle class people for several centuries. But the big public health push was late 1800s/early 1900s - as the germ theory of disease was widely adopted, and especially after the Spanish flu epidemic of 1918, I believe. Schools had "handkerchief drills." And the British of course did a further push in WWII, to keep everyone healthy, with public health films and so on.

Handkerchief use also spread culturally during the 20th century as US immigrant groups (say Catholics) and developing countries (say Africa) wanted to move up the scale of "respectability" and assimilate. Again, schools put an emphasis on teaching this and enforcing it.

Not sure about earliest illustration of sneezing but I would try Googling it - Google has a lot of digitized illustrations from 1800s or earlier.

[count tiszula]

I realise that I've never to my knowledge seen a real instance of elbow use , except on American Media.  Indeed I even wonder if it is done outside  the US; it seems to me such an unnatural perversion of the body, but then there are even odder descriptions of "covering",, like sneezing into one's own shoulder or neck.  Is this physically possible?  I keep waiting for someone to be described sneezing into their shoulder blade or spine.

When I was young, this would have been utterly verboten, if only because wiping one's nose on one's sleeve was a quintessential sign of rudeness.  Anyway, you would have to have your suit or blazer cleaned every time you sneezed; obviously impractical.   You always had to have a clean hankie, usually every day, and in the unlikely event of being able to foresee your sneezes, you were supposed to fumble.  Clearly then most sneezes were uncovered; in fact I remember seeing a schoolmate of mine  CENSORED CENSORED CENSORED..

The idea of being aardvarked out by shaking hands with someone who has sneezed into his hands is fascinating.  Obviously British people don't do all this foreign handshaking except  at the end of some awful game.  But I can't imagine anyone being so rude as not to shake hands  if some foreigner extended his hand.  Why would one be moleratted out.?

[allergyboy2001]

I forgot to mention that snuff use probably helped spread the idea of handkerchief use, 200-300 years ago - it wasn't exactly polite to sneeze tobacco all over one's neighbors. Some of the oldest illustrations of sneezing may be snuff-related.

[Chanel_no5]

I think the elbow thing became common as recently as around the Swine flu pandemic, so around 2009. I mean, I had seen it before, but very rarely and never done by the generation before mine. Nowadays most people I see sneeze in public sneeze into their elbow, but that was never anything I saw growing up.