While the concept of healthful living may seem like it has been consistently present in American society, historical evidence clearly suggests otherwise. In her extended historical work on the subject, Clean Living Movement: American Cycles of Health Reform (2000, 2001; Praeger Publishing, Westport, CT), Ruth Clifford Engs documents the periods in US history when clean living has emerged as a social movement in cycles of about 30 to 40 years, or roughly encompassing a generation of time.
The first period was from 1830 to 1860 (roughly corresponding with what historians call the Jacksonian era). The second was from 1880-1920 (roughly corresponding with the Populist and Progressive eras). The third period was from 1970 to about 2000 (corresponding with the counterculture and holistic consumer eras). Engs was seeing the end of the third era as she published her work.
In each of these eras a social movement arose that was intended to change not just individual behavior, but larger societal behaviors: that is, it is not enough that some people should adopt certain lifestyle habits of healthy living but that everyone should and social policies should be directed toward “make it so.” In the first era, the first “public health victory,” the eradication of cholera through applied public sanitation took place. And tellingly as Engs relates, there was a backlash against the “heroic” methods then favored by the medical “regulars” which included the emergence of alternative schools of thought: Thomsonianism, homeopathy, the Eclectic school (with a reliance on botanical medicinals) and significantly, hydropathy based on the work in Germany of Vincent Preissnitz and “Americanized” through the work of Joel Shew and Russell Trall.
As Engs noted: “Hydropathy, more than the other alternative therapies, integrated most of the other health reforms of the era. Like the other alternative medicines, it stressed self-responsibility for personal health care, including diet and exercise. Hydropathists can be viewed as early health educators, since they promoted since they promoted prevention through altered living habits, as opposed to physician directed cures.”
Another lay movement in addition to Thomsonianism grew into existence at this time. This was the “hygienic” school, which had its genesis in the popular teachings of Sylvester Graham and William Alcott. Graham began preaching the doctrines of temperance and hygiene in 1830. In 1839, he published Lectures on the Science of Human Life, two hefty volumes that prescribed healthy dietary habits. He emphasized a moderate lifestyle, recommending an antiflesh diet and bran bread as an alternative to bolted or white bread. Alcott dominated the scene in Boston during this same period and, together with Graham, saw that the American hygienic movement became well established in the Northeastern US during this first era.
In the second clean living era, chiropractic and naturopathy both were “born” based on similar core values to each other and to the alternatives of the first era. The earliest mechanisms of healing associated with the term Naturopathy, as used by Benedict Lust, involved a combination of hygienics and hydropathy (hydrotherapy). As he developed his philosophy he expressed it in 1918 in his Universal Naturopathic Directory and Buyer’s Guide (a yearbook of drugless therapy) this way:
“The program of naturopathic cure
ELIMINATION OF EVIL HABITS, or the weeds of life, such as over-eating, alcoholic drinks, drugs, the use of tea, coffee and cocoa that contain poisons, meat eating, improper hours of living, waste of vital forces, lowered vitality, sexual and social aberrations, worry, etc.
CORRECTIVE HABITS. Correct breathing, correct exercise, right mental attitude. Moderation in the pursuit of health and wealth.
NEW PRINCIPLES OF LIVING. Proper fasting, selection of food, hydropathy, light and air baths, mud baths, osteopathy, chiropractic and other forms of mechano-therapy, mineral salts obtained in organic form, electropathy, heliopathy, steam or Turkish baths, sitz baths, etc.”
In between these eras, almost as a backlash, Americans adopted habits not conducive to healthful living. Post WW II America virtually enshrined cigarette smoking and significant alcohol use, together with a meat and potatoes diet. Naturopaths staked out – almost in anticipation of another clean living cycle – a contrary position after the war. In Basic Naturopathy: A Textbook (1947; American Naturopathic Association, Inc.) Editor-in-Chief H. Riley Spitler noted (pg. 190):
“There are multitudes who are ready to pay large sums to buy health who would not sacrifice one small indulgence in order to deserve health. These are those people who do not understand that health is the logical and inevitable result of healthful living habits (emphasis in original).”
In the third era–against the backdrop of the holistic health consumer movement-the modern integrative medicine movement emerged, again based on similar core values of clean living, sound nutrition, dietary moderation, proper and sufficient exercise and disease prevention. All of this has been underscored by the concept of the physician as teacher, implanting these values in individual patients but also in society at large.
In the 21st Century American poor dietary habits and lack of exercise have given rise to a range of chronic illnesses and infirmities: when will the fourth era begin, and how will integrative medicine be positioned when it does?