HEALTH REFORM MOVEMENTS | Kickoff

HEALTH REFORM MOVEMENTS

12 May

Nineteenth-century physicians had little interest in disease prevention. Indeed, except for smallpox inoculation or vaccination, which involved a specific and somewhat dangerous operation, they had little to offer. But the prevention of disease was a major concern of the public and the promise of wellness through various hygienic regimens was irresistibly attractive. Health reformers and wellness advocates were a versatile and energetic group—juggling many good causes and dispensing avalanches of advice about health, exercise, diet, air, water, light, dress reform, sexual hygiene, family, community, temperance, tobacco, and drugs, in an endless recital of themes and variations. Disturbed by evidence of poor health and hygiene, and stimulated by new physiological knowl- edge, social reformers launched a moral crusade preaching the virtues of healthful living. Converts to the health reform movement attended lectures, sub- scribed to health journals, adopted special diets, engaged in novel exer- cises, indulged in therapeutic baths, or sought out health resorts, and spas. The popularity and influence of health reformers and newly emerg- ing medical sects empowered health seekers to free themselves from medically approved purging, puking, and bleeding. Health reformers shared the belief that prevention is better than cure and they urged their followers to follow the path to optimum wellness. But the roads to well- ness were many and diverse, even bizarre, although most emphasized control of the usual suspects—diet, exercise, sexual activities, personal hygiene, and so forth. Many of the most colorful and charismatic health reformers appealed to the latest findings of scientific research in support of their vision of a true physiological lifestyle, but they also assured their followers that their system of right living was mandated by God’s laws of hygienic living. Cynics like H. L. Mencken (1880–1956), American editor and social critic, was annoyed by the evangelical enthusiasms of the health reformers. Mencken called hygiene ‘‘the corruption of medicine by morality’’ because it was ‘‘impossible to find a hygienist who does not debase his theory of the healthful with a theory of the virtuous.’’ Leaders of health crusades largely abandoned the old Hippocratic call for ‘‘moderation in all things’’ and substituted the concept of abso- lute prohibition, although different reformers adopted different prohi- bitions. Foods and behaviors were divided into moral categories of good things permitted, in moderation, and bad things—such as meat, alcohol, and other stimulants—that must be avoided altogether. Although veg- etarianism is an ancient concept, the forms it has taken and the reasons for its adoption have varied considerably. Buddhists, Hindus, and Pythagoreans objected to the slaughter of animals for moral and reli- gious reasons, but health reformers advocated vegetarianism as an abso- lute prerequisite for a healthy, harmonious life. The most influential leaders of the early nineteenth-century American health reform move- ment, William Andrus Alcott (1798–1859) and Sylvester Graham (1794– 1851), claimed that their health advice, while in accord with Christian theology, was based on contemporary scientific knowledge about physi- ology and the nature of human beings. In addition to meat and other flesh foods, Alcott and Graham condemned alcohol, coffee, tea, tobacco, and spices because of their tendency to over stimulate the body’s animal appetites and passions. Presumably because of the eponymous graham cracker, Sylvester Graham is better known than William Alcott, his more prolific contem- porary. Graham was an ordained Presbyterian minister, a temperance advocate, and a lecturer whose area of expertise was nothing less than ‘‘The Science of Human Life.’’ Graham warned his followers of the destructive effects of intemperance, gluttony, sexual indulgence, flesh foods, mustard, pepper, and white bread made from ‘‘unnatural refined flour.’’ In Lectures on the Science of Life and the Graham Journal of Health and Longevity, Graham offered advice about every aspect of hygienic living, from the need for fresh air, sunlight, loose clothing, and frequent bathing, to the preparation and proper consumption of bread. Graham bread was made from coarsely ground whole-wheat flour and eaten when slightly stale. Perhaps to compensate for the rather tough, lumpy quality of such bread, Graham conscientiously explained how it should be chewed slowly and thoroughly. Many health reformers warned against excessive sexual activity, especially the ‘‘secret vice,’’ but Graham believed that, except for abso- lutely necessary procreation within marriage, all sexual activity was unphysiological and unhealthy.

The popularity of Graham’s message led to the establishment of Grahamite health food stores, restaurants, health retreats, and boarding houses. Legions of critics, however, pointed out that the inventor of Grahamism was a sickly semi-invalid for much of his rather brief life. Meat eaters ridiculed the vegetarian banquets of Grahamites, which featured such unappetizing selections as ‘‘Graham bread, stewed squashes, wheaten grits, and pure cold water.’’ William Alcott earned a very respectable M.D. at Yale, but he became disillusioned with medicine and decided to rely on the healing power of nature rather than conventional therapeutics. After discover- ing that drugs could not cure him of tuberculosis, Alcott reformed his diet, abstained from alcohol, and acknowledged nature as the only true physician. Alcott devoted the rest of his life to developing and preaching his gospel of Physical Education and Christian Physiology. A prolific author, Alcott disseminated his message through books, journal articles, and self-help guides, such as Lectures on Life and Health, The Laws of Health, The Physiology of Marriage, and Annals of Education, but he was best known as the author of The Vegetable Diet As Sanctioned by Medical Men and By Experience in All Ages. Alcott warned that meat and other flesh foods caused nervous excitement, which led to self- abuse, and an unnatural desire for further stimulation.

According to Alcott, a vegetarian diet was fundamental to all other reforms, ‘‘Civil, Social, Moral, or Religious.’’ In 1850, at a convention that established the American Vegetarian Society, William Alcott was elected President. When Alcott died, William Metcalfe, founder of the Bible Christian Church, took his place. Metcalfe argued that the Bible, properly interpreted, demanded abstention from flesh foods. Graham and Alcott, in contrast, based their dietary regime on contemporary science, primarily the physiologi- cal studies of Franc¸ois J. V. Broussais (1772–1832) and the anatomical researches of Xavier Bichat (1771–1802). In the simplified form adopted by Alcott and Graham, Broussais’s theory of pathology generally ascribed all disease to excessive stimulation of the digestive tract, which caused dyspepsia and generalized inflammation throughout the body. Vegetarianism was promoted as a healthful, hygienic, and natural way of life, but health seekers also needed to find natural, hygienic relief from acute and chronic ailments. A healing system known as hydropa- thy, or the water-cure system, was virtually inseparable from the health reform doctrines taught by Alcott and Graham. When the water-cure system was popularized in America in the 1840s, it incorporated many elements of Grahamite physiology, with its emphasis on fresh air, sun- light, exercise, dietary regimen, and dress reform. Hydropaths estab- lished formal treatment centers and educational institutions to train practitioners, who created a new group of professional healers who competed with orthodox practitioners and other sectarian practitioners. Hydropathy also represented a rejection of the long-held belief that excessive bathing or immersion in cold water was as dangerous as night air. For example, Benjamin Franklin (1706–1790) told fellow Americans that cold baths were very much in vogue in London as a tonic, but he thought the shock of cold water was too violent. As evidence of the dan- gers of cold baths, Franklin described the case of four young men who decided to cool themselves by plunging into cold spring water after working on a hot day. Two died immediately, the third was dead the next day, and the fourth barely recovered.

To avoid the dangers of immersion in cold water, Franklin preferred air baths, which involved sitting in his room without any clothes for 30 minutes or so each morning. On the other hand, Franklin believed that swimming was ‘‘one of the most healthy and agreeable’’ forms of exercise in the world. Towards the end of his life, suffering from several illnesses, Franklin sought relief in warm baths in a special bathing vessel made of copper and shaped like a slipper. Vincent Priessnitz (1799–1851), a Silesian farmer, is generally credited with the discovery of the fundamental water-cure methods. After an accident that left him with broken ribs and other injuries, Priessnitz claimed to have effected a miraculous recovery by drinking large quantities of cold water and wrapping himself in wet towels. The ingenious peasant then proved that the same methods also cured farm animals (which would tend to take the cure out of the realm of ‘‘mere suggestion’’). Dr. Joel Shew (1816–1855), one of the early promot- ers of the American water-cure movement, insisted that exercise and a strict vegetarian diet were essential adjuncts to hydropathic healing. Shew was soon overshadowed by Russell Trall (1812–1877), who was active in the temperance movement before discovering the remarkable health benefits of Hygienic Hygieo Therapy. In 1849, Shew, Trall, and others founded the American Hydropathic Society, which was renamed the American Hygienic and Hydropathic Society one year later. Trall was also an active participant in the American Anti-Tobacco Society and the American Vegetarian Society. Energetic and articulate, Trall enjoyed lecturing, debating, and challenging orthodox practitioners. In 1853, Trall founded the New York College of Hygieo-Therapy to instruct others in the use of water-cures, diet, and exercise regimens. Hydropaths generally rejected the use of drugs and claimed that the water-cure was a natural therapeutic system, effective in the treatment of acute and chronic ailments. Trall’s Hydropathic Encyclopedia included advice about water-cure, exercise, diet, and sexual hygiene. He also published a hydropathic cookbook. When the American Veg- etarian and Health Journal ceased publication in 1854, Trall agreed to reserve space in the Water-Cure Journal for articles written by members of the Vegetarian Society. Vegetarians did not have to worry about finding suitable foods when seeking a cure at a hydropathic spa, because water-cure establish- ments typically prepared and sold ‘‘pure and proper’’ health foods, including grits, hominy, farina, oatmeal, Graham flour, and Graham crackers.

Testimony from satisfied patients recalled how hydropathic treatments had cured them of complicated ailments such as ‘‘the horrors of dyspepsia, the depressions of nervous debility, the terrors of con- gestion of the brain.’’ Some orthodox physicians, such as Simon Baruch Ward (1840–1921), believed that hydropathy had positive physiological effects and that it was useful in the treatment of typhoid and other febrile diseases. Ward taught hydrotherapy at Columbia College of Phy- sicians and Surgeons from 1907 to 1913. Hydropathic spas were usually retreats for those with time and money, but Ward was particularly con- cerned with cleanliness and the need for public baths for the urban poor. Many water-cure physicians and patients were women who were active in various reform movements who adopted the uplifting ideology of hydropathic living. Mary Gove Nichols (1810–1884), for example, was well known as a social reformer, pioneering feminist, utopian thin- ker, and an alternative medical practitioner. She lectured and wrote about women’s health, anatomy, physiology, and sexuality, as well as equality in marriage, free love, the importance of happiness, and the benefits of the water-cure. Her second husband, Thomas Low Nichols (1815–1901) was a doctor, journalist, and social reformer. Mary and Thomas Nichols published several books, including Lectures to Ladies on Anatomy and Physiology; With an Appendix on Water Cure, Nichols’ Medical Miscellanies: A Familiar Guide to the Preservation of Health, and the Hydropathic Home Treatment of the Most Formidable Diseases, and Marriage: Its History, Character, and Results. Long after water-cure establishments ceased to exist as serious therapeutic institutions in the United States and Great Britain, water therapy spas continued to flourish in other parts of the world. German and Italian health seekers could enjoy therapeutic spas, knowing that at least half of the cost would be paid by their national health insurance system. In France, water-cure spas attained a prominent place within the medical establishment, and the treatment known as thermalism was included in the national health insurance system. In nineteenth- century France, the Academy of Medicine was involved in administra- tive supervision and scientific studies of mineral water spas. Elite and influential physicians promoted the development of the water-cure industry and hydrology became part of the curriculum of French medi- cal schools. Patients sent to French spas typically remained under medi- cal supervision for about 20 days. By the 1950s, however, the French government was struggling to reduce funding for thermal spas and medical school courses in hydrology. Most spas visitors hoped for relief from arthritic conditions, but others believe that thermalism cures a vari- ty of digestive, respiratory, dermatological, circulatory, and nervous ailments. Critics of thermalism denounced it as a form of paid vacation, if not outright quackery. One of the largest and most famous American water-cure sanitari- ums was the institution known as ‘‘Our Home on the Hillside,’’ founded by Dr. Harriet Austin and James Caleb Jackson (1814–1895) in Dansville, New York. Jackson published many books and pamphlets with the usual advice about diet, alcohol, tobacco, hygiene, hydropathy, exercise, recreation, education, and sex, including The Sexual Organism and Its Healthy Management. In addition to selling Grahamite health foods, Jackson attempted to create a form of Graham bread with a longer shelf-life. His cold, ready-to-eat breakfast cereal, which he called Granula, did not receive much attention until it was discovered and adopted by Ellen G. White (1827–1915), the spiritual leader and proph- etess of the Seventh Day Adventist Church, who visited ‘‘Our Home’’ when her husband was stricken with paralysis. Although White had great faith in the water-cure, James did not recover his health. Ellen White attributed this failure to the lack of an appropriate religious environment at Jackson’s spa. In a divine vision that came to her on Christmas day in 1865, White learned that Seventh Day Adventists needed to create a health retreat and hospital in Battle Creek, Michigan. The staggering burden of the Civil War eclipsed many aspects of the health reform movement, diverted attention and resources, and contributed to the disappearance of many hygienic institutions, spas, schools, and sanitariums. But as the story of Ellen White and Dr. John Harvey Kellogg (1852–1943) shows, new leaders and institutions sustained and reinterpreted fundamental ideals of the early health crusades—wellness, prevention, and right living. While Graham and Alcott emphasized physiological science in support of their theories of healthful living, Ellen White, the Adventist prophetess of health, told her followers that she had received her mes- sages from the Creator of the laws of hygiene. Initially, White’s visions dealt with theological issues, but after 1848 many were about food, drink, clothing, and other remarkably practical aspects of healthful living. In 1863, White had a vision of the relation between physical health and spirituality, the importance of a vegetarian diet, and the bene- fits of nature’s remedies—fresh air, sunshine, exercise, and pure water.

In keeping with White’s vision, Adventists launched a health education program with the publication of six pamphlets entitled Health, or How to Live. The fundamental principle that hygienic living was a religious duty was incorporated into Seventh Day Adventist doctrine. Critics of Ellen White, however, found her revelations less than wholly original and insinuated that a head injury sustained when she was young caused hallucinations, not divine visions. In response to the vision that occurred after her visit to Jackson’s hydropathic resort, White created a health spa and hospital where Adventists could benefit from natural therapies in an appropriate religious environment. The Adventist’s Western Health Reform Insti- tute of Battle Creek, Michigan opened in 1866 and offered natural methods of health and healing, through a vegetarian diet, hydrotherapy, exercise, light, fresh air, and instruction on the ‘‘right mode of living.’’ Recognizing the need for serious medical leadership at the Institute, in 1876 White appointed her prote´ge´ John Harvey Kellogg to the position of Physician-in-Chief. It was Kellogg who transformed the struggling Institute into the highly successful Battle Creek Sanitarium. In 1905, Ellen White published The Ministry of Healing, a book that summarized and clarified her teachings about the healing of body, mind, and soul. According to White, human beings became ill because they transgressed the laws established by God to govern health and life; they ignored the fact that improper eating, drinking, and licentiousness are sins that cause disease. Although White cited the Bible for directives about health and healing, she also provided remarkably detailed instructions that echo the advice of Alcott, Graham, and other health reformers. Modern ‘‘artificial civilization’’ was condemned as the source of customs, fashions, intemperance, crimes, and indulgences that con- tributed to an alarming and widespread decline in physical vigor and endurance. Artificial civilization, caused by rapid industrialization and urbanization, was condemned as the source of pollution, filth, over- crowding, corruption, vice, debility, and disease. Health could, however, be restored by natural remedies, such as pure air, sunlight, rest, exercise, proper diet, pure water, and trust in divine power. Because regaining health through natural methods required time and patience, many people resorted to powerful drugs and patent medicines, without realizing that such preparations con- tained poisons and addictive intoxicants. Moreover, even though drugs seemed to provide temporary relief, they did not cure disease. Patent medicines, medicines legally sold without a physician’s prescription, were very popular and widely used during the nineteenth century. Manu- facturers and retailers advertised heavily and claimed that their prod- ucts would cure virtually every disorder known to man and woman, from impotence, baldness, and female complaints to cancer, catarrh, tuberculosis, and arthritis. Patent medicines were fairly inexpensive compared to prescription drugs, but they were not necessarily innocuous. For the most part, their contents were secret and government regulation of such products was virtually nil, but popular pills and potions might contain cocaine, morphine, alcohol, or other addictive drugs. Until the Pure Food and Drug Act of 1906, there was little that could be done to regulate the marketing of patent medicines. Indeed most medical journals, including the Journal of the American Medical Association, relied on ads for such nostrums and many physicians prescribed them. Like previous health reformers, White insisted that it was better to prevent disease than to treat the sick.

Therefore, everyone should learn and obey the laws of life, study human anatomy and physiology, and understand the ‘‘influence of the mind upon the body, and of the body upon the mind, and the laws by which they are governed.’’ Serious brain work, for example, was physically debilitating and called for balancing rest and exercise in order to build mental and physical endurance. Dis- eases caused by mental depression, anxiety, guilt, and other emotions that ‘‘break down the life forces,’’ could be healed by contact with nature, White said, because the Creator had placed Adam and Eve in a garden, a place best adapted for human health and happiness. Campaigns for dress reform, physical education for women, and frequent bathing, were often ridiculed and trivialized, but White incor- porated these causes into her health message. Exercise promoted health and healing because it improved the circulation of the blood and brought pure, fresh air into the lungs. Dress reform was essential to health because tightly laced garments hindered the circulation of the blood and the movement of the lungs, while the weight of long skirts compressed the abdominal organs and the lungs. Scrupulous cleanliness of home, body, clothing, and frequent bathing were essential to both physical and mental health. Uncleanliness allowed the growth of germs, poisoned the air, and led to death and disease. Fashionable long skirts that swept the ground were, therefore, unclean, uncomfortable, incon- venient, and unhealthful, as well as extravagant. While White agreed that food and drink were largely to blame for disease and suffering, she based her dietary advice on the Bible, rather than physiological science. Because God originally told Adam that he had been given the herbs and fruits of the Garden of Eden as his food, it followed that human beings should choose a diet of grains, fruits, nuts, and vegetables. After the Flood, when every green thing on the earth had been destroyed, human beings received permission to eat flesh, but this was, presumably, a short-term, emergency measure.

Nuts and nut foods were meant to take the place of meat. Biblical wisdom, White noted, was in harmony with scientific research that proved that the tissues of domesticated animals were swarming with parasites, including the germs that caused tuberculosis, cancer, and other fatal diseases. Like Graham, White rejected the use of refined white flour, but she also called for baking whole wheat bread very thoroughly in order to kill the yeast germs. She insisted that milk should be thoroughly sterilized to avoid contracting disease, but she considered cheese ‘‘wholly unfit for food.’’ Members of the Church of Jesus Christ of Latter-day Saints also followed teachings on the preser- vation of health that were said to be divinely inspired. Many of the same kinds of dietary prohibitions were incorporated into Mormon tra- ditions. Allegiance to the ‘‘words of wisdom’’ decreed in the 1832 Mormon health code has been credited for lower cancer and cardiovas- cular mortality among Mormons. Like Ellen White, Mary Baker Eddy (1821–1910) became a health seeker after struggling with pain and illness in her youth. But the health message that Eddy imparted as the founder and leader of the Church of Christ, Scientist, commonly referred to as Christian Science, was very different from White’s eminently practical advice. Eddy had experi- mented with many cures, from Grahamism to homeopathy, but found no lasting, meaningful relief until 1866 when she discovered the religious doctrine that she believed would totally reform and revolutionize medi- cine. She first published an account of the ‘‘healing Truth’’ of her Meta- physical Science in a pamphlet entitled, The Science of Man, By Which the Sick are Healed (1870). Five years later she published the first edition of Science and Health with Key to the Scriptures. By 1900, the Christian Science movement had spread throughout the United States and about five hundred congregations had been established. The key to Eddy’s Moral or Metaphysical Science was the funda- mental concept that ‘‘all is mind and there is no matter.’’ According to Eddy’s teachings the remedy for disease is accepting the great ‘‘Truth .. . that disease is unreal.’’ Because matter ‘‘is a false mode of con- sciousness,’’ sickness, evil, and death are only mistaken interpretations of reality created by our fallible mortal minds. When human beings fail to transcend the tendency to believe in matter, they mistakenly believe they are vulnerable to sickness, evil, and death. By steeping their daily thoughts in the principles of Christian Science, believers would elevate their minds above such errors. Health seekers might not subscribe wholeheartedly to her meta- physics, but many became devoted followers after finding physical and spiritual relief though Christian Science healings. Eddy established the Massachusetts Metaphysical College in Boston in 1881 and many gradu- ates found a profitable vocation as full-time Christian Science healers. Although Christian Scientists have demanded payments from insurance companies for their practitioners, they have lobbied intensively to exempt members of the church from medical legislation, such as compulsory vaccination for school children. Some members of the church have been charged with involuntary manslaughter or child endangerment for refus- ing to obtain conventional medical treatment for sick children.

Christian Science can be viewed as a particularly striking example of the putative relationship between religious doctrines and human health. Followers of Christian Science argue, however, that their prac- tice is quite different from ‘‘faith healing’’ in Protestant and Catholic traditions. Christian Science healings exclude appeals to saints and sym- bolic acts just as strictly as they forbid the use of drugs and surgery. Nevertheless, the success of Christian Science stimulated other churches to establish ministries featuring religious therapeutics. The success of the health messages transmitted by Ellen White and Mary Baker Eddy might be seen as a resurrection of the healing role assumed by clergymen in Colonial America. Christian Science and Seventh Day Adventism offered views of health and healing that resonated with the search for spiritual and physical health. John Harvey Kellogg grew up in a devout Seventh Day Adventist family that accepted the ‘‘healthy living’’ tenants advocated by the church. Kellogg had been a sickly child, but at age 14, he read the work of Graham and became a devout vegetarian. Under Ellen White’s spon- sorship, Kellogg studied at Russell Trall’s Hygeio-Therapeutic College before earning a medical degree at New York’s Bellevue Medical College. Unlike many vegetarian health crusaders, Kellogg had good credentials in regular medicine and surgery. Despite his enthusiasm for natural healing and his condemnation of conventional drugs, Kellogg was a skillful and innovative surgeon, with a special interest in abdomi- nal surgery, and a member of the American College of Surgeons and the American Medical Association (AMA). During his long career, he per- formed more than 20,000 operations and published close to 50 books, including Man the Masterpiece, The Home Hand-book of Domestic Hygiene and Rational Medicine, which mainly dealt with his theories of ‘‘biological living’’ and the ‘‘Battle Creek Idea’’—that good health and fitness were the result of good diet, exercise, correct posture, fresh air, and proper rest. Although he died of pneumonia a bit short of his 100-year goal, contemporaries said that at 91 he was still an excellent demonstration of the rewards of simple eating and healthy living.

Kellogg saw the Battle Creek Sanitarium, familiarly known as the ‘‘San,’’ as a ‘‘University of Health,’’ as well as a hospital and retreat for the rich and famous. John D. Rockefeller, Jr., Henry Ford, J. C. Penny, Montgomery Ward, S. S. Kresge, Richard Byrd, Thomas Edison, Harvey Firestone, Sarah Bernhardt, Amelia Earhart, and President William Howard Taft were among some three hundred thousand patients who came to the San in search of wellness. Kellogg used the San to train doctors, nurses, physical therapists, dietitians, and medical missionaries. A new fireproof San built after a fire destroyed the old building in 1902 accommodated several thousand guests a year. The stock market crash in 1929 had a disastrous impact on the San and Kellogg eventually sold the main building. In the 1940s, the former Sanitarium building was converted into the Percy Jones General and Convalescent Hospital, which served as an orthopedic hospital during World War II and the Korean conflict. Although best known as a health reformer and proponent of vegetarianism, Kellogg also campaigned throughout his life for sexual temperance. Indeed, some of his critics said that Kellogg was opposed to all forms of sex; some even implied that he found his daily enemas more satisfying than conventional sexual activities. In his essays on the treatment of ‘‘self-abuse,’’ Kellogg suggested extreme methods of punishment, such as circumcising boys (without the use of anesthetics). The pain caused by the operation, Kellogg explained, would ‘‘have a salutary effect upon the mind.’’ For females who might be experiencing ‘‘abnormal excitement,’’ Kellogg recommended applying pure carbolic acid (phenol) to the clitoris. (In a dilute form, carbolic acid is used as a disinfectant and antiseptic. Pure phenol is very caustic.) A champion of vegetarianism, Kellogg would challenge his audi- ences: ‘‘How can you eat anything that looks out of eyes?’’ In addition to all the old arguments for vegetarianism, Kellogg shocked visitors to the San with a horror show of the microscopic germs and filth that could be found in meats coming from the slaughter house and warnings about the dire consequences of intestinal autointoxication. This theory was rather like E´ lie Metchnikoff’s (1845–1916) concept of orthobiosis, which linked health and longevity to the organs of digestion. According to Metchnikoff, microbial mischief in the large intestine produced harmful fermentations and putrefaction. Intrigued by the possibility that it might be possible to reverse the aging process, Metchnikoff sug- gested disinfecting the large intestine with a hygienic diet to neutralize the deleterious effect of bacteria harbored by this perfidious and useless organ.

Frustrated by evidence that traditional purges and enemas did more damage to the intestines than to the noxious intestinal flora, Metchnikoff recommended the consumption of large quantities of fresh yogurt as a means of introducing beneficial ferments into the digestive system. Both Kellogg and Metchnikoff were obsessed by the threat of autointoxication, but Kellogg believed that the status of the colon was central to good health. To combat the menace of slow digestion, intestinal parasites, lack of bulk in the diet, intestinal kinks, consti- pation, and autointoxication, Kellogg advised a diet rich in roughage, bran at each meal, paraffin oil as an intestinal lubricant, and daily ene- mas. In pursuit of inner hygiene, patients were stuffed with bran cereals and dosed with laxatives, herbal cleansing kits, enemas, and high colonic irrigations. Fear of internal filth and decay, in both the real and the symbolic sense, can be traced back to the time of the Egyptian pharaohs, but Kellogg and other health crusaders embraced the old doctrine with unprecedented enthusiasm. Concern with inner hygiene coincided with growing concerns about urban filth, pollution, and dirt as the cause of epidemic disease. Many health reformers and social critics agreed that constipation was caused by the unnatural pressures associated with modern life in crowded, industrialized cites. In search of solutions to bowel problems, people turned to patent medicines, laxa- tives, mineral waters, bran cereals, yogurt, electrotherapy, calisthenics, abdominal exercises, enemas, intestinal irrigation, rectal dilation devices, or even surgery to remove intestinal kinks.

To make it possible for his followers to give up meat, Kellogg developed new foods made from grains and nuts. Kellogg held more than 30 patents for food products and processes, primarily health foods and coffee and tea substitutes, as well as exercise, diagnostic and therapeutic machines. He is credited with developing such diverse products as peanut butter, a menthol nasal inhaler, a mechanical horse, and the electric blan- ket. His ideas about health foods led to the establishment of more than 40 cereal companies that competed with the one established by Kellogg and his younger brother, William Keith Kellogg (1860–1951). In contrast to Dr. Kellogg, W. K. Kellogg lacked any formal education beyond the sixth grade when he was hired to work at the San as clerk, bookkeeper, man- ager, and assistant in the search for health foods. One of his most profit- able discoveries was a process for making cereal flakes as opposed to the usual health food granules. Entrepreneurs quickly copied the Kellogg process and over 40 rival food companies were soon selling their own ready-to-eat cereals. One of the most successful was established by Charles William Post (1855–1914) in 1895. Suffering from ulcers and other problems, Post came to the San because he was attracted to vegetarianism and the Adventist prohibitions on stimulants like coffee. Hoping to find a new highway to health after Kellogg’s methods failed to cure him, Post turned to Christian Science. Convinced that coffee was a dangerous stimulant, Post developed and successfully marketed a replacement made of wheat, molasses, and bran that he called Postum. He also developed Grape Nuts and Post Toasties. Unfortunately, although Post made a fortune from health foods, neither vegetarianism nor Christian Science could cure his physical and spiritual ills, as indicated by his unsuccessful battle with depression and his suicide at the age of 59. Dietary reformers advocated bizarre diets or fasts of every possible type, but it was Horace Fletcher (1849–1919), the ‘‘Great Masticator’’ and author of Menticulture, or the A-B-C of True Living, The New Glutton or Epicure, The A.B.-Z. of Our Own Nutrition, and Optimism, who tried to teach all of them how to actually eat their food. At age 40, the formerly robust and athletic Fletcher found himself suffering from dyspepsia, fatigue, obesity, and frequent bouts of influenza. Determined to regain his health, Fletcher turned to the study of hygiene and launched a new career as a health reformer. Through self-exper- imentation, he discovered that thorough chewing of each bite of food led to complete digestion, weight loss, strength, endurance, and perfect health. Of course, Fletcher was not the first to call attention to the American habit of eating too rapidly. In Lectures on Life and Health, William Alcott had ridiculed this vile habit and Sylvester Graham, Ellen White, and other health reformers had urged slower eating.

In addition to promoting Fletcherism, or the ‘‘chew-chew’’ cult, Fletcher wrote and lectured on the importance of Menticulture, a system of positive think- ing that would create Physiologic Optimism, fitness, and freedom from nervous exhaustion and neurasthenia. By the end of the nineteenth century, the idealism of the health reform movement was increasingly subsumed by the entrepreneurial spirit of men like Bernarr Macfadden (1868–1955), self-proclaimed Pro- fessor of Kinesitherapy and Father of Physical Culture. According to Macfadden, Physical Culture would produce better as well as stronger people. Indeed, his magazine Physical Culture carried the motto ‘‘Weak- ness Is a Crime.’’ In contrast to the sexual repression taught by Alcott, Graham, and Kellogg, Macfadden’s writings, including his five-volume Encyclopedia of Physical Culture, glorified virility and healthy sexuality. His health advice appeared in Building of Vital Power; Deep Breathing and a Complete System for Strengthening the Heart, Lungs, Stomach and All the Great Vital Organs, Constipation, Its Cause, Effect and Treat- ment, Fasting for Health, Home Health Manual, and The Virile Powers of Superb Manhood. The indefatigable Macfadden also published movie, romance, and detective magazines, including True Story, True Confessions, True Detec- tive, and newspapers, and sponsored contests to select the World’s most perfectly developed man. Charles Atlas (Angelo Siciliano, 1892–1972), former 97-pound weakling, who won the contest in 1922, claimed that he had transformed himself with ‘‘dynamic tension’’ exercises he invented after watching a lion at the zoo. By 1927 Charles Atlas, Ltd. was a very profitable enterprise—selling mail-order physical culture courses.

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