ABSTRACT
At the beginning of the twentieth century, the British market for health services was characterised by a variety of orthodox and unorthodox practitioners. While the 1858 Medical Act had introduced a register of qualified medical practitioners, the right to provide therapeutic services was not limited to this group. In 1909, concerns about the prevalence of ‘quackery’ led to a review of unqualified healers to assess the extent of unorthodox practice ‘and the potential detrimental effect this might have on public health’ (Unqualified persons, 1910). Information compiled from reports by local medical officers recorded chemists and medical herbalists as the most numerous practitioners with both groups considered to be flourishing. Other healers identified in the report were bonesetters, dentists, electricians, faith healers, ‘wise women’ and hydropathic establishments. There was no reference to naturopaths, osteopaths or chiropractors. A Scottish correspondent commented on several difficulties inherent in the task of assessing unqualified practice. Distinguishing between orthodox and unorthodox methods or categorising individual practitioners was, as always, problematic because the boundary between ‘medicine and surgery’ and ‘hygiene’ was vague and constantly shifting. Classification of healers was further complicated as some unqualified practitioners worked under medical supervision, a problem compounded by ‘the frequent acceptance by the medical profession of ideas and methods first elaborated by unorthodox healers’. ‘Diet specialists’ and ‘massage establishment practitioners’ were examples of therapists who sometimes practised independently and sometimes acted in collaboration with a qualified medical practitioner. The chief threats to public health identified in the report were the excessive use of drugs and delays in referring cases of serious illness such as tuberculosis, venereal disease or cancer. Proprietary medicines (commercially produced products branded by the manufacturer) were widely available by post as well as from chemists and other retail outlets, a situation which facilitated the misuse of drugs not prescribed by orthodox practitioners. Concerns were also expressed about inappropriate treatment by unorthodox healers. In addition to wasting significant amounts of money on ineffective remedies, the public were deemed to be at risk of delays in receiving orthodox therapy, which could have serious consequences for their health as well as that of the wider community. Sales of abortificants were another worry, as was the continuing practice of unqualified midwives, despite recent moves to professionalise this area of practice. The issue of the efficacy and potential dangers of proprietary medicines was taken up by the British Medical Journal, which published analyses of various patent medicines from 1909. Although most were assessed as being harmless, even if ineffective, a few were identified as posing a threat to health. In 1912, greater awareness of these issues led to the appointment of a Select Committee to investigate patent medicines and foods. Its recommendations, delayed due to the outbreak of war in August 1914, included establishing a register of licensed manufacturers of patent medicines (Vaughan, 1992). An influential strand of medical holism which valued the ‘vis mediatrix naturae’ or healing power of nature persisted among some orthodox practitioners into the interwar years (Lawrence and Weisz, 1998). This period was also marked by a culture of positive health, and belief in the importance of hygiene attracted broad support (Zweiniger-Bargielowska, 2010). The prophylactic benefits of a healthy lifestyle were promoted by George Newman, the first Chief Medical Officer, who urged the need to address the burden of illness affecting all social classes through preventive as well as curative medicine. Better health for the nation was promoted by individual organisations too – for example, the New Health Society, run by Sir Arbuthnot Lane, who, after a career in surgery, had turned to promoting health principally through management of diet (Zweiniger-Bargielowska, 2007). Naturopathy was well placed to appeal to the diverse groups already persuaded of the importance of a healthy lifestyle in improving and maintaining
health. Several of the ‘natural’ methods they promoted were also used by orthodox practitioners. Unqualified hydropathists and those interested in lifestyle reform movements had contributed to the development of several physical therapies, including baths and douches, the use of hot air, steam and mud, massage and physical exercise systems after 1840. These methods were consolidated into orthodox medical practice through the specialty of balneology and hydrotherapeutics (the therapeutic use of water in baths and other applications) that developed from spa practice in the last decades of the nineteenth century. The specialty later developed into physical medicine encompassing a wider range of treatments, including electrical applications and heat and light therapy. Interest in these approaches had increased during World War I due to their use in the rehabilitation of wounded servicemen (Adams, forthcoming 2015). Despite rapid growth in medical knowledge, relatively few effective therapies had been developed by the 1920s. Although salvarsan, vaccine therapy and insulin had had some impact, many diseases, including common ailments such as constipation and catarrh, remained difficult to treat (Hardy, 2000). Action to encourage the body’s natural tendency to heal and the use of diet, massage and physical treatments were promoted by practitioners from both orthodox and unorthodox groups. For example, fresh air, nourishing food and exercise and rest played an important part in the treatment of tuberculosis. Issues of self-drugging, the safety of foodstuffs and medicines and the overlap in therapeutic methods adopted by qualified and unqualified practitioners were all relevant to the strategies adopted by naturopaths to develop their profile. A key slogan employed by the group was ‘drugless healing’ and pharmaceutical preparations were eschewed in favour of active measures used to promote the body’s natural healing propensities. These included fasting, vegetarian foods, hydropathic baths, sunbathing, exercise, massage and herbs as well as new manipulative techniques introduced by chiropractic and osteopathy. The British Association for Nature Cure, founded in 1906 by Watson Macgregor Reid, recognised diverse influences from radical healing traditions as well as more mainstream physical culture and mind cure (Brown, 1988, pp. 187, 193). The Nature Cure Annual and Health and Pleasure Guide for 1907/08 reported on a gathering organised to celebrate the centenary of the birth of Vincent Preissnitz, lauded as the founder of hydropathy in the 1840s. The volume included advertisements for publications authored by the established Scottish hydropathists Archibald and Annie Hunter, as well as a health home run by the well-known physical culturist Bernarr Macfadden at Orchard Leigh. Here, the regime was based on ‘Nature Cure methods of treatment; Hydropathy, Massage, Sun Baths, Open-air Gymnasia, Open-air Sleeping Châlets, Individual Dieting, Graduated Exercises and Open-air Games’ (p. xxxvi, inside front cover, p. 113 and p. xix). Despite cultural trends supporting their vision, British naturopaths perceived they were in a weaker position than their colleagues in America or Germany, who were presented as being at the forefront of a growing international movement. The foundations of nature cure were traced back to the work of Preissnitz in Silesia around 1830 and his influence, along with others, including Johannes Schroth in Austria and Father Sebastian Kniepp, led to a strong natural healing tradition becoming established in Germany. James Whorton notes that emigrants to the USA were an important conduit for the transmission of these practices and, from the 1890s onwards, a distinctively North Amer ican approach developed (Whorton, 2002). Benedict Lust founded the Naturopathic Society of America in 1901 and from 1900 published the Kniepp Water Cure Monthly, later renamed The Naturopath and Herald of Health. Like the founders of many unorthodox practices, Lust had been converted to naturopathy by personal experience. Following his own successful treatment for tuberculosis by Sebastian Kniepp in the early 1890s, he returned to the US to ‘go into the new World and spread the Gospel of the Water Cure’ (Whorton, 2002, p. 192). The connection between Germany and the US was further reinforced
by Henry Lindlahr, who set up a school of Natural Therapeutics in Chicago. Harry Benjamin, author of the most popular British treatise on nature cure, asserted that naturopathy’s ‘great home today is America’ (Benjamin, 1936, p. 8). The importance of this flourishing international movement is apparent in the personal experience of several of those who emerged as leaders of the British movement in the interwar period.
