Nature's Path: Interview with Susan E. Cayleff
Before 1870, medicine in the United States was completely unregulated. The lack of regulation and the limited effectiveness of 19th century regular medicine encouraged the development of multiple competing medical sects during the century. The three largest medical sects were regulars(traditional physicians), homeopaths, and eclectics. Even though these three sects were the most prominent, numerous other medical systems were created and survived on the margins. Eclecticism, osteopathy, chiropractic medicine, and hydrotherapy are just a few of the medical sects born during this era of United States history. At the very end of the 19th Century, a new system called naturopathy was created by Benedict and Louisa Stroebel Lust. Unlike many of the 19th Century medical systems created, naturopathy has persevered to this day. Naturopathic healing was founded and based on number of influences including botanics, hydrotherapy, eclecticism, temperance and vegetarianism.
John Hopkins University press has published a new book by Susan E. Cayleff about the history of naturopathic healing entitled Nature's Path: A History of Naturopathic Healing in America. Her book is a comprehensive account of both the origins of the naturopathy and examination of the controversial views by held naturopathic practitioners such as anti-vivisection, anti-vaccination, and the dangers of processed foods, pharmaceuticals and environmental toxins. Interestingly, women played a role not in the creation of naturopathy, but have been critical to its development and survival into 21st century. Cayleff's is important addition to the medical and social history of the United States.
Susan E. Cayleff is a professor in the Department of Women's Studies at San Diego State University. She has written Wash and Be Healed: the Water Cure Movement and Women's Health, Wings of Gauze: women of Color and he Experience of Health and Illness, Babe: The Life and Legend of Babe Didrikson Zaharis, and co-authored with Susan Stamberg - Babe Didrikson: The Greatest All-Sport Athlete of All Time.
Here is our interview with Susan E. Cayleff.
Why were you attracted to the topic of naturopathic healing? What spurred your interest?
I’ve researched and published on the intersections of women’s lives and the history of alternative healing and medicine for decades. I’ve focused on the 19th century cold water cure movement, patent medicines, self-help regimes, ethnic and racial folk healing ways and the stinging critiques levied against organized medicine by alternative healing sects: homeopathy, botanics, hydropathy, and women’s groups in the modern era. Around 1990, I was contacted by Cathy Rogers, N.D. (Naturopathic Doctor) then President of the American Association of Naturopathic Physicians who had read my book Wash and Be Healed: The Water Cure Movement and Women’s Health (1987, 1992). Since water cure was a foundational component of naturopathic healing she asked if I’d be interested in researching their movement. This triggered my interest and all these years later has resulted in Nature’s Path. This text looks at the Naturopathic movement within a social context of culture wars between organized medicine and the naturopaths, the notion of relying on an M.D. as “expert” vs. health choices and self-determination, women’s empowerment and much larger critiques of power and authority that permeate American society, 1890s-present.
What is naturopathy and what was its philosophy? How does it differ from Eclecticism, Hydrotherapy or Botanics?
Today, to quote the American Association of Naturopathic Physicians, naturopathic practice includes the diagnostic and therapeutic modalities of “clinical and laboratory diagnostic testing, nutritional medicine, botanical medicine, naturopathic physical medicine (including naturopathic manipulative therapy), public health measures, hygiene, counseling, minor surgery, homeopathy, acupuncture, prescription medication, intravenous and injection therapy, and naturopathic obstetrics (natural childbirth).” As in the past, naturopathy is a philosophy for a way of life, linking body, mind and daily purpose to stay healthy. (See The American Association of Naturpathic Physicians.)
Naturopathy is a comprehensive healing system that was introduced into the United States in the 1890s primarily by Benedict (1872-1945) and Louisa Stroebele Lust (1865-1925), both German born. It draws from a long and rich history of natural medicine that utilizes plants, cold water therapies (not mineral waters, but cold water applications), exercise, vegetarianism, nutrition, temperance in ways of living and food consumption, psychological wellbeing practices, and sunlight and air cures. Over time it has embraced--then sometimes rejected--affiliations with homeopathy, chiropractic, osteopathy and acupuncture.
Naturopathic authors assert through their numerous texts that the body has the ability to heal itself when healthy, natural, vitality-building (immunity strengthening) measures are followed. It’s through the ingestion of toxins, animal meat, processed foods, pharmaceuticals, vaccines, environmental degradation and so on that our bodies become toxic to us and lose the ability to effectively eliminate waste and toxins and to combat disease. In the early years they believed in Toxemia Theory (toxins introduced into our bodies cause disease); Vital Force (the body’s innate ability to fight off disease if one does not impede normal, healthy nerve, circulatory and organ functions); the Law of Crises (that the body works to expel toxic matter (e.g., through fever, blisters, etc.) and that expulsion should be facilitated, not suppressed with therapeutics) and Conscious Living (each person must take responsibility for maintaining their health to prevent illness). This is an individualistic approach to health, but naturopaths have always embedded it within a scathing critique of capitalist monopoly, poor treatment of ethnic minorities and urban poverty and called for a healthy environment to support individual health.
Naturopathy differed from the 19th medical sects of eclecticism, hydropathy, botanics (herbal medicinals) and chiropractic in many ways. It is not a single cause/cure premise. Bodily wellbeing cannot be attained through any one healing system like these, most especially not through regular medicine. The best methods must be combined from many practices to create a healthy world and body. It does have in common with these named an insistence that the individual cannot be a passive recipient of expert-driven health care. Rather, health is predicated on personal responsibility. Naturopathy also relied and still relies heavily on women’s knowledge and expertise as both professional practitioners and domestic healers.
===Who were the leading figures in naturopathy? Did women play a large role in both practicing and advocating for naturopathic healing?=== The Lusts were the premiere popularizers of the movement. Before and after their marriage in the late 19th century and first decade of the 20th century they founded the American School of Naturopathy in New York City, a health food bakery, numerous periodical publications, countless therapeutic texts, a hospital and clinic (of sorts) and three away-from-home agrarian health retreats all known as Yungborn (New Jersey, Florida and Cuba).
Advocates and practitioners of naturopathy came from a wide swath of alternative natural healers--this was at once a strength and a weakness for the movement. Benedict Lust welcomed all to claim the title of naturopath at first, but this diluted a stable definition and set of practices from emerging. Regular MDs, whose personal or professional “conversion experiences” inspired them, also joined the movement. Leaders in the anti-vivisection and anti-vaccination movements also embraced naturopathic philosophy and therapeutics.
Women co-created, co-led and benefitted immensely from the Naturopathic Movement. This has been true since its inception through the present day. Louisa Stroebele Lust embodied this most fully: she owned the Bellevue Sanatorium health retreat in New Jersey (1892) that offered natural healing methods; she authored the pivotal cook book The Practical Naturopathic Vegetarian Cook Book (1907), that charted nutritional advice so central to naturopathic living; she taught at the College, and wrote regular columns for the Naturopath and Herald of Health and other publications detailing women’s rights, responsibilities and unique powers to lead the movement—and their families.
Louisa Stroebele, prior to her marriage to Benedict, had served as the personal assistant to Tennessee Claflin on three world tours. Claflin, along with her sister Victoria Woodhull were advocates of Free Love ideology and radical positions on women’s rights that they addressed regularly in their Woodhull and Claflin’s Weekly (published intermittently, 1870-1876).
Tennessee’s views on women’s rights, women’s sexual self-determination, ambivalence towards monogamous marriage, and the male sexual double standard that weakened and demoralized women all tremendously impacted her young protégée who had been raised in a conservative Catholic environment. The notorious sister’s financial tutelage at the hands of Cornelius Vanderbilt (who set the sisters up in the first female-owned stockbrokerage company on Wall Street) gave Louisa significant monies and savvy that she then invested in Bellevue, various movement endeavors, and ultimately used to spring from prison the dozens of naturopaths who had been arrested for “practicing medicine without a license.”
Publically, naturopaths’ writing condemned the sexual double standard of sexual morality, advocated for women’s suffrage, asserted women’s health should be the family’s first priority and counseled men to give women the power to control reproduction.
In addition to Louisa dozens of women, some trained and licensed naturopaths, others complementary sectarian healers, authored texts, wrote advice columns for female readers, served as faculty, and led the movement as officers in state, national and international organizations. In the present day (since the 1990s) female students constitute more than half of all medical school students; women are also ever-present in strong numbers as faculty, administrators and national, state and local leaders of the profession.
By 1905, medical licensing (at least some of form it) had basically been implemented in almost every state. Did this force naturopathic healers to describe themselves as something besides doctors to avoid regulation?
One of the central themes of Nature’s Path was the “culture wars” that raged between regular physicians (who became the American Medical Association in 1847) and the numerous alternative healing sects who opposed their methods and political heavy handedness. The centralized power of the AMA meant that they controlled medical licensing, pharmaceuticals, public health authorities, police enforcement and military medicine. The government and major philanthropic foundations, through the AMA’s powerful lobby, deemed only the allopathic (regular/AMA) physicians as credible and skilled. All others, regardless of their credentials and acquired knowledge could be, and were frequently, arrested for “practicing medicine without a license” under the plethora of medical license acts.
This involved constant entrapments authorized by AMA leaders with paid spies who visited practitioners with fake ailments and were “prescribed” salves, teas, massage or hygienic regimens. If this sounds like cloak-and- dagger high drama, it was. One such informant, Frances Benzacry, worked for the New York County Medical Society. She was so infamous that she sold her story to the Ladies Home Journal in 1915. In it she chronicled the various “cases” against naturopaths and other sectarians she brought to court and admitted, with surprising candor, that none of the therapies she witnessed had brought harm to patients. Benedict Lust himself was arrested sixteen times on state and federal charges, despite his M.D., D.O. and, N.D. degrees, and degrees in homeopathy and eclecticism. Always at the ready was Louisa’s commitment to bailing out the accused. Some refused bail as a publicity ploy to rally attention to the unfair persecutions.
So yes, naturopaths, to avoid accusations of using the label doctor, physician, etc., first chose the word “naturopath” to distinguish themselves. But this was insufficient to stop the hounding by the politico-medical establishment.
This political, legal, and financial harassment helps explain why seeking licensure became so critical for naturopaths and the profession. After tireless lobbying and planning, in 1929 and 1931 naturopaths joyfully embraced the passage of two Acts in the US House of Representatives legalizing Naturopathy in the District of Columbia. The Acts made naturopathy a distinct healing profession on par with osteopathy, chiropractic, and allopathy in Washington, D.C. There had also been some success in the Pacific Northwest. These precedents offered a foundation for other states, but provoked increased allopathic backlash.
How did naturopathy spread across the country? What made it appealing?
Naturopathy’s root practices (botanics, eclecticism, water-cure, sun and air cures) were used nationwide. Naturopathy first grew popular along the east and west coasts and in Chicago, but it spread rapidly through national meetings, conventions, and Lust’s state-by-state lobbying for licensure. Naturopathy was first and foremost part of a nationwide populist movement. The desire for choice in medical practitioners and the relentless critique of invasive allopathic methods went hand-in-hand with the Progressive Era’s push back to industrialization, monopolies, and condemnation of capitalist greed, overbearing enforcement of expert-driven laws, governmental enforcement tactics of public health policies (forced vaccination) that removed agency from individuals. Naturopathy was part of the response to anti-immigrant sentiments and anti-Black racism that produced notoriously unhealthy slums and poverty.
It appealed to critics of the status quo and the two-tiered hierarchy of the haves and have-nots and also to the myriad alternative healers excluded from the right to earn degrees and practice medicine in disciplines of their choice. Socialists and other anti-capitalists joined a nationwide movement for, as they called it, medical liberty rights, advocating for bodily self-determination and practitioner choice. Naturopathy also appealed to those who rejected all drugs, including botanics, union activists, antivivisectionists who believed with naturopaths that animal life was sacred and not fodder for medical experimentation, anti-vaccinationists and so on.
Naturopathy’s appeal came from its clarion cry to allow people to choose for themselves and exercise self-determination, both fundamental principles of populism and cultural dissent.
Naturopathy grew again in the 1960s and ‘70s during the counterculture revolution. The biases and shortcomings of organized medicine were critiqued by the holistic health movement, anti-nuclear activists, feminist consciousness-raising groups, and health food industries.
===How has the profession persevered? Are naturopathic healers licensed today?=== Licensed naturopathy is thriving. The American Association of Naturopathic Physicians, long housed in the Pacific Northwest, a regional stronghold for the movement, relocated to Washington, DC to facilitate lobbying efforts. It is licensed in 17 states (AK, AR,CA, CO, CT, HI,ID,KS,ME,MN, MT, NH, ND, OR, UT VT, WA, Washington, DC., Puerto Rico and the US Virgin Islands). Its seven accredited educational institutions are Bastyr in WA, National College of Naturopathic Medicine, Portland, OR, Southwest College of Naturopathic Medicine and Health Sciences, Tempe, AZ, University of Bridgeport College of Naturopathic Medicine, CT, National University of Health Sciences in Lombard, IL, Canadian College of Naturopathic Medicine, Toronto, Ontario and Boucher Institute of Naturopathic Medicine in New Westminster, British Columbia. They offer the same basic sciences training as traditional medical schools, along with instruction in integrative medicine, botanical medicine, clinical counseling, homeopathy, laboratory and clinical diagnosis, minor surgery, naturopathic physical medicine and nutritional science. There are also dual degree programs in which students study for an additional period to obtain a Master’s in an area of specialization, such as acupuncture and Chinese medicine, midwifery, or counseling psychology.
Naturopathic Doctors (NDs) emerging from these accredited schools are licensed in states that allow it. Yet the same spectre that haunted early trained and skilled naturopaths continues to be an issue. A number of online for-profit institutions and correspondence courses claim to offer ND degrees and certification. Other accrediting agencies offer their “stamp of approval” to these less than rigorous (sometimes obviously bogus) programs. This reflects negatively on the licensed practitioners because much of the American public is unfamiliar with these distinctions. Also, the AANP’s members comprise only half of those who are licensed. This speaks to the radical sentiment still held by some that professionalization is itself elitist and undesirable. And, there are ongoing disagreements about certain “positions” the AANP will or will not take-- vaccination a case in point.
The national office provides guides and lobby kits, along with an annual “DC Federal Legislative Initiative” to bring workshops on political leadership and lobbying tutorials to increase the reach of the profession. These efforts resulted in the federally-sanctioned national Naturopathic Medicine Awareness Week celebrated for the first time in 2013. The Affordable Care Act holds promise for naturopathy and other complementary and alternative medicines. Insurance reimbursement remains a key concern: without it, only those able to afford the services out of pocket can consult a practitioner. The irony of this for a movement that has labored for inclusivity is evident.
How has Naturopathy changed from its roots?
This is a fascinating and complex question. To survive, naturopathic practitioners needed to secure legal licensure or be completely obliterated. This is contrary to the original philosophy that natural medicine should be taught to patients so they can be responsible for their own health--ideology that was foundational to the movement. Early naturopaths loathed AMA credential-based authority, in part because regular medicine insisted on complete control over natural health, labeling other healing philosophies as quackery. There were, indeed, quacks that sold so-called cure-alls—elixirs or opiate and alcohol-based “cures” for everything from cancer to headaches. There were also diploma mills cranking out bogus degrees (but the same was true for allopaths in the early years as well).
But naturopaths wanted the freedom to practice, and that meant finding legitimacy in an already-established system of expert-based medicine. They also realized they needed standards so as not to be confused with the charlatans. This set the stage for ongoing disputes between various factions of licensed naturopaths, self-proclaimed natural healers and old-time nature doctors. The arguments and infighting almost destroyed the profession a few times. Despite these tensions and ironies, I do think the migration to credentialed expertise was necessary precisely because of the countless charlatans and under-schooled (perhaps well meaning) “practitioners” who called themselves naturopaths.
Early naturopathy heralded agrarian living as ideal. This made it inaccessible to most urban dwellers--the precise population most in need of the therapeutics. Just basics of a clean environment, clean air, sunshine, and clean water would have made an immense difference to those in the crowded cities, and these were the essentials of long-term naturopathic health strategies. So authors, teachers, correspondents and practitioners modified that agrarian utopian vision to be in sync with real life possibilities—cooking, exercise, etc. This served to make women’s involvement and leadership even more critical: domestic knowledge, applied to familial health and wellbeing, became the first line of approach.
Many current licensed naturopaths are far more willing to embrace some of the benefits of biomedical medicine. This statement is complicated, perhaps overstated, but signifies an important shift nonetheless. Diminished are the carte blanche rejections of all pharmaceuticals (synthetic versus plant-based treatments) and vaccinations, replaced with a more tempered “weigh the evidence and outcomes” advice. Antibiotics are seen by some as having value, although a single-minded “fighting germs” approach still echoes as an inadequate theory of disease causality.
And professionalization itself can shift the focus from the political to the personal--again, antithetical to early philosophical leanings. Making a profitable living can be in conflict with an ethos of community betterment, which was so much the core of the original creators.
What surprised you the most when you were researching this topic?
I have been blown away by the scope and vision of early and current day naturopaths and naturopathic medicine. It has been from its inception a radical vision advanced by a devoted band of eclectic firebrands who view health, life, self-determination and environmental integrity as interwoven. They have dared to critique (and outright condemn) cultural “givens” such as animal experimentation, professionalization, vaccination (at a time when it was highly imperfect and unregulated for safety and effectiveness), AMA authority and profit-driven capitalists making decisions that affect the masses. Gender equity and social class consciousness is a continuous theme: women have not merely contributed to naturopathy, they have co-created it at all levels and their labors, ideas, analysis and skills have been openly recruited and deemed assets. Working people have the most to benefit-and lose-from accessibility to health care prevention and affordability. Few other healing systems keep these factors in the forefront as naturopathy does.
While I wasn’t surprised by this, I was delighted to learn of recent initiatives to tailor health care for LGBTQ+ people, address environmental toxins, especially in low income and communities of color; links with Green initiatives and a continued critique of dominant “truths” that so often injure so many.
If there was one thing that you wanted people to know about the history of Naturopathy what would it be?
The history of Naturopathy teaches us that a shared radical vision can bring about significant and lasting positive disruptions to power relations that can benefit human health and women’s empowerment. It teaches us that the causes of ill health--and of wellbeing--are integrally interwoven with how we live physically, mentally, and spiritually, and that what we value and how we function as individuals impacts the global community.
How would you recommend using your book in a history class? What type of classes would it be best suited for?
Nature’s Path can enhance curriculum in American history, Women’s Studies classes, health and healing and social change classes. The chapters and their detailed subheadings lend themselves to topical and chronological insertion into course syllabi. This is a terrific text for faculty wanting to introduce not only new content knowledge, but for those who want to generate analytic discussion about power relations, gender equity, institutional monopolies, the courage to defy the norm and radical thinkers and practitioners who dare chart their own vision.