Dissertations, Theses, and Capstone Projects

Date of Degree

6-2026

Document Type

Doctoral Dissertation

Degree Name

Doctor of Philosophy

Program

History

Advisor

Gerald Markowitz

Committee Members

Allison Kavey

Michael Pfeifer

Subject Categories

History of Science, Technology, and Medicine | United States History

Keywords

non-naturals, medical regimen, exercise, sleep, food and drink, health

Abstract

Now ubiquitous, “Wellness” was first written about in the late 1950s by Halbert Dunn, Chief of the National Office of Vital Statistics and former biostatistician for the Mayo Clinic. While the term dates to this period, the concepts behind it are millennia old, traceable to ancient Greece as regimen, a significant feature of Hippocratic medicine. The term “non-naturals,” referring to practices “for the body but not of it,” became common during the Islamic Golden Age. These included what we would now call exercise, diet, sleep, excretions, environment, and mental health. These ideas remained in use for centuries but fell out of common terminology in the United States by 1820, when this dissertation begins. The main argument in the historiography is that these practices declined within orthodox medicine due to the rise of heroic therapies, later further displaced by germ theory, while health reformers promoted gentler, “natural” alternatives.            

This dissertation intervenes by demonstrating that these practices did not disappear from mainstream nineteenth-century American medicine. Instead, they remained central and widespread, often under different terms, including regimen, hygiene, physiology, and physical education. Where most historians see absence or marginality, I find them everywhere in the medical literature.

Due to the breadth of material, this study focuses on three of the six non-naturals: exercise, food and drink, and sleep. It asks how these were used in mainstream medicine over the nineteenth century and how their application changed over time. This is an intellectual history grounded in the writings of elite physicians, in order to directly engage the claim that orthodox practitioners did not employ these approaches. It does not examine how patients implemented this advice.             Sources include medical lectures and treatises, domestic medical texts, journals, popular magazines, and professional manuals from collections such as the New York Academy of Medicine, the New York Public Library, the Brattleboro Public Library, and the Columbia University Medical archives, as well as online databases. Domestic medical texts are found to be nearly identical to professional works.

Exercise was consistently prescribed, initially in response to concerns about elites’ sedentary intellectual life, with physicians emphasizing enjoyable outdoor activity engaging both mind and body. After the Civil War, exercise became increasingly systematized and professionalized, with physician-led collegiate physical education promoting more rigorous regimens at a time when societal norms of gender were shifting.

Early in the century, most Americans were rural and caught, grew, gathered, or raised their food and drink. By the late century, especially in the Northeast where these MDs were based, people lived increasingly urban lives, and for the first time ate foods that were purchased from strangers, grown far away. This was a profound change in eating, yet medical prescriptions on food and drink as treatment stayed largely the same, while general advice incorporated emerging nutritional science, class-based distinctions, and the development of the calorie.

Sleep, largely absent from U.S. medical historiography, was treated early in the century as a mysterious and mystical phenomenon. Over time, it became increasingly medicalized. Sleep itself went from a semi-public event that occurred by necessity near sunset and sunrise, to an ideally private activity for those with the means to have private bedrooms by the century’s end. In medicine, the mechanisms of sleep were still not understood, and theories had changed little. Nevertheless, sleep discourse took on a less romantic tone and was medicalized. Instead of sleep problems being simply a normal part of life now and again, they were pathologized and drugged.

This dissertation demonstrates that regimen remained embedded in nineteenth-century American medicine. It challenges the historiographical divide between orthodox physicians and health reformers and places medical hygiene at the center of medical practice.

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