With the exceptions of Sylvester Graham and Mary Gove, the earlier Hygienists were all medical men, coming from one or the other of the four medical schools (allopathy, homeopathy, physio-medicalism, eclecticism). Growing dissatisfied with and losing all confidence in the poisoning practices, they abandoned drugging and took up other forms of practice.

Dr. Jennings escaped from the drugging practice by way of bread pills. Dr. Trall escaped from the drugging practice by way of the water cure--hydropathy. Most of the early Hygienists found their way out of what Dr. Alcott called the wilderness of pills and powders by floating down a stream of water. All too often the escape hatch became the outer world. Hygiene and hydropathy became so intermingled and confused that it was not possible to tell where one ended and the other began. With the exception of Jennings and Alcott, physicians were content to be known as hydropathists. Not all the water-cure practitioners became Hygienists. The two movements are so confused during the forties of the last century that separation is difficult and not always possible.

There came a time, however, in the fifties, when Trall and a large number of men recognized the need for another and more accurately descriptive name. The call went out for a name, one that would be acceptable, alike to the profession and to the public. Many names were proposed, such as hygieotherapy, medical hygiene, etc.; but finally the simple term Hygiene was settled upon. The New York legislature chartered Trall's college in 1857 as a college of hygieo-therapy, the term therapia being employed with the original Greek meaning "to attend" or "wait upon."

Water applications continued to be a prominent modality in their care of the sick and it is often difficult to draw a line of demarcation between the hydropath who employed some Hygiene and the Hygienist who used some hydropathy.

Among the American physicians who journeyed to Grafenberg to study the water cure under Priessnitz were Dr. Joel Shew and Dr. Kittredge, who has been frequently mentioned in the preceding pages. Returning to America, Dr. Shew opened a water-cure place first at Lebanon Springs, New York, and later in New York City. He founded and for four years published The Water Cure Journal and Herald of Reform. He was not among the hydropathists who thought of the water cure as a universal panacea, but did think that hydropathy and hygiene would rejuvenate the world. He adopted part of Graham's teachings and taught for a while in Trall's college before its name was changed to the College of Hygeo-Therapy. But he never identified himself with the Hygienic movement. He remained a hydropath to the time of his death.

Of Dr. Kittredge it may similarly be said that he did not identify himself as a Hygienist, although he wrote many fine articles for the journal that contain much Hygiene. The same may be said for Dr. Houghton. He remained a hydropathist to the end. There were many others who did likewise. Others who called themselves Hygienists were little more than hydropathists and it is difficult to separate the two groups.

Let us take the case of James Caleb Jackson, M.D., who founded the institution in Dansville, N.Y., and who made an international name for himself--was he a hydropath or a Hygienist? He called himself both; he employed both systems; he arrived at the point where he called his plan of care Psycho-Hygiene. In spite of this, I have never been certain where to place him.

He was an admirer of Graham and Jennings, a warm friend of Trall; his adopted daughter, Harriet Austin, graduated from Trall's college and he had many praises for Trall--but classifying him is still difficult. I have always given him the benefit of the doubt, because he claimed to be a Hygienist and because others recognized the validity of his claim. But it is still a fact that he gave predominance to hydropathy and regarded Hygienic means as secondary and subsidiary factors in the care of the sick, while crediting "water cure" with powers that belong only to the living organism.

Writing in 1857 and addressing his remarks to allopathic physicians, he said: "I have never used any other substance as a specific remedy for disease but water. All the hygienic agencies I use--air, light, heat, food, etc., etc.--I use, but I have never made use of any of them as specialties . . . I produce results with water which no man has produced by any other means . . . as far as I have strength, the people of this land shall be led to feel and believe, and act upon the belief, that in all cases of disease which do not involve surgery, water is the best medicamentum that man can possibly have. I have said in all diseases, and I repeat it. I want you . . . to understand me, and I repeat the statement, that in no case of disease can you apply anything else as broadly, as successfully, as water can be applied."

One may be excused for sensing a bit of bombast in his emphatic reiteration of his assertion of the superlative value of water applications; on the other hand, they may be but the expression of over-enthusiasm. But while he credited water with such superior curative properties, he was no less emphatic in assigning to Hygienic means inferior roles. He said: "I deny that my great success as a practitioner is to be ascribed mainly or chiefly to my dietary--the kind, the quantity, and the manner of eating food at the Glen; or to the fact that my patients live in the open air; or to the quiet seclusion of the Glen; or to their faith in me. The benefits derivable from all these I cheerfully admit, but each and all hold secondary place. They are auxiliaries which I could not well do without, but they do not constitute my right arm. It is in water as I use it that my success lies . . .

"While you and other medical gentlemen spend your knowledge and skill in treating disease by other methods, I have been a painstaking student, concentrating all my humble abilities in the elaboration and development of the Water Cure philosophy and practice . . ." Then saying that he was satisfied with the results of his applications of the water cure and stressing his unlimited confidence in it when assisted by "other" Hygienic agents or forces, he assures his readers that "water as a cure for human diseases will last as long as it runs down hill . . . Vincent Priessnitz was not born in vain. His apotheosis is yet to come."

If this looks like the opening gun in a move to elevate Priessnitz to the rank of a god, the modern successor of Aesculapius and Apollo, as the god of healing, let the reader be assured that it was not. Others had been as laudatory in their praise of Priessnitz before Jackson wrote. Priessnitz released flood waters on the earth that, like those of the Noahican flood, were to wash away all evil; but unlike the waters of Noah's flood, they were not to kill all life on the dry land.

In the Journal for November 1859, Jackson reaffirms his abiding confidence in the curative power of water. He says: "Perhaps there is no physician in this country--now Dr. Shew is dead; perhaps none in the world, now Vincent Priessnitz is dead--who relies more upon Water as the hygienic and curative agent than myself. Certainly the generality of so-called Water-Cure physicians do not; and I know of none who does . . . With all due regard for any and every means at my command, I have steadily grown into a wider and larger confidence in Water as a means for overcoming the morbid conditions of the human body."

He further says in this same article: "Having had as large an opportunity as any living man to test the uses of Water, with a view to effect Specific as well as General changes of conditions of the human body, I deem it but right to let you see, the longer I practice, the larger my faith in it is." He adds: "I do not mean to undervalue other means, but rather than rating them as highly as other hygeo-therapeutic physicians do, I rate Water much more highly than they do."

In this same article, Jackson said: "I am sedulously and faithfully studying the influences of light, heat, air, electricity, food, etc., in gaining knowledge in respect to and effects on the human organism, (but) as yet I know of no way in which to apply one, or all of them, so as to substitute them for Water, either in keeping the body in health or in overcoming its sicknesses. They have their several and collective uses, and great and essential they are; but I know of no one of them that I can use as I can use Water to change and overcome morbid conditions . . ."

Nobody acquainted with the history of Jackson doubts that he enjoyed a remarkable success and that he was widely patronized and very popular; but we may be permitted to doubt the correctness of his judgment when he assigns to water applications (hot and cold water) such a high rank in the work of restoring health and, at the same time, assigns inferior roles to Hygienic means. There remains always the possibility that he had the roles of these means reversed.

As the foregoing statements were made somewhat early in his long and successful career, it may be thought that he later altered his views and assigned a superior role to Hygienic factors. If he did so, I have failed to find a record of his change of mind. While his institution grew and acquired a number of European water-cure innovations, there does not seem to have been a lessening of his enthusiasm for water cure. Hence it is that, while Jackson frequently used Hygienic language and gave clear and emphatic expression to Hygienic theory, I have been doubtful about his true place in the early history of the Hygienic movement.

As pointed out at the beginning of this article, most of the early Hygienists (all but two of them physicians) made good their escape from druggery by way of hydropathy. They were known as hydropaths and their institutions were known as hydropathic institutions. When the cleavage came, there was a separation of the "sheep from the goats" and Hygienic Homes and Hygienic Institutes sprang up all over the land. But Jackson was not among those who re-christened his institution. He did not adapt the name Hygiene to his place. This may not have been thought to have been necessary as it was known as "Our Home."