Julian Sheather on public health: complex problems, simple truths – the case of Sebastian Kneipp

Near universal consensus then that we are in the grip of a public health disaster. Daily the evidence mounts: obesity, smoking, alcohol abuse, our very lives are killing us. And how insurmountable the problems seem, how high the hurdles. Massive corporations – the food, tobacco and drinks manufacturers – are ranged against us, saturating our lives with temptation. We now live, we are told in an “obesogenic environment.”

Our very streets and houses are conspiring against us. And to cap it all we are told that evolution itself helped set the trap. Our bodies evolved to store fat in times of plenty in order to see us through the lean, but, in the west at least, there is no lean. And if public health measures fail us we are unlikely to be able to rely on conventional medicine. For despite the enormous gains in average life expectancy over the last century, pound for pound the rewards for our research billions are dwindling.

Not a bad time then to remember the simple health teachings of an almost forgotten Bavarian priest. In the face of the dismaying complexity of modern medical technology, how pleasant it is to be reminded that simple truths can also be potent.

Sebastian Kneipp – that K is not silent – was once said to be one of the three most famous men in the world, the competition being Bismarck and the President of America, William McKinley jnr. But Kneipp was not a politician. Nor, despite being a Catholic priest, did he make himself a name for piety or theology, at least not of the orthodox kind. For Kneipp was a naturopath, one of the founders of the great nineteenth century ‘nature cure’ movement, a man who became famous for synthesising into a few simple precepts several millennia of accumulated folk wisdom in health.

Commentary on Kneipp leans toward the messianic. Born in 1821 to a family of weavers, Kneipp contracted tuberculosis in his mid-twenties. He became progressively more ill, and by the end of the eighteen-forties was clearly dying. Thrown back on his own resources, he came under the influence of the teachings of an eighteenth-century doctor and hydrotherapist Johann Siegmund Hahn. Given only weeks to live, Kneipp took to running from his lodgings to the Danube and immersing himself for a few seconds in the icy water. His tuberculosis went into remission and he won a scholarship to study theology in Munich. In 1852 he was ordained as a priest and, over the following years he gradually put together what can best be described as a personal health maintenance system. No not all of it could now be described as evidence-based. More a synthesis, as I have said, of folk wisdom, with a bit of nature worship thrown in. But the sheer sanity of some of it is astonishing, as is the fact that, over a century and a half later, it could, if we would but learn from it, transform our collective health.

So what are Kneipp’s few simple precepts? In no order of importance or evidential robustness he exhorts us to eat foods as close to their natural state as possible, to exercise regularly, to take to cold water, to seek mental equilibrium and to make us of botanical remedies. Cold water treatments have gone a little out of fashion, although a recent revival of interest in wild swimming might suggest a returning interest, and botanical cures clearly have their issues, but can we seriously argue with the others?

There seems to be a fondness at the moment for H L Mencken’s take on populist responses to difficult issues. “For every complex problem there is an answer that is clear, simple, and wrong.” Well yes and no. How simple the solutions to some of our most intractable woes could be. But how so very difficult their realisation.

Julian Sheather is ethics manager, BMA. The views he expresses in his blog posts are entirely his own.