The Kelloggs

by Howard Markel

  Hydrotherapy at the San Credit 60

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  THE NEW SAN WAS ESSENTIALLY a self-contained city. A modern telephone switchboard was built into the basement and connected every room, twenty-four hours a day, seven days a week, with the medical or support staff. Operators were always at the ready to facilitate long-distance lines for guests needing to contact business colleagues or family members during their stays. The massive laundry plant, staffed by sixty-five laundresses, was state-of-the-art. It had to be. Every day the guests went through more than 2,300 towels, 2,000 sheets, 165 tablecloths, and 1,400 napkins. Initially, the facility’s ice needs were met by cutting enormous blocks from the frozen Lake Goguac every January, hauled down to the San by truck, and stored for the remainder of the year in an icehouse. In 1912, the doctor installed modern ice-making machines to replace that antiquated method.44 Alongside this building was a massive power plant generating the steam and electrical energy required for the Sanitarium’s insatiable central heating and cooling, refrigeration, cooking, maintenance, laundry, bathing, electric, and lighting needs.45

  In 1903, rooms cost $10 to $16 a week ($278 to $444 in 2016) ascending in price with the size of the room and the floor level; suites were $15 to $20 per week ($416 to $555 in 2016). Many medical treatments were included in that price but there were extra charges for a personal nurse, surgeries, and various laboratory examinations. The rates for room, board, and a panel of treatments and exercises would more than double over the next decade as the place became ever more luxurious.46 Unlike the “average first rate hotel that only offered room and board but no other service except at high charge,” the San provided a much fuller package, including “outdoor sports, physical training classes, mechanotherapy [i.e., what we today would call physical and massage therapies], regularly prescribed bath treatments, daily consultations with physicians, health lectures, cooking demonstrations, and the services of trained dieticians.” Those on a tight budget registered as “day patients,” and took their meals and treatments at the San for approximately $4 to $10 per week ($111 to $278 in 2016). At night, the day patients retired to rented rooms in the cheaper boardinghouses lining the streets near the San. Special rates were offered to physicians, clergymen, and their families, as well as “to worthy objects of charity.”47

  Soon after checking in, a uniformed bellhop escorted the new patient to his room and gave him leave to unpack and settle comfortably into the room. Guests often rested a bit and became acclimated to their new surroundings before making their way upstairs to take their first meal in the dining room. A white-uniformed hostess led them to a special table for newcomers called the “Reception Table,” where a dietitian introduced them to the many “dainty and delectable health dishes” served there. Once a week, there was a “Get-Acquainted” banquet so that the patients might meet one another, share experiences, aches and pains, and meet the staff members.48 As one guest recounted, “everyone seems earnestly interested in the welfare of everyone else—and the workers are kind not only to guests, but to each other.”49 Following this session, the new patients returned to their rooms and were off to bed by 9:00 p.m.

  The next morning, at 6:00 a.m., an orderly knocked gently on the new patient’s door and escorted him or her downstairs to the bath department for morning sprays, swimming, and “surf baths.” Following this was a brisk rubdown and a few minutes under a fan to cool and dry the skin and stimulate the blood flow. Once massage therapy was complete, a prayer service was held in the Chapel for those wishing to attend. And when “breakfast time” was announced by the briskly walking bellhops clanging their loud bells, everyone “hastened to the big elevators to ascend to the dining room.”50

  After breakfast, a starched young nurse introduced herself to the new patient and escorted him down for the medical examination. A more proper name for this procedure might be a “physical inventory” because the examining doctor carefully went over all one’s strengths as well as health weaknesses with the express purpose of “divorcing many people from imaginary ills.”51 Each patient was matched with a physician who was “especially qualified by training and experience to best deal with his particular case.”52

  The wealthiest and most famous patients were typically assigned to the genial Dr. Kellogg, but when any patient requested him, as he routinely announced “all you have to do is leave word,” he would arrange an appointment.53 When John laid on his healing hands and charm, he reliably made each patient feel as if their case was of the utmost importance to him; and it was. A showman at the lecture podium but always a physician in the clinic, he was one of those rare doctors who took a deep interest in all his patients. When a patient spoke with Dr. Kellogg about his health problems, he felt as if he had the doctor’s undivided attention; and he did.54 Even for those who did not see Dr. Kellogg during the initial examination, the San’s promotional brochures reassured newcomers that he took great pains to supervise every case admitted to the San and attended a weekly medical staff conference monitoring their progress. In 1897, for example, Dr. Kellogg performed over one thousand operations and personally examined 75 percent of the patients admitted to the San.55

  A doctor examines a new patient at the San Credit 61

  IN THE EXAMINATION ROOM, both parties sat facing each other on comfortable chairs. The office was furnished with an examination table and a small roll-top desk overflowing with instruments and papers. Directly above the desk was a nine-drawer card catalog of patient files and a shelf holding a few cherished medical textbooks, including what many physicians considered to be the bible of medical practice, The Principles and Practice of Medicine by Sir William Osler.56 The entrance examination in 1916, for example, cost $25 (about $556 in 2016). Just as today, the fees for medical examinations and procedures increased with each passing year.57

  The doctors, a mix of mostly men and a few women who trained under the doctor’s tutelage at his missionary medical school, began by launching into a series of queries about the patient’s life, social circumstances, physical symptoms, aches and pains, bowel movement and urination patterns, sexuality, all the way to psychological questions pertaining to mood, stability, nervousness, and irritability.

  After a thorough medical history, the doctor began his physical examination by taking the patient’s blood pressure and pulse. It was a gentle prelude to the patient disrobing as modestly as they felt comfortable. From there followed a delicate dance of his hands and fingers across the chest and abdomen and elsewhere to percuss and palpate the organs for size, shape, consistency and for evidence of chronic constipation. Women complaining of menstrual disorders, vaginal pain, and other gynecological complaints underwent a pelvic examination in the presence of a chaperone, whether the examining physician was a man or a woman. Muscle strength and tone, physique, posture, and neurologic and reflex responses to the doctor’s rubber hammer were recorded on graph paper and, if found to be abnormal, documented by the San’s medical photography department.58

  Eager to show off the San’s allegiance to modern medical practice, the doctors tested every patient for evidence of diphtheria, syphilis, gonorrhea, typhoid fever, and trichinosis by means of bacteriological or parasitic cultures. These maladies were discovered or ruled out only after instructing the patient to deposit a specimen of urine and stool, obtaining a blood sample by means of a sharp needle and rubber tourniquet, and, perhaps most traumatic, snaking a long tube through the nose and down the esophagus, to capture an ounce or two of the stomach’s contents. All of these specimens were safely placed in small glass tubes and cups, sealed tightly with wax paper tops, and clearly identified by affixing the patient’s name on the container’s side in black grease pencil. An orderly appeared out of nowhere and whisked them all away to the basement where they were analyzed in the Sanitarium’s ultramodern chemical, bacteriology, and gastroenterology laboratories.

  The gastric laboratory, one of many clinical laboratories at the new San Credit 62

  The latter was desig
ned to approximate the laboratory of the famed gastrointestinal physiologist Ivan Pavlov.59 Dr. Kellogg was so enamored by Pavlov’s scientific methods that in 1907 he hired the Russian physiologist’s former student, Vladimir Boldyreff, to start up a Pavlovian laboratory of gastroenterology and digestion in Battle Creek. Upon his return, Dr. Kellogg wrote a gushing fan letter to Pavlov and told him that he had hung up a portrait of the Russian scientist in his office.60 Sixteen years later, in 1923, Pavlov made a grand tour of the United States and insisted on a special trip from Chicago to Battle Creek.61 Pavlov sought out Dr. Kellogg for more than the mere reunion between old friends. At the age of forty, the Russian physiologist was diagnosed with “neurasthenia or hysteria, but he believed he was suffering from a degenerative disease of the nerves.” Hence, the Sanitarium served as a superb place for him to relax in “extraordinary quiet and peace” and, if not to take the waters to, at least, take the enemas offered there every day.62

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  BY 1913, every patient at the San underwent a chest X-ray to rule out tuberculosis, and, if he or she complained of stomach or digestive distress, a fluoroscopic examination of the stomach. In all, the doctors had more than thirty radiologic tests to help make a diagnosis.

  Upon determining what course of treatment was required, the doctor then handed the patient a prescription booklet bearing his name and case number. Unlike the prescription pads so coveted by today’s patients as an “open sesame” to a pharmacopoeia of pills and elixirs, drugs were studiously avoided at the San. Instead, the thickly bound San prescription booklets listed the treatments specifically prescribed for each patient, demonstrating that nothing at the San was cut-and-dry. Each treatment was “based upon the exact knowledge of the patient’s individual needs.”63

  A patient undergoing phototherapy. Dr. Kellogg found that bright lights, resembling sunlight, improved one’s mood. Credit 63

  For example, there existed more than two hundred water, or hydriatic, treatments “comprising sprays, douches and baths, each having a different effect and being designed to relieve different conditions of suffering.”64 For obese patients, electrotherapy was used, at low levels of sinusoidal current, to produce muscular contractions, thus allowing the heavyset and sedentary to “passively exercise.” For those who were depressed, an electric light cabinet allowed them to spend time under bright “sun lights” that reproduced the naturally occurring phenomenon that was (and is) so rare in southeastern Michigan from late fall to the early spring.65 Dr. Kellogg was ahead of his time in considering the effects of sunlight on mood, an entity now known as seasonal affective disorder, wherein the gray, sunless winter literally, brings on “the blues.”66 Others underwent diathermy (electrically induced heat) treatments for muscle relaxation, and radium therapies, which were often overused to attack skin conditions like acne and warts and, in some cases, malignant tumors.67

  Most important was the dietary regime prescribed to each patient. At every meal, the patient found a marked-up menu left by his or her plate selecting the proper foods complete with a careful calculation of the calories, proteins, carbohydrates, and fats to be consumed during the meal, specially designed, counted, and analyzed for the patient.68 Well ahead of his colleagues practicing elsewhere, Dr. Kellogg was also certain to remind his dining guests about the importance of portion control as well. “There is a beautiful song,” he often told guests sitting down to dinner, “ ‘Count your blessings, count them one by one.’ Somebody has written a parody of it, ‘Count your calories, count them one by one.’ I think we shall have to have it sung here once in a while to remind you of it.”69

  Counting calories and eating the Dr. Kellogg way: a typical San dinner menu, May 19, 1916 Credit 64

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  WHEN THE NEW SAN OPENED, Saturdays were still strictly observed as the Sabbath, a complete day of rest in accordance with the Seventh-day Adventist Church. This practice continued for several years even after Dr. Kellogg was expelled from the Church because the majority of the San’s staff were the Seventh-day Adventist faithful and would not work on Saturday. Dr. Kellogg acquiesced because these former coreligionists worked for relatively low wages, helping his bottom line considerably. The doctor preferred to spend his Saturdays writing, lecturing, experimenting with new foods, and traveling to Chicago for his weekly medical missionary work.

  The guests who had no affiliation with the Seventh-day Adventists were less than pleased by the San’s shuttering down each and every Saturday. For example, the famed muckraking novelist Upton Sinclair and his often-ill wife, Meta, visited the Sanitarium in 1909, three years after his exposé of the meatpacking industry, The Jungle, jolted the U.S. government into enacting food purity laws. Sinclair, a well-known health enthusiast, socialist, and practicing hypochondriac, adopted many of the doctor’s dietary, exercise, and lifestyle recommendations. Nevertheless, he complained bitterly about how the place completely closed down every Friday evening all through to Saturday night, out of Adventist piety, only to return back to life on Saturday at sundown with “a little celebration, like Easter’s or New Year’s, with what I used to call ‘sterilized dancing’—the men pairing with men and the women with women.”70

  Dr. Kellogg gradually relaxed this schedule to appease his growing census of non-Adventist guests and maintain the San’s status as a tax-exempt, nonsectarian institution. The San held Sunday school classes and chapel services for those practicing other Christian denominations and wishing to observe the Sunday Sabbath. After Ella Kellogg’s death in 1920, the doctor grew less enthusiastic about the Saturday services. During the early 1920s, Saturday schedules included recreational events, although Saturday chapel services were still held for Adventists (many of them employees) seeking a place to worship.71 By the 1930s, the “Saturday Sabbath observance at the San was perfunctory.”72

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  FOR THE REST OF THEIR TIME in residence, the San patients rarely had more than a few unscheduled minutes during their day. The mornings after the initial examination were devoted to various exercise or therapy sessions, punctuated by breakfast and optional prayer services. At noon an hour of rest was strictly enforced followed by dinner at 1:30 p.m. Afternoons were devoted to the “fresh air cure and out-of-doors exercise” including tennis, horseback riding, swimming, badminton, croquet, and similar recreations on the San’s manicured campus. Also available was an army of bicycles, horse-driven carriages, and sleighs at the ready for rides through the San’s labyrinth of wooded trails and deer park. At 4:00 p.m., patients underwent a second treatment session but were back in their rooms to prepare and dress for supper at 6:00 p.m.

  Breathing exercises Credit 65

  Evening activities consisted of a full program of entertainments and diversions ending at the sounding of the “retiring bell” at 8:30 p.m. Each week plays, musicales, and later, motion pictures, were presented in a sumptuous auditorium boasting a state-of-the-art public address system. In the ballroom were nightly dances with a full orchestra. In the men’s parlor were billiard tables and, in the basement, a bowling alley. On most nights, at 7:00 p.m., one of the medical staff presented a lecture on a topic certain to draw a crowd. This excitement was especially the case when Dr. Kellogg was in residence.73

  Perhaps the farthest-reaching activity at the San was the “Grand March” held each evening on the San’s rooftop. It was essentially an aerobics and calisthenics session led by Dr. Kellogg to the accompaniment of the San’s orchestra brass section. So popular were these exercises that in 1923 the Columbia Gramophone Company asked Dr. Kellogg to record an album of ten 78-rpm shellac discs (each disc, much like a prizefighting match, was called a “Round”). The album was titled “Dr. John Harvey Kellogg’s HEALTH LADDER” and was accompanied by a booklet describing and diagramming dozens of strengthening exercises for the back, abdomen, legs, and arms that the doctor orchestrated every evening at the San. The person at home would play each disc on his or her gramophone, imagine himself in Battle Creek, and work out as the rec
orded Dr. Kellogg called out a menu of bends, bows, and stretches. To keep the beat, the doctor counted each repetition while the San’s brass band played rousing, rhythmic tunes in the background. Dr. Kellogg exhorted his long-distance listeners to work out and keep fit: “sedentary people die from stagnation….They are smothered to death…everyone needs exercise. Persons past middle age and chronic invalids (few persons over forty are wholly free from chronic disease) need exercise even more than do persons in health.”74

  The daily “Grand March” on the San’s rooftop Credit 66

  Making these records was no easy task and required many takes along with the exasperated assistance of John’s secretary, August Bloese:

  Dr. Kellogg acted like a drill sergeant and kept time while I performed the exercises. He invariably forgot to start the watch of [sic] lost track of the number of movements of the exercise. Something usually went wrong, so I had an exhausting time. The exercises were successfully recorded. The company, however, went out of business before the records could be put upon the market. All that Dr. Kellogg received for his trouble was a batch of records.75

  In fact, the records sold rather well and the Columbia Gramophone Company stayed in business for quite some time after recording the doctor’s exercise album. More to the point, decades before Jack LaLanne, Jane Fonda, Richard Simmons, and others made an industry out of exercise tapes and videos, John Harvey Kellogg was toning up thousands of listeners who may have never visited Battle Creek but who joyfully interacted with him daily by playing these inspiring (and expiring) recordings on their phonographs.