Old Medicine is New Again

Like a lot of people, I was surprised to learn that cupping had made a comeback. But unlike most people, I knew what cupping was before 2016.

Michael Phelps was sitting on the bench, listening to his warmup music and getting in the zone, but something was different. His back and shoulders were covered in perfectly circle-shaped purple bruises. And immediately I thought, Cupping? Really?

Phelps made cupping famous again during the 2016 Olympics. Like a lot of fad medicine that’s gained popularity in the last few years, cupping has a long, vaguely Eastern history. And this is part of the appeal, right? You turn to alternative medicine because it doesn’t have the history of the medicine you know, the medicine that, for whatever reason, you feel isn’t working. And in the current era, things that feel non-scientific and non-Western have an air of newness, a comfort and trustworthiness that can be a reprieve from the clinical sterility of our established system of medicine.

But it’s not just cupping. It’s an entire system of new-old medicines coming into style, and they seem to be appealing largely to an upper class (or aspiringly upper class) set of people who are mostly white women. It’s a short hop from restrictive diet juice cleanses that “clear your toxins” to a really sincere and “spiritual, not religious” practice of yoga to moon milk and oil pulling to customized vitamins and supplements.

What I find so interesting about the phenomenon of wellness as it encompasses this set of practices is that it’s not just individual isolated fads, but a conceptually consistent system of medicine. In the same way that I talk in my research about a philosophy of medicine in the Middle Ages, the current wellness trend is also a philosophy of medicine. Like the medieval version, it’s based on an underlying theory of balance in the body, which is disrupted by changes to diet and exercise and needs to be corrected in the same way. Both emphasize the individuality of both cause and cure, and the importance of wise and attentive practitioners to prescribe treatment. And indeed, the culprits are the same, the adherents are the same. Medieval medicine as we know it – leeches and all – was really a pastime for the wealthy. The books of medicine that have come down to us largely describe practices that only the wealthiest people could afford the money to buy or even the time to consider. According to medieval physicians, the body was thrown out of whack by a diet that disagreed with one’s individual constitution, and I can’t help but hear echoes of this whenever I witness a discussion about choosing to give up gluten or dairy or nightshades as a holistic dieting measure – Oh, I just have so much more energy when I don’t drink milk. Most medieval cures were diet-based as well, with occasional forays into the kinds of severe practices medieval medicine is known for (leeches, bloodletting, cupping, etc.). Wellness follows suit, with an emphasis on a whole grain- and vegetable-based diet, regular exercise, dietary supplements, and the occasional cryotherapy thrown in.

So it’s difficult for me to really criticize wellness as a whole, and in fact I respect it in a way as an exploration of a different medical approach. I think there are a lot of problems with a slavish adherence to the notion of progress, in part because it causes us to leave behind practices that we can’t currently defend but are still effective. But many of the practices that wellness as a movement has revived are not effective and are in fact harmful.* Maybe this is because there are a lot of quacks peddling cures under this heading. But I think it also has to do with the fact that wellness is not, ironically, about wellness. It’s about guilt and self-loathing. As a larger philosophy it’s about self-denial and “being good” because the things you want and the ways you want to be are “bad”. Processed foods are “bad”, sitting on the couch is “bad”, being fat is “bad”. This ideology is very medieval; rich foods are “evil”, staying inside is “evil”, being fat is “evil”. Monasticism, which was developed in response to material evils, remedied these personal weaknesses with intense disciplines like periodic fasting, a highly restrictive and boring diet, and a labor requirement. Ironically, treatments like bloodletting were actually cheats, luxuries that allowed a monk or noble to lie around in bed all day, eating rich food and chatting with friends. Like now, there was an air of insincerity to the whole thing, a performative goodness that could be bought for a day, a cheat day so that the self-denial could continue.

I have a friend with a history of a restrictive eating disorder, and when we took medieval studies classes together she would tell me that she had to avoid reading the sources about monks because they gave her ideas. She would start looking through their descriptions of how many servings of lentils were allowed in a day for tips on how to limit her calorie intake without passing out. This isn’t a coincidence – it’s the intended nature of the text. This modern wellness philosophy is, like the medieval one, a disorder. It’s based on a morality of eating and physical activity and acts as form of self-punishment. And it is popular with wealthy white women because in our time these are the people most likely to feel an intense guilt surrounding everything they do, caused by a dissonance between their desires and societal standards – they see the dissonance and their wealth and privilege gives them the means to remedy it.

So it’s not just the hokey pseudo-medical procedures that are old-is-new-again, it’s the underlying ideology. It’s the morality and guilt. We just have a different language to justify it now.

* I’m talking here about the recent lawsuit against Goop. You can read about it here.