Wellness might feel like a modern concept, attached to health-tracker apps, screen time, and green smoothies. But the concept of actively trying to lead a healthy life while keeping the body in a good state isn’t new. In fact, systems of preventative health stretch back more than 2,000 years to the medical traditions of the ancient Mediterranean world.
Speaking on the Life Lessons from History series from the HistoryExtra podcast, Sasha Handley, a professor of early modern history at the University of Manchester, says there used to be a “fantastic preventative healthcare culture” based on advice that dates back to ancient Greece.
As she sets out, there was a list of six lifestyle factors and behaviours that physicians, medical practitioners, and ordinary people alike knew they had to take care of for their long-term health. These were the ‘six non-naturals’ and the ancient Greeks believed that “temperance of all of those six things was key to long-term good health, according to the wisdom of the time” says Handley. The term “non-naturals” described factors external to the body that could be managed or regulated, as opposed to “naturals,” which were the body’s innate characteristics
So what were these six factors, and how much do they align with modern thinking?
Fresh air
The first non-natural to look after was fresh air – that is, “getting enough of it and making sure that you were not taking in fetid or corrupt air,” Handley says.
The Greeks thought that ‘bad air’ could cause disease and advocated for good airflow within houses to lessen exposure to stagnant air.
Today, we know there is no singular concept of ‘bad air’. But there are pollutants in the air that can be hazardous to people, and we do know that some diseases are airborne.
Food and drink
It was considered important that a person was “eating and drinking the right kinds of things for [their] bodily constitution, but also at the right times of day,” Handley says.
Theories about what was good to eat and when were based on the four humours: blood, phlegm, yellow bile, and black bile. Different foods being either cold or hot, or wet or dry, affected the balances of the four humours in the body, which led to different outcomes for people’s health and constitutions. For example, someone believed to have an excess of “heat” might be prescribed cooling foods such as cucumber or lettuce.
Galen, a Greek physician and philosopher whom the idea of the six non-naturals is attributed to, thought that warm food led to the production of yellow bile, while cold food led to the production of phlegm. Galen practised in the second century AD and became one of the most influential medical authorities in history.
Now, our understanding of food and diet is more scientific. But we do know that some specific nutrients have particular health benefits; protein helps to contribute to maintaining muscle mass, while vegetables can be a source of different micronutrients and vitamins.
Exercise and rest
Getting enough exercise and rest was also believed to be important. Exercise was seen as having a drying effect on the humours, and physicians recommended exercises to patients both to prevent and treat disease. The body, in humoural thought, was constantly shifting in balance; movement was one of the tools available to correct excess moisture or sluggishness.
Galen thought work and exercise were equal, defining them as vigorous movements that made you out of breath. The exercises that he prescribed to his patients, though, were more moderate. He recommended exercises that involved a small ball.
Massage and baths were also seen as having a similar effect to exercise, something that would be echoed in wellness modern wellness trends centred around saunas, sports massage, and cold plunges.
Sleep and waking
Sleep and dreams were important parts of ancient Greek philosophy as well as their medical knowledge. Dreams were deemed to be evidence of the state of the body, and therefore were helpful in diagnosing medical issues. But they were also important within ancient Greek religion.
The ancient Greeks believed that the gods could communicate via dreams and that sleep had healing properties through its link with the gods.
We might not bring up our dreams in doctors’ offices these days, but research increasingly shows the powerful health impact of sleep on physical, cognitive, and emotional health. Recent studies show that getting enough sleep can be associated with lower rates of chronic diseases such as dementia, diabetes, and heart disease.
Excretion and retention
The fifth non-natural “sounds fairly graphic, but it’s excretion and retention,” Handley says. “This refers to bowel habits, but also to things like sweating appropriately and keeping the body at the right temperature.”
It was thought that excretion, in all its forms, helped keep the four humours balanced. If one humour accumulated excessively, it could be expelled through sweating, urination, bleeding, or purging. Bloodletting in particular became a standard treatment in later medical traditions influenced by humoural theory.
Read more | Blood, guts and spectacle: 6 shocking events from the history of ancient Roman gladiators
Although we don’t think about regulating our excretions in terms of bloodletting and purging like the Greeks did, the increasing awareness of gut health – and therefore its impact on the bowel – is perhaps a modern descendant of this idea.
Passions of the mind
“The very last one is usually called the passions of the mind, which we read today as emotions,” Handley says. “So emotional health, making sure that you were not getting too angry, too sad, and keeping your mind and body in a good balance.”
Different emotions were associated with excesses of the four humours, so keeping your emotions in check contributed to your humoural balance. Too much blood might make you too happy and too much phlegm might make you too reserved, while too much black bile might make you melancholic and too much yellow bile might make you angry.
Clearly this idea links to our modern understanding of mental health – especially now we know that physical health and exercise are linked to mental health.
How similar are the non-naturals to ‘wellness’ today?
Nowadays, we think of ‘wellness’ as separate from ‘health’. Where health is the absence of disease, and wellness is a more general emotional and physical wellbeing that we can influence via lifestyle factors.
The ancient Greeks thought the same. Health was seen as the responsibility of individuals to regulate their non-naturals to look after their own health, and maybe even avoid having to see a doctor.
There was an element of taking personal responsibility for good health, leading to the idea that bad habits could cause certain diseases. But the six non-naturals also worked in tandem with the ‘naturals’ – or the innate factors that we have no control over that also cause disease.
Today, we see things similarly: some diseases and conditions are caused by lifestyle factors, whereas others develop independently of how we live.
And just like modern ‘wellness,’ ancient Greek health was about more than just the body, too. Medical knowledge was intertwined with ethics, morality, politics, and philosophy – which is why many of the most famous Greek physicians, such as Galen and Hippocrates, were also philosophers, and many philosophers also mused on issues of the body.
The ancient Greeks actually thought that achieving perfect health was essentially impossible since it required a precise balance of the humours, which changed every day. Instead, a ‘neutral’ body was the goal – something that doesn’t necessarily align with modern ideas on health optimisation and biohacking.
Dr David Musgrove was speaking to Sasha Handley on the HistoryExtra podcast. Listen to the full conversation.
