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NCAHF Fact Sheet on Naturopathy

William T. Jarvis, Ph.D.

The term "naturopathy" was coined by John H. Scheel in 1895 in New York. Naturopath is an Anglicized version of the term physician coined by Hippocrates from the root word physikos -- the Greek word for "nature." This was to denote that "every practitioner of medicine was to be skilled in Nature and must strive to know what man is in relation to food, drink, occupation and which effect each of these has upon the other." [1] Hippocrates meant to displace the idea that disease and healing were dispensed by the gods (i.e., supernatural forces). [2]

Naturopaths claim to be the "true inheritors of the Hippocratic tradition in medicine," [3] but no link exists that would connect naturopathy to Hippocrates. Naturopathy has its roots in the Central European health spas such as that of Father Sebastian Kneipp's "water cure." Kneipp's program was separate from the earlier American hydrotherapy practices based upon the ideas of Vincent Priessnitz. Priessnitz hydropaths rejected drugs, bleeding, blistering, cupping, etc., and emphasized prevention through healthy habits and self-care. Encouraging self-reliance worked against the establishment of a guild of practitioners, and these ideas were eventually incorporated into regular preventive medicine [4]. Kneipp water societies were established after the heyday of American hydrotherapy, but did draw upon the ideas of Priessnitz. They were also influenced by the popular ideas of Sylvester Graham, John Harvey Kellogg, MD, and others. A committee of Kneipp practitioners met in 1900 to broaden their practices to include all natural methods of healing. In 1902, German "Dr." Benedict Lust (1872-1945) purchased the term "naturopath" from John Scheel, formed the Naturopathic Society of America, and disbanded the Kneipp Societies. He also founded the American School of Naturopathy in New York [5]. Lust listed ND, DO, DC, and MD after his name. His MD was alleged to be from a homeopathic and eclectic medical college, but on the witness stand he was apparently unable to prove that he had graduated. He claimed to have osteopathic licensure in New Jersey. He was convicted of practicing medicine without a license in New York [6]. Naturopathy is also considered by some to be an heir of the Thomsonian, eclectic, and homeopathic movements -- all of which opposed medical doctors and science-based medicine.

In 1903, the Supreme Court of North Carolina was first to legally recognize naturopathy as a separate and distinct healing profession. Ten states (AK, AZ, CT, FL, HI, MT, NH, NV, OR, WA) and the District of Columbia license naturopaths. Florida does not issue new licenses but grandfathered existing NDs in 1985. Based upon a controversial court ruling, Idaho permits NDs to practice as long as they don't prescribe drugs or engage in procedures specifically assigned by law to medical doctors. Utah issues no new licenses but allowed those who were in the process of obtaining licenses in 1981 (when the practice act expired) to obtain and practice with Oregon licenses.

Beliefs and Practices

Naturopathy's attention to prevention by lifestyle, self-care, and conservative healing methods appears on the surface to be much like Preventive Medicine, an established medical specialty. However, its jabs at the "allopathic" straw man is typical of anti-science practice guilds. Allopathy (allos "opposite" pathos "suffering") was devised by Samuel Hahnemann (1755-1843), a German physician who created homeopathy. Hahnemann rejected the harsh medical practices of the era which included bleeding, purging, vomiting and the administration of highly toxic drugs. These practices were based on the ancient Greek humoral theory which attributed disease to an imbalance of four humors (i.e., blood, phlegm, and black and yellow bile) and four bodily conditions (i.e, hot, cold, wet and dry) that corresponded to four elements (earth, air, fire, and water). Physicians attempted to balance the humors by treating symptoms with "opposites." For instance, fever (hot) was believed due to excess blood because patients were flush; therefore, balance was sought by blood-letting in order to "cool" the patient.

Although medicine never accepted the label of allopathy, antimedical groups continue to misrepresent physicians as allopaths who merely suppress the symptoms of disease rather than treat their true causes. This apparently is to make differences between standard and "alternative" medicine appear based upon conflicting ideologies rather than scientific pragmatism. Medical writers often refer to medical doctors as "allopaths" but their use of the term reflects an alternate definition of allopathy: "a system of medical practice making use of all measures proved of value in treatment of disease." [7] This definition is inconsistent with the root words "allos" and "pathos." The duplicity of the term aids those who wish to misrepresent medicine as ideologically allopathic, i.e., interested only in symptom suppression. The absurdity of this idea can be seen in the use of antibiotics, immunization, and other medical procedures that deal with the causal factors of disease. Nonmedical practitioners, including many NDs reject the idea that germs per se cause disease. They believe that vitalistic forces are ultimately responsible.

Vitalism is "a doctrine that the functions of a living organism are due to a vital principle distinct from physicochemical forces" [8] -- which denotes a paranormal "Life Force." Vitalists are generally not only nonscientific, but antiscientific because they abhor the reductionism (v. holism), materialism (v. etherealism) and mechanistic (v. mystical) causal processes of science. Its belief in Vitalism (Vis Medicatrix Naturae) can be seen in its over-riding tendency to overstate the body's self-healing power, and the beneficence of "natural" remedies (eg, whole herbs alleged to be superior to drugs extracted from them).

Orthodox medicine assumes that the world is chaotic, mechanistic. We believe in the Vital Force which has inherent organization, is intelligent and intelligible. Chiropractors have adjustments, Acupuncturists have needles, we have Vis Medicatrix Naturae. Our way is to research the mystery and beauty of the life force, in which we have faith. Our power and our responsibility is to bring the life force into the light [9].

Naturopathy is an ideologic, not a scientific, system. Science is a community characterized by competence, openmindedness, critical analysis, objectivity, reproducible results, and social responsibility. Ideological systems fall short in all of these important areas. Competence is the most important attribute of a health care provider. The practice of medicine is not a right but a privilege that should be granted only to highly competent and trustworthy individuals. Like airline pilots, licensed health care providers can hold the lives of strangers in their hands. In real life, things sometimes go wrong. When they do, people have a right to look for blame. Reasonable, responsible health care providers need to be protected from undeserved retribution. NDs lack medical competence. No ND school or practitioner has contributed to the body of scientific knowledge that guides health care worldwide. Among ideologists, an ability to verbalize the ideology and engage in "conversational medicine" generally substitutes for competence.

Although they are fond of accusing their detractors of being closedminded, it is the minds of ideologists that are open only to evidence and ideas which support their views of reality. Ideologists do not engage in critical analysis, but seek to affirm their faiths by accentuating positive experiences and rationalizing negative outcomes. Subjective experience is deemed the ultimate proof and scientific objectivity is denigrated as insensitive. Established research methodology is often scorned. The use of control groups is considered immoral because control subjects are denied the experimental treatment. Double-blinding of observers is ignored in spite of the historical lessons scientists have learned from the pitfalls of non-blinded clinical observations. Ideologists rarely conduct studies with published protocols clear enough to enable replication. Even when the research methods are specified, replication is seldom, if ever, done. Ideological guilds lobby for laws which protect them from legal accountability. Such so-called "medical freedom laws" protect the practitioners of non-standard medicine, not consumers. NDs do not want to have to prove that their procedures are safe and effective. Instead, they substitute rhetoric for evidence. "Natural" is equated with proof of safety, and testimonials and unsubstantiated claims that "it works" are substituted for proof of efficacy.

Naturopathy is eclectic (practitioners select whatever he/she personally likes from a cacophony of philosophically-based procedures), and empirical (practiced by subjective clinical experience). Due to the lack of scientific effort on the part of naturopaths, it is difficult to assess their value. Naturopaths present testimonials while opponents supply reports of harm-- unfortunately, both are anecdotal and provide only a partial view. This leaves only the philosophy of naturopathy and the validity of the methods they employ for an evaluation of the guild.

Appeal

Naturopathy's appeal lies in its claim to be "natural, preventive and holistic." These are fine accolades, but have no substantive meaning in operational terms. No matter how appealing its rhetoric, naturopathy must ultimately be judged by what it does and its results. A review of the curricula of accredited naturopathic schools shows that their courses of study include a mixture of medical discards (eg, colonics, water therapies, herbalism), pseudosciences (eg, acutherapy, homeopathy, gravity guidance, hair analysis for nutritional assessment, cleansing--at least one college offers preceptorships at Mexico border clinics which traffic in cancer quackery), and modalities expropriated from biomedicine (eg, nutritional counseling, hypnosis, natural childbirth, psychological counseling). An important difference is that at medical schools these topics are likely taught by more a qualified faculty, and applied with greater restraint by better trained and more rational practitioners. Much financial support for naturopathic education comes from the health foods industry, herbal trade associations, homeopathic suppliers, and other's who disdain consumer protection law and science.

Risks to Patients

Because patients must rely upon clinical interpretations by their doctors for explanations of their health status, such judgments should be based upon sound science, not ideology. Naturopathic practices result in needless, avoidable harm. Risks naturopathy poses to patients include:

The basis for nature cure is found in the notion that the body innately knows what is best for it. Disease symptoms should not be suppressed because they represent the body's natural healing processes. Although selective examples may be cited to support the idea, it cannot be applied as universally as naturopaths believe. More dangerous is the corollary belief in the so-called healing crisis which holds that adverse reactions associated with their practices (herbal remedies, fasting, colonics, etc.) are due to "toxins" being expelled; and, that the worse such adverse symptoms are, the worse would have been the future disease(s) being prevented. This false belief allows a naturopath to assert that the patient is "getting better" if they feel good, bad, or indifferent. Such advice led to the death of a 35-year-old Herbalife salesman, Bivian Lee.

Lee had recently retired from the New Orleans Saints NFL team. He was in good health according to a life insurance physical six-months before his death. Lee read advice by Stanley Bass, ND, DC, PhC (Philosopher of Chiropractic) that adverse symptoms should be expected and welcomed. According to Bass, ill-feelings were due to the body's "re-tracing" and

The toxins being discarded are saving you from more serious disease which will result if you keep them in your body too much longer--possibly hepatitis, kidney disorders, blood disease, heart disease, arthritis, nerve degenerations or even cancer--depending upon your hereditary or structural weaknesses. Be happy you're paying your bills now in an easy payment plan.

With some, colds which haven't appeared for a long time may occur, or even fevers. THIS IS NATURE'S WAY OF HOUSECLEANING. DON'T--but DON'T try to stop these symptoms ...These symptoms are part of a curing process, and don't try to cure a cure.

Those who have lived worse lives and poisoned themselves more will experience more severe symptoms... Headaches may occur at the beginning; fever and/or colds may appear; the skin may break out; there may be a short interval of bowel sluggishness, occasional diarrhea, feelings of tiredness and weakness, disinclination to exercise, nervousness, irritability, negativity or mental depression, frequent urination, etc....

REALIZE DEEPLY that your body is becoming younger and healthier every day because you are throwing off more and more wastes which would eventually have brought pain, disease and suffering. Those who have the worst symptom -- reactions and follow through to their successful termination are thus avoiding some of the worst diseases which would eventually have developed had they continued their careless eating habits [10].

The notion that adverse symptoms should be disregarded or rejoiced about most likely caused Lee to ignore serious symptoms of cardiac myopathy. When Lee blacked-out, his wife discovered his condition and made an appointment for him to see a physician. Sadly, Lee died in front of his seven-year-old daughter before the appointment could be kept. The Herbalife company paid his widow a substantial (undisclosed) out-of-court settlement rather than defend its failure to control such misinformation.

Factions

Naturopathy has at least two major factions. The most politically active is the American Association of Naturopathic Physicians (AANP), which is made up primarily of graduates of Bastyr University (Seattle) and the National College of Naturopathic Medicine (Portland, OR). A naturopathic degree program at the Southwest College (Scottsdale, AZ) may now also be included. Graduates of these schools control the Council on Naturopathic Medical Education, an accrediting agency recognized by the U.S. Office of Education. Another group is the American Naturopathic Medical Association (ANMA), founded in 1982 in Portland, Oregon [11]. The ANMA is composed of practitioners from a variety of nonaccredited programs including correspondence schools. A third organization, the American Naturopathic Association (ANA) has recently appeared on the scene. It is located in Washington, DC and claims to have been founded by Benedict Lust in 1896, and incorporated in 1919 [12].

Reform Efforts

In NCAHF's view, current efforts to reform naturopathy are misguided for the most part, although there are individuals who envision an acceptable model. The misguided reform effort has focused upon eliminating diploma mill degree holders from licensure and practice. To help accomplish this, the Council of Naturopathic Medical Education was formed and eventually recognized by the U.S. Department of Education as the official accreditation agency for naturopathic training. On the surface, such an effort seems legitimate. The problem is that the accredited naturopathic schools teach invalid medical practices.

NCAHF has been in contact with reformer naturopaths (RNDs) who are leaders in a reform movement. They understand that NCAHF's objection to the recognition of naturopathy is based upon its traditional antiscience orientation. RNDs say that they hope to remove this objection and make naturopathy into an acceptable health care system. Their view of an ideal ND would be sufficiently trained in diagnosis and screening to serve as a primary entry health care provider practicing general medicine with an emphasis upon teaching healthful lifestyles, managing minor illnesses, natural childbirth, personal counseling, and so forth. Rather than automatically opposing drugs and surgery, they say, naturopathy would simply have a different emphasis. RNDs would teach appropriate lifestyle changes that are safe and effective alternatives to drugs. For instance, weight-loss and exercise would be used as an alternative to medication for high blood pressure. If it were found not to be working for an individual patient, he or she would be referred to a regular physician. RNDs believe that there is a selective patient population of people willing to make the extra effort required who would utilize naturopathic services. Naturopathic training would emphasize patient screening and practitioners would collaborate with MDs to whom more serious problems would be referred.

Counter to their tradition as "drugless practitioners," reformers say that the idealized ND might even prescribe some medications. RNDs say that they prefer to use herbal remedies, but acknowledge that these would have to meet scientific standards of safety and effectiveness. RNDs would apply contemporary medical standards to validate their practices and would open themselves to peer review by MDs. RNDs would rely upon the standard scientific medical literature for its knowledge base. RNDs would abandon homeopathy, iridology, reflexology, and other sectarian or pseudomedical practices. Recognizing the propensity for naturopathy to attract sociopaths, the profession would work to set a higher standard for self-discipline than is presently done with conventional medicine.

RNDs see the present dearth of family practitioners, its appeal to a growing health promotion-minded public willing to work at lifestyle changes, the high cost of high tech health care, and the high cost of medical education as favorable to their marketing strategy. RNDs would encourage immunization, pasteurization, fluoridation, and other proven public health measures. What the reformers have in mind sounds something like nurse practitioners, midwifery, barefoot doctor, and physician assistants, all rolled into a single role. This vision presents naturopathy, not as an "alternative" form of health care, but as filling a gap that has been left by the evolution of highly specialized, high-tech medicine. It would provide a low cost, low-technology brand of health care.

Whether this is a pipe-dream or a realistic model from which a useful profession could emerge from the ranks of present-day naturopathy with its unorthodox traditions remains to be seen. NCAHF is not aware of a visible effort to make this dream a reality. If it were to become a reality, could and would AMA-approved medical schools also offer to train these low-tech medical generalists? Several RNDs say that it can be done. NCAHF's president, William Jarvis, has advised these reformers to demonstrate by developing a model program in one or more of the states that presently license NDs and approve Naturopathic Medical Education. It may take a generation to accomplish, but once shown to be a responsible profession working within mainstream health care, naturopathy would have arrived and would grow rapidly. NCAHF has told RNDs that, just as it has done in the case of affiliating with a chiropractic reform organization, it would be willing to help build a bridge for RNDs to enter mainstream health care if they approached their practices objectively, and were open to careful scrutiny from the consumer protection perspective. As we have suggested to chiropractic reformers, RND's may find it advantageous to change the name of their profession to make it easier to purge itself of the incorrigible quackery rampant within their profession.

References

  1. Dubos R, Mirage of Health, Harper & Row, 1959.
  2. Garrison F. The History of Medicine. Saunders, 1929.
  3. Nat'l College of Naturopathic Medicine Catalog, 1984-85.
  4. Cayleff S. Wash and Be Healed. Temple Univ. Press, 1987.
  5. Baer H. "The potential rejuvenation of American naturopathy as a consequence of the holistic health movement," Medical Anthropology, 1992;13:369-83.
  6. Fishbein M. Fads and Quackery in Healing. New York: Blue Ribbon Books, 1932.
  7. Webster's New Collegiate Dictionary.
  8. Webster's New Collegiate Dictionary.
  9. Snider P, 1991 AANP Convention, Into the Light. Townsend Letter for Doctors, April, 1992, p.261.
  10. Bass S. What Symptoms To Expect When You Improve Your Diet. In: Herbalife Distributor Product and Sales Information. Metairie, LA (Undated).
  11. Hayhurst D. American Naturopathic Medical Association Submission to the United States Department of Education in Opposition to the Council on Naturopathic Medical Education. (undated, c.1989).
  12. Pamphlet The American Naturopathic Association, Inc., 1377 K Street NW, Suite 852, Wash., DC, 20005, 202-682-7352.

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© 1997, National Council Against Health Fraud.
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This article was posted on January 30, 2001.