How much do you know about naturopathy?
Abstract and Introduction
Abstract
“Naturopathic medicine” is a recent manifestation of the field of naturopathy, a 19th-century health movement espousing
“the healing power of nature.”
“Naturopathic physicians” now claim to be primary care physicians proficient in the practice of both “conventional” and “natural”
medicine. Their training, however, amounts to a small fraction of that of medical doctors who practice primary care.
An examination of their literature, moreover, reveals that it is replete with pseudoscientific, ineffective, unethical,
and potentially dangerous practices. Despite this, naturopaths have achieved legal and political recognition,
including licensure in 13 states and appointments to the US Medicare Coverage Advisory Committee.
This dichotomy can be explained in part by erroneous representations of naturopathy offered by academic medical centers
and popular medical Web sites.
Introduction
Two naturopaths were recently appointed to the US Medicare Coverage Advisory Committee (MCAC).[1] This contradicts the
conclusions of an inquiry made by the US Department of Health, Education, and Welfare (HEW;
now the Department of Health and Human Services), the department that houses Medicare itself.
In 1968, naturopaths asked HEW to consider Medicare reimbursement for their practices.
The department conducted an investigation and chose not to do so. Its report concluded:
Naturopathic theory and practice are not based on the body of basic knowledge related to health, disease,
and health care that has been widely accepted by the scientific community.
Moreover, irrespective of its theory, the scope and quality of naturopathic education do not prepare
the practitioner to make an adequate diagnosis and provide appropriate treatment. [2]
These conclusions are still valid. Thirty-five years later investigators from
Simon Fraser University in British Columbia reported similar findings:
In our research for this chapter, we provided naturopaths and their professional associations ample opportunity to
refute the conclusions of several major commissions of inquiry over the years that deemed their therapeutic rationale
lacking in scientific credibility. None of our informants was able to convince us that the field had taken these earlier
critiques to heart; in fact, precious few seemed to recognize that a problem still exists. [O]ur own bibliographic
searches failed to discover any properly controlled clinical trials that supported claims of the profession, except in a
few limited areas where naturopaths’ advice concurs with that of orthodox medical science.
Where naturopathy and biomedicine disagree, the evidence is uniformly to the detriment of the former.
We therefore conclude that clients drawn to naturopaths are either unaware of the well-established scientific
deficiencies of naturopathic practice or choose willfully to disregard them on ideological grounds. [3]
What follows is a summary of the current state of “naturopathic medicine.” Much of it comes from the position papers and other
articles on the Web site of the American Association of Naturopathic Physicians (AANP);
from the Textbook of Natural Medicine, the only general textbook of the field, coedited and largely coauthored by one of the
Medicare appointees[4,5]; and from the most visible naturopathic school, Bastyr University in Kenmore,
Washington, where the coeditor of the Textbook was founder and president and where the other new
MCAC appointee is associate dean. Thus, it reflects the health beliefs of these 2 appointees
and of the uppermost levels of “naturopathic medicine.”
The Naturopathic Belief System
Naturopathic beliefs — including those of “naturopathic physicians” — are rooted in vitalism, the pre-20th-century assertion that
biological processes do not conform to universal physical and chemical principles.
Naturopaths describe a “healing power of nature,” which is compromised by modern medicine.[10]
They state that they “treat the cause of a problem, rather than to merely eliminate or suppress the symptoms.”[6]
They state that they treat “the whole person.” They state that they can “boost the immune system”
with herbs and homeopathic preparations. They profess knowledge about preventive medicine that is, implicitly,
unknown to medical doctors, public health experts, nurses, nutritionists, and others. They profess special expertise
in nutrition and in the use of “natural remedies” made from animal, vegetable, and mineral sources.
Naturopaths invoke a few simplistic theories to explain the causes of disease.
These include the actions of
ubiquitous “toxins” (including most pharmaceuticals); widespread food allergies;
dietary sugar, fat, and gluten; inadequate vitamin and mineral intake; epidemic candidiasis; vertebral misalignments;
intestinal “dysbiosis”; imbalances of Qi; and a few others. To diagnose these entities, naturopaths use an assortment of
nonstandard methods, among which are iridology or iris diagnosis, which holds that the entire body is
represented on the iris of the eye[11]; applied kinesiology, by which an allergy to a food is detected by placing the
food particle in one hand of a patient and observing a resulting weakness in the other;
hair analysis for alleged toxins and vitamin and mineral deficiencies; electrodiagnosis,
which can purportedly detect parasites and other problems by measuring the skin’s resistance to a tiny electric current;
“live cell analysis”; “pulse” and “tongue” diagnosis; and others.[12,13]
