Naturopathy

My little post on naturopathy was more controversial than I had anticipated. Some of the commenters gently (and otherwise) suggested that I should learn more about the subject, so I’ve been doing a little reading. Here are the basic questions: what is naturopathy, and what might it have to offer that “conventional” medicine lacks?

One of the first places I visited was the website for Bastyr University, which is often cited as having the most prestigious naturopathic program. Their website posts a definition of naturopathy (all emphasis mine):

Naturopathic medicine is a distinct profession of primary health care, emphasizing prevention, treatment and the promotion of optimal health through the use of therapeutic methods and modalities which encourage the self-healing process, the vis medicatrix naturae.

Let’s start by examining this statement. Primary health care generally refers to a few specific medical fields: internal medicine, pediatrics, and family medicine. These medical specialties are tasked with long term, longitudinal care of patients, including prevention, diagnosis, and treatment of disease. When problems arise that are out of the scope of their practice, they refer to appropriate sub-specialists. Where naturopathy would appear to diverge is in encouraging “self-healing” and invoking the “healing power of nature” (the Latin phrase above), which is a concept derived from Vitalism (more on that later).

Modern primary care medicine works from evidence-based principles. For example, various professional organizations, such as the American College of Physicians, and government organizations, such as the U.S. Preventative Services Task Force, publish guidelines on the prevention and treatment of diseases. These guidelines are based on scientific study of these conditions. For example, studies have found certain tests to be useful in the diagnosis of coronary artery disease, and certain treatments to be useful in primary prevention (preventing a first heart attack), and secondary prevention (preventing subsequent heart attacks). The quality of available evidence is graded, and recommendations made. The physician then applies this science-based knowledge to an individual patient.

For example, an elderly male might come to you with severe pressure in the chest radiating to the right arm, and you may strongly suspect a heart attack. Another patient may present with indigestion, but based on your exam and your evaluation of the patient’s risk factors, including family history, may lead you to think that they are also having a heart attack, despite atypical symptoms. A test is then selected, and a treatment planned, based on decades of scientific studies.

I’m not sure what “self-healing” is, or what it would mean to “harness nature’s healing power”. When I prescribe an antibiotic for an infection, I’m still counting on the patient’s immune system to do most of the work—that’s “self-healing”. After a heart attack, the heart tends to “remodel” itself in a way that is detrimental to the patient. Certain drugs prevent this. Which is more natural, letting the heart get sick, or using medication to prevent it?

Reading the literature from the accredited naturopathic universities, you find classes on homeopathy, Chinese medicine, herbalism, and other unproven and disproved ideas. The naturopath might argue, “yeah, but we know all the conventional medicine too—we just offer this additional stuff that M.D.’s don’t have access to.”

What a steaming heap of crap. Any medical practice is either based on real science, or it is not. Given that there is no such thing as “healing energy”, “qi”, or any other non-material healing force, invoking these forces is simple quackery.

I really did go into this with an open mind. I was hoping that naturopathy might be “medicine-plus”, but it’s not. It is using primitive superstitions as medicine. This is never correct. Naturopaths may be well-educated, but they are not doctors—they are shamans.

Comments

  1. #1 stavros
    June 12, 2008

    This is getting out of control. I live and work in London and I am actually a bit ashamed of my academic institution (and employer) for topping the list of pseudo-scientific degrees. I am of course talking about the University of Westminster where you can find BSc in Homeopathy, Chinese Medicine, and other such crap…

  2. #2 Joe
    June 12, 2008

    I still don’t understand what you mean by naturos being well-educated. For example, some homeopaths (a practice used by naturos) say you can only get a proper treatment after evaluation by a thoroughly trained proponent. Others write books about self-treatment. Some say you must use just one remedy at a time, others prescribe multiple remedies. Some homeopathic remedies are even offered as mixtures.

    Then there is the question of dose. Some homeos use only remedies that are diluted to oblivion, others promote quite concentrated forms. I asked a colleague who is quite knowledgeable (as a skeptic, and an authority on the Organon; we coauthored a note in Homeopathy last year) if the extent of dilution makes the remedy. She responded “How long is a piece of string?” I am still measuring pieces of string, trying to figure that out.

    The bottom line- how can anyone be “well educated” on a method that has no standards? How does one reduce such a thing to practice?

    I maintain that naturos are un-educated.

  3. #3 daedalus2u
    June 12, 2008

    The most important factor in self-healing is helping the body to raise its NO/NOx levels to what they should be. Normally the body does this through sweating and releasing ammonia to the resident biofilm of ammonia oxidizing bacteria (which humans evolved to have on their skin). Some types of bathing practices remove these bacteria and so prevent this natural NO regulatory mechanism from working properly.

    It is the NO/NOx level that regulates the ATP level, vasodilation, angiogenesis, mitochondria biogenesis, and a lot of other things too. All of those things are critically important in self-healing.

    In the specific example you mentioned, cardiac remodeling occurs due to low NO in the heart. That allows capillary spacing to get farther apart causing dilative cardiomyopathy. It is complicated because the low NO is adaptive in the sense that it disinhibits the mitochondria in the heart and allows them to cope with the wider spacing of the capillaries. They pull O2 down to a lower level, increasing the O2 concentration gradient and allowing the same flux of O2 to diffuse a longer distance. The problem is if the NO levels stays too low for too long, then there isn’t enough mitochondria biogenesis to replace the mitochondria as they wear out, so the fewer mitochondria generate ATP by operating at a higher potential where they make superoxide which pulls down the NO level.

    That progressive deterioration is something to be prevented. That is not accomplished by woo.

    The most “natural” thing for very sick people to do is to die. If that is what a “naturopath” is going to encourage, I want no part of that for any of my family.

  4. #4 daijiyobu
    June 12, 2008

    PalMD, congrat.s, you’ve broken their code, because yes, healing in naturopathy is essentially a vitalistic phenomenon, when you get down to where the rubber meets the road [I went to an AANP AANMC school]:

    “given that there is no such thing as ‘healing energy,’ ‘qi,’ or any other non-material healing force, invoking these forces is simple quackery.”

    I like to think of naturopathy’s claims like this:

    three roads lead to an intersection and three vehicles have smashed into each other there,

    vehicle a: naturopathy’s claim that the essentially naturopathic is essentially scientific (for more, see http://thesciencethataintscience.blogspot.com/ );

    vehicle b: naturopathy’s simultaneous essential vitalism (for more, see http://thevitalismofnaturopathy.blogspot.com/ );

    vehicle c: science’s simultaneous profound rejection of vitalism [and supernaturalism, for that matter](for more, see http://novfsinscience.blogspot.com/ ).

    Remember Bastyr’s mission, to label — by decree — the profoundly science-ejected as science (much like their neighbors, the Discovery Institute {they must really teach sucky science in the Pacific Northwest!!!}) per

    “natural health sciences that integrate [blend] body, mind, spirit and nature [the vitalistic].”

    And did you know that the State of Oregon claims that the profoundly nonscientific is in fact scientific? Visit their OBNE.gov, where we’re told that naturopathy’s vitalism, spiritism and teleology are “in fact” and all pass scientific muster.

    In terms of logic and epistemology, naturopathy is NONSENSE.

  5. #5 nanoAl
    June 12, 2008

    Deadalus:
    your post is a bit of a word salad, until I read the last line I thought you were advocating naturopathy…

  6. #6 StuV
    June 12, 2008

    The most “natural” thing for very sick people to do is to die.

    Statement of the day. These unnatural, death-preventing bastards. Un-Darwinian, too.

    Bastards.

  7. #7 JustaTech
    June 13, 2008

    Daijiyobu (hope I got that right), I feel I must protest on behalf of the Pacific Northwest. There’s lots of great science up there; UW, the Fred Hutchenson Cancer Research Center, SBRI. The problem is that they’ve got a hippie infestation. Hippies are like termites, even once they’ve left, the damage is done. Most of their influence is good, or at least benign, but you do end up with more woo than you might otherwise.

    However, you cannot blame hippies for the Discovery Institute. There’s no explaining them.

  8. #8 GoodBrains
    June 13, 2008

    The really scary thing is that Washington State has given prescriptive authority to prescribe allopathic meds to ND’s! Luckily there is little risk of drug interaction with the homeopathic agents, but imagine the risks of prescribers with no residency training or experience giving out meds!

  9. I’m officialy a HOMEO-phobe! These morons can believe anything – no matter how stupid (much as that crazy daedalus crank thinks that EVERYTHING is due to a nitric oxide imbalance!).
    Creationsim, Intelligent Design, Naturopathy – remember how Lysenko screwed up the Soviet Union with his crazy take on agricultural pseudoscience? I guess we should be grateful. If it wasn’t for his stupidity we’d probably all have been wiped out in the nuclear winter.

    http://shlogblog.blogspot.com/

  10. #10 MarkH
    June 13, 2008

    Now be nice to daedulus, we love him here and he’s a bright guy. Yes, he’s obsessed with NO, but that’s alright, he’s obsessed with the science of NO. He might see NO where others don’t, but it’s an excess of enthusiasm, not crankery, and kind of charming besides.

  11. #11 Lilly de Lure
    June 13, 2008

    Goodbrains said:

    Luckily there is little risk of drug interaction with the homeopathic agents, but imagine the risks of prescribers with no residency training or experience giving out meds!

    Unfortunately we cannot say the same thing about those naturopaths who also give out herbal cures – quite a lot of them can interact in weird and not-so wonderful ways with prescription meds!

  12. #12 Anonymous
    June 13, 2008

    JustaTech, — of course, I was merely ribbing the NorthWest — but, regarding the Fred Hutchinson Cancer Research Center, they have drunk the naturopathic Kool-Aid per “NIH Center for Complementary and Alternative Medicine Funds First Naturopathic Physician as a Postdoctoral Fellow at Fred Hutchinson Cancer Research Center” (see http://www.fhcrc.org/about/ne/news/2002/02/05/greenlee.html):

    “[Our] Greenlee received her doctorate in naturopathy from Bastyr University [...] the nation’s leading university in natural-health sciences.”

    Also, Cancer Treatment Centers of America (see http://www.cancercenter.com/testicular-cancer/
    naturopathic-medicine.cfm) specifically states “life force [...as the] healing power of nature [...] the foundation for the practice of naturopathic medicine [...a] science.”

    Yes, just what I’d want, treat my very real cancer via an ideology that claims imaginary figmentations are indeed scientific facts.

    “Danger, Will Robinson, unethical sectarian pseudoscience!!!”

  13. #13 daijiyobu
    June 13, 2008

    The comment to JustaTech was mine.

  14. #14 Anonymous
    June 13, 2008

    @Goodbrains said “Luckily there is little risk of drug interaction with the homeopathic agents …”

    Not necessarily; there are cases where clinically effective doses of drugs are added to such preps. This puts the customer at risk. Whenever I see a positive result for a homeo-prep, I wonder if that is the explanation.

    @MarkH, I agree.

  15. #15 bob koepp
    June 13, 2008

    PalMD – Sorry, but the concept of vis medica naturae is most definitely not derived from vitalism. It refers, quite simply, to the capacities of organisms to effect some measure of self-defense and self-repair. And though I’m not about to rise to the defense of naturopathy, I’m more than willing to criticize “modern medicine” for neglecting these entirely natural capacities. Nesse and Williams have drawn attention to implications of this “oversight” in their work on “Darwinian Medicine”. Is their message being heard?

  16. #16 daijiyobu
    June 13, 2008

    bob koepp, I don’t think anyone is arguing that the body doesn’t often heal itself…

    it does, mechanically {one could even argue that these mechanisms are there because they’ve evolved within the genotype}

    but attributing healing as naturopathy does to a figment, a ‘purposeful life spirit,’

    that is a form of dualistic superstition.

  17. #17 bob koepp
    June 13, 2008

    daijiyobu – As I said, I’m not defending naturopathy, not even when I echo some of their criticisms of “modern medicine.” I’m less interested in combatting woo (there will never be a shortage of stupid people) than in criticizing the practice of medicine. And it deserves to be criticized for its neglect of vis medica naturae.

  18. #18 Davis
    June 13, 2008

    And it deserves to be criticized for its neglect of vis medica naturae.

    I’m not willing to take this claim of neglect as a given. Do you have some evidence that modern medicine neglects the body’s self-healing capabilities?

    I just did some quick searching, and from what I’ve read Evolutionary Medicine is not an example of what you’re asserting.

  19. #19 bob koepp
    June 13, 2008

    Davis – Did your quick search reveal anything that Nesse and Williams (or maybe it was Ewald…) have had to say about anti-inflammatory drugs, and the possibility that they might delay healing?

  20. #20 Ray C.
    June 13, 2008

    “the vis medicatrix naturae

    Quidquid latine dictum sit, altum videtur. That just means something like “medicating force of nature”.

  21. #21 MC
    June 14, 2008

    I don’t know much about “naturopathy,” but when you make comments like the following, I wonder about your ability to objectively study anything.

    Given that there is no such thing as “healing energy”, “qi”, or any other non-material healing force, invoking these forces is simple quackery.

    Please point me to the unbiased, scientific data you used to come to this conclusion.

    How does your reductionistic world view classify the placebo effect?

  22. #22 PalMD
    June 14, 2008

    MC, your comment reveals some common fallacies. You are asking me to prove to you that qi and other such unobservable, unmeasurable entities do not exist. However, if someone posits that something unmeasurable, invisible, etc. exists, it’s up to them to show the evidence.

    If I told you that invisible purple fairies live under my bed, it would be up to me to prove that to you, not up to you to prove that they do not exist.

    I’m not sure what you are getting at with your placebo question.

  23. #23 daedalus2u
    June 14, 2008

    There is a completely “hard science” explanation of the placebo effect that is completely consistent with all of EBM and is not consistent with the naturopathy crap. That would be the normal regulation of physiology through nitric oxide. I explain this in great detail in my blog on it.

    http://daedalus2u.blogspot.com/2007/04/placebo-and-nocebo-effects.html

    Invoking the placebo effect explains why woo-based techniques such as naturopathy sometimes work and why they sometimes don’t work. The woo-based technique is simply a magic show that tricks the patient into thinking they should get better, that triggers the placebo effect and there may (or may not) be some modest improvement in their symptoms. The improvement may even be “real”, but it is due to the placebo effect and any other placebo of equal effectiveness will work exactly as well. A better placebo will work even better, and an actual therapy when combined with a placebo effect will work the best of all.

  24. #24 LanceR
    June 14, 2008

    Wow! Was that a post from daedalus2u that *didn’t* refer to NO? <grin>

    Just kidding, daedalus…

  25. #25 MC
    June 14, 2008

    PalMD, that is my point exactly, science hasn’t proved anything one way or the other as far as non-material healing power is concerned, so your declarative statements of fact is as pure make-believe as the purple fairies argument you coped from Richard Dawkins.

    Daedalus2u, after reading your long-winded and much contrived essay, I realized you have no idea what you are talking about or writing about. Your whole ATP explanation of the placebo effect shows that you truly have not read any of the scientific papers on the placebo effect. Your entire argument is centered around this very unscientific statement,

    I suggest that placebos invoke the RnR response, and that nocebos invoke the FoF response.

    To put it mildly, your weak suggestions is not “hard science”. Geez, have you heard of double and triple blind placebo experiments, or is that fact conveniently left out of your “suggestion”?

    The problem with all the PZ Myers and Dawkins wannabees on science blogs is that they love to think of themselves as dragon slayers. They mistake their opinions for science, and applaud themselves when they get a few positive comments from the chorus that they preach to. Sad.

  26. #26 PalMD
    June 14, 2008

    MC, I actually didn’t make it past the first chapter or two of The God Delusion…I didn’t like the writing very much, and some of the reasoning was more circuitous than necessary.

    When you say that “science hasn’t proved…one way or the other” you make two errors. One, some specific cases, these have been “disproved”, but more importantly, it is impossible to a certainty of 100% disprove anything. That does not mean that the other option is “likelihood”. In fact, while I may believe in fairies, and you may not be able to disprove them, you can still tell me that, based on the nature of reality, their existence is much, much less probably than their non-existence.

    The same is true for non-materialist claims on medicine, mind, etc…there is no need to “disprove” them as they are completely at odds with reality, and, more importantly, assuming they do not exist does not change our ability to understand or manipulate the world.

    Oh, and be nice to daedalus. We like him around here.

  27. #27 daedalus2u
    June 14, 2008

    It is pretty clear you couldn’t follow what I wrote, and certainly didn’t even look at any of the 32 references I linked to, let alone read them, let alone understand them, not even a few of them, let alone all of them. You wouldn’t know a scientific idea if it hit you in the face. The idea that NO is what triggers the placebo effect isn’t my idea. That is George B Stefano’s hypothesis. It happens to be correct. Look him up, he has done a lot of excellent work on NO and how important the basal NO level is. He has been working at it a lot longer than I have been. I just added some details to it, included the ATP involvement, figured out that the bacteria are important and fleshed out some of the reasons for it. That is how real science works; scientists read what other scientists have done and add to it.

    I haven’t read the placebo literature? Ha, thats a laugh. There is virtually nothing in the placebo literature that I haven’t read. I don’t agree with everything I read, but I do like to read everything. I look at people’s data and come to my own conclusions. My explanation of the placebo effect explains the triple blind stuff better than any other explanation does. Actually it explains all the data in the literature. It also explains why humans evolved physiology that supports a placebo effect. No it wasn’t because of some immaterial connection to the Cosmic Muffin.

    Pretty clearly a denialist troll, know you are out of your league in the science but try to put on a bluff. Can’t understand all that hard sciencey stuff; make up crap about non-material woo-woo. Really, non-material healing processes? Give me a break. Whining that no one will “disprove” non-material woo-woo healing processes? Science doesn’t “disprove” anything. If falsifies hypotheses. Your idea of non-material healing processes isn’t even a hypothesis. It is what is termed “not even wrong”. Real scientists don’t waste time on things that are not even wrong, except as entertainment and as a public service.

  28. #28 MC
    June 15, 2008

    Real scientists? Oh Daedalus2u, you make me laugh…Lol. I think there’s an ego running wild in here. Though the funniest thing on your website is this –

    A blog by Daedalus, an inventor of Mythic Proportion. It will mostly focus on my current projects to save the World, of which there are now 2, Global warming mitigation, and repairing the deficient nitric oxide physiology that most individuals have.

    Unfortunately, all the posturing and primping isn’t going to get you the recognition you crave, you may actually have to approach research with an open mind one day, instead of trying to prove your own a priori hypotheses.

    Keep on blogging, brother.

  29. #29 daedalus2u
    June 15, 2008

    MC, I am glad you are able to see the humor in what I wrote. That humor was intentional.

    With people of limited ability modesty is merely honesty. But with those who possess great talent it is hypocrisy. Arthur Schopenhauer

    Again, real scientists evaluate ideas on their merits, not on the personality traits of the people expressing them. However quirky those personality traits might be they are irrelevant to the evaluation of the ideas. Of course to evaluate ideas you have to actually understand the ideas and the facts and logic on which they are based. Admitting that one doesn’t understand reality can be difficult for some. So difficult that they make up non-material woo-woo to trick themselves into believing they do understand reality. A scientist has to have an idea of the limits of their understanding if they can hope to extend it by learning.

    You are entitled to your own opinion. You are not entitled to your own facts. If you don’t like my hypothesis, show me where it is wrong using facts and logic. If you can do that I would actually greatly appreciate it. If my approach is wrong, I would like to know so I can abandon it. The authors of the thousands of papers I have read and relied upon to formulate my hypothesis would like to know too, so they can issue retractions and correct the errors in their work.

    Recognition is not what I am looking for. I want to make the world a better place. I know that my bacteria are an effective method for raising NO levels and improving ill health characterized by low NO. In the fullness of time that will be appreciated. That will occur in the not too distant future. There are programs being developed to isolate and characterize bacteria living on humans, the human microbiome. 99% of the bacteria that live on humans are not culturable by techniques used to date. They will be identified by the sequencing techniques that will be used in these programs. They will find the bacteria I am working with in abundance on people living in “the wild”. Diabetes, obesity, heart disease, asthma, allergies, hypertension are virtually unknown in the rural undeveloped world. The loss of the bacteria I am working with is the major reason for the deterioration in health that occurs following economic development.

  30. #30 MC
    June 15, 2008

    Yo D – I’m all for you making the world a better place through science. Just don’t try to turn science into your own exclusive country club.

    Educated, rational and non-materialist are also using peer reviewed science to study the mind-body potential. There’s no need to cling to super natural explanations to unravel the metaphysical, science is a great tool for all.

    So for you, or any other strict materialist, to dismiss, ridicule or try to exclude non-materialists scientists just because somehow their hypotheses offend your world view is a dangerous and elitist position to take.

  31. #31 daedalus2u
    June 15, 2008

    MC, no one is trying to exclude anyone, get some data or some evidence or something other than completely subjective reports which if true would contradict much that is very well known. Explain how something non-material can affect the material brain and cause the material nerves to fire and activate the material muscles. Explain it with theory and with data and then collect your ticket to Stockholm.

    If what you call a “hypothesis” can’t be explained or tested and contradicts stuff that is well known it isn’t one.

    For all the crank-like language on my blog, PalMD and MarkH are treating me pretty much like a non-crank (despite my best efforts to sound like one ;). It isn’t the language that makes one a crank or not, it is the facts and logic behind the ideas. If those pushing non-material idea had any facts and logic behind them, they wouldn’t be treated like cranks either because then they wouldn’t be cranks.

  32. #32 melior
    June 15, 2008

    non-materialists scientists

    My brain seized up at this point.

    Is that anything like “ineffability deconstructionists”?

  33. #33 D. C. Sessions
    June 18, 2008

    Now be nice to daedulus, we love him here and he’s a bright guy. Yes, he’s obsessed with NO

    My kids went through that stage.

    (G,D,&R)

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