Naturopathy-Putting Nature Back into Medicine
By Stephen Parcell, N.D. (2002)
Bastyr Center for Natural Health
Remember your last visit to a doctor's office? Chances are, your doctor spent all of ten minutes "visiting" with you before prescribing the "appropriate" drug to "handle" your complaint. Though that's the way it is nowadays, that's not the way it has to be. There is an alternative-you could see a Naturopathic Physician. While conventional "Allopathic" doctors usually treat symptoms, Naturopathic Physicians treat "the whole person," taking into consideration the mind-body-spirit interconnection and the individual needs of the patient. Spending up to 90 minutes for an initial visit and an average of 45 minutes for follow-up exams, the Naturopath asks numerous questions, performs a detailed physical exam, thoroughly investigates symptoms and complaints, explains treatment options and includes the patient in choosing a treatment plan.
Naturopathic physicians are primary care providers (family physicians)
and, like a conventional doctor, an ND will often use a number
of laboratory procedures, as well as the exam, to make a diagnosis.
Additionally, nutritional status, metabolic function, and toxic
load are frequently used to aid in diagnoses and treatment decisions.
The patient's mental, emotional, and spiritual status are also
assessed. Noninvasive therapies, such as lifestyle or behavior
modification and relaxation techniques, may be "prescribed."
Spinal manipulation, massage therapy, therapeutic nutrition, botanical
medicine, detoxification, physiotherapy, exercise therapy, homeopathy,
acupuncture and psychological counseling may also be included
in the treatment. In states where naturopathic physicians are
licensed, NDs may also perform minor outpatient surgery, give
vaccinations and administer selected prescription drugs. In the
state of Washington, NDs can treat most conditions, with the exception
of cancer or those requiring surgery. When prudent, an ND will
refer patients to a specialist for a definitive diagnosis and
advice.
Is A Naturopath Really A Doctor?
The first two years of naturopathic school are very similar to
conventional medical school, requiring anatomy, physiology, pathology,
biochemistry, neurology, radiology, minor surgery, microbiology,
obstetrics, immunology, gynecology, pharmacology, pediatrics,
dermatology and lab, clinical laboratory and physical diagnosis,
among other courses. The second two years focus on clinical skills
and a wide range of natural therapeutics. NDs receive training
in naturopathic therapeutics such as botanical medicine, homeopathy,
natural childbirth, acupuncture, physiotherapy and clinical nutrition.
Because coursework in natural therapeutics is added to a standard
medical curriculum, naturopathic doctors receive significantly
more hours of classroom education in these areas than graduates
of many leading medical schools. Students also complete a clinical
internship consisting of 1,500 hours under the supervision of
licensed naturopathic and conventional medical physicians in an
outpatient setting.
Naturopathic Philosophy
Naturopathic medicine is not identified with any particular therapy,
but with a philosophy that health and disease are a continuum,
and that the body has a profound ability to heal itself-when given
the proper conditions. Therefore, naturopathic patients are educated
in ways to access the body's innate wisdom, promote vibrant health
and prevent disease. Preventive care results in financial benefits,
as health is maintained, disease avoided, and costly procedures
averted.
Though Naturopathy came to the U.S just over 100 years ago, the
natural therapies and the philosophy on which it is based have
been effectively used to treat diseases for thousands of years.
In fact, the word "physician" is from the Greek root
meaning "nature." Hippocrates, a physician who lived
2400 years ago, coined the phrase, "nature is the healer
of all diseases." This concept underlies the principles outlined
in the "Hippocratic Oath," as stated below:
· First, do no harm.
· Act in cooperation with the Healing Power of Nature.
· Address the fundamental causes of disease.
· Heal the whole person through individualized treatment.
· Teach the principles of healthy living and preventive
medicine.
Natural substances to treat pathologies are carefully prescribed
and monitored before the consideration of surgery, toxic drugs,
radiation or chemotherapy.
A Brief History of Naturopathy
The predecessor of naturopathy may have been the great Jewish
philosopher Maimonides (1135-1204) who, in contrast to many of
his medical colleagues, downplayed the importance of drugs and
surgery and argued that diet, exercise, and mental outlook were
the keys to vibrant health. A court physician to the royal family
in Cairo, Egypt, his book Preservation of Youth, espoused completely
natural methods. Written for a dissolute young prince who suffered
everything from depression to indigestion, he warned, "overeating
is like a deadly poison to any constitution and the principle
cause of all diseases."
The German Christoph Wilhelm Hufeland (1762-1836), who served
as royal physician to the King of Prussia, is regarded as one
of the founders of holistic medicine. A prolific author and proponent
of "Nature Cure," which consisted of hydrotherapy (cleansing
the colon with a water flush), air and light baths, vegetarian
diet and herbal remedies, Hufeland was also a great fan of mineral
springs and "Water Cure" (popularized by Sebastian Kneipp).
His most successful written work, The Art of Prolonging Human
Life (1796), became one of the most widely read books on preventive
medicine and was the first natural health best-seller. Hufeland
coined the phrase "macrobiotics," later adopted by George
Oshawa, an admirer of Hufeland and founder of the modern Macrobiotic
movement. Hufeland was deeply influenced by the philosopher Jean-Jacques
Rousseau (1712-1778), whose ideology fueled the philosophy of
naturism and the nature cure movement, which became popular throughout
Europe.
Naturopathy On The Rise
Naturopathy, which combined nature cure with homeopathy, massage,
spinal manipulation, and therapeutic electricity, was developed
in America largely through the work of Benedict Lust (pronounced
loost; 1872-1945). From 1900-1938, naturopathic medicine flourished
in America. Interest then declined, due to the emergence of "miracle
medicine," surgical advances during WWII, and the growing
political sophistication of the American Medical Association (AMA).
Chiropractic and naturopathy were taught together until about
1955, when the National Chiropractic Association stopped granting
accreditation to schools that also taught naturopathy.
In 1956, doctors founded the National College of Naturopathic
Medicine in an attempt to keep the profession alive. Dr. John
Bastyr, considered the father of naturopathy, served as executive
director. A chiropractor, naturopath and obstetrician, he began
his practice in Seattle in the depths of the Great Depression;
Bastyr was so revered as a physician and teacher that the Naturopathic
College (Bastyr University) in Seattle was named in his honor.
The key to Bastyr's legendary clinical successes lay in his basic
philosophy. In a 1985 interview, asked to distinguish between
naturopathy and conventional medicine, he said, "The basic
difference is that in naturopathy it's not the doctor who does
the curing, it's the patient."
That idea appealed to many Americans in the 1970's, when the public's
growing awareness of the importance of nutrition and the environment,
along with disenchantment with organized institutional medicine,
brought new waves of students to Naturopathy.
A Real Life Case
Let's look at a real-life naturopathic "case." Bob,
a graduate engineering student in his 30s, came to the Bastyr
Center for Natural Health, complaining of a peptic ulcer and increasing
fatigue. He had been to his allopathic doctor repeatedly over
the last six years because "the ulcer kept coming back."
When he came to our office, we asked Bob about his stress level,
sleep, diet, drug use, social life, family support network, ability
to relax, and exercise. Bob's lifestyle was pretty good, other
than diet and his stress level, which was high due to school and
finances. Although he appeared to have a healthy diet, when considered
over a two-week period it fell short on fruits, vegetables and
healthy fats, while sugar intake was too high. When asked about
caffeine, Bob proudly said "gave it up-switched to decaf
a year ago." We asked him to stop the decaf because both
caffeinated and decaffeinated coffee increase acid production,
too much of which can cause over-acidic blood levels, creating
an environment for disease. We also explained to him how animal
fats are implicated in inflammatory disorders and that eating
high sugar foods can also increase stomach acid secretion.
After looking at his medical tests to make sure he was not someone
who secretes excess acid (people with peptic ulcers can have low,
normal, or above normal acid levels) we offered him an alternative
to antacids. We recommended he take deglyrrhizinated licorice
(DGL) and explained to Bob why most antacids are not good for
him:
"Most antacids are mixtures of aluminum hydroxide and magnesium
hydroxide that neutralize stomach acid. Complications of aluminum
hydroxide treatment include constipation and excess aluminum ingestion.
Magnesium stimulates gastrin release, leading to increased gastric
acid secretion (acid rebound). Calcium carbonate is another potent
and inexpensive antacid. Like magnesium hydroxide, calcium carbonate
ingestion is also associated with acid rebound. Chronic excessive
calcium carbonate administration may cause kidney stones and possibly
kidney disease."
Goals of treatment for Bob included pain relief, acceleration
of ulcer healing, and prevention of ulcer recurrence and complications.
In approaching a case like this we need to ask, "why is this
happening?" What is the cause of this person's inability
to maintain an adequate mucosal defense against stomach acid?
Many of us have H. Pylori but do not get ulcers, so clearly this
bacterium is not solely responsible.
The normal stomach and duodenum resist the corrosive effects of
acid and pepsin by secreting a gel-like coating that allows gastric
juices to flow in a one-way direction from the stomach lining
to the stomach cavity. Once secreted, the gel layer protects the
stomach lining from its corrosive effects. It is the breakdown
of this protective coating that predisposes to ulcer formation.
Food allergy can cause inflammation and a release of histamine.
Histamine strongly stimulates acid secretion (it is through blocking
histamine that drugs like Tagamet work to reduce acid). Our treatment
for Bob included:
Lab tests: blood tests to check for different types of anemias
and other abnormalities; a urea breath test to check for presence
of H. Pylori. To promote ulcer healing: DGL, the amino acid Glutamine,
zinc, and copper, and buffered vitamin C. To rule out food allergy:
a diet diary to take home and fill out; a recommendation for food
allergy screening. General supportive therapies: a probiotic supplement
to help reestablish healthy intestinal microflora (disrupted from
the antibiotics and the acid blocker); a high quality multivitamin
without iron; a diet that included more fish and olive oil and
less animal fat; a relaxing, enjoyable activity at least five
times a week.
Bob's Results
Bob returned for three visits over the course of three months,
after which time his ulcer symptoms were completely gone and his
fatigue had improved. He is currently taking only the multivitamin
and the DGL. Bob realized that he needed to reduce his stress
level and incorporate more fruits and vegetables into his diet.
To further improve his energy level, we suggested food allergy
testing. Because his insurance would not cover this, we had him
remove two of the most likely culprits: milk and wheat. As you
can imagine, Bob was pleased with the results of his Naturopathic
Care.
Naturopathic "Basics"
It can not be overemphasized how important factors such as stress,
nutritional deficiencies, food allergies, lack of sleep, toxin
overload, emotional distress, and poor diet play in the cause
of many illnesses. Stress alone can lead to a variety of common
complaints such as irritable bowel syndrome, constipation, ulcers,
stomach pain, and headaches, to name a few. Often, a prescription
drug is not the best long-term answer to treating and preventing
illness; whereas preventing disease in the first place through
maintenance of the immune systen makes much more sense.
So, How Do I find an ND
Currently, NDs are licensed in Alaska, Arizona, Connecticut, Hawaii,
Maine, Vermont, Montana, New Hampshire, Oregon, Utah, Vermont,
and Washington. In unlicensed states, NDs are allowed to practice,
but not to the full extent of their training. Look through this
magazine for a naturopath or go to the AANP website at: http://www.naturopathic.org.