Naturopathy



Naturopathy is a cornucopia of almost every quackery you can think of. Be it homeopathy, traditional Chinese medicine, Ayurvedic medicine, applied kinesiology, anthroposophical medicine, reflexology, craniosacral therapy, Bowen Technique, and pretty much any other form of unscientific or prescientific medicine that you can imagine, it’s hard to think of a single form of pseudoscientific medicine and quackery that naturopathy doesn’t embrace or at least tolerate. Naturopathy, or naturopathic medicine, is a field of practice in healing and maintaining health wherein practitioners use various "natural" remedies to treat their patients. The main idea behind naturopathy is that it supposedly helps the body's own self-healing process; this is based on the pre- and pseudo-scientific theory of vitalism, according to which the body has some sort of "energy" that is necessary for one's health. Naturopathic medicine disfavours surgery and drugs, preferring more friendly and fuzzy treatments like herbal medicine or outright woo such as "natural energy fields". Unlike medical or osteopathic doctors (M.D. and D.O, respectively), naturopathic doctors (N.D.) are not universally regulated, so on this page the term naturopath is used for both licensed and unlicensed practitioners of naturopathy.

Naturopathy doesn't have any real standards; what therapies one can expect from naturopathic care can vary wildly from practitioner to practitioner, and are very often contradictory. Some naturopaths, like nutritionists, may give quite good advice ("eat fruits and vegetables"), mixed with concepts that have no basis in reality, such as homeopathy, Reiki, unproven supplements, or whatever fad diet they happen to believe in. (It may be noted that the practice of naturopaths themselves selling their patients supplements is widespread and in fact encouraged by naturopathic organizations. No conflict of interest there at all.)

Naturopaths also very frequently claim to be holistic, meaning that they listen to their patients and sympathize with them, rather than just coldly treating them without any regard for their feelings. They "focus on the patient, not the disease". Which is actually pretty accurate, given that more often than not the "treatments" have no effect on the disease anyway.

Benedict Lust
Naturopathy claims ancient roots based on the Hippocrates quote, ("the healing power of nature"), but in reality it was cobbled together by a German immigrant to the United States named Benedict Lust. Lust used "Dr." before his name and claimed to have a degree from the New York Homeopathic Medical College in 1901 and a degree in osteopathy in 1902 from the Universal College of Osteopathy in New York, but there was no evidence that he was licensed for anything in the state of New York and he was convicted there of practicing medicine without a licence.

The term "naturopathy" was coined by Lust's colleague, John Scheel, in 1900. Lust popularized the term through his publications, by opening the first naturopathic school (the American School of Naturopathy in New York City), and from the establishment of health resorts known as "Yungborn" in Butler, New Jersey and Tangerine, Florida.

Lust credited several men who preceded him for the development of naturopathy, including Sebastian Kneipp (popularizer of the Water Cure), Friedrich Eduard Bilz (who wrote the book Das Neue Naturheilverfahren (translated as The Natural Method of Healing in 1898 ), and Louis Kuhne (see below).

By 1918, Lust included the following fields of treatment quackery within naturopathy in his book Universal Naturopathic Encyclopedia: electro-medicine, radiology, ozone therapy, magnetic field therapy, light therapy, vibration therapy, milk diet, chiropractic, raw foodism ("apyrtrophy"), fasting, hydrotherapy ("The Water Cure"), "astroscopy" (astrological medicine), phrenology, Christian science, iridology, diagnosis by facial expression, and "chromopathy" (color therapy). The main ideas during the Lust-era of naturopathy (roughly 1900 to 1945) were all-inclusiveness &mdash; all natural "cures" were of value and to be included under the umbrella of naturopathy, and "drugless healing" in the form of strong opposition to the medical establishment.

Lust's views on what is and is not naturopathy leads to irony both during and after the Lust era, when:
 * 1) Radiation therapy was promoted (natural, though ostensibly a drug) for use by non-physicians despite it being well-known (even before 1917 and even by its naturopathic advocates) that radiation caused cancer.
 * 2) Some modern naturopaths prescribe synthetic pharmaceuticals, including Benadryl, hydrocodone, oxycodone, anabolic steroids, Proscar, Finasteride and Propecia, Clomiphene, Phetermine, DHEA-7 Keto, SSRIs, Phentermine, Adderol, and Fentanyl. As of 2013, Arizona naturopaths were allowed to prescribe morphine (Schedule II) as well as all Schedule III, IV and V drugs. These prescriptions would be antithetical to Lust's view of naturopathy.

Louis Kuhne
The 1918 Universal Naturopathic Encyclopedia also includes within it a posthumously published book by Louis Kuhne titled, The New Science of Healing or The Doctrine of the Unity of Diseases (pages 223-488). The book contains some remarkable cures treatments that amount to a combination of vitalism, germ theory denialism and antivax. For measles, scarlet fever, diphtheria, smallpox, whooping cough, scrofula (lymphadenopathy), rheumatism, gout, and sciatica, the treatment consists of combinations of friction sitz-baths, cold baths and steam baths. Other ailments that Kuhne claimed could be treated include: cold extremities, hot head, nervous and mental diseases, lung inflammation, tuberculosis, pleurisy, lupus, venereal diseases, bladder and kidney disease, diabetes, uremia, bed wetting, liver disease, gall stones, intestinal diseases, heart disease, dropsy (edema), spinal cord diseases, hemorrhoids, chlorosis (anemia), epilepsy, anemia, epilepsy, agoraphobia, eye and ear diseases, dental diseases, head colds, influenza, throat diseases and goiter, headache and migraine, brain inflammation, typhus, dysentery, cholera, diarrhea, tropical fevers, malaria, yellow fever, leprosy, scabies, worms and parasites, hernia, cancer, wounds, and "diseases of women". The total lack of understanding of disease causes and treatment by Kuhne would seem to be evident simply by his placement of wildly unrelated diseases within the same chapter (e.g., "Epileptic Fits. Agoraphobia", p. 366).

Other founders

 * Vincenz Priessnitz was a German peasant farmer. He created the Water Cure, and with Johann Schroth created the "Nature Cure".
 * Johann Schroth was a haulage contractor. He promoted an austere diet and fasting, cold compresses, and steam baths.
 * Sebastian Kneipp was a German Catholic priest who promoted the Water Cure, sometimes known as the Kneipp Cure. The cure was part of Kneipp's five principles of water, plants (herbal medicine), exercise, nutrition and balance.
 * Emanuel Felke was a Protestant priest from Prussia. He advocated iridology and the "Felke Cure", which consisted of sitz-bath, light-and-air bath (nudity), clay bath and sleeping on the bare ground overnight.
 * Henry Lindlahr graduated from National Medical University, a "low-grade medical college" which is no longer extant.  Lindlahr promoted quackery in the form of "strange diets, airbaths, water cures, light treatments, chiropractic, osteopathy, homeopathy, herbals, [and] psychoanalysis".  Lindlahr was the author of Nature Cure, a foundational text of Naturopathy.

Early debunking
By 1932, Morris Fishbein had recorded an A-to-Z of quackery that fell within the naturopathy umbrella. Fishbein was an M.D. and was editor of the Journal of the American Medical Association  from 1924-1949. The quack treatments that he documented have since mostly fallen into obscurity: • 2

Definition
The things naturopaths do that are good are not special, and the things they do that are special are not good. As has been noted, naturopathy doesn't really entail anything very specific, and practitioners can run the gamut from slightly dubious lifestyle counselors to completely crazy germ theory denialists. Nevertheless, there are some positions which can be considered to be quite common among naturopaths as a whole. There is the appeal to nature, which is ubiquitous (although, as "natural" is a pretty vague term, the conception of which therapies are natural or not can vary depending on the practitioner) ; a distrust of vaccines and other "synthetic" products; use of herbs and vitamins; a tendency to prefer exotic, Eastern medicine (the more expensive and obscure, the better!) such as Ayurveda and traditional Chinese medicine (TCM); and the belief that our bodies are full of toxins like lead and mercury, which need to be purged by means of detoxing or chelation therapy. Ironically, Ayurveda and TCM actually consider mercury, lead, arsenic, and asbestos to be legitimate medical remedies, even as naturopaths wholeheartedly recommend these systems of "medicine". In addition, the American Textbook of Natural Medicine lists Unani (in addition to Ayurveda and TCM) as an acceptable form of naturopathic treatment, even though bloodletting and leeching are integral parts of it (even more so than in Ayurveda and TCM).

Quite a few naturopaths seem to have no problem prescribing pharmaceuticals or synthesized supplements, despite the anti-Big Pharma rhetoric of many. Chelation drugs, Benadryl®, colchicine, and various other pharmaceuticals are prescribed by naturopaths on a regular basis. It seems each individual naturopath just arbitrarily mixes and matches "synthetic" and "natural" treatments with no real rhyme or reason, depending on what "feels right". What is a toxic synthetic pharmaceutical for one naturopath may be a perfectly acceptable naturopathic treatment for another. To give just one of many examples, some blast Botox (which, incidentally, is completely natural) as being a horrible poison,  while others use it quite happily.

Principles
The principles of modern naturopathy according to the Association of Accredited Naturopathic Medical Colleges are: These may sound like common sense, but because they are not evidence-based, there is little understanding by naturopaths about what is less harmful or what is more effective. Why, for example do naturopaths eschew vaccines for their invasiveness (generally very safe and effective), but recommend invasive colonics (ineffective and potentially dangerous)? Why are vaccines considered to be unnatural by naturopaths (originally performed with cowpox and a simple lance ) but colonics are considered to be natural (which use plastic tubing and modern plumbing)?
 * 1) The Healing Power of Nature: Trust in the body's inherent wisdom to heal itself.
 * 2) Identify and Treat the Causes: Look beyond the symptoms to the underlying cause.
 * 3) First Do No Harm: Utilize the most natural, least invasive and least toxic therapies.
 * 4) Doctor as Teacher: Educate patients in the steps to achieving and maintaining health.
 * 5) Treat the Whole Person: View the body as an integrated whole in all its physical and spiritual dimensions.
 * 6) Prevention: Focus on overall health, wellness and disease prevention.

Modern treatments
There is no single list of what constitutes naturopathic treatment, but common treatments are covered at accredited naturopathic universities. The list of treatments has changed substantially from the olden days, perhaps because evidence-based medicine is not used there is no clear pathway between evolving treatments as there is in Western medicine. Common diagnostics and treatments include: • 2

Criticism
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.

In our inquiry, 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. Throughout, we found underestimation of the power of the placebo. At the same time, our own bibliographic searches failed to discover any properly controlled clinical trials that supported claims of naturopathy, 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. "Naturopathic medicine" is an eclectic assortment of pseudoscientific, fanciful, and unethical practices. Implausible naturopathic claims are still prevalent and are no more valid now than they were in 1968.

Naturopathic medical school is not a medical school in anything but the appropriation of the word medical. Naturopathy is not a branch of medicine. It is a combination of nutritional advice, home remedies and discredited treatments. … Naturopathic practices are unchanged by research and remain a large assortment of erroneous and potentially dangerous claims mixed with a sprinkling of non-controversial dietary and lifestyle advice.

Universities that teach naturopathic medicine
Accredited naturopathic schools are disguising the naturopathic education of nonsense as a distinct, and better, form of primary care medicine. Sadly, these schools are getting away with what I consider to be education fraud. The truth is that naturopathic education is riddled with pseudoscience, debunked theories, and experimental medical practices.

Bastyr University, which is accredited by the Western Association of Colleges and Schools, offers a Doctorate of Naturopathic Medicine as well as acupuncture and other natural healing degrees. Other accredited universities include &mdash; National College of Natural Medicine, Southwest College of Naturopathic Medicine, University of Bridgeport College of Naturopathic Medicine and Canadian College of Naturopathic Medicine. Education does include actual science (general biology and chemistry, anatomy/physiology, physics etc.) but these colleges generally reject vaccinations or the use of actual medicine. In many states the use of naturopaths is restricted or illegal. Some unaccredited schools also offer "degrees" in naturopathy, including Clayton College of Natural Health; the Trinity School of Natural Health, which is "accredited" by an accreditation mill; and the Natural Healing Institute, which is also "accredited" by an accreditation mill.

In 1987, the Council for Naturopathic Medical Education (CNME) was approved by the US Department of Education as an accreditation agency. In 2001, the approval was withdrawn based on evidence that the CNME "had not responded appropriately to violations of its standards at Southwest College of Naturopathic Medicine and Health Sciences." CNME approval was apparently restored in 2003.

In 2001, Arnold S. Relman, Emeritus Professor of Medicine and of Social Medicine, Harvard Medical School and Editor-in-Chief Emeritus of The New England Journal of Medicine, reviewed the primary textbook on natural medicine, eponymously called Textbook of Natural Medicine, which was then in its second edition. As of 2017, the textbook is in its fourth edition. The textbook has been edited by Joseph E. Pizzorno, Jr. (currently emeritus president of Bastyr University) and Michael T. Murray (former faculty at Bastyr University and currently on its Board of Regents). Relman found serious problems with the textbook, including:
 * Treatment of covered health problems are disorganized and deficient.
 * Recommended treatments are often not likely to be effective, while proven medical treatments are often ignored or deficient. This is so even for serious medical conditions such as heart disease, high blood pressure, epilepsy, HIV/AIDS, syphilis, asthma, tuberculosis, and meningitis.

Licensing
As of 2017, several states and territories within of the United States, and every province in Canada, license naturopathic physicians. Legislation is pending in several other states within the US. Britt Marie Hermes provides a guide to legislation of naturopathy in US states and Canadian provinces. According to Hermes, as of 2015 Arizona has the "broadest naturopathic scope of practice" and "may be the worst-case scenario of any state licensing pseudoscience as medicine." Problems in Arizona include:
 * Naturopaths have used dangerous treatments under the guise of pseudo-research with the cover of private naturopathic institutional review boards.
 * Naturopaths have the ability to write prescriptions for Schedule II drugs, which include opiates and amphetamines.
 * Naturopaths can perform minor surgery.
 * Naturopaths can administer substances intravenously.

There are currently seven colleges and universities that offer a "ND" ( Not Doctor Doctor of Naturopathic Medicine) degree in North America.

Diagnostic practices
The following is an example of naturopaths trying to make diagnoses based on a case study that was presented at the Institutional Review Board of the International American Naturopathic Clinical Research Institute/Naturopathic Oncology Research Institute/International Naturopathic Clinical Research Institute.

In real medicine, case studies are intended to have an educational purpose, either for medical students or for fellow-doctors; case studies are used to determine a proper diagnosis, differentiate between possible diagnoses and/or to determine a proper course of treatment. Naturopaths also use case studies, but they often look amateurish; compared to medical case studies, they often lack detail and focus. To compare the case below to an actual medical case study, see for example "Case Study in Del(17p) Chronic Lymphocytic Leukemia".

Note that all the "Dr."s below are actually NMDs (Naturopathic Medial Doctors) — not actual medical doctors.

At the end of this discussion, we still have no idea about what condition the NMDs thought was important to treat. There were no clear explanations on why any of the proposed treatments would be useful. And, there was no consensus on how to treat the patient. One is left to wonder whether each naturopath had their own pet treatment that they always recommended, and just happened to be offered at their own clinic.

Why do people see naturopaths instead of real doctors?
According to Hermes, medical doctors have historically struggled with making people feel heard, particularly women and people of color. In contrast the naturopoathic experience tends more towards empathy and learning about how people feel. To overcome this, medical doctors need to have a good bedside manner, to make patients feel like they've been heard and that they have the ability to make choices based on the medical evidence and the tools available to them (e.g. pharmaceuticals or lifestyle changes).

How naturopathic medicine can work
In some cases naturopathic medicine has an effect, because it is an unrefined proto-medicine such as willow bark (unrefined aspirin) or foxglove (unrefined digoxin). In many other cases, it works because of either regression to the mean (people naturally get better sometimes) or the placebo effect. It is known for example that some types of placebos are more effective than others. In the treatment of pain, for example, big, dark-colored, bad-tasting placebos are more effective than small, brightly colored, good tasting ones; placebos delivered intravenously are more effective than placebos delivered intramuscularly, which in turn are more effective than placebos delivered orally. Expensive placebos are likely to be more effective than inexpensive ones. So there are several ways that naturopaths are enhancing the placebo effect — counsciously or not — using non-evidence-based but possibly-effective logical fallacies: Despite being fallacious, these aspects of naturopathy can be effective because the placebo effect is primarily psychological, not physiological. Placebos may make you feel better, but they will not cure you. They have been shown to be most effective for conditions like pain management, stress-related insomnia, and cancer treatment side effects like fatigue and nausea.
 * Appeal to ancient wisdom — This treatment has been used since ancient times, so it must work.
 * Appeal to nature — Natural medicine is claimed to be better and/or less harmful.
 * Argument from authority — That ancient book on herbal medicine says that this works.
 * Argumentum ad baculum — That dry needling hurts worse than acupuncture: it must work! That slapping therapy hurts like fuckall: it must work!
 * Argumentum ad fastidium — This herbal medicine tastes awful (just like real medicine ), so it must work.
 * Sunk cost — This medicine costs a bomb: if it doesn't work I'll be out all that money and still be sick! Some supplements can be marked up an extraordinary 1600%+ — particularly galling for something that has an extremely long shelf-life.