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.