Definitions matter. I was at a Naturopathic Conference in Calgary, Alberta a few years ago. It had the usual monotonous and dull talks given by a few well intentioned speakers. One of the highlights of the conference was when Dr. Jacob Schor got up to speak. He started with the provocative but candid disclosure that he suffered from the same existential crisis that most naturopaths grapple with. He said it was inherently difficult to define exactly what naturopathic medicine is. He made the quip that naturopathic medicine is sort of like pornography. You know what it is when you see it, but it is really hard to define what it is. I chuckled when I heard this, but then I realized it was kind of true. 

Knowing your history and past is important to know where you are going in the future. 

The ancient Greek philosopher and physician Hippocrates is considered to be the father of naturopathic medicine upon which the core tenets are based. 

The German catholic religious clergyman Sebastien Kneipp was seen as the father of naturopathic medicine in Europe. He popularized the use of hydrotherapy, hot and cold treatments. 

Benedict Lust is considered to be the father of naturopathic medicine in North America. He learned techniques from Kneipp. He established schools of naturopathy. He integrated various forms of drugless therapies including diet considerations, herbal medicine, and homeopathy.

There have also been other individuals, including names like Bastyr, Boucher, Carroll, Jensen, Kellogg, Lindlahr, and many others too numerous to list here, who followed and practiced naturopathic medicine in darker times and kept the movement alive. 

After the publishing of the infamous Flexner Report by the Carnegie Foundation in the early 1900’s, and the introduction of penicillin and other drugs in the 1940’s, there was a decline in the acceptance of naturopathic medicine. In the 1980’s and beyond there has been a dramatic resurgence into the use of naturopathic medicine as a healing modality throughout North America. 

I started naturopathic school at Bastyr College (nee University) in 1987 at the wide-eyed age of 22 years old after graduation from the University of British Columbia in Vancouver. I was book smart but naïve to what the principles of naturopathic medicine meant. All I knew was I wanted to be a doctor and help people. I was passionate about sciences, but I wanted a vocation that integrated personal interaction with people. I was eager to learn, young and impressionable.

The constraints and limitations of naturopathic school prevented me from getting a lot of real-world experience. I graduated with the tools, but I really didn’t know how to use them. After graduation I spent a lot of time and resources taking courses and seminars that expanded my knowledge and repertoire. Although I learned a lot in school, I would come to realize in later life that experience is often the best teacher. It gives you the test first and the lesson afterwards. 

A Naturopathic Oath as listed by AANMC or American Association of Naturopathic Medical Colleges states: “I dedicate myself to the service of humanity as a practitioner of the art and science of naturopathic medicine. By precept, education, and example, I will assist and encourage others to strengthen their health, reduce risks for disease, and preserve the health of our planet for ourselves and future generations. I will continually endeavor to improve my abilities. I will conduct my life and practice of naturopathic medicine with integrity and freedom from prejudice. I will keep confident what should not be divulged. I will honor the principles of naturopathic medicine: First, to do no harm. To cooperate with the healing powers of nature. To address the fundamental causes of disease. To heal the whole person through individualized treatment. To teach the principles of healthy living and preventative medicine. With my whole heart, before these witnesses, as a doctor of naturopathic medicine, I pledge to remain true to this oath.”

Does a personal or institutional ideology supersede the basic tenets of medical practice? I don’t think so.

Medicine is the science and practice of caring for patients, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease. Medicine involves practitioners who use medicines which are chemicals to treat disease. Without being too rhetorical, medicine is also an art and healing is obviously more than just the interaction of chemicals.   

Most practitioners would agree that the purpose of medical practice is to prevent disease, pain and suffering. 

Medicines are chemicals or compounds that are used to cure, halt or prevent disease, ease symptoms, and help in the diagnosis of illnesses. Advances in medicines have enabled doctors to treat many diseases and save countless lives.

Chemistry makes up medicine. Chemistry is the study of matter, analyzing its structure, properties, and behavior to see what happens when they change in chemical reactions. Compounds from drugs, plants and other natural sources have a specific chemical structure that determines its actions and behavior in biochemical reactions. The interaction of chemicals provides a biochemical and physiological understanding of how the human body functions. 

Acetaminophen or paracetamol is the most popular OTC or over-the-counter drug used for pain in the world. This compound is a six-carbon benzene ring with two small r-groups attached. Acetaminophen was originally derived from crude oil or coal tar. More recently it has been synthesized from a similar compound found in poplar trees called para-hydroxybenzoate. Does this make acetaminophen natural? This question could be applied to any number of drugs and medicines derived from plants and other natural sources. 

Fifty to sixty percent of drugs have been isolated or derived from plants. Many drugs have been isolated from plants and other herbs and have then been synthesized in mass by the pharmaceutical industry. Aspirin from willow bark, digitalis from foxgloves, metformin from rue, colchicine from autumn crocus, atropine from belladonna, L-dopa from mucuna beans, ephedrine from ma huang, menthol from peppermint, reserpine from rauwolfia, penicillin from mold, theophylline from cocoa, and caffeine from coffee. 

Licenced naturopathic doctors have been allowed to prescribe most approved pharmaceutical drugs in British Columbia since 2009. This expanded scope of practice includes antibiotics, anti-inflammatories, and analgesics, hormones with the exception of testosterone and dhea. This reserved right has helped me become a better doctor and serve my patients better. I can use many naturally-derived drugs to assist the inherent healing power in the body.  

If the purpose of a doctor is to help sick people get better, then the more tools I have to use in diagnosis and treatment, the better. If I ascribe to a particular belief or philosophy that places limits on these tools I use and the approach I take, then that is limiting and perhaps not in the best interest of the patient.

Nothing is permanent except change. Over time, things change, evolve and adapt to new circumstances. The same can be true of medical practice. New diseases and illnesses emerge. New medicines and treatments are discovered.  

As naturopathic medicine grows in contemporary times it is advantageous that it incorporates practices that ultimately help the patient get better. You can still be true to your roots and still be loyal to the basic tenets and philosophy of naturopathy. It is how you use the medicine and principle involved in prescribing it that also determines whether it is “natural or not.” 

There is an old indigenous saying that says “even though there are many paths through the forest, they all lead to the same place on the other side.” 

One thing I have learned in more than 30 years of practice in naturopathic medicine, is that there are many ways to do things. By this I mean that there are many forms of treatment that are not mainstream or conventional. I like to think I follow an evidence-based medicine approach in terms of treatment that incorporates the best available practices. This can mean integrating plant derived chemicals now used as drugs. A drug is defined as any chemical substance that when consumed causes a change in the organism’s physiology. Many foods, plants, and plant-derived chemicals can be drugs. They can be natural because of their origin and natural in how they are used. If a drug is used to assist the inherent healing power of nature, then I suppose it is natural.  

I suppose sometimes natural medicine can be a bitter pill to swallow.