Naturopathy

What is Naturopathy?

The term naturopathy was first coined by the American John Scheel in 1896 and later popularized by the naturopath Benedict Lust, although the basic ideas of naturopathy date back to the earliest communities (Zeff, Snider & Myers, 2006). The ancient Greeks knew of the role of nutrition in maintaining health for example. Hippocrates (460-370 BCE) is associated with the concept of food as medicine; an observation which instigated a new era in medicine, for until the time of Hippocrates it was believed that disease was caused by offending the gods. Hippocrates argued that disease was actually due to a lack of attention to eating habits, lifestyle choices and environmental factors. He began a paradigm shift in medical thinking and is known to this day as the Father of Medicine. The Hippocratic philosophies were developed by the important medical scholar Galen (129-216 CE), physician to the emperors.

Galenic theory was constructed around the concept of what was oddly referred to as the six non-naturals. These were things which were ‘non-natural’ in the sense that they are not innate to health; so each individual had some influence over them. The non-naturals are air and environment; food and drink; sleeping and waking; motion and rest; retention and evacuation and the emotions (Berryman, 2012; Donato, 2017). An imbalance in the non-naturals could lead to the development of contra-naturals i.e. pathological symptoms. These concepts influenced medicine for over a thousand years, yet they also underpin modern naturopathic theory.

As well as influencing the development of Western medicine the Galenic theories became central to Arabic medicine (Unani Tibb) and Indian medicine (Ayurveda) which are both still widely practiced to this day. Many major medical theories from Hippocrates to Galen and beyond were later consolidated by the Persian scholar Avicenna (980-1037) in his Canon of Medicine where they later found influence in monastic medicine under the Franciscans and Benedictines. According to Chishti (1990) the Middle Eastern system of Unani Tibb would cross-pollinate with Western thinking and later form the basis of the Nature Cure movemen in Europe.

The origins of naturopathy in modern times begin with the fledgling Nature Cure movement in Austria. Vincent Priessnitz (1799-1851) developed a system called hydropathy using water as a remedial agent. The use of water for healing has a long history but it was Priessnitz who refined the method. His water cures at Graefenberg in Silesia became legendary, yet his fame brought with it accusations of quackery as he was otherwise untrained in medicine. He was publicly attacked by the medical orthodoxy, but following a letter of high recommendation from Baron Turkheim to the imperial cabinet in Vienna in 1838 Priessnitz was given a license to practice medicine. According to his biographer Richard Metcalfe, Priessnitz was the first person who had not attended medical school to be given such an honour (Metcalfe, 1898). His patients would include monarchs, dukes and duchesses, and as his legend spread the use of hydrotherapy became popular while the philosophy of nature cure began to flourish.

The nature cure philosophy was further advanced by the Bavarian priest, Fr Sebastian Kneipp (1821-1897). Kneipp had cured himself of tuberculosis using the theories of Preissnitz by regularly bathing in the icy cold waters of the River Danube. At the monastery of Wörishofen Kneipp used herbal medicine, exercise regimes and nutrition alongside hydrotherapy to treat local villagers without charge. His cures and generosity became renowned and soon his patients included Pope Leo XIII and Archduke Franz Ferdinanz (whose later assassination would lead to the start of WW1). Kneipp wrote a number of books, in particular My Water Cure (1886) ran to 33 editions! Essentially it was his combination of fresh air, regular exercise, hydrotherapy, herbal medicine and nutrition which echoed the ancients but also formed the bedrock for modern naturopathy.

Kneipp, and his contemporary Johan Schroth who had studied clinical nutrition as a therapy, traveled to America and influenced the beginning of the fledgling naturopathy movement there. Pioneers such as John Harvey Kellogg (1852-1943), inventor of the original Corn Flakes, set up a laboratory at Battle Creek Sanitarium during the 1880s, to study the clinical application of hydrotherapy and Nature Cure philosophy. The publication of his book  Rational Hydrotherapy in 1902 became the first scientific account of water cure. (A fictionalized Kellog and his ideas are gently mocked in the 1994 Alan Parker film The Road To Wellsville based on the novel by T. Corraghessan Boyle). Isaac Jennings (1788-1874), Sylvester Graham (1794-1851), Adolph Just (1853-1939) and especially Louis Kuhne (1823-1907) were also important figures in the rise of the naturopathic movement.

Louis Kuhne, a strict vegetarian, wrote that disease can only arise as a consequence of wrong food (Kuhne, 1917). In 1895 Christiaan Eijkman, stationed in Indonesia where he had been sent to investigate Beriberi disease, had discovered the significance of what he dubbed an ‘anti-beriberi factor’ present in brown rice yet not available in white rice. Later his anti-beriberi factor came to be known as vitamin B1 and it was realised that beriberi was actually caused by a deficiency of this essential vitamin. The processing of food, in this case rice, showed how foods could lose important nutrients. The role of nutrition began to develop as a science in its own right.

We know that many of the concepts developed by the early naturopaths were not entirely new. Ideas about water therapy and nutrition date back to the ancient world but new ideas were also advanced. Samuel Hahnemann (1755-1843), a German medical doctor and surgeon, grew increasingly antagonistic to the overzealous and dangerous use of bloodletting, drastic purging and toxic drug therapies commonly used in 19th century practice. He felt ‘heroic medicine’ as it was known did more harm than good and quit his practice in 1784. He became a writer and translator and while translating the work of the medical scholar William Cullen (1710-1790) he became interested in the use of Cinchona bark to treat malaria.

Hahnemann later experimented with cinchona and found that it brought on the symptoms of malaria in an otherwise healthy individual. From his experiments homeopathy was developed, based on the concept that ‘like causes like’ (simila similibus). Controversially he found that it was the administration of almost imperceptible doses created through a process of dilution and succussion that were most effective. Homeopathy became very popular especially in India and the United States. Its simplicity was contrasted with the protocols of general medical practice at the time such as bloodletting, purging and use of what were later discovered to be highly toxic substances such as the mercury-containing calomel, which definitely did do more harm than good!

Another new, and again unorthodox, practice was developed by the Hungarian Ignaz Von Peczely (1826-1911). Iridology, a study of iris signs and their connection to pathology, was certainly very subjective and immediately drew scorn from the medical establishment.

Many of these natural therapies and concepts developed at a time when orthodox medicine itself was beginning to consolidate into the institution it is today. The development of quick-acting drugs like aspirin (originally derived from plant sources by the Bayer corporation in 1897 incidentally) saw the rise of a modern medical establishment alongside the fledgling pharmaceutical industry. Insulin was isolated in the 1920’s. Antibiotics and penicillin came into vogue in the 1930’s. Biomedicine became the major medical paradigm.

The system of prescription drugs became commonplace. Yet research into these new pharmaceutical drugs was primitive until advancements in molecular biology and pharmacology became more considered. The branding and patenting of new drug products as a means to withstand a very competitive market allowed pharmaceutical companies rapid growth and influence. In part this was due to corporate culture in answer to the demands of public healthcare systems from the 1890s onwards (Liebenau, 1988). The new drug culture, initially unregulated, pushed itself under the banner of ‘science’ and pointed the finger at what it considered the quackery and pseudoscience of the Nature Cure movement. The question of what exactly ‘science’ is has dogged both philosophers and scientists for centuries.

Naturopathic medicine would always have its detractors. Writing as early as 1854 the naturopath J. Clawson Kelley commented: “it would seem that the principal variations made in the theories of physicians have arisen from a desire to overthrow the popularity of each other; but with little regard, if any, to the remedies likely to prove the most useful in disease” (Kelley, 1854).

Naturopathic medicine now encompassed a number of methods and schools of thought such as hydrotherapy, nutritional therapy, homeopathy, osteopathy and chiropractic, each of which established its own followers and leanings (Baer & Sporn, 2009). Naturopathy was the name used by Benedict Lust from 1902 onwards as a unifying term. Lust came to see the old-school nature cure of Priessnitz and Kneipp as a ‘distant cousin’ of modern naturopathy. Dr Andrew Weil later wrote that naturopathy emerged slowly and without clear definition from an informal grouping of people who shared certain beliefs about health and medicine (Weil & Rosen, 1983). Although Lust spoke out against ‘pseudo-naturopaths’ the various schools of thought would later unravel and some such as osteopathy and chiropractic shaped their own traditions and later found mainstream acceptability.

If hydrotherapy and nutrition were the most developed fields of naturopathy, the role of exercise was given prominence by the American naturopath Bernarr McFadden (1868-1955). His system of physical education culture gave birth to the world-wide phenomena of gymnasiums and individualistic exercise programs involving nutritional diets for bodybuilding and health. He also popularized the concept of fasting, and is noted for referring to bread as ‘the staff of death’. He wrote and published over 100 books and magazines and his clients included Rudolf Valentino, Clark Gable and Franklin D Roosevelt. McFadden’s publications were also popular in Britain where he opened the first sanitarium in Brighton in 1909. A student of McFadden’s, Stanley Lief, would later come to prominence for establishing naturopathy in the UK.

Benedict Lust (1872-1945) was the first modern campaigner for naturopathy however. A tireless advocate, he traveled extensively across the US, establishing the first naturopathic schools and lobbying for recognition of naturopathy as a bona fide medical philosophy (Zeff, Snider & Myers, 2006). Lust described his philosophy as ‘therapeutic universalism’, encompassing the many ideas of nature cure into an eclectic whole. He himself had been cured of tuberculosis during his early years in Munich by Sebastian Kneipp (Whorton, 2002). Kneipp used hydrotherapy and plant medicines and it was Kneipism especially that Lust originally hoped to emulate when he arrived in New York City in 1896. Lust used Kneipp’s methods alongside nutrition, massage and osteopathy. The formation of the Naturopathic Society of America and the American School of Naturopathy in 1902 consolidated his efforts (Baer & Sporn, 2009).

Naturopathy’s central tenet is that there is a natural healing force in everyone – the vis mediacatrix naturae – the healing power of nature. This healing force encourages our bodies to strive towards homeostasis and self-healing. The principle use of natural therapies (Lust’s therapeutic universalism) is to encourage this process. Illness is a result of living against rather than with natural phenomena and therefore the theory of prevention, by living more in tune with nature, became a mainstay of naturopathic philosophy. This concept was advanced by the naturopath Henry Lindlahr (1862-1924). Lindlahr, who also held a medical degree, is considered the first to give a greater scientific grounding to naturopathic principles. He posited in his Philosophy of Natural Therapeutics that our internal environment could accumulate ‘morbid matter’ through poor diet and lifestyle and in turn this created ‘the soil’ for opportunistic  pathogenic microbes such as bacteria, virus and fungi (Lindlahr, 1924).

This idea was not new. The French scientist Antoine Béchamp (1816-1908) had argued much the same; that our ‘biological terrain’ created the ideal conditions for microbes to thrive. He wrote that the primary cause of disease is “in us, always in us” (Béchamp, 1885). However a contemporary of Béchamp, one Louis Pasteur (1822-1895), argued that humans caught disease by contagion. Legend has it that on his deathbed Pasteur confirmed the insights of Béchamp, yet his Germ Theory had already significantly altered the course of modern medicine. Destroying or creating immunity to an infectious agent seemed a reasonable hypothesis after all. Pasteurization of foods to kill off microbes soon became commonplace, and yet it also changed the nature of foods.

Benedict Lust called Pasteur’s germ theory the most gigantic hoax of modern times, reaffirming that infection was an effect and not a cause (Whorton, 2002). If a group of people in a room is exposed to influenza why is that everyone doesn’t catch the flu? What caused some people to be immune? The naturopaths argued that correct nutrition and lifestyle were what gave us immunity, creating conditions in the body in which microbes could not thrive. Lindlahr, summing up the difference between naturopaths and regular physicians, wrote “There are two principal methods of treating disease. One is the combative, the other the preventive” (Lindlahr, 1914).

The use of vaccination also became more popular around the same time. An earlier process called variolation, in use in China from around the 16th century, had exposed children to small pox via the nostril where the virus would encounter an innate immune response. The children would then  build immunity after a brief and benign illness (Plotkin & Plotkin, 2004). Naturopaths also argued that it is early exposure that allows the body to build immunity. Vaccination was different in that it introduced the disease organism intravenously directly into the tissue, rather than via the respiratory tract or the digestive system where the body’s immune system could build resistance to it. The naturopaths began speaking out against vaccination. Indeed almost all orthodox medical theory at the time was rejected by them, which of course won them little favour among the ascendent medical orthodoxy.

Lindlahr had described naturopathy as a complete revolution in the art and science of living (Lindlahr, 1924). The naturopaths had studied and developed systems of living within natural laws in all areas of life. They challenged orthodox viewpoints, often vehemently and antagonistically, while concepts such as vegetarianism, drugless therapy, communal living and free schooling often went against the grain. But it is also fair to say that there was quackery, charlatanism, pseudo-religion and even racial prejudice among some advocates of the new movement alongside those who were developing more coherent clinical therapies. This is often used to tarnish the naturopathic movement as a whole, a generalization still rolled out by lazy critics to this day.

Benedict Lust formed schools, communities and a professional association but by the time of his death in 1945 naturopathy was in decline. The decline can be traced back in part to the infamous Flexnor Report of 1910. Abraham Flexner (1866-1959) of the Carnegie Foundation was tasked with examining the situation of medical education throughout America. He visited some 155 schools before producing his highly biased report which emphasized the importance of a scientific basis for medicine while condemning any school which didn’t meet with the dominant medical paradigm he had been employed to promote (Cook, Irby, Sullivan & Ludmerer, 2006). The report sent shock waves through the medical community at large. The central premise of the report was that analytical reasoning and reductionist drug therapy should form the bedrock of medical education. This went very much against the more holistic concepts of the naturopaths whose drugless therapy was anathema to the now dominant medical establishment whose dubious association with a growing pharmaceutical industry also raised serious questions.

It is interesting to note that the Flexner Report was created through a partnership between the American Medical Association (founded 1847), the Carnegie Institute (founded 1895) and the Rockefeller Foundation (founded 1910) which had considerable pharmaceutical affiliations at the time. The partnership, which later included the German pharmaceutical giant Bayer, worked extensively to undermine drugless therapies. Today the Rockefeller Foundation owns approximately half the pharmaceutical interests in the US (Lisa, 1994; Fraser & Beeston, 2010). The development of modern biomedicine coincided with the rise of the pharmaceutical industry, and alongside the enforced decline of naturopathy and herbal medicine.

Naturopathy’s decline can also be traced in part to a lack of cohesion among naturopaths themselves. Naturopathy had so many different techniques, from osteopathy and chiropractic to hydrotherapy and nutrition, under its collective banner that it seemed a convenient blanket term rather than a cohesive medical system per se. In-fighting and it’s own antagonism towards pharmaceutical companies, whose commercial influence had gained the ear of politicians, only furthered their fracturing. The schools of chiropractic and osteopathy, more therapeutically defined, went their own way though some still retained naturopathic principles and practices. This did not mean the end of naturopathy as the philosophy had already spread far and wide. The Universal Naturopathic Directory published in 1919 was a directory of naturopathic practitioners running to over 1400 pages which showed just how widespread the practice had become (Lust, 1919).

In Scotland James Thomson (1887-1960), a student of Lindlahr, founded the Edinburgh School of Natural Therapeutics in 1919 which would last until 1964. A 1932 publication listed 116 practitioners in Great Britain and Ireland who were affiliates of the Nature Cure Association of Great Britain and Ireland, the British Association of Naturopaths or the Society of British Naturopaths (Baer & Sporn, 2009). These organisations merged in 1945 into the British Naturopathic Association founded by Stanley Lief.

Stanley Lief (1890-1962), of Latvian descent, had an apparently incurable heart condition as a child but on discovering a publication by Bernarr McFadden he was able to cure himself with the techniques he learned. He went to the US to train with McFadden studying naturopathy, chiropractic and osteopathy. Lief eventually came to Britain and set up his own private practice following WW2. He established Champney’s Resort at Tring in Hertfordshire and edited the magazine Health For All from 1937-1960. Lief founded the British College of Naturopathy in 1949. Along with the Ayurvedic practitioner Dr Dawachand Varma he developed neuro-muscular technique (NMT) in the early 1930’s and is remembered as the key figure in establishing both naturopathy and osteopathy in the UK (National Osteopathic Archive, 2013).

In India the theories of nature cure were an inspiration to Mohandes K Gandhi (1868-1948). Gandhi, world-renowned for his activism and pursuit of truth, wrote often of the importance of living in tune with nature. His book Nature Cure compiled various writings on the subject in sections in which he discussed the use of the elements water, earth, air and fire – as healing modalities. Inspired in part by Louis Kuhne, Sebastian Kneipp and Ayurvedic tradition he describd his own personal experiences, and how he later helped found a nature cure clinic at Poona in India specifically to teach the poor. He wrote:

My Nature Cure is designed solely for villagers and villages. Therefore, there is no place in it for the microscope, X-rays and similar things. Nor is there room in Nature Cure for medicines, such as quinine, emetin and penicillin. Personal hygiene and healthy living are of primary importance. And these should suffice. If everyone could achieve perfection in this art, there could be no disease. (Gandhi, 1954).

Back in the United States naturopathy although in decline by 1945 had not disappeared. Dr John Bastyr (1912-1995) was noted as the the figure who not only revived naturopathy but gave it a greater scientific basis. He first trained as a chiropractor and later gained a degree in Surgery, Obstetrics and Internal Medicine, He was awarded a naturopathic diploma (ND) in 1957 after his residency. He practiced obstetrics at the Thomson Maternity Hospital from 1940-1968. From 1956 he was teaching obstetrics and gynecology at the National College of Natural Medicine (NCNM) where he later became professor emeritus. In 1987 he began the first of two terms on the Washington State Department of Health Naturopathic Advisory Board. Bastyr is credited with modernizing naturopathy by sound clinical observation and scientific scrutiny.

Several graduates of the National College of Natural Medicine – Joseph Pizzorno, Leslie Griffith and William Mitchell – founded the Bastyr University, named after their mentor in 1978, dedicated to amalgamating traditional and evidence-based naturopathy – ‘where science meets nature’. They instigated a paradigm shift in naturopathy by encompassing empirical research and orthodox medical techniques with sound biochemistry in their pursuit of understanding the influence of diet and lifestyle on health. The 6 non-naturals of Hippocrates had come full circle. In some ways this also led to a parting of the ways between those who considered themselves ‘traditional’ naturopaths, in isolation from the mainstream and the new trend of medical naturopathy (Baer & Sporn, 2009).

In the early 1970s Archibald Cochrane (1909-1988) had established the philosophy of evidence-based medicine (EBM) – that medical decisions should only be based upon evidence gained from research and specifically double-blinded randomized controlled trials (RCTs). It was argued that such a system was designed to eliminate bias. A meta-analysis or systematic review of RCTs could then be used as a benchmark for clinical decision making. EBM was designed specifically for pharmaceutical drugs which target a single molecular pathway and it has been argued that it is an unsuitable system for testing natural therapies because such systems have philosophical and methodological incongruities with it (Hammerschlag & Zwickey, 2006). EBM has even been called an “ideological assault” (Jagtenberg et al., 2006) because it stakes an epistemological claim to medicine.

EBM assumes that evidence does not exist for any intervention unless it has been subject to rigorous trials. And this despite the fact that many natural therapies have been successfully used for centuries. Modern biomedical science follows a particularly linear world view which certainly has its place yet true science must be based on the consideration of all perspectives otherwise it becomes biased and even subjective, the very thing it claims to avoid. Another issue with EBM is to do with external validity – how do the results of a standardised trial actually translate to real world situations?

Renewed interest in holistic philosophies and natural medicines resurfced in the culural melting pot of the 1960. The resurgence of naturopathy since the 1980s has in some ways been more concerned with scientific validation of naturopathic principles by EBM than what Whorton called the “nuts and berries approach of Lust and Lindlahr” (Whorton, 2002). Evidence-based naturopathy seeks to utilize modern scientific methods alongside the ancient traditions of nature cure to form a medical pluralism for the 21st century. As EBM took root in the medical establishment the holistic health movement began to regrow at the same time.

Smith and Logan (2002) define modern naturopathy as “an eclectic form of primary health care that encompasses many complementary modalities in the treatment and prevention of disease. Treatment protocols are integrative in nature, combining the most suitable therapies to address the individual patient’s needs” (Smith & Logan, 2002).

A new and particularly unhelpful term has emerged recently called Complimentary and Alternative Medicine (CAM). The term is unhelpful because it is a lumping together of any system which is outside the biomedical model, meaning that systems such as herbal medicine which have thousands of years of tradition, and indeed formed the bedrock for modern pharmacology, are lumped in with less-convincing therapies. A more useful approach might be to establish more clearly defined schools of thought in medicine (medical models), and in some respects modern naturopathy has attempted to do this.

But why should this be important? The annual sales of natural medicines are beginning to demonstrate a shift away from pharmaceutical products. In 1959 the Thalidomide scandal was the first time serious doubt was raised about pharmaceutical products on scale, when a number of birth defects were associated with the Thalidomide drug. There have been many other instances since the incidence of side-effects from pharmaceutical drugs has become commonplace. Incredibly it has been suggested that iatrogenesis, the incorrect use of drugs and surgery, is a leading cause of death and suffering worldwide (Starfield, 2000; Null, Feldman & Rasio, 2005; Shepherd, Mohorn, Yacoub & May, 2012)! It is also implied by some that ‘disease mongering’ is used by pharmaceutical companies to get people to buy drugs (Monynahan, Heath & Henry, 2002).

This should not be taken as a slur on modern medicine. Drugs and surgery are vital and life-saving in many situations. The problem, ironically, is that many drugs and surgeries have not been trialled according to EBM principles, while the general public are beginning to lose faith in the impartiality of research (Grande & Armstrong, 2012; Seife, 2012) and turning to more natural remedies. In turn this has led the medical establishment to warn of safety issues and the fact that many natural medications have not been tested for safety, efficacy and effectiveness according to the EBM model. Vested interests sponsor internet search engines and wikis to dominate enquiry. There are quite a number of peer-reviewed papers which use the phrase just because it’s natural doesn’t mean it’s safe or some variation of the same, which while certainly true needs to be contrasted with the caveat just because it’s a pharmaceutical drug and the subject of randomized controlled trials doesn’t mean it’s safe either. In fact evidence suggests that natural remedies are much safer in general. Statistics produced by the Alliance For Natural Health illustrate this point (Law, 2012).

In the meantime medical legislation has largely been driven by the EBM model, with restriction on herbal medicines and vitamin supplements in Europe being recently introduced or under consideration, for example the Traditional Herbal Medicine Product Directive (2004) and the EU Food Supplements Directive (2002). Advertising standards also place restrictions on medical claims which cannot be backed up by EBM. One could be forgiven for thinking that the legislation is a deliberate attempt to blur the idea that another medical model might exist. Research has exposed the multiple barriers which may prevent the scientific scrutiny of natural medicine (Veziarai,  Leach & Kumar, 2017). The stifling of debate will not stop the widespread use of alternative medicines however.

People tend to use and reuse things because they work and there are now more and more people leaning towards naturopathic therapies. In Northern Ireland research shows there is increasing use of natural medicines which many find to be effective (McDonough, Devine & Baxter, 2007; McDade, 2008), reflecting general trends elsewhere (Fox, Coughlan, Butler & Kelleher, 2010; Coulter & Willis, 2004; Ernst & White, 2000). Ernst and White (2000) deduce that this surge in popularity means there is an ‘ethical imperative’ to ‘validate’ these therapies as if to suggest that people are incapable of making up their own minds as to whether or not something is safe and efficacious (Ernst & White, 2000).

It is interesting to note that at a time when the healthcare system in the UK is struggling to meet targets within an uncertain economy, the integration of naturopathy could be viable (Baer, 2004). Research from a pilot project in Northern Ireland which allowed GPs to refer their clients to alternative practitioners shows that not only did 80% of patients see improvements to their health but 10 out of 12 GPs surveyed saw a positive role for the potential of naturopathy in primary care (McDade, 2008). Wardle and Oberg (2011) argue that collaborative relationships are also the way forward for research.

Naturopaths are not doctors. We acknowledge the vital role that modern medicine plays in the care of serious medical conditions. At the same time naturopaths have developed an alternative medical model based on a number of principles which can be called holistic and vitalistic:

• First do no harm – the Hippocratic oath
• Vis Medicatrix Naturae – The healing power of nature
• Treat the causes of disease, not the symptoms
• Education is a key element in a therapeutic relationship
• Treat the whole person
• Prevention is better than cure
• Treat the person and not the disease.
• Everyone is unique therefore treatment should be individualised
• Health is more than the absence of symptoms
• Illness is a product of the internal environment

These principles are combined with modern developments in nutrition, hygiene and biochemistry. Skeptics often consider naturopathy to be an antiquated philosophy dominated by pseudoscience and quackery. They are quick to point out ‘lack of research’ and the standard quip ‘just because it’s natural doesn’t mean it’s safe‘ as routine. On the one hand this presupposes that biomedicine has succeeded where naturopathy has failed. Statistics associated with iatrogenesis and increasing rates of cancer and heart disease suggest otherwise.

The skeptics also fail to notice that many naturopathic strategies are indeed evidence-based as a quick glance at peer reviewed literature reveals (Wong, 2012). Wardle and Sarris (2010) have compiled a comprehensive evidence-based guide to clinical naturopathy. They describe modern naturopathy as having two core modalities namely herbal medicine and nutrition applied using a patient-centred approach and an holistic underpinning (Wardle & Sarris, 2010). Although naturopathy embraces science it does not let go of its traditional values. Menzies-Trull (2013) writes naturopathy is a philosophy and system of healing using natural methods of healing and is a patient-orientated medicine. Naturopathy has six pillars of function for the enhancement of the life process; these are fasting, hydrotherapy, diet, light, air and exercise (Menzies-Trull, 2013). In other words the six-non-naturals of the ancients remain a fundamental concept in 21st century medical thinking.

Researchers are also becoming more interested in alternative medicine (Baer, 2002). In 2010 the CAMbrella network launched a pan-European project to work out a road-map for research into alternative medical models that is appropriate for the health care needs of EU citizens, and acceptable to the EU Parliament as well as national research funders and healthcare providers (Weidenhammer et al., 2011). Meanwhile The International Society for Complementary Medicine Research (ISCMR), an international non-profit scientific organization is also devoted to fostering research in this area at an international level (ISCMR, 2013). Naturopathy has come of age.

[This essay is intended as an introduction to the concepts and philosophy of naturopathy. It is not intended to suggest that naturopathy should replace standard medical care. Naturopaths are not doctors. Naturopaths do not treat disease. We treat people. Anyone with a serious medical condition should consult with their doctor. I trained in naturopathy with the College of Naturopathic Medicine in 2004. The ND course has been externally validated by QQI (Quality Assurance Agency) and accredited by BAC (British Accreditation Council).] I am a member of the Association of Naturopathic Practitioners and a Registered Naturopath with the General Naturopathic Council who maintain occupational standards.]

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