Naturopathic Medicine and the Sociology of Knowledge
David Schleich, PhD
The “natural medicine” family tree has innumerable roots and branches. The complexity of those limbs makes it increasingly important to settle on a definitional framework that makes sense to the political, social and educational professionals observing the growing practice of naturopathic medicine and its modalities. As more healthcare and higher education professionals across a variety of disciplines pay attention to the social construction of naturopathic medicine in North America, scholars in various disciplines are looking for reliable definitions of what our medicine is. They want to understand better its essential characteristics as they try not only to locate it in civil society, but also to understand where it came from and why.
For example, Richenda Power’s book, A Question of Knowledge(2000), adds a surprising dimension to the growing, complex discussion around defining naturopathic medicine. Power’s work is actually a social scientific inquiry into knowledge itself, part of an emerging literature on the sociology of knowledge (Bourdieu, 1990; Cant and Sharma, 1996; Foucault, 1974; Fox, 1989; Kuhn, 1970; Leslie, 1980; Power, 1998, 1999; Sharma, 1992; Stacey, 1988, 1992; Woolgar, 1988; Yawney, 1991).
Origins of “Naturopathy”
Many scholars have provided input into this long-standing conversation. Cody, for example, explains that the term “naturopathy” can be traced back to the teachings and concepts of Benedict Lust (Cody, 1985). He explains that naturopathy or nature cure is “both a way of life and a concept of healing employing various natural means of treating human infirmities and disease states” (p. 17). Two decades later, Smith and Logan point out that naturopathic medicine is a “unique system of primary healthcare that is not limited to a single modality of healing and cannot be identified with any one therapeutic approach” (2002, p. 173).
In an editorial in The Naturopathic and Herald of Health, Benedict Lust himself in 1902 explained that naturopathy was “purposely a hybrid word.” Alluding to the therapeutic practices of nature-cure doctors, homeopaths and other healthcare practitioners such as Connaro (nutrition and fasting), Priessnitz (hydrotherapy), Woerishofen (the Kneippcure), Kuhne (serotherapy), Macfadden (physical medicine), Willmans (mental science) and finally A.T. Still (osteopathy), Lust proclaimed a “new medicine” whose scope would encompass every “life-phase of the id, the embryo, the fetus, the birth, the babe, the child, the youth, the man, the lover, the husband, the father, the patriarch, the soul” (1902, p. 4). Lust had been especially interested in the hydrotherapy principles and practice of Sebastian Kneipp. However, Lust called his new and eclectic naturopathy the “medicine of the future.”
Smith and Logan indicate that the actual term “naturopathy” came from a word coined by German homeopath John Scheel. Dr. Scheel, it is reported, formed the word from a combination of Latin and Greek “to translate literally as nature disease.” The term, then, is an actual misnomer, but now widely describes an approach to natural medicine encompassing an eclectic group of therapies. Smith and Logan take care to explain that the understanding of “naturopathic medicine” and “naturopathy” varies among many geographic locales and regulatory jurisdictions.
In 1902, Lust had a practice that focused principally on medical herbs, hydrotherapy and exercise. He began to promote the concept and term “naturopathy” from a professional platform as a licensed osteopathic physician. To these therapies he gradually added homeopathy and “manipulative therapies.” Noteworthy is that Lust quickly abandoned his earlier investment in a string of “Kneipp societies” in Manhattan, Brooklyn, Boston, Chicago, Cleveland, Denver, Cincinnati, Philadelphia, Columbus, Buffalo, Rochester, New Haven, Minneola (Long Island), New Mexico, San Francisco and elsewhere (Wendel, 1951). The definition of naturopathic medicine was a moving target from the outset.
While Bloomfield explains that “naturopathy for some people means allthe forms of non-allopathic medicine which depend on ‘natural’ remedies and treatments” (Bloomfield, 1983, p. 116), Twaddle and Hessler (1987) insist, “American naturopathy appears to be an heir of the Thomsonian, eclectic and homeopathic movements.” At the same time as Lust was promoting naturopathy, Andrew Taylor Still was promoting osteopathy and D.D. Palmer was establishing chiropractic aggressively across America. As well, Henry Lindlahr, a German-born naturalized American, was establishing a sanitarium in 1903 in Elmhurst, Ill., along with the Lindlahr College of Natural Therapeutics.
Evolution of the Definition
Our medicine would continue to evolve for the next hundred years, and conversations about its nature and impact ultimately and inevitably began to move across disciplines. These early filaments of a social definition of naturopathy have even begun emerging in a broader academic discussion about not only the nature of the medicine, but also as part of an effort to define knowledge itself. For a variety of reasons, Power chose “holistic medicine” as one key example of a “body of knowledge in the process of construction” (p. 24). She concluded that “knowledge is embodied but not individualized, is public and personal at the same time, and deeply political” (p. 11). Power observed that because holistic medicine as a body of knowledge was in the process of being formed, ideas about “medicine, science and people would be on display and thus would be available as data” (p. 24). Using the word “holism” as a kind of barometer of the formation of a word within a system of knowledge, she triangulated patterns of usage of the word by specific groups.
Bourdieu (1990) identifies what Power was attempting. In his view, this is the “real task of the sociologist in describing the logic of the struggles over words” (p. 55). Bourdieu explains that Power is trying to identify who “appeared to be ‘formally’ constructing holistic medicine, and who was left out” (p. 29).
Power’s methodology is fascinating for those interested in exploring various definitions of complementary and alternative medicine. Power reviewed textbooks in psychological medicine, psychosomatic medicine, medical practice (specifically doctor/patient relationships) and holistic medicine itself. She included newspapers, magazines and journals in her review as well. She journeyed through texts emerging from the British Holistic Medical Association, the Research Council for Complementary Medicine, and turned to the ASLIB (a libraries directory) to amplify the search.
As early as 1984, she had discovered that the ASLIB did not recognize or utilize the terms “holistic medicine,” “complementary medicine” or “alternative medicine.” Although she took the trouble to study a list of library current holdings in the same year, which revealed no major relevant pattern, she did discover that during the same period a majority of dictionaries used in the health and medicine fields were indicating “an emergence of a body of knowledge and also thereafter of changing perceptions of holistic medicine” (p.32).
Power’s work eventually points out “a sudden emergence of the word ‘holistic’ as applied to medicine and healthcare.” She adds that there was “evidence of a general conflation of the labels ‘alternative,’ ‘complementary’ and ‘holistic’ ” by 1984 (p. 127). Significantly, within a few years, the U.S. profession at Rippling River itself had declared a definition that had wider circulation than previously. And today, the Foundations of Naturopathic Medicine (FNM) project is codifying the knowledge of a profession that is increasingly part of the fabric of modern life and knowledge.
David Schleich, PhD is president and CEO of NCNM, former president of Truestar Health, and former CEO and president of CCNM, where he served from 1996 to 2003. Other previous posts have included appointments as vice president academic of Niagara College, and administrative and teaching positions at St. Lawrence College, Swinburne University (Australia) and the University of Alberta. His academic credentials have been earned from the University of Western Ontario (BA), the University of Alberta (MA), Queen’s University (BEd) and the University of Toronto (PhD).
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