David Schleich
As the naturopathic profession forms more enduringly in North America than it was able to in the last century, the debate about the place of science in the naturopathic medical education institution’s curriculum continues …
The “yearning” that many of the “minor professions” experience in their professional schools – namely, a “yearning for the rigor of science-based knowledge and the power of science-based technique” (Schon, p. 9) – is well documented. For example, Bastyr University took a position early in its institutional formation to be committed to science-based medicine on a foundation of respect for traditional modalities. Its motto, “where nature and science meet,” attempts to capture this blend. There are those naturopathic physicians, though, who lament the demise of “pure nature-cure” in the evolving training paradigm of the naturopathic physician. C.D. Howell’s work (1984) describing mainstream medical doctors as elite largely because of the development of scientific medicine is helpful to us as we try to understand not only the nature of this debate, but also the accompanying tension in the naturopathic community.
Robert Duggan, co-founder of the Traditional Acupuncture Institute in Columbia, MD, also captures the flavor of that tension:
“In Baltimore, Wolfe St. runs between two groups of buildings: The Johns Hopkins Medical School on one side of the street, representing the finest in medical skill and technology, and the Johns Hopkins School of Public Health on the other, symbolizing a humanistic, community-based approach to healthcare. When differences between the two schools were more pronounced than they are now, people joked that Wolfe Street was the widest in the world. Our culture needs a blend of what’s on both sides of that street.” (Duggan, 1995, p. 241)
A Complete Look at the Naturopathic Field
In any case, building on the work of earlier scholars (Inglis, 1965; Lindlahr, 1975; Mitchinson, 2002, Cody, 1985; Coulter, 1973; Pinsky, 1985; Pelletier, 1979; Collins, 1985; Gevitz, 1988), Smith and Logan (2002) have summarized succinctly the philosophical principles, modalities, primary professional and educational requirements, and accreditation arrangements for naturopathic medicine: “one of the most widely regulated complementary healthcare professions in North America” (p. 177). Their snapshot includes a crisp look at the place of bio-medical science in that continuum. Others move more deeply into the layers of content and methodology in naturopathic medical training.
Gevitz (1988), for example, contends that there are “three competing and rather different ways of viewing alternative medicine: the orthodox, the unorthodox and the scholarly” (p. 2). His perspectives on quackery and how unorthodox – or what Baer (2001) calls heterodox – practitioners defend themselves are useful discussions within the literature of professional formation and the history of medicine. Another writer, Rothstein (1972), provides a thorough grounding in Thomsonism, “the first important challenge to orthodoxy in the United States” (p. 42). His review of medical practices in colonial, 18th– and 19th-century America, and of the contributions of the early eclectics such as Scudder from the Thomsonian herbalists and from practitioners of physio-medicalism, is a practical platform from which to understand the eventual launch of naturopathic medicine by Lust at the dawn of the 20th century in New York City, and helps us see why the race to implement bio-medical sciences took root in some corners of the health professions and not in others after Flexner. The key messages in Rothstein’s work lie in his identification of the conditions that led to the institutionalizing of social and medical movements, characteristics of which institutionalizing of popular discontent are present in the institutional memory of our current naturopathic colleges a century later.
A Philosophical Look
Whorton’s work is also especially helpful for us in understanding some of the philosophical underpinnings of the naturopathic field, including the place of science in that platform. He writes, “the best medicine of all is prevention instead of cure, and prevention is most effectively practiced by the patient instead of the doctor” (cited in Gevitz, 1988, p. 52). Whorton goes on to say that the role of science is not given first priority in such a paradigm and that “principles such as these have inspired any number of unorthodox health reformers over the past century and a half” (p. 52). For example, his survey of the Grahamite, Kellogg and Fletcher health reformers, who espoused a “positive state of health far above mere absence of disease” (cited in Gevitz, 1988, p. 68), puts the student of medical education history in mind of the manifestos and other publications of the American Association of Naturopathic Physicians and its Canadian counterpart, the Canadian Naturopathic Association.
Susan Cayleff’s documentation of the development of hydrotherapy (1987), Kaufman’s extensive summary of homeopathy (1971) and Gevin’s examination of the development of osteopathy (1988) are valuable sources of information about key modalities in the naturopathic repertoire, and all address the place of science in the core learning outcomes. Kenneth Pelletier’s exhaustive survey of CAM therapies (2000) also includes descriptions and definitions of alternative therapies and systems, including mind/body medicine, dietary supplements, phytonutrients and hormones, traditional Chinese medicine, acupuncture, western herbal medicine, naturopathic medicine, homeopathy, chiropractic, ayurvedic medicine and yoga, and spirituality and healing. Commenting on the origins of naturopathic medicine, Pelletier writes:
“Naturopathy particularly emphasizes the adage ‘do no harm’ by stressing the use of interventions that are largely free of side effects rather than pharmaceutical medicines and surgery. Naturopathy is one of the oldest forms of medicine known to humankind, tracing its roots to the healing techniques of ancient China, India and Greece, and to Native American cultures. It weaves these healing traditions together with modern scientific principles and technology.” (Pelletier, 2000, p. 178)
Pelletier further comments that “naturopathic medicine has gained increasing respect not only from American healthcare consumers, but also from government bodies and from the conventional medical community” (p. 198), and that naturopathic physicians are “the best prepared of all CAM practitioners for integration into the mainstream,” because of their “broad training in complementary and alternative practices, as well as in biomedical sciences” (p. 198).
In part 8 of this series, we continue to review the tone and extent of the science-vs.-nature debate in the formation of naturopathic medical education standards and practices.
References
Baer HA: Biomedicine and Alternative Healing Systems in America: Issues of Class, Race, Ethnicity and Gender, Madison, 2001, University of Wisconsin Press.
Cayleff SE: Wash and Be Healed: The Water Cure Movement and Women’s Health, Philadelphia, 1987, Temple University Press.
Cody G: History of naturopathic medicine. In Pizzorno J, Murray M (eds.), Textbook of Natural Medicine, Seattle, 1985, John Bastyr College Publications.
Coulter HL: Divided Legacy: The Conflict Between Homoeopathy and the American Medical Association, Berkeley, 1973, North Atlantic Books.
Collins D: Colon therapy. In Pizzorno J, Murray M (eds.), A Textbook of Natural Medicine, Seattle, 1987, John Bastyr College Publications, pp. III: ColonT-1-10.
Duggan RM: Complementary medicine: Transforming influence of footnote to history?, Alternative Therapies, 1(2):28-32, 1995.
Gevitz N (ed.): Other Healers: Unorthodox Medicine in America., Baltimore, 1988, The Johns Hopkins Press.
Howell CD: Elite doctors and the development of scientific medicine. In Roland CG (ed.), Health, Disease and Medicine: Essays in Canadian History, Toronto, 1984, Hannah Institute for the History of Medicine, pp. 105-22.
Inglis B: A History of Medicine, Cleveland, 1965, World Publishing Co.
Inglis B: The Case for Unorthodox Medicine, New York, 1965, Putnam.
Lindlahr H: Philosophy of Natural Therapeutics. Proby J (ed and rev), Essex, 1975, C.W. Daniel Company Ltd.
Mitchinson W: Giving Birth in Canada: 1900–1950, Toronto, 2002, University of Toronto Press.
Pelletier KR: The Best Alternative Medicine, New York, 2000, Simon & Schuster.
Pinsky L: Philosophy of naturopathic medicine. In Pizzorno J, Murray M (eds.), A Textbook of Natural Medicine, Seattle, 1987, John Bastyr College Publications, pp. I: Philo2-1-2-7.
Rothstein W: American Physicians in the 19th Century: From Sects to Silence, Baltimore, 1972, Johns Hopkins Press.
Schon D: Educating the Reflective Practitioner. San Francisco, 1987, Jossey-Bass Publishers.
Schon D: Knowing in action. The new scholarship requires a new epistemology, Change Nov/Dec, 27-34, 1995.
Smith MJ and Logan AC: Naturopathy. Complementary and Alternative Medicine 86(1):Jan. 173-84, 2002.
Whorton JC: Crusaders for Fitness: The History of American Health Reformers, Princeton, 1982, Princeton University Press.
Whorton J: The first holistic revolution: alternative medicine in the nineteenth century. In Stalker D, Glymour C (eds.), Examining Holistic Medicine, Buffalo, 1985, Prometheus.
Whorton J: Drugless healing in the 1920s: the therapeutic cult of sanipractic. Pharmacy in History, 28:14-25, 1986.
David Schleich, president of Truestar Health, is the former CEO and president of Canada’s accredited Canadian College of Naturopathic Medicine, where he served from 1996 to 2003. His 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).
