MEDICINE Re­liance on vi­tal forces leaves its prac­tices based on be­liefs without sci­en­tific back­ing

Vancouver Sun - - WEEKEND REVIEW - Peter McKnight

I“We be­lieve in the Vi­tal Force which has in­her­ent or­ga­ni­za­tion, is in­tel­li­gent and in­tel­li­gi­ble . . . Our way is to re­search the mys­tery and beauty of the life force, in which we have faith.” — Amer­i­can As­so­ci­a­tion of Natur­o­pathic Physi­cians Con­ven­tion;

Townsend Let­ter for Doc­tors f you re­ally want to up­set peo­ple, there’s noth­ing like at­tack­ing their faith. And the faith of natur­opaths and their pa­tients is cer­tainly the sub­ject of at­tack, given the B.C. gov­ern­ment’s plans to grant natur­opaths the au­thor­ity to pre­scribe cer­tain drugs.

Crit­ics, when they’re be­ing kind, sug­gest that there is in­suf­fi­cient ev­i­dence of the ef­fi­cacy of many natur­o­pathic in­ter­ven­tions.

When they’re not be­ing kind, crit­ics charge that natur­opa­thy is sim­ply so much pseu­do­sci­en­tific quack­ery.

Since many, though not all, of th­ese crit­ics are physi­cians, they’re in­evitably ac­cused of prop­a­gat­ing a turf war, of try­ing to keep the prac­tice of medicine to them­selves. Natur­opaths, such as B.C. Natur­o­pathic As­so­ci­a­tion pres­i­dent Christoph Kind, claim that “natur­o­pathic medicine is sub­stan­ti­ated by vo­lu­mi­nous re­search” and that “the sci­en­tific ed­u­ca­tion and train­ing that natur­o­pathic physi­cians re­ceive is no dif­fer­ent than the sci­en­tific train­ing med­i­cal doc­tors re­ceive.”

Con­se­quently, natur­opaths ar­gue that their prac­tices are a valid com­ple­ment to the prac­tices of med­i­cal doc­tors, though they’re not par­tic­u­larly com­pli­men­tary of medicine, which they of­ten ac­cuse of plac­ing pa­tients’ health in jeop­ardy.

A typ­i­cal state­ment in­dica­tive of this be­lief is found on the BCNA web­site: “Many natur­o­pathic pro­to­cols have re­sults sim­i­lar or equal to stan­dard med­i­cal treat­ments, but without the ad­verse ef­fects and risks.”

In ad­di­tion to dis­play­ing a cer­tain hos­til­ity to­ward medicine, this state­ment is self-re­fut­ing, for, as physi­cian Stephen Bar­rett says, “Any med­i­ca­tion (drug or herb) po­tent enough to pro­duce a ther­a­peu­tic ef­fect is po­tent enough to cause ad­verse ef­fects.”

It’s also easy to re­fute the all too fre­quent claims about the “vo­lu­mi­nous re­search” sub­stan­ti­at­ing natur­o­pathic prac­tices sim­ply by re­view­ing the lit­er­a­ture.

While some natur­o­pathic ther­a­pies, such as clin­i­cal nutri­tion and herbal treat­ments, have been sub­ject to study, there is lit­tle sci­en­tific sup­port for many other com­monly used pro­ce­dures, in­clud­ing home­opa­thy, hy­drother­apy and iri­dol­ogy.

And if there were ev­i­dence for such pro­ce­dures, then how would natur­opa­thy be dif­fer­ent from medicine?

In­deed, if the ev­i­dence ex­isted, one would ex­pect medicine to ab­sorb such ther­a­pies, much as it ab­sorbed prin­ci­ples of pre­ven­tive medicine, which natur­opa­thy, to its credit, has long em­pha­sized.

But then we would not have natur­o­pathic and con­ven­tional medicine — we would just have medicine. The dis­tinc­tion natur­opaths like to high­light is philo­soph­i­cal. As Kind put it, “it is the phi­los­o­phy be­hind the ap­pli­ca­tion of [the] sci­ence that dif­fer­en­ti­ates natur­o­pathic doc­tors (NDs) and med­i­cal doc­tors.”

Un­for­tu­nately, though, that very phi­los­o­phy ef­fec­tively de­stroys natur­opa­thy’s pre­ten­sions of be­ing sci­en­tific.

One pu­ta­tive philo­soph­i­cal dif­fer­ence, of­ten em­pha­sized by natur­opaths, we can write off from the start is that medicine tar­gets symp­toms while natur­opa­thy fo­cuses on re­mov­ing the cause of ill­ness. That this isn’t true is ev­i­dent from medicine’s use of im­mu­niza­tions, some­thing many natur­opaths view with sus­pi­cion.

This hos­til­ity to­ward vaccines does, how­ever, lead us to the an­ti­sci­en­tific phi­los­o­phy of natur­opa­thy. As William Jarvis, for­mer pro­fes­sor of pub­lic health and pre­ven­tive medicine at Loma Linda Uni­ver­sity says, natur­opa­thy’s sus­pi­cion of im­mu­niza­tions arises from doubts about the germ the­ory of dis­ease: “They be­lieve that vi­tal­is­tic forces are ul­ti­mately re­spon­si­ble.”

Natur­opaths like to trace their his­tory to Hip­pocrates and the doc­trine of “vis med­i­ca­trix nat­u­rae.” Al­though Hip­pocrates never used this phrase or its Greek equiv­a­lent, he did stress that liv­ing or­gan­isms pos­sess within them the “heal­ing pow­ers of na­ture,” in an ef­fort to purge Greek medicine of its be­lief the gods were re­spon­si­ble for health and ill­ness.

Th­ese heal­ing pow­ers took on a life of their own, and came to form the ba­sis of a phi­los­o­phy known as vi­tal­ism, which posits the ex­is­tence of “vi­tal forces,” mys­te­ri­ous and mys­ti­cal forces pos­sessed by all liv­ing or­gan­isms. In fact, it was th­ese vi­tal forces that were be­lieved to dis­tin­guish liv­ing from non-liv­ing mat­ter, and they be­came as­so­ci­ated with the four hu­mours (yel­low bile, black bile, phlegm and blood) in west­ern medicine and chi or prana in east­ern medicine.

An im­bal­ance of th­ese forces was be­lieved to be the cause of ill­ness, hence it was the physi­cian’s job to re­bal­ance them. This led to west­ern prac­tices such as bleed­ing pa­tients with an im­bal­ance of blood, and east­ern prac­tices such as acupunc­ture, which sup­pos­edly re­bal­ances the flow of chi.

Vi­tal­ist the­o­ries were also pop­u­lar in bi­ol­ogy and chem­istry, but sci­en­tific de­vel­op­ments — in par­tic­u­lar the germ the­ory of dis­ease and the de­vel­op­ment of the mi­cro­scope, which al­lowed for cel­lu­lar anal­y­sis — soon spelled the end of vi­tal­ism.

In ret­ro­spect, it’s as­ton­ish­ing that vi­tal­ism held sway for so long since it never ex­plained any­thing. On the con­trary, vi­tal­is­tic forces stood as a kind of marker for our ig­no­rance — in our in­abil­ity to ex­plain life sci­en­tif­i­cally, we sim­ply posited the ex­is­tence of a mys­te­ri­ous life force, some­thing sci­en­tif­i­cally un­ex­plain­able.

In aban­don­ing re­liance on weird meta­phys­i­cal forces and com­mit­ting it­self to a mech­a­nis­tic, ma­te­ri­al­is­tic re­search pro­gram (that is, to sci­ence), mod­ern medicine has made great strides in im­prov­ing health and elim­i­nat­ing dis­ease. But natur­opa­thy, which likes to boast of its long his­tory, seems stuck there.

In­deed, one look at natur­o­pathic lit­er­a­ture re­veals that long af­ter sci­ence con­signed vi­tal­ism to the dust­bin, be­lief in the life force lives on.

On the web­site of the Amer­i­can As­so­ci­a­tion of Natur­o­pathic Physi­cians, for ex­am­ple, we find a state­ment which posits the or­der­li­ness of na­ture and then con­tin­ues, “This de­pend­able or­der­li­ness is be­lieved to be guided by a kind of in­ner wis­dom that every­one has. This in­ner wis­dom can be as­sisted to re­turn a per­son to their best bal­ance by natur­o­pathic treat­ments.”

Not to be out­done, the web­site of the Cana­dian As­so­ci­a­tion of Natur­o­pathic Doc­tors speaks of home­o­pathic reme­dies, stat­ing: “When care­fully matched to the pa­tient they are able to af­fect the body’s ‘vi­tal force’ and to stim­u­late the body’s in­nate heal­ing forces on both the phys­i­cal and emo­tional lev­els, with few side-ef­fects.”

Given this re­liance on vi­tal forces, it’s not sur­pris­ing that natur­opaths are big be­liev­ers in tra­di­tional Chi­nese medicine and its em­pha­sis on the chi.

The CAND web­site there­fore states the fol­low­ing: “The chi of all or­gans must be in bal­ance, nei­ther too ac­tive nor too dor­mant, for a per­son to be healthy. The chi of the body’s or­gans and sys­tems are all con­nected in merid­i­ans or chan­nels that lie just un­der the skin. A natur­o­pathic doc­tor will use east­ern herbs and acupunc­ture to as­sist the body in reg­u­lat­ing the chi and achiev­ing bal­ance.”

Af­ter mak­ing th­ese un­sci­en­tific and anti-sci­en­tific state­ments, the CAND web­site nev­er­the­less states that “the natur­o­pathic pro­fes­sion rec­og­nizes the value of re­search and seeks to make ap­pro­pri­ate uses of sci­ence.”

But ev­i­dently aware that natur­opa­thy is not sci­ence, it speaks of the “chal­lenge” of find­ing ap­pro­pri­ate re­search method­olo­gies to in­ves­ti­gate natur­o­pathic prac­tices.

Of course, no sci­en­tific method­olo­gies will be forth­com­ing be­cause the life force is not a sci­en­tific con­cept. It’s an ar­ti­cle of faith, and one that ap­peals to many peo­ple pre­cisely be­cause it speaks to the ex­is­tence of some­thing greater than that which sci­ence can in­ves­ti­gate.

And that means that natur­opa­thy can never be­come sci­en­tific, un­less it aban­dons the very be­lief that makes it so pop­u­lar.

The de­bate be­tween doc­tors and natur­opaths has been rag­ing in Bri­tish Columbia since the pro­vin­cial gov­ern­ment an­nounced plans to let natur­opaths pre­scribe some drugs.


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