Restoring the Healing Paradigm

Abstract

Throughout the recorded history of Western medicine, 2 apparently contradictory paradigms have competed for dominance. One sees health and disease as dependent on the function of the body, while the other sees the body as making mistakes and the victim of a hostile environment. The first leads to the physician prioritizing promoting health, while the other sees the physicians as an interventionist fighting disease. The apparent inherent incompatibility of these 2 paradigms has been foundational to centuries of conflict between the various schools of medicine. This is a false dichotomy—our patients need both.

In an Ideal World, All Decisions About Medicine Would Be Based on Objective Science

In an ideal world, all advancement in medicine would be based on unbiased scientific evaluation. The best ideas would continue to evolve, while those found deficient would at best end up only in history books. Unfortunately, the real world of politics and vested interests seriously distorts and undermines the process of optimally evolving health care. Further impairing understanding is that each side almost only sees the other’s mistakes or failures. Conventional doctors see patients whose disease has progressed because of “unscientific” and ineffective “natural” interventions. Those on the other side see patients whose disease has progressed because of “scientific” interventions that primarily alleviate symptoms while allowing the underlying actual causes of disease to continue unabated. But perhaps the biggest challenge is fundamental disagreement on what should be the criteria for success.

A number of types of disease have obviously valid measures of success, and conventional medicine must be honored for incredible success in many of these. The examples are obvious: emergency medicine saving the life and limbs of the person crushed in an accident, antibiotics saving the life or organs of a person overwhelmed by a highly aggressive microorganism, the newly born with congenital deformities kept alive, providing insulin to the child with type 1 diabetes whose pancreas no longer functions—the list is long. Unfortunately, in the real world of the vast majority of illness modern societies suffer, the accepted measures are far less valid and much more susceptible to philosophical perspectives on how health and disease are defined.

There are many examples where the commonly prioritized measures obfuscate important understanding of the best ways to think about and care for patients. A good example is type 2 diabetes. If the measure of success for treating diabetes is safe blood sugar levels, then the conventional approach of first metformin and later insulin when it stops being effective makes sense. But if the criterion is restoring the body’s own ability to maintain proper blood sugar control, then these drugs are at best a short-term benefit. I have extensively shown in my editorial in volume 15, issue 4, “Is the Diabetes Epidemic Primarily Due to Toxins?”¹ that diabetes is not due to a deficiency of metformin. No, I am not being facetious! Well, a bit—but trying to make an important point. When the underlying causes are not addressed, the disease progresses relentlessly. Which is what we are seeing with the chronic disease epidemics—as predicted by the founders of naturopathic medicine a century ago. (This is well documented in the history and philosophy chapters in the Textbook of Natural Medicine.²)

If instead the approach is to understand what disruption of normal physiological function is causing loss of normal blood sugar control, intervention requires asking very different questions. Is the person deficient in the nutrients required for glucose tolerance factor? Are their insulin receptor sites being poisoned by phthalates?³ Or perhaps their public water supply is high in arsenic which damages the pancreas?⁴ For most chronic conditions, the body is not making a mistake requiring interventionist drugs. No one has a deficiency of metformin. Rather the body can’t function the way it evolved to because we changed to a diet that is depleted in required nutrients and an environment that is polluted with ever-higher levels of toxins that poison enzyme systems.

If blood sugar levels are the appropriate measure of type 2 diabetes treatment, then metformin is a good treatment and validation of the interventionist model. But if blood sugar control is the measure, metformin actually contributes to the underlying causes of insulin resistance by making the pericellular space more acidic, which decreases insulin sensitivity. But worse, the underlying causes—like blockage of insulin receptor sites by phthalates for example—are not addressed, so the disease progresses—AS WELL AS EVERY OTHER PHYSIOLOGICAL DAMAGE INDUCED BY THESE TOXINS.

These issues go even further and can be applied to the areas where conventional medicine is clearly very effective—but incomplete. For example, after a serious accident, what is done to support the body’s inherent repair processes that need higher amounts of many nutrients? Another is not applying the research showing that low levels of vitamin D greatly increase susceptibility to type 1 diabetes, which can be reduced with supplemental vitamin D. Further, why are children diagnosed with type 1 diabetes not immediately giving niacinamide to help prevent further damage? How about addressing the causes of the immune impairment that allowed an infectious agent to flourish? Even the congenital abnormalities also need to be addressed by the healing side of the paradigm wall. What can be done to improve areas with limited function? What is done to prevent the next child experiencing the same problems?

In the real world we function in, we see a lot of unnecessary conflict and misunderstanding. The conventionals assert patient cures from natural medicine treatment are spontaneous remissions (which certainly is quite fascinating considering what it says about the innate healing power), while the naturals assert that many medical successes are little more than symptom suppression.

However, as can be seen in the previous discussion, both paradigms are necessary for not only the patient’s immediate needs but for long-term health. Further, the health care crisis will not be solved by either paradigm alone.

Hygeia and Asclepius

As near as I can tell, in the Western world, the first historic indication of these competing philosophies of medicine were articulated with the Greek traditions of the god Asclepius and the goddess Hygeia. (Yes, Greek history buffs, I am definitely simplifying—making a point here rather than retelling history.) I think we achieve some insight when we consider the Greco-Roman concepts of Hygeia and Asclepius. Hygeia was the goddess and personification of health (Greek: ὑγίεια - hugieia), cleanliness, and sanitation. She was about the promotion of health and wellness in the patient. Asclepius, in contrast, promoted the doctor as the interventionist in control and eradicating disease. Hygeia gets closest to my definition of natural medicine as the promotion of health and reversal of disease through the support of the body’s innate healing powers. It is not about the source of the treatment, the name of the profession, or arcane philosophical strictures. It is about treating the person, not the disease, with what they uniquely need. But let’s not forget that bacterial pneumonia is a real disease that has a life of its own. Simply helping the immune system function more effectively is rarely adequate when the disease has progressed so far. We cynically critique conventional medicine with the adage, “The treatment was a success, but the patient died.” Is “We religiously followed our ‘natural medicine’ principles but the bacteria won” any better? On the other hand, simply killing the bacteria without dealing with the causes of the pneumonia is still not good medicine.

With the restoration of naturopathic medicine and the emergence of functional and integrative medicine, the healing paradigm of medicine is remerging and certainly has captured huge and growing public interest. I believe understanding the origins of the healing perspective, how it was kept alive in the culture (despite relentless persecution) and the ways this concept is evolving in clinical practice is hugely important to advance this medicine.

To My Naturopathic Sisters and Brothers

We have every right to honor and celebrate our forebears who, despite huge personal cost, fully embraced, evolved, and kept this medicine alive during over a century of active oppression. We are the most knowledgeable and clinically skilled in the full expression of this medicine. AND we do not own the truths of medicine, as they are fundamental laws of nature. AND just as many in the integrative and functional medicine communities have learned from us, we have also learned from them. My own story is illustrative. Clearly, as a student and new doctor in the 1970s, I learned the foundational concepts and natural therapies of this medicine from Dr John Bastyr and many other dedicated natural healers. AND my understanding and skills progressed substantially from the monthly study clubs with Dr Jeffery Bland—who taught us sophisticated nutritional biochemistry, and of Dr Jonathan Wright (with huge contributions from Dr Alan Gaby), who taught us how to apply to real cases. ND, DC, PhD, MD, MD.

In 1974, when I was a third-year student, the Washington State Supreme Court made a decision that basically nullified the practice in one of the few states sill licensing NDs. Struggling with whether or not to stay in school, I asked Dr. Bastyr if there was a future to this medicine. His response was elegant (paraphrasing Shakespeare) and prophetic: “No matter the obstacles they place, the truth of our medicine will out.”

Colleagues, this is about the truth of the medicine. As a whole, we as a profession are the most advanced in the truth of the medicine. But many other individuals have also seen this truth, which they have done their best to learn, advance, practice and teach. We are colleagues, not competitors. There are far too many sick people, and the health care crisis is only getting worse. Yes, they have unfair licensing and insurance advantages. So let’s fix this regulatory disparity, not isolate ourselves from our natural allies.

Summary

This editorial was a huge challenge for me to write. I started from the perspective of a journal editor wanting to ensure that the history of the development of these ideas was presented as accurate as possible. As I saw what we were learning, I realized I had a bigger obligation: to be sure the naturopathic medicine professional was treated honorably for heroically keeping these concepts alive despite huge oppression AND to properly recognize the many philosophically aligned non-NDs who contributed so much to advancement of this medicine. I could finally finish this editorial when I realized I did not have to get the whole story and its implications written completely now. Rather, this will be an ongoing process, the first step in an important journey.

I invite you to walk with me and George Cody (see below) to explore the origins of the ideas that make up this medicine we are creating/recreating together. As we understand where our foundational concepts came from and how they evolved, I think we will find not only a lot of common ground, but how we can collaborate to finally fully restore the healing paradigm side of medicine. And eventually, I hope the artificial schism between Hygeia and Asclepius will be healed and the health care crisis cured.

In This Issue

We begin an important new column, “Origins of a Transformative Medical Paradigm,” by George Cody. As has been said, “The victors write the history books.” This column will present in the course of several issues the largely unknown story of the courageous pioneers who worked to advance the healing paradigm that forms the foundation of natural/holistic/functional/integrative medicine. Thirty years ago, George wrote the first modern history of naturopathic medicine for the Textbook of Natural Medicine.² Over the years, he has continued to research the area, adding a second chapter about 10 years ago. As he discovered new sources of historical documents, we had fascinating discussions about the untold and misunderstood history of natural medicine. As I developed a better understanding of the origins of many of the foundational concepts, I realized IMCJ readers would likely find interesting as well. As we will see, the profession that most fully embraced this model and these thinkers and kept it alive in the culture was naturopathic medicine. However, no profession owns these ideas. They are foundational truths of nature that need to be understood and embraced by all health care professionals.

With the exception of a few brave academic historians, the full story of the health-oriented paradigm has not been told. In addition to the professions being suppressed, even historic mention was suppressed in conventional history books. Are our ideas that dangerous?

Over the millennia, insightful researchers, clinicians, and health-conscious consumers have worked, often in academically and regulatory hostile environments, to understand and evolve the health promotion side of these medical paradigms. IMCJ will continue to actively explore these ideas and now we will also document their origins and the special, courageous people who advanced them.

Readers of IMCJ are strongly encouraged to let us know about the underrecognized pioneers who had a big impact on your understanding of this medicine that you want to be sure are properly included and honored.

When reading George’s summary of the pioneers of this medicine, please remember that while they had remarkable clinical insights, their descriptions and explanations were limited by the primitive state of the sciences of anatomy, physiology, biochemistry, and pathology of their time. Regular readers of my editorials in IMCJ will be aware that I have explored many of these ideas from the perspective of modern science. Thus far, with only 1 exception (which I have not yet published, as I am still working through the research and implications), they have been consistently validated.

In “The Natural Roots of Functional Medicine,” associate editor, Jeffrey S. Bland, PhD, tells the fascinating history of the conceptual origins of functional medicine and the foundation of the Institute for Functional Medicine. As you read this in context with George Cody’s first column, I think you will join me in being excited that this history is finally being written.

John Weeks pays tribute to Josephine Briggs, MD, for her decade-long dedication to leading and advancing the National Institutes of Health National Center for Complementary and Integrative Health (NCCIH). He also critiques the drift while she was there from researching systems of healing to the much less important study of individual therapies. I especially appreciate John’s Top 10 from 2017.

Managing editor, Craig Gustafson, interviewed Lyn Patrick, ND, about “The Burden of Organophosphates and Glyphosate.” This is important, fascinating, and very worrisome. As an educator, there is little more gratifying than seeing a person who was once a student become a leader in her field. With Lyn, this actually started before my founding of the then named John Bastyr College of Naturopathic Medicine. In spring quarter 1978, an enterprising group of students from Evergreen State College in Washington State decided to dive deeply into understanding “unconventional” medicine in a course they titled “Is There a Healer in the House (ITAHITH)”. For faculty, they recruited evergreen professor, Betty Kutter, PhD; Jeff Bland, PhD; and yours truly. It was a remarkable 12 weeks and produced a number of leaders in this field.

I was so excited when we received the submission from Cynthia Ann Leaver, PhD, APRN, FNP-BC; Hang Yuan, PhD; and Gwenyth R. Wallen, PhD, on the apoptotic activities of Sanguinaria canadensis. While we do not normally publish cell culture studies, I made an exception in this case due to my own clinical experience. In my early days of practice in the 1970s, I specialized in women’s health and natural childbirth. One of the key interventions I learned from my mentor John Bastyr, DC, ND, to help women restore cervical health included as part of the protocol Sanguinaria to help slough off their precancerous cells. I helped many women go from class III—and one with class IV—PAPs to totally normal. Took several months, but no cervical scaring or progression to cervical cancer. And, of course, I worked with the women to improve every aspect of their diet and lifestyle. But, as typical for so many natural protocols, while there appeared excellent clinical success, there was no research evaluation. Delighted to see the research foundation developing.

We continue our comprehensive series on probiotics by Keren E. Dolan, MS; Jessica M. Pizano, MS, CNS; Crystal M. Gossard, MS, CNS; Christy B. Williamson, MS, CNS; Cathleen M. Burns, MS, RD; Margaret G. Gasta, MS, RDN, CCN; Heather J. Finley, MS, RD, LD, CEDRD; Emily C. Parker, MS, RD; and Elizabeth A. Lipski, PhD, CNS, CCN, BCHN, IFMCP. Gastrointestinal and genitourinary disorders are the focus of this part.

Very consistent with our theme of integrated care being best for the patient is a case report of “Unexpectedly Long Survival of Patient With Chronic Lymphocytic Leukemia,” by Gregory Haskin, MS; and Mikhail Kogan, MD.

I continue to be very receptive to nonpharmacological interventions to promote health, reduce pain, and increase psychological wellness. Can’t get much more natural than walking in a forest as described to us in the research letter from Alison Edwards, MSc, and Victor Woods, MES. As more and more of the population moves to crowded, noisy, toxic cities, reconnecting with nature has never been more important. I think especially interesting their differentiation of the clinical effects of sympathetic versus parasympathetic exercise.

Associate editor, Bill Benda, MD, finishes this issue with heartfelt guidance for his burned-out colleagues. To his “take a walk in nature” I (a nature’s-path physician) would add, start practicing the curative medicine we advance in this journal. I think the cognitive dissonance makes the stress of being a conventional physician much worse.

Joseph Pizzorno, ND, Editor in Chief

drpizzorno@innovisionhm.com

http://twitter.com/drpizzorno

Biography