Emunctorology: Synthesising Traditional Naturopathic Practice with Modern Science

Introduction

The concept of the emunctories, the organs of elimination, has been a component of traditional medicine since the Greco-Roman Period. The concept has been incorporated into traditional medicine practices throughout our recorded history, up to and including modern naturopathic medicine. The conception of Emmuctorology is much more recent and took place at the First International Editorial Skamania Retreat of the Foundations of Naturopathic Medicine Project in 2007.¹ Specifically, it arose in a breakout group of educators discussing the limitations of teaching the classical body systems relied on by conventional medicine. There was a general consensus that multi-system synthesis, such as psycho-neuro-immunology, was more representative of the naturopathic approach to the human body and made it easier to both teach and learn. During this discussion, Emunctorology was born, a multi-organ synthesis of the naturopathic approach to elimination synthesized with modern clinical and basic science. At the end of the discussion, the idea ignited in the larger plenary group when the break-out group reported. Within weeks a sponsor provided an untethered academic grant to develop an educational program which has now been taught in a number of North American Universities. It is obviously an idea whose time has come.

Definition

Emunctorology is a synthesis of traditional naturopathic medicine practice and modern science that provides a multisystem construct allowing the integrated study of the organs of elimination (the emunctories), their functional relationships, the role they play in maintaining normal physiology (homeostasis) through the elimination of waste material and toxic substances, the pathophysiology that occurs if the emunctories function sub-optimally or are diseased, and the clinical strategies that are used in modern naturopathic medicine to treat, nourish, tonify, stimulate and sedate the emunctories in the maintenance of good health.

Creating a Synthesis

The term emunctories come from the Latin root, ēmungere, for wiping or cleansing, and describes an organ or duct that removes or carries waste from the body. The etymological evolution into modern Italian, emungere, the verb ‘to drain’ is more indicative of the term’s modern use. The etymological relationship between the origins of the term mucous and emunctories finds a relationship to its use in modern naturopathic medicine. Emunctories describes organ or ducts with the physiological function that involves draining or removing waste materials from the body.

An important traditional concept in naturopathic medicine is that illness may result from the accumulation of potentially noxious waste products. Lindlahr noted that “Kuhne, the German pioneer of Nature Cure, claimed that ‘disease is a unit’ that it consists in the accumulation of waste and morbid matter in the system.”² Restated in modern scientific idiom, Kuhne postulated that underlying all disease is the accumulation of both toxins and abnormal organic material (which would include cells and cellular components). The corollary of this postulate which forms the basis of nature cure is that the elimination of toxins and abnormal organic material is an important part of the healing process. The Reverend Dr. Bronby noted in 1882 that these wastes, which include imbibed toxins, endogenous toxins and exhausted blood corpuscles, are dealt with by the emunctories on a constant, involuntary basis.³ The emunctories function to eliminate both the waste produced by the thirty thousand billion body cells and the exogenous toxins absorbed from the environment either deliberately or involuntarily. Dr Guenoit considered the emunctories as important to the condition of health as food and digestion.⁴

Emunctorology explores the complex processes by which the body rids itself of toxic substances or waste products and how the emunctories function to eliminate that which does not benefit the organism as a whole. Traditionally, the emunctories were divided into primary and secondary roles. The primary emunctories, classically, the bowel, kidney, lungs and skin, are the most efficient routes of elimination. When these are not functioning optimally, the body will attempt to compensate and use the secondary emunctories, including the stomach, liver, pancreas, spleen, lymphatic system, prostate and mucosal surfaces. These secondary emunctories are not as efficient at elimination as this is not the primary function of these organs or tissues. Consequently, when the primary emunctories are not functioning optimally, the secondary emunctories may also become perturbed and respond with a generalized inflammation. A chronic systemic inflammation therefore suggests to the naturopathic physician poor elimination through primary emunctories. This inflammatory state can present as a generalized fever with or without an inflammatory condition affecting specific emunctories such as bronchitis, colitis, vaginitis, sinusitis, eczema or gastritis.⁴

The basic functions of those excretory organs herein termed emunctories have been understood for some time. The overall role of the GI tract, the kidney, the lungs and the skin in elimination and excretion of both exogenous and endogenous toxins is well known. What is not very well understood is the interplay between these different organ systems and the early indicators of dysfunction or sub-optimal organ function. The functional disturbance of the emunctories has been a core component of naturopathic practice theory. In contrast, it is not a core concept within conventional medicine and there is surprisingly little known about the etiology and early natural history of deficits in these organ systems.⁵ It is the naturopathic view that normal homeostatic (perhaps better termed homeodynamic) mechanisms are singularly dependent upon the proper functioning of all the emunctories (the organs of elimination), and that a dysfunction in one will affect the function of another and, moreover, may result in a cascade of deficits and dysfunctions, including fatigue, leaky gut syndrome, vasculitis, chronic infections, pruritis, joint pains, migraines among others.⁶ The end-result may be systemic inflammatory responses and potential multiple systems dysfunctions. Lindlahr considered the accumulation of poisons (toxins) and morbid matter (abnormal organic materials) to be amongst the primary causes of disease and that their elimination was essential for health.²

The Future

The emunctories are a complex and highly integrated physiological system, upon whose structural and functional integrity our health is vitally dependent. It is hoped that Emunctorology, the integration of the traditional thinking about the emunctories synthesized with modern scientific understanding, research and discoveries can provide a tangible benefit to educators and students; and through our future clinicians to our patients and the global community.⁷