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The guiding principle of naturopathic medicine is to encourage the innate healing power of the body. This is not a hard concept to understand. In fact, healing is only possible through this innate capacity and the various therapies are used to either facilitate the healing or to interfere with it, or to simply entertain the patient while nature does its work.
A fundamental dilemma for the practicing naturopathic physician is deciding which of the various tools to use for awakening a healing response. I often describe my clinical skills (with some sarcasm) as being “a mile wide and an inch deep”. This is a reflection of the desire and attempt to be adept at many of the modalities that are possible for the unbridled naturopath.
It’s my nature to want access to most, if not all, of the various modalities that can facilitate the healing response. As my profession goes, we are able to have great latitude in therapeutics as we are ultimately guided by the dictum of “vis medicatrix naturae” (by the healing power of nature) and moderated by the principle of “above all do no harm”.
Although each state law defines differently what a naturopathic physician may do in their state, if a state’s law allows for practicing as taught, this allows for a variety of modalities. In my practice these include: traditional Chinese medicine, homeopathy, clinical nutrition, intravenous therapy, botanical medicine, various injection therapies including prolotherapy and neural therapy, pharmaceutical prescriptions, massage and other physical therapies.
The possibilities are daunting. Staying well versed in any of the modalities could define a practice. To attempt to use all of them at some level requires knowing where the limits of knowledge crash upon the rocky shore. The benefits are that I can apply a combination of modalities that better meet the needs of the patient.
Joe came to the clinic complaining of one of the more common problems seen in a doctor’s office, insomnia.
Treatment options are many and varied, but guided by the principle to “treat the patient, not the disease”, quickly narrowed my options. His insomnia came on shortly after a surgery to remove part of an enlarged parotid gland (the same gland that is swollen in mumps). From the time of the surgery on, he was virtually unable to sleep and was relegated to a combination of prescription drugs to induce something akin to sleep but without the satisfaction.
I briefly considered a non-pharmaceutical version of the prescription drugs but rejected that approach. It would perhaps have palliated the problem but would not have provided freedom from medication, if that were even possible. If I were to try to treat the cause of the complaint then I needed to treat the effects of the surgery.
A facet of the broad modality of neural therapy is “scar therapy”. Scar therapy is based on the observation that tissue damaged by injury can create an “interference field” or “focus”. This interference field can lead to disturbances of the central nervous system, autonomic nervous system and hormonal system.
Once this interference field is found it is treated with the use of local anesthetics, which can restore membrane potentials in nerve cells thus quieting the abnormal signaling and the various symptoms created from them. I suggested this approach with Joe and, odd as it may have sounded to his experience and expectation, he was quite receptive to the idea.
I treated his scar and finished our visit. One week later he returned for a follow-up visit and a repeat of the treatment. He greeted me in the waiting room and bore an eager expression. He excitedly revealed that he had slept well every night for the week following the treatment. Although equally excited by the response I suspended equal relief. Experience has taught me that early results are not always lasting; “fool’s gold” it has been called. Over several weeks the insomnia returned to some degree but has remained much improved since the first treatment. He now uses a single sleep-aid and routinely experiences satisfying sleep.
In more complex cases with multiple complaints and an unclear beginning point, I will often resort to the most fundamental of therapies, drainage or detoxification. This incorporates the principle of “removing the obstacles to cure” and to “treat the patient, not the disease”. Samuel had been diagnosed with fibromyalgia but this is not a particularly helpful diagnosis in that it may simply lead to treating pain with analgesics without much expectation of cure. Samuel’s history didn’t clearly suggest a particular event that lead to his muscle and joint pain and so I decided to begin to clarify the case with an elimination/cleansing diet for seven days along with nutrients for aiding the liver and gut to encourage detoxifying the body.
The “elimination” part entails temporarily withdrawing commonly allergenic food such as gluten-containing grains and dairy products as well as foods taxing to the adrenals or immune system, like sugar and caffeine. The first two days are clear liquids only, including herbal teas, water and vegetable broth. Following this, the cleansing/elimination diet begins, composed of virtually any aboveground vegetable, non-gluten grains, no meats or dairy for five days along with the liver support and gut support. What I hope to see is a clarifying of the symptoms so that if I need to focus my therapy it will be more evident where to focus.
I happened to see Samuel at the athletic club where we both are members after the two-day fast. He somewhat hesitantly asked if the program could have worked on the pain already. I commented that, although I wouldn’t have necessarily anticipated it, it could help quickly. He was already experiencing great relief from his aches and pains and in this case his relief has continued. It has become clear that among the insults to his health was sensitivity to gluten. As long as he avoids it he does well overall.
My reaction to the kinds of responses described here is one of a contained thrill. I know the sometimes fleeting relief that can be elusive in maintaining for the long haul. But what is being glimpsed is the tendency for the ill body to right itself when the proper conditions are present. Because I have seen that response, I tend to expect the tale of improvement and that is what I feel obliged to try to facilitate. When it works out as planned I do feel some satisfaction, but it’s the patient’s that don’t respond as expected that can plague me. The cases that I remember best are often the ones that ended without relief for me or for the patient. These disappointments help to winnow the chaff from my therapeutic options and hopefully guide me to greater effectiveness in the course of a long practice.
The principles of naturopathic medicine are immutable. They help to direct, like signposts along the road. The modalities available are the ground that takes the practitioner to the destination point and each patient is a journey of discovery.
Mark James has been practicing naturopathic medicine in for 23 years. His practice is an eclectic use of naturopathic modalities including Chinese Medicine, Clinical Nutrition, Homeopathy, Botanical Medicine, intravenous therapies, as well as prolotherapy, and bee venom therapy for pain relief. |