Is Naturopathy another weird therapy that pharmacists should know about? Fasting to relieve the symptoms of an upset stomach, bathing an aching joint or eating a sensible balanced diet to maintain good health are all examples of Naturopathy. But, Naturopathy is also more than this.

Is Naturopathy another weird therapy that pharmacists should know about? Fasting to relieve the symptoms of an upset stomach, bathing an aching joint or eating a sensible balanced diet to maintain good health are all examples of Naturopathy. But, Naturopathy is also more than this.

Naturopathy is an eclectic system of health care which integrates elements of complementary and conventional medicine to support and enhance self-healing processes.1 In Germany Naturopathy is known as Naturheilkunde.1

Origins and Background

The philosophy of Naturopathy can be traced back to Hippocrates.1,2 Disease was considered to be an effect of some imbalance and a cause was sought in the elements (such as air and water) and other natural factors such as food. The power of natural ways to cure ill health again gained ground during the 18th and 19th centuries when the German Vinzenz Prießnietz, and particularly the Austrian Dominican friar Father Sebastian Kneipp, established complex hydro-therapeutic interventions as a cure for many ailments. Kneipp treated an American by the name of Benedict Lust. Presumably as a result of Lust’s recovery, he stayed with Kneipp to study his particular methods of healing and upon returning to the United States, Lust established his own form of natural medicine, for which he coined the term Naturopathy in 1896. Lust advocated stopping all bad habits, among which he included overeating, the consumption of alcohol, meat, tea and coffee, and other similar excesses. Before considering a new lifestyle, corrective habits had to be introduced, such as exercising and breathing in the proper manner and, in general, a moderate approach to all things. At the beginning of the 19th century, Naturopathy began to be formally recognised. One of the early nature cure resorts in the United Kingdom was established in Hertford-shire in the 1930s.
The general principles of a healthy lifestyle, including a diet that is rich in fresh fruit and vegetables and a sufficient amount of physical exercise, are well recognised both in mainstream Western medicine and Naturopathy. Naturopathy can, therefore, be regarded as one of the closest alternative therapies to conventional medicine, which is also on par with the various complete systems of Oriental medicine.

The Naturopathic Philosophy

In Naturopathy, a person is seen as a complex amalgamation of physical, mental, intellectual and emotional factors, all of which govern the person’s state of health. The whole person must therefore be treated (a holistic approach). Treatment must promote and work in harmony with all the factors to bring about an improvement in health and well-being.
Naturopathy is furthermore based on the belief that health is influenced by nature’s own healing power, which is seen as an inherent property of a living organism. Ill health is viewed as a direct result of ignoring or violating the general principles of a healthy lifestyle. These principles are thought to be determined by an internal and external environment that optimises the health of the individual. Naturopathy aims to correct and stabilise the condition of the internal and external environment.
Naturopaths usually follow three main principles when prescribing any treatment2,3:
•    The body has the power to heal itself, so treatment should not be given to alleviate symptoms but to support the self-healing mechanism or vis medica-trix naturae (Latin for “natural healing force” or “vital force”).
•    The symptoms of a disease are not part of the disease itself but a sign that the body is striving to eliminate toxins and return to its natural state of balance or homeostasis. The cause must therefore be identified and treated (tolle causam).
•    In addition to being as natural and gentle as possible, all treatments should take into account the mental, emotional and social aspects of a person, as well as the physical. The multifactorial nature of health and disease are therefore recognised.
Other underlying principles include the “physician as teacher” (docere), implying that the therapist must create a health-sensitive interpersonal relation-ship with the patient.2 Also, therapeutic actions in Naturopathy should be complementary to and synergistic with the healing process, and are applied in an ordered fashion congruent with the internal order of the organism (the principle of “first do no harm” or primum no nocere).2 The ultimate goal in Naturopathy is prevention – the notion that “prevention is the best cure”.

Conditions Treated and the Treatment Process

Naturopaths treat any condition, but normally refer patients with serious medical conditions for conventional treatment. During an initial consulta-tion, a naturopath will usually take a detailed medical history of the person to get an overall view of his or her medical status. This will include questions relat-ing to lifestyle and diet and may be followed by a more conventional diag-nostic evaluation (which may include laboratory analyses). Based on the diagnosis, a treatment plan will then be decided on which often includes a change in lifestyle. Treatments for specific conditions may vary between practitioners. This therefore makes it difficult to comment on the safety of Naturopathy. The risks, contraindica-tions and adverse effects will be determined by the individual type of therapy given to a person, as well as the person’s own state of health.
The course of treatment is largely determined by the nature and severity of the condition, but generally one to two appointments per week for a period of one to several weeks is recommended. The lifestyle changes should, however, be permanent.
The treatment methods used in Naturopathy are wide-ranging and a practitioner may become a specialist in one particular area. The methods used most often are3:
•    Nutrition and diet – This includes the use of vitamin and mineral supplements when necessary. In examining the cause of a disease or condition, a naturopath may identify a particular mineral or other deficiency as a contributory factor. Supplements are therefore often recommended. A naturo-pathic diet for healthy people is based on whole foods (that is, foods that are unrefined and as near to their natural state as possible). This type of diet is universally recommended by nutritionists for healthy eating in people who are well.
•    Detoxification – Detoxification involves the use of short periods of fasting or controlled diets and supple-ments to aid the natural processes by which the body rids itself of toxic substances.
•    Methods to control and reduce stress – This includes recognising and eliminating the causes of stress whenever possible, exercise, relaxation techniques, modification of diet and the use of supplements, particularly to support the adrenal gland.
•    Hydrotherapy – The use of water to promote healing, possibly including colonic irrigation.
•    Herbal medicine – The use of plants and their constituents to promote healing.
•    Homoeopathy – A method of healing using minute quantities of natural substances, based upon the principle that “like cures like”.
•    Physical therapies – These include massage, chiropractic, osteopathy and cranial osteopathy, therapeutic exercises and soft tissue manipulation such as rolfing. It can also involve the use of various diagnostic and other equipment such as x-rays and ultrasound. Iridology is furthermore often used as a diagnostic technique.
•    Counselling and lifestyle modifica-tion – These may be of particular value in relieving psychological, behavioural and emotional problems, as well as physical illnesses. Treatment may include hypnotherapy, relaxation techniques and the use of imagery, with suggested adjustments in daily living. Other helpful measures may include colour, music and dance therapy.
•    Acupuncture and oriental therapies – Examples of therapies are shiatsu, yoga and Tai chi.
•    Exercise – The importance of exercise in the promotion of good health and in the treatment of illnesses is recognised by naturopaths and forms part of most programmes of therapy.

It is evident from the above that the full scope of Naturopathy is vast and one practitioner is unlikely to be an expert in all the disciplines. Also, the emphasis varies depending on the country in which it is practised. The core elements, used by naturopaths every-where, are diet, nutrition including supplements and detoxification, stress management, herbal remedies, physical therapies, exercise, counselling and lifestyle modification, and hydrotherapy.

In Conclusion …

Naturopathy is a combination of different methods of natural healing but, more importantly, it is also a way of life. The naturopathic lifestyle must be seen as a method of disease prevention, and not only of treatment.
The scientific evidence for Naturopathy varies according to each individual treatment. Some interventions are supported fully by conventional medicine (for example, some herbal remedies and some forms of hydro-therapy), whereas evidence for some other interventions is lacking. Similar to most other complementary therapies, the effectiveness of the totality of the Naturopathic approach needs to be investigated more extensively before firm conclusions can be drawn regarding its overall effectiveness. However, the basic belief in Naturopathy that health is influenced by nature’s own healing power is not against that of conventional medicine and this form of therapy may thus be worth considering when performed by a responsible and well-trained therapist.r

REFERENCES
1.    The Desktop Guide to Complementary and Alternative Medicine: An Evidence-Based Approach. 2001. Edited by Ernst E, Pittler MH, Stevinson C & White A. London: Mosby.
2.    Novey DW. 2000. Clinician’s Complete Reference to Complementary/Alternative Medicine. St. Louis: Mosby.
3.    Naturopathy: Pocket Reference Digest. 1999. New Lanark: Geddes & Grosset.