I borrowed a copy of the Textbook of Natural Medicine (the “Textbook”) and studied it carefully over a period of several days in an attempt to answer these questions. My conclusion is that the licensing of naturopathic medical practitioners as independent providers of primary health care would endanger the health and safety of the public and would not result in health benefits commensurate with its risks. There is abundant evidence in the Textbook to support this conclusion, but I summarize below only a few of the most problematic examples of the deficiencies and dangers in naturopathic practices.
1) The textbook describes the diagnosis and treatment of only 70 “specific health problems,” and they are simply listed in alphabetical order, without regard to the nature of the condition or the organ(s) involved. In comparison, standard textbooks of conventional medicine provide a much more rational and systematic presentation that includes hundreds of disease conditions and describes them in much greater depth and detail. The Textbook includes in its 70 chapters on specific diseases nothing about cancer, diseases of the blood (including leukemias and anemias), nothing about heart attacks or serious abnormal rhythms of the heart (such as atrial fibrillation), and virtually nothing about kidney diseases, chronic obstructive pulmonary disease, cirrhosis of the liver, or about many common and serious infections such as pulmonary tuberculosis, malaria, syphilis, meningitis, encephalitis or bacterial endocarditis. Lacking adequate education about these diseases, naturopathic practitioners might fail to diagnose them in a timely fashion or delay in referring patients for appropriate medical treatment,
2) Many of the treatments recommended in the Textbook for the 70 diseases are not likely to be effective, and treatments proven to be effective are often totally ignored. This could endanger the health and safety of patients with serious diseases who relied solely on care from a naturopathic practitioner. As explained in the Textbook, naturopathy objects to the use of pharmaceutical agents and depends instead an the use of herbal or “natural” remedies of unproven value. Here are some examples of common, serious diseases that are dangerously mistreated in the naturopathic Textbook:
A) The chapter on the treatment of anginal (coronary artery) heart disease does not even mention the use of nitrates, beta-blockers or calcium-channel blockers — all of which are standard, effective, FDA-approved treatment for this condition. Failure to use one or more of these agents in the treatment of severe angina would probably be considered medical malpractice. There is no mention of “statin” drugs to lower cholesterol and prevent further progression of coronary heart disease. The use of angioplasty or bypass surgery for patients unresponsive to pharmacologic therapy is dismissed. “Chelation” — a totally irrational and unproven form of treatment — is discussed favorably. However, at the end of this chapter, it is stated that “patients with unstable angina pectoris . . . should be hospitalized”, thus tacitly admitting that naturopathic methods may be ineffective and that serious cases may require medical or surgical treatment found only in hospitals.
B) The chapter on congestive heart failure recommends unproven nutritional supplements, but says nothing about the standard (and usually effective) treatment. with diuretics and ACE-inhibitors, which have been shown to give comfort to, and prolong, the lives of these patients, It does, however, admit that “In later stages, adjunct (prescription) drug therapy is Usually necessary”, but gives no details
From: The New England Journal of Medicine.
