In one room a woman with lower-back pain soaks contentedly in a whirlpool bath. In the next a doctor gives a neck massage to a woman with recurring migraines. Down the hall a grandmother complaining of chronic fatigue lies on a table, with a row of slender acupuncture needles in her back. Meanwhile, in the Chinese apothecary, a doctor concocts an aromatic herbal remedy for a woman with endometriosis.
At the naturopathic clinic at Bastyr University in Seattle, an array of natural therapies comes under one roof. It's the naturopathic way. Natu-ropathy, also called naturopathic medicine, incorporates a wide range of alternative treatments--Ayurvedic medicine (a traditional form of Indian healing), botanical medicine, exercise therapy, homeopathy, hydrotherapy, manipulation, massage, meditation, nutritional therapy and Traditional Chinese Medicine. Doctors of naturopathy mix and match different treatments, customizing therapy for each individual woman and her particular health condition.
Suffering from premenstrual syndrome? After taking you through a detailed interview and exam, a doctor of naturopathy (N.D.) may prescribe a high-fiber, whole-foods diet along with nutritional supplements, herbs and hydrotherapy. To prevent other health problems, she also might recommend meditation plus an exercise regimen.
The way naturopaths see it, their job is to teach you how to stay healthy. Should you fall, they're there to bolster your body's defenses with the best that natural medicine has to offer.
"The conventional medical approach is basically: Kill disease, kill disease, kill disease," explains Joseph Pizzorno, Jr., N.D., founding president of Bastyr University of Naturopathic Medicine.
"The natural medicine approach is to help the person live healthier. While we may use therapies that have a direct impact on disease, we're much more interested in utilizing therapies that help support the body's natural healing processes, rather than those that take over the healing process of the body."
COMPLEMENTS CONVENTIONAL MEDICINE
Naturopathy is an eclectic mix of therapies that traces its origins back more than a century to a time when conventional doctors doused their patients with heavy metals and were as apt to bleed them to death as save them. Gentler naturopathic alternatives like homeopathy and hydrotherapy won plenty of converts but lost them to conventional medicine when research led to improved surgical treatments and drug therapy.
Now, after decades on the sidelines, naturopathy is once more gaining ground. Bastyr's enrollment, for example, rose from 30 students in 1978, its first year, to 1,000 in 1996, nearly 20 years later. In 1994, Bastyr beat out Harvard and Columbia University, in New York City, for a hefty federal grant to study AIDS treatment. Not long after, the nation's third accredited school of naturopathic medicine, the Southwest College of Naturopathic Medicine, opened its doors in Scottsdale, Arizona. And in 1995, King County council officials in Washington voted to establish a government-subsidized naturopathic clinic in the greater Seattle area.
Dr. Pizzorno credits the growth of naturopathy to several factors. "To an extent, conventional medicine has reached the limits of what it can do by simply treating disease. Secondly, there's this growing awareness that you have to treat your body properly if you want to stay healthy, and people are looking for doctors who can teach them how. And finally, natural medicine makes a lot of sense."
Naturopaths don't reject conventional medicine out of hand. For acute health problems such as pneumonia and life-threatening illness such as cancer, conventional medicine is still your best bet, says Dr. Pizzorno. N.D.'s, who use blood, urine and other standard medical tests in diagnosis, will refer patients with such problems to M.D.'s. But naturopathic medicine is the ticket for chronic or less severe conditions that aren't life-threatening, he says.
Unfortunately, there aren't any scientific studies comparing naturopathy with conventional care. Even the best of researchers would be hard-pressed to design such a study: Naturopathy includes so many therapies, that controlling all the variables would be virtually impossible.
But studies have taken a look at individual therapies (like acupuncture, for example) for specific health problems. Results have been favorable. Sometimes they even got better results than conventional medical treatments, according to Dr. Pizzorno. Many herbal therapies have been extensively researched in Europe, he notes.
"I went to an M.D. first," says Ruth, a 26-year-old undergoing treatment at the Bastyr clinic. Diagnosed with Bell's palsy, a neurological disorder that causes partial facial paralysis, Ruth took her M.D.'s advice and took prednisone, a powerful steroid used to reduce inflammation. But her symptoms got worse.
"It got to the point that my vision and speech were affected. I really couldn't live a normal life," she says, looking quite comfortable, despite the acupuncture needles jutting out above her eyebrows and wrists. "Acupuncture helped right away. I wish I had tried it from the start."
MAKING THE MOST OF MANY OPTIONS
In naturopathic medical school, students study the basic sciences--anatomy, physiology, biochemistry, neurology, pathology and diagnostic techniques. In addition, they take courses in homeopathy, therapeutic nutrition, hydrotherapy, botanical medicine, spinal manipulation and other therapeutic modalities rarely taught in conventional medical schools.
One of the big advantages of the naturopathic approach, N.D.'s say, is that it offers so many options. To treat chronic muscle tension--a common cause of chronic pain--an N.D. might use spinal manipulation and massage, says Douglas Lewis, N.D., a faculty member of the physical medicine department at Bastyr University. But a naturopath might also prescribe hydrotherapy, at-home exercise routines and calcium and magnesium supplements. "The two minerals work as a wonderful muscle relaxer," he says.
After a woman that Dr. Lewis was treating injured her back and neck in a car accident, he recalls, the muscles surrounding the injured area tensed up, pinching nerves, cutting off circulation and causing pain that radiated out to her shoulder. He used manipulation and massage to ease the tension, prescribed supplements to relax the muscles and recommended at-home exercises. The combination of treatments worked better than any single natural remedy would have worked alone, he notes.
Natural remedies often work best in combination, as they support the body's own healing mechanisms and have a combined therapeutic effect, says Dr. Lewis. They tend to be gentler than prescription drugs and other conventional remedies, say practitioners.
"If I'm treating someone with, say, recurring sinusitis, I'll frequently recommend both dietary changes and herbal prescriptions," says Lisa Meserole, N.D., research consultant and faculty member in the botanical medicine department at Bastyr University.
It makes sense to combine food therapy with herbal remedies in cases like these, she says. Chronic recurrent sinusitis is often associated with a food or airborne allergy. According to Dr. Meserole, those with chronic sinusitis who normally consume a diet rich in dairy often improve when they eliminate dairy products. The residues in dairy foods seem to increase mucus production in susceptible individuals, she says. Combining dietary changes with the appropriate herbal tonics, she gets better results than she would if she prescribed either therapy singly.
"I'm not saying that herbs can't sometimes work alone," says Dr. Meserole, whose office bookshelves are stacked with botanical texts and jars containing plant samples. "But because they tend to be gentler and weaker than pharmaceutical drugs, herbs work better when combined with a holistic health program that is tailored to the individual."
THE GENTLER ROUTE
Depending on the state, some licensed N.D.'s can prescribe certain pharmaceutical drugs. But most prefer not to. They favor natural remedies, like herbs, precisely because the remedies are gentle and won't overwhelm the body's efforts at self-healing.
From the naturopathic perspective, symptoms are signs that the body is trying to heal itself. A rash, for instance, is a sign that the body is trying to protect itself from an irritant. Rather than override the body's attempts at healing--as when a person treats the rash by applying an anti-inflammatory cream--naturopathy aims to gently enhance the body's healing efforts.
A doctor of naturopathy might do this by prescribing a homeopathic remedy--in this case, an extremely dilute solution of a substance that would cause a rash in a healthy person. The theory behind homeopathy is that, by magnifying symptoms, the remedy will prompt the body to magnify its healing response. Again, the idea is to work with the body's healing efforts.
It seems to work.
"One woman that I treated had severe morning sickness, but her diet was fine, so I decided to prescribe a homeopathic remedy," recalls Pamela Snider, N.D., associate dean of the naturopathic medicine program at Bastyr University. The remedy--an extremely dilute solution of a substance that, in a nondiluted form, would have made a healthy woman queasy--did the trick. "Within two days, her morning sickness completely cleared up," says Dr. Snider.
While naturopathic physicians aren't as numerous as osteopaths or chiropractors, their numbers are growing.
To find a naturopathic physician in your area, follow the guidelines listed below.
Number of practitioners in the United States: Approximately 400.
Qualifications to look for: Doctor of Naturopathy (N.D.) degree from an accredited naturopathic medical school--Bastyr University of Naturopathic Medicine in Seattle or the National College of Naturo-pathic Medicine in Portland, Oregon.
Professional associations: American Association of Naturopathic Physicians (AANP), 2366 East Lake Avenue, Suite 322, Seattle, WA 98102.
To find a practitioner: A directory of naturopaths is available for $5 from the AANP at the address listed above.
Approximate cost: $30 to $175 for an initial consultation. Follow-up visits usually cost less.
Disparate as they are, all naturopathic treatments share this same philosophy: Help the body heal itself.
Sometimes a dietary and lifestyle change, possibly accompanied by an herbal tonic and a massage, are all the help that the body needs. Other times, a combination of vitamin and mineral therapy and hydrotherapy offers a sufficient boost.
"Some people need nutritional intervention, some need herbs, some need fasting and some need to be referred to an acupuncturist," says Dr. Snider. "We use the least-force approach, the one with the most ability to work with the body's inherent healing process."
AT-HOME FOLLOW UP
Naturopathic physicians offer a wide variety of therapies, but they ask their patients to do part of the job. Naturopathic "prescriptions" often include homework--exercises, dietary changes and stress-reduction programs that you have to follow through with at home.
To treat a woman with chronic migraines, for example, Dr. Lewis says that he may use massage and manipulation in the office and recommend both hydrotherapy and neck exercises for her to do at home.
For chronic constipation, Mark Groven, N.D., physical medicine supervisor at Bastyr University Natural Health Clinic, may recommend colon hydrotherapy--a type of enema that cleans your intestines--and herbal remedies, then suggest dietary changes and at-home exercise.
In addition to recommendations aimed at alleviating existing health problems, naturopathic physicians make recommendations aimed at preventing problems in the first place.