Naturopathy: Medicine That Asks Why

Oct 8, 2026 · @Thomas Lee Abshier, ND

Who Decides What Counts as Medicine?

Most discussions of natural medicine begin with a question about remedies: which herb, which supplement, which protocol. A better place to begin is a prior question. Who decided what counts as medicine in the first place, and on what grounds?

That question framed a recent conversation on Decentralize TV between hosts Mike Adams and Todd Pittner and Razi Berry, founder and publisher of the Journal of Applied Natural Medicine (ndnr.com), which has spent more than twenty years publishing case reports and outcomes from naturopathic physicians. The conversation ranged widely. This essay draws out its naturopathic substance: the history that shaped the present system, the logic of treating causes rather than symptoms, the clinical method that follows from that logic, and what it asks of the patient himself.

The argument is not that conventional medicine is worthless. It is that a medicine organized around the suppression of symptoms has lost sight of the question every good physician should ask first: why is this person sick? Naturopathy is, at bottom, the discipline of asking that question and following the answer.

How the Present System Was Built

Heroic medicine

In the late eighteenth and early nineteenth centuries, the scientific medicine of the day was what historians now call “heroic” medicine: aggressive bloodletting, purging, blistering, and large doses of calomel (mercurous chloride). Opium preparations were given freely, including to children for coughs and teething. These were not fringe practices. They were the standard of care, taught by the leading physicians and supplied by the leading apothecaries.

George Washington’s death in December 1799 is the most famous illustration. After riding in sleet he developed a severe throat infection, which modern physicians believe was probably acute epiglottitis. His attending physicians, among the best in the country, bled him repeatedly, removing an amount later estimated at roughly 40 percent of his blood volume, and dosed him with calomel and emetics. One of them, Elisha Dick, objected to the final bleeding and was overruled. Many historians conclude the treatment hastened his death.

A generation later, Surgeon General William Hammond of the Union Army saw what calomel was doing to his soldiers and in 1863 removed it, along with tartar emetic, from the army’s supply table. The order provoked fierce opposition from the profession. In 1864 Hammond was court-martialed and dismissed, officially on charges of irregularities in purchasing, though his calomel order had made him powerful enemies. He was exonerated in 1878. The pattern is worth noticing: the physician who challenged the accepted drugs paid for it professionally.

Nature cure and the eclectics

The reaction against heroic medicine took two main forms. In Europe, Vincenz Priessnitz and the Bavarian priest Sebastian Kneipp developed systematic water cures, combined with fresh air, sunlight, simple diet, and exercise, to rouse the body’s own healing response. One of Kneipp’s patients, a young German named Benedict Lust, recovered from tuberculosis under his care. Kneipp sent him to America to spread the method. Lust combined the water cure with nutrition, botanical medicine, homeopathy, and manipulative therapy, and around the turn of the twentieth century gave the combination a name: naturopathy.

In America, meanwhile, the eclectic physicians had founded their own medical schools. They were licensed doctors who rejected the toxic excesses of the regular profession and built their practice on botanical medicine, including the indigenous plants of North America, and on attention to the individual patient. At the same time, ordinary pharmacy was still largely plant- and mineral-based. The early pharmaceutical houses sent expeditions abroad to learn the healing plants of other cultures and sold them as tinctures, extracts, and pills.

The synthetic turn and the Flexner Report

The decisive shift came from chemistry. In the late 1800s, coal-tar chemistry produced synthetic fever reducers and pain relievers; Bayer brought phenacetin and then aspirin to market. A patentable molecule could be owned in a way a plant could not, and the economics of medicine began to follow the molecule.

In 1910 the Carnegie Foundation published Abraham Flexner’s survey of North American medical schools, known as the Flexner Report. Many of the schools Flexner condemned were genuinely poor, and the report’s call for laboratory science and clinical training had real merit. But it established a single model of legitimate medicine. Rockefeller philanthropy then directed large sums to schools that conformed to it. Within two decades the number of medical schools had roughly halved. The eclectic, homeopathic, and naturopathic schools were among those that did not survive; the last eclectic school closed in 1939.

What followed was a long campaign to define everything outside the new model as quackery. The American Medical Association’s ethics code had long forbidden members to consult with “irregular” practitioners. As late as 1987, in Wilk v. American Medical Association, a federal court found that the AMA had conducted an unlawful boycott aimed at eliminating chiropractic. Naturopathic medicine nearly disappeared in the mid-twentieth century and was rebuilt only slowly, beginning with the founding of a new naturopathic college in Portland, Oregon, in 1956.

The point of this history is not that every heroic-era drug was abandoned for good reason, or that every natural remedy was suppressed for bad reason. It is that the boundary between “medicine” and “alternative” was drawn by institutions with interests, not handed down by nature. The healing traditions now called alternative were, in fact, the first medicine of the West.

The Bias Built In Before the Doctor Enters the Room

Todd Pittner put the economic problem in one sentence: a company can patent a molecule, but no one can patent sleep, sunlight, exercise, or broccoli. That asymmetry shapes medicine long before any individual physician makes a decision. Research follows funding, and funding follows what can be sold. Journals, continuing education, clinical guidelines, and insurance billing codes are all built around interventions someone owns.

The result is a system that is very good at what it is paid to do. It names a disease, matches it to an approved protocol, and prescribes. The typical primary-care visit is now measured in minutes. In that time a physician can review a chart and write a prescription; he cannot take a full history of a patient’s diet, work, home, sleep, relationships, and chemical exposures. Lifestyle advice, if it comes at all, comes in the last minute of the visit.

Berry described what this has done to the physical encounter itself. Many patients now leave an examination without having been touched: no palpation of the thyroid, no look at the tongue, no attention to the pulse or the color of the skin and eyes. Pittner described a recent annual exam of his own that lasted about four minutes and consisted largely of a recorded conversation and a recommendation for medication.

None of this requires bad intentions on anyone’s part. It requires only that the incentives point one way for a long time. A system that is paid for interventions will produce interventions.

Treating the Cause: The Therapeutic Order

Conventional medicine is excellent at silencing an alarm. Naturopathy asks why the alarm went off. The principle is called tolle causam, “identify and treat the cause,” and it rests on an older conviction that the body possesses an innate, God-given healing force, the vis medicatrix naturae, that is always working toward repair. The physician’s first task is not to override that force but to find what is obstructing it.

Naturopathic physicians organize this conviction into a clinical sequence known as the therapeutic order. It runs from the gentlest, most foundational interventions to the most forceful, and the physician moves up the ladder only as far as the case requires:

1. Establish the foundations of health. Identify and remove what is making the person sick: toxic exposures at work or home, poor diet, disordered sleep, night-shift schedules, chronic stress. Restore what health requires: real food, clean water, light, movement, rest.
2. Stimulate the body’s self-healing. Sunlight, hydrotherapy, adjusted sleep and nutrition. Sometimes this means harder changes in the patient’s life: a different job, a different schedule, the end of a destructive relationship.
3. Support and restore weakened systems. Strengthen the specific organs and systems that have been depleted: digestion, the adrenal and thyroid axis, detoxification pathways, the microbiome. Nutrients, botanicals, and homeopathy belong here.
4. Correct structural integrity. Posture and alignment affect circulation and lymphatic flow. Massage, manipulation, and physical therapy belong here.
5. Relieve symptoms with natural substances. Only now does the physician address symptoms directly, using the least toxic means available.
6. Relieve symptoms with synthetic drugs. Pharmaceuticals are not forbidden; they are placed where their risks are justified.
7. Apply high-force interventions. Surgery, chemotherapy, and other aggressive measures are reserved for cases where the patient must be stabilized or where nothing gentler will do. Their aim is often to bring the patient back to where lower-force care can work.

The order is the reverse of ordinary practice, which typically begins with the symptom and the drug. In the naturopathic sequence, most of the work happens before the symptom is addressed at all. The reasoning is that a symptom suppressed while its cause remains active does not go away; it is driven deeper, and may return years later as chronic disease.

Berry gave two examples from her own experience. Years ago she suffered headaches and dizziness that a naturopathic physician traced to her gut, at a time when almost no one discussed the gut-brain connection. After the birth of her second child she experienced postpartum low mood; her naturopath prescribed minerals and dietary changes and told her it would resolve when she weaned the baby. It did, the day she weaned.

One Diagnosis, Many Causes

A diagnosis names a pattern of symptoms. It does not name a cause. Three patients with the same diagnosis may share nothing upstream.

Take eczema. In one patient it is driven by a food sensitivity. In a second it is a reaction to a chemical exposure. In a third, prolonged stress or trauma has disrupted the hypothalamic-pituitary-adrenal axis, altered cortisol, and with it the microbiome of the gut and skin. A steroid cream treats all three identically and cures none of them. Berry described a neighbor who owned a dry-cleaning business and suffered years of severe, peeling eczema. He went from doctor to doctor and received round after round of steroids. A naturopathic physician asked what he did for a living, and the answer was the diagnosis: daily exposure to dry-cleaning solvents. No amount of steroid could treat a cause that was still on his hands every morning.

The same reasoning applies to infertility, thyroid disease, multiple sclerosis, and cancer. For one patient the root may be an infection never fully resolved; for another, a tragic life event; for another, years of living beside a heavily sprayed golf course.

This is why the Journal of Applied Natural Medicine publishes what Berry calls “one doctor, one patient” reports: the history, the physician’s findings, the treatment plan, and the outcome. Such reports, called n-of-1 studies, are often dismissed as anecdote. But they preserve exactly what large trials average away: the individual. A randomized trial asks whether a treatment works on average across a population. A case report asks what worked for this person, and why. Medicine needs both kinds of knowledge, and the second kind is the one that has been neglected. Read across many such reports, one finds that no two patients are treated exactly alike.

There is a range within naturopathic practice as well. Some physicians are strict vitalists who work almost entirely at the foundations; others are more integrative. That variety is not a weakness. It allows the patient to choose what kind of care he wants and what kind of clinician he trusts.

The Exposome and the Question of Sunlight

Researchers now use the word exposome for the sum of everything a person is exposed to over a lifetime: food, water, air, chemicals, light, stress. A naturopathic history is, in large part, an inventory of the exposome. Consider an ordinary morning. A shower in chlorinated water; shampoo and soap with synthetic fragrance; fluoridated toothpaste; clothes from the dry cleaner or treated with dryer sheets; coffee in a plastic-lined cup. None of these is necessarily dangerous alone. Together, and repeated daily for decades, they form a chemical load that a standard office visit never asks about. A patient may be doing nearly everything right and still be undone by one exposure no one thought to question.

Sunscreen offered the conversation’s sharpest example. Oxybenzone, a common chemical UV filter, has been detected in the urine of about 97 percent of Americans tested by the CDC. It is absorbed through the skin into the bloodstream, it shows hormone-disrupting activity in laboratory studies, and it is a leading cause of photoallergic reactions to sunscreen. In 2019 the FDA declined to classify it as generally recognized as safe and effective pending further data, and Hawaii has banned its sale to protect coral reefs. Meanwhile the public message remains that a parent who does not coat his child in sunscreen is negligent.

The deeper issue is our relationship to the sun itself. Sunlight drives vitamin D synthesis, sets the circadian clock, releases nitric oxide in the skin, and stimulates melanin, the body’s own protection. A gradually built tan is a natural adaptation, not a disease. None of this means burning is harmless; it means the answer to the sun is wise, gradual exposure, shade and clothing when needed, and mineral blockers such as zinc oxide where protection is required, rather than fear. Berry raised a further question worth considering: whether the skin’s vulnerability to the sun is made worse by the chemical load that disrupts its barrier and microbiome to begin with.

Adams made the point metaphorically. A medicine that teaches people to fear the source of light has something backward. People naturally seek the light. In any restaurant or office, the seats by the window go first.

The Patient’s Responsibility and the Doctor as Teacher

One of naturopathy’s founding principles is docere: the physician is first a teacher. This follows directly from the therapeutic order. If the foundations of health lie in what a person eats, drinks, breathes, does, and believes every day, then the decisive work of healing is done by the patient, not to him. The physician’s job is to help him understand his own body well enough to do it.

This cuts against a message patients often receive: that disease simply happens, like being struck by lightning, and that there was nothing they could have done. Sometimes that is true. Often it is not, and the message, however kindly meant, takes away the patient’s power and leaves him dependent. Naturopathy says plainly that the body is built from what it is given. Every cell of the pancreas, the skin, and the brain is assembled from the materials a person supplies. A house built of straw will not stand in a storm. Saying so is not blame; it is the restoration of agency.

Berry described how she taught her own daughters. Handed cotton candy, they were asked to follow it: the sugar and blue dye are digested, pass through the intestinal wall into the blood, and become the raw material for hair, skin, nails, bones, and muscles. Is that what you want to be built from? Children taught this way grow into adults who cannot be easily frightened or easily sold. Pittner offered a similar question for adults to ask themselves privately: if your body could sue you for malpractice, what would it cite?

Building parallel systems

Berry’s practical conclusion was that a system built on these incentives is unlikely to reform itself from within. Well-informed and well-intentioned people have entered the highest health offices in the country and found the institution larger than their intentions. Her answer is to build alongside it: learn how the body works, teach one’s children, form communities of practitioners and patients, support journals and directories that preserve naturopathic knowledge, and grow and prepare some of one’s own food and remedies. Freedom carries risk, she said, but it allows a person to make his own decisions and learn from them, rather than walk blindly into a system that does not have his interests at heart.

What artificial intelligence will change

The conversation closed on artificial intelligence. Adams argued that medicine practiced as a fixed algorithm, matching diagnosis to protocol, is exactly the kind of work machines will absorb. What will remain distinctly human is the work naturopathy has always emphasized: the long history, the physical examination, the judgment about this particular person’s life. Berry added the necessary caution. An AI is only as good as what it learns from. A machine trained only on the existing literature will reproduce its blind spots at scale. If AI is to serve healing rather than merely automate prescribing, the knowledge of the natural-medicine traditions, including twenty years of case reports, must be part of what it learns.

The Right Medicine for the Right Day

None of this is an argument against emergency medicine. When a person is in a car accident, having a heart attack, or needs surgery, the emergency physician, the cardiologist, the surgeon, and the anesthesiologist are among the great achievements of modern civilization. The hosts said so plainly in their closing discussion. Conventional medicine is superb at the worst day of a person’s life.

The therapeutic order already makes room for this. High-force interventions sit at the top of the ladder, where they belong. The error of the present system is not that it uses them. It is that it begins there, and treats the slow work of chronic illness (diabetes, autoimmune disease, hormonal disruption, fatigue, depression) with the same tools it uses for trauma: identify the symptom, suppress it, and continue indefinitely.

Naturopathy offers a different starting point. Begin with the person. Ask what he eats, where he works, how he sleeps, what he is exposed to, and what burdens he carries. Remove what is harming him. Give his body what it needs. Support what is weak. Only then reach for stronger tools, and only as far as they are needed. This is not an alternative to science. It is the application of physiology, biochemistry, and microbiology to a single human life.

It is also, as Berry observed, the oldest medicine of the West. What we now call alternative was the original. What we call conventional is the newcomer. The question for every patient, and every physician, is whether the newcomer has earned the right to go first.