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from The Textbook Letter, Volume 12, Number 4


Keeping an eye on the scams, shams and swindles

The Quackwatch site exposes naturopathy, a kind
of pseudomedicine that is promoted heavily in a
"science" text issued by Holt, Rinehart and Winston.

An Informative Visit to a Very Helpful Web Site

William J. Bennetta

A few years ago, after writing some articles that told readers of The Textbook Letter how certain schoolbooks were endorsing quackery [see note 1, below], I offered a short "Editor's File" item in which I recommended a Web site called Quackwatch. That site, I said, provided a wealth of information that would help educators to identify quackery, to detect the promotion of quackery by schoolbook-writers, and to answer students' questions about claims made by quacks [note 2].

Since then, Quackwatch has expanded greatly in both size and scope, and I have used it often to learn about various forms of quackery, to get historical information about quackish treatments and nostrums, and to learn how lawmakers and regulatory agencies have sought to keep quacks from fleecing and harming the public.

I recently visited Quackwatch after I saw that the 2001 version of Holt Science & Technology: Life Science, a middle-school book sold by Holt, Rinehart and Winston, contains a full-page article devoted to promoting naturopathy. I already knew that naturopathy was a pseudomedical craft whose practitioners, called naturopaths, embraced various superstitions and various forms of supernaturalistic hooey; I knew that naturopathy was heavily entangled with homeopathy [note 3], and that it often was associated with the merchandising of quackish "dietary supplements"; and I knew that naturopaths were allowed to operate in many states of the Union. I wanted to know more about naturopathy, however, before I undertook to analyze the promotional article in Holt Science & Technology: Life Science, so I consulted Quackwatch [note 4].

An Ancient Superstition

Quackwatch offers several items that deal with naturopathy, the most helpful of which is an analytical essay, by Stephen Barrett, M.D., titled "A Close Look at Naturopathy." Barrett begins his analysis by telling this:

Naturopathy, sometimes referred to as "natural medicine," is a largely pseudoscientific approach said to "assist nature," "support the body's own innate capacity to achieve optimal health," and "facilitate the body's inherent healing mechanisms." Naturopaths assert that diseases are the body's effort to purify itself, and that cures result from increasing the patient's "vital force." They claim to stimulate the body's natural healing processes by ridding it of waste products and "toxins." At first glance, this approach may appear sensible. However, a close look will show that naturopathy's philosophy is simplistic and that its practices are riddled with quackery.

The notion of a "vital force" or "life force" -- a nonmaterial force that transcends the laws of chemistry and physics -- originated in ancient times. Historians call it the doctrine of vitalism. No scientific evidence supports this doctrine, but a huge body of knowledge, including the entire discipline of organic chemistry, refutes it. Vitalistic practitioners maintain that diseases should be treated by "stimulating the body's ability to heal itself" rather than by "treating symptoms." Homeopaths, for example, claim that illness is due to a disturbance of the body's "vital force," which they can correct with special remedies, . . . . Naturopaths speak of "Vis Medicatrix Naturae."

Barrett quotes from an undated flyer issued by an outfit called the American Association of Naturopathic Physicians, which says naturopathy "is effective in treating all health problems, whether acute or chronic." That absurd claim to omnipotence tells us all that we need to know about the American Association of Naturopathic Physicians. We must, however, give some attention to this organization's name and to the phrase "Naturopathic Physicians," which engenders the false impression that naturopaths are comparable to medical doctors [note 5]. In most of the fifteen states that issue licenses to naturopaths, a naturopath may lawfully use a title that incorporates the word "physician," but in Alaska and Maine this is prohibited [note 6]. In Tennessee and South Carolina, titles don't matter; in those states, the practice of naturopathy is illegal [note 6].

Barrett next cites a passage from a brochure that the American Association of Naturopathic Physicians published in 1989, complete with the assertion that "Naturopathic physicians treat patients by restoring overall health rather than suppressing a few key symptoms." This claim (or a closely similar one) appears regularly in publications issued by naturopaths. It is one of the naturopaths' favorites, contrived to project the implication that practitioners of real medicine merely manipulate symptoms without actually curing anything. That implication is obviously and outrageously false, and it could not fool any rational person.

A Meaningless Claim

Another of the naturopaths' favorites is the declaration that naturopathy is aimed at "treating the whole person" or "treating the person as a whole." That claim is meaningless, but meaningless claims are common, evidently effective devices for impressing gullible consumers. Recall, for example, the many advertisements that you have seen in which pseudomedical products were said to "boost the immune system."

I chose that example because airy-fairy claims that involve an alleged boosting or strengthening of the human immune system are prominent in naturopathy, and boosting the immune system seems to be the naturopaths' answer to a big array of diseases and derangements, including cancers and AIDS. Barrett comments: "[T]he notion that cancer reflects weakness of the immune system is false. If it were true, people given immunosuppressant drugs to treat arthritis or prevent rejection of transplanted organs, or who are immunodeficient because of hereditary disease or AIDS, would be prone to develop the common cancers. Rather, they tend to develop unusual ones -- such as Kaposi's sarcoma in AIDS."

Barrett goes on to describe the history of naturopathy and to list some of the quackish practices that have been included in naturopathy at one time or another. Then, in a section on "Education," he tells about schools that distribute naturopathy credentials:

Today, within the United States, a "doctor of naturopathy" (N.D.) or "doctor of naturopathic medicine" (N.M.D.) credential is available from four full-time schools of naturopathy and at least eight nonaccredited correspondence schools, . . . . (One correspondence school, the Progressive Universal Life Church, offers a "Ph.D. in Naturopathy" for $250 plus "life experience" with no coursework.) Another nonaccredited school offers a "Naturopathic Practitioner" diploma to eligible individuals who complete a 15-month program of home-study plus a dozen weekend seminars. . . . [note 7]

The leading naturopathy school, Bastyr University, in Seattle, Washington, was founded in 1978. Besides its N.D. program, Bastyr offers a B.S. degree program in Natural Health Sciences with majors in nutrition and Oriental medicine; a B.S. program in psychology; B.S. and M.A. programs in applied behavioral sciences; M.S. programs in nutrition and acupuncture/oriental medicine; and a certificate in midwifery. Bastyr has also provided health-food retailers and their employees with home-study programs that promote "natural" approaches for the gamut of disease. Students in the naturopathic degree program are required to take three courses in homeopathy and can elect to take three more. The Southwest College of Naturopathic Medicine and Health Sciences in Scottsdale, Arizona, was founded in 1992. The University of Bridgeport College of Natural Medicine in Bridgeport, Connecticut, began classes in 1997. Naturopathy schools receive much of their financial support from companies that market dietary supplements, homeopathic products, and/or herbal remedies.

In later sections of his article, Barrett covers the legal status of naturopathy and tells about some of the pseudoscience that he has found in naturopathic publications. Here, for example, are his remarks about some of the writings of Michael T. Murray, a member of the faculty of Bastyr University:

In The Complete Book of Juicing, Murray recommends juices for treating scores of ailments. He also advises everyone to use supplements because "even the most dedicated health advocate . . . cannot possibly meet the tremendous nutritional requirements for optimum health through diet alone." These ideas lack scientific validity.

In another book, Murray claims that juicing is valuable because fresh juice provides the body with "live" enzymes. This idea is absurd. The enzymes in plants help regulate the metabolic function of plants. When ingested, they do not act as enzymes within the human body, because they are digested rather than absorbed . . . . [note 8].

I hope that you will go to Quackwatch, find Barrett's essay (by using the site's internal search engine and the search-string a close look at naturopathy), and read it for yourself. I hope, too, that you will go to the Web site of the National Council Against Health Fraud and read the "NCAHF Fact Sheet on Naturopathy" [note 9]. If you do these things, you will be able to appreciate fully the article which Holt's writers have used for plugging naturopathy in Holt Science & Technology: Life Science, and which I now shall describe in detail.

More Extensive and More Elaborate

Holt has promoted pseudomedical rubbish before. In the 1994 version of the high-school book Holt Health, for example, Holt's writers depicted magic and scientific medicine as equivalent alternatives, endorsed vitalistic fantasies and presented them as facts, and tried to destroy the student's ability to think rationally about biomedical matters. They also endorsed two common forms of quackery -- ginseng magic and acupuncture -- while refusing to define or describe either of them [note 10]. This refusal was not at all remarkable; deep obscurity is common in the promotion of pseudomedical enterprises and quackish products, and we have seen this in other schoolbooks. In the 1993 version of Glencoe Health, Glencoe's writers plugged chiropractic but flatly refused to tell anything about what chiropractic was or about what chiropractors did [note 11], and the writers of the 1994 version of Addison-Wesley's Science Insights: Exploring Living Things promoted acupuncture while refusing even to tell what the word acupuncture meant [note 12]. Maybe they feared that if they disclosed what acupuncture was, students who used their book would laugh.

The endorsement of naturopathy in Holt Science & Technology: Life Science is more extensive and more elaborate than anything that appeared in Holt Health, and it obviously has been derived directly from promotional material concocted by one or more naturopaths. It occupies all of page 652 and appears under the rubric "CAREERS"; it is one of several feature articles, distributed here and there in the book, that purport to tell students about occupations that supposedly have something to do with science.

Immediately under the "CAREERS" label we see a photograph of a woman who is equipped with a stethoscope. Under the photo we see the caption "NATUROPATHIC PHYSICIAN" and this bit of text:

Dr. Stacey Kargman of Tucson, Arizona, is a doctor of naturopathic medicine (NMD), commonly referred to as a naturopath. An NMD has similar training to an MD but is less likely than a traditionally trained doctor to use prescription drugs or surgery to treat a patient's symptoms. Naturopaths tend to look for a natural way to treat a patient, using drugs or surgery as a last resort. Dr. Kargman tries to strengthen her patients' immune systems by focusing on things like nutrition.

Never mind the broken syntax in that passage. The important thing here is the implication that any naturopath, anywhere, can use prescription drugs just as a medical doctor can. That is false. In Alaska, a naturopath can't use prescription medications at all. In California, a naturopath's prescribing is subject to supervision by a medical doctor. In each of several other states, a naturopath's prescribing is restricted to certain substances that are listed in a naturopathic formulary, which is different from the medical formulary. And so forth.

Now we read a longer run of text:

Dr. Kargman attended the Southwest College of Naturopathic Medicine, where she studied all the sciences a medical doctor would study -- like biochemistry, anatomy, pharmacology, and physiology. Beyond the standard medical school sciences, naturopaths spend an additional four years studying subjects like botanical medicines, homeopathy, acupuncture, counseling, and nutrition. "Naturopathy is a way of looking at the person as a whole," says Kargman. [note 13 and note 14]

The Keystone to Good Health

Many naturopaths believe that nutrition is the keystone to good health. "Most MDs don't talk to their patients about their diets," Kargman explains. "I'm in a position to talk to them about what they eat and how it may be affecting their health. Food allergies can cause an immune reaction in the body -- anything from depression to skin problems to migraine headaches. Even though I can prescribe prescription medications, I usually defer to MDs when it comes to prescription medications." [note 15]

Dr. Kargman treats many HIV and AIDS patients. She encourages these patients and others who need prescription medications to work with their medical doctor and their naturopath at the same time. That way, patients get the best care. [note 16 and note 17]

A Fulfilling Career

Dr. Kargman says the best part of her work is making people feel better. "Someone might come to me and say they [sic] have terrible migraines that they can no longer live with and that they've seen every doctor. After examining them, I might be able to tell them something as simple as, `Stop eating wheat.' The simplest thing can change someone's life. . . It's not like putting a bandage on it. It's fixing the cause of the problem."

Next, we see another photograph of Stacey Kargman, over this caption:

Stacey Kargman, NMD, tries to treat the patient as a whole.

And finally, something for the student to do:

On Your Own

Do some research about naturopaths. Find out how an NMD's training and practice differ from the training and practice of an MD.

In the teacher's edition of Holt's book, page 652 offers a note which suggests that students, when trying to carry out the "On Your Own" assignment, may contact the American Naturopathic Medical Association.

Why Does Holt's Book Plug Naturopathy?

As I noted earlier, the endorsement of naturopathy in Holt Science & Technology: Life Science has clearly been derived from promotional material concocted by one or more naturopaths. It consists entirely of commercial propaganda, it fails to provide any valid account of naturopathy, and it is loaded with deceit. This deceit is reflected in the use of misleading part-truths, the use of statements that deliver false implications, the concealing of facts that might enable students to grasp what naturopathy really is, and the concealing of any information that might enable students to perceive the status of naturopathy in the real world.

When was Holt's endorsement of naturopathy composed? I do not know the answer to this question, but I know that "Dr. Stacey Kargman of Tucson, Arizona," no longer dwells in Arizona. She now is a resident of Maryland, where she runs a business called the Maryland Natural Health Center. According to the Center's Web site, Kargman left Arizona in 2000 and took control of the Center in April 2001. (Later, at her request, her license to do naturopathy in Arizona was retired.)

Why did Holt decide, in the first place, to plug naturopathy. I don't know the answer to that question either, but I can speculate.

Here is my first speculation. Some Holt functionary decided to embellish Holt Science & Technology: Life Science with a "CAREERS" article about an occupation that was related to healthcare, but he somehow overlooked all of the activities and specialties that constitute the profession of medicine. And, by bad luck, he missed all the medical sciences too. Eventually he descended to the queer realm of pseudomedicine, and there he noticed naturopathy -- but he was unable to find any source of legitimate information about it. More bad luck!

Here's my other speculation. The advertising for naturopathy was inserted into Holt Science & Technology: Life Science because Holt (or some Holt staffer) received money (or some other reward) for this promotional service.

Notes

  1. Quackery is the promotion, for commercial purposes, of treatments or remedies that have not been shown to be effective or that are known to be worthless. [return to text]

  2. See "Help Has Arrived" in TTL, Vol. 8, No. 1. [return to text]

  3. Homeopathy is a kind of magic. Homeopaths (as the practitioners of this magic are called) claim that they can create remedies by making aqueous or alcoholic solutions of plant or animal materials and then performing rituals in which these solutions are repeatedly diluted. Their enterprise is pure, undiluted quackery, and their so-called remedies are worthless. For an explication of homeopathy and the magical notions on which it is based, see my review of the 1993 version of Glencoe Health, a quackery-laden schoolbook that conspicuously promoted homeopathy, acupuncture and chiropractic. That review, "How Glencoe's Text Promotes Quackery," ran in TTL, Vol. 6, No. 1. [return to text]

  4. http://www.quackwatch.org [return to text]

  5. This corresponds to the effect that chiropractors create when they call themselves "chiropractic physicians." [return to text]

  6. See Overview of Naturopathic Regulation, published by the State of Colorado's Office of Policy, Research and Regulatory Reform (a unit of Colorado's Department of Regulatory Agencies). [return to text]

  7. Besides the nonaccredited schools, the United States has several naturopathy schools that hold accreditations. This may seem weird, but it is easy to understand. When a school of any kind seeks accreditation, the school usually is evaluated by an organization that has received accreditation powers from some government agency -- and the evaluation proceedings are focused on such things as the school's financial condition, its record-keeping system, its management practices, its marketing tactics, and so forth. The proceedings usually are oblivious to the nature of the material that the school teaches, no matter how perverse or ridiculous that material may be. Over the years, accreditations have been granted not only to naturopathy schools but also to acupuncture schools, astrology schools, chiropractic schools, "creation-science" schools, and other schools that teach bunkum and nonsense. [return to text]

  8. Enzymes are not alive. They are protein molecules, and they are destroyed during digestion, just as other proteins are destroyed. Murray doesn't grasp these points. When he claims that enzymes are "live" and that they remain "live" even after they have been processed in the human gut, he presumably is reciting some stuff that passes for biochemical information at Bastyr University. [return to text]

  9. http://www.ncahf.org/articles/j-n/naturo.html [return to text]

  10. See "Leading Students into the Clutches of Quacks" in TTL, Vol. 5, No. 3. [return to text]

  11. See again my review titled "How Glencoe's Text Promotes Quackery," cited in note 3. [return to text]

  12. See "Addison-Wesley Extends the Quack Attack" in TTL, Vol. 6, No. 2. [return to text]

  13. Homeopathy? Acupuncture? What are those? Why don't Holt's writers disclose what they are writing about? Here we see again the deliberate obscurity that is so beloved by writers who seek to promote pseudomedical treatments and products. [return to text]

  14. I cannot believe that would-be naturopaths learn the biochemistry and pharmacology that legitimate schools of medicine present to students who seek to become medical doctors. Naturopathy is pervaded by vitalism, but modern chemistry and pharmacology are entirely mechanistic and are free of vitalistic nonsense. The statement that naturopaths study homeopathy during their "additional four years" is especially significant because the very cornerstone of homeopathy is vitalism. The refuting of the ancient superstition of vitalism was a crucial event in the evolution of modern science. It began in the 1820s (with Friedrich Wöhler's celebrated synthesis of urea) and was complete by 1850 or so. Although vitalism may still persist in the haunts of homeopaths and naturopaths and sorcerers, it plays no role in science or in medicine. [return to text]

  15. How has Kargman determined that "Most MDs don't talk to their patients about their diets"? [return to text]

  16. If "Kargman treats many HIV and AIDS patients," what treatments does she provide? What does Kargman do that a medical doctor would not do in caring for patients who suffer from HIV infections or AIDS? Is there any reason to believe that Kargman's performances have a beneficial effect on such patients? Holt's writers, committed to calculated obscurity, refuse to provide answers to these obvious questions. [return to text]

  17. The "best care"? That doesn't make sense. If there is something to be gained by hiring a naturopath to supplement the services of a medical doctor, why stop there? Wouldn't it be even better to hire a naturopath plus a witch? How about a naturopath, a witch and an Eddyist? Better yet, how about a naturopath, a witch, an Eddyist, and a guy who claims to perform cures by using magical crystals? And so on. [return to text]


To learn more about Holt Science & Technology: Life Science, see the article "The Quota-Queens and the Empress" in this issue of TTL.


William J. Bennetta is a professional editor, a fellow of the California Academy of Sciences, the president of The Textbook League, and the editor of The Textbook Letter. He writes often about the propagation of quackery, false "science" and false "history" in schoolbooks.

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