What’s So Natural About Natural Medicine?

Susannah Meadows’ young son, Shepherd, was afflicted with juvenile idiopathic arthritis. Conventional drug treatments (naproxen and methotrexate) seemed to exacerbate his condition, but after regular doses of an ancient Chinese herbal remedy called “four-marvels powder,” his disease went into remission.[i] In 2013, the  New York Times Magazine published an article detailing Shepherd’s miraculous recovery. The implication was clear: Chinese herbs were “natural” and therefore, safer and more effective than pharmaceuticals.

When I read this article, I had just started research for a book on Chinese herbalists in the American West. At the time, I imagined it would recount their experiences serving a mixed-race clientele at the turn of the twentieth century, but the New York Times Magazine article prompted a new line of inquiry. Today, American patients often equate herbal remedies like “four-marvels powder” with “natural medicine.” The marketing of traditional Chinese remedies has exploited that equivalence. Search the internet for acupuncturists, and you will retrieve images of flowers, vines, and other foliage. Step inside any Chinese American herb shop and you will find plastic pill bottles bearing pictures of bamboo, grass, or birds in flight.[ii] The invocation of “nature’s remedies” is not unique to practitioners of traditional Chinese medicine. Other purveyors of what we now call “Complementary and Alternative Medicine” have staked a similar claim on nature. I began to wonder about the historical origins of this connection. How did American patients learn to associate irregular medical sects like homeopathy, naturopathy, and Chinese herbalism with nature and biomedical science with its opposite? In other words, what is so natural about natural medicine?

Nature’s Remedies and Nature’s Enemies

Beginning in the mid-eighteenth century, university-educated American physicians, aspiring to monopolize the medical marketplace, began to promote public licensure based on scientific standards set by them. [iii] Early efforts at regulation were quite feeble, but they rankled men and women without equivalent training and social standing. Leading the charge against licensure was Samuel Thomson, a self-educated herbalist with a following in the rural United States. Thomson called regular physicians “nature’s enemies” and claimed that they attacked their patients with mercury-based drugs like calomel. He defined biomedical science by its dependence on inorganic (or mineral) compounds, which he deemed “unnatural” and poisonous.[iv] His students – “Thomsonians” – successfully repealed public licensure laws in the 1830s and 1840s.[v]

Over the course of the nineteenth century, technological and institutional innovations widened the gulf between regular and irregular medicine. Regular physicians had always been separated by a combination of affluence, race, and gender from irregular physicians, but by the end of the nineteenth century, they were also distinguished by their ability to use new technologies in diagnosis and therapy.  [vi] In last decades of the nineteenth century, the American Medical Association (AMA), a professional organization of regular physicians, renewed efforts to pass licensing laws. State boards composed predominantly of AMA members began to administer mandatory licensing exams focusing on recent biomedical science and pharmacology.[vii] Doctors practicing without a license faced fines and imprisonment.  [viii]

Irregular physicians fought back with nature. They continued to use the term “nature cures” or “nature’s remedies” to characterize their therapies. Irregular physicians defined nature as something essential and democratic. The discourse of natural medicine implied that everyone could be his or her own doctor. Irregular doctors elevated the status of medical knowledge systems that emphasized self-care, noninvasive procedures, and organic (as opposed to inorganic or mineral-based) drugs.  [ix] Naturopathy is a prime example. As a school of medicine, naturopathy coalesced in the 1890s and promoted healing through contact with sun, fresh air, and other natural elements. Its adherents universally rejected biomedical science. Their opposition targeted not only the AMA’s politics but also the science it championed, including vaccination. Naturopaths viewed vaccination as interference with the body’s ability to heal itself.  [x]

Chinese herbalists, advertising in English and Spanish-language newspapers, similarly adopted the discourse of natural medicine. In its 1902 promotional booklet, Los Angeles’ Foo and Wing Herb Company asserted that herbal remedies were “founded upon a complete understanding of Nature’s laws. Americans carry their theories of science to extremes and get too far away from the simple, fundamental facts upon which health depends.”  [xi] In 1914, San Francisco doctor Chin Mai Fong, selling herbs by mail-order to patients in Arizona, invited them to “compare the medicines obtained from the mild, soothing, health-giving plants, provided by nature, used by the Chinese, with the strong drugs used by many of the American doctors.”  [xii]

For their part, AMA physicians saw their work as equally rooted in the natural world. If “nature’s remedies” were characterized by their use of organic compounds, biomedicine was no less dependent on nature than irregular medicine. Regular physicians relied on medicinal plants including belladonna, cannabis, opium (and its alkaloid, morphine), and emetine and, to a lesser extent, animal by-products.  [xiii] The speeches and academic papers published in the  Journal of the American Medical Association (JAMA) around the turn of the twentieth century reflect a prevalent sentiment that biomedical science was the study of nature’s laws of human health. In 1900, H.J. Herrick pondered the connection between medicine and nature: “The doctor adjusts the broken bones and keeps the fragments at rest; Nature unites them. He provides the conditions; Nature is the benevolent healer.”  [xiv] A 1908 article on infant feeding insisted, “We should not dictate to Nature and say, ‘Follow me.’ Nature dictates to us and we must follow.” [xv]

Yet regular physicians often expressed a desire to transcend nature’s limitations. “Letting nature take its course” was akin to withholding the physician’s power to heal.  [xvi] Regular physicians had ardent faith in their ability to understand nature, to improve upon it, and perhaps even to overcome it. Irregular physicians interpreted that faith as hubris. In a pamphlet on medical freedom, for instance, an early twentieth-century homeopath mocked regular physicians: “Tis nature that does it — but what right has she to be round curing people without a degree?”  [xvii]Arrogance and elitism did not endear regular physicians to their patients. By contrast, the discourse of natural medicine insisted the human body was simple and comprehensible. If left to run its course, it would heal itself. The intimidating instruments and impenetrable theorems of regular medicine implied the opposite. Moreover, by claiming special expertise in the nature of human health, regular physicians denied their patients sovereignty over their own bodies. For many patients, ceding such control could feel discomfiting and altogether unnatural. Thus, in the tug-of-war over nature, irregular medicine won.

Endangered Nature and the Dangers in Nature

The persistent coupling of irregular medicine and “nature” poses several dangers in our time. In the case of Chinese medicine, “nature’s remedies” have not led to sustainable relationships with actual nature. In North America, over-foraging of wild ginseng led to its depletion and disappearance in large areas of Canada and the eastern United States where it once grew.[xviii] In Asia, unsustainable foraging has imperiled other Chinese medicines traditionally grown in the wild, such as Cordyceps sinensis, (also known as Himilayan Viagra) a combination of a caterpillar and fungus found in the high altitude mountains of Tibet.  [xix] Hunting tigers and other animals coveted for their medicinal properties has accelerated and contributed to the endangerment of those species.  [xx]

Naturalism has also created a false sense of security with regard to the consumption of herbal remedies. The United States’ Food and Drug Administration (FDA) only lightly regulates traditional Chinese medicine as dietary supplements.[xxi] There remains a lot of uncertainty about dosage, side effects, and drug interactions.[xxii] Research has linked enhanced risk for bleeding, kidney damage, liver cancer, and depression to the consumption of Chinese herbal remedies.  [xxiii] Contamination is also a major concern. The FDA has established “Current Good Manufacturing Practices” for dietary supplements, but inspections have been sporadic.  [xxiv] A startling number of imported Chinese herbal remedies contain bacteria, pesticides, and other adulterants hazardous to human health.  [xxv]

The association of irregular medicine with “nature” and regular medicine with its opposite is also part of a climate of science skepticism that breeds misinformation at the least and dire health outcomes at its worst. For an example, one need only look as far as the rampant “anti-vaxxer” movement of parents who refuse to follow the vaccination schedule recommended by the Centers for Disease Control for their children. Their concerns about vaccines are not based on empirical evidence, but rather on a reflexive distrust of biomedical authority and its interventionism. In the case of the anti-vaxxer movement, “letting nature take its course” has allowed infectious diseases to roar back to life.[1] On the other side of the sectarian divide, biomedical scientists have been slow to adopt “alternative” therapies, manifesting a skepticism of their own.

For a century, the discourse of natural medicine has divided biomedical scientists and practitioners of other healing systems. Perhaps a bridge exists in the understanding that every medicine is based in and dependent on nature. In the treatment of juvenile idiopathic arthritis, naproxen is akin to the salicylic acid found in willow tree bark, methotrexate a derivative of folic acid, which one finds in beans and vegetables. Chinese “four-marvels powder” – a combination of quercetin, berberine, and achyranthine – is a blend of barks, grasses, seeds, and roots. Failure to recognize the common basis for drugs and healing practices has resulted in lost opportunities for common colloquy and most importantly, improved health for all.

Footnotes