Is Mother Nature Our Friend?

A remarkable resurgence of interest in "natural" remedies and the practice of "naturopathic" medicine has occurred over the last several decades. The underlying philosophy of this movement appears to be based upon the belief that we should avoid artificial medications, i.e. drugs that are not normally found in our environment. It is believed that because they are foreign to normal human metabolism, they are more likely to do mischief to our health. Ironically, medical cults based upon these and other "alternative" forms of medicine were successfully purged from accepted medical practice at the end of the nineteenth century, at a time when physicians had far less to offer their patients. It therefore seems appropriate to consider why the public and even some of our own colleagues have returned to this medical movement at the beginning of the twenty-first century.

The humble graham cracker provides some insight into the historical factors which promoted the concept of natural medications in America. In 1829, Sylvester Graham introduced this common household commodity made of unsifted, coarsely ground wheat flour. He advocated a complete health program that included hard mattresses and cold showers, vegetarianism and homemade bread (much to the consternation of bakers and butchers who attacked him on one occasion). Grahamites correctly argued that such a lifestyle was far more conducive to good health than the common medical practices of the day, which included generous doses of mercury, purgatives and phlebotomies. It is quite likely that much of the current popularity of natural remedies is motivated by the harsh side effects of many of the most useful drugs of today, including steroids, chemotherapy and some antibiotics.

Although understandable, the urge for more natural treatments is fundamentally flawed because the concept of "natural" is itself confused. Naturopaths generally seek medicinal products derived from various herbs and other vegetable matter, which they view as somehow friendly to our bodies. However many of the substances which are used for their medical properties evolved over millennia as poisons to prevent their ingestion and to promote the survival of the plant rather than the animal which eats it. Digitalis, belladonna and cocaine are good examples of this principle. Altruism is not commonly found in nature. Most plants are comprised of substances that we cannot digest or are toxic, and unless one has considerable information regarding the surrounding flora, it is far safer to eat meat in a new environment than to try local plants. Perhaps that is why so many of us are attracted to more carnivorous diets.

Survival in the natural world is a very precarious thing, and once procreation and child rearing have been accomplished, persistence of the individual becomes less desirable for the gene pool. "Nature" has provided a number of mechanisms, e.g. the telomeres, which ensure that we will not stick around too long and that there won't be too many mouths to feed. Indeed, it can be argued that anything that frustrates this process is "unnatural."

One criterion that helps distinguish natural from artificial medications is whether the constituents of the agent are defined. Natural products are unknown mixtures of innumerable ingredients, some of which may be the same as those in the artificial product. This complicates assessment of drug potency and toxicity and was responsible for the abandonment of some natural products, such a digitalis leaf, in favor of major effective ingredients, e.g., digoxin. However, there is a certain perverse comfort in not knowing what is actually present in a natural medication. After all, if Mother Nature has chosen to place one beneficial ingredient in a particular plant, it would stand to reason that this sentimental old lady would also place other useful agents in the plant, some of which may be hidden forever from scientists. I would argue that the more precisely we understand the chemical nature and biological properties of our pharmacopoeia, the greater the likelihood that we can design ever more specific and safer drugs to treat a wide variety of illnesses. Many of these drugs never appeared in nature, simply because the objectives of the physician are to treat disease, an activity which is basically unnatural.

Aside from the fact that what is generally referred to as Nature tends to be unfriendly, or at least indifferent, it can be argued that she doesn't exist. By Nature do we refer to the relatively moderate conditions on some parts of the planet (these might not include Wisconsin), or do we also refer to the hot sulfurous emanations of the Jovian moon, Io, the crushing gravity of Jupiter or the vast ammonia storms on the planet Neptune? References to Mother Nature are motivated by the hope that there is someone or something out there which will grant us the care and love which we received as children from our parents. It is certainly true that if we abuse this parent sufficiently, punishment of the most dire kind can be expected. However, I am not sure that we can depend upon this "mother" to extricate us from our own folly because of her affection for mankind.

When physicians are asked by patients whether they should use one or another "natural" medication or therapy, they must consider several factors. Financial - the physician does not want to alienate his patient and natural drugs are frequently inexpensive compared to conventional medication. Time - it is far easier to concur that to argue the issue. Education -- some of their own faculty may espouse and teach Naturopathy. Aside from warning about possible drug reactions or interactions, all physicians must ultimately be concerned about the most important aspect of the patient-doctor relationship: integrity. Do they really believe their own advice?

"Reflections" is a collection of essays by the health professionals of the Medical College of Wisconsin.