A Therapeutic Order - The Naturopathic Medicine …...A Therapeutic Order An approach to...

A Therapeutic OrderAn approach to naturopathic clinical theory

Jared L. Zeff, ND, LAc

Naturopathic Medicine Institute

VG3 October 12‐13, 2018

Why do well‐selected remedies or medicines not always work? How do many of us feel confident that we can truly cure a patient who suffers from arthritis, cancer, chronic fatigue, or endometriosis? Do we understand how to bring about cure?

Our medicine is based upon the observation of innate healing. From this observation we have extracted six principles by which we define ourselves. These principles also instruct us that our role is not to direct healing, but to help it emerge….

If this philosophy were better understood, and applied in a consistent and artful manner, we would know how to bring about cure and would approach our patients with a strong confidence.

Jared L. Zeff, ND

Journal of Naturopathic Medicine, vol. 7, #1, 1997

Vital Gathering 3 Oct 12-13, 2018: Therapeutic Order Jared Zeff, ND, LAc

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The Six Principles

I. Vis Medicatrix Naturae

II. Tolle Causam

III. Primum Non Nocere

IV. Docere

V. Tolle Totum

VI. Preventare

(Zeff, Snider: AANP, 1989)

Contrasting Models of Thinking

1. Diseases exist as discrete entities

2. Disease entities can be identified

3. Disease entities can be eliminated through treatment

4. Evidence-based application of drugs or surgery constitutes appropriate and effective treatment

1. The Universe is ordered, intelligent, wise, benign.

2. Health is the constant and natural state of being

3. Ill health is an adaptive response to disturbance in the organism

4. Correction of disturbing factors will result in the potential return of normal health

5. Intervention should involve the least force necessary to stimulate the self-healing mechanisms


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Disease as Process

Normal Health

Disturbing Discharge

Factors Process

Disturbance of Function

Reaction(fever, inflammation, etc.)

Chronic Reaction

Degeneration

Determinants of Health

Genetics

Intrauterine influences

Birth trauma

Spiritual life

Nutrition and digestion

Emotional stressors and traumas

Rest and exercise patterns

Relationships

Physical stressors, traumas, and exposures

Physical strengths and weaknesses

Illnesses (specific pathologies), sequelae, and addictions

Medical interventions: surgeries, drug effects, suppressions, etc.


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Determinants of HealthInborn and Maternal Factors

GeneticsIntrauterine/congenitalMaternal exposure (drugs, toxins, viruses, psycho-emotional)Maternal nutritionMaternal lifestyleConstitution and Miasm (determines susceptibility)

DisturbancesIllness and Sequelae (pathobiography)Medical interventionsPhysical and emotional exposures, stressors, and traumaToxic and harmful substancesToxemia and maldigestion

Determinants of HealthHygienic Factors/Lifestyle Factors –How we live

• Fresh air• Clean water• Exposure to nature• Light• Socio-economic factors• Spiritual health• Culture• Rest• Exercise

• Nutrition• Clean/pure/

unadulterated food• Loving and being loved• Meaningful work• Community • Stress (physical, mental

and emotional)• Trauma


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The Therapeutic OrderA Hierarchy of Therapeutic Intervention

Origins

And

Development

Confusion

• Graduate of NCNM 1979

• Class Valedictorian

• Passed board exam first attempt

_____________________________________

• Did not know how to effectively treat seriously ill people


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Sought more training

• “Residency” in Obstetrics

• Family practice in rural Oregon

•Applied to OHSU Medical School

• Fasted and prayed

•Met Dr. Harold Dick

• Saw serious illness healed

• Studied with him for several years

● Otis G. Carroll : 1879 – 1962

● Severe juvenile arthritis

● Healed by Alex LeDoux – Kneippe student

● Returned home and studied Thompsonian herbalism

● 1904‐1908 studied with Lindlahr


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Harold Dick ND

Harold’s Garage in Idaho

Introduced to OG Carroll – brother cured

Graduated in the last class of the last ND program in NA – Western States College

Practiced in Spokane

My primary mentor

What I learned

Organized and orderly approach to therapy

The significance of the wrong diet = toxemia

Vitamins are suppressive (?)

The function of hydrotherapy

The integrated use of homeopathic medicine

The integrated use of botanicals


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First Case

Chronic dermatitis not responsive to steroids

Diet through Dr. Dick, hydrotherapy, homeopathy

Cure of the impossible: RP

Article in Journal of Naturopathic Medicine

Therapeutic Order

A. Address acute concerns

1. Identify and remove causes of disturbance

2. Establish a healthy regimen

3. Stimulate the self healing mechanisms

4. Support weakened or damaged systems

5. Correct structural integrity

6. Address pathology

7. Suppress pathology


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The Therapeutic Order

A. Address acute concerns1. Establish the conditions for health

• Identify and remove disturbing factors• Institute a more healthful regimen

2. Stimulate the Vis Medicatrix3. Address weakened or damaged organs4. Correct structural integrity5. Address pathology: natural intervention6. Address pathology: pharmacologically7. Suppress pathology

1. Identify and Remove Causes

Spiritual disharmonyDiet and digestionStressToxemia


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2. Establish a healthy regimen

Spiritual connection

Appropriate diet

Stress moderation

Appropriate exercise

Appropriate rest

“Water, Air, Sunshine”

3. Stimulate the self healing mechanisms

General StimulationHydrotherapyExercise

Specific StimulationHomeopathyAcupuncture“Energy Medicine”


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4. Support weakened or damaged systemsBotanical medicineGlandulars Specific homeopathics - drainageSpecific nutrients, “nutriceuticals”Specific physiotherapy/hydrotherapySpecific exercise

5. Address structural integrity

Joint and soft tissue manipulationsMassageNon-force manipulationsSpecific exerciseSubtle energy manipulations


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6. Address pathology

BotanicalsNutrientsHomeopathyAcupunctureExerciseMassageIV applications

7. Suppress pathology

Drug therapy

Surgery


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“The highest ideal of cure is rapid, gentle and permanent restoration of the health, ... in the shortest, most reliable, and most harmless way, on easily comprehensible principles.”

s2, Organon of Medicine, Hahnemann, 5th ed.

A Case Illustration

Acute Cardiovascular Disease


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R M Case12/21/0959 y/o woman3 coronary artery blockages, surgery recommendedAspirin 81 mgLisinopril: 20 mgMetoprolol ER: 25 mgSimvastatin 20 mgGabapentin: 400 mg tidFish oil 1200 mgVitamin D/Calcium

RM

BP: 150/90

HR: 60 bpm

CHOL: 147

HDL: 61

LDL: 78

TRIG: 41


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RM

Chest pain predominates: near constant pain not responsive to nitroglycerine

Fear of surgery or of having an MI

BP 180/85

O2: 98%

HR: 60

RM

Tx:Cactus 200c prn for chest painCactus 6c qidRauvolfia/Crataegus/Cactus: gtt 30 tidPerfusia (L-Arginine 1,000 mg)Alli-CinnNiacin Call dailyFIT for dietary evaluation: Potato intolerance


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RM

1/5/10

Chest pain shorter: 3 minutes – responds to Cactus 200 (u. 1-2 hours)

BP: 124/68

HR: 51

P: Continue with regimen

Add Cardio Health Formula (MtPk): 2 tid cc

RM

1/29/10

Chest pain each evening 9-9:30, lower intensity

Feels stronger, able to return to work

128/68

O2: 96%

HR: 45 bpm

P: Continue regimen; add daily hydrotherapy


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RM

2/12/10Chest pain all day after dietary violation130/70O2: 97%HR: 54 bpmP: Continue regimenAdd: Botanical relaxing formula

Pharmacol (Pharmax)CoQ10 100 mg

RM

2/17/10: Phone: ”Chest pain all day”

P: Home made soup only, daily hydrotherapy

3/3/10: “No chest pain for 7 days”

132/65

O2: 97% HR: 55 bpm

P: Reduce Lisinopril by ½

Continue daily hydrotherapy


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RM

3/11/10: MD says she looks better

Minor episodes of chest pain with stress:

> Cactus 200c

BP: 120/70

O2: 97%

HR: 51

RM

3/19/10: MD says she’ll die without surgery

She is confused because she is doing much better

BP: 124/65

O2: 96% 51 bpm

P: Aconitum 200c prn for episodes of anxiety

Continue regimen


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RM

3/25/10: Angiogram scheduled for April

Told she needed surgery-still hopeful/scared

BP:132/76

No chest pain

Continue regimen

RM

4/13/10: “Miracle!” Significant improvement on angiogram: she no longer needs surgery

2 small vessels cleared

Large blockage reduced by 50%

“It must have been the statins, though statins don’t do that”

P: Continue regimen: reduce medications


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Naturopathic Medicine Institute“The Therapeutic Order”

Jared L. Zeff, [email protected]

www.salmoncreekclinic.com


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