Vital Gathering 3 Oct 12-13, 2018: Therapeutic Order Jared Zeff, ND, LAc. A Therapeutic Order. An approach to naturopathic clinical theory

Transcription

1 A Therapeutic Order An 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,

2 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 2

3 Disease as Process Disturbing Factors Normal Health Disturbance of Function Reaction (fever, inflammation, etc.) Chronic Reaction Degeneration Discharge Process 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. 3

4 Determinants of Health Inborn and Maternal Factors Genetics Intrauterine/congenital Maternal exposure (drugs, toxins, viruses, psycho-emotional) Maternal nutrition Maternal lifestyle Constitution and Miasm (determines susceptibility) Disturbances Illness and Sequelae (pathobiography) Medical interventions Physical and emotional exposures, stressors, and trauma Toxic and harmful substances Toxemia and maldigestion Determinants of Health Hygienic 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 4

5 The Therapeutic Order A 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 5

6 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 : Severe juvenile arthritis Healed by Alex LeDoux Kneippe student Returned home and studied Thompsonian herbalism studied with Lindlahr 6

7 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 7

8 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 8

9 The Therapeutic Order A. Address acute concerns 1. Establish the conditions for health Identify and remove disturbing factors Institute a more healthful regimen 2. Stimulate the Vis Medicatrix 3. Address weakened or damaged organs 4. Correct structural integrity 5. Address pathology: natural intervention 6. Address pathology: pharmacologically 7. Suppress pathology 1. Identify and Remove Causes Spiritual disharmony Diet and digestion Stress Toxemia 9

10 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 Stimulation Hydrotherapy Exercise Specific Stimulation Homeopathy Acupuncture Energy Medicine 10

11 4. Support weakened or damaged systems Botanical medicine Glandulars Specific homeopathics - drainage Specific nutrients, nutriceuticals Specific physiotherapy/hydrotherapy Specific exercise 5. Address structural integrity Joint and soft tissue manipulations Massage Non-force manipulations Specific exercise Subtle energy manipulations 11

12 6. Address pathology Botanicals Nutrients Homeopathy Acupuncture Exercise Massage IV applications 7. Suppress pathology Drug therapy Surgery 12

13 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 13

14 R M Case 12/21/09 59 y/o woman 3 coronary artery blockages, surgery recommended Aspirin 81 mg Lisinopril: 20 mg Metoprolol ER: 25 mg Simvastatin 20 mg Gabapentin: 400 mg tid Fish oil 1200 mg Vitamin D/Calcium BP: 150/90 HR: 60 bpm CHOL: 147 HDL: 61 LDL: 78 TRIG: 41 14

15 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 Tx: Cactus 200c prn for chest pain Cactus 6c qid Rauvolfia/Crataegus/Cactus: gtt 30 tid Perfusia (L-Arginine 1,000 mg) Alli-Cinn Niacin Call daily FIT for dietary evaluation: Potato intolerance 15

16 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 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 16

17 2/12/10 Chest pain all day after dietary violation 130/70 O2: 97% HR: 54 bpm P: Continue regimen Add: Botanical relaxing formula Pharmacol (Pharmax) CoQ mg 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 17

18 3/11/10: MD says she looks better Minor episodes of chest pain with stress: > Cactus 200c BP: 120/70 O2: 97% HR: 51 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 18

19 3/25/10: Angiogram scheduled for April Told she needed surgery-still hopeful/scared BP:132/76 No chest pain Continue regimen 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 19

20 Naturopathic Medicine Institute The Therapeutic Order Jared L. Zeff, ND 20