I recently had the opportunity to hear Dr. Joe Pizzorno ND, speak on the topic intestinal permeability. Dr. Pizzorno is one of the founding fathers of modern naturopathic medicine in North America. Among his many credentials, he has authored the definitive Textbook of Naturopathic Medicine, and is the co-founder of Bastyr University. Given his Italian heritage, I have taken to calling him “the godfather” of naturopathic medicine.
 
Dr. Pizzorno delivered an informative, scientific, and well executed presentation on intestinal permeability covering basic knowledge right up to the most current animal research. Despite his extensive clinical experience and familiarity with the literature it was Dr. Pizzorno’s respect for traditional wisdom that got me thinking. In his lecture, Dr. Pizzorno espoused the virtues of nature cure and traditional methods such as water fasting, and a fundamentalist approach to digestive health.
 
Personally, I have often struggled with integrating traditional wisdom with current science. In an age of designer biologic drugs that are custom-designed to target discreet receptors subtypes or to inhibit the function of specific isozymes, traditional methods can appear simple, even trite. Furthermore, as so-called “energetic” modalities like homeopathy, acupuncture and Reiki have come under greater scrutiny; faith in the current dogma of modern science causes us to question the teachings of the healers who came before us.  My problem is that while I respect the experience of authors like Weiss and Scudder, I like modern medicine. I like understanding exactly how things work; I like specifics like standardized extracts, dosing schedules, and odds-ratios. These give me a sense of security, that I’m practicing good medicine, and that I am choosing the best treatment that I have some idea what kind of outcomes to expect.
 
The beauty of reductionist science is its commitment to certainty. When we say we know something in science we can have a high level of confidence. The drawback, however, is that certainty can take time and resources to obtain. Currently, the pace at which we can learn things limits the breadth of what we can know for sure.  Dr. Pizzorno reminded me that while science often confirms the efficacy of traditional treatments or helps us to understand how or why they are so effective the knowledge that they are effective has long been established through observation. Traditional knowledge is the accumulation of thousands of years' science. Though scientific methods may become more robust it is impractical to reject everything we have learned up to this point simply because of the methodology by which it was learned.
 
Clearly if we practice only evidence-based medicine (in the strictest sense) it is possible that we will overlook countless valuable treatments that could dramatic improve patients’ quality of life. For that matter do patients even care about the level evidence used to recommend treatments? Could it be that by overlooking traditional approaches we could be missing out on the best treatments? I don't have the answers to these questions. Perhaps it is something we each need to determine individually. As for the Godfather, Dr. Joe Pizzorno seems to have found his peace by integrating new world science with old world wisdom.