The Vis Medica-what?
I would argue that, without much question, the vis medicatrix naturae (VMN) is the biggest hiccup in the way of Naturopathic Medicine’s widespread acceptance. There seems to be this notion that acknowledging a vis medicatrix naturae implies a lack of science or validity. But, I would like to argue that, without much question, everyone believes in and sees this vis medicatrix naturae in some way or another
“The power possessed by the human body of resisting disease and of restoring health. The primary force of all forces, coming from the great central source of all life; an expression of divine intelligence.” – Lindlahr, H. Nature Cure, Philosophy & Practice Based on the Unity of Disease & Cure.1913
“The healing power of nature is the inherent self-organizing and healing process of living systems which establishes, maintains and restores health. Naturopathic medicine recognizes this healing process to be ordered and intelligent. It is the naturopathic physician’s role to support, facilitate and augment this process by identifying and removing obstacles to health and recovery, and by supporting the creation of a healthy internal and external environment.” – Snider, P., & Zeff, J.L. (1989). Definition of Naturopathic Medicine. American Association of Naturopathic Medicine Position Paper. Select Committee on the Definition of Naturopathic Medicine. AANP House of Delegates, Rippling River, Oregon.
The vis is completely intertwined with, and cannot be separated from each and every aspect of life itself.
It’s only logical, actually.
For the “sciencey folk” like myself, let’s look at this with the premise that we live in a physical world bound by the physical limitations of chemistry and physics…
All things are composed of matter. All matter is composed of neutrons, protons, and electrons. All of those neutrons, protons, and electrons create the elements we learn in Chemistry 101.
So, now we have these little, humming, inanimate elements, like carbon (which actually wouldn’t look like a “C” if you saw it up close).
Various forces (Van der Waals, H-bonding, disulfide bridging, etc..) will attract or shove these elements together in such a way that they begin to create molecules. Our four basic macromolecules (“large-molecules”) of life include:
- Carbohydrates (e.g. Glucose, Cell membrane identification marker, etc..)
- Proteins (e.g. Muscle, Neurotransmitters, Enzymes, Fascia, etc..)
- Lipids (e.g. Myelin around nerves, Steroid hormones, etc..)
- Nucleic Acids (e.g. DNA/RNA, ATP, GTP, NADH, FADH, etc..)
Everyone knows the first three as things we eat, and the last one as the stuff of our genes.
Let’s talk donuts. Sticking with the premise of our physical world bound by chemistry and physics, a carbohydrate cannot (and does not) just “will” itself into a lipid. There is a series of sequential steps with multiple macromolecule players that occur in order for that sugary donut to appear on your belly (Grossly summarized: Carbohydrate –> Acetyl-CoA –> Lipid). We’ll come back to this later.
Let’s hold a brief space for religion and evolution…
So we just set the stage for our physical world; there are proteins, lipids, carbohydrates, and nucleic acids in all living things on this earth. Those macromolecules are all composed of elements, which are composed of protons, neutrons, and electrons – which are just matter.
Now if you are religious or spiritual and believe in a Deity or Divine Power, this part is inherent – the vis is your soul or universal consciousness. It is the divine energy that flows through you and our earth, animating these macromolecules, and giving life.
If you don’t fall into the above camp, let’s, at the very least, be amazed with this… In your mind, go back to high school biology and chemistry with this classic experiment.
The Miller (Miller-Urey) Experiment performed in 1952, published in 1953, showed that they could create these macromolecules for life, particularly amino acids (protein building blocks), with just hydrogen, water, methane, and ammonia in a sterile flask. The flask was heated and had electric sparks passed through to simulate Earth’s early conditions. The takeaway – it is possible that these macromolecules, with the potential to construct life, occurred spontaneously in Earth’s evolutionary history.
Raise your hand if you THINK, dare I say “KNOW,” that all organisms strive for life…
Reproduce and die. That’s what it’s all about, right?
Let’s look at this on a smaller level with proteins. Proteins are absolutely vital for life. Proteins are composed of amino acids (hydrogen, carboxyl, amino, and side chain).
In order to connect these amino acids to create a functional protein (e.g. hexokinase; an enzyme that deals with glucose metabolism) we NEED nucleic acids to be stored in such a sequence (codon) that it codes for these specific amino acids. Additionally, we NEED other proteins (ribosomes) to “read” this nucleic acid code in order to sequence together amino acids in a way that produces a brand new, functional protein.
These nucleic acids that hold this information is in the form of DNA. DNA is formed with a sugar(carbohydrate)-phosphate backbone that wraps the informational pieces (nucleotides) together.
Eventually, this double-stranded DNA is split (by a protein), an RNA strand is created (mRNA created with more proteins; transcription), and then that RNA strand is “read” (by proteins) to connect a different type of RNA together (tRNA; translation) in order to create a new protein.
We literally have feet (in length) of DNA that codes for proteins. And we use proteins (coded by that same DNA) in order to create more proteins (also coded by that same DNA). These proteins will then be used to create and destroy everything else in our human body. All of this happens without our conscious control (and doesn’t even tickle).
This means that somewhere in evolutionary (or religious) history, there was point in time where these molecules assumed highly specific “roles.”
Nucleic acids became the record keeper of all things and a form of energetic currency. Proteins became cell signaling molecules, and functional and structural workhorses of the body. Lipids became cell signaling molecules, insulators, and energy storage. Carbohydrates became energy storage and cell signaling molecules. (Please forgive me if I missed any functions in this general overview.)
Somehow all of these inanimate objects preserved and fine-tuned (evolved) these specific functions through time for the sole purpose of maintaining and perpetuating life.
*Notice, as you read this, we are not all unanimously cancerous blobs or teratomas. More often than not, we find that life is across the board beautifully organized and resilient.
If that is not incredible to you, I don’t know what would impress you.
Seriously, let’s recap and think about this for a second…
We know that there are four inanimate macromolecules that stand as the sole substrates for life to exist.
We know that these molecules can be, and have been, created in laboratory conditions.
We know that these macromolecules, in humans, create our cells. These cells create our four basic tissues:
- Epithelial Tissue
- Connective Tissue
- Muscular Tissue
- Nervous tissue
We know that these tissues form organs. These organs form organ systems. These organ systems orchestrate to form an organism – the human body.
We know that the human body has countless checks and balances in order for that human body to function beautifully and to stay alive.
Let’s talk donuts, again. Assume we ate a large amount of donuts at an eating competition. First, the body will actively absorb that sugar (glucose) from the donut using our digestive tract, and eventually insulin “drives” it into our cells. The insulin release was triggered by the sugar entering the blood stream, and this insulin binds surface proteins of cells which allow the glucose to be used as fuel (via glycolysis) and/or stored as glycogen for later use. In our scenario here, we are assuming massive amounts of carbohydrates (sugars) were ingested. When this is the case, the end product of glycolysis (Acetyl-CoA) will eventually accumulate. Acetyl-CoA is a valuable energy source – the body is “resourceful” and connects the Acetyl-CoA’s together to create lipids or fat (essentially a storage form of acetyl-CoA)!
This was a grossly simplified (and isolated) example of the beautiful mechanisms at play to keep our human body functioning and alive.
Somewhere in evolution it was “decided” that we implement means of storing energy in the form of adipose tissue for later use because it was advantageous to maintain life.
At the very least, amazing. Perplexing.
Regardless of your beliefs, even if summarized as “chance,” the world is full of life (made of inanimate molecules) just doing what it can to stay alive.
I guess what I’m saying is: If you believe in science, then you believe in the Vis. If you are alive, you are a living, breathing expression of the vis.
A simple Google search defines “science” as:sci·ence/ˈsīəns/noun: science1. the intellectual and practical activity encompassing the systematic study of the structure and behavior of the physical and natural world through observation and experiment…
Science, at it’s core, is the observation and study of the vis.
Physiology and biochemistry, the basis of modern medical understanding and intervention, are founded on the principles of physics and chemistry. (Though ignored for most of this article, psychology is also a vastly important piece of the medical puzzle.) All of the sciences were developed as a way for us to explore and explain our natural world and our place in it – not the other way around. Our natural world does not exist because we developed the sciences.
Life was happening long before we could look at it with a microscope or observe the molecules with modern imaging technologies (e.g. IR, NMR, isotopes, etc..).
The vis is simply a way to label this inherent push for life that we see in all, well, life. This vis is a way for us to label what we’re trying to explain with science.
The vis medicatrix naturae is an unimaginable, yet unquestionable, force that is an inextricable, omnipresent component of life.
To recognize this in medicine is not to lack validity, but is to have the humility to work with and honor the things in nature and science that we do not yet understand.
“I have been involved in naturopathic medicine for 35 years, and I still can’t define it. Nonetheless, we can see the Vis in others—it is something we all sense. As a clinician, you watch the level of a patient’s vitality; when it increases you know you are on the path to cure, but if it decreases then you are only palliating symptoms and suppressing the individual’s expression of the Vis.” – Joe Pizzorno, ND (2007)
*Fascinated with life like me? Check out this National Geographic Special – Cradle to Grave!
Extra Credit Material: A couple of excerpts from the 2013 Foundations of Naturopathic Medicine (FNM) Project presentation…
A visual depiction of the vis:
As mentioned in examples throughout the article, the vis medicatrix naturae is the push for life. The vis is all those tiny, amazing enzymes. The vis is the reflexogenic pathways, negative and positive feedback loops, and autonomic systems that allow us to seamlessly exist and pursue our human potential.
For a visual depiction of this, the slide following the picture below stated: “The vis is the flow chart itself.”
Food for thought, and an interesting distinction from Dr. Mitchell ND (Co-founder of Bastyr University):
If a cellphone loses charge, you can just plug it in. If the power goes out, when it comes back we just reset the clocks. If a young human loses life due to pulmonary embolism (clot in the lung) post-surgery, well, why can’t we just remove the clot, feed an IV, push some fresh blood, run a dialysis pump, and hook up an iron lung until life is restored?
Though, we “know” why (e.g. mechanisms like ischemia, pH disruption, necrosis, etc..), there is still something unimaginably humbling and mysterious about standing over the cadavers in a gross anatomy lab.
There lies a human body with all of the pieces that once facilitated a life of triumph, adversity, suffering, and joy. Once animated by a unique individual who made an impact, great or small, just by being a part of this world. Yet that human vessel, with all the “right parts,” looks empty on there on the table.
I feel this is worth repeating – The vis medicatrix naturae is an unimaginable, yet unquestionable, force that is an inextricable, omnipresent component of life. To recognize this in medicine is not to lack validity, but is to have the humility to work with and honor the things in nature and science that we do not yet understand.