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Twilight of the Idiopathic Era and the Dawn of New Possibilities in Health and Healthcare
 
Dr Alex Vasquez

This article was originally published in Naturopathy Digest in 2006; minor edits were made in 2010 and 2014
The original article is archived: naturopathydigest.com/archives/2006/mar/idiopathic.php

Among the perplexing paradoxes that exist in healthcare is coexistence of our adoration of allopathy for its “scientific method” along with the description of most chronic diseases as “idiopathic.” If the allopathic use of the scientific method were so adroit, then why are so many conditions described as having “no known cause”? Is the scientific method inadequate, or is the allopathic lens incapable of bringing disease causation into focus? Perhaps a third option exists: that some groups—namely the medical profession generally and the pharmaceutical companies specifically—benefit by convincing us that most diseases have “no known cause” and that therefore the best that doctors and patients can hope for is additive and endless pharmaceuticalization of all health problems. When the cause of our health problems is “unknown”, we are disempowered, and we must depend on “experts” and those who have "the cure" to help us and save us. When the causes of our problems are known, we are empowered to take effective action. Certainly, some groups have financial and political interests in keeping us as professionals and as patients confused and disempowered.
 
The End of the Idiopathic Era: A stark contrast exists between primary research literature and the “facts” that are selectively reported in medical textbooks and which are used to buttress “conventional wisdom” and the resultant status quo. While I have been aware of this contrast for many years, the divergence was impressed upon me with renewed vigor during the preparation of a recent article[1] and the completion of my 2006 textbook Integrative Rheumatology.[2] Arthritis in general and autoimmune and rheumatic diseases in particular are frequently described as “idiopathic” and as having “no known cause” by most mainstream medical books like The Merck Manual and Current Medical Diagnosis and Treatment; these contentions are inconsistent with the abundant and diverse research showing that—rather than being idiopathic—most chronic musculoskeletal disorders are multifactorial. When a disease is codified as idiopathic, doctors lose their incentive to look for and treat the causes [plural] of the disease because the codified conventional wisdom has already stated that “The cause [singular] of the disease has not been identified.” Similarly, patients are convinced to give up their hope of ever being cured; they chose what appears to be the second best option: lifelong medicalization. In these instances, acceptance of the codified conventional wisdom benefits doctors and patients by freeing them of the obligation to think, to mobilize their consciousness; the price paid for this exoneration from consciousness is perpetuated unconsciousness and drug dependence for doctors and patients. Being told by powerful institutions and ensconced authorities that “There’s nothing else you can do, and nothing more to think about” lulls us all into apathy and conformity at the price of our individual and collective lives and consciousness.

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Multifactorial—Not Idiopathic: Let’s look at psoriasis and rheumatoid arthritis as t