The History of Naturopathic Medicine in BC Revisited

- Glenn Cassie

British Columbia was a place of opportunity, growth and prosperity in the early 20th century. In Vancouver alone the population soared 271 per cent between 1901 and 1911.1 Across the province huge investments were made in infrastructure and schooling. More than 80 hospitals were built in BC, with a broad transition from Victorian charity houses to medical treatment facilities.2 Public health consciousness was also alive and well in the Pacific Northwest as various efforts to secure legislation for naturopaths (known at the time as drugless practitioners) occurred between 1900 and the early 30s.

Given this rapid development, it’s no surprise that many complementary health providers—drugless practitioners, osteopaths, chiropractors—also sought legal recognition. Oral history of the naturopathic profession commonly asserted that NDs have been licensed in BC since 1923, first in the Medical Act, then in their own legislation in 1936. This is not true. What is true, however, is that medicine and surgery has been regulated since 1867, with an ordinance being passed in the Legislature in 1886.3 Three years later, an amendment passed adding homeopaths to the register.4 To quote, “…the Medical Register will shew that he is registered as a homeopathist; and the same provision shall apply to allopathic physicians.” The ordinance became part of the statutes when BC became a province of the Dominion of Canada in 1871.5 Osteopaths were incorporated into the Medical Act in the same way, in 1909.

Drugless practitioners, who rebranded, later, as naturopathic doctors, fought repeatedly for legislative recognition. At the same time, medical doctors fought hard to prevent health options for patients. Although they sought to make osteopathy illegal, they reached a legislative compromise.6 From 1909 the College of Physicians governed entry to practice for osteopaths with artificially high standards guaranteed to keep the numbers low; and, in general, the medical profession sought to eliminate alternative health care in BC through legislation, the courts, and prosecuting care providers for illegally practicing medicine.7 In the 1910s medical doctors tried using legal means to ban chiropractic by charging them with “the illegal practice of medicine” and used the courts to try and eliminate drugless therapy.8 In 1920, the MD’s council had 12 Vancouver and five Victoria chiropractors charged and tried9; this of course led to a surge in the chiropractors organizing and making even a more determined effort for regulation.

While most drugless practitioners in BC were originally trained in chiropractic and there were similarities between the two professions, there was a break amongst chiropractors who practiced only spinal manipulation (aka “the straights”) and those who obtained training in sanipractic and natural therapies (aka “the mixers”). Both groups advocated separately for legislative recognition. In the early 1920s two separate drafts went to the provincial Legislature, one for chiropractic and the other, in the words of the Vancouver Medical Association, to give “a cult calling themselves Sanipractors the legal right to treat the sick.”10 A Select Committee, upon receiving submissions from both the College of Physicians and BCMA, wrote “that only those possessing a standard of scientific education should be entrusted with this great responsibility [to treat the sick].”11 On March 30, 1921, the Select Committee rejected both bills.

In an explanation by the committee chair as to why the bills were defeated, he stated that to guarantee to the public that all practitioners were qualified, the solution was to reject the bill and put the health providers under the Medical Act, the same way homeopaths and osteopaths were. Committee members expressed confidence that in so doing, the medical council would be “honest and fair” in its regulatory oversight.12

While naturopathic medicine was never regulated in 1923 in the Medical Act, the professionals trying to achieve recognition did not rest on their laurels. Over 20 separate bills (NDs and DCs separately) were sponsored over the next 15 years. There was no love lost between the two complementary professions either. The “straights” distanced themselves from the “mixers” enforcing an anti-mixer policy and, in respect to collaborating on legislation, noted “we as chiropractors cannot afford to become associated with Drugless Healers regarding legislative matters.”13 This in turn led the drugless healers (most originally trained at chiropractic schools) to rebrand first as sanipractic doctors then, at the turn of the decade, as naturopathic doctors.

Why then did some elders think naturopathic medicine was included in the Medical Act in 1923? While it’s hard to say definitively, some of the facts they recalled do stand up. Private bills respecting drugless physicians were introduced repeatedly. Further, the bills were accompanied by petitions, and the elders noted the volume of patient support for drugless therapies. And it was not uncommon for government to create a committee to hear and consider representations and report to the Legislature. But, in 1921 for example, the committee included both an MD and druggist who basically killed the proposal from the outset. Since most of the elders who recalled the 1920s were trained at chiropractic colleges, they may have confused the fact that chiropractors were subsumed under the Medical Act (in a 1922 amendment). This did not provide the regulation chiropractors were seeking: They were required to take entry to practice exams in “anatomy, physiology, chemistry, pathology, histology, neurology, physical diagnosis, gynecology, hygiene, medical jurisprudence.”14 No chiropractor ever took the exams; the profession chose instead to fight for legislation unique to its professional standards. Drugless physicians, despite a committee recommendation they also go under the Act, were never included, and no amendment was put forward.

Undeterred, in 1923 the Sanipractic Physicians Act (Bill number 17) was introduced.15 Rejected in 1924, the legislative subcommittee wrote that alternative healers did not have the training equivalent to medicine.16 Government eventually struck a Royal Commission in 1931 to examine whether the two professions would benefit from regulations. The commissioner did not weigh in on whether legislation would protect the public, but he did state that anatomy was essential to diagnosis, and that “no drugless healers dissect the human cadaver or any part of it” and therefore “in the public interest no change should be made in the existing law” leading to another stalemate.17 And, yes, both chiropractors and naturopaths sought legislation again, in 1932 (without success). Chiropractors tried again in the 1933, their bill failed at second reading, but in 1934 Premier Patullo supported legislation and the Act for DCs passed. The downside of this for naturopaths was that “straight” chiropractic was now legislated and “mixing” was illegal.18 Therefore, most drugless practitioners had to make the choice to give up natural therapies or utilize no manipulation. Many drugless practitioners did not change their treatment modalities, however, and this led to the new chiropractic board investigating them for practicing illegally. Naturopaths were now the target of both chiropractors and the College of Physicians and Surgeons. Fortunately, despite the antagonism amongst each group and the failures over 15 years, naturopathic physicians received legislation in BC in 1936.

How then did these two professions finally obtain legislation—the Act respecting Chiropractors and the Act respecting Naturopathic Physicians? Likely a mix of factors including a shift amongst elected officials, continued public pressure and repeated attempts. In BC, legislators in Victoria refused to advance naturopathic legislation eight times before finally passing the Act.19 The public was also a key factor. Even though both Premier Patullo and, prior, Premier Tolmie, did not support naturopathic legislation, they conceded public support was integral to passage.20 Patullo permitted a free vote in the Legislature and, by not forcing a vote to party lines, facilitated smooth passage. Another shift was how much political influence MDs had: MD MLAs were common in BC in the 1920s, less so in the 1930s, but regardless they tended to vote as a block and when in 1930 it appeared that the Tolmie government, alternative healers and even the medical profession had reached an agreement

on a legislative solution, the MD MLAs “continued to conduct the most strenuous kind of lobby against the drugless bill.”21 In fact, the Royal Commission was struck because MD MLAs halted debate, demanding it, therefore cleverly avoiding advancements for naturopathic doctors. (Between 1928 and 1922 one-sixth of MLAs were members of health professions.22)

As the profession nears amalgamation, another transition in regulation, it’s useful to remember the views of other health professionals, politicians and bureaucrats over the years. In the 1970s, “conventional” medical views were that naturopathic medicine had limited scientific merit, potentially not in the public interest. This was identical to the 1910s through early 1930s. The difference is, however, that in one era NDs were regulated, and patients benefited, and in another era NDs weren’t regulated, and patients desired regulation.

Endnotes

1 Adams, Tracey L, Regulating Professions: The Emergence of Professional Self-Regulation in Four Canadian Provinces, University of Toronto Press, 2018, p. 159.

2 Vandenberg, Helen and Geertje Boschma, The Evolution of Early Hospitals in British Columbia, BC Studies, Issue 208, Winter 2020.

3 An Ordinance Respecting Practitioners in Medicine and Surgery, 1867; An Act Respecting the Profession of Medicine and Surgery, 1886.

p. 37. Of note: An amendment to remove homeopaths passed on March 15, 1966. 4 An Act to amend the Medical Act, April 6, 1889, Victoria, BC,

p. 359. 5 Canadian Public Health Journal, Vol XXV, No 8, August 1934,

6 Adams, Regulating Professions, p. 228.

May 2015, p. 220. 7 Adams, Tracey L. and Nicole Etherington, The Emergence of Naturopathy in Two Canadian Provinces: British Columbia and Ontario, 1920-1970, Social History, Vol XLVIII, No 96,

8 Adams, Regulating Professions, p. 228.

9 Adams, Regulating Professions, p. 223.

10 Vancouver Medical Association Bulletin, January, 1925, p. 6

11 Medical Association, p. 6

12 Adams, Emergence of Naturopathy, p. 223.

13 Adams, Emergence of Naturopathy, p 223.

14 Adams, Regulating Professions, p. 224.

15 Legislative Journals, Tuesday, November 6, 1923, p. 40.

16 Adams, Regulating Professions, p. 224.

17 Report of the Royal Commission on Chiropractic and Drugless Healing, Victoria, BC, 1932, pp. 10-11.

18 Adams, Emergence of Naturopathy, p. 229.

19 Adams, Emergence of Naturopathy, p. 243.

20 Adams, Emergence of Naturopathy, p. 243.

21 Adams, Regulating Professions, p. 225.

22 Adams, Regulating Professions, p. 230.