The practitioner's first job, and not necessarily confined to naturopaths, is to find something to say or do that will respond to the patient's need, but confined to within certain prescribed limits. James C Thomson, who has taken a fair amount of stick in previous Files, nevertheless had the vision, hitherto lacking, of recognizing the need of the emerging Nature Cure to have the right sort of image and that would create an air of professional respect. To this end he moved from an old family home to the medical centre of Edinburgh in Drumsheugh Gardens occupying the whole of the grand house of no.11, and where The Edinburgh School of Natural Therapeutics had its origin in 1924. Amongst its pre war Graduates were Mrs Parke BSc, Bo Carswell BSc, and Bertram T Fraser MA BSc who was my practitioner in my early years and urged me to become a student. This collection of luminaries, when a University qualification stood for something distinctly above today's standard, and reflects on JCT's ability to attract a high standard of recruit.

The 'tools' available as we sat there in our collars and ties, clad in our white jackets and which were in themselves tools, were massage, diet reform, hydrotherapy and exercise, with the various sub divisions thereof. Noted but not stressed were the conditions that lay behind the symptoms discussed. Smoking was out, right from the start, and other social vices, like tea or coffee, cloaked with the raiment of the Devil. The worst of these two evils you may remember, was simply the one you liked the best. Smoking was clearly identified as the evil it was from the beginning of Nature Cure as we know it. Smoking, of any degree at all, was the great inhibitor of recovery. Clearly recognized. Nowadays in a classic bureaucratic exercise, smokers are hounded from all public places and reviled generally, although not a finger is raised to prevent the manufacturers exporting as many cigarettes as they can to Third World countries, along with other lethal weapons. That, it must be said, is the mark of a good pupil of JCT the polemic swipe at all adjacent targets. How can one isolate the outstanding target from all the forces that conspired to put it there?

The result of many a consultation has to be one of shock and horror for the patient. In the first place, and despite every effort to avoid it, the inevitable assumption by the would-be patient was that he was largely to blame for his present predicament. This was never the intention of the consultation which was more to list all the positive virtues of adopting a dynamic health regime. A consultation really going wrong left the patient with a seemingly impossible list of sins to be corrected. It is rare to get a patient who comes without a strong reference from a former patient, and this can save the day. The same applies in reverse. Personally I have been rescued from the depths of doom and gloom by the recognition that to some people of known intelligence who had become patients, it all made sense. If Nature Cure made sense to such as these, then it must be right! The huge advantage of a Kingston was that once the patient had been encouraged into its sacred portals, usually on the urging of a trusted third person, it could be demonstrated within days that the results were well worth the effort involved.

Times change. Your doctor at the Health Centre wears a tie but no jacket. Rarely does he wear that emblem of sanctity, the stethoscope hung about his neck. He is not concerned, nor does he have the time with the history of the patient, although it could be somewhere in the file he has before him. Nor for that matter is the alternative practitioner interested in the patient's history. Nor it has to be said, is the patient, urgent for the curing to begin. Yet, without reference to the reasons, how can healing begin and continue? Chronic illnesses come from chronic errors over many years. Yet changing a life style is one of the hardest things to do, and yet, must be done. It's the first step that counts.

Our tools are massively inadequate compared with the speed with which antibiotics, steroids, anti inflammatory medication and mood changers can be seen to work. Humans want action now. The future, like global warming, can take care of itself. Our tools are even suspect in themselves, and efforts are being made in the various Files to confront this issue without damaging the central issue of what constitutes a healing process.

We speak of the value of treatment, the package of understanding, advice and encouragement and in which, massage is the visible product. But massage has always been something of a problem. The healing properties of the laying on of hands is Biblical. To have some physical contact after an injury or in illness is immediately comforting and reassuring. To erect this simple, spontaneous gesture into a system to be codified, rationalized by such talk of improving the lymph flow and vital organ efficiency (which it probably does), administered by a superior being in formal dress on a plinth in a treatment room, that takes precedence in the patient s mind, is something else. Even with all the distancing devices in play the possibilities of involvement with are quite real. Massage, alas, has been reduced to an innocuous therapy in the alternative field, where it is not attached to any significant goal. The greater degree of involvement, the more dramatic the result and the greater the possibility of disaster. Yes, biblical. Massage is only effective if the good feeling is mutual. The practitioner has to find something he approves of as well as the patient. Despite the initial formal training, everyone's treatment is different, and some stress the importance of massage in treatment more than others. There are occasions where it is far more relevant to explain rather than to massage, although ideally there should be both. The hazard here is that all one's words of wisdom can be dismissed as just talk, and why, comes the implication, should one have to pay for that. The next difficulty is that the intelligent, cooperative patient can get all of what he feels he needs, in even just one session. Using the treatment as the norm for charging a fee is quite unrealistic. The fee should instead relate to the result obtained, more or less as it is with dentistry. Many a time has the ever struggling practitioner gazed with disbelief at the transformation a few treatments has made to the earning power of the patient, and how little the practitioner stands to gain from it. This lies at the core of our recruitment problem, and this in turn becomes a major issue in any programme of training.

The possibilities of cure are spelt out before arriving at the nuts and bolts of the business. People must be made to feel that becoming a patient is not an impossible proposition. One discusses diet reform, and ever so lightly, the use of water. If the practitioner still has in his old fashioned way, a cold bath in the morning he can demonstrate that at least that is possible. He will, if he feels a response still coming in, speak of hot and cold packs and the use of compresses. Compresses really gets us into something. Work up a belief in compresses, by trial and error as some have, or by a fervent belief in their efficacy that comes after finding them as near to a cure all as anything that exists, and they do just that. They work wonders. Frequently enough a childhood experience of being pulled through all sorts of illnesses and injuries by a mother devoted to their use, will leave a child a memory of being tortured with cold wet rags in much the same way that any sort of imposed fast can be seen as a punishment for being ill. Compresses work in part, because once warmed up (3 mins) they act as a warm cuddle, reassuringly firm, around the waist. As for a fast, an ill person will instinctively eat less unless indoctrinated about the dangers of loss of strength by not eating. It remains true that in the vast majority of cases a sick child will survive the attentions of a devoted mother, the strongest of chicken soups and other nostrums and interventions. A practitioner dances attendance on the greatest tool of them all, the Healing Power of Nature.

All that remains is to understand what is the cause of illness in the first place. The self eliminating acute body cleansing activities that we are all familiar with, and can believe are actually good for us when intelligently left alone, can be dealt with as comfortably as can be arranged. Chronic symptoms and illnesses point to something else. At a simple level, they point to some fundamental error in life style, whether they be dietetic, postural or attitude. But behind that is the conflict between conditioning and instinct, the 'I'm so happy except for my bad back' syndrome. The list is a long one. It includes difficulties with sleep and with digestion, and rituals that are used to circumvent the problem simply compound the problem. The immediate answer is to deal with it from a physiological viewpoint. Sleep is a natural function and a body will take all the sleep it needs for its survival if not necessarily for its comfort. So don't fight it; don't count sheep. Similarly the digestive system is adapted to handle and use a wider range than any other mammal. Intellectual conviction often fails totally, but trying to avoid digestive disturbance by avoiding all the foods known to cause it, will make a digestive cripple for life. But two points will emerge. If most other people dig their graves with their teeth, this person will tend to live a long time, but defensively. But also the cure can be worse than the disease when it means, as it can, giving up the things that provide security not only to oneself but to others as well. Symptoms that begin with retirement should not be treated by themselves but relative to the trauma of a changed relationship.

So much for the practitioner's murky art. We all have our personal tools within that context. For me, it's getting into the fresh air, its walking in all weathers; it includes a weakening devotion in recognition of the ageing process to the morning cold bath. I love gardening but it plays havoc with my skin. Those are my superficial tools. But not enough in themselves to allow me to grow old gracefully.

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