Confessions of a Quackbuster

This blog deals with healthcare consumer protection, and is therefore about quackery, healthfraud, chiropractic, and other forms of so-Called "Alternative" Medicine (sCAM).

Sunday, May 22, 2005

'Copeland's Cure': Medicine Show (homeopathy)

'Copeland's Cure': Medicine Show

Published: May 22, 2005

BRONCHITIS can be stopped in its tracks with a pack of Zithromax; but flu has to be endured. Or does it? Throughout the flu season, a homeopathic medicine with the mystical Latin name of Oscillococcinum flies off pharmacy shelves -- $20 million worth sold in 1996 alone. Its active ingredient is anas barbariae hepatis et cordis extractum. For English speakers, that's ''extract of the liver and heart of the wild duck,'' made into a kind of bouillon, filtered and freeze-dried, rehydrated, diluted and absorbed into tiny sugar pellets. Only one bird is needed to make a full year's global supply of these duck Tic-Tacs; which means there is about as much anas barbariae in a ton of this nostrum as there is Noilly Prat in an extra-dry martini. Why might this work?

As Natalie Robins explains in ''Copeland's Cure,'' her social history of the 150-year battle between conventional and alternative medicine in this country, the guiding principles of homeopathy are that ''like cures like'' and that small doses are better than big ones. These ideas are not bogus: after all, the vaccine for smallpox is made from a smidgen of the milder menace, cowpox. But why would a wisp of duck steam help a human? In the words of Michael Carlston, a homeopath whose work Robins consulted, ''We remain a long way from understanding how these extreme dilutions can directly create clinical effects.'' All that matters, he says, is that the patient get better. Ask someone who isn't a homeopath, and you'll get a different opinion. The Nobel laureate Murray Gell-Mann derided the notion that an undetectable molecule could have a therapeutic result as ''garbage physics''; other partisans of traditional medicine dismiss homeopathy as ''a masquerade fakery'' and ''pseudoscience.''

The two camps have been feuding since the get-go -- there was even a historic fistfight on the campus at Ann Arbor, Mich., in 1867. When the American Institute of Homeopathy was founded, in 1844, it was this country's first national medical organization. Three years later, rival doctors created the American Medical Association, and denounced homeopathy as a delusion practiced by unsavory foreign speculators ''who infest the land'' -- even though, at the time, both schools of medicine offered identical training. But apart from a few closing chapters that touch on current debates on alternative medicine (such as Oscillococcinum), Robins's curious book does not attempt to debunk or to defend either medical school of thought.

Her chief purpose is to explain the origins of homeopathy, and to show how a monomaniacal Midwestern doctor named Royal S. Copeland helped legitimize and popularize it. Robins, the author of ''Alien Ink: The FBI's War on Freedom of Expression,'' among other books, paints Copeland as a hero in his own mind; a well-meaning blowhard who promulgated his homeopathic vision over a long career that ultimately landed him in the United States Senate, where he earned the nickname General Exodus because congressmen fled in droves during his harangues. As an 11-year old boy in Dexter, Mich., in 1879, Copeland watched his grandmother save his father from a fatal fever by boiling ears of corn, packing them in linen, tucking them around him and sweating out the illness. The method -- using heat to cure a fever -- was homeopathic: like cures like. Copeland never forgot the lesson. With colorful examples like these, Robins shows how Americans' understanding of the physical world around and within them changed during Copeland's lifetime.

In the 19th century and well into the 20th, homeopathy and allopathy had a great deal in common. There were no microscopes, bacteria had yet to be discovered, the existence of viruses wasn't known; there were no X-rays, no M.R.I.'s, no penicillin. Aspirin tablets didn't go on the market until 1915 (the A.M.A. denounced the drug, comparing it to morphine). Luck and home remedies were what got most people through serious illnesses. Robins records Copeland's good-faith effort to save a poisoning victim in 1901. The patient was given raw eggs, enemas of turpentine, flax tea and hot milk and brandy, potassium salts, nitric acid, injections from a shrub called jaborandi, digitalis, marigold mouthwash, venom of the bushmaster snake, strychnia, dogbane and buttermilk. She did not get better.

Copeland's fortunes soon improved dramatically, however. In 1908, he moved to Manhattan, where he became head of the New York Homeopathic Medical College, and in 1918, he was appointed city health commissioner, just as the catastrophic Spanish influenza epidemic swept the country. As a preventive health measure, he advised New Yorkers to drink hot lemonade, and he put germ-blocking guards on his office phones. Copeland promoted his ideas in a syndicated newspaper column called ''Your Health'' and on a heavily advertised radio show; he also issued gramophone discs of his personal exercise program. Shameless self-promoter or no, he had sincere convictions, and his dedication was instrumental in strengthening the pure food and drug laws shortly before his death in 1938. That same year, with quaint derision, the A.M.A. declared homeopathy ''dead as a last year's bird nest.'' Which of us today, separated by a century from the folkloric, agricultural America that Copeland grew up in, knew that a bird's nest even had a life span?

Medical certainties, Robins shows, can't be separated from the people who hold them, or the times in which they live. And for all the advances of science, and for all the hopes of ailing humans today, who put their trust in echinacea or pine needles, streptomycin or stem cells, the role of doctors, whether conventional or alternative, will never be entirely separate from the role of faith healer -- at least not until somebody finds a cure for the flu that actually works.

Liesl Schillinger, an arts editor at The New Yorker, is a regular contributor to the Book Review.