Monthly Archives: February 2013

Patent Medicines and Alternative Medicine I: The Dawn of Patent Medicines

M0015903 'Dr. James's Powder for Fevers' (Picture credit Wellcome Images)

Patent medicines or nostrums were originally so named in the 17th century because those finding favour with the reigning monarch were given letters patent, which authorised the use of the royal endorsement in their advertising. It does not have anything to do with the modern concept of patenting. Indeed, throughout their history, most were not patented but trademarked instead, as patenting would have forced them to disclose the formula – something quite a few of them desperately wanted to avoid.

During the 18th century medicine was in flux. Old ideas – Galen and the Hippocratic tradition – were slowly on their way of being phased out as doctors influenced by Enlightenment sought to make medicine into a science, although it would take a very long time before medicine truly could be called scientific. At the same time, increased access to exotic plants brought to Europe during the Age of Exploration encouraged experimentation. People speculated freely on diseases, how best to treat them and systematise medicine. In addition to scientific progress – though slow – the 18th century gave rise to quackery on an unprecedented scale, some of which survives to this day, homeopathy being the most famous and widespread example.

This was also an age of therapeutic toleration, people with no medical training certainly produced, marketed and sold new mixtures, some of them gaining huge popularity, for example Dr Bateman’s Pectoral Drops. Despite the name, the inventor was not a doctor called Bateman, but a businessman named Benjamin Okell. Interestingly, the choice of the name gives a clear hint of what was to follow: quacks up to today have sought legitimacy by appropriating medical titles. Before restrictive legislation they were free to use whatever titles they liked, modern ones have to resort to diploma mills and institutes of dubious character.

Patent medicines and nostrums were popular for several reasons. Even when you could have an access to a doctor or a surgeon, you did not pay the doctor’s fee and then a separate price for the preparation of the prescription, you just bought the product. They were claimed to cure a whole host of conditions, a typical example being the claims made for Anderson’s Scots Pills:

Comfort and strengthen the stomach . . . purge Choler and Melancholy, but chiefly Phlegm and Waterish Matter . . . they comfort the Bowels and remove all obstructions in those parts.
Strengthen the Head and Senses . . .Giddiness and the Megrim . . . as they comfort and purge the Stomach, they do the like to the Head and Heart.
Kill all kinds of Worms . . .
Purge and throw out by stool all Choler in the Stomach and Bowels.
Hinder the procreation of many diseases . . . defend the body against Surfeit in Eating and Drinking, which frequently beget crude Humours; and are a sovereign help for the Gravel, Scurvy, Cholic, Dropsy, Green Sickness and Palsy.
If the Head, subject to defluctions, keepeth intelligence with a moist and Foaming Stomach . . . these Pills will stop their stream . . . be free from Gout and all other diseases of the joints, so also inward and outward rheumatism.
Extremely useful to all seafaring persons, especially in long voyages . . . kept from costiveness which is the cause of most sickness at sea, and preserved from scurvies, pestilential fevers and other malignant distempers frequent in Foreign Countries.

(This is a much-shortened version of a pamphlet in the Museum of the Royal Pharmaceutical Society)

The ingredients were Barbados aloes, soap, colocynth, gamboge and aniseed oil, making this product an aniseed-flavoured laxative. This was also another sign of times to come: incredible claims were made for a product that never had a chance of delivering those promises, a trend that continues to this day in alternative medicine.

These nostrums were also advertised as widely as could be for their time, so people were aware of their availability. Manufacturers and sellers used advertisements in the fledgling newspapers, printed and distributed broadsides and pamphlets extolling their virtues, and sold them from their booths and platforms. Interestingly, the word ‘mountebank’, meaning a charlatan, comes from Italian montimbanco, someone mounted on a bench, indicating a mode of gaining the attention of prospective buyers.

Engelmann_The-Charlatan

(Picture credit: Wikigallery.org)

The products were also the first to use branding by using very distinctive bottles. This feature also helped illiterate customers to pick the correct product. Despite being helpful in marketing, it also created a problem for the manufacturers: nothing prevented people from acquiring empty bottles and filling them with their own imitation mixture. This is why most advertisements of the time contained stern warnings about purchasing only the genuine article.

Three_early_medicine_bottles(Picture credit: Wikimedia Commons)

Another feature used in the early advertisement that still plagues us today in alternative medicine marketing was the use of testimonials. Robert Turlington, the inventor and manufacturer of a popular nostrum, Turlington’s Balsam, published a 46-page brochure that included numerous testimonials. Most of these came from ordinary people – a porter, the wife of a gardener, a hostler, a bodice-maker – who were all praising the product for restoring them to health. (This product actually had some medicinal properties.) It is unfortunately now very difficult to ascertain how large a part testimonials played in the 18th century marketing, as very little of such ephemera has survived. As today, most of the advertising printed material was thrown away.

What is certain, however, that there was a large market for these products. An incomplete list published in 1748 lists 202 proprietary medicines and by 1830 British parliament records list 1,300 of them. They were exported all over the British Empire, being especially popular in Colonial America, losing their popularity only during the Revolutionary War when they were not available and domestic substitutes were produced. British products never regained their market share in America.

What did these medicines contain? I already gave the ingredients for the widely popular Anderson’s Scots Pills – which indeed were manufactured until 1916. Many contained no active ingredients whatsoever, others had substances long used in medicine: alcohol, honey, opium, mercury, silver, arsenic, willow bark, quinine and other vegetable substances. For example, another popular preparation, Dalby’s Carminative, contained carbonate of magnesia, oil of peppermint, oil of nutmegs, oil of aniseed, tincture of castor, tincture of asafoetida, tincture of opium, spirit of pennyroyal and peppermint water. This medicine would have been effective against indigestion and diarrhoea, for which it was marketed. An example of a preparation which would have never had any medical effect – apart from possibly being a mild laxative – was Beecham’s Pills, which was advertised to cure 31 different medical conditions, but contained only soap, aloes and ginger (I know it’s from the 19th century, but it’s similar to many older preparations and I have the formula for it).

Thus the 17th and 18th century introduced changes in the way people thought of their health care. Mass-produced medicines were now widely available, complete with branding and marketing, and people resorted to these more readily than to the traditional homemade concoctions, though these were certainly not abandoned. Clever marketing created trust in their efficacy and value, and as everyone else was apparently using them, most people who could afford it wanted to stay with the trend. The comparative inaccessibility of regular medicine (though the term is somewhat misleading this early, Royal College of Medicine notwithstanding) also assisted the perceived value of these products. This change in thinking paved way to the patent medicine explosion in the next century.

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Live Blood Analysis – Is It a Worthwhile Diagnostic Tool or Pure Scam?

Live Blood Analysis – also known as live cell analysis, Hemaview or nutritional blood analysis – is a technique where the practitioner takes a few drops of the patient’s blood, smears them on a slide, covers it with a glass cover slip to keep it from drying out, and observes them in a microscope. They use special, highly expensive visual microscopes such as dark field or phase contrast microscopes that usually come equipped with a camera and monitor, so that both the practitioner and the patient can view the result. These microscopes are capable of 1000 X magnification. So it looks all nice and scientific, and probably reassures many patients that they are in reliable hands. But is this really the case?

Practitioners claim to be able to diagnose several diseases and conditions by observing the blood. They claim to be able to see in the plasma several objects, including:

Undigested food particles
Fungi
Uric acid crystals
Bacteria
Cholesterol plaques
Parasites
“Fibrous thallus”
Mold
“Rod forms”
Basophiles
“Black crystals”
Rouleaux

They also claim to see in the cells themselves

Yeast at the edge of red blood cells
Fermentations
“Anaesthetised white blood cells”

Let’s take these objects apart one by one (I’m drawing heavily from Mark Crislip’s excellent article):

Undigested food particles: No, just no. There is no way undigested food would be able to pass through the intestinal walls, the particles would be too big. I don’t know what the microscopist imagines he or she is seeing, but I suspect an artefact of a dirty slide is responsible.

Fungi/Yeast: There are conditions where you really may have fungi in your blood, but a Live Blood Analyst will never see a case. Why? Because at that stage you’re both immunocompromised and in an ICU near death from sepsis. Such people do not visit quacks, they’re too busy fighting for their life.

Uric acid crystals: They simply would not be visible, even if present. These are more artifacts of dirty slides or even microscopic splinters from the not properly cleaned slide itself. You know, they are made out of glass.

Bacteria: This is comparable to the case with fungi. You’re seriously ill with sepsis when you have bacteria in your blood, and definitely are not well enough to go visiting a quack.

Cholesterol plaques: More dirt on the slide. Cholesterol cannot be seen in a blood sample.

Parasites: More dirt or debris. While Plasmodium (malaria) species can be diagnosed from a blood sample, it needs to be stained before diagnosis. Live blood analysis would not spot these parasites. Anyone with malaria parasites in their blood once again would be too ill to visit a quack, as the symptoms are severe enough for them to check into A&E.

“Fibrous thallus”: An invented term by Live Blood Analysts. It is used of what is actually an artefact of fibrous debris on the slide.

Mold: What applies to fungi applies to mold, which really is fungus as well.

“Rod forms”: Unlike what the Live Blood Analysts claim, these are not “bacterial forms born out of red blood cells” as this is an impossibility. Blood cells do not transform into bacteria in anywhere else than the fantasies entertained by these quacks. In reality they are artifacts, and many times larger than any bacteria.

Basophiles: While blood can contain basophiles, it is impossible to detect these without staining the sample, so they would not be visible.

“Black crystals”: Not “tobacco, marijuana; chemical, recreational and prescription drugs” as they claim, but more dirt on the slides.

Rouleaux: Depending on the practitioner, these are alleged to indicate either “acid in the blood” or weak pancreas – pick your choice. In reality, it’s an artefact of the blood sample starting to dry out and a large number of red blood cells clumping together.

Yeast at the edge of red blood cells: This is a common artefact, a small irregular shape on the red blood cell.

Fermentations: Light spots on blood cells are interpreted as fermentation caused by high blood sugar. Fermentation requires the presence of yeast, as it needs to produce the enzymes to break down sugar. As explained before, a Live Blood Analyst will never see a patient with yeast in their blood, so they won’t ever see fermentation either.

“Anaesthetised white blood cells”: This is completely meaningless, as nobody has yet to come up with a way to anaesthetise a white blood cell. It sounds scary, though, as most people are aware of the white cell function as a part of the immune system.

Interestingly enough, no two Live Blood practitioners will see the same objects on the same slide.

At this point the poor patient is probably petrified with the thought of all that nastiness in his or her bloodstream. The practitioner then carries on to diagnose what all these things indicate. Claims of what they can diagnose include: multiple vitamin and mineral deficiencies, toxicity, tendencies toward allergic reaction, excess fat circulation, liver weakness, arteriosclerosis, cancer, arthritis, candida, chronic fatigue syndrome, prostate issues, multiple sclerosis, bacterial, viral and yeast infections, depression, sleep disorders, headaches, constipation, excess body fat, potency or fertility problems, memory problems, PMS, menopause etc.

Without fail, most practitioners will claim that any disease/s they have diagnosed are caused by the patient’s diet being too “acidic” (this is especially true of the ones trained by Robert O. Young or his accomplices) and that the patient will need expensive supplements – conveniently available from the practitioner, how surprising – to “alkalise” their body (see my previous post about how useful this in reality is). So now the poor patient leaves, with a much lighter wallet and laden with dietary advice and pricey supplements to begin his or her treatment.

As already indicated by the description of what the practitioners imagine they see in a slide, none of the above has any scientific validity, and most of it is based on profound ignorance of real human biology. Adherence to fantasies like pleomorphism, the long discarded idea that bacteria can morph to different forms according to its environment now actively promoted by Young and other alternative medicine characters or the even more insane idea that human cells can transform into bacteria in too acidic conditions, makes sure that this test is about as pseudoscientific as it can be. It has been described as “a fraudulent means of convincing patients that they are ill and require treatment by dietary supplements” – in other words a scam.

Where does this whole idea come from? It appears that one Günter Enderlein – who was not a medical doctor – was the first one to describe the use of dark field for live blood analysis in the early 20th century. He created his own terms for what he imagined he could see, calling them protits, symbionts or endobionts. Others soon followed, going equally wrong.

Gaston Naessens, developer of the worthless cancer nostrum 714X, built a microscope he called the “Somatoscope” and claimed it could enable him to see objects as small as 150 Å. This is actually physically impossible, as the refraction limit for light microscopes is around 2000 Å – this is a distance that depends on the wavelength of light. Only electron microscopes that do not depend on light can see objects this small. Naessens claimed to see organisms he called “Somatids” – needless to say no scientist has ever witnessed one, despite electron microscopes.

Nowadays probably the most influential – at least noisiest – proponent of Live Blood Analysis is above-mentioned Robert O. Young. He runs expensive courses for would-be Live Blood practitioners – the latest price being $9,995 for a single course – based on his so-called “New Biology” (not so new, the same principles were promoted already by Dr William Hay in the 1920’s). The scientific worth of his ideas can be judged from his writings, and a really telling example can be found here – I can’t repost it for copyright reasons.

So in conclusion, Live Blood Analysis was developed from Bechamp’s discredited hypothesis by Enderlein, and then was further developed by people who blithely disregarded laws of physics. It is now practised by people who imagine they have been medically trained but in reality are dangerously ignorant of anything resembling real medical knowledge and diagnostic skills. Do you really want to put your health into the hands of such people?

On the Value of So-Called “Alkalising” Diets

“Alkalising” diets are gaining popularity, and while the diet itself may be good and healthy, the thinking behind it is anything but. It is based on a complete misunderstanding of human anatomy and body chemistry. Let me explain.

Acid-alkaline chemistry is crucial in physiology, both at the cell level and the level of the complete body. There are two reasons for this: Many of the major chemical components of the body can themselves act as acids and/or alkalines. This means that proteins contain both acidic and alkaline groups and their functions are highly dependent on pH. Virtually every important metabolic process involves the uptake or release of hydrogen ions, so that being alive tends to change the surrounding pH – usually reducing it – and this will sooner or later kill the body in the absence of buffering agents.

Respiration, which is the most important physiological activity of a cell, is an acid-producing process. Carbohydrates are broken down into carbon dioxides and thus into carbonic acid, H2CO3.

The weak organic acids in the foods are in part in the form of sodium or potassium salts. So, when the body balances its pH level, some of the carbon dioxide (CO2) produced by metabolizing these food acids, it converts the acids into bicarbonate (M+ HCO3-). Do I need to tell you whether bicarbonate is acid or alkaline?

The acid-alkaline balance of the body is regulated by two general mechanisms, selective excretion of acids or alkalines and by the buffering action of weak acid-alkaline systems in body fluids. Over a 24h period, an adult human will eliminate carbonic acid which breaks down into carbon dioxide, which exits from the lungs. Kidneys also excrete lesser amounts of acid.

The major buffering system of the body is the carbonate system, and it exists mainly in the form of HCO3- at the normal physiological pH. Secondary buffering action is done by phosphate, proteins and other weak organic acids and hemoglobin in the blood cells.

No foods can change the pH of your body. Your stomach is so acidic – it evolved to be that way – that no food can change its acidity. All food that leaves your stomach is adicic. After leaving your stomach food enters your intestines, where pancreatic secretions neutralise the stomach acids. So it does not matter what you eat, the food in your stomach is acidic and the food in your intestines is alkaline. I know that “alkalising” cancer quacks claim that cancer cells cannot live in an alkaline environment, and that actually is true. What they leave out is that neither can any other cell of your body. So were you actually able to “alkalise” your body, you’d be very dead.

It’s actually a very good thing that you cannot “alkalise” your blood more than temporarily, as deviations from the normal blood pH of 7.4 by more than about 0.1 either way can be very serious. Some people who peddle “alkalising” claim that range of “healthy body pH is 6.0-7.5.” The term for anyone with a blood pH of 6.0 or lower is ‘dead’. Anyone with a blood pH of 7.0 is in deep trouble, and very close to death.

The easiest way of actually “alkalising” your blood is by hyperventilating. Give it a go, till your lips tingle and hands cramp – and then tell me how great you felt. If you still want to “alkalise” your blood, you can advance to depressurisation and dehydration. Be warned, though, alkalosis is a pretty painful way to die.

What you really can “alkalise” is your urine, and all “alkalising” woo peddlers capitalise on this fact. They huckster urine tests to determine whether your body is too “acidic” and then sell you books or products that won’t actually do anything at all about your body pH, only about your urine pH. There just is no evidence whatsoever that intentionally alkalising your urine prevents or treats disease.

This is why following an “alkalising” diet or buying “alkalising” supplements to cure or prevent cancer is a complete waste of time and money.