By Professor JP van Niekerk, Dean Emeritus, Faculty of Medicine, University of Cape Town.
Snake oil remedies
Nowadays the term ‘snake oil’ is associated with dubious products often peddled by unscrupulous marketers, with excessive and false claims about the benefits of their wares. The word originates from the late 19th century when Chinese workers on the American railways used oil from the Chinese water snake to relieve painful muscles, joints etc.
It did not take long for salesmen to concoct their own mixtures of cure-all remedies that they promoted with dramatic demonstrations in travelling medical shows. Snake oil equivalents and their sales people continue to flourish and a gullible public continues to fall for their unbelievable claims.
Some big swindles
Laterile is the name of a product derived from apricot kernels that has been promoted as effective in curing cancers since the 1950s. However, investigations by the US national Institutes of Health gave the warning: “Patients exposed to this agent should be instructed about the danger of cyanide poisoning, and their blood cyanide levels should be carefully monitored. Amygdalin is a toxic drug that is not effective as a cancer treatment”. It was banned in the US but desperate sufferers then poured over the borders to Mexico to receive treatment. It is still readily available via several websites that also list it as Vitamin B17 (it is not a vitamin). This has been described as one of the most successful and money-spinning cancer quack promotions in medical history.
The Virodene affair is one of the darkest episodes in South Africa’s health history. The then President Thabo Mbeki was an AIDS denialist and medical treatment was withheld from a large number of sufferers in South Africa. However, he and his cabinet enthusiastically endorsed a presentation of an illegally tested claimed cure for AIDS called Virodene. The Medicines Control Council (MCC) that regulates what drugs may be used in the country refused permission for human experimentation of the product as it was a poison (toxic solvent) with no proven benefit.
This led to the head of the MCC Prof Peter Folb, being fired from his post, for political reasons. Patients kept calling for Virodene to be made available as treatment, despite it being demonstratively harmful, and the ANC was incensed at being thwarted on medical and scientific grounds.
Another dark cloud descended when the then Minister of Health, Manto Tshabala-Msimang pronounced that HIV AIDS could be managed by dollops of beetroot, garlic, olive oil and the African potato. This made South Africa the laughing stock of the world and provided material for a frenzy of cartoons in the newspapers. She also supported the activities of Matthias Rath, who claimed that his programme of vitamins could cure AIDS (and also diabetes, cardiovascular disease and cancer). A subsequent Cape High Court judgement put an end to this, firmly establishing the duty of the state to enforce the scientific governance of medicines.
These gross cases illustrate the power of beliefs on humankind. We are programmed to look for patterns and solutions to life’s problems and readily fall prey to unscrupulous claims that we desperately would like to believe. We are programmed to believe – or as a friend put it ‘mense wil verneuk word’ (people want to be conned).
Preying on our desires: flim-flam is alive and well
For most of us life is hard and ordinary day-to-day living is demanding. Generally we all want to live longer, healthier and happier lives. And comparisons with others who seem to have these desirable characteristics in abundance invite envy with our apparently lesser lot in life. The advertisers are fully aware of this and are paid handsomely to promote products that are said to have been developed and promoted to meet all our desires and lull us into the belief that we can buy ourselves into better lives.
It is no accident that the beauty industry is one of the largest in the world, after the worldwide oil industry. Beauty depicted in magazines, television and the movies, and at public entertainments where celebrities abound, creates the powerful desire to emulate what we see. One of the leaders of the cosmetic industry when challenged about the beauty-enhancing and age-reducing claims that were made for his products conceded that there was no evidence or this but famously stated that he was ‘selling dreams’.
Another multi-billion dollar enterprise is the food supplement industry that claims to improve our health and add years to our lives.
Most people on the planet hardly look like models and obesity is one of the main problems. Thus the massive industry of diet books and all the weight loss devices and slimming ‘medicines’ that promise to rid the customer of kilograms without his having to try.
Even young and very healthy athletes wish to do better. The recent case of the fallen cycling idol, Lance Armstrong, who confessed to drug doping and was stripped of his honours and sponsorships, is but the tip of the iceberg of a huge worldwide sporting drug-enhancement scandal.
Clues on how to spot nonsense
Beware excessive claims
Products that claim to cure complaints such as high blood pressure, diabetes, dry skin or enhance sexual performance are likely to be bogus.
Pseudo-scientific language hides ignorance
Beware peddled products that claim to ‘enhance the body’s immune system’ or are strong ‘anti-oxidants’ or claim other pseudo-scientific statements – their producers usually have no clue themselves what it all means but hope to impress our similar ignorance.
‘Natural’ does not necessarily mean good
Claims that a product is ‘natural’ and therefore must be good is nonsense – arsenic is natural and so is snake poison but neither is good for us. Many ‘natural products’ have unknown substances and concentrations that may be detrimental to people’s health. A common problem at our hospitals is the admission of desperately ill babies as a result of treatment with unknown traditional remedies.
Personalities do not equal proof
Advertisers know that having prominent sports personalities endorse a product enhances its appeal for many people. But personal endorsement is a far cry from proof of benefit. Far more important is proof from properly supervised scientific trials.
More expensive does not necessarily mean better
Fancy packaging, higher prices and outrageous claims of benefits manage to con us that this therefore must be better than the standard product. This is dramatically illustrated in the cosmetics industry where, for example, expensive skin creams are most likely no better than the off-the-shelf products at the local supermarket.
Huge health enhancing benefits to the world’s population have resulted from general measures such as improved food supplies, clean drinking water (including chlorination to remove bugs and fluoridation to prevent dental caries), clean and uncrowded living spaces, and vaccination against common infectious diseases. At an individual level, most of us need to add more exercise to our daily routines. Unless there are good specific indications for medicines, we would do well to take fewer rather than more (our society is generally over-medicated). So-called beauty and health-enhancing products are mostly a waste of money and are more likely to be harmful than helpful.