Part 2

Natural Causes: Death, Lies and Politics in America's Vitamin and Herbal Supplement Industry
by Dan Hurley

(Page 2 of 2)

On the day Columbus first set foot in the New World at San Salvador in 1492, he wrote in his journal, "The natives brought fruit, wooden spears, and certain dried leaves which gave off a distinct fragrance." The dried leaves, it turned out, were tobacco, the first pharmacologically active herb (due to its nicotine content) brought back to Europe-not that tobacco would ever be regulated as a drug, despite being an addictive stimulant.

"When we discovered the New World, the Old World was looking for cures for diseases," says Michael R. Harris, who served as the historian of pharmacy at the Smithsonian Institution for twenty-six years before becoming the historian and curator at the Drug Enforcement Administration Museum. He also consulted as a historian to the television show Dr. Quinn, Medicine Woman. Beyond cures, Harris says, people wanted stimulants. That's why when tobacco, coffee, and tea all hit world markets in the sixteenth century, "they became instant hits worldwide. No drugs, except later for the amphetamines, have spread around the world so quickly."

In 1632, Catholic Jesuits who had gone to Peru brought back a powder from the cinchona tree, which natives used to bring down the fevers of malaria. In Europe, no effective treatment had been known for malaria, and physicians were soon calling the "Jesuit bark" as important a development in medicine as gunpowder was to warfare. The powder, French scientists would determine nearly two centuries later, contained quinine. When it cured the malarial fevers of King Charles II of England, it confirmed the view that great medicines could be found in the forests of the New World.

Indeed, today it is estimated that more than one fourth of modern medicines are derived from botanicals, including aspirin, from willow bark, and the cancer-fighting compound paclitaxel (Taxol), from the Pacific yew tree. Digitalis likewise is derived from foxglove, but the plant was originally used for everything from treating wounds to, as one herbalist put it, curing a "scabby head," and had developed a reputation by the eighteenth century for being poisonous. Then, in 1775, the Scottish physician William Withering was asked his opinion of a folk remedy for "dropsy," what is now known as congestive heart failure, a condition for which mainstream medicine then had no cure. Dr. Withering described the remedy in his 1785 book, Account of the Foxglove and Some of Its Medical Uses: "I was told that it had long been kept a secret by an old woman in Shropshire, who had sometimes made cures after the more regular practitioners had failed. I was informed also, that the effects produced were violent vomiting and purging ... This medicine was composed of twenty or more different herbs; but it was not very difficult for one conversant in these subjects, to perceive, that the active herb could be no other than the Foxglove."

As a medical student, Dr. Withering had hated his classes on the identification and preparation of herbs, thinking them dreadfully boring. But he developed a passion for them after meeting the beautiful Helena Cooke, who just happened to be an amateur painter of botanical specimens; they married in 1772. After witnessing a patient's remarkable recovery from dropsy after taking the old woman's remedy, Dr. Withering proceeded to test different formulations of foxglove extract on 158 patients, settling on a green powder made from the dried flowers harvested just before blossoming. Although only 101 of his patients experienced relief after receiving the foxglove treatment, Dr. Withering described all 158 cases in detail. As he wrote: "It would have been an easy task to have given select cases, whose successful treatment would have spoken strongly in favour of the medicine, and perhaps been flattering to my own reputation. But Truth and Science would condemn the procedure. I have therefore mentioned every case ... proper or improper, successful or otherwise." Even then, he emphasized the provisional nature of his observations, insisted that doctors use care in selecting which patients to treat with it, and gave instructions on how to titrate the dosage. The synthetic versions, digitoxin and digoxin, remain widely used to treat heart failure to this day.

With the New World's medicines, however, came the snake oil. In 1630, Nicholas Knapp of Massachusetts Bay was sentenced to pay five pounds, or be whipped, for selling a would-be cure for scurvy that turned out to be nothing more than "a water of no worth nor value," which he "solde att a very deare rate." But it was often difficult to tell mainstream doctors from the quacks. Ben Franklin's own mother-in-law developed a salve for lice and itching called Widow Read's Ointment, which Franklin advertised before the Revolution in his Pennsylvania Gazette. And George Washington himself died in 1799 after a throat infection led his doctors to bleed him-a practice dating back to Hippocrates in the fifth century B.C.-reportedly draining about half of the seven liters of blood in his body in twenty-four hours, which, in the view of some doctors, may be what actually caused his death. Even in the nineteenth century, while the emerging science of chemistry gave medical doctors an aura of respectability, precious little of value made its way from the laboratory to the bedside. The most eminent physician of the early 1800s, Benjamin Rush of Philadelphia, developed a theory that the cause of fevers and most other illnesses was "excitability" of the blood vessels, or high blood pressure. He lowered the pressure by bleeding patients, removing up to 80 percent of their blood, and purging their bowels. His purgative of choice was calomel, or mercury chloride, a tasteless mineral so powerful that patients sometimes ended up losing their teeth and jawbones. Even a useful remedy like quinine was turned into an all-purpose "tonic" and used for just about anything. The other two popular tonics of the nineteenth century were iron and-in small amounts-strychnine, derived from the nux vomica plant, and better known these days as a poison.

With "cures" like these, it isn't surprising that other theories no odder than those of mainstream medicine's would arise and find support. One came from a German chemist, Dr. Samuel Hahnemann, who in 1796 developed his hair-of-the-dog-that-bit-me theory. "Let likes be treated with likes," he said, proposing that a substance causing certain unpleasant symptoms in a healthy person could, if given in minuscule amounts, cure a person who was suffering those very same symptoms due to an illness. He called his method homeopathy, from the Greek homoios (similar) and pathos (suffering or disease). Another of his counterintuitive beliefs was that the less of a substance he gave to patients, the more powerful it became. In fact, he claimed, the substances worked best when diluted until no discernible trace remained. A spiritlike essence, he believed, was left behind that would revive the body's vital force. Although not supported by modern science, homeopathy did have one great thing going for it: it didn't injure patients like bloodletting and calomel did. Many doctors began using homeopathic treatments, and eventually many schools of homeopathy were opened in the United States.

Another challenger to what passed for mainstream medicine was an unschooled frontier farmer, Samuel Thomson, who attacked the doctors' harsh medicines and championed the healing qualities of simple herbs, particularly lobelia (its prime effect implied by its folk name, pukeweed). His theory was that all illness was caused by "cold," and that the cure was "heat," which he achieved with steam baths, sweat-inducing herbs like red pepper, and other herbs that would cause people to vomit or move their bowels in an attempt to remove "obstructions" to the body's natural heat balance. Doctors derided his simple theories and overemphasis on lobelia, and he was jailed on murder charges after one of his patients died. But Thomson succeeded in setting off a historic cultural swing away from "scientific" medicine overseen by experts who emphasized chemically derived medicines to "natural" medicine overseen by individuals using herbs on themselves.

Copyright © 2006 by Dan Hurley.

About the Author

Dan Hurley is an award-winning journalist specializing in health and medical writing, and a regular contributor to the New York Times. His work has also appeared in the Houston Chronicle, Men's Health, Psychology Today, and many other publications. He lives with his wife and daughter in New Jersey.