How a Folk Medicine Gets Started:
A Sugar Cube and a Drop of Kerosene
The following is a family story from my wife’s friend, Janice, whose father lived in Ojai during the 1918 Flu Pandemic. The 1918 Spanish Flu/Swine Flu was by far the most deadly disease in history, surpassing even the infamous Black Death of 1347 – 1351. Janice’s father was about 5 when the flu moved through his family home in Ojai and he’s still alive at 99. There were about 10 people living in his home and they heard that a drop of kerosene on a sugar cube would “cut the phlegm” and help victims to survive. (The kerosene would probably make users gag and cough up mucus, providing a few minutes of temporary relief). All the family used this folk remedy except one young mother and her two very young children. In tragic happenstance, all the family members became sick with the flu and survived… except the young Mom and her two children. Compounding this terrible incident, the community required their home to be burned immediately along with all their clothes – as was often done during smallpox epidemics (a virus) and during the time of the Bubonic Plague (a bacterial infection carried by fleas on rats). Despite these tragedies, this family survived and thrived and I shook the hand of the 99 year olds daughter a few weeks ago.
The obvious false association was made, that a drop of kerosene on a sugar cube would help you survive the deadly flu virus. Family members gave heart rending anecdotal testimony of the lifesaving practice, convincing others in this desperate time. People compounded the falsehood by their own confirmation bias, looking for confirming examples and discounting contrary information. The placebo effect made people who took this remedy feel confident that they were doing the best practice for their health.
All countries have their folk medicine practices which come into and out of vogue in different historical time periods. Often, people from one country become enamored of a folk medicine from another, more exotic, country. In America, many people are currently captivated by Chinese folk medicine and Indian Ayurvedic folk medicine. German folk medicine, Homeopathy, still attracts millions of followers who spend billions of dollars worldwide, on their pills and potions. The greatest folk medicine of all time, spanning 3,000 years (up until the 1870’s) and several civilizations, from the ancient Egyptians to the Greeks, the Romans, throughout the European countries, to India and even to the Americas, was bloodletting. It is still practiced today as a folk medicine in India and other countries.
All these folk medicines get started and have the same effect (the placebo effect) as the kerosene on the sugar cube remedy. But why does generation after generation, the best and the brightest of so many civilizations, continually make these wrong associations? There are two simple and straightforward reasons:
1. After we get sick, we get well for the same reason that all living things get well: we are the beneficiary of 3.4 million years of non-random, “survival of the fittest” selection (more recent information suggests that our Ardipithicus ancestors split from chimps about 5-6 million years ago). So while our bodies are naturally fighting off disease and recovering from injuries, any folk remedy or “snake oil” can step in and claim that it was their potion or procedure that made us better. This is why the tribal “medicine man” and “witch doctor” were tolerated: people tended to remember their successes (hits) and forget their failures (misses).
2. We have a pattern forming brain that is subject to consistent and continual human error. Sometimes we see patterns that are not there (sugar/kerosene) and sometimes we don’t see patterns that are there (survival of the fittest).
People who believe in the various folk medicines often say, “…but it works for me!”
What is actually working is millions of years of evolutionary benefits which are misunderstood with personal false associations, post hoc thinking, confirmation bias and the patient generated placebo effect.
The only way to insure that a particular remedy is producing a medical improvement is to do repeat, double-blinded, placebo controlled experiments at different research centers over several years. Then the results of the placebo control group have to be subtracted from test group to produce the evidence based improvement of the specific drug or procedure. That’s evidence based medicine and that’s the only medicine there is. As Harriet Hall, M.D. has written:
“We frequently criticize the media for gullible reporting of pseudoscience and inaccurate reporting of real science. But sometimes they exceed our fondest hopes and get it spectacularly right. On December 25, 2008, the Wall Street Journal gave us all a Christmas present: they printed an article by Steve Salerno that was a refreshing blast of skepticism and critical thinking about alternative medicine.”
“Salerno points out that 38% of Americans use ‘complementary and alternative medicine’ (CAM) and it is being increasingly accepted in hospitals and medical schools. He says this should be a laughing matter but isn’t because of the huge amounts of money being spent on ineffective treatments. Not to speak of the huge amounts of money being wasted on implausible research at the NCCAM. He highlights a painful irony: the same medical centers that once fought quackery are now embracing it, not because they think it will improve patient care, but because it will increase their revenue.”
“Salerno quotes Dr. George Lundberg, one of the many who have said there is no such thing as CAM…’There is only medicine that has been proven to work and medicine that hasn’t. If science showed that an alternative treatment really worked, it would be promptly and enthusiastically incorporated into standard medical practice and would no longer be considered alternative’. So the very term is misleading.”
“‘Alternative medicine’ is not a scientific concept. It is a political, ideological ploy intended to raise public respect for a mishmash of untested, unproven, and even disproven treatments that are rejected by the scientific community” – Dr. Harriet Hall, M.D.
Victor Dominocielo, M.A.
Victor Dominocielo, M.A., a California-credentialed teacher for 36 years, is the Human Biology and Health teacher at a local middle school. He earned his Master of Arts degree in Education from UCSB. The opinions expressed are his own.