Snake Oil Salesmen

NEWS&ANALYSIS ALTERNATIVE MEDICINE Scourge of Snake Oil Salesmen Bids an Early Farewell When Edzard Ernst became professor of who has worked at the Center for Comple- complementary and alternative medicine mentary Medicine Research in Munich, (CAM) at the University of Exeter in the Germany, says the quality of Ernst’s own United Kingdom, he thought he was in for work has declined in recent years. “He does a quiet life. “The fi eld is not exactly main- not always conform to the methodical stan- stream medicine, and Exeter is not the dards he demands from others,” says Linde, center of the academic world,” he remem- who points to errors in a recent system- bers reasoning. atic review of acupuncture. Ernst admits to Eighteen years later, he has publicly minor mistakes but says they don’t affect the clashed with the heir to the British throne, paper’s conclusions. been investigated for an alleged breach of Ernst has become embroiled in several confi dentiality, and forced to high-profi le affairs. In 2005, for instance, retire early in a deal to save a scandal erupted in the United Kingdom the department he helped when he dropped out of a panel investi- build. “It has been rougher gating the potential contributions of CAM than I expected,” he admits. to the British National Health Service Many see Ernst, 63, as (NHS). The report, commissioned by Prince the world’s leading figure Charles and led by economist Christopher in research on CAM. “His Smallwood, concluded that replacing output is incredible,” says some mainstream treatments with alterna- Michael Baum, a professor Convert. tive medicine could substantially cut costs. Edzard Ernst was once “really on September 5, 2011 emeritus of surgery at Uni- impressed” by alternative medicine Days before the report’s publication, Ernst versity College London who but now criticizes Prince Charles’s pro- called it “outrageous and deeply fl awed” in has collaborated with Ernst. motion of unproven therapies. a newspaper article. “They were suggest- But Ernst’s fierce and often ing asthma could be treated with homeo- undiplomatic criticism of unproven thera- to do more good than harm—a meager list pathic medicine. That would have killed pies has also made him many enemies. “He of 20 therapies, including music therapy 150 patients a year,” he says. is like a rottweiler; he won’t let go,” Baum against anxiety, acupuncture against nausea, The spat nearly cost him his job. Prince says. At a farewell press briefi ng in Lon- and aromatherapy in cancer palliation. Most Charles’s private secretary accused Ernst of don last week, Ernst called Prince Charles were herbal medicines, however. “And those violating a confi dentiality agreement, trig- www.sciencemag.org a “snake oil salesman”—a headlinemaking are not surprising at all, since there are phar- gering a 13-month investigation at Exeter sneer he doesn’t regret. “He owns a fi rm that macologically active compounds in plants,” that eventually cleared Ernst of any wrong- sells a tincture of artichoke and dandelion he says. Ernst didn’t discover a single case doing. “But the university ceased all fund- that supposedly detoxifi es the body. To me in which a fundamentally implausible treat- raising for my unit, and my department was that is snake oil,” he says. ment, such as homeopathy’s infi nite solu- systematically destroyed,” he says. Recently, A native of Wiesbaden, Germany, Ernst tions, had an effect. The stream of negative in exchange for an assurance that the depart- wasn’t always a critic of complementary results angered CAM supporters. “They ment will live on, Ernst agreed with Exeter medicine. On the contrary, his fi rst job after thought he was placed there to prove that to officially retire, though he has been Downloaded from becoming a physician was at Munich’s Hos- alternative medicine works,” Baum says. rehired on a half-time basis for another year. pital for Natural Healing, a bulwark of alter- Meanwhile, Ernst took aim at others in He hopes his successor will be “a really native therapies. “I was really impressed the burgeoning field of CAM research as good scientist and maybe someone a little by what I saw,” he recalls. Later, after he well. He’s highly critical of the National more diplomatic.” became the head of the department of Center for Complementary and Alternative Ernst’s legacy, Baum says, is a public physical medicine and rehabilitation at the Medicine at the U.S. National Institutes of and government more aware of the contro- University of Vienna, Ernst subjected alter- Health, for instance; in a recent article in versies surrounding CAM, especially in the native medicine to the rigors of science in which he examined 27 NCCAM-funded tri- United Kingdom. Last year, the science and his spare time. “I thought there was a real als of herbal medicine, he found “a pleth- technology committee of the British House possibility of discovering some fundamen- ora of serious concerns,” including a lack of Commons concluded, based in part on tal mechanisms,” he says. So when CAM of laboratory tests of key safety parameters Ernst’s evidence, that NHS should cease supporter and construction magnate Sir and a low or moderate risk of bias in 15 of funding homeopathy and that homeopathic Maurice Laing gave the University of Exeter the studies. The center, which also stud- medicines should not be allowed to make £1.5 million to establish the world’s first ies force fi elds and distance healing, should claims of effi cacy. For Ernst, it was a proud chair in complementary medicine, Ernst focus on the most plausible therapies, Ernst moment. Science may never win the battle took the opportunity with both hands. says. “NCCAM is swallowing up more than against snake oil, he says, “but that shouldn’t But over the years, he has reached a $100 million a year and has little to show for mean that we all have to pay for it.” sobering verdict. In a 2008 paper, Ernst it,” he says. –KAI KUPFERSCHMIDT CREDITS (TOP TO BOTTOM): COURTESY OF EDZARD ERNST; HUSSEIN SAMIR/SIPA/NEWSCOM HUSSEIN ERNST; EDZARD OF COURTESY BOTTOM): TO (TOP CREDITS summed up the treatments he had found Klaus Linde, a one-time collaborator Kai Kupferschmidt is a writer in Berlin. www.sciencemag.org SCIENCE VOL 333 5 AUGUST 2011 687 Published by AAAS 18 .

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