CMAJ News Salves and silver bullets Published at www.cmaj.ca on Mar. 24 t’s called black salve and accord - ing to dozens of websites, it will I cure cancer (skin, prostate, colon and breast), alleviate yeast infections, remove plaque and even eradicate gum disease. Marketed under such monikers as Grandma’s Black Salve, American Native Black Salve, Balm of Gilead or Compound X, it has testimonials galore: “In the 1960’s (Howard McCreary) . p r was diagnosed as having stomach can - o C s cer,” says one website. “He took an e g a m oral dose of Compound X the night i r e t i before his scheduled surgery. … On the p u J 5th day Howard said he passed a large 0 1 0 2 quantity of black, vile smelling feces, © apparently the growth itself. When the doctors took x-rays … the cancerous Potions and pills promising wondrous benefits have “always been with us,” says Jim growth was gone.” Connor, professor of medical humanities and history of medicine at Memorial Univer - sity in St. John’s, Newfoundland and Labrador. “About two years ago my Brother- in-law had a cancerous mole on his forehead,” says another. “My Brother- certainly directly respond to the mar - teristic 19th-century quack or charlatan in-law … used Black Salve that I had ketplace. They may take on different would maybe go to a fair and try to given him. He said that he experienced colours and hues and shapes and sizes drum up business with a crowd of a lot of pain with it but he tolerated it as over the years, but clearly they seem to maybe 10 or 20 people around you. But he knew it was working.” be able to exploit the public, or a if you put something on the Internet, Adam Zimmerman, competition law gullible public, or sometimes a very who knows how many millions of peo - officer with the Competition Bureau of willing public, with respect to a partic - ple you could hit in a millisecond.” Canada, which regulates false and mis - ular in-vogue ailment or problem or Hucksters may also be more adept at leading advertising, says there’s a good market niche.” “sensing where the gaps are” in the reason the user experienced a lot of There’s probably less quackery than market, Connor adds. “Obesity is pain. “It actually burns the skin. So you in the past due to stronger government clearly a market. It’s also perhaps a end up with scars and burn tissue. regulation and a medical establishment field where, I won’t say biomedicine Black salve is outright illegal in the US that quacks find harder to duck, Connor has failed, but there is a gap there [United States] and hasn’t been says. “The quack has to use different between what organized medicine approved for sale in Canada,” although media and you have to pay for that might be able to do and the quack can some websites claim otherwise. media and that means that they leave a slip through the cracks and appeal It’s also an excellent example of paper trail or some kind of record. If directly to the customer.” what are commonly called quack medi - you go back to the 19th century, I could Zimmerman says scammers often cines — salves and tonics, pills and just get on my horse and wagon and go seek to drive a wedge between patients potions, gadgets and cures that promise around villages and set up my stall and and doctors. “The scammers are con - wondrous benefits. sell my coloured water for everything stantly preying on the consumer’s sense “Quackery has always been with that ails you and move on. So I would of fear. The basic trick is to say, ‘I’m us,” says Jim Connor, professor of be very mobile and it would be very the only guy with the cure for this.’ medical humanities and history of med - difficult for the long arm of the law or When you’re at the point when you’re icine at Memorial University in St. the medical law to catch up with me.” saying, ‘Look, medical science isn’t John’s, Newfoundland and Labrador. But scammers can now tap a much doing anything for me,’ that’s when “Maybe the common factor is quacks larger audience, he adds. “The charac - you take the bait.” CMA J•APRIL 20, 2010 • 182(7) E285 © 2010 Canadian Medical Association or its licensors News The silver bullets include weight- that doesn’t mean some of those thera - apprised of what alternative therapies loss gimmicks and cures for life-threat - pies aren’t helpful, he adds. “Echinacea their patients are utilizing and to that ening conditions or diseases, he adds. for colds, for example. The clinical end, notes that medical students at It was ever thus. studies indicate that maybe it isn’t as Queen’s are now being taught to The Museum of Health Care in effective as you think. But who knows? approach patients with “very neutral, Kingston, Ontario, houses more than 30 I know I take it, for what it’s worth.” nonjudgmental questions. … If we 000 medical artifacts from the 18th Connor notes that acupuncture, reveal our hostility towards it, in the century onward. That includes surgical homeopathy and various spa treatments way we question them, they’re not tools, laboratory instruments and med - were deemed quackery for decades but going to tell us.” ical potions, including a large collec - are now often considered “complimen - History also shows that some legiti - tion of bottles of the enduringly popu - tary and alternative medicine. I think a mate therapies are appropriated by lar, “Lydia Pinkham’s Vegetable significant portion of mainstream medi - quacks just to hustle a buck, Robertson Compound,” a cure-all for “female cine would now view that as being a says. “Some electrotherapy was, I complaints.” useful adjunct to regular care. So that’s believe, legitimate but at one point it “It’s difficult to judge the effective - not a question of tightening up laws. I got a bad rep in the early to mid-20th ness of these things because it’s all in think it’s a question of redefining how century. One of the things that gave it the eyes of the beholder,” says curator a therapy or a medical system is inter - that bad rep were these electrical belts Paul Robertson. “If it’s effective for preted.” which men and women could use to you, then it’s effective therapy. It’s It’s easy to “demonize” therapies, electrically stimulate digestion. But it medicine. For many people who relied says Jackie Duffin, professor of medi - was largely marketed to men as the on them they often were effective in cine at Queen’s University in Kingston. Viagra of today. There were special that they felt better.” “One man’s quackery is another man’s loops that would attach around the gen - “For example, here at the museum, mainstream medicine. It’s a term that itals to give a little bit of an electrical we have cholera medication which, if gets bandied around all the time, but stimulation. That was supposed to help you analyze it, it has nothing to do with it’s the unlicensed and unregulated with so-called men’s weaknesses.” battling cholera but it probably took practise of health care.” Erectile dysfunction has now gone your mind off it,” he adds. “Oftentimes, That distinction was meaningless in mainstream, Connor notes. “I don’t you felt better because many of these an era in which everyone was prescrib - know about you, but I certainly get patented medicines from the 19th and ing alcohol, opium and other “drugs we plenty of email suggesting all the things early 20th centuries had a heavy alco - consider poison,” she adds. “The whole that are wrong with me and all of the hol base and often had an opiate base tilting towards improving medicine things that will fix me up. Is that quack - as well — morphine, cocaine, that kind means that we should be prepared to ery? What about Viagra and Cialis? The of thing were all standard ingredients view our current medicine as wrong, largest pharmaceutical corporation on for the time. It wasn’t a cure, even someday. So the word quack is a pejo - the planet is selling a drug for erectile though perhaps they purported to be rative. … Things that get labelled dysfunction. At one time that might cures in the early days. As regulations quackery are not only fraudulent have been considered quackery.” changed, of course they had to claw money-making. There are wise women, The line between mainstream medi - back on that, tone down the rhetoric. herbalists who get called quacks who cine and quackery can be blurry, But I think it was more the fact that really believe in their remedies and Robertson says, citing energy drinks as people felt better.” don’t make lots of money out of it.” an example. “This is really a modern Many of those therapies were more Such remedies only became “quack - version of the patent drugs of years affordable and accessible in an era ery” when doctors were given regula - ago. It’s partly the language. It cloaks it when doctors didn’t necessarily have as tory authority to essentially oversee the in a quasi-medical way and it’s build - lofty a status and weren’t as accessible. medical profession, Duffin says. “Once ing energy, it’s revitalizing.