The quackery political map has changed over the last three decades. I recently took a historial look over the landscape at characteristics and forms of quackery that could yield some perspective, and understanding.
Pseudoscience and quackery were identifiable long before we were here. Mesmer was deposed by Franklin and Lavoisier & Co. Samuel Hahnemann’s homeopathy was recognized as false by contemporaries, and by 1840s Oliver W. Holmes, Sr. had a merry time deriding the entire theory. Despite the ability of good scientists to recognize medical nonsense, much of 19th century medicine practiced was by school of thought or philosophy – sectarian practice. Some of these were homeopathic, herbal, hydropathic (water, baths) osteopathic, medicinal, surgical, empiricist, eclectic and naturopathic. Much of this was indistinguishable from quackery.
In 1911, most institutions of sectarian and ideological approaches were demolished by the Flexner recommendations, resulting in reform of medical schools. Quackery became the separate ideas of individuals – Hoxsey, Ivy, Gerson, Binkley. Some schools like homeopathy and sects like osteopathy and chiropractic continued separate from medicine.
After WW II quackery began to be promoted by political activity. Sects and schools began to lobby for licensure, recognition, and later, insurance payments. In the 1970s-80s sectarianism/quackery became recognized by political groups as vehicles for their political causes. The movement started in right wing causes. Not conservative, but high emotion, radical, scofflaw behavior. People who had to leave the country to do their things. Laetrile became a political symbol for anti-regulation and far right politics. The John Birch Society, then more prominent and radical than it is today, was one of the main support orgs. Most supporters berated regulatory agencies. They bore bumper stickers, “Go to Health, FDA.“
Left met right over the Laetrile conflicts, as both extremes considered Laetrile to be effective and wanted it available. (Laetrile was a science and commercial fraud, its biochemistry and biology made up by its creator, E. Krebs.)
The rhetoric then was near-revolutionary, paranoid, anti-government and anti-regulatory. Laetrile popularity was a product of anti-regulatory rhetoric. Steve Barrtett, Victor Herbert and a few others worked as experts for government agencies and boards against the problem. At that time, the agencies were largely free of both industry and ideological pressures. We exchanged information, we testified in court. There was general agreement regarding what constituted knowledge, good practice and quackery. Most elected officials were on the side of regulation and law enforcement.
Prime consultants were prominent academicians – from whom I learned most of my stuff. Robert Hodges MD of Berkeley and then Irvine, had determined the minimum daily requirement and intake of ascorbate, Tom Jukes PhD of Berkeley, had synthesized amethopterin and aminopterin, the folate inhibitors and first chemotherapy cures of acute lymphocytic leukemia (although the Nobel went to the docs at Farber in Boston who first used it). Robert Stockstad was Chairman of nutrition/biochemistry at Berkeley. All met at Jukes’s home, and formed what became the National Council against Health Fraud in 1976. Where are the academicians and faculty now? Accepting funding from NCCAM, Osher, Bravewell, and selling out for bucks.
I don’t recall any political differences among the scientists and physicians and the regulators, except that we all recognized the anti-science and anti-regulation propaganda of right wing and Birchers. Although we understood their political positions, we did not quite understand the depth of their fears of science and anti-fraud regulation. We considered those self-evident and part of a sane society. Neither did we have much understanding of their personal psychologies, or of the group and social dynamics that caused this first quacky-political movement.
We saw similarities to the episodes described in Extraordinary Popular Delusions and the Madness of Crowds. We were impressed by the scope and suddenness with which the Laetrile thing had developed. I called it a thing because there had never been anything like it to name it after. The economic delusions of the book, the Salem witch trials, the Nazi movement, most old-time quackery seemed different. The difference was that Laetrile had become a social, political, and economic movement besides its medical claims. Books were written. Meetings and rallies were held. An entire belief system surrounded the molecule and the apricot pit. Even the Mafia got involved in manufacture and sale.
Sen. Hatch (R Utah) had just emerged, and there was no other congressional sympathizer or advocate. Most activities were in the states. They were aided by Congr. Richardson (a MD from No. Carolina and a John Bircher,) and the Freedom of Choice in Cancer Therapy organization, all supporters of the Laetrile movement.
By 2000, a major shift had occurred. Although chiropractic seemed to adhere more to right wing principles, and right holdovers Hatch, Burton, and the old-style supplement set persisted, quackery’s advanced guard had become predominantly left-wing. It included the cultural relativism, post-modern wing that fertilizes “Integrative” medicine. The push in California for naturopaths and for loosening practice guidelines for sectarian practices came from the left. The ’90s had brought a surprising and revolutionary change – from the left, and recognizable as the outgrowth of the student rebellions of the 1960s – manifested in 40-50 year olds who bore the same anti-establishment psychologies of their youth. That part of the change was easy enough to see and understand. But what came next surprised and perplexed us, taking us another decade to figure out. It was political attack from the left.
While the anti-government freedom of choicers were easy to figure out – challenging regulation in the name of lying for profit – the force from the left was obscure and largely ideological. Its economic challenge hidden behind a new language that distorted meaning to the point where rationalists could not argue right and wrong any more. Unlike the political right, whose lines in the sand were visible, identifiable, definable and arguable, the new “holistic/alternative attacks changed descriptive language, and beyond that, managed to change the rules of the game without changing the laws.
Instead of attacking the regulatory agencies head on, they infiltrated academia – in fact used the new relativistic politic and post-modern rule bending and language distortion to confuse the traditionalists. So much so that rationalists – scientists, physicians, as well as agency officials had to re-define themselves in order to determine what they stood for. What are we, rationalists? Traditionalists? logical positivists? Obstructionists? Old farts?
In opposition were the PoMos who needed to do no such thing. They operated by stealth, infiltrating education, the press, got elected, taught in law schools, supplying judges and legislators. Thus a whole generation populated the elite of North America, thinking the way postmodernists do, reshaping laws, customs, mores, and language, using them as tools to re-form their surroundings to conform to their own specific outlooks. The mindset elevated neutrality to the highest good, demoted informed opinion to bias, and demeaned rationality to somewhere between learning the alphabet and learning to whistle. Little wonder that objective measurement yielded to “benefits” of placebo, or should be treated as equal to the effective method if it has “meaning” to the patient. or is that client?I glean several principles from this look-back. First, the social forms of pseudoscientific medicine changed in some unpredictable ways. From schools and sects to single ideas and practices, to cults with support groups, specific pseudoscientific ideation, culminating in political movements with press for legitimacy through legislation, courts, licensure, and sales forces for selling opinion to the public, then to assaults on science and medical ethics as tools for advancement.Second, the changing faces and mechanisms represent the opportunistic advances the movements make using defects in the social structure of the time. Analogies abound – epidemics, invasions, cultural terrorism being a few. Adaptable, changeable, surreptitious, audacious. That’s quite an objective to counter.