Oscillococcinum: The canonical quack remedy

Oscillococcinum is reportedly one of the biggest selling homeopathic “remedies” on the planet. It is touted as a cure for cold and flu symptoms, and by the unscrupulous as a remedy for the more serious variants of flu such as avian influenza.

Oscillococcinum. Note common homeopathy canards “natural” and “medicine”. It is, of course, neither.

Update: Alleged fraudsters Boiron are suing an Italian blogger for daring to point out the absurdity of their sugar pills. Shame on them, but high five to Samuele Riva.

Remember, folks, where you see the pack on the left, listen for the unmistakable sound of quacking.

Oscillococcinum is at the heart of a class action suit in the US alleging misrepresentation on two levels: lack of any credible link bwteen duck liver and ‘flu, and lack of any credible link between duck liver and the product. Oh, a third: lack of any credible link between the product and ‘flu.

It’s bogus. And I’m Brian, and so’s my wife.

About ‘flu

Before I go into detail about oscillococcinum itself, let’s take a moment to consider influenza and its significance. Here and now in 21st Century Western civilisation, flu has lost much of its terror. Sure, we had the furore over avian flu and H1N1, and people travelling on the underground wearing surgical masks, but sensible people never treated it as much of a threat. There are two reasons for this. First, we are conditioned to think of flu as man flu. Second, we have not had a really serious flu epidemic in living memory.

So, flu is just like a cold, but a bit worse, right? Up to a point, Lord Copper. The 1918 flu pandemic killed over 50,000,000 people, 3-6% of the entire global population at the time and at least 10% of those infected (half of them in the first six months). More died in the pandemic, which ran from July 1917 to December 1920, than were killed by the First World War. It is probably the single deadliest disease ever to strike the planet. A greater proportion of the population died than in the Black Death. It has been described as the worst natural disaster in human history. Ever.

Still convinced flu is no big deal? Thought not. So, flu can be dangerous, and it still is (yes, really, even everyday flu) if you are old, infirm, have respiratory problems, a compromised immune system or whatever.

About oscillococcinum

And now to oscillococcinum. What exactly is it?

The “twenty million dollar duck” – from one duck like this, Boiron make $20m of oscillicoccinum. The duck is not consulted and there’s no duck left in the final product anyway.

According to Wikipedia, supported by other sources, oscillococcinum is a name coined in 1925 by the French physician Joseph Roy, who acted as a medic in the military during the Spanish flu pandemic noted above. On examining the blood of victims he noted an “oscillating bacterium” he named oscillococcus. He decided that this was the cause of the disease (and subsequently of many others) so according to the principles of homeopathy, he believed it would cure the disease if sufficiently diluted.

There are a few problems with this. These problems highlight one of the particular failings of most complementary and alternative medicines (CAM). Even though the idea that flu is caused by oscillococcus is provably false, and has been known to be false since not very long after Roy’s original “provings”, it is still considered a valid remedy. CAM does not tend to self correct. Where science is embarrassed about its mistakes, re-evaluates evidence and tries to do better, CAM carries on as if nothing ever happened.

Why oscillococcinum is bogus

Oscillococcinum exhibits fractal wrongness. However you zoom in on its errors, you just find more errors just as big.

Error 1: Oscillococcus does not exist. If you look up oscillococcus in any credible medical reference you will not find it. It does not exist. Roy probably observed some other opportunistic infection in the less than sterile conditions of World War I field hospitals, or perhaps it was just observational error. Either way, there ain’t no such animal.

This is the virus that actually causes flu

Error 2: A case of mistaken identity: Flu is a virus, the technology did not then exist to observe viruses. The germ theory of disease was pretty much mainstream by 1917 but there were two major obstacles in Roy’s way: first, there was no known cure for bacterial infections (penicillin was discovered in 1928), and second, the optical microscopes of Roy’s time were not capable of resolving viruses, which are around a hundredth the size of the average bacterium. The Spanish flu virus is 80-120nm in diameter,the resolving power of the best optical microscopes is of the order of micrometres. Viruses are smaller than the wavelength of light and can only be seen with instruments such as the electron microscope, which was not invented until 1931.

Error 3: Roy falsely ascribed numerous other diseases to oscillococcus. Roy comes towards the end of the canon of alternative medicine practitioners who ascribed whole classes of diseases to a single cause, but he’s undoubtedly not the only one to fall prey to this delusion. Among the conditions he falsely ascribed to his misidentified bacterium are: herpes, chicken pox, shingles, eczema, rheumatism, tuberculosis, measles, and cancer. Of these only one, tuberculosis, is now understood to be of bacterial origin.

In modern science findings this disparate would be an indication that there is a systemic fault in your experiment. Roy failed to make this connection.

Error 4: Roy misidentified the bacterium in an animal source. Having decided that large numbers of serious diseases were the result of the (non-existent) oscillococcinum bacterium, Roy decided, quite reaosnably, to set about isolating a source for the purposes of preparing a remedy. He analysed a number of animals before deciding he had found the bacterium in the liver of the Long Island duckling (Pekin duck). The flu virus can, in certain circumstances, migrate between species (this was at the heart of concerns about H1N1 and avian flu) but it is quite rare; in any case Roy was on completely the wrong trail as he was looking for a bacterium and not a virus – which of course he could not have known about as his instruments could not detect it.

These are errors of Roy, the originator. Now they are compounded by other errors:

Error 5: He They use a different duck – and different organs. Oscillococcinum is prepared from the heart and liver of the Muscovy duck. While it is quite possible that any disease affecting the Long Island duck will also affect the Muscovy, it is by no means certain.

Error 6 Extending the specific to the universal: Even if Roy was right and oscillococcus existed, and was responsible for diseases rather than being a secondary effect of the diseases, and was also present in Long Island ducks, and was also present in Muscovy ducks, where is the evidence that the purported bacterium is present in all such ducks? It’s certain that manufacturers such as Boiron are not checking for the presence of oscillococcus in the ducks they use, because oscillococcus doesn’t exist.

Error 7: Extending yet again: Having arbitrarily decided that all ducks have this bacterium, an extract (or nosode) is taken from the hapless animal. This includes the liver and heart. If we were to believe that flu were caused by a bacterium (which it isn’t) and the bacterium is oscillococcum (which doesn’t exist) and the bacterium is found in the Long Island Duck (which it can’t be as it doesn’t exist) and that this means it’s also present in the Muscovy duck (which is speculation) and that this means it’s present in every Muscovy duck (which is more speculation), then where is the evidence that this bacterium will persist through the process of removing certain parts of the duck’s entrails? And who’s to say that some other entirely unrelated bacterium may not take root instead? How confident can we be that it is the (imaginary) oscillococcum bacterium and not the (entirely real and endemic in wildfowl) salmonella that is being harvested here?

Error 8: Active ingredient: None. The most common preparation on sale lists its “active” ingredients as follows: Active ingredient: Anas Barbariae Hepatis et Cordis Extractum (extract of Muscovy Duck liver and heart) 200CK HPUS 1×10-400 g; Inactive ingredient: 0.85 g sucrose, 0.15 g lactose. This highlights two of the major problems with homeopathy generally. First, the ratio of purportedly active ingredient to inactive is utterly preposterous. A typical dose of paracetamol is 500mg. To receive a 500mg dose of duck liver you would need to consume 0.5×10^400 g of the dilute remedy – that is 5×10^393 Tonnes. We’re a bit short of reliable comparators at that level, Earth has a mass of the order 10^21 T, the galaxy is of the order of 10^39 T, the known universe something less than 10^50 T.

Here’s another way of thinking about it: in order to reach a statistical probability of receiving a single molecule of duck entrails, the molecule being the smallest amount of a substance that can actually exist, you would need to consume of the order of 10^400 molecules of the mixture. The molecular mass of water is 18 (more or less; we’ll assume they use sterile and isotopically pure water since anything else would introduce the “memory” of entirely unpredictable impurities) so that’s 6×10^23 water molecules per kilogram,meaning you’d only need 1.7×10^376 kg of solute to be certain of getting a molecule of duck entrails. There is no easy way to describe how immense these numbers are; suffice it to say that we are far beyond one grain of sand in the Sahara – in fact we are many orders of magnitude beyond one atom among all the atoms in the known universe. You might subscribe to the homeopathic doctrine of “water memory” – if so, imagine a game of Chinese whispers where the instruction has to be passed on over a billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion billion times after the first in line.

CK refers to the Korsakovian dilution process. In this process, a single container is used for the preparation of the remedy. After succussion (or “magic shaking”) the container is emptied and the fluid clinging to the container walls is taken as the basis for the next dilution. Yup, you read that right. They shake it, pour the whole lot away, fill the vessel with fresh water and keep doing that until they have a dilution of less than one part for every atom in the known universe. For some reason, scientists find this a bit hard to take. Can’t imagine why.

Error 9: Where do the grammes go? The label says “Active ingredient: Anas Barbariae Hepatis et Cordis Extractum (extract of Muscovy Duck liver and heart) 200CK HPUS 1×10-400 g” – this is an absurdity. We have no way of measuring that kind of mass. Essentially this is saying the substance was diluted 200CK and then one gramme of the solution added to each gramme of sugar, but that 1:1 figure does not match with the percentages of the two sugars cited.Whoever wrote this label is deeply confused.

Error 10: Where does the memory go? After Avogadro gave us a figure for the level of dilution at which the source molecules entirely vanish, homeopaths invented the concept of “water memory” to explain the mechanism by which the “energy imprint” of the original active principle persists after the substance no longer exists. I say explain, actually it’s to avoid explaining.

Scientists dispute the existence of this memory. A Frenchman called Jacques Benveniste published a paper asserting that he had isolated the effect, but it was found to be subconscious bias on the part of an unblinded member of his team. Work by Luc Montagnier seemed to support it to some extent, but Montagnier told the Canadian broadcaster CBC that his work cannot be extended to cover homeopathy. So there is no credible peer-reviewed evidence that water memory exists.

Error 11: How long will this memory last? Montagnier’s experiment suggested that certain subtle effects might persist very fleetingly after an extreme dilution. There is no evidence whatsoever that this effect, if it exists, is persistent. Homeopaths claim that remedies a hundred years old have been used to good effect, though they warn that exposure to electromagnetic radiation can affect potency (albeit without proof that the supposedly potent century-old remedies have not been exposed to electromagnetic or ionising radiation). For real medicines we can measure the shelf-life; with homeopathic remedies, which are chemically and in every other objective sense indistinguishable from each other and from the sugar used as a delivery mechanism, there is no way we could ever determine shelf life or the decay of potency. Years? Decades? Millennia? Or perhaps milliseconds? In the absence of any way of objectively measuring the existence of the supposed effect, we cannnot possibly know.

Error 12: Water to sugar. The solution is transferred to sugar pills. There is no credible evidence that water memory exists, but what if it did? If every gramme of sugar is mixed with one gramme of water which is then evaporated, then who is to say how much, if any, of the memory then transfers to sugar? Whatever work has been done on water memory, there is none at all on the supposed transfer of this memory when the water itself evaporates.

Error 13: Sugar to enzymes. Homeopathic remedies are typically delivered orally, and that is the case for oscillococcinum. Where is the evidence that an effect so subtle as to be unmeasurable in water, can survive the enzymes of the mouth?

Error 14: Enzymes to acid. Having been attacked by enzymes, the preparation is then immersed in hydrochloric acid. This effect, so subtle it cannot be measured, can survive not only enzymes but acid? Prove it.

Error 15: Acid to blood. Assuming the effect survives the enzymes and the acid, it then has to transfer to the blood. I guess the request for evidence that this can happen will have to go to the back of the line. And it’s a long line.

So, I am not a specialist, but from my knowledge of basic chemistry and biology I can identify these flaws in the design of the single biggest selling homeopathic remedy in the world. Everything above is drawn from reliable peer-reviewed evidence. Individually, a series of questionable calls, but in aggregate a house of cards – conjecture built on hypothesis built on guesswork built on error.

And this is being marketed as a preventive for influenza, a disease which is commonly dismissed as unimportant but which actually has deadly potential. As a virus, the best of Western medicine has strictly limited ability to control a pandemic once it gets underway.

Short link: http://is.gd/quack

13 thoughts on “Oscillococcinum: The canonical quack remedy”

  1. High five to you!
    My “defamatory” article is similar to yours, I wrote about Oscillococcinum and the crazy Korsakovian process… be careful, Boiron is watching us !!
    Thanks for the support!

  2. Evidence, schmevidence! I wouldn’t even go into the detail until they proved the really important thing: that it actually has an effect on the condition it’s supposed to be treating. Afterwards, we could try to find out how.

    But so far, no proof that it works.

  3. British Journal of Clinical Pharmacology (British Pharmacological Society)
    Oscillococcinum in the treatment of influenza (1989) British Homoeopathic Journal
    Oscillococcinum in patients with influenza (1998)Cochrane
    Oscillococcinum for influenza (2003) FULL TEXT // Oscillococcinum reduces the length of influenza illness by 0.28 days  i.e. approx 7 hours

    1. So, no significant effect, then, which is in line with expectations and indeed the laws of physics (unlike homeopathy, which contradicts both). Thanks for that.

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