Holford Watch: Patrick Holford, nutritionism and bad science

A discussion of some of the comparatively recent history of patent medicines, supplements and some extraordinary, unevidenced interventions is taking place in the comments of a post about Patrick Holford’s claim to have visited all of the major nutritional research centres in the US. Whenever this topic comes up, people will refer to the patent medicine shows, hucksters and entrepreneurs of the US. If you will forgive a hobby-horse, I’d like to mention that we don’t need to look to the US for these fabulously self-aggrandising promoters of dubious pills and techniques.

We won’t go into any detail but we have been compiling an extensive review of the correspondences between the pill entrepreneurs of history and their contemporary counterparts (we don’t know if it will ever see the light of day but the topic is fascinating). We offer a few names for your further interest. You will see that the patent medicines and advice that these men offered were aimed at some of the same symptoms and diseases that are the target market for supplements today: gut troubles (with an emphasis on ‘cleansing’), fatigue, headaches, dizziness but, more widely, all manner of illnesses.

The UK produced one of the historically most successful, notoriously litigious and self-aggrandising patent medicine men in the form of Professor James Morison. Morison sold his own range of pills, set up his own training college^[a] to accredit his own health advisers (hygeists), and vigorously promoted his own range of pills and lifestyle advice in a voluminous work on family health. He hated the medical profession with a truly extraordinary passion and funded attacks on the mainstream medicine of the time: see, for example, Medical Confessions of Medical Murder (gif image; Morison has quote-mined quotations from prominent physicians and depicted them in ways to deprecate their practices. However, Shakespeare thoughtfully provides a testimonial to the general good-eggness of Morison and his products). (The resemblance to some modern lifestyle nutritionists is uncanny.)

Morison instigated a stream of legal actions against people who criticised him, his products or hygeism and aggressively defended his trademarks and patents. Morison’s influence is still felt in contemporary patent law and, as you might have guessed, his was a self-awarded professorship.

Morison’s denunciations of his critics were so astonishing and novel in many ways that he is the original citation for some expressions in the OED. He is also credited with the coining of humbuggery in an interesting context.

1831 J. MORISON in Morisoniana 386 The Jennerian vaccinic scheme.. should counteract the virulence.. which the past inoculating humbuggery had failed to effect. 1892 Voice (N.Y.) 25 Feb., Hypocrisy and humbuggery are openly declared to be the only traits that entitle a man to political support.

Thomas Holloway made his millions from patent medicines before endowing Holloway College. Both Holloway and Morison hated the medical profession with an unsettling passion: both of them recognised the influence of advertising and the potent persuasiveness of the personal testimonial.

One of the remarkable men to recognise and harness the power of advertising was James Crossley Eno of Fruit Salt fame, and, like Morison, he had some notable trademark victories. Eno’s Fruit Salt are still widely available in some parts of the world. Eno exploited the power of advertising to the maximum but, unlike other companies and advertisers, his advertising was valued for its moral tone.

It was estimated that in the 1920s three out of four ships sailing from London had a consignment of Eno’s Fruit Salt aboard. It was said that every known method had carried them, from sleighs in the arctic to caravans in the east! Two of the more remote places that Eno’s was shipped to at this time were Thursday and Easter Islands. At this time Easter Island only received mail once every nine months!

Thomas Beecham is (like the others) another self-made man from humble beginnings and no formal training who went on to formulate his own product; his company still exists, in some form, today in GSK.

The extensive use of advertising and the growth of the personal testimonial feels as if it is very important. Returning to the placebo discussion that we have had recently, the advertising, the home-grown qualifications and the moving testimonials were all probably an invaluable part of creating the aura of confidence that was essential to eliciting a successful placebo response.

We haven’t seen it but Homan, Hudson and Rowe’s Popular Medicines: An Illustrated History looks like it might have some interesting reading on this topic and the adverts from that period are always enjoyable.^[b]

The UK also has a rich history of food reform and diet crankery with many interesting historical figures: we haven’t been able to identify a suitable text for that so would welcome any suggestions. We have a towering mass of notes on food, diet and health reform for both the UK and Europe during this period but we probably haven’t scratched the surface.

We’ve occasionally wondered whether a better understanding of the traditions of patent medicine, the historical popularity of lifestyle gurus and their powerful use of advertising might account for what sometimes feels like a peculiarly british susceptibility to aggrandising them in our mainstream media. So, the next time that people are reaching for an example of patent medicine showmen, food reformers, lifestyle gurus and fearsome litigators, think british for all your entrepreneurs and eccentrics.

Notes

[a] Linus Pauling founded his own Institute of Science and Medicine in 1973 when he wanted to investigate vitamin C and his various theories. However, a closer comparison might be Patrick Holford and his Institute of Optimum Nutrition that had been offering unaccredited training since the 1980s until the University of Luton (now Bedfordshire) agreed to accredit the course as a foundation level degree. Morison had no formal qualifications in medicine, anatomy, physiology or biochemistry yet he felt qualified not only to teach his own health practitioners but to promote his own brand of health care and supplements. Whereas Morison and his British College of Health trained and turned out hygeists, Holford has been training and turning out nutritional consultants, clinical nutritionists, nutritionists and nutritional therapists. In the early years of ION, it looks like Holford was responsible for most of the teaching although both now and then, he had no formal qualifications in nutrition, medicine etc.

Extrapolating from Ben Goldacre’s Bad Science both have probably turned out a comparable amount of acceptable research, relatively speaking. Surprisingly, however, Morison may have had some more evidence-based attitudes towards vaccination than Holford (as per his OED remark about the relative merits of vaccination and inoculation although he was largely opposed to vaccination as he believed it to be ‘blood poisoning’): our investigations are continuing.

[b] Homan P, Hudson B, Rowe RC. Popular Medicines: An Illustrated History. 2007. Pharmaceutical Press. The synopsis:

The aim of this book is to provide a history of c20 popular branded medicines. Some will be familiar household names from the twentieth century, some are still on sale in some form today, and some data back to the earliest proprietary medicines in the eighteenth century. Each pictorial history will include biographical details of the inventor, the origins of the medicine and its subsequent history, and details of the medicine’s formula and intended purpose. Each entry will be highly illustrated including colourful historical adverts, portraits, photographs and images of the medicines themselves.

BPSDB