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Tempest in a Tonic Bottle: A Bunch of Weeds?
ISSUE:
Page:
32-43

Some readers may have strong feelings about the Harry Hoxsey cancer treatment story. We present this chapter on the herbal ingredients in Hoxsey’s formula from Kenny Ausubel’s new book When Healing Becomes a Crime—the study of this Dallas-based promoter of natural cancer cures. Modern research has revealed that many of the herbs in this formula contain compounds that have exhibited antioxidant and/or anti-tumor properties in experimental studies. In light of this data, author Ausubel asks whether this formula might be potentially useful in cancer treatment. We publish this chapter with the intention of stimulating discussion on the potential role of herbs and other natural products in the prevention and treatment of cancer and other serious illness and to draw attention to a fascinating chapter in American medical history. — The Editors

For decades organized medicine ridiculed the Hoxsey remedies as a bunch of "weeds" and refused to look into them. Typifying this kind of cavalier dismissal was a classic 1940s archival medical film we located called Fraud Fighters.1 Cast in much the same style as the heavy-handed antimarijuana propaganda film "Reefer Madness," the melodramatic movie relates the parable of "Elixerex," an ersatz nostrum in a thinly disguised Hoxsey-like tonic bottle. Under the Dragnet-style narration, the movie follows Elixerex through the FDA’s 1950s state-of-the-art labs, which today look as archaic as the era’s Univac computer. Elixerex lands in the blocky hands of grim, square-jawed junior G-men intent on rounding up the unscrupulous crook behind the scam. The medical ideology is as black and white as the film footage.

"And now the Food and Drug people want to know," booms the narrator’s voice over crescendos of music, "What is Elixerex? In every district station is a battery of crack chemists and microanalysts who fight the battle against filth and fraud. To one of these comes Elixerex. The magic formula to relieve sickness and pain turns out to be nothing more than a mixture of water and an alcoholic extract of certain herbaceous weeds that grow in profusion in the maker’s backyard."

During Hoxsey’s era, organized medicine took a uniformly contemptuous view of botanical medicine. Dr. Fishbein* himself mocked herbs as "veritable vegetable soups."2 It was in the unhappy wake of one of Hoxsey’s court victories affirming the efficacy of his tonic that the AMA Journal echoed the FDA’s frustration in its acerbically titled editorial "Cough Medicine for Cancer."3 "It is fair to observe that the American Medical Association or any other association or individual has no need to go beyond the Hoxsey label to be convinced. Any such person who would seriously contend that scientific medicine is under any obligation to investigate such a mixture or its promoter is either stupid or dishonest."

While sifting through the contentious terrain of the Hoxsey saga, I realized with consternation that no one seemed to have actually looked objectively at the ingredients of the Hoxsey tonic and salves. I decided to conduct an investigation for the film to ascertain what might be known about the herbs that caused this tempest in a tonic bottle.

In 1985 I set off for Washington, D.C., to meet with James Duke, Ph.D., a renowned botanist and author of twenty books and over two hundred scientific articles.4 He has devoted his professional life to the study of pharmacognosy, the branch of pharmacy that develops medicines from natural sources.‡ At the time, Dr. Duke worked for the U.S. Department of Agriculture (USDA), where he founded a world-class database on plant medicine. He also collaborated for many years with the National Cancer Institute as part of a modest government program for drug discovery from natural products including plants. Along with a small handful of other botanical explorers, Duke helped lead the way to plant medicines that have produced pharmaceutical drugs such as the cancer drug Taxol from the Pacific yew tree. During this period, the NCI reputedly screened about 10 percent of the plant species of the world, including all those in the Hoxsey formula.5

I sent Duke the revised list of Hoxsey herbs published in the 1950s, which Mildred Nelson§ ostensibly continued to use. Duke decided to tap not only his own extensive USDA database, but also NAPRALERT, the Natural Products Alert computer database at the University of Illinois in Chicago. Founded by Dr. Norman Farnsworth, a globally revered pharmacognosist, NAPRALERT gathers data from scientific and medical studies all over the world on plants and other natural substances, and collates them into a comprehensive, centralized information source. It can sort the data into multiple categories of chemical properties and biological activities, a task ideally suited to computers working with gargantuan volumes of information.6

When I arrived at USDA headquarters in Beltsville, Maryland, Duke shuttled me to his nearby Herbal Vineyard, the small farm where he lives.# A tall, gentlemanly figure sporting a trim goatee, he spoke in gentle, southern tones with understated authority. Guiding me around the lush Eastern deciduous forest, he delighted in pointing out a number of Hoxsey’s "herbaceous weeds" growing in his own backyard. We inspected red clover, burdock, prickly ash, barberry, poke, and buckthorn, as well as bloodroot, the herb in one of the Hoxsey external formulas.

Duke noted that all the Hoxsey herbs have a long empirical tradition of Native American usage for cancer, several stretching back as far as three thousand years. Some of the herbs such as red clover and burdock, which were introduced to North America from Europe during the 1700s, were immediately adopted by the Indians.

Duke’s first concern about the tonic was its safety, and he quickly pointed out that only one of the herbs, poke root, might be dangerous. A common plant throughout the Southeast, poke is a well-known herb and food to local residents, who like to parboil the leaves and add them to salads. The root, berry, and leaf are toxic in larger quantities. The amount in the Hoxsey tonic, however, is well below any threshold of danger. [Warning: Do not self-medicate with poke root. Eating the leaves can also be toxic without proper preparation.]

Back in Duke’s study, stacked high with books, papers, and oversized reference works, he lifted a hefty three-pound volume called simply Plants Used Against Cancer. The encyclopedic tome was authored by Jonathan Hartwell, a chemist and virtual founder of the National Cancer Institute who went on to become an assistant chief of the NCI’s new Cancer Chemotherapy National Service Center and head of the natural products section of the NCI’s Drug Research and Development Program.** Hartwell spent many years compiling a comprehensive cross-reference of information on the global folkloric traditions of anticancer plants. "The history of the herbal treatment of cancer," he wrote, is synonymous with "the history of medicine, indeed of civilization."7 Covering more than three thousand species, Hartwell’s compilation listed all the Hoxsey herbs. They ranged from having three to over thirty citations each—a very impressive score, Duke noted.8

A number of the plants, Duke pointed out, contained chemical compounds "of considerable interest" to the NCI. "At least three of the herbs—barberry, cascara sagrada, and buckthorn—contain compounds that have been studied by the Cancer Institute as effective in some tumor systems, though not studied in humans. So there are certainly biologically active compounds in these species."

The data Duke provided were sorted into several categories that indicate both the nature of the tests performed and their relevance to possible anticancer activities. One grouping was for antioxidants, which protect cells of the body against precancerous damage. Another was for antimutagenic properties, which shield against cellular mutations that can lead directly to cancer. A third was cytotoxic activity, which is a toxic action that can kill any cells, but is particularly effective at killing cancer cells since they are more sensitive by virtue of dividing so quickly. Another class of activity was antimicrobial (antiseptic), consisting of both antibacterial and antiviral activity. Antibacterial properties are considered indicative of potential antitumor activity, while antiviral activity is important because some cancers are now believed to be caused by viruses (as Hoxsey asserted in the late 1950s).

Dr. Duke ultimately wrote a short article based on his Hoxsey research, published in 1988 in HerbalGram, the peer-reviewed journal of the respected American Botanical Council.9 Eight of the nine herbs in the internal tonic showed antitumor activity in controlled laboratory animal tests. Five showed antioxidant properties as protectants against cancer. All showed antimicrobial properties with activity against viral or bacterial infections.

Duke’s assessment was that the Hoxsey internal tonic ingredients showed very significant chemical and biological anticancer activity. The formulation might or might not actually work, but in principle it definitely merited serious investigation.

In preparing this book, I revisited the initial 1985 herbal sleuthing begun by Jim Duke to learn what new data might have come on-line. I consulted again with Duke as well as with several other researchers who have conducted independent investigations into Hoxsey in what turned into a medical detective story. One of these was Francis Brinker, a naturopathic physician and scholar of botanical medicine who made his own visit to the Bio Medical Center in 1983. Brinker subsequently published a definitive article in the Journal of Naturopathic Medicine containing surprising conclusions about the Hoxsey tonic.10

Another was Patricia Spain Ward, Ph.D., an esteemed medical historian who prepared a contract report on Hoxsey for the federal Office of Technology Assessment, the former research arm of Congress. (The alarming episode of Ward’s controversial report is told in chapter 17.) Finally, the American Botanical Council’s executive director, Mark Blumenthal, supplied the most current update on the Hoxsey herbs from NAPRALERT, voluminous data filling 267 tightly spaced pages that Dennis McKenna, Ph.D., a prominent pharmacognosist, reviewed and appraised.

Before looking at these herbs, however, it is necessary to probe the mystery surrounding the secrecy of Hoxsey’s formula. The list of ingredients I originally provided Jim Duke was the one published in Hoxsey’s book in 1956.11 That formula contained barberry, buckthorn bark, burdock root, cascara sagrada, licorice root, poke root, prickly ash, red clover blossoms, and stillingia root in a water base with potassium iodide.

However, Hoxsey had previously given two different versions. After keeping its composition secret for twenty-five years, he first released it only under court order during the 1949 Hearst trial.12 Several years later Hoxsey listed on his labels yet another recipe almost identical to the one published in his book.13

In court depositions Hoxsey admitted changing the formula over time, starting out with his original inheritance but significantly augmenting it under the direction of Dr. Joseph Durkee from 1946 to 1952.14 Dr. Durkee saw himself as a serious researcher knowledgeable in traditional osteopathic and naturopathic medicines. Hoxsey readily admitted Dr. Durkee’s contributions, but he never specified what they were.

Hoxsey remained cagey as to whether any of these was the true formula. Pharmaceutical companies have always been notoriously and justifiably secretive about their recipes and manufacturing techniques until they gain patents. Even then, such commercial interests remain evasive, like Coca-Cola and its famous secret formula. Because Hoxsey’s herbal remedies were not patentable, he had reason to be cautious. Perhaps Hoxsey felt, as Winston Churchill once remarked, that the truth was so valuable that it had to be protected "by a bodyguard of lies." The MacGuffin might still be in play, after all.

So the question remains as to what exactly is in the Hoxsey tonic. Mildred Nelson [Harry Hoxsey’s valued nurse and assistant] has continued to hold the precise recipe close to the vest and never confirmed or denied its makeup. She gave a sly wink that Hoxsey might have admitted under court order only what the AMA believed to be in the tonic. However, botanical formulas containing multiple ingredients are famously complex, and the analytical methods of the day and understanding of plant chemistry were primitive. Mildred did hint to us that licorice may never have been in the formula at all, and has remained altogether opaque about the contents. In the last few years she elliptically stopped listing buckthorn and prickly ash bark on the label. She also maintains that the tonic formula may be customized according to the type of cancer and stage, as Hoxsey also claimed to do.15

As a naturopathic scholar, Francis Brinker delved deeply into the old literature of the Eclectic medical tradition. After attending the National College of Naturopathic Medicine in Portland, Oregon, his fascination with the rich heritage of the Eclectic physicians of the nineteenth century set him on an intensive review of their botanical remedies where he would eventually make a puzzling discovery about the Hoxsey tonic.

The name Eclectic originated with a group of doctors devoted to clinical research and the use of herbal preparations in treating disease. They flourished in the late nineteenth and early twentieth centuries, and between 1826 and 1939 had a string of medical schools that taught sophisticated methods of botanical prescribing, the mainstay of therapeutics of that era. Their work represented the apex of plant medicine in the United States and persists as a rich reservoir of practical knowledge, some of which has yet to be equaled.16

"The Eclectics were able to differentiate well the activities of various plants," the erudite researcher notes. "But most importantly, they were effective clinical observers. They could tell what worked and what didn’t. Even though their results were positive, their explanations were very often wrong, based on the limitations and understanding of medicine and science at that time. They had an empirical approach to medicine in which it’s clinical results that one looks for, not the absolute guarantee of understanding the process involved. They were willing to use anything that worked. In fact, conventional medicine eventually incorporated that philosophy of Eclecticism using clinical results and observations, which today are established through controlled, double-blind studies."17

In researching the Hoxsey formula, Brinker found that it bore a striking similarity to an old red clover-based Eclectic formula. He traced the origins of the Trifolium (red clover) extract back to the nineteenth century, when Parke, Davis, and Co. produced a Syrup Trifolium Compound approximating the modern Hoxsey formulas, except that in 1890 it did not contain buckthorn or licorice. "Several decades later," Brinker noted, "in advertisements appearing in medical journals, Parke, Davis, and Co. identified the Syrup Trifolium Compound as a long-established success prescribed in every civilized country in the world."18 Credited to an obscure Dr. Rush, about whom nothing more is known, the formula was also described in an official American Pharmaceutical Association listing of drugs called the National Formulary in 1926 and 1936.

Yet another Extract of Trifolium Compound was listed in the 1898 King’s American Dispensatory, the preeminent compilation of medicines used by Eclectic doctors. Produced by the W. S. Merrell Co. of Cincinnati, it was celebrated for "the alterative, tonic, and eliminative properties of the recently expressed juices of extracts from fresh or green plants with potassium iodide." It was prescribed for syphilis, scrofula, rheumatism, and glandular and skin conditions. This "Compound Fluidextract of Trifolium" contained all the Hoxsey ingredients except buckthorn, and also had mayapple root, Podophyllum peltatum.19 However, Brinker adds, there is no evidence that anyone ever applied the Trifolium compound to cancer before Hoxsey did, an innovation for which Brinker gives him formidable credit.

Why might Hoxsey apply it to cancer? Brinker points out that the Trifolium compound was essential to the very fabric of the Eclectic and naturopathic view of disease. It was used for its tonic, alterative, and eliminative properties. He explains these important concepts.

"Tonics, often bitter, were employed to increase the appetite and enhance the processes of digestion and assimilation. They improved the quality of the blood and the nutrition of the entire system.

"Alteratives, known in folk medicine as ‘blood cleansers,’ were seen as assisting organs that remove metabolic waste and toxins from the circulation. Alteratives were believed to improve the quality of the blood by assisting digestion, improving circulation, and accelerating the processes of elimination, thereby correcting faulty metabolism. The knowledge concerning their action was wholly empirical. Health was seen as a product of the quality of the blood, since the blood brings nourishment to tissues and cells and must remove the cellular waste." In the Eclectic view, an alterative favorably alters the course of an illness. It is used for chronic conditions in small amounts over prolonged periods. Dr. Durkee explicitly characterized the tonic as an alterative.

The eliminative function is also essential. "Cleansing the blood," Brinker continues, "occurs as it is filtered through the organs which excrete cellular waste products. When these organs of elimination do not function adequately, it becomes increasingly difficult to maintain a healthy ecology of the cells. This makes them more susceptible to carcinogens.20

"Attempting to enhance elimination and immune function can be done by utilizing a variety of methods and agents including herbs," Brinker observes. "This model for the action of alteratives was practically applied by the late-nineteenth-century Eclectic prescribers in the treatment of chronic and cancerous conditions. Such was their success that the alteratives were considered to have been among the most useful medicines in Eclectic therapeutics."

The Hoxsey formula’s real purpose was not to kill cancer cells directly. Rather, it was to create an overall terrain unfavorable to the growth of cancer cells. Simultaneously its effect was the enhancement of the body’s own immune response and capacity to eliminate toxins. From these perspectives, the Hoxsey tonic is a credible approach.

Independent scientific research has validated certain effects of the Hoxsey herbs on overall physiological function. "The tonic and alterative claims by Eclectics have been relatively substantiated," Brinker confirms.21

There is additional evidence that the tonic does also have a direct cytotoxic (cancer-killing) activity, according to Brinker. "All of the plants of the Hoxsey tonic or certain of their active constituents have shown some degree of antitumor activity in human cancer cell-culture laboratory studies or in living animal systems. Constituents of red clover, licorice, and burdock inhibit the effects of tumor promoters or mutagens." He cautions, however, that these results cannot necessarily be assumed to apply to human beings, but serve rather as a screening method useful for speculative hypothesis.22

When I met again with Jim Duke in 1998, he joked that the new data on the Hoxsey herbs were by now so abundant that I would need another briefcase to lug the papers home. He culled his own private plant database, one of the most extensive in the world (Duke retired from the USDA in 1997), and dug up even more contemporary evidence of compelling anticancer properties in the Hoxsey tonic herbs.23 Several are of special interest. Duke as well as the other researchers were particularly enthusiastic about recent discoveries concerning red clover, burdock root, and poke root.

Red Clover

Red clover blossoms, Trifolium pratense, which are proportionally one of the largest ingredients in the tonic, "show up in all the ‘quack’ remedies," Duke told me.24 Historically red clover blossoms have been used as a folk cancer remedy both internally as a "blood purifier" and externally as a plaster. But, he added, "now it turns out that it contains genistein, the same estrogenic isoflavone for which the soybean has been getting all the press lately. It also contains three other compounds which are estrogenic [mimic natural hormones]. I suspect those four are synergistic at preventing or slowing the development of cancer." These components have all been documented to produce anticancer effects.25

Duke further underscored the fact that these compounds are especially notable in light of recent findings about tumor growth. They are antiangiogenic, meaning that they prevent the formation of new blood vessels, thereby cutting off the ability of a tumor to grow.

Red clover contains many biologically active compounds, including phytoestrogens, plant compounds with hormonal estrogenic effects. These plant hormones may be responsible for the low incidence of breast and other female reproductive cancers among women in Japan, where soybean products are regularly consumed.26 Further research continues to confirm that consumption of soy as a dietary source of these phytoestrogens is associated with a lowered risk of leukemia as well as cancers of the breast, lung, and prostate.27 Among 150 herbs tested for such hormone activity, the top six included Hoxsey’s red clover and licorice, along with soy.28

Science News in May 1990 reported that a compound was discovered in soybeans that resembles the conventional cancer drug Tamoxifen. Duke noted that this "Tamoxifen look-alike may block cancer at an early stage. They attributed the results to genistein, found also in red clover. By blocking a wayward cell’s growth at this early stage, genistein might give the immune system a better shot at destroying the cells."29

Duke further highlights the fact that only recently have scientists acknowledged the data that phytoestrogens such as genistein regulate the immune system and appear to prevent the spread of breast cancer. The recent flurry of excitement around tests of the synthetic drug Tamoxifen, claiming it can prevent breast cancer in up to 50 percent of women, downplays the fact that it also can produce serious "side effects" such as uterine cancer and fatal blood clots.30 The compounds in red clover, says Duke, are a much safer natural alternative to this toxic synthetic drug.

This angiogenic direction in cancer research has gained some currency in recent years, and became the object of a media feeding frenzy in May 1998 around the research of Dr. Judah Folkman. Celebrated on the front page of the Sunday New York Times as a potentially momentous cancer breakthrough, two new drugs devised by Dr. Folkman were designed to utilize angiogenesis in preventing tumor growth by cutting off the blood supply that feeds cancerous tumors.31 Subsequent research has confirmed Dr. Folkman’s experiments, and several angiogenesis inhibitors are now being tested for tumor suppression in clinical trials.32 These new directions in cancer research, Jim Duke says, "make the Hoxsey formula seem even more credible."

Duke additionally points out that red clover’s folk tradition against cancer was strongly cited in Hartwell’s Plants Used Against Cancer, as well as in the foundational herbal book Back to Eden by Jethro Kloss, who devoted many pages to its anticancer properties. Duke also names it extensively in his own scholarly work, CRC Handbook of Medicinal Herbs.33

Francis Brinker adds that the Eclectics prized red clover as an excellent alterative. "It was said unquestionably to retard the growth of cancer when administered internally for a prolonged period and was given freely to those with a tendency toward getting cancer."34

Burdock Root

Duke considers burdock, Arctium lappa, an especially distinguished Hoxsey ingredient for its strong immune-boosting properties. It contains chemicals that have shown anticancer activity in laboratory tests on cancer cells, and has other compounds with potent immune-enhancing effects.35 Duke notes that burdock has been long used as a folk cancer remedy in Chile, China, India, Canada, Russia, and the United States.

Patricia Spain Ward’s medical research also turned up compelling evidence of burdock’s anticancer properties. One Hungarian study found "considerable antitumor activity" in a purified part of burdock. The researchers first included the plant in the project because of its history as a folk remedy for new growths and ulcerations.36 Another test demonstrated how burdock inhibits tumor growth.37 A Japanese study discovered a new substance in burdock uniquely capable of reducing mutagenicity. "So important is this new property that these scientists named it the ‘B-factor,’ for ‘burdock factor,’" Ward reported.38

Herbalists often recommend burdock as a blood purifier and alterative, and it is also famous for its inclusion in another herbal combination for cancer called Essiac. A formula widely used in Canada and the United States, Essiac originated in Canada in the 1930s with founder René Caisse (Essiac is Caisse spelled backwards), a nurse who attributed the formula to Ojibwa Indians as a traditional cancer remedy.39 It is notable when the same plant recurs in independent formulas.

Poke Root

Duke believes that poke root, Phytolacca americana, is another star in the Hoxsey tonic and he underscores its folk tradition. Poke roots, leaves, and berries, all of which can be poisonous, have long been used as anticancer remedies. Indians used the powdered root for cancer and early settlers applied the berry juice to skin cancers. Traditionally the juice was believed to alleviate cancer. As an ointment or decoction, the root as well as the leaf have long been used to treat cancer and tumors.

Poke was widely celebrated by the early Eclectics for its anticancer properties. After forty years of use, Eli Jones, a famous Eclectic physician whom science writer Ralph Moss has called "one of the founders of modern oncology," considered poke the most valuable general remedy available for treating cancer.40 Among its common names was cancer root.

Poke hit the headlines in 1998 when Antimicrobial Agents and Chemotherapy, the official journal of the American Society for Microbiology, published a study about a promising new drug that eradicates HIV infection (AIDS) in mice.41 The new agent contains a potent antiviral protein from the pokeweed plant and was found to be 100 to 1,000 times more active than any other anti-HIV agent produced to date. The new medication works like a magic bullet, delivering the plant-derived inhibitor selectively to AIDS-infected cells. The mice in the study were cured of human AIDS without side effects. Therapeutic drug levels were achieved in monkeys without side effects. Based on these very promising results, the FDA granted permission to start clinical trials in HIV-infected patients at treatment centers in the United States. Additional testing has begun in South Africa using this derivation from the folk cancer remedy.42

Patricia Spain Ward also found significant citations on poke in her research. She noted that in multiple studies poke’s activity helped trigger the immune system.43 Brinker unearthed yet other references from old Eclectic medical journals.44 "Phytolacca is so potent," Brinker suggests, "that I am surprised that conventional medicine doesn’t make more use of it."45 (Again, do not self-medicate with poke.)

Barberry and Prickly Ash Bark

Barberry and prickly ash have shown activity against cancer. Jim Duke highlights barberry, Berberis vulgaris, as especially significant for its anticancer activity, attributable to the alkaloid berberine in particular. (Alkaloids are bitter, organic bases found in plants.) Barberry contains a wealth of anticancer, antitumor, antioxidant, and mutation-preventing compounds, as well as cancer-preventive properties.46 Native Americans used the plant to cleanse the blood, among many other uses.

Duke emphasizes that prickly ash bark, Zanthoxylum americanum or Z. clava herculis, contains some of the same alkaloid compounds found in barberry, and he considers it another leading agent in the formula. Because the quantities in the tonic are relatively small, however, its possible effect should not be overstated.47

Buckthorn Bark, Cascara Sagrada, Stillingia Root, and Licorice Root

The rest of the Hoxsey herbs have all shown meaningful anticancer activity as well. Buckthorn bark, Rhamnus frangula, has traditionally been used for internal cancers.48 It has long been a remedy for cleansing the blood, liver disorders, and constipation. It contains aloe-emodin, a laxative compound that has shown activity in animal tests against several tumor systems including leukemia.49 Ward identified a study that isolates an antileukemic principle from buckthorn. This discovery prompted the scientists to recommend retesting other similar laxative plant components for antitumor activity.50

Cascara sagrada bark, Rhamnus purshiana, contains the same aloe-emodins as buckthorn in twice the amount.51 It has traditionally been used as a purgative, laxative, tonic, and liver medicine. An extract of cascara inhibited the tumor growth of breast cancer transplanted in mice after ten days.52

Stillingia, Stillingia sylvatica, also known as queen’s root, is a medicinal plant of the Southeast known for its unsurpassed alterative influence on lymphatic and secretory functions. Eli Jones listed stillingia‡‡ as another long-standing Eclectic remedy for internal cancer.53 An alcoholic extract of stillingia reduced tumor growth in mice with breast cancer transplants after nine days.54 According to Ward, in 1980 two German scientists discovered two new members of a chemical group with known antitumor activity in stillingia’s root, the part used by Hoxsey.55

Licorice root, Glycyrrhiza glabra, which may be used by Hoxsey, also exhibits many relevant activities. It has estrogen-like properties, enhances immune function, and further serves to assist elimination.56 It has long been employed as a tonic and blood purifier, as well as for soothing internal inflammations. It contains compounds potent against certain bacteria.57 A number of components isolated from licorice have shown antitumor activity in animal test systems.58 Recent studies have also found that a licorice fraction and amino acids helped prevent liver cancer in patients with hepatitis C.59 Licorice is highly prized in Chinese medicine for its synergistic effects in formulas with multiple ingredients.60

Potassium Iodide

The most overlooked factor in the tonic is its nonherbal ingredient, potassium iodide, the base in which the herbs are contained. It is a compound of potassium and iodine also known by its chemical symbols as KI. Potassium iodide has a long history of usage in Eclectic and folk medicine, as well as in veterinary medicine. The Eclectics used potassium iodide extensively, but not for cancer.61 Conventional doctors also employed it earlier in the century for many diseases.62

In the AMA’s own files I uncovered obscure but important articles showing anticancer properties for potassium iodide. They were published in The North American Veterinarian and in Veterinary Medicine respectively in 1926 and 1930 by Arthur Bryan, a Baltimore veterinarian.63

Bryan corresponded with the AMA in 1951 about his findings. Writing to the Bureau of Investigation, he noted that "Hoxsey’s treatments admittedly came from a veterinary surgeon. Some twenty-seven years ago, my brother, Charles Bryan, M.D., and myself found that solutions of potassium or sodium iodide, when injected or crystals instilled into all kinds of neoplasms [cancers] in domestic animals, broke them down, presumably by escharotic action, so that they usually disappeared in a week or so. Tumors of horses and cattle larger than a pumpkin responded to the treatment dramatically."64

Dr. Fishbein’s attorney, preparing for a Hoxsey trial, brought the publications to the attention of Oliver Field, who never acknowledged the studies.65 At the time, the AMA officially held that potassium iodide might accelerate the growth of cancer.66

Potassium iodide was also an important element of the therapy of Dr. Max Gerson. A German physician who emigrated to the United States, he achieved dramatic results against cancer and other conditions using a rigorous diet of natural foods, fresh juices, liver injections, and coffee enemas. He was celebrated by Nobel laureate Dr. Albert Schweitzer as "one of the most eminent medical geniuses in the history of medicine."67 Dr. Gerson believed that potassium iodide corrected important bodily defiencies and enhanced metabolism, which in turn retarded and inhibited tumor growth.68

Other physicians in the 1940s and 1950s experimented with potassium iodide for cancer with demonstrable results. Dr. Kleiner, a professor of biochemistry at the New York Medical College, and Dr. M. M. Black of the Brooklyn Cancer Institute treated advanced-cancer patients with KI with encouraging results.69

An interesting contemporary footnote is that U.S. public health officials dispensed potassium iodide pills to nearby residents after the Three Mile Island nuclear accident. The substance is believed to block ionizing radiation from damaging the thyroid gland.§§ The FDA itself distributed KI liquid to the population around Three Mile Island.

The same method was used in the former Soviet Union following the Chernobyl nuclear disaster. The Nuclear Regulatory Commission’s Report on the Accident at the Chernobyl Nuclear Power Station found, "The Russians were apparently well prepared for large-scale distribution of KI tablets to the general public. Thousands of measurements of I-131 (radioiodine) activity in the thyroids of the exposed population suggest that the observed levels were lower than those that would have been expected had this prophylactic measure not been taken. No serious side effects of KI use have been reported." Spurred by new research from Chernobyl, the Nuclear Regulatory Commission is today preparing to distribute potassium iodide to states with nuclear power plants.70 Clearly potassium iodide is an intriguing therapeutic agent.

Despite this encouraging data for the individual ingredients, the Hoxsey tonic has not been tested as a whole entity, and nothing is known about the complex synergy of its components. "When you’re talking about the contents of active constituents in a plant," comments Francis Brinker, "the variables are enormous. You’ve got not one active ingredient, but many. Then when you start combining nine different plants into this complex, you have no idea really how those various factors are interacting, and which is more important than another. Trying to develop drugs from plants by reducing crude extracts into their component parts in order to obtain an active isolated constituent never duplicates the effect of the whole plant. There are minor constituents that can have a very significant impact as part of the overall complex of components that work together to act therapeutically in a human system."

James Duke strongly concurs. "You’ll find that these plants have several different types of activities that might contribute toward cancer cure or prevention. Several compounds contribute to each of those types of activities."

Duke portrays the situation as a clash of paradigms between the isolated, purified magic bullet favored by allopathic medicine and the herbal shotgun shell preferred in the natural medicine tradition. "The whole is better than the sum of its parts," he asserts. "The suite is what’s most effective. But FDA regulations are such that, if you’ve got several active ingredients, you’ve got to prove not only that every one of them is safe and efficacious, but that all of them are safe and efficacious. All plants contain thousands of compounds, most of them biologically active. Are we going to have to prove all thousand of them safe and efficacious?"

The National Cancer Institute did perform laboratory tests on all the Hoxsey herbs using cancer cell lines in petri dishes. Almost all the results were negative, contrary to other data presented here.71 Most of these testing methodologies have since been abandoned because they are unreliable, and many scientists find that the outcomes do not match actual results with human subjects.## Both Duke and Brinker are not fazed by the preponderant failure of the Hoxsey herbs to show anticancer activity in the NCI screens because these experiments have been designed for one very narrow band of activity: the cytotoxic capability to kill cancer cells directly in a dish. "If it were tested against cell cultures and the tests came up negative, I wouldn’t be surprised or bothered," Brinker states. "That’s not what I’m expecting or looking for from that herb." While some of the plants may directly kill cancer cells to some degree, most work by indirectly interfering with malignant cell growth through other mechanisms.

Duke, who worked closely with the NCI, is critical of its protocols. "One of the major problems with the NCI screen is that they do not test the plants in the way humans use the plants. I don’t know that they have ever given an oral extract of red clover to a human being, and that’s how it’s used in folklore. If you’re going to test red clover tea, you’ve got to give it to a human being."

Dr. Richard Early, an Ohio physician with a family practice did conduct a modest laboratory experiment with the Hoxsey tonic as a whole entity. Not a sympathizer of alternative medicine, he decided to look into the herbal brew after his father unsuccessfully tried it as a last resort against his terminal cancer. In 1990 Dr. Early gave the leftover tonic to Dr. David Ho, a senior research associate in the Ohio State University College of Pharmacy, who tested it against cell lines for five types of cancer. "Surprisingly the mixture was active against all five of the lines," Dr. Early wrote. Dr. Ho verified the results by repeat testing.72

The overall evidence is that the Hoxsey tonic is a biologically active substance whose components have individually shown significant immunomodulating, anticancer, and antitumor properties. "You can make an educated guess," suggests Dennis McKenna from behind the thick glasses through which he daily pores over reams of scientific data, "that, yes, there is some potential here for anticancer activity. These are interesting leads. All this activity is indicative that these are biologically active plants. But it’s a long way from being able to say it’s effective."

McKenna further qualifies the data by pointing out that the compounds in the Hoxsey herbs are widely distributed in many plants. He notes the scarcity of human studies as a severe limitation preventing any definitive conclusions.

One admittedly preliminary review of Hoxsey patients did take place beginning in 1984 by a contemporary naturopathic doctor, Steve Austin of Oregon. The study tracked a small sampling of cancer patients from the Pacific Northwest over a five-year period who went to three Tijuana alternative cancer clinics offering, respectively, Hoxsey, Gerson, and laetrile (the extract of apricot pits).73

Published in the Journal of Naturopathic Medicine, the review found that six of sixteen Hoxsey patients survived for five years and were disease-free. These survivors included two cases of melanoma and two of lung cancer. In each category, one was very advanced, and both types of cancer are often fatal. There were no survivors from the other two therapies. Dr. Austin was entirely forthright in acknowledging the severe limitations of the modest study. "Our Hoxsey results are uncertain due to the preliminary nature of our investigation. Nevertheless, we note that several long-term survivors had very poor initial prognoses. Plausible explanations might include misdiagnoses, small sample size, and erroneous information from patients. However, we believe any apparently successful treatment of late-stage lung cancer and melanoma should provoke interest."

But Dr. Austin’s report certainly did not stimulate the media outpouring greeting the 1998 reports of Dr. Judah Folkman’s experimental work with angiogenic drugs. The excitement, upon closer examination, boiled down to laboratory tests showing only modest results on mice. It is well known that mouse systems often do not translate to human beings, and the NCI itself abandoned the mouse screening test several years ago. Nor was consideration paid to possible side effects. Given the well-documented antiangiogenic properties of Hoxsey’s red clover and licorice, why has there not been comparable attention paid to these and other plants? Is a difference of medical philosophy creating a double standard for research?

In her report to Congress, Patricia Spain Ward summed up her perspective on the Hoxsey tonic herbs. "More recent literature leaves no doubt that Hoxsey’s formula, however strangely concocted by modern scientific standards, does indeed contain many plant substances of marked therapeutic activity. In fact, orthodox scientific research has by now identified antitumor activity of one sort or another in all but three of Hoxsey’s plants—and two of these three are purgatives, one of them containing the anthraquinone glycoside structure now recognized as predictive of antitumor properties. Whether there is therapeutic merit in Hoxsey’s particular formula for internal use remains as much a question today as it was in 1925, despite provocative findings of antitumor properties in many of the individual herbs he used."74

The lack of human studies has not stopped thousands of desperate cancer patients from using the treatment. But only the scientific test that Harry Hoxsey sought can finally resolve the question of the tonic’s efficacy. The controversy surrounding it, however, belies a much deeper conflict of medical opinion about the very nature of treating cancer. How did Hoxsey believe his tonic worked?

Reprinted with permission from When Healing Becomes a Crime by Kenny Ausubel, Healing Arts Press, 2000. Ausubel’s documentary film about Harry Hoxsey won the prestigious "Best Censored Stories" journalism award, associated with Bill Moyers. Ausubel is the author of Seeds of Change and Restoring the Earth, and is the founder of the Bioneers Conference and Seeds of Change, Inc. The book can be ordered from ABC, $19.95, #B462. The video is $24.98, #822.

HerbalGram Editors’ and Peer Reviewers’ Comments

* Dr. Morris Fishbein was "editor of the influential Journal of the American Medical Association (JAMA)." Fishbein attended the operation in 1924 on Mannix, when Hoxsey, blacklisted from ever being a doctor, and Dr. Miller removed a huge tumor from Mannix’s shoulder, four weeks after Hoxsey had begun treating it.

Allegedly, Dr. Harris, representing Dr. Fishbein, offered Hoxsey a contract that was all for them and nothing for him. They later denied anything of the kind, but finally admitted there was a demonstration in the hospital, but denied all else. "For the next twenty-five years, Hoxsey would battle Dr. Fishbein and the AMA for an investigation in a spectacle of national dimensions."

Kenny Ausubel and Catherine Salveson produced a documentary film on Hoxsey, entitled "Hoxsey: How Healing Becomes a Crime."

‡ Dr. Duke worked for USDA as an economic botanist. He is recognized as an ethnobotanist, not as a pharmacognosist.

§ "In the McCarthyite wake of the 1950s, Hoxsey ultimately lost the war when the treatment was forced out of the country to Tijuana, Mexico. It was the first alternative clinic to set up shop south of the border. Hoxsey’s successor, nurse Mildred Nelson, has quietly treated patients there ever since. Like Hoxsey, she claims a success rate as high as 80 percent, but her contention is unverifiable since the treatment has yet to be rigorously tested." [Nelson died in January 1999 (HerbalGram 46, p.70).]

"She got involved with Hoxsey when her mother was successfully treated in Dallas in 1946 after being given up on by her doctors. Initially hostile, Mildred became a believer."

# This visit took place in 1988.

** It is not clear what "virtual founder of NCI" means. NCI was founded by Congressional mandate in 1938, under the direction of Carl Voegtlin, 1938-1943. Jonathan L. Hartwell worked there at a later time. He published his books, Plant Remedies for Cancer, in 1960 and Plants Used Against Cancer in installments in Lloydia from 1968-1971. Plants Used Against Cancer then was published in book form in 1981 by Quarterman Publications, Lawrence, Mass. (Out of print.)

Dr. Folkman’s research had nothing to do with herbs or herbal medicine, instead focusing on two proteins that occur naturally in the human body, angiostatin and endostatin.

‡‡ Stillingia compounds are phorbol esters, which show some activity in tumor models but are also tumor-promoters and very irritant.

§§ Potassium iodide prevents radioactive iodine from causing cancer by preloading the thyroid gland so that radioactive iodine is not absorbed. It binds in the thyroid gland temporarily and protects it from radioactive fallout that contains I-131 and other radio-iodine isotopes.

## Re NCI’s test methods, one peer reviewer commented: "Unreliable. Not really. Expensive and inefficient, yes. Poor predictors of clinical success, arguably."

Chapter 11 Notes - Tempest in A Tonic Bottle: "A Bunch of Weeds?"

1. Fraud Fighters." This is America" series, RKO Pathé, (1949) MCMXLIX.

2. Morris Fishbein, The New Medical Follies, (New York: Boni and Liveright, 1927), p. 148.

3. "Cough Medicine for Cancer," JAMA, Vol. 155, No. 7, 6.12.54, pp. 667-68.

4. Anne Raver, "A Man with a Garden That’s a Medicine Cabinet," New York Times, 10.15.98.

5. Principal sources for this chapter include: NAPRALERT; Father Nature’s Farmacy database (USDA) founded by James Duke, Ph.D. (http://www.ars-grin.gov/~ngrlsb); Dr. Duke’s private database; research conducted by Francis Brinker and published as "The Hoxsey Treatment: Cancer quackery or effective physiological adjuvant?" Journal of Naturopathic Medicine, Vol. 6, No. 1, 8.15.96, pp. 9-23; Patricia Spain Ward, "History of the Hoxsey Treatment," contract report to the Office of Technology Assessment," 1987, republished in Townsend Letter for Doctors & Patients, 5.97, pp. 68-72; Unconventional Cancer Treatments, OTA report to Congress, 1990, (GPO #052-003-01203-3), pp. 75-80; personal interviews with Duke, Brinker, and Ward during 1984-86 and 1998-99. For an expanded list of key medical/scientific citations for the Hoxsey herbs, see the appendix [of Ausubel’s book].

6. NAPRALERT(SM) is currently maintained by the Program for Collaborative Research in the Pharmaceutical Sciences within the Department of Medicinal Chemistry and Pharmacognosy in the College of Pharmacy of the University of Illinois at Chicago, 833 South Wood Street (m/c 877), Chicago, IL 60612, N.R. Farnsworth—Director and Editor-in-Chief.

7. Ralph W. Moss, Herbs Against Cancer (Brooklyn: Equinox Press, 1998), p. 277.

8. Jonathan L. Hartwell, Plants Used Against Cancer (Lawrence, MA: Quartermain Publications, 1982); originally published in eleven installments in Lloydia, 1970-1971.

9. James Duke, "The Herbal Shotgun Shell," HerbalGram, No. 18/19, Fall 1988/Winter 1989, pp. 12-13.

10. Francis Brinker, N.D., "The Hoxsey Treatment: Cancer quackery or effective physiological adjuvant?" Journal of Naturopathic Medicine, Vol. 6, No. 1, 8.15.96, pp. 9-23.

11. Harry Hoxsey, You Don’t Have to Die (New York: Milestone Books, 1956).

12. That formula listed alfalfa, buckthorn bark, cascara sagrada, prickly ash, red clover, potassium iodide, and honey drip cane syrup.

13. Here Cascara sagrada was replaced by Cascara amarga, a very different plant.

14. Hoxsey vs. Fishbein et al., No. 3203 Civil, pp. 26, 27, 139, 143, 197-98; Dr. Delmar M. Randall, William Prillmayer, Lloyd Rhode, Dr. G.A. Granger, "Memorandum of Interview," FDA memorandum, 6.16.55; Inspector W.L. Prillmayer, "Hoxsey Medications," FDA memorandum, 8.6.56; letter from Julius Keller Jr. to John Teeter, Damon Runyon Cancer Fund, 12.22.52, AMA files; Inspector W.L. Prillmayer, "Hoxsey Cancer Treatment (Possible Use of Laetrile by Hoxsey Cancer Clinic)," FDA memorandum, 2.26.53; Inspector Eugene Spivak, "Inj. 232-A," excerpts from depositions of Harry M. Hoxsey et al., Texas State Board of Medical Examiners vs. Harry M. Hoxsey et al., "File No. 22, 873-C," 6.5.57, FDA memorandum, 6.26.57, p. 30.

15. For people with stomach sensitivity or ulcers, there is another "pink" tonic with lactate of pepsin and without the laxative herbs burdock, cascara sagrada, and prickly ash.

16. Francis Brinker, "The Role of Botanical Medicine in 100 Years of Naturopathy," HerbalGram, No. 42, spring, 1998, pp. 49-59; "Where Does Eclectic Come From?" Eclectic Institute, Inc. promotional literature, Sandy Oregon, 1998.

17. Brinker went on to publish several peer-reviewed articles in the field of botanical medicine, as well as editing a series of old Eclectic reprints for a naturopathic herb company, the Eclectic Institute, and its publishing affiliate, Eclectic Medical Publications (Eclectic Institute, 36350 Industrial Way, Sandy, OR 97055: (800) 865-1487). Today he also works as a facilitator in botanical medicine for Dr. Andrew Weil’s Program in Integrative Medicine at the University of Arizona.

18. Public advertisements, Parke, Davis and Co.; Organic Materia Medica, Parke, Davis and Co., Second Edition (Detroit, MI: 1890), 1904; National Formulary, Fifth Edition, American Pharmaceutical Association, 1926; National Formulary, Sixth Edition, 1935.

19. King’s American Dispensatory, Felter and Lloyd, 1898-1900, p. 1996.

20. Brinker goes on: "These organs include the kidneys, liver, skin, and lungs. While the lungs expel gaseous waste from the blood, the sweat glands of the skin excrete some water-soluble substances. The kidneys excrete much of the soluble waste from the blood. However, it is necessary for many compounds to be processed by the liver before they can be excreted. If the liver does not adequately metabolize physiologic or foreign substances, these compounds accumulate and produce toxic symptoms. The liver excretes some of these metabolites along with bile into the intestines where they are hopefully eliminated through the colon along with the waste from undigested food.

"Maintaining optimal blood purification especially requires efficient elimination from the bowels. In cases of constipation, the reabsorption of waste compounds from the colon contaminates the blood. Toxins produced by intestinal bacteria from the breakdown of undigested protein can also be absorbed. An increased burden of waste excretion then falls on the skin, lungs, and kidneys as toxins accumulate in the blood."

21. Brinker: "They are taken to mean an increase in digestive secretions (barberry, prickly ash), increased bile secretion (barberry), laxative effect (cascara, buckthorn), or immunomodulating activity (licorice, barberry, poke, prickly ash). Other influences include competitive estrogen inhibition (red clover, licorice), thyroid stimulation (potassium iodide), antimicrobial activity (burdock, barberry), and anti-inflammatory effects (licorice). These combined effects could help improve cellular nutrition and metabolism and enhance elimination of waste, relieve inflammatory conditions, and improve resistance against infections, as was claimed for the Trifolium Compound alterative formulas. These formulas have been applied to treat a variety of mainly chronic conditions."

22. Conventional laboratory testing methodologies have relied heavily on two main protocols. One uses live human tissue-cell cultures in a petri dish which are exposed to various agents to ascertain anticancer or other effects. The second employs live mice, sometimes genetically engineered for specific attributes, which are also subjected to certain agents and observed for effects.

23. Father Nature’s Farmacy, http://www.ars-grin.gov/~ngrlsb/; also, http://www.inform.umd.edu/PBIO/MEDICAL_BOTANY/index.html.

24. Duke’s principal references for red clover and all the following Hoxsey herbs are the Father Nature’s Farmacy database and his own database as listed in previous citation, as well as his own books, especially the CRC Handbook of Medicinal Herbs (Boca Raton, FL: CRC Press, 1985).

25. Along with genistein, it contains daidzein, hormonal neuton, and Biochanin A, all of which are estrogenic and fungicidal. Kaufman P.B., Duke J.A., et al., "A Comparative survey of leguminous plants as sources of the isoflavones, genistein and daidzen: implications for human nutrition and health," The Journal of Alternative and Complementary Medicine, Vol. 3, No. 1, 1997, pp. 7-12; Kennedy A., "The Evidence for soybean products as cancer preventive agents," Journal of Nutrition, 1995, pp. 125, 733.

26. Kennedy A., ibid, pp. 125, 733.

27. Stephen Barnes, "Evolution of the health benefits of soy isoflavones," Proceedings of the Society for Experimental Biology and Medicine, Vol. 217, 1998, pp. 386-92.

28. Zava D.T., Dollbaum C.M., et al., "Estrogen and progestin bioactivity of foods, herbs and spices," Proceedings of the Society for Experimental Biology and Medicine, Vol. 217, 1998, pp. 369-78.

29. Kathy Fackelman, "Blocking Breast Cancer: Do Faulty Estrogen Receptors Make a Meaner, Tougher Tumor?" Science News, Vol. 137, No. 19, 5.12.90, pp. 296-97. Genistein may discourage tumor growth by blocking off estrogen receptors.

30. Dr. Samuel Epstein, The Politics of Cancer Revisited (Fremont Center, NY: East Ridge Press) 1998, pp. 484-89.

31. Gina Kolata, "A Cautious Awe Greets Drugs that Eradicate Tumors in Mice," New York Times, 5.3.98; Christine Gorman, "The Hope and the Hype," Time, special report, 5.18.98, pp. 39-51; Sharon Begley and Claudia Kalb, "One Man’s Quest to Cure Cancer," Newsweek, 5.18.98, pp. 55-62.

32. Nicholas Wade, "Progress Reported in Attacking Tumor Blood Supply," New York Times, 3.16.99; Wade, "Scientists Develop a Mouse That Resists Some Tumors," New York Times, 10.14.99.

33. Jethro Kloss, Back to Eden (Santa Barbara, CA: Woodbridge Press Publishing Company, 1972; original copyright 1939); James Duke, CRC Handbook of Medicinal Herbs (Boca Raton, FL: CRC Press, 1985).

34. Brinker, "The Hoxsey Treatment," op. cit., p. 13; personal interview. Brinker adds that water-soluble polysaccharides (long-chained sugars insoluble in ethanol) extracted from the plant have shown antitumor activity as well as immune-stimulating properties in laboratory tests with mice. Belkin M., Hardy W.G., Perrault A., Sato H., "Swelling and vacuolization induced in ascites tumor cells by polysaccharides from higher plants," Cancer Research. Vol. 19, 1959, pp. 1050-62.

35. Brinker further reported: "Two chemical lignins contained in burdock have shown anticancer activity in tumor cell-culture laboratory tests. Burdock also has polysaccharides in significant quantities which show strong immuno-modulating properties. A tumor growth-inhibiting mixture was isolated by extraction from burdock root. Several independent studies were positive (and several negative) for antitumor activity in animal systems." Personal interview; studies include: Belkin et al., op. cit.; Morita K., Kada T., Namiki M., "A desmutagenic factor isolated from burdock (Arctium lappa Linne)," Mutation Research. Vol. 129, 1984, pp. 25-31; Morita K., Nishijima Y., Kada T., "Chemical nature of a desmutagenic factor from burdock (Arctium lappa Linne)," Agric. Biol. Chem. Vol. 49, No. 4, pp. 925-32, 1985; Dombradi C.A., Földeák S., "Screening report on the antitumor activity of purified Arctium lappa extracts," Tumori, Vol. 52, 1966, pp. 173-76; Földeák S., Dombradi C.A., "Tumor-growth inhibiting substances of plant origin. I. Isolation of the active principle of Arctium lappa," Acta Univ. Szeged, Acta Phys. Chem. Vol. 10, 1964, pp. 91-93, (C.A. Vol. 62, p. 6339c); OTA, Unconventional Cancer Treatments, Chap. 4, "Herbal Treatments," pp. 69-87, Congress of the United States, Washington, D.C., 1990.

36. Dombradi C.A., and Földeák S., "Screening report on the antitumor activity of purified Arctium lappa extracts," Tumor, Vol. 52, 1966, p. 173.

37. Kupchan M.S., "Recent Advances in the Chemistry of Tumor Inhibitors of Plant Origin," Swain, Tony (ed.), Plants in the Development of Modern Medicine (Cambridge, MA, and London: Harvard University Press, 1972), pp. 261-78.

38. Morita K., Kada T., and Namiki M., "A desmutagenic factor isolated from burdock (Arctium lappa Linne), Mutation Research, Vol. 129, 1984, pp. 25-31.

According to Brinker, op. cit.: Along with cancer, burdock has been used to treat a wide variety of maladies including tumors and hardened spots in the breast, glands, intestine, knee, lip, liver, sinus, stomach, tongue, and uterus. The root decoction (water extraction) is said to alleviate ulcerated, glandular, and white tumors. The root is an alterative, mucosal tonic, and remedy for many skin diseases, as well as for treating syphilis and other venereal diseases.

39. There are several books on Essiac, but the most objective critical analysis is contained in Herbs Against Cancer by Ralph Moss, pp. 108-35.

40. Moss, Herbs Against Cancer, p. 45. Jones found poke root especially beneficial in cancers of the breast, throat, and uterus, particularly in patients past middle age. Lymphomas were also said to be cured by poke root. Eli Jones, Definite Medication, 1910, reprinted by (New Delhi, India: Jain Publishing Co., no date); Eli G. Jones, Cancer: Its Causes, Symptoms and Treatment (Boston: Therapeutic Publishing Co., Inc., 1911).

41. Uckun et al., "Pokeweed antiviral protein as a potent inhibitor of human immunodeficiency virus," Antimicrobial Agents and Chemotherapy, Vol. 42, No. 2, 1998, pp. 383-88; also see "Editorial: Phytolacca in Carcinoma," Eclectic Medical Journal, Vol. LVI, No. 1, 1896.

42. It is important to note that this modified antiviral poke protein is derived mainly from the plant’s leaves, though similar or equivalent factors have been isolated from the root as well.

43. As Ward cites in her OTA report: "Between 1964 and 1968, four articles appeared in the journals Lancet, Pediatrics, and Nature, describing the mitogenic activity of pokeweed, which triggers the immune system." According to Ward, the orthodox medical literature even during Hoxsey’s era "contained at least one suggestive article based on empirical observation by a regular orthodox practitioner. In 1896, in the Medical and Surgical Reporter (Philadelphia), a surgeon described the action of poke root as retarding growth of some cancers and increasing the patient’s survival time, if it was given before ulceration became extensive. Despite bibliographic tools that make it easy to search the medical literature back through the nineteenth century and beyond, this article had apparently escaped the attention of the AMA, the FDA, and the NCI." Farnes P., Barker B.E., Brownhill L.E., et al., "Mitogenic activity in Phytolacca americana (pokeweed), Lancet, Vol. 2, 11.21.64, pp. 1100-01; Barker B.E., Farnes P., Fanger H. "Mitogenic activity in Phytolacca americana (pokeweed)," Lancet, Vol. 1, 1.16.65, p. 170; Barker B.E., Farnes P., and LaMarche P.H., "Peripheral blood plasmacytosis following systemic exposure to Phytolacca americana (pokeweed)," Pediatrics, Vol. 38, 1966, pp. 490-93; Downing H.J., Kemp G.C.M., Denborough M.A., "Plant agglutinins and mitosis," Nature, Vol. 2317, 1968, pp. 654-55.

44. Brinker, "Periscope: Phytolacca," The Eclectic Medical Journals, Vol. II, no. 5, Oct/Nov., 1996, p. 2-4; W.H. Davis, M.D., "Art. XLVIII. - On the effects of Phytolacca Decandra on the glands," Eclectic Medical Journal, Vol. 36, 1876, pp. 259-60; "Phytolacca in Carcinoma," Eclectic Medical Journal, editorial, 1896, pp. 335-36; F.R. Millard M.D., "Some of the Uses of Phytolacca Decandra," Medical Surgical Reporter, Vol. LXXV, 10.3.1896, pp. 420-22.

45. Poke is conventionally used as a screening procedure for immune competence.

46. Hoshi A., Ikekawa T., Ikeda Y., et al., "Antitumor activity of Berberrubine derivatives," Gann, Vol. 67, 1976, pp. 321-25;Owen, Tsung-Yao, Show-yin, Su-Yin, Wang, et al., "A new antitumor substance-Lycobetaine," K’o Hsueh Tung Pao, Vol. 21, No. 6, 1976, pp. 285-87; Wolf S., Mack M., "Experimental study of the action of bitters on the stomach of a fistulous human subject," Drug Standards, Vol.24, No.3, 1956, pp. 98-101; lkram M., "A review on the chemical and pharmacological aspects of genus Berberis," Planta Medica, Vol. 28, 1975, pp. 353-58; Suess T.R., Stermitz F.R., "Alkaloids of Mahonia repens with a brief review of previous work in the genus Mahonia," Journal of Natural Products, Vol. 44, 1981, pp. 680-87; Velluda C.C., Goina T., Ticsa I., Petcu P., Pop S., Csutak W., "Effect of Berberis vulgaris extract and of the berberine, berbamine, and oxyacanthine alkaloids on liver and bile function," Lucr. Prez. Conf. Natl. Farm., Bucharest, 1958, pp. 351-54, (contained in Chemical Abstracts [C.A. henceforth] Vol. 53, p. 15345a); Turova A.D., Konovalov M.N., Leskov A.L., "Berberine, an effective cholagogue," Med. Prom. SSSR Vol. 18, No. 6, 1964, pp. 59-60 (C.A. Vol. 61, p. 15242f); Amin A.H., Subbaiah T.V., Abrasi K.M., "Berberine sulfate: antimicrobial activity, bioassay, and mode of action," Cancer Journal of Microbiology, Vol. 15, 1969, pp. 1067-76; Kumazawa Y., ltagaki A., Fukumoto M., Fujisawa H., Nishimura C., "Activation of peritoneal macrophages by berberine-type alkaloids in terms of induction of cytostatic activity," International Journal of Immunopharmacology, Vol. 6, No. 6, 1984, pp. 587-92; Schmitz H., "The influence of berberine on cellular metabolism," Z. Krebsforsch. Vol. 57, 1950, pp. 137-41, (C.A.