Let me point out that the active chemicals—yes, chemicals, the stuff everything is made from—in four-marvels powder include quercetin, berberine, and achyranthine, names that don’t smell quite as sweet as Montmorency cherry juice. Meadows is not unique in being seduced into complacency by language. Psychologists call this “processing fluency” —we cope better and trust information more when the words it’s couched in are easy to pronounce and familiar. Terms that don’t roll easily off our tongues make us nervous. Given the choice, more people would rather take smooth-sounding Aleve than naproxen, though they are the precisely the same chemical.
When Meadows’ husband has serious reservations about her desire to ditch the advice of not one, but two, pediatric rheumatologists, Meadows implies he was the poorly informed one: “I was nervous about keeping Shepherd on methotrexate, but Darin didn’t share my squeamishness. He has always been more comfortable with pharmaceuticals, more trusting in general.”
She seems blissfully unaware that the four-marvels powder that Walker’s naturopath recommended is a recognized pharmaceutical, just one from a pharmacopeia that she is unfamiliar with, that of traditional Chinese medicine. Four-marvels powder, or si miao san, has long been prescribed by Chinese medicine practitioners for arthritis and other inflammatory disorders. My quibble is not that it is ineffective (although many traditional medicines are pure placebos, several recent peer-reviewed studies have shown that at least one of the active drugs in four-marvels powder, quercetin, exhibits anti-inflammatory activity). My concern is that four-marvels powder is not a chemical-free remedy but a drug, and one that Chinese medicine practitioners would hesitate to prescribe to pregnant women, which might give me pause before I started pouring it down my young child’s throat. Apparently neither Meadows nor Walker is concerned that they are being too “trusting.”
The reality is this. Meadows has been tricked by the language, maliciously or not, into considering switching her child from a carefully measured weekly dose of this molecule:
To four doses a day of an unknown amount of this chemical:
I want to be absolutely clear. Neither of these chemicals is benign or nontoxic. The LD-50 (the “lethal dose” amount that kills 50 percent of mice fed the chemical) is about the same for quercetin as it is for methotrexate, roughly 150 milligrams per kilogram of body weight.
Meadows admits to obsessing at night over the potential side effects of methotrexate, which are clearly—and frighteningly—detailed on the prescribing information. Nausea, dizziness, liver damage. What was she doing to her little boy?
But what does Meadows know about the risks of what she calls Walker’s regimen? Four-marvels powder has no FDA-mandated, rigorously reviewed package insert. Berberine, one of the drugs found in four-marvels powder, has been documented to cause brain damage in infants. Hello? Exactly how much of this have you been giving your son? And that may be the most important question. Meadows has no idea that she is giving her son this drug, and she certainly has no idea how much he is taking. Appallingly, the FDA trusts manufacturers and marketers to decide for themselves if an herbal remedy is safe, they will take action only if problems are reported later, essentially letting the dietary supplement and herbal remedy industry field-test their products on the public, with no supervision.
Meadows’ “better the molecule I don’t know, than the molecule I do” stance may help her sleep better, but it is ignorance nonetheless. The chemicals are still there, even when you squint your eyes closed so you can’t see them.
As a chemist, a teacher, and a parent, I think (and blog) a lot about how to immunize people against chemophobia. It’s not because I want to keep chemical companies in business, but because I want to keep my students and friends from being duped into using chemicals that are unsafe, whatever their source. So here is my best advice to keep you from succumbing to the chemophobia pandemic: One, everything is a chemical. Two, don’t take medical advice from a magazine writer, however impassioned and well-intentioned, however popular her story is on the New York Times’ “most read” list, who trusts a massage therapist over medical experts. And three, there are risks to all chemicals, even the ones with friendly names like Montmorency cherry juice and four-marvels powder. Next time, before you click “share” on an article, be annoyingly skeptical. We can stamp out chemophobia in our lifetimes.
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