Like many Americans, I tend to look at the British royal family with bemusement at the realization that such an advanced nation still maintains such an outdated and unnecessary (not to mention expensive) appendage to the government as a queen and royal family, complete with medieval-style hereditary succession to the throne. That’s mixed with fascination at the antics of the modern royal family and awe at the spectacle of which British royalty is capable, such as the marriage of Prince William and Catherine Middleton. The wealth and pomp aside, I still can't help but feel sympathy for Prince Charles, who, at 66 years old, has been in essence waiting his entire life to become king. On the other hand, as a skeptic and managing editor of the Science-Based Medicine blog, my interest in Prince Charles’ activities is less cultural and historical and more medical, which is why I took notice of an impending royal visit to the United States this week.
On Tuesday, the Prince of Wales and the Duchess of Cornwall will arrive in the U.S. for a four-day visit. According to a press release issued by the Prince’s office, Charles and Camilla will “undertake a broad range of engagements to promote the U.K.’s partnership with the United States in key areas such as sustainability and climate change, creating youth opportunities, encouraging corporate social responsibility and promoting historical and cultural links.” They will spend their first three days in Washington, D.C., but that’s not what attracted the attention of those who care about science in medicine. Rather, it is the last day of the royals’ visit, Friday, when Charles and Camilla will travel to Louisville, Kentucky. There, according to the same press release, Charles will “highlight the work being done by members of the local community and charitable organizations to protect, preserve and promote the health and well-being of the people of Louisville through community cohesion, clean air and food literacy initiatives.”
It all sounds rather benign, and perhaps it is. However, not long after that press release, reason for concern began appearing in the form of an article by Nico Hines in the Daily Beast whose title is worth noting: “‘Witchcraft’ Believing Prince Charles to Lecture U.S. on Medicine.” This headline probably shocked some Americans who read it, but it is not unjustified. What the British know about the Prince of Wales that most Americans probably do not is that Prince Charles is a very vocal proponent of alternative medicine, including the what is arguably the most ridiculous form of quackery out there from a scientific standpoint: homeopathy.
In brief, homeopathy is a 200-year-old system of medicine invented by Samuel Hahnemann based on two laws: the law of similar, which states that “like cures like,” and the law of infinitesimals, which states that serially diluting a homeopathic remedy makes it stronger. In homeopathy, remedies diluted to “30C” (that is, 30 successive dilutions of 100-fold each) are not uncommon, a dilution that is more than 1036-fold higher than Avogadro’s number, which means it is incredibly unlikely that even a single molecule remains of the original remedy. One such remedy, Oscillococcinum, sold by Boiron as a flu remedy, consists of a 200C dilution of Anas Barbariae Hepatis and Cordis Extractum, which are extracts from the liver and heart, respectively, of a Muscovy duck.
As a result of Prince Charles’ support for homeopathy and other quackery, in 2008 British medical and science bloggers dubbed Charles the Quacktitioner Royal. David Colquhoun, a pharmacologist at University College London, blogger, and critic of alternative medicine has gone even beyond that, describing Prince Charles as a “threat to constitutional government and the health of the nation.”* In brief, critics have argued that for a long time Prince Charles has used his position of influence and authority to promote alternative medicine.
On what do British critics base these characterizations? For one thing, Charles has had a longstanding interest in unconventional medical therapies that goes back to his youth. Indeed, the young prince went on a journey of “spiritual discovery” with guru and guide Laurens van der Post into the wilderness of Kenya. Van der Post was described after his death by a biographer as a “a fraud, a fantasist, a liar, a serial adulterer, and a paternalist” who “falsified his Army record and inflated his own importance at every possible opportunity.” Van der Post was an adherent of vitalism, a belief that there is a “vital force” (also sometimes called “life force” and “life energy,” as well as qi or prana in traditional Chinese medicine and Ayurveda, respectively), and he was derided by many (correctly, as it later turned out) as a charlatan. Nonetheless, he became an adviser to Margaret Thatcher and a spiritual adviser—guru, even—to the young Prince Charles. It was also his belief in vitalism, apparently transmitted to Charles, that provided the “crucial link to alternative medicine,” given that so much of alternative medicine is based on vitalistic beliefs.
As an adult, the Prince of Wales has been outspoken in his support for quackery like homeopathy and other forms of alternative medicine, often using his official role to promote that advocacy. One glaring example of Prince Charles’ advocacy for “integrating” alternative medicine into conventional medicine occurred in 2006, when he addressed the World Health Assembly in Geneva to argue for the “integration” of “complementary therapies,” which he said “are rooted in ancient traditions that intuitively understood the need to maintain balance and harmony with our minds, bodies and the natural world” and that “modern medicine needs to accommodate a more integrated and holistic approach,” while advocating acupuncture and other forms of traditional Chinese medicine. The address provoked an article in the Federation of American Societies of Experimental Biology Journal by its editor Gerald Weissmann sarcastically titled, “Homeopathy: Holmes, Hogwarts, and the Prince of Wales,” which described a prince “at war with science.” The speech also led British science to strike back. Anticipating Prince Charles’ points, 13 of Britain’s most eminent physicians and scientists published an “Open Letter: Use of ‘Alternative’ Medicine in the NHS”, which was very critical of efforts, supported by the prince, to integrate “complementary therapies,” including homeopathy, in the U.K.’s National Heath Service.
Indeed, so committed to the integration of alternative medicine into mainstream medicine is Charles that he formed the Prince of Wales’ Foundation for Integrated Health in 1993 to explore “how safe, proven complementary therapies can work in conjunction with mainstream medicine.” And promote “integrated health” it did, including homeopathy. The FIH endured frequent (and justified) criticism of its activities as promoting quackery. Ultimately, the FIH was shut down in 2010 in the wake of the arrest of an aide for fraud following a police investigation into 300,000 pounds unaccounted for in the books of the charity. Amusingly, the FIH’s official statement claimed that closure of the charity had been planned for “many months” and that its trustees “brought forward” the timetable for closure because of the fraud investigation. Soon after, and less amusingly, out of the ashes of the FIH rose the College of Medicine, also dedicated to “integrative” health.
The prince has been known for practicing what he preaches, even trying to sell it to the masses, once promoting Duchy Herbals Detox Tincture, which is a food supplement combining artichoke and dandelion that promises to “rid the body of toxins while aiding digestion.” In response to the introduction of this product, the prince faced unprecedented criticism for peddling quackery.
Prince Charles clashed with academics as well, particularly persecuting a researcher named Edzard Ernst, as was related in Ernst’s memoir, A Scientist in Wonderland: A Memoir of Searching for Truth and Finding Trouble. Ernst is an emeritus professor at Exeter University and is noted particularly for having started out as a believer in alternative medicine. As Ernst himself describes on his blog, as part of his medical education in Germany in the 1970s, he "”eceived hands-on training in acupuncture, autogenic training, herbalism, homoeopathy, massage therapy, and spinal manipulation.” His first posting as a physician was at a homeopathic hospital in Munich, where he was “impressed” at the results.
In 1993, after having been the chair of physical and rehabilitation medicine at the Medical Faculty of Vienna, with 120 people under him, Ernst accepted the chair in complementary medicine at Exeter. His plans to subject therapies such as acupuncture, homeopathy, and reflexology to rigorous scientific scrutiny quickly faced resistance. As he studied the alternative medicine that was increasingly being “integrated” with conventional medicine, Ernst became disillusioned and convinced that most alternative medicine lacked scientific support. He ultimately published many scientific papers that failed to find evidence of efficacy of a variety of “complementary” treatments and two books, Healing, Hype, or Harm? A critical analysis of complementary or alternative medicine and Trick or Treatment? Alternative Medicine on Trial, the latter co-authored with Simon Singh.
According to Ernst’s memoir, in 2003, Ernst saw an announcement published in the newsletter of the FIH stating that “Peninsula Medical School [which is affiliated with Exeter] aims to become the UK’s first medical school to include integrated medicine at postgraduate level. The school also plans to extend the current range and depth of programs offered by including healthcare ethics and legislation.” The curious thing about this announcement was that Ernst had not been informed, which was a curious omission given that he was chair in complementary medicine and would, presumably, be expected to have a major role in any educational initiative in “integrative medicine” offered by the medical school. In an excerpt from his memoir, Ernst explains what he learned when he started asking why he hadn't been informed:
When I enquired, Tooke informed me that the medical school was indeed preparing to offer a postgraduate “Pathway in Integrated Health”; this exciting new innovation had been initiated by Dr. Michael Dixon, a general practitioner who, after working in collaboration with my unit for several years, had become one of the UK’s most outspoken proponents of spiritual healing and other similarly dubious forms of alternative medicine. For this reason, Dixon was apparently very well regarded by Prince Charles.
A few days after I had received this amazing news, Dixon arrived at my office and explained, with visible embarrassment, that Prince Charles had expressed his desire to him personally to establish such a course at Exeter. His Royal Highness had already facilitated its funding which, in fact, came from Nelsons, one of the UK’s largest manufacturers of homeopathic remedies. The day-to-day running of the course was to be put into the hands of the ex-director of the Centre for Complementary Health Studies (CCHS), the very unit that, almost a decade earlier, I had struggled—and eventually even paid—to be separated from because of its overtly anti-scientific agenda. The whole thing had been in the planning for many months. I was, it seemed, the last to know—but now that I had learnt about it, Dixon and Tooke leaned on me with all their might to persuade me to contribute to this course by giving a few lectures.
Ernst refused, particularly after he noted that the course was to be run by “someone who [Ernst] had good reason to reject and sponsored by a major manufacturer of homeopathic remedies” and because he correctly viewed “integrative medicine” as integrating quackery with medicine.
This was not, unfortunately, the last time Ernst butted heads with Prince Charles. Indeed, the irony of Ernst’s conflicts with the Prince of Wales is that Charles actually helped in the creation of the very chair in complementary medicine Ernst occupied and in its destruction. It happened this way. In 2005, Ernst publicly criticized a draft report commissioned personally by Prince Charles and written by economist Christopher Smallwood that claimed that complementary and alternative medicine was cost-effective, describing the report as “complete misleading rubbish.” This led to a letter of complaint from Sir Michael Peat, Charles’ former private secretary written on Clarence House stationery (Clarence House is the official London residence of the Prince of Wales) to the University of Exeter’s vice chancellor, accusing Ernst of a “breach of confidence.” Ernst reports that he was subjected to a 13-month investigation and ultimately exonerated:
But even while acknowledging that I had not been guilty of any misdemeanor, my vice chancellor had issued an unambiguous warning to me: If I even thought of applying my personal ethical standards in any similar situation in the future, I would not be so lucky as to get away with it again.
Prince Charles's attempt to silence me, it seemed, had been successful.
Over the next few years, support for Ernst’s department dried up, and it was disbanded in 2011, with Ernst being forced to take early retirement.
So why should Americans care about a visit from the Prince of Wales? Certainly, most of the activities planned for Charles and Camilla have little to do with medicine. However, it is odd how little has been reported about the Kentucky symposium where Charles is to be the keynote speaker.
Indeed, it was quite curious how vague original news stories were about the Prince’s keynote address in Louisville. It was just referred to as a “symposium on health,” and even in a press release from a week ago, no mention is made of any keynote address. I found this quite odd. For Prince Charles to visit anywhere in the United States is really and truly a Big Deal, and any organization that landed the Prince of Wales as its keynote speaker would be expected to be bragging about it and publicizing it. Yet there is precious little in the press about it. Nico Hines reported that the event is being organized “with the support of Democratic governor Steve Beshear, the mayor of Louisville, and the Owsley Brown Charitable Foundation, which was set up in honor of the former chairman of one of the great bourbon companies—his son-in-law Matthew Barzun is the U.S. ambassador in London.” In addition, The Courier-Journal and Kentucky Health News report that the symposium will be held by the Institute for Healthy Air, Water, and Soil, chaired by Christina Lee “Christy” Brown of Louisville, who is one of four board members of the England-based Sustainable Food Trust. Her son, Owsley Brown III, is one of three board members of the Sustainable Food Alliance, the trust’s U.S. partner.
Now it makes more sense. Prince Charles has addressed Sustainable Food Trust functions before. The Sustainable Food Trust appears to have an anti-GMO bias. For example, its chief executive, Patrick Holden, characterized a study in which consuming GMO-derived feed was reported to cause serious health issues in pigs as “another in a series of recent studies that have identified negative health impacts in animals consuming GM crops,” comparing it to the “study by Professor Gilles-Eric Séralini and colleagues in 2012 which found high rates of cancer and other problems in rats fed GM maize for two years,” concluding that “there should be no further moves to introduce GM crops into the UK, or GM food into the human food chain until these issues have been fully investigated by independent scientists.” Of course, GM foods have been “fully investigated by independent scientists,” and the Séralini study and the pig study were both absolutely awful studies whose conclusions were—to put it very mildly!—not supported by the data.
No wonder Prince Charles agreed to deliver the keynote address.
I suppose we can hope that Prince Charles will stick to vague and harmless comments about history and agriculture without spouting off about his favorite quackery. After all, it’ll only be four days that we in the U.S. have to put up with him. My poor fellow scientists and physicians in the U.K. have to put up with him all the time and could well have to put up with him as their king. At least Prince Charles’ visit to the U.S. provides an opportunity to highlight his support of unscientific and downright pseudoscientific medicine. Maybe he’ll surprise us Yanks and stay away from such topics and talk sense. I doubt it, though.
Correction, March 18, 2015: This article originally misidentified University College London as University College of London.