Weird medical history, ripped from the archives of Doonesbury

My introduction to Gary Trudeau's Doonesbury happened around the age of 8, when I discovered my father's anthology collections. (I was extraordinarily up on early 1970s pop culture for a late 1980s grade schooler.) Reading the new strip and the daily archives is still part of my morning routine. But, given that I was born in 1981, I don't always get all the references. Sometimes, that leads me to discover weird bits pop history.

For instance, the strip above ran on July 19, 1977. My first response this morning, "What the hell is Laetrile?" I mean, it's Duke, so I assumed it was a drug. But I wasn't expecting it to turn out to be a quack cancer treatment, the promotion of which led to a strange bedfellows situation where alt-med proponents joined forces with the John Birch Society to fight the federal government for the right to sell desperate cancer patients a potentially dangerous treatment that had never been tested for effectiveness or safety.

Laetrile is basically the brand name of amygdalin, a compound derived from bitter almonds, or from the pits of apricots and black cherries. It's sometimes called "Vitamin B17", although it's not a vitamin. Beginning in the 1950s, the father-son team of Dr. Ernst T. Krebs and Ernst T. Krebs, Jr. (The latter's only claim to a medical license was a "doctor of science" degree bestowed on him honorarily by an unaccredited Bible college) began marketing Laetrile as a treatment for cancer.

The downside to Laetrile is that it can break down and turn into cyanide in the presence of stomach chemicals. Also, it doesn't actually seem to do anything to cure or slow the progress of cancer. The upside to Laetrile is that selling it was extremely lucrative.

John Richardson was a general practitioner who began practice in the San Francisco Bay area in 1954. In 1971, after discussions with Krebs, Jr., he decided to become a cancer specialist. He had not encountered overwhelming success as a general practitioner. His 1972 income tax return revealed that he had grossed $88,000 in his medical practice, leaving a net of only $10,400 taxable income.

Richardson's practice boomed as a result of his newly found status as a cancer "expert." He states that "Our office soon was filled with faces we had never seen before—hopeful faces of men and women who had been abandoned by orthodox medicine as hopeless or "terminal" cases." In 1974, he reported that his medical practice had grossed $783,000, with a net income of $172,981. By charging patients $2,000 for a course of Laetrile, Richardson managed to increase his net income 17-fold in just two years. According to his income tax returns, Richardson grossed $2.8 million dollars from his Laetrile practice between January 1973 and March 1976. The actual amount of money he received may have even been higher. In Laetrile Case Histories, he claimed to have treated 4,000 patients, with an average charge of $2,500 per patient. Culbert states that by 1976 Richardson had treated 6,000 patients. If these figures are correct, Richardson would have grossed between $10 and $15 million dollars during this time.

Richardson's practice changed significantly after he began treating cancer patients with Laetrile. He also began treating what he termed "pre-clinical syndrome" patients with Laetrile. These were patients with no identifiable tumor or lesion who complained of feelings of "impending doom, malaise, unexplained or vague pains, headaches, bowel changes, loss of appetite, loss of energy, and depression." According to Richardson, cancer patients reported a reduction in pain, an improved appetite, return of strength, and an improved mental outlook. In addition, high blood pressure returned to normal.

In spite of these "dramatic improvements," Richardson admitted that most of his cancer patients died.

Cases like this one led to raids and prosecutions, as state and federal government authorities started cracking down on doctors for selling the bogus treatment. Richardson, for instance, was indicted in 1976.

Proponents fought back. Laetrile ended up in the Supreme Court in 1979—where justices rejected the idea that treatments given to terminally ill patients should be exempt from FDA regulation. And in 1977, when this Doonesbury comic came out, Laetrile was the subject of a Congressional hearing.

The full history is pretty amazing. Public interest in Laetrile petered off in the 1980s, after a National Cancer Institute study found no evidence that it worked (and did find evidence of cyanide poisoning in patients using it), and after actor Steve McQueen infamously used Laetrile to treat his cancer ... and then died. But there are still people pushing it. Because of that, it's worth noting that meta-reviews of research into Laetrile treatments for cancer, conducted in 2006 and again in 2011, still say the stuff doesn't work and that it's potentially dangerous.

Read the Quackwatch history of Laetrile, which is quoted above.

Read Wikipedia's entry on Laetrile, which refers to it as "a canonical example of quackery" in the medical literature.

Read the abstract for the 2011 review of research into Laetrile as a treatment for cancer.

Read The American Cancer Society's summary of the history and evidence (or, rather, lack thereof) behind Laetrile

• [cnoocy]

  Don’t forget Laetrile’s other classic comics cameo in Watchmen. (It’s the illegal substance that Rorschach attempts to bust Moloch for, leading to a great line by Moloch.)

  • [Victor Prince]

    Well, what was the line? =)

    • [NoWayJose]

      Paraphrased from memory:

      Moloch: “Heh. You know the kind of cancer you eventually get better from?”
      Rorschach: “Yes.”
      Moloch: “Well, that ain’t the kind of cancer I got.”

      One of many great moments from that series/GN.

      • [shadowfirebird]

         You’re word perfect, BTW.

  • [digi_owl]

    So that’s what the whole thing was about.

• [agraham999]

  My mother died of ovarian cancer when I was 12. We traveled the world in her quest for a cure. Laetrile was one of those. 

• [Oceanconcepts]

  Post undergrad, in the mid 70′s, I worked a while for an importer and distributor of both medicinal and culinary herbs.  They sponsored a conference, part of which involved an excellent presentation by a couple of MD’s- cancer researchers, as it turned out- on the history of plant derived medicines.  Unfortunately, in the audience were a handful of laetrile true believers.  I listened in slack jawed amazement as they spouted off about government and AMA conspiracies- a virtuoso performance of the crackpot paranoid imagination.  The MD’s did a great job of trying to bring them back to what actually works, explaining why testing and research is perhaps important in evaluating effectiveness, but it was clear that anecdote and paranoia trumped evidence and reason in their world.  I think they’re in the Tea Party now. 

  • [retepslluerb]

    Really? I think they wold have died from cancer by now.

    • [Theranthrope]

      Natural Selection’s cruel math at work, then.

  • [Mitchell Glaser]

    Steve Jobs, a man famous for getting his way in life, had cancer that could likely have been cured by an operation, particularly because it was discovered early enough. But he dicked around with fad diets and lemons and such until it had spread; then it was too late. I am still groping for the moral to that story. I can’t quite put my finger on it, by I know it’s important.

    • [retepslluerb]

      I don’t think it has a moral. But it is a poignant reminder that smart people can make extremely stupid decisions, especially when they are strong willed.

      He was clearly outside his area of expertise – and I truly believe that he was brilliant in many – and chose to disregard the expertise of others. 

• [Romeo Vitelli]

  Why does it always seem to be up to the skeptics to prove that these quack nostrums DON”T work?

  • [Theranthrope]

    Because for the FDA and other regulatory agencies, it’s like whack-a-mole (whack-a-quack). Woo is usually profitable enough to make potentially getting whacked by the FDA statistically worthwhile.

  • [Theranthrope]

    Also:
    “All that is necessary for the triumph of evil is that good men do nothing.”
    –Edmund Burke

• [Benjamin Schlotz]

  I had a nearly identical relationship to doonesbury comics growing up.  I remember asking my mom about precisely this strip, and her telling me it was a drug that didn’t work.  I assumed at the time it was a hallucinogenic drug that didn’t work (given duke’s proclivities), thanks for clearing that up maggie.

  • [Maggie Koerth-Baker]

    To this day, I still don’t understand why I laughed as a child at the strip where they have a 1960s-themed costume party and one guy comes as a giant tab of acid. For some reason, the punchline ( “What are you doing this summer?” “I’m thinking of turning on Detroit, man.”) was HILARIOUS to me when I was 9. 

• [dragonfrog]

  Interesting that Krebs is German for cancer (well, and for crab).

  • [shadowfirebird]

     Aha.  Ta.  Just finished reading Ian Fleming’s Moonraker.  That explains why it’s the name of a minor bad guy.

  • [Αντώνης Παππάς]

    Ernst Krebs actually means serious cancer in German. Though ernst is not used in this context as far as I know

    • [dragonfrog]

      Good point!  My German’s getting rusty, but I think I might use something like ‘ernste Krankheit’ for ‘serious illness’ – but maybe that would imply something more like ’serious’ as in not a passing cold, rather than ‘serious’ as in potentially fatal…

• [Heyref]

  Boy does this make me feel old!  I not only remembered laetrile, but this strip and the whole arc around it (the apricot farm turns out not to exist.)  The story of Steve McQueen’s search for a cure for his mesothelioma was a sad ending to the life of one of the really cool guys.  There was a lot of exposure to asbestos in the film industry in those days (the falling snow in White Christmas is asbestos.)

• [R J]

  Fernwood 2-Night. Leisure suits cause cancer. Solution? Laetrile leisure suits.  Thanks for stirring the memory of that show.
  If you enjoy researching pop references found in always satirical sometimes intellectual  newspaper cartoon, Pogo Possum is for you.

• [Mark Dow]

  Zonker looks pale. He should get out in the sun more.

• [Mazoola]

  Great. I’ve been feeling awfully old lately, with overtones of vulnerability and irreversibleness — and now I feel really, *really* old. Thanks.

  (OK, one last drug/generation gap anecdote:

  (A while back, we were sitting around the dinner table one night, polishing off whatever dribs and drabs were left, when one of our housemates, a woman in her early 20s, asked me to pass her one of the side dishes.

  (Shaking my head, I said, sadly, “I think it’s all gone.” Lifting the lid from the serving dish, I said, “Yep, it’s all down to stems and seeds.”

  (She stared at me blankly.

  (“You know,” I said, “like pot.”

  (She looked even more confused. 

  (“Weed doesn’t have seeds,” she said….)

• [Neuron]

  I think of this Doonesbury thread pretty frequently. I even thought of it this afternoon. Every time a reporter does a story about some idea someone has for a new treatment for a disease. Almost all such ideas fail and therefore none of them are newsworthy until they’ve been shown to be (1) effective in humans and (2) reasonably safe.

• [JBHemlock]

  I’m with you, mazoola. I woke up this morning not feeling old at all. Thanks, Maggie!

• [Amelia_G]

  We’re so lucky to have Doonesbury! It’s a wonderful history of the USA too. So many relevant themes that resurface in our society: But the Pension Fund was Just Sitting There, the oil-CIA connection, even the Donald (Give Those Nymphs Some Hooters).
  During W.’s administration I was concerned that the few examples of “elite”or at least good media the US has are the only ones of their kind and thus precarious. The New Yorker magazine, Doonesbury, Rachel Maddow’s radio show. The Wall Street Journal, fwiw, is tango uniform now… Glad there’s XKCD.

• [Mark Pitcavage]

  Your readers may not be aware that there has been a decades-long connection between “alternative” health proponents and the extreme right in the United States.  It was true of the laetrile incident of the early 1980s; it was true of the blue-green algae/shark cartilage/colloidal silver fads of the 1990s; and it is true of things like the “raw milk” movement in the 2000s.  The extreme right, especially the anti-government extreme right, not only distrusts governmental authority, but all forms of authority, including the medical establishment, which makes them extremely susceptible to bizarre/quack/alternative medical “theories.”

  • [Rachael Hoffman-Dachelet]

    And there is the strange and surreal place where the extreme right comes around and meets the extreme left on the other side.  I am interested in reading about food justice and organic agriculture issues and often end up shocked to find myself following links to survivalist Christian home-schooling organic sites.  The language of the hippy lefty version and the right wing versions are quite similar. 

• [Joshua Ward]

  Actually I know someone right now who uses Laetrile. And ends up in the ER frequently with cyanide-y symptoms. Nice guy. Not too bright, but nice