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'[[File:Ambalaj Oscillococcinum.jpg|thumb|right|250px|Oscillococcinum tablets]] '''Oscillococcinum''' (or '''Oscillo'''<ref name = "LATimes1">{{cite news | title = Oscillo may help, but not by much | work = [[Los Angeles Times]] | date = 2008-02-18 | url = http://www.latimes.com/features/health/la-he-oscillococcinum18feb18,0,908709.story }}</ref><ref>{{cite web |url= http://www.oscillo.com/press-room/oscillococcinum/ |title=How is "Oscillococcinum" pronounced? |publisher=Oscillo.com |date=2013-01-24 |accessdate=2013-11-08}}</ref>) is used to relieve [[influenza]]-like [[Influenza symptoms|symptoms]]. It does not provide any benefit beyond that of [[placebo|sugar pills]]. It is a popular preparation, particularly in [[France]]. It is manufactured by [[Boiron]], its sole manufacturer. Oscillococcinum is used in more than 50 countries and has been in production for over 65 years. The preparation is derived from [[domestic duck|duck]] [[liver (food)|liver]] and heart, diluted to 200[[Homeopathic dilutions#Potency scales|C]]—a ratio of one part duck [[offal]] to 10⁴⁰⁰ parts water.<ref name = "Nienhuys1" /> Homeopaths claim that the molecules leave an "[[water memory|imprint]]" in the dilution that causes a healing effect on the body, although there is no [[clinical trials|evidence]] that supports this mechanism or efficacy beyond [[placebo]].<ref name = "Ernst1">{{cite journal | journal = [[British Journal of Clinical Pharmacology|Br J Clin Pharmacol]] | title = A systematic review of systematic reviews of homeopathy | author = E Ernst | date = December 2002 | volume = 54 | issue = 6 | pages = 577–582 | doi = 10.1046/j.1365-2125.2002.01699.x | pmid = 12492603 | pmc = 1874503 | authorlink = Edzard Ernst }}</ref><ref name = "guo" /><ref name = "nih">{{cite web |url=http://nccam.nih.gov/health/homeopathy/#q8 |title=Questions a Oscillococcinum was originally proposed by the French physician Joseph Roy, based on his misidentification of an oscillating bacterium he named ''oscillococcus'' in victims of the [[Spanish flu epidemic of 1917]]-1918. Roy said he had seen the same bacterium in [[cancer]] sufferers, and proposed a homeopathic preparation (which he claimed to have isolated in a duck) as a remedy for the Spanish flu. The microbes Roy said he saw have never been independently observed by any other researcher. In addition, it is now known that flu is caused by a virus and not a bacterium.<ref>{{cite web |url=http://www.nhs.uk/conditions/Flu/Pages/Introduction.aspx |title=Flu - NHS Choices |publisher=[[National Health Service]] |date=April 2015 | accessdate=2017-01-14}}</ref> == Origin and history == The word Oscillococcinum was coined in 1925 by the French physician Joseph Roy (1891–1978) who was on military duty during the [[Spanish Flu]] epidemic of 1917.<ref name = "Nienhuys1">{{cite web | last = Nienhuys | first = Jan Willem | authorlink = Jan Willem Nienhuys |title = The True Story of Oscillococcinum | date = 2003-08-23 | url = http://www.homeowatch.org/history/oscillo.html | accessdate = 2007-02-23}}</ref> Roy wrote that on examining the blood of flu victims, he had observed what he thought to have been an oscillating [[bacterium]] which he named ''Oscillococcus''.<ref name = "Abgrall1" /> Roy claimed he had also detected the bacterium in the blood of patients that had viral diseases like [[herpes]], [[chicken pox]] and [[shingles]].<ref name = "Abgrall1" /> He thought it to be the causative agent of diseases as varied as [[eczema]], [[rheumatism]], [[tuberculosis]], [[measles]], and [[cancer]]. The microbes have never been independently observed by another researcher, and it remains unclear what, if anything, Roy actually saw.<ref name="McGillOSS">{{cite web | url=http://blogs.mcgill.ca/oss/2012/12/20/the-curious-%E2%80%9Cscience%E2%80%9D-of-oscillococcinum/ | title=The Curious "Science" of Oscillococcinum | publisher=Office for Science and Society, McGill University | date=2012-12-20 | accessdate=2013-04-11}}</ref> Believing he had detected it in the blood of cancer patients, he tried a [[vaccine]]-like therapy on them, which was unsuccessful.<ref name = "Abgrall1" /> Medical science has since disproved Roy's "universal germ" theory: rheumatism, for example, is not caused by bacteria, and measles is caused by a virus far too small for Roy to have observed in his [[optical microscope]].<ref name = "Nienhuys1" /> Roy searched for the "bacterium" in several animals until he felt that he had found it on the liver of the Long Island duckling.<ref name = "Abgrall1" /> The modern preparation is created from the heart and liver of [[Muscovy duck]] (see the preparation section for the details). In France the selling of all products manufactured according to the [[Korsakovian principle of dilution]] was forbidden until 1992, with the exception of Oscillo, thanks to a special measure made for it.<ref name = "Abgrall1" /> {{As of|2000}}, Oscillococcinum was one of the top ten selling drugs in France, was publicised widely in the media, and was being prescribed for both flu and cold.<ref name = "Abgrall1">{{cite book | title = Healing Or Stealing?: Medical Charlatans in the New Age | last=Abgrall|first=Jean-Marie|authorlink = Jean-Marie Abgrall | publisher= Algora | year = 2000 | isbn = 1-892941-51-1 | pages = 40–41 | url = https://books.google.com/books?id=HFs33ev0leUC&pg=PA40&dq=oscillococcinum }}</ref> As of 2008 it sells [[United States dollar|US$]]15 million per year in the U.S., and it also sells widely in Europe.<ref name = "Park1">{{cite book | title=Superstition: Belief in the Age of Science | last=Park|first=Robert L.|authorlink=Robert L. Park | publisher=Princeton University Press | year=2008 | isbn=0-691-13355-7 | pages=143–147 | url=https://books.google.com/books?id=eB1VJQQgGAUC&pg=PA143&vq=oscillococcinum&dq=oscillococcinum }}</ref> == Preparation == The ingredients of a one-gram tube of Oscillococcinum are listed as: * Active ingredient: ''Anas Barbariae Hepatis et Cordis Extractum'' (extract of [[Muscovy duck]] liver and heart) 200CK HPUS {{nowrap|{{gaps|1|×|10^&minus;400}} g}}<ref name = "Park1" /> which is much less than the weight of a proton ({{nowrap|{{gaps|1.67|×|10^&minus;24}} g}}<ref name = "Park1" />). * Inactive ingredient: {{nowrap|0.85 g}} [[sucrose]], {{nowrap|0.15 g}} [[lactose]] (100% sugar.<ref name = McGraw/>) The 200CK indicates that the preparation entails a series of 200 [[serial dilution|dilutions]] of the starting ingredient, an extract from the heart and liver of a [[Muscovy duck]].<ref name = "Park1" /> Each step entails a 1:100 dilution, where the first mixture contains 1% of the extract, the second contains 1% of the first mixture, etc.<ref name = "Park1" /> The K indicates that it is prepared by the [[Semen Korsakov|Korsakovian]] method, in which rather than 1% of the preparation being measured out at each stage and then diluted, a single vessel is repeatedly emptied, refilled, and vigorously shaken (in homeopathic terminology "[[Successive dilutions|succussed]]"), and it is assumed that 1% remains in the vessel each time.<ref name = "Kayne1"> {{Cite journal |vauthors=Kayne SB, Caldwell IM |year=2006 |url=https://books.google.com/books?id=w2IFcHJYTSYC&pg=PA98 |title=Homeopathic pharmacy: theory and practice |isbn= 978-0-443-10160-1 |edition=2 |publisher=Elsevier Health Sciences |pages=97 |postscript= <!--None--> }}</ref> The 200C dilution is so extreme that the final pill contains none of the original material.<ref name = "Park1" /><ref name = "voodoo">{{cite book | title=Voodoo Science: The Road from Foolishness to Fraud | last=Park|first=Robert L.|authorlink=Robert L. Park | edition=reprint | publisher=Oxford University Press | year=2002 | page=53 | isbn=0-19-860443-2 | url=https://books.google.com/books?id=71q1-BM4T68C&pg=PA53&lpg=PA53}}</ref> Oscillococcinum is generally considered harmless. When Boiron (the company that makes oscillococcinum) spokeswoman Gina Casey was asked if a product made from the heart and liver of a duck was safe, she replied: "Of course it is safe. There's nothing in it."<ref name = McGraw>Dan McGraw. [https://web.archive.org/web/20090510082018/http://www.usnews.com/usnews/biztech/articles/970217/archive_006221_2.htm Flu Symptoms? Try Duck]. ''[[U.S. News & World Report]]'' 2/9/97 page 2</ref> == Efficacy == There is no compelling scientific evidence that Oscillococcinum has any effect beyond placebo.<ref name = "Mathie"/> None of its active ingredient is present in a dose of the final product, nor is there any credible evidence that duck liver is effective in relieving (or causing) flu symptoms in the first place. Homeopaths claim the diluted molecules leave an "[[water memory|imprint]]" in the remedy, but there is no known mechanism for how this could occur.<ref name = "Park1" /><ref name = "Anastasia1">{{cite news |author=Toufexis Anastasia |url=http://www.time.com/time/magazine/article/0,9171,983466-2,00.html |title=Is homeopathy good medicine? |work=[[Time (magazine)|Time]] |date=25 September 1995 |page=2 |accessdate=2008-04-20 |subscription=yes }}(page numbering given from online version) </ref> Homeopathy as a whole is considered to be [[pseudoscience]].<ref name = "NSBattitudes"> {{cite web |author=[[National Science Board]] |date=April 2002 |title=Chapter 7 - Science and Technology: Public Attitudes and Public Understanding |url=http://www.nsf.gov/statistics/seind02/c7/c7s5.htm |location=Arlington, Virginia |publisher=National Science Foundation Directorate for Social, Behavioral and Economic Sciences }}</ref> As [[Robert L. Park]], a critic of alternative medicine, explains, some of the characteristics of flu may suggest that Oscillococcinum works. Since the flu normally goes away on its own in a variable number of days, the natural course of the disease is a potential source of error in assessing the efficacy of any intervention - if one takes any medication and one's flu goes away, then there is a tendency to attribute this to the medication even though the infection would have resolved anyway.<ref name = "Park1" /> Someone who gets over a mild strain of flu may attribute the mildness to the efficacy of the homeopathic preparation and not to the fact that it was a mild strain, and might recommend it to other people, spreading its popularity.<ref name = "Park1" /> Also, the most likely explanation for its effectiveness with flu symptoms is that patients are misdiagnosing the symptoms of several [[rhinovirus]] diseases or of allergies to several hundred substances, and attributing them to a flu infection that they do not have.<ref name = "Park1" /> A 2005 review of flu treatments (vaccine, medicine, homeopathy) has concluded that the popularity of Oscillococcinum in France was unsupported by any evidence of efficacy.<ref>{{cite journal | last1 = Van | first1 = | last2 = der Wouden | first2 = JC | last3 = Bueving | first3 = HJ | last4 = Poole | first4 = P. |date=Nov 2005 | title = Preventing influenza: an overview of systematic reviews. | url = | journal = [[Respiratory Medicine (journal)|Respir Med.]] | volume = 99 | issue = 11| pages = 1341–9 | doi = 10.1016/j.rmed.2005.07.001 | pmid = 16112852 }}</ref> In a 2007 review, the effectiveness of non-mainstream remedies against seasonal flu could not be established beyond reasonable doubt, and the evidence is found to be sparse and limited by "small sample sizes, low methodological quality, or clinically irrelevant effect sizes", and that the results strengthen using conventional approaches for flu.<ref name = "guo">{{cite journal | journal = [[The American Journal of Medicine]] | title = Complementary Medicine for Treating or Preventing Influenza or Influenza-like Illness | author = Ruoling Guo, Max H. Pittler, [[Edzard Ernst|E Ernst]] | volume = 120 | issue = 11 | date = November 2007 | pages = 923–929.e3 | doi = 10.1016/j.amjmed.2007.06.031 | pmid = 17976414 }}</ref> A [[Cochrane Collaboration|Cochrane]] review published in December 2012 found that there was insufficient evidence to make a robust conclusion about whether Oscillococcinum is effective for the prevention or treatment of influenza.<ref name = "Mathie">{{cite journal | journal = Cochrane Database of Systematic Reviews | title = Homeopathic Oscillococcinum(®) for preventing and treating influenza and influenza-like illness |vauthors=Mathie RT, Frye J, Fisher P | issue = 12 | date = December 2012 | doi = 10.1002/14651858.CD001957.pub5 | pmid = 23235586 | volume=12 | pages=CD001957}}</ref> == Lawsuits and criticisms == The non-profit, educational organizations [[Center for Inquiry]] (CFI) and the associated [[Committee for Skeptical Inquiry]] (CSI) have petitioned the U.S. [[Food and Drug Administration]] (FDA), criticizing [[Boiron]] for misleading labeling and advertising of Oscillococcinum. "One petition complains that Boiron’s packaging for Oscillococcinum lists the alleged active ingredient – duck liver and heart – in Latin only. Another petition complains that Boiron’s web ad for this product implies that it has received FDA approval." Ronald Lindsay, CFI and CSI president and chief executive officer, contends, "If Boiron is going to sell [[snake oil]], the least they can do is use English on their labels.”<ref name="The Pharma Letter">{{cite web|url=http://www.thepharmaletter.com/file/107384/citizen-petition-calls-on-us-fda-to-review-regulation-of-homeopathic-drugs.html| title=Citizen Petition calls on US FDA to review regulation of homeopathic drugs| publisher=[[The Pharma Letter]]| date=18 September 2011| accessdate=2011-09-20}}</ref> A [[class action lawsuit]] was filed against Boiron on behalf of "all California residents who purchased Oscillo at any time within the past four years." The lawsuit charges that Boiron "falsely advertises that Oscillo has the ability to cure the flu because it contains an active ingredient it claims is proven to get rid of flu symptoms in 48 hours." The lawsuit also states that the listed active ingredient in Oscillococcinum (Oscillo) "is actually Muscovy Duck Liver and Heart ... and has no known medicinal quality."<ref name="Top Class Actions">{{cite web|url=http://www.topclassactions.com/lawsuit-settlements/lawsuit-news/1309--boiron-oscillococcinum-class-action-lawsuit| title= Boiron Oscillococcinum Class Action Lawsuit| publisher=Top Class Actions| date=8 August 2011| accessdate=2011-09-24}}</ref> A settlement was reached, with Boiron denying any wrongdoing and agreeing to make several changes to its marketing of the product.<ref>{{cite web|title=The Law Office of Ronald A. Marron, APLC and Patton Boggs LLP Announce Preliminary Approval of Class Action Settlement|url=http://www.digitaljournal.com/pr/726925|accessdate=30 May 2012}}</ref> These changes include adding to their packaging notices like "These ‘Uses’ have not been evaluated by the Food and Drug Administration" and "C, K, CK, and X are homeopathic dilutions."<ref>{{cite web|title=Gallucci v. Boiron, Inc. et al Settlement Agreement|url=http://www.gilardi.com/boironsettlement/pdf/BRGL_SettlementAgreement.pdf|accessdate=30 May 2012}}</ref> Since 2011, at least two [[class action lawsuit]]s on behalf of customers who purchased Oscillococcinum have been filed against Boiron in the United States, alleging that Boiron falsely advertises that Oscillo has the ability to cure the flu.<ref>{{cite web|url=http://www.topclassactions.com/lawsuit-settlements/lawsuit-news/1309--boiron-oscillococcinum-class-action-lawsuit |title= Boiron Oscillococcinum Class Action Lawsuit | first=Mike |last= Holter|publisher=TopClassActions.com |date= 8 August 2011 |accessdate=2013-11-08 | quote= 'Unfortunately, Defendants fail to inform consumers of the truth regarding Oscillo and is purported active ingredient,' the Boiron class action lawsuit says. 'The truth is that the listed active ingredient in Oscillo, Anas Barbariae Hepatis et Cordis Extractum, is neither active in combating the flu nor is it actually an ingredient in Oscillo.'}}</ref><ref>{{cite web| url=http://www.courthousenews.com/2011/08/05/SnakeOil.pdf |format=[[PDF]]| title= Henry Gonzales v. Boiron Inc. et al | publisher= CourthouseMews.com | date= August 4, 2011}}</ref> A proposed settlement was reached in August 2012.<ref>{{cite web| url= http://www.gilardi.com/boironsettlement/MotionPDFs/Motion%2520for%2520Final%2520Approval%2520of%2520Class%2520Action%2520Settlement.pdf | title= Gallucci v. Boiron, Inc., et al. | publisher= gilardi.com | date= August 13, 2012 |format= [[PDF]] |accessdate=2013-11-08 | quote= Pursuant to the Court’s April 25, 2012 Order Granting Preliminary Approval (“PA Order”, Dkt. 89), Plaintiffs Salvatore Gallucci, Amy Aronica, Kim Jones, Doris Petty, and Jeanne Prinzivalli respectfully submit this Memorandum in support of their Motion for Final Approval of the proposed classwide Settlement with Defendants Boiron, Inc. and Boiron USA, Inc. }}</ref> While the settlement was challenged in the U.S. Court of Appeals for the Ninth Circuit by one class member who opposed the settlement, on February 24, 2015 the Ninth Circuit issued a decision upholding approval of the class action settlement.<ref>{{cite web|url=https://topclassactions.com/lawsuit-settlements/lawsuit-news/50513-9th-circuit-upholds-boiron-homeopathic-remedy-settlement/|title=9th Circuit Upholds Boiron Homeopathic Remedy Settlement|last=Bucher|first=Anne|publisher=TopClassActions.com|quote=On Tuesday, the 9th U.S. Circuit Court of Appeals upheld a Boiron homeopathic remedy class action settlement after disagreeing with an objector who had argued the 2012 deal was the result of collusion. In his appeal to the 9th Circuit, objector Henry Gonzales argued that the Boiron class action settlement was not fair, reasonable and adequate. He also argued that the $5 million false advertising settlement amount represents less than 1 percent of Boiron’s retail sales and that Class Members would have had a better shot at a fair deal if the class action lawsuit had gone to trial. The three-judge appellate panel disagreed with Gonzales and found that U.S. District Judge John A. Houston did not abuse his discretion by approving the Boiron homeopathic remedy class action settlement back in 2012.|accessdate=2015-05-20}}</ref> Boiron's legal threats against Samuele Riva for writing criticisms on his website were rebuffed by his web hosting company, and the debacle was described as producing a [[Streisand effect]] against Boiron.<ref name=labtimes>[http://www.labtimes.org/labtimes/issues/lt2011/lt05/lt_2011_05_58_58.pdf The Web’s Backstroke]. "In a classic case of "harm set, harm get", a French homeopathy giant earns public condemnation after threatening a private critic with legal action." ''Lab Times'', May 2011</ref> [[Jimmy Wales]], co-founder of Wikipedia publicly criticized the sale of Oscilloccinum calling it a "complete hoax product" in a Quora blog post in 2013.<ref>{{Cite news|url=http://observer.com/2013/01/wikipedian-at-war-jimmy-wales-sets-his-sights-on-homeopathy/|title=Wikipedian at War: Jimmy Wales Sets His Sights on Homeopathy|date=2013-01-31|newspaper=Observer|language=en-US|access-date=2016-12-16}}</ref><ref>{{Cite web|url=https://jimmywales.quora.com/Homeopathy-Oscillococcinum-in-particular|title=Homeopathy - Oscillococcinum in particular - Jimmy Wales - Quora|website=jimmywales.quora.com|access-date=2016-12-16}}</ref> == References == {{reflist|30em}} == External links == * [http://www.homeowatch.org/history/oscillo.html The True Story of Oscillococcinum], [[homeowatch.org]] * [http://www.usnews.com/usnews/biztech/articles/970217/archive_006221.htm ''Flu Symptoms? Try Duck''], ''[[U.S. News & World Report]]'', February 17, 1997 {{Homoeopathy}} [[Category:Homeopathic remedies]] [[Category:Influenza]] [[Category:Class action lawsuits]]'