thumb|right|250px|An open vial of Oscillococcinum tablets

Oscillococcinum (or Oscillo) is a homeopathic preparation marketed to relieve flu-like symptoms, although it does not provide any benefit beyond that of a placebo.

Oscillococcinum is promoted according to the homeopathic principle that "like cures like", and that a disease can be cured by small amounts of the substance that cause similar symptoms. Boiron is its sole manufacturer. Oscillococcinum is used in more than 50 countries, being particularly popular in France, and has been in production for over 65 years.

Oscillococcinum was originally proposed by the French physician Joseph Roy (1891–1978), on the basis of his misidentification of a supposed 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 influenza is caused by a virus and not a bacterium.

The preparation is derived from duck liver and heart, diluted to 200C—a ratio of one part duck offal to 10<sup>400</sup> parts water.

Origin and history

The word Oscillococcinum was coined by Roy in his 1925 book Towards Knowledge and the Cure of Cancer. Roy wrote that while on military duty during the Spanish flu epidemic of 1917 he had observed an oscillating bacterium in the blood of flu victims, which he named Oscillococcus. Moreover, 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. , sales in the United States totalled US$15 million per year; Oscillo also sells widely in Europe.

In 2019, the McGill Office for Science and Society released a survey of 150 pharmacies in Montreal, Quebec, finding that two thirds of them carried Oscillococcinum.

Preparation

The ingredients of a one-gram tube of Oscillococcinum are listed as follows:

  • Active ingredient: Anas Barbariae Hepatis et Cordis Extractum (extract of Muscovy duck liver and heart) 200CK HPUS This series of dilutions would result in one molecule of the original substance being present in 10<sup>400</sup> molecules of solute; for comparison, the atmosphere of the entire planet Earth is estimated to constitute around 1.04×10<sup>44</sup> molecules (i.e. one molecule of duck offal per 10<sup>356</sup> Earth atmospheres).

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."

Efficacy

There is no compelling scientific evidence that Oscillococcinum has any effect beyond placebo. Homeopathy as a whole is widely considered to be pseudoscience.

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 then one's flu goes away, there is a tendency to attribute this to the medication even though the infection would have resolved anyway, In a 2007 review, the effectiveness of non-mainstream remedies against seasonal flu could not be established beyond reasonable doubt, and the evidence was found to be sparse and limited by "small sample sizes, low methodological quality, or clinically irrelevant effect sizes", and that the results strengthened using conventional approaches for treating flu. A Cochrane review published in December 2015 found that there was insufficient evidence to make a conclusion about whether Oscillococcinum was useful for influenza.

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, contended that, "If Boiron is going to sell snake oil, the least they can do is use English on their labels."

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 charged 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 stated that the listed active ingredient in Oscillococcinum (Oscillo) "is actually Muscovy Duck Liver and Heart ... and has no known medicinal quality." A settlement was reached, with Boiron denying any wrongdoing and agreeing to make several changes to its marketing of the product. These changes included 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."

Since 2011, at least two class action lawsuits 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. A proposed settlement was reached in August 2012. 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.

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.

References

  • The True Story of Oscillococcinum, Quackwatch
  • Flu Symptoms? Try Duck, U.S. News & World Report, February 17, 1997
  • Pharmacies continue to sell sugar pills as flu remedy, Science-Based Medicine