"DNA science apparently settles the biological question of who these ancient, advanced Hopewell mound builders were. But where else is this DNA found? And where did it originate?"—The Lost Civilizations of North America

In Part One of our series on diffusionist perspectives espoused in the Lost Civilizations of North America documentary (SI, September/October 2011), we discussed allegations made in the documentary that the true history of ancient North America has been hidden, perhaps intentionally, by mainstream scientists and historians (Feder et al. 2011). In Part Two (November/December 2011), we addressed claims made by diffusionists in general and in the documentary in particular concerning the discovery of artifacts with written inscriptions presented in support of that alternative history (Lepper et al. 2011). Here, in Part 3, we will address the interpretation proffered by some of those interviewed in the documentary that DNA studies prove a direct biological and historical connection between the mound builders of the American Midwest and the ancient inhabitants of the Middle East.

Lost Civilizations: Genetic Evidence

DNA studies have helped to address important questions about the biological makeup of Hopewell mound builder populations and where their ancestors came from, but the genetic data do not provide any evidence for a direct link between the Hopewell and Israelite populations of the Middle East, as some interviewees in Lost Civilizations claim. To date, DNA has been extracted from the remains of seventy-three individuals buried at two sites exhibiting Hopewell archaeological features (the pete Klunk mound group in Illinois and the Hopewell mound group in Ohio). Maternally inherited mitochondrial DNA (mtDNA) was analyzed, and it shows that the genetic makeup of these populations was broadly similar to other ancient and contemporary Native American populations from eastern North America (Mills 2003; Bolnick and Smith 2007) (Figure 1). When the Hopewell population (as well as other Native Americans) is compared with Old World populations, they are most genetically similar to populations in Asia. The scientific consensus, based on more than 150 studies of Native American genetic variation, suggests that all Native Americans are descended from a single source population that originated in Asia and migrated to the Americas via Beringia (Figure 2) approximately fourteen thousand to twenty thousand years ago (Kemp and Schurr 2010). This consensus reflects not only the observed patterns of mtDNA variation but also studies of paternally inherited Y-chromosome markers and biparentally inherited autosomal markers.

Figure 1. Mitochondrial DNA (mtDNA) haplogroup frequencies for Native American populations from eastern North America and the Galilee Druze. Note the level of consistency in the distribution of mitochondrial haplogroups among Native Americans. The distribution of haplogroups in a Galilee Druze population is quite different.

While the Lost Civilizations video does mention this "mainstream" perspective, it emphasizes a different interpretation of the Hopewell genetic data. Specifically, the video suggests that the presence of a mtDNA lineage known as "haplogroup X" in the Hopewell population is evidence of a pre-Columbian migration of Israelites to the Americas because haplogroup X originated in the "hills of Galilee" in Israel and began to disperse out of the Middle East approximately two thousand years ago. This argument is seriously flawed for four reasons.

First, while several genetic studies indicate that haplogroup X may have first evolved in the Near East (Brown et al. 1998; Reidla et al. 2003; Shlush et al. 2008), these studies do not suggest that it originated specifically in Israelite or other Hebrew-speaking populations. Haplogroup X is found throughout the Near East, western Eurasia, and northern Africa, and it is not unique to (nor especially common in) Israelite or Jewish populations (Reidla et al. 2003; Behar et al. 2004). Shlush et al. (2008) did find a higher frequency of haplogroup X in the Galilee Druze, a (non-Jewish) population isolate that practices a distinctive monotheistic religion, but the authors themselves point out that their nonrandom sampling strategy does not provide an accurate estimate of population haplogroup frequencies. Furthermore, Shlush et al. (2008) argue that the Galilee Druze represent a contemporary "refugium" for haplogroup X, not that haplogroup X must have originated in the hills of Galilee (as diffusionist Donald Yates claims in the video).

Figure 2. This map shows the configuration of the modern coastlines of northeast Asia and northwest North America, along with the maximum Late Pleistocene extent of the Bering Land Bridge. Its existence, between thirty-five thousand and eleven thousand years ago, provided a broad avenue across which human beings first entered the New World from the Old.

Second, and more important, the forms of haplogroup X found in the Galilee Druze (and elsewhere in the Near East) are not closely related to the particular form of haplogroup X found in Native Americans. All members of haplogroup X share some mutations, reflecting descent from a common maternal ancestor, but other mutations divide haplogroup X mtDNAs into various subdivisions (subhaplogroups) that diverged after the time of the shared maternal ancestor (Reidla et al. 2003). The Hopewell and other Native American populations exhibit sub-haplogroup X2a, which is different from the subhaplogroups present in the Galilee Druze (subhaplogroups X2*, X2b, X2e, X2f) or other Middle Eastern populations (Reidla et al. 2003; Shlush et al. 2008; Kemp and Schurr 2010). Because subhaplogroup X2a is not found in the Middle East and is not particularly closely related to the forms of haplogroup X that are found in that region, the haplogroup X data do not provide any evidence for a close biological relationship between Hopewell and Middle Eastern populations or any support for a direct migration from the Middle East to the Americas in pre-Columbian times.

Third, it is misleading and inappropriate to focus exclusively on haplogroup X and to ignore all other mtDNA lineages when considering the genetic origins of the Hopewell mound builders-especially since haplogroup X was found in only one of the seventy-three Hopewell individuals studied. As noted earlier, when all mtDNA haplogroups present in the Hopewell population (as well as other Native Americans) are considered, the genetic evidence clearly indicates an Asian origin. Furthermore, if there had been a pre-Columbian migration of Israelites to eastern North America, we would almost certainly see other common Middle Eastern lineages in the Hopewell and other Native American populations. We don't. None of the thirteen other mtDNA haplogroups found in the Galilee Druze is present in the Hopewell or other pre-Columbian Native Americans (see Figure 1). Nor do we see any of the common Druze or Middle Eastern Y-chromosome haplogroups in indigenous Americans. The genetic data therefore provide no evidence whatsoever for a migration of Israelites to eastern North America.

Finally, DNA studies do not suggest that haplogroup X began to disperse out of the Middle East only about 2,000 years ago, as diffusionist Rod Meldrum claims in the Lost Civilizations video. Meldrum argues that there is a scientific controversy over the rate of mtDNA mutation, and he suggests that (a) the most accurate mutation rate estimates come from human pedigree studies and (b) those mutation rates demonstrate that haplogroup X began to diversify and spread approximately two thousand years ago. However, the particular controversy that Meldrum cites is a decade old, concerns the mutation rate in only one small segment of mtDNA (the control region), and has generally been resolved. Pedigree studies measure the rate of mutation observed in parent-offspring comparisons, but many mutations are eliminated within a few generations of their occurrence because of natural selection, genetic drift, and recurrent mutation at some sites in the DNA. The measurable rate of mtDNA evolution therefore decreases over time (Soares et al. 2009), making it inappropriate to use mutation rate estimates from pedigree studies for dating the origin and diversification of most lineages (for example, any that originated more than a few generations ago). Instead, the mtDNA mutation rate is calculated by measuring the number of genetic differences between two or more individuals (or species) and then dividing that number by the length of time since they diverged from a common ancestor. The timing of their divergence is based on fossil, archaeological, and/or geological evidence, and it is not simply "theoretical" (as Meldrum suggests). Furthermore, Meldrum does not rely on newer findings to argue that haplogroup X began to diversify and spread only two thousand years ago, as he claims, but rather on an old and unusually fast estimate of the mtDNA mutation rate (Parsons et al. 1997). Virtually all pedigree studies have found significantly lower mutation rates (Howell et al. 2003) than the one Meldrum uses, which suggests that haplogroup X began diversifying much earlier than he claims. Studies of the complete mitochondrial genome (rather than just the control region), using less controversial mutation rates for the mtDNA coding region, also suggest that haplogroup X began to diversify much earlier (~31,800 years ago; Soares et al. 2009).

Conclusion

In the past, many scholars have pointed to a sometimes explicitly racist agenda behind the claims of diffusionists who argue that the glories of Native American civilizations were achieved only through borrowing from various Old World groups. The producers of the Lost Civilizations of North America and the diffusionists they feature in their documentary turn this argument on its head by suggesting that it is instead those “mainstream” scholars who are the real racists because they deny Native Americans their role in an already globalized world of the early centuries of the Common Era. However, the only support for this picture of Native American–Old World interactions two thousand years ago comes from resurrected frauds and distorted history. There is no credible archaeological or genetic evidence to suggest that any Old World peoples migrated to the Americas after the initial incursion from Siberia prior to the tentative forays of the Norse beginning at around 1000 CE other than limited contacts between Siberia and the American arctic.

References

Behar, Doron M., Michael F. Hammer, Daniel Garrigan, et al. 2004. Mtdna evidence for a genetic bottleneck in the early history of the Ashkenazi Jewish population. European Journal of Human Genetics 12: 355-64.

Bolnick, Deborah A., and David G. Smith. 2007. Migration and social structure among the Hopewell: Evidence from ancient DNA. American Antiquity 72: 627-44.

Brown, Michael D., Seyed H. Hosseini, Antonio Torroni, et al. 1998. MtDNA haplogroup X: an ancient link between Europe/Western Asia and North America? American Journal of Human Genetics 63:1852-61.

Feder, Kenneth, Bradley T. Lepper, Terry A. Barnhart, and Deborah A. Bolnick. 2011. Civilizations lost and found: Fabricating history, part one: An alternate reality. Skeptical Inquirer 35(5) (September/October): 38-45.

Howell, Neil, Christy Bogolin Smejkal, D.A. Mackey, et al. 2003. The pedigree rate of sequence divergence in the human mitochondrial genome: There is a difference between phylogenetic and pedigree rates. American Journal of Human Genetics 72: 659-70.

Kemp, Brian M., and Theodore G. Schurr. 2010. Ancient and modern genetic variation in the Americas. In Human Variation in the Americas. Benjamin M. Auerbach, editor. Center for Archaeological Investigations, Occasional Paper No. 38: 12-50.

Lepper, Bradley T., Kenneth L. Feder, Terry A. Barnhart, and Deborah A. Bolnick. 2011. Civilizations lost and found: Fabricating history, part two: False messages in stone. Skeptical Inquirer 35(6) (November/December): 48-54.

Mills, Lisa. 2003. Mitochondrial DNA analysis of the Ohio Hopewell of the Hopewell Mound group. Unpublished PhD dissertation, Department of Anthropology, The Ohio State University, Columbus, Ohio.

Parsons, Thomas J., David S. Muniec, Kevin Sullivan, et al. 1997. A high observed substitution rate in the human mitochondrial DNA control region. Nature Genetics 15: 363-68.

Reidla, Maere, Toomas Kivisild, Ene Metspalu, et al. 2003. Origin and diffusion of mtDNA haplogroup X. American Journal of Human Genetics 73: 1178-90.

Shlush, Liran I., Doron M. Behar, Guennady Yudkovsky, et al. 2008. The Druze: A population genetic refugium of the Near East. PLoS ONE 3(5): e2105.

Soares, Pedro, Luca Ermini, Noel Thomson, et al. 2009. Correcting for purifying selection: An improved human mitochondrial molecular clock. American Journal of Human Genetics 84: 740-59.

Disclaimer

We are well aware that a claim underlying the Lost Civilizations documentary—that the mound-building people of the American Midwest were migrants from the Middle East 2,000 years ago—may be informed by religious doctrine. It is our position in this paper, however, that whatever inspires this claim is not nearly as important as the fact that it is plainly wrong. As such, we will leave it to others to assess the role played, if any, by religion in shaping Lost Civilizations and focus instead on scientific evidence relevant to that claim.

In May 2009 a meteorite impact was reported just thirty miles south of Fort Worth, Texas, but the mysterious object was of a very unusual composition for a meteorite. Had an impact occurred, it would have caused widespread devastation-yet nothing of the sort happened.

From my perspective, the event started to unfold at 8:20 AM CDT on May 18, 2009, when I received a phone call from Sue Stevens, the senior media relations officer at the University of Texas at Arlington (UTA). I'm an associate professor of physics and currently director of the astronomy program at the same institution. Arlington, well known as a sports and university city, is located in the center of the Dallas-Fort Worth metroplex. Stevens told me that she received an urgent phone call from Richard Ray, a reporter from a Fox TV affiliate, about a truly extraordinary event: a meteorite impact that occurred overnight, just south of Fort Worth. Richard Ray wanted to give me a call within the next few minutes, and he wanted to meet me at the impact site later that day.

Of course, I agreed. The reporter explained to me that the meteoric impact occurred close to Texas State Highway 67 at a location thirty miles south of Fort Worth, very close to the county line between the Erath and Somer­vell counties in the proximity of Chalk Mountain. In fact, this place is located at the northern outskirts of the Texas Hill Country, a geographical region of Central Texas four times the size of Connecticut. The Texas Hill Country is known for its vast diversity in botany and wildlife. Geological features include limestone and granite. It is noteworthy that the greater area of the alleged meteoric impact site is known for mysteries such as UFO sightings near Stephenville (January 8, 2008) and the "Creation Evidence Museum" in Glen Rose. Some of the UFO sightings have meanwhile been attributed to night flights and flares dropped by US Air Force F-16s stationed at Fort Worth (see "The Stephen­ville Lights: What Actually Hap­pened," Skeptical Inquirer, January/February 2009).

Overall setting of the meteoric site. Credit: Steve Hudgeons, Texas Mutual UFO Network (MUFON) lead investigator; forwarded by Richard Ray, Fox TV.

Visiting the Impact Site

Due to my work schedule, I decided to meet the television reporter at noon at the site of the alleged meteorite impact. I was accompanied by Aurelian Balan, the astronomy laboratory supervisor at UTA. At the site of impact, we met Corky Underwood, who owned the property. we also met Arthur J. Ehl­mann, emeritus professor of geology at Texas Christian University (TCU), a leading expert in meteoric research, as well as the current curator of TCU's Oscar E. Monning Meteorite Gallery. There were a few other spectators as well.

The site of impact was quite amazing. The supposed meteorite was nearly round in shape and as big as a standard refrigerator. It was of a grayish-white color and did not show any signs of heat-related coating or disintegration.
It was sitting near the end of a trench, and as a secondary feature it was sitting on a crater about three times the diameter of the meteorite. The trench itself seemed to indicate that the meteorite was partially sliding on the ground before coming to a complete stop. Corky Under­wood also pointed to some trees in the background that had apparently been damaged by the in­coming "meteorite." "These trees were perfectly all right before the meteorite hit," he said. The tracks on the ground as well as the smashed trees pointed to an extremely inclined meteoric trajectory.

My colleague Arthur Ehlmann chipped off a piece of the meteorite with his pocket knife. "This is limestone," he explained. "This can't be from outer space." Limestone is a sedimentary rock, one of the three major rock groups that form Earth's crust. It is composed mostly of calcium and magnesium carbonates and is formed via deposition in water. Limestone isn't found in meteorites.

Meteorite and crater. Credit: Steve Hudgeons, Texas Mutual UFO Network (MUFON) lead investigator; forwarded by Richard Ray, Fox TV.

Meteorite Origins

Meteorites are natural objects originating in outer space that survive impact with Earth's surface. Most meteorites derive from small astronomical objects called meteoroids, but they are also sometimes produced by impacts of asteroids, the large counterparts of meteoroids. When they enter the atmosphere, impact pressure causes the body to heat up and emit light. Meteorites have traditionally been divided into three broad categories: stony meteorites are rocks, mainly composed of silicate minerals; iron meteorites are largely composed of metallic iron-nickel; and stony-iron meteorites contain large amounts of both metallic and rocky material. Stony meteorites are by far the most abundant. Modern classification schemes divide meteorites into groups according to their structure, chemical and isotopic composition, and mineralogy.

Most meteoroids disintegrate significantly when entering Earth's at­mos­phere. If they hit the ground, the objects are known to arrive at their terminal velocity and typically create craters about ten times their size. Explosions, detonations, and rumblings are often heard during meteorite falls, which can be caused by sonic booms as well as shock waves resulting from major fragmentation events. These sounds can be heard over wide areas, up to many thousands of square miles. As meteoroids are heated during atmospheric entry, their surfaces melt and experience ablation. They can be sculpted into various shapes during this process. Obviously, all these features are in stark contrast to those of the meteorite encountered at Chalk Mountain.

The Meteorite in the News

The Chalk Mountain meteorite re­ceived significant news coverage, in­cluding from Fox TV. Although the Fox TV clip, which aired on the evening of May 18, 2009, was clearly skewed toward sensationalism, it was still technically correct because it stated that the so-called meteorite finding poses an unsolved mystery because its origin is still unknown. I also gave an interview to Whitney White-Ashley from a small local newspaper located at Glen Rose, the seat of Somer­vell County. Angelia Joiner later published an online article about the meteorite that tried to create the impression that there is chemical evidence that the rock is not from the immediate area. Joiner also quoted Steve Hudgeons, lead investigator of the Texas Mutual UFO network, who offered a calculation about the trajectory of the rock. At that time, the true origin of the meteorite was a mystery.

A piece of earth-moving equipment available from “RECS—Rental Equipment Contractor Supplies.” The company’s website identifies Elaine Underwood as owner and Corky Underwood as sales/operation manager.

Conclusion

I received an unexpected and intriguing clue via email on May 20, 2009, from John Maroul of Benbrook, Texas, who had previously forwarded me a list of science questions about meteorites. His email read in part: "Look what Corky Underwood does for a living: Rents and sells heavy equipment that can carve limestone and dig trenches. Not saying he hoaxed this but it is more than suspect."

The solution to the meteorite mystery at Chalk Mountain turned out to be both trivial and embarrassing. John Maroul's email also pointed me to the website www.recsinc.com, which contains detailed information on renting out earth-moving equipment. Accord­ing to the website, the company's equipment is able to handle dirt and all sizes of rock. Together with the overwhelming scientific evidence that the "meteorite" could not be from outer space due to its limestone composition and, additionally, would not have survived its path through Earth's atmosphere, this was the final piece of the puzzle. Problem solved-it was almost certainly a hoax.

For those of you who would like to find and visit the alleged site of the "meteorite impact," please be aware: the site is located on private property (indicated by a clearly visible sign), and most Texans, especially those in the Hill Country, own guns. There may be an admission fee.

Note

I later called the Fox News reporter to tell him my conclusion and the evidence on which it was based. Shortly after our phone conversation, the Fox News clip (which was about two minutes long) became unavailable.

References

Bennett, Jeffrey, and Seth Shostak. 2007. Life in the Universe, 2nd ed. Boston, Massachusetts: Addison-Wesley.

Comins, Neil F., and William J. Kaufmann III. 2008. Discovering the Universe, 8th ed. New York: W.H. Freeman and Co.

Creation Evidence Museum Online. Available online at http://www.creationevidence.org; accessed January 1, 2011.

Ehlmann, Arthur J. 2008. The Oscar E. Monning Meteorite Collection Catalog. Tucson, Arizona: Stanegate Press.

Joiner, Angelina. Mysterious crater and rock baffles all. Available online at http://www.angeliajoiner.com; accessed March 29, 2010.

"RECS-Rental Equipment Contractor Sup­plies." Accessed April 7, 2010; January 5, 2011. Available online at www.recsinc.com.

Seeds, Michael A. 2006. Horizons: Exploring the Universe. 9th ed. Belmont, California: Thom­son Brooks/Cole.

Ever since the FDA approved the human papillomavirus (HPV) vaccine in 2006, its introduction has been embroiled in a medical, social, cultural, and political controversy. This controversy has once again been rekindled in the recent Republican primary debates between Texas governor Rick Perry and Congresswoman Michele Bachmann from Minnesota, in which Bachmann emphatically stated that Merck's HPV vaccine, Gardasil, causes mental retardation.

As a physician, parent, and author of the award-winning book The HPV Vaccine Controversy: Sex, Cancer, God and Politics (Praeger, 2008), I feel compelled to comment on this issue.

A report presented by four different sources to the Advisory Committee on Immunization Practices (ACIP), an independent panel of experts that advises the Centers for Disease Control and Prevention (CDC) on vaccine policies, found no signals to link Garda­sil directly to any of the serious adverse effects that have been publicized in the media.

To clarify this and help consumers make the best-informed decision be­fore vaccinating, it is helpful to understand the difference between a side effect (caused directly by the vaccine) and an adverse effect (which usually occurs within six weeks after the administration of a vaccine but may or may not be related to the vaccine).

1) The most common side effects reported are pain followed by swelling and redness at the site of injection. These temporary symptoms usually resolve within a few days, as is the case with most other vaccines.

2) The number of adverse effects that link the HPV vaccines to the nervous system disorder Guillain-Barré Syn­drome is around one to two out of every 100,000 cases-about the same as the number of cases that occur in the general population as a sheer coincidence or chance-and such disorders have the same statistical occurrence as the population at large that has not been vaccinated.

It is obvious that the greater the number of shots administered (as of June 22, 2011, 35 million doses of Gardasil had been distributed), the more likely the chance for these rare and unexpected events to occur. It should be noted that there is no report from the CDC of Gardasil resulting in mental retardation.

The HPV vaccine has established a decent track record at five years post-licensure. Based upon these current findings, the FDA strongly recommends vaccinating the target population: nine- to twenty-six-year-old females and males. The CDC will continue to be vigilant and monitor safety data on an ongoing basis. Nevertheless, it is helpful to remind ourselves that regardless of how well studies are conducted, gray zones of risk exist. The history of medicine has shown us that such unfortunate events do occur for unknown reasons, and research is underway to study if genetics and environmental factors have a role to play in such rare and serious events.

One should always balance the great­er good with these potentially minimal risks when evaluating the ad­vantages offered by new and emerging medicines. Scaremongering for personal political gain does not bode well for the education and welfare of the public. In the case of the HPV vaccine, it would be a shame if negative attention created by a few rare effects hampers the efforts to reach millions of women and men who risk losing their lives to HPV-related diseases, including cancers and particularly cervical cancer, both in our country and around the world.

Herbal medicines are currently quite popular; consumers are spending billions on them each year. Enthusiasts praise them as natural and safe, while skeptics often see them as little more than glorified placebos. The general public is frequently confused by such controversies, by a plethora of misinformation, and by the bewildering categories of medicines derived from herbs (U.S. Government Accountability Office 2010). Here I will try to clear up some of this confusion by explaining what the different categories are.

Herbal Medicines

Herbal medicines are preparations made from whole plants or whole parts of plants. They are also called botanical medicines, remedies, or supplements. Invariably they contain a mixture of ingredients, some of which may be pharmacologically active. Frequently they are marketed as dietary supplements, which are not required to have proven efficacy, safety, or quality in the United States and most other countries (Marcus and Grollman 2002, 347). Thus the spectrum is wide with both high- and low-quality products often placed side by side. Calls for tighter regulation are made regularly (e.g., U.S. Government Accountability Office 2009) but are routinely frustrated.

Herbal medicines are mostly used by consumers for self-treatment of minor symptoms. Doctors rarely employ them (except in some countries, such as Germany) and, crucially, traditional herbalists use an entirely different approach with each treatment.

The majority of herbal medicines have not been scientifically tested. But some have been adequately analyzed, standardized, and submitted to clinical trials (Ernst et al. 2006). St. John's Wort (Hypericum perforatum) is perhaps the best-investigated example. We know that this herbal antidepressant has several pharmacologically active ingredients that have been standardized in high-quality products and tested for efficacy and safety in approximately fifty clinical trials and many post-marketing surveillance studies. The results leave little doubt that St. John's Wort is efficacious for mild to moderate depression. It is also relatively safe as long as it is not combined with other drugs (Ernst et al. 2006).

When taken together with other medications, St. John's Wort can powerfully interact such that it lowers the plasma level of many drugs (Izzo and Ernst 2001, 15) which, of course, can have serious consequences. Thus the example of St. John's Wort goes some way toward demonstrating that herbal medicines can do both good and harm to patients. In other words, some herbal medicines are complicated pharmacological treatments and are biologically plausible (Schulz and Hänsel 2003).

Many other herbal medicines are not well-researched; therefore we cannot be certain about their risk-benefit profile (Ernst et al. 2006). Even the well-researched examples like St. John's Wort should be approached with healthy skepticism: the few high-quality products available are outnumbered by supplements of low quality and dubious content. Thus the market of herbal medicines is littered with products that contain little or no herbal ingredients (Sievenpiper et al. 2004, 27), are adulterated with prescription drugs (Miller and Stripp 2007, 9), or are contaminated with heavy metals (Buettner et al. 2009, 24; Cohen 2009, 361).

Synthetic Drugs Derived From Herbs

Many of our modern drugs (e.g., aspirin, Morphium, Tamoxifen, Vin­cris­tin, etc.) were originally derived from botanical material. In fact, many skeptics wonder why we cannot also extract and synthesize the active ingredients from well-researched herbal medicines such as St. John's Wort and generate single ingredients derived from that plant. This would clearly solve several problems inherent in herbal medicine, such as standardization.

While this approach of creating pure compounds does work occasionally, it fails in other instances. One reason can be the fact that herbal medicines tend to have not one but a multitude of pharmacologically active ingredients. Thus extracting only one ingredient might reduce the pharmacological activity of the whole plant extract.

Single ingredients derived from herb­al extracts can no longer be considered herbal medicines as, by definition, herbal medicines are based on the whole plant. Nevertheless, such drugs are reminders of the fact that many plants contain molecules that are pharmacologically active and can thus have both beneficial and detrimental health effects.

Traditional Herbalism

If a patient consults a Chinese, Indian, Japanese, or European herbalist, he will be diagnosed and treated according to obsolete and untested principles of diagnosis, pathophysiology, and so forth. Treatment will typically be individualized according to the characteristics of each patient and based on complex, tailor-made herbal mixtures of several (up to ten) herbal extracts. This means that ten patients suffering from depression may receive ten different, individualized concoctions, none of which might contain St. John's Wort, the only evidence-based herbal antidepressant. In other words, the biological plausibility of traditional herbalism is questionable.

Traditional herbalism is thus dramatically different from the herbal medicine described above. To scientifically test its value can be complex but it is doubtlessly possible. Few rigorous studies of this approach are currently available, and those that have been published do not support the notion that traditional herbalism is effective (Guo et al. 2007, 83).

Neither can we be certain about its safety. Because the tailor-made concoctions of traditional herbalists may contain a confusing number of active ingredients, the potential for toxicity, herb-drug interaction, contamination, and so on can be considerable. More vigorous regulation of herbalists, a subject currently being discussed in Europe (Hawkes 2010, 339), is therefore required.

Homeopathic Remedies

The public frequently confuses homeopathy with herbal medicine. The error usually arises because many homeopathic remedies are produced from "mother tinctures," which are based on herbal extracts. Thus they can carry the same (or similar) names as herbal products. The difference is that homeopathic remedies are typically highly diluted and therefore contain no active ingredients at all. Thus homeopathy lacks any biological plausibility.

Arnica is a good example. It is used as an herbal cream as well as a homeopathic remedy. Because it is toxic, Arnica should not be taken as an oral herbal medicine. Being highly diluted, homeopathic Arnica is, of course, both nontoxic and entirely ineffective (Ernst and Pittler 1998, 133).

Bach Flower Remedies

These products are currently very popular for self-medication, particularly in Europe. They are produced by placing freshly picked flowers in spring water. Thus they are also plant-derived and frequently confused with herbal medicines. After the flowers have floated for a while, the water is mixed with brandy and sold at high prices as Bach Flower Remedies.

Bach Flower Remedies were developed by the British physician Edward Bach, who had previously worked as a homeopath. His remedies have, however, little in common with homeopathy except, of course, that they are neither biologically plausible nor of proven effectiveness for any condition (Ernst 2010, 140).

Anthroposophical Medicines

Rudolf Steiner developed his anthroposophical medicines about one hundred years ago (Ernst 2008, 150). They are produced according to protocols similar to those of homeopathic remedies. Unlike homeopathy, however, anthroposophical medicine does not follow the "like cures like" principle.

As many anthroposophical medicines are based on plants, they are also often confused with herbal medicines. The best known example is Iscador®, a fermented mistletoe preparation that is a highly popular treatment for cancer in Europe. Numerous trials exist, but collectively their results do not show that this is an effective therapy (Horneber et al. 2008, 16).

Conclusion

Many articles on herbal medicine conclude by stating that more research is needed. Between 1999 and 2007, the National Institutes of Health has spent US $1.9 billion on research into dietary supplements (Regan, Wambogo, and Haggans 2011, 141). Not all of this money was well invested (Ernst et al. 2011). I therefore advocate not necessarily more research but better-designed studies into the few plausibly beneficial aspects of herbal medicine. n

References

Buettner, C., K.J. Mukamal, P. Gardiner, et al. 2009. Herbal supplement use and blood lead levels of United States adults. Journal of General Internal Medicine 24(11): 1175-82.

Cohen, P.A. 2009. American roulette: Con­taminated dietary supplements. New Eng­land Journal of Medicine 361(16): 1523-25.

Ernst, E. 2008. Anthroposophic medicine: A critical analysis [in German]. MMW Fortschritte der Medizin 150(Suppl. 1):1-6.

---. 2010. Bach flower remedies: A systematic review of randomised clinical trials. Swiss Medical Weekly 140: w13079.

Ernst, E., and M.H. Pittler, 1998. Efficacy of homeopathic arnica: A systematic review of placebo-controlled clinical trials. Archives of Surgery 133(11): 1187-90.

Ernst, E., M.H. Pittler, B. Wider, et al. 2006. The Desktop Guide to Complementary and Alternative Medicine, 2nd ed. Edinburgh: Elsevier Mosby.

Ernst, E., S.K. Hung, and Y. Clement. 2011. NCCAM-funded RCTs of herbal medicines: An important critical assessment. Perfusion 24(3) 89-102.

Guo, R., P.H. Canter, and E. Ernst. 2007. A systematic review of randomised clinical trials of individualised herbal medicine in any indication. Postgraduate Medical Journal 83(984): 633-37.

Hawkes, N. 2010. A spanner in the herbal works. BMJ 339: b5441.

Horneber, M.A., G. Bueschel, R. Huber, et al. 2008. Mistletoe therapy in oncology. Cochrane Database Systems Review 16(2): CD003297.

Izzo, A.A., and E. Ernst. 2001. Interactions between herbal medicines and prescribed drugs: A systematic review. Drugs 15: 2163-75.

Marcus, D.M., and A.P. Grollman. 2002. Botanical medicines: The need for new regulations. New England Journal of Medicine 347(25): 2073-76.

Miller, G.M., and R. Stripp. 2007. A study of western pharmaceuticals contained within samples of Chinese herbal/patent medicines collected from New York City's Chinatown. Legal Medicine 9(5): 258-64.

Regan, K.S., E.A. Wambogo, and C.J. Haggans. 2011. NIH and USDA funding of dietary supplement research, 1999-2007. Journal of Nutrition 141(1):1-3.

Schulz, V., and R. Hänsel. 2003. Rational phytotherapie: A physician's guide to herbal medicine, 5th ed. Berlin: Springer-Verlag.

Sievenpiper, J.L., J.T. Arnason, E. Vidgen, et al. 2004. A systematic quantitative analysis of the literature of the high variability in ginseng (Panax spp.): Should ginseng be trusted in diabetes? Diabetes Care 27(3): 839-40.

U.S. Government Accountability Office. 2009. Dietary Supplements: FDA Should Take Further Actions to Improve Oversight and Consumer Understanding. United States Accountability Office, January: Report to Con­gressional Requesters. GAO-09-250. Available online at www.gao.gov/new.items/d09250.pdf.

---. 2010. Herbal Dietary Supplements: Examples of Deceptive or Questionable Marketing Practices and Potentially Danger­ous Advice. United States Govern­ment Accountability Office, May 26: Testimony Before the Special Commitee on Aging, U.S. Senate. GAO-10-662T. Available online at www.gao.gov/new.items/d10662t.pdf.

Members of the Independent Investigations Group and sixteen volunteers, including former Olympic gymnast Dominique Dawes, conducted a test of Power Balance bracelets. The results will not be surprising to skeptics.

Power Balance bracelets are silicone wristbands that are embedded with two Mylar holograms. On October 21, 2010, the Independent Investigations Group (IIG) conducted a double-blind test to determine whether Power Balance’s claims that the holograms on their bracelets (then selling online for $29.95) work with the body’s “energy field” to improve strength, flexibility, and balance by “optimizing the body’s natural energy flow.” The company’s website also included a tangle of information that attempted to draw connections between Eastern medicine, “body frequencies,” and “positive energy.” The following excerpt, once available on the Power Balance site, gives insight into the company’s rationale behind its product: “Most everything has a frequency inherent to it. Some frequencies react positively with your body and others negatively. When the hologram comes in contact with your body’s energy field, it allows your body to interact with the natural, beneficial frequency stored within the hologram. This results in improved energy flow throughout your body.” (See Harriet Hall’s excellent article about these claims, “Power Balance Technology: Pseudoscientific Silliness Suckers Card-Carrying Surfers,” in the May/June 2010 Skeptical Inquirer; also available online.) The company relies heavily on testimonials from blue-chip pro athletes like Shaquille O’Neal of the Boston Celtics, Lamar Odom of the Los Angeles Lakers, and Derrick Rose of the Chicago Bulls. Odom and others are paid to endorse the product and do wear the bracelets during games.

The Power Balance bracelets and their hologram stickers.

Power Balance once used highly subjective applied kinesiology tests to demonstrate that the bracelets work. In these types of “tests,” one person analyzes another’s resistance and balance by applying pressure in various ways. (The applied kinesiology videos are no longer on Power Balance’s website, www.powerbalance.com.)

A volunteer running the test course.

The applied kinesiology method of testing the bracelet’s effectiveness is problematic and full of flaws for a number of reasons. There is no way to know from videos of these tests how much pressure the tester is exerting, whether the technique used to apply the pressure is identical each time, or whether the resistance from the person being tested is the same each time. Most people’s flexibility seems to improve from their first stretch to their second stretch regardless of whether they are wearing the bracelet. (I invite you to try this for yourself using no bracelet.)

Also, the people being tested may unconsciously change their own resistance when they know the bracelet is on and think it should be helping. Indeed, the psychological effect of believing the bracelet will help may be the only real effect Power Balance can claim. Every athlete knows that confidence is an asset.

To remove this suggestive influence of the bracelets, we decided to test sixteen volunteers, including former Olympic gymnast Dominique Dawes, on a brief obstacle course that included a 16’×4”×4” balance beam, a figure-eight–shaped course (which our volunteers ran while holding two thirty-pound dumbbells), and a stretch test. Dawes was there with Yahoo News, which shot some video of our test for a story. Dawes, by the way, arrived with a healthy skepticism that seemed to get even stronger when she learned of the test results.

The test was double blinded: neither the test participants nor the testers knew which bracelet was the “real” Power Balance band.

In random order, each of the sixteen volunteers went through the course four times: once with the real bracelet on and three times with each of the bracelets that had no holograms. The test was double blind; we taped over the bracelets so that no one—volunteers and testers alike—knew whether each volunteer was wearing a real Power Balance bracelet or one that had had the holograms removed. The power of suggestion was therefore eliminated.

By the end of the test, each of the four bracelets (labeled A, B, C, D)—three sans hologram and one “genuine”—had been carried through the course a total of sixteen times. We distributed the bracelets equally among the volunteers through all four rounds of trials to ensure that no bracelet had a numerical or sequential advantage at any given time. (We considered that the experience of running the course in early trials might help the subjects improve their times in their subsequent attempts. To correct for improving scores due to familiarity with the course—sometimes called the “Order Effect”—four people wore bracelet A in the first round, four different people wore bracelet A in the second round, and so on, for each of the four rounds.)

So what happened?

If the one genuine Power Balance bracelet had an intrinsic value that really did confer better balance, flexibility, and strength upon its user, we should have seen cumulatively better scores from the people who wore that bracelet (C) when compared to the people wearing the three “dummy” bracelets (A, B, and D). The overall scores between the four bracelets were in fact very close together: half the participants who wore the real bracelet did slightly better, and half did slightly worse—exactly as would be expected by chance. Table 1 shows the results of the obstacle course. Bear in mind that a lower time indicates a better performance. When it came to flexibility, the results were much the same: the overall scores were very close. This time, the Power Balance bracelet (also C in Table 2) fared slightly better than the other bracelets but, again, not significantly so.

Our initial conclusion was that Power Balance bracelets have no discernable effect when the wearer doesn’t know whether or not he or she is wearing one with a hologram. In other words, the bracelet itself doesn’t seem to be doing anything. These results are consistent with work done by Richard Saunders for the Australian Skeptics (see “Power Balance Down and Out,” SI, News and Comment, September/October 2011) and by John Porcari at the University of Wisconsin at Lacrosse, both of whom conducted blinded tests of Power Balance’s efficacy and found no difference between Power Balance products and dummy stand-ins used to blind the user.

The IIG at CFI–Los Angeles has now added its findings to the growing pool of Power Balance’s negative test results. Although the bracelet might have some value as a sort of rabbit’s foot meant to boost one’s confidence, Power Balance bracelets are a bust as a boon to one’s athletic prowess.

It was like déjà-vu. In 2008, in a traveling exhibition called “Vatican Splendors,” I had seen the Holy Mandylion, also known as the Image of Edessa, which was once held to be the miraculous self-portrait of Christ (Nickell 2009). Now, in Genoa the following year, I was seeing another such image and recalling how in the Dark Ages the Image was said to be able to miraculously duplicate itself—one way to explain how there could be so many “originals.”

Pious Legend

The original, according to legend, was produced for King Abgar of Edessa after he sent a messenger, Ananias, with a letter to Jesus requesting a cure for the king’s leprosy. If Jesus was unable to come, Ananias was instructed, he was to bring the holy man’s portrait instead. But as Ananias attempted to paint a picture Jesus himself intervened, washing his face in water and inexplicably imprinting his visage on a towel—hence the name Mandylion, a unique word of Byzantine Greek coinage describing a holy facecloth (Wilson 1979, 272–290; Vatican 2008).

Alas, this legend is unknown before the fourth century; moreover, there are conflicting versions. One attributes the Image to the bloody sweat exuded by Jesus during his agony in the Garden of Gethsemane (Luke 22:44). A later legend holds that a woman named Veronica, who pitied Jesus as he struggled with his cross on the way to his crucifixion, gave him her veil or kerchief with which to wipe his bloody, sweaty face. In fact, however, this made-up tale obviously derives from the fact that veronica is simply a corruption of vera iconica, medieval Latin for “true image” (Nickell 2007, 71–76). In one revealing fourth-century text of the Edessan legend, the image is not claimed as miraculous but instead merely the work of Hannan (Ananias), who “painted a portrait of Jesus in choice paints” and gave it to the King (qtd. in Wilson 1979, 130).

Astonishingly, many Shroud of Turin devotees, following Ian Wilson (1979, 119–121), believe the “shroud” is the lost original of the Edessan Image! How do they equate the latter’s face-only image with the full-length, front-and-back bodily images of the Turin cloth? They imagine the shroud was folded so that only the face showed—never mind its lack of record for over thirteen centuries, a bishop’s report of the forger’s confession, pigments and paint that make up the image and “blood,” and radiocarbon dating to the time of the forger’s confession: about the middle of the fourteenth century (Nickell 1998; 2007).

Competing Mandylions

According to the authoritative source The Dictionary of Art (Turner 1996), the Edessan Image “entered Christian iconography during the 11th and 12th centuries, first in manuscript picture cycles that were elaborated to accompany narratives of the Edessan legend and then as part of a fixed scheme of images in church decoration.” Three of these “original” Mandylions have received the most attention, each supposedly having been the very one brought to Constantinople in 1204 by crusaders. One, the Parisian Mandylion, was acquired by King Louis IX in the thirteenth century and became lost in 1792, probably destroyed in the French Revolution.

Of the two surviving examples, the Vatican Mandylion has no certain history prior to the sixteenth century. In 1517 the nuns of San Silvestro in Capito were reportedly forbidden to exhibit it so that it would not compete with their church’s “Veronica” (Wilson 1991). The Vatican now concedes (in the official Vatican Splendors exhibit text [Vatican 2008]) that “. . . the Mandylion is no longer enveloped today by any legend of its origin as an image made without the intervention of human hands. . . .” I understand this to be an admission that not only is the Vatican version merely an artist’s rendering but that such is true of all Mandylions.

This brings us to the other surviving image, the Genoese Mandylion. It, too, lacks meaningful provenance. It is allegedly traceable to the tenth century, but its verifiable history dates only from 1362. At that time Byzantine Emperor John V donated it to Genoa’s Doge Leonardo Montaldo after whose death in 1384 it was bequeathed to the Genoese Church of St. Bartholomew of the Armenians. It arrived there in 1388; that is where it remains and where I photographed it (Figure 1), displayed in a gilt-silver enameled frame of the fourteenth-century Palaeologan style.

Interestingly, fragments of ancient Persian and Arabian fabrics were found stuck on the back of the Genoese icon panel. The Arabian fragment is from the sixteenth century, whereas the figural silk Persian one has been attributed to the tenth century on stylistic grounds. However, radiocarbon testing of the wood gave a more reliable date range of 1240–1280 (Wolf 2005).

Similarities

Both the Vatican and the Genoese Mandylions are painted (the Genoese in egg tempera, the Vatican apparently the same) on linen cloth that has been glued to a wood panel (Vatican 2008; Church of St. Bartholomeo degli Armeni 2009; Wilson 1991, 113–114, 137–138). However, both X-rays and tomography (an X-ray technique whereby selected planes are photographed) reveal that the Genoese image-bearing cloth covers an original image painted on wood (Bozzo 1994). Also, the Vatican’s on-cloth image shows alterations (in X-rays and reflectographic and thermographic photographs), especially in the nose, which was originally shorter, “so that the image originally must have had a different physiognomy” (Vatican 2008, 58).

In 1996, the Vatican Museum’s experts concluded (according to Vatican 2008, 58):

The version in the Vatican and the one in Genoa are almost wholly identical in their representation, form, technique, and measurements. Indeed, they must at some point in their history have crossed paths, for the rivet holes that surround the Genoese image coincide with those that attach the Vatican Mandylion to the cut-out sheet of silver that frames the image. . . . So this silver frame, or one like to it must also have originally covered in the Genoa.

See my summary comparison of the two Mandylions (Table 1—based on Vatican 2008; Bozzo 1974; Wolf 2005).

Table 1. Summary comparison of the Vatican and Genoese Mandylions.

Indeed, the images themselves, as they now appear to the eye, are remarkably alike. Measurement ratios—involving the most critical areas: the eyes, lengthy nose, and mouth—are strikingly similar. Therefore, when photographs of the images are brought to the same scale (based on inter-pupillary distance), those features effectively superimpose, as I determined by using computer-generated transparencies. (These were prepared by CFI Libraries Director Tim Binga using photos taken by art experts [Wilson 1991, plates 13 and 14]. However, the lack of a forensic scale in each prevents reaching a definite conclusion as to whether tracing might have been involved.)

Conclusions

Since the prototypical image for the later Mandylions and “Veronicas” first appeared in Constantinople in the tenth century, many copies have been made. In one known seventeenth-century instance, no fewer than six “exact” facsimiles were carefully made. Such replicas could later be mistaken for or misrepresented as the original, as happened, for example, with one that was specially made and sent to plague-ridden Venice in the 1470s; it later became known as the Holy Face of Alicante in Spain (Wilson 1991, 101–108).

Perhaps this is what occurred in the case of the two existing Mandylions. The Genoese image, with its older provenance and two-stage creation, appears to be the earliest. Its original image was certainly an artist’s copy, since it was painted not on cloth but directly on the wood panel. (One source reports that it has the same dimensions as the missing central panel of a triptych in the St. Catharine’s Monastery at Mount Sinai [Wolf 2005].)

Vatican experts acknowledge the evidence suggesting that their Mandylion is “a later replica of the one now in Genoa; that it was produced in the fourteenth century, when the Genoese version . . . was given its existing Palaeologan frame; and that it was then placed in the silver frame of the older version,” thus explaining the matched rivet holes (Vatican 2008, 57). Their main reservation is that the alterations in the Vatican image’s features (especially the nose) may be inconsistent with a simple, direct copy. However, it would seem that the alterations might be due only to the image having been alternately painted and corrected in the freehand process of copying it. Expert examination, in fact, showed “no signs of overpainting” (Vatican 2008, 57).

In brief, then, the totality of evidence is most consistent with the hypothesis that the Genoan Mandylion is a replica, made no earlier than the thirteenth century, and that the Vatican Mandylion is a fourteenth-century copy of that replica. There is no proof that either was directly copied from the now-lost twentieth-century “original,” and instead there is proof against it. Neither is there any credible evidence that there was an authentic first-century image of Jesus—miraculous or otherwise. The Shroud of Turin is not such an original, having been proven to be the work of a confessed forger in the middle of the fourteenth century. Thus, the shroud image simply followed the traditional likeness and not the other way around.

Acknowledgments

Many people helped with this research project. Massimo Polidoro saw to it that I was invited to Italy’s largest science festival (October 30–November 1, 2009); he and others, including Luigi Garlaschelli, Enrico Scalas, Beatrice Mautino, Stefano Bagnasco, Marta Annunziata, and Andrea Ferrero, showed me many kindnesses and accompanied me to various sites for research. I am also most appreciative of Fabio Lottero of Genoa, who returned to St. Bartholomew’s to obtain for me an English translation of the official brochure. Closer to home, I am grateful to Tim Binga, Lisa Nolan, Henry Huber, Matt Cravatta, Paul E. Loynes, Chris Fix, and Barry Karr for their help with various aspects of my travel and research—in addition to my longsuffering wife, Diana Harris, who accompanied me in 2008 to view the traveling Vatican exhibit.

References

Bozzo, Collette Dufour. 1974. Il ‘Sacro Volto’ di Genova. Rome: Instituto Nazionale d’Archeologia e Storia dell’ Arte; summarized in Wilson 1991, 88, 113–114, 138.

Church of St. Bartholomeo degli Armeni. 2009. The Holy Face (Official brochure, in English).

Nickell, Joe. 1998. Inquest on the Shroud of Turin: Latest Scientific Findings. Amherst, New York: Prometheus Books.

———. 2007. Relics of the Christ. Lexington, Kentucky: University Press of Kentucky.

———. 2009. The Image of Edessa revealed. Skeptical Briefs 19(2)(June): 9–10, 15.

Turner, Jane, ed. 1996. The Dictionary of Art. 34 vols. New York: Grove’s Dictionaries, 20:251, s.v. Mandylion of Edessa.

Vatican. 2008. Mandylion of Edessa. In Vatican Splendors: From Saint Peter’s Basilica, the Vatican Museums and the Swiss Guard. Vatican City State: Governatorato, 55–58.

Wilson, Ian. 1979. The Shroud of Turin: The Burial Cloth of Jesus Christ? Revised ed. Garden City, New York: Image Books.

———. 1991. Holy Faces, Secret Places: An Amazing Quest for the Face of Jesus. New York: Doubleday.

Wolf, Gerhard. 2005. Das Mandylion von Genua. Available online at www.mpg.de/840449/forschungsSchwerpunkt1.

Massimo Polidoro examines the icon that had wept while Father Avondios looks on.

Tears and a Strange Potato

“It was around 4:30 PM and we were cleaning up the church right before the Vespers,” said Archbishop Avondios. “Suddenly, somebody noticed that the painting with the Madonna in our church was weeping. The same way as it did last year.” In April 2010, the same thing allegedly happened, and it is said that there had been another weeping in 2008.

“A miracle? We don’t use that word,” said Avondios. “But something has happened. And it is not a trick.”

A few days after the event, an Italian television show devoted to the paranormal, Mistero, called me asking if CICAP, the Italian skeptics committee, was interested in investigating the case. Of course we were. After obtaining permission from the Archbishop, I went to the little church in Via San Gregorio. The place is quite unique, since the Orthodox Church has been established inside the only remaining building of what was once the Lazzeretto, the place where those suffering from the plague were brought between the fifteenth and seventeenth centuries. The building was once a huge square, but in the following centuries, when the city grew much larger, it was torn down in order to allow for the construction of roads and houses in what is now part of downtown—one of the busiest quarters of Milano.

Father Avondios was there waiting for me, and he was quite willing to help. However, before visiting the church and looking at the painting, we had to wait for the television crew to arrive. So he told me that there was at least one prodigious event that had already taken place since the latest weeping. He introduced me to a woman named Nechita from Eastern Europe who told me that until some weeks before she seemed unable to become pregnant. However, after visiting the icon and praying to the Madonna, the happy event took place and she was now with child.

A close-up of the sliced potato in its water box.

As further proof that something miraculous was going on, she showed me a curious relic. In a plastic box filled with water were two slices of a potato. While cooking at home, Nechita saw a strange dried-up shape that resembled a little tree inside a potato she had cut open. She took it as a sign and decided to keep the slices. Furthermore, although the potato had been cut awhile ago, it had not become dark: it still was clean and white, as if it would keep fresh forever. “We have asked around and nobody has ever seen anything like that,” said Nechita. “I am sure that is part of the miracle.” I photographed the slices just before the television crew arrived.

Tiny Drops of Something

We finally entered the cramped room that served as the main church hall, where dozens of sacred paintings, icons, reliquaries, and candles were kept and where women were allowed inside only with their head covered by a shawl. It contained a painting of the Madonna with baby Jesus and two little angels crowning her—a classic orthodox icon, probably not more than fifty years old, with gold and red as the prevailing colors and writing in cyrillic inside it.

The picture had now been put in a case with a glass cover over it in order to preserve it, whereas when the weeping occurred it was left in the open and people could touch it (and they constantly did, as a few films available on the web clearly show). For this occasion, while the cameras were rolling, Father Avondios promptly opened the case and took the painting out for us to see up close. There were traces of some liquid, which had oozed and had now dried up, starting at the eyes of both the Madonna and Jesus and trailing down. “You see?” asked Father Avondios. “There still are little drops of tears. It is still weeping.”

Father Avondios showing the sliced potato with tree shaped signs.

It was not actually “weeping,” but as I looked closely at the painting I could see that there were in fact tiny little drops of something that still hadn’t dried. By running some new cotton swabs on the painting, I was able to capture some of those traces. The idea was to take them to the lab in order to see if some kind of analysis was possible. Father Avondios, a quite young Archbishop with a nice eastern accent and a good sense of humor, was quite helpful. He even took off some splinters from behind the painting with a knife in case we needed to examine those as well.

For the moment that was all I could do. Later I gave the samples to my good friend and colleague Luigi Garlaschelli, a chemist at the University of Pavia, and he checked with their labs to determine what sort of analysis was possible.

A Partial Solution to the Mystery

While that was going on in Pavia, I was interested in checking on the mysterious potato slices. I reached the Agronomy Department at the Regione Piemonte in Turin, where I knew some people who had been crucial in solving a previous “vegetable mystery.” I had been shown some apples on whose surfaces odd drawings and dark wavy lines had appeared—bizarre but not uncommon. In fact, it turned out that the apples were suffering from an infection due to poor preservation. I got a similar answer in the case of the strange “tree” in the potato slices. It was a well-known form of plant disease called “empty heart,” which is caused by imbalances in nutrients and water. As for the potato remaining preserved, the agronomists explained to me that it is a natural reaction to the fact that the slices were kept under water. Oxygen is what turns a potato or a fruit dark, and the lack of it can only slow down the decaying process.

In a few weeks, Garlaschelli had the results from the Mass Spectrometry Labs in Pavia. It turned out that the substance found on the painting was some kind of vegetable oil. The suspicion that the painting itself had produced the oil was immediately discarded because a) oil paint is made with mineral oil because vegetable oils are easily perishable and b) if it was a natural transudation it would have taken place all over the painting and certainly not only around the eyes of the Madonna and her baby.

What conclusions can be drawn? The most logical one is that the oil came from outside the painting and it was either made to appear by some supernatural (and unproven) means or somebody put it there—it is now impossible to guess who and why. There were many people freely moving around the church area while I was there, and—as shown by various news clips—the painting had been left without a glass cover before our arrival, so anybody who wished could reach and touch it.

Father Avondios wrote to me later: “We have always been and will be very careful in our statements and in declaring true an event or an apparition, independently from the results of the analysis. I have always been open and curious, and that’s why I allowed for the tests to be performed. We will still worship and respect the icon of the Madonna not because of a supposed miracle but as an instrument of devotion to the Mother of our Lord.”

During our investigation, the police department had concluded work on another weeping Madonna case. This one was a print of a Madonna owned by a couple in Messina, Sicily, that they swore had wept blood. The house had since then been visited by thousands of pilgrims. Finally, the police were able to determine that the blood was human and that the DNA belonged to one of the owners. Now the couple risks charges of “abuse of popular credulity,” something that Italian law still considers a crime.

However, to patients suffering from an incurable disease a new idea represents one thing: hope. Science, by contrast, cares only about what works and is dispassionate, which is easily portrayed as heartlessness. Hopeful nonsense thus has a public relations advantage over pitiless science every time.

We are seeing this effect now with a new idea in the science of multiple sclerosis (MS). A lone Italian vascular surgeon, Paolo Zamboni, proposed that MS is not caused by an autoimmune process (the immune system attacking the nervous system) but rather by blockages in the veins that drain blood from the brain. He published his initial study that found a “dramatic” association between MS and these venous blockages (Zamboni et al. 2009). He called the condition chronic cerebrospinal venous insufficiency (CCSVI).

The paper set off a bitter controversy. Zamboni is suggesting that decades of MS research have been on the wrong track and that he has found the true cause—and potential cure—of MS with a simple diagnostic procedure. The press loved it—a lone maverick challenging the status quo with a bold new idea. Many patients with progressive and difficult-to-treat MS also loved it, for it provided hope of an effective treatment. (As an aside, there are several effective treatments for MS but not all types of MS or all patients respond.) When the neurological community treated Zamboni’s claims with (perfectly reasonable) skepticism, some patients began to weave conspiracy theories to explain the resistance. They wanted the new treatment, and they didn’t want stuffy neurologists getting in the way because their turf was being threatened by a surgeon (at least that is the narrative they told each other.) But science is pitiless and doesn’t care for narrative, turf, or good headlines.

Despite the low plausibility and the fact that Zamboni’s claims ran counter to the carefully accumulated MS research to date, many centers set about to replicate his findings. Replication is a key process in science. If a phenomenon is real, then it will be real in any lab. Zamboni’s findings were dramatic, so they should be easy to replicate.

Two years later we have several good replications. One study did produce similar findings to Zamboni, although the association was not as strong (Al-Omari and Rousan 2010). The next three, however, were all dead negative (Sundström et al. 2010; Doepp et al. 2010; Krogias et al. 2010). Skepticism mounted. Another study this year comparing MS patients to normal controls concluded, “This triple-blinded extra- and transcranial duplex sonographic assessment of cervical and cerebral veins does not provide supportive evidence for the presence of CCSVI in MS patients. The findings cast serious doubt on the concept of CCSVI in MS” (Mayer et al. 2011).

The largest replication to date (Zivadinov et al. 2011) found a small association between venous blockage and MS and concluded, “Our findings are consistent with an increased prevalence of CCSVI in MS but with modest sensitivity/specificity. Our findings point against CCSVI having a primary causative role in the development of MS.”

These findings are interesting. They do not entirely rule out a correlation between CCSVI and MS. However, the results are very ambiguous. There is a statistical correlation between MS and CCSVI, but there is also a correlation with other neurological diseases—with very different histories and probable causes from those of MS. CCSVI was also found in a quarter of healthy controls. So CCSVI is not specific to MS, and almost half of MS patients do not meet criteria for CCSVI.

To summarize all of the existing research on CCSVI and MS: The results are mixed with variable methodology used but are generally negative. No one has found the dramatic results first published by Zamboni. After a couple years of research, his implausible idea is not looking very good. At best we can say that there may be a small and inconsistent correlation between venous blockages and MS. If the correlation is true, it is also possible that these blockages are a result of MS, perhaps caused by inflammation, and are not necessarily a cause of MS.

Despite these largely negative findings, there are still many MS patients clamoring for treatment. The treatment of CCSVI is called the liberation procedure (essentially opening up the blocked veins, a procedure not without risk). Clinics are opening up offering the treatment to desperate patients—putting treatment ahead of the evidence or even using a treatment in the face of negative evidence, which is always a bad idea.

There are also calls, especially in Canada, for clinical trials of the liberation procedure. Such trials are not justified by the science that has been done so far, but because clinics are already offering the liberation procedure, this may force the hands of MS researchers. Before subjecting people to experimental medical interventions, ethics demands that we do sufficient basic science research to demonstrate that there is at least a reasonable chance of benefit. We have not crossed that line with CCSVI and the liberation procedure. Advocates of the procedure, however, are likely to succeed in making an end run around the usual safeguards of ethical medical research.

Those promoting CCSVI and the liberation procedure are likely to be portrayed by some in the media and by hopeful patients as brave mavericks. That is the hopeful, romantic, and sensational view. I suspect, however, that in the end the science will tell a different story.

References

Al-Omari, M.H., and L.A. Rousan. 2010. Internal jugular vein morphology and hemodynamics in patients with multiple sclerosis. International Journal of Angiology 29(2): 115–20.

Doepp, F., F. Paul, J.M. Valdueza, et al. 2010. No cerebrocervical venous congestion in patients with multiple sclerosis. Annals of Neurology 68 (2): 173–83.

Krogias, C., A. Schröder, H. Wiendl, et al. 2010. Chronic cerebrospinal venous insufficiency and multiple sclerosis. Critical analysis and first observation in an unselected cohort of MS patients. Der Nervenarzt 81(6): 740–46, DOI: 10.1007/s00115-010-2972-1.

Mayer, C.A., W. Pfeilschifter, M.W. Lorenz, et al. 2011. The perfect crime? CCSVI not leaving a trace in MS. Journal of Neurology, Neurosurgery and Psychiatry 82(4): 436–40.

Sundström, P., A. Wåhlin, K. Ambarki, et al. 2010. Venous and cerebrospinal fluid flow in multiple sclerosis—a case-control study. Annals of Neurology 68(2): 255–9.

Zamboni, P., R. Galeotti, E. Menegatti, et al. 2009. Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. Journal of Neurology, Neurosurgery and Psychiatry 80(4): 392–9.

Zivadinov, R., K. Marr, G. Cutter, et al. 2011. Prevalence, sensitivity, and specificity of chronic cerebrospinal venous insufficiency in MS. Neurology 77(July): 138–44.