Reviewing a high-school book in health

Glencoe Health
1993. 758 pages. ISBN of the teacher's edition: 0-02-652488-0.
Glencoe Division, Macmillan/McGraw-Hill School Publishing
Company, 936 Eastwind Drive, Westerville, Ohio 43081.
(This company is a division of McGraw-Hill, Inc.)

The Sales Pitch Is Grand,
the Book Is Unacceptable

Jeana D. Levinthal

The book opens with a long sales pitch directed at the teacher. "Glencoe Health is current," the pitchman says. "It's relevant. And it deals with the most critical issues in health education by going in-depth and striking a personal chord with your students."

Further claims appear to push the idea that a teacher who uses Glencoe Health will be able to give a course without having to do much of anything. "Every page," the pitchman says, "represents hours of research and preparation. So you don't have to do it -- we already have." To dispel any suspicion that the teacher might have to know something about health, he says that "All answers to Lesson Reviews and Chapter Reviews are provided," and he declares: "You name it, and we've done it for you." This announcement introduces an assortment of ancillary materials, including lesson plans, quizzes, posters, computer software, transparencies, and even some supplementary booklets.

Turning now to the body of the book, I find that, in comparison with the 1989 version, it is organized in a more logical way. Part One, titled "You," focuses on the individual and covers general health, mental health and social health. Part Two, "Your Body," has a unit about the life cycle and then a unit about various anatomical systems. Part Three, "Your Choices," consists of seven units and deals with fitness, nutrition, medicines, addictive substances, diseases, "Community and Environmental Health," consumer affairs, and safety. Throughout the book, the text is encyclopedic and includes a lot of material that has been carried over, complete with errors, from the 1989 version.

Where sections have been rewritten, the new text is generally clearer than the old text was. Another welcome change is that the new book puts less emphasis on vocabulary lists and generally avoids trying to tell the student how to pronounce new words.

The graphic design is still busy, still characterized by short paragraphs, lots of red headlines, lots of photographs, and lots of distracting sidebars and boxes.

What Is "Intercourse"?

"Is there any point [Gregory asked] to which you would wish to draw my attention?"

"To the curious incident of the dog in the night-time."

"The dog did nothing in the night-time."

"That was the curious incident," remarked Sherlock Holmes.

In fairness, I must acknowledge some improvements in Glencoe's basic treatment of the male and female reproductive systems. The illustrations pertaining to those systems are better than were the illustrations in the 1989 book, the descriptive text is much better, and it tells that "The functions of the male reproductive system are the production of sperm and the transfer of sperm to a female's body during intercourse." (In the 1989 book, the male system just made sperm cells. There was nothing to tell that reproduction required delivering those cells into a female.) But even though the 1993 book mentions "intercourse," it doesn't explain what "intercourse" means, and neither intercourse nor sexual intercourse appears in the glossary or the index.

The writers' refusal to deal with practical, critical aspects of sex shows up in other ways as well. The section called "What to Do After Rape" merely suggests that a rape victim "Get medical screenings for pregnancy, sexually transmitted diseases, and HIV infection." But what if the "screenings" yield positive results? The writers don't say anything about therapy. There is not a word about treatment with ethinyl estradiol to stop an incipient pregnancy. There is not a word about treatment with ceftriaxone and doxycycline to thwart incipient Chlamydia infections, gonorrhea or syphilis.

The passage titled "Menstrual Cramps" merely notes some folk remedies that involve exercise, a warm bath or a heating pad. Why don't the writers tell that dysmenorrhea can be treated with antiprostaglandins? Why don't they explain that women can prevent ovulation, and so can prevent dysmenorrhea, by "going on the pill"?

Particularly distressing, as a demonstration of how the writers have shunned intellectual honesty, is the section called "Advances in Human Genetics." It says:

One way to help prevent genetically caused birth defects is to identify carriers. Genetic counselors can advise families about the probability of having a child with a genetically related disease. They also can guide families of children with genetic disorders about possible treatment options.

That represents a tiny step beyond what the 1989 book said, because it acknowledges the idea of prevention, but it is still inaccurate and misleading. In the real world, the principal strategy for preventing congenital disorders is prenatal diagnosis, coupled with a decision about whether a defective fetus should be carried to term or should be aborted.

If teachers want to furnish students with practical, honest information about sex and reproduction -- the kind of information that can save lives -- they will have to look elsewhere. Glencoe Health does not provide it.

In the 1993 version, the treatment of tobacco, alcohol, illegal drugs and related topics has been greatly improved. The section about tobacco has been expanded from eleven pages to eighteen, and this seems appropriate, given tobacco's importance as a cause of disease.

Much less edifying is the collection of errors, half-truths and obsolete notions that have been carried over from the 1989 book. The twenty "reviewers" listed in Glencoe Health include an MD and four PhDs, so the perpetuation of wrong material surprises me. I would expect at least some of those "reviewers" to know (for example) that genes are not "tiny protein molecules"; that a "virus particle" does not consist merely of nucleic acid; that the management of acne is not limited to washing one's face; and that ear infections typically involve the middle ear (not the inner ear), typically arise as secondary effects of colds, and cannot be prevented by wearing ear muffs or a hat. I would expect some of the "reviewers" to be familiar with today's antibiotics and to know that Glencoe's passage about antibiotics is out-of-date by 30 or 40 years. I would even expect some of them to tell Glencoe's writers that the word bacteria is plural, so that we wouldn't have to put up with such phrases as "Bacteria is destroyed . . ." (page 417).

Along with old errors, the 1993 book has a lot of new ones. I know that a few errors are bound to creep into any big, encyclopedic book, but Glencoe Health has far too many. Here are just a few examples:

• Page 227: In a sidebar, a young man says that his right eye has "a palsy of the optic nerve," which makes the eye "go off to the right." But there is no such thing as "palsy of the optic nerve," and damage to an optic nerve can't make an eye go anywhere. The optic nerve has no motor function.

• Page 268: Bronchial asthma is no longer considered to be a condition arising from a sensitivity to things such as pollen or dust. Today it is seen as an inflammatory disease triggered by exertion, emotion, infection or allergens, or even by changes in the weather.

• Page 324: Treatment of amblyopia does not include "wearing an eye patch on the weaker eye." The patch is applied to the stronger eye.

• Page 427: In a note to the teacher, Glencoe's writers say that vaccines are "homeopathic" medicines. That claim strikes me as crazy. Homeopathy is a kind of quackery, and "homeopathic medicines" consist of worthless solutions that have no pharmacologic value and produce no medical results other than occasional placebo effects. They have nothing to do with vaccines, and vaccines are not "homeopathic medicines."

• Page 517: It is obviously false to say that all bacteria must have darkness if they are to survive. Think about all the bacteria that live on your face, not to mention all the bacteria that thrive on well illuminated surfaces in your kitchen, such as cutting boards and counter tops.

• Page 546: A note to the teacher says, "STDs are anaerobic organisms that cannot live in aerobic conditions." STDs are diseases, not organisms -- and the pathogens that cause STDs can live in aerobic environments.

• Page 707: "Treatment for rabies is an antibody given in five injections over a month's time." There is no treatment for rabies; rabies is fatal. Those five injections are intended to prevent rabies, and the injected material is a vaccine, not an antibody.

  To these errors, add unsupported claims that smack of pop psychology and psychological quackery. For example:

• On page 42, the student reads that "A new study suggests that writing and sharing your feelings in a journal can actually strengthen your body's immune responses -- its ability to fight infections." I'd like to know who did that "study," how the "immune responses" were measured, and in what medical journal the "study" was published. Glencoe's writers give no such information.

• On page 120, a note to the teacher says that people "who are lonely" have "a low level of killer-cell activity." What medical journal did that come from?

• On page 529: "[Communicable diseases] that were once dreaded can now be controlled through immunizations. . . . However, because some diseases are no longer the threat they used to be, people have become lax in obtaining immunization, and isolated cases of some diseases, such as polio are being reported. An immunization program is essential, just as is the practice of simple biofeedback." This leads to some confused paragraphs about biofeedback: The writers don't seem to know what the term biofeedback means, and they never explain what biofeedback has to do with any "immunization program."

In summary, the 1993 Glencoe Health shows some improvements over the 1989 version, but it is still not a respectable textbook. No matter what Glencoe's pitchman says, this book is not current, does not deal with the most critical issues in health education, and does not furnish "in-depth" information. As for the pitchman's claim that "Every page represents hours of research and preparation" -- I doubt it.

A Confused, Obsolete Text
That Is Not Recommended

David R. Stronck

Some of the book's good points show up in the first chapter ("Your Health, Your Responsibility"), which begins well by saying that health has three major elements -- the physical, the mental and the social. But even this chapter is flawed by a misleading, potentially harmful passage. Trying to promote a three-part conception of health, the writers say: "This approach to health is called a holistic approach. Holistic means `whole,' and the holistic approach considers physical, mental, and social influences on the whole person . . . ." That isn't accurate. The word holistic became popular in the 1960s, as a quasimedical term, but it never has had a reliable meaning. Now it serves prominently as a commercial buzz-word: It is used for dignifying a host of quackish "health" practices and "beauty" treatments, including many that involve spiritism or "Oriental medicine" or other kinds of magic. A health textbook should warn about this, rather than making glib statements that can lead students to accept "holistic" quackery. [See also "Leading Students into the Clutches of Quacks" in TTL, July-August 1994.]

Unfortunately, the idea of a three-part approach to health isn't reflected well in the rest of the book, nor is there sufficient emphasis on the need for individuals to take responsibility for their own health.

Chapter 21, entitled "Understanding Medicines," exemplifies the book's traditional approach. It seems to promote the use of prescription drugs and over-the-counter remedies, and it seems to encourage the attitudes that lead people to enlist such products automatically, for solving their mental or physical or emotional problems. The writers fail to recognize any of the key concepts pertaining to the misuse of legal drugs, and they fail to demonstrate how some non-chemical tactics (such as exercise and a judicious diet) can be used in forestalling or managing hypertension and other diseases.

A similar slant is evident in chapter 29, "Noncommunicable Diseases," which fails to emphasize that many noncommunicable diseases are caused or aggravated by inappropriate behavior. On page 578 the writers correctly say that "you can significantly lower your risk [of heart disease] by paying attention to the factors over which you do have control," and they then provide some short sentences that mention smoking, diet, weight, exercise, and so forth. Unfortunately, they don't offer any data to support their advice. They give much more attention to costly surgical procedures like open-heart operations or the use of artificial hearts.

Later, on page 583, a brief passage about the prevention of cancer includes the statement that "There is evidence that there is a relationship between diet and cancer." The passage is inadequate, and far more space is given to outlining how cancer can be treated by surgery or radiation or chemotherapy.

Here is a sampling of other significant features that I found in Glencoe Health:

Unit 3, "Family and Social Health," comprises chapters 5, 6 and 7 ("You and Your Family," "Your Relationships with Others" and "Marriage and Parenthood"). In chapter 7, marriage is said to be a "long-term, ongoing commitment" and then is defined from a governmental point of view: "In the legal sense, marriage is the joining of a man and a woman according to custom or law. It is a legal agreement between two people to live together and share their lives." The chapter avoids any mention of sex, and the reader does not learn that marriage is universally recognized as an exchange of sexual rights. Here and everywhere else, Glencoe Health shuns the concept or sexual intercourse; even chapter 15, "Reproductive Systems," fails to explain how reproduction happens. Glencoe's closest approach to acknowledging coitus is one sentence on page 303: "During intercourse, semen is deposited in the vagina." But "intercourse" is not defined, even in the glossary, and how "semen is deposited" remains a mystery. Certainly, high-school students need a clear understanding of reproduction, and they need to know about reproduction before they try to understand marriage.

Unit 4, "The Life Cycle," starts with chapter 8 ("The Beginning of the Life Cycle"), which displays some major scientific errors. On page 144 the writers falsely say that genes are "tiny protein molecules." But then they contradict themselves, on the next page, by saying that "Each gene consists of a part of a DNA molecule." The latter claim introduces a confused, erroneous passage that mentions something about "bases" but doesn't even tell what "bases" are. [See "Glencoe's Ridiculous Genetics" in TTL for May-June 1993.] How did such material get into print? According to the teacher's edition, the two authors of Glencoe Health hold PhD degrees, and the thirteen "reviewers" who examined this book included three PhDs and a physician!

The next chapter is titled "Adolescence," and we would expect it to say something about the anatomical and physiological changes that teenagers experience as they approach and attain sexual maturity. Understandably, these topics are of great interest to students. Strangely, Glencoe's chapter says very little about them. There is only a fleeting mention of "secondary sex characteristics," which "include body hair and the development of breasts in the female and muscles in the male." And though the term secondary sexual characteristics implies that there must be other traits called primary sexual characteristics, the chapter says nothing about these.

In Unit 5, "Body Systems," the chapter titled "Digestive and Urinary Systems" gives recommendations for "Care of the Digestive System," but it omits most of the guidelines that were issued in 1989 by the National Research Council. It makes a nebulous reference to a diet "low in fat," but it does not acknowledge the NRC's recommendation that no more than 30% of a person's calories should come from fats. It does not even tell that the NRC advised Americans to maker substantial increases in their consumption of fruits and vegetables.

Unit 6, "Personal Health and Physical Fitness," has a chapter called "Making Responsible Food Choices," and here the writers do a somewhat better job of dealing with diet. Some of the recommendations in this chapter are respectable. As a whole, however, the chapter is dominated by food-group legends, and it seems to owe something to the advertising messages put forth by the National Dairy Council and other commercial groups. An especially deplorable item in this chapter is the irresponsible "Health Update" box on page 391. Purporting to tell about the "issue" of eating meat, it lists alleged arguments without suggesting whether the arguments are supportable, and it indiscriminately mixes facts with opinions. For example, the idea that meat provides amino acids is treated as if it were just a notion held by "some nutritionists"; in reality, of course, it is an indisputable fact. The box also presents mysterious claims about "ill health effects" suffered by strict vegetarians, and claims about links between animal products and various diseases. Who has made those claims? What evidence is involved? The realm of diet and nutrition is a playground for cranks and quacks, so our students must learn to think critically about dietary matters. Glencoe teaches a contrary lesson.

In Unit 9, "Diseases and Disorders," chapter 27 is supposedly about sexually transmitted diseases other than HIV infection. In keeping with Glencoe's practice of evading and obfuscating anything that has to do with sex, the chapter is noticeably mysterious. It mentions condoms, but it doesn't tell what they are or what purpose they may serve. The mention comes on page 538, where the student reads that "Safer sex also means discussing the use of condoms before intercourse . . . ." That is meaningless, because the book never tells what "intercourse" is, and students will surely be puzzled by the suggestion that merely "discussing" condoms (whatever those may be) is a way to achieve safety. At the end of the chapter, the writers say that "the only sure way not to contract an STD is not to be sexually active." That is almost true, but it is of little help to the majority of our high-school students. Most students begin to have sexual relations before they finish the 12th grade, and few of them are going to stop.

HIV infection and AIDS are nominally treated in chapter 28, which is as muddy as chapter 27. On page 556 the writers say that "HIV can be transmitted during any form of sexual intercourse" -- another meaningless statement in a book that never tells what "sexual intercourse" is. On page 559, a list of ways to "lessen the risk of HIV infection" includes "using condoms correctly"; this presumably means discussing them. Various other items in the chapter are incomprehensible or misleading, and a statement on page 558 is false: "All donated blood is now vigorously tested for HIV so that those receiving blood transfusions are not at risk of becoming infected with HIV." Testing can reduce the probability that HIV-bearing blood will be used in transfusions, but testing cannot drive the probability down to zero.

In this sampling of material found in Glencoe Health, I have tried to show why I cannot endorse this book for use in schools. It is obsolete, it contains many factual and conceptual errors, and it evades subjects that teenagers need to understand.

How Glencoe's Text
Promotes Quackery

William J. Bennetta

Glencoe Health is so outrageous in its promotion of quackery that I view it as one of the most irresponsible and dangerous "health" texts on the market. Readers who have seen my article "How a Glencoe 'Health' Textbook Promotes Psycho-Quackery" know that Glencoe Health endorses the "recovered memory" racket. Here I shall describe how Glencoe Health plugs three other kinds of pseudomedical nonsense: chiropractic, acupuncture and homeopathy.

Chiropractic

This was, of course, a reworking of the old doctrine of vitalism, which held that living things possessed a "vital force" or "life force" that transcended the laws of chemistry and physics. Vitalism had already been definitively discredited by science, but science meant nothing to Palmer.

Palmer and his followers blended his "subluxations" with supernatural mumbo jumbo, creating a scheme in which every disease could allegedly be relieved by the manipulation of specific bones. Over the years, chiropractors have claimed that such manipulations can relieve such diverse disorders as amnesia, acne, crossed eyes, epilepsy, goiter, bronchitis, pneumonia, influenza, stomach ulcers, gallstones, whooping cough, dysentery, boils and hemorrhoids (to name only a few). Chiropractors also have become notorious for their irresponsible use of X-ray imaging. Many of them subject their victims to X rays, then use the resulting pictures to support absurd claims about "subluxations." Some even offer free X-ray imaging in their advertisements. ("Full spinal X-ray on your first visit, at no charge!") It is a disgrace that our laws allow quacks to expose members of the public to ionizing radiation as a sales-promotion gimmick.

Today's chiropractors can be divided into three groups:

• The "straight Palmer" chiropractors (as they call themselves) cling strictly to the fantasies that Daniel David Palmer put forth 100 years ago, and they are concerned only with manipulating bones to relieve imaginary "subluxations." This group can be regarded as a sort of cult whose members revere Palmer as a prophet.

• The "mixers" (as they are called by the "straight Palmer" types) combine Palmer-style chiropractic with other ideas and practices, which may include some techniques borrowed from medicine. Most mixers, however, merely combine chiropractic with supplementary forms of quackery, such as nutrition scams, phony "energy therapies," worthless electrical treatments, reflexology, or "applied kinesiology." (To learn about reflexology and applied kinesiology, see The Health Robbers.)

• The third group -- surely the smallest -- comprises some chiropractors who have renounced Palmer's "subluxation" codswallop and who function as physical therapists. These individuals have acquired some respectable training in anatomy, and they concentrate on treating patients who actually may benefit from certain physical manipulations. (In typical cases, the patients are suffering from lower-back pain.) Fewer than 1% of the chiropractors in the United States belong to this group. A vast majority of the chiropractors in this country are "straight Palmer" types or mixers.

Now let us see how chiropractic is promoted in Glencoe Health. This case is curious, for Glencoe's efforts are aimed entirely at duping the teacher. The student's edition of Glencoe Health says nothing about chiropractic, but the teacher's edition has a pedagogic item (on page 657) that purports to tell of "Chiropractic Medicine":

In the late 1800s, the American Medical Association (AMA) denounced chiropractic medicine as quackery and forbade medical doctors from associating professionally with chiropractors. To do so was deemed unethical. As a consequence, for a long time chiropractors were ranked right alongside the sellers of snake oil.

Due to lawsuits brought against the AMA by chiropractors, the AMA officially rescinded its position in the early 1960s. Since then, medical doctors increasingly refer patients to chiropractors, whom they recognize as better trained to deal with certain problems, particularly problems of body alignment.

Glencoe's writers don't tell the teacher what chiropractors are, what chiropractors do, or why the AMA declared chiropractors to be quacks. Instead they recite a deceptive tale that seeks to legitimize chiropractic, without ever describing it, through the use of part-truths, false statements and false implications. A teacher who doesn't know the facts of the matter will, I'm sure, infer that chiropractic once was wrongly condemned by the AMA, but that unspecified lawsuits have vindicated chiropractic and have convinced physicians that it is a valuable form of therapy.

All of that is false. What is true is that some chiropractors sued the AMA in 1976, claiming that they had suffered commercial harm arising from a provision in the AMA's code of ethics: "A physician," the code said, "should practice a method of healing founded on a scientific basis; and he should not voluntarily professionally associate with anyone who violates this principle." The plaintiffs alleged that the AMA had used that stricture to foster an illegal boycott of chiropractic, and they based their lawsuit on the Sherman Antitrust Act. The suit was not about the merits of chiropractic, and it surely didn't raise the question of whether chiropractors were or weren't comparable to the sellers of snake oil. It dealt only with commerce and a supposed restraint of trade.

The resulting case (Wilk et al. v. American Medical Association et al.) was tortuous. The chiropractors were defeated in a jury trial, but they appealed to the United States District Court for the Northern District of Illinois, which found procedural errors and overturned the jury's verdict. The case then was tried before Judge Susan Getzendanner, of the district court, who issued her ruling in 1987. Getzendanner found that the AMA had indeed promoted a boycott of chiropractors from 1966 until mid- 1980, but she concluded that the boycott reflected the AMA's genuine concern for the welfare of patients -- not an effort by the AMA to stifle competition or trade. Still, she deplored the boycott as an unduly strong tactic, and she said that the AMA could have used a "less restrictive approach" to maintaining patient-care standards.

Getzendanner knew that the plaintiffs were hoping for a result which could be used, somehow, to make chiropractic look legitimate, and she addressed that point explicitly. "The plaintiffs clearly want . . . a judicial pronouncement that chiropractic is a valid, efficacious, even scientific health care service," she said, but judgments about chiropractic's merits could come only from scientific studies. Her ruling, she declared, "is not and should not be construed as a judicial endorsement of chiropractic."

By the time Getzendanner made her ruling, the AMA had revised its code of ethics to say that physicians, if they were acting in their patients' best interests, could pursue professional interactions with anyone whom they chose. But this change definitely was not tantamount to an endorsement of chiropractors, no matter what Glencoe's writers imply, and the AMA has continued to warn physicians and the public about the fallacies and dangers of chiropractic. See, for example, the AMA publication Reader's Guide to Alternative Health Methods, issued in 1993.

Glencoe's deceptive tale ends with the claim that "medical doctors increasingly refer patients to chiropractors, whom they recognize as better trained to deal with certain problems, particularly problems of body alignment." That is a big falsehood fashioned from little falsehoods and part-truths. Here are the pertinent facts:

• The notion that "medical doctors" in general are indiscriminately sending patients to an undifferentiated herd of people called "chiropractors" is false. Most medical doctors recognize that most chiropractors are ignorant, dangerous charlatans, and most medical doctors won't have anything to do with such people.

• Only some 3% of the physicians in the United States ever send patients to chiropractors, and that percentage has been stable for some years. It is not increasing.

• The patients whom physicians send to chiropractors are typically persons who suffer from lower-back pain and who present no complications (such as osteoporosis or damaged intervertebral discs). The Glencoe writers are dealing in nonsense when they say that medical doctors refer patients to chiropractors for relief of "problems of body alignment." The term "body alignment" is chiropractic quack-talk; it has no medical meaning.

Acupuncture

The promotion of acupuncture in Glencoe Health is a sustained exercise in falsity. On page 224, in a box labeled "Culturally Speaking," the student reads this:

Acupuncture is the ancient Chinese method of treating disease and relieving pain through the use of fine, sharp needles inserted into specific body points then gently twirled. Many practitioners of acupuncture believe a life force called "chi" moves along meridians, or vertical channels of energy, and that using the needles along these meridians balances the body's energies. Chinese doctors have used this method to treat migraines, mental illness, asthma, arthritis, and other diseases, as well as to prevent pain during surgery.

Scientists speculate that acupuncture increases the brain's output of natural painkillers or that it sparks signals in the nervous system to interrupt pain messages headed for the brain.

Notice the deceptive first sentence, explicitly calling acupuncture a "method of treating disease." Notice the writers' failure to disclose that the idea of a "life force" is a superstition, discredited long ago. Notice how the writers ignore the scientific studies which have told that acupuncture, to the extent that it may function at all, merely functions as a placebo. Notice how they parrot the notion that acupuncture "balances the body's energies," never explaining that this is just meaningless quack-talk.

Most importantly, notice the writers' final claim: "Scientists speculate that acupuncture increases the brain's output of natural painkillers or that it sparks signals in the nervous system to interrupt pain messages headed for the brain." That claim embodies a trick that is used by quacks everywhere: To make their claptrap seem respectable, they try to link it, in some vague way, to "science" or "scientists."

Is there any reason why "scientists" should speculate that "acupuncture increases the brain's output of natural painkillers"? Yes, of course: Scientists know that a brain releases such painkillers (which are called endorphins) in response to countless different stimuli -- a pinch, a burn, a bite, a blow, or what-have-you. Glencoe's writers, however, do not tell this. They deceive the student by falsely suggesting a specific, unique connection between "natural painkillers" and the jabbing performed by acupuncturists.

The same applies to their fancy about "signals in the nervous system to interrupt pain messages." This is just a bogus reference to a common phenomenon: We sometimes can dull the pain associated with a particular stimulus if we can create a counter-stimulus. If you ever have reduced the pain of a burn or a blow by rubbing or squeezing the affected tissues, you are familiar with the phenomenon in question. "Scientists" may speculate that the same pain-dulling effect can sometimes be induced by the jab of a needle, but this doesn't mean that the effect is uniquely associated with acupuncture.

Homeopathy

A typical "homeopathic remedy" involves some material derived from a plant or an animal. This material is dissolved in water or alcohol, and the resulting solution is diluted repeatedly until -- in accordance with the "law of infinitesimals" -- the concentration of the dissolved material is reduced to virtually nil. A dose of the finished remedy may contain only a few molecules of the original substance (or no such molecules whatsoever!), but not to worry. Hahnemann divined that the solution would acquire the curative substance's essence, which evidently had nothing to do with molecules, and that this essence would revive the body's "vital force" and enable the body to heal itself. (Does that "vital force" sound familiar?)

It is worth noticing that all of modern chemistry and modern pharmacology would have to be wrong if Hahnemann's notions were right. Needless to say, there is no evidence that homeopathic remedies have any more medical value than placebos have.

Homeopathy, as such, isn't really popular, and the United States has only a few hundred private practitioners of Hahnemann's craft. The chief manifestation of homeopathy in this country is the purveying of mass-produced "homeopathic remedies" by health-food stores, by door-to-door salesmen, and by mail-order companies that specialize in quack products. Some of these "remedies" are made by the simple process of putting plain water into small bottles, which then are decked with deceptive labels that make (or imply) therapeutic claims.

The reference to homeopathy in Glencoe Health is downright weird. Here again, as in the case of chiropractic, Glencoe's writers are concerned only with fooling the teacher, and they mention homeopathy only in the teacher's edition of their book. Even stranger, they don't favor homeopathy with the sort of direct promotion that they have accorded to chiropractic and to acupuncture. Instead, on page 427, the try to dignify homeopathy indirectly, by equating "homeopathic medicines" with vaccines!

Here is their effort, in full:

Most medicines used today in the U.S. are allopathic, meaning "antagonistic to disease." Antibiotics work antagonistically by destroying disease-causing bacteria. Some medicines are homeopathic, meaning "similar to disease." Polio vaccine is a good example. Children are inoculated with a killed or milder version of the polio virus, which promotes the formation of antibodies without producing the disease. Other homeopathic medicines consist of less harmful strains of the bacteria that normally cause disease. The weaker strains stimulate an immune reaction to the more harmful bacterial invaders, thus enabling the body to heal itself.

Humbug! In truth, the term allopathic was invented by Samuel Hahnemann, as was the notion that all remedies must be either "allopathic" or "homeopathic." That dichotomy has no meaning in science or medicine, of course, though it is still recited by homeopaths and by promoters of "homeopathic" products. (Maybe Glencoe's writers found it in a brochure published by a quack-remedy company.) The writers' claim that polio vaccine is a "homeopathic medicine" is just daffy: There is no connection between vaccines and homeopathy, and vaccines obviously don't comply with Hahnemann's so-called laws. The writers' last claim, about homeopathic medicines based on "weaker strains" of bacteria, is wholly fictitious.

Health educators should have nothing to do with Glencoe's quack-book.

Jeana D. Levinthal is a physician who practices pediatrics in Petaluma, California. Her professional background includes research in virology and viral tumors.

David R. Stronck, a specialist in science education and in health education, is a professor in the Department of Teacher Education at California State University, Hayward.

William J. Bennetta is a professional editor, a fellow of the California Academy of Sciences, the president of The Textbook League, and the editor of The Textbook Letter. He writes frequently about the propagation of quackery, false "science" and false "history" in schoolbooks.

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