The Facts on Oscillococcinum

Intro

Oscillococcinum is an anomaly in the homeopathic materia medica because it is one of the relatively few proprietary preparations. The name is registered by Boiron.

Scarcely known to the English-speaking world, it is one of the most widely used and popular homeopathic medicines in France. But even in France it is anomalous. It is the only homeopathic medicine authorized for routine production in France in a dilution above the 30c, and by the Korsakovian method.

All other homeopathic medicines in France are prepared by the Hahnemannian method, in potencies not exceeding 30c, although higher dilutions may be prepared on a named patient basis. The Korsakovian dilution method involves repeated incomplete emptying and refilling of a single piece of glassware, whereas the Hahnemannian demands fresh glassware for each dilution.

One medical review has only been able to say that the results look promising without giving a recommendation to use it.
History

Oscillococcinum is a 200c potency of an autolysate of Barbary duck heart and liver. It was introduced in the 1930's by Dr Joseph Roy, who believed that it contained a bacterium, Oscillococcus, which caused influenza. We now know that this rationale was spurious, although it is not the first or last instance of an effective medicine being introduced on the basis of a theory subsequently shown to be incorrect. In a further twist, Roy's theory has been shown to be much closer to the mark than once supposed. Wild fowl have been shown to be a major reservoir of human influenza viruses.

Certainly Oscillococcinum is popular with the French public, and it was this popularity which made the legislature feel constrained to make it a special case when regulating the production of homoeopathic medicines.
Study

The popular reputation of Oscillococcinum has now been vindicated by a large scale, double-blind, placebo controlled trial published in the British Journal of Clinical Pharmacology. 487 patients were recruited by 149 general practitioners (mostly non-homoeopaths) in the Rhone-Alpes region of France during the influenza epidemic of January-February 1987.

Entry criteria were: rectal temperature of 38oC or above, and at least two of the following symptoms: headache, stiffness, lumbar or articular pain and shivers. The first manifestations had to have occurred less than 24 hours before entry. Patients with immune deficiency, local infection, or who had been immunized against influenza were excluded.

Diagnosis was purely clinical, although the A H1N1 influenza virus was subsequently identified as being responsible for the epidemic. Patients were randomly assigned to active Oscillococcinum (237 patients) or identical placebo (241 patients), 5 doses at 12 hour intervals. Recovery was defined as temperature less than 37.5oC, with complete resolution of the 5 cardinal symptoms.
Results

After 48 hours, 17% of the active treatment group had fully recovered, compared to 10% of the placebo group. This difference was statistically significant (p=0.03, X2 test). Further analysis showed that the effect of Oscillococcinum peaked at 36 hours, when 40% of recoveries were attributable to the treatment. It was most effective in younger patients - 68% of recoveries within 48 hours in the under-30's were due to treatment; and when the illness was relatively mild - 52% of the recoveries from illnesses classified mild or moderate were due to treatment. Patients on active treatment used significantly less other treatment for pain and fever (50% v 41%, p=0.04), they also judged the active treatment more efficacious than placebo (61% v 49% p=0.02).

The Lancet commented favorably on the trial, remarking that the authors were restrained in their discussion, and describing the difference between placebo and active treatment as 'respectable'. The Lancet's report was "quadruple-blind" mentioning only at the very end that the treatment was homoeopathic.
References

Ferley JP, Zmirou D, D'Adhemar D, Balducci F. A controlled evaluation of a homoeopathic preparation in influenza-like syndromes. Br J Clin Pharmac (1989) 27, 329-335.