Jacob Schor, ND, FABNO

March 9, 2020

I have always appreciated reading catalogs.  As a child much of what I knew of the outside world came from paging through Sears Roebuck and Montgomery Ward catalogs; all the things people could need or want were all listed with explanatory details.  One could pause and study the information and photos and contemplate why someone might want to acquire a certain object.  In my teenage years I switched to studying L.L Bean and REI catalogs and can probably still recite the relative merits of the offerings in each catalog.  Few things will ease me to sleep better than paging through a catalog, especially advertisements for things I have little interest in or use for.

My new favorite catalog comes from a company in Alabama called Forestry Suppliers.  I have on my nightstand their 71th annual catalog.  I chanced upon their company as they seem to be the only remaining manufacturer of a surveying tool called a Jacob Staff.  It may be hard to believe but I sought one of these out, not because of the name, but for its function, even before I knew what it was called.  It’s a simple wooden staff used in a simpler time to balance either a compass or inclinometer on for surveying.  In somewhat ancient times a slightly more complicated tool, a Jacob Cross, was used to calculate the height of objects at a distance, but I digress.  I found this catalog by chance and have enjoyed reading descriptions of various tools and implements that I never knew existed.

My current favorite Catalog

Take for example Skidding Tongs.  I count at least nine to choose from and that’s not including the various (half dozen) timber carriers that are basically a similar shaped tong attached to a crossbar so two individuals can carry a tonged-log between them (the cross pieces are available in both wood or aluminum), or the Cants used to roll logs or Pike Poles, Pickaroons or Hookaroons. There are photos of three dozen handheld compasses to compare.  As one would expect there are axes; throwing axes (including a competition axe sold for $370), splitting axes, felling axes, Yankee hatchets, German type hatchets, forest axes, Hudson Bay axes, boy’s axes, double bit saddle axes, single bit axes, belt axes, Pulaski and Council Axes.  Each are carefully illustrated and described.  Reading any of this material is guaranteed to put me to sleep.

My friend Clark, who I kayak with, carries a handheld gadget on his boat deck that measures windspeed and on particularly gusty days he aims it into the wind and quantifies what I already know, that it’s really windy.  If I was interested in such a gizmo, Forestry Suppliers offer the opportunity to choose between 3 dozen handheld ‘atmospheric data centers’, not to mention pages of weather monitors that will interconnect via Bluetooth in ways I do not understand but am saving up to study on a sleepless night. The catalog offers 15 different types of snake gaiters or chaps, most in a variety of sizes plus other gaiters designed to keep out ticks, chiggers and what not.

Oral Ivy from Boericke & Tafel

I think you’ve got the idea by now.  This catalog offers a compendium of reliable things needed by people who work in the woods, practical, pragmatic things that are used by people who expect and rely on performance.  

The reason I’m writing this article is that just after the pages listing insect repellents, Calamine lotion and other things to prevent itch, (including post contact skin cleansers dispensed either as towelettes or by the gallon (the dispensing pump is extra), there is an interesting product called Oral Ivy ™.  

Let me copy the catalog description:

“Natural protection from the irritation of poison ivy, oak and sumac.

Taken as directed Oral Ivy ™ helps the body safely and naturally fight off ivy, oak or sumac poisoning.  Taken orally you can protect yourself from direct and indirect ivy poisoning.  Just add 3 to 5 drops of Oral Ivy to ¼ glass of water or juice and drink it daily starting 1 to 2 weeks before exposure and continuing daily intake throughout the poison ivy season.  Note: Oral Ivy ™ is an over-the-counter homeopathic medicine extracted with alcohol form poison ivy leaves (Rhus Tox).”

The catalog goes on to say that it is manufactured in accordance to homeopathic principles set forth in the homeopathic pharmacopeia of the United States, so on and so forth.

In fact, this is the classic Boericke & Tafel product, Rhus toxicodendron 3x.

I found it peculiar and kind of out of place to find Oral Ivy  listed in my Forestry Suppliers catalog; it struck me to be something more likely to see at Whole Foods or Natural Grocers.  Perhaps I’m revealing a cultural bias but I’m not thinking that shoppers for hard hats, chain saws and logging boots are the sorts who prefer homeopathic approaches to health care.  The company does not hesitate to sell pesticide application equipment.  One can find pages and pages of herbicides, insecticides, and various sprayers from dainty one-quart handheld misters, to sprayer backpacks, to 65-gallon sprayers that you tow behind your ATV (that’s all terrain vehicle).

Those of us who work indoors might not appreciate what an occupational hazard poison ivy is to many people. Allergic contact dermatitis due to poison ivy (and poison oak and sumac) affects about 50 million Americans each year.  This is the number one cause of allergic dermatitis. [1]

To understand why we find Oral Ivy listed in Forestry Suppliers, we need to go back some years.

Starting in 1953, the year I was born, Elmer Gross, MD, of Wilmington, Delaware, ran a series of studies testing Oral Ivy.  Initially he enlisted 161 private patients from his medical practice; men women and children who had prior episodes of poison ivy reaction. Oral Ivy reduced the frequency and severity of poison ivy episodes in 75% in this group. Starting in 1955, Dr. Gross began enlisting individuals who were far more likely to be routinely exposed to poison ivy; he recruited one hundred employees of the Asplundh Tree Service Company. The results were similar:  again 75% reported significant improvement.  Of the 455 individuals (including 177 tree service workers) he eventually tested, Oral Ivy on, 76.9% reported improvements.  [2]

Ubiquitous Asplundh Truck

It’s hard to argue with something that works, and we must suspect those Asplundh employees were a pragmatic bunch and just kept using Oral Ivy, no matter what the scientific critiques say about homeopathy.  Nearly 70 years later they are still using it.

Reading Dr. Gross’s paper one gets the idea that he experimented with various Rhus tox products.  He notes that oil suspensions of the ivy toxin were judged unacceptable because they were slow to absorb and triggered pruritis ani.  An alcohol dilution was absorbed faster and worked better. [3]

Now there are some who will say that because Oral Ivy is only a 3x dilution, which is one part in a thousand dilution, it isn’t ‘real homeopathy.’ Thus, we might be tempted to make a distinction between its effectiveness and more dilute preparations.

Yet in 2003, Stein and Parsons reported that they had tested 56 subjects using a 6x/12x homeopathic preparation of ivy giving 3 ml orally once a week for 3 weeks and then 3 ml orally once a month for 7 months. Twenty seven of the 56 subjects reported less severe or fewer episodes of poison ivy and twenty-five reported no episodes. [4]  These are clearly in the well diluted ‘classic homeopathic’ range.

Robert Signore added several anecdotal cases in support of using homeopathic Rhus tox prophylactically in an article published in 2017.  [5]

I admit I was a bit surprised to find Oral Ivy in the pages of Forestry Suppliers. But Gross’s early work using it with early customers of this company offers a plausible explanation.  I reached out to the company; they have carried this product in their catalog since 1994.

The way Oral Ivy is used to prevent poison ivy puts it into a category called homeopathic prophylaxis.  This is different than acute prescribing, using homeopathy to try to reduce symptoms already present.  Prophylaxis is preventive.  The homeopathic research found on PubMed can all be divided into one of these two categories.  

There are quite a number of homeopathic preparations that are suggested for prophylaxis, though the research has not always come out in favor as it has with poison ivy products.

A Cochrane review published in 2018 looked at both prophylactic and acute use of homeopathy.  The review by Hawke et al, searched the medical literature for clinical trials using oral homeopathic products in kids to prevent or treat acute respiratory infection. The researchers narrowed findings down to 8 trials that included a total of 1,562 children who received either a homeopathic medicine or some type of a control treatment (placebo or conventional treatment) for upper respiratory infections.  Four studies asked if the treatment could prevent the infections after one to three months of treatment during the year that followed.  Many of these selected studies had significant weaknesses that included methodological inconsistencies, high attrition rates, protocol deviations, high risk of bias and other faults that those who perform these Cochrane reviews take to heart.  The inconsistencies made combining the data to perform a meta-analysis difficult.  The final results were not particularly favorable for the homeopathic treatments.  The studies at low risk of bias showed no benefit from the homeopathic treatments.  The high bias studies did report some mild beneficial effect.  The most statistically significant effects were seen in the two pooled individualized treatment studies (n=155) but these results favored the placebo over the homeopathic medicine.  In other words, these aren’t the sort of results anyone will be in a rush to highlight.[6]

Still, we have long seen homeopathic flu products sold for prevention.  Some of our colleagues promote homeopathic substitutions for standard vaccinations, though I have yet to see any evidence that argues doing so provides benefit.  We see dentists and plastic surgeons who advise patients to take homeopathic arnica before procedures.  This apparently is a fairly common practice in India. [7]  A 2020 review in the Annals of Plastic Surgery promotes a combination of homeopathic arnica and bromelain (though I am unclear whether the authors know what they are talking about as bromelain is typically not used in homeopathic form but as an active enzyme).[8]  I have long followed Dr. Jared Zeff’s recommendation to prescribe a combination of homeopathic remedies pre- and post-surgery (200c of hypericum, arnica, phosphorous, staphysagria, and bellis) and always thought it helpful for patients.  Of course, one may easily write off such perceived benefit as placebo action.

It’s harder to imagine placebo effects in veterinary practice: several recent studies suggest that a homeopathic product, DIA 100, is useful to protect newborn lambs [9] and calves [10] from diarrhea caused by gastroenteritis. 

The way I see this is that some, but not all, homeopathic preparations work.  Just because one particular homeopathic medicine is effective does not mean all homeopathic preparations are equally effective.  Over the years I’ve described that later belief as Arnica Syndrome.  People often get so excited about homeopathy after seeing arnica’s reliable action that they leap to the belief that all homeopathy works equally well; in fact, they sometimes take it a step further and justify believing that any implausible ‘medicine’ that they don’t understand may also work.  

Whatever the case, I plan to order a new wide brimmed aluminum hardhat from Forestry Suppliers, one that will protect me from falling acorns next fall.  And I’m adding a bottle of Oral Ivy to my online cart.

Acorn Protection

[1] Signore RJ. Prevention of poison ivy dermatitis with oral homeopathic Rhus toxicodendron. Dermatol Online J. 2017 Jan 15;23(1). pii: 13030/qt3rm4r9hk.  

Full text: https://escholarship.org/uc/item/3rm4r9hk

[2] Gross ER. An oral antigen preparation in the prevention of poison ivy dermatitis; results in 455 cases of ivy sensitivity. Ind Med Surg. 1958: 27(3), 142-144. Full text: http://www.wholisticderm.com/images/Poison_Ivy_Prevention_Study_GROSS_ER_Oral_Ivy_3X_1956_Indust_Med_Surg.pdf

[4] Stein MF, Parsons E. Effectiveness in Oral Rhus toxicodendron Solution for Poison Ivy. Int J Pharm Compd. 2003 Jul-Aug;7(4):272-5.

[5] Signore RJ. Prevention of poison ivy dermatitis with oral homeopathic Rhus toxicodendron.Dermatol Online J. 2017 Jan 15;23(1). pii: 13030/qt3rm4r9hk.

[6] Hawke K, van Driel ML, Buffington BJ, McGuire TM, King D. Homeopathic medicinal products for preventing and treating acute respiratory tract infections in children. Cochrane Database Syst Rev. 2018 Sep 9;9:CD005974. doi: 10.1002/14651858.CD005974.pub5.

[7] Ghosh S, Panja S, Ghosh TN, et al. Dental Practice Scenario in a Government Homeopathic Hospital in West Bengal, India. J Evid Based Complementary Altern Med. 2014 Jul;19(3):200-204. 

[8] Knackstedt R, Gatherwright J. Perioperative Homeopathic Arnica and Bromelain: Current Results and Future Directions. Ann Plast Surg. 2020 Mar;84(3):e10-e15. 

[9] Fortuoso BF, Gebert RR, Griss LG, et al. Reduction of stool bacterial counts and prevention of diarrhea using an oral homeopathic product in newborn lambs. Microb Pathog. 2019 Feb;127:347-351. 

[10] Fortuoso BF, Volpato A, Rampazzo L, et al. Homeopathic treatment as an alternative prophylactic to minimize bacterial infection and prevent neonatal diarrhea in calves. Microb Pathog. 2018 Jan;114:95-98.