Ian C. Ellul

Superstition has always been closely associated with medicine. Perhaps the most well-known illustration is the infamous Pandora’s box, first hinted at in 7th century BC, by the Greek poet Hesiod….

Superstition has always been closely associated with medicine. Perhaps the most well-known illustration is the infamous Pandora’s box, first hinted at in 7th century BC, by the Greek poet Hesiod. In Greek mythology, Pandora is the first woman on earth who disobeys Zeus and opens the box, releasing all the evil in the world, including illness and diseases.

Nonetheless, it is an earlier document, Ebers Papyrus, which evidences the intimacy between superstition and medicine. Dating back to 1550 BC, this 110-page Egyptian scroll is believed to reproduce knowledge from earlier texts, possibly 3400 BC. It illustrates the relationship between medicine and various Egyptian deities. Most interestingly, it encourages mothers to breastfeed their infants for three years, “Nothing accords more with natural law than one’s mother milk”. People considered the mother deity Isis to champion this concept since she repeatedly appeared in motifs breastfeeding her son Horus. Ebers Papyrus even describes the use of milk stimulants, “Spine of Nile-perch, fried in oil/fat, her spine is anointed therewith”. When breastfeeding failed, the mother recoursed to the deity of childbirth and fertility, Taweret.

Superstition still seems to be relevant today, at least in specific cultures. Let us consider Cambodia as an example. In 2012, it was acknowledged that 50-80% of Cambodian children < 5 years suffer from anaemia. There are various reasons for this, including iron-deficiency, vitamin A and other micronutrient deficiencies, helminths, malaria as well as hemoglobinopathies. Of these, the WHO estimates that approximately 50% is attributable to iron-deficiency. In view of this fact, iron supplements, iron fortified candies, fortified staples and micronutrient powders have all had varying degrees of success in offsetting this situation. However, such measures come at a cost and depend largely on patient compliance. Thus, researchers have advocated an adventitious source of dietary iron, namely, cast iron pots. Studies demonstrated that cooking food in iron pots increases the iron content of foods and that this iron is bioavailable. However, randomized controlled trials reported low acceptability since cast-iron pots were heavier and rusted more easily. What to do next?

A small, lightweight cast iron ingot in the shape of a smiling Cambodian fish, The Lucky Iron Fish, is being marketed as an alternative source of iron. Acceptance by the people was good since fish symbolize luck in Cambodian culture. Randomized controlled trials have indeed found that within a year this strategy has increased hemoglobin concentrations by 11.6g/L and reduced anemia by half, compared to the control group. This method simply involves cooking with the Lucky Iron Fish for 10 minutes and adding some citrus juice (to increase iron bioavailability). If this is not lateral thinking, then what is?