Trick or Treatment? Alternative Medicine on Trial, by Simon Singh and Edzard Ernst

An attempt to objectively evaluate various alternative therapies and come up with some clear conclusions about whether they're true.

I ordered this from the library, and at the same time I ordered Suckers, to which this book had been compared. Maybe reading them in this order gave Suckers the advantage of novelty, but I didn't think Trick or Treatment? was quite as good.

The books have different objectives: while Suckers felt like an impassioned argument against CAM by someone who's frustrated that so many people are taken in by it, ToT? specifically declares itself to be starting from the position of complete open-ness, with the intention of looking purely on a scientific basis at the best available evidence for CAM, in order to be able to present conclusions on how well it measures up.

So in ToT? there is a fair amount of introductory material explaining the basis of scientific investigation, clinical trials, etc. in order to justify why this is a sensible way to approach an evaluate alternative medicine. Fair enough, but nothing new here. The book then has four chapters, dealing with Acupuncture, Homeopathy, Chiropractic Therapy and Herbal Medicine.

To cut to the chase, the bottom line is that they conclude that:

At the more positive end of the scale, herbal medicine can claim a few successes, but the majority of herbs appear to be overhyped. Chiropractic therapy might offer some marginal benefit, but only for back pain - all its other claims are unsubstantiated. Similarly, acupuncturists might be able to offer some marginal benefit in terms of relieving some sorts of pain and nausea, but the effect is so borderline that there is also the strong possibility that acupuncture is worthless. And it is certain that acupuncturists are guilty of offering unproven treatments for a range of conditions, including diabetes, heart disease and infertility. Homeopathy is the worst therapy encountered so far - it is an implausible therapy that has failed to prove itself after two centuries and some 200 clinical studies. (p238)
They take quite a while to get to this stage: I assume because they want the reader to have reached these conclusions himself on the basis of evidence presented by the time he gets to the place where they're starkly laid out.

These conclusions are pretty much in line with Suckers - in fact if anything they're more damning: Shapiro concedes that there just might be something in acupuncture, but ToT? seems more critical even than that.

On the whole then I didn't find this such a good read as the Shapiro book, but I think that's because I started out from a position of believing that CAM is a load of tosh, and didn't really need a load of carefully balanced argument to convince me of this. And while this book does have a "why is it that people are so gullible?" section, it's not as good as the equivalent stuff in Shaprio.

Some of the same things that Shapiro mentioned were covered in the book, e.g. the stuff about blood-letting, and the balance of bodily fluids, and the quote from Mao about not believing in acupuncture. I think it was more interesting in the Shapiro book (although as I say, maybe that's because it was fresh).

Also, I don't think this book was particularly well structured. Each chapter has the word "Truth" in it: "How Do You Determine the Truth?" "The Truth about Acupuncture"; "The Truth about Homeopathy"; "The Truth about Herbalism"... "Does the Truth Matter?" but in fact the chapter contents wander about a bit, digressing into discussions about stuff that's not directly related to the chapter heading. This meant that when I look back, it's quite difficult to remember where in the book they made a particular point. The chapter headings look neat in the table of contents though.

In summary, this book would be better aimed at someone who's favourably inclined towards CAM and is open-minded enough to be persuaded through argument that CAM is total rubbish. Unfortunately, my feeling is that people who are favourably inclined towards CAM are not open-minded, or at least not open to the kind of rational argument presented in this book.

Suckers is a better book for someone who knows already that CAM is a waste of time.

Completed : 21-Sep-2008

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