Trick or Treatment?

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Trick or Treatment? Alternative Medicine on Trial
Cover of Trick or Treatment book.jpg
Cover of the first edition
Author Simon Singh, Edzard Ernst
CountryUnited Kingdom
LanguageEnglish
Subject Alternative medicine
Publisher Bantam Press
Publication date
2008
Media typePrint
Pages352
ISBN 0-593-06129-2
OCLC 190777228

Trick or Treatment? Alternative Medicine on Trial (North American title: Trick or Treatment: The Undeniable Facts about Alternative Medicine) [1] is a 2008 book by Simon Singh and Edzard Ernst. [2] [3] [4] The book evaluates the scientific evidence for alternative medicines such as acupuncture, homeopathy, herbal medicine, and chiropractic, [2] and briefly covers 36 other treatments. It finds that the scientific evidence for these alternative treatments is generally lacking. The authors concluded that homeopathy is merely a placebo. [5]

Contents

Although Trick or Treatment presents evidence that acupuncture, chiropractic and herbal remedies have limited efficacy for certain ailments, the authors conclude that the dangers of these treatments outweigh any potential benefits. Such potential risks outlined by the authors are contamination or unexpected interactions between components in the case of herbal medicine, risk of infection in the case of acupuncture and the potential for chiropractic manipulation of the neck to cause delayed stroke.

The book, dedicated in an ironic fashion to Prince Charles, is critical of his advocacy of alternative medicine and the actions of his now-defunct The Prince's Foundation for Integrated Health.

Contents

The book contains six chapters:

How do you determine the truth?

This chapter describes the methods and history of clinical trials, such as the trial to determine a proper treatment for scurvy by James Lind and the story of Florence Nightingale. James Lind was a British physician who pioneered naval hygiene. He recommended that citrus fruit and lemon juice should be included in the diets of seamen to eradicate the illness of scurvy. Lind was able to come to the conclusion that these remedies may reduce this particular illness through the various clinical trials he performed that were successful. Florence Nightingale is another example used in the novel as someone who practiced the scientific medicine and evidence based medicine as she pioneered the profession of nursing.

The truth about acupuncture

This chapter discusses the evidence surrounding acupuncture, a form of alternative medicine in which acupuncturists place needles in the body for the purpose of blocking Ch'i meridians throughout the body, thus encouraging full health. The authors examine the recent history of acupuncture and several various trials of the technique. The authors conclude that acupuncture is essentially a placebo.

The truth about homeopathy

This chapter discusses the evidence surrounding homeopathy, an alternative medicine technique which consists of finding a substance (which causes symptoms similar to the condition needing to be treated in a healthy person), then diluting that substance to an extreme degree. The chapter examines the history of homeopathy and reviews various trials regarding the technique, especially the trial done by Jacques Benveniste, a French researcher. The authors conclude that homeopathy is a placebo. The authors offered a £10,000 prize for anyone who could prove homeopathy was effective. [6]

The truth about chiropractic therapy

This chapter discusses the evidence surrounding chiropractic, an alternative medicine technique which aims to cure illness by manipulating the spine, based on the theory that almost all conditions and diseases are caused by misaligned vertebrae in the spine block the body's vital force. The history of chiropractic, as well as several of the trials on chiropractic are described. The authors conclude that there is no evidence to support most of chiropractic's claims. However, the authors state that chiropractic might be beneficial in certain limited situations concerning back pain. As well, the authors find that chiropractic can be very dangerous, especially when it comes to the manipulation of the neck, and state that patients should "try conventional treatments before turning to a chiropractor for back pain. They are generally cheaper than spinal manipulation and just as likely to be effective." [7]

The truth about herbal medicine

This chapter discusses the evidence surrounding herbal medicine, such as the use of St. John's Wort and Aloe vera. The authors conclude that several herbal medicines can be effective to treat illness, while others, such as billberry, chamomile, and ginseng, are ineffective.

Does the truth matter?

This chapter discusses the state of alternative medicine in society, focusing on Prince Charles's endorsements of alternative medicine. It is critical of the actions of his now-defunct The Prince's Foundation for Integrated Health.

Reception

In 2008 and 2009, Trick or Treatment received mostly favorable reviews for its clear and thorough writing although several reviewers were critical that the book lacked acknowledgement of problems present in conventional medicine. [8] [2] [9] [10]

Olivia Laing, writing for The Guardian , said "Singh and Ernst are scientists and their mainly dismissive conclusions are based on extensive, though bizarrely unfootnoted, research. In tones of quiet fury, they demolish the claims of acupuncture, chiropractic therapy, . . . and homeopathy." Laing criticized the book for a lack of "acknowledgement of the problems of funding adequate trials" and "discussion of the equivalent risks and inadequacies of conventional medicine" such as the side effects of pharmaceutical drugs. [8]

In a review for Nature, Toby Murcott described the book as "thoroughly researched and clearly written" where the authors, in discussing the available randomized clinical trials for each of four treatments, "make repeated claims that they provide the truth, and have even included this word in the title of every chapter. The balance of evidence from randomized controlled trials supports their arguments, but the authors are not tendering a disprovable hypothesis." Murcott expressed concern that the authors' sense of certainty "mirrors that of the proponents of alternative therapies, leaving each position as entrenched as ever." [2]

Harriet Hall, in reviewing Trick or Treatment, emphasized that Ernst's views were worthy of "special credibility" as he had previously prescribed homeopathic remedies and was supportive of alternative treatments that were proven to work. Hall said Ernst "accepts claims about herbs that many of us reject" and has "demonstrated his ability to change his mind and follow the evidence." [11] [12]

In a review of the book for Complementary Medicine Research, John Kapp said that although he did not agree with their conclusion, Ernst and Singh "deserve praise for bringing a vital subject to the attention of the public in a clear and readable way." Kapp was critical that the authors "castigate alternative medicine for not doing more clinical trials, but fail to acknowledge the cost" and said they fail to address the flawed nature of some drug trials in conventional medicine, pointing towards the 2004 removal of Vioxx from the market as a recent example. [10]

Writing for the British Journal of General Practice, Jeremy Swayne (former dean of the Faculty of Homeopathy [13] ) said the book was "thorough and clever" and that it "provides excellent counsel about the shortcomings of CAM (and there are many, if you take the whole nebulous field into consideration), and its susceptibility to popular and commercial exploitation. But a recurring lack of truthfulness is the lack of the perspective that would have been provided by relating these to comparable problems in conventional medicine." [9]

Donald Marcus reviewed the book for The New England Journal of Medicine and found the writing to be "clear and vivid" with historical anecdotes that "provide a valuable perspective on the subject." Marcus said Trick or Treatment "meets the need for a current, evidence-based survey of alternative therapies to balance the widespread misinformation about them." [4]

Writing for The Daily Telegraph, Katie Owen and Sally Cousins described the book as "a clearly written, scrupulously scientific examination of the health claims of key areas of alternative medicine: acupuncture, homeopathy, chiropractic therapy and herbal medicine. The results are stark. In no case, apart from in some limited ways in herbal medicine, do any of these 'therapies' work. On the contrary, they can be life-threatening." [14]

Subsequent libel case and freedom of speech

Singh was sued for libel by the British Chiropractic Association (BCA) for comments he wrote in a column [15] in The Guardian about the book. [16] In 2010, after two years, the BCA dropped the case after the Court of Appeal found that Singh was expressing opinion, rather than stating facts. The presiding judges commented that "this litigation has almost certainly had a chilling effect on public debate which might otherwise have assisted potential patients to make informed choices about the possible use of chiropractic". [17]

See also

Related Research Articles

<span class="mw-page-title-main">Acupuncture</span> Pseudoscientific needling treatment

Acupuncture is a form of alternative medicine and a component of traditional Chinese medicine (TCM) in which thin needles are inserted into the body. Acupuncture is a pseudoscience; the theories and practices of TCM are not based on scientific knowledge, and it has been characterized as quackery.

Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability or evidence of effectiveness. Unlike modern medicine, which employs the scientific method to test plausible therapies by way of responsible and ethical clinical trials, producing repeatable evidence of either effect or of no effect, alternative therapies reside outside of medical science and do not originate from using the scientific method, but instead rely on testimonials, anecdotes, religion, tradition, superstition, belief in supernatural "energies", pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources. Frequently used terms for relevant practices are New Age medicine, pseudo-medicine, unorthodox medicine, holistic medicine, fringe medicine, and unconventional medicine, with little distinction from quackery.

<span class="mw-page-title-main">Chiropractic</span> Form of pseudoscientific alternative medicine

Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudoscientific ideas.

<span class="mw-page-title-main">Naturopathy</span> Form of alternative medicine

Naturopathy, or naturopathic medicine, is a form of alternative medicine. A wide array of pseudoscientific practices branded as "natural", "non-invasive", or promoting "self-healing" are employed by its practitioners, who are known as naturopaths. Difficult to generalize, these treatments range from the thoroughly discredited, like homeopathy, to the widely-accepted, like certain forms of psychotherapy. The ideology and methods of naturopathy are based on vitalism and folk medicine rather than evidence-based medicine, although practitioners may use techniques supported by evidence. The ethics of naturopathy have been called into question by medical professionals and its practice has been characterized as quackery.

The National Center for Complementary and Integrative Health (NCCIH) is a United States government agency which explores complementary and alternative medicine (CAM). It was initially created in 1991 as the Office of Alternative Medicine (OAM), and renamed the National Center for Complementary and Alternative Medicine (NCCAM) before receiving its current name in 2014. NCCIH is one of the 27 institutes and centers that make up the National Institutes of Health (NIH) within the United States Department of Health and Human Services.

<span class="mw-page-title-main">Simon Singh</span> British physicist and popular science author (born 1964)

Simon Lehna Singh, is a British popular science author, theoretical and particle physicist. His written works include Fermat's Last Theorem, The Code Book, Big Bang, Trick or Treatment? Alternative Medicine on Trial and The Simpsons and Their Mathematical Secrets. In 2012 Singh founded the Good Thinking Society, through which he created the website "Parallel" to help students learn mathematics.

<span class="mw-page-title-main">Craniosacral therapy</span> Pseudoscientific alternative medicine technique

Craniosacral therapy (CST) or cranial osteopathy is a form of alternative medicine that uses gentle touch to feel non-existent rhythmic movements of the skull's bones and supposedly adjust the immovable joints of the skull to achieve a therapeutic result. CST is a pseudoscience and its practice has been characterized as quackery. It is based on fundamental misconceptions about the anatomy and physiology of the human skull and is promoted as a cure-all for a variety of health conditions.

Anthroposophic medicine is a form of alternative medicine based on pseudoscientific and occult notions. Devised in the 1920s by Rudolf Steiner (1861–1925) in conjunction with Ita Wegman (1876–1943), anthroposophical medicine draws on Steiner's spiritual philosophy, which he called anthroposophy. Practitioners employ a variety of treatment techniques based upon anthroposophic precepts, including massage, exercise, counselling, and substances.

<span class="mw-page-title-main">Edzard Ernst</span> German academic physician and researcher (born 1948)

Edzard Ernst is a retired British-German academic physician and researcher specializing in the study of complementary and alternative medicine. He was Professor of Complementary Medicine at the University of Exeter, the world's first such academic position in complementary and alternative medicine.

<span class="mw-page-title-main">Alternative cancer treatments</span> Alternative or complementary treatments for cancer that have not demonstrated efficacy

Alternative cancer treatment describes any cancer treatment or practice that is not part of the conventional standard of cancer care. These include special diets and exercises, chemicals, herbs, devices, and manual procedures. Most alternative cancer treatments do not have high-quality evidence supporting their use and many have been described as fundamentally pseudoscientific. Concerns have been raised about the safety of some purported treatments and some have been found unsafe in clinical trials. Despite this, many untested and disproven treatments are used around the world.

Alternative veterinary medicine is the use of alternative medicine in the treatment of animals. Types alternative therapies used for veterinary treatments may include, but are not limited to, acupuncture, herbal medicine, homeopathy, ethnomedicine and chiropractic. The term includes many treatments that do not have enough evidence to support them being a standard method within many veterinary practices.

Osteomyology is a multi-disciplined form of alternative medicine found almost exclusively in the United Kingdom and is loosely based on aggregated ideas from other manipulation therapies, principally chiropractic and osteopathy. It is a results-based physical therapy tailored specifically to the needs of the individual patient. Osteomyologists have been trained in osteopathy and chiropractic, but do not require to be regulated by the General Osteopathic Council (GOsC) or the General Chiropractic Council (GCC).

The Prince's Foundation for Integrated Health (FIH) was a charity run by King Charles III founded in 1993. The foundation promoted complementary and alternative medicine, preferring to use the term "integrated health", and lobbied for its inclusion in the National Health Service. The charity closed in 2010 after allegations of fraud and money laundering led to the arrest of a former official.

George Lewith was a professor at the University of Southampton researching alternative medicine and a practitioner of complementary medicine. He was a prominent and sometimes controversial advocate of complementary medicine in the UK.

Because of the uncertain nature of various alternative therapies and the wide variety of claims different practitioners make, alternative medicine has been a source of vigorous debate, even over the definition of "alternative medicine". Dietary supplements, their ingredients, safety, and claims, are a continual source of controversy. In some cases, political issues, mainstream medicine and alternative medicine all collide, such as in cases where synthetic drugs are legal but the herbal sources of the same active chemical are banned.

<span class="mw-page-title-main">Friends of Science in Medicine</span> Australian association which supports science-based medicine

The Friends of Science In Medicine (FSM) is an Australian association which supports evidence-based medicine and strongly opposes the promotion and practice of unsubstantiated therapies that lack a scientifically plausible rationale. They accomplish this by publicly raising their concerns either through direct correspondence or through media outlets. FSM was established in December 2011 by Loretta Marron, John Dwyer, Alastair MacLennan, Rob Morrison and Marcello Costa, a group of Australian biomedical scientists and clinical academics.

Klaus Linde is a German physician and alternative medicine researcher. He works at the Centre for Complementary Medicine Research at the Technical University of Munich in Germany.

Alternative medicine describes any practice which aims to achieve the healing effects of medicine, but which lacks biological plausibility and is untested or untestable. Complementary medicine (CM), complementary and alternative medicine (CAM), integrated medicine or integrative medicine (IM), and holistic medicine are among many rebrandings of the same phenomenon.

The infinitesimally low concentration of homeopathic preparations, which often lack even a single molecule of the diluted substance, has been the basis of questions about the effects of the preparations since the 19th century. Modern advocates of homeopathy have proposed a concept of "water memory", according to which water "remembers" the substances mixed in it, and transmits the effect of those substances when consumed. This concept is inconsistent with the current understanding of matter, and water memory has never been demonstrated to exist, in terms of any detectable effect, biological or otherwise.

References

  1. ↑ ISBN   0-393-06661-4
  2. 1 2 3 4 Murcott, Toby (12 June 2008). "Complementary cures tested". Nature . 453 (7197): 856–857. Bibcode:2008Natur.453..856M. doi: 10.1038/453856a .
  3. ↑ Metcalf, Fran (20 June 2008). "Alternative medicines draws fire". The Courier-Mail . Retrieved 21 January 2009.
  4. 1 2 Marcus, Donald M. (6 November 2008). "Book Review". The New England Journal of Medicine . 359 (19): 2076–2077. doi:10.1056/NEJMbkrev0805020.
  5. ↑ Leggatt, Johanna (8 November 2008). "Complementary medicine: seeking out alternatives". The Daily Telegraph . Archived from the original on 1 October 2012. Retrieved 21 January 2009.
  6. ↑ "Ernst-Singh Homeopathic Challenge". Archived from the original on 4 January 2012.
  7. ↑ Trick or Treatment? Alternative Medicine on Trial. 2009. p. 208.
  8. 1 2 Laing, Olivia (3 May 2008). "Quacks on the rack". The Observer. ISSN   0029-7712 . Retrieved 2 April 2023.
  9. 1 2 Swayne, Jeremy (1 October 2008). "Book review: Trick or Treatment? Alternative Medicine on Trial". British Journal of General Practice . 58 (555): 738–739. doi:10.3399/bjgp08X342525. PMC   2553545 .
  10. 1 2 Kapp, John (September 2008). "Trick or Treatment? Alternative Medicine on Trial". Complementary Medicine Research . 15 (4): 238–239. doi: 10.1159/000156459 . S2CID   140131150.
  11. ↑ Hall, Harriet (27 August 2008). "Trick or Treatment: The Undeniable Facts about Alternative Medicine (book review)". Quackwatch . Retrieved 21 November 2009.
  12. ↑ Hall, Hariett (26 August 2008). "Trick or Treatment". Science-Based Medicine. Retrieved 3 April 2023.
  13. ↑ Swayne, Jeremy (April 2008). "CAM". British Journal of General Practice . 58 (549): 280, author reply 280–1. doi:10.3399/bjgp08X279841. PMC   2277119 . PMID   18387236.
  14. ↑ Owen, K; Cousins S (10 May 2009). "Paperbacks: reviews". The Daily Telegraph . Retrieved 21 November 2009.
  15. ↑ Singh, Simon (19 April 2008). "Beware the spinal trap". The Guardian . Archived from the original on 23 April 2008. Retrieved 21 January 2009.
  16. ↑ Eden, Richard (16 August 2008). "Doctors take Simon Singh to court". Mandrake. The Daily Telegraph . Retrieved 12 December 2008.
  17. ↑ Boseley, Sarah (15 April 2010). "Simon Singh libel case dropped". The Guardian .
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