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Trick or Treatment—The Undeniable Facts about Alternative Medicine (Electronic book text)

Noted science writer Singh and British professor of complementary medicine Ernst offer a reasoned examination of the research on acupuncture, homeopathy, chiropractic, herbal medicine and other alternative treatments. Singh (Fermat's Last Theorem) and Ernst work hard to be objective, but their conclusion is that these therapies are largely worthless. As they examine the research on various alternative therapies, the authors explore the principles of evidence-based medicine on which their conclusions are based, including clinical trials and the placebo effect; they also explore related ethical issues. The authors report that many patients will improve with any alternative remedy—but no more than those given a placebo. Exceptions exist; some herbal remedies (e.g., St. John's wort, echinacea) can be helpful though not always advisable, and chiropractors can relieve low back pain under certain circumstances. This is a stimulating and informative account that will be indispensable to anyone considering an alternative treatment, though it may not dissuade true believers.

Edzard Ernst , Simon Singh

Медицина18+

Trick or Treatment

The Undeniable Facts About Alternative Medicine

Simon Singh & Edzard Ernst, MD

W. W. NORTON & COMPANY

New York London

First published in Great Britain in 2008 by Bantam Press, an imprint of Transworld Publishers, under the title Trick or Treatment? Alternative Medicine on Trial

For information about permission to reproduce selections from this book, write to Permissions, W. W. Norton & Company, Inc.,

500 Fifth Avenue, New York, NY 10110

Production manager: Anna Oler

Library of Congress Cataloging-in-Publication Data

Singh, Simon.

Trick or treatment: the undeniable facts about alternative medicine/

Simon Singh & Edzard Ernst. — 1st American ed.

p. cm.

Includes bibliographical references.

ISBN: 978-0-393-06986-0

1. Alternative medicine. I. Ernst, E. (Edzard) II. Title.

[DNLM: 1. Complementary Therapies. 2. Evidence-Based Medicine.

3. Placebo Effect. WB 890 S617t 2008]

R&33.S568 2008

610—dc22 2008019110

W. W. Norton & Company, Inc.

500 Fifth Avenue, New York, N.Y. 10110

www.wwnorton.com

W. W. Norton & Company Ltd.

Castle House, 75/76 Wells Street, London W1T 3QT

2 3 4 5 6 7 8 9 0

Dedicated to

HRH The Prince of Wales

Contents

Introduction

1 How Do You Determine the Truth?

2 The Truth About Acupuncture

3 The Truth About Homeopathy

4 The Truth About Chiropractic Therapy

5 The Truth About Herbal Medicine

6 Does the Truth Matter?

Appendix: Rapid Guide to Alternative Therapies

Further Reading

Acknowledgements

Picture Credits

Introduction

THE CONTENTS OF THIS BOOK ARE GUIDED ENTIRELY BY A SINGLE PITHY sentence, written over 2,000 years ago by Hippocrates of Cos. Recognized as the father of medicine, he stated:

‘There are, in fact, two things, science and opinion;

the former begets knowledge, the latter ignorance.’

If somebody proposed a new medical treatment, then Hippocrates declared that we should use science to decide whether or not it works, rather than relying on somebody’s opinion. Science employs experiments, observations, trials, argument and discussion in order to arrive at an objective consensus on the truth. Even when a conclusion has been decided, science still probes and prods its own proclamations just in case it has made a mistake. In contrast, opinions are subjective and conflicting, and whoever has the most persuasive PR campaign has the best chance of promoting their opinion, regardless of whether they are right or wrong.

Guided by Hippocrates’ dictum, this book takes a scientific look at the current plethora of alternative treatments that are rapidly growing in popularity. These treatments are piled high in every pharmacy, written about in every magazine, discussed on millions of web pages and used by billions of people, yet they are regarded with scepticism by many doctors.

Indeed, our definition of an alternative medicine is any therapy that is not accepted by the majority of mainstream doctors, and typically this also means that these alternative therapies have mechanisms that lie outside the current understanding of modern medicine. In the language of science, alternative therapies are said to be biologically implausible.

Nowadays it is common to hear the umbrella term ‘complementary and alternative medicine’, which correctly implies that sometimes these therapies are used alongside and sometimes instead of conventional medicine. Unfortunately it is a lengthy and clumsy phrase, so in a bid for simplicity we have decided to use the term ‘alternative medicine’ throughout this book.

Surveys show that in many countries over half the population use alternative medicine in one form or another. Indeed, it is estimated that the annual global spend on all alternative medicines is in the region of £40 billion, making it the fastest-growing area of medical spending. So who is right: the critic who thinks alternative medicine is akin to voodoo, or the mother who entrusts her child’s health to alternative medicine? There are three possible answers.

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