Reviewed: ‘Trick or Treatment? Alternative Medicine on Trial’ by Simon Singh and Edzard Ernst
Anyone aware of Simon Singh’s battle in the libel courts against the British Chiropractic Association will be able to make a cunning guess at what answer this book gives to the question posed in the title. What Singh and Ernst deliver is a rigorous, comprehensive and ultimately damning evaluation of all the major strands of alternative medicine, including acupuncture, homeopathy, chiropractic and herbal remedies, reviewing the scores of clinical trials that have sought to answer the question: are alternative therapies effective?
The resounding answer ringing from the entire book is NOOO!! (with a few little exceptions). While it may be important that such a book exists that is accessible to the average reader – indeed one of the comments on the back remarks that “physicians should recommend the book to their patients” – I cannot claim to have particularly enjoyed reading it.
The authors set off with a statement of open mindedness, making no prior assumptions before subjecting therapies to the ‘science test’. Nonetheless, it quickly becomes obvious what the conclusion is going to be, and the constant use of derogatory terms (“pure quackery” etc.) scuppers any pretence at engagement with believers in alternative medicine.
In the end, I think this is where Trick or Treatment? falls down – it convincingly argues for the absurdity and illogic of many therapies, but it is delivered in such a way that only those comfortably in the conventional-medicine-only camp, or at least very close to the fence, will be persuaded by it.
Of course, the fact that the book is unlikely to persuade ardent believers in alternative medicine does not make it a bad book. There is some fascinating stuff to keep the reader’s attention along the way. This is particularly true in Chapter 1 which gives a history of evidence based medicine – the fact that Hippocrates believed that the womb ‘wandered’ around the female body even won me a game of Trivial Pursuit! Plus, the sheer bizarrity of some of the things out there is incredible. I particularly enjoyed hearing about ‘tachyon therapy’ which uses hypothetical particles travelling faster than the speed of light to heal wounds.
Nonetheless, the overall drive of the book is negative with much repetition of how alternative therapies have been proven not to work, ultimately making for unexciting reading. None of the joy of scientific discovery and wonder at truths about the human body that science has uncovered is conveyed, which in the end would seem the best way of convincing those sceptical about the authority of science – it kinda reminded me of US foreign policy, the authors bomb the hell out of the enemy with impressive logical firepower, but “the battle for hearts and minds” is left by the wayside (I loathe that phrase by the way).
One interesting point is the mention of a libel case brought by a respected US doctor in the late 18th century against a campaigner who believed bloodletting was harmful rather than helpful for suffering patients. This resonates strongly with the libel case brought against Simon Singh by the British Chiropractic Association due to an article he wrote in the Guardian soon after Trick or Treatment? was published, reiterating many of the points about the questionable claims made by some chiropractors. Unlike the case described in the book, thankfully the BCA eventually backed down and a libel reform bill is currently making its way through parliament (though whether it goes far enough is debatable – check out www.libelreform.org and sign the petition!).
Overall, while I am completely on the authors’ side, Trick or Treatment? doesn’t pass the ‘would recommend to a friend’ test. Perhaps the subject matter is important enough to speak for itself. The global spend on alternative medicines is astounding and serious ethical issues come into play when patients are advised to give up on conventional treatments. However, if you are convinced that conventional medicine is the only wise choice then there is not much enjoyment to be gleaned other than gleeful ridicule of the wackier treatments, and if you are convinced that alternative medicine is viable then the combative style is unlikely to change your opinions, leading to the question – who is the book really written for?
Next to be reviewed:
‘The Periodic Table’ by Primo Levi