Trick or Treatment: The Undeniable Facts about Alternative Medicine

My full review of Trick or Treatment: The Undeniable Facts about Alternative Medicine is on Slashdot

While Trick or Treatment: The Undeniable Facts about Alternative Medicine is not a book about information security, co-author Simon Singh is well known to the RSA community. 

I first encountered co-author Simon Singh at the 2005 RSA Conference. In his presentation, he included a demonstration of the human brain's unique capability for pattern matching when specific patterns are expected, and used Led Zeppelin's Stairway to Heaven as an example. Stairway has long been rumored to have subliminal satanic messages. When played backwards, it is impossible to decipher any message. But when the message is known in advance, one can then hear the message imploring the listener to go to Satan's tool shed. Once Singh put the subliminal lyrics on the overhead, the subliminal message was now clear, not due to a subliminal message, rather via pattern matching.

While no reasonable person can believe in Stairway's subliminal lyrics, far too many people do believe in equally implausible things in the realm of alternative medicine. In the book, the authors tackle four main areas: acupuncture, homeopathy, chiropractic and herbal medicine. The books conclusion is that acupuncture, homeopathy, chiropractic are essentially worthless, while herbal medicine has limited value. 

Chapter 1 starts with an overview of evidence-based medicine (EBM), of which the authors are staunch believers. EBM applies evidence gained via the scientific method and assesses the quality of the evidence relevant to the risks and benefits of the treatments. The foundation of EBM is the systematic review of evidence for particular treatments via mainly randomized controlled trials. In the chapter, the authors reiterate the concept that the plural of anecdote is not data. Acupuncture, homeopathy, chiropractic have plenty of first-person anecdotes, but no a lack of controlled studies with real data to back up their spurious claims.  

EBM shows that homeopathy and other bogus cures are of no value, yet the public is oblivious to those facts. In a piece I wrote on this topic, New York News Radio - The voice of bad science, its shows that cheap radio advertising (with its mishmash of pseudoscientific claims) combined with a public that is ignorant of basic scientific facts, creates a perfect storm for the continuation of homeopathy and other bogus cures. 

A recurring theme the book stresses is that acupuncture, homeopathy, chiropractic and other alternative therapies are scientifically impossible, and often will violate fundamental scientific principles. A perfect example of this implausibility is with homeopathy. Contrary to what common sense and basic science, in homeopathy, a solution that is more diluted is considered stronger and as having a higher potency. The issue is that the end result is a product that is so diluted, that its contents when in solid form is pure sugar, and when in liquid form; 100% H20. When a homeopathic liquid is in its most diluted state, there is not a single molecule of the active ingredient. Therein lays the scientific implausibility of homeopathy. 

Chapter 1 also asks one of the book's fundamental questions: how do you determine the truth? The authors answer that it is via the scientific method. This is determined only after strict and careful analysis of a clinical study, of which the most effective is double-blind and randomized. 

In chapter 3, the book jokingly notes that since homeopathic liquid remedies are so diluted that they contain only water; their only use would be for dehydration. And since homeopathy is based on the fact that the strength of a remedy is based on its dilution, one could conceivably overdose on a homeopathic remedy by forgetting to take a dose. 

The chapter concludes with perhaps the strongest indictment against homeopathy; namely it's content. If one looks at the content of oscillococcinum, a homeopathic alternative marketed to relieve influenza-like symptoms, the packaging states that each gram of medication contains 0.85 grams of sucrose and 0.15 grams of lactose. Sucrose and lactose are simply forms of sugar, of which oscillococcinum is nothing more than am expensive sugar pill. 

In chapter 4, the authors write that while homeopathy is nothing more than a placebo, the added danger with it is that patients will often forgo real medications to take a homeopathic one. It reports of a study in Britain, which demonstrated that the most benign alternative medicine can become dangerous if the therapist who administers it advises a patient not to follow an effective conventional medical treatment. The study demonstrated that alternative medical practitioners often recommend homeopathic remedies for malaria, and ignore proven conventional medicines. Such an approach can often mean a death sentence for the person taking the homeopathic remedy. 

Chapter 5 deals with herbal medicine. The chapter is somewhat different in that the previous chapters about acupuncture, homeopathy and chiropractic showed them to be useless, herbal medicine does have value. The book notes that herbal medicine has been embraced by science to a far greater extent than acupuncture, homeopathy and chiropractics. The chapter lists over 30 herbal medicines and their levels of efficacy. An irony of herbal medicine is that some exotic ones, such as those with tiger bone or rhino horn are pushing the species to the brink of extinction, due to their level of popularity in certain parts of the world. 

Chapter 5 concludes with on why smart people believe such odd things? Alternative medicine has failed to deliver the health benefits that it claims, so why are millions of patients wasting their money and risking their lives by turning towards a snake-oil industry? The authors provide numerous reasons for this, from the concepts such as natural, traditional and holistic, to attacks on the scientific method by the alternative medical community and more. 

The appendix is a rapid guide to alternative therapies and lists over 30 new treatments with their benefits and potential dangers. The appendix gives single page summaries of the plethora other alternative therapies, from ear candles, colonic irrigation, reiki, to leech therapy and more. The authors write that most of these are bogus, many violate fundamental laws of sciences, and but a few have real, but limited value. 

Alternative medicine operates in the shadows, blithely touting that their products have not been evaluated by the Food and Drug Administration, and that they are not intended to diagnose, treat, cure or prevent any disease. While these products are not intended to diagnose, treat, cure or prevent any disease; consumers nonetheless spends billions of dollars per year on unproven supplements. Consumers can be quite fickle. On one side they are furious at the SEC for their lack of oversight around Madoff Investments Securities. Yet when the FDA requires products use their disclaimer of how ineffective the item is, consumers will throw billions of dollars on ineffective products. 

Trick or Treatment: The Undeniable Facts about Alternative Medicine is an incredibly important and eye-opening book. While Singh is a physicist and Ernst a medical doctor, the book is written in a clear and compelling style, avoids technical jargon, and sticks to the facts. In the spirit of the scientific method, the authors scrutinize alternative and complementary cures and the results show that the snake oil is still selling.

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