Trick or Treatment: The Undeniable Facts about Alternative Medicine by Simon Singh

Oct 20, 2008 Lena rated it 4 of 5 stars

Shelves: non-fiction, skepticism, medical

This is the third book I've read this year that examines the evidence for and against alternative medicine, so much of the ground it covers was already familiar to me. Despite that fact, I enjoyed this book a great deal and think it is likely to be the most accessible to those who have personal experience with alternative medicine.

The authors take an in-depth look at the four most popular modalities in the alternative medicine world: acupuncture, homeopathy, chiropractic and herbal medicine. The...more This is the third book I've read this year that examines the evidence for and against alternative medicine, so much of the ground it covers was already familiar to me. Despite that fact, I enjoyed this book a great deal and think it is likely to be the most accessible to those who have personal experience with alternative medicine.

The authors take an in-depth look at the four most popular modalities in the alternative medicine world: acupuncture, homeopathy, chiropractic and herbal medicine. They briefly discuss the history and public perception of each before they analyze what science has to say about the true effectiveness of these techniques.

The authors are not shy about stating those cases in which science does indicate possible effectiveness of these modalities, such as acupuncture for pain and nausea, chiropractic for low back pain, and certain herbs for various specified conditions. They take things a step further, however, by comparing these treatments with their conventional counterparts in terms of both cost and risk. While chiropractic may be effective for certain types of back pain, it has not been shown to be more effective than conventional therapies, is usually much more expensive, and carries a rarely discussed but very real risk of stroke, leading the authors to recommend against it.

Though the bulk of the book is spent on the four most popular CAM treatments, the appendix contains brief summary of their findings for 36 other CAM modalities from Ayuveda to spiritual healing that I found particularly informative.

I hope that the authors' willingness to give credit to those therapies that do warrant further study will make this book more likely to be read by those who could best benefit from this information. Unlike the authors of Suckers and Snake-Oil Science, Ernst knows this world from the inside. He is world's first professor of complementary medicine and also a former homeopath.

As the authors discuss, the placebo effect, the empathetic nature of CAM practitioners, and the preference we give to anecdotal over scientific evidence are likely to continue keeping the public confused about the true effectiveness of some of these methods. Those who would like to make certain they are getting good value for their hard-earned cash before trying one of these treatments, however, will find this book an invaluable resource.
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Nov 10, 2011 Alasse rated it 5 of 5 stars

Recommended to Alasse by: Rinzewind

Shelves: nonfiction, long-term-reading, skepticism, books-i-wish-i-d-written

DIE, HOMEOPATHY, DIE!!

This book is perfect. I've been thinking I had to write this book eventually, but now I don't have to because it exists and it's exactly as I imagined it. Now all I have to do is have a child and plant a tree.

It's a fact that otherwise smart people have a tendency to believe weird stuff. It's always there, right under the surface. My own mom just came in to tell me I have to be careful tomorrow (11/11/11), because the number 11 scares her. I don't understand it, but there...more

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Dec 30, 2012 Jennifer rated it 1 of 5 stars

Super biased in favor of conventional medicine, which shouldn't be a shock since it's written by an MD.
Not well cited at all, very anecdotal in the examples that prove how useless alternative medicine is (other than the super diluted homeopathic drugs).
Mentioned a FEW people have even been harmed with natural cures, but failed to mention the over 100,000 people who die in the US every year from correctly prescribed, properly taken conventional medicine (not including overdoses and illegally us...more

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Marc The book sets out to discuss the evidence for alternative medicine compared to mainstream medicine and placebos. It finds that this evidence strongly...more
Feb 23, 2013 02:45am

Jennifer What about the fact the he admitted that there was significant scientific evidence showing that acupuncture works, but he's still claims it doesn't. W...more
Feb 23, 2013 09:46am

Alex Gibson I personally think he does a great job in restraining himself from deriding the entire industry as a load of utter nonsense peddled by people largely...more
Apr 12, 2013 02:16am

Oct 05, 2012 Megha Guruprasad rated it 5 of 5 stars · review of another edition

What is this book about?

All these complementary treatments we hear about- homeopathy, acupuncture ,aromatherapy, spiritual healing,reflexology.. you name it. Well, do they really work? It aims at answering these questions for you.

This is a bold mission in itself, but while boldness might imply cheek, Simon Singh sticks to a fact-of-the-matter tone, still retaining adequate chutzpah.
I'd call this book a reinforcement of common sense,and it deserves credit for being one that NEEDED to have been wr...more What is this book about?

All these complementary treatments we hear about- homeopathy, acupuncture ,aromatherapy, spiritual healing,reflexology.. you name it. Well, do they really work? It aims at answering these questions for you.

This is a bold mission in itself, but while boldness might imply cheek, Simon Singh sticks to a fact-of-the-matter tone, still retaining adequate chutzpah.
I'd call this book a reinforcement of common sense,and it deserves credit for being one that NEEDED to have been written. As you get from one page to the next, you'll be thanking yourself for picking it up. For heaven knows the sea of 'alternative' therapies we're surrounded by today.

Strangely, this book impressed me so much by defying all the ways I would have expected it to be written.
-First of all, there are no sensational accusations, mud-hurling or alarmist warnings at the very outset. The chapters on each therapy follow the clean, systematic build-up that the authors advocate all through, giving you a very clear understanding and insight of what goes into a clinical trial.
-Secondly, the book is clean of any satire. Your health is a serious subject, it is addressed seriously. Period. However, the issue of alternative medicine so pervades the life of the common man that one can't but read the lines with one's own personal satirical goggles.

This is the sort of book you want to kiss, that leaves you a little bit enraged yet releived. The authors ensure that their point is well understood and clearly conveyed, the information is presented with a view of genuine social responsibility.They go out of their way not just to present scientific evidence , but to demonstrate the relevance,indispensibility and foolproof architecture of the scientific method of investiation.

Now if you think this is a tome toting laws and drab facts and figures, you couldn't be more wrong. Not that it should matter, but the text is replete with historical and recent anecdotes- ranging from intriguing, disconcerting to plain shocking. And for a book about clinical test procedures, regulating bodies and phoney practitioners, it is also miraculously- whats the word?- compassionate.
Do yourself a favour, read this book.

Either way, if you choose not to and just take my word for it, here's some lines from the last chapter that made me want to cheer on the final climax.

"Alternative therapists use the term 'alternative'to promote that they somehow exploit alternative aspects of science.The truth, however, is that there is no such thing as alternative science, just as there is no alternative biology, alternative anatomy, alternative testing or alternative evidence. The term 'alternative' is merely an attempt to escape from the truth by replacing knowledge derived from science by hunches derived from intuition, anecdote and tradition..."
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Sep 09, 2012 Sheri rated it 1 of 5 stars

Shelves: health-and-healing

Wow. The authors treat their readers as if we are unintelligent. I really thought this book was going to take a more neutral, and scientific based approach to exploring the efficacy of alternative medicines. I am also surprised to see some of the reviewers on here saying things like "this book just confirmed all my beliefs" and " I was already suspicious of alternative medicines". Why even read it if you have already made up your mind? It's always easy to convince you of something you already b...more Wow. The authors treat their readers as if we are unintelligent. I really thought this book was going to take a more neutral, and scientific based approach to exploring the efficacy of alternative medicines. I am also surprised to see some of the reviewers on here saying things like "this book just confirmed all my beliefs" and " I was already suspicious of alternative medicines". Why even read it if you have already made up your mind? It's always easy to convince you of something you already believe.
The book stereo-typed users and practitioners of alternative medicine, and even said that conventional medical doctors take a more holistic approach to treating patients than alternative practitioners. Don't you think that's always going to depend on who your doctor or alternative practitioner is?
It pointed out all the rare, isolated cases and possible side effects and drug interactions of many herbs, but failed to mention that most pharmaceutics have just as many side effects possible interactions and rare cases in which something went wrong. It had a chart giving ratings of good, medium and poor to about 35 different herbs. On page 204 the authors write "If a herbal remedy does not appear in the table, then it is probably safe to assume that there is no convincing evidence to support its use". Really? So you've covered everything worthwhile here in just a couple of pages huh?
Do your research, be smart about your decisions, and never "assume" anything, I say. There are many books, scientific journals, articles, etc out there to read. LOTS of scientific studies done. No, I haven't read them all. No one possibly could, including the authors. But I personally would never tell you what to assume, nor would I make the assumption that just because something is mainstream that makes it the correct way to do it. I'm not jumping off that bridge.
I do have to admit, however, that it did have some fun historical facts on the origins of alternative medicines, and a few nice quotes. I guess my time wasn't entirely wasted.(less)

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Marc The books sets out to discuss the evidence for alternative medicine compared to mainstream medicine and placebos. It finds that this evidence strongly...more
Feb 23, 2013 02:39am

Marc Obviously, the first two words should have said "The book".
Feb 23, 2013 02:47am

Manish Sinha Looking at the widespread usage of quackery, I would say that majority of people even the readers are unintelligent when it comes to medicine.
Mar 18, 2013 10:08pm

Oct 04, 2011 Campbell Mcaulay rated it 5 of 5 stars

Readable and interesting, if unsurprising and a little lightweight,

In "Trick or Treatment" Singh and Ernst summarise the cases for or against four of the more popular alternative health treatments, acupuncture, chiropractic, homeopathy and herbal medicine. This summary includes a resume of the history, theory and format of the therapy and an overview of the attempts that have been made to prove or disprove the efficacy of the treatment. An appendix gives a briefer overview of a much wider range...more Readable and interesting, if unsurprising and a little lightweight,

In "Trick or Treatment" Singh and Ernst summarise the cases for or against four of the more popular alternative health treatments, acupuncture, chiropractic, homeopathy and herbal medicine. This summary includes a resume of the history, theory and format of the therapy and an overview of the attempts that have been made to prove or disprove the efficacy of the treatment. An appendix gives a briefer overview of a much wider range of therapies, such as chelation, magic bracelets, cupping, hypnotherapy and so-on. A conclusion is then provided for each treatment as to its effectiveness and safety.

Of course, within the scope of a (relatively) short book, it is not possible to provide much detail of the testing regimes for each and the reader is left to trust that the authors have fairly and accurately summarised the evidence. Of course, the majority of this evidence is available in the public domain and to my knowledge no-one has yet seriously or successfully challenged the authors integrity or ability.

The authors themselves are respected scientists and capable authors and while the lack of /direct/ evidence in the book is one thing, the cases are put forward in a clear, methodical, comprehensive and logical manner and it would be hard to refute their conclusions on this basis alone.

It should surprise no-one that in the main, the book demonstrates that the four main therapies are founded on mystical or unscientific thinking and are for the most part unable to measure up to the claims their exponents make. There are a few exceptions and this reinforces the impression that Singh and Ernst have tried very hard to be fair. It should also surprise no-one that those who practise the therapies will continue to defend their art to the death. I would contend that, on the other hand, those with a genuinely scientific bent will continue to research the underlying physics/biology/chemistry and should their world-view be effectively challenged, good scientists will fall over themselves to publish proof that (for instance) there is such a thing as "innate intelligence" or "acupuncture meridians". Similarly, I would expect a good, commercial pharma company to be on the lookout for new treatments to improve, commercialise, patent and exploit. That none of these have (yet) come to pass for the majority of the therapies discussed is the foundation of this book and it speaks volumes to me.

Just a word to stave off commenters with anecdotes about how alternative medicine changed their lives when conventional medicine failed... I suffered with severe back pain for a couple of years. After spending (wasting) a huge amount of money on ineffective chiropractic treatment (and while the book actually tentatively supports the efficacy of chiropractic in the treatment of back pain, many of the criticisms of chriopractic practise match my personal experience) I eventually went to hospital for a (conventional) spinal decompression which cured the problem. Just saying. (less)

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Jul 11, 2011 Jenny rated it 5 of 5 stars

I'd been hoping to find a book like this. It was well done and interesting. The introductory chapter and explanation of the history of clinical trials was well done. Then the meat of the book (brief history of alternative therapy, and review of it's merit and/or risks based on trials and studies to date) was excellent reading. Acupuncture, Homeopathy, Chiropractic, and Herbal Medicine are examined in detail, and there is a nice appendix with summaries on a plethora of other alternative therapies...more I'd been hoping to find a book like this. It was well done and interesting. The introductory chapter and explanation of the history of clinical trials was well done. Then the meat of the book (brief history of alternative therapy, and review of it's merit and/or risks based on trials and studies to date) was excellent reading. Acupuncture, Homeopathy, Chiropractic, and Herbal Medicine are examined in detail, and there is a nice appendix with summaries on a plethora of other alternative therapies.

I would say it's a must read for anyone interested in alternative medicine, and if you do read it, I'd love to talk to you about it or just hear a note about what you thought about it. The discussion on the placebo effect and the ideas about why alternative medicine is increasing so hugely in popularity were also very interesting.

Here are a couple of the things that stuck out to me:

I had no idea that homeopathic remedies were THAT dilute, or that the practice had gained such a huge following in Europe. (Homeopathic hospitals? Wow.)

I found the chiropractic chapter surprisingly negative. Makes me want to dig a little deeper. If all they said was true, I'm surprised it's not making headlines. (Basic summary was Chiropractic is useful for back pain but not much else, and neck adjustments can be fatal(!))

One of the shining examples of "alternative" medicine triumphs over "conventional" medicine was echinachea. It really does shorten the duration of the common cold. (But, naturally, taking too large a dose for too long is not without some negative side effects.) It's neat that this plant (used appropriately) can do what no over the counter drug can.

And with my pro-natural-birth leanings I would have appreciated a little side note (by the way, maternity care is not very evidenced based), but I suppose the topic must be curtailed to fit in a single volume book, and the authors did the job of addressing the subject quite nicely.

The only critique I had that they should have indexed or footnoted their book with the studies they cited. It would add a little more weight to their work to say "We read all the clinical trials and mega studies, and they said x, and by the way here are the references" and to just say "Trust us, we did the research and the results are this." There was a recommended reading section at the end with some information, but not the detail that study by study footnotes would have provided.(less)

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Jul 11, 2010 Michael Greenwell rated it 3 of 5 stars · review of another edition

Trick or Treatment didn't have to carry me very far, I was already severely dubious of any from of alternative medicine, and it may in fact have made me reconsider my own point of view on a number of the treatments that apparently have some claim to efficacy, despite the authors' overwhelmingly negative conclusions with regards to the efficacy of alternative treatments.

However, I don't know whether I really appreciated its overall tone, which, while informative, struck me as too impassioned to b...more

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Jan 17, 2010 Harry Rutherford rated it 3 of 5 stars · review of another edition

This book reviews the evidence for the various main forms of alternative medicine. The take-home message, for me, was that most of these treatments are completely ineffective but harmless, with two major exceptions.

First is herbal medicines, which are largely untested but some of which work. Of course they can also have just as bad side-effects as anything your doctor will prescribe for you, and there's no guarantee of the quality of the product. So that's a bit of a crap-shoot.

And the surprisin...more

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Dec 13, 2009 Mike rated it 4 of 5 stars

So a while back a friend of mine used acupuncture to help with some nausea issues. I teased her about it and said it was just the placebo effect. Then I heard that some studies indicated that acupuncture may truly be useful for certain kinds of pain and nausea. In order to confirm this, I wanted to find a trusted source. I'm rather new to the skeptical community, but I have already heard much about Simon Singh and his battles with British libel laws to tell the truth about chiropractics. So I th...more

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Jun 08, 2009 Elaine Nelson rated it 4 of 5 stars

Shelves: health, non-fiction, history, science

My tongue-in-cheek instinct is to say that I'm posting spoilers, but not really: acupuncture might work for nausea & pain; homeopathy is BS; chiropractic might work for lower back pain; and herbal remedies are a mixed bag, some quite effective, others not so much.

More seriously, I like the detailed approach to these fairly common "alternative" techniques. The authors start with a history of evidence-based medicine and the application of the scientific method to human health, before going on...more My tongue-in-cheek instinct is to say that I'm posting spoilers, but not really: acupuncture might work for nausea & pain; homeopathy is BS; chiropractic might work for lower back pain; and herbal remedies are a mixed bag, some quite effective, others not so much.

More seriously, I like the detailed approach to these fairly common "alternative" techniques. The authors start with a history of evidence-based medicine and the application of the scientific method to human health, before going on to each of the modalities in particular. And throughout they introduce and reinforce scientific techniques for evaluating proposed remedies. Plus they personalize science by describing how the techniques evolved and the people involved. (It had never occurred to me, btw, that placebo also boosts the benefits provided by truly effective techniques.)

I've not been much for alternative medicine, but even I was surprised at the evidence in some aspects. (Except for homeopathy. The whole idea of it makes me giggle.) Chiropractic in particular -- some years back I saw a chiropractor for overpoweringly bad and frequent headaches. My regular doctor hadn't been a lot of help: I had some medication that provided symptom relief, but whacked me out and didn't reduce either the severity or the frequency.

To his credit, the chiropractor suggested massage (which I think gave genuine relief) and didn't encourage me to keep going after the headaches started to trail off. But after reading this, I have to wonder about my crazy popping neck, which didn't used to do that at all. Ultimately, it's my take that the headaches were somewhat psychosomatic, and were eventually "cured" with therapy and later antidepressants. (But anecdote != data and all that.)

In any case, very engaging and thought-provoking. Includes an appendix with quick reviews of a couple dozen other modalities.

Caveats: I'm not sure how effective this would be with someone who was really into alternative medicine, except that one of the authors is a former homeopath. The tone occasionally tips into LOLcrackpots! territory. For US readers, a lot of the data is UK-centered, although I didn't find that to be a huge barrier.(less)

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Apr 02, 2010 Matt rated it 4 of 5 stars · review of another edition

Shelves: dead-tree

Similar to Bad Science in some ways, and with some overlap, this important work covers some of the most popular "complementary and alternative medicine" (CAM) options available, focussing primarily upon acupuncture, homeopathy, chiropractic, and herbal medicine. Both authors bring their extensive combined experience in CAM, science, medicine, journalism and writing to bear in this excellent book.

Despite what you may expect from scientists writing about alternative treatments, they are not scath...more

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Sep 07, 2010 Joseph rated it 5 of 5 stars

This book is excellent for anyone that has ever wondered about the efficacy of alternative or complementary medicine. The book provides an in depth look at 4 major alternative treatments: acupuncture, homeopathy, chiropractic and herbal medicine. It also provides a glossary at the back with a run down of numerous other treatments of this nature.

Fear not, this book is not a hatchet piece determined to tear down the subject matter. Instead, it aims to convince the reader of the importance of evid...more

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May 15, 2012 Kirsty Darbyshire rated it 4 of 5 stars

Shelves: kindle

Before I read this book my opinion was that "alternative medicine" was largely "trick" and only occasionally "treatment", so much so that I almost didn't bother to read it. But since I struggle to explain that viewpoint to others sometimes I thought I'd have a read and see which bits were actually useful.

The authors look into four branches of alternative medicine in detail. Before reading I thought that homeopathy was a load of rubbish (though only since realising in recent years that this invol...more Before I read this book my opinion was that "alternative medicine" was largely "trick" and only occasionally "treatment", so much so that I almost didn't bother to read it. But since I struggle to explain that viewpoint to others sometimes I thought I'd have a read and see which bits were actually useful.

The authors look into four branches of alternative medicine in detail. Before reading I thought that homeopathy was a load of rubbish (though only since realising in recent years that this involves supposedly making medicines stronger by diluting them, before that I thought it was a synonym for "natural" medicine and I suspect many people have similar delusions); I didn't know much about acupuncture other than I've heard it recommended by doctors so I thought it would have some effect; I knew chiropractic was something to do with backs but chiropractors claim they can cure other things too which I was dubious about; and finally herbal medicine, which I thought would turn out to be genuine natural drugs.

Well, after reading I am a bit disappointed that what I thought was my sceptical viewpoint turned out to be a bit rosy! Homeopathy is definitely rubbish as expected, acupuncture pretty much too - the authors leave the possibility that it may have an effect on (IIRC) nausea and pain open but it is basically unproved either way and if it does have an effect then it's very minor. Herbal medicines are a jumble, mostly nonsense with a few mostly well known exceptions like St Johns Wort for mild depression. The most surprising bit for me was the evidence that chiropractors, whilst in general having some effect on back problems and none on anything else, actually employ methods that can cause strokes when manipulating necks. I will be steering clear of them!

So, the summary is that the vast majority of the effect of alternative medicine is down to the placebo effect, and the bit I hadn't really thought about before is that you also get a placebo effect when using a conventional medicine in addition to its pharmaceutical action. And much of the problem with alternative medicines is that they lead people to reject conventional medicine for no good reason.

I feel like I'm rewriting the book here...there are lots of things I would like to mention but will stop here. It's an easy read and well worth it if you want to find out a bit more about any of these "treatment"s and why they (mostly) don't work.(less)

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Oct 13, 2012 Keith Kendall rated it 4 of 5 stars

Shelves: health-and-fitness

This comes across as a extensive catalog of what trials have been made, and their result. Thus it comes across as a little tedious at times. Yet without such an in-depth listing of the many trials, advocates of alternative therapies might not be convinced of the scanty benefit and harmful effects of their favored treatment.

Evidence based medicine is the theme of this book. Until now, I was rather tepid to evidence based medicine, but after reading this book, I see the dangers of the failure to u...more

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Jan 05, 2009 Andrew rated it 5 of 5 stars

Shelves: non-fiction

I picked this book up at the library by chance. It is a fascinating exploration of both standard medicine and alternative medicine. It describes the successes and failures of standard medicine, and how the medical profession continually tests treatments to determine which work and which don't.

It then describes in detail acupuncture, chiropractry, homeopathy and herbal medicine, describing their history, their philosophy and their effectiveness. I never fully understood the first three, so this...more

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Mar 20, 2012 Yankey rated it 3 of 5 stars

This review has been hidden because it contains spoilers. To view it, click here.

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Aug 02, 2011 Tanja Seppä rated it 4 of 5 stars · review of another edition

Shelves: science, non-fiction

This book aims to explain the most common alternative therapies - acupuncture, chiropractic therapy, homeopathy and herbal medicine - and analyze their usefulness based on the same method as mainstream medicine is rigorously tested. The book details the history of clinical trials based on scientific method and explains simply and thorougly. It is thanks to clinical trials that medicine profession began to emerge from the dark ages 150 years ago and that we can now see our GP's without risking ou...more

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Apr 01, 2013 Margaret Lawrenson rated it 4 of 5 stars

A fascinating book. I've often felt I would like to be more drawn to the treatments of alternative and complementary therapists. I've had a few experiences over the years but few of them have been really positive.

This account, written by experts on both sides of the fence, is the well-researched and thoroughly readable story of the development of mainstream medical science and of some of the main alternative therapies. The book gives a clear and fascinating account of the history of medication...more

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Apr 02, 2013 David Dinaburg rated it 3 of 5 stars

I once watched a pigeon, waddling around on the sidewalk, launch into the air and bounce off a pedestrian’s chest. It shattered the illusion that the natural world is some sort of flawless, mystical place—that animals are so in tune with their surroundings that they never make mistakes or have poor judgments. “Yeah, I can totally achieve escape velocity before that giant lumbering treetrunk or whatever crosses my flightpath,” thinks the pigeon. No. You didn’t.

This sort of magical thinking—or per...more I once watched a pigeon, waddling around on the sidewalk, launch into the air and bounce off a pedestrian’s chest. It shattered the illusion that the natural world is some sort of flawless, mystical place—that animals are so in tune with their surroundings that they never make mistakes or have poor judgments. “Yeah, I can totally achieve escape velocity before that giant lumbering treetrunk or whatever crosses my flightpath,” thinks the pigeon. No. You didn’t.

This sort of magical thinking—or perhaps magical unthinking, since I often either consider squirrels or pigeons as fuzzy automatons running their behavioral scripts, or as exterior décor, like leaves or sunlight—permeates the world of self-proclaimed alternative medicine: “

Alternative therapists continue to wear the name ‘alternative’ as a badge of honour, using it to give substandard treatments an undeserved level of dignity. They use the term ‘alternative’ to promote the notion that they somehow exploit alternative aspects of science. The truth, however, is that there is no such thing as alternative science, just as there is no alternative biology, alternative anatomy, alternative testing, or alternative evidence.

Trick or Treatment: The Undeniable Facts about Alternative Medicine falls into the title-construction format the I find personally aggravating; a clever title and then an aggressive subtitle that cannot be denied. Outside of the feeling of being punched in the face with the subtitle, I knew—because I’ve read articles and books by Simon Singh before—that I was already in the same boat about homeopathy, acupuncture, chiropractic, and herbal medicine as the authors:

Chiropractors who manipulate the neck can cause stroke, which can be fatal. Some herbs can cause adverse reactions or can interfere with conventional drugs, thereby leading to serious harm. Acupuncture practised by an expert is probably safe, but minor bleeding is common for many patients and more serious problems include infection from re-used needles and the puncturing of major organs. Even homeopathic remedies, which of course contain no active ingredient, can be dangerous if they delay or replace more orthodox treatment.

Basically, it’s hokum.

If anything, I became more accepting of herbal medicine; I had dismissed it out of hand, because, well, herbal medicine. But Trick or Treatment isn’t ideological, it just dumps facts on your face: “There have been attempts to isolate the key active ingredient in St John’s wort, thought to be either hyperforin or hypericin, but when these have been tested, however, it appears that they are not as effective as the plant itself. In this particular instance, the herbalist’s view appears correct. In other words, it seems that the benefits of St John’s wort are due to a combination of chemicals, each one working to enhance the effect of the others.” My expectation of constant, confirmation-bias-based personal validation was brought up short, but it is affirming to be reminded that scientific testing—conventional medicine—will check whatever alternative bunkum spills forth from the mantra-and-placebo industry and use what is proven to be relatively safe and effective. Replicable results—that’s pretty much science, in a nutshell.

Scientists focused their attention on willow bark, which had been used to reduce pain and fevers for thousands of years. They successfully identified the active ingredient, this time naming is salicin, based on salix, the Latin word for willow. In this case, however, chemists took nature’s drug and attempted to modify and improve it, driven by the knowledge that salicin was toxic. Taken in either pure form or in willow bark, salicin was known to cause particularly harmful gastric problems, but chemists realized they could largely remove this side-effect by transforming salicin into another closely related molecule known as acetylsalicylic acid. The Bayer company in Germany started marketing this new wonder drug under the name of aspirin in 1899.

That’s science, in a willowbark.

The opening sections give a strong run-down of the historical context and comprehensible principles of the scientific method, the clinical trial, and the placebo effect. Simply having a working understanding of these three concepts is required to form an educated opinion on the actual content regarding the specific alternative medicine chapters. Having the historical background makes learning the necessary practical definitions and current applications more memorable; it is nice to be reminded this is a book, after all, not a white paper.

The word placebo is Latin for ‘I will please’, and it was used by writers such as Chaucer to describe insincere expressions that nevertheless can be consoling: ‘Flatterers are the devil’s chaplains that continually sing placebo.’ It was not until 1832 that placebo took on its specific medical meaning, namely an insincere or ineffective treatment that can nevertheless be consoling.

The ethical discussions contained near the tail end of Trick or Treatment are predicated on a working comprehension of the placebo effect:

For some conditions, such as back pain, conventional medicine struggles to offer a reasonably good solution, which means that a homeopathic remedy might be as good as anything else. After all, it will garner whatever psychological strengths the patient can bring to bear.... Our position—that the routine use of placebos is unacceptable because doctors should never lie to their patients—might seem draconian. Indeed, those who oppose our view would argue that the benefits of lying outweigh the ivory-tower ethical arguments. These opponents would feel that white lies are acceptable if they improve the health of patients.

I can’t really tell you how an ardent supporter of alternative medicine would view Trick or Treatment, but if you want to know more about acupuncture, homeopathy, herbal medicine, and chiropractic, this is a reliable place to become informed. Even if you dismiss the conclusions—that alternative medicine is often outright dangerous, or, at the least obfuscatory in finding effective treatment—the historical background and functional detailing is informative and at times fascinating.

By the start of the twentieth century, acupuncture was extinct in the West and dormant in the East. It might have fallen out of favour permanently, but it suddenly experienced a revival in 1949 as a direct result of the communist revolution and the establishment of the People’s Republic of China. Chairman Mao engineered a resurgence in traditional Chinese medicine. His motivation was partly ideological, inasmuch as he wanted to reinforce a sense of national pride in Chinese medicine. However, he was also driven by necessity...to deliver affordable healthcare in both urban and rural regions. Mao did not care whether traditional Chinese medicine worked, as long as he could keep the masses contented.

The medical data, mostly from clinical trials and meta-analyses of clinical trials, is pretty straightforward. It’s hard to dismiss the conclusions without succumbing to willful ignorance, and any book that closes out on a Carl Sagan quote is worth reading:

It seems to me what is called for is an exquisite balance between two conflicting needs: the most skeptical scrutiny of all hypotheses that are served up to us and at the same time a great openness to new ideas. If you are only skeptical, then no new ideas make it through to you. You never learn anything new. You become a crotchety old person convinced that nonsense is ruling the world. (There is, of course, much data to support you.) On the other hand, if you are open to the point of gullibility and have not an ounce of skeptical sense in you, then you cannot distinguish useful ideas from worthless ones. If all ideas have equal validity then you are lost, because then it seems to me, no ideas have any validity at all.

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May 08, 2009 Michelle Guffey rated it 4 of 5 stars

There's a lot of health stuff out there to make you wonder. This book gives you a clear and interesting point of view to think critically about alternative medicine. The authors want to provide a method to prove or disprove different methods like acupuncture, herbal remedies, etc. I thought it might be boring but it was not. The reading level is easily accessible and it starts out with history of how evidence-based medicine, and statistical research came about to disprove previously upheld medic...more

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Aug 13, 2011 Johan rated it 4 of 5 stars

This review has been hidden because it contains spoilers. To view it, click here.

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Jan 04, 2009 Laurie rated it 4 of 5 stars Recommends it for: Ruthi, Emma

Shelves: adult-nonfiction

With the growing popularity of alternative medicine, this new book is well-timed. It evaluates various therapies such as acupuncture, homeopathy, aromatherapy, reflexology, chiropractic, herbal medicines, and more. The authors analyze alternative medicines for their benefits and potential dangers, apply scientific scrutiny to various claims, and show where some underlying philosophies contradict what is already known scientifically. A section called, "Why do smart people believe odd things?" dis...more

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Oct 07, 2011 Peter Scholtens rated it 4 of 5 stars

Very solid book examining the scientific evidence on a number of different alternative therapies. The conclusion? Chiropractic and herbal medicines can be helpful, but are not demonstrably more helpful that evidence-based, modern medicine, and are sometimes more dangerous. Everything else (reflexology, homeopathy, iridology) is pretty much bunk.

Perhaps the best parts of the book are the explanations of why alternative medicines are appealing (they give hope and their practitioners are better at...more

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Mar 31, 2009 Todd Martin rated it 5 of 5 stars

Trick or Treatment takes a scientific look at the evidence for and against Alternative Medicine. The authors look at a broad range of clinical trials and use this data to describe:
• The claims as to how the treatments function
• Whether the treatments work
• If so, for what conditions
• The dangers involved

Unfortunately, alternative medicine makes many claims which are not supported by the evidence.

Acupuncture – There is no such thing as Chi or Meridians. Some evidence exists for minor and temporar...more

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Dec 30, 2012 Deslyn Brown rated it 4 of 5 stars

I was a little disappointed at the fact that the authors didn't really mention the possibility of the negative influence of the controlling money-hungry government having a part in all this(undeniable), esp in America. Other than that, it was very well-written, had a lot of interesting history behind every therapy & alternative approach, & overall very interesting facts & perspectives. Still makes me question whether or not the author were providing ALL the facts/studies on each subj...more

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Jul 29, 2011 Frank Jude rated it 4 of 5 stars

Shelves: general-science, medicine, skepticism

Here's a real challenging book that will most likely not be read by the very folks who need it the most! Singh and Ernst go deeply, using the highest benchmark of the scientific method and clinical research to investigate "alternative" medicine and treatments, including homeopathy, acupuncture, and chiropractic therapy.

If you use any of these -- or any other 'alternative' medicine or treatments (their appendix reviews many other treatments from 'magnet therapy' to 'crystal therapy' and many more...more

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Sep 28, 2012 Bruno rated it 4 of 5 stars

Shelves: medicina-psiquiatria

Um livro de leitura obrigatória para qualquer pessoa que esteja a considerar recorrer a "Medicinas Alternativas" e para os médicos menos avisados que as recomendam aos seus doentes. Algumas partes podem ser um pouco repetitivas para quem já está familiarizado com o método científico, mas para o público em geral serve como excelente introdução, defendendo a disciplina e rigor da Ciência contra as falsas promessas e absurda ineficácia da vasta maioria das "Alternativas".

Aborda em detalhe 4 das pr...more Um livro de leitura obrigatória para qualquer pessoa que esteja a considerar recorrer a "Medicinas Alternativas" e para os médicos menos avisados que as recomendam aos seus doentes. Algumas partes podem ser um pouco repetitivas para quem já está familiarizado com o método científico, mas para o público em geral serve como excelente introdução, defendendo a disciplina e rigor da Ciência contra as falsas promessas e absurda ineficácia da vasta maioria das "Alternativas".

Aborda em detalhe 4 das principais práticas alternativas da actualidade (Acupunctura, Quiropraxia, Homeopatia e Ervanários), revendo cuidadosamente a evidência disponível e concluindo, como seria de esperar, que a relação custo-benefício simplesmente não justifica a utilização deste métodos - dos pouquíssimos que mostraram ir além do efeito placebo, o resultado obtido é tão marginal que não compensa o investimento. Ainda mais importante é o enfoque dado aos perigos e efeitos secundários destas práticas, "naturais e tradicionais", erroneamente assumidas como seguras e inócuas.

Acima de tudo isto, o meu capítulo favorito é, sem dúvida, o penúltimo: corajosamente, os autores apontam o dedo aos "10 culpados" pela forte emergência destas pseudo-terapias na sociedade moderna, minando o trabalho realizado pela Medicina científica e pondo em risco a saúde dos doentes. Estes "suspeitos do costume" incluem: os "gurus das medicinas alternativas", que mentem e exploram os doentes com promessas irrealistas; os governos e entidades reguladoras que fecham os olhos ou, pior ainda, apoiam o recurso às práticas alternativas; a comunicação social, que distorce resultados de pesquisas científicas e apregoa curas milagrosas sem qualquer preocupação em assegurar a veracidade dessas alegações; os médicos, que se sentem tentados a despachar os doentes crónicos e chatos para o homeopata; a própria OMS, que emite pareceres ridículos, sustentados em estudos falaciosos e mal desenhados (e entretanto desacreditados), recomendando o uso de terapêuticas inertes.

Os autores deixam ainda um apelo à comunidade Médica, que eu subscrevo: é imperativo acabar com o medo de avisar os doentes sobre a realidade das Medicinas Alternativas. O dever de honestidade para com o doente deve ser prioritário e qualquer cedência ao misticismo é um retrocesso perigoso - especialmente quando consideramos o quão a Medicina evoluiu desde que se firmou nos fortes alicerces da evidência científica.(less)

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Jan 16, 2012 Cindy rated it 5 of 5 stars

An absolutely wonderful survey of the importance of evidence over anecdote in medicine. The bulk of the book delves into four of the largest areas of alternative medicine -- acupuncture, homeopathy, chiropractic, and herbal medicine -- and very clearly reveals most of them to be glorified placebos.

Alternative medicine aside, though, the introductory chapter concisely explains how science informs decisions about the safety and efficacy of both traditional and alternative therapies, starting with...more

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Apr 05, 2013 Paddy Srinivas added it

Recommended to Paddy by: Michael shermer

The chapter on Homoeopathy was very enlightening. I used to buy Homoeopathy pills for various common ailments. Not any more.
This book is neatly organized one chapter for each pseudo, non-scientific remedy type and I learnt so much from the book.
The book methodically demolishes arguments in favor of each of these pseudo remedies. In particular, the argument that many of these pseudo remedies are not conducive to double blind studies has been systematically annihilated.

You can skip the last coupl...more

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