Customer Reviews

Trick or Treatment: The Undeniable Facts about Alternative Medicine

5 star:		(34)
4 star:		(13)
3 star:		(6)
2 star:		(8)
1 star:		(9)

 

 

I have been meaning to write a review of Trick or Treatment for some months now and had a lot of sophisticated ideas how to phrase it. In the meantime, I had sent my mother a "care package", with dried cranberries, organic Earl Grey tea and a copy of Trick or Treatment. She called me last weekend and said:

"This book is so full of suspense and so extraordinarily well written. I understand what you mean now. I guess I will have to give up my beloved Arnica globules then. It *does* make sense that they cannot work if there is nothing in them. To bad that the German version does not come out until next year, I have some friends who should read this book."

There, that sums it up: Singh and Ernst obviously struck the right tone and paced the book appropriately for the educated user of "alternative medicine" to follow and accept the conclusions of many careful trials. That is excellent, because I myself somehow never muster the patience to go through the details, why this or that "alternative" is not even worth trying.

The only point that I found irritating (and so did my mum) is the sparseness of literature. Few sources are cited and they only refer to the chapter rather than a specific statement. This is something that would be worth amending in future printings and/or in other language additions. I want all necessary references in the book I am reading and don't want to be refered to another book of the author for background.

A must read for:

Any person in the medical field, so they understand who and what contributes to healing (the colour of the pill often as much as the ingredient).

Anyone with a longer lasting medical condition (since they are the prime "target" for most of the CAM methods and practitioners).

Any parent (most CAM products are essentially "Wellness" and parents should realize that they can generate "Wellness" for their child without the stringent rules of homeopathy, or the potentially dangerous upper spine manipulations of a chiropractor).

If you're a fan of acupuncture, homeopathy, chiropractic therapy,
or holistic medicine, you probably won't want to read TRICK OR
TREATMENT by Simon Singh and Dr. Edzard Ernst . . . its premise,
as stated in the subtitle, is to present THE UNBELEVABLE FACTS
ABOUT ALTERNATIVE MEDICINE.

In doing so, they state in the very first two paragraphs what readers
can expect to find:

* 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."

There's much to like about this book . . . for one, there were
interesting tidbits about famous people, including the following
about Florence Nightingale:

* Nightingale's passion for statistics enabled her to persuade the
government of the importance of a whole series of health reforms.
For example, many people had argued that training nurses was
a waste of time, because patients cared or by trained nurses
actually had a higher mortality rate than those treated by
untrained staff. Nightingale, however, pointed out that this was only
because more serious cases were being sent to those wards with
trained nurses. If the intention is to compare the results from two
groups, then it is essential . . . to assign patients randomly
to the two groups. Sure enough, when Nightingale set up trials
in which patients were randomly assigned to trained and untrained
nurses, it became clear that their counterparts in wards with untrained
nurses. Furthermore, Nightingale used statistics to show that home
births were safer than hospital births, presumably because British homes
were cleaner than Victorian hospitals. Her interests also ranged
overseas, because she also used mathematics to study the influence
of sanitation on healthcare in rural India.

I also liked how the authors clearly explained concepts and while
doing so, incorporated some humor into what otherwise could have
been very dry material . . . for example, as indicated in this passage:

* Scientists even began to poke fun at homeopaths. For example,
because homeopathic liquid remedies are so diluted that they
often contain only water, scientists would sarcastically endorse
their use for the treatment of one particular medical condition,
namely dehydration. Or they would jokingly offer to make each
other a drink of homeopathic coffee, which was presumably
incredibly diluted and yet tasted incredibly strong, because
homeopaths believe that lower amounts of active ingredient
are associated with greater potency. Similar logic also implied that
a patient who forgot to take a homeopathic remedy might die
of an overdose.

At the very end of the book, there's an excellent "Rapid Guide to
Alternative Therapies" . . . these cover some 36 others, including
Colonic Irrigation, Feldenkrais Method, Magnet Therapy, Osteopathy,
and Reiki.

Be forewarned that you might not like what you read in TRICK
OR TREATMENT, particularly if you believe in any and/or all
of the above . . . however, it will get you thinking--and that's
always a good thing.

This is an excellent book, and I would have given it a 5 star except for the fact that there is no reference given to many of the studies that are quoted in the book.

One of the authors, Prof. Edzard Ernst, was a professor of Complementary Medicine at Exeter University, he used to be a homeopath practitioner as well, happily doling out homeopathic "medicine" to his patients until one day, he decided to look at the science underpinning homeopathy and found there was none. He is therefore an insider of Complementary Medicine and has found that practice wanting.

He is very similar to Prof. R. Barker Bausell of Maryland University, who used to be the statistician at NIH responsible for analyzing the data in the NIH funded Complementary and Alternative Medicine Specialized Research Center, where after a couple of years of work there, found that there was no scientific proof that Complimentary/Alternative Medicine was better than placebo, he left the Center and wrote the book "Snake Oil Sciene" (ISBN 978-0-19-531368-0, available here at Amazon)

Both these books very clearly showed the claims of Complementary/Alternative Medicine do not stand up under the glaring light of science. Both were written by insiders, insiders who are scientists, and insiders where their honesty requires them to write these two books.

I will not add to what other reviewers have said except to voice my own personal opinion as to why CAM has been getting popular among the general population.

I think most patients want reassurance from their doctors that everything is alright. But because of the way the medical profession is now constrained to act, (I am a practicing clinical hematologist), we have to tell the patient the probability of success of the drugs we are using, the potential side effects and so on, this takes away the placebo effects of the drugs we are administering. When we treat someone with malignancy, we can never tell the patient he has a 100% chance of cure and that he will be alright, but there is no such constraint on the CAM practitioner. As "Trick or Treatment" says, CAM practitioners are never required by law to tell the patients the side effects or possible harmful effects of their treatments, instead their mantra is, 'this is holistic natural and has little side effect", the exact opposite of what the scietific medical community is required to do.

If you use any type of alternative medicine -- chiropractic, homeopathy, whatever -- you should read this book! Education, licensing, and other forms of regulation of alternative medicine practitioners DO NOT protect you from worthless treatments and physical harm (even death). An honest, factual risk-benefit analysis explained by your health care provider prior to treatment -- the cornerstone of informed consent in conventional medicine -- is virtually non-existant in alternative medicine. You must protect yourself with the type of unbiased, well-researched information this book provides. Don't worry about it being "too scientific." The authors do a fantastic job of explaining alternative medicine in easily understood language. Think about it: considering what you are paying for alternative treatments, isn't it worth the price of Trick or Treatment to find out if you're getting your money's worth? Or better yet, if you are risking your health for no good reason?

I'm a first year acupuncture student, and I'll also be withdrawing after this term. I found the book informative, entertaining, and relatively balanced.

A list of studies would have been nice. I ended up researching the acupuncture studies on my own. Healing is a mystery and people do heal regardless of whether or not clinical trials verify the treatment. People heal from Jesus, from standing on the Earth, from Qi Gong -- you name it. I believe there needs to be more humility from all sides in approaching this topic, however science is the best bet we have to determine what is really working and what isn't. Acupuncture may work for some things, however the theory behind has been debunked, given the fact that sham acupuncture has had the same benefit in so many studies.

Although this book is informative and well worth reading, it bothered me that it does not turn the same critical eye toward the "evidence based" medicine as it does to alternative therapies. While glorifying, often justifiably, the achievements of conventional medicine it does not address the many recent findings that have reversed well received conventional opinion. A well known example is the medical communities reversal on hormone replacement, but there are many others. Just this week a study has come out "scientifically" validating a form of magnet therapy for depression, something the authors dismiss out of hand.

It also bothers me that the author relies on rather dramatic anecdotal evidence to convince the reader of the dangers of various alternative therapies while not admitting anecdotal evidence to support the same therapies.

Furthermore the authors give only lukewarm endorsements to therapies such as yoga, that have received endorsements from the medical community after testing.

As I stated, an interesting read, but hardly the last word on the subject(s), even for those who already have a "confirmation bias" when it comes to rational argument.

This is an excellent primer on the history science based medicine (that should be a redundant), methodology and the top "alternative" therapies. Highly recommend for a balanced overview on the subject of complementary medicine. If there would be one book to cover this topic, this would be the one.

The argument of this book is that there is no scientific proof of alternative meidcines efectiveness.

I personally experienced with acupunture, digipunture, chinese massages, homeopaty and some forms of chiropratic treatments (osteopathy, etiopathy). I never experienced a clear benefit from all these treatments, except maybe from an osteopat that recommended me to stretch more often and drink more water (not sure if this advice qualifies as alternative medicine).

Despite this I still thought that these treatments may have some benefit (1.3 billion chinese can't be wrong) and that I was just unlucky. Furthermore, although I never believed in some of the foundations of these practices (like the chinese explanation for acupunture, with its energy flows and meridians), I thought there was a reasonable doubt that treatments may be benefitial due to some other, more scientifically accepted reasons.

Well, this book demolished my faith in all these treatments, and in the way made me feel like an idiot for spending so much financial, time and emotional investment in them.

A great read, then, but you need to approach it with an open mind. If you are already have a position on alternative medicine (or believe that "big pharma" control the world) don't waste your money on this book. If you are ambivalent about alternative medicine, and want to get more facts, this book is great for the "against" side. Just beware, it is a very, very, very convincing read.


Pros
- Good structure. Before entering into the specifics of each alternative treatment, the authors take their time to discuss the scientific method in general, including its origins, evolution and and how it applies to both conventional and alternative medicine.
- Good balance between citing scientific, statistic and anecdotical evidence to give the facts and illustrating them too.
- Extensive discussion of sources.
- Good explanation of the placebo effect, including an interesting discussion on whether alternative medicines are worth taking just for the placebo effect (which can be quite significant, after all)


Cons
- It focuses on only four medicines: acupunture, homeopaty, herbal remedies, and chiropractice. Other alternatives (Feng Shui, meditation, rectal cleansing, etc) are referred to in an appendix, on one page summaries. I would have liked to see more.
- The book concludes that many of the alternative treatments "don't work better than a placebo". However, a placebo can work remarkably well in some cases, and reading this book can eliminate it by making the reader loose faith in these treatments.

Worth the read for anyone. A good introduction to scientific research methods and comprehensive guide to alternative treatments.
Probably won't change the opinion of the fanatic but then again which reasoning will.

Trick or Treatment is a bluntly objective look at alternative medicine. It is written for the consumer, consequently the first chapter is devoted to the scientific method in order to introduce the layman to how data potential treatments should be evaluated. the authors challenge the reader to keep an open mind and read the rest of the book with the scientific method in mind.

Acupuncture, herbal remedies, homeopathy, and chiropractic get their own chapters. In fairness, the authors do point out what treatments demonstrate efficacy, though they also point out potential side effects and disadvantages (particularly cost). Since it is not possible to give all the alternative treatments offered today a full chapter, a reference guide at the end is offered. The guide is very helpful in that it offers a brief history of the treatment, a summary of what (if any) scientific investigation has been conducted, and a decision about whether the treatment is worthwhile.

Although Trick or Treatment's overall message is that alternative therapies are rarely effective and in the best cases only comparable to conventional medicine, the mountain of evidence presented and one of the author's background in homeopathy makes the conclusions laid out in the book difficult to ignore. This book is highly recommended for the conscientious consumer and patient.