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Book Review: Trick or Treatment

In Trick or Treatment: The Undeniable Facts About Alternative Medicine, Simon Singh and Edzard Ernst, M.D., set out to analyze the scientific literature on acupuncture, homeopathy, chiropractic, herbal medicine, and a host of other modalities of so-called alternative and complementary medicine. The book begins with a long, fascinating chapter about the history of medicine and the emergence of the modern, evidence-based approach to medicine—i.e., conventional, Western, or allopathic medicine. Their stated purpose is to keep an open mind while applying the principles of evidence-based medicine to popular alternative modalities. Their backgrounds as medical outsiders and the careful, measured language of the introduction gave this skeptical reader confidence that the authors would be able to satisfy this goal.

But in my case, Singh and Ernst were preaching to the choir. I listen regularly to several podcasts that focus on science and skepticism (e.g., QuackCast and The Skeptic’s Guide to the Universe) and I follow medical news and blogs (e.g., Science‑Based Medicine). So I probably have a better idea of the current medical consensus on some of these modalities than most members of the general public. I was not surprised by their conclusions, which found most alternative modalities to fall somewhere in the range between barely useful and downright dangerous.

I know a lot of alt-med True Believers, though, and I fear that Singh and Ernst are overly optimistic about the willingness of the proponents of alternative medicine to rely on science as the best way of understanding the world. Any sensible person who’s willing to spend 10 minutes googling “homeopathy” can figure out pretty quickly that this particular form of “medicine” has absolutely no plausible mechanism, and yet Americans spent $1.5 billion on homeopathic remedies in 2000. I suspect that believers in complementary and alternative medicine don’t want to know what science has to say about these modalities, because they don’t know enough about science to evaluate its conclusions. I would enthusiastically prescribe Trick or Treatment for anyone who’s interested in the facts about alternative treatment modalities. But I make no promises that it will cure the lack of intellectual curiosity that infects the alt-med True Believer.

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