Trick or Treatment

Rare are the people who don't consider themselves some kind of medical expert. This is a real problem, because most people know medicine as well as they know the composition of the Jupiter's inner core. I am not a medical expert, I don't even watch one TV. I notice the problem of the lay medical expert tends to be followers of Supplements, Complementary, and Alternative Medicine (SCAMs). I've been presented with a few SCAMs in my lifetime. The sellers are quite convincing, I think it's their confidence. What can you really count on though? Are they telling the truth. Two men dove into this cess-pool of crap and produced the work entitled Trick or Treatment: the undeniable facts about alternative medicine. Those men are Simon Singh and Edzard Ernst*.

As I stated, I am no medical expert. After reading Trick or Treatment I feel like one for sure; like I could correct Dr. Oz on a few things. Trick or Treatment is the best book I've read this year. If you read Trick or Treatment and still feel that much of Alternative Medicine is valid, check into Bellevue. Singh and Ernst take SCAMs to the cleaners.

The books it broken into four main chapters with each covering one of the major SCAMs: Acupuncture, Chiropractic, Homeopathy, and Herbal Medicine (the appendix provides an overview of several SCAMs with a brief analysis for each). In addition, the authors detail the history of medicine, specifically the emergence of the scientific trial and double-blind studies**.

While I found the whole book interesting and hard to put down, the opening chapter was the most important part. In this chapter, the authors detail the growth of the scientific trial and the emergence of a practice that can be referred to as Science-Based Medicine. Understanding how we can conclude what treatments are effective is essential in making sure people can recover from illness with minimal risk. All medicines and medical treatments must pass the FDA to be used in the US. Part of that process is showing the treatment works using double-blind studies to show the treatment works better than placebo and it is safe, relatively speaking. SCAMs do not have to go through the same rigor. In fact they don't have to go through any rigor.

In researching the treatments discussed in Trick or Treatment, the authors set a standard for their studies they were willing to accept. To insure they were getting the best information available, they left out studies that did not utilize proper scientific controls. Unfortunately including all studies would inaccurately skew the data. When the proper controls are not in place, many of the treatments appear effective. When the proper controls are put into place most of these positive results dry up. What good is a treatment if it only appears to work when you don't scrutinize it very well? Not good.

While four main treatments are covered, I'll focus on Homeopathy for the review. Homeopathy is the most nonsensical of all the treatments. Samuel developed the concept of Homeopathy in the late 18th century. At the time it worked better than the conventional medicine of the time. It worked better, not because it was an effective treatment, but because the conventional treatments of the day were dangerous. We're talking about things like bloodletting, which killed George Washington. The Homeopathic patients survived because they were avoiding the treatments of the day. As medicine improved and the scientific method was applied, the tables turned.

Homeopathy's premise is like cures like. That means an illness should be treated by a substance that features the same symptoms was the illness when ingested. An example would be an illness that causes vomiting. The treatment would be something like syrup of ipecac, which when ingest causes vomiting. The patient is not given the actual substance, but a super dilute substance. It is so diluted, one would need to ingest the entire Solar System to find one molecule of the original substance. This is accomplished by taking part substance to nine parts water. Shake it and take one part of that mixture to nine more parts water. Shake and repeat. The recommendation from Samuel Hahnemann is to dilute the substance 30 times. With Homeopathy, you are not being healed by the substance, but by the "memory" carried in the water from being mixed with that substance.

Homeopathy is pure placebo. There is nothing in the mixture that works. The only illness Homeopathy can heal is dehydration. On the bright-side, it's hard to over-dose. I guess you can drown or die for water intoxication.

The authors demonstrate the clear silliness of Homeopathy. Not one single studies shows any real effect over placebo. That's what's unique about Homeopathy among the SCAMs in the book. It is the only one that is pure BS. The others have some redeeming qualities, though they are few and far between.

In short this is a great book. It's easy to read and I think any ready will come away with a better understanding of the scientific method and modern medicine. This is the kind of book that should be discussed in schools, because it shows the scientific method and shows how it weeds out the bad ideas.

* Simon Singh is a UK science journalist and best selling author. He has a PhD in Particle Physics. Edzard Ernst is a former practitioner of Alternative Medicine as well as the first professor of Alternative Medicine at the University of Exeter.

** A double-blind study is one where neither the subject nor the administrator know what treatment is being given. This can be done by assigning each subject a random number and giving them generic pills. That way the subject can not know whether they are receiving the treatment or placebo. Ensuring the administrators don't know whether the treatment is genuine or placebo is important so they can't influence the subjects in anyway.