I was really frustrated by this book. So frustrated that I returned it with about 50 pages left to read. I'm not even sure I can tell you exactly why I didn't like it, but I found the attitude of the authors some what holier-than-thou, and not really very helpful or useful. It's particularly ironic that I didn't like the book, since I agree with most of what they said.

This book takes an empirical view to evaluate the clinical trial data on various alternative medicine. For each of the "therapies" analyzed in the book, there is a summary of the historical background, major proponents and controversies, whether the basic idea is "biologically plausible", and results of credible clinical trials. In the Appendix section of the book, there are angle-paged summary of popular alternative medicine, the evidence and conclusion. The overwhelming conclusion is negative. Even among the positive ones (such as yoga or T'ai Chi), the tone is still "conventional exercise would do". The phrase " a wast of money" is often repeated for most of the remedies. Clearly, the authors can barely hold back calling the whole field quackery and superstitions.Yet medicine is not a cut-and-dry field stocked only by clinical trial data. The psycho-emotional component of a patient's involvement and trust in care-givers influence their well-being greatly. Placebo is not a boogie to pass, but a phenomenon to understand in its own right. One waits for another book to understand why people still pay good money to seek alternative medicine. Calling all of them uninformed or lack of intelligence perhaps oversimplify the condition of workaday patient's relationship to the medical system itself. I personally find the book's writing style lack of neutrality, although there is unarguably much information on this topic.

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 thought he would be a good person to trust.I was very happy with my choice. The book is quite well written. It's not just a dry account of peer-reviewed studies. It tells the stories of how various forms of alternative medicine became so popular, some of which are very strange and interesting. The book also weaves in stories of how evidence-based medicine came to take hold in Western society. It's amazing how far medicine has come in just a couple centuries. So many people contributing in small ways that add up to change the world. And Florence Nightingale is so much cooler than they bothered to teach me in high school.As for my friend's acupuncture, well I guess it's still unclear whether or not acupuncture works beyond placebo for nausea. Further evidence may well show that it's useless, but at the time of her treatment, there was some apparently legitimate positive evidence. So it was a legitimate choice and I should probably go apologize.

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 be as neutral as they claimed to be. I agreed with their arguments, and I too was shocked and outraged when they presented the evidence and theory behind some of these treatments, homeopathy in particular. Unfortunately I don't think their arguments will be nearly as convincing when faced with someone who has a vested interested, or even a strong belief, in the treatments they describe. A lighter touch would probably be more convincing, and might have made it a slightly easier read.That said, I came out of this book feeling significantly more knowledgable on the subject than I was when I started. The references that I followed up on proved solid and intriguing, which leads me to believe that the authors' position is both well researched and dependable. I thought it was interesting that one of the authors, Edzard Ernst, is an expert in the field of Complementary and Alternative medecine, and has even practiced homeopathy.I should note that the book is written from a British perspective, and that all of the references to healthcare, costs, etc... are in pounds and the context of the NHS. I didn't mind this, as Canada's healthcare system seems fairly close to the UK system, and the majority of the information the book provides is location agnostic.

I once watched a pigeon, waddling around on the sidewalk, launch into the air and bounce off a pedestrians chest. It shattered the illusion that the natural world is some sort of flawless, mystical placethat 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 didnt.This sort of magical thinkingor 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 sunlightpermeates 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 knewbecause Ive read articles and books by Simon Singh beforethat 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, its 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 isnt ideological, it just dumps facts on your face: There have been attempts to isolate the key active ingredient in St Johns 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 herbalists view appears correct. In other words, it seems that the benefits of St Johns 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 testingconventional medicinewill check whatever alternative bunkum spills forth from the mantra-and-placebo industry and use what is proven to be relatively safe and effective. Replicable resultsthats 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 natures 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. Thats 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 devils 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 positionthat the routine use of placebos is unacceptable because doctors should never lie to their patientsmight 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 cant 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 conclusionsthat alternative medicine is often outright dangerous, or, at the least obfuscatory in finding effective treatmentthe 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 Peoples 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. Its 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.