Beata Bishop: “To CAM or Not to CAM?”


Review of:

Trick or Treatment:
The Undeniable Facts about Alternative Medicine

Edzard Ernst and Simon Singh
W. W. Norton & Company, 2009.

by Beata Bishop


Not for the first time, Professor Ernst has launched a full frontal attack on alternative medicine which, he claims, includes complementary therapies as well.

The most interesting thing about this handsome volume, written with science journalist Simon Singh, is the mass of contradictions it contains. To start with, Edzard Ernst is the world’s first professor of alternative medicine, yet he continuously discredits and ridicules the very subject he is supposed to teach. Next, he endorses a dictum of Hippocrates – ‘There are, in fact, two things, science and opinion; the former begets knowledge, the latter ignorance’ – but what we get, especially in the Rapid Guide to some 36 alternative therapies (all of which happen to be complementary) are Professor Ernst’s opinions. There are many more non-sequiturs scattered throughout the text, e.g. that while we are told repeatedly that homeopathic remedies are nothing but placebo, yet on p. 142 we read that ‘even homeopathic remedies, containing no active ingredients, can carry risks.’

The main part of the book concentrates on four well-known and popular CAM therapies: acupuncture, homeopathy, chiropractic and herbal medicine. All four deserve thorough scrutiny and a precise, objective analysis of their areas of usefulness or failure. Unfortunately that’s not what they get. The book’s subtitle, ‘Alternative Medicine on Trial’, presumes the subject’s guilt, and the authors’ claim to deliver ‘the ultimate verdict on alternative medicine with clarity, scientific rigour and absolute authority’ adds a thunder of finality.

But the thunder soon turns hollow. There is a list of suggested further reading, one third of the items being by Prof. Ernst et al., but in vain do we look for references. There aren’t any. Instead, we get vague phrases, like ‘Critics point out….’ Who are they? We are not told. Other statements contain words like may, might or could – namely cause harm to patients (or not). There is even less scientific rigour in the way facts are twisted and spun to support the promised ultimate verdict. One prize example concerns the 1854 cholera epidemic in London, when ‘patients at the London Homoeopathic Hospital had a survival rate of 84%, compared to just 47% for patients receiving more conventional treatment at the nearby Middlesex Hospital’. One might think that this proves the success of homeopathy, but no – the unnamed critics point out that the patients attending the Homoeopathic Hospital might have been wealthier, better fed and healthier before falling ill than the patients at the Middlesex; which helped them to recover; standards of hygiene at the latter may have been poorer, and finally the higher survival rate at the homeopathic hospital ‘was not indicative of the success of homeopathy, but rather it pointed to the failure of conventional medicine.’ QED.

After this illogical cartwheel it’s not surprising to be told that the stunning results of acupuncture, as performed in Chinese hospitals and shown on British TV, were faked – the results were ‘too good to be true’, we read (isn’t that an opinion?). Even the WHO gets its knuckles rapped for endorsing acupuncture. And there is a horror story of an Austrian acupuncturist (no reference, no details) who allegedly killed a woman patient by piercing her heart with his needle. Sounds impossible? Ah, the woman had a hole in her sternum and the needle, with uncanny precision, found its way through it. There are other equally unreferenced stories to show the risks of alternative medicine. Chiropractic handling of the upper spine can cause strokes, and taking X-rays of patients can cause cancer (but X-rays taken in conventional medicine can’t?). Acu­puncture can cause fainting, nausea, vomiting, and, above all, infection. Herbal remedies can be contaminated and may be ineffective. Homeopaths are dangerous, because they oppose the vaccination of children and, worst of all, take the place of conventional doctors. In brief, CAM is dangerous. However, considering the series of scandals over the past few years, exposing the dangers of ‘safe’ pharmaceutical drugs – step forward Vioxx, Prozac – and the alarming growth of iatrogenic illness, this worry seems exaggerated.

Ernst repeatedly attacks the Prince of Wales for his support of CAM – the book is snidely dedicated to him – and ridicules him for suggesting in 2004 that the anti-cancer Gerson therapy should be investigated for its possible benefits. Alas, he then displays his ignorance by writing that ‘the potentially harmful Gerson therapy starves already malnourished patients, depriving them of vital nutrients.’ In fact this therapy is based on hypernutrition, with patients consuming some 20 lbs of organic fruits and vegetables a day, partly in the form of juices. Research first, attack later might have been wiser.

And yes, of course there are badly trained or incompetent CAM therapists, just as there are incompetent doctors. But last year over seven months some 10,000 UK patients suffered serious adverse reactions to prescribed drugs; how many cases have been reported during the same period of life ­threatening conditions caused by vitamin tablets, herbal remedies or an overdose of acupuncture? All in all, this biased, unscientific book is worthless in itself, yet worth challenging, for it represents an outdated, Cartesian attitude which ignores all current worldwide research into dietary therapies, nutrition (does Prof. Ernst know the difference between those two?), the psycho­somatic connection, and the rigorous scientific exploration of – yes, complementary therapies. More damagingly, it reinforces the current attempt, orchestrated by commercial interests, to legislate all nutritional supplements, natural remedies and treatments out of existence, via Codex Alimentarius and weird EU directives. Cui bono? We hardly need ask. Since hi-tech modern medicine, wonderful in acute and emergency cases, can only offer symptomatic treatment against chronic degenerative diseases, alternative methods should be objectively examined and, if found effective, widely used.


To CAM or Not To CAM?
Beata Bishop, The Scientific and Medcal Network, 2014

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