Thursday, September 02, 2010

Trick or Treatment?

With the Flipkart voucher I won here, I bought "Trick or Treatment?: Alternative medicine on Trial" by Simon Singh and Edzard Ernst.

It is a must-read for everybody interested in health - and especially for those who rely on alternative forms of medicine. It is interesting, impartial, well-researched, and full of information.

Chapter 1 - Speaks about why such an impartial study is important - millions of people around the world spend billions of money on alternative therapies - are they effective, and safe? This chapter also examines the kind of clinical trials that are necessary to evaluate the effectiveness of any remedy. It speaks about how clinical trials evolved, why blind and double-blind studies are important, and examines the placebo effect and its importance. A very interesting and informative chapter.

Chapter 2 - Deals with acupuncture. Acupuncture is based on an ancient Chinese belief that Ch'i energy flows through a body, and ailments occur when some important nodes are blocked. Sticking needles into the body at such points releases the blockages and sets the energy flow right again. Acupuncture claims to treat all kinds of remedies. The presence of Ch'i itself hasn't been proven over all these centuries, and so the basic presumption of this therapy might itself be wrong. But anyway, many studies have been conducted, including some very clever techniques to test the placebo effects of acupressure. The overall conclusion is that there are indications for its efficacy for some types of pain and nausea, but the evidence of relief for any other ailment is not enough. It is a relatively safe kind of treatment if you are so inclined to take it, but there have been cases of death due to negligent needling.

Chapter 3 - Homeopathy. Now this has been causing me trouble for a long time now. On one hand, there is this remedy that offers patients medicines that are so dilute that there is not even ONE SINGLE molecule of the original substance in the resulting medicine. It defies logic. On the other hand, there are millions of people who swear by it, some of them very smart and informed people. So there are only two alternatives - either the basic principles of science as we know it are utterly meaningless, or those millions of people are wasting time, energy and money on a placebo.

I did a lot of research prior to reading this book, and none of the homeopathy jargon made any sense to me. On the contrary, all the critics of homeopathy had me nodding with them in agreement.

This book is unique in that it approaches homeopathy in a very impartial way. It is not important that we understand it in the beginning, they say. Thousands of remedies weren't understood in the beginning, but were applied nevertheless. Only later did researchers understand the science behind it. The same approach has been taken throughout the book.

First the chapter talks about the origin of Homeopathy (based on hunches, assumptions), its rise in popularity (conventional medicine at that time actually killed people - using techniques such as bloodletting. So people who took homeopathy were better off. So it was assumed that homeopathy was effective), and its spread across the world (different reasons for their spread - mostly politics - nothing to do with efficacy).

To cut a very long chapter short, 200 years and 200 clinical trials later (which has taken into account all the basic tenets of homeopathy - including individualized treatment, etc), it has been proven beyond doubt that homeopathic treatment is no better than a placebo.

One of the authors, Edzard Ernst, is a trained homeopath, who has even practiced for sometime, before stepping back and opening his eyes. He says that nobody would have been happier than him if it had been proven that homeopathy is effective, as it would have opened up an entirely new world of research.

But why does homeopathy "seem to work"? All is explained in the book - and I guide you there for any more questions you might have.

Chapter 4 - Chiropractic therapy - Chiropractors claim that the spine is the key to the body's health, and adjustments to the spine can cure all diseases. Often it involves very rough manipulation of the spine and neck, and there are severe side effects, and several cases of death. Over the centuries, one section of chiropractors have broken away from the traditional beliefs and follow a more moderate form of this therapy, claiming to treat mostly back pain. But studies have shown that spinal manipulation might help, but it is in no way better than regular physiotherapy, which is safer and cost-effective.
If you remember, Simon Singh was unsuccessfully sued for libel by the British Chiropractic association for an article in The Guardian, criticizing Chiropractic therapy.

Chapter 5 - Herbal Remedies - Now this chapter was something of a shock to me. I was one among those who tended to believe that herbal remedies can't go wrong. After all, mainstream medicine also sources much of its remedies from plants. But what I found was that, yes, drugs are certainly made from plants, but the particular effective substance is isolated, and then synthesized or extracted to make medicines.
Very often, eating the whole leaf or nut or bark as the case may be, results in unwanted side effects. There have been many cases of people taking a herbal remedy along with mainstream treatment, and some substance in the plant has reacted adversely with the mainstream medicine and caused severe ill-effects. Even some commonly used herbal products that we use as home remedies might cause undesired side-effects when taken in excess. A mix of herbs, especially, that is common in herbal medicine can be particularly dangerous. This book suggests that before going in for herbal remedies, do your research well. Besides, many regular drugs go through years of testing to certify that it is safe and effective, whereas herbal remedies appear on shelves overnight. And it is not fair to the consumer.
An eye-opener of a chapter.

Chapter 5 - Asks "Does the truth matter?" and explores the reasons why it does. It is, once again, a beautifully enlightening chapter.

After this, there is a section where most of the other alternative therapies are discussed, each in one page. These include magnetic therapy, reiki, feng shui, meditation, massage therapies, totally thirty such alternative therapies. In case you are wondering what is the verdict on Indian systems of healing... Yoga, they conclude is an excellent way of life to maintain good health, and meditation and relaxation is also proven to be beneficial, unless you have a mental illness. Ayurveda - the verdict is mixed. Some remedies are proven to be effective and safe, but others are not. Many ayurvedic medicines have very high levels of metal, as it is believed to be beneficial (I'd heard about this disturbing fact before). But no metal in high amounts is good for the body. Ayurveda is a very complex system, and needs much more study to test its effects. In the meantime, keep your eyes open.

Disclaimer: I'm not a promoter of regular medicine, I don't pop pills left right and centre. I am well aware of underhand activities by greedy pharma companies, pushing untested drugs into the market, etc. I am a believer in the natural healing ability of our body, and I let the body do its job. Only when I see it might get out of hand do I resort to mainstream medicine. After all, its the best we have.

I've just tried to condense the material in the book in a few paragraphs. But I highly recommend that you read the book.


hAAthi said...


i have been on homoeopathic meds for pretty much as long as i remember, pretty much by default becuase my mother had/has faith in it.

i dont know if its the mere psychological faith or actual medicinal properties in the tiny white pills, but 9 out of 10 times it works for me..:)

Mangala said...
This comment has been removed by the author.
Mangala said...

*"So there are only two alternatives - either the basic principles of science as we know it are utterly meaningless, or those millions of people are wasting time, energy and money on a placebo."*

IMHO, it isn't as open and shut as that. Science that conventional medicine is based on is only half the circle - by no means do they know everything, and even what they do know keeps getting pruned and revised as time rolls on. The basic fallacy seems to be in taking that kind of black and white approach to reality as this article suggests:

While regular medicine is undeniably the best resort for major illnesses/accidents, the indigenous and alternative systems of healing, mostly stemming from a more holistic philosophy, have much to offer for various human afflictions and conditions, and cannot be dismissed so summarily based on a linear subject-object kind of thinking.

People seem drawn to one system or the other based on their beliefs, convictions and worldview...and I think it is ALL good. It would be a poor world without the variety - whether in humans or medicines.

snippetsnscribbles said...

Homoeopathy - I'm not sure how to define it. My mom was suffering from almost 10-12years of allergic cold and had tried various (including IISc experiments and medicines thereof) types of medicines but what ultimately worked was 1year of dedicated homoeopathy medicines that did not have any eating/drinking restrictions attached. Today, she has absolutely NO complaints and her allergy is GONE. The doctor has a lot of successes to his credit and many of his patients recommend him to us. We also took some of our other friends to him and they swear by him now. Infact, I myself took some medicines sometime back for toe fungus and it was cured in 3months whereas other English medicines invariably have a liver toxicity fear attached to the medicines.

Chiropractic practice - I was scared to death when he took a look at me. You know that. I gave up on him and have gone for physiotherapy now. But there were many people who recommended him to us. Only it dint work for us.

I'd be very interested to read this book :) Thanks for writing a post on this one.

Anonymous said...

This debate only proves that medicine is not completely a is a combination of science and art....because human beings are involved in this. A simple experiment will prove this fact. I am sure most of you have heard that some patient's blood pressure tends to go up when they visit the doctor.
Irrational exuberance of stock market gyrations are another example of 'human behaviour' response to what appears to be highly mathematical computations when it comes to stock valuations. Just food for thought....

Shruthi said...

hAAthi, I bet 9 out of 10 comments here (if I have that many readers) will tell me the same thing you said!

Mangala, science doesn't claim to know everything. The gaps remain, sometimes getting wider, sometimes getting closed. But that doesn't mean we fill the gaps with unproven stuff just because it seems right. And just because science doesn't understand something doesn't mean that it is not true. But it has to show up, prove itself. In that aspect, there has to be a black and a white. Because it is okay as long as people depend on alternative medicine for minor ailments. Very often, they depend upon it for major illnesses, and that has very frequently resulted in tragedy.
As for alternative medicine enriching life, all I can say is that it definitely enriches its practioners!

Snippetsandscribbles, exactly - examples like yours were what caused me to trouble my head about homeopathy. But finally, I've laid those ghosts to rest!

Anon, you are right. In fact, just talking to a nice, confident, relaxed doctor in detail is enough to cause half the ailments to vanish!

parijata said...

I have not read the book yet, but here are my 2c about alternative medicine.

My grandpa practised homeopathy, so my siblings and I were practically raised on it. Of course, my Mom took care to not let it interfere with any vaccinations that we had to take. My cousin had a very rare disease where the protein-metabolism in the body went awry. Putting her through allopathy would mean that the chance of her getting juvenile diabetes was very high, and there would be numerous other side-effects. My uncle, who is an allopathic doctor himself, took her to a homeopathic practitioner. Now she is a bubbly 20-year old, without any trace of her disease. I do not know if this was mere psychology doing its job.

I agree about the herbal medicines causing some unwanted side-effects. But it is the same with conventional medicine too. For example, almost all anti-allergy medications make you drowsy.

Then there is this fact about Ayurveda. The percentage of Ayurvedic medicines with metals is very small (AFAIK, less than 5%)- just like allopathic medicines with steroids (pardon me if I have not gotten the percentage right). But I agree that more research has to be done before giving any verdict.

There are these things that have to be followed with any medicinal system. One - Do your research well. Two - Never ever mix any two forms of medicine. And of course, three - try your best to not take any medicine!

Anonymous said...

i had rosacea(skin disease) and went to three allopathy doctors and they all prescibed steriod ointments and told there is no perticular tretment for this and have to keep on applying those onitments. Then i went to a homepathy doc and took the medicine for an year and now its totally gone no ointment nothing.

Anonymous said...

All discussions on Homeopathy peters out into personal or second hand experience. I have equally numerous examples of Homeopathy or Homeopaths killing or maiming people. Homeopathic killing is a case of not doing anything at all to kill. Perhaps called unintended manslaughter?

Incidentally all discussions about the god hypotheses peters out in a similar way too.

But the thing that bugs the hell out of me is the word holistic. For whateveritmaybe'ssake can anyone tell me what that means? In my opinion, after lots of struggle to find out what it means, the word is the biggest placebo/hoax ever created and it means nothing whatsoever.

I believe that critics/opponents/questioners of "alternative" medicines are too polite and do not get the same courtesy from the proponents of what they oppose.

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