Holistic Hooey

Trick or Treatment: The Undeniable Facts About Alternative Medicine
By Simon Singh and Edzard Ernst
W.W. Norton, 352 pages, $25.95

The yearly global expenditure on alternative medicine is $77 billion. To put that number in perspective, consider that the National Institutes of Health 2009 budget for H.I.V./AIDS research is not quite $3 billion, and that Croatia’s gross domestic product is about $51 billion. Granted, if you believe that back-cracking and pin-pricking, energizing lotions and herbal potions actually work, then it’s not unreasonable for the spending on such remedies to exceed a European country’s G.D.P. But in that case—at least according to Simon Singh and Edzard Ernst, authors of Trick or Treatment—you’re a sucker.

Dedicated to the Prince of Wales, an enthusiastic advocate of homeopathy, Trick or Treatment sets out to give a definitive verdict on the efficacy of nonconventional therapies. Messrs. Singh and Ernst warn in their introduction that if you’re an adamant believer in alternative medicine, you might as well save your $25.95, because you won’t like their findings. And sure enough, in lengthy chapters devoted to acupuncture, homeopathy, chiropractic and herbal medicine (plus an appendix covering 36 treatments, including feng shui and reiki), the authors deploy evidence from numerous clinical trials to demonstrate that the overwhelming majority of alternative "cures" are just placebos. In other words, bunk.

Getting duped into spending hundreds or even thousands of dollars on what is, essentially, a sugar pill with a Chinese character on it is arguably the best possible outcome for those who wander into the holistic realm. Alternative remedies, Messrs. Singh and Ernst argue, are often hazardous: Upper spine manipulation, a common chiropractic technique, can cause strokes; needling at the base of the skull during acupuncture can lead to brain damage; and herbal medicines may be laced with pharmaceuticals.

Aware that nanny finger-wagging and prose like a warning label listing side effects isn’t everyone’s cup of ginseng, Messrs. Singh and Ernst frequently drop in anecdotal accounts of history’s worst sham remedies. Also, careful not to fall into a "trust insiders, mistrust outsiders" dichotomy, they point out that many bad ideas have been endorsed by the medical establishment. Just one example: Bloodletting, though it had been a mainstream procedure for centuries, was arguably to blame for the death of George Washington, whose doctors drained half his blood in less than a day because he was having difficulty breathing.

What’s missing from Trick or Treatment is a satisfactory explanation for why so many people spend so much money on such transparent quackery. In their last chapter, Messrs. Singh and Ernst include a "top ten culprits" list; they scold the usual suspects, such as celebrities and the media, but also health care staff who have "too little time, sympathy and empathy" for their patients. This brief aside on the brisk or even cold bedside manner of doctors hints at a crucial factor in the motivation of otherwise rational people who shun the lab-coated class and embrace alternative practitioners: They’re looking for a better therapeutic relationship. This is a matter worthy of a whole chapter, if not a whole book. Suckers aren’t born; they’re made in anonymous hospital waiting rooms.

Juliet Lapidos is an assistant editor at Slate. She can be reached at books@observer.com.

Holistic Hooey