I’ve been reading Trick or Treatment, which is a book about testing alternative medicine. It starts off with an interesting account of the death of George Washington (via bloodletting) and the history of mainstream medicine. (For a long time, mainstream medicine was just ancient Greek medicine that nobody had ever bothered to question and mainly involved bloodletting. It was horrible and ended up killing more people than it helped.) Then, one day, a dude thought, “Hey, maybe we should actually test this stuff.” Everybody else got mad and sued the dude. The book talks about acupuncture and chiropractic therapy, which are both the manipulation of magical energy (chi and “innate intelligence”) in the body that “can’t be detected through any physical means.” It talks about homeopathic medicine, which some German guy came up with in the 1700s (before we even knew about germs) and claims that the more you dilute homeopathic medicine, the more powerful it becomes. So, super-diluted homeopathic medicine (water) can cure almost anything because water has a “memory”. (Who knew?) The descriptions of chiropractic manipulation were just downright scary…having some guy shoving your spine around using 1800s pseudoscience. Sounds like a plan.
But the book also points out that these things actually help people feel better. How can this be? It turns out that if you really expect something to make you feel better, then it may do the job. The example cases were pretty amazing. Because of a lack of morphine at a military field hospitals, an anaesthetist in World War II, Henry Beecher, would sometimes inject saline into a patient and say he was giving a powerful painkiller. The patients relaxed and showed no signs of pain. The book also points out that there is great variety in the quality of studies out there. There are many ways you can cheat in a study…even unintentionally. Biased researchers who want to make their theory come true, lack of any group who thinks they’re getting the treatment but aren’t really (to check for placebo), lack of reproducibility, stacking the deck with different types getting the treatment and the placebo. It takes careful examination of a study to make sure it’s of good quality and not cheating in some subtle way.
So what’s the harm in these treatments if they make people feel better? For one, people may think it’s working and forego something that might work better, as in the case of malaria or even something as simple as eczema. Another problem is the cost. It can all be very expensive for no real reason. As an example, a single duck’s liver goes into making millions of dollars worth of oscilicoccinum (a homeopathic flu remedy). (Remember, the more diluted, the more powerful.) That’s an expensive duck!
The book points out that clinical studies aren’t just a conspiracy to take down alternative medicine, but that such studies also take down conventional medicine theories that turn out to be invalid and even validate alternative medicine theories that turn out to be useful. The book is willing to admit when good clinical trials show a remedy to be effective, as in the case of some herbs that are actually effective in some cases…not because a bunch of anecdotes say so, but because of good testing.