Healthy living
Complementary therapies
Trick or treatment?
Investigative journalist Simon Singh, co-author of a new book on ‘traditional’ medicine, warns about the danger of falling victim to hype
In 2006, the BBC series Alternative Medicine presented a truly remarkable clip in which a young Chinese woman underwent open-heart surgery while still awake. According to the presenter: “She’s still conscious, because instead of a general anaesthetic this 21st-century surgical team are using a 2,000-year-old method of controlling pain – acupuncture.”
Along with everyone else who was watching, I was amazed by the apparent pain-killing power of acupuncture. The programme inspired me to spend the next two years investigating the supposedly miraculous benefits offered by traditional Chinese medicine (TCM) and a host of other alternative treatments.
Together with the world’s foremost expert in alternative medicine, Professor Edzard Ernst of Exeter University, I set about finding answers to the key questions – which therapies work and which don’t, which ones are safe and which ones are potentially dangerous?
TCM embraces a wide range of treatments, all of which aim to balance Ch’i, the vital energy that flows through our bodies and governs our health. Herbal medicine is a popular branch of TCM, and hundreds of Chinese herbal shops claim to treat a whole range of conditions with herbal preparations.
Many patients take it for granted that these medicines must be safe, because they are natural. Similarly, patients often assume that herbal remedies must be effective, because they have been used for centuries. But we concluded alternative treatments may also be dangerous, ineffective or both.
For example, the herb aristolochia is a natural medicine that has been used by the ancient Chinese, Greeks, Romans and Native Americans to treat everything from snake bites to headaches. Because the curved shape of the plant resembled the birth canal, European herbalists in particular encouraged the use of aristolochia to ease labour, hence its other name of birthwort. Then, in the Nineties, Belgian doctors were disturbed to discover that the herb was linked to kidney damage. Women had been taking aristolochia as part of a slimming programme, and by 1994 there were 70 confirmed cases of kidney damage, 30 of them fatal.
Even though herbalists have used aristolochia for centuries, they would have been oblivious to the resultant damage because it might have taken months or years before the herb caused kidney failure. It is only through modern testing and monitoring that researchers have been able to pin down the hazards. Although plants can sometimes have potent healing properties, it is important to remember that they may also have adverse side-effects.
For example, St John’s wort is a herb that has been shown to help patients with mild or moderate depression, but it also enhances the liver’s ability to break down chemicals, and affects the body’s ability to transport drugs into the bloodstream. So taking it might alleviate mild depression, but it can seriously interfere with the impact of around half of prescription drugs, ranging from contraceptives to immunosuppressants.
There is nothing natural about sticking needles into the body, but acupuncture is certainly traditional, with a history that possibly dates back 5,000 years. Therefore, patients often think that it must be effective to have survived for so long. Clinics recommend it for everything from hay fever to high blood pressure, and from depression to diabetes.
Detailed studies fail to support the use of acupuncture for any condition, except perhaps nausea and some types of pain, and even for these the evidence is borderline.
Dozens of clinical trials have been conducted in which patients with a particular condition were divided into two groups, one of which received real acupuncture and the other so-called sham acupuncture. “Sham” means that the needle was inserted in the wrong place, or to a superficial depth or was even constructed like a stage dagger, so that the needle retracted without even piercing the skin. Patients did not know which group they were in. Typically, they all showed similar levels of short-term and minor benefit. It appears that it is merely the thought of having acupuncture that is responsible for making patients feel a little better, which is known as the placebo effect.
But can the placebo effect and wishful thinking explain the open-heart surgery that was conducted with acupuncture and without any general anaesthetic? No.
According to a report by the Royal College of Anaesthetists, the patient did not receive any general anaesthetic. She was, however, given two powerful sedatives, a pain-killing drug that is considerably more powerful than morphine, and large volumes of local anaesthetic. Unaware of this, viewers did not realise that the use of the acupuncture needles was merely cosmetic.
Alternative treatments are sometimes good, often bad, and occasionally downright ugly. My advice is to ignore the hype and to always err on the side of caution. Before investing your hope and your money, talk to your GP to ensure you are following a path that is likely to be safe and effective.
Trick or Treatment? Alternative Medicine on Trial (Bantam Press £16.99) by Simon Singh and Edzard Ernst, examines the benefits and risks of therapies, including homeopathy, reflexology and chiropractic.
This article first appeared in the April 2008 edition of Saga Magazine.
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