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In particular, we will answer the fundamental question: ‘Is alternative medicine effective for treating disease?’ Although a short and simple question, when unpacked it becomes somewhat complicated and has many answers depending on three key issues. First, which alternative therapy are we talking about? Second, which disease are we applying it to? Third, what is meant by effective? In order to address these questions properly, we have divided the book into six chapters.

Chapter 1 provides an introduction to the scientific method. It explains how scientists, by experimenting and observing, can determine whether or not a particular therapy is effective. Every conclusion we reach in the rest of this book depends on the scientific method and on an unbiased analysis of the best medical research available. So, by first explaining how science works, we hope to increase your confidence in our subsequent conclusions.

Chapter 2 shows how the scientific method can be applied to acupuncture, one of the most established, most tested and most widely used alternative therapies. As well as examining the numerous scientific trials that have been conducted on acupuncture, this chapter will also look at its ancient origins in the East, how it migrated to the West and how it is practised today.

Chapters 3, 4 and 5 use a similar approach to examine the three other major alternative therapies, namely homeopathy, chiropractic therapy and herbal medicine. The remaining alternative therapies will be covered in the appendix, which offers a brief analysis of over thirty treatments. In other words, every alternative therapy that you are ever likely to encounter will be scientifically evaluated within the pages of this book.

The sixth and final chapter draws some conclusions based on the evidence in the previous chapters and looks ahead to the future of healthcare. If there is overwhelming evidence that an alternative therapy does not work, then should it be banned or is patient choice the key driving force? On the other hand, if some alternative therapies are genuinely effective, can they be integrated within mainstream medicine or will there always be an antagonism between the establishment and alternative therapists?

The key theme running throughout all six chapters is ‘truth’. Chapter 1 discusses how science determines the truth. Chapters 2–5 reveal the truth about various alternative therapies based on the scientific evidence. Chapter 6 looks at why the truth matters, and how this should influence our attitude towards alternative therapies in the context of twenty‑first‑century medicine.

Truth is certainly a reassuring commodity, but in this book it comes with two warnings. First, we will present the truth in an un apologetically blunt manner. So where we find that a particular therapy does indeed work for a particular illness (e.g. St John’s wort does have antidepressive properties, if used appropriately–see Chapter 5), we will say so clearly. In other cases, however, where we discover that a particular therapy is useless, or even harmful, then we shall state this conclusion equally forcefully. You have decided to purchase this book in order to find out the truth, so we think we owe it to you to be direct and honest.

The second warning is that all the truths in this book are based on science, because Hippocrates was absolutely correct when he said that science begets knowledge. Everything we know about the universe, from the components of an atom to the number of galaxies, is thanks to science, and every medical breakthrough, from the development of antiseptics to the eradication of smallpox, has been built upon scientific foundations. Of course, science is not perfect. Scientists will readily admit that they do not know everything, but nevertheless the scientific method is without doubt the best mechanism for getting to the truth.

If you are a reader who is sceptical about the power of science, then we kindly request that you at least read Chapter 1. By the end of that first chapter, you should be sufficiently convinced about the value of scientific method that you will consider accepting the conclusions in the rest of the book.

It could be, however, that you refuse to acknowledge that science is the best way to decide whether or not an alternative therapy works. It might be that you are so close‑minded that you will stick to your worldview regardless of what science has to say. You might have an unwavering belief that all alternative medicine is rubbish, or you might adamantly hold the opposite view, that alternative medicine offers a panacea for all our aches, pains and diseases. In either case, this is not the book for you. There is no point in even reading the first chapter if you are not prepared to consider the possibility that the scientific method can act as the arbiter of truth. In fact, if you have already made up your mind about alternative medicine, then it would be sensible for you to return this book to the bookshop and ask for a refund. Why on Earth would you want to hear about the conclusions of thousands of research studies when you already have all the answers?

But our hope is that you will be sufficiently open‑minded to want to read further.

1. How Do You Determine the Truth?

‘Truth exists–only lies are invented.’ Georges Braque

THIS BOOK IS ABOUT ESTABLISHING THE TRUTH IN RELATION TO alternative medicine. Which therapies work and which ones are useless? Which therapies are safe and which ones are dangerous?

These are questions that doctors have asked themselves for millennia in relation to all forms of medicine, and yet it is only comparatively recently that they have developed an approach that allows them to separate the effective from the ineffective, and the safe from the dangerous. This approach, known as evidence‑based medicine, has revolutionized medical practice, transforming it from an industry of charlatans and incompetents into a system of healthcare that can deliver such miracles as transplanting kidneys, removing cataracts, combating childhood diseases, eradicating smallpox and saving literally millions of lives each year.

We will employ the principles of evidence‑based medicine to test alternative therapies, so it is crucial that we properly explain what it is and how it works. Rather than introducing it in a modern context, we will go back in time to see how it emerged and evolved, which will provide a deeper appreciation of its inherent strengths. In particular, we will look back at how this approach was used to test bloodletting, a bizarre and previously common treatment that involved cutting skin and severing blood vessels in order to cure every ailment.

The boom in bloodletting started in Ancient Greece, where it fitted in naturally with the widespread view that diseases were caused by an imbalance of four bodily fluids, otherwise known as the four humours : blood, yellow bile, black bile and phlegm. As well as affecting health, imbalances in these humours resulted in particular temperaments. Blood was associated with being optimistic, yellow bile with being irascible, black bile with being depressed and phlegm with being unemotional. We can still hear the echo of humourism in words such as sanguine, choleric, melancholic and phlegmatic.

Unaware of how blood circulates around the body, Greek physicians believed that it could become stagnant and thereby cause ill‑health. Hence, they advocated the removal of this stagnant blood, prescribing specific procedures for different illnesses. For example, liver problems were treated by tapping a vein in the right hand, whereas ailments relating to the spleen required tapping a vein in the left hand.