Consulting a healer usually involves a short conversation about the nature of the problem. The healer then starts the healing ritual. Initially this can be diagnostic by nature. For instance, the healer’s hands may glide over the patient’s body to identify problem areas. Eventually the healing starts, and ‘energy’ is supposed to flow. Many patients experience this as extremely relaxing, while healers often feel drained after a session.
With other forms of spiritual healing, however, there is no personal contact between healer and patient. Sessions can be conducted at great distances, over the phone or the internet. Some healers offer their services for free, while others charge up to £100 for a half‑hour session.
What is the evidence?
The concept of healing ‘energy’ is utterly implausible. Many clinical trials of various healing techniques are available. Some initially generated encouraging results, but about twenty of these studies are now suspected to be fraudulent. More recently, rigorous trials have emerged and shown that spiritual healing is associated with a large placebo effect–but with nothing more.
Conclusion
Spiritual healing is biologically implausible and its effects rely on a placebo response. At best it may offer comfort; at worst it can result in charlatans taking money from patients with serious conditions who require urgent conventional medicine.
Traditional Chinese Medicine
An ancient healing system which employs various treatments to restore the balance of Ch’i, the vital energy that governs health.
Background
According to Traditional Chinese Medicine (TCM), all ill‑health is viewed as an energy imbalance or blockage, while optimal health is a state of perfect balance, often symbolized by the yin–yang image. The aim of any therapy must be to restore the balance or to prevent any imbalance in the first place. For this purpose, TCM offers a range of treatments, including herbal mixtures, acupuncture, cupping, massage and diet, which are all discussed in more detail elsewhere in this book. All conditions are said to be treatable with TCM.
A TCM consultation will involve diagnostic techniques, such as tongue and pulse diagnoses. Although these techniques are also part of conventional medicine, TCM practitioners make un reasonably ambitious claims about their diagnostic power. Treatment will be tailored to the individual. One session would typically last 30–60 minutes, and treatment can be long‑term, if not for life.
What is the evidence?
The TCM system is complex and not easy to evaluate. Thus its various elements are usually tested separately (see acupuncture in Chapter 2, for instance). Chinese herbal medicines usually contain a multitude of herbs which are individualized according to the specific needs of every patient. This approach has recently been tested in cancer patients and shown to be no better than placebo in alleviating symptoms. In another rigorous study, Chinese herbal medicine was tested in patients with irritable bowel syndrome against a standardized herbal prescription and against a placebo. The results suggested that individualized treatment is better than placebo in controlling symptoms, but not better than a (much simpler) standardized herbal medicine.
Some individual herbs used in TCM (e.g. liquorice, ginger, ginkgo) undoubtedly have pharmacological effects; some have even provided the blueprint for modern drugs. On the other hand, some Chinese herbal medicines are toxic (Aristolchia) and others may interact with prescription drugs. Chinese ‘herbal’ preparations may also contain non‑herbal ingredients (e.g. endangered animal species), contaminants (e.g. heavy metals) or adulterants (e.g. steroids).
Conclusion
TCM is difficult to evaluate. Some elements may be effective for some conditions, while other elements (e.g. cupping) are unlikely to offer any benefit above placebo. Many aspects of TCM are potentially harmful.
Further Reading
The following books, articles and websites offer readers more information about the topics discussed in each chapter. Many of the references are books aimed at the general reader, but we have also included some key research papers, which can either be downloaded from the web or ordered at your local library. We have deliberately listed only a few of the main research papers relating to each alternative therapy, but these papers include references to many other pieces of research mentioned in this book.
Chapter 1: How Do You Determine the Truth?
Wootton, David, Bad Medicine: Doctors Doing Harm Since Hippocrates, OUP, 2006.
Porter, Roy, Blood and Guts: A Short History of Medicine, Allen Lane, 2002.
Harvie, David, Limeys: The Conquest of Scurvy, Sutton, 2005.
Evans, I., Thornton, H., Chalmers, I., Testing Treatments: Better Research for Better Healthcare, British Library, 2006.
Doll, R., Hill, A. B., ‘The mortality of doctors in relation to their smoking habits’, British Medical Journal 1954; 228:1451–5.
Moore, A., McQuay, H., Bandolier’s Little Book of Making Sense of the Medical Evidence, OUP, 2006.
Chapter 2: The Truth About Acupuncture
Kaptchuk, T. J., The Web That Has No Weaver: Understanding Chinese Medicine, McGraw‑Hill, 2000.
Ernst, E., White, A., Acupuncture: A Scientific Appraisaclass="underline" A Scientific Approach, Butterworth‑Heinemann, 1999.
Evans, D., Placebo: Mind Over Matter in Modern Medicine, OUP, 2004.
Linde, K., et al., ‘Acupuncture for Patients with Migraine: A Randomised Controlled Trial’, JAMA 2005; 293:2118–25.
White, A., Rampes, H., Campbell, J. L., ‘Acupuncture and related interventions for smoking cessation’, Cochrane Database of Systematic Reviews, 2006.
Ernst, E., ‘Acupuncture–a critical analysis’, J Intern Med 2006; 259:125–37.
Chapter 3: The Truth About Homeopathy
Shelton, J. W., Homeopathy: How It Really Works, Prometheus, 2003.
Hempel, S., The Medical Detective: John Snow, Cholera and the Mystery of the Broad Street Pump, Granta, 2007.
Ernst, E., ‘Evaluation of homeopathy in Nazi Germany’, Br Homeopath J 1995; 84:229.
Maddox, J., Randi, J., Stewart, W. W., ‘High‑dilution experiments a delusion’, Nature 1988; 334: 287–91.
Linde, K., ‘Impact of Study Quality on Outcome in Placebo‑Controlled Trials of Homeopathy’, Journal of Clinical Epidemiology 1999; 52:631–636.
Shang, A., et al., ‘Are the clinical effects of homeopathy placebo effects? Comparative study of placebo‑controlled trials of homoeopathy and allopathy’, Lancet 2005; 366:726–32.
Ernst, E., ‘A systematic review of systematic reviews of homeopathy’ Br J Clin Pharmacol 2002; 54:577–82.
Chapter 4: The Truth About Chiropractic Therapy
Salsburg, D., The Lady Tasting Tea: How Statistics Revolutionized Science in the Twentieth Century, Owl, 2002.
Ernst, E., Canter, P. H., ‘A systematic review of systematic reviews of spinal manipulation’, J R Soc Med 2006; 99:192–6.