On the Shoulders of Giants

The debate regarding the healing potential of alternative and complementary medicine can be a heated one. In his book, Snake Oil Science: The Truth About Complementary and Alternative Medicine Barker Bausell, professor at the University of Maryland, Baltimore, dissects alternative medicine practices, and finds that much of their healing powers lie in the placebo effect. In the post below, he takes a tongue-in-cheek look at the battle between alternative medicine and the placebo effect.

One of the many daunting tasks I faced in writing Snake Oil Science: the Truth about Complementary and Alternative Medicine was to compare the biological plausibility of the theories supporting the analgesic effects of alternative medical therapies with that of their chief rival, the placebo effect. In the end this didn’t turn out to be as difficult a call as I suspected—all the placebo effect had going for it was the brain’s propensity to release endogenous opioids in the presence of a conditioned expectation of pain relief, such as going to an alternative therapist.

The placebo effect didn’t have anything rivaling the rich history, the diversity, or the depth of thought that characterize its alternative rivals: acupuncture, homeopathy, iridology, and uncounted others. Most damning of all, the placebo effect could not even begin to rival the quality or quantity of originating intellectual giants claimed by such therapies.

Thus while Hippocrates may have recognized the importance of instilling the expectation of benefit in his patients, acupuncture had already been practiced for at least a millennium. And even today its biological mechanism of action remains so subtle and sophisticated that physicists have yet to measure chi, that subtle energy force that pervades the universe yet can be precisely redirected by nothing more than tiny needles strategically placed along meridians, so well hidden (undoubtedly by evolutionary forces) that it has eluded detection by our best physiologists, and is somehow still capable of ameliorating such debilitating syndromes as warm, wet kidney deficiency. Syndromes whose true implications (it is rumored) have never really been understood by anyone.

Not content to rest upon these ancient laurels, more recent alternative scientists have made even greater biological discoveries. The great Samuel Hahnemann’s 19th century discovery of the important medical principle of “like cures like,” for example, comfortably predated the equally counterintuitive theory of quantum mechanics by decades. Incredibly, he followed up that breakthrough with the realization that when substances such as cuddle fish discharge or poison oak are diluted to the point that not a single molecule remains in the original solution, they become even more potent due to the memory of the water used to dilute them in the first place.

And the list goes on and on and on. Ignatz von Peczely, another brilliant 19th century physician constructed the entire biological theory of iridology (i.e., that all of our body parts are perfectly represented in the iris) based upon nothing more than a fleeting childhood memory coupled with that astute gift of observation so important in both medicine and science. Peczely’s personal epiphany occurred when he noted a pattern in the eyes of a man with a broken leg that reminded him of a similar pattern in the eyes of an owl whose leg he had accidentally broken as a child. And so not only was a great diagnostic tool born, but also the first owl disease model known to science.

Thus while my editors and publicists at OUP won’t permit me to reveal the winner of my placebo vs. alternative therapy plausibility comparison – or even my detailed evaluation of the credibility of the evidence supporting the very existence of their respective therapeutic effects – I do suspect that the readers of such a serious and intellectual blog as this won’t have a great deal of difficulty predicting the ultimate winner. So given the obvious nature of this outcome, I hope no one will suspect self-interest in my suggestion that my book, Snake Oil Science: The Truth About Complementary and Alternative Medicine, would provide a most excellent holiday gift for anyone’s favorite acupuncturist, chiropractor, herbalist, or homeopath. And certainly my accompanying suggestion that you sign your gift prominently on the book itself is not proffered to prevent its return, but only to serve as a perpetual reminder of your thoughtfulness.