trick or treatment

Written by a respected science journalist Simon Singh, and Britain’s first professor of complementary medicine, Edzard Ernst, Trick or Treatment: Alternative Medicine on Trial claims to be “the definitive book on alternative medicine… honest, hard-hitting and impartial.”  I had high hopes.

The book has six chapters, the first of which has a discussion of the scientific method, clinical trials, and evidence-based medicine.  This is important to set up the arguments of the next four chapters, each of which looks at the evidence for the efficacy of four branches of alternative medicine: acupuncture, homeopathy, chiropratice, and herbal medicine.  Each of these chapters discusses the history of each therapy, how it is administered, and any clinical studies or other evidence of its effectiveness in treating certain conditions. Acupuncture and homeopathy get scathing reviews as being little more than placebos. Chiropractice scores on a few illnesses/conditions, and herbal medicine gets a conditional pass.

The final chapter tries to answer the question does it matter if alternative medicine is effective or ineffective, and then lists the “top ten culprits in the promotion of unproven and disproven medicine”: celebrities, medical researchers, universities, alternative gurus, the media (twice), doctors, alternative medicine societies, government and regulators, and the World Health Organisation.  There is also a substantial appendix with a short evaluation for each of a long list of alternative therapies (some of which I’d never heard of, which is quite an achievement for someone who lived in Glebe for seven years).

Three of the four therapies chosen for in-depth analysis, according to the authors, have little evidence to show that they are effective (compared to some which are only given a short analysis in the appendix).  The authors claim they have chosen the four therapies listed above because these are the most widespread – this is probably true in Britain, where homeopathy has been part of the establishment for hundreds of years and is available on the NHS, but probably not true in other countries where the book has been published.

The authors make some good points in the book about the lack of evidence for some alternative medical practice, beyond the placebo; and they also expose how many practitioners have been shown to be unethical in not operating on principles of informed consent, and in failing to keep records of how their patients have been treated, why, and any subsequent ill-effects.   Another point they make very strongly is that alternative medicine is a financial rip-off.  Again, this is probably more true in the UK, where conventional medicine is free, perhaps not so much in Australia or the US where alternative medicine can be a comparable price or covered by insurance.

I was a bit disappointed by this book.  I found the language somewhat sensationalist and biased (in contradiction of its claim to being impartial and honest).  The book is preaching to the choir to some extent, and is unlikely to win across any alternative medicine ‘believers’ to the authors’ side.  If they want to do that, they need to tone down the rhetoric.

To me, the more interesting question which the book scarcely touched, is not “what” alternative medicine is, but “why”.  We’ve never been healthier or lived longer, we’ve never had a more educated population, yet we are still yearning, it seems, for miracle cures and magic.  Maybe that’s a question for another book, best answered by a different set of authors.

Trick or Treatment: Alternative Medicine on Trial
Simon Singh and Edzard Ernst
Bantam Press

Cross posted at Booklub

question of the week

People who need bookmarks aren’t paying attention to what they’re reading

keep yourself nice – part ii

Clean: a History of Personal Hygiene and Purity
(part i is here and covers the period from pre-historic times through to the medieval period).

It took the catastrophe of the Black Death to drive cleanliness rituals out of the public sphere and into the private, leading to the closure of public baths, saunas, and sweat baths, and the decline of open-air swimming.  The private bath, once the privilege of the very few, became the norm, although the development of a dedicated ablutions space in every home was still many years away.

The next big thing to happen to personal hygiene was Protestantism, though not always in the way you might expect.  When it came to keeping clean, Protestants fell into two camps: those who continued and intensified the old Catholic idea of flesh being abhorrent; and those who reverted back to the ancient Greek idea of a pure mind in a pure body, whereby personal cleanliness became a matter of morality.  Some of this latter group took this idea further than others: for example, some of the early Quakers were also nudists; but eventually the ideas of this second group prevailed and became the foundation of the public health movement of the 19th century.

The book gathers  pace at this point, and gallops through the 19th and 20th centuries an about a chapter and a half.  I would have liked to read more detail about these times, particularly as this was the time when health, hygiene and cleanliness moved out of the private spaces where they were driven by the Black Death, and back into being matters of public concern and action.

Virginia Smith is particularly good at drawing out how historical practices and ideas persist through to the present.  Examples include alternative medicine and the concept of detox, which are both very old ideas.  She also discusses Rousseau and his ideas on child health, and how similar his many of his ideas (such as strictures on ‘pure’ food for children) are to modern-day helicopter parents.  Rousseau’s advocacy of the ancient Spartan/Irish/Scottish practice of exposing small children to extreme cold to increase their immunity to disease led to the tradition in England of small boys wearing short pants in all seasons, which can still be seen in private boys’ school uniforms today.  It really is amazing how deeply ingrained many of our unconscious grooming and hygiene habits are, and how much they form part of our sense of ourselves as individuals

As you’ve probably gathered from the above, this is a very detailed  but fascinating and engaging book.  It’s very well written, and I enjoyed it immensely.  Very much recommended, and I’m happy to lend my copy to anyone who’s interested.

Clean: A History of Personal Hygiene and Purity
Virginia Smith
Oxford University Press

keep yourself nice – part i

CLEAN:  A History of Personal Hygiene and Purity

This book looks at the interrelated histories of grooming, cosmetics, ritual, public health, purification, preventative medicine and cleanliness  from pre-historic times to the present. It’s a big topic, so this is a long review, and I’ve split it into two parts.

The book starts with observations of how animals such as apes and monkeys groom each other, and how this behaviour creates social cohesion and reinforces norms as well as having a hygienic function.  Virginia Smith shows how grooming behaviour manifests in modern humans, both as individuals and groups, ranging from brushing teeth and trimming nails, to stroking each others hair, picking fluff from others clothes, and submitting to grooming from others, like hairdressers and dentists.

Smith then goes on to a fascinating account of how primitive tribal grooming behaviour evolved along with settled human society in the Fertile Crescent, becoming intimately connected to both spirituality and to economic and material development.  “Keeping yourself nice” became synonymous with living a good and moral life; and cosmetics and medicines were major drivers of trade that led to the growth of cities and kingdom around the Mediterranean and across to India and China.  Smith also discusses the rise of a bathing culture. the development of medicine and the beginnings of concepts of ritual cleanliness.

With the decline of the Roman empire, action shifts to the Dark Ages and medieval Europe.  Smith contends that medieval times may not have been as filthy as we portray them in contemporary culture: she points out that pre-christian, pre-Roman practices such as river bathing and saunas continued for many centuries.  The Church was keen to stamp out what they saw as as pagan and immoral practices, such as public baths and cosmetics, but never really succeeded – it would seem that people’s urge to be as physically clean and pretty as they could manage far outweighed their desire for salvation.

In part ii, to be published Thursday: the Black Death, saucy aspects of Quakerism, Rousseau at your mothers’ group, and what I actually thought of the book.

nine hours north

Adam has reached the last few weeks of a long stint teaching English in Japan.  Marianne, a friend of his girlfriend Sarah, arrives to begin a similar venture.  Adam gets a ‘thing’ for Marianne, begins to draw away from Sarah, becomes confused about who he is and what he wants.

You’ve read this story before, right?  It’s an old plot.  What is different about Nine Hours North and what made it so enjoyable for me is how sparse it is and how few words are needed to tell this old story in a way that makes is fresh and sweet again.  It’s almost a series of poems, each word carefully chosen, around 150 on each page with a title:

exult

What else can I do?
I run.  I shout.
I feel the rain
as it sticks to my shirt to my chest,
feel the tug of soggy denim on my thighs,
feel my head pushed under
the warm-rain waterfall of sky.

This hand-holding water birth,
this mad running baptism -
clutch at the hand that holds you in the rain
and feel the bliss course up
from the unlikeliness of city streets.

Everything short circuited.
All wires crossed,
all boundaries open,
all barricades torn down.

We breathe only in the gaps
between our screams.

We scream only in the gaps
between our laughter.

We laugh to fill the spaces
between every single raindrop.

At first I didn’t think this was going to work. I am not fond of authors who get tricksy with structure (see also diatribes against David Foster Wallace and Cloud Atlas) because I often suspect that it disguises a lack of content.  But in Nine Hours North it works beautifully.  It creates a distinctive voice for Adam and capture the fragility and gossamer of his attraction to Marianne, a thing that hardly exists because it can’t be expressed.  The story seems to ripple outwards from a single point, like a pebble dropped in a still pool.  The number of words there are exactly the number the reader needs to tell the story to themselves.

I really recommend reading this book and it’s easily the best fiction I’ve read in a long time.

Nine Hours North
Tim Sinclair
Published by Penguin

Disclaimer: I think I’ve met Tim Sinclair at one of seagreen‘s birthday shindigs but I didn’t remember this until I’d finished the book.  Tim Sinclair is also the author of the most amusing The Dog Ate My Serial.

inspector anders and the ship of fools

An anti-capitalist group sets off a bomb in Frankfurt, killing the board members of two companies as they sign off on a merger.  Inspector Anders, an Italian seconded to Interpol is assigned to help the German police with the case.  As he criss-crosses Europe chasing false leads, from former Baader-Meinhof associates to respected economics professors and journalists, the group begins to eliminate his suspects for him in increasingly grisly and bizarre ways. Each time, they quote part of a fifteenth century satire, the Ship of Fools.

After switching between Frankfurt, Munich, Brussels and Paris, the action settles in Strasbourg where another corporate merger is underway.  The terrorist group begin to pick off the directors of these two banks, one by one, and Inspector Anders is drawn into a race to unmask the group.

The book was slow to start, and at first I found it hard to like Anders, a tired, solitary, patient and polite man of few words, constantly plagued by chafing from his prosthetic leg.  The first part of the book was a bit chaotic, probably reflecting the lack of concrete information available to detectives and the false trails they follow.  However, once settled in Strasbourg, the plot tightens, suspense begins to build, and Anders becomes more likeable.

I liked the premise of the plot, which makes a nice change from the straight-out murders of most detective novels and gives the author more interesting characters to play with.  Anders is not my favourite fictional detective (that’s a tie between Murray Whelan and Phryne Fisher), but on the basis of Ship of Fools, I’d be happy to read more of his adventures.

Inspector Anders and the Ship of Fools
Marshall Browne
Duffy & Snellgrove 2001

simplexity

This book by Jeffrey Kluger explores the emerging field of simplexity: the study of systems for complementary relationships between complexity and simplicity.  It moves along at a galloping pace, trying to cover the application of simplexity to economics, sports, government, linguistics, technology, diseases, Jackson Pollock and human behaviour.  This is a drawback, and means that many interesting topics are glossed over or merely mentioned in passing.

The most interesting idea to me was the idea of an ‘arc of simplexity’ – a continuum from complete organisation to utter chaos that can be applied to many different systems, with the idea that there is a sweet spot somewhere along that arc where things function perfectly because there is the right amount of simplicity and complexity.  However systems at this point are also vulnerable, and it’s very easy to tip them one way or the other.

The book reads more like an extended feature piece for a newspaper or magazine, using a lot of direct quotes from people working on simplexity and examples of specific experiments or studies, rather than analysing and explaining.  It loses its way a little when it attempts to apply simplexity theory to art while trying to maintain that art is special and different to other systems.  Overall, it’s not a bad book, it explained a few things that I’ve vaguely wondered about, and piqued my interest in the theory.  Seek it out if you want an easy non-fiction read that’ll give you plenty of anecdotes to impress people with.

Simplexity: the simple rules of a complex world
Jeffrey Kluger
John Murray Publishers