What Harm Can It Do?

викWhy is reflexology more popular than iridology? In the absence of an evidence-base, what makes one treatment more successful (in terms of uptake) than another? Put another way, if I wanted to create my own alternative remedy, is there anything I could do to promote its chances of gaining popularity?

At the last Cardiff skeptics in the pub we were discussing the “why not try x” question. As in: “Why not try homoeopathy? What harm can it do?” There are lots of reasons why this is tempting, especially with “remedies” that really are harmless, such as homoeopathy (what harm can a sugar pill do anyway)? If evidence based medicine is making you no better, or worse you’ve not been prescribed anything but rest, the urge to find some alternative is understandable. Isn’t the rational choice try anything that might help (unless it’s harmful) even if the chances are so small as to be negligible?

But if you are in such a position, how do you pick just one ineffective “remedy” from so many? The question “what harm can it do?” is fine for one or two, but if you had to try everything that might help it would take all of your time and energy.

And so then this led on to wondering: what is it that makes certain alternative “medicines” catch on while others do not, given that there is no more evidence for their efficacy?

I wondered if there’s a pattern to be found in the way those that appeal are described, or if it’s just due to the lucky chance of a few well-timed anecdotal results. A couple of examples of the latter were related by the speaker that evening, Simon Singh: D. D. Palmer believed he’d cured a janitor’s deafness by manipulating his spine encouraging him to develop chiropractic; and New York Times journalist made acupuncture popular in the west after experiencing pain relief following an emergency appendectomy in China while he was there accompanying a diplomatic visit by Henry Kissinger.

Singh is the co-author of “Trick or Treatment” which surveys many of these alternative “medicines” with whole chapters dedicated to those that have gained most traction, and I’d hoped to ask him whether he’d spotted any pattern – but despite allowing extra time for questions he was so inundated we would probably have kept him there all night if it had been up to us. It was an excellent talk.

So, is there magic ingredient in the “rationale” (for example the like cures like concept and succession ritual of homoeopathy) or are the popular alternative remedies simply the ones that have benefited from a series of fortuitous coincidences?

About Simon Wood

Lecturer in medical education, lapsed mathematician, Doctor Who fan and garden railway builder. See simonwood.info for more...

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