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Simon Singh

Modern Mountebanks

Killing Us Softly: The Sense and Nonsense of Alternative Medicine
By Paul Offit (Fourth Estate 322pp 13.99)

First of all, I have to admit that Paul Offit, the author of Killing Us Softly, is a hero of mine. Not only is this American paediatrician one of the world's foremost experts on infectious diseases, but he is also the co-inventor of a rotavirus vaccine, which protects against gastroenteritis, a condition that results in half a million deaths every year.

Moreover, rather than restricting himself to his clinic and his laboratory, Offit has spent the last decade battling the forces of pseudoscience, working hard to defend the interests of patients against a tide of irrationality. In particular, he has stood up to those who have trashed vaccination programmes and peddled misinformation about autism, and he is probably best known as the author of Autism's False Prophets. Despite the fact that he wrote that book to increase understanding and to support families (he even donated his royalties to the Center for Autism Research at the Children's Hospital of Philadelphia), its publication resulted in countless emails containing abuse and threats. When one man wrote, 'I will hang you by your neck until you are dead,' an armed guard began to escort Offit to meetings.

Although Killing Us Softly touches on autism and continues to criticise those who promote unproven or disproven treatments, it is a much broader attack on snake oil of all types, ranging from homeopathy to herbal medicine, from therapeutic touch to cancer quackery. There have been several books in recent years that explore this area, including Trick or Treatment? by Edzard Ernst and yours truly, Suckers by Rose Shapiro, and the particularly successful Bad Science by Ben Goldacre. Nevertheless, those who have read these books will still find some new topics in Offit's latest publication.

For example, he offers a thorough examination of alternative medicine in the context of cancer. Offit begins by quoting Morris Fishbein, former editor of the Journal of the American Medical Association, who wrote, 'Of all the ghouls who feed on the bodies of the dead and the dying, the cancer quacks are the most vicious and heartless.' What follows is a no-holds-barred history of alternative cancer therapies, starting in the early 1900s with Albert Abrams, known as 'the dean of twentieth-century charlatans'. This Californian quack proposed that cancers and other diseases emit particular vibrations, so he invented a 'Dynamizer' to detect these vibrations and offer diagnoses. Although Abrams became a millionaire thanks to the Dynamizer, Nobel Laureate Robert Millikan described it as something 'a ten-year-old boy would build to fool an eight-year-old'.

The story of alternative cancer treatments is brought up to date with an analysis of the claims made by Texan doctor Stanislaw Burzynski, who was the subject of a BBC Panorama investigation earlier this year. He has been offering his so-called antineoplaston therapy for four decades and often charges patients in excess of $100,000 to take part in trials of his treatment, but so far he has neither published any solid evidence to support his therapy nor convinced academic colleagues that he is selling anything more than false hope.

Offit is also outraged by the vitamin supplements industry, which preys on our insecurities and persuades us to spend billions on unnecessary pills. The Nobel Laureate Linus Pauling was a passionate advocate of vitamin C, and his book Vitamin C and the Common Cold was largely responsible for persuading millions of Americans to consume fifty times the recommended daily allowance. However, studies have never backed up Pauling's claim that vitamin C can prevent or tackle colds. For example, when researchers at the University of Toronto gave either a dose of vitamin C or a placebo to 3,500 volunteers, it was found that the vitamin C supplement offered no protection against the common cold. At least 15 studies have confirmed this conclusion.

Lack of benefit is bad enough, but there is also evidence of potential harm. In 2005, a review of 19 studies involving more than 136,000 people found that vitamin E supplements were linked with an increased risk of death. One of the researchers, Dr Benjamin Caballero, stated: 'This reaffirms what others have said. The evidence for supplementing with any vitamin, particularly vitamin E, is just not there.'

When Offit points out that the global alternative medicine industry has an annual turnover of $34 billion, it is easy to think that he is fighting an unwinnable battle on behalf of patients and reason. However, Offit is not alone in his mission. He is part of a siblinghood of rationalists, who all care about helping patients avoid fraudulent or downright dangerous treatments. He dedicates Killing Us Softly to this band of geeks and nerds: 'To all the science writers, science advocates, and science bloggers who have dared proclaim that the emperors of pseudoscience have no clothes.'

Lobbying against quackery and in favour of evidence-based medicine is an uphill struggle, but the tide (on this hill?) seems to be turning and there are occasional victories. In June, NHS Lothian made the wise decision to stop spending 240,000 on homeopathy and instead spend the money on nurses and effective treatments. While NHS Lothian was open to reasoned argument, there will be many people, alternative therapists in particular, who will blind themselves to the evidence and steadfastly ignore everything in Paul Offit's book. One Amazon reviewer wrote: 'Yet another book by a very evil and deranged man.'

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Simon Singh is a science writer. His first book was Fermat's Last Theorem and his forthcoming book is The Simpsons and Their Mathematical Secrets.

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