Fortunately I was able to get to a doctor who took my temperature, peered down my throat, made the diagnosis- my father had already guessed correctly- and prescribed some antibiotics. The visit lasted only a few minutes- there was no time for a lengthy lifestyle analysis or discussion of my psychological state and so could hardly be called “holistic” but the whole experience was pleasant one, the doctor was chatty and very affable, I hadnt even had to wait long, and most importantly, within 24 hours I had made a miraculous recovery and had no barely symptoms left at all after 48hours.

Now, this is just anecdotal of course and proves nothing- maybe I would have got better anyway- but since this was a very rare trip to the doctor- my mother refers to all doctors as “quacks” – it seems worth noting that it was as pleasant and as trouble-free an experience as I could have hoped for.

However, as I sat in the waiting room I couldnt help noticing a prominent sign advertising the services of Homeopaths and Reflexologists; if I hadnt been so sick and had there been more time I would have loved to have asked the kind doctor his views on promoting such fraudulent “remedies” in his surgery, and to have had a chat about evidence-based medicine and the public perception of in general.

All this is by way of prelude to drawing your attention to the new 10:23 campaign in the UK: “Homeopathy- there’s nothing in it”.

http://www.1023.org.uk/

 This campaign is tackling head on the inconsistent postion of high street pharmacists like Boots who claim to have the best interests of their customers at heart and yet sell sugar pills and water as medicine.

One of the main excuses of homeopaths is that their methods are more “holistic”- they incude a lengthy interview covering many detials of the patients’ personal life before making proscribing the remedy, while allopathic medicine “only treats the symptoms”- the implication here is that there is always some kind of emotional/psychologiclal/spiritual component to illness.

Apart from the fact that this is largely mystical mumbo-jumbo- my tonsillitis for example was caused by the bacterium actinomyces and not by some kind of negative energy in my chakras- this whole process is side-stepped by the fact that anyone can just walk into a chemists’ shop and buy whatever type of sugar pill they fancy straight off the shelf. If homeopaths themsleves think that remedies should only be given by a trained practitioner after lengthy holistic interviews surely they should be coming on board fully behind the 10:23 campaign themselves.

The other aspect of this is that belief in quack medicine is inherently anti-science. I could give loads of examples from conversations I have had with mystically minded folk. Start by telling them that there is no scientific evidence to support the efficiacy of things like homeopathy and they will recount anecdotes along the lines of “homeopathy cured my hamster”, even though many conditions people seek treatments for- like the ‘flu- are self-limiting.

 If like me you are more insistent, 9 times out of 10 they will attack science in general as being biased- “science has been wrong before” “science doesnt know everything” or most infuriatingly invoke something they call “the observer effect”- the idea that you can discount any scientific evidence whenever it suits you on the basis that the observer will affect what is being observed, possibly on the quantum level.

The claim here is that their own opinions are more vaild- infallible even- and less biased than science, which just displays a complete ignorance of the scientific method, which is by definition an attempt to overcome our own personal, subjective bias. Anecdotes are not evidence; lots of anecdotes do not constitute data.

I recently was discussing evidence-based medicine with a herbalist who had just completed a degree. I asked him about whether he had looked at clinical trials during his degree course; he had to some extent, but was quite happy to tell me that he didnt think it necessary to have evidence for everything.

His real interest it turned out was plant-spirit medicine and shamanism (which were not you will be relieved to hear covered on the degree); the degree was just a front to give more credibility for what he was really practicing. Since he made his own preperations from home-grown herbs I asked him how he could control the concentrations of active ingredients, which could vary wildly from plant to plant; his response was just to shrug his shoulders and say, “I know I make good stuff, the clients like it and know it is good stuff”. In other words, weather the treatments worked or not was immaterial; all that counts is can he sell them. 

Another  conversation I had on this topic was with someone I would certainly expect to support the role of science in the environmental movement, specifically climate change. When she questioned the value of evidence-based medicine, I pointed out that clinical trials on medical treatments are routine and trivial compared to say the incredibly complex body of evidence from many different scientific disciplines accumulated over decades that constitutes climate science; yet the evidence that homeopathy and other “alternative” therapies do not work is much less ambiguous than the evidence for climate change. I was shocked that her response was that there is no scientifc consensus on climate change, that science is all just a matter of opinion.

Quack medicine is not just an assault on science and reason but appears to lead people to abandon even the most basic standards of ethics, honesty and common sense.

Unfortunately, as I have covered on Zone5 many times, the environmental movement seems to have no discernment when it comes to quack medicine. Wherever you see the word “Green” or “Organic” you can be sure the homeopaths and the herbalists will not be far behind. Alternative therapists seem to make up a significant part of the environmental movement in general and are keen to protect their public image of progressive, natural and holistic alternatives to the nasty world of Big Pharma.

In fact, the persistence of these practices undermine our ability to understand and respnd to the much more serious issues confronting us and make the green movement the laughing stock of the more rational sections of society, and thereby feeds the climate change deniers’ case.

The 10:23 Campaign looks like being the start of a more direct way of tackling these issues head on, let’s all get behind it.

More information on this week’s episode on the Pod Delusion:

http://poddelusion.co.uk/blog/

Fascinating account of the inside world of CAM and more insights into homeopathy here:

http://aillas.blogspot.com/2009/12/open-university-perspectives-on.html

Warning! Not suitable for Breatharians

Andy Murray

The Good Elf Press  2009

187pp

Astrology is an amazing tool to run your life by, without having to waste time with the fraudulent pseudo-scientific mumbo-jumbo of Science. Astrology explains wars, thunderstorms and plagues. We can even use it historically. For example, if we know exactly when and where Queen Elizabeth was born, we can find out exactly who she was without having to waste time on fictitious history books. With it we can even discover why Einstein was so damn clever. Astrology is way better than sex.

You don’t have to be a vegan to enjoy Andy Murray’s brilliant Heretic’s Guide, which is packed with dozens of tasty simple recipes to satisfy even the most hardened omnivore at least some of the time, you dont  even need to have any great interest in cooking  or even food. That is because for our amusement and philosophical delectation there are numerous passages in between the recipes giving us fascinating and hilarious perspectives from the Mecca of New Age beliefs in Britain, the town of Glastonbury near where the author lives.

While waiting for the pumpkin soup to cook  or in between  making preperations for the Hazelnut and Celery Risotto you will be able to work up an appetite by rolling around clutching your belly after reading the sure -to-become-classic passages “Reiki Reiki Rise and Shine” “Cooking with Astrology” or “Breeding Gurus for Profit”.

This book has it all really- great advice on cooking with fresh ingredients and all the usual good reasons to grow your own and buy local; loads of easy to follow recipes including a big choice of soups, salads and dips; and inspirational chapter on cooking in the great outdoors, including a useful guide to wild food; Posh Things to Do with Vegetables; Main Meals; Side Dishes and Extras; Desserts, and Cakes and Biscuits.

And then the alternative Contents covers everything else- Cults, Gurus, Satanism, Religion, Crop Circles, Homeopathy- nothing is sacred and nothing is spared the sharp rib-splitting egg-whisk of Murray’s irreverence.

Homeopathic Cookery Doubters of this form of cookery pour scorn on the fact that a diner might receive a drop of gravy and a shred of carrot on a plate. How can this be a meal, they ask? What they fail to understand is that carbon,the building block of all life, has a memory. A potentised meal maintains a complete carbon hologram, the information of the whole, even down to the smallest atomic sum of its parts.A homeopathic amount of food is of course more than sufficient to provide all the nutritional benefits that would be expected from a plateful of food, and puts paid to any shrill cries of fraud. Filthy skeptics who come to the  homeopathic table having already made up their tiny minds will trhow down their napkins and walk away still believing what they believe tio be true, and little can be done to change their wrongness.

Even the his own sacred Creed of Veganism is given the once-over. This is something I know a little about, because I once lived in a vegan community on the Welsh Borders. I was not especially into veganism per se and went there to learn to grow vegetables; I happily lived a vegan diet however, but was aware of an accute divide between some of my fellow communards, who seemed to be at each other’s throats all the time.

On  one extreme there were the the vegans who were happy to eat anything so long as it was vegan, including skip food, vegan chocolate from Malaysia (or somewhere) and chip butty’s. This group of vegans were also keen to give over some of the best land we had to rescued sheep and ageing dogs, and generally turn the place into an animal sanctury.

All this tended to jar somewhat with the second group who apart from being rather snobby in their choice of edibles- Vegan Organic Wholefoods only, no white flour allowed, lots of Miso- didnt seem to like animals at all anywhere near them. Wild animals were OK in their own wild homes, but no pets, farm animals or incontinent retired donkeys of any kind permitted.

Murray gives a total of 7 Vegan groups, including the Fat Vegan, the Sensitive Vegan and the Style Vegan, but presumable fitsd into he first category of The Common Vegan:

The most widespread of all vegans, the common vegan has been quietly animal free for years and still hasn’t died. Usually healthy, fit and happy, they tend to be quite normal, although sometimes a little willowy to stand in a strong wind.

For Murray, veganism might well play a role in a sustainable future, but is mainly just about bloody good food. While no longer a Vegan myself,  my animal-free taste buds have been re-awakened by the Heretics Guide and who knows, so have  some of my chakras.

And with that I think Ill go and make a quick Potato Rosti.

This week:

David Nutt’s Sacking and Government Policy by Simon Howard A.N Wilson’s Attitude to Science by Pete Hague Irrationality and Environmentalism by Graham Strouts Collective Worship in Schools by Owen Duffy

This is a weekly podcast full of great material on lots of interesting stuff including politics, current affairs, skepticism etc.. Enjoy!

Many thanks to ThetisMercurio for making the connection and getting me onto the Pod Delusion.

Lawson quotes research suggesting farmers may have lower cancer rates possibly because pesticide use may protect against cancer! Now that has just got to be corporate spin…

The findings in last weeks’ FSA report that there is little to choose between organic and “conventional” food in terms of the major nutrients is hardly a surprise.

For many including myself, less rigidly defined labels such as “local” and “chemical-free” have been more important especially if we can see for ourseleves how the food is grown.

What is more surprising perhaps is some of the responses from some parties in the organic movement, which are not helping us understand the issues raised, or move the discussion onto other aspects of sustainable food and farming.

Rob Hopkins wrote to me to ask:

Might it be possible that this is actually an example of bad science, which just might have set out to prove a point, been subject to some kind of political interference and the might of the multinational food industry? Clearly it is very useful for some quite unpleasant institutions if we all believe organic farming is a waste of time. Might one argue that to believe that such a study is completely impartial and rigorous is somewhat naive? Might this report be an example of where we need to take what is presented as ‘good science’ with a rather large pinch of ‘organic’ salt?

In order to assess whether or not the review meets the highest standards of science, it is necessary to understand something about how science works, and this is an issue which goes right to the  heart of what is wrong with environmentalism, because the movement in general is poorly informed about science, despite being dependent on it for assessing the general health of the environment.

As explained on Bad Science, the review followed the internationally accepted protocols established by the Cochrane collaboration, which does not accept corporate funding. These include deciding criteria for including studies before actually doing the review. The studies that were excluded were because they were either not relevant to this review, or of poor quality.

Contrary to the SA’s press release, the review found no statistically significant difference between organics and conventional foods, as explained here.

Goldacre says:

sadly, like many industries in a corner, the Soil Association seek to undermine the public’s understanding of what a “systematic review” is (which itself causes collateral damage to everybody’s ability to engage in debates on evidence).

(It came as a surprise to me, naive as I am, to discover that the SA advocates the use of homeopathy in treatment of some animal diseases, which might lead one to question whether it has any interest in evidence at all.)

The charge of vested interests seems rather paranoid, but unfortunately is all too common amongst the alternative community which  often holds the view that science and technology in general is just a conspiracy to poison us for profit. We forget just how hard it is to eek a living from Mother Nature, and our separation from the means of our sustenance has the price to pay of igorance of what is actually involved in feeding ourselves.

We all have agendas, even jobbing permaculture teachers like me, so the important thing is to be upfront about them.

It seems worth noting then that  Craig Sams, the vice-chair of the SA, and founder of Green and Black’s chocolate, retained a post for with Cadbury’s after the posh chocolate brand was sold to the multi-national in 2005. This kind of association between the SA and large corporations which sell sweets and use the organic/fairtrade labels to expand the market does rather seem to undermine the arguments being made about the supposed nutritional benefits of organic food. It seems reasonable to ask the question: is the Organic label nothing more than a marketing strategy?

It’s not all Black and Green: Anecdotal evidence suggests that 9 out of 10 under-12s and many adults as well find organic chocolate more yummy than non-organic carrots

Many people have said, as does the SA, that higher nutritional content is not the main reason why they might buy organic. This is certainly true; however, the SA has certainly used the perceived nutritional benefits of organic food as a major reason to favour it, as in this piece:

There is a growing body of research that shows organic food can be more nutritious for you and your family. Put simply, organic food contains more of the good stuff we need – like vitamins and minerals – and less of the bad stuff that we don’t – pesticides, additives and drugs.

The first sentence here is false as the FSA review demonstrates- although one of the conclusions of the report is that the number of good quality studies is small, and research in the area generally poor, the fact is there is no good evidence of higher nutritional content in organic food, so we should not claim that there is. We might guess that there might be, and there seems plenty of anecdotal evidence that the quality and taste may be better, but for the major nutrients that keep us generally nourished and healthy, there is no difference.

Of course, it may be that further research will show up this evidence, but the fact that it is not evident to date indicates it is unlikely to be a major difference. The SA should lobby the Big Organic growers to fund more research if it is not satisfied.

There are several other good reasons why we might nonetheless prefer organic food:

-avoidance of pesticide and fertiliser chemical residue;

-supporting sustainable farming;

-supporting small local growers;

-supporting animal welfare;

-better farming practices including better care of the soil;

• protection of biodiversity and wildlife habitat on farms;

-less dependency on fossil fuels.

-building self-reliance and local community resilience

Avoidance of pesticide and fertiliser chemical residue

The first question here is, how much residue of chemicals is actually found on non-organic food and how bad is it for us? Seems like a reasonable concern and I admit that this would have been a major reason that I have favoured organic since a teenager.

But is it really true?

Firstly, a serious criticism of organic standards is that they are inconsistent and still permit the use of fairly noxious substances such as copper sulphate, used in the control of potato blight.

On the other hand, given that most of our food is grown using pesticides etc, there doesnt seem to be any real evidence that our health is suffering as a result of consequent environmental contamination: we still have one of the longest life-expectancies in history of the race, and although there is an increase of such modern diseases, many of these may be a result of old age and of the kind of food we eat, not pesticide poisoning.

A key issue here is that as mammals we need high-energy foods like carbohydrates to keep going- in an oil-rich world, this basic need is easily satisfied, and obesity can set in if we have endless cheap supplies especially in the form of corn-syrup (fructose). That is why the emphases on “eating your greens” becomes so important for the affluent ape.

This issue goes back to Rachel Carson’s  “Silent Spring” and the rapid destruction of the environment that was apparent in the post-war rapid expansion of industrial agriculture, but deeper than that it touches on one of the most prevalent post-modern myths that “nature is better”.

In a world dominated by our one over-successful species, the concept of “natural” may not mean very much. Practically every last square inch of the planet- and certainly nearly all of the industrial and over-crowded Europe- has been modified by humans.

More than that, we have been modifying our food since we started cooking it. Farming started some 10,000 years ago and began the process of breeding plants and animals to be more amenable to meeting our needs. The “natural” world is full of complex chemicals many of which are toxins designed to keep predators at bay. The reason our tender young salad seedlings are so vulnerable to slugs is that they have not yet developed the resistance to pests their wild cousins have.

The question then is, are artificial chemicals more nasty than natural ones? The answer is certainly not, in general- but of course each one needs to be looked at case-by-case. In the development of chemicals, many trials are conducted to ensure they are only administered at doses well below what would be fatal- in many cases this may be far below the fatal dose of, say, a glass of lager.

That is not to say that we should not be vigilant with the introduction of new chemicals, and there may be justifiable concern about long-term effects, but this issues goes to the heart of what is wrong with post-modernism. The whole of human history has been a struggle for survival and whatever the negative effects of the modern world, few of us would survive long in the natural environment without the benefits of modern science, and fewer would voluntarily choose to dispense with the comforts of modern life completely.

We need to acknowledge that naturally occurring chemicals can be just as dangerous as synthetic ones, but the latter have the advantage of being tested, and have the potential to be applied as and when we need them, in carefully controlled quantities, which cannot be achieved for their naturally occurring counterparts.

In Permaculture: Principles and Pathways Beyond Sustainability , David Holmgren also suggests that use of appropriate herbicides to aid tree establishment may be acceptable, but for many any kind of spray remains simply taboo.

Biodiversity and care of the soil

One of the great contributions of the organic movement has been an emphases on better care of wildlife habitats, and care of the soil. However, while organic farms in general may be better than conventional in this sense, this is also not a clear cut issue.

Michael Pollan in The Omnivore’s Dilemma discusses how many organic farms may have to harrow and cultivate more often for weed control, which can be more harmful to the soil than spraying, as well as using more fossil energy for this at least. He also saw evidence of the use of low-paid migrant labour on big organic farms to make up for the extra work involved.

A 2004 review of organic vs “conventional” farming practices by  Anthony Trewavas concludes:

The article concludes that in the UK, at least, when problems with agriculture emerge they usually hinge around poor management not mode of agriculture. In environmental terms no-till farming currently seems to be better than others.

So in terms of soil health, no-till practices- as prioritized in permaculture for example- may be more influential than not spraying; while organic farmers may in general be more aware of issues of soil health and environmental protection, improvements in farming on some conventional farms show that good practice is possible there as well. It depends on the farm, not the mode of agriculture.

Animal Welfare

This is a key ethical issue and one that has certainly motivated by buying habits; but is it an issue for specifically organic production? Again, the target should be large-scale factory farms, the worst excesses of profit-driven industrial farming, rather than converntianl farming per se. Personally, I am far more concerned about avoiding intensive factory farming than buying organic.

Fossil fuels dependency

Organic farming may be less fossil-fuel dependent, but on the other hand, yields may be lower and therefore more land may be required. Some crops may require more fossil fuels; clearly, the increased use of refridgeration and the habit in some cases of flying in fresh organic produce would not help reduce fossil-fuel dependency. There is a lot of studies referred to on Wikipaediabut again there are many other factors apart from the specific industry standards of “organic” that effect fossil fuel inputs.

Food plant diversity

The greatest threat to our food security, and the greatest tragedy of modern farming, is the loss of food crop diversity.

The vast range of food crops, adapted and bred for specific characteristics for specific locations and conditions, was a hallmark of traditional food resilience; but industrial methods have lead to an inexorable decline as the priority has been towards a “one size fits all” type for mechanical harvesting and ever-bigger fileds of monocrops.

For the smallholder or home gardener, seed saving to protect diversity and home plant breeding for varieties more suitable to the home gardener, has become increasingly important.

The organic movement is to be applauded for raising these issues and encouraging the protection of seed diversity. The work of Vandana Shiva highlights the loss of biodiversity in food plants and the corproate complicity in this process.

Most scientific research goes into breeding varieties geared for maximum yields, ability to intake nitrogen and and withstand pesticide use; and allow for mechanical harvesting, global transport and storage.

As much as anything, the perceived superior quality and tast of organic produce may be down to variety.

However, if the resources of science could be harnessed to produce varieties of greater diversity for the home gardener or small producer, this is an area where a real difference could be made. It is of course quite correct for the organic movement to lament the increasing influence of big business on the uses of science in this area, with the miuses of GM technology for profit and control of seed the most obvious example.

Self-reliance and building community resilience

These may be the most important contributions that the organic movement have made. It is obviously important for people to know how to grow food without the addition of chemicals they have no chance of producing themseleves on a small scale; on the other hand, organic farming may be reliant on many other inputs from plastic tunnels to mulch.

Home gardening is a fascinating and fulfilling activity which can contribute to local food security, and it is essential to retain and develop the skills needed for people to grow at least some of their own food.

Peak oil-ists have long been advocates of growing food,and far more people will need to be working on the land in an energy descent future- but this is not something most are yet willing to accept and would involve considerable change in lifestyle.  Goldacre for example says that most food “will always be industrial”. It would be interesting for him to consider more seriously the peak oil issue and whther this will indeed always be possible into the future.

Conclusion

The “Organic”  label is primarily a marketing device to sell an expensive product with “added value”; in times of recession  fewer will be willing to pay for it.

There is an obvious difference between an organic lettuce flown in fresh from israel and a regular lettuce from a sprayed field down the road where you know the farmer.

It should be said though that where “organic” does mean “local, small farmer using natural methods and trying to limit fossil input” many of us will be willing to pay more as a “sustainability subsidy” and to support local growers. Food has become unrealistically cheap during the last 50 years when we learned to increase yields with fossil energy, and there is every indication that we will have to pay more in the future, and that a lot more of us will have to be involved in actually doing the work to produce it. Food has been a declining proportion of our weekly grocery budget and this has lead to it becoming undervalued and treated as just another commodity; consumers have come to resent the farmer asking for a decent wage and demand cheap food. I don’t resent the extra cost becasue much of what I buy comes from the ocal grower; but I wouldnt favour “Big Organic” over “Big Conventional” otherwise.

There is lots of reasons however to feel that some organic produce, especially meat and salads, taste better and are produced more ethically, and are of superior quality.

In addition, the organic movement should be applauded for raising the issues of the environmental impact and pesticide use, and perhaps playing an important role in reigning in big AgriBusiness from the worst excesses of profit-fuelled conventional farming practices.

As environmentalists, we should reject the simplistic notion that “natural is better” and we should demand that groups like the Soil Association and other prominant environmental lobby groups such as Transition Towns stop trying to confuse us about the workings of science, and should make their own agendas more transparent. The anti-science stance of many prominent environmentalists is a shameful disgrace to the movement, discrediting it in the eyes of those who actually understand just how science works and how profoundly we depend on science to survive.

In an age of climate change, which will effect food and farming more profoundly than anything, our understanding of science is paramount, and it is a tragic irony that sectors of the environmental movement itself are undermining this understanding at a time when we need it most.

The question still remains as to whether organics or small-scale farming can really feed a population of 6.7 billion and still retain at least some of the benefits and creature comforts the modern world has brought us; all too often the “green” lobby conveniently forgets how tough life can be on the farm, and red in tooth and claw “nature” really is.

For these reasons alone we should salute the farmer, any farmer, who is able to at least temporarily cheat the natural competitve forces of nature and put food on our plates.

When science is reduced to a game, anyone can play. Scientists say the arctic ice sheet is disappearing; I say they are stuffy old sausages; and besides, the world is actually getting colder. Maybe it is all about sunspots, or whatever other discredited theory can be shoehorned to match my intellectual whims. We trusted science to deliver dramatic improvements in health and life expectancy, as well as genuine technological advances . Now, at the time of our greatest peril, we have turned to the quacks, blow-hards and snake-oil salesmen. As Samual Beckett observed: “We are all born mad; some remain so”.

Fair to play to John for bringing this issue out into the mainstream press- and he gets extra marks for endorsing the brilliant Ben Goldacre.

Book Review:

The Transition Timeline

for  a local, resilient future

Shaun Chamberlin

Forward by Rob Hopkins

190 pp pbk

Chelsea Green 2009

The follow-up to Rob Hopkins’ seminal The Transition Handbook uses the method of “backcasting” from an envisioned  future from which we create a timeline of how the transition to a more local, resilient world unfolded.

The first part goes through four different scenarios presented as “cultural stories” roughly along the same lines as the scenarios we are familiar with from Holmgren’s Future Scenarios, this time under the headings:

-Denial

-Hitting the Wall

-The Impossible Dream

-The Transition Vision

The transition approach is to look at these possible futures in terms of the cultural stories that we tell ourselves, the idea being that we have the power to make our own cultural stories and thereby empower ouselves to guide the future to a more desirable outcome:

Human Nature is the ability to choose our own path

The second part of the book takes a deeper look at the Transition Vision in the five areas of population and demographics; Food and Water; Electricity and Energy; travel and transport; Health and Medicine.

Each of these sections presents a thorough and well-researched overview of the current situation, ending with a Timeline of how we reached a more desirable situation by 2027.

At the back of the book Chamberlin states that “This book has not attempted to quantify the energy/emissions footprint of each aspect of the Transition Vision, but this represents a critical avenue for further work.”

Unfortunatley, this lack of analysis seriously compromises the usefulness of the book, as the projected scenarios may be widely implausible or purely aspirational.

Many other authors have put work into this already, which could have been drawn from, a recent example being the Mayo Energy Audit, which also uses a scenario format, but successfully puts values and figures on the scenarios.

The population chapter, is to be lauded for highlighting an issue often neglected in the environmental movement; however, the author falls into the same trap that others tend to by visiting the “population or consumption” debate over which is the bigger issues:

…population is not (as some claim) the single most crucial environmental issue. It is clearly has a significant effect as a multiplier, but our chosen way of life and ecological footprint are bigger contributors to climate change, energy resource depletion and the other challenges facing us today and in the near future

As I have written previously

this is really a straw dog issue because as Ehrlich (whom he refers to) pointed out in The Population Bomb population and consumption are two sides of the same coin. It is in my opinion quite meaningless to speak about which is the greater issue, like we are dealing with some kind of Top of the Apocalyptic Pops.Ehrlich’s famous formula- which should be on every high-school curriculum- is: I (Impact) = P (population) x A (Affluence) x T (Technology) The issues of consumption and population are quite simply inseparable. If the population increases, there will be less resources to go around, so in theory we can increase the population so long as we reduce per capita consumption- and vice-a-verse.

The difficulty I have with making population/consumption an either/or issue is that it simplifies the challenges we have have as a species; I believe we are disposed by our evolution to increase both our population AND our consumption- see the recent discussion by Nate Hagens on environmental psychology.

It is the interplay between demographics and the natural impulse to increase our standard of living that needs to be explored here.

What would be essential to make this section work would be some kind of analysis of what a reasonable standard of living might be- it is not much use talking vaguely of reducing population without some assessment of what a sustainable level would be, which must be gauged against an acceptable level of consumption (I suggested Cuba, at about half the per capita energy use of Europe as a starting point in the above post.)

The food section gives an excellent analysis of the predicament, importantly drawing our attention to issues such as the huge “water footprint” of our food, particularly in meat and dairy- Fred Pierce in “When the Rivers Run Dry” calculates that the equivalent of 20 Nile rivers  move from developing to developed countries each year- a stunning image of the sustainability of our food production at present.

The transport section proposes a lift-Hiker system using GPS and mobile phone technology, similar to that of “the Smart Jitney” proposed by Pat Murphy in Plan C.

I particularly like the notion  of “hypermiling” which by 2018 has become a fashionable trend as it becomes socially unacceptable to waste resources.

The Health and Medicine section begins well by highlighting the oil dependency of the NHS, and presents the astonishing fact that while by far the largest cost of treating injuries is road accident related, the NHS itself generates as much as 5% of all UK transport!

Issues such as the challenge new diseases being brought by climate change, the inefficiency of big scale health services, and even euthanasia are mentioned; as well as a comparison with Cuba, which appears to have at least as healthy a population as the UK’s but with far less energy dependence.

But then, in the Timeline section, we read:

What used to be known as ‘alternative’ medicines were embraced, as practices like herbalism, acupuncture, massage and osteopathy became core pillars [my emphases] of public healthcare, with a big investment in teaching these skills leading to a blossoming of independent regulated practitioners in most communities.

Oh nooooo! Quackery! This paragraph is deeply concerning, betraying the New Age and pseudoscientific influences in the transition movement.

What is known as “alternative” medicine is simply medicine for which there is no good evidence of effectiveness; certainly, not all “conventional” medicine is evidence-based either, but new-Agers tend to use this as an excuse for throwing out the need for  evidence altogether. Often these therapies are based on dubious or discredited “ancient wisdom” which simply has not been born out by the discoveries of modern science. It is modern medical research and science which has lead to an increase in life expectancy, a decline in infant mortality etc..

Now, certainly the problems with modern medicine are manifold, in particular the over-dependence on oil, horrific levels of waste and a level of corruption amongst Big Pharma. None of this is evidence that alternatives like acupuncture work, while many repeated, verifiable blind trials indicate they do no better than placebo.

All these issues and their many nuances are discussed brilliantly in Ben Goldacre’s book Bad Science and I urge you to read it if you are of an alternative disposition when it comes to health care.

The fact is, some remedies work, some don’t; some herbs work, some dont; there is absolutely no way of knowing for sure without large scale clinical trials of the sort the medical establishment does routinely, and which the alternative sector has apparently no knowledge nor interest in.

The curious thing here is that the whole basis of the Transition Movement is based on the verifiable science of Climate Change and Peak Oil; but when it comes to quack medicine, the evidence offered is as useless as that offered by climate change deniers- personal anecdotes along the “it worked for me” kind and pseudoscience.

Transition founder Rob Hopkins provides some startling examples of this on recent comments to Zone5.

In the discussion after this post for example, he comments:

“I have had a great deal of acupuncture in my life, I think it is extraordinary. Had some on a painful back the other week, worked a treat. Acupuncture is based on many centuries of the observation of subtle phenomena.”

Many will say the same or similar, but anecdotes do not constitute evidence; if they did we would have to accept that global warming is not happening on the basis of it being rather cool today for the time of year. I’m only slightly exaggerating – climate change deniers do routinely use the same kind of reasoning to dismiss the science of anthropogenic climate change; and even more so, they point out the failings of Big Science in general terms as a way of discrediting evidence- it is corrupt, in the pockets of the government and corporations etc. “therefore we can dismiss the evidence.”

Even more worrying, Rob goes on to say:

“None of my children have ever been vaccinated, nor have they ever had any antibiotics. They are strong and healthy (touch wood).”

The irresponsibility and naivete of this statement is shocking- the reason his kids have not got measles is likely to be either just luck, or because everyone else’s kids have been vaccinated. (Unvaccinated children may also put at risk certain categories of children who cannot safely be vaccinated for medical reasons, or who may be more susceptible in the event of catching measles.)

Let’s be clear here: the evidence for the safety and effectiveness of the MMR vaccine is just as clear as the evidence for man-made climate change; the kind of thinking that refutes one is pretty much the same as that which is used to discredit the other. By throwing in “alternative medicine” in such an uncritical way Chamberlin panders to the  reactionary and retarded element of the New Age meme which believes mainstream medicine is all a con designed to make money and poison us, and alternatives can be uncritically accepted as “safe, holistic alternatives”.

In fact, they are expensive lifestyle products which can in no way replace modern medicine other than as being different forms of TLC- Tender Loving Care. Nothing wrong with that, but they need to be seen as such and drop the false claims of being able to cure specific diseases.

And God help us if they are to become a “core pillar” of public healthcare.

Partly as a result of the kind of delusional thinking expressed by Rob in the above comment, the UK is now facing the worst measles epidemic in decades. It is about time the Transition Movement took a stand on this and put out good information on the subject.

Not only that, but by promoting alternative medicine in this way, Chamberlin is actually undermining his arguments for understanding climate change and Peak Oil. This is all the more ironic since the book covers the need for evidence on these two issues very thoroughly, plenty of graphs and stats and quotes such as that of Daniel Moynihan who said “Everyone is entitled to their own opinion, but not their own facts” – a thought that proponents of alternative therapies would do well to meditate on for some time.

The Cuban example is really useful but although their state health service has embraced complimentary therapies including Homeopathy, there is little indication that this has become anything like a core pillar, the success of the Cuban situation being more likely a result of following evidence-based medicine to a high standard, putting in sufficient resources, and focussing on community care and prevention.

Energy Descent Planning

Rob Hopkins  writes the next section, Timelines and Energy Descent Plans which is an account of community planning tools and “visioning” processes for changing the communities’ cultural story to the more agreeable Transtion Vision.

An EDAP (Energy Descent Action Plan) is, he says “as much as anything, a new story for the community…

We often stress in Transition that we need to create visions of a post-carbon world so enticing, so compelling and attractive that people leap out of bed in the morning determined to dedicate their lives to its implementation. An EDAP is an embodiment of this.

“Determined to dedicate their lives” does sound a bit cultish and scary to me, and not a little evangelical; however, this chapter concerns itself only with the visioning processes, again with barely a mention of the need to actually count and quantify energy demand and supply; I understand that the movement is working on a more detailed follow-up to the Timeline on how to write an Energy Descent Plan, but it is a little disappointing that after two publications and several years, Transition has not even produced a few pages on basic energy literacy or how to do a simple domestic energy audit, all of which would make this book much more useful.

Rob writes as if this is all that is involved in writing an EDAP, while these visioning processes, useful and inspirational as they are, surely do not provide the meat of a true EDAP, which would start with an audit, and then assess local available resources and then assess how best to use them.

The last section of the book gives more detailed explanation of Peak Oil and then Climate Change; the Peak Oil section is fine, but adds little to existing literature; but the Climate Change section I found really excellent, surprisingly learning plenty of new things, for example about how different measures of greenhouse gas concentrations are used in public discourse which are little understood and distort the picture.

In conclusion, the Transition Timeline has plenty of useful information and some great ideas, but fails to really move the work of transition on in a way we might expect at this stage; and, perhaps inevitably, tends to paint a rather rosy picture of how the transition will play out. Personally, I would hope to see a more realistic view, which includes more on emergency planning and a future which may not be able to deliver the kind of smart technology envisioned for some of the areas explored.

(Andy Wilson of the Sustainability Institute has suggested to me that Peak Car use has probably already passed, while the Timeline puts it as not happening until 2016- a very pessimistic (sic) view!)

Predictably(!), I am highly critical- and will continue to be- of the New Age influence in the Health section,which will feed the suspicion in some quarters that transition is adopting some cultish attributes, and insist on the promotion of evidence-based medicine; and I feel, the lack of detailed energy auditing just means that the Transition Vision will tend to move further away from the observed reality.

It is not yet generally accepted that measles can be a dangerous illness. Believe me, it is. In my opinion parents who now refuse to have their children immunised are putting the lives of those children at risk.

“Measles cases in England and Wales rose by 36% in 2008, figures show…

“Professor David Salisbury, director of immunisation at the Department of Health, said it was “irresponsible” for parents not to have their children vaccinated.

He said: “I think it’s irrational, I think it’s putting children’s lives at risk. I can see no shred of benefit.

“There is no evidence that having vaccines separately is better. There are good reasons why it’s worse.”

Professor Steve Field, chairman of the Royal College of GPs, said confidence in the MMR vaccine was returning but it was vital that parents made sure all their children had received both doses.

“Measles is a sinister and nasty illness and shouldn’t be taken lightly.”

For anyone who thinks that it is cool and trendy and somehow “alternative” or even “mystical” to avoid the MMR vaccine have a look at Ben Goldacre’s recent forray into the subject.

Some of the transcript of the broadcast he is writing about is available here and the comments after this blog are worth reading to get an idea of the different points of view, and where they come from.

“We shouldn’t forget that the children who weren’t vaccinated many years ago are at real risk.”

” ‘Big pharma is evil’, goes the line of reasoning, ‘therefore homeopathy works and the MMR vaccine causes autism’. This is probably not helpful”.

So says Guardian columnist and evidence-based medical blogger Ben Goldacre in his highly recommended and also hilarious book Bad Science.

Some of the comments in response to my review of Greer’s The Long Descent before Christmas lead me to think I should follow up with more explanation on acupuncture and alternative therapies,  and I  can do no better than give a brief review of Goldacre’s superb explanation of the scientific method in this book.

He begins with a chapter on homeopathy, not as he says because it is particularly important but because it provides such a good example of how to test therapies and see if they work:

Homeopathy is perhaps the  paradigmatic example of an alternative therapy: it claims the authority of a rich historical heritage, but its history is routinely rewritten for the PR needs of a contemporary market; it has an elaborate and sciencey-sounding framework for how it works, without scientific evidence to demonstrate its veracity; and its proponents are quite clear that the pills will make you better, when in fact they have been thoroughly researched, with innumerable trials, and have been found to perform no better than placebo. Homeopathic remedies- in liquid drops or pill form- in fact contain nothing at all- perhaps explaining why they are often promoted for their qualities of “being natural alternatives to mainstream medicine without the side-effects”.

When you take homeopathy you are in fact taking a sugar pill or just plain water- the effect is purely placebo, as more than 200 clinical trials have shown.

Goldacre’s explanation of just how these clinical trials are conducted, how they are “blinded” and how use of a control groups is essential reading for understanding how and why people still believe that homeopathy works: they dont trust the science, which they associate with the evils of Big Pharma.

However, Goldacre shows that “its a little bit more complicated than that”… the problem is, few of us have the training to separate “good” science from the bad. There may be a world of difference between different quality of trials and studies:

on the one hand, there is the high-grade trial with randomised samples of statistially relevant numbers, properly blinded, with controls, that is testing the relevant variables and excluding others; that is published in peer-reviewed journals; that is transparent in its methodologies and in the presentation of its results; that offers itself to the scrutiny of other researchers, and to the public, inviting flaws to be uncovered and the next study improved upon.

Yes, such studies do exist. Not all researchers are unscrupulous hoaxers with no concern over anything other than huge payouts from Big Pharma for bogus studies designed only to discredit “natural” and “alternative” therapies in order to seize market share, as Greer has claimed.

(For those fond of conspiracy theories, you might consider why no evidence is found for something that is believed to work- either a) it doesnt work or b) a conspiracy- but what is the conspiracy? Big Pharma would take homeopathy of any other pill-type alternative and make a billion out of it like that- if it worked. The reason that modern medicine may be failing is because of a public expectation of constant new developments and new products- and the growth economy, of course. The truth is more interesting-  most big developments in medical research were made long ago in the realm of vaccines, germ theory etc- thus medical innovations may have peaked.)

On the other hand, however, we do have very poorly conducted studies with unrepresentative samples, riddled with such phenomena as comfirmation bias, which are reported as “proving” something when in fact they prove nothing at all.

The trick, then, is how to tell the difference, and the only way we can really do this is by reading each study closely to see how good it was- exactly how to do this is what Goldacre’s book is all about.

But wait a minute- if Homeopathy is just water, why do so many people still believe in it? Why are so many happy customers going back for more? Why do more and more doctors prescribe homeopathy, why are there still universities offering degrees in it, and why is it such a successful and lucrative industry?

I think that this past point should be emphasised before moving on- homeopathy is Big Business, the European market worth more than 2.5 billion euros, with the big companies promoting it feeling increasingly corporate in their stance. Part of its success lies in the low-cost inputs. A single French Duck sacrificed each year for the manufacture of a homeopathic flu remedy for the company Boiron, and then diluted to such a degree that not a single molecule  will remain in the remedies, generates $20 million a year in sales, making it arguably the most valuable animal on the planet! (See Rose Shapiro, Suckers- How Alternative Medicine Makes Fools of Us All Harvill Secker 2008)

Now, this may be relatively small potatoes compared with the billions of profit made by Pfizer and the like, but the wider point Goldacre brings home is that there is really a merging of mainstream and alternatives, at least in the way they are marketed. It doesnt really hold water to argue on the one hand, mainstream medicine is bad, and then happily pay good money for a sugar pill marketed as “alternative” and sold in the same pharmacy. Dohhhhhhh! (It’s all in the marketing, you see- there are parallels with another alternative holy cow, organic food- see Michale Pollan’s the Omnivore’s Dilemma).

Back to why people still think this stuff works: well, the placebo effect is a fascinating topic in itself, and is explored in the following chapter. If you know nothing of science at all, you might be forgiven for thinking this must be a deeply mysterious subject that maybe proves “mind over matter” or “quantum healing” or something. But in fact, like everything else, it can be studied scientifically. Strange though the results may seem, Goldacre takes us through some of the best experimental data on the subject of the placebo effect, finding for example that two sugar pills may work better than one; that the colour of the pill may effect its efficacy, as will whether it is administered by a man in a white coat with letters after his name.

…the placebo effect is about far more than just a pill: it is about the cultural meaning of the treatment. Pills dont simply manifest themselves in your stomach: they are given in particular ways, they take varying forms, and they are swallowed with expectations, all of which have an impact on a person’s beliefs about their own health, and , in turn, on outcome. Homeopathy is a perfect example of the value in ceremony.

The same may be true for a range of other alternative therapies which people swear blind are curing them- acupuncture being a good example, but also anything from Reiki to Aromatherapy- nice people giving you lots of care and attention in comfortable “healing” environments can work wonders- why wouldnt you feel better afterwards? Far preferable to the perhaps abrupt and peremptory 2-minute consultation you might get in a cold doctors’ surgery- which is precisely why many doctors are indeed willing to refer patients to an alternative practitioner who, for a price, may in reality be more help than they doctor can be- especially if it is for a chronic condition or a condition for which there is no complete cure anyway.

Many kinds of back and knee- pain and similar conditions come under this category- there may indeed by lifestyle causes, or you might just need a nice rest. No reason why a massage wouldnt help you to feel better- but that is a little different from claiming some esoteric cause for presumed healing powers of a therapy. There is no substitute for well-conducted clinical trials to establish the true efficacy of a treatment.

There is also the issue of “regression to the mean”- people often seek help at the peak of distress, after which many illnesses tend to revert to a “mean” or average degree of severity. This is not always the case, but these kinds of conditions are typically the ones people claim have been cured by alternative therapies. Fact is, lots of things just get better by themselves or at least fluctuate and improve, and a bit of TLC can help this along nicely.

(Homeopathy often turns this on its head, claiming success even if your symptoms deteriorate first- a win-win situation!)

I have many friends who swear blind that homeopathy does wonders for their young child for teething troubles- how could this be placebo? Try a Smartee- its cheaper. Regression to the mean, rest and relaxation, the gentle healing properties of time… all these would be relevant to animals too.

Having dispensed with sugar pills and rituals, Goldacre raises the game with his examination of Nutritionism- singling out Patrick Holford for particular dissection. Nutritionism is largely pseudo-science, it seems, but again, it is Big Business- and so we have a burgeoning industry of supplements which make up for our food being just not good enough to feed us anymore.

Holford’s books are instructive for their weighty-tome feel, their sciencey jargon and its pages of footnotes- a sample of which Goldacre takes us through to give an indication of how spurious they are.

For anyone still finding Goldacre’s discrediting of alternative remedies too  bitter a pill to swallow, his chapter “Is Mainstream Medicine Evil?” should set your mind at rest. The conclusion is inescapable- what is needed is more high-grade evidence based medicine, not less: the whole problem with mainstream medicine is essentially the same as the problem with alternatives: the science is very poor and often used to mislead.

The only difference is, Big Pharma is much more sophisticated in its deceptions and obscurifications. Goldacre does a superb job in taking us through how this process actually works, and in so doing, gives us the tools we need for uncovering the truth about medical science.

It is not even the deceits of Big Pharma, howver, who are the main culprits in Goldacres’ Rogues Gallery of the Bad in Science: for this he turns to the media and how it promotes the public misunderstanding of science.

With many examples to choose from he shows how science in general is portrayed as quirky and boffiny, with whacky scientists finding the formulae for the “perfect wiggle” and other such nonsense- and dont think this is confined to the tabloids either.

The following chapter is entitled “Why do Clever people Believe Stupid Things?” Goldacre gives many examples of how our intuitions and perceptions can mislead us- and yes, this also is based on high-quality peer-reviewed studies. Here is where we will find a wealth of potential research opportunities for understanding why, for example, people cant understand peak oil or Climate change, or respond appropriately.

The final chapters discuss health scares, in particular what he calls The Media’s MMR Hoax. This all seems to go back to a paper published in 1998 in the Lancet by one Andrew Wakefield from the Royal Free Hospital in London which Goldacre claims “now stands as one of the most misunderstood and misreported papers in the history of academia.” This whole extraordinary story has clearly played a big part in the public’s suspicion of mainstream medicine and the rising popularity of alternatives- and yet is based on bad, bad science, as Goldacre explains. In one study he refers to, over 50% of homeopathists surveyed warned against use of the vaccine- but now there are fears that measles cases may be on the increase as a result of many parents’ misguided avaersion to the vaccine through the early 00′s after the publication of Wakefiled’s flawed study.

Tragic indeed. This is one of the more serious results of general public ignorance of science and the media’s complicity in spreading misinformation- all aided and abetted by an alternative industry waiting in the wings to sieze its chance to “increase market share”.

As an aside, and I refer you back to Rob Hopkin’s comment on the Greer post, Goldacre makes a comparism with the work of 1999 study by Pustzai showing a link between GM potatoes and cancer in rats- according to Goldacre, equally flawed as Wakefild’s- but his main gripe is, “during the crucial two days after the GM ‘Frankenstein Foods’ story broke in Feb 1999, not a single one of the news stories ...on the subject were written by a science journalist.”

Damningly he goes onto say:

Witnessing the blind, seething, thoughtless campaigns against MMR and GM- which mirror the infantile train of thought that ‘homeopathy works because the Vioxx side-effects were covered up by Merck’- it’s easy to experience a pervasive sense of lost political opportunities, that somehow all of our valuable indignation about developmental issues, the role of big money in our society, and frank corporate malpractice, is being diverted away from anywhere it could be valid and useful, and into puerile, mythical fantasies.

But perhaps an even more disturbing and far-reaching effect of the prevalence of woo-woo, Bad Science and the Age of Endarkenment that we see in the world today is the background to the whole MMR scare story, which reached its crescendo in 2002. This background story was the coverage of Tony and Cherie Blair’s baby Leo and their refusal to state whether he had infact been vaccinated.

The stories coming out around this time about the Blairs covered Cherie Blair’s close friend and aid, the New Age guru Carole Caplin.

Goldacre tells us

It was also reported- doubtless as part of a cheap smear- that Cherie Blair and Carole Caplin encouraged the Prime Minister to have Sylvia [Caplin, Carole's mum] ‘douse and consult The Light, believed by Sylvia to be to be a higher being or God, by use of her pendulum’ to decide if it was safe to go to war in Iraq .

Did Blair ask a dowser to help advise on the invasion in Iraq?

Could it be true? Did Blair use a New Age dowser to help him decide about whether or not to invade Iraq? Seems incredible, but given the known propensity of the Blair’s for some of the more extreme and bizarre aspects of New Age religion, it has to be considered a possibility.

To sum up, the next time any of you feel like defending dowsers, New Agers of any kind, or alternative therapies like homeopathy or acupuncture, just consider the kind of company you are keeping, and the kind of mindset and thinking processes you are buying into and promoting.

And before you write into me claiming that you just know homeopathy or whatever therapy works because little Johnny was very sick and then as if by magic got better after taking the magic pill, please, please, read Ben’s book- it’s brill.

John Michael Greer has also recently written an interesting post discussing the legacy of science and rationality and whether they can or will be saved as we move through energy descent.

The scientific trial, including use of controls and blinding to avoid observer or experimental bias. is a recent human innovation that has revolutionized the way in which we investigate and gain knowledge about the world. The whole point of this process is that it provides a way of checking our own experience and seeing if they are indeed correct. Evidence is collected and carefully verified by independent parties carefully checking the experiments. Over time, with increasing confidence, testable, verifiable data is accumulated and knowledge about the world and the universe and the nature of Nature can be asserted with increasing confidence.

What is becoming increasingly clear to me is that although this rationalist approach has given us much of the modern technology which we depend on and use routinely in our daily lives- including computers, machinery of all kinds, industrial foods and pharmaceuticals- few people have any idea what is involved in a scientific trial and there is a very strong cultural prejudice against the scientific method in general. This ignorance and suspicion towards science extends to teachers, magazine editors, community leaders and many others including many of my friends and colleagues in the environmental community.

I find this tragic because i believe a case could be made that the scientific trial properly applied may be the cherry on the cake of the Oil Age. It may be the true genuine and lasting benefit which modern society has come up with- the ability to see beyond our own prejudices and personal experience and uncover at least some remarkable but hitherto hidden mysteries of the Universe. The most prominent examples of this would be Quantum Theory and ecological systems theory- a kind of Enlightenment of the human mind.

It is extraordinary however how nearly everyone I have discussed this with recently refuse to accept the validity of scientific testing because of the “observer effect” which they believe has been proved by Quantum theory to invalidate any observations of any kind! This is sheer Quantum Quackery and muddled thinking in the extreme- it is only ever applied to the testing of paranormal phenomena and never to anything else.

Perhaps the most controversial aspect of this is to be found in the area of “alternative” or “holistic” medicine and therapies.

Anyone interested in whether or not therapies such as Reiki, Homeopathy, Herbal Medicine or any of 40 other unregulated therapies are actually effective in treating the conditions they claim to be able to treat, and how we know, should read the new book by Professor Edzard Ernst and Dr Simon Singh, Trick or Treatment? Alternative Medicine on Trial

The book is written in clear layman’s language and tells the story of how these therapies emerged, often- as with the case with homeopathy for example- prior to clinical trials becoming the norm in assessing medicines- and a thorough review of all the scientific data available to date. The process of a clinical trial is clearly explained and some of its maverick heroes- Florence Nightingale for example- come to the fore as pioneers who went against the wisdom of the day to insist on statistical analysis and verifiable trails to save lives.

It is clear that alternative medicine is riddled with fraud and misinformation and most importantly for the most part has no internal regulation of any kind. Many alternative practitioners and their organisations- chiropractic therapy for example- make quite spurious claims for the conditions they can treat. Homeopathy is just an expensive placebo- there is generally no active ingredient in the remedies: they are just sugar pills.

There are many dangers in this -even placebos as they may dissuade people from using cheaper conventional therapies which are as more effective or more so. The insanity of this becomes clear when you realize that there are homeopaths who claim to be able to protect you against malaria with sugar pills- and earn their living by doing so.

Perhaps a weakness of the book is that is fails to address in detail the downfalls of conventional medicine and how it is also manipulated by big business. However, the authors are clearly aware that this can happen and call for more rigor and openness in all medical research.

Most interestingly, the authors themseleves have both been involved with practicing alternative therapies but never took it for granted that they worked, instead repeatedly checking the evidence and looking for further tests.

On the other hand, there is no discussion of the future of medicine in an oil-hungry world. Most of modern pharmaceuticals have a very high energy and oil content. In the future we may all become much more dependent on whatever folk knowledge happens to be around to help us get well and stay well; but we would still do well to keep the knowledge of the clinical trial and the deeper understanding of our world and ourselves that this has given us, lest the future be a return to the dark ages of leeching and snake oil.