www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=559711&in_page_id=1774Just how safe is alternative medicine? Here, in the second part of our series, Professor Edzard Ernst and scientist Simon Singh explain how "natural" doesn't necessarily mean "safer".
Most people view alternative medicine as a safe option.
On the other hand, conventional medicine is often criticised because of the side-effects of pharmaceutical drugs or the risks associated with surgery.
But does alternative medicine generate more good than harm?
We saw last week that chiropractic therapy carries a range of risks - so, too, do other alternative therapies.
Studies have shown that acupuncture treatments can result in slight pain, bleeding or bruising.
These adverse reactions are only minor and transient, but they occur in roughly 10 per cent of patients so are relatively common.
Slightly more serious side-effects include fainting, dizziness and vomiting, but these are less common and usually associated with anxious patients who may have a fear of needles.
Although most patients may accept such risks as an unsurprising consequence of being pierced with needles, there are two serious adverse effects to consider.
The first is infection. There have been several documented cases of patients contracting diseases such as hepatitis.
The journal Hepatology documented how 35 out of 366 patients contracted hepatitis B from an acupuncture clinic in America.
The infection was caused by re-using needles that have not been properly sterilised, and part of the problem may be due to the Chinese tradition of storing needles in alcohol solutions, which is not sufficient to protect against hepatitis viruses.
The second is that needles might puncture a major nerve or organ.
For example, needling at the base of the skull can lead to brain damage, and there are more than 60 reported cases of punctured lungs.
Most worrying of all, there is a report of an acupuncturist inserting a needle in the chest of an Austrian patient which pierced her heart and killed her.
Normally, needling at this point is entirely safe because the sternum protects the heart, but one in 20 people have a hole in that bone which cannot be felt or seen.
Although acupuncture carries some common and serious risks, it is important to stress that the common risks are not at all serious and the serious risks are not at all common - they need to be seen in the context of the millions of treatments given each year.
Moreover, the serious risks can be minimised by visiting a medicallytrained acupuncturist who has a full knowledge of anatomy and uses disposable needles.
On the other hand, the evidence for the efficacy of acupuncture ranges from zero for a range of conditions to borderline for some types of pain relief and nausea.
Hence, it's only worth considering for pain relief and nausea - and only then if you feel the supposed benefits outweigh the small risks.
Homeopathy is another treatment generally seen as totally harmless but it is, in fact, associated with risks.
The evidence is that the benefits of homeopathy are purely placebo, which is hardly surprising bearing in mind that the final medicine often contains no active ingredient.
One might assume, therefore, that homeopathic remedies must be harmless.
Unfortunately, homeopathy - and similar therapies - can have surprising and dangerous side-effects.
These have nothing to do directly with any particular homeopathic remedy, but rather are an indirect result of what happens when therapists replace doctors as sources of medical advice.
The widespread anti-immunisation stance among alternative therapists is one example.
There are numerous reports of patients with serious conditions (cancer, Aids) suffering harm after following irresponsible advice from alternative practitioners.
This problem was clearly demonstrated by the death of Sylvia Millecam, a Dutch TV star.
In 1999 her GP noticed a small lump in her breast and referred her to a radiologist, but the tests were inconclusive.
Instead of visiting a surgeon for further investigation, she underwent electro-acupuncture.
Even when it was absolutely clear that she had breast cancer, Millecam rejected conventional medicine and visited 28 alternative practitioners over two years, each one claiming to be able to help her.
The pointless treatments she received included homeopathy, salt therapy and psychic healing.
The cancer spread and Millecam was admitted to hospital in August 2001, but it was too late.
She died four days later, aged 45.
A medical panel concluded that she had received "unfounded methods of treatment" and that her alternative therapists had denied her "a reasonable chance of recovery" and caused "unnecessary suffering".
ACUPUNCTUREWHAT IS IT? The process of puncturing the skin with needles to improve health.
This is said to restore the flow of Ch'i, the energy or life force that flows through our body.
Illness is due to imbalances or blockages in the flow of Ch'i.
DOES IT WORK?
Over the past three decades a huge number of clinical trials have tested acupuncture's efficacy.
The high-quality research papers fail to show that acupuncture works for a whole range of conditions, except as a placebo. Research does support its use for some pain - pelvic and back pain during pregnancy, lower back pain, headaches and nausea.