Book Review: Neuropathic Physical Medicine

Book Review
L. Chaitow, Neuropathic Physical Medicine: Therapy and Practice for Manual Therapists and Neuropaths , Elsevier-Churchill Livingstone (2008) ISBN 9780443103902 Price £41,99, No. of pages 594.

Edzard Ernsta, (Manual therapy, in press)

This multi-author book covers those aspects of neuropathic medicine which are not pharmacological or mind-body by nature. I did ask myself whether there is a physical medicine that is not neuropathic. The answer was, I thought, no. So perhaps this book is about physical medicine and, having been a professor of physical medicine once, I thought this is right up my street.

As it turns out, I was wrong. The book embraces all sorts of concepts which a scientific mind is likely to think of as mumbo jumbo. Examples are ‘Constitutional considerations, (p. 89) and ‘detoxification’ (p. 81). I know that most neuropaths would disagree with me, but I fail to see any good evidence for there validity. More disturbingly I found that the concept of scientific evidence was dealt with in a most peculiar and misleading way. This culminates in a graph which implies that data from clinical trials and meta-analyses are just as relevant as case reports and in vitro studies for evaluating the effectiveness of a therapy. I don’t think this is true and I am sure that most methodologist would agree with me. The last part of the book is devoted to treatment of specific conditions. I was unconvinced by much of this too. For example, the implication that one can effectively treat serious heart conditions with manipulation worries me. Similarly the notion that “irrespective of the named condition”, patients can be helped by physical medicine simply does not tally with my scientific knowledge nor my clinical experience. I am sorry not to be able to strike a more positive note after reading this book.