It’s common knowledge that Prince Charles is a persistent and outspoken champion of alternative medicine, but the full story has never been told—until now. Edzard Ernst reveals all the shocking details in this unauthorized biography. The shocks come from Charles’s own words, which Ernst quotes extensively.

It is ironic that Charles’s supporters were responsible for getting Ernst’s research funds withdrawn and forcing him into early retirement. Ernst has done more than anyone else in the world to investigate alternative medicine, trying to ferret out which treatments are effective and safe. He once practiced homeopathy and was enthusiastic about alternative medicine, but as new evidence emerged, he changed his mind; Charles did not. As the first professor of complementary medicine, for two decades Ernst led an incredibly prolific multidisciplinary team of twenty researchers. They published over 700 papers in scientific journals, with many systematic reviews of the existing evidence. They also published research papers on various alternative modalities; in a box at the end of chapter 2, Ernst lists thirty-eight they investigated. These included the ABCs of acupuncture: Bach flower remedies and chiropractic on down the alphabet through exercise, moxibustion, reflexology, and yoga.

Charles had been peripherally involved in establishing Ernst’s position at the University of Exeter. He has repeatedly called for more research, but he doesn’t want the kind of research Ernst does. Charles envisions research that will find evidence to provide scientific support for alternative medicine.

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As a young man, Charles embarked on a private voyage of spiritual inquiry. He was intuitively averse to scientific materialism and drawn to mysticism. He fell under the spell of Laurens van der Post, who introduced him to the teachings of Carl Jung and the idea of the collective unconscious. Van der Post interpreted Charles’s dreams and urged him to give up all his duties and withdraw from the world to seek an “inner world truth.” Charles repeatedly sought his advice and made him a godfather to Prince William. After his death, van der Post was shown to have been a compulsive fantasist who constantly lied about everything, including every detail of his fictitious personal history. It was revealed that he had seduced, impregnated, and then abandoned a fourteen-year-old girl. Charles has never commented on these disclosures; in fact, he doesn’t even mention van der Post in his book Harmony, in which he explains his underlying philosophy.

Ernst quotes the ever-eloquent Christopher Hitchens: “We have known for a long time that Prince Charles’s empty sails are so rigged as to be swelled by any passing waft or breeze of crankiness and cant.” Charles has chosen to surround himself with unscrupulous people and listen to bad advice unquestioningly. The finance director of the Foundation for Integrated Health (FIH), a charity founded by Prince Charles, was given a three-year sentence for siphoning off £253,000 of FIH’s funds; the FIH was later closed. Shortly after his thirty-fourth birthday, Prince Charles was elected president of the British Medical Association and asked to address that august body. They were surprised when he went on a full-frontal attack, saying science had become estranged from nature. He accused them of unfairly rejecting anything unorthodox or unconventional, of failing to address the whole patient, and of ignoring traditional wisdom.

You can guess their reaction. Ernst quotes from a biography written by Tom Bower:

For a thirty-four-year-old with a mediocre degree in history to preach the power of spiritualism, based on a jumble of ideas inherited from van der Post, Jung, and … Paracelsus … to an audience of doctors, the science that produced the drugs that had eradicated polio and tuberculosis, was as frightening as it was brazen.

This pattern of behavior was repeated many times. Ernst quotes Charles’s open letter to The Times and his lecture to the World Health Organization (WHO) in their entirety, with the addition of lists of his own specific comments debunking what Charles said.

Charles repeatedly interfered in politics, writing to politicians and to the Health Secretary, lobbying for the National Health Service (NHS) to fund alternative medicine. After a protracted legal battle, some of Charles’s private letters and memos were disclosed to the public over the objections of the palace. Ernst points out numerous false statements in that correspondence, including the assumption that it would reduce costs. He rightly points out that there cannot be cost-effectiveness without effectiveness.

Charles misrepresents conventional medicine as limited to “pills and procedures” and “focusing on symptoms alone.” Ernst points out that conventional medicine includes care, compassion, dialogue, empathy, and concern for the welfare of the whole person. Adding unproven treatments would only make conventional medicine more imperfect. Overuse of antibiotics has endangered our health, but homeopathy is not the solution to that problem.

Charles claims he wants research, but his idea of research is to validate his beliefs about alternative treatments—not to investigate whether they are effective and safe. In one biography, Charles was quoted as saying, “the evidence of experience is just as important as scientific evidence.” In his experience, a cow got better after homeopathic treatment, so he assumed the treatment caused the improvement. That’s a classic post hoc ergo propter hoc fallacy. Experience never amounts to reliable evidence, because it doesn’t tell us what might have happened without the treatment. It doesn’t take into account factors such as the natural history of the condition, regression to the mean, the placebo effect, and concomitant treatments. As Mark Crislip said, the words “in my experience” are the three most dangerous words in medicine. Evidence without a control group is no more reliable than an untrustworthy anecdote.

Ernst asks whether Charles is really ignorant about science or if this is just “motivated ignorance,” a lack of knowledge due to a conscious decision to ignore information that he perceives as inconvenient, disturbing, or unwelcome. Ernst says “Today, the Enlightenment is celebrated as a symbol for rational thinking and scientific analysis.” Charles is intuitively poised against reason and science. When accused of being the enemy of the Enlightenment, he said, “I felt proud of that.” Charles acts on his intuitions and beliefs. Ernst says he is welcome to his own opinions but not to his own facts. When he talks about architecture, he is expressing his opinion. When he pretends his opinions about alternative medicine amount to evidence and interferes with healthcare, he stands in the way of progress.

Ernst calls Charles’s passion for homeopathy “the best example for showcasing the failure of his promotional activities.” The number of homeopathic hospitals in the United Kingdom has dropped from five to zero, and the NHS is no longer reimbursing the costs of homeopathy. Charles managed to get chiropractic and osteopathy regulated by statute; he was unable to do the same for homeopathy. He believes homeopathy is harmless and has been scientifically proven to work; both ideas are demonstrably untrue.

Each chapter of the book ends with a box of information points. The box for the chapter on homeopathy made me laugh; it is a list of forty examples of homeopathic remedies that are not based on any material at all, including essence of Milky Way, emanations from Stonehenge, vacuum, wind, and the color blue! I thought the homeopathic remedy Berlin Wall was ridiculous, but these examples take the cake.

In chapters on specific alternative modalities such as chiropractic, osteopathy, and homeopathy, Ernst first states Charles’s views then covers the evidence and describes the consequences. For instance, Charles’s support led to statutory regulation of chiropractic, but chiropractors published very little research, there were widespread failures to comply with the General Chiropractic Council’s own standards, and they failed to establish a monitoring system for adverse effects of spinal manipulation.

Ernst calls Charles’s book Harmony “a lasting document of his often-bizarre views,” demonstrating that he is ill-informed, ill-advised, and often dangerously wrong. Charles claims acupuncture is a proven discipline, and he endorses osteopathy, homeopathy, and Ayurvedic medicine. He also endorses several diagnostic methods that have been tested and shown useless. He claims that pulse and tongue diagnosis, foot reflexology, and iridology are based on thousands of years of ancient wisdom and are immensely valuable. Ancient? I don’t doubt that people have been massaging aching feet for eons, but modern foot reflexology is a twentieth-century invention. And wasn’t iridology invented by the nineteenth-century Hungarian physician Ignaz von Peczely based on his observations of an owl?

Charles became an alternative medicine entrepreneur when he launched his Duchy Originals Detox Tincture in 2008. It was a mixture of globe artichoke and dandelion extracts that promised to remove toxins and aid digestion. The company falsely claimed it had been tested for efficacy when in fact it had been tested only for safety and quality. It was quickly censured by the UK Advertising Standards Authority for violating advertising rules, and it provoked international criticism and ridicule. Ernst wrote that the idea of detox flies in the face of science; he called it implausible, unproven, and dangerous. Steven Novella called it snake oil and an old con. The British Dietetic Association chimed in to say the idea of detox was a load of nonsense. The product was withdrawn from the market. It was not only a financial failure but also damaged Charles’s reputation.

One might think Edzard Ernst would hate Prince Charles for his role in getting funding withdrawn from Exeter University. Did he write this book to get revenge? I don’t think so. There is no hint of personal animosity in this book. And Ernst is not prejudiced against alternative medicine per se. He only asks that all claims for efficacy be based on credible evidence, regardless of whether they are alternative or mainstream.

In the foreword, Nick Ross says he believes Prince Charles is a fundamentally good human being, and his motives are right even when he is wrong. Ross characterizes the controversy as “a contest between honest belief and honest evidence.” In the last chapter, “Final Thoughts,” Ernst says he still believes that alternative medicine has a few hidden gems to discover. But to find them, we need good science and people with influence to support research:

Charles could so easily have been that person. Instead, he took consistently poor advice and chose to follow a different path. He pursued a largely anti-science agenda and promoted the uncritical integration of unproven treatments into the NHS. … He became an obstacle to progress in healthcare and generated more harm than good. My predominant feeling about that is sadness over a missed opportunity.

I can recommend this book wholeheartedly. It should be interesting reading for anyone who wants to learn more about science, skepticism, and critical thinking. It tells the whole story of Prince Charles’s ignorance and folly matter-of-factly, relying mostly on Charles’s own words. It is clear, well-written, and divided into easily digestible short chapters. It emphasizes the principles of good science and why science is superior to intuition as a way of finding out the truth. My only complaint is the typos that the publisher’s proofreaders missed. My favorite was “heir to the thrown.” It made me wonder if Queen Elizabeth had ever been thrown in a wrestling match; I think that’s unlikely!