After four years and five days of nearly continuous blogging about skepticism, quackery, science- and evidence-based medicine, and a variety of other topics, you’d think there wouldn’t be much that I haven’t seen before. Certainly, lately, I’ve been wondering lately if there was anything left that could surprise me or horrify me anymore, and jaded is not a good way to be as a blogger. Indeed, in retrospect, I wonder if jadedness was why I had to stop Your Friday Dose of Woo for a while, the death of my dog notwithstanding, and why I’m happier now that I no longer feel obligated to do it every Friday. And, even now, every so often, there’s something so bizarre, something I’ve never heard of before, something that takes me by surprise.
This is one of those times.
Lately, I’ve been ragging on acupuncture–and justifiably so, I like to think. Having gone from sort of believer (or at least being somewhat open-minded about it) to realizing what that it is no more than an elaborate placebo and produces nonspecific effects that one would expect of an elaborate placebo, thanks to having actually taken the time over the last couple of years to read the clinical and scientific literature on acupuncture, I’ve yet to find compelling evidence that can convince me that I’ve made a mistake or that there is something to this woo. After all, what is acupuncture at its heart but another “energy healing” modality? Think about it. The entire basis of acupuncture is the scientifically risible claim that by sticking tiny needles into hundreds of small points along “meridians” through which qi (“life energy”) flows, an acupuncturist can “unblock” or “redirect” the flow of qi. But acupuncturists don’t make the claim that they can unblock or redirect the flow of qi but add to that claim another claim, namely that they can do this for therapeutic intent for all sorts of physiologically unrelated conditions. The only reason I used to give acupuncture a bit of a pass was because it actually involved a physical act, sticking needles in the skin.
Another reason I used to tend to give acupuncture a bit of a pass was that, like Dirty Harry Callahan, whose famous tagline from the second Dirty Harry movie Magnum Force was, “A man’s got to know his limitations.” And so it was with most acupuncturists, who (mostly) treat chronic pain syndromes, headache, or other conditions with a large subjective component, almost as if they acknowledge that what they provide is a placebo and a little TLC for patients who might be fed up with many of the shortcomings of scientific medicine. I almost never heard of an acupuncturist claiming to be able to treat life-threatening conditions, such as cancer. Indeed, such claims were uncommon enough that I can’t remember the last time I’ve heard of an acupuncturist claiming to cure fatal diseases.
Until now, unfortunately.
Behold Tom Tam, an acupuncturist in the Boston area who, based on dolls that map acupuncture meridians, has created a “healing modality” that he calls Tong Ren. Here he is on a poorly conceived and typically credulous local news report:
That’s right, it looks as though Tom Tam is using acupuncture meridians as a guide to voodoo therapy, and I do mean voodoo therapy. Watch the video to see what I mean. Or read this description of Tong Ren:
Tong Ren is based on a belief that disease is related to interruptions, or blockages, in the body’s natural flow of chi, neural bioelectricity, blood, or hormones. Tong Ren seeks to remove these blockages, restoring the body’s natural ability to heal itself, even when illnesses are chronic, debilitating, or otherwise untreatable.
Tong Ren combines western knowledge of anatomy and physiology with the ancient principle of “chi,” or life force energy, to create what many consider to be a powerful new healing modality. Drawing on the Jungian theory of the “collective unconscious,” Tong Ren is believed to access energy from this universal source and direct it to the patient. Because no physical contact is involved or necessary, Tong Ren is often practiced as distance healing.
In a typical therapy session, the Tong Ren practitioner uses a small human anatomical model as an energetic representation of the patient, tapping on targeted points on the model with a lightweight magnetic hammer. The practitioner directs chi to blockage points corresponding to the patient’s condition, breaking down resistance at these points. As blood flow, neural transmission, and hormone reception are restored, the body is then able to heal.
That’s all there is to it. Tom Tam taps on a voodoo–excuse me, acupuncture–doll and claims that this tapping (along with “intent,” of course) treats cancer, multiple sclerosis, AIDS, and other diseases. He even runs frequent classes to teach people to use Tong Ren for cancer, emotional problems, weight loss, and even animals. But that’s not all. Tom Tam also claims to be able to treat chemotherapy side effects, surgery side effects, autoimmune disorders, and thyroid disease, to name a few more, by teleconference, even!
Is there any evidence for this? I think you know the answer to that. I had wanted to save Tong Ren for an installment of Your Friday Dose of Woo. As you will see, it definitely qualifies. However, one thing I learned from my inclusion of the German New Medicine two years ago, and that’s that I want YFDoW to be light-hearted, and I have a hard time being light-hearted about a charlatan, however well-intentioned, who is plying his quackery on people with life-threatening diseases. So Tong Ren was out for YFDoW. But it’s in for a heapin’ helpin’ of not-so-Respecful Insolence because it isn’t worthy of Respectful Insolence. Just look at this “explanation” of how Tong Ren “works”:
Tong Ren healing is not affiliated with any religion, nor should it be viewed as a mystery. My belief in Tong Ren healing is associated with the philosophy of the collective unconscious and the power of the mind. Many people accept the idea that there is an unconscious and that the mind is powerful. These philosophical views can be found in many books. When a group comes together to form a collective unconscious, as in healing meditation, this collective mind can become healing power. A leader is required for this type of healing power. When we form a group with a collective unconscious mind, we need a, just as a computer needs a font to show a letter on a monitor.
In Tong Ren Therapy we use a regular plastic acupuncture model to form the healing image. The acupuncture model becomes an energetic representation of the patient’s body. By placing the needles in the appropriate spots on the model and connecting the mind with our collective unconscious, the practitioner can give a patient a treatment. A connection between the therapist and the patient is formed. This connection can be modified by the energetic representation of the acupuncture model. Just as light shining through a slide will display an image, the Chi directed to the patient is modified by the image of the acupuncture model with needles inserted at specific points. The pattern of needles and the points selected are the same as the acupuncturist would use if inserting the needles directly into the patient’s body. Both inserting needles in the model and in the patient’s body are means to balance the patient’s Chi. The difference, of course, is that when the model is used the patient can be treated over long distance. This is similar to some Japanese acupuncture methods in which the needle is just touched to the skin but not inserted. Because Chi and the collective unconscious are not limited by space; the only thing is to establish a connection. The healing power is not from the acupuncture model–it is from our mind, and this mind transforms into a healing force. This healing energy we call Chi. In the human body, Chi has its own way to circulate. We must regulate the Chi and make it run on its track. This is the same theory that a Chi Gong master uses to make Chi circulate in a patient’s body.
There are seven pages of just that sort of woo. In fact, there’s more than just seven pages. A lot more. Just get a load of this document describing the techniques of Tong Ren. I’ll boil its nine pages of super-concentrated black hole density woo down for you. Basically, it says that you can use a hammer, laser, or pins on the acupuncture doll to redirect the flow of qi and heal. Actually, this last method makes me wonder if there is something inherent in humans that leads them to think that sticking needles in a doll can have an effect on another human being, be that effect bad (voodoo) or therapeutic (Tong Ren). But I digress. In fact, there was a fourth method, which Tom Tam calls “Discing.” I was horrified to read this description of treating breast cancer using “Discing”:
To do Discing, one requires a disc or a dish as a tool. You may use the lid of a sugar jar, a teapot lid, a teacup lid, or a small saucer. Simply set the disc or lid above the Ouch Point on the doll or directly onto the patient. Each practitioner places one or two fingers on the disc or the lid. When we use the doll, we can use the bigger acupuncture model, as it is easier to position a lid on it. If we put the lid directly onto the patient, the patient may sit down in a comfortable position or lie down and relax. When we treat cancer or tumors, we ask the patient where the tumor is located, then let the patient position the lid or disc on top of the tumor.
Before the treatment, we usually ask the patient to do self-examination by pressing on the tumor (Ouch Point) and remembering the size and level of pain. After the treatment, they should press the same area to compare the before and after conditions. Doing Discing on the Ouch Point takes about five minutes. Usually the patient feels sensations such as tingling, heat, warmth, heaviness or body aches as when other Tong Ren healing techniques are being applied. After we are done with treating the tumor or Ouch Point, we apply the same technique on the spinal blockage points.
For example, when we treat breast cancer, we first treat the tumor or lump on the breast area, and then treat T4, where the blockage causing the breast problem is located. After treating T4, the next area we can work on is on the head at BL6 and GV22. In the Tom Tam Healing System. BL6 and GV22 are the pituitary gland and 7 hormone area. The mammary gland is a hormonal organ, controlled by the pituitary gland. When we put the center of the lid on GV22, it automatically covers BL6; we do not need to separate GV22 and BL6 when we do Discing. Before doing Discing on a patient with a breast tumor, the patient should check the size of the lump first if the lump can be found. After the treatment, the lump should be checked again so we can compare the size. Very often, the lump may be smaller or may even have disappeared after the treatment.
How much easier my job would be if I could just take a dish or the lid of a sugar jar, put it on the “ouch point” of my patients, and think happy thoughts at them, visualizing healing. I guess that’s just the nasty materialist, Western, reductionist, science-based physician in me talking, though. That nasty science-based physician in me also wants Tom Tam to show me the evidence, if you know what I mean. What I would want would at the very minimum be good, well-documented case reports, but preferably such evidence should take the form of well-designed clinical trials, prefereably randomized and double-blinded. If you’ve been reading this blog, you know already Tom Tam has no such thing. You probably also know what he does have.
That’s right, testimonials.
Look at the news report above. An unfortunate woman with liver cancer is told she has only six months to live. She is still alive and feeling fairly good a year later. Never mind that she’s probably still taking conventional therapy. Never mind that he is not disease free, as far as I can tell from the news story; her tumor is still there. Never mind that she is probably just one of the lucky ones who are “outliers” on the bell-shaped curve. She attributes her good fortune to Tom Tam’s woo. The second testimonial is even less convincing than the first. It’s a guy with leukemia. Although nothing is said one way or the other about chemotherapy, it’s a good bet he got standard chemotherapy. He felt like crap and lost a lot of weight, as leukemia patients undergoing chemotherapy are prone to do. Now he feels better, and he attributes it to Tom Tam. Anyone want to guess that he started to feel better because the chemotherapy took care of his tumor and then later because his chemotherapy ended? Then there’s this testimonial:
It’s a pleasant and lovely Asian woman who had ductal carcinoma in situ. She underwent surgery and radiation (no mention of hormonal therapy), but her tumor recurred as an invasive breast cancer, after which she underwent mastectomy and chemotherapy. After that, her tumor appears to have recurred in an axillary lymph node, which was removed surgically. She then went to Tom Tam, and, of course, she attributes her continued survival to him. Of course, it’s possible–likely, actually–that the surgery to remove her axillary lymph node recurrence is what’s responsible for her current disease-free state. Indeed, her case is very much like the prototypical breast cancer testimonial that I wrote about nearly four years ago. Unfortunately, it’s also possible–likely, even–that her tumor will recur again. But it might not. If it does recur, you can bet that she won’t blame Tong Ren for failing. If it doesn’t, you can bet that she’ll give Tong Ren the credit for “healing” her.
The other thing that’s mentioned is that Harvard is supposedly “studying” Tong Ren. That’s a bit of a stretch, as you will see if you follow the link, which leads to a study entitled A Pilot Investigation of the Tong Ren Healing System: A Survey Study. It looks like nothing more than a survey of users of Tong Ren to me, and its purpose is unclear. Personally, if the people doing the survey are using this survey to see if there is anything to Tong Ren, this is about the worst way possible to find out. All it will end up doing is to collect testimonials, perhaps like this one:
In April of 2005, my life-long friend Rick Kuethe called me from Boston (I live in Omaha, Ne) to tell me about a new therapy he’d been working with called Tong Ren, developed by a wonderful Chinese healer named Tom Tam. Rick knew that for years I have suffered from fibromyalgia, lumbar stenosis, and most importantly, lung cancer in May of 2003. At that time I was lucky enough to have an operable tumor in the upper lobe of my left lung, and surgery was successful. However, at my quarterly oncology checkups over the last two years, small spots had still appeared. They were too small to biopsy, but never went away.
Rick started treating me weekly, by phone, in April 2005 with the following results: my FMS pain went from a daily 8 to about a 3 (on a pain scale of 1-10 with 10 being the worst), my general energy levels went up, and my blood pressure and weight went down. After three months, in July 2005, at my quarterly oncology checkup, my lung spots were completely gone. In October 2005, my lungs were once again completely cancer free!
If there’s one thing we in the cancer field know, it’s that “spots too small to biopsy” in the lung may or may not be cancer. Often, even in patients treated for cancer, we will watch them to see if they grow, because taking out a chunk of lung in someone who’s already had cancer to try to find such tiny lesions is generally riskier than careful observation. And guess what? Many times these “spots too small to biopsy” will either remain stable or disappear on their own. True, sometimes they will grow, but that’s why oncologists keep a close eye on them.
Such is the “evidence” upon which Tom Tam bases his claim that Tong Ren cures cancer and even disses regular acupuncture:
Most acupuncturists have a hard time believing that Tong Ren is more powerful than the use of acupuncture needles for treating cancer. In fact, Tong Ren Therapy has successfully healed many cancer cases, whereas there has not been any report about cancers having been cured by the exclusive use of acupuncture.
Well, one out of two ain’t bad, I guess.
But how does Tong Ren work? If you’ve been reading this blog and other skeptical blogs about “alternative” medicine, I bet you know what’s coming next, don’t you? (If you don’t you should.) What is a modality like Tong Ren incomplete without? How can woo-meisters “explain” a modality that involves imaginging an “energetic imprint” on a doll and then either tapping it, shooting a laser at it, or sticking pins in it? How can woo-meisters “explain” a modality that can be used for “distance healing? There’s only one way. That’s right. It’s all quantum theory:
My brain hurts. It’s all there, the dubious appeals to “energy” and “quantum theory,” along with the usual silliness about how “Western” doctors aren’t interested because they can’t understand it or sell it. There’s an absolutely ridiculous bit about how there’s “no economic benefit” how “all medicine is political,” and how this woo-meister can “treat” a woman with breast cancer over the phone. Truly, brain pain, and I don’t think Tong Ren is going to help.
But, you’re thinking: Orac, you’re such a downer. Come on, what do you have against curing cancer? After all, Tom Tam assures us this is all science, maaaan:
Yes, a high school student named Miles Sarill applied Tong Ren to mouse neuroblastoma cells ordered from ATCC and claims that they reverted back to “normal” and then underwent apoptosis. Of course, anyone who’s ever done cell culture knows that it’s very easy to get anomalous results, and it wasn’t explained if the control cells were subjected to any sort of sham treatment. For instance, he says he’s treating the cancer cells every day as shown in these pictures (1, 2, 3). Is he also taking the control cells out of the incubator in exactly the same fashion and for the same amount of time? I also wonder how he’s keeping the control cells from being exposed to the powerful woo–I mean Tong Ren–”healing” energy. After all, Tom Tam claims that distance is irrelevant and healing can occur over hundreds of miles. Is a mere incubator and maybe 10 feet of distance going to protect the control cells from the powerful woo rays emanating from the tapping of the Tong Ren doll? I think not, if Tong Ren were real. Let’s see, his video was made nearly a year ago, and our intrepid young woo investigator said he was going to repeat the experiment. On his blog, we see a picture of cells allegedly treated with Tong Ren undergoing apoptosis, but there are no pictures of the controls shown, and no quantitative data. The blog entry is dated February 15, 2008. There hasn’t been any update since then.
I wonder if later experiments showed that he had discovered nothing more than an artifact or had not used proper controls? It wouldn’t surprise me. Hopefully, if that happened, he learned a thing or two about the scientific method. Given that Miles is an inquisitive high school student who appears to have gone astray, I’m hopeful he can be brought back into the fold of science. Maybe he’ll even stop referring to himself as a “paraneuropsychopharmacologist.”
The bottom line about Tong Ren is that it is magical thinking. Indeed, Tong Ren gives homeopathy and its sympathetic magic a run for its money in terms of pure magical thinking. Moreover, I’m particularly disturbed that Tom Tam and his acolytes are selling this woo to cancer patients, especially breast cancer patients. As a cancer surgeon, I get pretty pissed off about things like that. But Tom Tam doesn’t limit himself to just cancer. Oh, no, he treats AIDS, heart disease, and a whole slew of other complaints. Truly, this is an example of combining acupuncture and voodoo dolls, two crappy tastes alone that taste even crappier together.