Respectful Insolence

Every so often, our “friends” on the other side of the science aisle (i.e., the supporters of “complementary and alternative medicine”—otherwise known as CAM or “integrative medicine”) give me a present when I’m looking for a topic for my weekly bit of brain droppings about medicine, science, and/or why CAM is neither. It’s also been a while since I’ve written about this particular subject; so it’s a win-win for all sides! I get a topic. A certain CAM journal gets extra traffic. And you get the benefit of my usually brilliant deconstruction of dubious science. What could go wrong?

In any case, there is a journal called Medical Acupuncture. Sadly, it’s published by a real scientific publisher, Mary Ann Liebert, Inc., a publisher that has a stable of decent, if not top tier, journals. Unfortunately, it also has a stable of CAM journals, including, of course, the aforementioned journal Medical Acupuncture. Because I happen to be on the mailing list for Mary Ann Liebert, Inc., I recently got an e-mail with an announcement:

How Does Acupuncture Work? The Science behind the Therapy Is Explored in a Special Issue of Medical Acupuncture

New Rochelle, NY, April 16, 2013—Even as medical acupuncture is increasingly being validated as an effective treatment for a broad range of medical conditions, what has been missing is an understanding of the basic science and mechanisms of action of this age-old method of healing. A special issue of Medical Acupuncture, a peer-reviewed journal published by Mary Ann Liebert, Inc., publishers presents a series of articles by authors from around the world who provide diverse and insightful perspectives on the science and physiologic responses underlying medical acupuncture. The issue is available free on the Medical Acupuncture website.

“Understanding acupuncture in the same manner that we understand the mechanism of action and pharmacokinetics of a particular drug will, similarly, enable us to match treatments better with conditions,” states Guest Editor Richard F. Hobbs, III, MD. “The net effect will be improved outcomes,” he writes in his editorial “Basic Science Matters.”


The beauty of this gift to me is that not only can I write about the contents of this issue, but the articles are available for free; so you can read them too. No paywalls! One wonders what possessed the editors of this particular journal to provide such an awesome gift to both me and you, our readers.

In any case, I would certainly agree that basic science matters. After all, that’s the whole point of science-based medicine (SBM), isn’t it? That evidence-based medicine (EBM) in its current incarnation relegates basic science considerations to the lowest rung of evidence on its hierarchy of clinical evidence. Indeed, a certain “friend” of mine spent quite some time talking about just that in his talk to the National Capital Area Skeptics a month and a half ago. Basically, EBM suffers from what I like to refer to as “methodolatry,” which an epidemiologist fellow blogger defined as the “profane worship of the randomized clinical trial as the only valid method of investigation. Indeed, the gods of EBM, namely the reviewers for the Cochrane Collaborative, are particularly prone to methodolatry. Indeed, one of the key points I try to make is that this sort of methodolatry provides and opening for pseudoscientific treatment modalities like acupuncture to gain the appearance of efficacy in some parts of the medical literature. Basic science considerations are, in essence, ignored in determining whether there is sufficient prior scientific plausibility of acupuncture to treat, for instance, infertility or depression, and equivocal, bias-prone clinical trials are ranked much higher than the basic science considerations that make the hypothesis that acupuncture can do anything for infertility so implausible as to border on impossible, barring new evidence speaking to its plausibility.

Of course, in a way acupuncture is a special case. I’ve said it before, and I’ll say it again (at the risk of boring my readers): I actually used to think that maybe there was something to acupuncture, for the simple reason that it involves an actual physical act on the human body, namely sticking needles into it. On a strictly conceptual level, one can speculate that maybe sticking needles into the skin does something. However, the more I read about acupuncture, the more I delved into the actual scientific literature purporting to support acupuncture, the more I realized that there’s no “there” there, even from studies done by advocates, in which negative or equivocal results are almost uniformly spun to be supportive of acupuncture, and mechanisms that probably have little to do with any purported effects of acupuncture. The “adenosine” mechanism I wrote about three years ago comes to mind. The bottom line when it comes to acupuncture is that it’s almost certainly all placebo. It doesn’t matter where you stick the needles. In other words, acupuncture “meridians” are nonsense, which is not surprising, given that attempts to associate any real anatomical structures to meridians have uniformly failed. It doesn’t even matter if the needles are stuck in; twirling toothpicks against the skin does just as well, dubious systematic reviews of acupuncture not withstanding.

So let’s see what Dr. Hobbes, who is based at Plum Blossom Acupuncture and Integrative Medicine, a clinic that offers woo ranging from acupuncture to cupping to moxibustion, has to say about how “basic science matters“:

Medical acupuncture is a part of medicine and is being validated, increasingly, as an effective treatment for a wide range of conditions.1 However, for the most part, we are missing the foundation, the basic science piece. This is a deficiency which, in my view, we must correct. Understanding acupuncture in the same manner that we understand the mechanism of action and pharmacokinetics of a particular drug will, similarly, enable us to match treatments better with conditions. The net effect will be improved outcomes.

How does one define “basic science” in the field of acupuncture? There are traditional paradigms that many of us use every day in treating patients, and then there are views that are informed by those subjects we studied in medical school. So far, efforts to “connect the dots” have not been completely successful. However, progress is being made, and once that goal is achieved, the sharp lines of demarcation between Western and Oriental medicine will disappear.

For this special issue, we encouraged the submission of exemplary studies or comprehensive review articles dealing with research methodologies, physical properties of points and channels, signaling mechanisms, and mechanisms of acupuncture effects.

Apparently, Dr. Hobbes has a different definition of what constitutes “exemplary studies” or “comprehensive review articles” than I do. For instance, the article he cites to support his claim that acupuncture is being increasingly “validated as an effective treatment” for a wide range of (I note, unrelated) conditions is Vickers et al, a systematic review that has been a chew toy of various skeptical bloggers, including Steve Novella, Mark Crislip, and myself. Basically, Vickers et al was an article that found a “statistically significant” but clearly clinically insignificant difference between pain scores in sham control versus acupuncture-treated patients with chronic pain syndromes, as I discussed in inordinate detail. If this is “clinical validation,” then we should cease all acupuncture studies right now as a pointless waste of money that unethically subject patients to risk with no likelihood of benefit! Amusingly, just a month and a half ago Andrew J. Vickers, the first author of the review, published a followup rebuttal in (of course!) a CAM journal in which he whined about how those nasty, nasty “skeptics” (he even used the term “sceptics movement” in full U.K. spelling) were so unfair in their criticisms, singling out Steve Novella, a blogger who also wrote about the study under the ‘nym askeptic, and my alter-ego for particular opprobrium.

But let’s look at the rest of what Dr. Hobbes wrote. Truly, it could very well have qualified for Kimball Atwood’s much missed feature, the Weekly Waluation of the Weasel Words of Woo. I particularly like the part where he contrasts the “traditional paradigms that many of us use every day in treating patients” versus the “views that are informed by those subjects we studied in medical school.” Notice how he refers to his beliefs about “acupuncture” as “paradigms” and what he was taught in medical school about the science that says that acupuncture is pseudoscience as “views.” It’s a simultaneously subtle (if you’re not familiar with CAM weasel words) and not-so-subtle (if you are) denigration of scientific medicine. I also like how he uses what I consider to be the racist distinction between “Western” medicine (i.e., evidence- and science-based medicine) and “Oriental” medicine (i.e., traditional Chinese medicine). Seriously, does he even realize the implication he’s making, namely that “Western” medicine is scientific and “Oriental medicine” is touchy-feeling and “holistic”? Doesn’t he realize that there are some damned good “Oriental” scientists, every bit on par with “Western” scientists, and that they have come to the same conclusion, namely that acupuncture is placebo?

So let’s take a look at some of these studies and review articles. The first one that caught my eye was one by John Longhurst, MD, PhD of the Samueli Center for Integrative Medicine at the University of California, Irvine, entitled Acupuncture’s Cardiovascular Actions: A Mechanistic Perspective. Dr. Longhurst begins:

The practice of acupuncture began 2000–3000 years ago. Until the last 50 years, acupuncture developed empirically and its art was passed on from teacher to student through practical application. More recently, practitioners began to find that acupuncture had a rightful place in mainstream medicine and could be used to treat a number of conditions and symptoms. The public outside the Orient has accepted acupuncture because of a perception that it reduces pain effectively and successfully reverses a number of other medical problems. Western medical and scientific communities have been more reluctant to accept this practice because of the absence of controlled clinical trials and scant scientific evidence for its mechanisms of action. However, there may be reason for this skepticism to change. The number of articles published on acupuncture research (451 articles worldwide in 2009) has been increasing almost exponentially over the last several decades, with the United States and China both taking lead roles in advancing understanding of this ancient therapy.1

Don’t you just love the argumentum ad populum (appeal to popularity)? The point is that, because there are now lots of articles on acupuncture and the number has been increasing, it must mean there is something to acupuncture. Never mind that the vast majority of articles are of low quality and that the higher the quality of the research the more likely the findings are to be negative, just like homeopathy. Then there’s also the “appeal to antiquity,” which argues or implies that, just because people have been doing something for a long time, there must be something to it. I like to point out that bloodletting was viewed as an excellent treatment for almost any ailment for hundreds, if not thousands of years, before the late 19th century, when the rise of scientific medicine showed that it was not.

One thing I noticed about this review article right away is that nearly all the studies it discussed were about electroacupuncture (EA). This is, in my mind, a classic “bait and switch,” in which therapy is described as acupuncture but is in reality nothing more than electrical nerve stimulation clumsily grafted onto acupuncture. One might reasonably expect that electrical stimulation of certain nerves might have physiological effects. For instance, anyone who’s ever undergone a nerve conduction study, as I have, know this. (It’s a study that could easily be used as torture, let me tell you.) The very basis of nerve conduction is electrochemical, and it can be influenced by electrical currents. That doesn’t make it acupuncture. Worse, the insistence of using acupuncture points, instead of nerves that might actually have physiological relevance, only muddies the waters, making it less likely that an actual, useful therapy might be derived from the mix of electricity and the vitalism of traditional Chinese medicine that is “electroacupuncture.” Basically, it’s nothing more than a “rebranding” of acupuncture, which doesn’t work, by disguising something that might work (electrical nerve stimulation) as somehow being acupuncture. After all, the Chinese of hundreds (or thousands) of years ago who supposedly invented acupuncture did not have knowledge of electricity, nor did they have the technology to construct batteries or generators. Personally, I think that it’s telling that in many places I saw references to “acupuncture,” but when I clicked on the citations to support the claim I found papers on EA. Indeed, the authors even point out that they focus on EA because “this form of acupuncture is easy to standardize.” No kidding. And they should stop calling EA “acupuncture,” because it’s not.

Next up is an amusing little study from the New England School of Acupuncture, led by a naturopath named Keith Spaulding, entitled Acupuncture Needle Stimulation Induces Changes in Bioelectric Potential. It’s a study of 14 healthy volunteers from ages 24 to 52 in which the investigators tried to tell if there were differences in electrical potential attributable to acupuncture based on needle positioning on “real” acupuncture sites and “sham” acupuncture sites:

Randomized clinical trials (RCTs) of acupuncture often include stimulating verum acupoints and nearby so-called “sham” acupoints. Clinical effectiveness has been reported with both verum and sham stimulation. The verum acupuncture is often only marginally better than the sham acupuncture.6–8 This leads researchers to question if sham acupuncture is indeed a physiologically inactive control placebo.9 An electrophysiological correlate of these clinical findings would be eliciting from the sham acupuncture at a nonacupoint a bioelectrical response that is nearly as strong as the bioelectrical response from stimulating a verum acupoint.

The aim of this study was to document changes in the bioelectric potential that occur in response to needling Pericardium 4 (PC 4) and PC 4cont (control) at four sites on the forearm PC 4, a nearby nonacupuncture point (PC4cont) and two distal points (PC 6 and a nearby nonacupoint (PC 6cont) It was hypothesized that a greater bioelectric potential amplitude was induced distal to the point of stimulation only when the needling site was on the acupuncture point and the distal measured site was on the meridian.

One notes that this was not a blinded study, which pretty much sinks it right there. The acupuncturists knew who was getting what, and they decided the depth of insertion of the needles. They could easily have unconsciously inserted needles into the “true” sites in a systematically different way than they did for the “control” sites. Moreover, the placement of the reference electrode in the umbilicus, by the authors’ own admission, produced a “noise floor” acting as an artifact. Even with the lack of blinding, the results of this study are completely underwhelming. Basically, the investigators found that when the PC4 site was stimulated there was a greater response compared to when a control site (a non-accupoint) was stimulated, leading the authors to observe, “A translation phenomenon (an induced polarization) was seen at the distal site when the proximal site was stimulated. At PC 6 with PC 4 stimulated there was a larger amplitude (p<0.05), compared to the control response.” One notes that out of three sets of comparisons, only one was statistically significantly different, and then only with p=0.02. Also, since multiple comparisons were being made (in reality, six sets, rather than three sets of two) one could argue that an adjustment for multiple comparisons should have been made, which might have made the single result obtained no longer statistically significant. Be that as it may, this is hardly a “highly rigorous” study and basically demonstrates nothing.

The remaining studies were even less “interesting.” For instance, there was a study of “laser acupuncture” in depression. (Whenever I hear the term “laser” attached to acupuncture, I can’t help but think of Dr. Evil demanding to have “sharks with frickin’ laser beams attached to their heads,” but that’s just me.) This study looked at functional MRI imaging of patients with and without depression subjected to laser acupuncture on four putative antidepressant acupoints, and concluded:

Laser acupuncture on LR 8, LR 14, and CV 14 stimulated both the anterior and posterior DMN in both the nondepressed and depressed participants. However, in the nondepressed participants, there was consistently outstanding modulation of the anterior DMN at the medial frontal gyrus across all three acupoints. In the depressed participants, there was wider posterior DMN modulation at the parieto–temporal–limbic cortices. This is part of the antidepressant effect of laser acupuncture.

There’s one problem. (Well, there are a lot of problems, but this is the most glaring.) Nowhere could I find out whether the analysis of the fMRI images was blinded; i.e., nowhere does it say whether the radiologists analyzing the images knew which patients were depressed or not or which image series represented patients receiving “real” acupuncture versus sham. Given how finicky interpreting fMRI studies can be and how easily they can show something where there is nothing, blinding of the radiologists analyzing an fMRI study is essential. That’s at a minimum, not even including whether the patients or the practitioners were blinded or not. One would think that if the fMRIs were analyzed in a blinded fashion that the investigators would have mentioned it; so I have to assume that they were not.

Perhaps the most hilariously pointless study in the group was done by a group in Germany and entitled Transcontinental High-Tech Teleacupuncture Studies and Integrative Laser Medicine. Wow. That sure sounds science-y, doesn’t it. Very impressive. But what the heck does it mean? Basically, the investigators studied subjects in China undergoing laser acupuncture therapy and “integrative laser therapy” (whatever that means), as well as EA and regular acupuncture, and had the subjects’ electrocardiogram readings transmitted to their facility in Germany at the Medical University of Graz, where they were analyzed. Quite honestly, this is about as pointless a use of telemedicine as I can imagine, and it’s not even that sophisticated. I mean, really. We’re doing telesurgery over thousands of miles now, and all these investigators could do is to transmit ECG data from China to Germany?

I’m not impressed.

There are other articles, of course, all of about the same level of scientific rigor or less. None of them validate acupuncture in any way or provide any compelling evidence for a physiologically plausible mechanism, all of which makes the introduction by Richard C. Niemtzow, MD, PhD, MPH (yes, that Richard C. Niemtzow, the one who has promoted “battlefield acupuncture” for our troops in combat), entitled Basic Science: Mysteries and Mechanisms of Acupuncture, all the more cringe-inducing. First of all, it’s quite telling that Niemtzow begins with a quote from Hamlet (Act 1, Scene V), “There are more things in heaven and earth, Horatio,than are dreamt of in your philosophy.” It’s a Shakespeare quote that quacks love as a means of claiming that science can’t study their quackery. Ironically enough, Niemtzow uses it to introduce a short article in which he tries to paint himself as a hopeless dinosaur dedicated to science:

Every day, acupuncturists insert tiny metal needles into acupuncture points located on meridians, hoping to combat a myriad of clinical pathologies. For the most part, we practitioners are witness to a clinical benefit. Otherwise, physicians would have stopped performing this technique several thousand years ago, and we would not be using it today. However, while we witness healing, none of us has ever seen an acupuncture point let alone a meridian. Modern investigational technology, at its best, fails to provide evidence of these two very basic structures.

One notes that the obvious conclusion from this summary of the existing evidence regarding acupuncture meridians and points is that they do not exist. Somehow, Niemtzow fails to take the logical next step to that conclusion. Instead, he writes:

With this in mind, I know that many of us have asked: “How does acupuncture work?” Perhaps we depended, somewhat, on mythical explanations influenced by the classic readings. When I hypothesized Western mechanisms that might offer an explanation, I was told, by one of my esteemed colleagues, that acupuncture does not follow Newtonian physics. I thought, perhaps, that was an excuse to avoid “drilling” deeper to uncover the same mechanisms that enriched our understanding of allopathic medicine. My wife, who was trained in acupuncture in China, told me that exploring acupuncture on a molecular level to seek an explanation as to “how it works” is, somewhat, a fallacy. She posited that, to understand acupuncture, one most [sic] explore its relationships to the environment, animal and plant life, weather, seasons, and the universe. However, I have to admit that I am an “old die hard”; for me, natural events do have scientific explanations and placing a needle in an acupuncture point on a meridian and producing a physiological effect could be understood by using the scientific technology used to understand allopathic medicine.

Good for you, Dr. Niemtzow! Maybe there’s hope for you yet! Or maybe not. In a way, Dr. Niemtzow reminds me of one of the past presidents of the American Association of Naturopathic Physicians, Carl Hangee-Bauer, ND, LAc (note that he’s an acupuncturist as well), taking umbrage at criticisms of naturopathy as unscientific and then declaring his allegiance to rigorous science, even though his practice is rife with what I consider to be pseudoscience, such as traditional Chinese medicine, “biotherapeutic drainage,” detoxification, and others, as well as unproven modalities such as breast thermography. “Science,” Dr. Niemtzow. You keep using that word. I do not think it means what you think it means. (Hint: It does not mean acupuncture.)

Amusingly, in that same editorial, Dr. Niemtzow admits that “a collection of high-quality basic science articles is very difficult to obtain, given the fact that, over the years, we have received and only published a few articles on this topic.” One wonders why not. Could it be because we’re dealing with acupuncture? Sure it could. In any case, it’s hard not to feel a little bit sorry for Dr. Niemtzow. He thinks he’s scientific, while his wife in reality provides a closer approximation of what real acupuncturists think. He also thinks he’s scientifically studying acupuncture, when in fact what he is doing is curating articles designed to validate the treatment rather than to see if there really is anything to it from a scientific standpoint. That fundamental tension makes me wonder when he’ll just give up and let his true proclivities rule. He’s not fooling anyone anymore, if he ever did.

Comments

  1. #1 herr doktor bimler
    April 29, 2013

    there is a journal called Medical Acupuncture

    The name implies that there are non-medical applications. Recreational acupuncture? Cosmetic acupuncture? Inquiring minds are boggling.

  2. #2 elburto
    April 29, 2013

    “Medical acupuncture” sounds as jarring as “recreational surgery” or “natural sigmoidoscopy”.

    The whole thing is pure comedy gold. I can imagine you reacting with absolutely unbridled joy when you received the initial email.

    I’m envisioning a level of excitement that could only occur in a labradog that’s just discovered the world’s filthiest lake, and then noticed that there’s an island in the centre and it’s covered in tennis balls and bacon sandwiches.

    My favourite Niemtzow anecdote has to be this one:

    “I was told, by one of my esteemed colleagues, that acupuncture does not follow Newtonian physics”

    Now somehow, instead of laughing in the guy’s face and saying words to the effect of “No sh*t Sherlock, that’s why it’s absolute toss”, he takes it as a confirmation that the ~ancient Chinese ways~ are too mystical and magical for mere mortals to understand. Perhaps “T”CM practitioners are noetic wunderkind, tapping into the Agent Intellect? Hell, it makes as much sense as any other explanation I’ve heard.

    I despair. Physics isn’t optional! Newton > Aristotle.
    OTOH there is some hope, I didn’t see the word “quantum”. It’s a start, no?

  3. #3 al kimeea
    www.quackademiology.com
    April 29, 2013

    Hamlet. It’s always Hamlet. Shakespeare had a way with words therefore my woo woiks despite all the evidence to the contrary. And stop with all the negative waves, Moriarity. You big meanie.

  4. #4 Darwy
    Røde grøde med fløde
    April 29, 2013

    I’m with HDB.

    What’s next? “Acupuncture for gits and shiggles”?

  5. #5 Cthulhu
    Germany
    April 29, 2013

    Last time I checked, we have not yet started a fourth reich, and Graz was still in Austria :-)

  6. #6 herr doktor bimler
    April 29, 2013

    For the most part, we practitioners are witness to a clinical benefit. Otherwise, physicians would have stopped performing this technique several thousand years ago, and we would not be using it today.

    The fact that we are doing X proves that X must be beneficial because if X wasn’t beneficial then we wouldn’t be doing it.
    TRADITION!!

  7. #7 Guy Chapman
    April 29, 2013

    I’ve been looking for the websites, journals and articles devoted to trying to make the case that, despite all evidence to the contrary, pharmaceuticals have objective effects on the human body.

    Oddly, I cannot find any.

    Presumably the idea that measurable quantities of pharmacologically active compounds might materially affect health, is so far-fetched that nobody has seriously tried to promote it.

  8. #8 GR
    April 29, 2013

    I haven’t read up on acupuncture. I have only a lay person’s knowledge. I have never had acupuncture done to me, and I don’t think I know anyone who has had acupuncture and seen benefits.
    My dog was old and was hobbled by pain and stiffness in her hindquarters. She was too old to risk surgery and steroids were no longer effective. The vet suggested acupuncture as a “won’t make it worse” alternative.
    My dog’s mobility improved dramatically within a day or the acupuncture treatment. Since I doubt a placebo effect can occur in a dog, I believe I probably saw an effective administration of acupuncture.

  9. #9 Anton P. Nym
    http://anton-p-nym.livejournal.com/
    April 29, 2013

    Reading the comments here, I’m now so tempted to write up a bad PSA on recreational acupuncture abuse… “Reefer Madness” for CAM, perhaps?

    — Steve

    PS: for some reason, the comment option ticky-boxes (for notifications?) are in German. Nicht sprecken zie Deutch…

    PPS: tickled that, apparently, the German word for “email” is “E-Mail”.

  10. #10 Eric Lund
    April 29, 2013

    I’ve used that particular Hamlet quote myself, referring to a phenomenon where the problem was not the lack of a mechanism but rather that at least half a dozen mechanisms had been observed. Those two lines can mean whatever the person using them wants them to mean.

    @elburto: Post-Newtonian mechanics actually does exist. Quantum mechanics is one such, and general relativity is another. Both of these have Newtonian mechanics as a limiting case. Of course, there is no evidence that any putative mechanism for acupuncture (other than possibly the placebo effect) involves a region of parameter space where Newtonian mechanics is not a good approximation.

  11. #11 Eric Lund
    April 29, 2013

    @A. P. Nym: Yes, those boxes are supposed to be for notifications. The approximate translation to English is, “Notify me of follow-up comments by e-mail.” Curiously, although I think one of them is supposed to refer to subsequent blog posts and the other is supposed to refer to comments on this post, the German text for these two tick boxes is identical.

  12. #12 Calli Arcale
    April 29, 2013

    Acupuncture requires non-Newtonian physics? Really? Now, what is it that gives me the feeling that the anonymous person being cited in the paper hasn’t the slightest idea what Newtonian physics actually is? That’s like saying that homeopathy doesn’t follow celestial mechanics. It doesn’t make any sense. What Newtonian physics are they saying it contradicts? Perhaps that every action has an equal and opposite reaction? Are they arguing that when you insert an acupuncture needle, the amount of force used to penetrate the skin cannot be calculated as F = ma? Or do they argue that objects in motion do not actually remain in motion until acted upon by an outside force? Since Newton developed all this as part of ballistics studies, I do wonder what sort of acupuncture their practicing where ballistics becomes relevant. Sounds hazardous.

    Mind you, Newton was also into alchemy. So maybe they just mean you can’t transmute lead into gold using acupuncture. :-P

  13. #13 Denice Walter
    April 29, 2013

    A while back, I discovered that one of my uh… gentlemen and his friend were both traipsing off to the local acupuncturist for a sports-related injury and RA ( respectively), wasting money. Sometimes woo strikes near home, thus I had to proselytise directly.

    I informed them about how unlikely the “relief” they “experienced” was real because acupuncture is based upon principles that are largely products of fevered imagination ( a detailed explanation about chi and meridians vs physiology followed), then I explained how people are often fooled by woo ( courtesy of Dr Barrett) and last and certainly not least, I presented the results of the toothpick study ( in mind-achingly precise detail) and Orac’s write-up.

    I added other incentives for for attitude change:
    suggesting that “You could use the toothpicks on yourself, get the same ‘relief’ and save money” and then, use the money to -
    buy yourself a really nice shirt at Hugo Boss/ donate it to charity ( the former has a long history of donating money to disaster relief worldwide) and
    take a chance with the Market, respectively.(thus, I hit their usual modes of spending excess money).

    I present in capsule form programmed anti-woo, anecdotally of course.

  14. #14 Denice Walter
    April 29, 2013

    OT- but are venom-drenched, self-serving invectives from our most vocal ‘thinking mom’ EVER truly OT @ RI?

    Today MamaMac discusses why she is “Not Celebrating”:
    she is offended by the yearly autism awareness month because her son is “so ill”, not a “quirky, happy” child.

    A “happy, healthy baby, he was until he was injured by vaccines and antibiotics”: “injured from top to bottom”, followed by a laundry list of “destruction” – “brain inflammation” to “flat feet”. And yes, GI symptoms are included, as required by law at this site..

    “Many of these damaged children will contribute very positively to the world despite the physical and neurological damage done to them”.

    “You can’t destroy a generation of children and simultaneously tell people to celebrate it!”

    She’ll be at AutismOne spewing woo and disregard for Dr @sshats as is her cherished tradition.

    Too bad, yours truly can’t be there to question her.
    Perhaps someone else will.

  15. #15 sirhcton
    April 29, 2013

    “. . . Clinical effectiveness has been reported with both verum and sham stimulation. The verum acupuncture is often only marginally better than the sham acupuncture.6–8 This leads researchers to question if sham acupuncture is indeed a physiologically inactive control placebo.9 . . .”

    One wonders why it does not lead researchers to question if acupuncture actually works. Surely there could be no confirmation bias or lack of critical examination going on.

  16. #16 Pareidolius
    Wooville Station
    April 29, 2013

    “I believe I probably saw an effective administration of acupuncture.”

    And I know an anecdote when I see one. I also know the desperation when faced one is faced with a beloved, animal companion that is in terrible pain. We’ll try anything. It sounds like you tried other things first and acupuncture was a last resort. The problem is, the that the SBM you tried may have had an effect or the pain was transient. This is why we do studies, and the studies show nothing above placebo.

    http://www.sciencebasedmedicine.org/index.php/animal-acupuncture/

  17. #17 elburto
    April 29, 2013

    Congratulations on the new recruits Shill Walters! Lord Draconis is going to be chuffed to bits.

    WRT the “thinking” mommy, I wonder what the mechanism of action is that makes vaccination lead to flat feet. Hmm.

    Oh, and GR, the poster above:

    “I doubt the placebo effect can occur in a dog”

    Our survey says… wah-wah. Dogs are especially prone to the placebo effect. They’re conditioned to respond in certain ways to certain situations, and have expectations about the basic outcome of certain. events. Going on a car ride with parents, kids, a picnic basket and a football (soccer ball)? OMG OMG BEACH! PARK!! BEST DAY EVER!!

    Going on a car ride with mam-parent, alone, with the crate in the back of the car? OH NOES! VET!! SAVE MEEEE!!!

    Also, simple human contact produces measurable physiological effects on animals like reduced heart rate and BP. Then there are observations of apparent behavioural changes, acting as if pain is reduced, seeming happier.

    Many animals are susceptible, horses are notoriously difficult to test drugs on because they’re so prone to responding positively to placebo. Even that most helpless (and apparently fairly inert) of baby animals, the naked ape, responds positively to placebo effects.

    SBM (as ever!) has an interesting post: http://www.sciencebasedmedicine.org/index.php/is-there-a-placebo-effect-for-animals/

  18. #18 Mephistopheles O'Brien
    April 29, 2013

    GR – There’s no reason why you and the dog cannot reinforce each other in a placebo effect, particularly with something as variable as pain. You think the dog improves, you act like the dog improves, the dog responds to your behavior, you see that as further proof of effectiveness.

  19. #19 elburto
    April 29, 2013

    Curse you Pareidolius! *shakes tiny fist*

    Great minds and all that.

  20. #21 Todd W.
    http://www.harpocratesspeaks.com
    April 29, 2013

    Transcontinental High-Tech Teleacupuncture Studies and Integrative Laser Medicine

    And here I thought they were placing cell phones on acupuncture points and calling them long-distance while using lasers pointers for…something.

    The practice of acupuncture began 2000–3000 years ago.

    Surprised no one mentioned this yet, but didn’t it begin as a form of blood-letting? Modern acupuncture, IIRC, had its start in the mid 20th century.

    @DW

    flat feet

    Holy crap! Vaccines and antibiotics cause flat feet? Is there anything they cannot do?

  21. #22 Old Rockin' Dave
    The Island of Misfit Major Appliances
    April 29, 2013

    GR, permit me to pile on, both as dog owner and possessor of a number of banged-up and misused joints.
    When you see something like this, you have to ask some simple questions. Was your dog also on any anti-inflammatory medications? Was the weather warmer, or did she sleep in a warmer spot that night? Was there some reason why she might have been happier (“You were do brave getting the acupuncture today! I’m going to give you this nice piece of steak for dinner”)?
    I find that sometimes when I power through the pain, I am rewarded with less pain and greater mobility for a while. Did you get your dog into an exciting game of chase or fetch after the acupuncture? I am well aware of the placebo effect and have used it in medical practice, as a last resort or a time-buyer, but I am still susceptible to it. If you distract me I can ignore my joint pains for a time and move freely.
    The list of questions and comments here make a nice illustration of the pitfalls of using anecdotes as evidence,
    Anecdotes do have their place. The discovery of quinidine,as an example, was stimulated by an anecdotal observation, but it took scientific inquiry to make something out of it.

  22. #23 Old Rockin' Dave
    At the Fountain of Middle Age
    April 29, 2013

    Denice Walter, #14.
    I am on the autism spectrum and I have flat feet too.
    I must rush off to my podiatrist; if he can give me better orthotics, maybe I can be CURED!

  23. #24 Oesterreicherin
    Austru
    April 29, 2013

    Fact check: Graz is a City in Austria, not Germany.

  24. #25 Denice Walter
    April 29, 2013

    @ Todd W.:

    I attribute my wavy hair ( and therefore, my ability to look fashionably disheveled at the drop of a hat, literally) to extra vaccination** in childhood.

    ** lost records, multiple schools, travel.

  25. #26 MI Dawn
    April 29, 2013

    @DW: so THAT’S where my curly hair came from! Vaccines! Why, if I hadn’t that those evil vaccines, my hair would be straight, and lustrous, and sniny. (spelling intentional).

    And now I can blame my flexible arches (I don’t have flat feet, but VERY flexible arches) on vaccines too! Woo-hoo! Everything I don’t like about my body I can blame on vaccines!

  26. #27 herr doktor bimler
    April 29, 2013

    Transcontinental High-Tech Teleacupuncture Studies and Integrative Laser Medicine

    Lost Kraftwerk lyrics.

  27. #28 Melissa G
    April 29, 2013

    “Teleacupuncture” = Telepathic acupuncture? :D

    (…Crud, I shouldn’t give them ideas.)

  28. #29 Mephistopheles O'Brien
    April 29, 2013

    Telepathic acupuncture?

    Hmmm…combine psychic distance healing with the crunchy woo of acupuncture. That’s as good as recorded homeopathy over the phone or internet connection.

  29. #30 imr90
    Springfield, MA
    April 29, 2013

    Placebo effect in dogs? Ask Dr. Pavlov!

  30. #31 Barnesm
    April 29, 2013

    “is increasingly being validated ….. really where?

    is anyone else terrified of the concept of Laser acupuncture, I mean you reference Dr Evil for me its Goldfinger leaning over me “No Mr Bond I expect you to get acupunctured”.

  31. #32 Christine (the public servant Christine)
    April 29, 2013

    @elburto, cannot beLIEVE you didn’t think of “recreational sigismoidoscopy.” Or even better, “recreational colonoscopy.” My favourite way to starve for a few days.

  32. #33 Etaoin Shrdlu
    April 29, 2013

    Anton P. Nym: That there is no recreational (ab)use of acupuncture is pretty compelling evidence that it does nothing. Similarly homeopathy: consider the ease of concealing and smuggling a substance indistinguishable from plain water.

  33. #34 Drydoc
    April 29, 2013

    Crispian Jago at “The Reason Stick” has a very humourous look at meridian maps. A bit rude in places, but spot on. http://crispian-jago.blogspot.ca/2011/08/scientifically-accurate-labelling-of.html

  34. #35 Denice Walter
    April 29, 2013

    My dearest Lord Draconis, friends, shills and minions:

    It has come to my attention that extremely salacious, nasty rumours are circulating around the internet concerning our annual Bealtaine-Walpurgisnacht-Pax Glaxana festivities that will commence prompty next evening at sunset:

    our detractors have been whispering self-righteously about the scheduled bonefires, bacchanalia, hallucenogenic spiked beverages, wanton drunkeness, ritualised orgies, recreational medical procedure abuse, Morris dancing, unsupervised swimming, fertility rituals, blood letting, animal/ human sacrifice, organised worship of phallic symbols, pharmaceutical cocktail parties, pyrotechnic displays etc etc etc.,

    It’s about time that we squelch their vicious fabrications and announce:
    there will be NO recreational medical procedure abuse, pyrotechnics or Morris dancing. AT ALL. Period.

    Things like that might give us a bad name. We are actually kinder, gentler pagans and IT”S ALL IN GOOD FUN! We work hard and deserve a little R&R. LIke everyone else. And d-mn it! It’s May Day.

    Most sincerely yours,
    DW

    -btw- Draconis, please exercise some restraint: you KNOW what happened last year, can’t have a re-play. ‘K?

  35. #36 herr doktor bimler
    April 29, 2013

    That there is no recreational (ab)use of acupuncture is pretty compelling evidence that it does nothing. Similarly homeopathy: consider the ease of concealing and smuggling a substance indistinguishable from plain water.

    Step 1: Extensive program of “provings” to isolate materials causing misery or anhedonia (e.g. naltrexone; party political broadcasts).
    2: Homeopathic dilution — optionally using alcohol as the solvent instead of water.
    3: ECSTASY. Also, PROFIT.

  36. #37 Mephistopheles O'Brien
    April 29, 2013

    Wait – no pyrotechnics?! As a former chemistry major (i.e. someone who likes to see things spark and go “boom”) I can’t say I approve of that.

    Can’t we just forgo the Pimm’s Cup instead?

  37. #38 Glaxxon PharmaCOM Orbital
    Festivity Vault, Deck 7, Arm 12
    April 29, 2013

    MESSAGE BEGINS——————–

    Division Domina Walter (DW,DL,CMA, etc.), Shills and Minions:

    I’m up here with the hatchlings and we’re making the last of the papier maché hats for tomorrow night’s bonefire. They’re all awfully excited.

    First let me congratulate our newly minted Division Domina Walter on her appointment. Her Imperial Highness Clopidogra Invicta XXIII (may her wrath be intense and brief) has been most impressed with your service to the Corpus and the promotion is well deserved. You’re going to need another offshore account, methinks. And congratulations to Cadre Leader Elburto, I’m sure that you will display diplomacy with our allies and, well, we know what you can to to an enemy. But enough of ceremony, what to do about our little company fete.

    Yes, Domina Walter, we certainly can’t have a repeat of last year’s debacle. There will be no pyrotechnics, recreational medical procedure abuse and absolutely, positively, under penalty of flensing <b<NO Morris dancing! As those of you who attended no doubt recall in your darkest nightmares, the frequency of those damned bells sent the happily-playing hatchlings into a pre-senescent swarming frenzy and, well, those of you who didn’t lose a limb were lucky. Our advanced surgical techniques are usually able to deal with the occasional random party dismemberment, but that requires that there be some member left to attach!

    So, this year, let’s all just try to comport ourselves with a little more dignity, shall we? Certainly, spirits and pharmaceuticals will be consumed, there will be horseplay and we have plenty of plasma on hand should things get frisky. But really Shills and Minions, we don’t want to be seen as . . . monsters.

    Domina Walter will be keeping an eye on you (at least until the Ayahuasca cupcakes kick in) and Cadre Leader Elburto will have her Sloth on high alert, and make no mistake, her conveyance has considerable firepower.

    And please, will someone keep an eye on the Rothschilds this time, I’m still trying to get the stains out of my palanquin from last year.

    See you at the soiree,
    Lord Draconis Zeneca, VH7ihL

    Forward Mavoon of the Great Fleet, Pharmaca Magna of Terra, Host with the Most

    Glaxxon PharmaCOM Orbital
    00101111011101001010101110111111

    ——————————MESSAGE ENDS

  38. #39 Khani
    April 30, 2013

    #14 Flat feet means you’re “damaged”? … goodness, I didn’t even know that I was damaged. Oh well, I think I’ll go on pretending to be just weird.

  39. #40 Khani
    April 30, 2013

    #37 We could have elburto launch some weasels!

  40. #41 Shay
    April 30, 2013

    But I’m still working on a propellant that won’t smell of scorched fur! Damn…I hate deadlines.

  41. #42 Khani
    April 30, 2013

    I prefer to think of that as a bonus!

  42. #43 elburto
    April 30, 2013

    If the weasels aren’t ready in time for the celebrations then that’s ok, I’ve had Swiftly’s claws sharpened. It was hard keeping her still long enough*, but we managed. Now each three-toed hand is both stylish and deadlo!

    @Lord Draconis . Thank you for confirming that the morris dancing was a vicious hoax. However, just in case one of our enemies tried to sabotage the festivities, I took the liberty of having the Mountbatten-Windsor unit throw a garden party, inviting every cursed jangle-dancer in mainland UK.

    Once the cursed folk-freaks arrived at the palace they were offered some of the test compound for your new drug DUllmanix, which overloads the brain’s boredom sensors, inducing ambulatory coma. Then they underwent a modified Ludovico program with the theme “lizards good, jingles bad” They now weep openly if they so much as hear a cat’s collar bell. Huzzah!

    I’ll see everyone there!

    @Public Servant Christine – I’d rather have recreational kidney stones than than undergo flexicam funtime again! It was an emergency procedure, I wasn’t mentally prepped for it, and the sedation+pain relief didn’t kick in until after the procedure was finished, and was in the CT scanner. Not fun.

    *RIP Minion Kevin Ferguson. May you rest forever in an eternal Costa Rican paradise, surrounded by the very animals that you loved, and gave your life for.

  43. #44 herr doktor bimler
    April 30, 2013

    Possibly I am alone in thinking that pyrotechnics and Morris dancing would make a perfect combination.

  44. #45 Krebiozen
    April 30, 2013

    I’m not sure if it’s funny or sad that Christine’s humorous suggestion of “recreational colonoscopy” is so close to the truth of colonic irrigation. Similarly with HDB’s suggestion of homeopathic naltrexone that is echoed in low dose naltrexone*. Not recreational as such, perhaps, but close to it. I’m almost tempted to quote Shakespeare.

    * There might be something to low dose naltrexone, but it has undoubtedly been appropriated by woomeisters.

  45. #46 Todd W.
    http://www.harpocratesspeaks.com
    April 30, 2013

    @DW and Lord Draconis

    What? No Morris dancers? But I just finished building the trebuchet for launching them at large pegs. Sort of a candlepin bowling with baton-wielders. I even had the scoring all worked on, based on whether you used a regular dancer, a bagman, ragman, squire or foreman.

  46. #47 sheepmilker
    April 30, 2013

    Too late! Morris dancing has already been infiltrated by an alien species: Daleks

  47. #48 Denice Walter
    April 30, 2013

    @ Todd W.:

    Although I like you- I really do- we do need to draw the line *somewhere*: I agree launching a few Morris dancers and listening to the final poignant tinkling of their bells as they arc across the sky prior to their eventual landing in the newly plowed fields accompanied by fireworks CAN be highly entertaining but NO!

    If we allow a few in before you know it, we’ll have a full-fledged folk festival on our hands and that would interfere profoundly with our true purpose. And you know what that is: prostrating ourselves before the powers of the universe in exchange for prosperity and all of its accoutrements Just like every year.

    You may recall that I forever rue the day when I unfortunately chanced unawares on a folk dance festival in a mountain village: those dancers were tall, strong, proud and wholesome and seemed to like me. I can’t have that again.

    So instead focus on what we will tolerate: public drunkeness, drug-induced trances, lascivious and lewd carnal gratification, groveling before our masters, cosplay etc.

    I hope that your costume will reflect your devotion: I’m going as Nehalennia this year- it’s sort of like Vesta – but with boats.

  48. #49 Todd W.
    http://www.harpocratesspeaks.com
    April 30, 2013

    @Denice Walter

    You’re forgetting the other possible end of including Morris dancers: we get a Renaissance Faire. That fits the rest of your description phenomenally. As for my costume, I will as always attend in the only appropriate garb for me: plague doctor. The mask always thrills people.

  49. #50 dandover
    April 30, 2013

    @Calli

    Since Newton developed all this as part of ballistics studies, I do wonder what sort of acupuncture their practicing where ballistics becomes relevant. Sounds hazardous.

    I think you’re on to something. Acu-archery-puncture. Sounds like it would be fun! As long as I’m not the one standing in the target area.

  50. #51 JGC
    Did you hear the one about the arrow?
    April 30, 2013

    There are actually Chinese origin myths for acupuncture that tell the story of warrior who, taking an arrow to his foot in battle, was cured of in battle by an arrow to his leg (or variously his foot) who was cured of some chronic condition.

  51. #52 Denice Walter
    April 30, 2013

    Todd W,:

    Yeah but faires have FOLK DANCING… which might distract us from the festivities and ceremonies.
    If we don’t grovel well, no bonuses.

  52. #53 JustNuts
    April 30, 2013

    Telepathic acupuncture?

    Wouldn’t the inverse-square law make it ineffective?

  53. #54 Todd W.
    http://www.harpocratesspeaks.com
    April 30, 2013

    @Denice Walter

    Are you kidding? Ren Faires are made for groveling. Where do you think the power grovel originated? It takes the truly dedicated to launch oneself into the air and land in proper groveling position.

    Then there are the pluses of acceptable wearing of swords, maces and other assorted melee accoutrements with which folk can be kept in line. That should take care of the rogue dancing.

  54. #55 Todd W.
    http://www.harpocratesspeaks.com
    April 30, 2013

    @Calli and dandover

    Want to know what kind of acupuncture they’re doing that involves ballistics? Lawn darts.

  55. #56 Mephistopheles O'Brien
    April 30, 2013

    Telepathic acupuncture?

    Wouldn’t the inverse-square law make it ineffective?

    Not if it’s homeopathic telepathic acupuncture. The farther away, the stronger it gets.

  56. #57 JustNuts
    April 30, 2013

    Yes… Of course – I think I slept through that lecture at Altie camp!

  57. #58 Shay
    April 30, 2013

    lascivious and lewd carnal gratification

    I’m ok with that.

  58. #59 Calli Arcale
    April 30, 2013

    JGC — I used to be an adventurer like you until I took an arrow to the knee. But it cleared up my asthma!

    :-P

    And who else thinks Ballistic Acupuncture would make a great name for a band?

  59. #60 Denice Walter
    April 30, 2013

    LIsten:
    brothers and sisters, I want you to imagine the vibrant awakening of the earth tonight, as it blossoms forth from the slumbering death of winter, its diverse sweet and acrid perfumes wafting through the mild breezes as we wander indolently through the gathering twilight at moonrise.

    We travel together as though through time to the dawn of our species and in rapturous communion, experience the wonder and mysteries of eternal renewal: our spirits rising as we surrender to our own true, deeper nature beyond the superficial trappings of identity, culture and education, gathering close together around the fire to hear the tales and legends of our ancient lineage.

    We gratefully sample the bounty of the earth- fruit and fowl, fish and herb- eating and drinking from its harvest and satisfying our longings for sensuality and release amongst our own as the bonfires roar and gleaming sparks reveal the outlines of the dense forest through the encompassing darkness while intriguing visions flicker and capture the essence of our desires and fears mingled together, illuminated by the moonlight and enlivened by the hypnotic music of rushing waters beside us, fuelled by the magical essences we consumed knowing truly of their miraculous powers and guiding force.

    Eat your heart out, Draconis!

  60. #61 dandover
    Where not a drop of LSD is to be found.
    April 30, 2013

    I really must figure out how to get invited to Denice’s parties. :D

  61. #62 Todd W.
    http://www.harpocratesspeaks.com
    April 30, 2013

    @Calli Arcale

    Next time, bring me along. I am your sword and your shield.

  62. #63 Denice Walter
    May 1, 2013

    @ dandover:

    (( shaking the vine leaves out of my hair))

    You are always invited, Dan:
    our next fete will be the Solstice – current location undisclosed- we wouldn’t want Jake trekking up to the U of Northu.. oops
    and aggravating the two Mrs elbur… oops

    followed by Draconis’ birthday at the Bohemian Grove as usual: you’ll need photo ID

    Then there’s Las Vegas but I can’t go as usual.

  63. #64 Thomas Blasejewicz
    Japan
    May 1, 2013

    Well, I can only assume, that the people who present these wonderful articles on “science” HAVE never been sick and WILL never be sick.
    Medicine is NOT science for the sake of science. Medicine is the art of CARING for PEOPLE. Neither of which can be preciscely defined – to the best of my knowledge.

    After 30 years of clinical experience I can assure you -presuming that our science advocates have never been sick – that patients who come to see a medical facility (any kind of) usually SUFFER (please precisely define “suffer” or care; -> there was this wonderful movie “starman”, where an alien that does not speak English asks a lady, when the sujbect arises: “Dfine love”. I am sure, there is a totally scientific explanaton …) from some sort of ailment. Depending on the condition, I can assure you, they do NOT give a s**t about the scientific basis, chemical reactions, academic research etc. They seek relief. As a practitioner you are a CAREGIVER, your job is to CARE for those people. Not to run absolutely objective scientific tests on subjects like the “Terminator”. To speak with Hippocrates: “Cure sometimes, treat often, comfort always.”

    But … well, our science guys will probably NEVER need to be cared for. I can only hope (for them), that they will find sufficent comfort in science when the time comes …

  64. #65 Calli Arcale
    May 1, 2013

    Thomas — you’re wrong. Many have been sick, some extremely sick, yet still care about medical science.

    See, you’re right that people who go to a hospital to be cured care far more about getting better than the exact mechanism by which they get better. But that is WHY you need science. Otherwise, how do you know you’re treating them and not accidentally making them worse? For centuries, doctors used bloodletting and purging to treat ailments, on the basis that they *knew* it worked, and it was more important to treat patients than to spend time studying the methods they already used. Then somebody studied it and found out they were actually killing people. Whoops.

    I have no comfort in a doctor who spends his or her time mostly in boosting my ego rather than treating my ailments with something that’ll actually work. Granted, as the old joke goes, a fair bit of medicine is the art of entertaining the patient while the body heals itself. But I don’t want acupuncture to treat my asthma just because some practitioner is convinced it’ll help me and is very sincere in caring about me. I’d honestly rather have a science-based practitioner with a lousy bedside manner give me a one-month supply of Pulmicort, because at least that’ll address my inflammation. Unlike the acupuncture.

    Because that’s the bottom line. Yes, patients want to get better. That’s why doctors have a responsibility to know that what they’re suggesting actually works.

  65. #66 Craig Thomas
    May 2, 2013

    Recently visited the “Wellcome Trust History of Medicine” exhibition at the London Science Museum.
    http://www.sciencemuseum.org.uk/broughttolife/aboutus/collectingmedicine.aspx

    There were extremely generous displays devoted to nonsense like “Chinese Traditional Medicine”, “Acupuncture”, and Homeopathy. Each of them was given very sympathetic treatment, mainly centred around an anecdote that had been devised for each, (in the form of, “Ben Roberts had been suffering from a sore foot for years and the doctors weren’t able to help. He received acupuncture and it solved all his problems. blah blah blah.” total crap.

    These weblinks from the Museum’s website are very similar to the displays I saw, but they don’t seem to include the bullshit anecdote and are slightly different in other ways. I should have taken photos.

    In a *Science* Museam, FFS!!
    http://www.sciencemuseum.org.uk/broughttolife/techniques/acupuncture.aspx
    http://www.sciencemuseum.org.uk/broughttolife/techniques/chinesemedicine.aspx
    http://www.sciencemuseum.org.uk/broughttolife/techniques/homeopathy.aspx

  66. #67 Martin
    May 2, 2013

    Thomas:

    I can get warmth and compassion and encouragement from my loved ones.

    What I want when I seek the aid of physicians and surgeons is effective treatment, competently applied.

  67. #68 Calli Arcale
    May 2, 2013

    Craig — there is a section at my local science museum devoted to things like that, but ah, with rather a different slant. ;-) The Science Museum of Minnesota was the lucky beneficiary when the owner of the Museum of Questionable Medical Devices decided to retire, and so they rotate out pieces of his collection into the anthropology hall. There are some very nice pieces, including a fluoroscopic shoe fitting machine with three viewing ports, a phrenology device that maps the head’s bumps mechanically, and an orgone accumulator. It’s pretty awesome.

  68. #69 Christine (the public servant Christine)
    May 3, 2013

    @elburto: that’s awful. Colonoscopies are bad enough when you prep for them. They are horrible, horrible HORRIBLE all round.

    @kreboizen: a couple of years ago the IBD resulted in a particularly nasty constipation. It got so bad my GP mentioned surgical disimpaction, which he described as “sort of like colonic irrigation but carried out with an anaesthetic and carried out by people who know what they’re doing.” Fortunately the enemas worked before it got to that stage.

    Incidentally, my experience with enemas makes me want to beat anyone who would use them to treat anything other than rectal obstructions, or surgery prep.

  69. #70 Narad
    May 3, 2013

    After 30 years of clinical experience I can assure you

    Are you speaking as an acupuncturist or as a patient?

  70. #71 Krebiozen
    May 3, 2013

    Christine (the public servant Christine),

    Incidentally, my experience with enemas makes me want to beat anyone who would use them to treat anything other than rectal obstructions, or surgery prep.

    I feel for you. I had a long period of gastrointestinal problems (they turned out to be due to chronic giardiasis), and went through a range of investigations. I can only assume that since some people appear to have colonic irrigation for fun, poking objects up a non-inflamed rear end must be less unpleasant than my experiences would suggest.

    There was a group of medical students observing my sigmoidoscopy. As I lay there, trying to look dignified, I wondered why the consultant had positioned them in front of me, instead of round the back where they could see what the consultant was actually doing. A little later I realized that the consultant’s statement, “this may be a little uncomfortable”, was perhaps intended ironically. I remember looking up through my involuntary tears to see the horrified faces of the medical students, and understood that the intention was for them to understand just how uncomfortable the procedure can be, through observing my reaction. It was at that point that I heard the consultant ask for the biopsy scissors, which was alarming, but the biopsy itself was painless. I imagine a colonoscopy is even more fun.

    I can’t resist passing on another anecdote. My brother, a doctor, told me about his experience being shown how to perform a sigmoidoscopy. The consultant was talking the medical students through the procedure, and watching his progress on the screen above him. When he looked down he realized that he had fed his necktie into the patient’s rectum along with the sigmoidoscope. Without missing a beat he asked a nurse for a pair of scissors, snipped off his tie and left his registrar to finish up.

  71. #72 herr doktor bimler
    May 3, 2013

    After 30 years of clinical experience I can assure you

    Ah, acupuncturists, always the purse-snatchers of medicine… wanting the white coats, and the talk of “clinical experience”, and the whole cargo-cult rigmarole, without the inconvenience of the “curing people” part.

  72. #73 Christine (the public servant Christine)
    May 3, 2013

    Kreboizen, the only decent thing about a colonoscopy is that the actual procedure comes with a general anaesthetic, so you don’t actually feel anything while they are… doing what they’re doing. It’s the prep and the aftermath that makes them awful.

    Incidentally, I found a “clinic” not far from me that offers colonics… pay for 5 and get the 6th free! And combine with a therapeutic massage! Recommended for people with colitis! (No mention of Crohn’s – maybe they don’t know about the sibling condition yet). Funny how the Australian Crohn’s and Colitis association warns against them…

  73. #74 al kimeea
    www.quackademiology.com
    May 3, 2013

    Lord Draconis, my liege. You have my undying love and fealty, one suggestion.

    Morris Dancing with Roman Candles.

    It would groove with the cupcakes

  74. #75 lilady
    May 3, 2013

    http://www.scoop.it/u/thomas-blasejewicz

    “I am a native German acupuncturist living/working in Japan and believe “Japanese acupuncture” has to offer precious ideas/treatments the “Chinese acupuncture” cannot.”

  75. #76 stephen allen
    May 4, 2013

    No one knows how paracetamol, general anaesthetics or acupuncture achieve their effects. Should we stop using them because they have evaded the basic science step and brand them CAM?

    Evidence Based Medicine is science at its most useful to the human race. Lots of treatments are sound in vitro but are found to be dangerous in vivo; should we take basic science over RCTs and use them anyway? No the best evidence is pragmatic trials with real patients obviously.

    There are several positive Cochrane reviews using acupuncture. Acupuncture features in several government evidence based guidelines such as NICE.

    You rubbish both science and anything you feels is not scientific which leaves what exactly? You must be desperate to keep writing this blog to talk yourself into that spot.

  76. #77 stephen allen
    May 4, 2013

    One thing I noticed about this review article right away is that nearly all the studies it discussed were about electroacupuncture (EA). This is, in my mind, a classic “bait and switch,” in which therapy is described as acupuncture but is in reality nothing more than electrical nerve stimulation clumsily grafted onto acupuncture.

    On what planet has acupuncture ever been anything other than a needle being placed it he skin and stimulated? EA is not a direct current. It mimics manual stimulation only. Its purpose is to save acupuncturists wrists and create a reproducible level and frequency of stimulation.

  77. #78 stephen allen
    May 4, 2013

    ” It doesn’t matter where you stick the needles.”

    This point or using tooth picks (have you not heard of acupressure) does not invalidate acupuncture. It means “bad” acupuncture is still pretty good. It encourages us to look at the basic science to understand how it works so we can treat patients more effectively. I would direct you this review but I am sure you will disregard it. Perhaps your readers might enjoy it though.

    Vickers, Andrew J., et al. “Acupuncture for chronic pain: individual patient data meta-analysis.” Deutsche Zeitschrift für Akupunktur 55.4 (2012): 24-25.

  78. #80 Emily
    Canada
    May 10, 2013

    Orac, have you come across the infrared imaging technique used to show the existence of meridians?

    Here’s a couple sites your readers might be interested in:
    http://www.ncbi.nlm.nih.gov/pubmed/18050626
    http://www.tcmclineek.com/Pages/ACUScientificProof.aspx

    I’m an acupuncturist with a science background. During my education I was continuously looking for Western interpretations and explanations. Originally not comfortable with the meridian and Qi talk.
    Here’s what I came up with:

    1) The act of putting a foreign body, such as a needle, into the body stimulates a response. The body tries to fight off the in vader by sending white blood cells and blood in general to the area, thereby increasing circulation and decreasing inflammation.

    2) Over 70% of points overlay nerve ganglions. Sticking a metal object and stimulating it (twisting, electrics machine) sets off the all-or none response in nerves. Nerves go to the brain and direct EVERYTHING our bodies do. They go to organs, muscles, control our hormones etc.

    3) Acu points have been shown to stimulate particular parts of the brain depending on point chosen.
    http://www.ncbi.nlm.nih.gov/pubmed/18684074

    You do realize that our scientific method and money driven society has led to the introduction of drugs, the majority of which (but not all) are lemons. The leading cause of death in hospitals I believe and with lengthy lists of negative side-effects. I’m sure you’re also aware of the fact that most of these studies are led my the manufacturer and often use hormone resistant rats or whatever means they can to legitimize their work. Assuming you find this acceptable, this leads me to think your skeptic ‘nature’ is biased to CAM. Am I wrong?

    Unfortunately, when it comes to costly scientific studies and our society in general, money talks, bottom line. You just can’t deny this. Who could gain in a huge upsurge of acupuncture patients? Who’s pocket book would be adversely affected?

    More unfortunate is the difficulty in testing acupuncture with double-blind placebo tests. As another blogger mentioned, acupressure discounts sham acupuncture and the fact that TCM treats based on symptoms that accompany Western diagnoses and not the disease name itself further confounds the variables. How can one be random, but ensure all patients with say low back issues are Kidney yang deficient for instance To take a random sample and treat them all with exactly the same acu points for the same Western disease is not what we do, so how can these count?

    The blindness bit is equally hard to control, no? The ‘zing’ one should achieve when needling a point is determined by the patient telling the acupuncturist. Is this done in studies? How do they ensure a blind acupuncturist? I can tell the difference between a toothpick and a needle.

    I would seriously be interested if you knew of any studies that were somehow able to get around these problems.

    Fortunately for us, the Western doctors aren’t able to help many desperate people that we can. What a friend reports is, if you think about it, is more reliable than what big pharma does. 100,000 deaths occur each year in the U.S. from pharmaceuticals being taken as prescribed (and correctly prescribed). My understanding is zero death occur by properly inserted acu needles.

    My advice, be aware of anyone who is so black and white on such a complex topic as the human body and who puts so much faith in such a young medicine which is learning new things constantly about how we work. Neurology is particularly in it’s infancy.

  79. #81 Scottynuke
    May 10, 2013

    Pegamily, is that you?

    If not, I can tick off many familiar memes: “let’s focus on pharmaceutical risks and ignore benefits;” “Big Pharma funding taints all medical research that doesn’t agree with mah magic;” “medicine kills XXX people a year;” the quasi-racist “Western medicine;” and the “your puny science can’t measure mah magic” gambits.

    Alt-Med Bingo!!! And I’m not even a regular commenter.

  80. #82 AdamG
    May 10, 2013

    acupressure discounts sham acupuncture

    Prove it.

    so much faith in such a young medicine which is learning new things constantly about how we work.

    How old is “Traditional Chinese Medicine,” exactly?

  81. #83 herr doktor bimler
    May 10, 2013

    http://www.ncbi.nlm.nih.gov/pubmed/18050626

    It was fortunate that the system of meridians in “mongrel rabbits” was empirically mapped out in advance, so that the areas of raised skin temperature after moxibusting the rabbits could be shown to coincide with the meridians.
    Rabbits?

    Over 70% of points overlay nerve ganglions.
    Citation required.

  82. #84 Narad
    May 10, 2013

    The body tries to fight off the in vader by sending white blood cells and blood in general to the area, thereby increasing circulation and decreasing inflammation.

    Let me see if I’ve got this straight: In response to a very minor inflammatory stimulus, the body does the opposite of what it usually does, which is to restrict flow from the larger vessels and increase capillary permeability at the site of the injury, and profit! this anti-inflammatory inflammation is magically transported by meridians to distant sites?

  83. #85 Narad
    May 10, 2013
    Over 70% of points overlay nerve ganglions.

    Citation required.

    Well, Cheng Danan did redo the meridians with precisely this goal in mind. Strangely, modern acupuncture is apparently so wedded to its ancient (80 year old) tradition that they can’t get it up to 100%.

  84. #86 herr doktor bimler
    May 10, 2013

    Emily tells us it’s the physical ‘invasion’ of the body that matters for acupuncture while Steven Allen #78 insists that toothpick pressure is just as effective. Whom to believe? I hate it when authorities disagree.

    most of these studies [...] often use hormone resistant rats
    Can’t argue with the use of hormone resistant rats.

  85. #87 Shay
    May 10, 2013

    “Hormone Resistant Rats.”

    This blog comes up with the best garage rock band names evar.

  86. #88 herr doktor bimler
    May 10, 2013

    Every time you stick pins in a patient, a voodoo doll feels pain. Will no-one think of the voodoo dolls?

  87. #89 Mephistopheles O'Brien
    May 10, 2013

    If I understood the references, if you burn someone’s skin in certain points then there will be heat patterns (caused perhaps by magnesium ion metabolism) which are vaguely like what acupuncturists call meridians. That and if you stick a pin in someone, the signal goes to the brain (which I’d have thought was a “duh” moment).

    Is there any high quality data that suggests that acupuncture has a significant clinical benefit compared to a placebo?

  88. #90 Emily
    May 11, 2013

    A more detailed explanation of the local circulation phenomenon and the role of nitric oxide:
    http://www.ncbi.nlm.nih.gov/pubmed/17242084

    The following site says ‘…most acupuncture points correspond to the high electrical conductance points on the body surface….’ (known since the 1950s) It says a lot more for anyone interested, more than I can recap here.

    http://med-vetacupuncture.org/english/articles/mechan.html

    Herr Doktor Bimler, are we reading the same entry? I don’t see where Stephen Allen says a toothpick is just as effective. In fact, we are saying the same thing. Acupressure isn’t the same as a sugar pill. Get it?

    Narad, we’re not so wedded to the ancient modality that it isn’t continually evolving. New points being added, old points being moved a touch, etc. Do you have a source for the restriction of flow in large vessels? From how much trauma exactly? I know that acupuncture is relaxing (after the needles are in – ha). When the PNS is activated flow to the digestive organs increases and flow to the limbs decreases.

    O’Brien: How does this study stack up? For me it’s not perfect as ‘placebo’ group had some sort of acupressure, but seems to still be statistically sound. I’m thinking it’s not double-blind either. I could look harder (first thing that came up), but like I said the blindness bit is difficult to reproduce.
    And, by the way, we don’t ‘burn the skin’ in North America.
    http://www.ncbi.nlm.nih.gov/pubmed/22905352

    And yes, duh, pain sensation and all sensations are signals from the brain, but I am referring to specific lobes lighting up in response to stimulation of specific meridians. For instance, the occipital (vision) lobe activation by a point for vision in the foot (and not by nearby points). http://www.pnas.org/content/95/5/2670.full.pdf

    Orac, please do join the party :) Apparently you guys struck gold with me – ha!

  89. #91 Emily
    May 11, 2013

    Here’s another one of my favourite studies (small sample size, but still quite intriguing). Summary: AcuPRESSURE applied to a bladder meridian point on the medial end of the eyebrow (BL2) generates heat at the END of the meridian at the baby toe. No modern science connection known……yet.
    http://www.medicalacupuncture.org/aama_marf/journal/vol16_2/article_5.html

    Personal anecdote: (shield your eyes, double-blind placebo hardies)
    After a treatment I had (before entering the profession) for ‘general wellbeing’. Ie. I wasn’t looking for a particular outcome, except for maybe relaxation. I experienced a loss of distance vision for about an hour after the treatment. I could see, but things like faces and street signs I normally could see fine (I’m 20/20) were blurry. Needless to say, I was a bit freaked, but my point is that the placebo couldn’t explain this. No needles were near my eyes. Though this story may not give acupuncture a good name, it is actually beneficial for vision in the long run. Not going to try and convince you guys on that one however.

  90. #92 Narad
    May 11, 2013

    It says a lot more for anyone interested, more than I can recap here.

    Indeed. It might require the full resources of the Riddled Research Laboratory.

    Do you have a source for the restriction of flow in large vessels?

    Histamine will cause smooth muscle cells around larger vessels to contract and produce vasoconstriction, but in retrospect, this is probably a minor effect in producing the flow retardation necessary for margination as compared with increased permeability. Note that none of this supports the notion of “increasing circulation and decreasing inflammation,” since producing inflammation is the whole point of the exercise.

    It also remains thoroughly unclear to me what you think this has to do with nerves or “meridians.”

  91. #93 Denice Walter
    May 11, 2013

    @ Narad:

    I don’t want to get started over acupuncture: “specific lobes”/ “specific meridians” and “loss of distance vision”/ “beneficial for vision in the long run” because I am expected elsewhere soon but I do wish someone else would address it.

  92. #94 AdamG
    May 11, 2013

    Acupressure isn’t the same as a sugar pill.

    You still need to prove this. That bladder study is a joke. Bad/nonexistent controls, and a complete disregard for statistics.

  93. #95 Narad
    May 11, 2013

    Here’s another one of my favourite studies (small sample size, but still quite intriguing). Summary: AcuPRESSURE applied to a bladder meridian point on the medial end of the eyebrow (BL2) generates heat at the END of the meridian at the baby toe “The simple visualization of the infrared images did not show true temperature variations”.

    This sound an awful lot as though, for the money figure, they had to resort to image “enhancement,” which is described in no detail whatever. On the other hand, they seem to be quite worried about variations in “atmospheric transmission” over a distance of a meter. The use of the thermocouple to establish a suitable initial state is hilarious.

    So, some questions: If they subtracted the “contrast image” from the subsequent frames, why is all the macro structure still visible in Fig. 8? Why don’t they explain what’s going on with subject 4 in Fig. 9? Why are there data points missing from Figs. 10 and 11? Why do the “placebos” and “BL 2″ have different starting times and durations?

    (CITIZEN JIMSERAC, aka James Pannozzi, predictably loves this item. In fact, he also pairs the Shang item with it. What a coincidence.)

  94. #96 herr doktor bimler
    May 11, 2013

    are we reading the same entry? I don’t see where Stephen Allen says a toothpick is just as effective. In fact, we are saying the same thing.

    I cited Allen’s comment #78:
    This point or using tooth picks (have you not heard of acupressure) does not invalidate acupuncture.

    Two comments later in #80 you are adamant that a physical penetration of the skin — rather than just toothpick pressure — is necessary:
    The act of putting a foreign body, such as a needle, into the body stimulates a response. The body tries to fight off the in vader by sending white blood cells and blood in general to the area

    This is “saying the same thing”? Possibly we are *not* reading the same entry.

  95. #97 herr doktor bimler
    May 11, 2013

    I am referring to specific lobes lighting up in response to stimulation of specific meridians. For instance, the occipital (vision) lobe activation by a point for vision in the foot (and not by nearby points). http://www.pnas.org/content/95/5/2670.full.pdf

    The most eye-catching part of that document, for me, was the big red block of letters in the top right corner of the page, where it reads “SEE RETRACTION PUBLISHED JUNE 21 2006″.

  96. #98 Krebiozen
    May 11, 2013

    Emily,
    I used to be curious and open-minded about acupuncture, but have become more and more skeptical over the years.

    The following site says ‘…most acupuncture points correspond to the high electrical conductance points on the body surface….’ (known since the 1950s) It says a lot more for anyone interested, more than I can recap here.

    I used to own an electrical acupuncture gadget that detected these points, and indeed they did appear to correspond with “traditional” acupuncture points. However, I found that there are literally thousand of other points of low resistance all over the body that don’t correspond with any “traditional” acupuncture points, which makes it much less impressive. I use quotes around traditional because the modern points used were first mapped in the 1930s. Before that acupuncture was indistinguishable from medieval European bloodletting (that’s why acupuncturists take your pulse), and only itinerant folk-healers carried it out.

    After a treatment I had (before entering the profession) for ‘general wellbeing’. Ie. I wasn’t looking for a particular outcome, except for maybe relaxation. I experienced a loss of distance vision for about an hour after the treatment. I could see, but things like faces and street signs I normally could see fine (I’m 20/20) were blurry. Needless to say, I was a bit freaked, but my point is that the placebo couldn’t explain this.

    Temporary myopia is associated with stress and fatigue, which it seems likely you were suffering from if you sought a treatment that would induce relaxation and general well-being. A nocebo effect is also quite possible in the sense that something entirely unrelated may have caused your blurred vision, and you assumed it was related to the acupuncture session.

    I don’t find any of the evidence you have presented very impressive. There may be a counter-irritative effect of acupuncture, and I think any treatment that involves ritual and a bit of discomfort can be a very effective placebo. The trials of acupuncture that show some effects are usually in subjectively assessed conditions that are susceptible to placebo effects.

    For example, the study of acupuncture in COPD you linked to looked at changes in MBS score after 12 weeks of real acupuncture (and conventional treatment) as compared to placebo acupuncture (and conventional treatment). MBS is a subjective assessment of difficulty in breathing, which raises questions about blinding (see the subsequent letters about the study). Other studies of asthma have found acupuncture leads to reports of subjective improvement that are not reflected in objective measures such as FEV.

  97. #99 Ann
    Ireland
    May 31, 2013

    I am practising Traditional Chinese Medicine for over 10 years and have seen results which should be proof that acupuncture works. I will give examples of what is does
    Turns the fetus in breech baby cases, stops day time sweating, night time sweating, lowers body temperature in case of high fever, resolves pathogens in cases of fever,
    increases red blood cells, strenghens immunity
    detoxes organs i.e. liver, ovaries, lungs, gb, kidney etc
    promotes labour in a shorter time span, stops nausea and vomiting during pregnancy, treats vertigo, diziness,
    treats palpitations, chest pain, anxiety
    I could go on and on, it has its place in medicine in China in the department of Chinese Medicine, Acupuncture Section of the Hospital and The Chinese Herbal Medical Pharmacy, and then their are the other Medical Deparments in their Hospitals. I think it was great people would walk into the hospital, be seen by chinese herbalists and walk out with herbs for one week and can return to discuss their condition with their doctor of traditional chinese medicine the following week. Lets not forget Acupuncture is a subject in Traditional Chinese Medicine where you train as a Doctor, Professor like any other profession, and all these doctors and professors are Medical Herbalists and could possibly be masters of tuina, qi gong, Lecturers and Consultants in their own Country. Irish people are very happy with Acupuncture and the practise of Traditional Chinese Medicine including Medical Herbalism. and are very impressed with the results.

  98. #100 MI Dawn
    May 31, 2013

    Hi, Ann. And can you also give examples of each of those things resolving WITHOUT acupuncture? Because I sure can.

    And no, I don’t even need to use any medicine at all. (except for the BS about detox and strengthening immunity with acupuncture)

  99. #101 Beamup
    May 31, 2013

    @ Ann:

    That’s nice. Any actual, oh, EVIDENCE that acupuncture had the faintest bit to do with any of that?

  100. #102 JGC
    May 31, 2013

    Turns the fetus in breech baby cases, stops day time sweating, night time sweating, lowers body temperature in case of high fever, resolves pathogens in cases of fever, increases red blood cells, strenghens immunity, detoxes organs i.e. liver, ovaries, lungs, gb, kidney etc, promotes labour in a shorter time span, stops nausea and vomiting during pregnancy, treats vertigo, diziness, treats palpitations, chest pain, anxiety.

    Citations desparately needed.

    I’m particularly interested in the claims re: ‘detoxing’ organs, so ask that you also answer the following questions:

    How is the degree of toxicity present in these organs before and after treatment accurately measured?

    In what units is this value expressed?

    By what percentage does accupuncture reduce organ toxicity compared to untreated and placebo-treated controls? (BTW, what type of placebo accupuncture was used as the corntrol–retracting needles? Toothpicks twirled against the skin? needles actually inserted but at irrelevant meridian points?)

    To what extent is the observed reduction in measured toxicity statistically signficant–p=0.05? p>0.05? p<0.05?

    Anxiously awaiting the evidence that accupuncture actualy does all the marvelous things you claim it does.

  101. #103 Beamup
    May 31, 2013

    The particular claim I find hilarious is “promotes labour in a shorter time span.” Shorter than what? You’re not exactly having women give birth twice, once with and once without acupuncture. So you haven’t the faintest idea how long it would have been otherwise.

  102. #104 lilady
    May 31, 2013

    @ Ann: Could you show us on a human anatomy chart, where the Qi channels are? BTW, what is Qi?

    Now, how did that acupuncture needle get into this man’s lung?

    http://www.reuters.com/article/2011/05/03/us-korea-roh-idUSTRE7420XB20110503

  103. #105 Mephistopheles O'Brien
    May 31, 2013

    Ann – you might be interested in David Colquhoun and Steven Novella’s discussion of the subject at http://www.dcscience.net/?p=6060.

  104. #106 MI Dawn
    May 31, 2013

    Awwww….did Ann hit and run? Or was she just too busy sticking needles into people to answer us?

  105. #107 TBruce
    May 31, 2013

    Ann:
    Many of your examples are of conditions that often resolve spontaneously (turning of breech presentation, sweating, fevers, nausea and vomiting in pregnancy, vertigo, dizziness, anxiety).
    Many others are meaningless or unmeasurable (strengthening the immune system, detoxification, shorter labour).
    A few are dangerous . I don’t see anything about attempting to identify pathogens in fever, finding out the cause of anemia when increasing red blood cells or seeing if there’s an MI or pulmonary embolism before treating chest pain or palpitations.

    I am not impressed.

  106. #108 Ann
    June 6, 2013

    All are welcome to attend my clinic and i will offer my tcm knowledge/treatments at anytime, I am so blessed to have an outstanding tcm clinic in the west of ireland overlooking the Burren in Co Clare surrounded by Nature and I meet the most amazing people. Go raibh meile mait agat…a chairde..

  107. #109 JGC
    Anne, is there a reason you failed to answer my questions?
    June 6, 2013

    How is the degree of organ toxicity measured?
    In what units is toxicity expressed?
    By what percentage does acupuncture reduce toxicity, compared to what controls?
    To what extent is that reduction statistically significant?

    You must know the answers to these questions, in order to. claim acupinctute can ‘detox’ these organs. Right?

  108. #110 Krebiozen
    June 6, 2013

    Ann,
    I assume you are unaware that acupuncture was invented in the 1930s. Before that it was indistinguishable from medieval European bloodletting (that’s why acupuncturists take your pulse), and only itinerant folk-healers carried it out. I’ll pass on the invitation to your clinic, thanks.

  109. #111 Denice Walter
    June 6, 2013

    Alternative travel advice:
    go see the Burren and the west – it’s probably better for you than tcm.

  110. #112 Shay
    June 6, 2013

    @Ann

    póg mo thóin.

  111. #113 Ann
    June 12, 2013

    Yes the Burren is very healing place and I would recommend anyone to visit this area with its rare flora. One last point on acupuncture on how it works is simple, the acupuncture needle is inserted into the acupuncture point which is attached to the channel to a particular organ, lets say the stomach, if it was a stomach complaint i.e. pain for example the pain would be resolved even after one treatment, is that not enough proof. The patient is free to have an ultrasound endoscopic examination. Acupuncture needles, are healing tools and I find it amazing that it can cure so may illness, it never ceases to amaze me even Kidney infections. Their should be a dempartment of TCM Acupuncture & Herbal Medicine in all hospitals including other therapies and thats what will happen in the future. 2013 is the year after all that more people are concerned about eating organic foods rather than genetically modified foods to improve their health and demanding clean water that isnt contaminated with flourine. There is a very awakended public now and they deserve the best therapies available and tcm acupuncture and herbal prescriptions if they wish.

  112. #114 Todd W.
    http://www.harpocratesspeaks.com
    June 12, 2013

    @Ann

    the acupuncture point which is attached to the channel to a particular organ

    Can these channels be observed or measured? If so, how? If not, then how do you know they exist? This is a rather pertinent question, since studies have found that it does not matter where you stick the needle.

    I find it amazing that it can cure so may illness, it never ceases to amaze me even Kidney infections.

    Can you provide a link to the well-controlled studies showing that acupuncture can cure a kidney infection? If not the link, then the PubMed ID or the title/authors/publication year should suffice. Thanks.

  113. #115 Calli Arcale
    June 12, 2013

    Healing kidney infections with acupuncture? SERIOUSLY? That’s incredibly foolish. Kidney infections resolve very easily with antibiotics — and without them, often lead to permanent kidney damage or death. Any acupuncturist willing to treat a known or suspected kidney infection is gambling with the lives of their patients with very poor odds, and in my opinion should be prosecuted for doing so. That’s right up there with treating meningitis with chiropractic.

  114. #116 JGC
    June 12, 2013

    Ann, I note you have once again ingored my questions regarding the use of acupuncture to ‘detox organs’.

    Why? Can I expect you’ll ever explain how the degree of organ toxicity measured. in what units the measured toxicity is expressed, and by what percentage acupuncture is observed to reduce toxicity compared to controls?

    As for “How it works is simple, the acupuncture needle is inserted into the acupuncture point which is attached to the channel to a particular organ”, the next question obviously has to be “And then what happens? What exactly does inserting a needle into a channel do, what physiologic changes does it cause,to ultimately result in healing?”

    Fill in the rest of the steps in your proposed mechanism of action, please.

  115. #117 Mephistopheles O'Brien
    June 12, 2013

    One last point on acupuncture on how it works is simple, the acupuncture needle is inserted into the acupuncture point which is attached to the channel to a particular organ, lets say the stomach, if it was a stomach complaint i.e. pain for example the pain would be resolved even after one treatment,

    So to summarize:
    1. Insert needle in the acupuncture point.
    2. ???
    3. Healing!

  116. #118 JGC
    June 12, 2013

    Ann, I note you have once again ignored my questions regarding the use of acupuncture to ‘detox organs’.

    Why? Can I expect you’ll ever explain how the degree of organ toxicity measured. in what units the measured toxicity is expressed, and by what percentage acupuncture is observed to reduce toxicity compared to controls?

    As for “How it works is simple, the acupuncture needle is inserted into the acupuncture point which is attached to the channel to a particular organ”, the next question obviously has to be “And then what happens? What exactly does inserting a needle into a channel do, what physiologic changes does it cause,to ultimately result in healing?”

    Fill in the rest of the steps in your proposed mechanism of action, please.

  117. #119 JGC
    Another browser hiccup...
    June 12, 2013

    Apologies for the double post

  118. #120 Calli Arcale
    June 12, 2013

    As the classic cartoon goes, I think you need a little more detail in step 2. ;-)

  119. #121 Skye Van Munster
    Canada
    June 23, 2013

    As an acupuncturist I see dramatic results with my clients each and everyday. Is this placebo? Honestly from the scientific research i cant say i know 100%.
    I worked on cruise ships for a number of years and treated many skeptics, most of them doctors. My treatments still worked when everything else had failed. This is what matters to me and why I continue to practice.
    The medical system is extremely overburdened acupuncturist commonly provide the nurturing which instigates self healing.
    Is placebo bad? here is an interesting Ted Talk on the topic of how powerful our mind is.
    http://www.youtube.com/watch?v=LWQfe__fNbs

    Acupuncture training and regulation is extremely lacks and their are many allowed to practice who have not had sufficient clinical hours. Acupuncture is a small part of chinese medicine and a trained Traditional Chinese Medicine practitioner does not solely rely on acupuncture to treat all ailments and disease.
    Our world is in desperate need to focus on preventative medicine and chinese medicine advocates this and should be used to empower people to put responsibility of their health into their own hands.

  120. #122 Narad
    June 24, 2013

    The fine and true element of the foregoing, I should think, is the following:

    Fire Safety Training/ Fire Risk Assessment Training

  121. #123 al kimeea
    www.quackademiology.com
    June 24, 2013

    One of the traits of wooliganism is the immediate assumption of the believer that the doubter knows little to nothing of the woo in question.

    So, to relive an overburdened 21st century medical care system, we need to regress to a system of ancient superstitions regarding human physiology that has no basis in reality AND is poorly regulated in training and practice.

    In fact, Ontario is trying to setup a Quackwarts for these snake oilers and they are refusing to play nice, for the betterment of their patients marks.

    The new College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario is committed to putting public safety first in regulating the practice of traditional Chinese medicine. The college will ensure Ontarians receive quality health care services by practitioners who possess the knowledge, skill and judgment required for safe practice.

    I have it on good authority that chronic lower back pain is the result of the “liver processing gamma rays in the skull”. The medical professionals at the Toronto Acupuncture Studio operate on this principle.

    Can any of the needling pros here confirm this?

  122. #124 Krebiozen
    June 24, 2013

    Skye Van Munster,

    That Ted Talk is extremely irritating, credulous BS that regurgitates a number of refuted urban legends. It’s plugging a book, of course.

    Krebiozen (which also happens to be my ‘nym) is an example of a quack cancer remedy that didn’t work, and the speaker tells the old tale of the patient with cancer who allegedly rallied due to the placebo effect and died when he found out the drug he had been given was useless. You can read this tale in its entirety here. I’m very suspicious that any doctor would inject a patient with water, as this burns, BTW.

    Anyway, this was back in the 50s and it has apparently never happened again, despite large numbers of people with cancer being persuaded to reject conventional treatment and use alternatives instead. If belief could cure cancer, at least some of these people would have had miraculous recoveries, wouldn’t they?

    Then she talks of three girls “cursed at birth”, who allegedly succumbed to the curse due to the nocebo effect (no citation), and moves on to bald men in a Rogaine trial who grew hair even though they got a placebo, which simply isn’t true, at least I couldn’t find any studies that suggest any such thing. Hair loss can be temporary, and cured by treatment for hypothyroidism, for example, so a patient on a placebo whose hair grew back would not necessarily be miraculous.

    People on placebos in chemotherapy trials vomit and lose their hair – more often than what? People do sometimes vomit and lose their hair for other reasons. Some ulcers heal with placebos? Some heal without any treatment. She also brings up Kaptchuk who has been dealt with here in the past. Then she suggests that telling a cancer patient that they have a 5% chance of surviving 5 years might contribute to killing them.

    Most of these observations from clinical trials are the result of comparing the ‘effects’ of placebos to baseline, not to no treatment.

    She moves on to positive thinking and happiness leading to physical well-being. I have looked at a lot of the studies she mentions, that show a correlation between social connectedness and health, but the trouble is that it isn’t at all clear which way this works. If you are sick you are less likely to mix socially, to be married, to go to church etc..

    “Happy people live 7-10 years longer than unhappy people”, she says, but are those people happy because they are healthy, and unhappy because they have underlying health problems, or unhealthy because unhappy people are likely to look after themselves less well (diet, drinking, smoking…)?

    I’m pretty sure that interventional studies that helped people to feel happier through counseling, relaxation or guided imagery etc. have found little effect on physical health. That’s certainly the case with breast cancer patients. Personality type may have an association with heart disease, but even then confounders abound, with type A personalities more likely to smoke tobacco, drink to excess and get less exercise, though stress may cause high blood pressure as well.

    Stress can also interfere with normal healing of wounds, but it’s a large leap from this to our beliefs killing us or curing major illnesses like cancer. I’m not suggesting that relaxing and reducing stress aren’t a good idea, of course they are, but the idea that these might be able to replace proper medical care is just silly.

    The talk ends, not a moment too soon, with a horrible New Age exercise intended to increase levels of healing oxytocin and dopamine in the audience. Dopamine is healing? Tell that to a schizophrenic or a meth addict.

  123. #125 Krebiozen
    June 24, 2013

    P.S. Now I have elevated cortisol and epinephrine levels. Grrr.

  124. #126 lilady
    June 24, 2013

    Amazing isn’t it, that someone who worked in a spa aboard cruise ships and has a bachelor degree/applied science, now claims that sticking needles in meridians can cure acute and chronic diseases.

  125. #127 lilady
    June 24, 2013

    “…Acupuncture training and regulation is extremely lacks and their are many allowed to practice who have not had sufficient clinical hours…”

    (Translation)

    Acupuncturists lack training and the licensing board composed of other acupuncturists is the oversight agency to make certain the applicant is trained in needling, cupping and moxibustion:

    http://www.acupuncturealberta.ca/documents/StandardsofCompetencyandPractice_000.pdf

  126. #128 Militant Agnostic
    Where acupuncture is pointless and we keep bears wild.
    June 24, 2013

    @Skye Van Munster

    Acupuncture is a small part of chinese medicine and a trained Traditional Chinese Medicine practitioner does not solely rely on acupuncture to treat all ailments and disease.

    Yes, there is also ground up endangered species and bear bile extracted under the most inhumane conditions.

  127. #129 Denice Walter
    June 24, 2013

    ‘Dramatic results’ reported by practitioners and subjects are amongst the cjeif supporting pillars of pseudo-science. You might ask,” Why is that?” Why are testimonials of efficacy the mainstay of alt med?

    Because they don’t rely upon SB data and research, they need to spread the gospel via emotionally self-interested reports rather than the cold, clear light of observaton not immediately beholden to any interest. Which is the ideal so that we – emotionally-bound, self-interested creatures that we are- don’t fool others or ourselves. Hnnest people can and do fool themselves.

    Self-report is notoriously inaccurate in regards to judgments about illness/ disabilty – people don’t always know if something is wrong with them- that’s why there are medical tests: imaging and chemical as well as external judements of movements, ability etc.- otherwise we could just ask them or ask the observer- it would save money. Often people feel fine despite having an underlying life threatening condition ( aneurysm, blockage of arteries, stage 4 cancer) or feel terribly when tests can find nothing wrong.

    People can mix up feeling poorly due to illness with deleterious emotional and social conditions in their lives:
    this is an area fertile for manipulation by practitioners of alt med healing arts. Usually no objective tests are involved- no imaging or blood chemistries- the standards are purely subjective perception.

  128. #130 Denice Walter
    June 24, 2013

    ( pardonnez les typos, svp )

    Feeling better and *getting* better are usually two different areas of inquiry: a person with a terminal condition can “feel better’ for many reasons- friendship, assistance, hearing music- it usually will have no effect on the underlying condition. Medical intervention can be measured by focusing on how it affects the underlying physiological mechanisms that define that illness or condition- another ball of wax entirely.

    Talking with someone or having social interaction often is associated with a subjective perception of improvement but it usually has nothing to do with physiological mechanisms associated with illness. However, testimonials would have clients associate the good feelings they experience with a belief about underlying improvement.

    Stress can be relieved – at least momentarily- by many methods that alt med advocates ( massage, relaxation exercises), as well as daily activities like exercise, socialising, entertainment, reading etc.- most make people feel better without making them improve physiologically- I am not talking about minor physio. changes like bp, some changes like Kreb mentioned above- but changes affecting the roots of the condition.

    Woo-meisters like to focus on stress reduction as curative because it is very easy to affect well being temporarily with superficial intervention. However, it alone is not highly implicated as causative or curative of most serious illness as they would have their followers believe. This is advertising and promotion.

    SBM can tease the underlying, confusing threads apart- that’s what research is for- “to understand the causation of things”- and why we’re here.

  129. #131 Mephistopheles O'Brien
    June 24, 2013

    I am reminded of the supposed eyewitness accounts of the Indian Rope Trick. http://en.wikipedia.org/wiki/Indian_rope_trick

  130. #132 Denice Walter
    June 24, 2013

    What people perceive or remember is highly malleable and un-reliable:

    subjects’ judgment about a line’s length can be affected by the response of others: they often comply;
    subjects’ estimation of the speed at which a vehicle in a film was travelling is affected by how the investigator asks the question ( the car was described with leading verbs that implied great speed or not- for the same film, -btw-).
    It’s easy to influence what others *think* they perceive.

    People may believe that their own actions or choices affect outcomes more than they really do:
    subjects were either given a ‘lottery ticket’ or told to choose one from a bin: those who chose valued it more highly than those given one when given a chance to “sell” it back- both were told earlier that there were only 1000 tickets- each one valued the same. The choice group thought that somehow their own actions “increased” the value- it really didn’t- all were still equally valuable.

    Subjects remember things that fit together:
    shown phrases that appeared in various combinations describing a scene that could be visualised, subjects tended to believe most strongly that they had seen those that included all 4 phrases-
    in reality, they only saw combinations of one, two or three phrases- they never saw what they rated having seen most confidently-

    Salesmanship and advertising make use of how perception and memory work- including odd quirks like those above. Many of these results are described in articles about attitude change, person perception, attribution of causation, eyewitness report etc.

    Woo-meisters, proselytisers and ad creators won’t tell you about these tricks… I just did.
    And there are hundreds more.

  131. #133 Krebiozen
    June 24, 2013

    People may believe that their own actions or choices affect outcomes more than they really do:

    We have a problem in my part of London with a proliferation of bookmakers filled with gambling machines carefully designed to exploit on people’s cognitive vulnerabilities in these areas. You can gamble up to £100 at a time, and up to 5 times a minute. Of course the machines are designed so the punter always loses in the long term. It isn’t a coincidence that the industry is doing best in the poorest areas.

  132. #134 Krebiozen
    June 24, 2013

    I meant “exploit people’s” – delete the “on”.

  133. #135 Mephistopheles O'Brien
    June 24, 2013

    And of course we all know that the more you cheer for your favorite sports team, the better they will do. Especially if you’re wearing the same filthy t-shirt you wore during every winning game this season. Even if you’re cheering at home and only the cat can hear you.

  134. #136 Denice Walter
    June 24, 2013

    @ Krebiozen:
    @ Mephistopheles O’Brien:

    Sure. And I win at tennis because of my effort, dedication and talent but my opponent obviously only wins because she is a witch.

    -btw- re gambling: intermittent reinforcement keeps the players at it. As do superstitions that derive from random coincidence.
    Also the games are advertised as an avenue to wealth. People do miserably at understanding odds. One miilion to one is precisely that: most likely NOT you.

  135. #137 Mephistopheles O'Brien
    June 24, 2013

    Also the games are advertised as an avenue to wealth. People do miserably at understanding odds. One miilion to one is precisely that: most likely NOT you.

    And yet, in the notebooks of Lazarus Long it is written, “Certainly the game is rigged. Don’t let that stop you; if you don’t bet, you can’t win.”

  136. #138 Krebiozen
    June 25, 2013

    Denice,

    -btw- re gambling: intermittent reinforcement keeps the players at it. As do superstitions that derive from random coincidence.
    Also the games are advertised as an avenue to wealth. People do miserably at understanding odds. One miilion to one is precisely that: most likely NOT you.

    That’s the same cognitive vulnerability that leads people to believe in bloodletting, homeopathy, acupuncture, MMS etc.. The gaming machines I mentioned are carefully designed to exploit these vulnerabilities using a combination of speed of play, stake and perception of ‘near wins’. There’s a huge amount of psychological research on this, mostly looking at addiction. It annoys me because there used to be laws in the UK that limited the stake and potential win, but they were changed a few years ago, due to pressure, I suspect, from the gambling industry.

  137. #139 JGC
    June 25, 2013

    As an acupuncturist I see dramatic results with my clients each and everyday.

    For what non-self-limited illnesses and injuries, based on what objective metrics, and compared to what control population?

    I mean, if it does work as advertised surely there’s something more you can point to in the way of evidence than “Well, on the basis of personal experience I’m convinced it works”

  138. #140 Agashem
    Hungrily waiting for the party to start
    June 25, 2013

    I have to address Emily above at number 80: seriously, Emily has not been to a hospital and believe that drugs are the leading cause of deaths in a hospital. This assertion irks the hell out of me because most patients in hospital are well over 65 years old and have multiple issues that require attention (e.g. diabetes, cardiac insufficiency, high blood pressure, etc, etc) all which need to be managed. And sorry, acupuncjunk is not going to make one whit of difference. Volunteer at your local hospital Emily and see who is there and what your useless needles would be good for (hint: nothing)

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