What’s the harm? Cupping edition

There are so many ridiculous alternative medicine treatments being “integrated” via “integrative” medicine into medicine, no matter how ridiculous they are, that it’s not only hard to believe, but it’s hard to keep track. Homeopathy is, of course, the most ridiculous, although “energy medicine” definitely gives homeopathy a run for its money in the Department of Stupid. The depressing thing is that most physicians, even “integrative medicine” physicians, know that homeopathy is bunk (at least when they even know what homeopathy is—most think it’s just herbal medicine). However, those same physicians don’t mind naturopathy, thinking it nothing more than—you guessed it—herbal medicine, never realizing that you can’t have naturopathy without homeopathy and that homeopathy is an integral part of naturopathic education and practice. In other words, you can’t embrace naturopathy without embracing homeopathy. Apologists for alternative medicine and “integrative medicine” physicians often ask, “What’s the harm?”

Among the silliest of alternative medicine therapies is something called cupping. Cupping is a prescientific, premodern medical practice based in the philosophy of traditional Chinese medicine (TCM) that involves sticking cups on a patient’s skin under suction n order to make them better. Basically, cupping involves heating the air inside of a cup and placing the inverted cup on some part of the body. Thanks to the wonders of physics, as the air in the cup cools, it contracts and produces a vacuum, which produces suction. (Physics geeks, I know that’s a highly simplified explanation. Just go with it.) As is the case with acupuncture, in TCM it is believed that disease is due to blockages or incorrect flow of qi, which is the TCM equivalent of the “vital force” or “life energy.” Acupuncture posits that by sticking needles into specific points in “meridians” through which qi flows the flow of qi can be unblocked. Cupping is much like acupuncture in that it, too, claims that it unblocks and realigns qi, thereby restoring health.

Proving that no woo goes uninvented anywhere, cupping is not unique to TCM. As has been noted elsewhere, Native Americans throughout North America also used wet cupping as a means of blood letting, although it is unknown how long ago they started the practice, using animal horns. In fact, unlike acupuncture, cupping is truly an ancient practice. The ancient Greeks practiced it, and Hippocrates himself used it. There is documentary evidence that cupping was practiced in ancient Egypt as far back as 1,500 BCE. So, using the appeal to antiquity, cupping must be the greatest thing since sliced bread, which it predates by millennia. Obviously.

There are two forms of cupping. “Wet cupping” involves puncturing the skin before applying the suction cup. (Yes, that’s basically what cupping is, applying a suction cup.) The idea is that this will allow the “poisons” or “toxins” to be sucked out of the body by the cup. Dry cupping omits this step. There are also other methods besides relying on the cooling of heated air to produce suction, such as using a pump to to siphon air out of the cup. These days, glass or clear plastic cups are commonly used, in order to allow monitoring of the skin. Given that, you’d think that harm would be very, very difficult. You’d be wrong.

Witness this story from Australia, Popular treatment known as ‘cupping therapy’ leaves man with seven holes in his back:

A MAN has been left with seven holes on his back after undergoing cupping therapy that went horribly wrong.

The man identified as Li Lin, 63, began taking the treatment every day from May to June in the hope of treating his scapulohumeral periarthritis — more commonly referred to as “frozen shoulder”.

He was told the therapy, which has a history of several thousand years in traditional Chinese medicine, would help with the pain and stiffness and allow him to move freely.

The treatment, known in Chinese as “ba guan”, traditionally uses heated glass cups to create local suction on the patient’s skin, causing circular bruising that is believed to be the result of now mobilised and free-flowing blood.

However, instead of having his condition cured, the man from Chengdu, capital of southwestern China’s Sichuan Province, was left with holes on his back that were essentially very serious, deep burn wounds.

This is what the article is talking about:

Cupping burns

I’m a general surgeon. During my residency, I rotated on the burn unit a number o ftimes, during the last of which I was the chief resident there. I know burns. Looking at that picture, I can say that those are some nasty burns, particularly the middle two. They look at least full thickness.

What do I mean by full thickness? Burns, as you might know, are categorized as first, second, and third degree. First degree burns are basically of the sort that just causes redness. Second degree burns are partial thickness, and third degree burns involve the full thickness of the skin. Take a look at that picture again. As a trained general surgeon who has extensive experience with burns, I see burns on Li Lin’s back that can only be described as third degree or full thickness.

How could such burns have come about? Remember, the cups used were almost certainly heated before being placed on Li Lin’s back. However, these wounds probably aren’t thermal burns because the cups usually aren’t heated enough to cause thermal injury, at least if the practitioner is not completely incompetent. A hint of how this could happen is in the story about Li Lin:

Lin said he went for the treatment every day, and his therapist placed the cups in the same position on his back.

After 10 days he reportedly began to notice blisters on his back, but convinced the treatment would cure his aching shoulder, Lin asked his wife to remove the blisters so he could continue the therapy.

Two days before the scheduled end of his treatment, however, Lin started experiencing severe pain on his back and also developed a high fever.

A trip to the doctors then revealed horrifying circular wounds on his back that had started to fester.

The suction from cupping breaks capillaries, which is why not infrequently there are bruises left in the shape of the cups afterward. Think of it as a hickey, which is basically what cupping is: Making hickeys without the fun part. If you repeatedly injure the same area of skin over time, the way the TCM practitioner did to Li Lin by placing the cups in exactly the same place over and over again, the skin there can actually die. In a burn, the skin dies due to fire, but anything that kills the outer layers of skin (the epidermis and dermis) can look and behave like a burn. Lin is not entirely innocent there; he started to get blisters, and a blister is a sign of a second degree burn, now more commonly described as partial thickness burn because it involves the partial thickness of the dermis. In other words, it was an indication that significant injury had occurred, and continuing the cupping the way he did could well have turned a partial thickness burn into a full thickness burn. Given that infection of the burn is the most common (and potentially deadly) complication in patients with major burns, it’s not surprising that Li Lin’s burns got infected. He’s lucky he didn’t become septic.

Oh, wait. He did. His high fever was almost certainly due to sepsis from burn wound infection.

You’re probably thinking: So what? This is just China and maybe a few New Age Gwyneth Paltrow types in the US and Europe. Would that it were just that! Cupping is showing up everywhere, from “integrative” medicine programs in academic medical centers to our very own Department of Defense:

The Army has been using acupuncture to treat post-traumatic stress disorder, despite a lack of evidence that it works. And now it is hiring acupuncturists for its pain clinic at Fort Sam Houston at an annual salary of $68,809 to $89,450. The job description says the candidate will “offer a full array of the most current and emerging evidenced based approaches in integrative medicine for patients with acute and chronic pain who have not responded well to conventional treatment modalities.”

One could argue that acupuncturists have nothing “evidence-based” to offer in the first place, but what is really alarming are the duties listed for the position. They include things acupuncturists are clearly not trained to do, like prescribing orthotics and braces and counseling patients on nutrition. Worse, the duties include providing cupping, moxibustion, and visualization techniques, none of which are effective and two of which directly injure patients. Cupping is the application of glass bulbs filled with heated air to the skin. It creates a vacuum as the air cools, sucking up wads of skin into the bulbs and leaving ugly bruises. Moxibustion involves burning mugwort on or near the skin and can cause burns and permanent scars (and does so deliberately in some forms of moxibustion).

Clearly, our soldiers suffering from PTSD deserve better. They deserve real medicine.

Cupping is nothing more than an ancient medical practice based on a prescientific understanding of the body and disease, much like bloodletting and treatments based on the four humors. As the case of Li Lin shows, it’s all risk for no benefit. It has no place in modern medicine, or at least shouldn’t. After all, we don’t still believe in the four humors that Hippocrates and ancient “Western” medicine invoked for many hundreds of years. TCM is based on much the same concepts, just with different names, substituting, for example, the Five Elements for the Four Humors and attributing disease to imbalances in them, just as ancient Western physicians attributed disease to imbalances in the four humors. Yet “integrative medicine” rejects one and embraces the other when it should be rejecting them both.

Comments

  1. #1 MI Dawn
    July 1, 2016

    I was the “demonstration body” for fire cupping (as noted above, using a flame to heat the glass cup before it’s placed on the body). While the heated glass felt good on my skin – the demonstrator was very careful to monitor skin temperature and the heat of the glass – the cupping sensation did nothing for me. To be honest, I found it unpleasant, so the cups were removed after only a few minutes. I had minimal marks that lasted a short time; though a friend did note some mild bruising in a few locations the next day, I didn’t feel it.

    I know several others who say the sensation is relaxing or erotic, depending on the placement of the cups. They use either fire cupping or suction cupping. But none of them believe it will cure any illnesses. It’s done purely for enjoyment.

  2. #2 The Smith of Lie
    July 1, 2016

    Wow, that takes me back. Cupping used to be standard of care in Polish hospitals few decades back. I remember the tales of my grandma using cupping in her work as a nurse. Hell, as a child I got cupped few times “cause it is good for you and will suck out the sickness”.

    To be honest I think she didn’t even know what the mechanism is really supposed to be, she was just taught that you do cups and so she did. However I don’t remember when I last heard about cupping as viable therapy (or at all). Which I choose to interpret as sign of the therapy being dropped by hospitals.

  3. #3 Pris
    The Dark Side of the Force
    July 1, 2016

    I need to take an ECG every year.

    And the electrodes my GP uses are inherited from the previous owner of the practice, so likely older than I am.

    The consist of metal half spheres with a rubber thing at the closed end to produce suction.

    So getting an ECG is paired with cupping, so to speak.

    I bruise easily and since my skin is so pale it is translucent I look like I’ve been attacked by a giant squid for a few days afterwards.

    That’s the only thing the suction does for me.

    Aside from that I always end up cursing the freezing cold metal when the electrodes are placed.

  4. #4 Eric Lund
    July 1, 2016

    Some of the cooking I do involves glass pans in a 350 degree F oven. It takes a while for the glass to cool to room temperature afterward–I usually put it on a towel on the counter to minimize the danger of cracking due to thermal stress. Until it has sufficiently cooled, I can only handle the glass with hot pads, due to the obvious burn danger..

    From the description of how the glass is heated for cupping, it sounds unlikely that the cups get as hot as the glassware in my oven does. But that strikes me as a likely failure mode of this so-called therapy.

    Cupping is nothing more than an ancient medical practice based on a prescientific understanding of the body and disease, much like bloodletting and treatments based on the four humors.

    AFAICT, wet cupping is exactly a form of bloodletting, using suction cups instead of leeches to draw the blood out. I think I’d rather deal with the leeches.

  5. #5 MI Dawn
    July 1, 2016

    @Eric Lund: I can’t speak for all types. The cups used on me were fairly thick glass but not, AFAIK, the type of glass you could put into an oven.

    The demonstrator put the flame inside the cup and around the edges for maybe 5-10 seconds. I don’t think, in my case, the cups got warmer than 102-104 degrees; the suction was more due to the heated air than the heat of the cups.

    They certainly didn’t get hot enough that he couldn’t hold them with his bare fingers nor did I feel they were too hot when I touched them (he had me feel the first cup with my fingers to show me how warm/hot it was and to check if I felt it was too warm.)

  6. #6 Orac
    July 1, 2016

    That’s why I don’t think it’s the heat that causes the burn. It’s the repeated suction disrupting the blood supply of the skin and causing necrosis (death) of the epidermis and dermis.

  7. #7 Panacea
    July 1, 2016

    Although I’m sure the heat didn’t help.

    Wow. Those are some nasty burns. He probably needed skin grafts.

  8. #8 jrkrideau
    At the bottom of the lake (the bottom end that is)
    July 1, 2016

    Heck, if you did not have PTSD before you got to that army base, you’d leave with it.

    #4 Eric Lund
    Some leeches are actually beneficial—used for debriding. IIRC they are a certain kind of European leech and there are strict guidelines on raising them. You’re a lot better off with the leeches, well some brands anyway.

    Don’t try anything with leeches from your local pond.

  9. #9 Double Shelix
    July 1, 2016

    Oy. Speaking of PTSD, i’ve had a couple of 2nd and 3rd degree burns myself from chemical spills at work. One was just last November. That photo definitely sent my brain down a very dark hole just now. I can’t fathom people doing that sort of damage to themselves willingly 🙁

  10. #10 Alia
    July 1, 2016

    @The Smith of Lie #2.
    I underwent cupping as a child in Poland in 1980s and early 1990s. My mother was a nurse, so she administered the cups herself. They weren’t very hot and they were put only once during the whole course of my illness (usually cold), leaving just circular bruises. And then I had to spend at least 2 days in bed because otherwise “your cupping marks would get cold and that’s very, very bed”. So, bed rest combined with natural course of the illness meant that I felt better after cupping and I believed in it at that time.
    And then, there was one more thing. It was either cupping or antibiotic. Intramuscular, because as a child I would vomit all oral antibiotics, I couldn’t help it. Considering most of my childhood illnesses were probably viral, I guess cupping _was_ better then antibiotics, although I would be best with just bed rest and plenty of liquids.

  11. #11 Helianthus
    July 1, 2016

    @ Orac

    It’s the repeated suction disrupting the blood supply of the skin and causing necrosis

    *iiick*
    I was unaware of this possibility.
    I was initially thinking the poor guy got somehow his skin carroted by the cups. Necrosis by interrupted blood flow is a more sneaky mechanism, but that would explain why the guy didn’t see it coming. I don’t think you can be burned by glass hot enough to sear your skin away and ignore it.

    @ Eric Lund

    AFAICT, wet cupping is exactly a form of bloodletting, using suction cups instead of leeches to draw the blood out.

    Cupping was indeed one of the Renaissance medicine’s stereotypical treatments aiming at “detoxifying” the four humors, along bloodletting and enema.
    While leeches were used to draw blood, I think that “ventouses” (suctions cups) were more of an all-purpose treatment to magically draw out all types of bad humors.

  12. #12 Denice Walter
    July 1, 2016

    Oh J-sus!

    A few weeks ago- as part of my gift-funded foray into TCM- I experienced cupping as the grand finale of my third ( and final, thankfully) treatment.

    The practitioner ( I think) heated the cups first and applied them along the merid… I mean, in a line that connected the parts of my leg that hurt. I believe that there were about 15 of varying sizes from mini fishbowl to a tall 1 liter jar. Several of them really hurt because they ‘pulled’ the skin and those are the ones which left marks.

    And what marks they left! It looked as though I had been ‘involved’ with an octopus in an indecent manner. I was a bit worried because I was scheduled to take a trip where I would ( hopefully) go swimming in a rather posh environment.
    Fortunately, the worst marks were hidden by the bathing suit and the lesser ones were practically gone by the time I got to the hotel ( 1 week later).

    Did cupping help? NO no no. It made it hurt worse than it did before I experienced the woo altho’ briefly. It probably serves as a distraction from the original pain.

    Of course, the faithful might ask about how I feel NOW after the culmination of the treatments. I would add that about 2 weeks have passed, I take anti-inflammatories ( recently, a lot less) and do mild physiotherapy. I was able to self-navigate airports, ferries, rental cars, hotel pools and city streets at my destination.

    As I’ve noted previously, I do believe that the initial treatment of acupressure (? tui na?) that preceded the first acupuncture treatment *did something* that helped. Immediately. But that was a bout all.

  13. #13 Denice Walter
    July 1, 2016

    Oh and there was some ( inadvertent) bloodletting because one of the needles during the first treatment bled all over the paper table cover.

  14. #14 Heidi_storage
    July 1, 2016

    OT: People on this site, please tell me you don’t agree with the recent EU ban on claims that drinking water can lower your risk of dehydration. I read what seemed to me to be a really stupid article defending the ruling:

    https://www.theguardian.com/science/the-lay-scientist/2011/nov/18/1

  15. #15 Eric Lund
    July 1, 2016

    It looked as though I had been ‘involved’ with an octopus in an indecent manner.

    I am told there is an entire genre of Japanese pornography along those lines. Given Rule 34, I am willing to believe that (and for obvious reasons am not about to go Googling it from my work computer). I hope that wasn’t the intended effect, and that any release you signed didn’t cover film rights.

  16. #16 Denice Walter
    July 1, 2016

    @ Eric Lund:

    I know. There was something about the genre on a travel show I watched which showed many examples of the art form.

    I really appreciate both old and new Japanese culture but sometimes I don’t understand it. Harajuko girls I understand though. Any big city has a form of them.

  17. #17 Denice Walter
    July 1, 2016

    That should be HARAJUKU

  18. #18 Jazzlet
    July 1, 2016

    @ Heidi_storage

    Five years ago is hardly ‘recent’. So wy are you bringing it up now?

    And the ruling makes sense, all it is saying is that manufactuers can’t say ‘drinking this bottle of water will cure dehydration’ because the context the bottle of water is drunk in will affect dehydration, the body also needs salts etc etc etc.

  19. #19 Selina Spence
    United States
    July 1, 2016

    Seems I’ve seen then be useful in draining cysts and boils and things like that fairly effectively by regular people not wanting to go to a doctor. Sometimes it’s because they can’t afford it. I think in draining something it might be a good short term fix but it’s just going to happen again. Aside from that and people using them for pleasure yeah it does nothing.

  20. #20 JustaTech
    July 1, 2016

    I remember reading that cupping was a form of treatment at monastic hospitals back in the middle ages in Europe. Yeah, no thanks. I’d skip pretty much everything from a monastery except maybe the chanting.

    Eric @15: That form of Japanese erotica started as a way to get around the censorship laws.

    Denice @16: That was a great episode!

  21. #21 Robert L Bell
    July 1, 2016

    What can it hurt?

    Under perfect circumstances, maybe yes maybe no maybe third degree burns.

    Out in the wild, maybe a woomeister lets it drop when rebuffed. Or maybe she pulls back when her husband says “I’m a scientist, and I know that crap doesn’t work so stop it” only roar up with her mother and her uncle (the Traditional Chinese Medicine Doctor) when her husband is on his death bed and has no strength to resist.

    Did she kill him? Did he die from the shame? We don’t know.

  22. #22 Robert L Bell
    July 1, 2016

    #20 Surely you fancy a spot of the old Bishop’s Finger, perhaps even the Grand Chartreuse.

  23. #23 JustaTech
    July 1, 2016

    Robert: Eww, no! Maybe someday I’ll develop a taste for those medicinal liquors, but not now.

    Brother Cadfael mysteries, yes, everything else, nope.

  24. #24 Robert L Bell
    July 1, 2016

    #23 Let me suggest, in a spirit of “hail fellow, well met,” that the one gave us “Nun’s Delight” as a Bywater shibboleth while the other gave us “Wandering between two worlds, one dead, The other powerless to be born.”

    Forty years I have been wandering, trying to bring a scientifically literate and economically enlightened Left into being in this America. Maximum Likelihood Forecast says that I will fail.

  25. #25 doug
    July 1, 2016

    I had a look round the toobz for photos of cups. Given the design of many and how deeply a glob of flesh is drawn in, it wouldn’t surprise me if they not only damage capillaries but occlude larger vessels.
    Question for MDs and pathologists: If cupping does occlude larger vessels, would there be a risk of thrombi forming during the cupping and and continuing to restrict blood flow even after the cups are removed? There could be some nasty consequences to venous thrombi that floated off to parts unknown (and subsequently unknowing).

  26. #26 The Smith of Lie
    July 2, 2016

    I had a chance to talk with my grandma today. She explained supposed mechanism of cupping as “foreign protein”. It is supposed to bring up… well I guess something, inside the body up and then have it re-assimilated as a “foregin protein”. Which then helps somehow.

    Well at least I know it was w woo-babble and not straight up prescientific vitalism that made her believe in them. Not that much beter, but it’s the small mercies…

  27. #27 Art
    July 2, 2016

    IMHO the biggest reason these application of woo seem to work, as in producing a therapeutic result, comes entirely from the fact that humans are social animals and it feels good, and relives stress to be touched in a caring manner.

    We like going into pleasantly decorated room that is relatively quiet. We like to have people come in and express concern. We like being the center of attention. We feel reassured by someone who is firm and resolved to help us, even if what they do is somewhere between useless and dangerous. The actual mechanism is largely, except where it is destructive, meaningless.

    People have long gone to hair dressers, barbers, beauticians, massage parlors, brothels and manicurists to help themselves feel better. A friend of mine goes to the spa when she is stressed. A few hours later she is relaxed and ready to face life, and she has a well cared for nails, top and bottom, a new hairstyle, and a glowing complexion.

    De-stressing is important for health. Or at least it is when the mechanism isn’t causing tissue damage and poverty.

  28. #28 Old Rockin' Dave
    July 2, 2016

    I know that eastern European Jews brought the practice with them. My mother remembers seeing my grandfather getting cupped for lumbago (Last time you heard that word used instead of ‘lower back pain’?). They used heavy glass cups in the shape of a flattened sphere with a very thick rim. The cups were not directly exposed to flame. Instead a red-hot iron poker or similar substitute was held inside the inverted cup. I’m not sure but I think that the thickness of the rim and the fact that only the air inside the cup was directly heated would have reduced the risk of burns.
    If you want to see cupping being done watch “Zorba the Greek”. Actual cupping was done on Lila Kedrova for that scene.
    [Incidentally, that movie heads up the Old Rockin’ Dave All-Time List of the Greatest Movies Ever Made.]

  29. #29 Daniel Corcos
    July 3, 2016

    You think this is harm? What is the harm compared to what stupid people can do with conventional medicine? Treating patients requires a certain level of intelligence, and the scandal is that many people allowed to take care of people don’t have it.
    If they do conventional medicine, they do medical “errors”. We must acknowledge that there is a cost of drugs when they are not used properly, when doctors are stupid and/or greedy. When people are stupid enough to believe in CAM, the first question to ask is: why are they allowed to take care of people? The second question is: is it a bad thing they use CAM instead of medicine? Those who prescribed diuretics for treating obesity frequently used CAM also, but CAM did less harm than diuretics.

  30. #30 Old Rockin' Dave
    July 3, 2016

    PZ Myers, having an inordinate interest in everything cephalopodian/cephalopodic/ cephalopoidian/cephalopedic (?), from time to time addresses matters tentacular in conjunction with human body parts.
    At the link he offers a short but entertaining video that tells everything you need to know about tentacle porn:
    https://freethoughtblogs.com/pharyngula/2016/05/14/tentacle-porn-is-all-my-fault/

  31. #31 Sara
    July 3, 2016

    I don’t even understand this diagnosis. I had a frozen shoulder last year and understand that it is typically called adhesive capsullitis. If this involved the scapula, it might entail another problem I’ve had, which is extremely rare: entrapment of the suprascapular nerve. That can be only be definitively diagnosed by EMG. Long personal histories about both problems, but I wonder whether this physician really understand what his problem was.

    Remember that “physicians” in China need only the equivalent of a nursing degree–four years of undergraduate training in a specific clinical area–to be credentialed as “doctors” there. Thank you, Cultural Revolution, Mao, and the paucity of real medical care during that time that necessitated this extreme corner-cutting.

    We had several people like this at my last university who supposedly had solid medical training. They were qualified to be lab techs acc. to our criteria.

  32. #32 Alain
    July 3, 2016

    Heidi_storage@14,

    Why do you don’t think I said some months ago that somewhere close to 8 litre of water would kill me and that no one here contested that comment. Would it be because the dose of anything could make the poison, even water?

    Al

  33. #33 Alain
    July 3, 2016

    8 litres of water in a day that is.

  34. #34 The Smith of Lie
    July 4, 2016

    @Daniel Corcos

    Just because airplanes sometimes crash it does not validate flying carpets.

    Medical error do happen and they can result in death or permanent harm. But at the same time there are two things conventional medicine has going for it.

    One, if it is done right it actually works. Unlike woo, which “done right” at best won’t actively harm the patient, but it won’t help him either. Which for conditions that are not self-limiting may be dangerous.

    Two, there are standards of care and systems of oversight in place, that aim at minimizing any and all harm that may come to patient from medical errors. CAMsters can and do whatever they want all willy nilly, generating much greater risk of outcomes such as this.

    Finally the cases like the one presented by Orac in this article illustrate that the trope of “what’s the harm” that is often used to defend CAM therapies is flawed. There is real risk in following them and even if anecdotal, stories such as this one illustrate it well. Obviously not everyone who uses cupping will end up with such burns. But if there is no therapeutically value of such intervention even a minimal risk outweighs benefits.

  35. #35 Daniel Corcos
    July 4, 2016

    The Smith of Lie
    “Just because airplanes sometimes crash it does not validate flying carpets.”
    If the pilot is not able to drive a plane, I prefer that he drives a carpet. My point is that all pilots should be able to drive a plane, and that doctors should not treat patients if they are not able to understand the logic of disease and the rationale of treatment. CAM therapists are the tip of the iceberg.

  36. #36 The Smith of Lie
    July 4, 2016

    @Daniel Corcos

    You are aware that your arguments are not entirely relevant to the point of article?

    Imagine now the headline “Man convinces 8 people to jump from the roof of Empire State Building in attempt to fly away on a magic carpet.”

    Would you rebuff comments lamenting gullibility of people falling for magic carper ride by saying “But airplanes crash and people die in those too!”

  37. #37 Helianthus
    July 4, 2016

    @ Daniel

    My point is that all pilots should be able to drive a plane, and that doctors should not treat patients if they are not able to understand the logic of disease and the rationale of treatment.

    IOW, that professional people should know what they are doing.

    And your point posting this, in an article about some health care provider who obviously didn’t know what the heck he was doing?

    Also, I would point out that there is a difference between an incompetent doctor and an incompetent CAM provider.
    The first one had have a chance to learn to do things right, if the medical school curriculum and training was any good. Sure, we could improve lots of things, but the potential was here.
    The latter, by learning a trade based on outdated or unscientific treatments, never had that chance. It’s a dead end.
    In short, a few incompetent doctors may be diplomed by medical schools; but all CAM therapists are incompetent by nature.

    CAM therapists are the tip of the iceberg.

    True. But magical thinking is pervasive, and all the efforts by CAM therapists to “integrate” with mainstream are pushing medicine in the wrong direction, making its shortcomings worse.
    You cannot advocate for doctors to better understand treatment rationals and simultaneously don’t worry that they have to learn nonsense like acupuncture meridian lines or homeopathy.
    Just for this, CAM is an important target to battle down.

  38. #38 Daniel Corcos
    July 4, 2016

    @ Helianthus
    “You cannot advocate for doctors to better understand treatment rationals and simultaneously don’t worry that they have to learn nonsense like acupuncture meridian lines or homeopathy.”
    Well I hope there is no teaching of acupuncture or homeopathy in medical schools. If there is, that would mean that all the teaching is dubious.
    @ The Smith of Lie
    Your example could work only with Darwin award candidates.

  39. #39 Dangerous Bacon
    July 4, 2016

    Daniel: “You think this is harm? What is the harm compared to what stupid people can do with conventional medicine?”

    The following applies to CAM in general, but ask yourself: What’s the harm in people following useless and potentially dangerous alt med, while ignoring real solutions to significant medical problems?

  40. #40 Daniel Corcos
    July 4, 2016

    @ DB
    I agree with you, the main harm is not to have the best treatment, but, then again, it is highly unlikely that a doctor practicing CAM would be able to deliver it.

  41. #41 Ben
    United States
    July 4, 2016

    @#29, Daniel Corcos

    I think what you are saying is that if an aspiring medical doctor isn’t cut out for medicine, they’d do less harm as a CAM practitioner than as a sub-standard medical doctor, is that correct?

    I suppose that’s arguable (though DB in #39 raises a good point about why that might not actually be true), but I think an even better scenario would be if those people were prevented from practicing in any sort of healthcare profession of that caliber, to whatever extent is feasible.

  42. #42 Daniel Corcos
    July 4, 2016

    @ Ben
    I agree with you, but medical schools need to deliver degrees, doctors must make money, and so on. Or may be we should question the economic model of medical schools.
    For the rest, if people still want to deal with quacks that do not have an MD, it is their responsibility..

  43. #43 Vicki
    July 5, 2016

    “Doctors must make money” is the same kind of argument that leads to “but if we ban this fraudster from the securities industry, he won’t be able to find another job.”

    In both cases, that means something like “the person won’t be able to find another well-paying, respectable upper-class job.” If a person who has gone through medical school isn’t competent to treat patients, there are a huge variety of other jobs out there, ranging from stocking supermarket shelves to medical editing.

    I realize that incompetent doctors don’t want to give up the pay and prestige of medicine, but that doesn’t justify their risking patients’ health or even survival.

  44. #44 Calli Arcale
    http://fractalwonder.wordpress.com
    July 5, 2016

    JustaTech:

    I remember reading that cupping was a form of treatment at monastic hospitals back in the middle ages in Europe. Yeah, no thanks. I’d skip pretty much everything from a monastery except maybe the chanting.

    How about the beer? 😉

    Daniel Corcos:

    If the pilot is not able to drive a plane, I prefer that he drives a carpet. My point is that all pilots should be able to drive a plane, and that doctors should not treat patients if they are not able to understand the logic of disease and the rationale of treatment. CAM therapists are the tip of the iceberg.

    Well, that’s why the FAA has strict rules over pilot licensure. Pilots must undergo a specifc number of hours of training, including sufficient hours in a simulator and sufficient hours in the cockpit, a specific number of takeoffs and landings with an instructor, and so forth before they can receieve their pilot’s license. After that, there are additional credentials for things like multi-engine aircraft, jet aircraft, and particular models of aircraft. There’s also extensive testing, performed on a regular basis, and they must pass a medical exam regularly to maintain their certifications.

    This doesn’t guarantee, for instance, that your pilot won’t respond to a flameout by shutting down the good engine by mistake, as happened just last year on a flight out of Taipei, resulting in a dramatic crash captured on the dashcams of passing motorists. But it’s why air travel is vastly safer than, for instance, driving.

    State medical licensing boards have strict standards for physicians here in America. As with the FAA requirements for commerical pilots, these standards ensure that physicians undergo rigorous training and exams and many hours in residency before they’re turned out as independent physicians. It’s far more extensive than the training required to be licensed as an acupuncturist, which in many cases is comparable to the training required for a tattoo artist. Sure, they *can* get more training, but it’s not required for the license. A medical license does not guarantee no mistakes will be made, nor even that the doctor in question is not a lying, thieving scumbag. (See also: Burzynski.) But it greatly improves the odds your practitioner will actually know what they’re doing. An acupuncturist, well, you know from their license they’ve at least been informed of the local health codes and should be wearing gloves and usign clean needles. That’s about it.

    So, going back to aviation, while we know not all pilots are good, and some are downright evil (see also: the Germanwings crash last year, in which the copilot committed suicide and took the entire aircraft with him), the licensure process weeds out the vast majority of these. Go on the roads, and the drivers probably aren’t blind, and managed to pass a basic skills test when they were 16.

    I know where my odds are better. 😉

    I do see your point, though, that the world would be safer if, for instance, the Germanwings pilot had been driving a car instead of a jet. I think the system we have is working pretty well. A few bad pilots do get through, but the vast majority have to find some other career because they are weeded out by the testing and training.

    As far as CAM therapists being the tip of the iceberg — well, that is somethign Orac has written about before, in his articles on “quackademic medicine”. And maybe this aviation comparison is helpful. Could we regard quackademic medicine as analagous to airlines making dangerous decisions in the name of increased profit? Things like creative scheduling to squeeze maximum productivity out of flight crews, compromising rules intended to ensure they get enough sleep. Maintenance shortcuts that save time and money but maybe aren’t as effective. It’s not a direct parallel, but from a management perspective, probably rather similar. Stuff that improves the bottom line but maybe if they thought about it a little longer isn’t something they should be doing if they really put their clients’ wellbeing first.

  45. #45 Marry Me, Mindy
    July 5, 2016

    This is a different type of cupping than what Martin Gardner discussed in Fads and Fallicies, then?

    I think there it was cupping your eyes to improve vision, but I don’t think it was suction cupping, just covering.

    At least I’d sure as hell hope it wasn’t suction cupping on their eyes.

    It’s been a while since I read that book though

  46. #46 Chris
    July 5, 2016

    Marry Me, Mindy: “I think there it was cupping your eyes to improve vision, but I don’t think it was suction cupping, just covering.”

    It has been a while since I read that book too. Also Amazon preview does not have a search function. I think the cupping of the eyes was in the discussion of the Bates Method:
    https://en.wikipedia.org/wiki/Bates_method

    I have severe myopia and the type of astigmatism that meant the only contact lenses I could use where weighted down soft lenses, called “toric” lenses. And they were a pain.

    I got very annoyed at people who would tell me that it was my fault because I did not do proper eye exercises. Sorry folks, it is genetic. My brother, mother and I could borrow glasses from any of the three of us.

  47. #47 Narad
    July 6, 2016

    At least I’d sure as hell hope it wasn’t suction cupping on their eyes.

    Temples, according to The Art of Seeing (not recommended by Huxley).

  48. #48 doug
    July 6, 2016

    I’ve had suction cups on my eyes! They left rings of red from broken capillaries. They held my eyeballs motionless while the laser burned neat rings in my lens capsules then a waffle pattern in the lenses.

  49. #49 Chris
    July 6, 2016

    Yikes, doug! Was that laser therapy to correct your vision?

    My sister, who has the same genetics towards myopia, had that done. She now has to use reading glasses to see anything less than half a arms length away.

    Our father had perfect vision until he hit his forties… then he said he either had to reading glasses or longer arms. My youngest has apparently inherited those genes from him, she does not need glasses.

    I, on the other hand, value my near sight capabilities. As I near my sixties I like that all I have to do is remove my glasses to read a good book. I also sew without my glasses since my myopia acts like a magnifying glass for near things.

    One reason why I gave up hand embroidery (which I did quite well) is that I spent too much time on the fine details that no one else could see. When I am using one tiny strand of embroidery floss to accent an owl’s wing, I knew that it was a bit too much… and I was only eighteen years old. I decided then to stick to a sewing machine. Especially since I had calculus and physics finals to study for!

  50. #50 Helianthus
    The meaning of life is just escaping me
    July 6, 2016

    @ Daniel 42

    medical schools need to deliver degrees, doctors must make money, and so on.

    Chicken and eggs, Daniel.
    None of those are of any issue if medical schools are any good at forming reasonably good doctors. That stays true for any professional branch, actually.

    Also, medical schools have some reputation to have a high dropout rate during the first years. That’s not exactly the behavior of institutions only in for giving diploma away.
    I will grant you these are not the dropout rate of Spetsnaz training. But do we want those? Could we afford a higher dropout rate?

    Now, if you want to provide reasons for the statu quo, you may also point out that the society at large is clamoring for more nurses and physicians, rightly or wrongly. There is definitively some pressure on healthcare schools for churning out more specialized workers.
    Actually, that’s one of the reasons for the popularity of CAM. It’s not so much that regular doctors are bad, rather than there is a lack of man-hour resources: a lot of people would like more doctor time – again, for good or bad reasons.

    may be we should question the economic model of medical schools.

    Well, question away, no-one is stopping you.
    Your modus operandi is to say “pish-posh, this or that is worthless”. PhD are worthless, medical schools are worthless, scientific papers are worthless…
    For a change, why don’t you propose us a fix, instead of general and meaningless “we shouldn’t rely so much on this”?

    For the rest, if people still want to deal with quacks that do not have an MD, it is their responsibility..

    Funny how it is our responsibility to have good doctors, scientists, or airplane pilots, but everything else could take a hike.

    So when I become old and frail, with half my wits gone to Alzheimer (and having not much to start with), and some con-artist knock at my door to sell my a bridge in Arizona, it’s my sole responsibility to tell him no.
    Got it.

    Be sure to tell Li Lin this – you know, the guy whose harm you dismissed so lightly in #29 (again, something you found worthless).

  51. #51 doug
    July 6, 2016

    Chris,
    My story is rather like yours. I used to be very near sighted, with no astigmatism and both eyes requiring nearly identical correction. When I was young, I could focus to about 4-5 cm from the end of my nose, which I found quite useful, but without my glasses I couldn’t swear the things at the ends of my legs were feet. By the time I got to mid-fifties, I lost some of the myopia and a good deal of accommodation, but I got by quite nicely with two pairs of conventional bifocals – my “indoor” pair and my “outdoor” pair. Then things went to hell.
    It started with vitreous separation in my right eye (tends to happen earlier for those with significant myopia). It wasn’t too bad except for a relatively large “floater” that is pretty annoying at times (it really isn’t a floater – it travels within definite bounds). Then my “good” left eye started to change very rapidly, requiring a big change in prescription (more negative lens) and even that wasn’t all that helpful. I noticed one evening when there was a full moon that without my glasses the moon looked like a ring of disks instead of one that was out of focus – I was developing a fly eye, it seemed.
    The laser was the first step in removal of my lenses. The waffle pattern makes it easier to chop up and ultrasonically liquefy the lens with an ultrasonic tool. This is standard cataract surgery, except many surgeons open the lens capsule by actually tearing a hole with forceps after making an initial cut with what is essentially a modified fine hypodermic needle (process called capsulorhexis). Overall: stab access wounds through cornea just at edge of sclera, inject “viscoelastic” goop to keep workspace full, make the hole in the front of the capsule, free the lens from the capsule, spin the lens to be sure it is free (I could “see” this bit), break the lens into quarters then suck out each piece, clean up any leftovers, insert the lens implant, inject some antibiotic, and its all done – about 20 minutes. I had only topical anesthetic – drops for the laser work, lidocaine gel for the stabby part, and more lidocaine (I think) injected with the viscoelastic before breaking the lens – the latter because the iris is sensitive). The greatest discomfort was from the eyelid speculum press against my nose bone.
    I opted for some expensive Baush & Lomb implants that were supposed to allow some reasonable degree of natural accommodation, but I got zero benefit over standard implants that would have cost me nothing (covered by Alberta Health Care). $6000, like my natural lenses, down the drain. Very, very disappointing. I now have nearly 20/20 distance vision, but can’t resolve much at less than 1.5 metres without glasses. For close work, things have to be at exactly the right distance for sharp focus. It impacts use of binoculars and microscopes.
    I then developed vitreous separation in my left eye. Its main floater is a ring, so I have a built-in beanbag toss game – ring in left eye, beanbag in right; if I practiced, I could probably get the beanbag to appear to go through the ring.
    The separations carry risk of causing retinal detachment early on, but that risk drops dramatically with time. I still have very minor flashing lights, but they’re almost gone.

    I called a provincial health info line to get advice on what to do after the first vitreous separation. The nurse to me I should go to emergency – not “immediately” but in the next hour or so. This was hours after the event. There is nothing that can be done unless there is retinal detachment, then haste is critical.

    Tip: getting home on a day with fresh snow and bright sun is not a happy-making thing when you forget your sunglasses and your pupils are dilated to the max. Everything looked pink when I got in, presumably because I’d depleted my “blue chemicals”.

  52. #52 Daniel Corcos
    July 6, 2016

    @ Helianthus
    You don’t understand my point. There is a real problem with evaluation: if a PhD or MD really believes in homeopathy, there is something wrong with the selection process. If an institution gives value to a nonsense paper, there is a serious problem in evaluation. We all know that degrees are hard to get, and papers difficult to publish. However, if degrees do not relate to intelligence, and scientific papers have nothing to do with science, we must change our system accordingly.
    And, if we cannot make science work properly, I don’t see how we can influence the rest of society.

  53. #53 Alain
    July 6, 2016

    I’m the unlucky sod who will soon need reading glasses as well as far sighted glasses (these one I do wear since I’m 10 years old, I’ll be 40 in September). Furthermore, I need a metric ton of lighting to see well. Can’t adjust to the dark…

    Alain

  54. #54 Chris
    July 7, 2016

    doug: “..said some really scary stuff…”

    AAAARgh! I will stick to my several pairs of glasses, thank you very much. I have a few pairs of the variable lens strength types, a computer version and swim goggles.

    As I said before, I value my close up vision so I will not have any kind of optical surgery. Hey! I can crawl into bed and read without my glasses, so all is well in the world.

  55. #55 DLC
    July 7, 2016

    Once upon a time there was a movie called “Mark of the Vampire”, in which a murder is carried out by someone who mimics a vampire bite by using a needle and a heated wine goblet. http://www.imdb.com/title/tt0026685/?ref_=nm_flmg_act_48

  56. […] Edit: Orac has of course written a great blog post on cupping: What’s the harm? Cupping edition […]

  57. #57 Unidades Imaginárias
    August 8, 2016

    […] Scienceblogs:What’s the harm? cupping edition […]

  58. […] Scienceblogs:What’s the harm? cupping edition […]

  59. […] le fait remarquer le chirurgien David Gorski sur le site Science Blogs, les blessures de M. Li ont l’aspect de brûlures au troisième degré. C’est sérieux, et […]

  60. #60 Hem
    Earth
    August 8, 2016

    That is very obviously a photoshopped picture. Not to say the author photoshopped it but the thing is clearly shopped.

  61. #61 Dr. Zin
    August 8, 2016

    This is a picture of a failed procedure. You dont get burns woth this type of treatment. It leaves circular hickies typically. This journalist is a hack going for shock value and not posting a bit of research citations. Which makes this post unreliable. Don’t buy into negative hype people. Do your own research.

  62. #62 Orac
    August 8, 2016

    Oh, goody. The news from the Olympics has brought the quack apologists here defending cupping.

  63. #63 JustaTech
    August 8, 2016

    OK, Dr Zin @61, I’ll bite. What does the glass bowl style cupping do that I can’t do with my own mouth suction?

    Does anyone else remember that game you played as kids, where you would suck on your wrist really hard to give yourself a “watch”? (Also known as a big hickey.)

    Anything that was popular with the monks of Medieval Europe isn’t going to be popular with me.

  64. #64 Mephistopheles O'Brien
    August 8, 2016

    This is a picture of a failed procedure.

    Which is precisely what it says in the news article from Australia which Orac quoted from: “A MAN has been left with seven holes on his back after undergoing cupping therapy that went horribly wrong.”

    BTW – which of you is correct? Is it Dr. Zin who claims this is a picture of a failed procedure or Hem who thinks it’s obviously Photoshopped?

  65. […] liked an article at Motherboard on the various Olympic placebos. This year it’s cupping (please see Orac on this–only look at the second photo if you are not completely squicked out b…); 4 years ago it was brightly colored tape, and before that it was magnets. And there is a […]

  66. #66 Michael Kay
    Brooklyn, NY
    August 8, 2016

    This is an example of extreme incompetence and malpractice. Cupping should never treated daily on the same spot. Besides, the practitioner should have been paying attention to the affect.
    Cupping is an effective form of therapy, but must be practiced properly by a licensed professional.

  67. #67 monica
    August 8, 2016

    Has anyone here tried cupping?

    Why would a swimmer do it if it didn’t work?

  68. #68 Nar
    https://narciblog.blogspot.com
    August 8, 2016

    Why would people wear magnetic bracelets if they didn’t work? Why would people do crystal therapy if it didn’t work? Why would people make the sign against the evil eye if it didn’t work?

  69. #69 Chris
    August 9, 2016

    monica: “Why would a swimmer do it if it didn’t work?”

    Because he does not know any better?

    Why would we expect a swimmer to look up PubMed indexed studies on the efficacy when we are sure he does not even know that a medical study index even exists?

  70. #70 Mmetzler
    Chicago
    August 9, 2016

    If anyone wants to consider cupping, please first watch the scene in the film 1994 Oscar-winning film “The Madness of King George” in which it’s shown being used. If you’re still a fan of 18th century medicine after that, feel free to waste your money.

  71. #71 Narad
    August 9, 2016

    Does anyone else remember that game you played as kids, where you would suck on your wrist really hard to give yourself a “watch”?

    No.

  72. #72 Mr. B
    Hawaii
    August 9, 2016

    Guys, you have the Olympic marks all wrong. The reason those guys swim so fast is that (during practice only, of course) they are pursued by giant octopi. The marks are from the times that they -almost- were not fast enough to escape, not from cupping.
    And the extra bonus from my explanation: It could maybe perhaps be slightly plausible that it would work (by providing some serious motivation!), as opposed to the practice discussed above.

  73. #73 monica
    August 9, 2016

    Maybe it is Chris that doesn’t know any better?

    Have you ever been cupped before? Or do you believe everything you read on PubMed?

    If you do, I have an Obokata Study to show you.

  74. #74 monica
    August 9, 2016

    Deaths from Cupping [1999-1014] = 0
    Deaths from Opiates [1999-1014] = 165,000

  75. #75 gaist
    August 9, 2016

    monica, unless you’re arguing that cupping and opiates used medically treat the same thing, comparing those two numbers are meaningless.

    Deaths from inhaling daisies = approximately 0
    Deaths from traffic accidents = a lot bigger number

    See?

    I’ve had cupping done to me twice by a professional, both times as an alternative to traditional massage, in China. Curious ergonomics at the office I was working there left me with a knotted muscle between the shoulder blades, where my usual stretching regime not my girlfriend couldn’t reach.

    Did it help? The first time I thought so. The second time, only for a couple of hours. My completely amateurish take is that it increases blood flow and maybe, mildly stretches underlying muscles (maybe – skin is thick and elastic layer between). If this is what it takes to help you, plus you expecting it to, cupping can be helpful. For almost all the other things they promise (like the flu, which big posters in that Chinese massage parlor proclaimed it would cure), I doubt it.

    Would I use it to control pain after serious surgery? Absolutely not, whereas (doctor prescribed) opiates…

  76. #76 Helianthus
    August 9, 2016

    Why would a swimmer do it if it didn’t work?

    The French (Quebecois?) Metronews article pingbacked above is making an interesting point.
    Apparently, the usual way cupping is applied is right after a nice, relaxing massage.
    I will posit a daring hypothesis: it’s the massage, and then laying still for half an hour afterward, which provides most of the observed benefits.

    Sidenote: the reporter is using the English word “cupping” where any French older than me knows perfectly well we are talking about “ventouses” (suction cups).
    Using this latter word in French makes it a loss less sexy and a lot more like wearing your grandmother’s moth-eaten dresses.

    Or do you believe everything you read on PubMed?

    No.
    But it beats believing everything your personal guru / witch doctor tells you.

    Deaths from Cupping [1999-1014] = 0

    Let’s ante the game a bit, shall we?
    Let’s add the years 2015-2016, so we can talk about the Chinese guy Orac was talking about in this thread.

    He didn’t die, but since he got harmed and infected following incompetent cupping, I will put him in the columns “harmed by cupping ” and “saved by mainstream medicine”.

  77. […] promoting it as though it works, even though there is no evidence that it does. In fact, there is evidence that cupping can cause harm. That’s what irritates me. Just because an Olympic champion like Michael Phelps believes that […]

  78. […] than review the evidence here, I refer you to a thorough takedown of cupping written last month by Orac, a well-known science blogger who is also a […]

  79. #79 Deb
    Uk
    August 9, 2016

    I have cupping done on my knee. The cups are not heated, the acupuncturiest just uses heat to remove the oxygen. I told him I bruise easily so he keep a strict eye on things. I only have it done once a week and the marks are gone within hours. I would also add that the general medical profession has harmed me so much more than any alternative medicine practitioner ever has. If the medical profession would accept alternative therapies instead of try to debunk them then there could be more regulation and protection. A lot of people get a lot of help and support from alternative medicine where general medicine lets them down.

    • #80 Orac
      August 9, 2016

      The cups don’t have to be heated to cause damage. In fact, it’s rare for burns to occur due to cupping. It’s the suction and the breaking of blood vessels because of the suction that can cause damage. When done repeatedly, this damage can result in full thickness skin necrosis, as described above. Such full thickness skin necrosis is, for all intents and purposes, a full thickness burn, with the same potential complications and the same treatment required. Damage short of full thickness skin necrosis is, for all intents and purposes, a bruise. The same result could be attained by hitting the same area hard enough.

  80. […] They’re cupping to, they imagine, improve their performance. Orac has the rundown on the pointless wickedness of the practice. […]

  81. #82 Angela
    Wisconsin
    August 9, 2016

    This is clearly done from a poorly trained professional. All professions have them EVEN SURGEONS! Because surgery is always 100% successful? No it is not. Traditional Chines Medicine dates back 5000 year. It helps thousands for people worldwide. USA does zero research for our veterans. Look at the studies done worldwide and you will see. TCM help everyone with no side effects. Western Medicine should do its proper research. Many doctors recommend TCM BECAUSE IT HELPS AND WORKS. At least the doctors whom abide by Hippocrates oath, and DO NO HARM!

  82. #83 Elizabeth
    United States
    August 9, 2016

    I had cupping done to my back. It wasn’t anything like the cupping in this article, with cups repeatedly put in static places over and over. The cups were not heated (just the air inside them, which took all of five seconds). After they were applied to my back, the (state-licensed) TCM practitioner slid them over some parts of my upper back (muscular portions, not spine). It felt delicious, like the best massage ever only better (because no pushing/digging sensation).

    Afterwards my shoulder felt much better. It was looser, and I had more range of motion. The bruising was minor, and went away in about a week. The effect lasted, and I wondered if maybe–possibly, didn’t go research this–breaking a small amount of capillaries then caused my body to flood the area with white blood cells and allt he other goodies necessary to fix them back up…and maybe the presence of all that stuff in the ouchy area (the reason I had the area cupped) helped to fix it up a little bit too? Random thought, again, not claiming this is any type of science.

  83. #84 Rod Wilson
    Connecticut
    August 9, 2016

    Until now the only time I’ve heard of using suction medically is for penis pumps. I know they dont work ( not that I’ve ever tried one) but now I’m wondering if anyone’s seriously injured their penis by using one. I can almost imagine their penis turning necrotic and falling off…which would be a very big disappointment for the user.

  84. #85 andrew
    United States
    August 9, 2016

    ‘Think of it as a hickey,’

    Woohickeys.

  85. […] the harm? Cupping edition, Respectful Insolence am 1. Juli […]

  86. #87 Helianthus
    August 9, 2016

    @ Angela

    And another fact-free post…

    TCM help everyone with no side effects.

    For starter, a few TCM remedies are using parts harvested from wild animals, such as bears and tigers. The way the bear’s bile is collected is pure torture, any western scientist doing it would be send to jail.
    But I guess animals don’t count.

    As for doing no harm, TCM has a few entries on the What’s the harm website.
    Not exactly a success story.

  87. #88 gaist
    August 9, 2016

    Traditional Chines Medicine dates back 5000 year.

    And up until the last century (at least), so by your count 4900 of those years they* believed consuming elemental mercury would extend life – if done in sufficient quantities even immortality! No doubt IT HELPS AND WORKS, like you so candidly put it.

    Several emperors demonstrably died from mercury toxicity. What was it you said? Do no har- sorry, DO NO HARM. EXCLAMATION POINT.

    But surely it’s not because mercury is bad for you, nooo, it’s because those skeptical emperors didn’t manifest the correct “physiological intent to recover”…

    * at least some of the practitioners.

  88. #89 Tenfold Shrew
    August 9, 2016

    Well, atleast the Chinese Emperors didn’t inject mercury into infants like so many pediatricians.

  89. #90 gaist
    August 9, 2016

    Tenfold Shew. Do you think water is flammable?

    Because that’s what your argument basically comes down to.

    Oxygen is requirement in burning, and hydrogen is extremely flammable chemical. Now for the big the really really big question: What is water made of?

  90. #91 gaist
    August 9, 2016

    requirement for burning.

  91. #92 Tenfold Shrew
    August 9, 2016

    Gaist, You make no sense at all.

    You are trying the element≠molecule gambit and that does not work for thimerosal and mercury. You are insulting my intelligence and making yourself look ignorant.

    Try a better one please.

  92. #93 gaist
    August 9, 2016

    You’re mistaking elemental mercury for ethylmercury

  93. #94 gaist
    August 9, 2016

    And as for my 4900-years….

    It seems 5000 is a nice round number.

  94. #95 Tenfold Shrew
    August 9, 2016

    @You’re mistaking elemental mercury for ethylmercury

    Only literally; for the sake of brevity. But guess which one is better at crossing the blood brain barrier?

    Elemental mercury would bond to the tissues faster, so ethyl mercury has a better chance at reaching the brain.

    Plus, the lipophilic ethyl group gives another mechanism why ethyl mercury is better at crossing the BBB. We all know that lipophilics cross easier; this is a well-know concept of pharmacology.

    Organic mercurials are more neurotoxic. I can cite studies if you are ignorant enough to doubt this.

  95. #96 gaist
    August 9, 2016

    Only literally; for the sake of brevity.

    I noticed you describing marketing spiel as “scientific” in the other thread… Maybe aim for precision next time?

  96. #97 Chris
    August 9, 2016

    monica: “If you do, I have an Obokata Study to show you”

    PMID please. And each PubMed indexed article must be read with a critical eye. To understand why please read Snake Oil Science: The Truth About Complementary and Alternative Medicine by R. Barker Bausell Ph.D.

  97. #98 Chris
    August 9, 2016

    Tenfold Shrew: “Elemental mercury would bond to the tissues faster, so ethyl mercury has a better chance at reaching the brain.”

    Citation needed. Argument from blatant assertion is not sufficient, so please post the verifiable scientific documentation to support your statements.

  98. #99 Tenfold Shrew
    August 9, 2016

    OK: http://acb.sagepub.com/content/43/4/257.full.pdf

    You can see in Table1 that parenterally delivered ethyl mercury was found in a much higher concentration in brain tissues than parenterally delivered inorganic mercury on autopsy.

    The difference is highly significant.

  99. #100 Narad
    August 9, 2016

    Traditional Chines Medicine dates back 5000 year.

    An impressive assertion, given that actual Chinese writing is about 2000 years shy of that figure, which kind of bolloxes the “traditional” part.

  100. #101 monica
    August 9, 2016

    And another one for Chris: http://www.ncbi.nlm.nih.gov/pubmed/17080402

    The results showed that the level of mercury was higher in the liver and kidney of the inorganic mercury group than in the thiomersal exposed group. However, the brain and blood concentrations of mercury were higher in the thiomersal exposed group.

  101. #102 Chris
    August 9, 2016

    Now while one of the paper is downloading on the hotel’s wifi, can someone tell me what mercury has to do with the validity of cupping?

  102. #103 Chris
    August 9, 2016

    Monica’s downloaded first, and it seems you need lots of ethyl mercury to cause damage. Methyl-mercury is more dangerous. And this has to do with cupping being valid how?

  103. #104 Chris
    August 9, 2016

    And the other one was a study in rats. I believe the most recent SafeMinds sponsored paper supersedes that one:

    Environ Health Perspect. 2015 Jun;123(6):579-89. doi: 10.1289/ehp.1408257.

    Examination of the safety of pediatric vaccine schedules in a non-human primate model: assessments of neurodevelopment, learning, and social behavior.

    I still don’t understand what it has to do with cupping. And if it about vaccines, it is a moldy fifteen year old argument. Kind of like a weird appeal to antiquity, which is exactly what claiming that Chinese traditional medicine works because it is old is all about (and still wrong).

  104. #105 monica
    August 9, 2016

    See #97 Chris. You challenged the assertion that ethyl mercury would cross the BBB easier than elemental mercury.

    It has been shown that etHg does indeed cross the BBB easier than inorganic mercury.

    Stop prevaricating Chris.

  105. #106 monica
    August 9, 2016

    You asked for proof and you got it.

    Mercury toxicity doesn’t change in 15 years Chris!

  106. #107 Chris
    August 9, 2016

    Actually I was challenging the bit about metallic versus ethyl, and both papers show ethyl is safer. Plus thimerosal was essentially removed from pediatric vaccines fifteen years ago, so it is an old stale argument.

    Still you both are trying to hijack a cupping thread to something else, so I suspect sock puppet trolls.

  107. #108 doug
    August 9, 2016

    I might believe that cupping, if not done to excess, would be akin to use of a counterirritant. And cupping has the added “benefit” of being theatrical, what with the flaming of the cups by the recipient’s personal attendant, whereas rubbing in some Bengay or Absorbine isn’t nearly so flashy.

  108. #109 monica
    August 9, 2016

    Liar Chris. You said: Tenfold Shrew: “Elemental mercury would bond to the tissues faster, so ethyl mercury has a better chance at reaching the brain.”

    Citation needed. Argument from blatant assertion is not sufficient, so please post the verifiable scientific documentation to support your statements.

    And both studies showed that ethyl mercury was deposited in the brain at a higher rate than inorganic mercury.

    And then you said: and both papers show ethyl is safer.

    Safer than what Chris? Both papers show that ethyl mercury has a higher affinity for the brain than inorganic mercury.

    How is that safer?

  109. #110 monica
    August 9, 2016

    Do you expect people not to read the studies and find out how idiotic you are?

    Summary of what just happened
    Chris: Cite Studies
    Monica: OK, here they are
    Chris: Well actually, they say the opposite of what you said
    Monica: No Chris, you are an imbecile. They say exactly what I had said.

  110. #111 Chris
    August 9, 2016

    Again, what does mercury in any form have to do with cupping?

    I see that Tenfold Shrew has already been banned as a mercury obsessed sock puppet. Dear little monica is following suit. So this is a lovely song for her/him/it:

    Trollin’ Trollin’ Trollin’
    Trollin’ Trollin’ Trollin’
    Trollin’ Trollin’ Trollin’
    Trollin’ Trollin’ Trollin’
    Rawhide!
    Trollin’ Trollin’ Trollin’
    Though the threads are swollen
    Keep them comments trollin’,
    Rawhide!

    Move ’em on
    (Head em’ up!)
    Head em’ up
    (Move ’em on!)
    Move ’em on
    (Head em’ up!)
    Rawhide!
    Cut ’em out
    (Paste ’em in!)
    Paste’em in
    (Cut em’ out!)
    Cut ’em out
    Paste ’em in,
    Rawhide!
    Keep trollin’, trollin’, trollin’
    Though they’re disaprovin’
    Keep them comments trollin”,
    Rawhide
    Don’t try to understand ’em
    Just rope, laugh, and ignore ’em
    Soon we’ll be discussin’ bright without ’em

  111. #112 Quackery Is Everywhere
    August 10, 2016

    […] Any unnecessary burns and bruises are preferably avoidable, and on some occasions the procedure can go wrong. But mainly, I think that the bilking of money from anyone, Olympians or otherwise, for a placebo […]

  112. #113 gaist
    August 10, 2016

    I like that this:

    ethyl mercury was less neurotoxic than methyl mercury. Moreover, in two victims who died from ethyl mercury poisoning, blood mercury concentrations were 15.0 and 15.5 mg/L,91 which is three times the 5 mg Hg/L level found in fatal cases of methyl mercury intoxication in the same country.89 The difference between the kinetics of the two alkylmercurials has been demonstrated in animal experiments. Given identical doses, more total mercury is deposited in the brain of mice,82 rats 86 and monkeys 87 after the administration of methyl mercury than after ethyl mercury. The concentration of inorganic mercury was much lower in the brains of methyl-mercury-treated rats than in those of rats given the same dose of ethyl mercury. The methyl-mercury-treated rats suffered brain damage, whereas rats identically dosed with ethyl mercury had no brain damage. The dose of ethyl mercury had to be increased to the borderline of a lethal dose to elicit some brain damage.86

    (emphasis added)

    …was in the link the latest sock puppet lambasted as proof that thimerosal was so terribly dangerous.

    monica, how many flu vaccines does one have to get to reach close to those 15 mg/l values of ethyl mercury?

  113. #114 Lucius Willson
    August 10, 2016

    What amazes me is the amount of people who don’t know a photoshop when they see one. The above picture is a photoshop of a popular facebook meme that has been going on for years called; fear of holes or Tryphobia. The top three “burns” are actually lotus seed heads with the color distorted and blurred.

  114. […] is “improper” cupping: cupping that isn’t done by experts on pampered athletes. Over at Respectful Insolence, Orac points out some of the dangers, as in this man in China who tried cupping to help a form of […]

  115. #117 penga
    August 10, 2016

    In a country that pumps patients full of pills to treat and mask the symptoms versus trying to get to the root of the problem, you want to say ” although “energy medicine” definitely gives
    homeopathy a run for its money in the Department of Stupid.”

    What is stupid is fat lazy fucks who cannot comprehend eating a proper diet. No, Pizza is not a fucking vegetable, but I am sure the writer of this article will argue that it is.

    What is stupid is that as a society you want to toss a pill at an issue and when the pill causes more issues, you throw more pills at it.
    not to mention the list of side effects that come with each adn all the interactions.
    So I am sorry that I cannot get past the first paragraph because the author feels the need to interject their opinion rather than stick to facts.
    I will be more than happy to run the numbers with the author on how many iatrogenic cases there really are and why the “american methods” of treating illness have failed, but yet people still treat doctors as gods even as they are loaded up on pills and their organs are slowly being eaten away.
    Yay America, first in obesity, first in cardiovascular issues and first in incarceration. boy that sounds like a place to be happy to brag about being from and oh the politics as well….. trump and clinton…. ya’ll are screwed…..

  116. […] voy a entrar en disquisiciones sobre el nivel de evidencia científica de este abordaje (con tan poco tiempo para hacer los deberes eso se lo dejo a blogs […]

  117. #119 gaist
    August 10, 2016

    What is stupid is fat lazy fucks who cannot comprehend eating a proper diet. No, Pizza is not a fucking vegetable, but I am sure the writer of this article will argue that it is.

    Are you sure it’s the right forum you’re commenting on?

    So I am sorry that I cannot get past the first paragraph

    Ah.

    I think your basic mistake is thinking “energy medicine” is about calorie intake and diet.

    But thank you for trying. Better lick next time.

  118. #120 Narad
    August 10, 2016

    What is stupid is fat lazy fucks who cannot comprehend eating a proper diet. No, Pizza is not a fucking vegetable, but I am sure the writer of this article will argue that it is.

    Are you sure it’s the right forum you’re commenting on?

    The only question left is whether “penga” is also in fact fat, but I doubt that it can be relied upon to settle the matter.

    It’s a bit long for a Phildo attempt.

  119. #121 JustaTech
    August 10, 2016

    gaist @119: “Better lick next time.” – Given that this is an article on cupping (hickies) that’s the best typo ever!

  120. #122 Bill Gibbs
    August 10, 2016

    Why do you only focus on the energy medicine aspect? Cupping, especially as used by athletes, is more of a myofascial treatment. Or did you leave that out because it doesn’t fit your narrative?

  121. #123 Akira
    August 11, 2016

    We need to ask Chris Hickie. The is the authority on hickies.

  122. #124 The Vicar
    August 11, 2016

    Just a footnote: cupping is not a Chinese “alt medicine” treatment… or, rather, not JUST Chinese. Medieval Europeans did it too, as part of the “4 humours” theory of medicine which you mention at the end of the article. In one of his books, the late neurologist Harold Klawans describes treating a patient in the 1970s or so who was brought to the hospital in a state of confusion (with amnesia, among other things) as a result of the fever he got from an infection which he treated with cupping. (I think it’s in the book Newton’s Madness, although it could be another one.) (It’s also remotely possible that it was actually the late Oliver Sacks, whose books are somewhat similar, who wrote about it. Not having the books in front of me, I can’t be 100% certain.)

  123. […] July 2016, Orac posted in ScienceBlogs. "What’s the harm? Cupping edition". He used his expertise as a surgeon to explain the appalling wounds that can be produced by […]

  124. […] topic of discussion recently with some defending there use for some, such as elite level sport, and others have have questioned there worth and the potential harm they can […]

  125. #127 TR
    Los Angeles
    August 12, 2016

    This is bullshit. Standard western medicine is just one of many technologies in a whole pantheon. If you’re down for adverse reactions to Big Pharma meds and many times ludicrous, outrageous (and money-making) surgeries, then be my guest. Stay on that one narrow medical track.

  126. […] more here: NYT CBC David Gorski Steven […]

  127. #130 Tanveer
    India
    August 20, 2016

    Cupping is a pro inflammatory procedure under controlled environment.which triggers immune system to work by activating antibodies,and releasing toxin’s from interstitial spaces ,and decompression by displacement of stagnant lymph .

  128. #131 Tanveer
    India
    August 20, 2016

    Cupping is a pro inflammatory procedure under controlled environment.which triggers immune system to work by activating antibodies,and releasing toxin’s from interstitial spaces ,and decompression by displacement of stagnant lymph fluid .

  129. #132 Chris
    August 20, 2016

    Tanveer, that is some darn fine argument by blatant assertion full of lots of fancy science words arranged to make it pure nonsense. Well, I am sorry but there is not reason to believe what you have written.

    Try harder, only with extra coherent data and evidence.

  130. #133 flewk
    August 21, 2016

    Cupping is pretty good at temporarily removing pain, especially soreness as much of that is related to lactic acid. All cupping does is suck fluids from the body and promote circulation.

    Cupping, much like other parts of TCM, is actually evidence based. The problem is that the evidence was collected in a haphazard manner over thousands of years. The evidence is not centralized nor the proper technique. Cupping can have immediate effects on localized pain if used correctly; the problem is no one actually knows what the proper method is since there is no central repository of cupping knowledge.

    Same thing for acupuncture pretty much. While “qi” may not exist, blood and lymph certainly do. Improving circulation tends to help with a lot of ailments simply because the body has evolved to take care of itself. Any help you can provide to make transportation go smoother is probably good.

  131. #134 gaist
    August 21, 2016

    Cupping can have immediate effects on localized pain if used correctly; the problem is no one actually knows what the proper method is since there is no central repository of cupping knowledge.

    Not a very strong endorsement, in my humble opinion, if the effectiveness is a crap shot. I mean, buying lottery tickets might make me a millionaire, or make millions lose their change.

    All cupping does is suck fluids from the body and promote circulation.

    What fluids and where do those fluids go? (with dry cupping). From my two experiences, on first one I remember being surprised there wasn’t any condensation, on the second time there was been some, as the room was really really hot, but no more than I’d expect sweating out from a coffee cup sized area of skin.

  132. #135 doug
    August 21, 2016

    Every time I run across the “stagnation” nonsense, I’m reminded of a character from All Creatures Great and Small.
    “Aye, it’s a daft fella that can’t accept scientific facts, Mr. Harriot. It’s plain as day his beast died of stagnation o’ t’ lungs.”
    Jeff Mallock, knacker

    Far from reducing “stagnation”, cupping does exactly the opposite. While in place, the cup will occlude any efferent flow of lymph or blood, causing stagnation. Furthermore, the damage to capillaries causes red blood cells to enter the interstitial spaces in the tissues. RBCs outside of the vascular compartment have no function. They become scrap that has to be cleaned up. When capillaries are damaged, endothelin, which constricts blood vessels is released, maintaining reduction in blood flow for some time after the cup has been removed.

    … no one actually knows what the proper method…

    which says to me that no one should be doing it

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