As I mentioned yesterday, there are news events involving medicine (more specifically pseudoscience in medicine) that are so ubiquitous and irritating that they’re enough to bring me briefly out of my vacation to bang out a quick post. So it was when I wrote my post yesterday about Michael Phelps’ enthusiasm for cupping, a practice attributed to traditional Chinese medicine that is actually an ancient practice that seems to have been independently thought up in multiple cultures, such as the ancient Egyptians. Basically, cupping therapy is a near-universal practice dating back at least 3,500 years that was commonly practiced until at least the 1800s. Not surprisingly, the very ancientness of the practice is frequently used by advocates of cupping to argue for its efficacy, but I tend to like to turn that argument around and point out that a practice that’s it’s very telling that a practice that’s been around some 3,500 years has so little evidence for its efficacy. That’s plenty of time to prove a treatment works.

Be that as it may, it hadn’t been my intent to revisit cupping after yesterday, but then a reader pointed something out to me, namely how a part of the reason why cupping is now so accepted is because of the embrace of the prescientific medical system known as traditional Chinese medicine (TCM) by some of our most respected academic medical centers as part of “complementary and alternative medicine” (CAM) or, as it’s more commonly referred to, “integrative medicine.” Of course, it is obligatory (for me, at least) to point out whenever discussing integrative medicine that what integrative medicine involves is “integrating” pseudoscience, prescientific mystical beliefs, and quackery into real medicine. Traditional Chinese medicine is, after all, a prescientific belief system that is largely quackery in today’s world retconned by Chairman Mao to seem as though there’s something to it but that did, as many ancient medical systems have, find the occasional gem that actually works. The rest, particularly acupuncture, cupping, and tongue diagnosis, is based in prescientific vitalism.

Athletes, however, are notoriously superstitious. So it’s not too surprising that Michael Phelps and a lot of other American athletes would embrace cupping, particularly given that the US Olympic Swim Team trainer is clearly a believer. However, physicians, particularly physicians at our greatest academic medical centers, should know better. Unfortunately, they do not, which is a large part of the reason why integrative medicine is flourishing. Unfortunately, the Michael Phelps story revealed this to anyone paying attention. Here’s how. Basically, when on Sunday reporters noticed the large, ugly hickeys all over Michael Phelps’ shoulders and back, asked what the heck that was all about, and found out about cupping, they needed “experts” to interview for their stories. Integrative medicine programs all over the country provided those “experts,” who all gave answers that ranged from endorsement to what Kimball Atwood used to like to call the weasel words of woo.

For example, take a look at what Dr. Alex Moroz, director of the Integrative Sports Medicine program at NYU Langone Medical Center’s Rusk Rehabilitation, says in this story in VOGUE:

Dr. Alex Moroz, director of the Integrative Sports Medicine program at NYU Langone Medical Center’s Rusk Rehabilitation, uses cupping at home on himself and his family. He believes there’s wisdom in the ancient practice, as well as common sense. Cupping’s effect, he says, is “mechanical, much like a massage,” and though Moroz has not treated professional athletes personally, he says, “It makes sense that it would work for that group of muscular skeletal injuries and problems.”

One notes that massage doesn’t involve intentionally popping a bunch of capillaries in order to produce a bunch of huge hickeys that, when they get out of hand, can turn into full thickness necrosis of the skin. Yes, this complication is very uncommon, but when there is no objectively detectable benefit to cupping, that makes cupping all risk and no benefit.

Joining the crowd of academic “integrative medicine” specialists, there was a story this story from CBS Newsfeaturing Dr. Adam Perlman, director for Duke Integrative Medicine:

Perlman said he first spotted an Olympic athlete with telltale cupping marks while watching the women’s gymnastic competition this past weekend with friends.

“I was pleasantly surprised to see cupping marks. It really speaks to this level of integration we’re seeing with many things that are considered complementary medicine,” said Perlman, who has tried cupping for back pain and said it gave him relief.

Did you hear that? Dr. Perlman was happy to see Olympic athletes with cupping marks on them because they were evidence of the popularity of “complementary medicine.” Meanwhile, Dr. Robert Glatter, an ER doc at New York’s Lenox Hill Hospital, lays down a load of credulous BS:

“It causes blood vessels to dilate and increases blood flow,” said Glatter, an emergency physician at New York’s Lenox Hill Hospital, who is in Rio de Janeiro for the Olympics.

The aim of cupping is to relieve any blockages in the flow of energy and blood and lead to better recovery, Glatter explained.

“Blockages in the flow of energy”? It would appear that Dr. Glatter buys into the prescientific vitalistic thinking at the heart of TCM. One wonders what he would say if he were to be asked specifically what form of “energy” flow is “blocked” and describe a physiological mechanism that doesn’t involve handwaving and appeals to mysticism by which cupping “unblocks” it. One wonders if Dr. Glatter knows he’s spouting pure bullshit. Indeed, while admitting there’s no good evidence that cupping does what its proponents claim it does, Dr. Glatter joins Dr. Perlman in laying down more of the same:

But both Glatter and Perlman said the ancient therapy isn’t scientifically proven to heal anything.

“There’s no scientific evidence. There are multiple trials out there but no quality evidence. Producing giant welts on the body which basically make you feel better locally but injure local tissue doesn’t have any systemic impact,” said Glatter.

Of course, “integrative medicine” physicians like Dr. Perlman are anxious to claim legitimacy for cupping in light of so many Olympic athletes having shown their enthusiasm for the procedure. Perhaps they see potential new business coming their way. Wait. Scratch that. There’s no “maybe” about it:

If athletes or anyone else in the audience is seeing the alternative therapy and is interested in trying it, they should seek a qualified health expert, said Perlman.

“People should be looking for someone trained in traditional medicine and licensed and trained in Chinese medicine and who has graduated from an accredited school,” he advised, noting that cupping is usually part of a more comprehensive medical approach, used in combination with other therapies.

It’s an approach also advocated by another director of “integrative medicine” in another story about Phelps and cupping in TIME Magazine:

There is a difference between how cupping is practiced in traditional Chinese medicine and how it is used in Western medicine, says Dr. Brent Bauer, director of the Mayo Clinic Complementary and Integrative Medicine Program. Bauer says a traditional Chinese medicine practitioner would likely offer cupping as part of a larger integrative health check, which might include recommendations around nutrition and other health things, and not just as a one-off therapy. “It’s kind of an American phenomena, I think, to consider cupping by itself,” he says.

In traditional Chinese medicine, the theory is that cupping can influence the flow of energy or “qi” through the body, says Bauer. If someone’s flow is blocked or stagnant, a practitioner might use cupping to impact the flow. Western practitioners may focus more on what the therapy might be doing to muscles or blood flow.

Yes, like Duke, the Mayo Clinic has gone all in for quackademic medicine. It has one of the bigger and more prominent “integrative medicine” programs. Be that as it may, it’s amazing how much alike Dr. Perlman and Dr. Bauer sound. It’s also depressing that, even more than Dr. Glatter, Dr. Bauer, who is faculty at one of the most respected academic medical centers in the country—nay, the world!—is spewing vitalistic nonsense as though it were legitimate medicine, with his credulous discussion of “qi.”

The list of once proud and science-based academic medical centers that offer cupping is depressingly long. For instance, the University of Maryland offers it. So does Beth Israel Deaconness. In fact, it’s a pretty good bet that any academic medical center that offers acupuncture and TCM probably offers cupping because cupping is an integral part of TCM. Perhaps the most disturbing and irresponsible media statements on cupping came from the Cleveland Clinic, which, as I’ve described before, has gone all-in with TCM and “functional medicine” quackery. Check out the Cleveland Clinic’s Twitter feed:

Note that this video features a TCM practitioner from the Cleveland Clinic touting the benefits of cupping. The complete video is right here on the Cleveland Clinic media page, which features Jamie Starkey, Lead Acupuncturist, Center for Integrative Medicine:

Yes, you saw it right here. A major academic medical center features on its media website a video showing one of its own employees, the “Lead Acupuncturist,” administering a quack therapy to a patient and touting its benefits for chronic pain and even asthma. (Yes, you heard that right, asthma.) There’s something wrong here, but unfortunately, the Cleveland Clinic apparently doesn’t see it. It gets worse, though.

More disturbing was this Tweet:

Yes, that’s the Cleveland Clinic’s official Twitter account. It’s sort of backing off Starkey’s claim that acupuncture is useful for asthma, while not really backing off. More importantly, in response to numerous requests from other Twitter users for actual scientific evidence supporting the use of cupping, the Cleveland Clinic can’t or won’t provide any. It’s almost as though the Cleveland Clinic knows that what it’s offering in its integrative medicine program is pure quackery but doesn’t care.

Sadly, the overall message coming from advocates of “integrative medicine” quackery is as disciplined and consistent as that of any political party and candidate. In this case, it is: When seeking pseudoscientific or prescientific treatments, be very sure that you only utilize a “qualified” and “licensed” practitioner (i.e., someone employed by Dr. Perlman’s program or other “legitimate” academic “integrative medicine” programs). Personally, I like to characterize this ploy as: Come for the cupping. Stay for the “comprehensive” quackery that “integrative medicine” integrates into real medicine.

That’s the message. Cupping is basically a gateway to the rest of the quackery integrative medicine “integrates” into real medicine.

Comments

  1. #1 GiJoel
    Mobile Command Bunker
    August 10, 2016
  2. #2 Wzrd1
    United States
    August 10, 2016

    Yesterday, I was half tempted to mention that bloodletting still is a valid treatment for hemochromatosis, but honestly, I suspect some of the woo peddlers that have been hanging about would’ve run with it for their usual plethora of things other than iron overload.

    As far as physicians offering woo based treatments, should one offer such to me, well, you’ll see the fastest running physician in the world. Our conditions are serious and nonsensical mistreatments being offered will not be tolerated.

  3. #3 Ellie
    Still on the green side of the grass
    August 10, 2016

    Asthma. Sure. I could combine cupping with some of those nifty homeopathic asthma cures found on the shelves of various drug stores! No more Big Pharma inhalers for me!

  4. #4 Michael Finfer, MD
    Edison, NJ
    August 10, 2016

    I received a letter in the mail yesterday from Memorial Sloan-Kettering inviting me to participate in a clinical trial of acupuncture for insomnia in cancer patients, as if causing pain by sticking needles in me would help me sleep better.

    I have half a mind to send it back with a nasty note.

  5. #5 MI Dawn
    August 10, 2016

    @Dr Finfer: I would, saying, “How would sticking useless needles into cancer patients help me sleep at night?” 🙂

  6. #6 Zach
    August 10, 2016

    The trick is in the language. These quacks talk about how cupping *MIGHT* relax muscles, *MAY* help blood flow. They are admitting that they just don’t know, but phrasing it in a way that most people won’t read into.

  7. #7 darwinslapdog
    The Beagle
    August 10, 2016

    The Chinese divers (women’s synchronized) were covered in tape–all over their backs, some on shoulders. Others had it on their ankles. This was a 10 metre board and I realize they hit the water at 30-35 mph, so I can see the wrist braces, but what does atletic tape (at least it was flesh colored) do for the back? I read up here and at the other blog, and couldn’t find much to support it.

    At least none of them had giant hickeys. Honestly, I can no longer look at Michael Phelps. His greatness is much diminished by his gullibility. I now expect to see cupping offered at mall kiosks along with those Chinese neck massages.

  8. #8 doug
    August 10, 2016

    It causes blood vessels to dilate and increases blood flow

    Prove it, quack. Prove that sucking a gob of flesh into a cup with a relatively thin rim which will result in high contact pressure around that rim does not in fact occlude vessels well above the size of capillaries and actually reduce blood flow. Provide a reasonable hypothesis for how static suction, which might conceivably encourage blood flow “out” of arteries does not prevent blood flow into veins. It can’t simultaneously suck from one and blow to the other.

  9. #9 Ellie
    Still on the green side of the grass
    August 10, 2016

    @7 A local news channel did a piece on the cupping, which, IMO, was just a free advertisement for a PT business that offers it. When I went to their website, lo and behold, I found Rock Tape. It’s kinesiology tape, which is apparently an ancient Japanese secret. The company charges $10 a body part for taping. Perhaps that’s what it was?

    In addition to making athletes perform better, it also cures all kinds of things:
    Achilles tendonitis
    • Plantar fasciitis
    • Jumpers knee (PFS)
    • ACL/MCL issues
    • Rotator cuff
    • Groin and hamstring pulls
    • Lower back issues
    • Shin splints
    • Tennis and golf elbow
    • Pain associated with pregnancy
    • Postural correction
    I haven’t been able to stand up straight in a couple of years. Maybe I need to get taped….after I have the cupping for my asthma.

  10. #10 jrkrideau
    At the bottom of the lake (the bottom end that is)
    August 10, 2016

    #5 MI Dawn
    Perhaps Memorial Sloan-Kettering know he’s a sadist and would get a kick out of it? That warm feeling as you finish your warm milk and cookies just before going to bed?

    The level of irrationality that seems to be overtaking the medical profession is not giving me warm feelings. It’s making me more sympathetic to Wzrd1’s approach.

    When something like the Mayo Clinic is doing this, it gets scary.

    Note to self: Check my doctor’s clinic website before making any appointments.

  11. #11 MI Dawn
    August 10, 2016

    When my eldest was doing sports (field hockey and softball), she had problems with her kneecap dislocating. I forget the actual diagnosis now; it’s been 10+ years. The orthopedist gave her PT, exercises, and taught us to do some specific taping until her muscles were strong enough to keep the kneecap in place. It helped for that purpose, though it was tricky to do. I don’t know if it helps for all the reasons listed above, or was a placebo for my daughter.

  12. #12 Eric Lund
    August 10, 2016

    I have half a mind to send it back with a nasty note.

    Do it. Tell them they shouldn’t be wasting time, money, and manpower on clinical trials of treatments with no plausible mechanism whatsoever.

    That goes for anything involving qi. In real medicine, terms have specific meanings, and while a layman like me may not always be familiar with a given term, I can ask any physician and be reasonably sure I’ll get substantially the same answer as any other physician would give me. Qi, as far as I can tell, does not have a specific definition, so it can mean whatever the speaker wants it to mean. How can we scientifically study what qi allegedly does when the word means different things to different people?

  13. #13 Orac
    August 10, 2016

    Or e-mail the flyer to me and let me look up the clinical trial. Muhahahahaha!

  14. #14 has
    August 10, 2016

    Athletes, however, are notoriously superstitious. So it’s not too surprising that Michael Phelps and a lot of other American athletes would embrace cupping, particularly given that the US Olympic Swim Team trainer is clearly a believer.

    The most plausible explanation is that it sucks all the brains out of their heads, thereby making them lighter and more buoyant.

    It certainly sucks the money out their wallets effectively enough.

    However, physicians, particularly physicians at our greatest academic medical centers, should know better. Unfortunately, they do not, which is a large part of the reason why integrative medicine is flourishing.

    I rest my case. Funny how we never hear alties condemning that corruption in medicine.

  15. #15 Eric Lund
    August 10, 2016

    I don’t know if [taping] helps for all the reasons listed above, or was a placebo for my daughter.

    At least with taping there is a plausible mechanism. Like an emergency splint for a broken bone, it may help stabilize the joint by preventing it from bending too far in a certain direction, which is what a dislocation basically is. I have had occasion to tape certain fingers myself.

    I’m not sure what taping might do for the back, though. If I thought someone’s spine needed it, I wouldn’t let her participate in any kind of athletic competition, for reasons that should be obvious.

  16. #16 Chris Hickie
    August 10, 2016

    Kinesio tape is Ancient Egyptian Medicin (AEM) and here’s proofs: http://basementrejects.com/wp-content/uploads/2013/10/mummys-ghost-kharis-mummy-lon-chaney-jr.jpg . How can you argue against something that works so well that it makes the dead walk?

    Playing high school football I remember after an ankle sprain getting my ankle taped for support. That was nothing like a single piece of this silly kinesio tape. It was much more like a cast, requiring a lot of tape (foam and sticky tape) to basically keep my ankle from inverting.

  17. #17 Scott K
    CT
    August 10, 2016

    Duke Integrative Medicine…appropriate acronym.

  18. #18 Mike
    August 10, 2016

    It’s disheartening to see the quackiness legitimized by real medical institutions. The Duke Center for Integrative Medicine (like any good center for legitimizing nonsense) even has a lawyer teaching a course called “Legal Issues in Integrative Medicine” which seems designed get around those pesky consumer protection laws.

  19. #19 Eric Lund
    August 10, 2016

    Duke Integrative Medicine…appropriate acronym.

    And it would be particularly appropriate to have the Duke University Marching Band perform at any and all of the center’s celebrations.

  20. #20 Denice Walter
    August 10, 2016

    As a recent participant, I believe that cupping caused increased pain- I found it difficult to wait the ten minutes or so until the practitioner returned to remove the bloody, miserable things.

    Perhaps that’s the point: the NEW pains ( caused by cupping) distracts you away from feeling the older pain which prompted you to seek out help.

    Perhaps distraction is the secret of woo in general.

  21. #21 Denice Walter
    August 10, 2016

    That should be: the NEW pain

  22. #22 Science Mom
    http://justthevax.blogspot.com/
    August 10, 2016

    Honestly, I can no longer look at Michael Phelps. His greatness is much diminished by his gullibility.

    I know what you mean. What was even worse was his grotesque display upon winning the 200 Fly.

  23. #23 Denice Walter
    August 10, 2016

    Believe it or not, good old Mikey is still selling cupping supplies ( Natural News/ Store) : a set of four costs 37.95 USD and the gift pack- which includes oil- is 85.95 USD.

    I wonder the oil is for? ( I ask incredulously)

  24. #24 Rich Woods
    THE TRUTH ABOUT QI
    August 10, 2016

    After many years of dedicated, in-depth research, I am now ready to publish my results. All the work I have done, all the analysis and measurement and hard graft, all can now be revealed.

    Count yourself most fortunate, my friends, for here is the truth, the absolute truth which encapsulates all that any intelligent and conscientious person must know about qi.

    Are you ready to hear it?
    .
    .
    .
    .
    .
    .
    Steady yourselves.
    .
    .
    .
    .
    .
    .
    Here we go…
    .
    .
    .
    .
    .
    THE TRUTH ABOUT QI

    It’s an incredibly useful word to know when playing Scrabble.

  25. #25 Mike
    August 10, 2016

    Doing a search now for other quotes from employees of academic integrative medicine programs, I was impressed to see that Barrie Cassileth of Sloan-Kettering was strongly critical of cupping (while still endorsing acupuncture) in a 2014 Wall Street Journal interview:

    There’s absolutely zero evidence that cupping has any kind of positive role in medicine,” said Barrie Cassileth, the chief of integrative medicine service at Memorial Sloan Kettering Cancer Center in New York. She said the post-cupping bruises result simply from the suction on the skin, which may be more harmful to circulation than helpful.

    “I cannot conceive of any benefit except a psychological benefit,” said Cassileth, who has written books on alternative treatments and noted that, unlike cupping, holistic therapies such as acupuncture have been proved effective in medical tests.

  26. #26 doug
    August 10, 2016

    Perhaps that’s the point: the NEW pains …

    I suspect that is exactly what happens. As I posted in the old thread, I could believe that cupping has the same effect as using a counterirritant, with added theatre that just isn’t there when rubbing in some Bengay. It’s the same sort of thing you get if you mash your fingers when your foot hurts.
    Is it on the continuum to self-mutilation?

  27. #27 Gilbert
    August 10, 2016

    Look at the pretty acupuncturist demonstrate the ‘cupping’. Look at the trauma of that lifted flesh:

    https://www.youtube.com/watch?v=Iw3a6pL6u4E

    Blood stagnation. Whatever, it looks brutal — and now all the kids will be doing it; It could be a nepharious world government plot.

  28. #28 doug
    August 10, 2016

    A new article at the CBC website: ‘Very little evidence to support it’: Why some scientists give cupping a poor score.
    I haven’t looked at the comments yet. CBC recently went to a no-psuedonym policy, so many of the more intelligent commenters have departed (while many that remain have obvious pseudonyms).

  29. #29 Chris Hickie
    August 10, 2016

    To me, if parents do this to kids, it should be considered child abuse.

  30. #30 rs
    August 10, 2016

    “I wonder the oil is for?”

    To allow the money in your wallet to slip more easily into his.

  31. #31 stewartt1982
    Oxfordshire/Ibaraki
    August 10, 2016

    @28 doug
    I’ve always commented non-anonymously at the CBC, but between losing my long commenting history due to not having my account linked to social media (had some really nice climate change denial rebuttal posts there that could be mined) and seeing the no-pseudonym policy fail (not that I ever thought it would work once they let their plans be known) my urge to read the comments/post comments has dropped off significantly.

  32. #32 Gilbert
    August 10, 2016

    Here ya go, Chris Hickie; Cupping for kids @1:45

    https://www.youtube.com/watch?v=IH6CWyn63iQ

    I bet the Peter Pump market gets a bump outta this!

  33. #33 jrkrideau
    At the bottom of the lake (the bottom end that is)
    August 10, 2016

    # 28 doug
    RE: CBC comments
    I don’t have time to read them all but Daimon Corston has a great one
    Cupping is ridiculous! What he needs is a couple of lines of rhino horn, then wash it down with bird’s nest soup.

  34. #34 Eric Lund
    August 10, 2016

    It’s an incredibly useful word to know when playing Scrabble.

    I concur on this point.

    For those readers who are unfamiliar with Scrabble, I’ll explain the reasons. First, it’s a two-letter word, and those are handy to know for making high-scoring plays, as you get to count the letter twice–especially valuable with the Q, which (at least in the English language version of the game) is worth 10 points, the highest (along with Z) scoring tile in the game. It’s also one of a handful of words that allow you to play the Q without a U, which is the rarest vowel in the game (there are only four U tiles, not counting blanks; for comparison there are 12 E’s in the game). The others I can name offhand: qanat, qat, and qibla (all three are words of Arabic origin).

    French and Spanish versions of Scrabble probably don’t weight the Q as highly, as that letter is much more common in those two languages. I also don’t know if they have adopted the Pinyin transliteration of qi–in older transliteration schemes it’s usually spelled chi (the Q in Pinyin represents the “forward” CH sound). The French still call China’s capital Péking, so it’s unlikely they have adopted the Pinyin spelling.

  35. #35 Narad
    August 10, 2016

    The others I can name offhand: qanat, qat, and qibla

    “Qabala” is good and admits a plural for a seven-tile play, per Hasbro.

  36. #36 Narad
    August 10, 2016

    ^ “Initial” play, I suppose I should have said (I find the pace of the game tedious with the people I know), but “qabalah” is also good, as well as the plural.

    I guess there’s an obligatory mention of the Chevy Chase film Foul Play here, as well.

  37. #37 Jes
    August 10, 2016

    “much like a massage”…except uncomfortable, possibly painful, probably more expensive… Why not just get the massage, which feels awesome?

  38. #38 JustaTech
    August 10, 2016

    I love how everyone is talking about cupping as a “Chinese” thing when I know I saw a travel show where the host was subjected to wet cupping (the kind that draws blood) in a Finnish spa just a few years ago. (No Reservations)

    Since it’s basically just a hickey, I’m now imagining “I’m such a god cupper they used me at Rio” as a new terrible pick-up line.

  39. #39 Old Rockin' Dave
    August 10, 2016

    I think the most telling point against the alleged value of “Traditional Chinese Medicine” is the millions of death from plague, cholera, yellow fever, malaria, influenza, typhoid, hepatitis, and every other transmissible what-have-you over the millennia, almost up to the present decade.
    Why didn’t they ever work out a cure for any of those when they had 3 or 5 thousands of years to work on them?

  40. #40 Old Rockin' Dave
    August 10, 2016

    Jes, #37:
    Not only does a massage feel awesome, but in cupping there’s zero prospect of a “happy ending”.

  41. #41 rs
    August 10, 2016

    Olympians are overfond of cupping
    and each evening they pair up for spooning,
    …As quacks slither into their confidence
    …with vague promises of a golden ambience
    Athletes are twice primed for forking.

  42. #42 Helianthus
    August 11, 2016

    @ doug #26

    Is it on the continuum to self-mutilation?

    I am thinking so.
    If an athlete, professional or not, is adhering to the “no pain, no gain” motto, a slightly painful ritual before the show may fit right in.

  43. #43 Emma Crew
    August 11, 2016

    @ORD #40 I dunno, I’m sure one could find BDSM porn with cupping-like techniques in it (and the hentai joke’s already been made). Rule 34 and all…

  44. #44 DrBollocks
    August 11, 2016

    I have thought of one useful role for cupping. They are the visible marks of ….er…marks. It means grifters can focus their efforts when attempting to relieve excess cash from people with more money than sense. Saves the rest of us, and grifters, a lot of bother.

  45. #45 JDSAF
    August 11, 2016

    I know this isn’t really related, but I have a picture of something I found yesterday that I think Orac would be interested in looking at and maybe writing a post about. I was out on a walk when I walked by a really stupid sign advertising some sort of reflexology foot massage quackery crap. I don’t know how to send the picture, though. Orac, I think you should look at it and give it your usual insolence, but I have no idea how to show it to you! Um…help me help you?

  46. #46 Science Mom
    http://justthevax.blogspot.com/
    August 11, 2016

    If the US is being made fun of by Brits over their choice of woo, it has to be bad: https://www.theguardian.com/commentisfree/picture/2016/aug/09/ben-jennings-on-the-cupping-of-uncle-sam-cartoon

    • #47 Wzrd1
      United States
      August 11, 2016

      @Science Mom, it’s about time that the UK gives fair play.
      I’ve forever been picking on them over, England, the land who gave the world civilization and blood pudding.
      Even native Brits pause, then laugh. 🙂

  47. #48 Eric Lund
    August 11, 2016

    “no pain, no gain”

    This motto has an often overlooked corollary: No brain, no pain.

  48. #49 Dangerous Bacon
    August 11, 2016

    Jim Thompson has an appropriate cartoon:

    https://thompsonsportsart.com/

    • #50 Wzrd1
      August 11, 2016

      @Dangerous Bacon, while my wife and I have been married for 34+ years and despite certain, general significant medical issues, we’re still quite sexually active together and have successfully avoided various rut times via learning and experimenting.
      We learned, around a decade and change ago about the suctioning cupping method being abused today as medicine.
      We also learned how to utilize it for, erm, marital excitement, utilizing erogenous zones. Some, mutually discovered.
      We’d have written a book, however, we’re both dyslexic and our families would have and still would be scandalized by our vanillaness being so hedonistic. Hell, OPM might not actually recover from the discovery and they know everything else about us (as does China, via the OPM hack).
      Although, usually, we stopped short of the hickey phase of injury, only toying about with the pleasure phase.

      As for a former comment, there is indeed, not only BDSM films on the subject, but more mainstream films. Not a one of which are to our tastes.

      So, yeah, I’m a dirty old man, my wife’s a dirty old lady, with each other.
      Those younger would just call it having fun as a couple.
      Figuring out out, one dysfunction of the body through another. Once we find ridiculous, we’ll seek absurd and abuse that into extinction. 😉

      All, while she’s laying in bed, due to two verterbral fractures, secondary to sever, premature osteoporosis, has an L5-S1 herniation, times 20+ years and ignored by previous providers, lacks a single cervical disc that isn’t impinging upon the spinal cord and creating very concerning symptoms. Me? Osteoarthritis is nearly global, too many years doing combat things in the Army, L4-L5 disc has likely failed after catching her a couple of weeks ago after her gallbladder was removed and her c-section scar failed in the umbilical region, causing significant discomfort (read: pain, sufficient to limit her activities).
      I’m currently using my deceased father’s cane and honestly, I’ve not kept it around out of fondness for him, but because I’ve actually used it while caring for him in his final years, when he became immobile.

      Alas, our cupping set was lost on a move. Still, it was trivial enough to purchase and alter a breast pumping set.
      And a plethora of other things.

      Know that herbal infusion needle used on beef? I use it on lamb. 😉
      And chicken.
      I’d need one of my smaller gauge needles to use it on rat. 😛

      Still, for healing, we go to the physician. Although, personally, for a short stop, should I have a hypertensive period in short term, I do have a tea that used to give me four hours of relief. Lately, not so much, but it still tastes good.
      The latter is far more important to me. Medicinal effect is measured, taste is far more important in foodstuffs. Medicines are far more important, as prescribed.
      All, while annoyed and awaiting a five time repeated request for an ophthalmological referral, to both laser a posterior lens capsule opaccification *and* measure, record and gauge lattice degeneration, first observed in 2009, when I had a trauma related cataract treated.
      And a sixth time requested referral for a separated shoulder, which was injured in 2010.
      For the record, this primary and we first met at the beginning of this year. He’s still not well trained yet with us.

      Some drives don’t vanish with injury and disability. 🙂
      They’re merely adapted around.

      As for this young and fit young man, younger than either of our children, no clue, beyond accepting woo and superstition.
      As for us, I’m considering a cow milking machine, it’ll clear out the basement sump and work additional duty for other usages.*

      *That’s a *really* dirty joke, as we both lack a basement and lack a need for such an absurdity.
      But, we’ve reached some absurdities in negative directions, time to provide TMI.
      Enjoy your nightmares. 🙂

  49. #51 Dangerous Bacon
    August 11, 2016

    And one more (this really needs to be blown up to a larger size, framed and in color for our clinician contributors to display):

    https://www.facebook.com/photo.php?fbid=10154191853576558&set=gm.792762467530402&type=3&theater

  50. #52 Denice Walter
    August 11, 2016

    re doug ( 26):

    Often cats, when experiencing discomfort, lick or bite themselves until they remove fur – & occasionally skin as well.

    I had a large male tabby who ripped out about 30% of his hair when being treated with steroids for asthma. He actually didn’t look bad.. sort of punk rock 1978-ish.
    Cat with a Mohawk.

    • #53 Wzrd1
      August 11, 2016

      @Denice Walter, we still scratch our head over our Russian Blue, who, not long after we moved into our new home (we adopted him while in transit to our new home at a hotel), lost, to the point of appearing shaved, all of his lower abdomen fur, from just above the hips down.
      Finer shaven than a shaving commercial, but grew back over time, at a similar rate to usual hair growth.
      But, the line across his abdomen was surgically straight.

      Hair pulling or exploring someplace with a metal straight edge?
      As he’s lost zero fur since, I have my suspicions.

  51. #54 Gilbert
    August 11, 2016

    we adopted him while in transit to our new home at a hotel

    Your new home was a hotel, or you scobbed the cat from there? A displaced cat can loose fur like that. Cat napper!!

  52. #55 A in Ca
    August 11, 2016

    In June we heard from
    http://shanghaiist.com/2016/06/23/cupping_fail.php
    (and others):
    “After undergoing cupping therapy for a month, a 63-year-old man from Sichuan is feeling the effects, namely seven gruesome marks on his back….”
    (apparently victim was _very_ convinced about cupping benefits, ignoring his pain.
    The best is the ending:
    “You know what might help to relieve the pain from all those marks? A Fujian fire massage session:”

  53. #56 Graham
    August 12, 2016

    Just found an article from January 2015 which discusses the practice and it contains a fairly disturbing statement attributed to swimmer Kayla Hutsell:

    “Hutsell has assured us that the bruises don’t hurt at all. Though they do make quite the fashion statement!”

    The link is below. Interestingly despite the above, pictures of this swimmer with cupping marks seem to be very rare…

    https://www.swimmingworldmagazine.com/news/cupping-therapy/

  54. #57 spike
    August 12, 2016

    Are you sure, that cupping doesn’t have a beneficial effect for muscle soreness for athletes?
    I’m sure cupping is useless for internal ailments (gout and so on), but athletes use massage, external analgesics, ice packs, etc. on their skin. Perhaps irritating the skin with cupping makes muscle soreness less apparent to the athlete, improving performance. This is one case where dismissing things out of hand may be wrong, particularly when you have evidence of the best swimmers in the world winning races following cupping.

  55. #58 Gary(Ivan I)
    Oakland
    August 12, 2016

    The term “cupping” is also used to refer to a procedure for assessing the quality of coffee. Too bad it has been appropriated for this purpose.

  56. #60 stewartt1982
    Oxfordshire/Ibaraki
    August 14, 2016

    @57
    This is pretty thin evidence for the effectiveness of cupping.

    … when you have evidence of the best swimmers in the world winning races following cupping.

    By your own word these are the best swimmers in the world … you might well expect them to win regardless of cupping.

    Michael Phelps, who has drawn the most attention regarding cupping at the Olympics, has won 28 medals at multiple Olympics. If he won medals in the past before cupping, why would you assume he is now winning because of cupping?

  57. #61 stewartt1982
    August 14, 2016

    Blockquote fail … *sigh*

  58. #62 Narad
    August 14, 2016

    I’m sure cupping is useless for internal ailments (gout and so on)

    I’m oddly fascinated by how you arrived at gout as the exemplar here.

  59. #63 Richard Clarke
    August 15, 2016

    Will not work for gout. The best way to stop gout is to simply eat less purines.

    This is a disease of meat-eaters.

  60. #64 Pie
    August 15, 2016

    This is one case where dismissing things out of hand may be wrong, particularly when you have evidence of the best swimmers in the world winning races following cupping.

    What you have seen is evidence that Phelps is a world-class swimmer (cos of the medals) and evidence that he has undergone cupping (cos of the bruises).

    I’d like to point out that in 2004 and in 2014 he was arrested for driving under the influence. Few, if any, of his competetors have been caught driving drunk, and I note that he has beaten them and won an enviable amount of gold medals. Surely you can see the evidence that alcohol combined with irresponsible driving has been a key part of his success?

    • #65 Wzrd1
      United States
      August 15, 2016

      Wow, if I had only been caught driving drunk in my youth, I’d have become world emperor by now!
      Oh well, just as well.

    • #66 Wzrd1
      United States
      August 15, 2016

      Wow, if I had only been caught driving drunk in my youth, I’d have become world emperor by now!
      Oh well, just as well. Being an emperor looks to be way too much work.

  61. #67 KayMarie
    August 15, 2016

    @Pie #64

    Don’t be ridiculous, according to my Facebook feed it certainly wasn’t the drunk driving charges that are the one and only reason for Phelps’ success, we have documentation that he has smoked pot at least once, and it is the pot he smoked that was the performance enhancer!!!

    • #68 Wzrd1
      United States
      August 15, 2016

      @KayMarie #67, indeed!
      Bill Clinton didn’t inhale, all he made was POTUS and Monica, Phelps inhaled and got a body full of hickeys and a bunch of gold medals.
      Although, I can think of more exerting ways to accomplish the former…
      Alas, neither my wife or I are up to that kind of exertion any longer.

      Getting older sucks, but nowhere near as much as not being able to get older. Otherwise, a lot of departed friends would’ve been back to tell me how great dead is and that I should really try it.
      Instead, I’ve only had live people suggest that and honestly, I don’t believe that they had my best interests at heart.

  62. #69 Denice Walter
    August 15, 2016

    re the stone…. athletes and their drug of choice

    I’ve always suspected that snowboarders who won gold medals despite their usage may in fact be accomplishing more than non-smokers. Same with Phelps – they DESPITE being stoned.

    But you never know- perhaps they are just extremely nervous sorts and the drug calmed them down enough to achieve peak performance.

  63. #70 Denice Walter
    August 15, 2016

    they win DESPITE

  64. #71 Gilbert
    August 15, 2016

    we have documentation that he has smoked pot at least once, and it is the pot he smoked that was the performance enhancer!!!

    Yes, KayMarie #64. At the very least, it is a bronchiodilator — good for runners and swimmers.

    But THC, the main mind-altering chemical in marijuana, wasn’t even included in the International Olympic Committee’s banned-substances list at the time (it is now, but at a much higher level than the one he tested at). Rebagliati was allowed to keep his victory and medal. (He is now in the medical-marijuana business.)

    http://www.businessinsider.com/how-marijuana-affects-working-out-2015-1

    After winning the gold, he was found to have Tetrahydrocannabinol (THC) in his circulatory system following a blood test and he was automatically disqualified. This decision was eventually overturned, largely on the basis that marijuana was not on the list of banned substances, and Rebagliati was given back the medal.

    https://en.wikipedia.org/wiki/Ross_Rebagliati

    So, yes. The IOC now considers cannabis a ‘performance enhancing’ drug — They bungled about for years on the issue and resisted the classification, presumably so as not to send mixed messages to the kids.

  65. #72 Gilbert
    but have you ever run an ultramarathon -- On weed??
    August 15, 2016

    addendum:

    Despite the prohibition, running on weed has become an increasingly popular trend among athletes, who use it either as a way to avoid fatigue, boredom or anxiety during long runs, or as a pain-reliever and anti-inflammatory medication during recovery periods.

    https://www.theguardian.com/society/2016/may/02/marijuana-athlete-running-performance-enhancing-drug

  66. #73 Richard Clarke
    August 15, 2016

    My god! I would be too paranoid to do sports on Marijuana.

    I would be hugging the diving board; and crapping myself on the luge.

  67. #74 Gilbert
    August 17, 2016

    You know Bond was ripped during this chase; Just because you’re paranoid doesn’t mean they aren’t out to get you!!

    https://www.youtube.com/watch?feature=player_detailpage&v=RpBWIr4EWb8#t=119

    Sad fact: Stuntman Paolo Rigoni died during the filming of the bobsled chase.

    http://www.imdb.com/name/nm0726808/

  68. […] performance.” The benefit that Phelps and other Olympians perceive from cupping treatment is likely a result of the placebo effect. Treatments may also become part of a ritual for athletes or a superstition. Orac says […]

  69. #76 Gilbert
    August 28, 2016

    It is thought that the suction of the love bite – also known as a ‘hickey’ – caused a blood clot that travelled to Julio’s brain and caused him to have a stroke.

    http://www.mirror.co.uk/news/world-news/love-bite-horror-teen-dies-8718037

  70. #77 JP
    August 28, 2016

    My god! I would be too paranoid to do sports on Marijuana.

    I’m just going to leave this here.

  71. […] on the CAM bandwagon and recommends a number of interventions that are not science-based, such as traditional Chinese medicine and even cupping. Yes, the Mayo Clinic used to be a bastion of science-based medicine, and in many ways it still is. […]

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