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Puncturing the Acupuncture Myth

Note: This is slightly revised from an article I originally wrote as a “SkepDoc” column for Skeptic magazine. It was pre-released online in eSkeptic and it has already generated a lot of comments, including “a truly amazing piece of peurile pseudo-intellectualism,” “an ad hominem attack on one form of alternative medicine so beset by poor thinking that one must come to the conclusion this woman might just be paid to write such propaganda,” and “twaddle wrapped in swaddling rhetoric.” (I treasure comments like those as evidence that my critics are so bankrupt of real arguments that they have to dip into the insult pouch for ammunition.)  I thought it would be interesting to post it here on the blog and see how much controversy it would stir up among my co-bloggers and readers.  Please keep in mind that it was written for a popular audience and excuse the lack of scholarly citations. You may recognize some of the studies I refer to from previous blog entries.

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“Alternative” medicine is by definition medicine that has not been scientifically proven and has not been accepted into mainstream scientific medicine. The question I keep hearing is, “But what about acupuncture? It’s been proven to work, it’s supported by lots of good research, more and more doctors are using it, and insurance companies even pay for it.”

It’s time the acupuncture myth was punctured – preferably with an acupuncture needle. Almost everything you’ve heard about acupuncture is wrong.

To start with, this ancient Chinese treatment is not so ancient and may not even be Chinese! From studying the earliest documents, Chinese scholar Paul Unschuld suspects the idea may have originated with the Greek Hippocrates of Cos and later spread to China. There’s certainly no evidence that it’s 3000 years old. The earliest Chinese medical texts, from the 3rd century BC, don’t mention it. The earliest reference to “needling” is from 90 BC, but it refers to bloodletting and lancing abscesses with large needles or lancets. There is nothing in those documents to suggest anything like today’s acupuncture. We have the archaeological evidence of needles from that era – they are large; the technology for manufacturing thin steel needles appropriate for acupuncture didn’t exist until 400 years ago.

The earliest accounts of Chinese medicine reached the West in the 13th century: they didn’t mention acupuncture at all. The first Westerner to write about acupuncture, Wilhelm Ten Rhijn, in 1680, didn’t describe acupuncture as we know it today: he didn’t mention specific points or “qi;” he spoke of large gold needles that were implanted deep into the skull or “womb” and left in place for 30 respirations.

Acupuncture was tried off and on in Europe after that. It was first tried in America in 1826 as a possible means of resuscitating drowning victims. They couldn’t get it to work and “gave up in disgust.” I imagine sticking needles in soggy dead bodies was pretty disgusting.

Through the early 20th century, no Western account of acupuncture referred to acupuncture points: needles were simply inserted near the point of pain. Qi was originally vapor arising from food, and meridians were channels or vessels. A Frenchman, Georges Soulie de Morant, was the first to use the term “meridian” and to equate qi with energy – in 1939. Auricular (ear) acupuncture was invented by a Frenchman in 1957.

The Chinese government tried to ban acupuncture several times between 1822 and WWII, when the Chinese Nationalist government tried to suppress it. Mao revived it in the “barefoot doctor” campaign in the 1960s as a cheap way of providing care to the masses; he did not use it himself and he did not believe it worked. It was Mao’s government that coined the term “traditional Chinese medicine” or TCM, to include acupuncture, herbal medicine, moxibustion, and other traditional practices.

In 1972 James Reston accompanied Nixon to China and returned to tell about his appendectomy. It was widely believed that his appendix was removed under acupuncture anesthesia. In reality, acupuncture was used only as an adjunct for pain relief the day after surgery, and the relief was probably coincident with the expected return of normal bowel motility. A widely circulated picture of a patient allegedly undergoing open heart surgery with acupuncture anesthesia was shown to be bogus. If acupuncture is used in surgery today, it is used along with conventional anesthesia and/or pre-operative meds, and it is selected only for patients who believe in it and are likely to have a placebo response.

As acupuncture increased in popularity in the West, it declined in the East. In 1995, visiting American physicians were told only 15-20% of Chinese chose TCM, and it was usually used along with Western treatments after diagnosis by a Western-trained physician. Apparently some patients choose TCM because it is all they can afford: despite being a Communist country, China does not have universal health coverage.

There were originally 360 acupuncture points (based on the number of days of the year rather than on anatomy). Currently more than 2000 acupuncture points have been “discovered” leading one wag to comment that there was no skin left that was not an acupuncture point. There were either 9, 10, or 11 meridians – take your pick. Any number is as good as another, because no research has ever been able to document the existence of acupuncture points or meridians or qi.

Does acupuncture work? Which acupuncture, and what do you mean by work? There are various different Chinese systems, plus Japanese, Thai, Korean and Indian modalities, most of which have been invented over the last few decades. Whole body or limited to the scalp, hand, ear, foot, or cheek and chin. Deep or superficial. With electrified needles. With lasers. With dermal pad electrodes and no skin penetration.

Acupuncture works, but placebos work too. Acupuncture has been shown to “work” to relieve pain, nausea, and other subjective symptoms, but it has never been shown to alter the natural history or course of any disease. It’s mostly used for pain today, but early Chinese practitioners maintained that it was not for the treatment of manifest disease, was so subtle that it should only be employed at the very beginning of a disease process, and was only likely to work if the patient believed it would work. Now there’s a bit of ancient wisdom!

Studies have shown that acupuncture releases natural opioid pain relievers in the brain: endorphins. Veterinarians have pointed out that loading a horse into a trailer or throwing a stick for a dog also releases endorphins. Probably hitting yourself on the thumb with a hammer would release endorphins too, and it would take your mind off your headache.

Psychologists can list plenty of other things that could explain the apparent response to acupuncture. Diverting attention from original symptoms to the sensation of needling, expectation, suggestion, mutual consensus and compliance demand, causality error, classic conditioning, reciprocal conditioning, operant conditioning, operator conditioning, reinforcement, group consensus, economic and emotional investment, social and political disaffection, social rewards for believing, variable course of disease, regression to the mean – there are many ways human psychology can fool us into thinking ineffective treatments are effective. Then there’s the fact that all placebos are not equal – an elaborate system involving lying down, relaxing, and spending time with a caring authority can be expected to produce a much greater placebo effect than simply taking a sugar pill.

There are plenty of studies showing that acupuncture works for subjective symptoms like pain and nausea. But there are several things that throw serious doubt on their findings. The results are inconsistent, with some studies finding an effect and others not. The higher quality studies are less likely to find an effect. Most of the studies are done by believers in acupuncture. Many subjects would not volunteer for an acupuncture trial unless they had a bias towards believing it might work. The acupuncture studies coming from China and other oriental countries are all positive – but then almost everything coming out of China is positive. It’s not culturally acceptable to publish negative results – researchers would lose face and their jobs. In a recent survey, “No trial published in China or Russia/USSR found a test treatment to be ineffective.” We can’t reach a valid conclusion based on positive published studies if we don’t know about negative studies that never saw the light of day.

The biggest problem with acupuncture studies is finding an adequate placebo control. You’re sticking needles in people. People notice that. Double blinding is impossible: you might be able to fool patients into thinking you’ve used a needle when you haven’t, but there’s no way to blind the person doing the needling. Two kinds of controls have been used: comparing acupuncture points to non-points, and using an ingenious needle in a sheath that appears to have penetrated the skin when it hasn’t.

In George Ulett’s research, he found that applying an electrical current to the skin of the wrist – a kind of TENS (transcutaneous electrical nerve stimulation) treatment – worked just as well as inserting needles, and one point on the wrist worked for symptoms anywhere in the body.

Guess what? It doesn’t matter where you put the needle. It doesn’t matter whether you use a needle at all. In the best controlled studies, only one thing mattered: whether the patients believed they were getting acupuncture. If they believed they got the real thing, they got better pain relief – whether they actually got acupuncture or not! If they got acupuncture but believed they didn’t, it was less likely to work. If they didn’t get it but believed they did, it was more likely to work.

Acupuncturists can rationalize with great ingenuity. In a recent study using sham acupuncture as a control, both the sham placebo acupuncture and the true acupuncture worked equally well and were better than no treatment. The obvious conclusion was that acupuncture was no better than placebo. Their conclusion was that acupuncture worked and the placebo acupuncture worked too!

One researcher decided it’s not meaningful to use placebo controls in acupuncture research because any stimulation of the skin might be effective – which seems to me to pretty much destroy the whole rationale for acupuncture, but he didn’t seem to notice that. If that’s true, why not just caress or massage our patients instead of lying about imaginary qi and meridians?

Considering the inconsistent research results, the implausibility of qi and meridians, and the many questions that remain, all the current evidence is compatible with this hypothesis: acupuncture is nothing more than a recipe for an elaborate placebo seasoned with a soupcon of counter-irritant. That is what R. Barker Bausell concluded in his book Snake Oil Science. The world’s first professor of complementary medicine, Dr. Edzard Ernst, is more accepting of low-prior-plausibility evidence than some of us; but even he used the words “tentative” and “might” when he recently wrote, “While there is tentative evidence that acupuncture might be effective for some forms of pain relief and nausea, it fails to deliver any medical benefit in any other situations and its underlying concepts are meaningless.”

Acknowledgement: Part of this article was adapted from a PowerPoint presentation prepared by the late Dr. Robert Imrie. That entire presentation is available on-line . It’s well worth a visit; it includes great pictures of camelpuncture, goatpuncture, and chickenpuncture.

ADDED AFTER ORIGINAL POSTING:

At the request of several readers, I am adding these references. They are by no means comprehensive. Many of these references contain long lists of primary sources.

History of Acupuncture:

Unschuld P. Medicine in China: A History of Ideas (Comparative Studies of Health Systems and Medical Care). University of California Press, 1988.

Imrie RH, Ramey DW, Buell PD, Ernst E, Basser SP. “Veterinary Acupuncture and Historical Scholarship: Claims for the Antiquity of Acupuncture” The Scientific Review of Alternative Medicine. 2001, 5: 133-9.

Imrie, RH, Ramey DW, Buell PD. “Veterinary Acupuncture and Historical Scholarship: The ‘Traditions’ of Acupuncture and TCM.” The Scientific Review of Alternative Medicine. 2003-4. 7:61-8.

Basser S. “Acupuncture: A History” The Scientific Review of Alternative Medicine. 1999. 3: 34-41.

Imrie R, Ramey D, Buell P. “Veterinary Acupuncture and Historical Scholarship, Part III: Politics , Popularity, and the Promotion of TCM” The Scientific Review of Alternative Medicine. 2005. 9: 69-74.

Acupuncture for Heart Surgery:

Posner G and Sampson W. “Chinese Acupuncture for Heart Surgery Anesthesia” The Scientific Review of Alternative Medicine. 3:2, p. 15-19. 1999.

Posner G. Questioning Dr. Isadore Rosenfeld’s China Acupuncture Story, Skeptical Inquirer. 1999: Vol. 23 No. 4.

Mao not believing in acupuncture:

Zhi-Sui, Li. The Private Life of Chairman Mao. Random House, 1996.

Origin of ear acupuncture:

“Organ Representation on Extremities” on the American Acupuncture website. http://www.americanacupuncture.com/ear_ac.htm. Accessed Oct 21 2008.

James Reston’s Appendectomy:

James Reston. “Now, About My Operation in Peking” New York Times, July 26, 1971.

Current status of acupuncture in China.

Beyerstein B and Sampson W.“Traditional Medicine and Pseudoscience in China: A Report of the Second CSICP Delegation” (Part 1). Skeptical Inquirer. 1997.

http://www.csicop.org/si/9607/china.html

Beyerstein B and Sampson W. “Traditional Medicine and Pseudoscience in China: A Report of the Second CSICOP Delegation (Part 2)” Skeptical Inquirer, 1996. http://www.csicop.org/si/9609/china.html

Sham acupuncture studies, research methods, meta-analyses:

Bausell, RB. Snake Oil Science: The Truth about Complementary and Alternative Medicine. Oxford University Press, 2007.

Ulett’s research:

Ulett, GA and Han, S. The Biology of Acupuncture. Warren H. Green, 2001.

Preponderance of positive studies from China:

Vickers A, Goyal N, Harland R, Rees R. “Do certain countries produce only positive results? A systematic review of controlled trials.” Control Clin Trials, 1998: 19(2):159-66.

Excuse for not using placebo controls: http://www.sciencebasedmedicine.org/?p=44

Why ineffective treatments seem to work:

Beyerstein B. “Psychology and ‘Alternative Medicine’: Social and Judgmental Biases That Make Inert Treatments Seem to Work.” The Scientific Review of Alternative Medicine. 1999. Vol 3.

http://www.sram.org/0302/bias.html

Beyerstein B. “Why Bogus Therapies Often Seem to Work” http://www.quackwatch.org/01QuackeryRelatedTopics/altbelief.html

General:

Singh,S and Ernst, E. Trick or Treatment: The Undeniable Facts about Alternative Medicine. W.W. Norton, 2008.

Bausell, RB. Snake Oil Science: The Truth about Complementary and Alternative Medicine. Oxford University Press, 2007.

Carroll, R. “Acupuncture” The Skeptic’s Dictionary. http://skepdic.com/acupunc.html
Acupuncture Watch website. http://www.acuwatch.org/

Barrett, S. “Be Wary of Acupuncture, Qigong, and ‘Chinese Medicine’” http://www.quackwatch.org/01QuackeryRelatedTopics/acu.html

Imrie, Robert. “Acupuncture: The Facts.” 2005. PowerPoint presentation available online at http://drspinello.com/altmed/acuvet/acuvet_files/frame.htm

Posted in: Acupuncture

Leave a Comment (76) ↓

76 thoughts on “Puncturing the Acupuncture Myth

  1. Tom Nielsen says:

    I love you for writing this. Short, clear and concise, and pretty much answers all questions.

    Though I didn’t learn anything new, I now have an easy and accessible summary of acupuncture, I can refer people I know to. Thank you.

    Btw, for anyone interested in more ressources on this subject, I can recommend the book “Complementary and Alternative Veterinary Medicine Considered”. It also has an accurate historical account, and discussion, on acupuncture. It’s an awesome general skeptic book – and don’t worry about the veterinary part, it’s very accessible.

  2. Very interesting look at acupuncture’s history! I did not know much of this. Also, I think “chickenpuncture” may just beat out “monkeypants” as the funniest word of all time.

  3. Karl Withakay says:

    A excellent post Harriot. I think it would be worth the effort some time for you to add the source citations for this post to provide a single article to point people to as a concise but comprehensive and authoritative treatment/ summary of acupuncture.

    The are dozens of posts both here and elsewhere that I could direct people to, but with source citations, this would provide a single concise, readable, scientific summary of acupuncture that couldn’t be written off as another persons unsupported opinion.

  4. zntneo says:

    I would like very much if Harriot would add some source citations. The orginal powerpoint didn’t have any either so before i start linking to this article i would like there to be some citations.

  5. I agree with Karl. I’ve had a post called “Acupuncture Anesthesia: a Proclamation of Chairman Mao” on the back burner for some time, which gives several of the references that are also pertinent to Harriet’s article. I’ll try to get it posted in a couple of weeks.

    Meanwhile, Unschuld on Hippocrates:

    http://www.amazon.com/Medicine-China-History-Comparative-Studies/dp/0520062167/ref=sr_1_1?ie=UTF8&s=books&qid=1224604015&sr=8-1

    Mao not believing in TCM:

    http://www.amazon.com/Private-Life-Chairman-Mao/dp/0679764437/ref=sr_1_1?ie=UTF8&s=books&qid=1224604086&sr=8-1

    History of acupuncture:

    4-part series in Sci Rev Alt Med by David Ramey, Robert Imrie, Paul Buell, approx. 2003-2006 (see: http://www.sram.org/back-issues.html but website is not updated). Probably similar material to that in the book mentioned by Tom Nielson, because Dave Ramey is one of the authors: http://www.amazon.com/Complementary-Alternative-Veterinary-Medicine-Considered/dp/0813826160/ref=sr_1_10?ie=UTF8&s=books&qid=1224604491&sr=8-10

    Reston’s appendectomy:

    “Now, About My Operation in Peking.”

    New York Times July 26, 1971

  6. delaneypa says:

    I read your article when it came out in eSkeptic, and have printed out a “dead tree” version so I won’t accidentally delete.

    You will not convert any True Believer. But I plan to hand out your article to my patients considering acupuncture. Thanks very much for a version suitable to share with curious patients.

  7. And, of course, the most useful article to explain why “inert treatments seem to work,” which needs referencing but rarely is (except by “us”) in nearly every article that purports to address that question:

    Beyerstein BL. Social and judgmental biases that make inert treatments seem to work. Sci Rev Alt Med. 1999;3:33. Available at: http://www.sram.org/0302/bias.html

    Barry Beyerstein, the author of that article, was head of the Brain Behaviour Laboratory at Simon Fraser U in Vancouver, and one of the sweetest human beings ever to walk the earth. His untimely death last year was a terrible loss to those who knew him and to skepticism. Several of your humble bloggers are proud to have called him a friend.

    Bob Imrie, another author mentioned here, was a veterinarian who also died much too soon. “Sweet” he wasn’t, but he had a huge sense of humor to match his huge voice and presence, which almost certainly comes through in the PowerPoint show linked by Harriet (I haven’t looked at that, but I saw the original talk at a conference in 2003 and almost fell on the floor).

    David Ramey, the other skeptical veterinarian cited above, is alive and well. He’s a prolific author with a vast breadth of knowledge; one of these days we hope to entice him to “join the team” here at SBM.

  8. DevoutCatalyst says:

    Tom Nielsen wrote:

    “Btw, for anyone interested in more resources on this subject, I can recommend the book “Complementary and Alternative Veterinary Medicine Considered”.”

    Would be nice if some people who’ve read it would review this book at Amazon.com to counter the low reviews it currently has.

  9. Harriet Hall says:

    Bowing to popular demand, I will try to track down all the citations and add them to the article.

  10. Jules says:

    There is one question I have about acupuncture: if it is a placebo effect, then how does it work on animals?

    I’m not sure if there’s any studies on animals and acupuncture, but there are several anecdotes about acupuncture helping dogs’ behavioral issues–Jon Katz, who knows a few things about dogs (though he’s not a vet), claims it helped Orson for a while.

  11. Joe says:

    @ Jules,

    John Katz writes nice books; but his anecdotes about acupuncture prove nothing (just like every, other anecdote).

    You will have to show us properly-done studies that support acupuncture for animals. Such research requires an expert, blinded observer who evaluates the animal before and after (randomized actual or sham) treatment, and a lot of pets.

    I think you will find the placebo effect is manifest in the expectations (leading to wishful observations) of the owners who see improvement in their (treated) pets.

  12. jonny_eh says:

    Harriet, according to one of the books you referenced and recommended, “Trick or Treatment?”, acupuncture may date back a few thousand years. They talk about the tattoos on the ‘ice man’ that was discovered near the Austrian/Italian border that had tattoos that may be meridian lines. Is this just a fringe idea, or is it gaining ground? I ask because this conflicts with your claim that acupuncture is in fact not as ancient as people believe, and is only a few centuries old.

    Thanks for another great article, and references!

  13. Harriet Hall says:

    Not everyone knows about the history of acupuncture; most authors simply repeat the myths from another source without investigating the facts. I referenced Trick or Treatment not for the history, but for the question of whether acupuncture works.

    I thought the Iceman idea was pretty far fetched. Definitely a fringe idea.

  14. Tom Nielsen says:

    @DevoutCatalyst

    I wrote a review on my no longer updated website skepticsanctuary.com. I think I will copy paste it onto amazon.

    @Jules

    To answer shortly. There is no evidence that it does works on animals.

    Animals are not subject to the placebo effect, but the people who measures the effects in the animals are. They expect an effect, and tell them selves that they can see an improvement in the animals. Plus, the vast majority of the acupuncture trials on animals, are extremely poorly done. One could also speculate that the veterinarians who wishes to do these trials, are biased towards acupuncture to begin with.

  15. Tom Nielsen says:

    @Harriet Hall

    Oh btw, the newly updated cited version is great. Thanks.

    @Kimball Atwood

    If you recruited David Ramey, I would definitely read all his posts.

  16. daedalus2u says:

    Actually social animals likely are subject to the placebo effect. Certainly dogs should be subject to it. If their master leads them to believe that they will get better, a dutiful dog likely will.

  17. Tom Nielsen says:

    @deadalus2u

    How exactly do you mean?

    One could keep a dog busy and happy so it would ignore, or even forget, whatever is bothering it, but that is just distraction. Just like speaking with a baby voice, and gesturing in an happy manner, makes dogs wiggle their tail. I doubt that it will be anything permanent, because it’s just a response to the presence of it’s owner.

  18. daedalus2u says:

    My understanding of the placebo effect is that it is the “standing down” of physiology from the fight or flight state so that metabolic resources can be diverted to healing.

    During the fight or flight state resources are mobilized and held at the ready for immediate use. Under such circumstances healing has too low a priority and so it is greatly slowed, saving resources for what ever the emergency is.

    Learning how to allocate resources efficiently is an extremely important thing to learn, and it is something that parents teach their children. A mother’s “kiss it and make it better” is a placebo, it is a placebo that tells the child that everything is all right, and they can stand down from the fight or flight state they were in. Learning how to invoke the placebo effect when mother is not present is an important life lesson for a child.

    As social animals that hunt in packs, I presume that dogs communicate with each other with sufficient fidelity so that the whole pack can enter the fight or flight state simultaneously to bring down large prey. I presume that they can also communicate with each other to stand down from the fight or flight state simultaneously. To me, that is the essence of the placebo effect.

    A human master saying “sic em” invokes the fight or flight state and an attack. The “atta boy” after the successful attack brings the dog back down. The “atta boy” is a placebo.

  19. nwtk2007 says:

    Daedulus – “The “atta boy” is a placebo.”

    Really. Have you consulted the Dog Wisperer about this?

  20. Vaklam says:

    , “No trial published in China or Russia/USSR found a test treatment to be ineffective.”

    Thank you for linking to the survey which produced the above quote. I am not surprised by the findings but I hadn’t heard about that before.

    I was also unaware of the history of acupuncture. Now I have another bit of ammunition to use against the woo-peddlers.

  21. Jules says:

    To clarify: I don’t really believe it works on animals. I’m just pointing out that there are a lot of people who swear it works on their fuzzbutt, and not all of them believe in woo. TBCH, you’d have to be pretty desperate to find a vet who will administer acupuncture to your pet, and pretty desperate (at least, I would hope so) to think that it would work.

    But at the same time, I find it hard to believe that you could “will” a behavioral change into your pet, keeping in mind that most pet owners are especially attuned to their pets’ behaviors. I, for one, can tell immediately whether I should worry that one of my cats isn’t eating her food (most of the time, no), or that my other cat is expecting her daily dollop of cream (yes, I know cats aren’t supposed to drink milk, but this is just a regular treat as opposed to the main source of her calories) and not the rest of her dinner–she eats her dinner in pieces. I don’t know if this means that they can be entirely trusted when they say that their dog has “calmed down significantly” since they started poking him with needles, but at the same time, to suggest that the change is all in their heads is just…well, insulting. I mean, that would suggest that the calming effect from giving dogs Prozac (and yes, dogs can get Prozac) is also a secondary placebo effect. Yet nobody would challenge that finding.

    Again, I’m just pointing out the inconsistencies–I’m not suggesting that acupuncture works on pets, as others have claimed. People see what they want to see–that’s true. And who knows, maybe Prozac for dogs really doesn’t work. Who’s to say what’s a “significantly calming” effect? For that matter–how do we know that antidepressants actually work? (Yes, I know they work–I’ve been on them for a year–and I know that there are tons of trials showing that they’re better than placebo, except for one which suggested they weren’t. The point is that if we question the results of a therapy in animals which are removed from us–and presumably whatever placebo effect there is–then how can we say with any certainty that the therapy works in humans?)

    Just food for thought.

  22. regarding animal placebo effect – you also have to consider who is doing the assessment of the animal. It’s not reported by the animal, it is the observations of a person, and that introduces new potential for confirmation bias and other biases.

    “The” placebo effect includes all variables other than a physiological effect from the treatment.

  23. David Gorski says:

    We’re in the process of recruiting a veterinarian to blog here occasionally, and I hope to have a couple of posts on just this issue on SBM soon.

  24. Fifi says:

    Jules – You say that even people who don’t believe in woo believe that their dog was cured by acupuncture?

    Er……yeah…since dog acupuncture is woo (according to the evidence) then technically these people who believe their dog was cured using acupuncture DO believe in woo. See how that works? ;-) It’s like saying “I don’t believe in ghosts but I saw a ghost” – clearly the person DOES believe in ghosts or they wouldn’t believe they’d seen a ghost.

    Interestingly, vets (and dentists) are also targeted by WISE and Scientology recruiting fronts that teach “business techniques”. It’s quite illuminating to look at the big picture of these professions and how certain high pressure and low ethics sales tactics have become increasingly commonplace, and have crept into commercial medicine as well.

  25. Fifi says:

    If the pet owner calms down then so will the pet, it really is that simple. If an owner is worried and fearful, a pet will be worried and fearful. Dogs in particular look to the leader of the pack for their cue as to how to feel and behave (this is the owner but it can be the dog if they’re not running the pack due to an owner who doesn’t know how to lead).

    It’s no surprise that a desperate pet owner who is soothed by the manner of the vet/acupuncturist and the ritual of “doing something/anything” will calm down and then the dog will calm down. It’s actually to be expected.

  26. James Fox says:

    Dave, “We’re in the process of recruiting a veterinarian to blog here occasionally, and I hope to have a couple of posts on just this issue on SBM soon.”

    Horse chiropractic is getting quite popular among my horse owning wife’s horse owning friends. I’d love to have some good skeptical writing to send her way when the topic comes up.

  27. icon says:

    Holistic ambulance:
    http://www.hs.fi/fingerpori/1135240410596
    “Larger acupuncture needles, quick”

  28. Blade says:

    Hi everyone. I just saw the video on Youtube that featured Dr. Sampso

    I can say that doctor has done very little research on the subject of Oriental Medicine before he made his statements in the video as we as in this article. Now let me make that clear that I am only a student in Oriental Medicine not a fully qualified practitioner and I can already point out a lot of mistakes and misunderstandings by Dr. Sampson. To start with the article stating the first thing I was surprised to read about is him stating that the first mention of ‘needling’ only appears on a text from 90 B.C. Now I don’t claim to know the first book to deal with the subject but I am currently studying from the book of the ‘Yellow Emperor’s Classic of Medicine’ which has several sections on needling techniques and this book was written between 200-300 B.C. This book in oriental medicine is considered one of the most important of all books so this immediately told me that Dr. Sampson is lacking serious research on the subject.

    Also stating thin metal manufacturing didn’t start till about 400 years ago, this is true, however acupuncture has been done with needle shaped stone (called bian stones) thousands of years ago. This has been proven by the founding of a grave in Rizhao County of Shandong province, from the New Stone age 10,000-4,000 BC that contained such stones! In 1968 in Mancheng County, Hebei province another tomb that dates back to 113 B.C. was opened and in this tomb among the relics there were four golden five silver needles! Two silk scrolls recording meridians and collaterals were also found in an excavation of a tomb from the Han Dynasty (third century B.C.) at Mawangdui, Hunan province.

    From these – and other facts I could state but are limited because of space and time – it can be clearly see that Dr. Sampson lacks even the very basic knowledge to make any kind of statement or judgment about this medical science and mislead the public with his incorrect and limited knowledge on the subject.

  29. Harriet Hall says:

    I suggest you read the references I supplied on the history of acupuncture.

    The ancient Chinese described vessels containing blood as well as other elements and may have used various sharp instruments including needles for blood-letting. Scholars who interpret some of the early texts as describing acupuncture may have been reading them through their retrospectoscopes. Bob Imrie’s research revealed that the original Chinese text accompanying a supposed horse acupuncture diagram was mistranslated and actually sounds far more compatible with bloodletting.

    There is no textual or archaeological evidence that anything resembling today’s acupuncture was practiced 3000 years ago.

  30. Jules says:

    @ Fifi: Don’t be so sure. Jon Katz (who I’m not citing as an expert or anything, but he happens to be the most convenient example and he’s a rather prominent writer) writes rather eloquently about what acupuncture did for Orson–or rather, something did something for Orson, as he’s still rather skeptical about acupuncture, but willing to acknowledge something’s changed.

    Cesar Milan (another celeb I’m not particularly fond of, but he’s a good example) claims to teach people how to acquire his “alpha aura”. Is there such a thing? If there is, then what is it? And why do some people have it and some people not? If you suggest that any changes in dogs are due to the changes in the people around them, then how can we say that dogs can be trained at all? Or does this imply some sort of permanent tabula rasa state of their personality? And if so, then why are some vicious dogs permanently vicious and others trainable?

    By that extension–do mice and rats really exhibit depressive behaviors in the presence of “bully mice” (study mentioned in SciAm Mind, can’t recall the authors)? Is this something that we want to see, or is it real? Does every behavior have to be measurable before it’s “real”? Does this mean that Jane Goodall made everything up? I.e., who gets to decide what’s a valid observation and what’s not?

    Hehe…right now I’m running assays that uses live cells. We’re talking about things that grow in a petri dish. You wouldn’t think that there’d be much of a difference between cells and cells, but I can look at a dish and decide if it’s “good” or not–cells look “healthy” or they don’t. Am I imagining this, or is the fact that every single assay I’ve run on questionable (as opposed to healthy) cells turns out badly, while every assay I’ve run on good cells turns out well, merely a coincidence?

    Point being that intuition plays a much bigger role in our observations than we think, and that if you want to start questioning one, you have to start questioning every one. Where do you draw the line as to what’s valid?

  31. Fifi says:

    Jules – The point stands that one can’t say “I don’t believe in ghosts but I just saw a ghost” – clearly one believes one saw a ghost and therefore not only believes in ghosts but believes to have seen one. You’re describing faux skepticism – someone who wants to give the appearance they’re skeptical to convince skeptics but who is really a believer.

    I’m not sure what you think dog temperments have to do with acupuncture but both genes and enivornment adequatedly explain personality/termperment in dogs just as well as in humans without any need for magical attribution (we actually have a better understanding since we’ve been consciously breeding dogs for specif traits for a long time). This has little to do with dog’s social structures and the fact that they’re pack animals that look to their master/leader for direction (including whether they are safe, need to be defensive or whatever). Dogs really aren’t particularly complex, they’re just their own species so have their own rules of socialization and communication.

    Just becuase someone calls something an “alpha aura” doesn’t mean it’s magic – the alpha dog is merely the leader of the pack so it’s all just about acting like the leader and knowing how to “talk/act dog”.

    I don’t see what point you’re trying to make about intuition and observation and how that relates to dog acupuncture. There are plenty of very direct and obvious reasons why dogs would calm down when their owners do so attributing it unnecessarily to acupuncture seems, well, unnecessary and reaching for confirmation where none exists.

  32. Jules says:

    @ Fifi:

    My point is this: we say that there’s no such thing as dog acupuncture–if it “works” it’s because the owners are making faulty observations based on their own biases.

    Biases are everywhere, and there’s no reason to assume that scientists are any less prone to being biased than anybody else–and nowhere is this more obvious than interpreting Western blot data. What makes scientists’ observations about whether a phenomena is true any more valid than that of a lay person?

  33. Fifi says:

    Jules – I don’t assume scientists are less prone to bias (though I do expect them to be more aware of it within themselves, though this isn’t always the case). I have pointed that out here numerous times. Clearly a trained observer is generally superior to an untrained one in any field they’re trained in but that’s neither here nor there.

    Really it’s erecting a strawman to try to make it into a scientist vs non-scientists battle of subjectivity since that’s beside the point. The point is that scientists use a methodology that is designed to minimize bias as much as possible – it’s the methodology that is superior not the scientists. And note the use of “as much as possible”. After the experiment or study is done, it then needs to be repeatable to be valid (and not just repeatable by the same person but another scientist should be able to get the same or similar results if they do the same experiment). So, as you can see, it’s quite a well designed method that has multiple stages specifically designed to minimize bias. Anyone can learn the methodolgy (though obviously people who have a gift for analysis and observation will find it easier, and no doubt less boring ;-)

    What makes you think a lay person’s observations about a phenomena are just as valid as the scientific process and methodology?

  34. Fifi says:

    It’s a con to sell someone something as medicine if it’s just a placebo effect (and just as unethical to use someone’s love of their pet to manipulate them as it is to use someone’s love of their child). An ethical vet wouldn’t sell a useless procedure but would explain to the owner that the dog was upset because they are and show them how to calm down their dog (of course, any vet running a con will want the person to keep coming back so teaching them how to make their pet less anxious on their own would lose them money). I am not at all surprised that Scientology also targets vets with “sales/business” seminars like they do dentists and chiropractors.

  35. chocolatesauce says:

    Hey Harriet, normally i think your articles are great and provide a lot of sensible direction for people struggling to navigate the onslaught of medical media and rumors we encounter on a daily basis.

    However, while reading this article i found it hard to believe the subtle implication that the foundation of TCM acupuncture theory (qi & meridians) was a modern western invention thereby invalidating its historical foundation which a lot of the belief in its effectiveness is built upon.

    I sent the article to one of my friends who is a longtime acupuncture patient and student of shaolin kungfu, and he responded with the following:

    “Maybe Georges Soulie de Morant was the first to use the english word “meridian” (no citation?), but Chang San Feng from 1300 ad spoke of chi movement in meridians, as well as General Yue Fei who is credited with inventing the chinese martial arts style of xing yi. Not to mention chen village, where chen tai chi was invented in the 1800. All well before someone in france
    in 1939. She really doesnt seem to have done much research into martial arts, where the idea of qi and meridian is quite ancient ”

    This isn’t an argument for or against historical use being a valid indicator of somethings worth (i personally think its completely irrelevant), i just find it hard to leave such a bold and seemingly implausible claim unchallenged that qi and meridians were invented in modern times and everyone (including the chinese people themselves) were duped into their historical legacy.

  36. Harriet Hall says:

    chocolatesauce,

    I did not say meridians and qi were invented in modern times. I said,

    Qi was originally vapor arising from food, and meridians were channels or vessels.

    This referred to early Chinese ideas. Then I said,

    A Frenchman, Georges Soulie de Morant, was the first to use the term “meridian” and to equate qi with energy – in 1939.

    This referred to transmission of information to the West.

    If the way I juxtaposed that information led to misunderstandings, I apologize.

    Chinese is a difficult language to translate, and there is some controversy about what early Chinese writers really meant by the terms meridian and qi and energy. Even today, when some people speak of “energy” they mean something very different from what physicists mean when they say “energy.”

  37. KauaiFinn says:

    I am so pleased to find that you have a website! I’ve read all your articles in Skeptic magazine -some of which I have printed copies of to carry with me.

    Living with a chronic illness, I am approached *constantly* by peddlers of all types of woo medicines/treatments/therapies.
    I have found that it is handy to carry your articles -as well the data from your sources- with me to defend myself when the peddlers will not accept a simple “Sorry, not interested” for an answer.

    Big Mahalos (thank you) for all your work!

    Aloha,
    J

  38. Janh64 says:

    I’m an engineer, I thrive on science, research, cause and effect. However, I have absolutely had excellent results from acupuncture as treatment for chronic L4/L5 pain from an anular tear, sinus headaches, and – yes, Virginia – ACUTE VERTIGO!

    I see two different TCM doctors in Austin Texas. They are instructors at the AOMA clinic, and have extensive research backgrounds. To be honest, they have demonstrated more medical knowledge and professionalism than most of the physicians I have visited over recent years, and certainly more than the family practitioner who nearly killed my mother due to his indifference. (This is NOT a claim I make lightly – I’ll save that for later :-/

    No placebo, muscle relaxer, tequila or pain killer has eased the excruciating pain I endure when my back pain flares up. Physical therapy is not even an option due to the inability to stand straight. I have a fairly high tolerance for pain, when I say “I cannot move” – I really mean it! After visits to the local spine clinic, several x-rays, mris, and a doctor who would not return my calls to advise me if the disk was finally herniated, I went to see Dr. Liu again (I’d seen him for some shoulder “thoracic outlet syndrome” (latest generic diagnosis!) previously with some success. He and his students had to place me on the table. He probably placed more than 20 needles in my back, legs, and feet. Within 30 minutes, I was able to get up from the table without assistance. Hey – that is pretty convincing evidence to this old gal! My orthopedic doc? He finally called – TEN DAYS after my tearful, “fortheloveofgodpleasekillme” visit to his office.

    I have had immediate results for treatment of acute vertigo. Until I discovered acupuncture, these attacks would disable me for weeks at a time. Dr. Luo treated this, the vertigo was gone when I left his office.

    An AF Colonel, Richard C. Niemtzow had done some type of research on acupuncture treatments of vertigo, I don’t remember all of the details. I believe he still practices medical acupuncture, specializing in palliative care for cancer patients.

    I do know there are a lot of quacks out there (within the western field, as well!!) but there are many dedicated TCM doctors who take their studies as seriously as the western docs. The docs I see are very curious about my “whole body” health, and never hesitate to recommend a western doc for certain ailments. Dr. Liu worked with me to lower my blood pressure, AFTER discussing what my family doctor said. He taught me some tricks for lowering it when I feel stressed, talked to me about diet, sleep, etc. More than my family doctor did, and more than my mother’s doctor did before he stuck her on one pill after another, resulting in one of the most appalling cases of pharmacology I could describe!!

    When western doctors speak with such scorn of a treatment which may be very effective for a patient, it breaks down the trust and respect patients have for the western medical society. I have some medical background, I’m not illiterate, nor ignorant. My pain is not psychological, I don’t need placebos. My posture, my loss of sleep, etc due to the chronic pain seems to exacerbate the pain impulses, so the signals are much more intense than the existing injuries. Acupuncture seems to better align the nerve impulses with the “true level” of pain. (I have NO explanation for the vertigo treatments, though!)

    And one more thought before I go….
    I consulted with both of my TCM doctors regarding treatments on my mother for incontinence. I wanted to know what kind of questions to ask, what kind of TCM professionals to seek, etc in her home town. They explained various placements on the ankle, which have had good results, they discussed concerns a good doctor would have about diabetes, skin conditions, etc.

    I could not locate any TCMs in her region. But – her own urologist has recommended a treatment percutaneous tibial nerve stimulation (PTNS) which uses the same principle, (for a lot more $$$$$$!)

  39. Harriet Hall says:

    Janh64,

    Very nice testimonial. I could find any number of those.
    What I couldn’t find was acceptable scientific evidence.

  40. Ben Kavoussi says:

    Great analysis and comments. Could you please indicate the reference for the fact that the technology for manufacturing thin steel needles appropriate for acupuncture didn’t exist until 400 years ago. Thank you.

  41. Harriet Hall says:

    Ben Kavoussi,

    Sorry I can’t verify the original source for the statement about thin steel needles. I took it from a secondary source, the PowerPoint by Bob Imrie that I cited. He is now deceased, so I can’t ask him where he found it.

  42. Ben Kavoussi says:

    Thank you. I will use this info in my next article and I will just reference your posting. I sent you the manuscript yesterday.

    Regards

  43. razvan says:

    I’ve been working both as an western medical trained doctor and as an acupuncturist for 15 years now. According to my experience and to my patient’s testimonials, acupuncture works. Do I have any scientific proof for that? No, I don’t! Should I give it up because of lack of scientific evidence? I don’t think so.
    What you call “skepticism” is the modern “inquisition” like dogma. Science has become for you what religion used to be in the catholic middle ages.
    According to skepticism, unless one has evidence that breathing works, breathing isn’t sure!
    I think the right attitude should be: “although there is no solid scientific evidence, clinical proof sustains the efficiency of acupuncture in some certain conditions”. That would be, in my opinion, the right way of informing people about acupuncture.

    Regards,
    Razvan

  44. Mark Crislip says:

    re: endogenous opiates, have a listen to the science show http://www.abc.net.au/rn/scienceshow/stories/2008/2426424.htm#transcript

    it suggests that grooming and stroking the skin releases endorphins; the effect of acupuncture for endorphins may be a non specific response.

    re: razvan

    When it come to therapeutic interventions, I always tell the residents that the three most dangerous words in medicine are “In my experience.”
    I bought a pair of topsiders two years ago. I have not had a cold since. I wake up some mornings and I dont feel well, I think I might be coming down with a cold, but I put on my shoes and by 9 am all the sx are gone.

    In my experience my shoes treat and prevent colds.

    in diagnostics experience is key. physicians have difficulty in separating the importance of experience as a diagnostician and its lack of importance in therapy.

    also, I would bet (and I am a third generation physician) that there is no group of people (excluding razvan of course) more filled with hubris and self importance than MD’s making them far more able to be fooled than the usual person. it is part of why I have had no interaction with drug reps for over 20 years. I can be fooled and manipulated and not know it and refuse to admit it, so I dont put myself in the situation where it can occur.

  45. Harriet Hall says:

    razvan,

    Since you are willing to reject the scientific approach in favor of experience, testimonials, and “clinical proof,” I’m wondering if you practice bloodletting to balance the humours. There are at least as many testimonials for bloodletting as for acupuncture. For many centuries, doctors practiced it and in their experience and their patients’ testimonials, it worked. It even saved lives, a claim that is rarely made for acupuncture. Clinical proof was plenty good enough for those people. They were wrong and they were actually doing more harm than good. But they were just as sure that bloodletting worked as you are that acupuncture works. Do you admit that they were wrong? If you do, what reason do you have to think you couldn’t be just as wrong about acupuncture?

    I’m not suggesting you should give up acupuncture. Even if your good results are only due to placebo effect, placebos do make people feel better. I only think you should recognize that the treatment is based not on science but on superstition. And patients should give informed consent based on that knowledge. If you tell them “Science doesn’t support acupuncture and it may be only a placebo but I believe it has helped some of my patients” then I have no quarrel with you.

  46. pmoran says:

    Medical practitioners have been repeatedly shown to be hopeless at assessing treatment effectiveness, at least with subjective and self-limiting complaints. They superimpose an extra layer of biases and misiniterpretations onto patient data that is already distorted by “answers of politeness” and pressures to conform.

    Acupuncturists are not immune, overestimating treatment success by a factyor of four in this study—

    Schmerz. 2005; [Epub ahead of print]
    [Do physicians overestimate effects of acupuncture treatment?] [Article in German]

    Lungenhausen M, Endres HG, Kukuk P, Schaub C, Maier C, Zenz M.

    Abteilung fur Schmerztherapie, Klinik fur Anasthesiologie,
    Intensiv- und Schmerztherapie der Berufsgenossenschaftlichen Kliniken Bergmannsheil Bochum, .

    BACKGROUND: Physicians’ ratings about their patients’ pain prove to be invalid compared to patients’ ratings. This is especially true if pain rating acts as an indicator for therapy outcome. The aim of this study was to compare physicians’ and patients’ ratings of pain relief following acupuncture and to identify correlations between patient characteristics and potential miscalibrations.PATIENTS AND METHODS: In a cross-sectional study 291 pain patients with gonarthrosis or chronic low back pain and their attending physicians were asked to give their rating of patients’ pain relief following acupuncture. Patients were interviewed by telephone, and doctors responded to
    questionnaires.RESULTS: The proportion of false-positive physicians’ ratings was 81% referring to patients without self-reported benefit from acupuncture. Just every fifth patient without pain relief was correctly classified by his physician. There was no correlation between patients’ characteristics and false-positive ratings of physicians.CONCLUSIONS: Evaluation of treatment in daily medical routine should be primarily based on information provided by patients.

  47. Blade says:

    I apologize I was away and only now I am replying to the Oct. 23 statement. Quated: “The ancient Chinese described vessels containing blood as well as other elements and may have used various sharp instruments including needles for blood-letting. Scholars who interpret some of the early texts as describing acupuncture may have been reading them through their retrospectoscopes. Bob Imrie’s research revealed that the original Chinese text accompanying a supposed horse acupuncture diagram was mistranslated and actually sounds far more compatible with bloodletting.”

    Acupuncture does still uses blood letting on a rare case, however text books clearly refer to controlling the chi movement of the body. Reading any text books (such as the 2,300 year old Nei Jing – or The Yellow Emperor’s Classic of Medicine) there are clear instructions to leave the needle in for 15 – 30 minutes depending on the seriousness of the illness and let the chi circulate through the body. Now if they meant to perform blood letting at any of these points, why would you leave the needle in for that long before you do blood letting? Chinese did do blood letting just as early western medical doctors but these were clearly defined and instructed as such. If these were also ‘misinterpreted’ as chi movement regulation, then why are there text that were translated by early europeans that simply went to China to translate books and merely translated the medical books, not even having any medical training yet described these instructions in the same exact manners. They weren’t biased, didn’t know anything about Chinese medicine or even any type of medicine. And if the Chinese changed these blood letting instructions to chi regulations, at what point this this happen and why western medicine never changed to it? The concept of Chi first appeared in one of the earliest books of all time, the I-Ching (or book of change). The then current medicine (mainly herbal medicine, spiritualism) then accepted this concept as a natural occurence and began to integrate it into the ancient medical practices.

    Scientific evidences can be obtained from many places including the U.S. I would recommend reading a Craig Benson’s case for example (ex-governor of New Hampshire) who had an advancing heart condition that the top heart specialist couldn’t cure or even stop from its advancement. Governor Benson was informed that it was likely that he will die in a few years. He then heard of an acupuncturist on the east coast and for someone’s recommendation paid a visit to. He was skeptical* that this person could help him in any ways but has given it a try. Today governor Benson’s condition isn’t slowed down or were stopped from further advancement but he is COMPLETELY cured from it. He clearly states that he has no idea how this healing method works but he went from constantly pounding heart in his chest to ‘not even feeling that I have a heart’.

    The same acupuncturists have cured several advancing as well as terminal illnesses (such as breast and lung cancers).

    I put an * after the word skeptical because with that I would like to expand on this point. Many people also believe that acupuncture is sham medicine, people believe that they are cured but they really aren’t in reality. Governor Benson’s case is a very good example of someone who believed in the highest trained heart specialist who could do little for him and he went as a skeptic to the acupuncturist. So if sham medicine would have worked on him, it would have been the heart specialists that would have cured him, and the least likely the acupuncturists.

    Sorry for the long comments….

  48. Harriet Hall says:

    Blade,

    While we can quibble about translations and about what the early Chinese really thought, some things are clear:
    (1) acupuncture as practiced today is very different from what the early Chinese did
    (2)Whatever the early Chinese did, the antiquity of a practice says nothing about its efficacy.
    (3) there is no evidence that ‘chi” exists

    Your story about Gov. Benson is a meaningless anecdote better explained by a spontaneous improvement in the natural course of a disease (and you don’t even tell us what his diagnosis was or offer any references to substantiate your story).

    Acupuncturists have never cured cancer or any other terminal diseases.

    The fact that you make these “life-saving” claims for acupuncture without even offering a reference insults our intelligence. Have you read any of the other posts on this blog? If I told you a story about a patient being cured by bloodletting, would that make you believe bloodletting really works to balance the humours? If we changed our minds based on comments like yours, we would not deserve to call our blog “science-based.”

  49. Blade says:

    “Acupuncturists have never cured cancer or any other terminal diseases. ”

    1) http://www.youtube.com/watch?v=glAxA7GVSFo&feature=related
    2) http://www.youtube.com/watch?v=FmjUrcd7zt4&feature=related
    3) http://www.youtube.com/watch?v=zdBxZ3kTP08&feature=related

    Just one acupuncturist – whose student I know. Please contact these people and asked them about that.

    “There is no evidence that ‘chi’ exists”

    There is no evidence that gravity, or magnetic field or even energy exists either. This might surprise a lot of people but it is true!

    All great scientists have shown the existence of these by demonstrating their effects (on objects) and not one has given a definition of what they are! ‘Energy is motion or transfer of motion’. ‘Gravity is a field that attracts object’. ‘Magnetic field is a field that affects specific objects, namely certain metals’. These are statements referring to what they do but not what they are. Even today not a single scientists has given a scientific – or other – explanation to what these things really are, they merely demonstrated what they do!

    The existence of the Chi can be measured the exact same way, inserting a needle for example into a liver channel clearly demonstrate changes in the state or function of the liver. The existence of its functionality is never questioned. It is the chi itself that is only defined as ‘energy’ which can not be visually shown but this is the exact same way true to gravity or magnetic fields.

    Just a few days ago I talked to a good friend of mine who is the highest skilled technician at his company with over 30 years of experience. Working on telecommunicational equipment, he is the single person (with a couple of part timer backups) who is responsible for the most important equipment performing the highest level of jobs. All equipment – over 1,200 data collecting computers transferring data from 1.5 million customers’ monitoring system – send the data to the equipment he is responsible for (so we can say he is a highly qualified person in the field). I asked him: what is magnetic field? Not to my surprise he put both of his hands up in the air and smiled at me: ‘I don’t have an idea. We know a lot about working with magnetic fields but we don’t know a single bit about its being or what it is.’ I purposely asked this question from him because all too often I hear western medical doctors asking acupuncturists to provide a proof of existence of the ‘chi’. We don’t know much about it but we know a lot about working with it.

    So I think before we get into deeper details on what chi is and how it really works in the body I’d like to ask this question: why is Newton’s, Einstein’s and all other scientists theory were commonly accepted even though they have done nothing but demonstrated the existence of energy, gravity or magnetism from simply measuring their effects? No one to this date can provide a proof or explanation of what these things really are. All Einstein’s work are showing effects of gravity but not one sentence explains what it is. Anyone, please give me an answer then we can surely move on.

    Thank you!

  50. Blade says:

    I apologize for the late comment, I just wanted to add that the person who healed the above referred cancer patients is the same person who healed Gov. Benson also. I highly doubt that all these – as well as here not mentioned other cases by the same TCM doctor – happened by chance, on its natural healing course.

  51. Harriet Hall says:

    Blade,

    You are clearly operating outside the scientific paradigm. This is a science-based medicine blog: Youtube video testimonials are not acceptable evidence here.

    We can measure the effects of gravity, magnetism, and energy; we can do calculations and base predictions on them. When chi meets those same standards of evidence, we will all accept its existence. Right now we have no more evidence for the existence of chi than for the existence of phlogiston, N-rays, the four humours, tabletop cold fusion, or the ether. Maybe you believe in them too!

    You didn’t even answer my question about bloodletting. Maybe you believe in it too, since there is just as much evidence for it as for chi.

  52. pmoran says:

    I, too, despise the submission of video testimonial as “evidence” of cancer cure. It illustrates how testimonial is targeted at a desperate and ill-informed cancer public, not those who quite sensibly think that claims to a cancer cure are too important to too many people to rely on anything less than solid evidence — which, incidentally, should be easy to produce with most cancers with present technology..

    So, I want to see biopsy slides, and before-and-after photos, x-rays, scans and marker studies. I want to be sure of ALL the treatments the patient has received. I want to have a clear time-line laid out so that if the cancer went into remission it is clear that this has an appropriate temporal association with the treatment used.

    The first two cases seem to cover a very short time period, and it is not clear in either that there has been any definite cancer response. What is the PSA level in the man with prostate cancer? Why are we not told this, even in a video?

    Why are we offered a testimonial from a man whose cerebral secondaries are still present (no 2)? Are we supposed to be impressed that he temporarily is feeling OK?

    The third case is probably one of breast cancer with secondaries to the lungs. While she denies having surgery, chemo, or radiation, can we know that she did not have hormonal intervention? She might still be a remarkable case, but if so, there are avenues where such cases can be published as a signal that all material relating to them is available for examination. That is how science works, as opposed to the marketing of dubious products.

    How to read a testimonial –

    http://www.users.on.net/~pmoran/cancer/how_to_read_a_testimonial.htm

  53. Blade says:

    There are more cases by this TCM doctor, I know of a couple of more cases, breast cancer patients that he healed, one of them is now free of cancer for three years (http://www.youtube.com/watch?v=mG5xrioTapE&feature=related) and another interview I’ve watched by Fox 25 with another female patient whose cancer cells has completely cleaned up. This latter patient only consulted her family doctor to monitor her progress, no intervention of any kind was done. The family doctor was puzzled of her healing process and not able to give an explanation as to how it happened.

    Personally I do not know the healer, I sometimes communicate with another acupuncturists who was actually a student of his. The student’s name is Chad Dupuis and he is now a full time practitioner at the Chattanooga Acupuncture and Wellness Center (http://www.yinyanghouse.com/). I am sure upon contacting Chad he can point anyone in the direction of finding more information on the patients or perhaps contacting their doctors and consult about their data. Another thing I know about these cases is that these – and further other results – now got the attention of the local cancer research center and they began studies on it. Maybe you can contact them as well.

    Again I have to stress that I am merely a TCM student and not qualified to explain the diagnosis and healing processes applied for these cases, I did read some of the work the TCM doctor posted and from my knowledge he is using legitimate TCM diagnostics procedures but I am not able to completely understand the relation of the diagnostics and his treatments.

    Now a little bit on the existence of the Chi (or internal energy) that the Chinese believe are channeled in the body the same way as the blood is. Again, any TCM text that talks about the Chi states that it is not detectable with the eyes or with any known instrument today, however the effects of it can be clearly measured in the body – let me point out again that this is the same case for gravity, magnetic fields or just ‘energy’ itself.

    Probably one of the most measurable and visually demonstrative effects can be seen by using point ‘Zhi Yin’ (BL67) on the bladder meridian (http://acuxo.com/meridianPictures.asp?point=BL67&meridian=Bladder). Clinical research shows that stimulating this single point has a success rate of 60% in turning a breeched fetus the correct way if the treatment is applied by moxibustion (warming the channel instead of puncturing – http://en.wikipedia.org/wiki/Moxibustion) from the 34th to 37th weeks of gestation. This research has been done in many countries with official randomized clinical trials.

    This is one case of measuring the function of the chi in the body. The example is completely explainable from the TCM point of view, where the bladder channel is indirectly linked with the channel to the uterus, unblocking the stagnated energy flow to the uterus ‘realigns’ the fetus . Although this success rate isn’t very high, it has to be understood that this is a natural healing method with no additional substance administered – and is completely free of side effects.

    At this point I would like to ask anyone – since I am merely a student of TCM with only a few years of studies – any doctors to explain the mechanism of the above describe acupuncture results from the western medical point of view. This is a proven method and from the TCM point of view there is an explanation to it. Please provide an explanation to this occurrence supported with scientific evidence. This procedure has been successfully used for 100s of years in China and the far east.

    Thank you.

  54. Harriet Hall says:

    Blade,

    You say acupuncture is “a proven method” when my article explains why it is not. I am sorry that you were unable to understand what I wrote. Please read it again, slowly and carefully. If you still are unable to understand it, there are a couple of books that might help give you the comprehension skills you need: “Snake Oil Science” by R. Barker Bausell and “Trick or Treatment” by Singh and Ernst. You might also try reading the acupuncture article in the Skeptic’s Dictionary at http://skepdic.com/acupuncture.html

    What you need to understand is
    (1) Testimonials are not acceptable as evidence.
    (2) Studies to date are compatible with the hypothesis that acupuncture is no more effective than placebo.
    (3) Studies like the one you cite do not “measure the function of chi” and do not demonstrate that chi exists, because there are other possible explanations for the observations. Trying to use such studies as evidence for chi is circular reasoning that would get you thrown out of a Logic 101 course. It’s a bit like claiming that ghosts are made of ectoplasm and then saying people’s reports of seeing ghosts prove that ectoplasm is real.
    (4) It is pointless to ask for a scientific explanation of acupuncture results when science shows those results are questionable or nonexistent. And I provided a whole list of factors that can “explain” why people like you and the Governor are fooled into believing ineffective treatments work. It’s quite possible that acupuncture “works” by stimulating endorphin production; but placebos “work” by stimulating endorphins too.
    (5) Your explanation is not an explanation: it says chi can be affected by needle insertion, but it doesn’t explain how that could happen.

  55. Blade says:

    Moxibustion DOES NOT release endorphins – I can’t believe people try to explain acupuncture with such a naive explanation and even worse, I can’t believe others (doctors!) would believe this – when it is so easy to prove that it is NOT the case using moxibustion. Applying moxa treatment at the acupuncture points create similar effects as needling. Using moxibustion anywhere else on the body does not replicate the same results.

    Again: using moxibustion at point Zhi Yin (Bladder 67) turns malpositioned fetus. No endorphins are released, patient DOES NOT feel better – not placebo, no sham – but actual physical change happening inside the body. This has been tested all around the world, I have seen the lowest 62% success in a Swiss clinic to as high as 93% success rate in the U.S.

    Please explain this with SCIENTIFIC EXPLANATION – so far no one was able to.

    Thank you!

  56. Joe says:

    Blade on 07 Jan 2009 at 6:37 pm wrote “Moxibustion DOES NOT release endorphins …”

    Please tell us how you know this; that is, studies measuring endorphin release (or, lack of it).

    Blade on 07 Jan 2009 at 6:37 pm wrote “Please explain this [turning a fetus via moxibustion] with SCIENTIFIC EXPLANATION”

    I refer you to Harriet Hall on 15 Dec 2008 at 1:03 pm writing “(2) Studies to date are compatible with the hypothesis that acupuncture is no more effective than placebo.”

    In other words, there is nothing to explain.

    You are welcome.

  57. Harriet Hall says:

    Blade,

    A quick search of PubMed for moxibustion and endorphins brings up several articles that indicate moxibustion does have effects on endorphin production.

    You might as well ask us to provide a SCIENTIFC EXPLANATION for the Tooth Fairy. Why bother trying to offer a scientific explanation for something that has not been shown to exist? A recent Cochrane review concluded “There is insufficient evidence to support the use of moxibustion to correct a breech presentation.” http://www.cochrane.org/reviews/en/ab003928.html

    And here’s a study that says moxibustion doesn’t work http://www.ncbi.nlm.nih.gov/pubmed/15924530?ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

  58. pmoran says:

    Blade: “The family doctor was puzzled of her healing process and not able to give an explanation as to how it happened.”

    When such statements have to be used to prop up a cancer cure testimonial it invariably means that evidence is lacking for a clear-cut treatment effect. Otherwise, why does it not suffice to merely describe what happened to the cancer?

    I am not going to chase up other results from this TCM practitioner, although I have with many other alternative cancer “healers” (see my primitive web site). His preparedness to put out worthless personal testimonials tells me everything I need to know about him. Even if he is sincere, the testimonials prove that he is an untrustworthy source of information, eager to fool himself as to what he is achieving.

    http://www.cancerwatcher.com

  59. Blade says:

    ‘A very successful “do it yourself” technique with a proven high success rate is to use locally applied heat treatment: http://www.birthinternational.com/articles/andrea13.html

    http://parenting.ivillage.com/pregnancy/plabor/0,,42zd,00.html

    http://parents.berkeley.edu/advice/pregnancy/breech.html

    http://www.chiropracticresearchreview.com/crr/article.php?id=923

    I need scientific evidence of the functionality of this. Provide physical link (neurological or any other) between this point on the toe and the uterus. Any TCM concepts MUST be excluded.

    Thank you!

  60. Blade says:

    Promoran:

    Far as I could tell, this practitioner is also still experimenting but he is on some kind of a track where he can identify certain diagnostic patterns. I read a little bit of his papers and I could tell that he is using legitimate TCM diagnostic methods (focusing on something called the Hua Tou and something called the ‘Sky-Window points’ – http://www.yinyanghouse.com/acupuncturepoints/point_categories#windowsky) and he describes how these relate to the occurrence of certain type of cancers. The scope of his research is beyond my knowledge so it is not clear to me how these are used for the treatment.

    The local cancer institute they have in town – Boston? – already started a research work on him and his methods. That is pretty much all I know about it. It seems to be leading to somewhere though but like I said I am not affiliated with him so I don’t know any more specifics than what I have posted here. I do feel encouraged though that even if he found something from the TCM stand point he can at least help people. The results at least sound good, just need to do researches and document all the findings.

    I do, however encourage anyone to do more research on it and see where it is leading to. I am only a student in TCM and don’t have the time/qualification to do so. As mentioned earlier, once a while I am talking to Chad Dupuis, who has worked with this person, Chad’s website is: http://www.yinyanghouse.com and I am sure he can help anyone to point to the right directions.

    I am still hard at just getting down the basics so I can only understand so much of his research.

  61. Harriet Hall says:

    Blade,

    There is no connection between the big toe and the uterus. The idea that any treatment to the toe could turn a fetus is laughably implausible. Despite this implausibility, if robust evidence confirmed that moxibustion turned fetuses, we would have to accept it first and look for an explanation second. The evidence is far from robust – it is such poor quality that we can discount it. And if you think we are going to be convinced by secondary reports and opinions from parenting newsletters, you have not understood anything about this blog. Of course, the fact that you are studying TCM shows that you either don’t understand the scientific method or don’t care.

  62. Blade says:

    Dear Dr. Hall:

    So you’re saying that all the below posted higher ed. institutes (which are just some I could quickly gather) base their teachings on endorphin release, placebo, mind control medicine. From the tens of thousands of professors, students, physicians not one single of them realized this so far? Please let me know if that is what you believe:

    Guangzhou University of Traditional Chinese Medicine:

    http://www.evergreentcm.com/images/school.jpg

    Guangzhou University of Traditional Chinese Medicine is one of the oldest colleges of its kind in China and is governed directly by the State Administration of TCM. The university is located at Sanyuanli, near the foot of Baiyun mountain in northern Guangzhou. The campus covers an area of about 400,00 square meters and has a building area of about 290,000 square meters (including the affiliated hospitals).

    Shanghai University of TCM:

    http://kamponews.com/kamponews/images/shanghai%20TCMbuilding2_web.jpg

    The university was established with 16 subsidiary colleges and departments, 4 affiliated hospitals, 13 affiliated or cooperative research institutes, 8 research centers, the earliest museum of medical history in China and a library with a collection of over 50,000 books.
    This college is also established as an International Acupuncture Training Center under the World Health Organization (WHO); providing multiple language services in educational and exchanging activities including English, Japanese, French and Korean languages. Currently, there are over 500 international students from around the world studying here. The university has a large collection of medicine and historical books, about 500,000.

    Nanjing University of TCM:

    http://farm4.static.flickr.com/3244/2912468842_33d79802e2.jpg?v=0

    (Hospital of the Nanjing University)

    http://farm4.static.flickr.com/3095/2909273451_30773864b8.jpg?v=0

    (Library of the Nanjing University)

    http://farm4.static.flickr.com/3065/2911619667_3efccd7df2.jpg?v=0

    Chengdu University of TCM:

    Photos: http://www.cdutcm.org/Html/university/162833868.html

    The University is characterized by TCM traditional teaching with 12 sub-colleges. It is the only state base for the basic researches of sciences and the foundational cultivation of the talents in Chinese pharmacy. There are over 500 professors and associate professors, 88 tutors for doctors and 283 tutors for masters. CDUTCM holds around 10,000 students (over 1300 students for doctoral and master degrees), including more than 100 students from Hongkong, Macao, Taiwan and foreign countries. And every year over 200 students come for the short-term training programs. Since its founding, it has cultivated 35,000 talents.
    • CDUTCM has great capability in researches and has made contributions to the society. With 6 Research Institutes and 37 Research Institutional offices, it also has the states’ GCP center, Chinese Pharmaceutical Screening and Evaluation Center and ADR Monitoring Center. In recent years, the university has taken the state key project of the tenth Five-year Plan”, “973 program” and “863 program”, key programs of the National Fund of Nature and Science. Various prizes have been awarded. Cultural Museum of TCM and Museum of Chinese Drug Specimens are with abundant collection.

    Anhui University of TCM:

    http://bp1.blogger.com/_QFnSn9-cfsE/RjRteoTxcaI/AAAAAAAAAAM/pybwV4oo6sA/s1600-h/07_1_10_11_35_16%5B1%5D.jpg

    Liaoning University:

    http://www.admissions.cn/lnutcm/

    Three affiliated LNUTCM hospitals have been assessed as top-class, State-best institutes with five State-bureau-level and eleven provincial-level specialized clinics. For clinical training and internship LNUTCM has agreements with 30 hospitals, while 23 pharmaceutical training bases fill the need in that field.
    —————————–

    Would you be willing to make a statement that in your honest believe these people are all under some sort of mind control and base their healing methods merely on endorphin release and they haven’t even realized this up to today?

    Thank you!

  63. Harriet Hall says:

    I already made it clear in my article that all the scientific evidence for acupuncture is consistent with the hypothesis that it is no better than placebo.

    Placebos “work”, and quackery and the whole CAM industry take advantage of that fact. As placebos go, acupuncture is probably the most effective placebo system there is.

    You list a number of institutions that support acupuncture. Go back two centuries and we could list every medical school, every hospital, every medical text, and every doctor in support of bloodletting to balance the humours. They were all wrong.

  64. thehatinthecat says:

    We’ve seen a number of the studies that speak out against the use of acupuncture, but not many have posted those that do favor its use and also that it may work. I’m not saying it does or it doesn’t just providing some more information for the debate.

    Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial.
    Rheumatology (Oxford). 2008 Jun;47(6):887-93. Epub 2008 Apr 10

    Time-variant fMRI activity in the brainstem and higher structures in response to acupuncture.
    Neuroimage. 2009 Apr 1

    Acupuncture treatment of severe knee osteoarthrosis. A long-term study.
    Acta Anaesthesiol Scand. 1992 Aug;36(6):519-25

    The effect of acupuncture on the acute withdrawal symptoms from rapid opiate detoxification.
    Acta Anaesthesiol Sin. 2002 Dec;40(4):173-7

    Neural substrates, experimental evidences and functional hypothesis of acupuncture mechanisms.
    Acta Neurol Scand. 2006 Jun;113(6):370-7.

    Moxibustion and other acupuncture point stimulation methods to treat breech presentation: a systematic review of clinical trials.
    Chin Med. 2009 Feb 27;4:4.

    Evidence based acupuncture practice recommendations for peripheral facial paralysis.
    Am J Chin Med. 2009;37(1):35-43

    Randomized Controlled Trials of Acupuncture for Neck Pain: Systematic Review and Meta-Analysis.
    J Altern Complement Med. 2009 Feb 13

    Acupuncture’s Effects in Treating the Sequelae of Acute and Chronic Spinal Cord Injuries: A Review of Allopathic and Traditional Chinese Medicine Literature
    Evid Based Complement Alternat Med. 2009 Feb 25

    Delayed Effect of Acupuncture Treatment in OA of the Knee: A Blinded, Randomized, Controlled Trial.
    : Evid Based Complement Alternat Med. 2009 Jan 5.

    The Influence of Acupressure at Extra 1 Acupuncture Point on the Spectral Entropy of the EEG and the LF/HF Ratio of Heart Rate Variability.
    Evid Based Complement Alternat Med. 2008 Sep 30.

    Acupuncture Effects on Cardiac Functions Measured by Cardiac Magnetic Resonance Imaging in a Feline Model.
    Evid Based Complement Alternat Med. 2008 Jan 23.

    Prospective tests on biological models of acupuncture.
    Evid Based Complement Alternat Med. 2009 Mar;6(1):31-9. Epub 2007 Nov 21.

    Ten Years Evidence-based High-Tech Acupuncture A Short Review of Peripherally Measured Effects.
    Evid Based Complement Alternat Med. 2007 Nov 12.

    Acupuncture Treatment for Low Back Pain and Lower Limb Symptoms-The Relation between Acupuncture or Electroacupuncture Stimulation and Sciatic Nerve Blood Flow.
    Evid Based Complement Alternat Med. 2008 Jun;5(2):133-43.

    The 2001 STRICTA Recommendations for Reporting Acupuncture Research: A Review with Implications for Improving Controlled Clinical Trial Design
    J Altern Complement Med. 2009 Feb 1.

    Effects of acupuncture on symptoms and muscle function in delayed-onset muscle soreness.
    J Altern Complement Med. 2008 Oct;14(8):1011-6.

    Randomized controlled trial of traditional Chinese medicine (acupuncture and tuina) in cerebral palsy: part 1–any increase in seizure in integrated acupuncture and rehabilitation group versus rehabilitation group?
    J Altern Complement Med. 2008 Oct;14(8):1005-9.

    Forty-six cases of vertebrobasilar insufficiency treated by acupuncture plus intravenous infusion of ligustrazine.
    J Tradit Chin Med. 2008 Dec;28(4):245-9.

    Effect of acupuncture on the brain in children with spastic cerebral palsy using functional neuroimaging (FMRI).
    J Child Neurol. 2008 Nov;23(11):1267-74

    Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain.
    Am J Med. 2008 Jan;121(1):79.e1-7.

    Effect of acupuncture in a patient with 7-year-history of Bell’s palsy.
    J Altern Complement Med. 2008 Sep;14(7):847-53

    Just to name a few.

  65. thehatinthecat says:

    @Harriet Hall
    Doesn’t the article you site that moxibustion doesn’t work actually say that they can’t prove one way or another that it works?

    “CONCLUSIONS: The results underline the methodological problems evaluating of a traditional treatment transferred from a different cultural context. They do not support either the effectiveness or the ineffectiveness of moxibustion in correcting fetal breech presentation.”

    Wouldn’t that imply the need for further study since there are trials that do show a possible effectiveness of this treatment?

    Moxibustion and other acupuncture point stimulation methods to treat breech presentation: a systematic review of clinical trials.
    Chin Med. 2009 Feb 27;4:4.

    Side-effects of moxibustion for cephalic version of breech presentation.
    J Altern Complement Med. 2008 Dec;14(10):1231-3.

    Effectiveness of acupuncture-type interventions versus expectant management to correct breech presentation: a systematic review.
    Complement Ther Med. 2008 Apr;16(2):92-100.
    (Though this review suggests a need for better research)

    Acupuncture plus moxibustion to resolve breech presentation: a randomized controlled study.
    J Matern Fetal Neonatal Med. 2004 Apr;15(4):247-52.

  66. Harriet Hall says:

    thehatinthecat,

    I pointed out in my post that there are many studies that appear to support acupuncture. When examined in the context of all the published studies including higher quality studies that come to opposite conclusions, their significance diminishes. To understand why the studies you cite are not convincing, please read the book Snake Oil Science by R. Barker Bausell. All the published evidence to date is compatible with the hypothesis that acupuncture is no more effective than placebo.

  67. Antonio1 says:

    Thank you for the scientific and historical background given about acupuncture. If I google ‘acupuncture’, many ideas come out and the majority coming on the first page is non-scientific and basically advertises the method. On Wikipedia, although the subject does have some relevance and I see that the WHO ‘published a review of controlled trials using acupuncture and concluded it was effective for the treatment of 28 conditions and there was evidence to suggest it may be effective for several dozen more.’ It fails to tell me if scientific proven medicine does the same effect – e.g. an aspirin can treat a headache avoiding needles to be inserted in me. Anyway, a placebo effect does no harm and If my pain goes away due to a placebo that causes no addition harm, then I can’t actually criticize anyone for using the method. What I feel is harmful and should be avoided is substituting scientifically proven medicine for homeopathy or acupuncture, especially on children. There continues to be reports on newspapers (reduced amount – fortunately) on parents that trust these medicines (without any scientific evidence – independently to their results) and substitute their children’s medicine for acupuncture and other non scientific medicines (e.g. children with diabetes that stop insulin intakes; ….etc.) If anyone wants to take these ‘medicines’, I don’t see any harm, but don’t substitute your medicine which is scientifically proven to do you good.

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