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The Good Rewards of Bad Science

All the world sees us
In grand style wherever we are;
The big and the small
Are infatuated with us:
They run to our remedies
And regard us as gods
And to our prescriptions
Principles and regimens, they submit themselves.

Molière, The Imaginary Invalid (1673)1

The passage above is part of a burlesque doctoral conferment ceremony, where the French playwright Molière (1622-1673) mocks the unscrupulous physicians of his time. “All the excellency of their art consists in pompous gibberish, in a specious babbling, which gives you words instead of reasons, and promises instead of results,” he writes. In Moliere’s plays doctors never cure anyone; they are put on stage just to display their own vanity and ignorance.2 The Spanish painter Francisco de Goya (1746-1828) also took on the same issue by painting in 1799 a well attired jackass taking the pulse of a dying man, in a pose that accentuates the large gem on his hoof.


Image 1. De qué mal morirá (Of what illness will he die?) by Francisco de Goya is held at the Biblioteca Nacional, Madrid, and The Metropolitan Museum of Art, New York.

But if the asinine doctors of Molière and de Goya’s time never cured anyone, it is because they held prescientific views, and believed that disease was caused by imbalances in “humors,” and by malefic influences of the Heavens. Even the most educated among them treated illnesses in good faith by purging, bloodletting and enema at astrologically auspicious times. In contrast, current physicians who for the sake of funding embrace and endorse unscientific views and practices under the guise of CAM or integrative medicine, do so knowing that they often contradict the established principles of physics, chemistry, and biology. Therefore, in addition to promoting “snake oil science”3 (as R. Barker Bausell calls it), these physicians are also guilty of bad faith. Most of this takes place at large academic centers, where funding seems to outweigh the concern for science. As Val Jones, MD, writes in 2009′s Top 5 Threats To Science In Medicine:

Often referred to by David Gorski as “Quackademic” Medical Centers – there is a growing trend among these centers to accept endowments for “integrative” approaches to medical care. Because of the economic realities of decreasing healthcare reimbursements – these once proud defenders of science are now accepting money to “study” implausible and often disproven medical treatments because they’re trendy. Scientists at these centers are forced to look the other way while patients (who trust the center’s reputation that took tens of decades to build) are exposed to placebo medicine under the guise of “holistic” healthcare.


A list of these centers, available at the Academic Woo Aggregator website, reveals the prestigious University of California (UC) as the most represented, with 3 centers: the UCSF Osher Center for Integrative Medicine; the Susan Samueli Center for Integrative Medicine at UC Irvine; and the Collaborative Centers for Integrative Medicine at UCLA, which includes the Center for East-West Medicine. The William R. Pritchard Veterinary Medical Teaching Hospital at UC Davis, with its Acupuncture and Traditional Chinese Veterinary Medicine (TCVM) clinic, should perhaps be added to the list.

Among them, UCSF’s Osher Center for Integrative Medicine has the largest funding, with a cumulative sum of over $28 million. Established in 1997 by the Dean Emeritus of the School of Medicine, Haile T. Debas, MD, and the very generous support of the Bernard Osher Foundation, the UCSF Center collaborates with Harvard University, and the Karolinska Institute in Stockholm.

Some of the “integrative” medicine research involves acupuncture, even if it might end up being a source of scientific embarrassment. Consider, for instance, the dubious research during the 1990s at UC Irvine by the physicist Zang-Hee Cho, who claimed to have in vivo evidence by fMRI for acupuncture’s putative effects. Cho and his colleagues published a series of papers, notably one in the Proceedings of the National Academy of Sciences (PNAS), where they claimed to have observed a correlation between the visual cortex and an acupuncture point on the toe. Based on this unconfirmed observation, they became persuaded that acupuncture involves the activation of the cortical region associated with the targeted organ.4 Cho went as far as claiming that the cortical activation depends on the subject’s personality type, which could be yin or yang! Fortunately, the PNAS article, which is often referenced by acupuncture apologists, was retracted in June 2006 by Cho himself and a number of its coauthors:

Accumulating evidence suggests that the central nervous system is essential for processing these effects, via its modulation of the autonomic nervous system, neuro-immune system, and hormonal regulation. We, therefore, carried out a series of studies questioning whether there really is point specificity in acupuncture, especially vis-à-vis pain and acupuncture analgesic effects as we originally reported in our PNAS article, that had not yet been confirmed by other studies… Having concluded that there is no point specificity, at least for pain and analgesic effects, and that we no longer agree with the results in our PNAS article, the undersigned authors are retracting the article.

Z. H. Cho
S. C. Chung
H. J. Lee
E. K. Wong
B. I. Min5

Cho has since left the University of California, and is now the Director of the Neuroscience Research Institute at Gachon University of Medicine and Science in Korea. However, his research lead to a $5.7 million gift to UC Irvine in 2000 by Henry and Susan Samueli to research acupuncture, herbal therapy, and the “Indian science of life,” Ayurveda. This funding was used to create the Susan Samueli Center for Integrative Medicine.

UCLA’s “integrative” medicine also involves acupuncture. Although several separate groups and individuals provide acupuncture at UCLA, most of it is now centralized at the Center for East-West Medicine, which was founded in 1993 by its current Director, Ka-Kit Hui, MD. The Center’s website states that in March 2005, the Annenberg Foundation awarded $2 million to UCLA to establish the Wallis Annenberg Endowed Chair in Integrative East-West Medicine. An additional $115,790 grant allowed for the creation of a “healing environment.” Meanwhile, the Center is using UCLA’s international fame to lend legitimacy to Chinese folk medicine. Take a peek at UCLA Today of Jun 17, 2010:

Representing a 5,000-year history of traditional Chinese medicine, Chinese Vice Minister of Health Dr. Wang Guoqiang and a six-person delegation came to campus June 11 to see what they could learn from UCLA, which has long been at the forefront of research in integrative medicine and education in the western world… The Chinese delegation, which had a four-day stay in the U.S., chose UCLA as the only academic medical center to visit to learn how traditional Chinese medicine (TCM) and integrative medicine are practiced as a new health care model… Wang is the highest-ranking official in China overseeing the development of Chinese medicine and integrated medicine.

Image 2. UCLA Vice Chancellor for Health Sciences, Dr. Eugene Washington (left); Chinese Vice Minister of Health, Dr. Wang Guoqiang; and Dr. Ka-Kit Hui, Director of the UCLA Center for East-West Medicine (right). Image Source: UCLA Today.

Now read the following grim news about UCLA’s budget, announced just three months before, which might put the arrival of the Chinese delegation in a whole new perspective. UCLA Today wrote on Feb 18, 2010 that:

In planning for next year’s budget, campus leaders believe that UCLA will face a permanent loss of $117 million in state funding for 2010-11, the same as in 2009-10, but with one difference. The $55 million cut that was made on a one-time basis in 2009-10 will become permanent… And although Gov. Arnold Schwarzenegger seeks to restore the one-time $305 million reduction made to UC’s budget this fiscal year — $55 million of which was cut from UCLA’s budget — campus leaders said they are assuming that the State Legislature is going to reject his proposal.

With UCLA experiencing an unprecedented drop in state support, even snake oil science is welcomed, as long as it leads to further funding prospects. After all, as the Roman Emperor Vespasian once said: Pecunia non olet (money does not smell).

In my 2009 post Astrology with Needles, I presented images from European manuals of bloodletting, which clearly indicate that the acclaimed 5,000-year history of traditional Chinese medicine does not include acupuncture as we know it today. What the Chinese practiced is lancing and bloodletting with bodkins and lancets, which significantly resembled what Europeans and Muslims also practiced. This is why the venipuncture points portrayed in European medieval manuscripts significantly overlap with key points described in the Chinese classics. In addition, the evidence presented in my recent post, The Acupuncture and Fasciae Fallacy, shows that the tools described in the Chinese classics resemble fleams and other venipuncture instruments of medieval Europe, and have little resemblance to what is currently considered an acupuncture needle. This is because acupuncture with fine needles is a modern invention; one that was transformed from a side-lined practice of the early 20th-century to an essential and high-profile part of the national health-care system under the Chinese Communist Party.6

Finally, the visit of the Chinese delegation to UCLA reminds me of a 1998 French film called The Dinner Game (Le dîner de cons). In it, Pierre and his Parisian friends organize a dinner party each week, where everyone invites the most ridiculous character he can find, so they can all have a good time mocking him. But when Pierre invites François, who he thinks will steal the show, his clueless guest inadvertently exposes hidden and embarrassing aspects of Pierre’s life. The visitors that have come to UCLA to represent 5,000 years of hocus-pocus, and are eager to learn about an integrative medicine that is mainly a showcase to obtain funding, might have–like François–unknowingly exposed a mockery, and with it, a great charade.

REFERENCES:

1. Poqulin JB (Author), Frame DM (Translator, Introduction). The Misanthrope and Other Plays. Signet Classics. 1968. The quoted section was translated by Barbara J. Becker, PhD.
2. Livingston PN. Comic Treatment: Molière and the Farce of Medicine. Vol. 94, No. 4, French Issue: Perspectives in Mimesis (May, 1979), pp. 676-687.
3. Barker Bausell R. Snake Oil Science: The Truth about Complementary and Alternative Medicine. Oxford University Press. 1st edition. 2007.
4. Cho ZH, Chung SC, Jones JP, Park JB, Park HJ, Lee HJ, Wong EK, Min BI. New findings of the correlation between acupoints and corresponding brain cortices using functional MRI. Proc Natl Acad Sci U S A. 1998 Mar 3;95(5):2670-3.
5. Retraction in Cho ZH, Chung SC, Lee HJ, Wong EK, Min BI. Proc Natl Acad Sci U S A. 2006 Jul 5;103(27):1052.
6. Taylor K. Chinese Medicine in Early Communist China, 1945-1963: A Medicine of Revolution. Routledge. 2005.

Posted in: Acupuncture, Medical Academia

Leave a Comment (12) ↓

12 thoughts on “The Good Rewards of Bad Science

  1. windriven says:

    Primum non nocere.

  2. Josie says:

    It’s not just the Universities themselves but their closely associated research institutes as well –eg Scripps.

    Several times a week I run by the Arcana Pharmacy with its neon sign of “HOMEOPATHY” in the window –part of the Scripps Center for Integrative medicine. This building is nestled in between two hospitals, multiple various clinics, UCSD down the street and numerous BioTech companies along the same road.

    I suppose it’s bought ‘legitimacy’. Unfortunately the ‘legitimacy’ is going to erode the good name of the institutes and universities being bought.

  3. Ben Kavoussi says:

    @ Josie. Yes, this fake legitimacy will affect the fame of the institution; just like the cold fusion nonsense affected University of Utah.

  4. cervantes says:

    Yeah well check out the comparable bullshit from Hahhvahhd. Of course it’s NCCAM that pays for all this crap so they’re happy to slurp away at the gravy train.

  5. Ben Kavoussi says:

    @ cervantes, well, Harvard is a special case. Have you read Kimball Atwood’s postings called “Harvard Medical School: Veritas for Sale” (Parts I to IV)?

    Also, did you know that Ted J. Kaptchuk, Director of Complementary Specialties at the Osher Research Center who portrays him self as holding a “doctorate in East Asian medicine from Macau Institute of Chinese Medicine,” actually does not hold a doctorate degree of any kind?

    Here are the documents we have obtained under the California Public Records Act (Government Code Sections 6250-6270) on the credential of Mr. Kaptchuk. Please let me know if you find a college degree in any type of healthcare:

    http://www.scribd.com/bkavoussi4603

    This is all a “big charade,: as David Ramey calls it.

  6. windriven says:

    @Ben Kavoussi

    I don’t see Utah and medical school Quackology departments the same way at all. Within a few years both Pons and Fleischman were gone. Med school and medical center Quackology programs roll on, with damned few red faces to be found in their corridors.

  7. Ben Kavoussi says:

    @ windriven, thank you, I was not aware of that. You are right, Quackology brought money to institutions, cold fusion did not.

  8. Wallace Sampson says:

    Excellent summary, Ben. We have followed the UC various programs at SF, LA, Irvine over the years, and I’ve had opportunity to have input to 3 of them; Irvine twice.

    One relates to the Cho study in the J Nat. Acad. Sci. on the correlation of acupuncture at the VA 1, the vision acupoint, and functional MRI activity in the visual cortex. (Cho ZH et al, Proc Nat acad Sci USA. 1998, 95:2670-2673.)

    A friend and fellow faculty member of the Skeptics Toolbox, Jerry Andrus, was passing through our area and several of us, mostly magicians, met for lunch near SFO airport. Persi Diaconis, the mathematician from Harvard and Stanford, brouht a paper for me to critique. It had been sent to him from a friend, a physicist at AT&T Labs and Rutgers. A professor of physics at Irvine had been sponsor for a prior publication. This present paper concerned stimulation of an ear acupoint and activation of a temporal cortical area of the brain. The paper’s authors were radiation physicitsts in Korea, where the sudy had been done.

    Coincidently a prior study abstract by the same authors had been distributed by the Office of Alternative Medicine to certain key individuals and sent to me by one “FYI”. The study’s authors claimed to have found that stimulating the VA1 point on te foot resulted in activation of the occipital cortex in the same time sequence as occurred with retinal light stimulation.

    I wrote the sponsor for a copy of the visual points paper. So looking at the published study setup and reporting, there were no reported normal control data, only the above statement, and photos of the one trial run reported out of twelve done. They did not specify which side of the cortex lit up from which stimulus site. ( Anatomists will recall that the retinal fibers from nasal halves of the retina cross at the optic chiasm, joining lateral fibers from the opposite side so that each visual field half is represented on the same side of cortex. )

    Looking at the photos, the timing of the changes were synchronous with visual stimulation, but only four subjects showed stimulus response whereas eight subjects showed a decreased cortical activity when acu-stimulated. The authors attributed this difference to differing personalities of yin (positive correlation) and yang (negative correlation.) These commenrts were not followed by smiley faces.

    As to lateralization, there was none I could see – the changes were random. The same goes for the positive and negative correlation, as there was no listing of yin/yang personalities.
    or data showing the correlation.

    I found similar lack of correlating data in the hearing paper, and sent the analysis on to Dr. Diaconis or the requesting physicist (I cannot recall which.) The ear paper was not published.
    I published my findings of the vision paper in SRAM (1998;(3):56-57.)

    I met one of the Proc NAS editors at an NIH meeting 2 years later, telling her about this. She confirmed that Proc. NAS was not peer reviewed, and that any NAS fellow could publish or sponsor any paper one wished. Linus Pauling’s original vit C papers were in Proc NAS.

    So this is the first I’ve seen that Cho withdrew his paper. Good. But it remains a fine example of how to find patterns in randomness, how belief can alter scientific mindsets and thinking, the defects in the present scientific literature and other sources of error in our data bases.

    And, of course SRAM, blackballed by sCAMmers from NLM, my paper will not be found on Pubmed. I hope it will be on the SRAM page – near future?
    WSampson

  9. Ben Kavoussi says:

    @ Wallace Sampson.

    Thanks for the comments. The University of CA is an interesting place where woo and science co-habituate, and where funding seems to matter more than science. In the past I have written about nutrition research at UCLA, where conflicts of interest do not seem to matter. Consider the dietary supplement research by Dr. David Heber, the founder of UCLA Center for Human Nutrition, who is also the chairman of Herbalife’s Nutrition Advisory Board:

    http://www.herbalifescience.com/advisory-board/david-heber

    Is it nutrition science that drives UCLA supplement research, or is it the funding and financial interests?

    The same thing applies to acupuncture.

    Indeed, the acupuncture fMRI studies at UC Irvine were a mockery of science. As you know, in any good research confounding factors need to be ruled out. Perhaps needling the toe was painful and the patient opened his eyes, activating the visual cortex. None of these studies has addressed this.

    I am astonished to see how little those who do CAM studies know about the guiding principles behind scientific research. Or is it willful ignorance, or even delirium; because stating that negative or positive results are linked to yin and yang personality types is outright laughable! As you say, it is fine example of how belief can alter scientific mindsets and thinking, and funding has a lot to do with it.

    Concerning your paper, Pubmed, and the pressure from NLM sCAMmers, perhaps you should write these experiences in a book, someting like R. Barker Bausell’s book: “Snake Oil Science: The Truth about Complementary and Alternative Medicine.”

  10. clgood says:

    I have been seing a hematologist at Alta Bates, a hospital of putative good repute in Berkeley. She works at their Comprehensive Cancer Center. Every time I went there and saw the sign for “Acupuncture Services” it made me sad and angry. Offering that kind of false hope to cancer patients strikes me as cruel.

    I should probably start answering those letters asking for foundation donations with “maybe after you stop selling snake oil”.

  11. pmoran says:

    I doubt if acupuncture would be being used by your hospital as a treatment for cancer.

    There is interest in whether such attentions may prove of use in the treatment of cancer pain. If they can reduce the need for opiates through placebo or other non-specific influences it will be difficult to object to their use.

  12. Ben Kavoussi says:

    @ clgood,

    I agree with pmoran. I am sure it is used for pain management. If they use electro-stimulation (e-stem), this is not really acupuncture but PENS, even though they call it electro-acupuncture, and neuro-stimulation via e-stem has limited analgesic properties. Again, this is not acupuncture, even if they use needles to deliver a low-voltage current in the proximity of nerves to interfere with pain-signal conduction. It is called electro-analgesia.

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