I have as much of a sense of nostalgia as anyone. I love history. I think that there is lots to be said about the “good old days,” whenever the heck they were. I do not, however, think that the “good old days” generally include medicine.
The fact is that it’s only been about 100 or so years since medical practitioners really got their acts together and started to be able to figure out if they were actually doing anything good. Prior to that, medicine was a world of humo(u)rs and miasms, treated by bleeding, burning, and purging, plants and animal matter of all sorts (the 6th century Chinese apparently liked otter feces) and all sorts of other awfulness. In light of some of the things that were done, it’s kind of amazing that anyone survived their treatments. Mostly, people (and horses) survived in spite of the crazy things that were done to them.
Nevertheless, in those wild and wooly days of yesteryear, enterprising medical entrepreneurs turned out an endless stream of products, with some pretty fantastic claims. They designed some absolutely artistic advertising cards to go along with those claims, too. These trade cards surged onto the scene in the 1870’s, coinciding with the advent of color printing.
One cannot play charades forever.
European veterinary groups have long been more skeptical about “alternative” veterinary practices than their American counterparts. For example, the European Board of Veterinary Specialties refuses to grant continuing education credits for non-scientific endeavors attempting to masquerade as a way to improve one’s clinical knowledge, and the practice of veterinary homeopathy is forbidden in Sweden.
Now comes good news (for pets, and pet owners), out of the UK. In an effort to improve animal health and welfare, the Veterinary Medicines Directorate’s (VMD) has targeted “alternative” remedies, which, of course, pose both real and potential dangers to pets. The VMD is the body responsible for the authorization of veterinary medicinal products in the United Kingdom.
Specifically, the VMD is targeting a number of unauthorized products that lack scientific proof of effectiveness, including:
Make the lie big, make it simple, keep saying it, and eventually they will believe it
– A. Hitler
It seems that just about every article about acupuncture makes some reference to it having been used in China for thousands of years. The obvious reason for such a statement is to make the implication that since it’s been around for so long, it must therefore also be effective. Of course, longevity doesn’t argue for efficacy, otherwise everyone would likely agree that astrology is the way to chart one’s life; astrology has been practiced for many more years than acupuncture.
What’s maddening about the acupuncture longevity myth is that it isn’t true, and demonstrably so. In human medicine, “needling” was illustrated in the 17th century by western observers: no points, no “meridians,” just a big awl-like “needle,” driven in with an ivory-handled circular hammer. In addition, the rationale for hammering these little spikes into various spots (of the practitioner’s choosing) was said to be “exactly the same” as Greek humoral medicine (see, Carruba, RW, Bowers, JZ. The Western World’s First Detailed Treatise on Acupuncture: Willem ten Rhijne’s De Acupunctura. J Hist Med Allied Sci (1974) XXIX (4): 371-398).
Periodically, one sees newspaper articles extolling the virtues of acupuncture for animals. To those familiar with the practice of acupuncture, the tag lines are nauseatingly familiar, e.g., acupuncture has been around for thousands of years, it works to stimulate the animal’s natural energies, etc., etc. Ditto the testimonials; Fluffy wasn’t helped by anything else; now, after a few months of treatment (and plenty of time), Fluffy is running around happily. Some may even take such testimony further, asserting, for example, with some rather tortured logic, that since acupuncture “works” in animals, and animals aren’t thought to be susceptible to placebo effects, then acupuncture must therefore work in people.
In fact, other than testimonials, there’s really no good evidence that acupuncture does work in animals. In fact, acupuncture isn’t much practiced in veterinary medicine – a distinct (but very vocal) minority of veterinarians may practice it. In fact, the most recent review on the management of canine arthritis concluded, “There was weak or no evidence in support of the use of” various modalities, including electrostimulated acupuncture and gold wire acupuncture,”1 and a recent study of electroacupuncture for postoperative pain after back surgery in dogs concluded that there was “equivocal evidence” for an effect, even though there was no difference in analgesics used between treatment and control groups.2
Without question, vaccination has been one of the most important interventions in disease prevention that has ever been developed. In spite of the demonstrable, and ongoing, success of vaccination, a small, but vocal, anti-vaccination movement has developed in human medicine, occasionally buttressed by horrifying instances of adverse reactions, as well as the occasional publications in scientific journals (vis, the Wakefield debacle). Vaccine development continues, and human health continues to benefit, as new vaccines are developed and tested prior to release.
In veterinary medicine, vaccination has also proven to be a boon for animal health. Diseases such as canine parvovirus and canine distemper, feline leukemia, or equine tetanus, have been greatly reduced – in some cases, nearly eliminated – by vaccination. And, as in human medicine, a small, but vocal, anti-vaccination movement has developed, regaling fearful listeners with tales of acute harm, or chronic, low-grade disease (sometimes termed “vaccinosis”).
One of the occasional arguments used in support of “alternative” approaches to human medicine is the observation that since “alternative” medicine is used (with anecdotal success) in animals, and animals don’t know anything about the treatment that they’re getting, then they must work a priori. Of course, the fallacy of such an observation is pretty obvious to anyone with a logical/skeptical frame of mind, because it assumes that the therapies do work (even though there’s little evidence of that).
Clearly, however, some people perceive that the therapies work, including veterinarians – there are veterinary acupuncturists, chiropractors, homeopaths, etc., etc. Since there’s very little scientific support for the idea that the therapies actually have any clinically significant effect on biological processes, including the processes that result in disease, questions arise as to whether there are other effects of “alternative” treatments on animals. Specifically, people may wonder whether or not animals can benefit from placebo effects.