I’d refer people to Harriet Hall’s column in the volume 14 number 3 2008 issue of Skeptic magazine on pages 8 and 9 where she proposes a modern origin of Acupuncture.
I’m interested to get other’s opinions on the article.
[QUOTE=SimonM;900540]I’d refer people to Harriet Hall’s column in the volume 14 number 3 2008 issue of Skeptic magazine on pages 8 and 9 where she proposes a modern origin of Acupuncture.
I’m interested to get other’s opinions on the article.[/QUOTE]
is this available online anywhere?
[QUOTE=SimonM;900540]I’d refer people to Harriet Hall’s column in the volume 14 number 3 2008 issue of Skeptic magazine on pages 8 and 9 where she proposes a modern origin of Acupuncture.
I’m interested to get other’s opinions on the article.[/QUOTE]
Link Biotch !
AFAIK it is not available online. IF it is it would be at www.skeptic.com
But the magazine has a wide Canadian and American distribution. It’s my second favorite magazine.
http://www.quackwatch.org/01QuackeryRelatedTopics/acu.html
"Harriet Hall, a retired family practitioner who is interested in quackery, has summed up the significance of acupuncture research in an interesting way:
Acupuncture studies have shown that it makes no difference where you put the needles. Or whether you use needles or just pretend to use needles (as long as the subject believes you used them). Many acupuncture researchers are doing what I call Tooth Fairy science: measuring how much money is left under the pillow without bothering to ask if the Tooth Fairy is real."
I’m interested in that article too.
“Traditional Chinese Medicine” (TCM) is modern, that’s pretty well known. Acupuncture as is taught and practised in China and much of North America today is TCM. There have definitely been certain modern developments such as electro-acupuncture, laser acupuncture, and ear acupuncture (the system was actually developed in the US.) 5 element acupuncture as practised by JR Worsely is also a modern derivative. Both TCM and 5 element acupuncture have their roots in Classical Chinese Medicine, but have deviated from the Classics in certain ways.
“Classical Chinese Medicine” (CCM) is pre-TCM Chinese medicine. Acupuncture definitely played a major role. It consists generally of the classically defined methods found in the Nei Jing, the Nan Jing, the Jia Yi Jing, and the Zhen Jiu Da Cheng Jing. Funnily enough, this form of acupuncture strongly influenced French Acupuncture, which in turn influenced European acupuncture in general.
I know next to nothing about Japanese or Korean acupuncture.
“Ancient Chinese Medicine” (ACM) is Chinese medical literature that has been discovered archeologically. The MaWangDui silk texts from 168 BC demonstrate that meridian theory was well established, a rudimentary form of acupoint theory existed, and Qi Gong was already in use. The text also contains many herbal prescriptions.
The meridians described in the Ma Wang Dui texts differ only slightly from those described in the CCM text of the Ling Shu, which is the second book of the Nei Jing.
A translation of the Ma Wang Dui medical texts exists, it’s called “Early Chinese Medical Literature,” but it’s pricy: $500 on Amazon! You can often do an interlibrary loan for it, though.
TCM may be modern, but acupuncture is old.
[QUOTE=taai gihk yahn;900581]http://www.quackwatch.org/01QuackeryRelatedTopics/acu.html
"Harriet Hall, a retired family practitioner who is interested in quackery, has summed up the significance of acupuncture research in an interesting way:
Acupuncture studies have shown that it makes no difference where you put the needles. Or whether you use needles or just pretend to use needles (as long as the subject believes you used them). Many acupuncture researchers are doing what I call Tooth Fairy science: measuring how much money is left under the pillow without bothering to ask if the Tooth Fairy is real."[/QUOTE]
May I refer you to a book called “The Basics of Acupuncture”
and of course the WHO’s perspective.
Also, 99% of the studies are done from a TCM model standpoint, as opposed to CCM, and yet there are still marked successes. Interestingly, what is considered “Sham acupuncture” in TCM is actually a distinct methodology in and of itself within the CCM model.
[QUOTE=Xiao3 Meng4;900584]
“Ancient Chinese Medicine” (ACM) is Chinese medical literature that has been discovered archeologically. The MaWangDui silk texts from 168 BC demonstrate that meridian theory was well established, a rudimentary form of acupoint theory existed, and Qi Gong was already in use. The text also contains many herbal prescriptions.
.[/QUOTE]
References to needling in early texts is actually addressed in the article I originally mentioned. Apparently there was some ambiguity over the use of the term as using a stout needle for the purpose of bloodletting and for the lancing of boils and sores was part of early Chinese medical practice. This is rather different than stimulating magical channels full of breath in the skin with thin steel needles.
[QUOTE=Xiao3 Meng4;900588]May I refer you to a book called “The Basics of Acupuncture”
and of course the WHO’s perspective.
Also, 99 of the studies are done from a TCM model standpoint, as opposed to CCM, and yet there are still marked successes. Interestingly, what is considered “Sham acupuncture” in TCM is actually a distinct methodology in and of itself within the CCM model.[/QUOTE]
the problem with the WHO report is that it says little about inclusion criteria of studies beyond that most were randomized and some were not, but says noting about what sort of methodological review was done to determine if in fact a cited study was either reliable or valid;
Cochrane Review is considered the “gold standard” for review and meta-analysis of extant research, and has a much different perspective in general…
here is a sample when you search for Chinese Medicine; almost without exception, the conclusions refer to the poor methodological quality of available studies;
of course, one can argue TCM / CCM don’t do well when assessed in this manner; and I do not disagree - but if the TCM crowd wants to play the EBM game, then they have to play by the rules, do good research and accept the outcome; otherwise, they should go the other route and say straight out that TCM and other similar forms of medicine are highly subjective in their application, and that while they may be individually successful on a case-by-case basis, no generalized conclusions can be drawn
[QUOTE=SimonM;900591]References to needling in early texts is actually addressed in the article I originally mentioned. Apparently there was some ambiguity over the use of the term as using a stout needle for the purpose of bloodletting and for the lancing of boils and sores was part of early Chinese medical practice. This is rather different than stimulating magical channels full of breath in the skin with thin steel needles.[/QUOTE]
The Ling Shu has a description of the 9 needles in scroll 12 (chapter 78.) The detail of their description is much greater than what I’m posting here; the list below comes just from their initial introduction.
- Big needle with head whose tip is sharp - Shallow puncture
- Straight needle with round tip - Used for massage
- Large needle with round tip - Used for massage
- Tubular needle with lance-like tip - Used for bloodletting
- Needle that is like a lance - Used to drain pus
- Needle that is pointed like a hair from a horse’s tail; that is both round and sharp; whose body is slightly large - Used to extricate “cruel Qi”
- Needle whose tip is like the beak of a mosquito or gadfly
- Needle with long body and sharp tip
- Needle whose tip is like a [flat] plane, whose tip is slightly round
Needle 1 and its CCM uses correlate with the method which is known today as “sham acupuncture”; shallow needling. The Ling Shu recommends this method for fevers and heat in the body, which in CCM and TCM theory could be true Yang excess (heat), relative Yang excess due to true yin deficiency (deficiency heat), or invasion of pathogenic heat. No mention is made of using particular regions of the body or particular acupoints, although there is mention of seasonal recommendations and prohibitions.
Heat is the root (and branch) of many problems. In TCM, certain point prescriptions for heat are given, and the needle is inserted deeply to attain Qi (De Qi). In Randomized Controlled Trials, Sham acupuncture is considered to be superficial needling at points that are not acupoints. The CCM treatment of heat uses simple superficial needling and does not mention acupoints at all. Therefore the “Sham” Group is actually getting true CCM treatment for heat syndromes. If the disease being researched is primarily a heat syndrome, the results between TCM needling and “Sham” needling will be inconclusive; often, the “sham” group may have better results than the TCM group!
Needles 7, 8 and 9 are considered to be the precursors of modern acupuncture needles. Needle 7 is for “fever and chills, and painful rheumatism in the luo channels.” Needle 8 is for “Deep and distant rheumatism.” Needle 9 is for “Grasping the Great [True] Qi, which is unable to flow through the gates (points) and joints.” Needle 9 is the closest in nature to modern acupuncture needles.
http://www.itmonline.org/image/bleed1.jpg
The picture shows the nine needles, from right to left.
Needles 7 and 8 collectively belong to needle type 7.
[QUOTE=taai gihk yahn;900596]almost without exception, the conclusions refer to the poor methodological quality of available studies;
of course, one can argue TCM / CCM don’t do well when assessed in this manner; and I do not disagree - but if the TCM crowd wants to play the EBM game, then they have to play by the rules, do good research and accept the outcome; otherwise, they should go the other route and say straight out that TCM and other similar forms of medicine are highly subjective in their application, and that while they may be individually successful on a case-by-case basis, no generalized conclusions can be drawn[/QUOTE]
I agree that most RCTs are not well organized, either due to a lack of proper understanding or a lack of Rigor on the part of the researchers. My post above explains one of the problems that I myself see with the research methods.
Regarding generalized conclusions… that’s a tough one. I personally think every patient is unique, and should therefore have a treatment customized for their particular condition… to use a standard “point prescription” for certain syndromes is very TCM… of course, TCM is the way it is because China, in an attempt to gain credit with the West, “modernized” CCM by reformatting the medicine to conform more with Western Biomed: Pasteurian theories of disease, point prescriptions, and taking out many things that the Western biomed community would have a hard time understanding. As a result, I think TCM is not as complete, not as customizable, and certainly not as effective as CCM… yet it’s TCM which is being “researched,” to play the EBM game as you say. **** politics.
[QUOTE=taai gihk yahn;900596]
Cochrane Review is considered the “gold standard” for review and meta-analysis of extant research, and has a much different perspective in general…
[/QUOTE]
Wow, cool site! Thanks for that, I’ve bookmarked it.
[QUOTE=Xiao3 Meng4;900608]I agree that most RCTs are not well organized, either due to a lack of proper understanding or a lack of Rigor on the part of the researchers. My post above explains one of the problems that I myself see with the research methods.[/QUOTE]
having done research myself, I agree that it is very difficult to design a good study, and in some cases it may not be possible to accurately asses certain things w/RCT’s (although anecdotal case studies can be a great alternative!)
[QUOTE=Xiao3 Meng4;900608]Regarding generalized conclusions… that’s a tough one. I personally think every patient is unique, and should therefore have a treatment customized for their particular condition… to use a standard “point prescription” for certain syndromes is very TCM… of course, TCM is the way it is because China, in an attempt to gain credit with the West, “modernized” CCM by reformatting the medicine to conform more with Western Biomed: Pasteurian theories of disease, point prescriptions, and taking out many things that the Western biomed community would have a hard time understanding. As a result, I think TCM is not as complete, not as customizable, and certainly not as effective as CCM… yet it’s TCM which is being “researched,” to play the EBM game as you say. **** politics.[/QUOTE]
well, you’ve hit the nail on the head; I agree 100% w/your assessment of TCM versus CCM (my sifu would agree too - he learned CCM from some old guy in NYC Chinatown by the nick-name of “One Needle Wong” - you can imagine what that might have entailed…); TCMis very much a construct and does try to dovetail, almost desperately, w/biomed approach, which sort of strains both…
and yes, everyone is unique - which is why when you use a standard formula to evaluate and treat someone w/something like osteopathy, you get into trouble real fast, because if you use the same maneuver on everyone with similar symptoms, some will get better, others won’t, because for some it was the right thing, for others not; and so you will not get statistically significant effect; OTOH, if you individualize the dx/ rx. for each participant, then you get nailed on poor methodology! and as far as the rules of the RCT game go, you fail, and rightly so!
look, if people would read my posts a bit more thoroughly, they might notice that I don’t actually dismiss TCM /etc.as a viable modality; heck, my manual background is primarily osteopathic, which takes at least as much heat as TCM, but IMPE works better than anything I’ve ever come across; but what I am critical about is the whole “have your cake and eat it” bit - meaning that on the one hand TCM tries to paint itself as “alternative” to biomed approach, but then tries to also say that it can be validly judged by biomed standards; so which is it?
so, as you point out, TCM is playing the EBM game for whatever reason - and unfortunately, it’s getting creamed; just mention “TCM research studies” and “from China” together and you will get everything from eye rolls to snorts from anyone who has ever tried to decipher one of those things; bottom line: designing good research is hard; it’s not just about measuring blood levels and throwing around stats and bingo, instant credibility; it’s predicated on a way of thinking that is reductionist first, with the desire to reassemble into the whole, versus the way TCM tries to look at big picture; furthermore, studying the effects of a standardized medication’s effect is hard enough - when you get into something like TCM (or manual medicine), where the skill of the operator is a factor, as well as his ability to synthesize a series of interactions that can behave in a very non-linear, complex-systems sort of way, and you are just asking for trouble; as you say, a lot of the intangibles can get lost in the process; but even my OB/GYN wife when talking about RCT’s will tell you that they don’t tell you the whole story even in “standard” medical practice (to me, RCT’s get you into the neighborhood - but you still have to go door to door afterwards); on the flip side, anecdotal case studies can be very valuable because they express those nuances that RCT’s can’t; and this is my point: I think that a lot of TCM guys want so desperately to be “accepted” or “respected” by allopathic medicine that they figure they have to do this sort of research - and that’s where they get nailed, because first off most of them aren’t trained in research design / methodology / stats and second because what they do is highly subjective in a lot of ways - like tongue or pulse dx. - each practitioner has their own take on it, and can make it work for them - but they may totally contradict the next guy - meaning that intra-rater reliability is good, but inter-rater su(ks! and right there you have a major problem from an EBM perspective
which is why I say this: personally, I have no problem with the notion that TCM, like a lot of osteopathic stuff, is very subjective, and multifactorial, and that the ability to reproduce results from one person to the next by some sort of formulaic approach just doesn’t really work; what’s wrong with the unique interaction between doctor and patient being a factor in that person’s healing? nothing; but if you want to be able to claim efficacy from this perspective, what you can’t do is generalize to a certain herb or acupoint being “effective” for treating something like chronic bronchitis; fact is, we are still human beings, and if placebo effect is operating to varying degrees during TCM or similar types o treatment, I think that’s ok, it’s part of the process along with the more “objective” aspects (problem is, insurance companies don’t want to pay for that, of course);
anyway, don’t mistake my skepticism for dismissal - a true skeptic always pushes hard - but when presented with solid evidence will change his opinion based on that evidence; my feeling is that you can’t pull any punches: if TCM is going to try to legitimize itself via the EBM route, the biggest favor that we can do is rigorously critique those studies, point out their flaws, really look critically at the data; only in this way will TCM / acup. be taken as credible by the main, if it can stand up to scrutiny at this level; of course, if it can’t succeed in this venue, then it should consider letting it go and embrace the fact that it doesn’t fit into that mould - meaning it may not be able to make global claims, but at least it has a chance to be taken seriously on its own terms…
[QUOTE=Xiao3 Meng4;900615]Wow, cool site! Thanks for that, I’ve bookmarked it.[/QUOTE]
glad you like it - it is the “gold standard” for evaluation of research, meaning that the medical establishment will look to this for guidance - meaning whether we like it or not, we had better pay attention to it…
[QUOTE=taai gihk yahn;900581]http://www.quackwatch.org/01QuackeryRelatedTopics/acu.html
"Harriet Hall, a retired family practitioner who is interested in quackery, has summed up the significance of acupuncture research in an interesting way:
Acupuncture studies have shown that it makes no difference where you put the needles. Or whether you use needles or just pretend to use needles (as long as the subject believes you used them). Many acupuncture researchers are doing what I call Tooth Fairy science: measuring how much money is left under the pillow without bothering to ask if the Tooth Fairy is real."[/QUOTE]
I cordially invite anyone who believes the statements quoted above to visit me for empirical clarification on this subject. I will gladly stimulate the appropriate energy point or points in order to cause your body site of choice to become either totally numb and devoid of any feeling or sensation whatsoever, or to become so sensitive that the lightest touch will be quite painful.
Alternately or additionally, I would be happy to dramatically increase or decrease the the internal organ function of your choice by similarly stimulating and manipulating the appropriate acupuncture points. For example, I could cause you to experience multiple, copius bowel movements everyday for next several days, or cause you to have no bowel movement whatsoever for the next week or two. :eek:
Your choice, of course, but be careful what you ask for…! These affects can be convicingly demonstrated whether you believe that I can do so or not, and does not depend on mental suggestion or the like to be effective. :rolleyes:
Real Classical Oriental Medicine is a precise method of energy healing which easily transcends what people believe to true or false about it, and has done so with such success for such a long time, that it has unwittingly created a major problem. Namely, that more than half of the total human population of our planet is Mongoloid by race and living in Asia, they are too healthy on the whole, they live too long, and there is not enough of almost anything to meet their needs.
The World Health Organization (WHO) has estimated that more human suffering, illness and disease has been successfully treated thus far in human history by Classical Chinese/Oriental Medicine than all other healing and medical modalities combined to date.
Not too bad for supposed quackery, eh? 
Doc Stier, OMD
I’ll say this about it, I never believed it.
Then I was getting rehab on my left shoulder for tendonitus and an “impingment”.
The therapist suggested Accupunture, I laughed and said I don’t believe in that stuff.
He replied I had nothing to lose so I said sure.
Well, he put a needle in my hand, on that web between the thumb and index finger and some on shoulder, put a pad that contracted my muscle ( we had used just the pad before to no real difference) and after 20 min session, I had almost total ROM and after 5 sessions I was MUCH better.
That’s all I can say.
[QUOTE=taai gihk yahn;900632]having done research myself, I agree that it is very difficult to design a good study, and in some cases it may not be possible to accurately asses certain things w/RCT’s (although anecdotal case studies can be a great alternative!)[/quote]
My vision of the future of Medicine is an integrated approach. A major component of this is inter-disciplinary respect, understanding and communication. I don’t want to oppose other models, I want to work with them for the benefit of my patients.
In this vein, it’s very tempting to want to “speak the local language”; to have some kind of Western BioMed explanation as to why what I’m doing actually works… and I will admit that I’ve collected a few choice pieces of research which I feel to be well designed and up to snuff, or at least vetted by a respectable international body. However, I am 100 in agreement that studies from China are NOT reliable, RCTs are often not able to accurately assess certain components of acupuncture due to their propensity towards generalization, and TCM studies often leave huge gaps in their approach. It’s to the point where I feel that I’m better off explaining acupuncture to MDs via the standard “Foreign Body Invasion” model (“Look, it’s like simultaneously capitalizing on the inflammatory/autoimmune effects of getting a sliver and the effects of triggering a selected nerve fibre response…” Super crude, limited in scope, but understandable at least.)
The anecdotal case studies method is definitely the route I prefer these days. In Canada, many medical tests are government subsidized, so it’s very easy to have patients get a bunch of tests done before beginning treatment, and have them track their progression in part through regular testing. Of course, the changes in their symptoms are also an important component, as are the changes in their signs… although often times acupuncture deals with subclinical signs, so it’s sometimes difficult to point to these when talking with a Western Doctor. Naturally, it’s easier when there’s some kind of true clinical sign. In combination, they provide a strong picture of the results of treatment for myself, the patient, and their doctor.
Actually, my father went to see an acupuncturist in Toronto a few years back. He had quite poor liver funtion and high cholesterol. His bloodwork has always been a cause for concern. After his treatments, he went and had new bloodwork done, and his MD called him in to discuss the results. The first thing he asked was, “are you on any medications or treatments that I’m not aware of?” My dad, being a classic “don’t p!ss off the MD” personality, said No. His MD continued on to say, “Your bloodwork is the best it’s been it 15 years.” If only my dad had explained himself!
The rest of your post was a truly enjoyable and informative read. In no way do I feel you to be criticizing acupuncture, and I commend you for your rigorous approach to research analysis.
Haha Doc, way to throw down the gauntlet! 
Glad to hear you had a positive experience! 
You going to pay for my bus ticket down to Texas Mr. Strier?
Alternatively you could contact James Randi and try to claim your million bucks.
[QUOTE=SimonM;900706]You going to pay for my bus ticket down to Texas Mr. Stier?
Alternatively you could contact James Randi and try to claim your million bucks.[/QUOTE]
Sorry, Simon, you’re on your own for the bus fare.
And I don’t think my work qualifies for James Randi’s challenge, as it does not fall into the ‘magic’ or ‘psychic phenomenon’ categories, and besides, he has that whole offer set up in a way which guarantees that nobody will ever collect the million dollar prize. :rolleyes:
Doc
No.
Nobody ever has collected the prize because nobody has been able to provide verification under scientific conditions of a supernatural ability.
The ability to regulate the organs of the body by manipulation of an un-measurable, invisible, energy field would certainly qualify as supernatural. And that is what you claim to do right?
[QUOTE=sanjuro_ronin;900668]I’ll say this about it, I never believed it.
Then I was getting rehab on my left shoulder for tendonitus and an “impingment”.
The therapist suggested Accupunture, I laughed and said I don’t believe in that stuff.
He replied I had nothing to lose so I said sure.
Well, he put a needle in my hand, on that web between the thumb and index finger and some on shoulder, put a pad that contracted my muscle ( we had used just the pad before to no real difference) and after 20 min session, I had almost total ROM and after 5 sessions I was MUCH better.
That’s all I can say.[/QUOTE]
well, I have had similar results with people who have had the run-of-the-mill-PT (that is, crap) and I’ve gotten my hands on them and they’ve had full shoulder AROM in minutes; reason is that most shoulder “impingement” has nothing to do w/the suprasipnatus tendon getting stuck, it has to do with hyperteonicity of muscles that resist shoulder abduction (lifting it up sideways), such as intercostals, subscapularis and / or latissimuss, which are easily treatable with one or two simple manuevers; alternately, doing a simple HVLA to the thoracic spine can dramatically increase available AROM as well; once in a while, it’s more complex, like treating the same side hip / pelvis (quadratus lumborum being a big culprit here), sometimes you have to squeeze their head for a while as well…
anyway, I don’t know what points in the shoulder were needled, but the LI4 pt. seems to have some sort of generalized detonification effect on arm flexors / internal rotators (of which subscap and lats could be considered contributory); anyway, I completely believe that it worked, I just don’t consider it that amazing in context of how readily that sort of thing responds to other intelligent interventions - the really amazing thing to me is that so many PT’s are just thick-skulled and insist on continually cranking on people’s arms with no discernible positive effect…