Posted by: Ticktock | June 28, 2009

Acupuncture – An Implausible Premise Lacking Evidence

How could something thousands of years old be wrong?

How could I ignore acupuncture’s popularity?

I received the same typical questions from friends and family when I told them that I oppose acupuncture. They also told me anecdotes of how acupuncture worked for them. My family and friends have a powerful ally on their side, Dr. Oz of Oprah fame, who makes many of the same arguments. It seems the deck is stacked against me on this.

I think what they’re getting at is this… where do I get the balls to say with confidence that acupuncture, an ancient medicine with hundreds of satisfied customers, is useless bunk? Let me state up front that, besides having a wife who studied acupuncture, I am not an authority on alternative medicine. I’m a skeptic, I respect science, and I’ve spent some time researching the subject, but I don’t hold a PhD in eastern or western medicine.

As for anecdotes, they are outside the realm of what I can assess. There can be any number of reasons that acupuncture may seem to be effective; I have no way of analyzing or comparing one person’s positive anecdote with any number of uninteresting negative anecdotes. The only way to test whether a claim works is to verify it using properly controlled peer reviewed studies, and under those conditions, the extraordinary claims made by acupuncturists have been found to be lacking.

But what I’m about to write may shock you, considering my introduction to the topic… acupuncture works for some conditions. People feel better after they’ve been treated with acupuncture, and I won’t deny that. Yes, needles piercing strategic points along specific invisible meridians have been shown to reduce pain, but… fake non-piercing needles placed at random points on the body also reduce pain. It’s been proven numerous times that acupuncture is only as effective as a sham placebo.

There may even possibly be an endorphin response of opioids that comes from being needled, further adding to the placebo effect detected in research trials.

So why am I hating on acupuncture if it has an actual effect? Because acupuncture doesn’t work as claimed, because people who seek an acupuncturist may need actual medicine, and treating with placebo is unethical because deception must occur for the response to be most effective.

As for the endorphins, those aren’t anything special. You can get the same response by pinching your skin, running a mile, or having sex.

The Concept of TCM

Before the origins of accepted traditional Chinese medicine, the Chinese believed that illnesses were caused by ancestors and demons. Those who say that there is a value in ancient ideas should remember that even the Chinese have justifiably abandoned ideas even more antiquated than acupuncture.

Acupuncture itself is rooted in the ancient Chinese philosophies that led to Taoism, associated with Lao-Zi of the 6th century but understood to be much older, which says that humans should strive to be in harmony with nature.

In TCM, the force that separates humans from nature is Qi (chi), an energy which Taoists believed to be flowing through our bodies, giving us life. There are two opposing forces, yin (dark and cold) and yang (light and hot), representing the duality of nature. The chi flows through twelve meridians (one for each month of the year), or channels, and each meridian is associated with a specific organ. Along the pathway of these meridians are supposed points where needles can be inserted to stimulate the chi. There were originally around 365 acupuncture points (one for each day of the year), but now there are nearly 2000, with no explanation of how these points were determined.

The meridians are based on the philosophical Taoist philosophy that there are six elements represented in the body, each associated with two major organs (one for yin and another for yang): water (kidney/bladder), wood (liver/gallbladder), earth (spleen/stomach), metal (lungs/large intestine), fire (heart/small intestine), and finally, inexplicably, an imaginary sixth element called Minister Fire, which is associated with the debatable meta-organs called the pericardium and san jiao or “Triple Warmer”.

A patient of Chinese medicine might be diagnosed with a combination of external pathogens: damp, cold, heat,wind (+ summer heat and dryness). The four main external pathogens are, in turn, an exchange of ideas from the ancient Greek idea of humourism: damp is “phlegm”, cold is “black bile”, heat is “yellow bile”, and wind is “blood”.

Further evidence of an association between external pathogens and the four humours include the fact that they are diagnosed for exactly the same diseases as the four external pathogens. You’ll also find recommendations in both cultures to adjust your diet depending on the pathogen or humour in which you are in excess. Down the line, pathogens and humours match up: the seasons, the colors, the foods, etc… The only major difference is that the Chinese have two extra, and I suspect that those two were added because the Chinese prefer the number six (which is why they have six seasons).

In addition, the TCM technique of “cupping”, lighting a vacuum under a glass bowl and placing it onto the skin, was also used to treat an imbalance of the humours.

Could it also be that acupuncture may have been a form of bloodletting, the idea of puncturing the body to release excess humours? Many of the earliest references to acupuncture talk about needling the blood vessels and draining blood. At the least, acupuncture and humourism share the same origins, and yet, society dismissed humourism as implausible many years ago.

The History of TCM
The oldest evidence of acupuncture is not 4000 years old, as is sometimes claimed. There have been arguments by some that the Iceman Otzi found in the mountains of Italy might have acupuncture marks tattooed on his back that correspond with his medical condition, but this idea is speculation (and extraordinary speculation since he would predate the earliest known acupuncture texts by thousands of years – and he was a full continent away from China).

The earliest confirmed documents on TCM are the Yellow Emperors Classics of Internal Medicine, or the Huang Ti Nei Ching, which probably originated in the first century CE. Although the manuscript is attributed to the Yellow Emperor, it’s authorship is dubious. In fact, the historicity of the Yellow Emperor is debatable; he has been described as a virgin-born legend who ascended to heaven after living a life of miracles. Sound familiar? Scholars are certain that the Huang Ti Nei Ching was written and revised over the years, much like the Bible. It does not give specific instructions on how acupuncture works, but instead gives zodiacal recommendations for the best times to perform needling in the form of Socratic dialogue.

The earliest reference to Chinese needles references lancing abscesses and bloodletting of blood vessels, and what is now known as acupuncture points were probably spots that were suggested for bloodletting. Archaeological and historical evidence of the time indicates nine large bulky needles were used, and they would more likely draw blood than stimulate energy.

A rudimentary form of acupuncture was first tried in America in 1820, when needles were used, to no avail, in an attempt to revive drowned kittens. Acupuncture was popular in Europe at this time, but lost favor during the opium wars of the mid 1800s.

The Chinese government attempted to ban the use of acupuncture several times, until it was revived by Chairman Mao in the “barefoot doctor” campaign. Mao did not believe in acupuncture, nor did he treat himself with it, but he used it as a way to bring his people the inexpensive health care he had promised . “Even though I believe we should promote Chinese medicine. I personally do not believe in it. I do not take Chinese medicine.”

New York Times journalist James Reston wrote a front page article about how he was treated for an appendectomy while he was in China. It’s common for acupuncturists to say that instead of using anesthesia, he was treated for pain with needling. In fact, this is not true. He was treated with chemical anesthesia and an epidural during the surgery, and he reported getting a shot for the pain in post op. It wasn’t until a few days after the surgery that he was treated with acupuncture. Reston described it as painful, and his only words of kindness was that the pain from the needles distracted him from the mild discomfort in his stomach. His stomach discomfort went away, as it naturally would, the following day.

Where did TCM theories come from?
We don’t know who discovered chi, the meridians, the acupuncture points, or any of the other complex diagnostic techniques of TCM. We don’t know how these things were found, since they can’t be detected, measured, or verified. How can we believe in a system based on invisible energy that flows through invisible channels and is regulated by needles stuck in invisible points? Furthermore, this is a claim that doesn’t meet testable predictions, such as other invisible universal properties like gravity and magnetism.

Truth be told, medieval Chinese did not have a practical understanding of anatomy, nor did they have any concept of the measurable forces of nature. Indeed, their explanations of internal organs are quite lacking. Chinese anatomy is even embarrassingly described in the introduction to the Huang Ti Nei Ching by the English missionary, Dr. Lockhart as if “…some person had seen some imperfect dissection of the interior of the body, and then sketched from memory a representation of the organs, filling up parts that were obscure out of his own imaginings, and portraying what, according to his own opinion ought to be, rather than what they in reality are.”

Chi has the same symbol as the character for “steam from cooked meat”. It was a way to describe the vapor that comes out of our mouth on cold days. Somebody who doesn’t have an understanding of water vapor and gas can be excused for describing it as a life force, but we understand anatomy and physics well enough now that such early descriptions should be ignored. Western culture had a name for this imagined element also: the quintessence.

Meridians, as I’ve suggested, were an explanation for blood vessels and the pulse. The ancient Chinese did not dissect cadavers, so they had no way of knowing that blood pumps through those channels that are mapped all over the body. But, they could feel the pulse, and it must have seemed supernatural. Indeed, the pulse is one of the first diagnostic tools that modern acupuncturists use when treating a patient.

Who knows how they came up with acupuncture points, but based on my experiences, the points correspond with recognizable pressure points that my wife loves to jab violently with her thumb when she wants to prove to me that the acupuncture points are real.

Modern veterinary acupuncture uses points that were transposed from a human chart onto an animal chart, which is why you’ll find a “gall bladder” meridian on an animal that has no gall bladder. Oops.

The Acupuncture Process
The initial TCM diagnosis has five components:

  • Inspection – She examines your tongue and looks for any discoloration, bumps, or layers of film. The tongue like other body parts is thought to be a symbolic map of the body.
  • Auscultation – She listens to your breathing and your heart beat.
  • Olfaction – She smells you.
  • Palpation – She checks your pulse. Acupuncturists claim to detect many problems from irregularities of the pulse.
  • Inquiring – The acupuncturist asks a series of health questions, including questions about your poop.

Based on this input, the acupuncturist chooses which points to needle, or if required, she will do another form of TCM. The patients almost always lie prone and are told to relax during the session.

The points are found by using a unit of measure called sun (pron. soon), but the points are invisible. Many of the points are based around nerve clusters, so the patient can easily confirm whether the acupuncturist is at the right point. Needling a specific meridian does not necessarily correspond to the body part that needs healing. For instance, if I came in for a stomach ulcer, the acupuncturist might needle my lung meridian. The names of the meridians are arbitrary and do not signify their purpose.

Moxxibustion is when the dried mugwort herb is burned and waved over an area that is “cold”. It smells like marijuana, and the plant in its raw form can be hallucinogenic. Mugwort or Moxxa has been used by many cultures for many purposes.

Gua Sha is a technique that is used for congested individuals (with stagnant chi). Oil is rubbed on the patients back and then a spoon is used to scrape the back until it’s nice and red. The idea is that the aggravation draws toxins to the surface and away from the infection.

Cupping is a technique that involves lighting a vacuum into the bowl of a cup and placing the suction onto the patient’s skin.

Testing TCM
There are a few problems testing acupuncture, the most classic of which is finding a way to perform sham acupuncture. In order to have a well designed study, at least on group should be treated with fake needles. It’s been difficult to design a needle that stays upright but does not pierce the skin. A retractable needle has been developed that serves the purposes.

Placebos
The term placebo means “I please”, and it’s a complicated physiological response that we don’t fully understand. It’s been proven that placebos work better when the treatment is more psychologically convincing. We do know that the best way to test a medical claim is to compare two groups: one who receives the proper recommended treatment and one who unknowingly receives a fake treatment. Each group must be blind to whether they are receiving the real treatment of the fake treatment; in addition, an ideal situation would require each doctor to be unaware of which treatment they are providing.

Acupuncture is the perfect habitat for placebos, which thrive in situations of perceived power and perceived authority. When you arrive at an acupuncture clinic a doctor in a white coat spends time diagnosing you, asking you health and wellness questions, checking your pulse, and examining your tongue. The environment for TCM is usually very relaxing and calm and, of course, it’s also very hands-on. The strategic placement of needles gives an impression of precision, and knowing that the treatment is ancient provides enough perceived mysticism to boost the placebo even more. It’s been proven that the ritual of sham acupuncture outperforms the effects of a sugar pill, so there is something special about the acupuncture clinic’s placebo effect that must be noted. These are not excuses to explain away the anecdotes of TCM patients, but they are simply reasons to control for placebo.

Perhaps the best description for a placebo response in acupuncture comes from Ch’i Po in the manuscript Haung Ti Nei Ching. He said, “This is the way of acupuncture: if man’s vitality and energy do not propel his own will his disease cannot be cured.”

An article from NPR dances around using the term “Placebo”. In the interview, Cherkin refused to use the word “placebo” because he claimed that people usually dismissed it as “something that doesn’t work”. But just because a term has a negative connotation, doesn’t mean that using the definition of the term (and not the name) will help your argument.

Researchers are also unclear how the ancient practice actually stimulates a healing effect. An interesting twist to Cherkin’s findings is that people who were given simulated acupuncture — the needles push on the skin, but don’t penetrate — reported just as much benefit as those who had standard acupuncture.

It’s possible, says Cherkin, that stimulating these standardized points on the body, even without piercing the skin with needles, does cause a specific physiological process that reduces pain.

But there’s another possible explanation, too: Perhaps the whole ritual of performing an acupuncture treatment has a generalized effect. “The patient is feeling that they are getting a helpful treatment,” explains Cherkin, “and as result the brain reacts in a way that leads to improvement.”

False Placebos
In addition to placebo relief there are false placebo indicators, such as natural regression, additional treatment, and answers of politeness. Natural regression means that the symptoms disappeared naturally and that causation does not imply causation. A patient could also be on other medications and treatment and simply attribute their relief to needling. Answers of politeness are a significant problem depending on the culture. There are countries and regions where they are compelled by a social code to submit their will to authority. None of these examples are excuses, they are just more reasons why we must have adequate controls.

Logical Fallacies

  • Appeal to Antiquity – Just because a treatment has been used for “thousands of years” does not mean that it has value. Acupuncture was developed in a time when we knew very little about human anatomy, when very few understood biological processes. I don’t think any of us would accept bleeding with leeches or treating the humours, and yet both of those ideas were developed thousands of years ago too.
  • Three Men Make a Tiger (Argument Ad Populum) – I use the Chinese saying here to illustrate my point. It means that if one man says that there’s a tiger in the marketplace nobody would believe him, but people might start believing the story if three men were to say that there’s a tiger in the marketplace. Just because more people are receiving acupuncture doesn’t mean that it’s true. The merits of a medicine are not defined by it’s popularity, but by it’s objective value.
  • Special Pleading – Acupuncture should not get a special pass that excludes it from the laws of science. It’s not the job of science to invent new ways to detect something that is undetectable. Chi is a cultural concept that has no anatomical meaning, so anyone who insists that chi is real should examine whether they are asking for special treatment that would defy observation.
  • Confirmation Bias – We have a tendency to note (even exaggerate) the occasions when our beliefs are verified, and ignore the times when our beliefs are contradicted.
  • Appeal to Personal Anecdote – Humans have an enormous capacity to fool themselves into a belief based on what seems to be a very real personal experience. Personal Anecdotes are not an acceptable way to explain a claim. We all know of products and services which were once verified by anecdotes (even dating back to bleeding with leeches), but no matter what somebody says subjectively, it doesn’t change the objective facts best explained through the scientific method.


Claims

Unlike western doctors, acupuncturists can make any claim without being legally challenged by a regulatory system. I examined the claims of a Cincinnati acupuncturists to see whether they are supported by the evidence compiled by the Cochrane Review. The following claims by Carol Paine, a Cincinnati acupuncturist, are contradicted by the evidence against them: stroke, asthma, Bell’s Palsy, depression, drug addiction, smoking addiction, insomnia, and period pains.

Evidence against TCM
There are several factors that go into judging the quality of a study. As stated before, we must control for placebo by providing a control group who receives sham acupuncture. We must also make sure that a low number of the study’s participants had a prior positive belief of the treatment’s value. The study should have at least 25 individuals in each group, and it should have a low attrition rate. Finally, the study should be published in a reputable peer reviewed journal, and it’s even better if the study has been independently vetted via replication and critical analysis.

Included in these studies are examples of when acupuncture seemed to help significantly, but failed to show greater results than the placebo group. Acupuncture makes specific claims that acupuncture only works at specific points on specific meridians, and those claims should be considered false if well designed studies show those points and meridians to be no better than placebo.

Evidence that seems to be in favor of TCM but the studies lack quality

Evidence in favor of TCM


What’s the Harm

  • This treatment typically costs $100 a session and most insurance companies don’t pay for it.
  • An acupuncturist will treat you even if you are healthy and claim that it is preventative.
  • Nine million dollars and more are spent every year studying acupuncture by our govt’s NCCAM program.
  • There is a pervasive belief in TCM that symbolic medicines can heal certain ailments, but this belief has led to the endangerment and extinction of several animals, such as the tiger, the rhino, and the sea horse.
  • It teaches a false idea of anatomy and physiology.
  • Putting off scientifically proven western medication in favor of unproven eastern medicine may delay medically necessary or appropriate treatments.
  • Using herbs that have not been tested may end up doing more harm than good. One study showed that Chinese herbs that were supposed to stop cancer made the cancer cells grow faster.
  • The placebo effect is only good for certain things like reducing pain and discomfort
  • TCM practitioners are not sufficiently regulated, and they are not subjected to the same protocols as western doctors. Their claims do not have to be proven.

Responses

  1. […] Dad over at Science-Based Parenting blog has a very thorough take-down of acupuncture, including this gem: acupuncture doesn’t work as claimed, because people who seek an […]

  2. Let me start by declaring my bias. I am a Chinese Medicine Practition in Australia, and hold degrees in Chinese Medicine (Herbs and Acupuncture) and Human Biology, I have done my internship in China and also provided Acupuncture in a major hospital Emergency Department.
    I have just been reading your comments and I was interested to see that you quote research as the standard by which Acupuncture should be measured. However, if that be your yardstick then let it also be the yardstick by which Western Medicine be measured. If that be the case then there is more than enough research that is conflicting and down right contradictory in Western Medicine. I would also assume that you believe in Surgery when needed and yet there is no DBP research for that, nor is there scientific evidence on how most anti- depressants work, or is your requirements only that the old needs to prove itself to the new!
    I would also direct your attention the The World Health Organisation web site where you can find innumerable research documents saying acupuncture works and is not so good. If you want the proof it is there, you only have to look and listen!
    I believe your comments to be a one sided attempt to put down something that you don’t really understand, perhaps that is frightening but so is Western Medical Science.

    • I don’t believe you about anti-depressants and surgery. They’re thoroughly tested just like the rest of western medicine.

      The WHO includes all the acupuncture research, including several decades worth of poorly controlled non-blinded studies. They also include studies performed in Communist China, where scientific research has to be rubber stamped by the government. Their inclusion of acupuncture is a reflection of their political correctness and not on the objective efficacy of needling.

      I’m pretty sure that I understand acupuncture. I do not think that imaginary energy is frightening. I think it’s frightening that you read that whole article and still felt like you had an argument worthy of support.

    • Ian,

      Western medicine is frustrating. One of the main reasons it is frustrating is because you have to provide evidence that your treatment works. One of the mainstays of obtaining this evidence are double blind studies. Within those studies one of the first things that researchers look for it to see if the new treatment works better than a reasonable placebo. So far, acupuncture has not broken that threshold in well designed studies as TT stated very clearly above.

      In Western medicine that is a game stopper. In CAM, for some reason, people just ignore it and continue treating people.

    • Your closing sentence is where you fall on your sword; it clearly an Ad ignorantiam – an argument from ignorance that basically states that a specific belief is true because we don’t know that it isn’t true.

      It seems that any practitioner of pseudo-science relies on logicically fallacies to argue their point and not overwhelming evidence put forward in peer-reviewed medical and scientific studies.

  3. One of the issues I tend to have with skeptics (that I have noticed while having debates with them) is the attitude that other cultures are somehow more “ignorant” or “primitive” and therefore there is this condescension regarding them that allows people to blow them off.

    “Well.. they didn’t know anything.. so we can excuse them for their primitive ignorance”…

    that leads to this idea that somehow WE.. in 2009 Western America are superior in knowledge and ways of thinking.. I don’t think this is true. Maybe this is not what you believe.. but you did insinuate this in your talk. “well we can excuse them.. “.. like they didn’t know anybetter.

    Yet.. in our “advanced” way of thinking.. we have taken on a hubris that disregards vital knowledge from our elders and ancestors. Please do not throw out the baby with the bathwater.

    There are many wise elders from cultures older than ours that have knowledge that has been found to be true and correct and wise…

    I know you stated that the idea that a culture is old means that somehow it is better. That is not what I am insinuating… however.. be careful to do the reverse and say .. “Well they are a bunch of primitive ignorant people that didn’t have SCIENCE and REASONING on their side”.. I have noticed A LOT Of skeptics adopting this attitude… and it is a dangerous path of thinking.

    There are things that even WESTERN medicine did 100 years ago that we have disregarded.. but we don’t say that all Western Medicine is bad.. because early ideas about bleeding were common among medical doctors at one time….

    we took the good and left the bad. Don’t you think that we could do the same for Eastern Medical modalities?… There is a LOT of wisdom to be gained by understanding the body and illness from an Eastern Perspective… things that I truly believe that Science will and have indeed come to verify.

    • It’s a fact that our ancestors, whether they be from the east or west, did not have our current understanding of the sciences that we’ve accumulated over the years. I think you could point to single individuals, including myself, who are ignorant of practical means of survival, but that’s not really my point when I compare our knowledge. My point is that they should be excused for being ignorant of facts that had yet to be discovered, and that modern individuals do not have that excuse. If that came across in a way that seemed like I was belittling their wisdom, then I should have been more clear. I’m not saying they were stupid; I am saying that they were justifiably uninformed about reality due to their circumstances, just as we are uninformed about certain facts that have yet to be discovered.

      There’s a lot that we can learn from our ancestors, such as their philosophical view of nature. I have a lot of respect for their concepts of yin and yang, and I even use the elemental personality theory in my acting classes. What I do think we should discard are antiquated ideas of medicine that have been disproved by quality science. Any claim, whether they be contemporary or primitive, should be assessed by reasoning and the scientific method.

      -Colin

  4. I also want to state upfront that I edited the description of my talk that I posted several weeks ago. Mrs. Kagin pointed out that my broad attack of CAM was unfair. Instead of calling all CAM “innocent quackery”, I have edited to say that most CAM is implausible and ineffective, and I base that choice on the negative alternative medicine studies coming out of NCCAM.

  5. Another quick point I would like to make is that you focus on “invisible” alot when referring to CHI … as thought the fact that it is “invisible” somehow proves it does not exist.

    You of all people should know that there are a LOT of things that are “invisible”.. but we can still measure, feel etc..

    What about Gravity? Gravity is something we FEEL. it is a force .. yet we cannot SEE it.. so..does that mean that the nature of it’s INVISIBILITy makes Gravity “supernatural”?

    Some people at some point MAY have looked at that in that way…

  6. Yes, but I made it very clear in the above text (perhaps not in my speech) that gravity and magnetism are theories that have been proven because we can make testable predictions about them that have all been verified.

    The only testable predictions of chi have failed.

    Also, I’m assuming that if you attended a meeting hosted by atheists that you’re an atheist (forgive me if you’re not). Christians have made the same argument, and it’s called the “special pleading fallacy”, which I mention in my article. Even invisible forces must meet testable predictions before they can be considered a fact. Otherwise, Camp Quest owes every one of it’s campers $100 for the inconvenience and hypocrisy.

  7. Caelidh, do you realize how gobbeldy-gooky this comment is? Gravity has been proven to exist for centuries, much of physics is based on it, successful engineering projects are designed with it in mind. Bridges I drive over would fail if they weren’t. There’s nothing mysterious about it. It’s there.

  8. I have heard recently that a study at UCLA has developed telemetry which is able to measure a “subtle form of bio-electrical energy” that seems to flow through the fascial sheaths of the body.

    In addition, I wish that you would use the term “sceptic” more appropriately. To be a true sceptic requires that I have an open mind that observes the evidence of my senses and critical thinking without prior prejudice. From your article, I see a person who has made a decision rather than an observation about TCM. Further, it seems that this decision is based more upon the attitudes and prejudice of the author, than on significant personal experience.

    As a long time student of a great many things, including Chinese martial arts, philosophy and medicine, it is clear to me that you are making the most common Western mistake in approaching the subject of TCM. That being the expectation that the oriental mind experiences the world in the same fashion as the occidental mind. There was an interesting study I read in which students at a western university and a Japanese university were shown a film under identical circumstance and then asked to describe what they had seen in their own words. The film was focused on underwater nature. The western students wrote of the fish, the divers and various things that happened in the film. The eastern students wrote of the background, the relationships between different elements and the overall rhythms and flow of the action. This is just one indication of the cultural differences which lead to such a divide in how we and they perceive questions of health and medicine.

    Finally, please consider the adage I have heard arise in different ways in various cultures: It’s not the technique, but the technician that makes the difference. I good allopathic doctor will be more effective than a bad acupuncturist. For the same reason, a good acupuncturist will be more effective than a bad doctor. Any honest doctor will tell you that a great deal of what they do is based on the placebo effect. It is generally understood by any effective medical practitioner from any culture that our own bodies are their own best healers. It is the doctors’ job to encourage our bodies to engage their healing capacity.

    Each kind of medicine has its place. If I get a broken arm or other physical trauma, I want to go to a western doctor. However, if I have a chronic illness – or simply want to strengthen and maintain my currently excellent level of health, I will consult a Chinese doctor. Both studies and personal experience have led me to observe that this approach engages the strengths of both systems of medicine.

    I also find it curious that the article above seems to address “belief” in TCM, as if it were a form of religious devotion. I certainly don’t require my clients to “believe” in my abilities. Either I am able to help them, or I am not. In the vast majority of case, I am. What else matters?

  9. If it’s determined that there really is an energy that runs through our meridians and controls our health, then I will re-examine my conclusions. Forgive me for not changing my mind on something that a stranger may “have heard”; cite your source. And when you do cite your source, please let me know how that information explains specific meridians, specific acupuncture points, and how needles stuck in those points can manipulate your health.

    You can see my definition of “skeptic” in my “about me” section. It falls in line with other prominent skeptics, such as Steven Novella, whom I quote in my definition. I’m more than happy to have an open mind and change my stance when proven wrong, but you have failed to put forth any evidence. I find it amazing that you can read that entire article with multiple links to research, and not see that I present more than my own prejudice.

    As a matter of fact, by stating your bias in martial arts and Chinese medicine, you are trumpeting your own hypocrisy on the matter. I have news for you. I also attained the highest belt in karate, believing for years that my “kiai” would send forth an invisible energy. I also defended my wife’s interests in acupuncture and it’s cultural importance to other skeptics, and it wasn’t until they presented me with the evidence that I changed my mind. That’s the true meaning of having an open mind.

    Your statements about cultural differences are more appropriate in a discussion on psychology. They are irrelevant to my argument that acupuncture is implausible and lacks evidence.

    Proven medicine has it’s place. Medicine without evidence is not medicine.

  10. Yea, like chi there is this funny thing in the west called ‘love’. You cannot prove it exists with any hard evidence but people claim that this ‘love’ is the reason for all sorts of odd behaviors. For instance, marriage is ususally based on nothing but this unprovable and unscientific feeling. People say they love their offspring but can provide no evidence that love even exists. I hope you don’t mind the suggestion but perhaps your next presentation could be on love?

    • I’ve made that same argument before, that chi should be considered an abstract thing like love. Except, when I made that argument to other skeptics, I was appropriately corrected that acupuncturists don’t claim that it’s an abstraction. They claim that it’s a real life force flowing through real meridians. But, speaking as someone who has used that argument, I respect it more than others that I’ve heard.

      As for love… it hurts me to do this because I know it sounds so cold and robotic, but love is a chemical reaction in your brain. When you’re in love (or when you’re doing cocaine), your brain squirts out a chemical called dopamine which gives you a sudden rush. Then, once you’re in the mood, your brain uses norepinephrine to focus your mind into an infatuation on the object of your affection. Both dopamine and norepinephrine are fleeting one-night-stands. But, there’s hope for us all because there’s also a chemical called oxytocin for long term commitment that keeps your romance burning like an eternal flame (thanks Bangles).

      I think doing a presentation on love would be wonderful, despite your sarcasm. Unfortunately, I’d have to borrow heavily from the Radiolab podcast, as I just did with my explanation of the chemicals involved. I recommend it.

  11. The way you seem to reduce all of human experience to brain chemicals and atoms and physics is limited. I admire skeptical inquiry and find it useful in many areas. However to reduce poetry, or the beauty of the new Wilco record, or love to these terms seems to miss a vast array of human experience. You fall into what Charles Taylor scoffs at in the following interview.

    Richard Rorty one of the leading American philosophers and an atheist himself called Charles Taylor one of the top four or five philosophers writing in the English speaking world. Here is Taylor’s take on the “new atheism” of figures
    like Dawkins, Harris, and Hitchens:
    >
    > (TOJ)-The Other Journal (Interviewer)
    > (CT)-Charles Taylor
    >
    > TOJ: Just to bring us back to the topic of atheism, I wonder if you have any
    > opinion regarding those who are being called the “New Atheists,” say Christopher Hitchens, Richard Dawkins, and Sam Harris, who happen to be quite
    militant in their rhetoric.
    >
    CT: Yes, I happen to have quite a negative view of these folks. I think their work is very intellectually shoddy. I mean there are two things that perhaps I am just totally allergic to. The first is that they all believe that there really are some knock-down arguments against belief in God. And of course this is something you can only believe if you have a scientistic, reductionist conception and explanation of everything in the world, including human beings. If you do have such a view that everything is to be explained in terms of
    physics and the movement of atoms and the like, then certain forms of access to God are just closed. For example, there are certain human experiences that might direct us to God, but these would all be totally illusory if everything could be explained in scientific terms. I spend a lot of time reflecting and writing on the various human sciences and how they can be tempted into a kind of reductionism, and not only would I say that the jury is out on that, but I would argue that the likelihood of that turning out to be the proper understanding of human beings is very small. And the problem is that they just assume this reductionistic view.
    >
    > The second thing I am allergic to is that they keep going on and on about the relationship between religion and violence, which on one level is fine because there is a lot of religiously-caused violence. But what they consistently fail to acknowledge is that the twentieth century was full of various atheists who were rampaging around killing millions of people. So it is simply absurd that
    > at the end of the twentieth century someone would continue to advance the thesis that religion is the main cause of violence. I mean you’d think these
    people were writing in 1750, and that would be quite understandable if you were Voltaire or Locke, but to say this in 2008, well it just takes my breath away.
    But then what we need to do, and this is something many religious people fail to do, is to consider why this phenomena of the new atheism is happening at this
    time. Atheists are reacting in the same way that religious fundamentalists reacted in the past. They are people who have been very comfortable with a
    sense that their particular position is what makes sense of everything and so on, and then when they are confronted by something else they just go bananas
    and throw up the most incredibly bad arguments in a tone of indignation and anger. And that’s the problem with that whole master narrative of secularization, what’s called the secularization thesis, that people got lulled into—you know, that religion is a thing of the past, that it’s disappearing, that it did all these terrible things but it’s going to go away and so
    > on—because when it comes back people are just undone.
    >
    > TOJ: Or when they realize it never went away….
    >
    > CT: Yeah right, not only did they not notice that it was always there and never really went away, but phenomenologically in their experience it came back
    > suddenly. Religion returned! And why? Well, for no apparent reason. It doesn’t make any sense in light of the secularization thesis. And it’s wrecking the
    whole universe they had tidily built. So they get terribly angry. And that makes for a very curious kind of atheism. So this tells us something about the
    zeitgeist, about what’s happening, about people’s having bought very deeply into a particular master narrative, namely the secularization thesis that
    religion is on its way out, and from which they are getting a certain degree of spiritual comfort, and now that this has been disrupted they are reacting with
    > rage.
    >
    > TOJ: That’s very interesting. So if I’m hearing you correctly you’re saying that
    > the extreme atheist reaction to the return of religion is actually a spiritual reaction to an interrupted spiritual narrative.
    >
    CT: Exactly, and people are very deeply invested, I mean we’re all deeply invested in our spiritual narratives, but we don’t all have this sense that
    > history is on our side. It’s terrible in that sense.
    >
    > TOJ: In A Secular Age you suggest that there is a parallel between these militant atheists and really dogmatic religious people. Would it be on that
    > score?
    >
    > CT: Exactly, exactly. The militancy is stronger in the U.S. than in Canada because there is this sense among many American Christians, more so among Protestants than Catholics, that America is founded on a certain kind of inter-denominational Protestant Christianity. I mean we know that a lot of these founders were closet Deists, like Thomas Jefferson, but for the majority of Americans it really was about a providential carrying out of God’s plan and
    > so on. And America is now split between people who hold onto this kind of
    > national identity and others, a much smaller but more influential group who
    > dominate the media and the universities and so on, that have a completely
    > different read. The same constitution and the same constitutional rules are
    > read in a secularist light; that is, there is no privileged position and that
    > all religions are equally to be abstracted from. And the upshot is that each of
    > these groups thinks the other has betrayed America, and is being un-American.
    >
    > TOJ: So would you see both the religious fundamentalists and the militant
    > atheist then as reactionaries? You know, driving wedges between people and
    > leading to more misunderstanding and demonization?
    >
    > CT: Absolutely.
    >

    • Dude. That is way off topic, and I refused to be sidetracked in my own comments section.

      Whether you feel comfortable or not with chemicals interacting in our brain to create the sensations of love, they are there. I certainly don’t like referencing them (I regretted playing that hand and called it “cold and robotic”), but my own distaste for the facts don’t change the facts. The simple truth, whether we like it or not, is that science can even make testable predictions on something as abstract as love, so that argument doesn’t hold water. Even if it did hold water, chi is not considered an abstract force by most people who believe in it.

  12. I just wanted to publicly thank Colin for the presentation he gave to the Free Inquiry Group. We are a group of Secular Humanists, Agnostics, Atheists, and Free Thinkers who could use a little more skepticism and critical thought when it comes to certain issues. I think that skepticism and atheism go hand in hand and am constantly puzzled by non-believers who accept ideas of alternative medicine and New Age hocum. It seems natural to apply the skeptic tools to all claims, not just religious ones. Thanks again Colin, I enjoyed your presentation.

    John Welte, President, Free Inquiry Group

  13. The question isn’t if we like a testable hypothesis, the question is wheather this is how we want to define human experience. It seems like the end all be all for you (another form of fundamentalism albeit a popular one) but I find this paradigm extremely limited. This argument goes back to the death of positivism (empirical evidence is the only way of knowing something) but has been brought back to life with the advent of new atheism. Your atheistic 18th and 19th centruy forebearers are rolling over in their graves.

    Read the interview, I don’t think you understand it or its connection to the underpinnings of your blog.

    • @Bernard
      Oh, I totally understand it. I just think it’s a non-sequitur that doesn’t address my arguments against acupuncture. I use skepticism to assess claims, not to define my life experiences. I happen to think the universe is amazing enough that I don’t have to convince myself that every fantasy dreamed up by every culture needs to be honored like abstractions such as love. New atheists, and I guess I am one now that you’ve lumped me into them, see the beauty of the natural universe, and that’s just fine with us. If you want to judge my character, that’s another topic, perhaps more appropriate in a private mail. What you’ve done is sidestepped the issue so that you don’t have to confront your own sacred cows. No matter how many ad hominems you want to insinuate against my point-of-view, it won’t make you any more correct.

  14. Sorry I’ve offended you. I hope you don’t convince yourself of anything. My attempts to prod you to understand your own belief system have obviously been misguided. My apologises.

    ps Ad hominem attacks by definition have to be about a person not a point of view.

  15. I’m honored that you forfeit the debate.

  16. what debate? you avoided all the issues I brought up by saying is was off topic. I don’t visit here often, I wish you well in being a true skeptic. Question EVERYTHING including your assumptions and belief system and you may be onto something.

  17. I was being a smart ass because the back and forth has become circular.

    You have yet to point to evidence that I have prior assumptions about acupuncture. You don’t know me, and if you think you know me, you should evaluate your characterization of me. I may have called you out for a non-sequitur, but I addressed your non-sequitur.

    What issue specifically did I avoid because when I look back at our (non-debate?), I see that I’ve answered your points. Did I have a prior disbelief in acupuncture? No, I was open to the existence of chi, and I believed that a bio-energy made sense. I defended the concept of chi when other skeptics dismissed it. It wasn’t until they provided strong arguments and evidence that I changed my mind. I presented the arguments here with links to the research. Forgive me for not making equivocations on the topic for the sake of being a good skeptic, but I did say right off the bat that I would be willing to reassess my observations if provided with evidence that contradicts the current evidence.

    How is it that you are the judge of true skepticism? Your assessment of my abilities as a skeptic wouldn’t sound so hypocritical if you would acknowledge that I addressed your points, of which you have not provided any evidence.

    Tell me this, Bernard, what are your specific problems with what I wrote? What point did you make in the comments that I dismissed? If I’ve made some error, please be specific about it.

    I don’t mind having my balls busted if the observation is useful and based on examples, but you’ve made assertions that you can’t back up.

  18. For a scientific explanation of Chi, you might also want to check out: Body organs relases energy (chi) and creates an electro-magnetic field ~ Professor Julia J. Tsuei M.D. http://tinyurl.com/mgsc5u

    Will also post other links in my http://www.Twitter.com/GreatDoubt account as I find them. Thanks!

  19. @Sherman

    The first specific link you provided proves my point. Acupuncture did no better than placebo. That means it doesn’t work any better than a sugar pill – the power of suggestion.

    The second link takes me in to a login page, but the abstract does not seem impressive.

    The third link actually proves that piercing the skin with a needle has an effect on opioid receptors, something that has been theorized (specifically, by Dr. Oz), but has not been proven until now. Their conclusion seems to be that when true acupuncture shows a slight advantage over placebo, that the difference can be attributed to opioids (not chi and not meridians).

    If you acknowledge the many studies that disprove acupuncture for pretty much everything except pain and nausea, how will you handle that information when it comes time to treat those conditions? What’s the ethically appropriate thing to do when you know that your treatment doesn’t work for various conditions? I’m just wondering whether you will ignore the evidence and lie to the patient to boost the placebo, or if you will admit that it doesn’t work and refuse to treat them. How will that affect your bottom line?

  20. Ticktock, the reason why I am planning to shift from my entrepreneur work to study TCM (which covers more than acupuncture by the way) is because I want to be able to at least heal myself when I get older.

    Healing pain without having to rely on chemicals is already a major plus point for me. As a martial artist, I also get to feel firsthand the effects of pressure on my acupressure points plus the incredible effect I get from pressing them to heal myself so acupuncture can’t be too far off. Of course, western medicine is still needed as it is faster at addressing symptoms but I do believe that TCM is better at balancing the entire body and keeping one in good shape as we grow older simply because it deals with the health of the entire body as a whole.

    As for the research, we all know that scientists are always changing their points of view. One day, research shows that eating eggs and milk is good for our body and the next, it is not. To me, it is all about balance and you can read more about my philosophy at http://www.GreatDoubt.com Life is what we make of it and is an illusion when our mind steps in and thinks too much creating a reality of its own. We can never be to sure about anything. We all know smoking is bad for us but some smokers easily outlive non-smokers while some non-smokers just die from secondhand smoke. Life and the human race itself is constantly evolving and we are not created equal. One man’s treasure is another man’s poison. Even the qualities of good and bad are merely an illusion. Is something good just because everybody else says it is good? Do we follow a book supposedly acknowledged by God or do we follow nature? Books can be altered by humans and nature is nothing like the “good” defined by us – My hamster just ate her babies. It’s about the survival of the fittest but what qualifies as the fittest? Aren’t humans being the fittest by harnessing Earth to create technology? At least until our planet dies out and we still haven’t found another planet to plunder.

    Despite what we think, we are not all that important. The universe always balances itself in the long run and in trillions of years, we are just like pimples on the skin that come and go. Nevertheless, we just have to see the perfection in the imperfection. Chaos is a pattern in itself.

    Back to your question about ethics. In a hypothetical situation, of course it would be silly of me not to treat a patient unless I very well know that acupuncture won’t help at all. Call it a placebo if you want but if it helps, I don’t see why not. However, I don’t see the harm in telling someone the truth – that what they are feeling might just be the placebo effect. I do Reiki and funnily, I don’t really believe in it and I tell that to the people who come to me. Still, they come to me and they feel the effect. Heck! Even my own wife asks me to heal her with it although she very knows that Reiki doesn’t seem to have the slightest effect on me unless I let it. Then, it all boils down to the placebo effect, doesn’t it? But our brain is a very powerful too if used properly and even scientist have not understood how it works completely or why only such a small percentage of it is utilized. What is to say that the world doesn’t only work a certain way because we believe that it only works that certain way? We can very well see how money is given value even when it is not backed by gold. If we all do not believe that money is worth anything, what then becomes of money? And why is gold even worth that much in the first place – it is soft as a metal and we can’t eat it. It is just all a matter of perspective in my humble opinion. Of course you are free to have your own opinion because our world is just that – a collection of opinions based on our limited sensory perceptions. We suffer when we are too attached to any one opinion. The solution is just to accept all but do what is best for us given the situation.

  21. Also, check out Richard Goodman’s blog: http://classicalmedicine.wordpress.com/2009/07/08/5000-years/
    He’s a TCM author who is realistic about it. ^_^

  22. I liken the effects of acupuncture to our knowledge of black holes. We “know” black holes exist because of the effects it has on everything around them. By their very nature they can’t really be seen or measured. Acupuncture is the same way. We know that it works and is real by viewing the effects. We don’t really know why. The language of Chinese Medicine is not much help because it’s largely metaphorical and poetic in nature since it predates modern scientific methods by hundreds of years.

    Eventually we will develop the instruments to truly measure the workings of acupuncture. This is the normal path of science. Bacteria didn’t “exist” until the microscope. However the results of bacteria were everywhere and undeniable,. We just didn’t have the tools to see it.

    To wait for science to tell you what is right before acting on evidence is foolish. I don’t need a scientist to prove that eating bell peppers is a pick me up to understand that when I eat them it perks me up.Meat gives me heartburn (so I became a vegetarian and solved that problem)Is there “proof” that meat can give you chronic heartburn. Yes, I’m walking living proof. Can I point to a study to back it up. Probably not.

    Everybody is different and reacts differently to the same stimuli. Why we expect empirical evidence for everything is beyond me.

    I know you’ll never accept the fact that acupuncture cured my debilitating tendinitis (I was on workman’s comp for two years) after physical therapy, ultra sound, anti-inflammatory drugs, and cortizone shots failed to help. But I know my body very well. I was a total skeptic. Still am and still give my acupuncturist a hard time. I make him work for it. But when you finally feel all the tissues in your had soften up, the inflammation subside and the pain go away for 3 days after only one treatment…well that’s gets your attention. Going from constant pain and stiffness for two years to total relief in one hour is not my imagination nor a placebo effect.

    • Actually, we know that acupuncture is wrong by viewing the effects. As in, it has no effects other than a noticeable placebo effect and endorphin response.

      It’s not the job of science to catch up with antiquated pre-scientific beliefs. That’s called “special pleading” when someone claims that their brand of pseudoscience has the unique ability to remain invisible to all methods of detection and measurement.

      Your anecdote about acupuncture working doesn’t tell me anything. For all I know, you could have been taking anti-inflammatory drugs and cortizone shots at the time you visited the acupuncturist. I never claimed that placebo was imagination. It’s a real effect of your body healing itself without direct agency. Acupuncture has not passed this simple test to show that it’s efficacious beyond placebo. I don’t know what else to tell you.

      • Just for clarification. I was off the anti-inflamation drugs. Not good to take over along period of time. The cortizone shots were a one time thing and were months earlier. No reputable doctor will give you repeat cortizone shots as it dissolves bone and connective tissue over time. By the time I reluctantly tried acupuncture my injury had stabilized for a long time and was not improving. So I had a baseline status to measure against. Acupuncture gave me permanent and dramatic results. This is a fact. Still doesn’t make sense to me, but acupuncture has changed my life (saved my professional life) and continues to improve my life.

  23. I agree that your evidence is very strong. However, I know it’s anecdotal, must admit, I have found chinese medicine the only thing that resolved severe back pain I’ve had since I was 8. Been to every quack and non quack to fix it, so there was plenty of placebo opportunity. Ineffectual. Acupuncture, over a number of sessions over a year or so has improved the back issue – structurally, it’s actually visible, no other changes were made such as different exercise schedule etc – perhaps it would have done that anyhow, who knows and I dont have an xray to prove it. I am thankful for the relief it gives me. I am however extremely critical of my acupuncturist telling me that taking psychiatric medication weakens my kidney chi and I should reduce it! To me this is extremely reckless, especially as many people fail to conform to treatment for mental health issues if they suffer delusions or mania and will believe just about anything a nat. med person tells them! I posted this just to say, if it works, ok fine, but open your mind to objections and DO NOT stop taking your western medecine meds except under the advice of a Western medical specialist. Go to your trusted GP first…
    I am thankful to those ‘evil people in the pocket of BigPharma’ who came up with the drugs that balance out what genetics mucked up, and enable me to be a fun, outgoing, person who is still creative and quirky, but also a steady Mum, wife and teacher. I am thankful that my governemnt funds a Pharmaceutical Scheme not a homeopathy or natural meds scheme.


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Categories

Follow

Get every new post delivered to your Inbox.

Join 63 other followers

%d bloggers like this: