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September 26, 2007

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Hmmm I'm going to have to read all your links about acupuncture. I personally originally followed a dogmatic line that acupuncture was mere quackery, but pretty much everyone around me assures me that it's been proven to work. "Everyone" includes doctors, scientists, members of my skeptics org. My brother is a doctor who did his medical degree at the most elite, respected, mainstream university around, and there he was taught that acupuncture works.

Naturally I'm sceptical of treatments explained using mythology, but the vast number and range of people who accept it just amazes me ... does it actually work in some small way, or is it the best con job out of all CAM ?

Yes, I'll start reading those links.

Christopher - I think it's a case that people confuse (probably helped by the CAM proponents) "sticking needles in people may have a therapeutic effect" and "sticking needles in particular Chi\Qi points has a therapeutic effect". Many people who haven't looked carefully at the procedure equate the two procedures and are probably helped along by the hand waving and obfuscation of it's practitioners, in much the same way that many homeopaths won't go out of their way to explain the differences between homeopathy and herbalism.

I love all the acupuncture ads that show up due to this post! Its kind of funny.

Soo, can someone teach me to insert the needles? Is there a special technique? That seems to be all I need to know to make this work.

Then I can open an acupuncture clinic with many articles backing up my claim that my acupuncture works as well as anyones. I'll call it Techupuncture. It will be better than acupuncture at 1/2 the price.


disclaimer: the views and claims made by Techskeptic have not been evaluated by the FDA.This service is not intended to diagnose, treat, cure or prevent any disease. I just want your money.

Hi, enjoying your site. Thanks for all the links to astrology tests, btw. I was looking for a nice collection for the course I'm teaching.

Here's a random question that maybe you have seen: Do you know if any of these studies actually made any correlations with this:

"What does matter is that the victim patient believes you are sticking them in the right place."

In other words, in the latest one in the news quoted above, what was the breakdown of people in each group (acupuncture, sham acupuncture, 'traditional' medicine) that actually believed the treatment they were receiving would work?

I would be willing to bet (without knowing, though) that more of those taking medicine probably didn't believe it would work, whereas those doing the acupuncture/sham believed it would work. I'd be curious to see the numbers, if they exist.

Christopher, you are treading dangersously close to edge of making "wooish" statements. I am even suspicious that you are a "woo" believer pretending to be a skeptic. Your statements are completely unsupportable as they stand.

Please ask your "brother" to name the "most elite, respected, mainstream university" at which he received his medical degree, and the course in which he was taught that accupuncture works, and to name as well the professor who taught that course. Report back to us with that information so the possibility of corroborating your story exists. Failure to do so will result in complete disregard for your comments.

Hi there Paul, trying to walk a fine line here. I have quite strong Skeptical credentials but feel it would be irrelevant to trot them out here. (I could show my badge? ;-)

Just to make things clear, I am not a supporter of acupuncture, have never experienced it, and for all I know it may not work. I have also not yet finished reading the linked articles in the blog.

Also, I am well aware that mere weight of people does not make something true.

I would not be able to mount a cogent argument as to why acupuncture does - or does not work, other than the implausibility of a technique that is still described in supernatural terms. I have, in passing, seen tv doco "discoveries" that appeared to confirm some kind of medical basis for some of this stuff, but maybe they've been since disproven.

I was merely commenting on the suprisingly wide acceptance of acupuncture in the community. It seems that it is more even accepted than other popular CAMs like chiropractic and homeopathy which is certainly quackery.

I reiterate, that I have not read all the articles yet so maybe I'll find all my answers there.

My brother and his friends graduated from the medical degree from Melbourne University, Australia and are adamant that there is a vast body of research that supports acupuncture, and that their undergraduate course covered this.
Yes, I should ask them for details of this.
Perhaps they've been mislead ... or maybe not?

(My impression is that unofficially doctors fear losing "trade" to CAM and so are increasingly offering such services - regardless of whether they actually work)

When attending a Skeptics convention a few years back, there was a speaker from Melbourne University talking on some issue. I queried the teaching of acupuncture to medical students, and it generated absolutely no debate - it seems people see it in the "grey area" - ie that it probably doesn't do all it's claimed to - but might still help in some ways ...

BUT ... let me read those articles and pray that I understand them ;-)

If my neurologist at Melbourne (he is a teaching doc) suggested accupuncture, I would probably run away.

Having something taught does not correlate to beleiving it to be true. I had to learn post-moderist political theory in my post-grad at Deakin, among other theories, but it remains a giant pile of crap. I have a feeling two things are happening: the doctors fear losing patients so are offering more CAM procedues (so teaching more of these), and they are not differentiating between accupuncture as a chi-related concept and accupuncture as just sticking needles in.

Apologies for the odd phrasing--my apostrophe key is on the fritz. You would not believe how hard it is to write a post that does not sound like I put it through babelfish.

Thanks for posting about this. What a fantastic little piece of research the Germans did! Exciting!

But you don’t mention the single most interesting thing about it, I think: not only did the Archives of Internal Medicine show that real acupuncture is no better than sham acupuncture for low back pain, they also showed that the “effectiveness of acupuncture, either verum or sham, was almost twice that of conventional therapy.“ Yes, that’s right: both acupuncture and the placebo were significantly better than standard physical therapy approaches.

Cool. Weird.

But of course it probably has quite a straightforward explanation. As brilliantly demonstrated by Schultz">http://SaveYourself.ca/bibliography.php?sch">Schultz et al. in 2004, by far the most important factor in whether or not people recover from back pain is whether they expect to recover from back pain.

I imagine that the acupuncture, real and sham, involved more “TLC” and therefore probably gave people more hope than conventional physical therapy — which most people are pretty cynical about, because it really doesn’t work very well, as most people with back pain have discovered. Back pain is a difficult problem, even with science on your side.

Being a product of Melbourne Uni myself (Commerce), I find it extraordinary and difficult to believe that what was once regarded as Australia's best Medicine school is churning out such rubbish as what Christopher is suggesting.

I'd be curious to know what subject this is being taught in - if it's being taught at all.

Is there a possibility that you could find this out for us, Christopher?

Then I'm going to have words with the Alumni organisation to apply some pressure to have the offending lecturer fired, assuming he's not tenured.

Just wanted to post again and say: yeah, wow, that BBC article is crrrrrrazy! After reading a couple more of your posts on this subject, I have a clearer sense of your complaint with reporting on acupuncture research ... and it is simply frackin’ amazing that the BBC slanting manages to make a study that is quite devastating to acupuncture sound like GOOD NEWS for acupuncture! I mean ... wow. Yeah, wow. Wow. That is ... amazingly dishonest. Fantastically, amazingly dishonest reporting.

I’m off to complain at the BBC.

(Of course, we do have to give them credit for that wonderful exposé of homeopathy. ;-)

Also, it’s interesting to note that the comments on this post are actually NOT full of angry true-believer stuff. Reassuring.

Okay, one more comment on this! Turns out the BBC has a complaints department, easy to access ...

http://www.bbc.co.uk/complaints/

Its not your fault. You never meet a master in real life who could prove to you how to channel energy in the matter of seconds. You ever see what sholin monks are capable off. He who has ears to hear let them hear.

Hehe, I guess it's no one's fault that such a master doesn't exist then, because as of now, no one has been proven able to do as you say in any amount of time, let alone a matter of seconds.

Of course we know what Shaolin monks are capable of. We just know a thing or two about how they do a lot of their tricks. Hint: It ain't magic.

Apparently these meditating monks are capable of taking over the temperature control mechanism of their body.

I wonder if this technique could be successfully learned without actually believing that in fact there was some kind of energy (real or not) flowing through the body, and thus making rational thinking a hindrance in this case.

I've actually seen this, but not to the degree they are implying.

When I was in India, I visited Dharamsala (where the Dalai Lama is)and met quite a few monks who could do this. I went in december in to the edge of the hymalayas. Its not super cold there, but it sure was chilly at nights.

Anyway, It was definitely real that these guys could "meditate away" the sensation of being cold that I had. As for their body temp actually being different than normal, well I didnt bring along my rectal thermometer. :/

As for drying sheets.... well if i wear wet clothes, they dry out in time. If my body temp is higher than the outside, they will steam. I'm not sure what is amazing about that part of it.

Lowering body temperature is also quite understandable if you are capable of reducing you breathing and/or heart rate.

I'm not saying that meditation doesnt do anything healthy. It very well may. but applying something mystical to visualization techniques to helping bring for a meditative state is a bit absurd.

Skeptio, I might not be as quick to denounce your little anti-acupuncture rant were it not for your seriously flawed logic.

So, sham acupuncture leads to a given result. And real acupuncture leads to a given result. You know, if I'm hungry, I've found that I can eat a Snickers bar, or a turkey sandwich, or any number of things, and I'll be less hungry. But somehow, I've never been able to make the leap that just repeated swallowing for 15 or 20 minutes, and some mime-chewing in between would do the trick just as well. Maybe you're on to a whole new form of enlightenment. Or maybe you should think about the dis-enlightenment you're spreading around instead.

Oh, and by the way, I wouldn't be too proud of quoting someone who regards the era of acupuncture's foundations as "pre-scientific". Last time I checked, the Chinese invented gun powder. And I believe, though not geographically connected, the wheel was also invented sometime back then. Pre-scientific? Jackass.

So, sham acupuncture leads to a given result. And real acupuncture leads to a given result. You know, if I'm hungry, I've found that I can eat a Snickers bar, or a turkey sandwich, or any number of things, and I'll be less hungry. But somehow, I've never been able to make the leap that just repeated swallowing for 15 or 20 minutes, and some mime-chewing in between would do the trick just as well.
You're absolutely right. Eating has a real effect, which just chewing can't provide. There is a substantial difference between eating and chewing, which leads one to have a significantly different effect from the other.

So, assuming that acupuncture is the same as eating in your example, we would expect to see a significant difference between the effect of "real" acupuncture ("eating") and "sham" acupuncture ("just chewing"). Study after study, however, demonstrates no such difference. Sham acupuncture is just as effective as "real" acupuncture, which shows that there is no substantial difference between the two. Given the explanations behind acupuncture (involving chi and meridians), this shouldn't be possible, suggesting that the whole justification and foundation of acupuncture is bunk. Since we have no evidence of chi and meridians, and since there appears to be no difference in effects between "manipulating chi and meridians at specific points to achieve specific effects" and "jamming in needles at random," we have no reason to think that acupuncture is effective at all.

Oh, and by the way, I wouldn't be too proud of quoting someone who regards the era of acupuncture's foundations as "pre-scientific". Last time I checked, the Chinese invented gun powder.
And? Inventing things, in and of itself, is not particularly scientific. Science is more than just innovation. Just because people had wheels doesn't mean they weren't still pre-scientific.

Incidentally, you're right in that the Chinese invented gunpowder. The difference is that the Chinese people who invented gunpowder are separated from the Chinese people who first started performing acupuncture by around 4,000 years. Your comment is akin to saying "how can you say the Old Testament was written by pre-scientific people? A Jewish person came up with the theory of relativity!"

Skeptico replies to Cupo

The reason this is important, and the reason your silly analogy about eating if irrelevant, is explained here:

Novella goes on to explain the real problem with believing in this “chi” nonsense – namely that it prevents anyone from discovering what (if anything) is really happening when someone receives acupuncture treatment.

It was right there in the post.

And the “chi” hypothesis was pre-scientific. As were humors. But we don’t say humors were not pre-scientific because they came after Galileo looked through his telescope, do we?

You should be careful who you’re calling a jackass, jackass.

Gentlemen,

First of all, so that my salutation is not seen as a departure from my earlier post, I was calling Mr. Novella a jackass for calling that time period, and its discoveries, "pre-scientific". Just because Western technological tools can not describe a thing, does not mean it is not scientific. Do we know why Stonehenge or the Pyramids are there? Completely and exactly, do we know?

Prejudice is seated in misunderstanding. You both perseverate a prejudice by stating that a different method of thinking, deducing, evaluating and concluding is not "scientific", in fact you imply it is not even a method, simply because it does not fit into your guidelines. That's just ignorant.

As for "chi", or Qi. Yes, Skeptico -- I read your whole post. And those precious tools of yours... the scientific ones... they have indeed begun to show acupuncture to be effective treatment method. Look it up. MRI of brain activity of people receiving acupuncture reveal signals in the regions of the brain that control the organs that the acupuncturist means to manipulate. What is being manipulated is described by the Chinese as Qi. No nerve impulses were found chasing up a nerve. But even if that had been found, I'm sure you'd make up some other argument. You're arguing against a label.

Again, my point here is that our Western science shouldn't have to be applied to a thing before it is accepted as real. Not always. Proof is important, yes. How about 2,000+ years of a culture of now 1 billion people who use this as their primary method of preventative healthcare. Oh... I guess that doesn't count. They aren't Westerners.

Next to last: neither of you adequately commented on the logical flaw in Skeptico's first post: that sham acupuncture and real acupuncture lead to the same result means that real acupuncture is a sham.

Let's see. Your argument is this: A begets D. B begets D. Well, of course, that must mean that B = A. Right? Wrong!

This is what my analogy tried to communicate (albeit without connecting all the dots). Just because different foods cure hunger does not mean those different foods are all equal! A turkey sandwich is not a snickers bar. The same goes for the logic you applied to sham vs. real acupuncture. Just because they both produced the same effect (in that test), you can not conclude that real = sham. Where's your scientific background now??

I'd like to learn upon what exact symptoms the sham vs. real acupuncture test was performed. It certainly could not have been an exhaustive list of symptoms.

Finally: have either of you... have any of you skeptics, actually received or even observed someone receiving acupuncture?

-- Cupo

PS: Thanks for calling me a jackass, Skeptico. Glad my post got you that riled up. Think about it.

Skeptico replies to Cupo

Re: First of all, so that my salutation is not seen as a departure from my earlier post, I was calling Mr. Novella a jackass for calling that time period, and its discoveries, "pre-scientific". Just because Western technological tools can not describe a thing, does not mean it is not scientific. Do we know why Stonehenge or the Pyramids are there? Completely and exactly, do we know?

Prejudice is seated in misunderstanding. You both perseverate a prejudice by stating that a different method of thinking, deducing, evaluating and concluding is not "scientific", in fact you imply it is not even a method, simply because it does not fit into your guidelines. That's just ignorant.

No, it is factual. If the idea of “chi” was not derived scientifically then it is not scientific.

Re: As for "chi", or Qi. Yes, Skeptico -- I read your whole post. And those precious tools of yours... the scientific ones... they have indeed begun to show acupuncture to be effective treatment method. Look it up. MRI of brain activity of people receiving acupuncture reveal signals in the regions of the brain that control the organs that the acupuncturist means to manipulate.

A citation, please.

Re: Again, my point here is that our Western science shouldn't have to be applied to a thing before it is accepted as real. Not always. Proof is important, yes. How about 2,000+ years of a culture of now 1 billion people who use this as their primary method of preventative healthcare.

This is a fallacious appeal to other ways of knowing. Science has proved to be the most reliable method we know for evaluating claims and figuring out how the universe works. If the you claim there is a better method, it is up to you to justify that claim – something you haven’t done. It’s also an appeal to ancient tradition and an appeal to popularity. Perhaps you should read the comment guidelines.

Re: This is what my analogy tried to communicate (albeit without connecting all the dots). Just because different foods cure hunger does not mean those different foods are all equal! A turkey sandwich is not a snickers bar. The same goes for the logic you applied to sham vs. real acupuncture. Just because they both produced the same effect (in that test), you can not conclude that real = sham. Where's your scientific background now??

It shows that the idea of chi in the meridians cannot be real. Of course, your analogy fails because in this case we are trying to determine what the mechanism is for any effect from acupuncture. In your food analogy, you just note the person is not hungry any more. So the fallacy was yours – false analogy.

Re: I'd like to learn upon what exact symptoms the sham vs. real acupuncture test was performed. It certainly could not have been an exhaustive list of symptoms.

It was on pain. As are most acupuncture studies.

Re: Finally: have either of you... have any of you skeptics, actually received or even observed someone receiving acupuncture?

Why would that tell me anything more accurately than this study?

Re: PS: Thanks for calling me a jackass, Skeptico. Glad my post got you that riled up. Think about it.

Thought about it. Didn’t get me riled up at all. But your points are all ones I have heard before. However I note your use of the Gadfly Corollary. Try posting without the logical fallacies and with something new.


Just because Western technological tools can not describe a thing, does not mean it is not scientific.
You're right; what makes CAM unscientific is that it was developed without any application of the scientific method--no controls, no experiments, no studies; they started with the baseless "theory" of chi and worked from there. It's the same as alchemy, trepanation, humours, bloodletting, phrenology, and virtually every other pseudoscientific or pseudomedical practice throughout history and well into the modern era. People start with an unsupported "theory" of how some process works, then develop treatments or "experiments" based on that unsupported "theory." What makes CAM pre-scientific is that it was developed in an era and region where the difference between unsupported unscientific bunkum and good science was not clearly delineated, and there was no real standard in the society to judge one from the other.

Sorry for all the scare-quotes, I just want it to be clear that these are not 'theory' and 'experiment' in the scientific sense.

Do we know why Stonehenge or the Pyramids are there? Completely and exactly, do we know?
No. What's your point?
You both perseverate
I'm pretty sure you mean perpetrate. Perseverate doesn't mean what you're trying to make it mean there.
by stating that a different method of thinking, deducing, evaluating and concluding is not "scientific",
That's not prejudice, that's fact. Science is a specific method of thinking, deducing, evaluating, and concluding (and revising); a different method of those things, by definition is not science.
simply because it does not fit into your guidelines. That's just ignorant.
No, what's ignorant is your attempt to couch special pleading in an accusation of prejudice. The beauty of the scientific method is that it works to eliminate bias and human error. It's not perfect in that regard, but it's the best process available. Science doesn't give a fat flying damn whether a claim is made by a Far Eastern mystic or a Midwestern physician; what science cares about is whether or not the claim is supported by evidence. The claim's origination point is utterly immaterial. Acupuncture could have been invented in Scranton for all science cares; what matters is whether or not it works.

What you're suggesting is that the standards for judging whether or not a treatment works, the standards of evidence, should be different for western medicine and CAM, by virtue of the fact that CAM comes from some different culture. Why is CAM a special case? If something works, it works, regardless of where it came from and where it's done.

Incidentally, that bit of special pleading you just did? That's one of the errors that science specifically works to correct.

they have indeed begun to show acupuncture to be effective treatment method.
For what? According to whom? Where are your citations, son?
MRI of brain activity of people receiving acupuncture reveal signals in the regions of the brain that control the organs that the acupuncturist means to manipulate.
Gosh, I would think that we'd see activity in the organs that the acupuncturist seeks to manipulate, not just the brain bits that control those organs. Are the patients aware of what organs the acupuncturist seeks to manipulate? Has the possibility of psychological error been ruled out (i.e., are these parts of the brain flaring because the acupuncture is affecting them, or because the patient thinks the acupuncture is affecting them?)? And, most importantly, how on Earth does this show the efficacy of acupuncture? All this shows is that acupuncture may cause some interesting effects in the brain, certainly not that it cures ailments or treats illnesses effectively. If acupuncturists claimed "this process of turning you into a pincushion will cause some effects in your brain," you'd have a point. They don't.

Of course, much of this might be cleared up if you'd provide a simple citation, as opposed to a vague reference and an admonition to "look it up."

But even if that had been found, I'm sure you'd make up some other argument. You're arguing against a label.
Of course we'd come up with another argument--that's what science does. It's not a matter of "prove you work and we'll leave you alone." It's "keep showing that you work under tighter and tighter controls and more and more stringent standards." Science doesn't let things slide on one test, it continually retests, rechecks, and reviews everything.

And no, we're not arguing against a label (though you're arguing for special treatment based on a label), we're arguing against unsubstantiated extraordinary claims based on a preconceived framework as opposed to observation and evidence. We're arguing against giving some people a free pass on their claims because they have some sort of ill-defined different method of evaluating efficacy. We're arguing against letting people practice "medicine" for pay without having those treatments tested first.

Again, my point here is that our Western science shouldn't have to be applied to a thing before it is accepted as real. Not always.
Gosh, it's not often you see special pleading laid out so blatantly. I can't wait to see the justification for this.
Proof is important, yes. How about 2,000+ years of a culture of now 1 billion people who use this as their primary method of preventative healthcare. Oh... I guess that doesn't count. They aren't Westerners.
Wow. Argumentum ad populum, two distinct genetic fallacies, and even a bit of doggerel.

Here's the scoop: just because lots of people believe something doesn't mean it's true. Just because something is old, doesn't mean it's true. Lots of people used to believe the Earth was the center of the universe, and that idea is a lot older than heliocentrism, so by your standards we should accept it as fact.

No, we should only accept as true that which is supported by evidence. Preferably reliable, controlled, experimental evidence, with human biases and errors corrected-for. In other words, things that have been vetted by the scientific method.

East or West, evidence is evidence and efficacy is efficacy. If it works in reality, it should work under controlled conditions.

This is what my analogy tried to communicate (albeit without connecting all the dots). Just because different foods cure hunger does not mean those different foods are all equal! A turkey sandwich is not a snickers bar. The same goes for the logic you applied to sham vs. real acupuncture. Just because they both produced the same effect (in that test), you can not conclude that real = sham.
And your argument by bad analogy (a fallacy) is far more flawed. The point is not that real acupuncture and sham acupuncture are different kinds of the same thing (as Snickers bars and turkey sandwiches are different kinds of food). The point is that according to the "theory" of chi and meridians on which acupuncture is based, "real" acupuncture should work and "sham" acupuncture should not; according to the CAM practitioners--according to the only justification for doing acupuncture, its "theoretical" framework--"sham" acupuncture should be to the real thing what chewing is to eating: similar in appearance, different in effect.

The studies show that "real" acupuncture and "sham" acupuncture work equally well for pain treatment (which is itself particularly susceptible to psychological effects). This demonstrates that the "theory" behind acupuncture--that manipulating chi at meridians around the body can cure ailments (and specifically relieve pain)--is false. Since this, and not a huge body of efficacy of evidence, is the sole justification for the effectiveness of acupuncture, that effectively knocks the legs out from under the treatment.

In other words, there may indeed be a benefit to sticking needles in the skin, as the evidence of this (and other studies) suggest. Acupuncture, however, entails more than just human pincushions: it includes doctrines of chi energy and meridian points, which are not substantiated by the evidence and are contradicted by tests such as this one. If there's a real benefit to poking people with pointy things, we should find out what the extent of that benefit is and what causes it, with the same rigorous methods we use to find out anything else about possible medical treatments and quirks of human physiology.

See, this is how science works: it starts with the observations and the evidence, then develops a theory based on those things. Acupuncture, like most pseudomedicine, started with the theory (chi, meridians, etc.) and worked from there, which almost inevitably leads to failure.

I'd like to learn upon what exact symptoms the sham vs. real acupuncture test was performed. It certainly could not have been an exhaustive list of symptoms.
And it certainly wasn't. It was one simple, easy-to-treat, easy-to-affect-with-placebo symptom: pain.
Finally: have either of you... have any of you skeptics, actually received or even observed someone receiving acupuncture?
Nope, and I don't plan to. Once again, I don't believe in giving some people a free pass on proving their claims, while expecting others to engage in rigorous double-blind trials and experiments, coming to conclusions based on evidence. If acupuncture is shown to be effective for pain relief or disease treatment, using the same rigorous standards I expect from any other medical treatment, then I might drop the cash on it. Until then, I see no reason to pay for the unproven, particularly when I know how susceptible humans are to confirmation bias, the placebo effect, the post hoc ergo propter hoc fallacy, and other errors of thought and reasoning that can misattribute cause and effect.

Once again, that's why we look to science, which is specifically designed to mitigate and eliminate precisely those errors of thought and reason by doing large-scale, placebo-controlled, double-blind trials, and by subjecting the results to a review process which double- and triple-checks the results before making any claims to even tentative certainty.

Thanks for calling me a jackass, Skeptico. Glad my post got you that riled up. Think about it.
Touched a nerve? Yeah, we've heard that one before.

I love this justification of woo:

How about 2,000+ years of a culture of now 1 billion people who use this as their primary method of preventative healthcare. Oh... I guess that doesn't count.

If "ancient chinese medicine" was so good, why was the average lifespan of chinese people only 35 years long as late as mid 1950's? In India it was only 32, great Indian health secrets? While 50 years before that, our 'horrible' western medicine was letting us live to 47 on average?

Real preventative.

Now the life span is up to 71. Thanks largely to the influx of western medicine.

Granted, it wasn't all western medicine, western sanitation and western health education also helped.

argh. I hate when my name doesnt get included with my post

I'm always surprised how some people keep clinging to their favourite piece of woo.
Why would you accept a healing process that doesn't have a measurable effect if you can have one that does have a measurable effect?

I think I can answer that....

Its nice to have people pay attention to you for an hour, talking to you, physically interacting, giving you reasons for your discomfort in an atmosphere with music, low lights, and calm atmosphere.

Its the one thing I think western medicine could learn from woo practitioners.

I don't think our current medical environment allows that to work economically.

But isn't that what real doctors do, except for the music and the low light?

I love getting asked to provide a reference by someone who references themselves…. and often!

As much as I hate to encourage your fallacy-ridden discussion, here is a reference. One of several from peer-reviewed journals:

"Functional MRI in healthy subjects during acupuncture: different effects of needle rotation in real and false acupoints"
From the Springer journal: Neuroradiology

Received: 6 August 2003 Accepted: 2 October 2003
Abstract The cerebral activation pattern due to acupuncture is not completely understood. Although the effect of acupuncture on cerebral haemodynamics has been studied, no previous report has focused on different puncture and stimulation methods. We used functional MRI (fMRI) in 15 healthy subjects to investigate cortical activation during stimulation of two real acupoints (Liv3 and G40) and one sham point, needled in a random and, for the subjects, blinded order employing rotating and non-rotating methods, using a blocked paradigm on a 1.5 tesla imager. Compared to the non-rotating stimulation method, during rotating stimulation of the real acupoints, we observed an increase in activation in both secondary somatosensory cortical areas, frontal areas, the right side of the thalamus and the left side of the cerebellum; no such effects of the needling technique were seen while stimulating the sham point. The observation that rotating the needle strengthened the effects of acupuncture only at real acupoints suggests that, as claimed in Chinese traditional medicine, stimulation of these acupoints has a specific effect on cortical neuronal activity, absent with sham acupoints. These specific cerebral activation patterns might explain the therapeutic effects of acupuncture in certain subjects.
end of abstract

Enjoy your skepticism, Gentlemen. Flawed, though it is.

And in closing, I just want to share that I find it unfortunate that all my arguments earlier were really lost on you. It’s clear you’re not out to be educated (which is the power of most skepticism), but rather just to point out why you are right and others are wrong.

Techskeptic:

Its nice to have people pay attention to you for an hour, talking to you, physically interacting, giving you reasons for your discomfort in an atmosphere with music, low lights, and calm atmosphere.

I'm sure that's part of it; after all, doctors tend to be a little impersonal, largely due to time and scheduling issues. But I think the bigger reason is that CAM practitioners can make claims both to absolute certainty in their treatments' efficacy and a complete lack of nasty side-effects. This gives them an edge over the uncertain world of real medicine, where every treatment has some down-side. It's the same kind of thing that makes religions look effective: they claim absolute knowledge, while science is always changing and hedging its bets. When scientific treatment fails, it's due to some real uncertainty or problem; when religion fails, it's due to flaws in the person seeking treatment. The religion comes out looking spotless because it needs show no proof and always shifts the blame when things go wrong; the same is true of CAM. The result to the casual observer is that the real treatment looks shabby due to real risks, real uncertainties, and real failures, while the quackery keeps on keepin' on with unsubstantiated claims and total blamelessness.

Cupo:

I love getting asked to provide a reference by someone who references themselves…. and often!

Add "ad hominem" to the list of logical fallacies tossed out by Cupo. Anyone have Bingo yet?

The fact that Skeptico refers to other pages here on the site does not invalidate your burden of proof. What it does is demonstrate how easy it would be for you to find out why your arguments here are fallacious, since they've already been torn apart on this site.

Incidentally, and here's the point you fail to understand, Skeptico also refers to his sources, both here and on other pages. The fact that he references his own past work on the subject has nothing to do with the validity of his arguments or the validity of his (and my) request for your sources.

But, you know, good try.

As much as I hate to encourage your fallacy-ridden discussion,
You keep claiming that our discussion is full of fallacies: could you provide a specific example? We've torn apart your (fallacious) argument by analogy, and other than that you haven't offered any evidence whatsoever that our reasoning is faulty. If I've made a genuine error, I'd like to know where and how, so that I can correct it in the future. I'm sure I speak for Skeptico and the others commenting here with that sentiment.

In the meantime, we've pointed out the numerous fallacies in your own argument, which you have not addressed in the least, and to which you continue adding, what with that ad hominem up above.

I do have to give you props for actually finding a source, and a peer-reviewed journal, no less. Of course, that doesn't change the fact that I still have questions. I wouldn't be much of a skeptic if I just accepted everything I read in peer-reviewed journals, without considering possible problems with the experimental design and other sources of error. F'r instance, 15 subjects is a tiny sample size for any study; while the results may be promising, I'd like to see multiple replications of the results, or a replication on a larger scale. I'm working through the full article (available here), and I'll post my thoughts as I go.

All [test subjects] were informed about the acupuncture sensations they might experience during needle manipulation, before entering the magnet. They were told that of the three points stimulated, any could be real or false acupoints. They were also blinded concerning the needling techniques.
This was one of the concerns I had when reading the abstract: how much the patients knew when entering into the treatment and how many points were stimulated at any given time. I see no real fault in the procedure as it's explained here.
All stimulation paradigms were performed by one experienced acupuncturist (J.L.F.).
That, however, I find fault with. Experienced acupuncturist and primary author of the piece, J.L. Fang of the China Academy of Traditional Chinese Medicine, was the one administering the pricks. This means that the test was only single-blinded, naturally introducing a fairly significant source of error. Since Fang, an experienced acupuncturist, naturally knew which points were "real" and which were "sham," it's entirely possible that he (consciously or otherwise) employed a different technique with the sham point and the "real" points. It's equally possible that he didn't, but I'd like to see this test replicated with a double-blinded setup. It shouldn't be difficult to train a researcher or intern to properly insert and manipulated needles without teaching him where the real acupoints are. Send him in with his experienced technique and lack of knowledge of the points, tell him specifically where to poke the needles, and study the double-blinded results.

I'd also like to see a second sham point, near the lateral malleolus where the second acupoint was located. The first two points were fairly close together, and there ought to be a control for the second acupoint as well.

The characteristic De-Qi sensation at Liv3 was felt by 13, at G40 by seven, and at the sham point by five of the 15 subjects.
A full third of the test subjects felt the characteristic acupuncture sensation at the sham point? Only slightly less than one of the real points? Interesting.

On a tangentially-related note, I'm curious as to how much prior experience the test subjects had with acupuncture. I can't find any information in the article on where the test was conducted; one might expect different results in a test done in China from one done in Germany, based on the subjects' prior experience with acupoints and acupuncture techniques.

Two subjects' heads moved more than 2 mm, so they were excluded from the statistical processing.
So the results only cover 13 subjects, again, vanishingly small.
There was remarkable overlap between the cortical activation of the real and sham acupoints. No significant difference in brain activation with stimulation of real and false acupoints, was, therefore, observed.
Gosh, that sounds familiar.
However, there was a remarkable and highly statistical significant difference when comparing the two needling techniques for each of the three points. Rotating the needle as described, we found, compared to the state with the needle in place but not rotating, significant activation [...] but only when stimulating the real acupoints. There was no statistical significant difference between rotating and retaining the needle in the sham acupoint.
Certainly an interesting result. I do wish there were images from the sham points, however.
On the other hand, it might be argued that the pain sensation following insertion of a needle activates the pain system regardless of whether it arises at sham or real acupoints. It is difficult to design controlled experiments for acupuncture studies and few have satisfied Western scientific standards because of the difficulty of finding a true sham point.
I hardly think that's the reason why they haven't satisfied "Western" scientific standards. Seems to me it's more of an opening for ad hoc rationalizations by the "Eastern" practitioners. "The reason there's no difference is because that sham point is too close to a real acupoint, and it must just be causing a stimulation there!"
An ideal sham point would be an area of skin some distance from any known acupoint or trigger point. But some physiological effects of acupuncture, such as De-Qi, have been observed when such supposed sham points were stimulated; and sham acupuncture has also been found to have certain therapeutic effects and cannot therefore constitute a valid control.
Why can't it constitute a valid control? Because it produces effects that TCM claims are impossible? These tests are designed to validate (or invalidate) TCM's claims; claiming that sham points are invalid controls on the basis of those same TCM claims is circular reasoning.

At least, that's how I'm interpreting that passage. If I've made an error there, let me know.

I agree with the researchers that the results of this study--rotation of the needles in "real" acupoints produced different effects from rotation at the sham acupoint--warrant further research. I hope further research takes steps to double-blind the damn study. This is an interesting result to be sure.

What it isn't, however, is validation of the claims of acupuncture practitioners. So rotating needles in some places may produce a cerebral effect while rotating them in other places may not. That provides no evidence for the existence of Chi, it provides no evidence for the claim that acupuncture can relieve pain, and it provides no evidence for the claim that acupuncture can cure other ailments. The study even supported the fact that there is no significant difference in effect between inserting needles at "real" and sham acupoints. What it does show is that acupuncture (with needle rotation) may produce some effects in the brain. That's hardly reason to use it as a treatment, and certainly not reason to accept its claims with regard to supernatural energy and curative powers. It's reason to do further study, both to find out if this effect is more than just an anomaly or an error, and to find out what causes this effect, if it is indeed real.

Incidentally, the study provides no evidence for your claim that "MRI of brain activity of people receiving acupuncture reveal signals in the regions of the brain that control the organs that the acupuncturist means to manipulate." Stimulation of the "real" pain-relief acupoints in this test led to effects in the "pain network" of the brain. I can stimulate your brain's pain network by poking you with needles too, and I'm not even an experienced acupuncturist. Nothing in the study mentions points on the body or regions in the brain associated with specific organs; it's acupoints associated with pain relief and regions of the brain associated with pain. Significantly broader and far less impressive than your initial claim would suggest.

And in closing, I just want to share that I find it unfortunate that all my arguments earlier were really lost on you.
All your arguments? Do you mean your fallacies, your bad analogy, or your misunderstanding of science? Sadly, none of those were lost on anyone here.
It’s clear you’re not out to be educated (which is the power of most skepticism), but rather just to point out why you are right and others are wrong.
Ah, another woo crying "closed-minded" because we refuse to accept "it's been around for a long time," "lots of people believe it works," and "here's a study that shows an interesting effect that doesn't even come close to approaching the claims made by the practitioners" as absolute proof. The reality is that I'd love to believe that sticking needles in people can ease their pain and cure their diseases with no side-effects. And the studies suggest that the process may in fact have some effect on pain. But so far the results have been largely inconclusive even on that front, and they largely provide proof against the traditional Chinese model of how and why acupuncture is supposed to work. Until there's some solid, reliable information as to the efficacy of needle-poking on ailments, the difference (if any) between real and sham acupuncture, and the mechanisms behind these effects, you're better off taking aspirin and seeing an M.D.

Incidentally, if anyone's interested, the abstracts linked as #23-26 in the references for the article look pretty interesting. Anyone have a subscription to those full-text services?

I have access to some of those via my college. Unfortunately, Pain only has electronic copies of its journal dating back to 1995, and the two articles referenced in that journal are from 1986. But I could get you the other two if you want. Should I e-mail them to you?

Tom, where did you find the full study? Do you have to buy it for $32?

Cupo,

Could you answer my question (from above) about why you contend that ancient eastern medicine (choose your brand) is better than western medicine, when longevity rates clearly show western medicine, sanitation and health education to be a far superior approach to health? all the links are above.

If you don't want to answer that, could you inform me of what fallacy you think I am committing by asking you that?

Clearly you "skeptics" have committed the little known but extremely common fallacy expectio woos to make sensum.

Jeez you "skeptics".

Now, I don't want to hear any bad comments about sheep shagging until you've experienced it yourself. The fact that none of you have means that you are all in fact satanists and obviously part of the big pharma conspiracy to cause autism through the intake of nitrous oxide.

"Western" "science" would tell you that sheep shagging doesn't work, but Welsh farmers have been doing it for thousands of years, so don't call it pre-scientific because they use wheels.

The fact that you don't understand my arguments proves them.

You see, it's a bit like the difference between making love to a beautiful woman and making love to an inflatable sex toy. They are the same so both lead to conception.

The fact that someone will get worked up by this is proof that it's true.

Jackass.

Skemono:

Should I e-mail them to you?

That'd be fantastic! It's tfoss1983 [at] gmail [dot] com.

Skeptico:

Tom, where did you find the full study? Do you have to buy it for $32?

No, I did a search for "acupuncture" at the journal website that Cupo linked to, and they had the full text online. It's possible that I was able to get it because I'm on a University server, though. This is the direct fulltext link, if it works for you. If not, I might be able to e-mail it to you if you want.

Jimmy_Blue:

Clearly you "skeptics" have committed the little known but extremely common fallacy expectio woos to make sensum.

I'm glad I wasn't drinking anything when I read that. Fantastic post, Jimmy.

Nah, Tom, the full text of the study is only for subscribers. Looks like you get it for free through your university.

And I sent you an e-mail with the other studies.

I'm sure that's part of it; after all, doctors tend to be a little impersonal, largely due to time and scheduling issues.
I've been to quite a few doctors in my time and I didn't think they were impersonal.

But I think the bigger reason is that CAM practitioners can make claims both to absolute certainty in their treatments' efficacy and a complete lack of nasty side-effects. This gives them an edge over the uncertain world of real medicine, where every treatment has some down-side.
I think that's a weak reason to choose acupuncture.
Real medicine may have side-effects, but at least I know it has effects!
Besides, being poked with a whole lot of needles probably isn't very comfortable, so if that's not a down-side, what is it?

Skeptico replies to Cupo

Re: As much as I hate to encourage your fallacy-ridden discussion,

Except you failed to demonstrate I had used any fallacies – you just assert. You, on the other hand, relied on several fallacies. More of that below. First, your study.

Re: here is a reference.

Except you didn’t provide a link. Never mind - I’ll do it for you. The abstract anyway. Have you read the full study? I have.

Re: One of several from peer-reviewed journals:

So you say. But we can only go on the one you provided.

Some problems with the study:

  1. The main problem – it was only single blinded. This may be especially important when interpreting the fMRI. These can be difficult to do well as many different parts of the brain are being activated at the same time, and if the persons interpreting the scans knew which ones were for the “real” acupuncture then we cannot know they did not just see what they wanted to see. For evidence of how easy this is to do, just recall Benveniste’s results studying very dilute solutions. Results that disappeared after the experimenters were blinded.

    In addition, the non-blinded acupuncturist (and there was only one) could have inadvertently communicated information to the subjects. Single blinding makes the results dubious at best.

  2. Small number of subjects – only 13. The study I wrote about in this post had over 1,100 subjects. Statistical significance is virtually impossible to determine with this small number of subjects, unless the results are extremely clear.
  3. The full paper (and I have read it now) shows no statistical calculations at all, so I don’t see how we can tell if the difference was statistically significant. As far as I can see from the study, there were no numerical measurements made (none reported, anyway), so I don’t see how the researchers could tell either. All they say is “there was stronger activation” at the real acupuncture points. But how much stronger? If there is no measure of how much, then they have no basis for claiming a “highly statistical significant difference”. Statistics require numbers, I’m afraid.
  4. Finally, your claim was that there were studies that “reveal signals in the regions of the brain that control the organs that the acupuncturist means to manipulate”. Even if this study had found something significant (which I doubt), I’m still not sure it shows what you claim it shows.

in summary, without blinding and without a statistically significant sample size, and without some way of measuring the difference statistically, the study is virtually worthless. On the other hand, the study I wrote about included more than 1,100 patients, and found no statistical difference in actual pain reduction felt. And this result is consistent with all other well run studies on acupuncture. So nice try. At least you did try to find a study, which is more than 95% of the woos who come have manage to do.

Now, on to your analogy. The thing is, I did understand it. It was just false. In your analogy, a turkey sandwich and a snickers bar both satisfy your hunger, but they are not equal. The snickers bar is not so good for you (and so presumably by analogy the snickers is the sham acupuncture), but you get the same effect of feeling full (reduced pain from the treatment). Except that real and sham acupuncture are the same – same needles / same amount of penetration – if they are not then it wouldn’t be a true test of sham. Sham and real acupuncture are not turkey sandwiches and snickers bars. They are BOTH turkey sandwiches. (Or both snickers, if you like.) So your analogy fails.

The correct way to apply your analogy would be to say that both real and sham get (by analogy) the turkey sandwich. But the real treatment gets to chew the sandwich in the mouth and swallow it down the throat (by analogy, the real acupuncture point). The sham gets the turkey sandwich shoved up his ass (sham point). Which patient’s hunger is satisfied? I think such a study would show a difference – and the “sham” feeding would not satisfy hunger. (I’m sure this test could be arranged for you, if you don’t believe me.) But the study I wrote about says there is no difference. So acupuncture is not like eating – it matters where you put the needles (stuff the food), because there really is a digestive system linked to the mouth and throat (“chi”). Or in plain words – there is probably no such thing as chi.

Re: Enjoy your skepticism, Gentlemen. Flawed, though it is.

Except you have failed to identify any actual flaws. Your arguments, have many.

Re: And in closing, I just want to share that I find it unfortunate that all my arguments earlier were really lost on you. It’s clear you’re not out to be educated (which is the power of most skepticism), but rather just to point out why you are right and others are wrong.

And in closing Cupo, I just want to share that I find it unfortunate that all my arguments earlier were really lost on you. It’s clear you’re not out to be educated (which is the power of most skepticism), but rather just to point out why you are right and others are wrong.

You see – you really were just talking to the mirror. It’s funny how content-free rants can just be turned back on you, isn’t it?

Now – to YOUR fallacy ridden comments. Lets list them:

False analogy

Appeal to other ways of knowing.

Appeal to ancient knowledge.

Appeal to popularity.

The Gadfly Corollary.

And btw, posting links to other places where I have described the fallacy you are using, is not a fallacy. The links explained why the fallacies you were relying on were fallacies. Just because I didn’t repeat the whole post for you in the same comment, doesn’t invalidate what I wrote. However, your inability to explain why my explanations were wrong means you are not entitled to claim you were not employing fallacies. (Or that I was.)

I think several of you are confusing the scientific method with the academic process.

At least, in practice, anyway. In the way you’ve been writing. You, especially Skeptico and Tom, have been using a lot of rhetoric, and not a lot of facts. I admire the debate skills. But with all the talk of science you've been doing, I would have expected a bit more of an open debate. I’ll get into that below, or maybe in post 2. But I also want to point out here, at the outset, that I have no burden of proof as far as acupuncture is concerned. As I have said from the beginning, I am not trying to prove acupuncture is be effective. I am just pointing out flaws in the argument used here to claim that it isn’t. So, the burden of “dis-proof” if you will, lies with you, to back up that argument. The burden of proof of the fallacy does lie with me. So let me try again.

Let’s start from the beginning, shall we?
And don’t worry – I’ll address points from recent posts, too.

This is from the original post all the way up.

The study CLEARLY shows that sham acupuncture – needles put in the “wrong” place – works no better than the “real” stuff. Therefore acupuncture - releasing of blocked “chi” by placing needles at specific positions – does not work.

My problem, from the beginning, has been with this statement, and that it is logically insufficient to draw from it the conclusion that is the title of the page: “One More Time -- Acupuncture Does NOT Work”.

I’ll explain.

From the study you quote, they conclude that, for pain abatement, effects of sham acupuncture and real acupuncture can not be distinguished. Both produced similar effects. Agreed?

If not, please explain my error. If agreed, please someone explain how to draw a logical line of progression from that premise (that these two procedures produce equal effects) to the conclusion (that acupuncture does not work).

My analogy, which you both (Tom and Skeptico) misinterpreted, tried to whimsically point out the lack of logic here. Just because a thing (sham acupuncture or a turkey sandwich) produces the same result (hunger abatement) as another thing (real acupuncture or a snickers bar) does not mean those two things are equal. Period. You alter it by equating the snickers to sham if you want. But that’s it. That was my point.

There is much missing from the deductive reasoning you’re trying to apply here. I'll get to that. The misinterpretations were interesting. Acupuncture was not to be related to eating, Tom. My bad for the poor parallelism. And no, Skeptico, the method of accepting the food (oral or anal) was not the difference to which I was drawing attention. I was thinking of chewing as being like the needles – these are the tools (needles, chewing) used to accept the “medicine” (food or acupuncture). The two different kinds of food were analogies for the two different kinds of acupuncture. Your logical deduction above equated these two. Your statement made the turkey equal the snickers. That isn’t my argument. My point is to show how that logic is flawed.

Again, because the analogy causes too much confusion, and opens too many other variables, let’s drop it. Let's keep the discussion pared down to the root. Again, please someone explain how to draw a logical line of progression from the premise, that these two procedures produce equal effects, to the conclusion, that acupuncture does not work.

You both, Tom and Skeptico, then began adding “information” to your arguments, about what acupuncture is supposed to do, and how. Without any citations or backup, you both began listing how this study supported your claim:

POSTED BY: Tom Foss | November 25, 2007 at 09:52 PM “Sham acupuncture is just as effective as "real" acupuncture, which shows that there is no substantial difference between the two. Given the explanations behind acupuncture (involving chi and meridians), this shouldn't be possible, suggesting that the whole justification and foundation of acupuncture is bunk.”
POSTED BY: Skeptico | November 26, 2007 at 07:29 AM It shows that the idea of chi in the meridians cannot be real.


Really? Does it say that? If you can provide a citation, I would like to learn more.

What I know of acupuncture is that, yes, there are acupoints. But there are many of them, thousands of them. Any there are sets that all can elicit a similar response. How accurately were the “sham” points chosen in the study you quoted, I wonder.

But there is an even better point to be made: again, I ask you to take Tom’s first statement above (“Sham acupuncture…”), and then either his second (“Given the…”) or yours (“It shows that the idea of chi in the meridians cannot be real.”), and connect them please.

Not real? How do you arrive at this conclusion? What laws of chi and meridians are you citing or even using that state that needle insertion off an acupoint should elicit no response at all?

No response at all has never appeared as an expectation for needle insertion in any acupuncture text I have seen. If you know of one, I would love to see the citation, and learn more about it.

As for thinking of having to have a specific response depending on the point manipulated, well, as Tom points out, pain is a bad example to use for this, as it is prone to false negatives.


POSTED BY: Tom Foss | November 26, 2007 at 04:18 PM
It was one simple, easy-to-treat, easy-to-affect-with-placebo symptom: pain.

Readily affected by placebo will result in a lot of placebo signal. Hard to evaluate. So I wouldn't choose pain as a method of evaluation if I was a scientist exploring this effect. Instead, I might choose brain function. I’ve provided one link about specific acupuncture effects and how they are different than sham points. I will have more references in a later post.

This is already long, but as a good segue, I'd like to return to the point of science versus rhetoric.

There are many things I've been accused of on this blog. My favorite has to be the Gadfly thing. What was that? Yes, I read the link. But did you really think I was drawing attention to being called a jackass so that my argument would be seen in a better light? I was just trying to elicit an apology for a misplaced slur. I don't need the approval of anyone on this blog (reader or poster) to support my sense of credentials or prop up my arguments. That was just rhetoric on your part (and probably effective, too) to discount my post to other readers. Building consensus that your views are better... accurate.

That's not science. That's rhetoric.

Science looks at all the facts. With an unbiased eye. Skeptical, of course. Biased, never. There is plenty of anti-CAM bias in your posts, Tom and Skeptico. I'll point out some of my favorite rhetoric in my next post.

So, what you are basically trying to say is, it doesn't matter whether you "know" what you are doing or just jam in the needles at random, it's both acupuncture?

By the way, should I change my name?
We've got two Toms here, now.

Skeptico replies to Cupo

Re: My analogy, which you both (Tom and Skeptico) misinterpreted, tried to whimsically point out the lack of logic here. Just because a thing (sham acupuncture or a turkey sandwich) produces the same result (hunger abatement) as another thing (real acupuncture or a snickers bar) does not mean those two things are equal. Period. You alter it by equating the snickers to sham if you want. But that’s it. That was my point.

But that isn’t what I did. I didn’t equate the snickers to the sham. I specifically said this was a false analogy. What is wrong with you?

Re: There is much missing from the deductive reasoning you’re trying to apply here. I'll get to that. The misinterpretations were interesting. Acupuncture was not to be related to eating, Tom. My bad for the poor parallelism. And no, Skeptico, the method of accepting the food (oral or anal) was not the difference to which I was drawing attention. I was thinking of chewing as being like the needles – these are the tools (needles, chewing) used to accept the “medicine” (food or acupuncture). The two different kinds of food were analogies for the two different kinds of acupuncture.

Yes, I know that was your thinking. But as I pointed out – this is a false analogy. Different types of food are NOT analogs for different types of acupuncture. The whole point is that the sham is indistinguishable from the real. A sandwich and a snickers ARE distinguishable. The point is that with acupuncture, the patient is getting exactly the same needles with real or sham, therefore two different types of food cannot be analogs for sham and real acupuncture. I explained all this very carefully. What is the matter with you?

Really, you need to stop arguing by analogy – it’s a flawed method. Try using evidence, facts and logic.

Re: Your logical deduction above equated these two. Your statement made the turkey equal the snickers.

Don’t be stupid. I said no such thing.

Re: That isn’t my argument. My point is to show how that logic is flawed.

And you failed. Again.

Re: Again, because the analogy causes too much confusion, and opens too many other variables, let’s drop it. Let's keep the discussion pared down to the root. Again, please someone explain how to draw a logical line of progression from the premise, that these two procedures produce equal effects, to the conclusion, that acupuncture does not work.

Here we go again:

Acupuncture is the manipulation of “qi” … by inserting needles at key points in 12 “meridians” to restore the flow of vital energy and balance yin and yang. This is supposed to restore health to the whole body. And the points are very specific: NCCAM states that the body has more than 2,000 acupuncture points; the ones you use depend on the illness you are trying to fix.

So if it doesn’t matter where you stick the needles, acupuncture, as acupuncturists define it, does not work.

And please do NOT ask me to explain again why this is important. It’s in the post.

Re: Readily affected by placebo will result in a lot of placebo signal. Hard to evaluate. So I wouldn't choose pain as a method of evaluation if I was a scientist exploring this effect.

They you’d be out of luck, because “pain” is one of the very few things that acupuncture is ever shown to help. It’s certainly the major one.

Re: Instead, I might choose brain function.

Why? Surely you want to show that it provides some therapeutic benefit? If it provides no benefit then what is the point?

Try reading what I actually wrote, respond to my actual points, and don’t repeat the arguments I have already shown to be false.

Tom S. Fox:

Yes, that does appear to be all he is saying. I have this trouble with acupuncture apologists again and again. Somehow, no matter how it is explained to them, they never seem to get the point, and keep bouncing back like those unsinkable rubber ducks.

No need to change your screen name btw. Unless you want to.

Alright, I'll keep it, if it doesn't cause confusion.

Anyway, you would think that my short question suffices to debunk this kind of thinking.

I had to post one more comment. It’s to highlight the intellectual dishonesty displayed here by Cupo, as he shifts the goalposts. It’s this comment of his:

Re: Yes, I read the link. But did you really think I was drawing attention to being called a jackass so that my argument would be seen in a better light? I was just trying to elicit an apology for a misplaced slur.

I was replying to this:

PS: Thanks for calling me a jackass, Skeptico. Glad my post got you that riled up. Think about it.

No, you were not trying to “elicit an apology”. “Glad my post got you that riled up” is not a request for an apology.

“Glad my post got you that riled up” was you reveling in the attention, pleased that you had apparently got me “riled up”. And implying that this somehow meant your argument had more validity. So I call out your intellectual dishonesty. You are a liar. You are an intellectual fraud. As is evidenced by the above, and by your continued and willful misinterpretation of every argument presented by others. I am running out of patience with your games. Respond to my actual arguments, present some genuine arguments of your own with valid logic, or piss off. I am not going to put up with your dishonest crap for much longer.

I have to post another comment, too.
This whole thing is actually quite simple.

1. Acupuncture supposedly works by releasing blocked chi using needles, which means that it has a (I assume strict) set of rules that tell you where exactly put the needles.

2. If you jam in the needles at random, without regard for the rules of acupuncture, you are not performing acupuncture, you are perfominc sham acupuncture at best.

3. Therefore: If real acupuncture doesn't have better results than sham acupuncture (and it doesn't), then it means acupuncture doesn't work!

How could anyone possibly disagree with that?

Damn! Why did this fucking thing send the uncorrected version of my post?!

Cupo:

Acupuncture.

As the basis of Acupuncture, Shen Nung theorized that the body had an energy force running throughout it. This energy force is known as Qi (roughly pronounced Chee). The Qi consists of all essential life activities which include the spiritual, emotional, mental and the physical aspects of life. A person's health is influenced by the flow of Qi in the body, in combination with the universal forces of Yin and Yang . (I will discuss Yin and Yang a little later). If the flow of Qi is insufficient, unbalanced or interrupted, Yin and Yang become unbalanced, and illness may occur. Qi travels throughout the body along "Meridians" or special pathways. The Meridians, (or Channels), are the same on both sides of the body (paired). There are fourteen main meridians running vertically up and down the surface of the body. Out of these, there are twelve organ Meridians in each half of the body (remember they are in pairs). There are also two unpaired midline Meridians. There will be a diagram of Acupuncture points for treating diseases of the Meridians at the end of the digestive system paper. (See Appendix 1). The acupuncture points are specific locations where the Meridians come to the surface of the skin, and are easily accessible by "needling," Moxibustion, and Acupressure. The connections between them ensure that there is an even circulation of Qi, a balance between Yin and Yang.

Energy constantly flows up and down these pathways. When pathways become obstructed, deficient, excessive, or just unbalanced, Yin and Yang are said to be thrown out of balance. This causes illness. Acupuncture is said to restore the balance.

acupuncture points

If acupuncture is defined as the insertion of needles in specific points, in specific ways, to treat the flow of Qi along meridians (which it appears it is unless you can show otherwise); then if inserting needles in ways that are not consistent with acupuncture still elicits the same outcome as acupuncture the logical conclusion is that the theory behind acupuncture is wrong and acupuncture does not work because acupuncture is a very specifically defined practise.

The study shows that sticking needles in anywhere can have a result. Acupuncture states by definition that only sticking needles in at specific points produces a desired effect. The logical conclusion therefore would be that acupuncture does not work and that there is something else going on.

If sham acupuncture produces an effect similar to 'real' acupuncture then logically one or more of the following key parts of the theory of acupuncture are wrong:

1. Qi is unblocked by acupuncture needles inserted at specfic acupuncture points.

2. Acupuncture points are consistent with meridians approaching the surface of the skin.

3. Meridians exist.

4. Qi exists.

5. Yin and yang exist.

6. Yin and yang can be unbalanced.

7. Qi can be blocked and unblocked.

8. Inserting acupuncture needles can unblock Qi.

9. Unblocking Qi balances Yin and Yang.

If any of these is wrong, acupuncture does not work.

Just because a thing (sham acupuncture or a turkey sandwich) produces the same result (hunger abatement) as another thing (real acupuncture or a snickers bar) does not mean those two things are equal.

Your analogy is flawed. The sandwich and chocolate bar are both food, hence they have the same result. 'Real' acupuncture and sham acupuncture are not the same thing by definition.

If you wanted to use food for your analogy you would have to say a real turkey sandwich and one made from some non-food like substance that had been made to look like the real thing. One claims to be the real thing, one just looks like it. If both then quelled hunger it would mean the theory that only real food prevents hunger was wrong and that something else was happening.

It is your logic that is flawed. Your point was wrong because your analogy was not consistent with what it was supposed to represent.

There is much missing from the deductive reasoning you’re trying to apply here.

Actually, the problem is with your reasoning.

The two different kinds of food were analogies for the two different kinds of acupuncture.

This is the problem. You have been fooled by the terms. Sham acupuncture is not a form of acupuncture by definition. It is sticking needles in the body at some point. It is not simply another version of acupuncture, which is a very strictly defined procedure. The sandwich and the chocolate are both versions of the same thing. Acupuncture and sham acupuncture are not.

It is you who is the victim of poor reasoning, based on your faulty assumption that sham and real acupuncture are two versions of the same thing.

You both, Tom and Skeptico, then began adding “information” to your arguments, about what acupuncture is supposed to do, and how.

It would seem that they understood this better than you. Their understanding equates to the understanding of acupuncturists themselves, yours apparently then does not.

What I know of acupuncture is that, yes, there are acupoints. But there are many of them, thousands of them. Any there are sets that all can elicit a similar response. How accurately were the “sham” points chosen in the study you quoted, I wonder.

Someone hasn't been paying attention. Tom quoted from the study you cited, Skeptico couldn't access it. The sham points were chosen by an acupuncturist. The one that wrote the paper that you cited. Did I mention that it was the paper you cited?

If he screwed up picking sham acupuncture points, then the study is invalid. The study that you cited.

But there is an even better point to be made: again, I ask you to take Tom’s first statement above (“Sham acupuncture…”), and then either his second (“Given the…”) or yours (“It shows that the idea of chi in the meridians cannot be real.”), and connect them please.

Ok.

If sham acupuncture (remember, this is sticking needles in points that are not consistent with the theory of 'real' acupuncture) has the same effect as 'real' acupuncture then that means that the theory behind 'real' acupuncture is not correct.

It means that given the explanation for the purpose of sticking needles in acupuncture points within 'real' acupuncture; acupuncture does not work. It means that the needles do not unblock the flow of Qi through meridians. It means acupuncture does not work.

Not real? How do you arrive at this conclusion? What laws of chi and meridians are you citing or even using that state that needle insertion off an acupoint should elicit no response at all?

This is a strawman. Neither Tom nor Skeptico said that inserting needles away from acupuncture points would produce no response at all. However this does highlight your apparent ignorance of acupuncture. The theory of acupuncture does state that needles must be placed in a specific way, in a specific place, to gain a desired effect and that not doing so will not produce the desired effect. So if not doing so does produce the desired effect, then the theory behind acupuncture is wrong.

For instance. If I wanted to get some desired effect on the lung associated with the zhongfu point, but I placed the needle at the Touwei point and got the same effect, then the theory would be wrong. Likewise, if I wanted some effect on pain that was associated with specific points, but got the same result from points that aren't even recognised as acupuncture points; that would suggest the theory behind acupuncture is wrong and that acupuncture does not work.

No response at all has never appeared as an expectation for needle insertion in any acupuncture text I have seen. If you know of one, I would love to see the citation, and learn more about it.

Just keep piling on the straw there.

So, are you saying that acupuncture does expect a response no matter where you stick a needle. This undermines 'real' acupuncture, doesn't it?

But did you really think I was drawing attention to being called a jackass so that my argument would be seen in a better light? I was just trying to elicit an apology for a misplaced slur.

Perhaps you owe someone an apology then since your very first post ends with the same slur you seem upset about. If you can't take it, don't dish it out ya big baby.

Science looks at all the facts. With an unbiased eye. Skeptical, of course. Biased, never. There is plenty of anti-CAM bias in your posts, Tom and Skeptico.

You do understand irony, don't you?

Regarding acupuncture points being very specific:

I'm a little confused as to the definition of acupuncture you guys are working with, because from what i understand there are several different schools of acupuncture:

"In the Chinese system the points are at very exact locations that are fixed from person to person. An example would be that the point is located 3 units above the crease of the wrist between this and that tendon. In the Japanese tradition the points are seen to be more of living entity. The anatomical location is considered to be only a starting point. Then to find the actual point the practitioner must be able to feel where it is. Countless hours are spent among the Japanese style acupuncture community developing the ability to sense with one’s hands where these “Live Points” are. Subtle changes in temperature, moisture, skin resilience, etc. are all sought while looking for the spot. Then treatment is applied to the felt point to bring about healing."


Good luck with the DBCS for the Japanese style acupuncture.

Maybe i should have added this on the localizing of "live points", and my short comment on DBCS:

"Acupuncture points are more than anatomical landmarks, they are manifestations of a functional problem in the body. As such, they are normally dormant, becoming active when a pathological condition begins to form."

In the Japanese tradition the points are seen to be more of living entity. The anatomical location is considered to be only a starting point. Then to find the actual point the practitioner must be able to feel where it is.

My god, someone combined acupuncture with water dowsing.

Water dowsing works because there is almost always water, a dowsers "wrong rate" is extemely low.

If "Japanese acupuncture" has any effect at all its because sham acupuncture has some effect.


Cupo,

Again, please someone explain how to draw a logical line of progression from the premise, that these two procedures produce equal effects, to the conclusion, that acupuncture does not work

I want to recognize thatI understand your query and upon reading that, I can see your quandry. I think both Tom and Skeptico have now answered that. It lies in the definition of acupuncture, one that you seem to be more lenient about, and they are not. They both recognize (all of us do) that jabbing needles may reduce pain, but that this pain reduction may be 100% placebo (the patient will always know he is being jabbed, and will alway attribute this to a treatment that is supposed to help him). so when skeptico says "acupuncture does not work" he is talking about the "theory of acupuncture", not just effects of sticking in needles wherever.

I see a lot of effects of Clarks Law being thrown around here and thats a rut easy to get into.

Now will you please help me understand the assertion you made by saying this:

Proof is important, yes. How about 2,000+ years of a culture of now 1 billion people who use this as their primary method of preventative healthcare. Oh... I guess that doesn't count.

The assertion being: old medicine used by a lot of people is good, better than western medicine. Meanwhile they have suffered until very recently very low longevity rates, india even worse (links above). When we decide to use these very practices, aren't we simply asking to have our lifespans reduced? Aren't we simply paying people to, literally, make our lifespans worse? Exactly what benefit to humanity do you see them providing, that western medicine isn't providing 100% better?

I'd like to add that every treatment triggers the placebo effect.
If a treatment doesn't work better than placebo, you can't say it works!

My god, someone combined acupuncture with water dowsing.

Surely this isnt an appeal to riducule is it?

Water dowsing works because there is almost always water, a dowsers "wrong rate" is extemely low.

And surely, you being a skeptic and all, this isnt a red herring by any chance?

If "Japanese acupuncture" has any effect at all its because sham acupuncture has some effect.

By now i should probably just take your word for it.

Cupo replies to Jimmy_Blue:

Perhaps you owe someone an apology then since your very first post ends with the same slur you seem upset about. If you can't take it, don't dish it out ya big baby.

I explained my initial use of the term. It was directed at Mr. Novella. That was in my November 26 06:59 AM post. I still haven’t heard a response from Skeptico about it. To be clear, I'm only upset about him misreading my use of it and therefore redirecting back to me. But I'll get to that, and his claim that I'm a liar, in a later post.

Re: Science looks at all the facts. With an unbiased eye. Skeptical, of course. Biased, never. There is plenty of anti-CAM bias in your posts, Tom and Skeptico.

You do understand irony, don't you?

I understand irony. But I don’t yet see how it applies to this quote of mine. Read on, perhaps you too will see why it doesn’t.

Cupo replies to Skeptico, Tom S. Fox, Tom Foss, et al. (meaning other skeptics posting here)

You guys, Tom S. Fox, Tom Foss and Skeptico, clearly misunderstood the analogy. I apologize for ever introducing it. And I definitely should not have tried to revisit it.

I still maintain that your arguments against the efficacy of acupuncture or the existence of it (both of which I believe have been argued here) using the facts you have assembled against it are flawed arguments. Yes, I’ll explain.

You did not look at the results specifically enough. Or, your knowledge of acupuncture is too limited.

There are many things missing from the line of argument you (Skeptico, Tom S. Fox, Tom Foss, and now Jimmy_Blue) have been following. The most essential and problematic of these is unclear understanding of the tenets and definition of acupuncture.

You have argued here that Qi does not exist, and can not be proven to exist. What definition of Qi do you use when you state it can not be proven to exist? I define Qi as something that acupuncture manipulates. You’re welcome to call question to that, if you like.

I provided an article that offers some evidence that this Qi does exist – that something is manipulated exclusively by acupuncture. I have provided data showing a physiological response to acupuncture needles being manipulated at only acupuncture points. There was no patient subjectivity in these results. I agree it was not double-blind, but by your assertions, it needn’t be. If acupuncture were false, wouldn’t the same physiological response be seen by any needle anywhere, no matter how applied or by whom? That wasn’t observed. The placebo effect didn’t hold up here. And yet no one, aside from Tom S. Fox (TSF), has voiced any hint at considering altering their hypothesis to accommodate these new findings.

At a minimum, that article provided a clue that it may be possible to measure existence of Qi. Only TSF commented that the article was interesting, and it deserved more research. I am beginning to believe that among you, only TSF is actually looking for evidence, here. Others of you appear interested in forwarding your own opinions of the interpretations of facts. Still, even TSF hasn’t fully grasped my argument.

So, what you are basically trying to say is, it doesn't matter whether you "know" what you are doing or just jam in the needles at random, it's both acupuncture?

No, but thank you for the question mark. At least you asked. That is not what I am trying to say. What I am trying to say is the effect matters, the details matter, that you aren’t looking closely enough at the results (in that article) to equate the two. At least, not with a full understanding of the definition of acupuncture.

This takes us back to Skeptico’s article and his line of argument:

Beyond the observation that a significant pain abatement response resulted from both sham and real, no further correlation of the two methods was made.

I asked for someone to connect the dots. I invited someone to show me how this disproves acupuncture exists. No one responded to that, expect Skeptico with a reference to his original post, which I’ll get to in a moment; and then Jimmy__Blue, which I mention here.

If acupuncture is defined as the insertion of needles in specific points, in specific ways, to treat the flow of Qi along meridians (which it appears it is unless you can show otherwise); then if inserting needles in ways that are not consistent with acupuncture still elicits the same outcome as acupuncture the logical conclusion is that the theory behind acupuncture is wrong and acupuncture does not work because acupuncture is a very specifically defined practise.

The study shows that sticking needles in anywhere can have a result. Acupuncture states by definition that only sticking needles in at specific points produces a desired effect. The logical conclusion therefore would be that acupuncture does not work and that there is something else going on.

First off, no, acupuncture is not just insertion of needles. See definition cited below. I also disagree with your equating “a result” with “treating the flow of Qi”. These aren't equal, one may be evidence of the other, but that doesn't make them equal. Nor do I believe “a result” equals “a desired effect” in this context. Neither of these reflects the requirement of your first paragraph, which I agreed with, that the two procedures "elicit[s] the same outcome". Without looking closely at "the outcome", your association of the two procedures (sham and real) is much too loose.

I believe the latter phrases accurately describe the effects of acupuncture. Facts supporting this appear below and in earlier posts on this page.

I do believe “a result” from sham acupuncture has been observed. I’ll even concede that this sham-incited result, in the context of pain abatement, appears similar to the results that real acupuncture provides. And I’ve discussed that. Pain is an response easily-affected by placebo. I know, Skeptico. You commented on this.

They[sic] you’d be out of luck, because “pain” is one of the very few things that acupuncture is ever shown to help. It’s certainly the major one.
I’ll refute those statements “few things that acupuncture… shown to help…certainly the major one” at the conclusion of this post.
Re: Instead, I might choose brain function.

Why? Surely you want to show that it provides some therapeutic benefit? If it provides no benefit then what is the point?

Try reading what I actually wrote, respond to my actual points, and don’t repeat the arguments I have already shown to be false.

I am not out of luck. It is you who are using that study as attempted proof that acupuncture does not exist. My data does not rely on subjective pain scale or readily-false negative metric such as pain.

I have read what you wrote.

Really, you need to stop arguing by analogy – it’s a flawed method. Try using evidence, facts and logic.

Yes, I tried doing that. You evaded it. This was my previous, non-analogy-based statement:

… Again, please someone explain how to draw a logical line of progression from the premise, that these two procedures produce equal effects, to the conclusion, that acupuncture does not work.

And here is your flawed response. Flawed, because it does not take into account a true definition of real acupuncture.

Here we go again: Acupuncture is the manipulation of “qi” … by inserting needles at key points in 12 “meridians” to restore the flow of vital energy and balance yin and yang. This is supposed to restore health to the whole body. And the points are very specific: NCCAM states that the body has more than 2,000 acupuncture points; the ones you use depend on the illness you are trying to fix.

And please do NOT ask me to explain again why this is important. It’s in the post.

I’m not asking you anything. I am telling you: your understanding of acupuncture is incomplete. You post a paragraph and claim that makes your case. You claim it’s in the post. It’s not. I read the post. Your conclusion is the same:

So if it doesn’t matter where you stick the needles, acupuncture, as acupuncturists define it, does not work.

As I stated to Jimmy, I believe you are operating under the false assumption that the responses are the same. I also don’t agree with your definition of acupuncture, even if you claim it's the acupuncturists' own. I also read the page that you partially quoted from. What was before the ellipsis (…) up there? Did you read that page you referenced? Perhaps you missed this paragraph:

The term acupuncture describes a family of procedures involving stimulation of anatomical points on the body by a variety of techniques. American practices of acupuncture incorporate medical traditions from China, Japan, Korea, and other countries. The acupuncture technique that has been most studied scientifically involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation. NCCAM acupuncture information

There is much more to acupuncture than where you stick the needles. The goal is to manipulate Qi to achieve the desired response. Not to stop pain by jamming a bunch of needles in.

  • “family of procedures”
  • “points on the body” (not the skin – many of these are subcutaneous points)
  • “variety of techniques”
  • “penetrating the skin with … needles that are manipulated”

None of your arguments above take that list into account. Worse – you apparently quote-mined from the website to find facts to support your claims.

The results of the sham vs. real acupuncture article you quoted doesn’t say anything more than these two procedures produce the same result. In that instance of readily-placebo-affected pain management, which is also troubled by a measurement scale that is wholly subjective.

On the other hand, the article I provided shows how MANIPULATION at acupoints elicits a characteristic and different physiological response than at sham points.

I have now offered a more accurate definition of acupuncture. And have tried to show how your arguments do not hold up when acupuncture is defined correctly. I am not arguing that the study I provided proves the existence of "Qi", or the efficacy or existence of acupuncture. I am simply arguing that your statements do not prove the contrary.

Finally, to pull some other supporting information from the same NIH website Skeptico and I have been quoting. There are a number of maladies that acupuncture has been found, by the NIH, to be helpful in treating. In support of Skeptico’s request for beneficial effects:

Why? Surely you want to show that it provides some therapeutic benefit? If it provides no benefit then what is the point?

here is their statement:

Does acupuncture work?

According to the NIH Consensus Statement on Acupuncture, there have been many studies on acupuncture's potential usefulness, but results have been mixed because of complexities with study design and size, as well as difficulties with choosing and using placebos or sham acupuncture. However, promising results have emerged, showing efficacy of acupuncture, for example, in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations--such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low-back pain, carpal tunnel syndrome, and asthma--in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. An NCCAM-funded study recently showed that acupuncture provides pain relief, improves function for people with osteoarthritis of the knee, and serves as an effective complement to standard care.7 Further research is likely to uncover additional areas where acupuncture interventions will be useful.8

7 Berman BM, Lao L, Langenberg P, et al. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Annals of Internal Medicine. 2004;141(12):901-910.
8 National Institutes of Health Consensus Panel. Acupuncture: National Institutes of Health Consensus Development Statement. National Institutes of Health Web site. Accessed at consensus.nih.gov/1997/1997Acupuncture107html.htm on December 14, 2004.
http://nccam.nih.gov/health/acupuncture/#work”>NIH: Does Acupuncture Work


Cupo replies to Skeptico:

No, you were not trying to “elicit an apology”. “Glad my post got you that riled up” is not a request for an apology.

“Glad my post got you that riled up” was you reveling in the attention, pleased that you had apparently got me “riled up”.

You’re half right. My second sentence there “glad …” was me reveling in attention; but not the kind you think. I was reveling in the attention of pointing out that you wrongfully called me a jackass.

The first statement “Glad…” was mostly that – I was happy to engage you in a good debate about proof and reason. I was happy my comments elicited a long response. That did not mean I thought mine were somehow superior. Please.

True, I also wrote it as a reverse-psychology way of eliciting a response - hopefully an apology. I thanked you for something I wanted you to take back.

And implying that this somehow meant your argument had more validity. So I call out your intellectual dishonesty.

That’s a big assumption on your part, Skeptico. I don’t think you want to go there. You make a large jump to assume what’s going on in my head. I do not need this forum’s approval to give my arguments validity. Obviously I’m in the tiniest minority here, and yet I still return, I still try.

You are a liar. You are an intellectual fraud. As is evidenced by the above, and by your continued and willful misinterpretation of every argument presented by others.

There is at least some hyberbole in there, and it might border on libel. I request you retract it. At least the liar part.

I am running out of patience with your games. Respond to my actual arguments, present some genuine arguments of your own with valid logic, or piss off. I am not going to put up with your dishonest crap for much longer.

I hope I did that with the earlier post today. If not, say so. If that's the case, I apologize now, and I will not visit your blog again.

I am a scientist. I have been practicing science for more than 20 years. A little research would have revealed this to anyone. It’s clear to me that there is a lot of emotion in this discussion – among all of us, I’m not singling anyone out here, and certainly I'm not immune to it – and that emotion is a danger to reason and to science. Just something to keep in mind.

In closing, I apologize for using the term jackass in my post in a way that was misinterpreted as being directed at you.

Cupo replies to TechSkeptic

Cupo,

Could you answer my question (from above) about why you contend that ancient eastern medicine (choose your brand) is better than western medicine, when longevity rates clearly show western medicine, sanitation and health education to be a far superior approach to health? all the links are above.

If you don't want to answer that, could you inform me of what fallacy you think I am committing by asking you that?

When did I ever contend that? I don't think I made any statement close to that. In this blog, I’ve never compared acupuncture (or any eastern medicine) to western medical practices.

I’m guessing this (following) was the question you wanted me to answer?

If "ancient chinese medicine" was so good, why was the average lifespan of chinese people only 35 years long as late as mid 1950's? In India it was only 32, great Indian health secrets? While 50 years before that, our 'horrible' western medicine was letting us live to 47 on average?

I think you answered your own question: Western sanitation techniques.

I certainly didn’t imply that I think the western techniques are ‘horrible’, or anything like that. I don't think I did...

Yes you did. I'll quote it again...

Again, my point here is that our Western science shouldn't have to be applied to a thing before it is accepted as real. Not always. Proof is important, yes. How about 2,000+ years of a culture of now 1 billion people who use this as their primary method of preventative healthcare. Oh... I guess that doesn't count. They aren't Westerners.

lol... why is it sanitation methods and not the actual medicine? The sanitation methods are part of the same type of science that brings you the medicine. Germ theory was a big part of the reason western sanitation methods work and they are a big part of how medical procedures and cures are effective.

You dont get to choose one without the other.

why would you choose a "primary method of preventative care" that only gives you 1/2 the lifespan of another, new, better documented method?


I define Qi as something that acupuncture manipulates.

I see that I was right about you liberal definition of Qi. By this definition your skin is Qi. The air above your skin as you insert a needle is Qi. The blood that flows around the needles are Qi. The parasites and bacteria on the skin where the needle in inserted is Qi.

Its not a useful definition, is it? Its almost as useful as the definition: Qi is nothing.

Qi is not an effect (which is the way you defined it), its a hypothesis that was created. If it were true, acupuncture, in its formal definition would work and would work better than placebo or sham.

All your talk above about NIH lukewarm validation of acupuncture just leads to the conclusion that it should be studied rigorously and thrown out if its crap (which most of the strong studies currently portray), or developed to the place where we know what it is really good for and what it isnt. so far, looks like its just about pain, and that it doesnt matter where the needles go. "Promising results" is truly nothing, wouldnt you agree? Leeching and bloodletting also had "promising results".

When do you give up on something? When do you stop using astrology, palm reading and water dowsing as a guide? How often does it have to be shown to be useless before we as a society say "this is nonsense?". At some point it makes sense to stop wasting money on something.

We have generated an overwhelming amount of data that says putting needles in the back provides a pain relief mechanism (which in turn allows for greater joint movement). But on a limited number of studies with a limited number of patients that show placing needles in the "right" places with the "right" method does anything. Isnt it time to stop, and perhaps look solely at why needles in the back, wherever they are placed provides pain relief? Should we look at the relative amount of pain relief compared with drugs? shouldn't we find out the minimum number of needles required, to make the process efficient?

shouldn't we cast of the bunk associated with acupuncture and focus on what works?


Martin,

My god, someone combined acupuncture with water dowsing.

Surely this isnt an appeal to riducule is it?

no it wasn't it was just a way to show the close similarity between pricking the ground and pricking your skin in the woo way and in a random way.

Water dowsing works because there is almost always water, a dowsers "wrong rate" is extemely low.

And surely, you being a skeptic and all, this isnt a red herring by any chance?

no, it was a brief description of why water dowsing has an extremely high confirmation bias associated with it. There is always water, the dowser doesn't tell you how deep it is.

If "Japanese acupuncture" has any effect at all its because sham acupuncture has some effect.

By now i should probably just take your word for it.

I dont really care if you do or don't. In both cases it doesn't matter where you prick the surface. In both cases the natural phenomena (water available everywhere, sham procedure working) leads to strong confirmation bias. Skeptico already provided plenty of link to how sham acupuncture is as effective as any other kind.

Cupo replies to TechSkeptic

Yes you did. I'll quote it again...

RE:Again, my point here is that our Western science shouldn't have to be applied to a thing---

Wsit, wait, wait. That wasn’t a reference to western medicine. I thought you asked me to justify my thoughts about why I view western medical techniques as "horrible"?

One step further: even that comment above doesn’t imply that I believe Western science techniques are terrible or horrible, or in any way negative. I was just asking for justification of why they are the one and only set of rules by which we should judge things. They aren't perfect. See below about the universe and weather. Also,check out my Lost Philosophies blog. Oh wait. It’s not posted yet. Coming soon...

You dont get to choose one without the other.

why would you choose a "primary method of preventative care" that only gives you 1/2 the lifespan of another, new, better documented method?

I don’t refute your comments about western sanitation and germ theory being an essential tool to help spread disease, so I didn’t repeat it here.

What you will get me to admit (which I haven’t before – my other posts were not in favor of acupuncture. I only asked for a more rigorous debunking, if one is to be had. But hey, I've been labeled as such here anyway)… so I’ll admit here, I believe acupuncture to be another tool in that toolbox of health.

BUT when did I ever say anything about "primary method"? Did you read the paragraphs I posted from the NIH site? There is nothing in there even implying primary. It's all about a complementary tool.

Re: I define Qi as something that acupuncture manipulates.

I see that I was right about you liberal definition of Qi. By this definition your skin is Qi. The air above your skin as you insert a needle is Qi. The blood that flows around the needles are Qi. The parasites and bacteria on the skin where the needle in inserted is Qi.

Its not a useful definition, is it? Its almost as useful as the definition: Qi is nothing.

Actually, some Chinese mystics might not argue with your statements. LOL But I will. I didn’t say Qi is ‘anything’ that acupuncture manipulates. I said it was something it manipulates. And the article I shared provided some evidence of what that Qi might be. The placebo did not elicit the response. Only properly inserted and manipulated acupuncture needles did.

Qi is not an effect (which is the way you defined it), its a hypothesis that was created. If it were true, acupuncture, in its formal definition would work and would work better than placebo or sham.

My definition did not characterize Qi as an effect. I would not characterize Qi as an effect just as I would not describe body temperature as an effect of Tylenol.
I agree with your logic of hypotheses. And in my opinion, I have provided proof of real effects of acupuncture working better than sham or placebo, at least at stimulating brain regions, which is an expected result, and may offer clues to Qi. (I could give you some others now, but I left that computer in my office. Let me know if anyone is still interested.) I said this all before, in the 1:09 post.

All your talk above about NIH lukewarm validation of acupuncture just leads to the conclusion that it should be studied rigorously and thrown out if its crap (which most of the strong studies currently portray), or developed to the place where we know what it is really good for and what it isnt.

I have no argument with that (well, except for “lukewarm”, and your parenthetical statement). I never did. And I especially like your use of the word if... "if its crap". I haven't seen enough proof of that here, or in the articles out there. I have a problem with the conclusion you and others have offered:

so far, looks like its just about pain, and that it doesnt matter where the needles go.

Um... debunking that was the point of my 1:09 PM post. If you guys are all only going to talk about pain studies, then I'm done.

When do you give up on something? When do you stop using astrology, palm reading and water dowsing as a guide? How often does it have to be shown to be useless before we as a society say "this is nonsense?". At some point it makes sense to stop wasting money on something.

Good question. In my opinion, I’d say the 20 or so years (that's probably being extremely generous) Western scientific techniques have been used to “study” acupuncture hasn’t been enough.

How long did the search take to reverse the hypothesis of the electron being a particle that carried positive charge, before they discovered it carries negative?

You might point to this as a bad example, since that hypothesis was proven false. My point is that the hypothesis of Qi and effectiveness of acupuncture hasn't yet been proven at all -- one way or the other.

You all can quote all you like about pain studies. You have not seen a stroke patient regain speaking ability in days, not weeks years or ever. Regain ability to move, to regain brain function. You have not given acupuncture a chance to prove itself beyond a few (or even many) pain studies. And you don’t have to. Your opinion is yours. But to claim that these studies conclusively prove that acupuncture is fake is something that I do not see your facts supporting, and so I can not support such a thing being propogated.

And here's the thing. Those results are real. Explaining them will take a while. Our Western scientific tools are great, but they don't work universally. They haven't unlocked all the mysteries of the universe yet, have they? Hell, we can't even predict weather accurately, because we can't accurately model (or even know?) all the inputs and interactions that govern that system. Again, my point about time to study. I'm not for not studying acupuncture with science. I'm all for it. Hey man, I'm a scientist! But I am for avoiding jumping to conclusions too early, especially in light of unexplained observations. Many unexplained observations.

By the way, don’t start with me about drugs. You want to hold high this Western Medicine of yours? Save the humans, extend life and all that? Turn on you television and watch what the pharmaceutical industry that Western Medicine has spawned is peddling. Don’t get me started. I’m sure it’s effective. Healthy? Yeah right. Great Western Medicine, that is. Great.

Looks like I'm late to the party.

Cupo:

I think several of you are confusing the scientific method with the academic process.

Oh, I can't wait to see the reasoning behind this.

At least, in practice, anyway. In the way you’ve been writing. You, especially Skeptico and Tom, have been using a lot of rhetoric, and not a lot of facts.
What facts would you like us to use? There's only so many times we can repeat the fact that acupuncturists are unwilling to test their treatment with DBCTs, the fact that the claims of acupuncture's efficacy are not evidence-based, the fact that tests reliably and consistently show that acupuncture is no better than placebo for pain treatment, and the fact that there is no evidence, mechanism, or justification for acupuncture's claims of treatment for other ailments.

But that's neither here nor there. The fact is that this post discusses the facts of a study, we've evaluated the facts of another study here in the comments, and we've pointed out the fact that both acupuncture and your arguments are based in logical fallacies rather than evidence and reason. I'd say we're doing pretty good on the fact front.

I admire the debate skills. But with all the talk of science you've been doing, I would have expected a bit more of an open debate.
What exactly do you mean by open debate? Are you suggesting that we ought to be arguing from equal positions? That would seem to undermine both your complaint that we're using too few facts and your complaint that we're following the "academic process," whatever the hell that is. Perhaps in that "academic process," a side with no evidence and a side with significant evidence can debate openly as if they have equally-valid arguments, but that ain't science. Science is not democratic, it's meritocratic: either you have positive evidence to support your position, or you have, at best, unsupported hypotheses.

Perhaps I misunderstood what you meant by "open debate," in which case I ask you to clarify your position.

I’ll get into that below, or maybe in post 2. But I also want to point out here, at the outset, that I have no burden of proof as far as acupuncture is concerned.
No, you have a burden of proof as far as your claims are concerned. Claims like:
*Skeptico (and others here) base their arguments in "seriously flawed logic."
*There are other, non-scientific methods that reliably describe reality.
*MRI-based studies in which "people receiving acupuncture [exhibit] signals in the regions of the brain that control the organs that the acupuncturist means to manipulate"
*We are "arguing against a label."
*2,000 years of history and personal anecdotes constitute proof comparable to that found in controlled scientific studies.

With at least those claims, you have a burden of proof. But we'll continue that thought in a moment.

As I have said from the beginning, I am not trying to prove acupuncture is be effective. I am just pointing out flaws in the argument used here to claim that it isn’t.
Except you haven't pointed out any such flaws, and your "pointing out" has had fallacies in spades. I could go off on how claiming a position of Devil's Advocate doesn't mean you get to pose arguments without meeting a burden of proof (playing Devil's Advocate entails making a counterargument, which still needs to be supported by the evidence), but that's not really the point here. Even if you had no burden of proof with regard to the efficacy of acupuncture, the acupuncturists do, and they have not met that burden.

But let's get back to your position, shall we? Please correct me if I misrepresent you. You're saying that we are wrong to reject acupuncture, or that our reasons for doing so are flawed. The reason we reject acupuncture is that there is no evidence to suggest that it actually does what it claims. So, pretty much by necessity, your position must be "in (at least) this case, it is wrong to reject claims that are not supported by evidence," or it must be "rejection is wrong because there actually is evidence to suggest that acupuncture does what it claims." In the former case, it's up to you to justify that position with logic and reason; if the latter, it's up to you to show that we're wrong in thinking that there is no evidence to support acupuncture.

Which leads right back to that whole "burden of proof" thing. If your position is that there is evidence for the efficacy of acupuncture, then it is up to you to support that position with said evidence.

So, the burden of “dis-proof” if you will, lies with you, to back up that argument.
I think you are confusing the "burden of dis-proof" with something that actually exists. See, this is where your claim that we're misunderstanding the scientific method falls apart. For any claim, science accepts the null hypothesis--essentially that the claimed phenomenon does not exist--until evidence is found in support of the positive hypothesis. If you want, I can go into the reasoning behind this, but it is a non-negotiable and absolutely necessary part of the scientific method.

So, for the positive claim "acupuncture is an effective treatment," (or whatever the claim is--"there is an energy called chi in the human body, with the following properties," "acupuncture can relieve pain," "there are points on the body where sticking needles will have an effect, other points where they won't," etc.) science will automatically assume that acupuncture is not an effective treatment (the null hypothesis opposing that positive claim) until there is evidence to support the positive hypothesis. Once there is such evidence, we reject the null hypothesis and tentatively accept the positive one, conditional on future examination and evidence. That's the basic starting point of science, period.

So, it's not enough to claim that there are flaws in our argument; even if that were the case, and you haven't demonstrated that it is, science is still justified in rejecting the claims of acupuncture until said claims are supported by evidence. It doesn't take much to reject that null hypothesis, but somehow acupuncturists can't quite muster up the proof.

The burden of proof of the fallacy does lie with me. So let me try again. [...] My problem, from the beginning, has been with this statement, and that it is logically insufficient to draw from it the conclusion that is the title of the page: “One More Time -- Acupuncture Does NOT Work” [...] From the study you quote, they conclude that, for pain abatement, effects of sham acupuncture and real acupuncture can not be distinguished. Both produced similar effects. Agreed?
Agreed, and that's why Skeptico's statement is logically supported. As has been repeatedly said in this comment thread, if the claims of acupuncture are accurate--specifically that it works by "releasing of blocked 'chi' by placing needles at specific positions"--then there should be a clear difference in the effects of "real" and "sham" acupuncture, just as we would expect there to be a real difference in effects between a "real" experimental drug and a sugar pill. The experiment showed no such difference between real and sham acupuncture. Since the positive hypothesis--acupuncture works by "releasing of blocked 'chi' by placing needles at specific positions"--predicts a difference between "real" and "sham" acupuncture, the discovery that there is no difference supports the null hypothesis and causes us to reject the positive hypothesis.

Which is precisely what Skeptico said in the passage you quoted.

As for the title of the post--that "Acupuncture Does NOT Work"--we return to the point about drugs and sugar pills. This test was set up, from the perspective of the "theory" behind acupuncture, with a "real" treatment and a "placebo" treatment. Just as in any other medical test, when there is no difference between the real treatment and the placebo treatment, we conclude that the real treatment does not work. It's true that both may have resulted in some positive effect, but that's the point of the placebo effect: it's entirely psychological. If the treatment performs no better than the placebo, then the treatment itself has no real effect.

Now, there's a possibility that sticking needles into people might have analgesic properties, and that ought to be studied. What this experiment showed, however, is that all the mystical baggage which supposedly explains how and why acupuncture works is utter bunk. If sticking needles into people has an analgesic effect, it's not because of releasing blocked chi at specific points on the body, it's because of some other mechanism. This would imply an experiment in which "sticking with needles" is pitted against a real, known-to-be-effective pain relief treatment, and a placebo treatment as well (which is one of the places where the study in the original post went wrong--there was no medical placebo). Such a test would demonstrate, from a medical perspective, whether or not "sticking with needles" is an effective way of relieving pain. In either case, Skeptico is justified in saying that acupuncture does not work, just as he would be justified in saying that any drug or treatment which performed no better than placebo does not work.

My analogy, which you both (Tom and Skeptico) misinterpreted, tried to whimsically point out the lack of logic here. Just because a thing (sham acupuncture or a turkey sandwich) produces the same result (hunger abatement) as another thing (real acupuncture or a snickers bar) does not mean those two things are equal. Period.
Your analogy, as we've said before, is flawed, for the following reason: we expect the same result from eating a turkey sandwich and eating a Snickers bar. On the contrary, acupuncture predicts a marked difference between "real" acupuncture and "sham" acupuncture.

To put it in terms that you should understand, it's as though someone tells you that eating a turkey sandwich will satisfy your hunger, but eating a Snickers bar won't. You eat both, and you say "actually, they both satisfied my hunger." This would cause you to reject the person's claim.

According to the claims of acupuncture, "real" acupuncture should produce a pain relief result, and "sham" acupuncture should produce no such result. The experiment wasn't testing whether "poking with needles" had an effect on pain, it was testing whether or not there's a difference between poking needles in specific places, and poking them at random. Acupuncture predicts such a difference, just as your friend predicted a difference in satisfaction between a turkey sandwich and a Snickers bar. The study found no such difference. The result is that you reject the claim that there is a difference, which with regard to acupuncture, means rejecting the whole shebang about meridians and specific locations.

Again, please someone explain how to draw a logical line of progression from the premise, that these two procedures produce equal effects, to the conclusion, that acupuncture does not work.
P1. Acupuncture predicts that "real" acupuncture should be more effective at treating pain than "sham" acupuncture.
P2. Reliable studies show that "real" acupuncture is no more effective than "sham" acupuncture.
C1 (P1, P2). The predictions of acupuncture are wrong; there is no difference between the "real" and "sham" treatments.
P3. The "theories" behind acupuncture would consider "sham" acupuncture to be a placebo, and "real" acupuncture to be a real treatment.
P4. In science, when a real treatment performs no better than the placebo, we conclude that the treatment does not work.
P5. "Real" acupuncture performs no better than the placebo.
C2 (C1, P3-5). "Real" acupuncture does not work.

Now, note again that this was not testing whether or not sticking needles in people has an analgesic effect; it was testing the specific claims of the theory underlying acupuncture. What this test shows is that according to the standards of acupuncture, their "real" treatment is no more effective than their "placebo" treatment. According to the standards set by the theory behind acupuncture, acupuncture does not work.

Now, from a scientific perspective, all this means is that we've shown that "sticking needles in specific places" and "sticking needles in random places" have the same effect. It's entirely possible that the collective "sticking needles in people" has some better-than-placebo effect from a scientific perspective, but in that case it needs to be tested against something that would be considered a placebo according to the standards of science--a sugar pill, a treatment that simulates needle-sticking but doesn't actually stick them, etc. But in that case we're no longer testing the claims of acupuncture, that there's some difference between different kinds of poking needles in people, but we're testing whether there's a difference between poking needles in people and not poking needles in people.

It's easy to see where one might get confused in all that; that's part of why science has to be so explicit, and part of why it's useful to use diagrams and charts.

You both, Tom and Skeptico, then began adding “information” to your arguments, about what acupuncture is supposed to do, and how.
...Which is what the experiment tested, effectively.
What I know of acupuncture is that, yes, there are acupoints. But there are many of them, thousands of them. Any there are sets that all can elicit a similar response.
And that sounds like grounds for easy ad hoc rationalizations. "The reason you saw no difference was because all your 'sham' points were too close to real points for the same thing!"

Here's the thing with that; if there are real points which correspond to real effects, then that implies that there are points without real effects. I, personally, would like to know how many sham points were chosen. If there are regions and clusters of points in acupuncture that correspond to different ailments, then it's reasonable that some of the sham points, depending on how they were chosen, might be close to or within those regions or clusters. But what are the chances that all or even most of the sham points just happened to be close enough to the pain-relief acupoint regions/clusters that they activated the effect? If only some of the randomized points were close enough to acupoints to activate the effect, shouldn't we still see a difference in effectiveness between the "real" treatment, in which all the needles are placed in the right points, and the "sham" treatment, in which some of the needles might accidentally be placed in or around the right points? Yet the study showed no such difference. If the regions are so broad that all or even most of the sham points were actually real points, and all the real points were real points, then acupuncture results in the same conclusion that the study did: it doesn't matter where you put the needles, the effect is the same.

Not real? How do you arrive at this conclusion? What laws of chi and meridians are you citing or even using that state that needle insertion off an acupoint should elicit no response at all?
I don't give a flying damn about laws of chi and meridians, I care about the scientific method and the testable claims. We have no evidence that chi exists. We know a lot about energy, we know a lot about the human body, we know a lot about the energy in the human body, and yet we have no evidence that this mysterious chi exists. Until such evidence shows up, science rejects the claim that chi exists and accepts the null hypothesis.

Acupuncturists have made a testable claim, though not necessarily explicitly: if chi exists, then we should expect to see a difference between "real" acupuncture, designed to manipulate chi in certain ways, and "sham" acupuncture, designed to turn people into pincushions.

Now, here's the thing that you seem to be missing: if the claim "X exists" predicts "Effect A," and we run a test to find "Effect A," but no such effect turns up, we can reasonably conclude that X does not exist. This is true whether X is Chi or phlogiston or the luminiferous ether.

The laws of Chi and meridians have nothing to do with it, except in that acupuncture's concept of them is what leads to the falsifiable prediction.

No response at all has never appeared as an expectation for needle insertion in any acupuncture text I have seen.
Nor does it appear as an expectation for anyone here. What we expect, if acupuncture is correct, is that "sticking a needle in" will have one effect, and "sticking a needle in a meridian" will have a different one. Once again, it's like any placebo test: we expect both the placebo and the experimental drug to have an effect, we just expect that the effects won't be exactly the same.
As for thinking of having to have a specific response depending on the point manipulated, well, as Tom points out, pain is a bad example to use for this, as it is prone to false negatives.
I'm sorry, what? Did I say that?
Readily affected by placebo will result in a lot of placebo signal. Hard to evaluate. So I wouldn't choose pain as a method of evaluation if I was a scientist exploring this effect.
You obviously have no idea what the placebo effect is or what it does. General pain (or in this study, back pain) often has a psychological component; sometimes pain varies in severity as a patient's attention to the pain, or preoccupation with other things, varies. Not to mention that chronic pain tends to naturally wax and wane in severity as well. What all this means is that even without treatment, a certain percentage of patients in any study of pain relief will report an improvement in their symptoms--the placebo effect (in a nutshell). If a treatment actually works, a much greater percentage of respondents will report an improvement than the placebo group. Because pain is such an ephemeral, changing, hard-to-measure-empirically quantity, it's actually more likely to lead to false positives, due to various factors. It's really easy to tell whether or not you've cured someone's warts or jaundice, those are objectively observable. The strong subjective nature of pain makes it a more slippery quantity.

To wrap that all up, it should actually be easier for acupuncture to prove its efficacy over placebo with pain than just about anything else, because even if it doesn't work, a more significant portion of people will subjectively report improvement than if you use it to treat something objectively examinable.

So I wouldn't choose pain as a method of evaluation if I was a scientist exploring this effect. Instead, I might choose brain function.
Define "brain function." If you mean to test whether or not poking people with needles makes neurons fire in the brain, great--except that such a test does absolutely nothing to show whether or not the claims of acupuncturists are true. Acupuncturists don't claim that they can make your brain do neat things, they claim to be able to treat and cure physical ailments. While such a test might be interesting, and it might tell us things about the effects of needle-poking on the brain (if there are indeed significant effects), it's useless for evaluating the curative properties and the extraordinary claims of acupuncture enthusiasts.
I’ve provided one link about specific acupuncture effects and how they are different than sham points. I will have more references in a later post.
I should hope so, because the study in the first post kind of blows the one you cited before out of the water. See, while your study of 13 individuals showed some difference between "rotating needles at real points" and "rotating needles at sham points," the report Skeptico cited at the top showed no difference whatsoever between just inserting (and not deeply) needles at sham points, and inserting, manipulating, rotating, and doing all that other mumbo-jumbo to needles at "real" points. Note also that that study was over nearly ten times the sample size.
There are many things I've been accused of on this blog. My favorite has to be the Gadfly thing. What was that? Yes, I read the link. But did you really think I was drawing attention to being called a jackass so that my argument would be seen in a better light? I was just trying to elicit an apology for a misplaced slur.
Yeah, pretty much. That's how most folks who pull out the "looks like I've gotten you all riled up" canard use it. "I've made you angry, therefore I must be doing something right/therefore you're just getting defensive because you know I'm right/therefore you lose the argument because you got emotional first."

And no, you weren't just trying to elicit an apology. Trying to elicit an apology would have been "I wasn't calling you a jackass, I was calling Novella. I apologize for being unclear, and I'm a little offended that you thought I'd stoop so low as name-calling." What you said was "Glad my post got you that riled up. Think about it." Exactly what is meant by the smug rejoinder "think about it"? Certainly not "I would like an apology, please."

That was just rhetoric on your part (and probably effective, too) to discount my post to other readers. Building consensus that your views are better... accurate.
What the hell are you even talking about? Are you claiming that calling you out for your obvious employment of the whole Gadfly thing was tantamount to an ad hominem attack? Here's the rub, Cupo: it's only ad hominem if we're claiming (implicitly or explicitly) that some aspect of your character invalidates your argument. No one here made such a claim; we've shown your arguments to be invalid regardless. Calling you out for the Gadfly thing was merely demonstrating that you're not saying anything new or winning any points (rhetorically or scientifically) with such a comment.

And really, "Glad my post got you that riled up. Think about it." No, that wasn't rhetorical at all.

Returning to a slightly earlier comment:

I don't need the approval of anyone on this blog (reader or poster) to support my sense of credentials or prop up my arguments.

You're right, you don't. What you do need, and what you lack, is sound logic and evidence, as we've pointed out throughout this conversation. No one here gives a damn about approval or consensus, what we care about is evidence and logic, and you're lacking on both counts.

That's not science. That's rhetoric.
This isn't a laboratory, it's an argument. What's your point?

Incidentally, reasoning and argumentation are kind of key to science.

Science looks at all the facts. With an unbiased eye. Skeptical, of course. Biased, never. There is plenty of anti-CAM bias in your posts, Tom and Skeptico.
Really? Where? I could quibble about the definition of bias, but I'll leave the semantics be. The thing you're misunderstanding here is that science looks at all the facts with an unbiased eye, and science has already evaluated the available facts regarding CAM. I'm not biased against CAM, I know that there's currently no evidence to support it. Once there's evidence, I'll absolutely accept it. So far, the evidence is strongly weighted against acupuncture, chiropractic, homeopathy, and a gazillion other forms of quackery.

Other Tom:

Alright, I'll keep it, if it doesn't cause confusion.

I'm terribly confused! I think I'm on the verge of an identity crisis!

Actually, I'm just glad I don't go by "Thomas" on these boards. That might indeed be too close. You know, if we were saying them out loud.

Skeptico:

So I call out your intellectual dishonesty. You are a liar.

Way to go, Skep.

Martin:

In the Japanese tradition the points are seen to be more of living entity. The anatomical location is considered to be only a starting point. Then to find the actual point the practitioner must be able to feel where it is. Countless hours are spent among the Japanese style acupuncture community developing the ability to sense with one’s hands where these “Live Points” are. Subtle changes in temperature, moisture, skin resilience, etc. are all sought while looking for the spot. Then treatment is applied to the felt point to bring about healing.

I'd like to know specifically what criteria are used to find the points in Japanese acupuncture. Seems like one way to test this would be to do the same kind of test you'd use on Tarot readers or Feng Shui artists--bring in several separately to look at the same patient with the same ailment. If they all, without knowing that there are multiple acupuncturists there (and preferrably without knowing the patient's specific ailment, if possible), find the points at the same location, then that provides some evidence that what they're doing has objective standards. If they all pick different points, then we see that the standards aren't objective. That'd be the start of it, if nothing else.

Techskeptic:

so when skeptico says "acupuncture does not work" he is talking about the "theory of acupuncture", not just effects of sticking in needles wherever.

Precisely. As Rockstar Ryan is fond of saying (though it's not entirely etymologically accurate) just because there may be a benefit to "puncture" doesn't mean that "acupuncture" works.

I see a lot of effects of Clarks Law being thrown around here and thats a rut easy to get into.
I just looked up Clark's Law, and I find it to be awesome. Thanks!
The assertion being: old medicine used by a lot of people is good, better than western medicine. Meanwhile they have suffered until very recently very low longevity rates, india even worse (links above). When we decide to use these very practices, aren't we simply asking to have our lifespans reduced?
To be fair, Techskeptic, you're rubbing up against a correlation/causation fallacy here. Yeah, China had woefully low life expectancy rates back before the introduction of evidence-based medicine, but they (and India especially) also had other factors to contribute to that: hygeine, sanitation, nutrition, etc. If we all switched over completely to CAM, we might not see quite the huge drop in life expectancy that those numbers suggest, because we'd still have all the other innovations that have contributed to our longer lifespan.

Martin:

Surely this isnt an appeal to riducule is it?

No, I'm pretty sure it's just ridicule. I didn't see any "therefore it's wrong" or anything of the sort in there.

Back to Cupo:

To be clear, I'm only upset about him misreading my use of it and therefore redirecting back to me. But I'll get to that, and his claim that I'm a liar, in a later post.

Instead of being upset about him (and everyone else who has thus commented on the "Jackass" remark) misreading your comment, take responsibility for your lack of clarity and move on.

I understand irony. But I don’t yet see how it applies to this quote of mine.
No, it applies to the rest of your position, and your clear bias toward acupuncture, as specifically demonstrated in your willingness to accept it based on its age and the number of people who believe in it.
You guys, Tom S. Fox, Tom Foss and Skeptico, clearly misunderstood the analogy. I apologize for ever introducing it. And I definitely should not have tried to revisit it.
No, no one misunderstood your analogy, save perhaps you. Your analogy was flawed, your inability, after repeated explanations, to see why demonstrates the same unwillingness to learn that you accused us of several posts ago.
I still maintain that your arguments against the efficacy of acupuncture or the existence of it (both of which I believe have been argued here)
No one argues that acupuncture doesn't exist; people perform it, whether or not it works, so it must exist. We have argued that Chi doesn't exist, but that's not the same thing. The nonexistence of Chi invalidates acupuncture by definition, but leaves open the possibility that "sticking needles in people" has some effect.
You did not look at the results specifically enough. Or, your knowledge of acupuncture is too limited.
Ah, the sweet sound of special pleading.
There are many things missing from the line of argument you (Skeptico, Tom S. Fox, Tom Foss, and now Jimmy_Blue) have been following.
When will you address the logic and evidence that are missing from your own line of argument?
The most essential and problematic of these is unclear understanding of the tenets and definition of acupuncture.
Funny, seems to me that just such a definition has been repeatedly posted.
You have argued here that Qi does not exist, and can not be proven to exist.
Straw man. Yes, we have argued that Qi does not exist, no one has argued that it "can not [sic] be proven to exist." The existence of Qi is testable; I outlined such a test earlier in this post, and the report in the original post cited just such a test. We argue that Qi does not exist because it has not been proven to exist, and because predictions made on the basis of its existence fail.
What definition of Qi do you use when you state it can not be proven to exist? I define Qi as something that acupuncture manipulates. You’re welcome to call question to that, if you like.
That sounds a bit circular to me. How about this definition of Qi: an otherwise undetectable energy field in the human body which can be manipulated at specific points to cause specific curative effects. This process of manipulation at specific points to cause specific effects is called acupuncture.
I provided an article that offers some evidence that this Qi does exist – that something is manipulated exclusively by acupuncture.
No, you most certainly did not. Did you read that study? Not only was the De-Qi sensation--the sensation supposedly elicited when the needle meets the Qi energy at the acupoint, where the Qi is closest to the skin--sensed at both real and sham points (which is the opposite of what we'd expect if Qi existed), but the only thing your study showed is that there may be an effect in the brain when rotating needles in some places as opposed to others. Given the tiny sample size, the lack of double-blinding, and the lack of diagrams in the study to show what the effects were from the non-rotated needles, it's difficult to conclude even that. And the study cited in the original post, with its significantly larger sample size, even calls that into question, as no difference in effect was perceived between rotated real points and non-rotated sham points. Sure, there might have been a difference in effects in the brain, but if those effects aren't translated to the things that acupuncture is meant to treat, then they do not validate acupuncture's claims regarding the effects and function of Qi, and they end up little more than a novelty.
If acupuncture were false, wouldn’t the same physiological response be seen by any needle anywhere, no matter how applied or by whom?
No, not if there were administrator error involved. If the acupuncturist, knowing which point was false, treated it differently from the other points (consciously or subconsciously), or cued the patients that it was the fake point, then the results could be skewed.

And, regardless of error, the existence of effects in the brain would act as evidence for the existence of Qi if Qi predicted different effects in the brain. It doesn't, it predicts different effects in the body, different effects on specific ailments--in other words, it predicts what was tested in the original report. Your study, at best, shows that there may be some neurological effect to rotating needles at some places, and not at others. It does not then follow that there is a magical energy field flowing through meridians in the body, or that manipulating it in specific places can have curative effects.

That wasn’t observed. The placebo effect didn’t hold up here. And yet no one, aside from Tom S. Fox (TSF), has voiced any hint at considering altering their hypothesis to accommodate these new findings.
My comment on that specific finding: "Certainly an interesting result. I do wish there were images from the sham points, however." And later, "I agree with the researchers that the results of this study--rotation of the needles in "real" acupoints produced different effects from rotation at the sham acupoint--warrant further research. I hope further research takes steps to double-blind the damn study. This is an interesting result to be sure." No, no hint whatsoever as to a consideration of altering my position. But it takes more than a single-blinded study of 13 patients, with results that are significantly mixed with regard to acupuncture's claims and no statistical calculations, not to mention some serious design flaws (why no second sham point to correspond with the second real point?), to convince me that acupuncture is effective. As I said then and say now, I want to see more research, and I think these results are interesting. But I don't think they do much at all to prove the actual claims made by acupuncturists.
At a minimum, that article provided a clue that it may be possible to measure existence of Qi.
No, it didn't. You're making half a dozen unsupported leaps to get to that point. Gosh, what is there in the foot that might cause effects in the brain if you stimulate it? If only there were some system designed to carry signals from distant parts of the body to the brain...
Only TSF commented that the article was interesting, and it deserved more research.
Actually, he said no such thing. I said that. Sorry, Other Tom, it looks like your name is confusing after all.
No, but thank you for the question mark. At least you asked. That is not what I am trying to say. What I am trying to say is the effect matters, the details matter, that you aren’t looking closely enough at the results (in that article) to equate the two. At least, not with a full understanding of the definition of acupuncture.
This is at least the second time you've made this claim without clarifying what a "full understanding" of acupuncture entails.
Beyond the observation that a significant pain abatement response resulted from both sham and real, no further correlation of the two methods was made.
Actually, such a correlation was made by several people, most thoroughly Jimmy_Blue. Your inability to recognize that speaks either to willful ignorance, dishonesty, or blindness.
I asked for someone to connect the dots. I invited someone to show me how this disproves acupuncture exists.
Except that no one claimed "acupuncture doesn't exist." Your straw man is obvious.
First off, no, acupuncture is not just insertion of needles.
You're right, it isn't. And Jimmy didn't claim it is. What Jimmy said, in the passage you quoted, was "If acupuncture is defined as the insertion of needles in specific points, in specific ways, to treat the flow of Qi along meridians..." (emphasis added). Yes, there is (in at least some practices) manipulation of the needles following insertion. Some practices also include the use of electricity. These variations are not, so far as my reading indicates, universally practiced among acupuncturists, or even necessarily practiced in the same way. The common trait to all acupuncture is the insertion of needles at certain points.
I also disagree with your equating “a result” with “treating the flow of Qi”. These aren't equal, one may be evidence of the other, but that doesn't make them equal.
There is no evidence for the existence of Qi. If Qi exists (as defined by acupuncturists), then there should be a difference in pain relief (and other treatments) between "acupuncture" (which 'treats the flow of Qi') and "sticking in needles" (which doesn't). A lack of such a result supports the null hypothesis--that Qi does not exist.
I do believe “a result” from sham acupuncture has been observed. I’ll even concede that this sham-incited result, in the context of pain abatement, appears similar to the results that real acupuncture provides.
If by "similar" you mean "precisely the same," then yes.
And I’ve discussed that. Pain is an response easily-affected by placebo. I know, Skeptico. You commented on this.
And you have no understanding of what the placebo effect is, which is why you think this somehow supports your position. It does not.
I am not out of luck. It is you who are using that study as attempted proof that acupuncture does not exist. My data does not rely on subjective pain scale or readily-false negative metric such as pain.
You're right, your study relies on effects in the brain of inconclusive purpose and result. And if acupuncturists claimed "acupuncture will cause things to happen in your brain, with no other apparent effect," your study would go some way to proving acupuncture effective at what it claims. Unfortunately for you, this is not the case. Acupuncturists don't claim that their treatment has some esoteric effect in the brains of some of the people who use it, they claim it reduces pain (among other things). In terms of evaluating whether or not acupuncture does what it says it can do, the original report is very relevant, and yours is almost entirely useless.
And here is your flawed response. Flawed, because it does not take into account a true definition of real acupuncture.
There's number three. Mind providing that "true definition"? Or do I have to get it from a Scotsman?
There is much more to acupuncture than where you stick the needles.
And yet, nothing in the paragraph you quoted with such sinister insinuation has any bearing on the conclusion drawn by Skeptico and others. Yes, there is more to acupuncture than where you stick the needles; the point is that where you stick the needles is, according to acupuncturists, of prime importance. If you get the same effects from sticking the needles in specific places (and doing all the usual acupuncture stuff), and sticking the needles in random points (without doing the acupuncture stuff), then that major part of the "theoretical" basis for acupuncture is debunked.
The goal is to manipulate Qi to achieve the desired response. Not to stop pain by jamming a bunch of needles in.
The "desired response" in this study was to "stop pain." Your list of bullet points is utterly insignificant to the results of the study.
The results of the sham vs. real acupuncture article you quoted doesn’t say anything more than these two procedures produce the same result.
And that's enough to invalidate the claims of the acupuncturists! Why, exactly, can't you see that? What do "family of procedures," "points on the body," and so on have to do with the results of this study? From a scientific perspective, what matters is whether or not the procedure works and how well. All these details you're bringing up--details from the evidence-free rules of acupuncture--are utterly insignificant with regard to the questions of "does the treatment work?" and "how well?"
On the other hand, the article I provided shows how MANIPULATION at acupoints elicits a characteristic and different physiological response than at sham points.
Neurological, not physiological. And not sham "points," sham "point." And, once again, "acupuncture makes the brain light up" and "acupuncture reduces pain" are not equivalent statements; one does not necessarily follow from the other. Now, surely you see which one of those claims most accurately represents the claims of the average acupuncturist.

But, just to prove a point, here's a smorgasbord of claims from acupuncture providers here in Illinois:

Acupuncture has been shown to help ease pain, promote health, address disease-related symptoms and treat the root cause of health disorders--http://www.oasiscenterforhealth.com/

Acupuncture can help individuals who experience pain as a result of a variety of conditions. It is used to treat:

Dr. Feely personally carries out the individualized acupuncture treatment to alleviate pain as well as many physiological dysfunctions.--http://www.drfeely.com/


Gosh, not one said "acupuncture may make some parts of the brain flare up in some patients" (I just re-read the study: nowhere is it mentioned how many of the patients responded in this fashion to stimulation at the real points, only that the images provided are a composite--so we have no idea what percentage of the 13 experienced this differential effect, nor if they were experiencing it in the same places), but they all claimed to relieve pain. One even claimed to relieve back pain, the specific type of pain tested in the original report.

And have tried to show how your arguments do not hold up when acupuncture is defined correctly.
Where? I didn't see it. I saw nothing in your post here which changes the results of the original report, nor anything which would require significant reinterpretation of said results. Furthermore, you have provided no evidence for the efficacy of acupuncture, beyond the study that has already been discussed at length, which doesn't support your point nearly as well as you seem to think it does (I wonder if you've read the entire thing, or just the abstract).
True, I also wrote it as a reverse-psychology way of eliciting a response - hopefully an apology. I thanked you for something I wanted you to take back.
That is one of the dumbest things I've heard today. And I've heard a reference to "Adam and Steve" today. You are simply unwilling to take any responsibility or accept any fault with anything, Cupo.
I hope I did that with the earlier post today. If not, say so.
"Not."

Or is that "so"? I'm so confused.

I am a scientist. I have been practicing science for more than 20 years.
I am unimpressed with your argument from authority.
A little research would have revealed this to anyone.
Ah, yes. "Industry: Science." I was so foolish not to have accepted everything you said before, based on your claim of scientific authority. I defer to your greater wisdom, oh industrious scientician.

See also: Linus Pauling and Vitamin C. Scientists make mistakes too. It saddens me that someone who has been "practicing science for more than 20 years" doesn't understand what the null hypothesis is and can't see the flaws and alternative explanations in a cited journal article, even when the authors provide alternative explanations themselves.

It’s clear to me that there is a lot of emotion in this discussion – among all of us, I’m not singling anyone out here, and certainly I'm not immune to it – and that emotion is a danger to reason and to science.
Why? Emotions don't change the facts, and scientists aren't androids or Vulcans. Whether or not acupuncture works better than placebo has nothing to do with my emotional state. The pile of red herring is starting to smell.
In closing, I apologize for using the term jackass in my post in a way that was misinterpreted as being directed at you.
And I apologize for saying that you're unwilling to take any responsibility or accept any fault with anything. At this point, however, it remains "most things," and that's unfortunate.
When did I ever contend that? I don't think I made any statement close to that.
Cupo, November 26, 2007 at 06:59 AM
Again, my point here is that our Western science shouldn't have to be applied to a thing before it is accepted as real. Not always. Proof is important, yes. How about 2,000+ years of a culture of now 1 billion people who use this as their primary method of preventative healthcare. Oh... I guess that doesn't count. They aren't Westerners.
To which Techskeptic replied with the figures on life expectancy before the introduction of "Western" medicine.
I think you answered your own question: Western sanitation techniques.
But not Western medicine? Please. You're cherry-picking, and while I criticized Techskeptic above for not accounting for those same sanitation techniques, I certainly don't think they account for the entire jump in life expectancy. To suggest, as you have here, that things like vaccines, modern drugs, and other medical care have not contributed to an overall increase in health in the East is an exercise in denial.
I certainly didn’t imply that I think the western techniques are ‘horrible’, or anything like that. I don't think I did...
No, you just suggested that age and popularity are viable indicators of efficacy. They aren't. That's pretty much Logic 101, there.
I was just asking for justification of why they are the one and only set of rules by which we should judge things. They aren't perfect.
Can we add the Perfectionist Fallacy to the pile? This is getting out of hand. Just because science isn't perfect doesn't mean that any other methods are equal or better, particularly methods which would accept "age" and "popularity" as viable metrics of reality.
I’ll admit here, I believe acupuncture to be another tool in that toolbox of health.
Shock of shocks! I never would have guessed. And by what standards do you accept that tool into your toolbox, Cupo? Do you evaluate "Western" medical claims with the same loose criteria?
BUT when did I ever say anything about "primary method"?
Once again: "Proof is important, yes. How about 2,000+ years of a culture of now 1 billion people who use this as their primary method of preventative healthcare." Emphasis added.
Actually, some Chinese mystics might not argue with your statements.
There's probably a reason for that. Have I mentioned ad hoc hypotheses yet? I imagine there are Chinese mystics who wouldn't argue with the claim that Qi is "an energy field, created by all living things, that surrounds us, penetrates us, and binds the galaxy together," either. But that doesn't mean it'll help me fly an X-Wing.
I said it was something it manipulates.
And such a definition is utterly without explanatory power. "Something" is a word that doesn't belong in definitions, period. It's so vague as to be utterly meaningless.
And the article I shared provided some evidence of what that Qi might be.
The peripheral nervous system is Qi?
The placebo did not elicit the response. Only properly inserted and manipulated acupuncture needles did.
And yet, the placebo did elicit the De-Qi response associated with the needle reaching Qi. And yet, the report in the original post showed no effective difference between "properly inserted and manipulated acupuncture needles" and improperly inserted, unmanipulated placebo needles.
My definition did not characterize Qi as an effect. I would not characterize Qi as an effect just as I would not describe body temperature as an effect of Tylenol.
Please, please, never use analogies again. Ever.
And I especially like your use of the word if... "if its crap". I haven't seen enough proof of that here, or in the articles out there.
1. "If it's crap" is three words.
2. Null hypothesis. It's not up to science to prove that acupuncture is crap, it's up to acupuncture to prove it isn't. "It made (a maximum of) 13 people's brains light up" is not proof of acupuncture, nor is it any but the smallest evidence of Qi. Again, if a primary claim of acupuncture were that it had neat effects in the brain, then this would be some evidence of that. It isn't. A primary claim of acupuncture is that it relieves pain better than the placebo. It doesn't.
Um... debunking that was the point of my 1:09 PM post. If you guys are all only going to talk about pain studies, then I'm done.
Why is your brain study more salient than the pain study? The brain study had an incredibly tiny sample size, poor controls, no calculations, omitted significant information, and did not address any of the substantive claims of acupuncture and its providers. The pain study had a much larger sample size, better (though still inadequate) controls, better transparency, and addressed a key claim of acupuncturists--that it can treat pain effectively. Can you please use your 20+ years of science industriousness to explain why your study is so very valid and the report above is less so?
Good question. In my opinion, I’d say the 20 or so years (that's probably being extremely generous) Western scientific techniques have been used to “study” acupuncture hasn’t been enough.
20 years and no solid evidence in its favor? Sounds to me like grounds to call it a waste of time. We don't spend 20 years on drug trials; why does acupuncture get different rules from regular medicine?
How long did the search take to reverse the hypothesis of the electron being a particle that carried positive charge, before they discovered it carries negative?
I'm going to have to say 0 years. Leaving aside the fact that "positive" and "negative" are arbitrary terms, I can find no evidence that anyone thought the electron was positively charged. When Thomson discovered the electron in 1897, it was through an experiment which found that the negative charge in a cathode ray tube couldn't be separated via magnet from the cathode ray, but that the ray could be deflected with an electric field.

So, even if they thought at the time that the electron was positive, Millikan measured its charge in 1909. So, 12 years. At most, 15, if you go back to when the term "electron" was first proposed.

If you want a good example of how science works when presented with hypotheses like Qi, check out the history of the luminiferous ether or phlogiston.

You might point to this as a bad example, since that hypothesis was proven false. My point is that the hypothesis of Qi and effectiveness of acupuncture hasn't yet been proven at all -- one way or the other.
And so, as an experienced scientist, you recognize that in such a situation the only reasonable option is to assume the null hypothesis until positive evidence demonstrates otherwise. Because it's impossible to prove a negative and the fence-sitting "maybe, maybe not" position is useless in science.
You have not seen a stroke patient regain speaking ability in days, not weeks years or ever.
Actually, I have. My grandpa suffered a stroke less than a month ago. While he's certainly not up to 100%, he has improved significantly in the intervening time, specifically with regard to his speaking ability. And through regular therapy, no less.

Of course, I would hope as an experienced scientist that you aren't committing a post hoc ergo propter hoc fallacy, and that you aren't misattributing to treatment what may be an effect of time and natural recovery.

You have not given acupuncture a chance to prove itself beyond a few (or even many) pain studies.
The opportunity is open. It's the acupuncturists who seem to have some problem with double-blind studies.
But to claim that these studies conclusively prove that acupuncture is fake is something that I do not see your facts supporting, and so I can not support such a thing being propogated.
That poor, poor straw man.
They haven't unlocked all the mysteries of the universe yet, have they?
There's that perfectionist fallacy again.
Hell, we can't even predict weather accurately, because we can't accurately model (or even know?) all the inputs and interactions that govern that system.
And yet, none of those inputs or interactions require the assumption of some unproven, undetectable, physical-law-defying energy source. They all work according to known laws and known substances, it's just that to be able to make reliable predictions, you'd need to know an unrealistically large amount of information, corresponding to the velocity and position of trillions of air (and other) particles around the world. If we knew all those things, then we could model the weather, asymptotically to an accuracy of hbar/2.
Hey man, I'm a scientist! But I am for avoiding jumping to conclusions too early, especially in light of unexplained observations. Many unexplained observations.
It's not "jumping to conclusions" to assume the null hypothesis until evidence shows otherwise. It's good science.
By the way, don’t start with me about drugs. You want to hold high this Western Medicine of yours? Save the humans, extend life and all that? Turn on you television and watch what the pharmaceutical industry that Western Medicine has spawned is peddling. Don’t get me started. I’m sure it’s effective. Healthy? Yeah right. Great Western Medicine, that is. Great.
Oh yes, Big Pharma, so terrible. How effective was acupuncture at wiping out polio? Smallpox?

Oh yes, great western medicine, what with its requirements for evidence and double-blind trials and years of study before release to the public. Much better to practice some untested treatment on paying customers with no proof as to its efficacy at treating any ailments, based on the justification of "we've been doing the same thing for over 2,000 years." Indeed, the Traditional Chinese way is much better.

Also, "Western" medicine ie more than just "American" medicine. Not every nation has such a huge problem with pharmaceutical companies.

Sorry for the long post.

Oh great, Martin's back. Someone count how long it takes him to say something about 'systems'.

Martin:

I'm a little confused as to the definition of acupuncture you guys are working with

Obviously when you were very carefully reading and considering this thread you somehow missed the webpage I linked to and the really big passage that I quoted. I know you didn't just skim read and let your own bias form your opinion.

The anatomical location is considered to be only a starting point. Then to find the actual point the practitioner must be able to feel where it is.

Making it unrepeatable, subjective, untestable and basically worthless. Not to mention based on an untestable assumption

"The difference you feel, that's Qi."
"How do you know?"
"Because where there's Qi it feels different. Duh."

"Acupuncture points are more than anatomical landmarks, they are manifestations of a functional problem in the body. As such, they are normally dormant, becoming active when a pathological condition begins to form."

"How do you know this point fixes that problem?"
"Because it feels different."
"Why does it feel different?"
"Because that is the point associated with the problem. Duh."

It's so circular it is embarrasing.

Cupo:

I explained my initial use of the term. It was directed at Mr. Novella.

I did not say you owed Skeptico an apology, I said that you owed whoever it was you directed the term at an apology, just as you expected one. Can we expect you to apologise to Mr Novella on his site now?

I understand irony. But I don’t yet see how it applies to this quote of mine.

Your posts demonstrate a bias towards acupuncture. Hence you accusing others of bias carries with it a sense of irony.

There are many things missing from the line of argument you (Skeptico, Tom S. Fox, Tom Foss, and now Jimmy_Blue) have been following. The most essential and problematic of these is unclear understanding of the tenets and definition of acupuncture.

So you disagree with the definition of acupuncture I am using from acupuncture.com? Perhaps you should write and tell them that their definition is wrong then.

How is the definition I have used wrong? If it isn't, in what way have I failed to understand it?

What definition of Qi do you use when you state it can not be proven to exist? I define Qi as something that acupuncture manipulates. You’re welcome to call question to that, if you like.

Ah. So if you define Qi to mean something that no-one else in TCM has, then you are right.

Here is what acupuncture.com defines Qi as, just in case you missed it first time:

Shen Nung theorized that the body had an energy force running throughout it. This energy force is known as Qi (roughly pronounced Chee). The Qi consists of all essential life activities which include the spiritual, emotional, mental and the physical aspects of life. A person's health is influenced by the flow of Qi in the body, in combination with the universal forces of Yin and Yang . (I will discuss Yin and Yang a little later). If the flow of Qi is insufficient, unbalanced or interrupted, Yin and Yang become unbalanced, and illness may occur. Qi travels throughout the body along "Meridians" or special pathways.

Did you get it that time? That is what acupuncturists define it as. Not me. Not Skeptico. Not 'western' science. It is you who does not understand Qi, not us.

I provided an article that offers some evidence that this Qi does exist

Now you are making assumptions not supported by the evidence. The article demonstrated that manipulation of needles at points determined by the theory of acupuncture provokes a response. It most definitely does not offer evidence that Qi exists unless you already accept that it is Qi that causes that response. I'm sure that as a scientist you recognise this fallacy, right?

that something is manipulated exclusively by acupuncture.

Incidentally, this also demonstrates that it is you who are unaware of the TCM position on Qi. As someone who spent 8 years learning Tai Chi and Qi Gong I can tell you Qi is most definitely not believed to be manipulated exclusively by acupuncture. Your version is once again out of step with the TCM community. But hey, my teachers could have been wrong. I mean, two were only Chinese grand masters, one from the Chen family village. What would they know?

I have provided data showing a physiological response to acupuncture needles being manipulated at only acupuncture points.

A poorly controlled study with inherent problems in its protocols it appears. Incidentally, 5 patients did report feeling De-Qi at the sham point. How did you miss that?

There was no patient subjectivity in these results.

Really? And you know this how? So they weren't informed about what they should feel when the needles were inserted? And this wouldn't have provoked a subjective response? You know that none of the patients had prior knowledge of the principles of acupuncture, and you know the level of this knowledge?

This assertion of yours is not supported by the evidence. Naughty Cupo. Doing what he accuses others of doing.

And let us not forget that some patients did report feeling the De-Qi at the sham point. Why that sounds almost, well, subjective.

Wait, you mean patients had to subjectively report a sensation? How could this be? Cupo said there was no patient subjectivity in these results.

And wait, Tom Foss even quotes from the paper:

There was remarkable overlap between the cortical activation of the real and sham acupoints. No significant difference in brain activation with stimulation of real and false acupoints, was, therefore, observed.

The reported difference comes from how the needles are manipulated. By the person who wrote the study. Who is an acupuncturist. No, I can't imagine how anything subjective could have crept in there.

If acupuncture were false, wouldn’t the same physiological response be seen by any needle anywhere, no matter how applied or by whom? That wasn’t observed.

Yes, it was observed. Cortical activation was similar in real and sham points. The difference came in the part of the experiment most open to subjective actions and responses, the manipulation of needles at real and sham points.

And yet no one, aside from Tom S. Fox (TSF), has voiced any hint at considering altering their hypothesis to accommodate these new findings.

Except for all those times that Tom Foss states a result is interesting and he'd like to see them tested further and with stricter controls. Except for all those times, then yes no-one has hinted at all that they might be open to new findings.

Only TSF commented that the article was interesting, and it deserved more research.

Yes only him. Oh, and Tom Foss. So only TSF. And Tom Foss. It's a good thing we are the biased ones here, no hint of irony or sarcasm intended.

I am beginning to believe that among you, only TSF is actually looking for evidence, here.

I suppose you have some evidence for this?

Others of you appear interested in forwarding your own opinions of the interpretations of facts.

Right. Because I can't think of anyone else here who is using thier own interpretation of the facts. Like, for instance, on what Qi is. Or how Qi can be manipulated.

Nope, no-one else has stated their own definition of any of the concepts being questioned. Have they?

What I am trying to say is the effect matters, the details matter, that you aren’t looking closely enough at the results (in that article) to equate the two.

Actually it is painfully obvious that we are and you aren't, but this I am sure will just go back and forth.

At least, not with a full understanding of the definition of acupuncture.

Please do show how my understanding of the definition I quoted is lacking, and how your definition of Qi matches it.

First off, no, acupuncture is not just insertion of needles.

How embarrasing for you, another strawman. Re-read what I said:

If acupuncture is defined as the insertion of needles in specific points, in specific ways, to treat the flow of Qi along meridians (which it appears it is unless you can show otherwise);

Naughty Cupo. Clearly I understand that acupuncture is more than merely inserting needles. Why would you distort that? Bias perhaps?

I also disagree with your equating “a result” with “treating the flow of Qi”. These aren't equal, one may be evidence of the other, but that doesn't make them equal. Nor do I believe “a result” equals “a desired effect” in this context.

Ah semantics, the last refuge of someone desperately trying to find fault with something.

Allow me to re-write that paragraph to meet your exacting standards and to clear up any confusion:

The original study on pain shows that sticking needles in anywhere and anyhow can have the desired effect of relieving pain. Acupuncture states by definition that only sticking needles in at specific points in specific ways produces a desired effect. The logical conclusion therefore would be that acupuncture does not work and that there is something else going on.

Without looking closely at "the outcome", your association of the two procedures (sham and real) is much too loose.

How?

I’ll even concede that this sham-incited result, in the context of pain abatement, appears similar to the results that real acupuncture provides.

Similar in the sense that the results were almost exactly the same you mean? (47% reporting a difference on acupuncture and 44% on sham.)

It seems to me that you are arguing that the only conclusion you can draw is that sham acupuncture, through some mechanism not determined by Qi or acupuncture theory, has a similar effect to real acupuncture and that this has no bearing on the efficacy of acupuncture. Is this the case?

If it is, then acupuncture is still left with a problem. The theory of acupuncture states that health is controlled by the flow of Qi in the body. However, if health can be improved without manipulating Qi, then this falls down. The central concept of Qi is found wanting. Unless Qi is also manipulated by sham acupuncture. Which would invalidate points 1 and possibly 2 from the list I presented earlier.

I can now however add a tenth point to my earlier list that would show acupuncture doesn't work if found to be untrue:

10. The flow of Qi influences a person's health.

My data does not rely on subjective pain scale or readily-false negative metric such as pain.

That's right. Your data relies on a poorly designed and conducted biased test on a tiny sample (13 compared to 1,100). Much better.

Flawed, because it does not take into account a true definition of real acupuncture.

Please do show how my definition of acupuncture is not a true definition, and how yours is. In fact, provide us with your definition of acupuncture.

As I stated to Jimmy, I believe you are operating under the false assumption that the responses are the same.

The responses to what? If you mean the responses to real and sham acupuncture then how do you know that they are not the same. You wouldn't be making an assumption that isn't supported by the evidence, surely?

I also don’t agree with your definition of acupuncture, even if you claim it's the acupuncturists' own.

How about my definition? The one I took from acupuncture.com. The one that is the acupuncturist's own?

Are you saying that you not only use a different definition of Qi to everyone else, but acupuncture as well?

There is much more to acupuncture than where you stick the needles.

Man, your posts are becoming inflammable packed with all this straw. Who said that?

The goal is to manipulate Qi to achieve the desired response. Not to stop pain by jamming a bunch of needles in.

And the pain study shows that real and sham both stop pain. So manipulating Qi is not what the needles are doing since the sham points are not placed on the meridians that carry the Qi. They are manipulating nothing (although it seems you might not agree with this), but they have the same outcome.

None of your arguments above take that list into account.

You'll have no trouble demonstrating this and not just asserting it then, will you?

The results of the sham vs. real acupuncture article you quoted doesn’t say anything more than these two procedures produce the same result. In that instance of readily-placebo-affected pain management, which is also troubled by a measurement scale that is wholly subjective.

So let's get this straight. You want to dismiss this study as saying anything meaningful about acupuncture because you think it is subjective and because you have apparently redefined what Qi and acupuncture are.

However, your piss poor little study proves to you that only real acupuncture produces a desired effect. And you call yourself a scientist? And you accuse us of bias?

You also seem to be suggesting that sham acupuncture could actually be a treatment in and of itself, seperate to acupuncture, that produces the same results, is this correct?

On the other hand, the article I provided shows how MANIPULATION at acupoints elicits a characteristic and different physiological response than at sham points.

Or it could show how not blinding, designing and conducting a test correctly can introduce false positives.

There may very well be a different result from manipulation at sham and real points, but this test is so poorly designed you cannot draw that conclusion definitively as you have. You can also not conclude from the results of this that Qi is the medium that causes the response because you haven't yet proved the existence of Qi.

Your bias has apparently overridden your application of the scientific method.

I note also that in your passage from the NIH it mentions acupuncture having an effect on post operative nausea. I wonder if they are basing this on the same studies the FDA did. One of which showed that acupuncture had no effect on children when used as an antiemetic.

Can you think of a reason why acupuncture might not have an effect on children Cupo?

You can find more here.

One step further: even that comment above doesn’t imply that I believe Western science techniques are terrible or horrible, or in any way negative. I was just asking for justification of why they are the one and only set of rules by which we should judge things

What is this drivel about western science? You yourself talked about gunpowder coming from China. The scientific method as we know it today was first established by Islamic scientists in the middle east. The reverse racism that this implies is ludicrous ("Only people in the west use rigorous controls, procedures, experimentation and observation.")

so I’ll admit here, I believe acupuncture to be another tool in that toolbox of health.

No. I never would have guessed that from what and how you had written.

And here's the thing. Those results are real. Explaining them will take a while. Our Western scientific tools are great, but they don't work universally. They haven't unlocked all the mysteries of the universe yet, have they?

And you call yourself a scientist? If you can't figure out what is wrong with this statement then I'm done talking to you, since you have no idea of the progression of ideas, their reliance on technology, and how science works. Nevermind the cyclical nature of illness, the bodies regenerative power and confirmation bias.

Hell, we can't even predict weather accurately, because we can't accurately model (or even know?) all the inputs and interactions that govern that system.

This is a problem with technology (computing power specifically), not science. One would have thought a scientist could appreciate this. Now go on, bring up the flat earth.

Hey man, I'm a scientist!

That, it would seem, is open to debate. For the record, no I am not a scientist.

But I am for avoiding jumping to conclusions too early, especially in light of unexplained observations. Many unexplained observations.

Ever heard of the null hypothesis? Or being so open minded your brains fall out?

By the way, don’t start with me about drugs. You want to hold high this Western Medicine of yours? Save the humans, extend life and all that? Turn on you television and watch what the pharmaceutical industry that Western Medicine has spawned is peddling. Don’t get me started. I’m sure it’s effective. Healthy? Yeah right. Great Western Medicine, that is. Great.

I knew it would come out eventually.

"It's all big pharma man."

Only, when you say western medicine you actually mean the medical system in the USA. In Britain and Europe they don't have all these drug adverts and the national health services do not jump at the chance to pump you full of pills.

The west is more than just the USA you know.

Now who is showing their bias?

Damn you Foss, saying everything I wanted to say first and better.

Git.

Damn you Foss, saying everything I wanted to say first and better.

Git.


Is it strange that I feel the same elation at being called "Git" that I did the first time someone called me a "mensch"?

I don't know about "better," Jimmy. Seems to me a component of that would be brevity, which you have in spades. Not to mention your actual experiential knowledge of Qi and whatnot. Color me impressed.

Is it strange that I feel the same elation at being called "Git" that I did the first time someone called me a "mensch"?

I hope not, if you take it in the sense it was meant!

I don't know about "better," Jimmy. Seems to me a component of that would be brevity, which you have in spades. Not to mention your actual experiential knowledge of Qi and whatnot. Color me impressed.

Thanks. I had the good fortune to be taught by a guy who was a nurse. He understood the concepts of Qi and all the other mystical stuff, but he was firmly evidence based.

He would explain the ideas and concepts, then say that you can take or leave the mystical stuff depending on your conclusions from the evidence and just get on with the great exercise and martial art side of it. He put the sensations described as Qi firmly in the physical response to stimulus and exercise, but was open to evidence to the contrary.

Being taught (albeit all too briefly) by the grand masters was pretty fricking awesome though, regardless on how I differed to them on the concept of Qi.

Skeptico replies to Cupo

I’m not going to refute your points line by line – Tom Foss has already done an excellent job of doing that and you have ignored most of what he wrote anyway. Below are my answers to your points.

Re: Tenets and definition of acupuncture

You define Qi as something that acupuncture manipulates. This definition is (1) Circular and (2) Unfalsifiable. Under your definition, if acupuncture has an effect it’s because it manipulated qi. Therefore qi exists. If it has no effect then it’s not acupuncture, but qi still exists. The effectiveness or otherwise of needling has no bearing on whether or not qi exists, and so no test of acupuncture could ever falsify qi. The definition of qi and acupuncture has to include some definition of where the qi points are, otherwise it’s just randomly sticking needles.

Since you’re a scientist, I presumably don’t have to explain falsifiability, or why it matters.

But a third problem with your definition, is that acupuncturists define acupuncture and qi more precisely than you do. Your definition of acupuncture is wrong.

From the NCCAM link:

Among the major assumptions in TCM are that health is achieved by maintaining the body in a "balanced state" and that disease is due to an internal imbalance of yin and yang. This imbalance leads to blockage in the flow of qi (vital energy) along pathways known as meridians. It is believed that there are 12 main meridians and 8 secondary meridians and that there are more than 2,000 acupuncture points on the human body that connect with them.

An no, I did not quote mine that. There are specific points that are supposed to relate to blocking qi for specific maladies. You may claim this is not true, but you are wrong. You are describing your own made-up version of acupuncture.

This">http://www.holistic-online.com/Acupuncture/acp_meridians.htm">This site explains it too:

Chinese use the term "jing luo" which means, channels, conduit, meridian etc. According to acupuncture, these are the invisible channels through which qi circulates throughout the body. The acupuncture points (or holes as the Chinese term xue is more aptly translated means) are the locations where the qi of the channels rises close to the surface of the body. There are 12 main meridians, six of which are yin and six are yang and numerous minor ones, which form a network of energy channels throughout the body.

[Snip]

To restore the balance, the acupuncturist stimulates the acupuncture points that will counteract that imbalance. So, if you have stagnant Chi, he will choose specific points to stimulate it. If the Chi is too cold, he will choose points to warm it. If it is too weak, he will strengthen it. If it is blocked, he will unblock it, and so on. In this way, acupuncture can effectively rebalance the energy system and restore health or prevent the development of disease.

Clearly, if the same effect is recorded when the “wrong” points are needled (sham points), then any benefit that is gained from acupuncture cannot be due to qi. It’s hard to understand why anyone, let alone a professed scientist, would need “a logical line of progression [drawn] from the premise, that these two procedures produce equal effects, to the conclusion, that acupuncture does not work". The clear and unambiguous conclusion is that qi either does not exist, or does not run where the acupuncturists say it does. (And in that case, no one knows where it runs which means acupuncturists are just guessing. Which in my view means acupuncture doesn’t work.) But perhaps you need it spelt out for you. Tom Foss already explained it clearly, so I’ll just quote him:

P1. Acupuncture predicts that "real" acupuncture should be more effective at treating pain than "sham" acupuncture.

P2. Reliable studies show that "real" acupuncture is no more effective than "sham" acupuncture.

C1 (P1, P2). The predictions of acupuncture are wrong; there is no difference between the "real" and "sham" treatments.

P3. The "theories" behind acupuncture would consider "sham" acupuncture to be a placebo, and "real" acupuncture to be a real treatment.

P4. In science, when a real treatment performs no better than the placebo, we conclude that the treatment does not work.

P5. "Real" acupuncture performs no better than the placebo.

C2 (C1, P3-5). "Real" acupuncture does not work.

It’s really not that hard, and quite obvious Cupo if you take off your blinkers. My understanding of acupuncture is not “incomplete”. Yours is just wrong. But I give you points for redefining acupuncture to fit your conclusion. Unfortunately for you, we saw through your rhetorical trick.

Oh, and regarding this piece you quoted:

The term acupuncture describes a family of procedures involving stimulation of anatomical points on the body by a variety of techniques. American practices of acupuncture incorporate medical traditions from China, Japan, Korea, and other countries. The acupuncture technique that has been most studied scientifically involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation.

So what? There is nothing there that states you can stick the needles anywhere. Acupuncture still relies on qi flowing at specific points. If the effect is gained at the “wrong” points, acupuncture is still falsified. If this were not true, how would any “sham” points ever be identified? How would any real v sham tests (including the test you think proves something) ever be performed?

Re: Pain Studies

You seem to be making a big thing about how acupuncture is about more that just pain reduction. Well, I know it is supposed to. But I am only going on the studies that have been done. I can’t help it if pain is one of the few things acupuncture has been actually shown to help. That and “nausea” I guess. Show me a study of acupuncture (real v sham) that cures some other ailment, where the real is better than the sham.

And I mean an actual ailment, not some dubious fMRI results. Which brings us to:

Re: Your cited study of acupuncture

You still claim that the article you provided shows how manipulation at acupoints elicits a characteristic and different physiological response from the ones noted at sham points. But you have completely ignored my explanation of why this study cannot be said to do what you claimed it does. Since you selectively read what I write, I’ll repeat it. Please READ IT THIS TIME:

  1. The main problem – it was only single blinded. This may be especially important when interpreting the fMRI. These can be difficult to do well as many different parts of the brain are being activated at the same time, and if the persons interpreting the scans knew which ones were for the “real” acupuncture then we cannot know they did not just see what they wanted to see. For evidence of how easy this is to do, just recall Benveniste’s results studying very dilute solutions. Results that disappeared after the experimenters were blinded.

    In addition, the non-blinded acupuncturist (and there was only one) could have inadvertently communicated information to the subjects. Single blinding makes the results dubious at best.

  2. Small number of subjects – only 13. The study I wrote about in this post had over 1,100 subjects. Statistical significance is virtually impossible to determine with this small number of subjects, unless the results are extremely clear.
  3. The full paper (and I have read it now) shows no statistical calculations at all, so I don’t see how we can tell if the difference was statistically significant. As far as I can see from the study, there were no numerical measurements made (none reported, anyway), so I don’t see how the researchers could tell either. All they say is “there was stronger activation” at the real acupuncture points. But how much stronger? If there is no measure of how much, then they have no basis for claiming a “highly statistical significant difference”. Statistics require numbers, I’m afraid.
  4. Finally, your claim was that there were studies that “reveal signals in the regions of the brain that control the organs that the acupuncturist means to manipulate”. Even if this study had found something significant (which I doubt), I’m still not sure it shows what you claim it shows.

In summary, without blinding and without a statistically significant sample size, and without some way of measuring the difference statistically, the study is virtually worthless. On the other hand, the study I wrote about included more than 1,100 patients, and found no statistical difference in actual pain reduction felt. And this result is consistent with all other well run studies on acupuncture.

You say your study is not a placebo effect and so doesn’t need blinding. Please go back and READ my point # 1 above. The blinding needs to be on the people interpreting the MRI. Without it, if they know which are the “real” tests, they will see what they want to see. Read my link about Benveniste too – that was about experimenters seeing what they wanted to see.

Until you can refute every one of my points above, you are not entitled to blandly state that your study shows different effects at real v sham points. I have shown you are wrong. You may think no one will notice you have completely ignored my refutation of the study. You are wrong as usual. We noticed.

Re: The “Jackass” etc comments

Strange that you would expect an apology for my calling you “jackass”, when you had used the insult yourself first with no apology. And you expected me to realize this was a request for an apology, without explicitly asking for one, and despite the fact that you clearly went first and had offered no apology of your own. I also note that you apparently expect some special treatment because you are a scientist, but that you are quite happy to call Steven Novella “Jackass” although he is a Neurologist. Still, if you say you were not gloating as I thought, I will accept your explanation. I apologize for calling you a jackass and a liar.

Now, if you want me to continue to accept your arguments as genuine, you’re going to have to start replying to the actual points raised, and to the actual criticisms of your arguments and of the study you linked. To that end I have drawn up a list of:

Questions For Cupo

These are questions that have arisen from what you have posted here.

  1. Do you believe there are specific “correct” points for placing needles, and that there are also “wrong” (sham) points where qi cannot be manipulated?
  2. If you answer “yes” above, then how do you explain the negative result in the test I posted about? If the “real” acupuncture is no better than placebo, then what is wrong with saying that acupuncture doesn’t work?
  3. If you answer “no” then what is a “sham” point? How is any test of real v sham acupuncture (including the study you referenced) carried out?
  4. If Qi is just “something that acupuncture manipulates”, how would you falsify Qi?
  5. What, exactly, is missing from Tom Foss’ explanation of the logical line of progression that you wanted?
  6. What exactly, in the piece you quoted (beginning “The term acupuncture describes a family of procedures…”), changes the definition of acupuncture as I reported it? What part of that paragraph means that comparing real to sham points is not a valid way of falsifying qi?
  7. Regarding the test you referenced:

  8. Why could the person reading the fMRI scan not possibly be just seeing just what they expect to see when they look at the MRI scan? In other words, why doesn’t that person need to be blinded? Why would that person not be subject to the same potential errors as the scientists in Benveniste’s team>?
  9. Why were the results without rotating the needles, the same at the real and sham points?
  10. Why could the acupuncturist not possibly subconsciously be communicating the information to the patient when the real points were being manipulated?
  11. How is a study of just 13 people more relevant than one with 1100 people?
  12. How did the researchers measure “stronger activation” at the real acupuncture points? What was their measure of “strength”?
  13. How did they calculate a “highly statistical significant difference” between real and sham, when they didn’t measure anything using numbers or statistics of any kind? Please show the calculations.
  14. If you don’t think that science contains “the one and only set of rules by which we should judge things”, then what is your better method for evaluating claims. What method do you recommend that is better than science?


Well, I can safely say I have virtually nothing to add. So I am going to venture a little bit off topic (you can delete this if you like skeptico).

Tom, was that the longest post ever?

I'll just defend one thing I said.

From tom:
"To be fair, Techskeptic, you're rubbing up against a correlation/causation fallacy here."

Rubbing up? I was pretty much having sex with a correlation/causation fallacy. thanks for pointing that out. The problem being that I didn't back up my statement enough. But if you read about the history of 'western' medicine into China, you'll see that the ida of embracing science based medicine into China didn't really get started until near 1940 (with many previous attempts), and it slowly became more widespread after that.

There are no other influences that should have caused such a rapid increase in lifespan (far more rapid than we experienced) besides the other two things I mentioned, western sanitation, and western health education (all three go hand in hand). Other aspects that help to reduce mortality are related to modern technology such as car safety.

for 2000 years ancient medicine was able to prove an average lifespan of 25 years (is this truly different than the average lifespon for the last 10,000 years? I'm not sure). In the 1900's science based medical practices started to influence the world, in particular with the eradication of smallpox (china being one of the hold outs in that effort, and humorously, trying to inject the vaccine only into accupuncture points). Now China and India are relatively close to us in longevity. More data here. (i.e. lets not discuss ancient medicine on this thread, there are plenty all around)

so, sure I got a little causation/correlation going on there, but i dont see any other causation. So I am going with it. Call me a fallacist.


I have one more question about acupuncture points. Its mostly rhetorical i guess.

How was each point discovered?

If I came up with the Qi theory, I would then have to go an prick everywhere on the body to find the placed that worked. I'm damn sure this is not what happened, but i realize my assertion is baseless, becuase i truly don't know how each point was "discovered".

Why arent they still discovering new points? A needle tip is pretty damn small, you can fit more than 2000 all over the body.

I know our answer, I was wondering what the answer from a pro-woo would be.

One more thing occured to me. This study that Cupo presented reminds me a lot of this

A bizzarre hypothesis (happy messages in water affect 'Hado' and make better ice crystals) supported by a technological imaging method (photography). Conclusions based in the interpretations of a person who already has a belief in the hypothesis.

One little gripe skeptico.

How did they calculate a “highly statistical significant difference” between real and sham, when they didn’t measure anything using numbers or statistics of any kind? Please show the calculations.


There are statistical methods that are catagorical in nature as opposed to numerical.

You still need more than 13 biased interpretations to make that work. Also, the catagories are measurable, such as "green", or "full" or "works". If this study chose a threshold for what was a "higher" and what was a "lower" activation, it would have been better (still not great with its bias and extremely low population). That is why it was just a little gripe.

Skeptico replies to techskeptic

Re: How was each point discovered?

I don’t know either, but I’m pretty sure they were discovered the same way that humors were discovered, the same way homeopathy was discovered, the same way the rules of astrology were discovered – ie they just made it up. As I say – I don’t know this for sure. But it seems likely they wanted to understand how the body works, how to cure illnesses etc, and so made up this qi theory. Perhaps with some observation of what happened when needles were stuck at certain points – and with post hoc reasoning and confirmation bias they were off to the races. It probably seemed like a good explanation at the time. But since modern scientific equipment can’t even detect qi, it seems unlikely the ancient Chinese would have been able to do so even if it does exist.

For an example of the difficulty anyone would have had in determining all this, take a look at this Complete Acupuncture Point Listing and this list of Meridians. I think it would have required detailed study with thousands of people, and the most rigorous controls against bias to arrive at the correct data for all of this. And this without any actual method of directly measuring Qi.

If we truly don’t know how they derived it, and if we can’t measure qi now, this makes qi theory an extraordinary claim. Far more extraordinary than treatments that were derived from earlier work (on results from molecular biology, say, or from positive animal studies). This means we should require more extraordinary evidence for qi and acupuncture than we demand for therapies that have scientific plausibility. But as with homeopathy and astrology, believers always want us to accept weaker evidence.

BTW, looking at the list of points, I note that the Liv3 and the G40 that were used in this test, are supposed to relate to the Liver and the Gall Bladder respectively. I’m no neuroscientist, but I don’t see how this test (even if the results were good, which I dispute), shows that

MRI of brain activity of people receiving acupuncture reveal signals in the regions of the brain that control the organs that the acupuncturist means to manipulate.

…which was Cupo’s claim. All they claimed to show was “an increase in activation in both secondary somatosensory cortical areas, frontal areas, the right side of the thalamus and the left side of the cerebellum”. So how does this “increase[ed] activation” in those areas of the brain, apparently the same result for both the Liver and Gall Bladder points – how does this support Cupo’s claim that the needles stimulate areas of the brain that control “the organs that the acupuncturist means to manipulate”?

I guess that’s another question for Cupo. Up to 14 now.

Re: Categorical data

Interesting. If I’m reading you right, you still need to assign measurements – “full” or “works” as in your example. And I think you would still need to do some math to determine statistical significance. (Correct me if I’m wrong there.) The full paper doesn’t mention any calculations of how they arrived at their conclusion of a “a remarkable and highly statistical significant difference”. The only metric mentioned is “stronger activation”.

I'm sure Cupo, being familiar with this study, will be able to explain it for us.

Yes, for example, to do a catagorical statistical analysis with in input being 'full' or 'empty' You still have to define full and empty. for example you would say any cup with more than 6 ounces of fluid is 'full', if its not full, its empty.

this is really useful for Design of Experiment type set ups where you dont have a good model of the system, and want to try to understand how the inputs can be done so as to maximize or minimize an output.

For this study, if they wanted to say that one technique performs differently than another, and they wanted to use MRI scans as the output, they still would have had to define exactly how one scan shows "more" activity than another scan. A threshold needs to be defined. Otherwise its just personal interpretation. further, someone who is not running the test should be doing these measurments or running the whole test...all too often does someone say "oh that point is close enough".

Regardless, a population of 13 for statistical analysis is virtually useless. More useless if the differences are small. Most people who know statistics far better than me, will say that 20 is your minimum (again depends on the variances).

I've heard as low as 6. but this is only to get a general feel of how something behaves or if the variances are extemely small.

I think I see what you mean. In the example you give there would be a binary result – above or below the threshold. But you would have to define that threshold, and I don’t see where they define that in the study. You would also need calculations to determine statistical significance, and I don't see that either. That’s why I asked Cupo the questions. I’m sure that he, being intimately familiar with the study, will be able to clear it up for us.

I decided to add question #14 to the list for Cupo:

Regarding the test you referenced:

The Liv3 and G40 “real acupoints” activated in the study relate to the Liver and the Gall Bladder respectively. How do the fMRI results confirm that these two points are indeed for these two organs, confirmed to a remarkable and highly statistical significant difference from (a) any other organs and (b) the placebo needles?

Cupo replies to Tom Foss

First of all, as a scientist, I know what the null hypothesis is. I also know that science accepts that hypothesis, or any hypothesis, so long as the observed phenomena do not disagree with that hypothesis. The working hypothesis must be adjusted to accomodate new observations, unless for some reasons those observations can be excluded. I'll be happy to discuss the T-test for outliers if you like.

My argument here has been that holding on to the null hypothesis is flawed because that conclusion either (a) ignores many observations where acupuncture works well, or (b) poorly defines the definition of what acupuncture is supposed to do, or both of those. See below for more on (a).

If my language here or earlier was not accurate enough, we can go into those details. I'll again make reference to this being more of a rhetoric blog than a scientific one.

But let's get back to your position, shall we? Please correct me if I misrepresent you. You're saying that we are wrong to reject acupuncture, or that our reasons for doing so are flawed. The reason we reject acupuncture is that there is no evidence to suggest that it actually does what it claims.

Yes, I believe you (collectively) are wrong to reject acupuncture because of how you define "evidence", or how I think you are defining it. When you look for only random control trials of only acupuncture for pain treatment as the only acceptable evidence (which I think you're doing, but I'll be happy to be corrected), then whatever theory you propose for why acupuncture doesn't work will only be based on that pain treatment analysis. It will not accommodate all the observations of acupuncture working, and working well, for other conditions. The NIH page gives a good list of those, and I again highlight stroke patients. Crazy results with stroke patients.

So, pretty much by necessity, your position must be "in (at least) this case, it is wrong to reject claims that are not supported by evidence," or it must be "rejection is wrong because there actually is evidence to suggest that acupuncture does what it claims."

Correct - my position is the second statement, that acupuncture does work (does what it claims sounds fishy, because you might trap me up with person A's definition, and study B's refuting it). Basically, I am calling to question your definition of evidence, and stating that there are other forms of good evidence for the efficacy of acupuncture.

if the latter, it's up to you to show that we're wrong in thinking that there is no evidence to support acupuncture.

OK. Point well taken. If I am to support acpuncture (which I wasn't doing originally), I'll provide evidence. See next paragraph. However, I do not go back on my earlier statements that those who would seek to 'logically prove' that acupuncture doesn't work based on a few pain studies, with very many subjects yes, but, based on just those studies, as I said above, the argument might prove that acupuncture doesn't work better than placebo for pain... but it does not universally prove that acupuncture doesn't work, and can not be generalized to do so without misrepresenting the practice of acupuncture. Supporting the statement that acupuncture universally fails as a treatment requires more proof. But on to the evidence that I should supply...

Here's a good example of other evidence in favor of: this is for treatment of nausea and vomiting, from chemotherapy symptoms, etc.:

Ezzo J, Streitberger K, Schneider A.
"Cochrane systematic reviews examine P6 acupuncture-point stimulation for nausea and vomiting"
J Altern Complement Med. 2006 Jun;12(5):489-95.
link to article
(By the way, I can send the PDF if you like. Let me know to where.)

OK, there is another huge discrepancy to clear up here. And this one is glaring:


But not Western medicine? Please. You're cherry-picking
...
To suggest, as you have here, that things like vaccines, modern drugs, and other medical care have not contributed to an overall increase in health in the East is an exercise in denial.

As I said to TechSkeptic... Please. "suggested that things...have not contributed..." Where? Show me where anything I wrote even hinted at that conclusion?
First of all, I answered these in an earlier post to TechSkeptic. In fact, that was my last post, and immediately before yours. Perhaps my responses there did not satisfy your question?
I am not cherry-picking, as I do not mean to, nor have I ever implied that one should, supplant all our Western medical techniques with acupuncture. I have always focused on my initial argument here, that the evidence provided earlier against acupuncture was insufficient to universally discount it, that was all. Point to a quote if you think I said otherwise -- anything before my posts on Nov 30, when I finally admitted to TechSkeptic that I believe acupuncture to be a good complementary therapy. And in that post, as I had to clarify again later, I never said Primary Care anything. TechSkeptic used that. In my posts: Not primary. Not stand-alone. Not my stand on this.

Skeptico, I see how frustrated you were at me not reading your earlier posts carefully enough.

Tom (Foss), if I misread you, let me know -- but those points, both of them: cherry-picking or having it both ways, and that massive accusation that I ever, EVER made degrading comments about Western medicine (other than that bit about the drugs, yeah -- got me there, Jimmy... that was pure generalization bias...busted. But I still think our US healthcare system is backwards to be so profit-driven) otherwise, I haven't said anything negative about Western med. or Western science.

Folks -- me saying that our system of Western science can't describe every phenomenon that we observe doesn't mean there's anything better than it. It just means, right now, at the level of analysis, measurement, and observation that we have arrived at, we can't describe -- accurately describe, to the point of statistically significant prediction -- every phenomenon that we observe. The reason I choose that definition of "describe" is because that is my understanding of the goal of random control trials -- to show statistically significant difference, and to be able to predict the outcome next time.

Again, ask a meteorologist. That's all physics in there... and macro physics at that. But the system is so complex, they can't tell me how much more snow will be on the ground tomorrow morning.

My reason for going here is to point out what some on this site think is my bias against science is not that at all. It is simply that our point-of-view has been directed by a decision, made sometime in the mid 18th century by Descarte, that the mind and body are separate. Since then, it seems to me (at least in broad brush strokes) it has been dissect and discover for advancing western medicine. My point is that the Chinese method of looking at the body is not "pre-scientific", as described here, but simply otherly scientific. Same method. Different language. Instead of analyzing the body as a collection of coupled but individual systems, they see it as a whole. One organism (macro- or super-organism, whatever)... but they see it as a whole. It is still analysis. It is still deduction.

Now the argument of Qi is something different. I tried to get to TechSkeptic on that, but I haven't read a response to it yet (it might be out there, I am behind on my reading). Most of our modern discoveries started with a hypothesis (and yes, evidence has to be collected to support it and reject null, I know). And at first, many of those hypotheses could not be measured or proven with physical science for decades after their conception. The conjecture in the last few oosts about the origins of Qi and the points and meridians is interesting in this respect. There is no written record of the earliest "experiments" with Qi and acupuncture. Some may qualify that as pre-scientific. But unless you can prove otherwise, that this idea of Qi was truly just an imaginary wisp of dust in someone's dreams or something, and prove that it was not hypothesized due to any observations, and its development was not supported by any trial and error... unless you can prove one of those or the other, you can't call it pre-scientific. And I can't call it scientific. Likewise, however, there are all these observations out there -- and those don't fit in any hypothesis that suggests that acupuncture is a sham.


Skeptico, I will get to your questions, too. They're good questions. Sorry for the delay.

-- Cupo

Cupo:

My argument here has been that holding on to the null hypothesis is flawed because that conclusion either (a) ignores many observations where acupuncture works well, or (b) poorly defines the definition of what acupuncture is supposed to do, or both of those.

But where the observations that acupuncture does not work as specified far outweigh those observations that acupuncture does, what are we to do? What about when the observations that show acupuncture works well come from very badly designed experiments, like the one you linked to?

You haven't yet shown your definition of acupuncture, or how ours are wrong and/or misinterpreted. You have demonstrated that you are out of step with the TCM community on this though.

Yes, I believe you (collectively) are wrong to reject acupuncture because of how you define "evidence", or how I think you are defining it.

How are we defining evidence? I feel some more straw is about to be added to the pile.

When you look for only random control trials of only acupuncture for pain treatment as the only acceptable evidence (which I think you're doing, but I'll be happy to be corrected)

And there we go. Where do we say we only accept trials on pain and they are the only acceptable evidence?

Basically, I am calling to question your definition of evidence, and stating that there are other forms of good evidence for the efficacy of acupuncture.

No, your calling into question a strawman that you constructed, and ignoring criticism of trials that seem to show acupuncture works. Hell, as Skeptico has pointed out the first study you cited did NOT show acupuncture works, it showed sticking needles in a person and manipulating them might provoke some unspecified reaction somewhere in the brain. That is not acupuncture no matter what definition you choose.

but it does not universally prove that acupuncture doesn't work,

Good job that we don't hold to your strawman then isn't it?

and can not be generalized to do so without misrepresenting the practice of acupuncture.

You have yet to show how anyone here other than you has misrepresented acupuncture.

Supporting the statement that acupuncture universally fails as a treatment requires more proof.

There's bucket loads of proof.

Here's a good example of other evidence in favor of: this is for treatment of nausea and vomiting, from chemotherapy symptoms

Did you read the posts I linked to earlier? The study that discussion was about showed that acupuncture had no effect on children as an antiemetic when it appeared to on adults. Can you think of an obvious reason for that?

Please do provide the PDF though:

jimtyacke@msn.com

I never said Primary Care anything. TechSkeptic used that. In my posts: Not primary. Not stand-alone. Not my stand on this.

So what does this mean then:

Again, my point here is that our Western science shouldn't have to be applied to a thing before it is accepted as real. Not always. Proof is important, yes. How about 2,000+ years of a culture of now 1 billion people who use this as their primary method of preventative healthcare. Oh... I guess that doesn't count. They aren't Westerners.

But I still think our US healthcare system is backwards to be so profit-driven

Which has nothing to do with whether or not it works, and whether or not it is better than TCM.

It is simply that our point-of-view has been directed by a decision, made sometime in the mid 18th century by Descarte, that the mind and body are separate.

Who said that we all agree with Descartes? Since when is modern science and medicine based on Descartes's views?

Incidentally, Descartes died in 1650. So that would be early seventeenth century.

If you can find any skeptic here that thinks the mind and body are seperate in the sense that Descartes meant, do let me know.

This statement is nothing but philosophical nonsense on your part.

Instead of analyzing the body as a collection of coupled but individual systems, they see it as a whole. One organism (macro- or super-organism, whatever)... but they see it as a whole. It is still analysis. It is still deduction.

Well it wasn't Martin this time, but I knew 'systems' and 'the body as a whole' would come up. It's funny, but my healthcare provider just looked at my whole body, and they are using plain old 'western' medicine.

Most of our modern discoveries started with a hypothesis

I am not sure what version of science it is you practice, but it isn't one I recognise. Modern discoveries start with an observation, then the collection of evidence, then a hypothosis, then some experiments, then some replication, then some peer review. Then you might have something.

The version you describe is exactly the sort that leads to psuedoscience. I have an hypothosis, then I look for evidence that supports it, then I say I'm right.

"There must be a lifeforce in us. Let's call it Qi. If we are ill, it must be blocked. If I put a pin in it might unblock this lifeforce. Look, the person says they feel better. Therefore putting the pin in at the spot I chose to, and wiggling it in the way I chose to made them better. I'll call it acupuncture."

Likewise, however, there are all these observations out there -- and those don't fit in any hypothesis that suggests that acupuncture is a sham.

Like what?

Hm...got blocked by the filter. Let's see if splitting the post has any effect.

Tom, was that the longest post ever?
Only if I never get over to that John Best thread and do a huge reply.
Rubbing up? I was pretty much having sex with a correlation/causation fallacy. thanks for pointing that out.
LOL. Just make sure you go get tested. You don't know where that fallacy's been, and you wouldn't want to end up with post-hoc lice.

I had sex with a sketchy slippery slope fallacy a couple of times. Oh sure, it started off totally innocent, just some kissing and petting, but next thing I knew I was dying in a hospital bed. Happens every time.

There are no other influences that should have caused such a rapid increase in lifespan (far more rapid than we experienced) besides the other two things I mentioned, western sanitation, and western health education (all three go hand in hand). Other aspects that help to reduce mortality are related to modern technology such as car safety.
Oh, certainly. And you'd said all that before, too; I figured you'd just left bits of it out for brevity's sake, and wanted to make sure that we've got all our t's crossed and lowercase j's dotted.
(china being one of the hold outs in that effort, and humorously, trying to inject the vaccine only into accupuncture points)
A needle's a needle, right?
so, sure I got a little causation/correlation going on there, but i dont see any other causation. So I am going with it. Call me a fallacist.
Oh, I don't think you're wrong, not in the least. It's just that you'd mentioned sanitation and education before, and not in the passage that was making the bad argument with two backs. As you said, they're a package deal.
How was each point discovered?
A PKQi-Meter. It'll detect Qi, acupoints, and even free-floating, full-torso, vaporous meridians.
I know our answer, I was wondering what the answer from a pro-woo would be.
Slightly more jargon-laden and unfalsifiable as the one from the amateur woo, I think.
A bizzarre hypothesis (happy messages in water affect 'Hado' and make better ice crystals) supported by a technological imaging method (photography). Conclusions based in the interpretations of a person who already has a belief in the hypothesis.
I have a special place in whatever the opposite of my heart is for "Dr." Emoto and all that water memory ice crystal garbage. For some reason, of so much woo out there, that one really, really rubs me the wrong way. I could write pages on what was wrong in that series of experiments, yet I see half a dozen books by that jackass every time I go to Borders.

Skeptico:

I think I see what you mean. In the example you give there would be a binary result – above or below the threshold. But you would have to define that threshold, and I don’t see where they define that in the study. You would also need calculations to determine statistical significance, and I don't see that either.

Yeah, I would think that setting up a binary test (passed/not passed) and performing it multiple times, as they did in this article, would require some calculation of what you'd expect from chance. It looks to me quite similar to the format of some of Randi's tests--either the testee is correct or not in the test, but he/she must pass a certain number before that success can be ruled out as a statistical anomaly. Even so, neither a binary outcome nor a threshold nor the effects of chance appear to have been taken into account for the experiment Cupo supplied, leaving us with only the researchers' unsupported claim that the tests were "highly statistical [sic] significant" to tell us how statistically significant it was.

Single-blinding, a tiny subject pool, no statistical calculations, no additional placebo point for comparison, a nonspecific hypothesis, and a result which has nothing to do with the claims of acupuncture's efficacy. What does this study support again?

Oh good, Cupo's back:

My argument here has been that holding on to the null hypothesis is flawed because that conclusion either (a) ignores many observations where acupuncture works well, or (b) poorly defines the definition of what acupuncture is supposed to do, or both of those. See below for more on (a).

I'll address these in reverse order: (b)We've demonstrated that your definition of "acupuncture" and "qi" are completely different from the definitions employed by the practitioners of acupuncture. We've repeatedly demonstrated that the claims of acupuncturists regarding what the treatment does are wildly different from your claims. Now, I agree, if we redefine all the terms in the study, we might come to a positive conclusion regarding the efficacy of acupuncture. If we redefine "ghosts" to mean "EMF signals," then we can reasonably conclude that ghosts exist too. And if we redefine God to mean "the universe," then no one will disagree about the existence of God. The problem with this process is that it renders the terms completely useless to provide them with such flexible, malleable, wide-open definitions. If we define "qi" as "something that acupuncture manipulates" and leave it at that, then we have given Qi absolutely nothing to distinguish it from anything else that might be manipulated by acupuncture (skin? needles? gullible patients?), and we have effectively defined it into existence. It's an ontological argument for the existence of Qi, and like most ontological arguments, it's utter bullshit.

So we work with established, well-accepted definitions for the items we're testing, and we don't redefine terms halfway through to try to make our points valid.

As to your first point, I don't see many observations where acupuncture "works well." I see one heavily flawed observation in which acupuncture causes effects in the brain, which is not "working well" in any established definition of what acupuncture is supposed to accomplish. I also see one flawed, but not so heavily, observation in which acupuncture is shown to "work," but no better than the placebo treatment.

This is the point where we would be well-served to make explicit which null hypothesis we're talking about in each of these cases. There isn't just one, and conflating multiple of them together as though rejecting one would cause us to reject them all has gotten you into trouble here repeatedly, Cupo. Here are some of the null hypotheses as I see them:

  1. Sticking needles in people has no real analgesic effect.
  2. There is no difference in effect between sticking needles into people and sticking them in and manipulating them.
  3. There is no difference in effect between sticking needles into specific "acupoints" and sticking them in randomized "sham" points.
  4. There is no difference in effect between manipulating needles at specific "acupoints" and manipulating needles at randomized "sham" points.
  5. Qi, defined as a form of energy which flows along specific pathways, affects illness, and can be redirected and redistributed through the manipulation of needles at specific points along these pathways, does not exist.
  6. The "De-Qi" sensation is not produced by the manipulation of Qi energy.

I'm sure I haven't hit them all, but let's go down the list, shall we? For brevity's sake, I'll refer to the study Skeptico cited in the original post as "OS," the study Cupo cited as "CS," and the Null Hypotheses as NH#.
  • OS provides some degree of evidence against NH1, though not enough evidence to reject NH1 entirely. In order to do that, the study would need better controls, better blinding, and a known placebo. CS did not test for NH1.
  • CS provides evidence against NH2, in that there appears to be such a difference neurologically at the real points; on the other hand, OS provides support for NH2, in demonstrating no difference in external effect between manipulating needles at real points and not-manipulating needles at sham points. It's possible that the same neutological effects happened in OS, but were not noticed because no fMRI machine was implemented. However, if the effect is entirely neurological and does not change the analgesic properties of the treatment, then it certainly does not validate the claims of acupuncture, and we must wonder what value it has beyond being a neurological curiosity.
  • NH3 is supported by both OS and CS.
  • NH4 was not tested by OS; the sham needles in OS were not manipulated. CS provides evidence against NH4, but not enough to reject NH4, based on the various problems cited above (not the least of which is the lack of a second sham point for comparison to the other sham point).
  • OS provides significant evidence against NH5, despite not testing explicitly for it. The fact that the same effect was observed in both the "real" and "sham" treatments provides evidence against Qi as defined by acupuncturists. CS provides no evidence one way or another with regard to NH5, since there is nothing tested with regard to affecting illness or redirecting energy flow.
  • CS supports NH6 directly, by demonstrating that De-Qi is felt at the sham points almost as much as at the real ones. Traditional definitions of Qi and De-Qi would count this as evidence against Qi, but I think it may be too indirect to act as any kind of conclusive evidence.

So, what null hypotheses are rejected? The closest we come are in NH4 and NH1. NH2 is subject to conflicting evidence, with the greater weight in support of the null hypothesis, due to the construction of the two studies.

So, at most we can say "sticking needles into people may have an analgesic effect" and "there may be a difference between manipulating needles at specific 'acupoints' and manipulating needles at random 'sham' points" (although the combination of NH2 and NH3--both supported--would contradict that), and that there ought to be more tests with better controls.

Gosh, that sounds familiar...who has been saying that all along?

I'll again make reference to this being more of a rhetoric blog than a scientific one.
And I'll again make reference to this being an idiotic complaint, which provides no support whatsoever for your position, and ultimately makes very little sense. Exactly what would a "scientific blog" look like? Bubbling chemicals, graphs, tension meters, dissection trays? What?

This is a skepticism blog. When there's science to discuss, in the form of evidence or studies or experiments or empirically-verifiable claims, then we'll discuss the science. When there's no science to discuss, but unverifiable claims or fallacious arguments, or claims without empirical support, then we'll assess the logic and note the lack of science involved. If you're complaining that we don't conduct the experiments ourselves, then I'm afraid I have to tell you a sad truth about science: it requires money, time, and resources. The minute I find someone willing to fund my ideal DBCT of acupuncture, I'll start contacting people right away.

Yes, I believe you (collectively) are wrong to reject acupuncture because of how you define "evidence", or how I think you are defining it.
Oh, this should be good.
When you look for only random control trials of only acupuncture for pain treatment as the only acceptable evidence (which I think you're doing, but I'll be happy to be corrected)
Then you ought to be pretty happy. First, I don't know exactly what you mean by "random control trials." What I want to see is a double-blinded placebo-controlled test of acupuncture's effectiveness, versus sham acupuncture, real treatment, and some actual placebo (or two), on any ailment. Pain just happens to be good for all sides: it's good for testing acupuncture's claims, since acupuncturists claim to be able to relieve pain. It's good for acupuncture, because pain is very subjective. It's good for science, because there are lots of people with pain and lots of known effective treatments for pain, which means it'd be easy to have a large sample size and easy to find both placebos and real analgesics to test against the acupuncture. Besides all that, pain is rarely fatal or severely debilitating, which makes it easy to do this test ethically. It would not be ethical to do such a test with a more severe ailment.

It's not that I'd only accept a DBCT, though that would be the best (and not particularly difficult to do with this treatment, which makes it strange that so few have been done). I'd accept a number of well-controlled corroborative tests instead, if necessary. It's not that I'd only accept a test on pain; I'd accept tests on any ailment that acupuncturists claim to be able to treat. Pain just seems to be the easiest on all counts. Ideally, I'd like to see tests on every ailment that acupuncturists claim to be able to treat. Once again, I don't think that anyone should get a free pass to make unsubstantiated claims.

then whatever theory you propose for why acupuncture doesn't work will only be based on that pain treatment analysis.
I don't have to propose a theory for why acupuncture doesn't work. I thought you said you understood that Null Hypothesis thing. If it can be shown that acupuncture works, then we will construct hypotheses and develop theories for why it does work. Until such a thing can be shown, the only "theory" we need to explain why acupuncture doesn't work is "there is no known mechanism which would cause cutaneous needle manipulation to produce analgesic (or other) effects." It's the same "theory" we need to explain why phrenology, chiropractic, and homeopathy don't work.

See, in science you generally start with the observed effect, then work up to the theorized mechanism.

It will not accommodate all the observations of acupuncture working, and working well, for other conditions. The NIH page gives a good list of those, and I again highlight stroke patients. Crazy results with stroke patients.
Show. Us. The. Tests. Do these tests take into account natural recovery from stroke? Do they take into account the fact that stroke victims can have wildly different degrees of severity? Not to mention that there are fewer stroke victims than people with simple pain, or that it would be highly unethical to prescribe a placebo treatment to someone who has recently suffered a stroke in order to get a halfway decent metric for comparison, let alone the number of placebo patients necessary to get any kind of study with statistical significance. So, not only would I not recommend conducting an acupuncture experiment on stroke victims, but I would severely doubt that any such study has ever been done.
Correct - my position is the second statement, that acupuncture does work (does what it claims sounds fishy, because you might trap me up with person A's definition, and study B's refuting it).
I have no idea what you're trying to say here. Are you suggesting that I'd play with definitions to make you look wrong? Because that sounds like projection. The only person who has been playing around with definitions here is you.
Basically, I am calling to question your definition of evidence, and stating that there are other forms of good evidence for the efficacy of acupuncture.
And here you go, mucking about with definitions again. What's your definition of evidence? How do we judge whether or not it's valuable and reliable? What are these "other forms" of evidence which seem to be somehow exempt from the same scientific scrutiny that we require of all other scientific and medical procedures?

And here's the kicker: are these "other forms of good evidence" corrected for errors of thought and attribution, specifically confirmation bias and post hoc and regressive fallacies?

OK. Point well taken. If I am to support acpuncture (which I wasn't doing originally), I'll provide evidence.
I can't wait.
See next paragraph.
I just said I can't wait!
However, I do not go back on my earlier statements that those who would seek to 'logically prove' that acupuncture doesn't work based on a few pain studies, with very many subjects yes, but, based on just those studies, as I said above, the argument might prove that acupuncture doesn't work better than placebo for pain... but it does not universally prove that acupuncture doesn't work, and can not be generalized to do so without misrepresenting the practice of acupuncture.
I'm going to explain this in very short sentences with very bold, capital letters, so hopefully you won't scroll past it this time:

IT. IS. NOT. OUR. RESPONSIBILITY. TO. PROVE. THAT. ACUPUNCTURE. DOESN'T. WORK. It is the acupuncturists' responsibility to show that it does. Until there is sufficient reliable evidence to reject the null hypothesis, we are absolutely reasonable in accepting it. You're right, it doesn't show that acupuncture doesn't work on strokes or acne or hangnails, but we don't accept claims as true just because they haven't yet been disproven. What we can show, and what the original study supports, is that the "theory" behind acupuncture--Qi, meridians, imbalance of yin and yang cause illness, etc.--is bunk. If the "theory" behind a practice is bunk, and said theory is the only justification for using it to treat a variety of ailments, then what might we conclude, at least until there's evidence to the contrary, about the practice?

And, furthermore, exactly what are you talking about with regard to "misrepresenting the practice of acupuncture"? What, exactly, has been misrepresented here?

Supporting the statement that acupuncture universally fails as a treatment requires more proof.
I agree. Who made that statement?

That's neither here nor there, though. The point is that the statement which really requires more proof is "acupuncture is effective at treating [insert ailment here]." Until that statement is supported by evidence, we reject it.

But on to the evidence that I should supply...
Oh goody!
Here's a good example of other evidence in favor of: this is for treatment of nausea and vomiting, from chemotherapy symptoms, etc.:
And nausea and vomiting, the former at least very subjective, both subject to natural recovery, are better than pain...how, exactly? I'm not saying that's a reason to ignore the study, it's just that you seemed to have such a problem with pain as the subject of a test that to use something equally subject to variations over time and subjectivity seems rather hypocritical.
"Cochrane systematic reviews examine P6 acupuncture-point stimulation for nausea and vomiting"
Now, I could be wrong here, just looking briefly over the abstract, but this looks like a literature review or meta-analysis. This combines 43 or so different studies to come up with its results, which apparently include a huge variety of different treatments, from acupuncture to electroacupuncture to acupressure, for a wide variety of different sources of nausea and vomiting. Not only would I like to see the PDF of this report, but to give any kind of accurate evaluation, I'd have to see (at least) the individual articles on the 11 chemotherapy studies. E-mail the former over (tfoss1983 [at] gmail [dot] com), and I'll start looking to see if I can access any of the latter. A meta-analysis of poorly-conducted experiments is ultimately worthless, except to collect a list of poorly-conducted experiments; to see whether or not this review has any value whatsoever, I'd have to see the methodology--specifically the controls--of the cited studies.

Note this, and I'm making this explicit: I am more than willing to accept that acupuncture is an effective treatment for nausea and vomiting, if the evidence so suggests. I know that some studies have shown marijuana to be effective on the same front; I'd be curious to know if it's both would cause the patient to relax, regardless of any chemical or metaphysical meddlings. Nausea can, after all, be caused and/or exacerbated by stress. However, even if it's shown that poking people with needles is effective at easing their nausea, that doesn't say one thing about there being a magical undetectable energy stream running through the body which can be manipulated to cure illness. I see that this abstract mentions the comparison of one acupuncture point to a sham point; I'll be paying specific attention in the studies to see where these points are, how they're compared, and how all the treatments compare to drugs and placebo.

As I said to TechSkeptic... Please. "suggested that things...have not contributed..." Where? Show me where anything I wrote even hinted at that conclusion?
How about 2,000+ years of a culture of now 1 billion people who use this as their primary method of preventative healthcare.
I think you answered your own question: Western sanitation techniques.

You initially claimed that the efficacy of acupuncture was proven by its wide use as preventative healthcare for thousands of years. Techskeptic then noted the low life expectancy rate of Chinese people until well into the 20th century. Techskeptic attributed the jump in life expectancy to the introduction of western medicine and sanitation. When Techskeptic asked you to weigh in on what caused that jump, you attributed it solely to sanitation. Your omission of medicine was glaring and led to a ridiculous conclusion. Now, of course, you're going to claim that you meant to insinuate no such thing, and so on. If that's the case, why did you only mention sanitation? Why not acknowledge the effect that western medicine had on health in the east?

First of all, I answered these in an earlier post to TechSkeptic. In fact, that was my last post, and immediately before yours.
Funny, I just read through that post again, and I don't see any acknowledgement that western medicine had a beneficial effect on Chinese lifespan. I see you saying that acupuncture should be a tool in the medical toolkit, and I see you making accusations about Big Pharma and the healthiness of western medicine, but not answers to those questions. Perhaps you should quote the relevant passage so I can see what you're referring to specifically.
I am not cherry-picking, as I do not mean to, nor have I ever implied that one should, supplant all our Western medical techniques with acupuncture.
Nor did anyone say you claimed that. What you did say was that acupuncture's use as the primary form of preventative healthcare in China was proof of its effectiveness. Even if that were true, the jump in life expectancy after the introduction of western medicine and sanitation suggests that acupuncture isn't nearly as effective as western medicine. I guess we could keep old, obsolete tools in our medical toolbox, but why?
I have always focused on my initial argument here, that the evidence provided earlier against acupuncture was insufficient to universally discount it, that was all.
And we have focused on the contrary point, that we will continue to discount it, as is the reasonable, scientific, course of action, until there is sufficient evidence to demonstrate otherwise. Incidentally, you keep offering support for the null hypothesis with regard to your claims of understanding the null hypothesis.
I never said Primary Care anything. TechSkeptic used that. In my posts: Not primary. Not stand-alone. Not my stand on this.
And the only time anyone has said anything back to you regarding primary care was in reference to your claim about acupuncture's use by the Chinese as preventative healthcare. Once again:
How about 2,000+ years of a culture of now 1 billion people who use this as their primary method of preventative healthcare.
cherry-picking or having it both ways, and that massive accusation that I ever, EVER made degrading comments about Western medicine
I'm sorry, where did I claim that you made degrading comments about western medicine (other than where you clearly made comments about western medicine)? I said you were cherry-picking in your response regarding the increase in Chinese life expectancy in the mid-20th century, because you only cited sanitation and omitted, apparently deliberately, any mention of western medicine. By omitting western medicine from your answer--which, since Techskeptic stated it clearly and explicitly in the explanation you referenced, looks like a deliberate act--you effectively suggested that sanitation alone was responsible for the increase in Chinese life expectancy, and that western medicine had no effect. If this was not the intent of your response, then you probably shouldn't have omitted any mention of medicine from it.
Folks -- me saying that our system of Western science can't describe every phenomenon that we observe doesn't mean there's anything better than it.
Then how can you make such a claim? What criteria do you use to determine "observable phenomenon that can be tested by science" from "observable phenomenon that cannot be tested by science"? If something can't be tested by science, then how is it observable? We can only observe with a limited number of senses, all rooted in the physical world. If something is observable, then it must have effects in that same physical world which allow it to be observed--reflecting photons, exciting air molecules around it, being composed of matter or energy, etc. If something has an effect in the physical world, then it's testable by science. Why is it that the people who shout about "other ways of knowing" and "open-mindedness" and avoiding "western bias" are the ones most likely to turn around and say "science can't study that"? You can't declare something untestable by fiat.
It just means, right now, at the level of analysis, measurement, and observation that we have arrived at, we can't describe -- accurately describe, to the point of statistically significant prediction -- every phenomenon that we observe.
If the effects of acupuncture are so esoteric that they can't be described by modern equipment, then how on Earth can they possibly be effective at curing physiological ailments? We're not talking about finding bosons here, we're talking about tennis elbow and nausea. This is the thing that some woos have so much trouble understanding: we don't need to understand the mechanism in order to study the effects. Once again, most science proceeds from observed effect to theorized mechanism. If we observed that poking people with needles helped cure their sick tummies, then we would proceed to hypothesis-testing and question-answering--does it matter where we stick the needles? Does it matter how many needles we use? Does it matter what the needles are made of or what we do to them after poking? Does electricity have any effect?--and so on. And once we've done oodles of studies surrounding that well-supported observed effect, we might have some theory about how it works. Will said theory rely on unproven magical energy streams? Probably not; if it relies on energy streams, it'll be well-understood (even if not directly observed) energy streams, not magical ones.

Right now, at the level of analysis, measurement, and observation we have arrived at, we can't directly observe quarks, yet we're reasonably certain that they exist, and we're reasonably certain that we know how they work, because we've been able to see the indirect effects of them. We can say this about countless scientifically-confirmed properties, both past and present, from atoms to spacetime curvature. What makes Qi special?

The reason I choose that definition of "describe" is because that is my understanding of the goal of random control trials -- to show statistically significant difference, and to be able to predict the outcome next time.
No, the goal of DBCTs (still not sure exactly what a random control trial is) is to determine with some degree of certainty whether or not some effect is significantly greater than what would be expected from chance, psychological effects, natural recovery, and whatnot.
Again, ask a meteorologist. That's all physics in there... and macro physics at that. But the system is so complex, they can't tell me how much more snow will be on the ground tomorrow morning.
No, but they can tell you with a good degree of certainty whether or not there will be snow tomorrow morning, and they can give you statistics describing the likelihood of their predictions. Someone with a better understanding of meteorology may set me right on this, but my understanding of weather prediction is that they take records of similar situations in similar areas, dating way back, and they calculate the likelihood of various outcomes. So when they report that there's a 60% chance of rain, it means that 60% of the time in the past, in situations similar to the one observed now (cross-referenced, no doubt, with radar readings, barometer readings, and so on), it has rained 60% of the time.

So, they observe effects, and from those effects they calculate statistics, despite the described system being too complex to model precisely. Why can't we do this with Qi again? The human body is significantly less complex than the Earth's atmosphere.

My reason for going here is to point out what some on this site think is my bias against science is not that at all.
No, you're just biased towards acupuncture, and think it deserves special consideration.
It is simply that our point-of-view has been directed by a decision, made sometime in the mid 18th century by Descarte, that the mind and body are separate.
I'm going to go out on a limb here and say that most of us, skeptics I mean, don't buy into Cartesian dualism. Descartes was good with math, and I'm partial to the whole "Dubito ergo cogito, cogito ergo sum" thing (though it might be a little wordy), but his philosophy left something to be desired. It's not entirely his fault, he wrote his dualistic stuff before there was such a thing as neuroscience. But modern science has pretty much put to bed the whole "ghost in the machine" model, finishing a job that philosophy started. We know now that the pineal gland isn't some metaphysical soul-receiver, and that when you alter the brain, you alter any of the properties that might reasonably be considered part of the "soul" or "mind." Despite the ravings of people like Deepak Chopra, modern science is pretty solid on the theory that the "mind" is an emergent property of the brain.
Since then, it seems to me (at least in broad brush strokes) it has been dissect and discover for advancing western medicine.
What does this have to do with anything?
My point is that the Chinese method of looking at the body is not "pre-scientific", as described here, but simply otherly scientific.
Science is a process with an established set of criteria and methods. If something is "otherly scientific," then it's not scientific, by any accepted definition of science.

But, assuming your argument isn't leaking like a sieve, what is this "otherly scientific" process? How does it develop an understanding of the universe? What set of criteria does it use to evaluate claims? How does it correct for human bias and error? Do we use this "otherly scientific" method to evaluate anything else, or just TCM? And, once again, the kicker: how is this anything but special pleading?

Same method. Different language.
If it's the same method, then there should be the same kind of scientific evidence to support acupuncture and the existence of Qi. What tests were done to determine the various acupoints and what parts of the body they affect? What records are there to show that acupuncture was developed and Qi discovered through the "same method, different language"? Are you aware that science is practiced all over the world, in a variety of languages? Why were Qi and acupuncture discoverable and subject to study by Chinese "scientists" 5,000 years ago, but aren't explainable by science now?

If these things were discovered and evaluated through the scientific method, then we should still be able to evaluate them through the scientific method today. A large part of science is replicability: any scientist should be able to do the same tests and come to the same conclusions as any other, regardless of time or location. Otherwise, we reject the results. If you know that acupuncture was developed through the scientific method, then you must know of some record which demonstrates this, and so we should be able to follow the same line of evidence and reasoning that led those Chinese scientists to discover the effects of acupuncture.

Instead of analyzing the body as a collection of coupled but individual systems, they see it as a whole.

Um...and?

One organism (macro- or super-organism, whatever)... but they see it as a whole. It is still analysis. It is still deduction.
None of this says anything about magical energy streams or needle manipulation. Your implication is that either the body isn't a collection of interrelated systems, or that Western medicine doesn't see the body as "a whole," or both. Show some evidence that either of these things is true. Then, show how "seeing the body as a whole" somehow leads to the conclusion that "the whole body is controlled by magical energy streams that can be pushed around with needles." Because I'm not seeing it.

Incidentally, the body isn't one organism. It's one big organism working with and against gajillions (rough estimate) of teensy tiny organisms in a tenuous balance. The recognition of this fact, that illness was often due to some of those other organisms, which led to modern medicine--you know the germ theory, and all that.

Most of our modern discoveries started with a hypothesis (and yes, evidence has to be collected to support it and reject null, I know).
No, most of them started with observation.
And at first, many of those hypotheses could not be measured or proven with physical science for decades after their conception.
Such as? We don't exactly come up with hypotheses for things we can't observe; when we do, they're usually either guesses (see: Heraclitus and atoms) or mathematical derivations (see: the speed of light as a constant). The former we usually reject until there's evidence to the contrary; the latter are usually the predictions of tentatively-accepted theories, the testing of which will either support or refute said theory.
The conjecture in the last few oosts about the origins of Qi and the points and meridians is interesting in this respect. There is no written record of the earliest "experiments" with Qi and acupuncture.
Then how do you know that they were developed through "experiments" or "otherly scientific" methods, and not through personal revelation or seances?
But unless you can prove otherwise, that this idea of Qi was truly just an imaginary wisp of dust in someone's dreams or something, and prove that it was not hypothesized due to any observations, and its development was not supported by any trial and error... unless you can prove one of those or the other, you can't call it pre-scientific.
Once again, you seem to have this real problem with the null hypothesis. Since there is no evidence that Qi was developed through science, since modern science is unable to find Qi (despite major advances in understanding what energy is and how to detect it), since science has not confirmed the indirect effects supposedly attributable to Qi with any consistency (and has often achieved results contrary to the doctrines of Qi), and since we cannot trace the reasoning and evidence or replicate the trials which you claim led to the discovery of Qi, the most parsimonious explanation is that these things do not exist. Sharpen up your Occam's Razors, boys and girls, and tell me which explanation requires few unknown, unproven quantities:

A. Pre-scientific mystics developed a model of the body and illness with little basis in reality, and developed various ineffective treatments based on it. Modern science shows that the model is incorrect and the treatment is ineffective.

Or:

B. Ancient scientists developed an understanding of the human body and illness which far exceeds our own, based around a type of energy different from all other recognized forms of energy, and came about this understanding through a rigorous application of the scientific method which left behind no records whatsoever. Through trial and error, they were able to develop a highly detailed understanding of how this energy moves through the body, its relationship with illness, and how to manipulate it with needles at 2,000 or so different points in order to specifically cure a variety of ailments. All this speaks to either far greater efficiency than modern scientists, far more advanced technology and models of the human body and illness than modern scientists, or both. Despite this amazingly advanced understanding of illness and the human body, Chinese life expectancy was very short until the introduction of sanitation methods from a less-advanced scientific culture. Modern science is unable to discover this energy, because it is somehow beyond the scope of western science, and we are unable to describe with accuracy the process by which this practice works, because we don't yet have the tools. Despite all this, we shouldn't use this ancient-but-advanced technique as primary care, because of something.

Gosh, which one should I reject until new evidence arises? Which?

Likewise, however, there are all these observations out there -- and those don't fit in any hypothesis that suggests that acupuncture is a sham.
Oh, out there. See, I was looking for observations in the other direction. Now that you mention it, I totally see all those observations. If I'd known that you only had to make a broad, nonspecific gesture to completely justify and prove your claims, then I would've asked for that a long time ago.

Jimmy_Blue (and Cupo, indirectly)

But I still think our US healthcare system is backwards to be so profit-driven

Which has nothing to do with whether or not it works, and whether or not it is better than TCM.


Good point, Jimmy. In addition, there's an implication here that TCM is somehow not profit-driven. Last I checked, acupuncturists still charged a fee. The difference is that pharmeceuticals go through years of development and testing to ensure that they have an effect greater than placebo, and that they aren't particularly dangerous, before any consumer spends money on them. TCM practitioners, however, have no such expensive trial period and no expectations of efficacy. I wonder, who makes the greater net profit per patient?

Who said that we all agree with Descartes? Since when is modern science and medicine based on Descartes's views?

Incidentally, Descartes died in 1650. So that would be early seventeenth century.


Damn, that's a takedown. Thanks, Jimmy.

This statement is nothing but philosophical nonsense on your part.
No, no, remember, Cupo is a scientist. He doesn't sully himself with all that rhetoric stuff.
The version you describe is exactly the sort that leads to psuedoscience. I have an hypothosis, then I look for evidence that supports it, then I say I'm right.
Yes, right, that's what I meant to say with all those words up there. Thanks :).

Tom Foss

In section 4.2.1 (roughly) of chapter 2 in your last post you said

"The human body is significantly less complex than the Earth's atmosphere."

According to Vilayanur Ramachandran the human brain is the most complexly organised structure in the the universe. Maybe it is my english letting me down, and the earth's atmosphere is not a structure per se, but somehow i feel your statement is not correct (Score: Martin 1 v Tom 43).

Somewhere else you said

"Not to mention that there are fewer stroke victims than people with simple pain, or that it would be highly unethical to prescribe a placebo treatment to someone who has recently suffered a stroke in order to get a halfway decent metric for comparison, let alone the number of placebo patients necessary to get any kind of study with statistical significance."

I'm just curious, but how do they test conventional stroke medicine then?

Regarding the future of this discussion, i have a feeling that if there was something (insert magic word here) that could change your mind about this subject, you would already have done so. Anyway i know you enjoy the sparring so i'll let you guys get on with it.

Tom,

What I want to see is a double-blinded placebo-controlled test of acupuncture's effectiveness, versus sham acupuncture, real treatment, and some actual placebo (or two), on any ailmen

I've wondered about a placebo controlled acupuncture study. How do you do that in a way that isn't simply sham? The patient will always know if someone is touching them with something sharp.

Do the patients know that the study is for evaluating acupuncture? If so, then I dont see how you can do placebo. However if all the patient knows is that its an evaluation of non-drug methods of [insert ailment] treatment, then I suppose you could expose some people to acupuncture, some to drugs, some to sham acu, and some to clown-dancing-in-the-corner-of-the-room.

Is that how you mean?

BTW...Now you have another post length record.


Dammit! Why does it always remove my sign in info?

LOL!again!

-tech

Martin:

According to Vilayanur Ramachandran the human brain is the most complexly organised structure in the the universe. Maybe it is my english letting me down, and the earth's atmosphere is not a structure per se, but somehow i feel your statement is not correct (Score: Martin 1 v Tom 43).

I'm speaking complexity solely in terms of number of components and degrees of motion. There are significantly more of both in the atmosphere, which in addition to be full of gaseous atoms and molecules moving all over the place, is really really incredibly huge. The human brain's amazing, but it's also mostly solid and well-contained within the human skull, which is substantially less amazing. Not to mention that the human brain is biologically required to operate according to certain narrow parameters in order to maintain life, while the atmosphere is restricted only by laws of physics.

I guess where I'd differ from Ramachandran is exactly where you suggested: the human brain is an organized structure, which, in addition to its construction (solid and liquid tissues, cells, a limited energy source, a requirement to maintain homeostasis, etc.), imposes some restrictions on its function. The atmosphere is not structured or organized, has a much larger store of energy to pull from, and is limited only by physics and chemistry, not biology. Which is why we have to resort to chaos theory to explain atmospheric trends, but only to neuroscience to explain brain functions.

I knew that statement was going to cause confusion; I should have been clear as to what I was using "complexity" to describe in the first place.

Techskeptic:

I've wondered about a placebo controlled acupuncture study. How do you do that in a way that isn't simply sham? The patient will always know if someone is touching them with something sharp.

I've given some thought to this, and there are a number of different ways, I think, to accomplish it. First, let me reiterate that my ideal-though-unrealistic test would have five test groups: a known treatment, a known placebo, a "real" acupuncture treatment, a "sham" acupuncture treatment, and a placebo treatment that shouldn't work by medical or acupunctural standards. It depends on the setup of the other acupuncture treatments, but I could see using blunt plastic "needles" with a sticky end, poking them into the patient's back and moving them around without ever penetrating the skin. Not a lot of fine sensation in some of those broad body areas. The problem with that would be blinding the tester, though I can see moderately easy ways around that (fake retractable needles, like the knives used in stage productions, for instance).

However if all the patient knows is that its an evaluation of non-drug methods of [insert ailment] treatment, then I suppose you could expose some people to acupuncture, some to drugs, some to sham acu, and some to clown-dancing-in-the-corner-of-the-room.

Is that how you mean?


Sort of. I'd want to keep the various test groups largely (if not entirely) unaware of what treatments the other groups were receiving; the drug-takers would think it was a drug trial, the acupuncture-receivers would think it was an acupuncture trial of some sort.

BTW...Now you have another post length record.
I don't know, I've written some epics before. In this thread, though, MS Word counts 6486 words in that last post, and 8896 in the previous book-length screed. So I haven't quite topped myself, but FSM knows I'll try.

Tom,

I hate to say it, but Martin is right. There is no way you can evaluate the complexity of the brain vs the atmosphere. You bastard.

Of course there is no way that this Ramachandran fellow can make that statement either.

Martin,

i have a feeling that if there was something (insert magic word here) that could change your mind about this subject, you would already have done so.

The magic phrase is: Double Blind Controlled Test.

If the acupuncturists, homeopaths, ayervedics, etc etc are soo damn certain that their stuff works, why don't the conduct a properly done study? The rest of the medical companies have to, why not them? They would be standing on firm ground if they did. They have plenty of money, they've had years to do it.

If a well run test (or tests, shall i say as verification is an important part) showed even a small amount of improvement over placebo, especially over western medicine then everyone on this board would jump on the band wagon.

Tom has described how to do this many times here and on other threads. You dont even have to understand how water dowsing works to show that it works (it doesn't). You dont even have to mention the word Qi to show that acupuncture works, much less understand how it works. You just have to have someone who uses the theory of acupuncture to stick needles in say 20 patients, and someone who only knows how to stick needles into patients but has no knowledge of Qi to stick needles into 20 other patients. The patients should not know which treatment they are getting. Then you need someone who doesnt know which patients got which treatment to evaluate any improvement in whatever symptom they are trying to address and tally the results.

you should do this for pain, then start again for nausea, then again for depression, then again for diarhea, or whatever you claim it will fix.

I have to give kudos to the Templeton foundation who performed a Prayer-Healing study properly

This study, with 1800 patients, had 3 groups to see if prayer helped heart patients. One group was prayed for and knew they were being prayed for. Another group was prayed for and didn't know they were being prayed for, and a third group wasn't prayed for. All patients had similar degrees of heart conditions.

Guess what...prayer doesnt do anything. In fact, by a small, probably not statistically significant, prayer made things worse.

templeton, spent 2.4 million on this and is a foundation that supports 'research' into spirituality. They had the balls to do this..why don't homeopaths and acupuncturists? Im sure if all the homeopaths and ancient medicine practitioners got together they could flip the bill here. It is a 40 billion dollar industry for god's sake.

So yeah, there is a 'magic' thing that will make tom and me and skeptico and jimmy and others change their mind quickly. Peer reviewed and validated double blind controlled tests.

-tech


LOL, I should have just waited for you to post...

sorry

-tech

Sorry I missed this before.

I'm just curious, but how do they test conventional stroke medicine then?
Conventional treatment for stroke victims has little to do with medication and more to do with surgery and rehabilitation. From what little I just read on the subject, there are some anti-clotting drugs which can be beneficial after initial treatment. The point here, though, is that we have treatments based on our understanding of the ailments and drug trials that didn't require giving placebos to stroke victims (because we can test anticoagulants on anyone who isn't a hemophiliac, and we can use our knowledge of what causes and exacerbates strokes to hypothesize that anticoagulants would be beneficial to recent stroke victims).

Correlational studies (I think that's the right term) may then be conducted by comparing recovery rates of stroke victims who received the anti-clotting drugs to those who didn't. These tests aren't as certain as DBCTs, but are necessary in some situations where DBCTs wouldn't be practical or ethical. Since these come out of existing understanding of ailments and conditions, we start from a position of greater knowledge and understanding than we would with some esoteric, untested treatment like acupuncture.

Regarding the future of this discussion, i have a feeling that if there was something (insert magic word here) that could change your mind about this subject, you would already have done so.
Evidence would change my mind. It's possible that evidence will eventually arise which will change my mind. So far, what I've seen has been either so flawed or so paltry as to be terribly insufficient.

Techskeptic:

LOL, I should have just waited for you to post...

No, I like the way you said it. Thanks!

Sorry, Other Tom, it looks like your name is confusing after all.
Bummer! I'll come up with another one.
Regarding the future of this discussion, i have a feeling that if there was something (insert magic word here) that could change your mind about this subject, you would already have done so.
You know, I find it pretty darn ironic that you talk about magical proof.

Tom S. Fox:

I find it pretty darn stupid that you claim i talk about magical proof, when i talked about a magic word.


Tech:

What i was trying to say was that even though you dive into PubMed or wherever and swim around all day looking for some evidence (i.e a DBCT) to support your stance that acupuncture works, you wouldn't find it (contact me for more breaking news). It doesn't exist, so there isn't anything anyone could say that would change your mind.

Re: "If the acupuncturists, homeopaths, ayervedics, etc etc are soo damn certain that their stuff works, why don't the conduct a properly done study? The rest of the medical companies have to, why not them?"

I agree. Of course they should. The only soft spot in all this as i see it, is in the design of the studies. Unfortunately i have no experience with acupuncture (at all) nor with DBCTs, so i'm not sure i would have recognized a proper study if i ever saw one. I think your brief outline of a DBCT is over-simplified and does not reflect an actual acupuncture treatment. Some of my concerns revolve around if it is only the needle sticking that triggers a healing process, if somehow there is some other component of the treatment that fails to get tested in the current DBCT design. I guess i could probably just slice away a lot of my somewhat unreasonable concerns (i left some out just to keep Jimmy at a safe distance, lol) with Occam's razor, but for now i choose not to.

Re: "Guess what...prayer doesn't do anything. In fact, by a small, probably not statistically significant, prayer made things worse."

Well if it doesn't do anything it can't have made things worse. ;)

Tom:

Re: "The problem with that would be blinding the tester, though I can see moderately easy ways around that (fake retractable needles, like the knives used in stage productions, for instance)."

I don't think retractable needles blinds the tester though. They require some kind of special handling from what i understand. But in theory it should be possible i guess, if the point of the needle was hidden in some container or something of that nature. In addition to that, this study (i only skimmed through the abstract) seems to cast some doubt about the effectiveness of the patient blinding as well. Also, even the retractable needle will have to touch the acupuncture point, although i don't know what effect this might have.

Perhaps the ideal DBCT is out of reach and maybe not what one should hope to achieve either, but getting the placebo treatment right in this case seems to me to be a pretty critical part.

Regarding your 'ideal-though-unrealistic test' i think it looks better than a more simple version like the one TechSkeptic proposed (i guess he was only giving an example). I have one request though and that is that you add this guy (he's obviously a grand master acupuncturist, with that beard and everything) to your team. You might wanna give him a 5 yrs science education first though. Then we might have something.

martin, the DBCT isn't meant to disprove accupuncture in its entirety, it's to disprove whatever the DBCT is studying. So if you say "sham and real accupuncture accomplish the same thing" and the DBCT proves taht, then you can do one with "the needles don't even have to pierce the skin..." but how do you blind the patient?

The problem isn't with the double blind. the problem is with the wording accupuncturists use to describe what it is they do.

ANd you can blind the patient. Just find patients that have never had accupuncture (like me, for instance, and everyone else i know) that wouldn't know what it feels like. then run four blinded tests, sham puncture, sham no puncture, real puncture, real no puncture. In all honesty i think the no puncture ones are bound to be classified as "abnormal results" --not in favor of accupuncture, but more along the lines of the people will feel better because they DIDN'T have a foreign object inserted in them.

Other Tom:

Bummer! I'll come up with another one.

It may be that it's early in the morning and my irony meter is still warming up, but my comment was sarcastic (since Cupo couldn't keep us straight). I wouldn't change your name on account of him.

Besides, I like addressing responses to "Other Tom" :).

Martin:

I find it pretty darn stupid that you claim i talk about magical proof, when i talked about a magic word.

That "magic word," which you referred to here:

if there was something (insert magic word here) that could change your mind about this subject

Is proof (or, more precisely, evidence), which is hardly magic at all (or, alternately, the most magical thing there is). I think that's what Mr. Fox was referring to.

What i was trying to say was that even though you dive into PubMed or wherever and swim around all day looking for some evidence (i.e a DBCT) to support your stance that acupuncture works, you wouldn't find it (contact me for more breaking news). It doesn't exist, so there isn't anything anyone could say that would change your mind.
It's entirely possible that it doesn't exist and will never exist, because acupuncture doesn't work. It's also possible that it doesn't exist yet, but better tests in the future may reveal it, in which case we're going to continue looking. But until all that looking turns something up, we'll retain the current judgment, supported by the lack of contrary evidence.
Unfortunately i have no experience with acupuncture (at all)...I think your brief outline of a DBCT is over-simplified and does not reflect an actual acupuncture treatment.
And I think you're right on the precipice of a No True Scotsman fallacy there. What is needed for this to be an actual acupuncture treatment? A believing practitioner? A certain sort of bedside manner? Incense and candles? If it's the demeanor of the practitioner which causes acupuncture to work, not the insertion and manipulation of needles, then why not bypass the whole needle thing entirely?

I apologize if my assumption there of what you think constitutes an "actual" acupuncture treatment is inaccurate, but without further explanation of what "actual" acupuncture is, I'm a little at a loss.

Some of my concerns revolve around if it is only the needle sticking that triggers a healing process, if somehow there is some other component of the treatment that fails to get tested in the current DBCT design.
Then we'd do another DBCT. The point of an experiment isn't to cover everything at once, it's to rule out one (or several) potential answers at a time in order to find the correct one. After that DBCT, where we might find something out about needle-sticking, we could do one to find out something about bedside manner, or whatever.
Well if it doesn't do anything it can't have made things worse. ;)
No, the hypothesis is that the people did; the ones who were told that they were being prayed for tended to do more poorly, and it's been suspected that they were stressed due to performance anxiety--they pressured themselves to get better in order to show that prayer was effective. Bit them in the ass, that did.
I don't think retractable needles blinds the tester though. They require some kind of special handling from what i understand.
Guh? If retractable needles actually exist, I was unaware when I wrote the post. When I was looking up stuff about acupuncture earlier in this thread, I found a kind of needle with binding around the part that the practitioner would hold, to provide a grip and to keep the needle from penetrating too deeply into the patient. The idea for a "placebo" needle would be to use something like that, where placing pressure on the point of the needle slides it back up into the binding (again, like stage daggers, where the spring-loaded blade slides back into the handle). These would have to be specially constructed, so far as I know, in order to make them largely indistinguishable from the "real thing," both for the practitioner and the patient.
In addition to that, this study (i only skimmed through the abstract) seems to cast some doubt about the effectiveness of the patient blinding as well.
One of the key terms in that abstract is "acupuncture-experienced patients." Again, working from the ideal, the subjects would not be experienced acupuncture-users. I believe I also mentioned that these points would be best on the back in areas that lack fine sensation--in the study you linked, one point was on the hand (a bastion of fine sensation), and the other was in the lumbar region of the back. Subjects tested at the latter point, it seems, were less able to distinguish the real and sham needles.
I have one request though and that is that you add this guy (he's obviously a grand master acupuncturist, with that beard and everything) to your team.
I don't know about acupuncture, but I'm interested in having him weigh in on the strength-enhancement properties of spinach.
And I think you're right on the precipice of a No True Scotsman fallacy there.

ah...at least he wasn't rubbing up to it or having sex with it!


I don't know about acupuncture, but I'm interested in having him weigh in on the strength-enhancement properties of spinach.

LOl, that took me a second...


-tech (offering nothing useful today)

I've never had acupuncture, but I know many people who swear by it for alleviating pain. It makes sense to me that if there is a blockage of energy one could open that block by inserting a needle. But I'm writing because I was fascinated by something a friend told me the other day. She was receiving an acupuncture treatment and her rf meter jumped when the acupuncturist inserted the needle in a spot where she could feel it.

You may be wondering why she had an rf meter on. I've been working on the issue of ill health effects from radio frequency waves from wireless devices such as cell phones and wifi. This woman, as I do, believes she is sensitive to the electromagnetic radiation emitted from the devices.

When she told me about her meter spiking when she felt the needle it got me to thinking of things like telepathy. If we can send images and sounds through the air with wireless technology it seems pretty likely to me that thoughts can be sent as well.

It makes sense to me that if there is a blockage of energy one could open that block by inserting a needle.

Yeah because when there was a blackout in the northeast a couple of years ago, the utility companies fixed it by sticking pins into the powerlines. Makes perfect sense!

Also, when patients with Lou Gehrig's Disease has signals in their nerves blocked due to deterioration, the doctors stick needles in the nerves and it gets totally fixed! Makes Perfect sense!


Did you even read this thread?

Your RF stuff has been pretty thoroughly studied. It wasn't 2 women walking around with EM meters. Stop worrying about your cell phone.


I hope you plan on turning off the power to your house. Your proximity to the power lines in your walls provides the same RF field you are scared of from exterior powerlines.

Maybe you should wear a tin foil hat.

Ok, First off I am not scared of the rf field. I feel it has an effect on me. Mostly I feel mad that the science has been covered up or dismissed on the subject. Have you checked out the BioInitiative Report - www.bioinitiative.org

The BioInitiative Report is a review of 2000 studies of bioeffects and adverse health effects of non-ionising radiation (electromagnetic fields (EMFs) including extremely-low frequency ELF-EMF and radiofrequency (RF) / microwave or RF-EMF fields). The conclusion is that public exposure guidelines for emissions from mobile phone masts, Wi-fi and other mobile/wireless devices are set too high to protect public health. There are now plausible mechanisms for why microwaves cause illness at levels way below the current microwave radiation (ICNIRP) guidelines, which only cover heating effects and thus do not adequately protect against the biological non-heating effects seen.

It is not only cancers and brain tumours that are of concern. The Report offers evidence that a very large range of illnesses and other adverse health effects are linked to mobile phone technology. This year the Swedish and German authorities have put the health of their nations ahead of profits for their own mobile phone companies - they are issuing warnings to reduce exposure.

When the power goes out in my house no one come to my house to fix it. They go to the spot where the break occurred. Often this is miles away from my house. Everything is connected. I met a man last night who said he had a dislocated shoulder and received accupunture in his knee which fixed his shoulder. What can I say? It worked for him.

Have you ever thought of adding an edit option here? I hate when I have typos. It could be set up where you can only edit a post immediately after posting so that people couldn't come back days later and change things.

Angela:

Sorry, I can’t add an edit field – it’s packaged blogging software and I can’t modify it. The only option is for you to push preview before you post. If there are any major typos that effect the meaning, and you let me know, I can edit them if you ask. I try to limit those to essential edits though.

Re EMF, you might like to read my article from two years ago, Power cables reduce brain tumor risk

Angela:

It makes sense to me that if there is a blockage of energy one could open that block by inserting a needle.

Why does it make sense? Where is your proof that there is an energy, and that it needs unblocking, and that acupuncture does this?

When the power goes out in my house no one come to my house to fix it. They go to the spot where the break occurred.

So are you claiming that the power doesn't come into your house? Of course, if the break was at your house, where do you think they would come to fix it? Your statement makes no sense at all in reply to what Techskeptic said.

I met a man last night who said he had a dislocated shoulder and received accupunture in his knee which fixed his shoulder.

Acupuncture can relocate bones and joints, is that what this man claimed? Or was it that it helped with the pain of a dislocated shoulder? Before or after he'd recieved conventional medical teatment for it?

Oh and Cupo, thought you might find this interesting since it talks about your 'P6' study:

Acupuncture and Misdirection

Incidentally, the article also refers to using sheathed needles to create a blinded no acupuncture group in another study.

angela i really got a kick out of your false analogy.

allow me to try and give a true analogy of what you are trying to say.

electrical current, when running through a conductor, causes electrons to move in an arbitrary direction. With Direct Current(DC), this direction does not change. With Alternating Current(AC) it changes at an arbitrary number of times per second. This is measured in a unit called "Hertz"(Hz). When you have electrical current running through a conductor, such as a power line, or an extension cord, it creates an electromagnetic field around that conductor. All of this was discovered last century, back when people were trying to figure out what magnets and electricity had in common. If you wiggle a magnet inside a loop of conductive material, you create a measurable current inside of said conductive material.

All of this can be explained to a young child, very accurately, and it can also be explained to a graduate level physics student - very accurately. At no point do you need to say "it just works" or use very complicated language to describe what is going on. There's no faith involved. If, for some reason, you have an electronic device that is not working, you can pinpoint exactly why. If there were faith involved, you may never know why something that was electronic did not work.

Allow me to restate that in a different way:
If at any point when someone is explaining something to you, and you ask for more information, and they say "i don't know why, it just works" - that is not the person you want to be taking advice from, listening to, and repeating when you're discussing it with other people.

For instance, everything you could possibly want to know about electromagnetic radiation and radio frequency, I can answer, using real world knowledge of the subject. I've never read, or even met someone who could answer the full gamut of questions about any "faith based" thing. Ever.

You see, back when people didn't understand how electricity worked, they did experiments. you may remember thomas edison's story of inventing the light bulb by running electrical current through various types of conducting materials. We still use the same light bulbs TODAY. We don't use the types of materials he used in the failed experiments, even if they worked "sort of well" or "sometimes". Why? Because it's not efficient. Real world application of "stuff" requires that it solve a real world problem, and that it solves it efficiently and cleanly.

The amount of radiation you receive from your household appliances is nothing compared to the amount of radiation you receive from the sun from going outside. Radiation generally passes between the cells of your body without causing any trouble. you really have to worry about "High power" radiation, such as that you'd get from working at a nuclear power plant, or standing in front of a microwave broadcast station. there is a difference, and it doesn't take a brainiac to see that.

Acupuncture, like other "faith based" stuff on this planet, has no accountability to reality, science, knowledge, anything. it'd be as if you were walking with your little RF meter past a power plant, and it spiked, so you went and asked them why, and they answered "Because god is here, and he's busy, and he does that sometimes"

Jimmy_blue: You have your heart in the right place, but your approach is slightly off in this circumstance. We know (us being the regulars here and elsewhere on scientific and reality based forums) that woo won't change their minds even when presented with questions that are thought provoking. I'm beginning to wonder if, rather than ask them questions, we started to just point out how asinine the stuff they say sounds to people who know the difference between BS and chicken pot pie is.

and i like the metastudy of 2000 studies. i bet that's a real fun read.

genewitch:

I agree that woos rarely if ever change their minds, I'm not doing this for them though.

I want to reach the people who stumble here and aren't woo but are curious. They can then see that the woos can't answer questions, won't answer questions, or do in a ridiculous way that is easily refuted. They are who skeptics should be talking to and aiming to reach.

I also ask the questions because quite often you need to pinpoint just what a woo thinks before you can point out the crap they believe.

I'm going to try splitting this...spam filter problems again.

I've never had acupuncture, but I know many people who swear by it for alleviating pain.
And just because a lot of people believe in it, that makes it true? You might want to take a look at confirmation bias, post hoc fallacies, regressive fallacies, and the placebo effect.

Oh, and the appeal to popularity.

It makes sense to me that if there is a blockage of energy one could open that block by inserting a needle.
Why does that make sense to you? See, I'm wracking my brain, trying to think of types of energy that can be "blocked." Kinetic and potential energy can't be blocked, it doesn't even make sense to say that chemical energy could be blocked, thermal energy can be slowed down. Some varieties of radiant energy can be absorbed or reflected, but not really blocked. I suppose you might say that an insulator "blocks" electricity, or that shielding "blocks" radiation. But unless you've got quite a lot of rubber or lead in your system, the human body wouldn't be able to cause such "blockages" with any amount of energy that would be noticeable.

But putting that aside for a moment, what about this "open the block by inserting a needle" business? I suppose, if you've got some sort of insulator blocking your electrical current, and the needle is made of conductive material, then you might unblock the "energy"--but you'd have to bridge the gap across the insulator, by sticking the needle through it. If radioactive, you'd have to somehow drill through that shielding and leave an opening for the radiation to get through.

But these scenarios are vanishingly unlikely. The human body is filled with electrolytes--electrically conductive chemicals--and not filled with good insulators and current pathways. Even if 'twere, a charge follows the path of least resistance, it doesn't get backed up at an insulator when it's surrounded by electrolytic fluid. And the body certainly isn't filled with radioactive material (if it were, you'd have bigger problems than acupuncture could solve).

Now, I suppose I could see where you might have a buildup of electrical energy on the surface of the skin, causing mild discomfort and affecting the body hair. If an acupuncturist touched an uninsulated needle made of electrically conductive material, he or she might be able to relieve that charge buildup. This might cause the acupuncturist a sharp pain known medically as a "static shock."

Personally, I'd just touch a doorknob, but if you want to spend money so someone can relieve you of the energy buildup you suffered from walking across carpet in fuzzy socks, be my guest.

She was receiving an acupuncture treatment and her rf meter jumped when the acupuncturist inserted the needle in a spot where she could feel it.
Gosh, there must then be a causal relationship! Because needles give off radio waves...or something. I can't imagine what else could cause fluctuations in radio frequencies around someone, particularly not inside a building that might use cordless phones and intercoms.

Tell me, what kind of RF meter was your friend using? What was its tolerance set to? What units? How big was the jump?

I've been working on the issue of ill health effects from radio frequency waves from wireless devices such as cell phones and wifi.
Really? And by what mechanism do these radio frequency waves cause illness?
This woman, as I do, believes she is sensitive to the electromagnetic radiation emitted from the devices.
What kind of electromagnetic radiation, specifically? Why would wifi and radio waves affect you and cause illness, when EM waves with greater frequencies (such as, um, light) don't?
When she told me about her meter spiking when she felt the needle it got me to thinking of things like telepathy.
Oh, you are just a smörgåsbord of unsubstantiated beliefs!
If we can send images and sounds through the air with wireless technology it seems pretty likely to me that thoughts can be sent as well.
Why on Earth would that seem likely? Do you have a transmitter in your head? Where is your power source? Your antenna? You do understand that thoughts (electrochemical impulses between neurons in the brain) and radio waves (electromagnetic waves beamed out of transmitters and interpreted by receivers) are very, very different things, right?

So, which is it that makes telepathy and acupuncture "make sense" to you: your complete misunderstanding of physics, your complete misunderstanding of human anatomy, or your complete misunderstanding of science?

I feel it has an effect on me.
Science isn't based on feelings, it's based on evidence. Do you have any evidence to back up your feelings?
Mostly I feel mad that the science has been covered up or dismissed on the subject.
Oh wonderful, you're a conspiracy theorist too. And who has been covering up the "science" on the subject?
Have you checked out the BioInitiative Report - www.bioinitiative.org
I'm checking it out now. Anyone else see anything wrong with their DNA helix graphic? And not just that I'm pretty sure it was the cover to an ID book.

So, where's the peer review on this report? Why are all the primary researchers from the same Bioelectromagnetics "society"? Why do they claim that people are exposed to two main types of electromagnetic fields (low-level from powerlines and such, and radio frequencies from cell phones and antennas) when they're missing the electromagnetic field of the Earth, which is orders of magnitude greater than any man-made field you're likely to experience in everyday life? Why does the WHO dispute their claims of adverse health effects?

There are now plausible mechanisms for why microwaves cause illness at levels way below the current microwave radiation (ICNIRP) guidelines, which only cover heating effects and thus do not adequately protect against the biological non-heating effects seen.
And what are those mechanisms? What are those non-heating effects? What intensities and frequencies cause these non-heating effects? What evidence is there to suggest that microwave radiation is the cause?
Everything is connected. I met a man last night who said he had a dislocated shoulder and received accupunture in his knee which fixed his shoulder. What can I say? It worked for him.
I don't even know what to say to this. There's so much wrong here, so well-concentrated.

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