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February 13, 2007

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Summary of debate with Martin

Martin has now agreed that his only reason for this lengthy debate in which he supported the qi/meridians claims of TCM, is that this is what he has been told by practitioners of TCM. There is, in fact, no evidence any of it is true. He has no idea how the ancients figured it all out. In fact, no one knows how it was all figured out because it was most likely just made up. He claimed there is much clinical evidence to support TCM but when pushed (after being asked several times), he finally admitted he has no such clinical data supporting acupuncture and withdrew the claim. He still hides behind “modern science isn’t as smart as the ancients” and “TCM needs its own special way of being tested” type of rhetoric, although he can’t explain why this would be or what better way there is than science. And yet despite this total lack of any rational reason for us to accept what he is telling us, and despite the fact that all his arguments have been debunked numerous times, and despite the fact that he ignores all arguments he doesn’t like and yet he still insists he is right – despite all this – he has the damn nerve to call the skeptics’ arguments “an ignorant stance”! Martin, your continued insistence acupuncture works despite not having one shred of evidence to support that view, is the definition of “an ignorant stance”. I don’t think there is one thing on this list of typical woo fallacies that you haven’t used (and continue to use even in your last post above). I’m glad you’re finished. I don’t think I can bear to hear any more of these same old lame debunked arguments even one more time.

I think you missed my point. Here it is in short form so it will not confuse anyone:

Even though scientifical methods has not detected the flow of qi or its effects in the human body, there is still a possibility that the phenomena is in fact real.

Do you disagree with this? (yes/no is enough)

I might as well mention one of my entries: Doggerel #46: "Don't knock [woo] until you've tried it!"

I won't base my conclusions about a form of woo on personal experience. I already know I, like everyone else, can fool myself.

I also won't pretend that a sample size of 1 is something to base a conclusion on: If I have 1 really nasty encounter with 1 member of [insert race/nationality/political party/religion], I am not about to assume that that was a typical case. The same logic applies to quackery: One troll I know reported a positive outcome for his altie cure. Another report was death. Of course, said troll is very much against running a DBT on his pet woo. He says it's unnecessary, and that a single uncontrolled, unblinded anecdote is supposed to be more convincing than scientific studies on large numbers of people. If we were to follow his advice, there'd be far, far, far more Vioxx scandals because the pharmaceuticals as well as the quacks wouldn't even have tests and results they'd have to spin into looking good. It'd the good old double-standard.

Just did a quick scroll up. Seems that our current troll still thinks that this is still about east versus west. Is he even capable of toning down his racial favoritism AND recognizing that we reject all racial favoritism?

Even though scientifical methods has not detected the flow of qi or its effects in the human body, there is still a possibility that the phenomena is in fact real.

Do you disagree with this? (yes/no is enough)

Yes, it's possible. Possibility, however, means nothing, since just about anything and everything is possible. Thus far, I think it's very improbable.

The lack of evidence is unconvincing, hence, I ask for evidence.

Skeptico replies to Martin

Re: Even though scientifical methods has not detected the flow of qi or its effects in the human body, there is still a possibility that the phenomena is in fact real.

Do you disagree with this? (yes/no is enough)

Martin, anything is possible. It is possible my room is filled with invisible fairies holding all the furniture on the floor. It is possible there is a teapot orbiting between Earth and Mars. All these things are possible – I certainly can’t prove they are not true. But the flaw in your way of thinking is this: “is it possible” is the wrong question. The correct question is: is there any reason to suppose that qi exists. So far, the answer to that question is NO.

Your argument is a version of the fallacious appeal to “science doesn’t know everything” THAT I HAVE ALREADY REFERENCED. (Did you read it?) As I wrote at the link, a version of your argument would go:

Hundreds of years ago we didn’t know radio waves existed, but they obviously did exist, so how do you know “qi” (or whatever woo idea they are promoting) does not exist today?

The response to that is:

The answer is – we don’t. But, no one imagined radio waves existed, or claimed to be using them before they were scientifically discovered either.

You see, in this analogy “qi” is not the radio waves that did exist although we didn’t know it. “Qi” in this analogy is the “humors” that doctors used to think caused disease, but no one believes in any more.

Martin:

I’m sorry but I’m deleting this comment as being unnecessarily vulgar.

- Skeptico.

Yeah you do that. Or maybe just censor it, because there was some vital info there for him?

No Martin, it was the vulgar reference. And you know what I mean.

It’s a bit lame to cry censorship when I’ve allowed your posts here without moderation. Repost it without the vulgarity if you like. But don’t play victim.

No what i meant was that you could edit it, so he could get the other info in the post. I will repost it later.

OK, this is Martin's post, without the vulgar sentence that started it off:

"Bronze

Its not about east verus west you puppet. If anything, it's about the integration of east and west, and taking the best from both "worlds"."

Looks like I missed it. Think I can make a couple guesses, though.

It'd be really nifty if this qi stuff existed, but I'm not one to confuse niftiness with plausibility. All it'd take to convince me is a handful of double-blind control studies.

I'm reminded of some guy who came up with some weird mix of chiropractic and some kind of biofeedback stuff and said that through some technique, the patient's body would be able to identify whether or not an unknown substance was good or bad for it just by holding it. It's weird.

Anyway, after failing a double-blind test, he said that "obviously" the test was inappropriate. Because he KNEW his magic woo was real, any test where he failed must be rigged. Yeah, and because I KNOW I'm the best at Armored Core, anyone who beats me in a straight fight must be cheating.

Of course, I've just picked up AC4, so I may run into a lot of "cheaters" tonight.

"best of both worlds"? I'm sure doctors in the east have better to offer than acupuncture! That's all we were trying to say. And that eastern folk medicine doesn't hold any more water than western folk remedies. I have a toothache - should I go chew a piece of bark, or stick a needle in my skin? I was suggesting that people who get caught up in "ancient eastern knowledge" are perhaps guilty of seeing eastern culture as "other" and mysterious, therefore don't ask the same questions about evidence and scientific method, which is bias.
madaha

Martin (and anyone else who checks in, though I'm doubtful about what effect I would have):

Science does not need to know HOW qi works to see IF it works.

Acupuncture states that it works by altering the flow of qi. Can science say this is valid or invalid? No, because science doesn't recognize that qi exists. Yet.

However, that's a statement of how.

Acupuncture also states that it can cure diseases. This is a statement of what. It's a simple statement: If you have disease X and a trained practitioner uses acupuncture on you, disease X will go away.

It doesn't matter what disease X is. It just matters that it's something that we can test for. If you go to the doctor, can they tell that you have disease X? Then we're good to.

Now, if the doctor can tell that you have disease X, they can tell when you *don't* have disease X. This is the only part where "western science" comes in. We need a medical doctor to assemble a group of people that have disease X before the treatment, and to test whether or not they still have it after the treatment.

Now, here comes the test. There are a few ways to set this up, but I'll only go over one. Have an acupuncturist detail exactly how they would treat disease X. Write this down. Now, make up a different acupuncture treatment that seems similar to the one given by the acupuncturist, but differs in important details. Let the acupuncturist tell you which details are important.

Give the two sets of instructions to testers, without telling them which is the real instructions and which aren't. For authenticity, the testers could even be actual acupuncture students. As well, don't tell the people who have disease X which set of instructions their testers are working with. This way, no one that is actually doing the tests knows whether the procedure is real or not.

Follow up on them. The people who do the followup should *also* not know which people had a real procedure and which had a fake one.

Once you've got all your data together, separate them out into the people who got the real treatment and the people that got the fake treatment. Remember, you had the acupuncturist tell you what details were important, so the fake treatment is maximally wrong. Now, compare the results of the two groups.

If the real acupuncture group had significantly more cures (using statistics) than the fake group, you've just given an excellent proof that what was done has a real effect. It can now be studied, perhaps even by studying mysticism and such, if it does turn out that it is required to fully understand the phenomena.

If the two groups were statistically equal, though, then you've got a good reason to believe that acupuncture isn't real, or at least that the acupuncture practitioner you consulted is a fraud.

You see? No need to ask a single question about how acupuncture works during the study? Does it manipulate qi? Who cares! It claims to cure people, and we test if they're cured (even if we don't know how they were cured), so we can test if it works (even if we don't know how it works). We even have an entire field of science devoted to testing if people have a disease or not; it's called medicine.

Double-blind controlled studies don't give a damn about the mechanism. All they care about is the effects. If acupuncture claims to cure a disease, then we can use DBCT to see if people who have the disease are cured by acupuncture. After we've established whether or not it works we can start investigating into the how.

Xanthir:

Regarding the double-blind experiment:

Although i fully agree this is the best way to test conventional medicine, and perhaps the only way of giving a valid scientific proof that a treatment is working, i still have some reservations regarding the use of this method on an alternative treatment, such as acupuncture. My concern is that because of the fact that we do not know the details of HOW the treatment works, we may somehow interfere with the effect of the treatment if we try to measure it with a method not suited to this type of treatment.

If we were to use some kind of fake needles, the acupuncturist will invitably know if he is giving the patient a real or fake treatment. And because we don't know scientifically how this treatment works, we cannot know how/if this effects the treatment. If, hypothetically, there is a connection between the patient and acupuncturist that we still do not understand, blinding the acupuncturist may distort the results (does the enthusiasm of the acupuncturist effect the patient? etc.).

The only way to fully blind the acupuncturist is to make him give an acupuncture treatment which is a real treatment, but for another illness. This will ultimately alter the energy flow in the body of the patient (according to TCM), and thus influence the outcome of the trial. So i don't see how we would give the placebo-group of patients a true placebo treatment? I guess what i am suggesting here is that our efforts to measure the effect of acupuncture may intefere with the outcome of the trial.

What am i missing here?

What am i missing here?
The point.
My concern is that because of the fact that we do not know the details of HOW the treatment works, we may somehow interfere with the effect of the treatment if we try to measure it with a method not suited to this type of treatment.
Apparently you missed the part where the Double-Blind Controlled Test doesn't require us to know how any treatment works in order to produce useful information. It works for everything else, for every claim made regarding any treatment, Eastern or Western, why not acupuncture?

Furthermore, you assert that the DBCT isn't suited to this kind of treatment, but what proof do you have for that? How do you know? What makes acupuncture so special that it's exempted from the basic global methods of quality control? Does acupuncture make claims? Is there a "before" and "after" condition which can be compared? These are the necessary components for a double-blind test.

If we were to use some kind of fake needles, the acupuncturist will invitably know if he is giving the patient a real or fake treatment.
Which is why we have acupuncturists tell us what to change in order to make one test a placebo. They'll be able to make subtle changes that would invalidate the treatment, but also wouldn't fool the testers.
And because we don't know scientifically how this treatment works, we cannot know how/if this effects the treatment. If, hypothetically, there is a connection between the patient and acupuncturist that we still do not understand, blinding the acupuncturist may distort the results (does the enthusiasm of the acupuncturist effect the patient? etc.).
And those effects will be shown in the results of the test. If the two groups are statistically similar, but are statistically different from recovery rates observed and recorded outside this test, it would show that there is some variable which must yet be accounted for, and would suggest the need for further testing.

It would also suggest that the prevailing "theory" of acupuncture--that it works through stimulation of specific regions to direct qi--is incorrect, since both different treatments had the same effect. Instead, it would suggest, perhaps, that the placement of the needles wasn't important, and that the connection between the acupuncturist and patient is important.

The only way to fully blind the acupuncturist is to make him give an acupuncture treatment which is a real treatment, but for another illness.
Why is this the only way? Even if it were, it'd be a fine way to perform a test.
This will ultimately alter the energy flow in the body of the patient (according to TCM), and thus influence the outcome of the trial.
No, it won't influence the outcome of the trial. If we're testing acupuncture's claims to cure Athlete's Foot, then all we're looking for at the end is whether or not the Athlete's Foot has been cured. If the placebo group gets a treatment for arthritis, how does that affect whether or not their Athlete's Foot was cured?

And if the arthritis (placebo) group recovers from Athlete's Foot with the same rate as the experimental group, then that again would suggest that the specific placement of the needles doesn't matter, which would cast doubt upon the TCM theory of how acupuncture works.

I guess what i am suggesting here is that our efforts to measure the effect of acupuncture may intefere with the outcome of the trial.
If taking down statistics on the cure rate would affect the results, then how can it be said to work well at all? How can acupuncturists claim any kind of success rate if measuring that rate would invalidate the successes?

It's been a while, there are a LOT of posts between my last one and this one... I apologise if I ramble, There's a lot to this issue and I haven't planned out my argument in advance. I hope the picture gets conveyed...

Thanks for the reasoned discussion, so far there hasn't been much in the way of flaming, etc. It would be nice if all parties can agree to hold a discussion with respect and manners - even if we may disagree violently in principle...

Not even getting into the whole idea that acupuncture was designed to be a health-maintenance system, not only a disease-focused therapy. (Yes, that means that treatment is still useful when you feel OK...)

It's probably a stretch to imagine that it would be rigorous enough for medical science to accept, but the evidence for acupuncture's effectiveness is to be found in case studies. Of actual treatments (where patients often get better, get worse, symptoms change, injuries happen, life continues, hangovers are acquired, seasons change, Colds & Flu are fought, etc... Sometimes disasters occur). Case studies of treatment over time.

The other area that should be the topic of a lot more trials is phenomenology - what happens when we put a needle in, on or near the body? Then, how can we apply this in the presence of a symptom or disease?

For some phenomenological research into the effects of acupuncture, please keep an eye out for Victor Vickland's forthcoming research. (He's currently finishing up a PhD trial into the physiological effects of needling). I haven't seen any of even his early results, but his experiment design and procedures sounded like 'Good Science' as well as 'Good Acupuncture'- Pubmed has another one of his collaborations, on whether physicians are actually using evidence to back up their decisions or relying on what they were taught at school..

Back to RCT's... They seem to be copping a fair bit these days...

RCT's are inherently suited to working with simple interventions - add one substance, observe results. Acupuncture (or just dermapuncture) by its very nature is a complex intervention- very hard to control, in the sense of 'placebo controlled', and as the body is wrapped in a contiguous network of nerves, blood vessels, connective tissues and there are NO parts of the body with zero connections to other parts of the body- there can be no 'sham' or 'non-Meridian' points that can be needled...

Show me an area on the surface (or down to the bone) of a human body with zero circulation, zero capillary action, zero electrical activity, zero nerve supply, zero sensitivity to touch (sharp, pain, heat, pressure), zero proprioceptive fibres and no response to any form of mechanical stimulation- and you will have shown me a 'non-acupuncture point'.

My problems with most of the research on acupuncture can be summed up by a few simple points:
- Most of the studies use treatments that do not resemble what happens in any clinical situation... (Bad Acupuncture and Bad Science- remember, Science is the observation of nature) Acupuncture treatments (like acupuncture patients) are never EXACTLY like what appears in a textbook, yet the treatments being researched are more often than not simply a collection of acupoints harvested from a couple of textbook treatments.
- Most of the studies are poorly designed, planned and executed... (Bad Science and Bad Acupuncture, generally)
- The vast majority of studies involve only TCM acupuncture (which is only one, particularly heavy-handed, system of acupuncture), thus do not resemble what I do in my clinic- which is mostly very superficial needling (less than 5mm) and without any strong sensation. (Which many of the trials would have us believe is a 'sham' procedure, like arthroscopic knee surgery... OK, that may have been too cheeky)

As I stated (and as a professional acupuncturist/herbalist) I have no problem with the idea that acupuncture healing is a result of stimulating or regulating (de-stimulating?) the nervous, cardiovascular, mesenteric, or any other system of the body - in fact, I welcome all of the phenomenological information that comes out from time to time. I don't think that all of the effects of dry-needling are sufficiently understood to demonstrate that there can be no positive effect from an acupuncture treatment (no matter how poorly performed it may be).

My understanding of the 'classical' approach and explanations of acupuncture as an educational system - just one way of looking for the right, receptive areas on the body that have a significant effect.

The other aspect of this idea is that acupuncture is a system based on palpation of the body- reactive points are the ones where something is different from the surrounding tissue. They may be painful on pressure, exhibit resistance to pressure, depressed areas (dips, holes, decreased elasticity of the skin), increased skin drag (run your finger along the skin of your wrist and see if there are any points where it naturally 'sticks'- it's most likely going to be a textbook location for an acupoint)... There may be lumpy bits of connective tissue, maybe hard bumps, maybe an area where the capillary return is slowed down (press for a few seconds and count till the white finger-marks disappear).. These are the sort of things that acupuncturists look for and target in treatments..

This sort of observation, and the phenomenological study that may be inspired by it- for instance we could correlate the traditional 'Mu' diagnostic points with the presence of inflammation or other disease in the related organ (or along the related meridian), possibly by sampling and testing for c-reactive proteins, etc... This could prove to be a very useful tool, and one that could be used to research ACTUAL acupuncture practices and to gain more scientific understanding of both acupuncture and the body.

RCT's are not the tool of choice for researching acupuncture. They're simply not designed to cope with complex, multi-system interventions- there will always be too many variables (in an acupuncture treatment) that are too hard to consider or calculate. Even 1 millimetre of difference in the depth of needling makes a significant difference to treatment.

RCT's are great for looking at drugs, useful for multi-agent preparations (like herbal formulae, to an extent), pretty good for problem A=Treatment B therapies like some schools of Chiropractic or Osteopathic medicine (probably also dirty words around here)- but they're essentially useless for acupuncture/moxibustion therapies. That's why I find PubMed, Medline and all the other research databases so damn frustrating.

Oh, and last- acupuncture as a therapy is aimed at improving 'general' health- so sometimes, even if the patient's back pain is still there (as they don't follow advice and move their body), but over the course of their acupuncture treatment they're sleeping better, have more energy, improved sense of wellbeing/relationships with family, friends and society, they've gotten over their Irritable Bowel Syndrome (Med-speak for 'I don't know what's wrong and I can't help) and their blood pressure is down, blood oxygenation is up, niggling pains in the shoulders have cleared up, etc. etc. then would you say that treatment was a failure?

It's yet another reason why RCT's are not suitable for acupuncture research.

Tim.

It's probably a stretch to imagine that it would be rigorous enough for medical science to accept, but the evidence for acupuncture's effectiveness is to be found in case studies. Of actual treatments (where patients often get better, get worse, symptoms change, injuries happen, life continues, hangovers are acquired, seasons change, Colds & Flu are fought, etc... Sometimes disasters occur). Case studies of treatment over time.
The problem, of course, is that many diseases clear themselves up over time, and case studies are full of variables, particularly with regard to the placebo effect. Case studies are usually reserved for treatments where it would be impossible or unethical to do a blinded placebo-controlled study. What about acupuncture would force such a concession? And if it is so risky, then why are we performing it without looking at the case studies first?

If acupuncturists make claims that their treatment can help cure specific diseases (since not everyone gets the treatment as a regular health-maintenance procedure, and it's not advertised as such), then they should be able to do double-blinded controlled tests on it. If acupuncture cannot help cure specific diseases, then acupuncturists need to stop advertising the treatment as such.

The other area that should be the topic of a lot more trials is phenomenology - what happens when we put a needle in, on or near the body? Then, how can we apply this in the presence of a symptom or disease?
You're missing an important step: we first need to answer whether or not anything does happen when you put a needle in, on, or near the body. Your question assumes that something does happen, when that's simply not clear.
Acupuncture (or just dermapuncture) by its very nature is a complex intervention- very hard to control, in the sense of 'placebo controlled', and as the body is wrapped in a contiguous network of nerves, blood vessels, connective tissues and there are NO parts of the body with zero connections to other parts of the body- there can be no 'sham' or 'non-Meridian' points that can be needled...
So, all meridian points are all used in the same ways to treat all illnesses? That suggests to me that the placements of the needles don't matter, and thus that the "theory" behind acupuncture is bunk.

Somehow, I doubt that's what your saying. In which case, it should be entirely possible to do a placebo acupuncture treatment, in which the patients are given the procedure for an illness that they do not have, or that is not being tested.

Incidentally, there are quite a lot of "complex procedures" which can be placebo-controlled. New medicines are not exactly simple things.

Acupuncture treatments (like acupuncture patients) are never EXACTLY like what appears in a textbook, yet the treatments being researched are more often than not simply a collection of acupoints harvested from a couple of textbook treatments.
Okay, so every point on the body is an acupuncture point (despite the fact that people have different body sizes and therefore different numbers of points, and despite the fact that there are technically an infinite number of points in any space, since points have no dimensions), but acupuncture treatments differ from the textbook explanations. So, how can an acupuncturist know that they're hitting the right points for their treatment? If every point on the body is an acupuncture point, wouldn't the slightest deviation from the designated points result in a different treatment? Or are there regions of points which all correspond to the same thing, so you only need to be in the right general area? And if you only need to be in the general area, then isn't it a bit disingenuous to say that every point is an acupuncture point?

And if you deviate from the textbook examples, how do you know whether or not you're doing things right? Either you can't tell, in which it would seem that it doesn't matter where and how the needles are placed, or you can tell, in which case there is a standard to go by. One method does not have a result, the other does. If this is the case, then we have a difference (effect vs. no effect or different effect) on which we can build a DBCT.

- Most of the studies are poorly designed, planned and executed... (Bad Science and Bad Acupuncture, generally)
How? Citations? Evidence?
These are the sort of things that acupuncturists look for and target in treatments..
They're also the sorts of things that Witchfinders used to determine who had communed with Satan. If every point on the body is an acupuncture site, then why list these indicators of acupuncture sites?
RCT's are not the tool of choice for researching acupuncture. They're simply not designed to cope with complex, multi-system interventions- there will always be too many variables (in an acupuncture treatment) that are too hard to consider or calculate. Even 1 millimetre of difference in the depth of needling makes a significant difference to treatment.
Then how can people deviate from the textbook examples and still be effective?

DBCTs are designed to eliminate the pressures of all the complex variables that go into medical research. If acupuncture can be used to cure specific ailments, and if there is a difference between doing acupuncture "right" and "wrong" for a specific ailment, then there should be a way to do a DBCT on acupuncture. If acupuncture can't submit to this most basic of medical tests, then I submit that its practitioners should stop making unverified medical claims. If real medicine were able to make excuses for complexity, then, like several have said, we'd have a hell of a lot more Vioxx scandals.

Oh, and last- acupuncture as a therapy is aimed at improving 'general' health- so sometimes, even if the patient's back pain is still there[...]then would you say that treatment was a failure?
If the claim of the treatment was that it would cure back pain, then yes. If I give you a medicine that I say will cure your baldness, and instead it cures your incontinence, it still failed to do what I claimed it would do. That's grounds for all sorts of lawsuits and prosecution, no matter what the pleasant side-effects may be.
It's yet another reason why RCT's are not suitable for acupuncture research.
So, let me get this straight: one of your reasons for refusing DBCTs is because acupuncture may not be as effective at treating specific ailments as acupuncturists claim?

Then why do they still claim to be able to treat specific ailments?

Tim,

Let me turn this thing around: what will convince you that acupuncture doesn't work?

Oh, and last- acupuncture as a therapy is aimed at improving 'general' health- so sometimes, even if the patient's back pain is still there[...]then would you say that treatment was a failure?

Yes, if I had been complaining about back pain. I don't think I'd feel particularly happy to be told, "Well, your back's still a disaster area, but your kidney efficiency has improved by 17%".

If a doctor came up with those results, say, "Look, mate, I'm paying you to fix my back, not mess around with my glomeruli. Do what you say you can do, and what I'm paying you for!"

Does acupuncture never, ever do something wrong, such as increasing a hypertensive person's blood pressure or vice versa? It always kinda "knows what needs fixing", even if the patient doesn't?

Reply to Tom Foss's reply to me.. :

Just a few words on some of your comments, and hopefully ShinkyuTim's post(s) will give you some further knowledge about acupuncture, which is always nice to have when you are discussing something.. Ok some random quotes:


"It works for everything else, so why not acupuncture?"

That's your skeptical scientific answer?? And btw, does DBCT work for any treatment? How do you know? Can you perfrom a DBCT with the type of treatment you get from a psychologist? What about certain types of surgery? etc..


"Furthermore, you assert that the DBCT isn't suited to this kind of treatment, but what proof do you have for that?"

Proof? I dont have any proof..!? What seems to be the case here is that experiment the theory (TCM) do not agree. Instead of instantly discarding the theory, i choose to leave both options open. I thought you guys were supposed to be skeptical? And the next time you decide to write a post where every other sentence is your own speculation presented as facts, maybe you should consider not asking me to prove anything. I'm am asking questions, because i want to find the truth.


"What makes acupuncture so special that it's exempted from the basic global methods of quality control?"

How does one answer this without understanding fully how acupuncture works?


"No, it won't influence the outcome of the trial. If we're testing acupuncture's claims to cure Athlete's Foot, then all we're looking for at the end is whether or not the Athlete's Foot has been cured. If the placebo group gets a treatment for arthritis, how does that affect whether or not their Athlete's Foot was cured?"

I thought the idea was to give a real treatment to half the group, and _nothing_ to the other group. If you were testing aspirin in a double-blind trial, and you give half the patients cyanid, surely you would alter the outcome? And i still don't know how a treatment for arthritis would affect someone with Athelete's foot, so i wouldn't know how to adjust the results of the test. In addition to this there are just generally more factors to take into consideration due to the holistic approach of TCM. And then you should ask, "what is your better method?", and i would have to admit i don't have one. And then i would add that even though i don't have a better method, the DBCT method might be incorrect in this case.

"If taking down statistics on the cure rate would affect the results, then how can it be said to work well at all? How can acupuncturists claim any kind of success rate if measuring that rate would invalidate the successes?"

I was talking about the DBCT in relation to acupuncture.

It's as if the acupuncture believers are going out of their way to give excuses for why a DB trial wouldn't work. However, it would seem pretty reasonable to have a group of people with, say, elevated blood pressure (a measurable factor), with some given acupuncture at the prescribed points for the ailment, and others given acupuncture at a specified point for some other ailment the patient doesn't have.

The acupuncturist would work behind a screen, only seeing the relevant area to be punctured, and would not talk to the patients.

A qualified doctor, not present during the testing, would measure the patients' blood pressure before and after the trial.

Why would that not work as a DBT?

That's your skeptical scientific answer?? And btw, does DBCT work for any treatment? How do you know? Can you perfrom a DBCT with the type of treatment you get from a psychologist? What about certain types of surgery? etc..
That was one of several skeptical scientific answers. While I'm not certain how you could do a DBCT with psychologists, I also fail to see what it has to do with the matters here of physical and medical health. The DBCT is the gold standard of medical treatment, not necessarily other scientific studies, so branching out into psychology is a non sequitur. As far as surgery goes, yes, you could do a DBCT with surgery. The problem is one of ethics, not of ability. It would be entirely possible to take a sample of patients with appendicitis and perform real appendectomies on one group and placebo surgery on the other, and I think you'd find quite a bit of difference between the two groups at the end. The problem is that this is horrendously unethical.

I know that DBCTs work for treatments of specific ailments because that's how said treatments are tested and approved. If acupuncture can be used to treat specific ailments, then it should be able to do so under double-blind conditions. If it would be unethical due to danger to do an acupuncture test, then I would suggest we cease all acupuncture until a decent case study can be shown to assess the benefits versus the dangers. If, as Tim said, every point on the body is an acupuncture point and every millimeter of depth means large differences, and if deviations from what acupuncturists are taught are common, and there is a danger which renders DBCTs unethical, then aren't we putting acupuncture patients at risk by allowing practitioners to deviate from their teachings? Aren't we putting patients in danger by allowing the procedures to continue without a real assessment of the risks involved?

Proof? I dont have any proof..!?

If you have no proof for your claim that acupuncture is ill-suited for a DBCT, then why do you keep saying it? Why should your treatment get a pass when no other medical treatment does?

What seems to be the case here is that experiment the theory (TCM) do not agree.
What seems to be the case where? I'm honestly not sure what precisely you're saying. Are you citing the specific examples of the DBCTs which show that acupuncture is no different from random needle puncture when it comes to relieving pain? Or are you suggesting that the DBCT and Traditional Chinese Medicine are somehow incompatible fundamentally? If the latter, what proof do you have to support such a claim. If you have no proof, why do you keep stating it?

The DBCT doesn't care about the theory behind acupuncture. All you need in a DBCT is X condition, a treatment A which can be substituted with a placebo treatment P, a subsequent not-X condition, and a group of participants with X. You apply A to one group, P to the other, and see how many at the end have become not-X. If the two groups are statistically different, it suggests that there may in fact be something to treatment A.

This says absolutely nothing about the theory behind treatment A, it says absolutely nothing about other conditions that the groups have, it's essentially binary. In the beginning, all the subjects are X. In the end, some aren't, and you count how many.

If acupuncture claims to be able to treat specific ailments, as many of its practitioners say, then there should be the possibility of a DBCT, unless there are serious ethical reasons not to. If there are such reasons, then we should stop practicing acupuncture until a responsible case study can be produced.

Instead of instantly discarding the theory, i choose to leave both options open. I thought you guys were supposed to be skeptical?
"Skeptical" doesn't mean "accepts that something may be possible." It means "considering claims based on the evidence which supports them." If there is no evidence for the "theory" behind TCM, then there is no reason to accept it. Skepticism and science both assume the null hypothesis (X does not exist) until evidence shows that the opposite may be true. Until we have credible evidence that acupuncture has a real, non-placebo, physiological effect, we have no reason to accept it.
And the next time you decide to write a post where every other sentence is your own speculation presented as facts, maybe you should consider not asking me to prove anything. I'm am asking questions, because i want to find the truth.
Where have I presented my own speculation as fact? I'm sure I've given examples of alternative explanations for the effects seen in acupuncture, but until proof is shown that those effects are due to the theory behind TCM, then those explanations are at least equally valid.

Meanwhile, you talk about qi and acupuncture points and the effect of needles on the body, Tim talked about meridian points and body palpatations, and all of these things are totally hypothetical until you show evidence to the contrary. Your claims are entirely speculation, since you have not shown any evidence to support them. The difference between my "speculation" (what, where I discuss the possible outcomes of DBCTs and the implications for acupuncture? Or where I discuss your unstated reasons for why DBCTs can't be used for acupuncture?) and yours is that I'm not building a medical procedure on my speculation and selling it to people as a viable alternative to evidence-based scientific treatment.

If you have indeed just admitted, as it appears you have, that acupuncture is based on no proof, then I would suggest that you grow a set of ethics and stop claiming that it is any kind of alternative to "Western" medicine, or that it can be used to treat specific conditions with any kind of success rate. Such claims, if unsupported, are irresponsible and reprehensible.

How does one answer this without understanding fully how acupuncture works?
The same way we answer this question about numerous medical treatments where we're unclear on the mechanisms governing them. There are some mood-altering medications where we're not quite clear on the details of their operation, yet they can still be tested under double-blind controls. The double-blind test only cares about the results, not the mechanisms, not the theory governing the procedure, just whether or not X was cured. That's the absolute beauty and utility of the DBCT: we don't have to know how the experimental treatment works (after all, if we knew how it worked, chances are we'd know if it works, and then we wouldn't need to do a DBCT to find out), we really don't have to know anything about the treatment at all. We just have to know that it is targeted at some condition X, and we need to know the difference between X and not-X.
I thought the idea was to give a real treatment to half the group, and _nothing_ to the other group.
You thought wrong.
If you were testing aspirin in a double-blind trial, and you give half the patients cyanid, surely you would alter the outcome?
Yes, which is why you wouldn't give them cyanide, you'd give them a sugar pill. A sugar pill still has an effect on the body (it is, after all, eating like eating a bit of sugar), but the effect is unrelated to the variable being tested. If you were testing, for instance, the effect of sugar on the energy level of a child, the last placebo you'd give is a sugar pill. The placebo is any treatment which would not affect the outcome of the tested variable, and which would not be seen as an obvious placebo by the patient or administrator.
And i still don't know how a treatment for arthritis would affect someone with Athelete's foot, so i wouldn't know how to adjust the results of the test.
So you're telling me that you don't know what will happen if you give a specific treatment for a specific ailment to a person who does not necessarily have that ailment? You're telling me that it's possible that a treatment for arthritis may affect athlete's foot? If acupuncture cannot be targeted at specific ailments, if it cannot be used to produce knowable results, then why do its practitioners claim that it can?
In addition to this there are just generally more factors to take into consideration due to the holistic approach of TCM.
And such factors don't exist in "Western" medicine? If TCM is limited to its holistic approach, then why do acupuncturists claim to be able to treat specific ailments?
And then you should ask, "what is your better method?", and i would have to admit i don't have one.
Then how can you ethically continue to claim that there is any kind of success rate for this procedure? How can you honestly claim that this procedure can be used to cure specific ailments? How can you continue to practice this without knowing whether it is doing more good than harm?
And then i would add that even though i don't have a better method, the DBCT method might be incorrect in this case.
And your reasoning for this boils down to "although I have no proof to support my claim, I say that TCM is too complicated for the DBCT to work." Now, imagine if a pharmeceutical company were able to say that and get away with offering it to the masses. Why should we make concessions for TCM that we do not make for any other available treatment? Why should we allow acupuncturists to make unproven, untested claims that their method works and is comparable to medical treatment? Why should we allow unethical TCM practitioners to engage in fraudulent advertising and potential malpractice to an unsuspecting public? Why should we allow you to put people's lives in danger by making the evidence-free claim that your treatment is as good as or better than treatment received from a medical doctor? Because you say we wouldn't understand? Because you say that, despite not even trying the most basic test in medicine, it wouldn't work? If your treatment has effects comparable to those of "Western" medicine, better in some ways, according to the claims of many practitioners, then why can't you adhere to the same standards of ethics, evidence, and responsibility as medical doctors?

You want to play doctor? Then you should be ready to meet the people playing lawyer, or you should stop claiming any sort of efficacy.

I was talking about the DBCT in relation to acupuncture.
You were suggesting that the very act of a DBCT may influence the results. All a DBCT does is record the change in condition, cross-referenced with who received what treatment. What in there would influence the results? If recording a change in condition will change the outcome of an acupuncture treatment, then how can you claim any sort of success rate? Wouldn't recording the changes in those conditions affect the outcome? Acupuncturists make claims with reference to "Western" treatments all the time, which suggests that they can cross-reference the group of acupuncture patients and the group of non-acupuncture patients, but you're saying that might influence the results. Where does the influence arise?

I see there was a response to my suggestion that everyone go and have a go at palpating their own body - How is one to prove that different parts of the body exhibit reactions without touching it?

Angrydoc- I really can't imagine anything that would convince me that acupuncture doesn't work.. The evidence of my own practice contradicts that idea. Especially when there are so many 'medical acupuncturists' jumping on the bandwagon..

Bad acupuncture can still 'work', probably because of the inherent nature of dermapuncture itself. More on this later. The general consensus amongst the 'acupuncture skeptics' is that there aren't enough (DB) RCT's to demonstrate it's effectiveness. What I keep saying (and not all acupuncturists agree with me) is that RCT's are NOT APPLICABLE to acupuncture. I've suggested alternative ways to look at acupuncture from a scientific perspective, but people keep harping on about RCT's anyway. Again- I'll summarise one of my objections: In order to perform an RCT on acupuncture treatment, you need to compromise either on the treatment itself, or on the science (experimental design). If you simply treat according to the presentation of the patient, there's no longer a proper control, so the RCT is flawed. If you adhere to a strict protocol (even if it's close to what you would use to treat that patient at that time), you're not providing an adequate acupuncture treatment.

The difference between bad acupuncture (such as I see being performed by medical practitioners and other, non-acupuncturists- physicians, physiotherapists, chiropractors, etc- as well as some acupuncturists) is that the less-skilled practitioners tend to needle local points around the site of disease and don't make use of distal points much at all. Reduced to the minimum, find a painful point and put a needle in it still works - physicians were using novocaine injections for trigger point treatments until it was demonstrated that the effect came from the needle itself.. Some are still injecting the drug- but it's really not necessary..

Skill level makes an enormous difference. Acupuncture remains a manual technique, like playing guitar or chopping vegetables really fast - it takes practice and commitment. How could you possibly control the number of hours of practice that a practitioner doing a trial has put in?

Manaka Yoshio (who was a surgeon before turning his hand to acupuncture) theorised (sorry, I refuse to mis-spell 'theorised' for my US readers) that the meridian system a) exists, and b) acts as an 'extra' communication network in the body. His primary speculation was that it is an informational system, and that it deals with and is affected by stimuli that are very, very small. Please have a look at his work: 'Chasing the Dragon's Tail' is a good start.. It also details his treatments of surgical and burns cases in a hospital setting.

One factor making research into this idea of acupuncture more difficult is that there aren't any machines that we can use that are sensitive enough to read (without affecting) the micro-currents and electrical potentials on the small scale he theorised. (This is by no means unique in Western science. Why do we keep building better microscopes?)

Tom Foss - I couldn't find the reference on PubMed, but there's a recent collaboration between the engineering and science departments at Berkeley that looked at the production/release of cytokines upon insertion of an acupuncture needle. There have been numerous studies using various kinds of scans to observe the effects of needling (more specifically needle sensation) on different areas of the brain and so forth. Here are some others:

Neurol Res. 2007;29 Suppl 1:42-8.
fMRI review on brain responses to acupuncture: the limitations and possibilities in traditional Korean acupuncture.

* Chae Y,
* Park HJ,
* Hahm DH,
* Hong M,
* Ha E,
* Park HK,
* Lee H.

Acupuncture and Meridian Science Research Center, Kyung Hee University, Seoul 130-701, Korea.

[Study on brain response to acupuncture by functional magnetic resonance imaging--observation on 14 healthy subjects]
[Article in Chinese]

* Fang SH,
* Zhang SZ,
* Liu H.

Sir Run Shaw Hospital Affiliated to College of Medical Sciences, Zhejiang University, Hangzhou. [email protected]

Brain Behav Immun. 2005 Jul;19(4):318-24. Epub 2004 Nov 25.
Repeated acupuncture treatment affects leukocyte circulation in healthy young male subjects: a randomized single-blind two-period crossover study.

* Kou W,
* Bell JD,
* Gareus I,
* Pacheco-Lopez G,
* Goebel MU,
* Spahn G,
* Stratmann M,
* Janssen OE,
* Schedlowski M,
* Dobos GJ.

Department of Medical Psychology, University of Duisburg-Essen, Germany.

Again - these are from PubMed.
Please show me a study that demonstrated no physiological response to acupuncture needling.

The challenge of acupuncture is to try and make use of these physiological changes to gain a positive effect on symptoms/diseases and quality of life - we haven't even touched on the role of acupuncture in palliative care...

Tim..

Angrydoc- I really can't imagine anything that would convince me that acupuncture doesn't work.. The evidence of my own practice contradicts that idea. Especially when there are so many 'medical acupuncturists' jumping on the bandwagon..
This is a speculative exercise, Tim. What would you need to see in order to reject acupuncture as a treatment? What hypothetical situation would cause you to reevaluate your position? I'm sure any of us could come up with a hypothetical situation which would cause us to rethink or reject something we accept as true, whether it's a specific medical treatment or a physical law. Show me an otherwise normal situation in which two masses are not attracted to one another via an inverse square relationship, and I'll have to rethink the law of gravity. Why is it so hard for you to come up with something that would cause you to rethink acupuncture?

This little gedanken experiment is designed to test the falsifiability of an idea. To scientists, falsifiability is always a major concern, as it is one of the traits which separates science from pseudoscience. As such, we've got to have some idea about what is necessary to falsify any given theory or hypothesis. All the evidence may support it, but we have to be aware not only that it may be overturned at any time, but also of what it would take to do so.

Bad acupuncture can still 'work', probably because of the inherent nature of dermapuncture itself. More on this later. The general consensus amongst the 'acupuncture skeptics' is that there aren't enough (DB) RCT's to demonstrate it's effectiveness.
And that's just the first complaint. That doesn't even get into the lack of proof for the existence of qi, and thus the hypotheticality of the entire theory behind the procedure.
What I keep saying (and not all acupuncturists agree with me) is that RCT's are NOT APPLICABLE to acupuncture.
And what we keep asking is why? I have yet to see a reason for that claim which is both supported by some sort of proof, and which doesn't ultimately invalidate the practice or theory of acupuncture.
I've suggested alternative ways to look at acupuncture from a scientific perspective, but people keep harping on about RCT's anyway.
Perform your case studies, then. But stop offering the treatment to the public in the meantime. Stop making claims about what it can do in the meantime. Until you have some hard data which suggests that the treatment is both effective and safe, you shouldn't be performing it publicly and making unsupported claims.

Again- I'll summarise one of my objections: In order to perform an RCT on acupuncture treatment, you need to compromise either on the treatment itself, or on the science (experimental design).

You're going to have to be a little more specific. What precisely gets compromised in the treatment?

If you simply treat according to the presentation of the patient, there's no longer a proper control, so the RCT is flawed. If you adhere to a strict protocol (even if it's close to what you would use to treat that patient at that time), you're not providing an adequate acupuncture treatment.
Why? You give no reason for why this treatment is not "adequate," and it sounds more than a bit like a "No True Scotsman" fallacy.

Let's lay it out again: do people come to acupuncturists for the treatment of specific ailments? Are there acupuncture treatments which treat those specific ailments? Are there acupuncture treatments which treat other unrelated ailments? If the answer to these questions is 'yes,' then why exactly can't we do a DBCT?

physicians were using novocaine injections for trigger point treatments until it was demonstrated that the effect came from the needle itself.. Some are still injecting the drug- but it's really not necessary..
Citation? Because I guarantee you, there has been a great deal of difference between the novocaine shots I've gotten and just getting poked with a needle. Next time you have a cavity filled, tell your dentist just to poke you, not to put any medicine in. See how well that works out for you.

This claim is patently absurd. I'd love to see you back it up.

Skill level makes an enormous difference. Acupuncture remains a manual technique, like playing guitar or chopping vegetables really fast - it takes practice and commitment. How could you possibly control the number of hours of practice that a practitioner doing a trial has put in?
Why do you need to? If there are specific treatments for specific ailments, with a success rate comparable to "Western" medicine, then there shouldn't be a huge amount of difference between the treatment provided by people of somewhat different levels of experience. Of course you'd expect the more experienced party to be somewhat better at it, but cured back pain is cured back pain.

And how difficult would it be to get two practitioners with similar levels of experience? Two who are only recently out of acupuncturing school, perhaps. Two who have been serving for the same number of years.

Or, you could perform the test multiple times, increasing the data pool, so that errors like the one you described tend to even each other out.

Manaka Yoshio (who was a surgeon before turning his hand to acupuncture) theorised (sorry, I refuse to mis-spell 'theorised' for my US readers) that the meridian system a) exists, and b) acts as an 'extra' communication network in the body.
Oh, but you did misspell it. It's actually spelled "hypothesized." A theory requires evidence.
His primary speculation was that it is an informational system, and that it deals with and is affected by stimuli that are very, very small. Please have a look at his work: 'Chasing the Dragon's Tail' is a good start.. It also details his treatments of surgical and burns cases in a hospital setting.
G. Lucas speculated that some people are filled with tiny bacteria called Midichlorians, which mediate a person's control of the Force. The Force is the invisible energy field which binds us and penetrates us and holds the universe together. Take a look at his work, I'd suggest 'A New Hope' as a good start, though the theory really takes off in 'The Phantom Menace.'

See, until there's some proof for qi or meridians or the Force, anything you say about the 'theory' of how they work is pure speculation, and from a reasonable, scientific perspective, pure fiction.

One factor making research into this idea of acupuncture more difficult is that there aren't any machines that we can use that are sensitive enough to read (without affecting) the micro-currents and electrical potentials on the small scale he theorised. (This is by no means unique in Western science. Why do we keep building better microscopes?)

The difference is that we didn't start believing in microscopic organisms before we started building microscopes to see them. You assume that the micro-currents and electrical potentials are there, and that they are also the "qi" of acupuncture, but while there may be some proof for the former, it's an unproven leap to equivocate the two, especially since the way qi is explained goes quite contrary to many of the facts of how electricity operates.

Plus, you know, we can measure electrical currents and potentials in the body. The EEG does so with electricity in the brain, while we also have tools to measure the voltage and current across single cells. Strange that we can't yet measure that elusive, omnipresent, ever-important qi.

So, any chance you could print the full journal titles of the two (three? It's hard to tell) articles you cited? Maybe link to the abstracts, so we can see what they claim, rather than what you say they claim? Your half-remembered Berkley article is hearsay until I see something a little more solid than "it happened, I swear."

Repeated acupuncture treatment affects leukocyte circulation in healthy young male subjects: a randomized single-blind two-period crossover study.
Wait, did I read that right? Blind? Random? Can we assume that the word "control" is implied by "single-blind"? I thought you said "RCT's are NOT APPLICABLE to acupuncture." In fact, I'm almost sure of it. So, if you can do a single-blind randomized controlled test on acupuncture, why not a double-blind one?
Again - these are from PubMed. Please show me a study that demonstrated no physiological response to acupuncture needling.
When have I said that there is no response to needling. I'm sure there is a response. In most people, I'd imagine the response is "ow, you stuck a needle in me." What I doubt is that needling can do any of the amazing things which acupuncturists claim it can do. Show me a study which proves even one of them.

Yeah, I'll bet the brain responds to the body being poked with needles. The brain responds to all physical stimuli. But a brain response an a leukocyte stimulation are not curing disease and relieving pain. At most, they suggest further research, but they do not support the claims of the acupuncturists with regard to disease cures and pain relief. And they certainly don't support the existence of qi. Brain activity is expected, and leukocyte circulation has any number of more prosaic explanations.

Show me the study which does support the claims of the acupuncturists with regard to disease cures and pain relief. You're the one with the burden of proof in this situation.

The challenge of acupuncture is to try and make use of these physiological changes to gain a positive effect on symptoms/diseases and quality of life - we haven't even touched on the role of acupuncture in palliative care...
No, the challenge of acupuncture is to show some evidence for the panacea-esque claims made by its practitioners, to show that it has some validity as a treatment.

Skill level makes an enormous difference. Acupuncture remains a manual technique, like playing guitar or chopping vegetables really fast.

I play guitar, and I can quite easily conceive of a DBCT for that. You have a number of experienced guitarists and a number of tyros, all playing the same tune. I think the results of the practice would speak for themselves, and I'm sure even a layman could tell the difference without knowing beforehand who were the experienced players and who the learners.

Likewise, with chopping vegetables, a time trial involving qualified chefs and amateur cooks would sort the wheat from the chaff easily.

There's nothing arcane about either of these skills - practice, practice and practice spring to mind, as you said. However, the results are clear and demonstrable, and could be proven by DBCT.

Xanthir:

Regarding the double-blind experiment:

Although i fully agree this is the best way to test conventional medicine, and perhaps the only way of giving a valid scientific proof that a treatment is working, i still have some reservations regarding the use of this method on an alternative treatment, such as acupuncture. My concern is that because of the fact that we do not know the details of HOW the treatment works, we may somehow interfere with the effect of the treatment if we try to measure it with a method not suited to this type of treatment.

This actually is a problem. This is why I suggested exactly the solution that I did. Start by consulting a skilled acupuncturist on what we can change to make the procedure completely useless. Then, allow other acupuncturists that would not be able to distinguish between the two treatments to administer them. That way we aren't removing any subtle skills that may be necessary for the correct procedure to work, that a scientist may not appreciate.

If we were to use some kind of fake needles, the acupuncturist will invitably know if he is giving the patient a real or fake treatment. And because we don't know scientifically how this treatment works, we cannot know how/if this effects the treatment. If, hypothetically, there is a connection between the patient and acupuncturist that we still do not understand, blinding the acupuncturist may distort the results (does the enthusiasm of the acupuncturist effect the patient? etc.).
Yep, which is why we have real acupuncturists perform the study, just so long as we can find ones that can't distinguish the two procedures (such as students skilled enough to perform it but without enough knowledge to know that one is wrong).

The only way to fully blind the acupuncturist is to make him give an acupuncture treatment which is a real treatment, but for another illness. This will ultimately alter the energy flow in the body of the patient (according to TCM), and thus influence the outcome of the trial. So i don't see how we would give the placebo-group of patients a true placebo treatment? I guess what i am suggesting here is that our efforts to measure the effect of acupuncture may intefere with the outcome of the trial.
This is one possible method, but as you note it may have unforeseen consequences, making the control group unreliable. My outlined method above hopefully controls for that a bit better - we have the acupuncturist who is designing the methods specifically design the fake procedure so that it will not do anything.

Note that even if we were forced to go with using a 'proven' but incorrect method, it can still be quite useful. As noted, modern medicine isn't exactly simple - it has the same problems with trial design that we're experiencing here.

My concern is that because of the fact that we do not know the details of HOW the treatment works, we may somehow interfere with the effect of the treatment if we try to measure it with a method not suited to this type of treatment.

I'm not sure that this is a valid concern. Karl Kruszelnicki, an Australian TV and Radio Science guy is fond of using the example of anaesthetic when this excuse is given.

Last time I heard him use it, which is a couple of years ago, he said that we don't know HOW anaesthetic works, but the scientific method tells us WHETHER it does or not.

Given that we know it does, that would make the reasoning behind it largely excess baggage.

I would like to see a number of acupuncturists examine a group of patients and come up separately with their diagnoses. It would be interesting to see how well they agree.

Has any such study been done to anyone's knowledge?

Anecdote time again!

"In addition, studies using functional MRI (magnetic resonance imaging) clearly show that particular parts of the brains of test subjects are activated when specific acupuncture points are needled."
- Jeff

I had a friend who was studying to be an EMT. He and three other guys were on a ride along and they were called to the scene of a car accident.

One of the drivers (middle aged male) had been thrown violently enough from his vehicle that his skull had broken open, revealing his brain.

The man was unresponsive, but alive. One of the brilliant EMT trainees decided to be curious and began a gentle poking of the man's brain and soon discovered that stimulating certain areas caused the man's body to twitch! One of the other EMTs decided to join in. Safe to say, these two ended up not competing their training.

Talk about in depth acupuncture. I'm suprised there isn't a mention about acupressure on this comment board. Some people want the benefit of acupuncure without the needles. Maybe there is and I missed it... meh.

But regardless, just because our nervous system may be complex enough that different parts of our body may respond to nerves in another part, it's QUITE a leap to say that if an unrelated area is poked, prodded, or pricked, that will HEAL (even temporarily) another body part. That's magical thinking.
madaha

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There is an easy way to see if acupuncture works. Try it yourself, and see if it works. If you live near a school, the students have free clinics. Why would people continue to see their acupuncturist if it didn't help them? Does natural selection not apply to TCM and alternative medicine? If it doesn't work... people will stop going.

I'm a skeptic AND my wife is an acupuncture student (or was). There is a lot more to TCM than needles, and that interests me too. For instance, she did this technique of scraping my back with a ceramic spoon until it was nearly raw, and it made my cold congestion go away. It's worked for several colds. Why? Science would just ruin the traditional explanations of excessive wind or whatever. Who cares? It's harmless, as far as I know.

In addition, there is moxxabustion, cupping and herbs, as well as an entirely different philosophy in maintaining the human body. Western medicine is so overwhelmed by the pills of pharmaceuticals (my own father gobbling 7 different ones a day). How can any scientific testing be done on these people who take one pill that leads to another problem and another pill... and the cycle continues on and on? Double blind studies are problematic under the circumstances of complex humans living in complex situations.

Also, acupuncturists have very specific diagnostics that they go through with every patient. They look at their tongue, ask about bowel movements, check their pulse. I think you would find that their results for diagnosis would be quite similar, but it would be confusing too because the diagnosis would be excessive dampness and heat, which means nothing to us. It's a way for the Chinese to describe what they see and how they feel the body inter-relates. They don't really mean that the body is literally excessively damp and hot.

One thing I've always wondered, though, is that the Chinese believe that the qi force lives in the sperm, the appendix, the kidney, and the lungs. What about someone who is missing their appendix and a kidney? Are they missing those components of qi? That seems like an easily verifiable test, right? Another thing that confuses me is how do they know where all these meridians are and how they connect? If it's a system that is unexplainable and enigmatic, then how can they be so sure that the thumb is connected to the liver channel (or whatever)? My guess is that all that stuff is made up.

Ticktock:

I’ll just note that in that page of drivel you just posted, you failed to address even one of the criticisms I raised in my post, and you even confirmed some of them.

There is an easy way to see if acupuncture works. Try it yourself, and see if it works. If you live near a school, the students have free clinics. Why would people continue to see their acupuncturist if it didn't help them? Does natural selection not apply to TCM and alternative medicine? If it doesn't work... people will stop going.

Please Google the following terms:
Placebo effect
Confirmation bias
Argumentum ad populum

Then, before you mistakenly call yourself a skeptic again, put some thought into that statement you just made. Is that how you judge every decision you make? "If lots of people do it, it must work. If it didn't work, people wouldn't do it." Really? So how many fad diets have you gone on? How many phone psychics have you called? How often do you visit your local faith healer? Did you ever play "Bloody Mary" at some grade school slumber party? How did you survive when the evil ghost came out of the mirror for you? How often do you request that the doctor give you bleedings and leeches and trepanation? After all, if they didn't work, why did people keep doing them for so long?

People do lots of things that don't work, and they always have. That's why we have things like the scientific method and double-blind placebo-controlled studies to weed out human error. Your suggestion requires the infallibility of the individual.

For instance, she did this technique of scraping my back with a ceramic spoon until it was nearly raw, and it made my cold congestion go away. It's worked for several colds. Why? Science would just ruin the traditional explanations of excessive wind or whatever. Who cares? It's harmless, as far as I know.
Harmless right up until you're using it in place of real medical treatment, or paying for it.

The neat thing about cold congestion is that they fluctuate with time, position, environment, and activity, and over time, they usually go away on their own. See, I notice that when I'm really congested, it'll usually go away if I'm active outside. And it'll come back when I stop, or when I realize that I haven't had to sniffle or cough for the last fifteen minutes. Which nostril is congested will change without my noticing, and I'll be more congested lying down than sitting up. Science will ruin it by telling you that it's probably just a placebo effect, confirmation bias, or a "post hoc ergo propter hoc" fallacy. In the first case, your belief that the treatment has an effect on your variable condition ends up causing you to perceive a significant effect where none exists, or to invent an effect. In the second case, you might be privileging this situation where your cold congestion went away after having the treatment, but forgetting all the times it went away without having that treatment. And in the third case, which seems highly likely, you're attributing your recovery to the treatment simply because the treatment preceded it, when you have no evidence to suggest a causal relationship. Just because X happens before Y, doesn't mean X causes Y.

Western medicine is so overwhelmed by the pills of pharmaceuticals (my own father gobbling 7 different ones a day). How can any scientific testing be done on these people who take one pill that leads to another problem and another pill... and the cycle continues on and on? Double blind studies are problematic under the circumstances of complex humans living in complex situations.
And the alternative is simplistic medicine based solely on ancient tradition, with no standards of evidence or testing? Somehow, I'll take the double-blind studies any day of the week.

Just because you have a hard time imagining how scientists study the effects of different medication doesn't mean they aren't able to. You don't know everything, and your ignorance doesn't constitute proof of anything.

Also, acupuncturists have very specific diagnostics that they go through with every patient. They look at their tongue, ask about bowel movements, check their pulse.
Wow, sounds like what a nurse or receptionist does before my checkup. If that's the be-all, end-all of acupuncturist diagnostic techniques, then I'm glad I don't waste my time and money on them.
but it would be confusing too because the diagnosis would be excessive dampness and heat, which means nothing to us. It's a way for the Chinese to describe what they see and how they feel the body inter-relates. They don't really mean that the body is literally excessively damp and hot.
No, what it means is that the Chinese are working on a model of health that is incredibly similar to the Four Humours model that was popular in the Middle Ages. People's physical states were divided into hot, cold, moist, and dry, corresponding to the four quasi-mystical humours. Imbalances in these humours would cause disease and ailment, so the patient would have to be given treatments like leeching and bleeding, herbal remedies, and the like, in order to bring the humours back into balance. It didn't work, it had a horrendously high mortality rate, and it went right out the window when the germ theory of disease was developed.

So, you're saying that "we wouldn't understand" TCM practitioners, because they're working from an understanding of the body that was debunked several hundred years ago, and this is supposed to be a good thing?

With modern medicine, I can understand every single thing that my doctor does to me, and every single thing that is wrong with me, within our current boundaries of knowledge. I might have to do some research, I might have to ask for some explanation, but if I'm being prescribed a medication or diagnosed with an ailment, my doctor can tell me exactly what is wrong, how the medication works, and what it will do to make me better. And if necessary, I can verify it myself. How is that inferior to secrecy and inexplicability?

Are they missing those components of qi? That seems like an easily verifiable test, right?
Gotta define qi and what it does specifically and in potentially falsifiable terms, first. And there are quite a few better, simpler tests to see if acupuncture works better than placebo. So far, the answer seems to be a resounding and unsurprising "no."
Another thing that confuses me is how do they know where all these meridians are and how they connect? If it's a system that is unexplainable and enigmatic, then how can they be so sure that the thumb is connected to the liver channel (or whatever)? My guess is that all that stuff is made up.
And yet you think it works? See, if I think the entire ideological foundation of a treatment is made up out of whole cloth and doesn't represent reality, it ought to occur to me that perhaps the treatment itself doesn't actually work.

Regardless of whether we poor benighted Westerners will understand what the acupuncturist says, that's not really important.

It has been stated that acupuncturists first carry out a thorough and "holistic" diagnosis of the patient. If there were something real to it, I'd expect a group of acupuncturists to come up with the same conclusions when faced by a patient with a given ailment.

That can easily be tested.

I can see the following test scenario:

A number of acupuncturists examine and diagnose a number of patients with known ailments. The patients may divulge symptoms if the acupuncturist asks, but may not reveal the name of the ailment, if they know it.

The diagnoses are numbered and passed to other members of the group, who then determine what the correct treatment for the given symptoms is. These treaments are numbered and passed out among the group.

These treatments are then assessed by the various acupuncturists to determine what ailment the treatment is for.

The process is repeated with medical doctors instead of acupuncturists.

This can be kept totally double-blind, and it doesn't rely on "sham acupuncture", "wrong" needle placement or fake needles. All it does is verify the ability of an acupuncturist to identify a given ailment and select a consistent treatment, compared to a medical doctor.

If the diagnoses are no good, then how can acupuncture hope to work? All I'm looking for is the least evidence that acupuncture is repeatable and self-consistent.

I'm not really defending acupuncture, just giving my POV as a skeptic married to an acupuncturist. Do I have to be unkind and argumentative to be a skeptic, or is there another definition you prefer? Sorry that I'm not textbook skeptic enough for you.

Thanks, Tom, for taking the time to pick my comments apart. It's a lot better than calling them "drivel". I could google all day long, but it won't change the fact that people claim that acupuncture works. DOCTORS claim that acupuncture works. Western hospitals even have resident acupuncturists. Does it work? It's a harmless option that might work, and has worked on some. Isn't that fair to say?

I'm not interested in debating the original Dr. Oz post because I don't disagree with it. I just thought I'd add to the conversation since people were asking questions about how the diagnostics work. Acupuncturists look for different things than western nurses when they check your pulse and tongue. Not that it matters.

The technique used on my back worked instantly, so it wasn't placebo or natural effects. It's an old chinese folk remedy that works for whatever reasons. This is a classic example of skeptics ignoring the evidence when it's not in their favor. You guys did the same thing with the allergy commenter.

"With modern medicine, I can understand every single thing that my doctor does to me, and every single thing that is wrong with me, within our current boundaries of knowledge."

You have way more faith in modern medicine than I do. For one thing, modern medicine is fallible because it's conducted by humans, most of whom are controlled by pharmaceutical companies that encourage them to over-prescribe medications. And to be honest, we don't know everything there is to know about these medications and their effects or we wouldn't have a different pill recalled every two years because they cause heart attacks or whatever. And I highly doubt that these pills are tested on how they interact with each other in various combinations. I might be ignorant on these thoeretical tests, but I don't see how they could be conclusive anyway since there are about a million possible negative results that would be nearly impossible to trace and millions of combinations of pills.

I think acupuncture works in various ways, but I highly doubt that it works by channeling qi through meridians. If this is the definition of acupuncture (and it is, pretty much), I don't believe in it at all (even if my wife does it). We've gotten in arguments about it, so I try to see her side too. But, I can't really argue for her on this blog because I can't stand behind the explanations of it.

I guess I'm trying to say that it works for some people and it's harmless, but the explanations for TCM are bogus (see the humours example Tom provided). It's kind of like Christianity for me. I don't want to eradicate it from the planet because it works for some people, but the explanations are bogus. Is that fair, or have I broken some skeptic's code of conduct?

Ticktock,

A skeptic is someone who requires evidence before he/she will believe in something. For you, that "evidence" seems to be that your back got better. The trouble is, this isn't very good evidence.

Once, I had a troublesome wart on my hand. Over the course of about 5 years, I tried just about everything, including old wives' tales: acid, silver nitrate, burning, nettle stings, honey... you name it. It just wouldn't go away, and it was quite uncomfortable.

In the end, I gave up attacking the wart. About three years after my last assault, it disappeared. Despite all my vicious attacks on it, there isn't even a scar showing where it was.

If I just happened to have taken acupuncture that day, it might have appeared miraculous, that acupuncture had cured me. However, I didn't take acupuncture.

I have psoriasis. It moves around, except for my elbows and knees, which it never leaves. However, for several years straight, I had it between the fingers of my right hand all the time - very painful at times, and quite debilitating. I can't name a day when it disappeared, but it did. If I'd had acupuncture that day, it might have seemed that that had cured it, but I didn't. I just noticed it was gone, and it hasn't come back in 10 years.

I had alopecia. Two large chunks of hair fell out on either side of my head. You could have painted an "8" in each of them and from the back, my head would have looked like a pool ball. It went away. I didn't have any miracle cure to lay at the door of that one.

Oh, and I've had long-term serious back pain, too, and I had to use a back brace. However, the "do absolutely nothing" treatment worked its wonders on that, too. One day I had it, the next I didn't. No more back brace.

A personal anecdote is worthless as evidence, my friend. I'm glad your back's better, but I don't see evidence that acupuncture made it so. If acupuncture was always so effective for back pain, I suspect the scientists would be researching it like mad, but they don't.

People can get better spontaneously: cancers can remit, broken bones knit, cuts heal. It happens all the time. However, post hoc ergo propter hoc rears its ugly head, and the grateful ex-victim puts it down to acupuncture, Lourdes water, a prayer to Our Blessed Lady, homeopathy, meditation or est.

We shall all die after our last meal, but that doesn't mean we were poisoned. The fact that sick people can and do improve without intervention is undeniable.

To posit that sticking a needle in one's foot was the crucial factor seems to be an added complication. Occam's Razor says I should ignore it.

The technique used on my back worked instantly, so it wasn't placebo or natural effects.

Why can't placebo or natural effects work at once? Why is it then that in previous tests, acupuncture has seemed no different to placebo effect? Wouldn't the difference be plain to see?

It's an old chinese folk remedy that works for whatever reasons.

Except when it doesn't. And when illness goes away on its own.

This is a classic example of skeptics ignoring the evidence when it's not in their favor. You guys did the same thing wit the allergy commenter.

What is the evidence? Your back getting better? Puh-LEEZE!

The evidence was the guashau (Sp?) used on my back cleared up the congestion in my lungs immediately. On more than one occasion. It doesn't mean that needling has merit, but it does mean that TCM isn't total woo.

I'm the type of skeptic who believes in something that I can experience myself. You can show me all the studies in the world, but that technique worked on me several times. Why bother arguing about something that I'm giving honest testemony about? I didn't try to exlain it will all of their meridian garbage, I just said it worked. You can't even accept that???

It's a lot better than calling them "drivel".

Ticktock, it is drivel when all of your points have been refuted not only in the article, but in the comments section of the article.

DOCTORS claim that acupuncture works.

We understand this, and have stated and overstated this in this comment thread. But only as a temporary pain reliever. However, it is unlikely that acupuncture works the way they say it does - redirecting chi and all. A more reasonable explanation is that puncture works to relieve pain temporarily by:

1. Placebo
2. Temporary mood improvements due to the personal nature of the treatment
3. Psychological investment of the patient in the success of the therapy
4. Misdirection
5. Incorrect diagnosis to start with
6. The cyclical nature of the illness (gets worse/gets better/gets worse/gets better…)
7. Other medicines the patient is taking
8. The illness just goes away by itself.
9. Release of endorphins

If you have a DBT showing that acupuncture can cure/relieve anything but pain, please show me. Then visit this website to win a million dollars. I would like 10% of the winnings as a finders fee, though.

But I'm not trying to disagree with the original post or what people are commenting. I'm just making observations like everyone else.

Acupuncture doesn't harm people. I won't take anything away from your arguments that the explanations and qi-woo are bogus, but it's a traditional alternative medicine that has worked for people.

Did you guys know that leeches are now being used again in modern medicine because research has shown that they are helpful in certain situations? Maybe we can look at acupuncture the same way, and see why (or how) it works in certain situations.

P.S -

DOCTORS claim that acupuncture works.

Appeal to authority.

Hm...something happened to my post. Good thing I wasn't too far in it, and I apologize if I'm repeating myself.

Thanks, Tom, for taking the time to pick my comments apart. It's a lot better than calling them "drivel".
If you'd take the time to look at some of the other articles on acupuncture here, or even the post you're responding to, you'd see why Skeptico didn't take the time for a detailed evaluation. You've said nothing new, even for this comment thread. But I've got more free time than Skeptico does.
I could google all day long, but it won't change the fact that people claim that acupuncture works. DOCTORS claim that acupuncture works.
People claim lots of things. Do you believe all of them? Doctors aren't infallible, and as Ryan said, you're engaging in an argument from authority. It doesn't matter what people claim, it matters what the evidence says.

And next time you chastise someone for not "taking the time" to address all your points, perhaps you could take five minutes to address your responses. But, since Google is beyond your effort, I'll link you to the relevant pages: confirmation bias, the placebo effect, the appeal to popularity, and the post hoc fallacy.

Western hospitals even have resident acupuncturists. Does it work? It's a harmless option that might work, and has worked on some. Isn't that fair to say?
You keep using this word "harmless." Is it "harmless" to charge people for a treatment that may have no effect? Is it "harmless" for people to stop medical treatments in favor of these TCM treatments which may or may not have any effect? Is it "harmless" to waste a patient's time with an unproven treatment if they're suffering from a disease?

If your doctor came to you and said "well, we know what's wrong with you, and we have some treatments, but instead we're giving you a pill which is probably nothing more than a placebo. Here's your bill," chances are you'd consider that harm. Chances are, you'd have a good malpractice case on your hands. But when it's an acupuncturist who tells you that, well, slap the credit card on down and come back in two weeks!

Acupuncturists look for different things than western nurses when they check your pulse and tongue. Not that it matters.
And what are they looking for, specifically? What evidence supports their reasons for looking at your pulse and tongue? Nurses check your pulse, temperature, throat, and eye dilation because they give specific information about your current health level and what may be wrong with you.
The technique used on my back worked instantly, so it wasn't placebo or natural effects.
Placebos can work quite instantly, and natural effects are unpredictable. That's the thing about the placebo effect: when it's working on you, you have no idea whether or not it's a real effect. That's why we do things like double-blind tests; the patient's perceptions simply aren't reliable.
It's an old chinese folk remedy that works for whatever reasons. This is a classic example of skeptics ignoring the evidence when it's not in their favor. You guys did the same thing with the allergy commenter.
No, sir, it's a case of TCM-defenders ignoring more plausible alternative explanations. You say "it works for some reason," but disregard many known reasons for why it appears to work. See, when the only evidence is highly unreliable personal testimony, you're left with three possible explanations for the apparent success: 1. It only appears to work because of known factors like the placebo effect, post hoc attribution, and confirmation bias. 2. It actually does work, due to as-yet-undemonstrated natural qualities. 3. It actually does work due to effects on supernatural qualities like qi and meridians. Given the dearth of reliable evidence, we're left with three equally valid explanations, and a principle called Occam's Razor, which would instruct us to choose the explanation that requires the fewest hypothetical qualities. In this case, since we have one explanation that works entirely from known physiological and psychological effects, and two explanations which work from hypothetical effects, we accept the first.

But it's because of this that we're calling for double-blind tests! Double-blind placebo-controlled tests would provide evidence that's far more reliable than personal testimony, and free from the thinking errors that influence results when the tests aren't properly controlled. How can you say we're ignoring evidence when we're the ones asking for more reliable, verifiable evidence? What we want is some solid proof, which would give us a reason to accept explanations 2 or 3 over 1, or to accept explanation 1 due to positive evidence and not a lack thereof. If the reliable tests show that acupuncture performs significantly better than the placebo, then we'll be the first to say "we need to run some more tests, but that's a good indication that acupuncture is effective."

You have way more faith in modern medicine than I do. For one thing, modern medicine is fallible because it's conducted by humans, most of whom are controlled by pharmaceutical companies that encourage them to over-prescribe medications.
You have too much faith in your conspiracy theories. Modern medicine isconducted by humans, but so is TCM. Modern medicine has a financial component, but so does TCM. The big difference is that modern medicine is regulated by several national and international agencies to make sure that the treatments offered are effective and safe, while TCM has no such oversight. If my doctor tells me I have problem X, I can get a second opinion and compare it to the specific information given by my first doctor. If the information is in conflict, I can determine for myself that perhaps something more is going on than typical diagnosis. TCM doesn't give that kind of specfic information. And furthermore, I don't know about you, but my GP typically gives me free samples or prescriptions for generic drugs whenever such drugs are necessary and available. If his primary concern were getting kickbacks from Big Pharma, why would he (and the majority of doctors I've ever had) give me prescriptions and drugs where the money doesn't go back to him or to the pharmeceutical companies? Meanwhile, TCM practitioners get the money directly, without having it filter through bureaucracy. If you're worried about people doing dishonest things for money, you ought to be looking a lot more closely at the TCM types.
And to be honest, we don't know everything there is to know about these medications and their effects or we wouldn't have a different pill recalled every two years because they cause heart attacks or whatever.
You're right, we don't know everything there is to know about medications and illnesses. Which is why we're constantly refining our knowledge through reliable tests and the scientific method. How do you think they discovered that things like Phen-Phen were harmful? By doing more testing, by constantly running these treatments through reliable methods of finding evidence. Occasionally something harmful will slip through and make it to the general populace, but the various organizations which provide oversight make that a rare occurrence, and tend to catch it pretty quickly once the harm is determined.

No such oversight exists in TCM. There's no method for evaluating the effectiveness of the treatment, there's no way to incorporate new understanding of the human body and new evidence over how things work. TCM today works from an understanding of physiology that has not changed in centuries, even though the knowledge about illness and the human body has increased immesurably. We don't know everything there is to know, but while scientific medicine is constantly increasing, expanding, and refining what it does know, TCM is frozen in the distant past, when what little we did know was largely incorrect.

Seems like you're arguing against TCM, whether you realize it or not.

And I highly doubt that these pills are tested on how they interact with each other in various combinations.
Again, you're arguing from personal incredulity. "I can't imagine how they did it, therefore they couldn't have." When I'm prescribed a new medication, I get a list of substances that may cause a reaction when taken with that medication. Do you think they just pulled those lists off the tops of their heads?
I might be ignorant on these thoeretical tests, but I don't see how they could be conclusive anyway since there are about a million possible negative results that would be nearly impossible to trace and millions of combinations of pills.
Yes, there's a near-infinite combination of individual pills that a patient might be taking. To test all the possible combinations and permutations would be insane, when you look at it that way.

So instead, you narrow the playing field (I'm not sure if this is how it's actually done, but this is one potential way to test for combination effects). First, you look at the vast quantities of drugs consumed by patients nationwide, and you organize them by popularity and prevalence. You're not going to be as eager to test some drug that nine people in the world take for some rare disease as you would be to test it against Prozac or Acetominophen.
Then, you can break down that list of drugs into their component chemicals. A lot of drugs are based around the same or similar chemical compositions in different quantities. When you stop looking at brand names and dosage amounts and look instead at chemical names and molecular shapes, you can start working from a chemical framework. How will the active chemical in drug X and the active chemical in drug Y react to each other? Would basic chemistry suggest that they combine or oxidize or otherwise react?
Then, you can look at what your drug (let's continue calling it Drug X) is designed to treat, and what other ailments might be likely in your target population. If Drug X is designed to treat Chicken Pox, then it's mostly going to be used by children. As a result, it's unlikely that you'll have to test it very rigorously against the effects of Viagra or Menopause supplements or prostate pills. If Drug X is designed to treat depression, then you'll have to test it pretty heavily against alcohol and various neurological drugs. Once you recognize that not every drug needs to be tested against every other drug, that people who need Drug X might be highly likely to be taking Drugs A, B, and C, and less likely to be taking Drugs 1, 3, and 7, then suddenly the amount of tests you need to perform becomes a much more manageable number.

I guess I'm trying to say that it works for some people and it's harmless, but the explanations for TCM are bogus (see the humours example Tom provided). It's kind of like Christianity for me. I don't want to eradicate it from the planet because it works for some people, but the explanations are bogus. Is that fair, or have I broken some skeptic's code of conduct?
The point that we'd make is that first, it's not harmless. At the very least, it's financially harmful to charge for a service which cannot be reliably shown to work. We don't want to eradicate it from the planet necessarily, we want it to show some evidence that its claims are true. The only skeptical code of conduct you've broken (other than recognizing common errors of thought and alternative explanations) is this relativistic, laizzes-faire view of reality. Skeptics care whether or not a claim is true, and want people to be able to back up their claims with evidence. Making claims that you can't back up, to us, seems irresponsible, unethical, and borderline malicious. When you start claiming that your unproven, ancient treatment is superior to well-proven, ever-advancing scientific medicine, you'd better be able to back that up, or you'd better be able to accept responsibility when people choose your treatment over chemotherapy or psychology or physical therapy and end up worse than if they'd stuck with medicine. What we're looking for, ultimately, is oversight, and making sure that people aren't misleading others in dangerous ways. If you want to pay for something and you don't care whether or not it's true, that's up to you. But if someone's paying for acupuncture thinking it works as well or better than medicine, we think there ought to be some proof behind it.
I'm the type of skeptic who believes in something that I can experience myself. You can show me all the studies in the world, but that technique worked on me several times. Why bother arguing about something that I'm giving honest testemony about? I didn't try to exlain it will all of their meridian garbage, I just said it worked. You can't even accept that???
The problem is that we're very good at fooling ourselves. There's a reason we keep telling you about post hoc ergo propter hoc fallacies: humans generally tend to attribute recovery due to whatever preceded it. If I drink a gallon of milk and my headcold suddenly goes away, I'm going to attribute my recovery to the milk. I'm not going to realize that the milk may be a red herring, and that my headcold may have just gone away whether or not I gorged on dairy. Humans are very good at determining patterns and determining cause-and-effect relationships. Our brains are hard-wired to figure those things out. However, that hardwiring results in a lot of false positives: seeing patterns where none exist, and determining causal relationships incorrectly. This is why personal testimony is so unreliable; it's entirely likely that you're fooling yourself without realizing it.

When you say "I believe in what I experience myself," you're essentially saying "I believe my mind and senses are infallible." Next time you're driving on a hot day and you see puddles on the road ahead, which disappear as you approach, maybe you'll be reminded that human senses and human minds are far easier to trick than we'd like to think. Science is designed specifically to eliminate or at least mitigate those common errors of mind and sensory errors.

Did you guys know that leeches are now being used again in modern medicine because research has shown that they are helpful in certain situations? Maybe we can look at acupuncture the same way, and see why (or how) it works in certain situations.
Yes, let's do that. Let's use leeches as a perfect example: doctors stopped using leeches when they realized that leech-treatments didn't have any real effect. After many years of not using leeches, some tests and research showed that they were particularly good for one specific kind of treatment (I think it has to do with anti-coagulants), and so they started using leeches in a more controlled, evidence-supported fashion.

Let's do the same with acupuncture. Close down the practitioners, and let's do some tests on the procedure. If the evidence shows no effect better than placebo, we'll discard the procedure (until it can be shown to have some positive effect), and if it shows an ability to treat some specific ailment well, let's use it to treat that ailment. But by all means, let's base our medicine on evidence, experimentation, and observation, and not on ancient tradition and personal testimony.

I really like that you presented a thorough debate against my argument. My points are all made very casually and don't really stand up well obviouisly.

Maybe I'm looking for a way to make sense of acupuncture to validate my wife's passion. You'll have to forgive me for thinking out loud in this blog. I can't argue for something I don't really believe in.

I guess I'm still learning here.

And I highly doubt that these pills are tested on how they interact with each other in various combinations.
Again, you're arguing from personal incredulity. "I can't imagine how they did it, therefore they couldn't have." When I'm prescribed a new medication, I get a list of substances that may cause a reaction when taken with that medication. Do you think they just pulled those lists off the tops of their heads?

I can help with this one, Tom. My wife has a book that shows the different uses of drugs and their interactions with other drugs. Recently, there's even the known interactions with herbal remedies, if any.

She gets one, every few years for her own use, but has access to one in the hospital she works in. She gets the one for personal use, because of our families chronic ills, and she wants to keep up with what is being done for them.

Now, I will admit that I don't know how the information for the book is gathered. They could just give the possible intereactions, from knowing how some ingredients have interacted with others before. It could also be derived from animal testing. I'm not sure. Still, there is a book out, that anyone can buy. If needed, I can even find out the title.

Maybe I'm looking for a way to make sense of acupuncture to validate my wife's passion.

Don't worry about it, ticktock. My wife's Roman Catholic and I'm an atheist. Fortunately, she's more of a Deist, and thinks the Pope's a moron. (My words, not hers.)

Since you're skeptical, try finding out additonal information to the procedure? Are there herbs rubbed on the spoon, is the spoon only rubbing along the back in a certain way (clockwise, counter-clockwise, up and down, side to side, etc.), and/or in a certain spot?

Take each step, and use only it alone in a future treatment. Then, when/if you find a step that works, change it up some. Such as, instead of rubbing with a spoon use an item of similar shape but different material, or use an item of the same material but a different shape.

You spoke of having immediate effects. So, with each step, give it a few minutes, and see if it clears up. Then, the next time, do only that step. If that works, try it on other volunteers. If it works for all of them, then maybe you can convince some real scientists to check it out with a DBT.

Oh, and FYI, it's accupuncture, as I found out.

Maybe I'm looking for a way to make sense of acupuncture to validate my wife's passion.

Don't worry about it, ticktock. My wife's Roman Catholic and I'm an atheist. Fortunately, she's more of a Deist, and thinks the Pope's a moron. (My words, not hers.)

Since you're skeptical, try finding out additonal information to the procedure? Are there herbs rubbed on the spoon, is the spoon only rubbing along the back in a certain way (clockwise, counter-clockwise, up and down, side to side, etc.), and/or in a certain spot?

Take each step, and use only it alone in a future treatment. Then, when/if you find a step that works, change it up some. Such as, instead of rubbing with a spoon use an item of similar shape but different material, or use an item of the same material but a different shape.

You spoke of having immediate effects. So, with each step, give it a few minutes, and see if it clears up. Then, the next time, do only that step. If that works, try it on other volunteers. If it works for all of them, then maybe you can convince some real scientists to check it out with a DBT.

Oh, and FYI, it's accupuncture, as I found out.

Oh, and FYI, it's accupuncture, as I found out.
I've seen both used, and a woo corrected Ryan to "acupuncture" some months ago here. Skeptic's Dictionary lists it as "acupuncture" and the OED has no listing for "accupuncture."

One thing I have found very informative about acupuncture were the studies that Stephanie or whatever her name was linked earlier.

If acpuncture works, why does it appear it does not work on children?

If acupuncture is specific, why does it appear that sham acupuncture appears to work at least 50% as effectively as 'real' acupuncture?

Haven't seen a bleever or woo explain it yet.

Ticktock, you really should brush up on logical fallacies if you are going to claim to be a skeptic but still throw them around in your thoughts as the basis for an argument.

Tom Foss (and others):

You are correct that I am pushed for time currently – thanks for stepping in with the detailed responses.

Btw, I have updated the comments policy to add the fallacy of quoting personal experience as evidence that a therapy works.

I'd just like to address the "doctors are now using leeches again" argument.

In the middle ages, leeches were used for one "therapeutic" purpose only - to drain the patient of blood. A little education:

Medical "theory" at the time ran that all substances consisted of combination of four elements - earth, air, fire and water. This is, of course, wrong. None of these is an element.

There was a fifth element, the quintessence, which was believed to be what the spirit was made of. There is no evidence that this substance even exists.

Humans possessed four essential humours - blood (air), phlegm (water), black bile (earth) and yellow bile (fire).

Excessees of one humour over the others caused changes - too much blood made one sanguine, too much phlegm made one phlegmatic, too much black bile made one melancholic and too much yellow bile made one choleric. These words have survived in the English language, although their roots are largely forgotten.

The trouble was, there was very little the quacks of the time could do to remove excess bile or phlegm. What they could remove with ease was blood. And boy, did they love to remove blood! It was held that the function of blood was purely to cool the brain. This is an assertion that has not been sustained by research.

I have heard of a case where an ailing man was bled until he died, but the physician said that was because he hadn't been bled enough!

Now, you didn't go to a physician just because you had a headache or an upset stomach - you only went if you were seriously ill, and you needed all the blood you had. Leeches were the bloodsucker of choice, unless you were so ill that pints of blood were needed to be removed.

When the humour theory of bodily function fell into disrepute, medical leeches were retired. However, lately, the anticoagulant nature of leech saliva was discovered, and this has found a sound medical niche.

The reason for using leeches in the middle ages has ABSOLUTELY NOTHING to do with the way they're used now. The medieval "theories" weren't gleaned by painstaking research, but by bearded patriarches sitting in comfortable chairs and scratching their arses to come up with something that sounded good and authoritative.

It always annoys me when people plead from antiquity without even doing more than cursory historical research. It's like when people claim that alchemy was a forerunner to chemistry: well, maybe they invented a few retorts, tongs, flasks and the like, but alchemy is NOT any kind of proto-science.

Oh, and telling me Isaac Newton believed in it is an appeal to authority.

Just closing the bold tag.

Big Al,

I agree about the humours thing. It was just plain stupid. And the bleeding thing caused more problems than it solved. However, a few years ago, I heard an application for leeches.

Surgeons could reattache the arteries, so blood would go to the reattached finger, but the veins were too difficult to reattach. They would eventually reattach themselves, but in the mean time blood could be pumped into the finger but not out.

So, one surgeon did some studying. He found out that there was a place that actually raised leeches for saliva testing like you mentioned. They also made sure the leeches were disease free. Getting some, he would attach one to the tip of the finger, allowing the blood to provide the finger with the oxygen, iron and nutrients. Once the leech was full, it would just let go and fall off. Then, they would reattach another. After a few days, the veins would heal themselves, and the leech treatment could be stopped.

I can't remember when or where I saw this, but I do remember it fairly clearly.

Right, but the point being that the reason leeches are used now (sound medical reasoning based on experimental evidence) has little or nothing to do with why they were used in the Middle Ages (to relieve whichever humour). The only thing in common is the bleeding process.

I gave up. A skeptic's real position on accupuncture. I don't think you're a moron ticktock, I appreciate the fact you're willing to learn.

A moron is someone who continues to ignore things even when directly confronted with facts.

Summary of my part in this discussion:
---------------------------------------

Me: Science does not understand TCM, have to improve science first.

Skeptic: Science has proved to be the most reliable method we know for evaluating claims and figuring out how the universe works. Prove that acupuncture works first.

Skeptic: What is this other way of knowing that does not come under the heading of "scientific methods"?

Me: "Improved scientific methods"

Skeptic: If we can’t test it now, how did the ancient peoples do it?

Me: With a holistic approach to the problem most probably. (Speculation)

Skeptic: The Double-Blind Controlled Test doesn't require us to know how any treatment works in order to produce useful information.

Me: Maybe it is a requirement of the treatment? Since it is a holistic treatment, shouldn't every "part" of the treatment be tested together in a DBCT? That's like testing every drug in drug store in one big trial. (i made that up, sorry)

Skeptic: But it claims to treat specific illness. Why can't we see an effect?

Me: Maybe it does. See previous answer.

---------------------------------------

I will now try to justify why I think the DBCT is not suited to acupuncture.

Since the concept of health itself depend crucially on one's view of living organisms and their relation to the environment, this is what I want to discuss. Most of the following are fragments I have borrowed from Fritjof Capra's book "The Turning Point" (1982), and a fair share of my own drivel of course.

One of the problems, Capra claims, is that biomedical science has concentrated too much on the machinelike properties of living matter and has neglected to study its organismic, or systemic, nature (this http://www.guardian.co.uk/life/science/story/0,12996,1477776,00.html”>article might shed some light on the subject). Knowledge of the cellular and molecular aspects of biological structures will continue to be important, but an even deeper understanding of life might be possible with a 'systems' approach. This means we have to leave Descartes mechanistic view of life, and look at the functioning of living organisms as something more than a well-defined cellular and molecular mechanism.

Some general properties of a systems view:
- The systems view looks at the world in terms of relationships and integration.
- Systems are integrated wholes whose properties cannot be reduced to smaller units.
- Systemic properties are destroyed when a system is dissected, either physically or theoretically, into isolated elements. The nature of the whole is therefor not the same as the sum of its parts.
- An important aspect of systems is their dynamic nature.
- The activity of systems involves a process known as transaction - the simultaneous and mutually interdependent interaction between multiple components.
- Their forms are not rigid structures but are flexible yet stable manifestations of underlying processes.


Machines function according to linear chains of cause and effect, and when they break down, a single cause for the breakdown can usually be identified. In contrast, a living organism is a self-organizing system, and its functioning is guided by cyclical patterns of information flow (feedback loops). When a system of this kind breaks down, the breakdown is usually caused by multiple factors that may amplify each other through these interdependent feedback loops. Which of these factors was the initial cause of the breakdown is often irrelevant.

Because of this nonlinear interconnectedness of living organisms, I feel there is reason to be critical of the way biomedical science associate diseases with a single cause. It was from this conceptual platform that the DBCT was designed for testing treatments. I believe (oops..) the "theory" of TCM can be better analyzed through a systems view approach. Reductionism and holism, analysis and synthesis, are complementary approches that, used in proper balance, can help us obtain a deeper knowledge of life. Hopefully most of you will see that what I am suggesting is that biology is a field of science that needs to catch up with modern science, something the guardian link might indicate is happening.

Broken link:

this article

Martin:

Me: Science does not understand TCM, have to improve science first.

Science does understand TCM, that's why scientists accept it as bollocks. Prove that science does not understand TCM before you can make that assertion.

Me: "Improved scientific methods"

And what exactly are these? If by 'improved' you mean 'accepting of woo' then how is that an improvement?

Your argument seems to be that science can only improve when it accepts the unscientific, but in order to accept the unscientific it has to improve.

Me: Maybe it is a requirement of the treatment? Since it is a holistic treatment, shouldn't every "part" of the treatment be tested together in a DBCT? That's like testing every drug in drug store in one big trial. (i made that up, sorry)

Again an argument that begs the question. You can't prove it until you accept it exists and design a test to prove it does. That's not how science works, and this is a good thing.

Some general properties of a systems view:
- The systems view looks at the world in terms of relationships and integration.

Scientific medicine couldn't work if it didn't do this, and it does.

- Systems are integrated wholes whose properties cannot be reduced to smaller units.

Really? So transplanting individual organs (smaller units) doesn't work?

- Systemic properties are destroyed when a system is dissected, either physically or theoretically, into isolated elements. The nature of the whole is therefor not the same as the sum of its parts.

Again, are you arguing that organ transplants don't work?

- An important aspect of systems is their dynamic nature.

Great.

- The activity of systems involves a process known as transaction
- the simultaneous and mutually interdependent interaction between multiple components.
- Their forms are not rigid structures but are flexible yet stable manifestations of underlying processes.

Yeahbuwha?

In contrast, a living organism is a self-organizing system, and its functioning is guided by cyclical patterns of information flow (feedback loops). When a system of this kind breaks down, the breakdown is usually caused by multiple factors that may amplify each other through these interdependent feedback loops. Which of these factors was the initial cause of the breakdown is often irrelevant.

Presumably you'll tell the next medical doctors that treat you this, and then refuse the treatment they offer, right?

I mean, say your heart was suffering from an arrythmia, the cause would be irrelevant, right?

Because of this nonlinear interconnectedness of living organisms, I feel there is reason to be critical of the way biomedical science associate diseases with a single cause.

What you feel about this is irrelevant. It's the facts that count. Take this recent scientific discovery for instance:
Serious Diseases Genes Revealed

I believe (oops..) the "theory" of TCM can be better analyzed through a systems view approach.

I fed this through the wooterpreter and combined with previous statements it came out as:

Since science continually disproves my pet woo theory, I think we should change science until it proves it.

Hopefully most of you will see that what I am suggesting is that biology is a field of science that needs to catch up with modern science, something the guardian link might indicate is happening.

Oh I can see what your saying, but it is laughable. You are arguing that biology, one of the sciences we are making the most rapid advances in, is behind the other flavours of science. And it's demonstrably false.

As for the Guardian article, I thought it interesting but not surprising, and then got to this quote:

And what about "selfish genes", the concept introduced by the Oxford biologist Richard Dawkins to describe how some genes promote their own proliferation, even at the expense of the host organism?

Now, I admit I am only half way through reading the Selfish Gene, and I am not a professor in molecular genetics like the articles author, but this seems a distortion of what Dawkins is arguing. The selfish gene would be failing if it did anything to the detriment of the organism before it had a chance to propogate, and this is central to Dawkins' argument. The author of this article is, as I understand Dawkin's argument, wrong in this summation.

A gene that acted to the detriment of it's host organism reduces it's chances of proliferation, and this is contrary to Dawkin's argument.

I suspect some bias or agenda on the part of the author for him to include what seems to me such a gross distortion of Dawkins because otherwise I am baffled as to this misrepresentation.

I'm feeling shades of Behe's attempt to change the definition of science to include ID and astrology, when astrology is actually more scientific (but still wrong) than ID.

What I find really funny about all the systems talk is the same thing I find funny about 'holistic' 'medicine' that tracks everything down to their one pet cause of the season.

Real medicine is holistic: Doctors want to see your and your family's medical history for a lot of decisions, and will test for several factors before determining if a treatment is appropriate for you.

I've never seen that sort of rigor with acupuncturists: They preach it, but I never see them practice it.

So, when's that basic double-blind control study coming? Let's see if there's any effect we don't already know about (and are generally unimpressed with) before you talk about its merits.

I'd still like to see if multiple acupuncturists' diagnoses are even remotely consistent for the same patient. The control would consist of people who are posing as acupuncturists and guessing.

That should be easy to check in a double-blind triaL. I fail to see the problem. No needles even needed.

Don't know why the last post came out anonymous. Anyway, I made it.

Martin wrote in the 62nd Skeptics Circle thread:

Jimmy_Blue

Now that you have finished searching for strawmen in the chopra article, when are you going to critically examine your own comments? Starting with your last comment in the acupuncture thread.

Skepticism is not an image.

Can you actually address my arguments, or do you just want to continue to imply they are wrong in the hope that will make them wrong?

I explained why the author's comments were, I thought, a misrepresentation of Dawkins in the article you linked, do you disagree with the arguments I made and can you say why, or do you just want them to be wrong?

Since I clearly reference your words, how can I be making a strawman argument?

Unless you can address my arguments, I suggest you stop trying to pretend there is something wrong with them.

Oh, and one more thing. This:
Skepticism is not an image.

Is not something any skeptic on here has ever argued. So if you are saying that is what we think, then you're making a strawman argument. If you are just making a statement of fact. Well, duh.

Jimmy:

I immediately regretted that i wrote that comment in the other thread, but i guess i now have to follow through and give you an answer, even though i don't think it will be of any help to either of us, and ultimately writing this is a waste of time.

Anyway..

I believe the following are misrepresentations of my position:

1) If by 'improved' you mean 'accepting of woo' then how is that an improvement?

Hardly sounds like an improvement. Then again.. i never said so, did i? What i meant with 'improved', was in fact 'improved'.

2) Your argument seems to be that science can only improve when it accepts the unscientific, but in order to accept the unscientific it has to improve.

No Jimmy. That was not my argument. I was presenting systems theory as an alternative way to analyze the claims of TCM. And systems theory is hardly unscientific.

3) So transplanting individual organs (smaller units) doesn't work?

Here you are arguing against a list of general properties of a systems view. Maybe i could have chosen my words a bit more carefully here, or used a bullet list or something, to avoid confusion.

4) Presumably you'll tell the next medical doctors that treat you this, and then refuse the treatment they offer, right?

I mean, say your heart was suffering from an arrythmia, the cause would be irrelevant, right?

Again, i fail to see your point here. I was describing a feedback system and arguing that the human organism has these traits.

5) What you feel about this is irrelevant. It's the facts that count. Take this recent scientific discovery for instance:
Serious Diseases Genes Revealed

In the article you refer to the author says:
"Many of the most common diseases are very complex, involving both 'nature' and 'nurture', genes interacting with our environment and lifestyles.

"By identifying the genes underlying these conditions, our study should enable scientists to understand better how disease occurs, which people are most at risk and, in time, to produce more effective, more personalised treatments."

This is almost what i am saying (or maybe not, haha), except that this is the reductionist path to, what i see as, the common goal; improved health. I still want to pursue this path, but what i am asking is: can we understand even more by studying the human organism as a (sub-)system and how this system interacts with other systems.

6) Since science continually disproves my pet woo theory, I think we should change science until it proves it.

I fed this through the what-i-actually-said-terpreter and it came out as:

Since the human organism has both molecular/cellular/genetic/etc properties, AND systemic properties, shouldn't both kinds of properties be taken into account when dealing with human health? And, in the past at least, i argued that science has focused mostly on the first kind of properties, which are typically associated with an old-fashioned cartesian worldview.

And the reason i linked to that guardian article was to show one example of how system theory has benefited science, not to discuss genes. As for your suspicion of bias/agenda on the part of the author..."What you feel about this is irrelevant. It's the facts that count."

So it seems you can spew out this garbage reply, and at the same time you yell and shout to others about straw men, facts and what else, when you have nothing.

As for your other questions which were not just stuff you made up:

7) Science does understand TCM, that's why scientists accept it as bollocks.

Maybe you are right. You certainly seem to believe so.

8) Prove that science does not understand TCM before you can make that assertion.

I suspect I'm digging my own hole here, but I'll ask anyway: If the argument is that method A cannot show the effect of phenomena B, wouldn't one need some other method C which does show the claimed effect of phenomena X, to actually show with certainty that method A cannot show phenomena B?

Ok there you go Jimmy, hope that gave you something to argue about...

Martin:
Hardly sounds like an improvement. Then again.. i never said so, did i? What i meant with 'improved', was in fact 'improved'.

Improved in what way? this has been asked multiple times in this thread and no-one seems to give a concrete answer. In what way does science need to improve? Well, we already know your opinion from your very first post here.

Your opinion is that science needs to improve in the sense of accepting what is unscientific, i.e. TCM. I won't re-post your own words because they are already there for everyone to see.

Your argument in your very first post was that in order for science to explain acupuncture, it must understand TCM. Science must accept the unscientific. Those are your own words, not a strawman, not something I made up, not a misrepresentation.

No Jimmy. That was not my argument. I was presenting systems theory as an alternative way to analyze the claims of TCM. And systems theory is hardly unscientific.

Having read through your previous posts on this thread, you claim outright that science cannot explain acupuncture unless it understands TCM, as well as claiming that science can't explain acupuncture at all. You say that In the meantime, using a scientific method to _understand_ something science cannot explain seems like a bad idea to me.

You reject outright the ability of science to explain acupuncture, but now want to use something that is 'hardly unscientific' to explain it.

Your argument runs:

science can't explain acupuncture ->
TCM is not science ->
in order to explain acupuncture science must accept TCM ->
accepting TCM would, in part, lead to 'improved science' because science would then be able to explain what it currently can't ->
'improved science' (systems theory being part of this) would lead to the acceptance of TCM ->
this 'improved science' will be able to explain acupuncture.

You want science to improve by accepting the unscientific, in order for it to explain what you think it can't explain without improving.

Don't worry, your argument is very clear. Science doesn't explain acupuncture the way you think it should, so science needs to change. You think science must be wrong.

Here you are arguing against a list of general properties of a systems view. Maybe i could have chosen my words a bit more carefully here, or used a bullet list or something, to avoid confusion.

Actually, I am arguing against one specific point in your list of systemic properties, a specific point which in the context of this discussion was demonstrably false, and which you have tried to avoid addressing by implying I must be wrong in some way to address the point.

The human system can be reduced to smaller units and is, and with success.

Again, i fail to see your point here. I was describing a feedback system and arguing that the human organism has these traits.

You said:
When a system of this kind breaks down, the breakdown is usually caused by multiple factors that may amplify each other through these interdependent feedback loops. Which of these factors was the initial cause of the breakdown is often irrelevant.

My response was to point out this is absurd, the initial cause of a breakdown (arrythmia) in the system (human body) is hardly irrelevant, since failure to address this means failure to resolve the breakdown. So, presumably, since you feel the initial cause of the breakdown is irrelevant, you would refuse treatment offered to correct that initial cause? Or do you often type things you don't mean? Are you saying we should only treat symptoms not underlying causes?

This is almost what i am saying (or maybe not, haha),

Try maybe not. They used the scientific method remember, the one you say needs improving/doesn't work properly. They say specific genes can cause disease, or in your words, specific genes can be the irrelevant initial cause.

I still want to pursue this path, but what i am asking is: can we understand even more by studying the human organism as a (sub-)system and how this system interacts with other systems.

We already do, it's called physiology. It's the biological study of organisms and it's vital to medical science. It simply suits your argument more to pretend we don't do this.

Since the human organism has both molecular/cellular/genetic/etc properties, AND systemic properties, shouldn't both kinds of properties be taken into account when dealing with human health?

They are.

My interpretation is, based on the entirety of your posts here, still more accurate. You think science doesn't explain acupuncture (because you don't like the explanation it does give) and so you think science is wrong and needs to be improved in some esoteric way until it does explain it. If science still doesn't explain it, then it just hasn't improved enough.

And the reason i linked to that guardian article was to show one example of how system theory has benefited science, not to discuss genes.

Oh, so only the bits that aren't wrong count, everything he got wrong can be ignored and we don't have to wonder at all if there may be some cause to question what else he has written? Is that what you are saying? Even though a large part of his argument is that in his opinion system theory discredits an aspect of gene theory that he misinterpreted massively? You don't think that undermines his position in any way?

As for your suspicion of bias/agenda on the part of the author..."What you feel about this is irrelevant. It's the facts that count."

That's why I highlighted this as a suspicion. If you have some other reason why the author may have been so massively wrong about Dawkins' argument feel free to enlighten us. Having done some more research on the guy, and seen his opinion on global warming, my suspicions have just deepened.

But don't worry, you just keep cherry picking the bits that suit you and ignore everything else. Just like you obviously do with acupuncture.

Maybe you are right. You certainly seem to believe so.

I see. And obviously you don't believe TCM is not understood by scientists, you have some hard evidence. Right?

I suspect I'm digging my own hole here, but I'll ask anyway: If the argument is that method A cannot show the effect of phenomena B, wouldn't one need some other method C which does show the claimed effect of phenomena X, to actually show with certainty that method A cannot show phenomena B?

Do you have a legend for this, because quite honestly I have no idea what you mean.

So it seems you can spew out this garbage reply, and at the same time you yell and shout to others about straw men, facts and what else, when you have nothing.

Why do you people insist on arguing against something that you know nothing about?
It's plain ignorant. You all speak like you know it all, but from what you're saying you don't know anything about acupuncture.

You all have this notion that if your logic can’t explain it, it must be false. So, according to you, LOGICALLY acupuncture can’t work THEREFORE it must be false. So, you intelligent people are trying to tell me that if something is true according to your logic (which is based on amazingly limited knowledge of the subject), then it must be true in reality. Wow. That is an INCREDIBLE leap of faith for a skeptic.

Why do you people insist on arguing against something that you know nothing about?
We know quite a bit about medicine, the scientific method, logical fallacies, the placebo effect, and, yes, acupuncture.
It's plain ignorant. You all speak like you know it all, but from what you're saying you don't know anything about acupuncture.
I know the explanations defy all scientific knowledge. I know that well-controlled studies have repeatedly shown it to be no more effective than placebo. I know that there have been few (if any) double-blind placebo-controlled studies, despite the relative ease of designing one. I know that it hasn't passed the basic tests of efficacy and safety that we require of any medical treatment or drug, and yet people practice it, charge for it, and claim it works based on nothing more than anecdotal evidence and logical fallacy.

Should I go on?

You all have this notion that if your logic can’t explain it, it must be false.
Not really. We all have this notion that if there's no evidence to support it, then there's no good reason to believe it's true. It's a pretty reliable metric for the real world.
So, according to you, LOGICALLY acupuncture can’t work THEREFORE it must be false.
Nice straw man. No, according to us, until acupuncture shows some evidence to support its claims, there's no reason to believe that it works. And until acupuncture passes the same basic tests we require of all other medicine, the practitioners have no grounds to be making claims of it's usefulness.
So, you intelligent people are trying to tell me that if something is true according to your logic (which is based on amazingly limited knowledge of the subject), then it must be true in reality.
Why do you insist on arguing about something that you know nothing about? Namely, in this case, the scientific method and our position on acupuncture. It has nothing to do with whether or not something is true according to logic, it has to do with whether or not acupuncture can provide evidence that it works.

So, to correct your idiotic straw man, "unless something can be shown to be true in reality, then it would be unreasonable to accept it as true."

See, this is the beauty of double-blind controlled tests and other scientific trials: the logic is secondary, the mechanisms are secondary, what really matters is the simple evidence of whether or not something, in this case acupuncture, works. Why, if acupuncture is so effective, can't it supply that simple bit of evidence?

We'll offer you the same option that every other acupuncture supporter has been offered and has failed to meet in the last several weeks: provide some good evidence that acupuncture's claims are true, or go away.

You people love to insult challenges to your stance. Do you think calling me an idiot gives weight to your position?

You are the one making he claim, hence you are the one who should provide evidence that acupuncture does not work.

PROVE TO ME THAT ACUPUNCTURE DOES NOT WORK.

And I will go away when I'm ready.

Countless studies have been done, i'm sorry you haven't seen them. It's sad that you are so passionate against something in which you are so little informed.

This is the only reasonable statement that you made: "No, according to us, until acupuncture shows some evidence to support its claims, there's no reason to believe that it works." I can live with that. But that is not really your stance at all, you are outright denouncing it.

Also, if you really did know anything about the workings of acupuncture and TCM, like you say you do, then you probably wouldn't be saying any of this. So please don't tell me that because you are a scientist or a conventional doctor that you automatically understand the foundations of Chinese Medicine.

Here's an interesting item that I have just used in another debate. I just got this off google in about 3 seconds. Just type 'acupuncture' on this site http://www.ncbi.nlm.nih.gov/sites/entrez
to get a few examples of the mountain of studies done on this subject annually. You can't read the studies because you need to subscribe (which is what is preventing me from sending you about 1000 links) but the abstracts should give you an idea.

Should I go on?

You people love to insult challenges to your stance. Do you think calling me an idiot gives weight to your position?
Actually, I called your fallacious straw man argument idiotic, not you. Nice reading comprehension skills, there.
You are the one making he claim, hence you are the one who should provide evidence that acupuncture does not work.

PROVE TO ME THAT ACUPUNCTURE DOES NOT WORK.


Remember that whole "don't argue against things you don't understand" thing you said earlier? That still applies. You clearly have no understanding of the burden of proof, and specifically where it lies in any situation. Acupuncture makes positive claims that it is effective at treating a number of ailments. I (and other skeptics) respond that such a positive claim requires evidence. We, as we would with any other scientific hypothesis, assume the null hypothesis until evidence demonstrates otherwise.

So, no, we aren't "the ones making the claim," except to claim that acupuncture has not shown enough evidence to reject the null hypothesis with regard to their claims. It's up to acupuncturists to prove that their treatment works.

Nice try, though. Shifting the burden of proof, in addition to your straw men from the previous post, and the fallacies that Berlzebub pointed out at Ryan's...you're racking up quite a litany of bad arguments.

Countless studies have been done, i'm sorry you haven't seen them. It's sad that you are so passionate against something in which you are so little informed.
I've seen quite a few of the studies. They tend to fall into two categories: studies with flaws that a sixth-grader could point out, and studies that show no significant difference between acupuncture and placebo. If you've got one that doesn't fall into those categories, I'd be more than happy to see it. So far, your appeal to nonspecific "countless studies" is unimpressive.
This is the only reasonable statement that you made: "No, according to us, until acupuncture shows some evidence to support its claims, there's no reason to believe that it works." I can live with that. But that is not really your stance at all, you are outright denouncing it.
I'm assuming the null hypothesis ("acupuncture is not effective at treating X") until evidence refutes it. I hate to tell you, Chachi, but that's how science works.

Of course, that's a simplification of the situation. In fact, I've seen plenty of evidence supporting the null hypothesis. Not just the basic physics that goes against the "theory" of chi and meridians and whatnot, but also studies refuting predictions made by said "theory", and again, a variety of large-scale studies and meta-analyses that show little to no difference between acupuncture and placebo.

The best evidence I've seen says that poking people with needles may be effective, possibly more than placebo, for relieving pain. The well-controlled studies, however, haven't been done to rule out placebo effect or other potential explanations.

Also, if you really did know anything about the workings of acupuncture and TCM, like you say you do, then you probably wouldn't be saying any of this.
"If you really did know anything about fine royal fashions and fabrics, like you say you do, then you wouldn't be saying that the Emperor is naked." If you've got evidence that acupuncture and TCM are effective, then provide it. This "if only you knew what I know" is a diversionary tactic.
So please don't tell me that because you are a scientist or a conventional doctor that you automatically understand the foundations of Chinese Medicine.
I don't have to understand "the foundations of Chinese medicine" to be able to evaluate whether or not it works. "Working" is completely independent of "the deep and rich history and 'theories' behind TCM."
I just got this off google in about 3 seconds.
Excellent research skills there, slick.
to get a few examples of the mountain of studies done on this subject annually.
Um...you're a fool. Plain and simple. "Look at all the studies that have been done, therefore it works!" Have you read any of the studies? Have you looked at the methodology, the sample sizes, the controls, the blinding, and most importantly, the conclusions? As I said, most of the studies I've seen can either be thrown out because of poor methodology, or end up concluding that there's no better effect than placebo. I've read dozens of these studies, on PubMed and elsewhere, and I have yet to see one that has a high validity and a pro-acupuncture conclusion.
You can't read the studies because you need to subscribe (which is what is preventing me from sending you about 1000 links) but the abstracts should give you an idea.
Yes, an idea, but not the details. Or should we just believe every abstract, regardless of how the study was conducted? On the other hand, we do have some members with PubMed subscriptions, so why don't you pick a handful that you think support your point, and we'll evaluate them.

You guys are funny.

What is the point of discussing anything "in detail".

It's pretty clear. You are not interested in the truth. You are concerned only with propagating your opinions. It really doesn't matter what I bring to the table or what I show. You have already formed your unmovable stance long ago and anybody who threatens that is worthy only of name-calling.

this whole site is funny. It is exactly like a church, you don't come to this site to learn anything new, you come only to hear regurgitations of what you already think you know.

It seems to be working for you so keep it up.

Skeptico replies

Re: You guys are funny.

What is the point of discussing anything "in detail".

It's pretty clear. You are not interested in the truth. You are concerned only with propagating your opinions. It really doesn't matter what I bring to the table or what I show. You have already formed your unmovable stance long ago and anybody who threatens that is worthy only of name-calling.

You are only describing yourself pal.

Re: this whole site is funny. It is exactly like a church, you don't come to this site to learn anything new, you come only to hear regurgitations of what you already think you know.

Oh yes - The Woo Handbook #12, plus more describing yourself. You’re not original, clever or even right. Thanks for playing though.

Gosh, that post looks familiar, Dave. I'll say here what I said there: if we were only concerned with propagating our own position, we wouldn't be calling for well-controlled, double-blinded trials to find out whether or not acupuncture actually works.

You're right, bringing fallacies and nonspecific links and personal experience to the table doesn't matter. The only thing that matters is evidence, which you have conveniently failed to provide. If you brought some evidence, some actual solid evidence, of course we'd accept acupuncture. But at this point, all the evidence points to "it works no better than placebo."

And yes, we're just like a church, all demanding evidence before we accept things, and refusing to believe things just on flawed subjective personal experience and other people's say-so. That's exactly what happens in church.

Dave:

Why do you people insist on arguing against something that you know nothing about?

Prove we know nothing about it. We have all posted the definitions of acupuncture we are referring to, show how they are wrong. I practised Tai Chi and Qi Gong for 8 years. I recieved training in Tai Chi, Qi Gong and meditation from Chinese grand masters, including one approved by the Chen family. What is your experience level with the traditional Chinese arts?

It's plain ignorant. You all speak like you know it all, but from what you're saying you don't know anything about acupuncture.

And yet you make this assertion and have in no way shown it to be true with supporting evidence. Prove it or withdraw the accusation.

You all have this notion that if your logic can’t explain it, it must be false.

This is known as a strawman. It basically means that this position you attribute to us is not one we ourselves have professed, it is one you have made up for us. It is a sign of ignorance of your opponents position. If you are ignorant of our actul position, then it would mean claiming we are wrong is the height of arrogance on your part. It would mean that you don't know what you are talking about.

So, according to you, LOGICALLY acupuncture can’t work THEREFORE it must be false.

Please cite where one of us has said that or admit this is wrong and you lied about our position.

You are a liar.

So, you intelligent people are trying to tell me that if something is true according to your logic (which is based on amazingly limited knowledge of the subject), then it must be true in reality. Wow. That is an INCREDIBLE leap of faith for a skeptic.

Again you highlight your ignorance of your opponents position. Why do you people insist on arguing against something that you know nothing about?

You people love to insult challenges to your stance.

You are not a challenge.

Do you think calling me an idiot gives weight to your position?

No. It's more like calling a car a car. It's a statement of what is.

You are the one making he claim, hence you are the one who should provide evidence that acupuncture does not work.

So do you claim that skeptics started to claim acupuncture does not work before acupuncture was invented? If not, then it is proponents of acupuncture who are making a claim. That claim is that acupuncture works. We say it does not. The burden of proof lies with you, not us.

Put simply for you:

If I claim that a giant yellow babboon faced midget horse made the universe whilst singing "I'd like to teach the world to sing" and you claimed it did not I have the burden of proof, not you. If you don't understand this there is very little point in trying to reason with you further.

PROVE TO ME THAT ACUPUNCTURE DOES NOT WORK.

PROVE TO ME THAT A GIANT YELLOW BABBOON FACED MIDGET HORSE DID NOT MAKE THE UNIVERSE.

And I will go away when I'm ready.

Take your time. Morons like you don't even cause us to break a sweat anymore. Too easy.

Countless studies have been done, i'm sorry you haven't seen them.

Most of them massively flawed. The ones that aren't generally show no effect greater than placebo.

Tell me, why do studies show that acupuncture does not work as an antiemetic for kids when the same studies conclude it may for adults?

It's sad that you are so passionate against something in which you are so little informed.

You do understand irony, don't you?

Also, if you really did know anything about the workings of acupuncture and TCM, like you say you do, then you probably wouldn't be saying any of this.

If you only knew the power of giant yellow babboon faced midget horses, you wouldn't deny the true origins of the Universe.

So please don't tell me that because you are a scientist or a conventional doctor that you automatically understand the foundations of Chinese Medicine.

OK, we won't. However, since we have studied the words of acupuncturists themselves we'll say that unless you can prove otherwise, we do understand the foundations of TCM. We're waiting.

Should I go on?

You could, but we've heard it all before. You are not an original.

You guys are funny.

We are aren't we. You however are boring.

What is the point of discussing anything "in detail".

Spoken like a true proponent of pseudoscience, quackery, supernaturalism and bullshit.

It's pretty clear. You are not interested in the truth.

Unlike little virtous you. Who lied about us from his very first post. Thou hypocrite.

You are concerned only with propagating your opinions.

I suppose you came on here not to propogate your opinions, right? So you'll be shutting up then. Excellent. We're bored of you already.

It really doesn't matter what I bring to the table or what I show. You have already formed your unmovable stance long ago and anybody who threatens that is worthy only of name-calling.

You are full of yourself aren't you? So, what would it take for you to accept that you are wrong?

It is exactly like a church, you don't come to this site to learn anything new, you come only to hear regurgitations of what you already think you know.

Yes, just like a church. Apart from it not being a building. Or having an ideology associated with it. Or a creed. Or a presiding religious figure. Or tax exempt status. Or pronouncing dogmatic nonsense. Apart from that, just like a church.

I've learned plenty of new stuff here.

Don't worry though, we understand you're afraid. That's why you hold to three thousand year old supernaturalism instead of modern science and medicine. Tell me, what was the last new addition to the theory behind TCM?

Yup, you all did it!

You cracked the case, Columbo!

Thank you all so very much. What would the world be without you? Yes, I am very afraid. It's a good thing we all have you guys to protect us from all the madness out there. Thank you for being the great bastion of all that is macho, ego-centric, testosterone-driven, rigid, left-brained and everything that is wrong with the world.

If you took away all your left-brains you would have nothing. I leave you now to your silly sermons.

Oh, and please call me more names after this post, please prove what big strong, ultra-smart men you all are. I see it doesn't take much to get all your frilly-panties in a tight bunch.

Been a blast boys.

Translation:

"And thus, having said absolutely nothing of substance, I take my leave, secure, as ever, in my complete correctness.

You're all mean!"

I felt like doing a bunch of psychobabble, but I'm just going to get to the point:

1. Don't lie. That means not skipping over the critical parts of our posts where we shred your logical fallacies, parroting woo bigotry, and then stroking your martyr complex when you find that we've called you ignorant for performing a logical fallacy. (Okay, so I slipped in one piece of psychobabble.)

2. Talk about acupuncture! This is an acupuncture thread! Stop wasting our time showing off your bigotry!

If you're not going to do either of those, at least leave your cynicism, nihilism, and hatred for wonder in a basement somewhere, where it won't interfere with people trying to find out more about the real wonders of the world by encouraging people to move past failed dogmas that serve only to obscure the complexities of a wonderful system.

To Dave, or whatever your name is:

So far you’ve posted I think four comments and there has been no content to any of them, just self-aggrandizing babble and insults to everyone else. If you want to post here again you’re going to have to offer some actual reasoned argument, citations to support your case etc, or your posts will be deleted and you banned. This is your first and only warning. Many people post here and disagree with what is being said, and they continue to post many comments and continue the discussion over sometimes many weeks. Disagreeing with me will not get you banned, so don’t try to play martyr. But this is not your playground – if you want to rant freestyle get your own blog. Post some reasoned content or you will be booted.

To everyone else – perhaps it’s time to stop feeding this troll.

"Dave" has been banned and his last post just deleted.
You were warned. You apparently just posted pretending to be someone else supporting "Dave". Post using sock puppets and you'll be banned.

Please do not be an even bigger jerk than you have been so far by trying to get around the banned IP list. If you do, and if you continue to post, I will have to implement comment moderation which will inconvenience everybody else - people who are actually interested in a discussion. I realize you probably don't care who you inconvenience, and probably think this is all very funny, but for once in your life don't be a jerk. Go away. You had your chance; you didn't take it.

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