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Acupuncture research – the path least scientific?

A recent, rather flattering, article on acupuncture on this website holds a mirror to a broader problem in the world of acupuncture research. A problem that goes to the heart of the most fundamental scientific…

The idea of Chi (life force) flowing through meridians has an allegorical quality and the appeal of an ancient provenance. jacqueline/Flickr

A recent, rather flattering, article on acupuncture on this website holds a mirror to a broader problem in the world of acupuncture research. A problem that goes to the heart of the most fundamental scientific principles.

There’s no doubt that acupuncture is gaining traction on the grounds that it holds up under scientific interrogation. But does it really?

Let’s go back to basics. The scientific method involves proposing a theory based on plausible principles, and then trying to disprove it. Let’s say the theory proposes that a particular treatment is effective for a certain condition.

First, we ask whether it’s based on plausible principles. And, if so, we design studies to rule out every possible explanation for the observed effect except the explanation captured in the theory. If the effect remains after all reasonable controls have failed to remove it, we conclude that, on balance, it’s probably real.

Shaky foundations

Acupuncture is based on implausible principles. The concepts of Chi – an invisible, unmeasurable life force, flowing through meridians (unobservable pathways with no known anatomical correlation) - have both an allegorical quality and the appeal of an ancient provenance. But these aren’t held up by anything the scientific method has revealed.

Perhaps despite its implausible principles, acupuncture point combinations are based on centuries of practice and consistent observations of this effect. Very unlikely – we have previously reflected on this. Even limiting the number of needles that are inserted to four (in order to develop crude evidence that specific points are effective for specific ailments) requires an astronomical number of tests.

Let’s presume, for instance, that in China at the time when the first acupuncture tomes were generated with their 400 or so acupuncture points, the average lifespan was 50 years. In order to get all the needle combinations tested, every member of the Chinese population would have had to suffer from the same condition throughout their lifespan, and then receive eight separate treatments a year for every year of their life.

For a number of reasons, this estimate should be considered wildly conservative – and this is for just one condition. Acupuncture is recommended for an astounding range of afflictions.

Research evidence

Ensuring robust double-blinding studies of acupuncture is a tricky business. Nonetheless, good quality trials across a range of clinical conditions and outcomes, overwhelmingly show that acupuncture fails to outperform sham.

What’s more, when the studies are good, it appears that it doesn’t matter where one inserts the needles, how deeply they are inserted, whether or not they are manipulated once in situ, and, crucially, whether they are inserted at all.

So, according to scientific method, the theory has been disproved. In more classical scientific parlance, the key hypotheses that arise from the founding principles of acupuncture have been refuted.

Intriguingly, despite this the studies keep coming. A recent meta-analysis of individual patient data received a great deal of media attention as it was suggested to provide compelling evidence that acupuncture works. It found that while acupuncture was better than no treatment controls, there was a small, clinically trivial but statistically significant benefit of acupuncture over sham.

It took the power of a large sample to demonstrate that effect, and the authors conclude that it represents the active ingredient of real acupuncture. But as we have already seen, in imperfectly blinded trials, one would expect to see some small difference simply from the resulting bias.

So which interpretation is more plausible? Have the authors really fulfilled their obligation to falsify more plausible alternative explanations?

Fundamental problems

There’s a great deal of energy being devoted to unpicking the potential mechanisms of acupuncture. We’re told that acupuncture causes local tissue changes or activation differences in certain areas of the brain. We suggest that it’s hardly surprising that inserting needles into the skin causes a reaction in the tissues or a change in the brain. Indeed to not find such changes would be considered genuinely revolutionary.

These findings neither validate acupuncture nor provide a cogent mechanism for its therapeutic action. Indeed, we think this approach reflects some fundamental problems with much acupuncture research. The retrofitting of physiological mechanisms to explain a non-existent effect is scientifically upside down. Designing experiments to demonstrate that something works or hunting down an elusive mechanism for a cherished idea is not scientific.

We would suggest that if experiments that control for all possible explanations except acupuncture clearly show no benefit, but experiments that don’t control for other possible explanations clearly do show a benefit, then we should be investigating those other possible explanations rather than acupuncture.

There’s a thriving industry of acupuncture research that will no doubt continue to optimistically mine pockets of subtle or manufactured uncertainty. This is understandably human - what else would one do if one absolutely knew something was true but could not prove it?

But from a scientific viewpoint, acupuncture shouldn’t work, and comfortingly, when tested properly, it doesn’t.

The sharpest experimental probes have dismantled the principles on which acupuncture is based but have failed to puncture the balloon of naïve acceptance that floats aloft in the popular media, the public consciousness and in the acupuncture research community. A re-acquaintance with the most basic scientific principles may just be the sharp prick required.

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  1. Yoron Hamber

    Thinking

    Don't think this is totally correct. We use it Sweden to reduce and block pain, and in a lot of our hospitals too as I understand? If you want it all to be placebo we should see cases where it doesn't work too, and so put the practice into question, but as far as I know it's a accepted practice here?

    When it comes to terminology and the framework of ideas behind it we have to remember that this is a Chinese art, not Western, a different way of looking at things and defining 'forces' as yin and yang. You are right in that there are studies questioning acupuncture, but in Sweden we use it to alleviate pain, and there we find it to work.

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    1. Martin Linder

      logged in via Facebook

      In reply to Yoron Hamber

      I´m a physical therapist working in Swedish primary care and have used acupuncture in treatment. Of course there are cases where it doesn´t work. Sometimes it reduces pain, sometimes it doesn´t, it´s hardly 100% effective and it could very well be explained by placebo effects.

      Personally, having read some of the recent debate, I´m now very hesitant to employ this type of treatment.

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    2. Shanna Cowell

      logged in via Facebook

      In reply to Martin Linder

      No treatment is 100% effective.
      Perhaps, since you are a physical therapist and not a Licensed Acupuncturist, your treatments are not as focused or complete as when done by a qualified, trained professional in Chinese Medicine.
      Why is it that when something works outside the "mainstream" and can't be explained, it's called placebo. And when a pharmaceutical "works" for something for which it's not indicated and no one knows why it's called "off-label"?
      Why would you be "hesitant to employ this type of treatment" if it works for some and injures none to few? Why are we more concerned with what can be proven than what can help? Especially when in this case, the treatment is safer than surgery, pharmaceuticals etc and waaaaayyyy cheaper.

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    3. Craig Morton

      Biomedical Research Scientist

      In reply to Shanna Cowell

      "And when a pharmaceutical "works" for something for which it's not indicated and no one knows why it's called "off-label"?"

      Because we are able to subsequently identify the mechanism by which it works? So we have both an observation of clinical effect and evidence to support it?

      "Why are we more concerned with what can be proven than what can help?"

      Because if we're using a technique that only works by accident and isn't able to be shown to work by the mechanisms claimed by 'experts' in the field, then it's a complete waste of time, resources, and brain-space that could be applied to something that can help and can be proven as well.

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    4. Father Æthelwine

      Priest and researcher.

      In reply to Martin Linder

      So the essay made you doubt yourself - so it was successful. When the community that professes to be scientific finds something that it cannot understand, due to the blinkers applied during training, it feels that it has to hit it with some argument or other. I await the attack on reflexology, which works on the same principles and works wonders. However regarding acupuncture I suspect that there is a good reason why an acupuncturist I know, who studied the subject in Japan for seven years has more…

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    5. Martin Linder

      logged in via Facebook

      In reply to Shanna Cowell

      My comment was a response to the poster above, who stated:
      "If you want it all to be placebo we should see cases where it doesn't work too.."
      I merely explained that of course those cases exist in acupuncture as well.

      Naturally my treatments differ from those of Chinese medicalists. Don´t know if theirs are inherently "better" though. How would you define "focused" and "complete" as used in reference to acupuncture treatment? Aren´t they somewhat contradictory to each other?

      I don´t share…

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    6. Martin Linder

      logged in via Facebook

      In reply to Father Æthelwine

      What makes you think it was this particular essay that made me "doubt myself"? For that matter I have made no reference to doubting "myself" at all.. only the specific effects of a treatment modality.

      When the "scientific community" finds something it cannot understand it investigates it. Hence the myriad of research articles into the field of acupuncture, for example. Years and years of research, testing, comparing, thinking, pondering. The result, for now, is it´s probably placebo. It can be a strong placebo effect, mind you, but still, probably placebo.

      Do you believe acupuncture cured your friends cancer? Or chemotherapy?

      Noone complains when it works for them, but who listens to those for whom it doesn`t?

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    7. Michael Macdonald

      Chemist

      In reply to Shanna Cowell

      I think you're confusing off label (not licensed by FDA, TGA, et al) with 'no evidence'. Just because a pharmaceutical is not licensed (off-label) for a particular indication doesn't mean that it doesn't have evidence of benefit for that particular indication or age group.

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    8. Shanna Cowell

      logged in via Facebook

      In reply to Michael Macdonald

      Science is not always able to "subsequently identify the mechanism by which it works" concerning off-lable uses. That's why they are called "off-lable".
      As for "isn't able to be shown to work by the mechanisms claimed by "experts" in the "field"". No experiments are allowed to occur in the "field" when acupuncture is "studied". By definition, double blind placebo controlled trials are a hindrance to obtaining results with Chinese Medicine. It is an individualized medicine practiced according to…

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    9. Craig Morton

      Biomedical Research Scientist

      In reply to Shanna Cowell

      "Science is not always able to "subsequently identify the mechanism by which it works" concerning off-lable uses. That's why they are called "off-lable"."

      Or you could actually check the science, and discover that "off-label" studies are common in the scientific literature and getting to the basis for why a drug works in a particular off-label context is standard practice. Over 1200 Medline references to off-label studies (http://www.ncbi.nlm.nih.gov/pubmed?term=off-label%20study)!

      "By definition…

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    10. Shanna Cowell

      logged in via Facebook

      In reply to Craig Morton

      Accident is not the only other way something can help. The main objective is to help the patient which is never a "complete waste of time, resources and brain-space. The set of things possible to "help and be proven" is substantially smaller than the set of all things which can help and are not necessarily "proven" by a microscope or test tube.
      Since the ultimate objective is to help the patient, then certainly the practices which reside in the set of "Things which can help and are not necessarily proven and are low risk and low cost" should be considered. Very rarely do patients refuse to try safer, less invasive, cheaper treatments. If the patient is satisfied, isn't that the goal? Where are all the screaming hoards with their lawsuits suing the acupuncturists?

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    11. Sue Ieraci

      Public hospital clinician

      In reply to Shanna Cowell

      Shanna - you have misunderstood the meaning of "off-label". All it means is that a medication is found to have an action in addition to the one it has been registered for under the pharmaceutical licensing regulations. That doesn't mean that it shouldn't be used for the additional indication, or that nobody knows how or why it works.

      Medication use is underpinned by the clinical science of pharmacology, which again is underpinned by physiology (how the body systems work).

      We don't have perfect…

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    12. Dennis Alexander

      logged in via LinkedIn

      In reply to Shanna Cowell

      "The set of things possible to "help and be proven" is substantially smaller than the set of all things which can help and are not necessarily "proven" by a microscope or test tube." This is a red herring argument: define "can help" in terms that excludes charlatanism and it morphs to a straw man argument. "... the set of "Things which can help and are not necessarily proven and are low risk and low cost" includes the "low risk" condition and risk includes risk from not working as well as side effects - all in all a sugar pill fits your conditions very well and there is medical evidence for the placebo effect.

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    13. Patrick Stokes

      Lecturer in Philosophy at Deakin University

      In reply to Shanna Cowell

      "The set of things possible to [sic] "help and be proven" is substantially smaller than the set of all things which can help and are not necessarily "proven" by a microscope or test tube."

      Except that the only way we can know, with any degree of confidence, that something can help (where 'help' is understood in terms of effecting positive physical responses in the human organism) is via scientific investigation. So "the set of all things which can help and are not necessarily "proven" by a microscope or test tube" turns out to be empty, because we cannot say that anything helps that has not been proven to help.

      Here you might object that we do in fact have other criteria for whether treatments can help: after all, if I visit an acupuncturist for a condition that then remits, and I'm receiving no other treatment, then acupuncture works, right? But of course there's no non-scientific way to know whether the remission was caused by the treatment or by something else.

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  2. Laurie Willberg

    Journalist

    Suggesting that a treatment option that is highly successful (and has been for thousands of years) is "implausible" at this stage of the game is worthless and obviously false. The pronouncement of implausibility is in itself completely unscientific.
    Just more Scientism (more like religious fundamentalism) with the authors apparently deriving "comfort" from their opinions.
    Their objective is nothing more than attempting to manufacture doubt in the minds of the "undecided", however this is like closing the barn door after the occupants have left the building. Acupuncture is so well known, established and accepted worldwide you have to wonder what's the point in trying to undermine it on such flimsy arguments.
    FYI people learn through experience and observation -- not opinion.
    Gee, experience and observation sound pretty scientific don't they?

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    1. Craig Morton

      Biomedical Research Scientist

      In reply to Laurie Willberg

      The Sun spins around the earth - starting in the east and heading west across the sky - just as we've seen for thousands of years. Suggesting this is "implausible" at this stage of the game is worthless and obviously false. The pronouncement of implausibility is in itself completely unscientific.

      Just more Scientism (more like religious fundamentalism) with the authors apparently deriving "comfort" from their opinions.

      Their objective is nothing more than attempting to manufacture doubt in the minds of the "undecided", however this is like closing the barn door after the occupants have left the building. Movement of the Sun through the sky is so well known, established and accepted worldwide you have to wonder what's the point in trying to undermine it on such flimsy arguments.

      FYI people learn through experience and observation -- not opinion.

      Gee, experience and observation sound pretty scientific don't they?

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    2. Martin Linder

      logged in via Facebook

      In reply to Laurie Willberg

      I didn´t see the authors suggesting that acupuncture treatment is implausible but rather the principles on which it is built. There´s a difference.

      For example, it´s hard to deny the existence and impact of gravitational forces (acupuncture treatment and correlated effects). It would, however, at this stage of the game be considered an implausible explanation that these forces are due to the inherent desire of the objects to return to their natural elements (the principles of chi, yin and yang to explain those effects).

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    3. Shanna Cowell

      logged in via Facebook

      In reply to Martin Linder

      Oh Martin, but exactly!!
      Here's an interesting fact: When people go into outerspace, and escape the gravitational pull of the earth, their bones start to literally disintegrate. That's "dis-integrate." The Metal element (which is the mother of Water) in the form of copper, dislodges from the calcium matrix of bone (goverened by Water Kidney) and causes calcium wasting. When the Lung metal can no longer nourish Kidney water, the creative cycle of the 5 elements is broken. Our very existence is dependent on our residence here, from where we sprung. And on so many levels yet to be elucidated and appreciated.

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    4. Shanna Cowell

      logged in via Facebook

      In reply to Craig Morton

      If we always bowed to science over experience and observation, we'd be a long gone species.
      Science is just behind experience and observation. Always trying to catch up and explain it.
      Only in the last few hundred years have we been able to be scientifically certain how babies were made. But that didn't stop people from knowing by "experience and observation" how they were made nor did very many skeptics sit in the wings with arms folded refusing to participate in baby making until it was proved exactly how these so-called babies were just sprung out of thin air.
      Or maybe there were quite a few to begin with. But look what that got them.
      I say give acupuncture a try from a reputable practitioner and if it helps, you can say you were never sick to begin with and be the better for it. If it doesn't help, odds are you've tried everything else and more than likely no harm done.

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    5. Craig Morton

      Biomedical Research Scientist

      In reply to Shanna Cowell

      Except... that's all gobbledegook.

      There's lots known about the mechanisms and physiology of bone resorption in low gravity. Weight bearing exercise, vitamin and calcium supplementation to prevent calcium loss from bone etc. etc. Here's a review article on it: http://www.kjm.keio.ac.jp/past/54/2/55.pdf

      There's still more to learn, and we are. Is it just aquaporins involved in switching the osteoclast/osteoblast activity balance? What's the mechanism from sensing the changed load? All perfectly good science.

      So what does "Water Kidney", "Lung Metal" or the "creative cycle of 5 elements" add to the discussion?

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    6. Craig Morton

      Biomedical Research Scientist

      In reply to Shanna Cowell

      "Only in the last few hundred years have we been able to be scientifically certain how babies were made. But that didn't stop people from knowing by "experience and observation" how they were made..."

      Do you have an notion of how many cultures *didn't* know how babies were made?

      "...nor did very many skeptics sit in the wings with arms folded refusing to participate in baby making until it was proved exactly how these so-called babies were just sprung out of thin air."

      Ah yes, but the baby-making process has all sorts of advantages unconnected with the end result. Being stuck full of needles doesn't. Does it?

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    7. Sue Ieraci

      Public hospital clinician

      In reply to Shanna Cowell

      Shanna says "If we always bowed to science over experience and observation, we'd be a long gone species"

      Not so, Shanna. Science IS systematised experience and observation.

      An episode or two of experience and observation, without any control of confounding factors, can (and frequently does) lead to erroneous interpretations and conclusions. So, we take the scientific approach to see whether the things we observe occur in the way we thought, or by chance, or by association and not causation…

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    8. Sue Ieraci

      Public hospital clinician

      In reply to Craig Morton

      Right, Craig.

      And the other aspect is this - understanding the mechanisms of how the body systems work doesn't just allow us to explain things that we have observed, but also to prodict things that will occur, and to prevent and treat.

      The mystical story described by Shanna is an attempt at explanation of an observed phenomenon. What we can now do is understand, at the mechanical, biochemical and cellular levels, why bones behave the way they do under different conditions, and how to prevent or treat these phenomena. Why repeat the myth when we know about osteobalsts and osteoclasts, the influences on the movement of calcium and what the lung actually does?

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    9. Shanna Cowell

      logged in via Facebook

      In reply to Craig Morton

      Because the "myth" represents the algorithm at work. This algorithm represents systems and elements which interact--like in ecology. Chinese medicine had it all figured out a long time ago--how things work. Why not learn something from recognizing it's truisms. It's only natural law at work. It's algorithms are being proven as true by modern science. Metal creates Water creates Wood creates Fire creates Earth creates Metal was known for a lot longer than why do astronauts experience bone loss in…

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    10. Craig Morton

      Biomedical Research Scientist

      In reply to Shanna Cowell

      "Because the "myth" represents the algorithm at work. This algorithm represents systems and elements which interact--like in ecology. Chinese medicine had it all figured out a long time ago--how things work. Why not learn something from recognizing it's truisms. It's only natural law at work. It's algorithms are being proven as true by modern science."

      You keep asserting this Shanna, but you give no evidence to back it up. What 'algorithm'? What 'natural law'? You're using words that, while they have meaning in and of themselves, don't make sense in the context you place them.

      "We are an inextricable part of our environment. Why not use the common sense things we know about the environment to help explain how our bodies work."

      Because we're not our environment. Part of our environment? Sure - but that does not mean that "Metal creates Water creates Wood creates Fire creates Earth creates Metal" has any real meaning.

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    11. Shanna Cowell

      logged in via Facebook

      In reply to Craig Morton

      The algorithm is the creation cycle I elucidated above. It is a statement of fact and it bears out in our bodies as well as in nature. The subject is too vast to enter into further in this forum. I suggest further readings including Hara Diagnosis: Reflactions on the Sea by Kikko Matsumoto and Stephen Birch. The middle several chapters around "Science Revisited" are quite pertinent to how acupuncture could plausibly work on our health and functioning in terms of western bioscience. Please read something…

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    12. Shanna Cowell

      logged in via Facebook

      In reply to Sue Ieraci

      Why repeat the myth? Because it represents the natural law which should frame our assumptions in going forward with hypotheses. The fact that this chemical process, only recently elucidated, reflects the ancient knowledge and natural laws is relevant; and those who learn to heed this now are going to become the breakthrough scientists of the future.
      Sometimes, we miss the forest for the trees. Chinese Medicine has never made claims to all truth. Western Science describes truths as well. But one…

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    13. Shanna Cowell

      logged in via Facebook

      In reply to Sue Ieraci

      "So much better now"??????
      Fact: ALL pharmaceuticals are toxic. All surgeries carry profound risk. Acupuncture can prevent the above.

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    14. Carolyn Ee

      PhD Candidate at the Department of General Practice; GP and Acupuncturist at University of Melbourne

      In reply to Tim Scanlon

      Tim, you have referred to one randomised controlled study on acupuncture for low back pain and have concluded from that that "acupuncture can't prevent anything". I am unclear as to how one study can lead to that conclusion? You are reacting to one extreme statement with another extreme statement here.

      Nobody suggested acupuncture is always safe. It has recognised adverse effects as that prospective study suggested. However, as it concluded, "serious adverse events are rare". Compare this to NSAIDS (which are available over the counter) which cause GI bleeding http://www.nelm.nhs.uk/en/NeLM-Area/News/2010---March/04/Risk-of-upper-gastrointestinal-bleeding-among-NSAIDs-systematic-review-of-observational-studies/

      This "conversation" should not degenerate into a "conventional vs alternative" medicine debate where proponents of either side start making wild statements. So far I see little science in what is being bandied about.

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    15. Tim Scanlon

      Debunker

      In reply to Carolyn Ee

      You have missed my point and what points I was addressing. And my statements were neither wild or lacking in science, in fact my views are informed by the weight of science in this matter.

      I was pointing out that acupuncture isn't always safe because Shanna was suggesting acupuncture could protect us from the bad things that everything else does. Thus, the study I cited was valid and illustrative.

      The next point, is that you are assuming I have drawn a conclusion based upon one study, which…

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    16. Sue Ieraci

      Public hospital clinician

      In reply to Shanna Cowell

      Shanna - the ancient Chinese explanation of an observed phenomenon with a mythical story has nothing to do with "natural law". Are you trying to tell us that the ancient Chinese knew that bone would demineralise without the effects of gravity? And what of all the other world cultures - did they have a different "natural law"?

      Science does not claim "truth"- it is the best possible model constructed from the evidence available at the time, updated and refined as new evidence emerges. The fact is, people with a scientific approach, using their human curiosity and openness to new ideas, and found that - other than a modest pain-relieving effect - little evidence exists for its efficacy, and even less for its theoretical model.

      Yet another predictable anti-medicine attack on "Big Pharma" and the AMA as a substitute for rational argument.

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    17. Sue Ieraci

      Public hospital clinician

      In reply to Shanna Cowell

      Myths were useful ways of seeking to explain observations that could not be understood in ancient times. The Chinese had their models, the Greeks had "humours". IN those times, philosophers were the scientists of the time because there was no technology to measure and image the body - only the intellect to construct theoretical models.

      We now have the benefit of technology in so many areas of life. We don't use smoke signals or drums to communicate - even the developing world now uses the internet…

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    18. Sue Ieraci

      Public hospital clinician

      In reply to Carolyn Ee

      Carolyn Fe - the study that has been quoted, showing a modest improvement in pain for some painful conditions, is a well-conducted meta-analysis of the better quality trials of acupuncture. This is not because nobody looked - it's because this is the best there is.

      There is no "conventional" vs "alternative"- there is therapy that works, and "other".

      It is not logically plausible for a single therapeutic modality to be effective across the spectrum of types of pathology, from injury to infection to high blood pressure.

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    19. Shanna Cowell

      logged in via Facebook

      In reply to Sue Ieraci

      This is not a myth. The cycle of creation is obvious describing the transformation of elements--water nourishes wood creates fire to ashes which are earth condensed to metal which releases water (hot springs around ore deposits). These are things the ancients observed without benefit of microscope in the macro environment. The amazing thing is that they were then able to overlay our organ systems onto this same cycle and create a predictable way the body works.
      Just like they were able to map the stars in ancient times. There were "Einstein"-like people walking the earth then as there are now. Just because a technology is ancient doesn't mean it's worthless.
      Yet another anti-Chinese Medicine attack from Big Parma and the AMA as a substitute for genuine curiosity and respectful discussion and exploration.
      How were the pyramids built anyway? HHmmmmm....ancient technology.

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    20. Shanna Cowell

      logged in via Facebook

      In reply to Sue Ieraci

      Chinese Medicine does not contradict modern science. It's theories are lasting and serve to underpin modern science. There is no clash. If one studies both, it becomes quite obvious. I would not throw out the bath water or the baby.

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    21. Shanna Cowell

      logged in via Facebook

      In reply to Sue Ieraci

      And yes.The Ancient Chinese predicted that bone would demineralize without the effects of gravity.
      Gravity is Earth. Earth nourishes Metal which nourishes Water per my post above. Remove Earth from the equation and Metal and Water begin to separate. To the ancient Chinese, this would have been obvious.

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    22. Shanna Cowell

      logged in via Facebook

      In reply to Sue Ieraci

      One example: We have finally "discovered" that mindfulness based meditation can help improve health from depression to high blood pressure and heart disease. Through advanced imaging with fMRI the ancient theories supporting brain plasticity and mind body connection have been "proven" with modern science. Meditation has been included in Chinese Medical therapy all along. The acupoints can even be stimulated using meditation as well as heat, pressure, scraping. It's only a matter of time before science can satisfy itself. Meanwhile, what is true continues to be true.

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    23. Sue Ieraci

      Public hospital clinician

      In reply to Shanna Cowell

      Shanna - your arguments get more and more convoluted.

      Of course the ancients could map the stars - they could see them - with their own eyes.

      The pyramids were largely built from human physical effort - in great quantity. The ancients were basically limited to what they could perceive with their own senses.

      "Just because a technology is ancient doesn't mean it's worthless."

      But there was just so much less of it - don't you see this (while you sit typing at your computer)?

      Did you know…

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    24. Sue Ieraci

      Public hospital clinician

      In reply to Shanna Cowell

      Meditation can have health benefits. Acupuncture cannot cure fibroids.

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    25. Sue Ieraci

      Public hospital clinician

      In reply to Shanna Cowell

      Sorry, Shanna, but just saying it doesn't make it true. Just like all your miracle instant cures.

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    26. Carolyn Ee

      PhD Candidate at the Department of General Practice; GP and Acupuncturist at University of Melbourne

      In reply to Tim Scanlon

      Tim, You are right, I did miss your point. And you are completely correct, acupuncture could be one of those placebos. Certainly the bulk of research on acupuncture so far has failed to show a difference between "placebo" and true acupuncture. However, to reference one study and make a statement "Acupuncture can't prevent anything" seemed a little extreme to me but I see where you are coming from - it was in reply to Shanna's comment which was similarly extreme.

      Sue, agree that it is not logically…

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    27. Sue Ieraci

      Public hospital clinician

      In reply to Carolyn Ee

      Carolyn - after that long discussion, I think we are in agreement about one fundamental thing: and that is that acupuncture studies have shown a modest improvement in pain perception.

      There is no sound evidence that acupuncture has any therapeutic or systemic effect beyond that. If people want to try acupuncture for pain relief, and it is administered for that purpose (and audited), I have no issue with that. Used simply for that purpose, the risk of harm is negligible, benefit ispossible, and…

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  3. Murray Webster

    Forestry-Ecology Consultant/Contractor

    The main problem I have with this article is that it degrades into sarcasm and pejorative, offensive, terminology.

    e.g."We suggest that it’s hardly surprising that inserting needles into the skin causes a reaction in the tissues or a change in the brain" and many other phrases

    I suggest that use of such terminology crosses the line between objective science and personal beliefs.

    Not surprisingly, science has not discovered everything yet. When I had serious back problems (L5-S1 disc herniation…

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Murray Webster

      Murray Webster - I didn't see see the quote you copied in your second paragraph as sarcastic, perjorative or offensive.

      The author as acknowledging that there are studies that purport to correlate needle insertion with brain changes, as imaged by functional MRI. (This was mentioned in teh previous artcile about acupuncture, and cited as evidence of efficacy). The comment merely states that the fact that inserting a needle into skin correlates with a reaction in the brain does not mean that the needle insertion is therapeutic. What is sarcastic or pejorative about that? It;s not about personal beliefs at all - it's about logic.

      Of course, it is true that knoweldge and evidence accumulates slowly and gradually. After centuries, however, very little evidence for the efficacy of acupuncture has accumulated, and what exists is only relatively strong in the area of pain relief, and only with mild to moderate effect.

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    2. Murray Webster

      Forestry-Ecology Consultant/Contractor

      In reply to Sue Ieraci

      No problem with "merely states that the fact that inserting a needle into skin correlates with a reaction in the brain"

      its the "We suggest that it’s hardly surprising..." that is obviously unnecessary. Why then is it there?. Its pompous and arrogant. There are other examples in the text.

      It detracts from their main argument and I expect better from lecturers and professors paid for by the public purse.

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    3. Sue Ieraci

      Public hospital clinician

      In reply to Murray Webster

      Why is it there, then?

      "it's hardly surprising", in this context, means "of course, but".

      Here is how the logic goes:
      1. A previous article on The Conversation cited research showing that sticking acupuncture needles in the skin correlated with changes on functional MRI.
      2.The author, in response to this, says "Sure, sticking pins in the skin might correlate with brain changes, but that doesn't mean that acupuncture is therapeutic.

      "Reject your sense of injury, and the injury itself disappears."

      (Translation: sometimes, insult is in the eye of the beholder.)

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  4. David Colquhoun

    Professor of Pharmacology, UCL at University College London

    Oh dear, Laurie Willberg describes himself as a journalist, yet he says

    "Suggesting that a treatment option that is highly successful (and has been for thousands of years) is "implausible" at this stage of the game is worthless and obviously false. "

    That seems remarkably gullible for a journalist. Who says it has been successful? Does Willberg not realise that in 1822 acupuncture was banned in China itself. It was regarded as fraudulent. It was moribund in the West and in China too until…

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    1. Laurie Willberg

      Journalist

      In reply to David Colquhoun

      Consumer protection organizations have no power to prosecute anyone for anything -- what world is David Colquhoun living in? If they did, they'd put pharma companies out of business instead of simply fining them.
      I wonder how David Colquhoun, as a "professor of pharmacology", handles questions from his students and others regarding the ongoing prosecutions in the criminal justice system of pharmaceutical companies for outright fraud and falsification of data in order to support the marketing of…

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    2. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to Laurie Willberg

      @Laurie Willberg

      As Laurie Willberg is so determined to defend mythical magic medicine, I'm not surprised that he's happy to distort the history, just as he distorts, or ignores altogether, the empirical evidence.

      The "Web that had no Weaver" was written in 1983, when
      Kaptchuk was going through a hippy phase. i recommend the review at http://bit.ly/rrpeTM His recent work, in the placebo effect, is more interesting.

      And before you say that I'm in the pay of Big Pharma, I suggest that you look at http://www.dcscience.net/?p=5538

      It's well known that there are still big areas in which medicine can't do much. The answer to that problem is to admit ignorance and keep researching. The answer is not to invent nonsense and rely on myths which, empirically, don't work.

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    3. Laurie Willberg

      Journalist

      In reply to David Colquhoun

      @David Colquhoun
      Now David Colquhoun would like to make ad hominem remarks about Ted Kaptchuk... Yes, his current research is indeed very interesting and groundbreaking.
      "The Web that has no Weaver" is a fundamental text for Western TCM students which include thousands of conventional MDs, physiotherapists, nurse practitioners, midwives, etc. I guess these people believe in "mythical magic medicine" too. Guess all of those positive clinical outcomes are just too magical to ignore.
      I agree that David Colquhoun should admit ignorance and keep researching, perhaps repeating the positive studies he disputes to see if he can geniunely and honestly derive a different outcome and then publish it.

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    4. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to Laurie Willberg

      Laurie Willberg
      As I keep trying to point out, after over 3000 trials, the result is clear. Acupuncture has no clinically useful effects. There is nothing there to research.

      It is horrifying toe learn that ""The Web that has no Weaver" is a fundamental text for Western TCM students". It is time that students we stopped feeding students with mystical gobbledygook (and fired the vice-chancellors who allow this sort of thing to go on in their universities)

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    5. Sue Ieraci

      Public hospital clinician

      In reply to Laurie Willberg

      Excerpt from Australian Journalists Association Code of Ethics:

      "9 Do not allow personal beliefs or commitments to undermine accuracy, fairness and independence. Where relevant, disclose."

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    6. Laurie Willberg

      Journalist

      In reply to David Colquhoun

      David Colquhoun, your opinions (and many of your very questionnable assertions of "facts") are not going to be considered absolutes by anyone but you and other pseudoskeptics.
      The world has embraced TCM, including many mainstream medical practitioners.
      It's time that dinosaurs like you stopped trying to reverse the clock on a fait accompli and retired before you're fired for your biased and propagandist views. Perhaps spend some of your copious free time policing the frauds committed in your own profession?

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    7. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to Laurie Willberg

      You say "The world has embraced Chinese medicine"

      Your capacity for self-delusion seems endless. Most people think of Traditional Chinese Medicine as a relic of the past (which is exactly what it is).

      What has happened is that large numbers of Chinese medicine shops have sprung up on High Streets, where they profit from the gullible and do a certain amount of harm.

      And I have already given a reference to my activities in exposing fraud in regular medicine. In case you didn't read it…

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    8. Shanna Cowell

      logged in via Facebook

      In reply to David Colquhoun

      Here, at least, in US, none of the above mentioned medicinals are allowed because of endangered status and ethical treatment issues; though poaching continues and their use are not as well regulated worldwide unfortunately.
      Are not pharmaceuticals many times derived from plants or animal parts or minerals?
      Have you considered the chemistry of taste as it applies to phytochemistry?
      Look at the bitter taste and Berberine and all her sisters in plants like Huang Lian and Yin Qin Hao which yields quinine. The science of taste is an emerging discipline which will serve us well in learning about Traditional Herbal Medicines worldwide. I'm not able to find much about possible healing properties of the other tastes.
      Most pharmaceuticals are bitter taste by the way.

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  5. David Stewart

    Writer, civil engineer at Self-employed

    Firstly: the human being (as all life) is an astonishing mechanism, a wonder of physics, chemistry, engineering and information systems. That a few experiments by a couple of scientists fail to prove a hypothesis says much about the hypothesis and the tests. How the the mind, the brain and the human IT system manages our body's health and repair is very poorly understood. Acupuncture may tap into this at a level not yet comprehended.

    Secondly: scientific theory relies on setting hypotheses…

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    1. Craig Morton

      Biomedical Research Scientist

      In reply to David Stewart

      "How the the mind, the brain and the human IT system manages our body's health and repair is very poorly understood. Acupuncture may tap into this at a level not yet comprehended."

      Or it may be garbage.

      And the balance of data between the two options is leaning heavily towards acupuncture being as useful as powdered rhinoceros horn or prayer.

      "Acupuncture as for other alternative health treatments still have much good to offer and are usually of low financial and physiological cost to the…

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    2. David Stewart

      Writer, civil engineer at Self-employed

      In reply to Craig Morton

      To the primary authors and to Craig Morton;
      1. Assertions require evidence; the original article and CM's only contain assertions. More documentation of evidence is required before broad assertions are accepted.
      2. You all state or infer that ... "acupuncture is based on implausible principles." ... so is there weakness in the general understanding of what is plausible? And here see Greg Horgan's comment below, and mine that the human being is a fantastic mechanism of which we cannot presume…

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    3. Craig Morton

      Biomedical Research Scientist

      In reply to David Stewart

      "1. Assertions require evidence; the original article and CM's only contain assertions. More documentation of evidence is required before broad assertions are accepted."

      No, the original article contains links to the documented evidence. Once that has been made available it can be asserted with confidence without the need for repeatedly posting the same data.

      "2. You all state or infer that ... "acupuncture is based on implausible principles." ... so is there weakness in the general understanding…

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    4. Paul Savage

      Theme Leader, Biotechnology at CSIRO

      In reply to David Stewart

      David Stewart provides almost the perfect laundry list of arguments that are routinely trotted out for quack medicine (see The Seven warning signs of bogus science: http://tinyurl.com/ydhbs3o). Paraphrasing:

      1. "More evidence is required to prove to me that acupuncture *doesn't* work". Putting the shoe on the other foot. Of course the burden of proof should rest with those making the claim it does work.

      2. "The situation is so complex we can't possibly understand it, therefore in the meantime…

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    5. David Stewart

      Writer, civil engineer at Self-employed

      In reply to Paul Savage

      This is hardly "conversation" and both Morton and Savage are verging on the abusive. I am not a current "research" scientist, I am a practising technologist with strong research interests and I see in the threads of this long conversation a split between pure scientists and the rest.
      I have examined several of the authors' references and quoted them. They are contradictory and the largest study gives positive support to acupuncture. This point has not been acknowledged in responses. I did not…

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    6. Sue Ieraci

      Public hospital clinician

      In reply to David Stewart

      David Stewart - you say: "That a few experiments by a couple of scientists fail to prove a hypothesis says much about the hypothesis and the tests. How the the mind, the brain and the human IT system manages our body's health and repair is very poorly understood."

      It is possible that you have poorly understood (a) the extent of the findings about acupuncture; and (b) what is known about human physiology. One needs to be cautious about pronouncing mystical possibilities in an area outside one's…

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    7. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to David Stewart

      David Stewart
      You say "That a few experiments by a couple of scientists fail to prove a hypothesis says much about the hypothesis and the tests."

      I think perhaps you should do your homework before writing. There have been well over 3000 trials of acupuncture. There is now consensus that any effect that it may have is too small to be clinically useful. It doesn't really matter in practice whether the small effects are real or bias.

      So that's the end of it. Since it doesn't work, there is nothing to explain.

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  6. Greg Horgan

    The Bush Philosopher

    Long ago I gave up academia and entered the real world of private practice and you know what? My patients have taught me one thing that your brand of science never could (perhaps never will) and it's this: - there is more to this world than what one finds at the end of a microscope. Occasionally you need to cast your eyes upwards and see what is in front of you and wonder at the mystery of that.

    Quite frankly, my patients, and the billions who came before them won't read your article, and probably wouldn't give a toss if they did. What they care about is results. They know it works for them. Wouldn't it be better to spend some time figuring out why that's the case. Hiding behind your scientific dogma won't change that one little bit. Unfortunately the horse has indeed - bolted.

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    1. Craig Morton

      Biomedical Research Scientist

      In reply to Greg Horgan

      Ah yes - they know it 'works for them'.

      And you're hardly going to tell them it's all crap while they continue to pay you for nonsense, are you?

      "Wouldn't it be better to spend some time figuring out why that's the case."

      The whole point of the article here is that we know why it 'works' - it's in their heads, just like with homeopathy, faith healing etc. etc.. And the effect is minimal, not clinically relevant and anyone charging for the service is ripping them off.

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    2. Shanna Cowell

      logged in via Facebook

      In reply to Craig Morton

      But, "it works for them" means ultimate success with the patient. The mechanism is not the point. The patient and their pain is the point.
      Health care in the 21st century exists to please the "researchers" and "blood test givers". The patient still feels like poo.

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    3. Craig Morton

      Biomedical Research Scientist

      In reply to Shanna Cowell

      If "it works for them" means someone took money from them and they would've got better anyway, then that's EXACTLY the point.

      This is the whole issue with treatments for conditions like lower back pain. No matter what you do, people tend to get better in a few weeks all by themselves, for well understood reasons. What matters is immediate treatment of extreme pain and trying to ensure that it doesn't happen again - ie: drugs for the immediate pain and then physiotherapy with surgery as an option…

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    4. Shanna Cowell

      logged in via Facebook

      In reply to Craig Morton

      I "stick" people daily who have had back pain for months or even years and who have instant relief with no further treatment required. While this is not the case in every case, it is far more common than not being able to help at all or taking more than a few treatments to effect a cure. I have seen too many patients with migrains or high blood pressure or uterine fibroids or insomnia or hot flashes or lymphedema or pain or whatever "just get better" when nothing else seemed to help. Just because you do not know how it works nor speak the language and philosophy from which it was developed doesn't mean it has not merit. Just because it sounds implausible to you with your current understanding of living systems, doesn't mean that someone else doesn't understand it.
      As for "pretend medicine:" how many times are we prescribed "medicine" only to have side-effect's which make us more uncomfortable and eventually even more ill? Who is pretending here?

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    5. Tim Scanlon

      Debunker

      In reply to Shanna Cowell

      But you don't know how it works, in fact you can't even prove if it does work or if it is just a placebo. How can you prescribe or use a treatment that has no proof? How can you be sure it has treated anything? You can't. Science certainly isn't able to discern any actual difference between acupuncture and a placebo, so why not just throw darts at people instead?

      Your final point is a false cause. Medicine is actually tested and is understood. For any given medicine you can get a list of associated population statistics for side-effects, efficacy, dose response and mode of action (the latter being not always fully understood due to test subject ethics). Thus a medicine is actually a proven and known quantity, you can look up what it does and what the risks are. Pretend medicine can't even prove it works, let alone how, what the risks are or the response rate, the only thing pretend medicine can tell you for certain is the price.

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    6. Sue Ieraci

      Public hospital clinician

      In reply to Shanna Cowell

      Shanna - do you audit your practice? How many patients do you really have in your case series, verified, who had years of pain and got "instant relief" from your treatment? As they say, things that sound too good to be true generally aren't true.

      The only vaguely positive evidence for acupuncture, which is only slightly different to placebo, is in the subjective perception of pain. There is absolutely no reason why sticking needles into the skin would do anything for uterine fibroids or lymphoedema. Do you even know that those conditions are?

      Side effects of effective medicine are not "pretend"- they occur because the medicine has an effect on the body. And nobody in medicine pretends that unwanted effects do not exist.

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    7. Patrick Stokes

      Lecturer in Philosophy at Deakin University

      In reply to Greg Horgan

      "there is more to this world than what one finds at the end of a microscope" - yes there is. But there's not more to your body. It's a physical object and as such it's bound by the same physical laws as everything else, and as such claims made in this area have to be tested using the same methodology and evidentiary standards.

      Of course, if you *do* believe that organic matter can be acted upon by non-physical factors, could you please, as a philosopher, share with us your answer to the Interaction Problem?

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    8. Shanna Cowell

      logged in via Facebook

      In reply to Tim Scanlon

      If the "medicine" makes us feel worse (ie side-effects) what's the point? It's quite satisfying to the doctor to be able to look up the "associated population statistics, side-effects, efficacy and dose response and mode of action". But how satisfying is it to the patient who must bear the brunt of these side-effects and risks? So what if you can look it up? The patient feels like poo much of the time. That's why they come see people like me.
      So what if we can't prove to "you" that it works? The…

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    9. Shanna Cowell

      logged in via Facebook

      In reply to Sue Ieraci

      Sorry Sue but yes, in my 13 years in Acupuncture practice and 22 years in Complementary Medicine, it is a regular occurrence to provide instant relief. That's why people like me are still in long-lived practices.
      I know you think there is no reason that sticking needles into the skin would do anything for uterine fibroids. I used to think that too after getting my degree in biology many years ago. But there is a subtle system at work in the body that provides conduits from the outside to the inside…

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    10. Shanna Cowell

      logged in via Facebook

      In reply to Patrick Stokes

      "It's a physical object and as such it's bound by the same physical laws as everything else, and as such claims made in this area have to be tested using the same methodology and evidentiary (sic) standards."
      Again, the body is not a physical object: it is an animate living organism. It is not subject to the same physical laws as everything else. It is self-organizing, self-regulating and self-creating--unlike a rock or a car or a game of billiards. It is not known precisely how it was created nor…

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    11. Patrick Stokes

      Lecturer in Philosophy at Deakin University

      In reply to Shanna Cowell

      Hi Shanna,

      Not sure what your problem with the word 'evidentiary' is; to quote the Simpsons, it's a perfectly cromulent word :)

      Yes, the body is an 'animate living organism' - but organisms are still physical objects i.e. made of matter. Organisms display a wonderful form of complex, interactive organisation (what the philosopher Warwick Fox has called "responsive cohesion"), and that form of organisation may even give them a moral value that simpler things don't have. But that doesn't mean…

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    12. Sue Ieraci

      Public hospital clinician

      In reply to Shanna Cowell

      Shanna - your statement that " there is a subtle system at work in the body that provides conduits from the outside to the inside probably via the piezo-electric properties of fascia." is just pseudo-sicence mumbo-jumbo. Fascia generally encloses muscles and sits between tissue layers - it can't "provide conduits from outside to inside" .

      In your "13 years in Acupuncture practice and 22 years in Complementary Medicine" have you ever audited your practice? How many cases of uterine fibroiods have you treated? How were they diagnoses? What size were they? Do you claim to have reduced their size? By how much?

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  7. David Stewart

    Writer, civil engineer at Self-employed

    The main article presents outcomes from Derry CJ, Derry S, McQuay HJ, Moore RA, 2006 with a conclusion that ... "Six reviews with more than 200 patients [over a 9 year period] in randomised, double blind studies had good evidence of no benefit." Samples of 200 patients over nine years is very weak statistics for analysis of very complex systems - we, the human!
    The authors also quote Vickers AJ et al. 2012 with ... "CONCLUSIONS Acupuncture is effective for the treatment of chronic pain and is…

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    1. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to David Stewart

      Please note that Vickers et al said "However, these differences are relatively modest". If you read the paper, not just the abstract, you'll find that this wording is a euphemism for "too small to be clinically useful".

      The authors of Vickers et al are notoriously in favour of acupuncture. The fact that even they have come up with the conclusion that acupuncture is not clinically useful (albeit heavily spun) is one of the strongest arguments yet.

      There have already been over 3000 trials. Just about every one of them has concluded "more research is needed". Luckily the results are now clear so there is no need to waste any more money on further research. That money can now be spent on more promising treatments.

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    2. David Stewart

      Writer, civil engineer at Self-employed

      In reply to David Colquhoun

      Professor Colquhoun and Sue Ieraci,
      My expertise in this debate is the statistical basis which is strong, and my concern is that statistical validity is at odds with much anecdotal reporting of efficacy.

      The argument that research money should be curtailed, or stopped, for acupuncture has validity for you researchers which I do respect, there are other important areas for research also. That the case is proven against acupuncture I am not so certain. I have not closed the book on it.

      I do…

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  8. Tim Scanlon

    Debunker

    Lets imagine the human body is a car, and lets pretend that this car has a problem. Do you take it to a mechanic who will look around, run some tests, tinker with parts, etc and fix the problem? Or do you instead take it to a guy who stabs holes in the car to cure the "blockages of energy"? Taking your car to either will make you feel as though you are doing something to fix the problem, but only one is actually doing anything worthwhile.

    Our bodies are complex machines and science has been working to understand them for millennia. Science is pretty good at understanding how the body works, so when someone comes along with a treatment that throws that knowledge aside, I tend to avoid that treatment like the plague. If I'm going to have treatment for an ailment, I don't want to be getting a placebo, I want to actually treat the problem. People selling a placebo are nothing more than charlatans offering false hope.

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    1. Shanna Cowell

      logged in via Facebook

      In reply to Tim Scanlon

      This perfectly illustrates the problem with where modern medicine is headed. Imagining the human body as a car. Ludicrous.
      There are very important and basic differences between matter which is "animate" and matter which is "inanimate". That's why the study of Biology is separate and considered a "softer" science by mathematicians and physicists. Life is self regulating, self organizing and self creating. No one knows precisely how it is possible to happen nor can anyone currently replicate it from scratch. It's negative entropy defies all rules.

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    2. Craig Morton

      Biomedical Research Scientist

      In reply to Shanna Cowell

      There are no fundamental differences between 'animate' and 'inanimate' matter.

      Biology is only considered a 'soft' science by those who have never studied any. Many of us (including me) working in the areas where biology and physics overlap - the atomic-level detail of molecular structure and drug function, in my case.

      " No one knows precisely how it is possible to happen nor can anyone currently replicate it from scratch. It's negative entropy defies all rules."

      Again you display a breath-taking lack of basic understanding of science.

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  9. Swetha Srinivasa Murali

    PhD Scholar at University of Sydney

    A very quick comment, the only good science I've seen to date with respect to acupuncture is by this guy:

    http://faculty.uci.edu/profile.cfm?faculty_id=4903

    He has done many years of work looking at the cardiovascular effects of acupuncture, and has actually dissected out the mechanisms underlying the effects (including looking at the brain regions and neurotransmitters involved). He's well-published in peer-reviewed, established scientific journals.

    Giant caveat: he only looks at a few of the traditional acupuncture points, which happen to coincide with the anatomical location of major nerves, and is very, very open in pointing out that the cardiovascular effects are only seen with certain points and not others. Also, this research only pertains to cardiovascular effects.

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Swetha Srinivasa Murali

      Even more giant caveat: he only deals in theoretical concepts - he doesn't actually measure patient outcomes.

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  10. Carolyn Ee

    PhD Candidate at the Department of General Practice; GP and Acupuncturist at University of Melbourne

    This article glosses over much of acupuncture research in coming to its conclusion. While the authors point out several valid points, for example, that the "retrofitting of physiological mechanisms" is "scientifically upside-down" and that the (Chinese medical) principles underlying acupuncture appear to be "implausible", there are some flaws to the argument proposed that need clarification.

    It is recognised within the acupuncture research community that there is an "upside-down" approach to…

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    1. Shanna Cowell

      logged in via Facebook

      In reply to Carolyn Ee

      Well done, Carolyn! I see no one has touched this thread with a ten foot pole. Wish I were as well read and organized in my argument as you.

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    2. Swetha Srinivasa Murali

      PhD Scholar at University of Sydney

      In reply to Carolyn Ee

      Carolyn, a few thoughts:

      "It is recognised within the acupuncture research community that there is an "upside-down" approach to research. Drug trials typically begin with examination of the pharmacokinetics etc of the drug in question and then proceed on to clinical trials. The opposite has happened with acupuncture and we may never know what exactly an acupuncture point is and what meridians are. The question is, do we need to know?" The authors fail to mention that the vast bulk of research…

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    3. Craig Morton

      Biomedical Research Scientist

      In reply to Carolyn Ee

      ""There’s a thriving industry of acupuncture research that will no doubt continue to optimistically mine pockets of subtle or manufactured uncertainty." Its unclear what sort of "industry" they are referring to, and what exactly is being "mined"."

      Allow me to clarify this point for you then.

      Do acupuncturists treat cancer? Do they treat appendicitis? Do they treat bacterial infections? Do they treat HIV? Do they treat glaucoma? Do they treat cataracts? Do they treat broken bones?

      No. They…

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  11. Geoff Taylor

    Consultant

    The first time I ever saw acupuncture used was in a video from a surgery in China many years ago, I think in an ABC doco.
    The patient was a young woman and she was conscious when her appendix was removed while she was treated with acupuncture.
    Was this a fake or charlatanism? Others may be able to contribute knowledge of similar events.

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    1. David Colquhoun

      Professor of Pharmacology, UCL at University College London

      In reply to Geoff Taylor

      Yes, it has been shown at least wice that "acupuncture anaesthesia" is fake. The first time I know of was in 1972 when the (UK) Medical Research Council sent a delegation to China to investigate the claims.

      Most recently, a rather gullible TV programme showed film of a patient having open heart surgery while impaled with acupuncture needles.

      It turned out that the Chinese authorities forgot to mention that the patients.also had been punped with local anaesthetics and various depressant drugs. These shows are merely part of the Chinese givernment propaganda machine.

      In fact essentially no clinical trial of Chinese medicine conducted in China has ever produced a negative result. I guess it is just part of their export drive,

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  12. David Colquhoun

    Professor of Pharmacology, UCL at University College London

    I think it is time to stop commenting here. Laurie Willberg and Shanna Cowell are doing such an excellent job in showing that the proponents of Chinese medicine live on another planet, or at least in a different century from most people, it's hard for me to improve on it.

    The really ironic thing is that they are using the internet to propagate their pre-enlightenment ideas. The internet is just a product of what I expect you would call "scientism". It's all nonsense, right?

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