Talk:Acupuncture/Archive 1

message: Just wanted to clarify. The edit by 209.178.189.56 on Dec. 18 was me -- I guess I wasn't logged in. -- [User:Bcrowell]
----
Supporters of acupuncture claim that it works on animals, which are not influenced by placebos. Could somebody mention this? -- Error
*ah, but the result is interpreted by humans, with all the associated problems such as confirmation bias.
---------
This page required major editing, apparently was written by someone with an ax to grind against acupuncture, but little depth of knowledge. It was riddled with errors and omissions, starting with the first sentence referring to acupuncture as a "surgical" procedure. Also, it made no reference to any literature within the past decade (such as the NIH consensus statement). I retained the NCAHF excerpts in the interest of healthy skepticism.  Yes, most research on the physiology of acupuncture has been performed on animals. I admit to bias, being a practitioner and student of the medical art of acupuncture for 18 years; also I am an MIT graduate and am no more fond of exaggerated claims or fuzzy thinking by my colleagues re acupuncture than is the NCAHF.[user:barrylevine]
----
When I asked my father, a respected doctor with 25+ years experience, about his opinion on acupuncture, he said 'of course it works, and it isn't just opiates either'.  He is a firm believer in the energy field, and claims to sense it himself, actually.  In fact, hundreds of doctors apparently sense this energy field, along with vortices which correspond curiously with the chakras...  To deny the possibility of such an energy field is only closed-mindedness...  It sickens me how much the religion of science has taken hold of social opinion.  Any real scientist recognises science for what it is--a tool, rather than a dogma.  People who go about calling others 'psuedoscientists' are actually, ironically, the epitome of psuedoscientists themselves, in having directly conflicted with the essential nature of science as both a tool and an artform which includes no absolute certainty, but only theory.  It is more aligned with Tao than with dogma, it seems.  Khranus
*Let your father show James Randi or CSICOP that he can sense that energy field, take a million dollars and probably a Nobel Prize to boot. I'm afraid he wouldn't recognize energy if he got hit on the head by it. Science has investigated (using science as a tool) the energy field, found absolutely nothing and moved on to more useful things. And 'only theory'? You should look up what 'theory' means in a scientific context before using it like you do.
*Ironically? Only theory? You seem to not understand the meaning of theory and irony... 
-----
This thing is like the art of drawing blood.  Some doctors could poke holes in their patient's arm for hours until a more experienced nurse takes over.  The difference is that the bruises on the arm is a visual indication that if the poke is successful or not.  Acupuncture does not show immediate feedback.  A researcher may be spending years poking at the wrong spots and draw a wrong conclusion about the effectiveness of acupuncture. It is like proving no one could fly by asking a child to build an airplane.
12.234.73.11 08:26, 20 Oct 2003 (UTC)
thread_title:  Various 

message: === PubMed ===
The following link
* PubMed - US National Library of Medicine search engine with hundreds of scientific article on acupuncture is imperfect in that the site offers no URL that produces the effect of keying in the word "acupuncture".  That is certainly no excuse for removing it, but if one of our programming or searching gurus could come up with a means of single click access, it would be a significant improvement. --Jerzy 17:58, 2004 Feb 19 (UTC)
:Okidoki. -- Kimiko 19:17, 19 Feb 2004 (UTC)
replies: text: Su Jok TM acupuncture stands as one of the aspects of the ONNURI TM medicine founded by Professor PARK JAE WOO, a scholar from South Korea are an adv, and i have removed them. --Jerzy 17:58, 2004 Feb 19 (UTC)
===Photo===
I could put my photo (currently linked) here, but with the drawing and the infobox, it seems like a bit much.  Thoughts?  heidimo  02:09, 4 May 2004 (UTC)

text: Dear 195.198.190.70, I agree, and have edited the offending section. Fire Star 22:47, 28 Jul 2004 (UTC)
thread_title:  re External links sec'n 

message: The following link
* PubMed - US National Library of Medicine search engine with hundreds of scientific article on acupuncture is imperfect in that the site offers no URL that produces the effect of keying in the word "acupuncture".  That is certainly no excuse for removing it, but if one of our programming or searching gurus could come up with a means of single click access, it would be a significant improvement. --Jerzy 17:58, 2004 Feb 19 (UTC)
:Okidoki. -- Kimiko 19:17, 19 Feb 2004 (UTC)
thread_title:  PubMed 

message: I could put my photo (currently linked) here, but with the drawing and the infobox, it seems like a bit much.  Thoughts?  heidimo  02:09, 4 May 2004 (UTC)
thread_title: Photo

message: I've edited out a pretty blatant and rather clumsy POV paragraph and somehow the Wikipedia managed to remove any access to the previous version which included it dated 4 July, 2004. I've had some problems before with the Wikipedia not registering edits, but this is the first time that this has happened. Unfortunately, I don't remember the name of the contributor whom I reverted. If it does somehow return to us, and if such a thing belongs anywhere, it should be cleaned up and posted at Qi. Fire Star 04:48, 5 Jul 2004 (UTC)
replies: text: Dear 195.198.190.70, I agree, and have edited the offending section. Fire Star 22:47, 28 Jul 2004 (UTC)
thread_title: Something weird

message: An anonymous user at 62.49.59.192 keeps adding
this link:
* A Very Informative Site about Acupuncture
and now with a new domain:
* A very informative site about Acupuncture
to the External links section. Incidentally, 62.49.59.192 is an IP address of tai-chi-chuan.demon.co.uk, no less... This “very informative site about acupuncture” is in fact an advertisement of “The College of Chinese Medicine, Three Year Part Time Weekend Professional Training Course in Acupuncture Chinese Herbal Medicine and Traditional Chinese Diagnosis.” The first time it got posted, I changed
that link to the real website title, wondering whether that advertisement should stay at all. (At that time I didn’t know that it was added from an IP in the same domain.) Later, someone else has removed it, and now someone from the IP of that website has added another “very informative site about Acupuncture” link, which I am now removing. Please stop adding links to your website. If you want traffic for your training course, consider buying AdWords on Google. Wikipedia is not a place for spamming. Rafał Pocztarski 03:55, 23 Nov 2004 (UTC)
thread_title: Spamming

message: 1) Overview of acupuncture as one element of Traditional Chinese Medicine (TCM) 
:a) Alternative medicine caveat, 'bioenergy field' observations are an issue, etc.
:b) Brief history of highlights in TCM over last 1,000 years (extends back 5,000)
:c) Growth and spread of availability, acceptance within medical community, NIH
:d) Insurance plan provisions for acupuncture treatments and diagnoses treated.
:e) Do not ever avoid or put off seeing a regular doctor for medical complaints.
2) Theory and Practicse of Traditional Chinese Medicine
:a) Yin Yang, 5 Phase association and Elements, Organs, Meridians, Acupoints etc.
:b) Nature of healthy harmonious function versus disease/pathological function
:c) Modalities of treatement: needles, moxa, massage, exercize, diet, meditation, herbs, lifestyle
:d) Updated theories and models explaining how TCM treatment may provide effective benefits
:e) The as of yet unexplained and yet to be substantiated aspects, i.e. claims only supported by tradition.
:f) References for more information, studies, and study guides.
3) A visit to the TCM practioner
:a) Referal from doctor for conditions and treatments with ICD9 codes (yes, insurance pays some.)
:b) Assessment and diagnosis, appearance, tongue, pulse, sound, smell, palpitation; informing practioner of drugs taken, diseases, STDs, etc.  Use of accessories, electronics.
:c) Treatment plan: acute versus chronic treatment plans, cooperation with other plans, modalities
:d) Not intended to supplant/replace needed surgery, drugs, and contemporary medical treatement.  
:e) Assessing the practitioner
::i) Level of education and supervised hours clinical training
::ii) Level of cooperation with medical clinics, hospitals, etc.
::iii) Scope of practise and specializations
::iv) BBB rating, issues with state licensing body, etc.
::v) Quality of referrals from other practioners, patients
4) Table with Pro & Con arguments concerning validity of Traditional Chinese Medicine Acupuncture
:a) Replicable studies, tested hypotheses and outcomes, NIH articles
:b) Links to university articles/studies concerning medical value of acupuncture
:c) Summary arguments and conclusions pro and con
:d) Editorial observations and comment
5) Lists of accredited colleges
:a) US, CA, UK, Europe
:b) China, Japan, Pacific Rim
:c) Elsewhere
6) Lists of reference books and other resources
:a) overview texts, introductions, basics
:b) reference material covering material appearing on board exams.
:c) internet sites with reasonable quality information
:d) books covering intesting developments
:e) electronics and other devices used in current treatments
COMMENT: I do not believe we should ever be seeing referrals here to specific practioners/clinics. Colleges with accreditation may be listed especially if they are host to teacher/researchers publishing peer reviewed articles of scientific value.  It should be reasonable to link to peer reviewed journals, studies, etc. and where permitted by the author/publisher.  These might provide a sound starting point for serious debates.  
At this point, I have to admit newcomer Unipedia seems to have a better written article than this current one:  
http://www.unipedia.info/Acupuncture.html
:I don't understand. The article referenced above appears to be a straight copy of the Wikipedia article. P0M 03:25, 26 Mar 2005 (UTC)
thread_title:  A proposed outline to help organize all that's written before  

message: I have a fairly good background in this subject for someone who is has not been trained in traditonal Chinese medicine.  The problems that I see, actually, are with the POV of the people whose critiques of accupuncture are referenced in this article. Interested readers should study The Theoretical Foundations of Chinese Medicine, Manfred Porkert, 1974. (MIT Press?) to get a more adequate basis for understanding these issues. Complaining that Chinese texts on accupuncture do not conform to Western terminology and do not use Western concepts is a little like criticizing Ravi Shankar for not playing Indian music in the equal tempered scale that is the standard of most (but not all) Western music.  
Before one can tell whether an Indian musician is playing "out of key," one would have to know the rules for the tuning that s/he is supposed to be using.  
With regard to Chinese medicine and its theory, one should first understand what the practitioners are actually claiming as their rationales, and then one can evaluate their medical practice on two different bases: (1) whether their rationales are logically coherent, internally consistent, and whether they are responsibly evaluating the efficacy of the various treatments that are available to them. (2) The efficacy of their treatments as compared to other available treatments.
The fact that some treatments used in Western medicine are not very effective is not an argument against the legitimacy of Western medicine. It simply reflects the fact that some diseases are more difficult to treat than others, and that Western medicine may not have discovered a really satisfactory treatment yet.  The fact that some treatments work better with some patients than with others is, likewise, not an argument against Western medicine but only an objective recognition that matching treatment to patient may require time and effort.  The same standards should apply to Chinese  medicine. This article should aid the general reader to understand the theory and practice of Chinese medicine. Questions of what Western medicine thinks about Chines medicine should be secondary. 
Bad medicine happens when theory takes precedence over objective evidence that some treatment is useless or even counterproductive.
P0M 03:16, 26 Mar 2005 (UTC)
thread_title:  Neutrality 

message: The article says: "acupuncture needles are very thin and can break."  I can see where hypodermic needles might break, because they are made to be rigid. But the ordinary acupuncture needle is made of spring steel, and, moreover, it is designed for one-time use.  I spend lots of time in my pasture trying to get ordinary iron wires to break (being too lazy to walk back to the house for a pair of nippers), and getting any kind of wire to break requires bending it back and forth at a sharp angle very many times.  The same thing applies to guitar strings, which are steel wires of the same type as the acupuncture needles. They break, but only when tuned very tight and then played very enthusiastically for some time. If I were chained to a desk and forced to make an acupuncture needle break I think I would try to drive the needle as rapidly as possible through flesh into some nice flat bone and hope that the needle would shatter. But it would only shatter if at some point the metal had been crystallized. So I would only try each needle once and hope that my captors would mess up and give me a lot of needles that hadn't received good quality control. Of course, if I were permitted to cheat I would heat treat it so that it became very rigid and brittle. 
Some acupuncture needles are special-purpose and not made of spring steel. Is that the kind of needles that are known to break? Am I missing something?  I just can't see spring steel breaking under any normal circumstance. P0M 04:37, 24 Apr 2005 (UTC)
thread_title:  Any proof pf breakable needles? 

message: I'm fairly surprised to see that the impression given by the BBC article (to which I'd linked: http://news.bbc.co.uk/1/hi/health/4493011.stm ) could be as far from the truth as the abstract () appears to prove it to be. Is the abstract misleading when out of context perhaps? Can somebody with full access to the journal's database please check and compare with the BBC news article to see if their story is completely wrong? If it is I'd like to ask the BBC for an explanation. 
--wayland 11:58, 3 May 2005 (UTC)
thread_title:  New Research links 

message: As an acupuncturist in North America, I can see first hand the beneficial effects of acupuncture on my patients who come to me primarily because they find that Western medicine cannot help them or that the side effects of medication/surgery outweigh the benefits. 
On the question of the efficacy of acupuncture, with the thousands of years experience notwithstanding, the so-called "studies" done today in North America are mostly ill designed and under funded. The question always comes down to money - who gains and who loses from a properly done study that would actually show the benefits of acupuncture. To be more precise, those who gain are the practitioners of CAM and the general public, while those who lose are the pharmeceutical companies. Doctors have nothing to lose because all they need is 300 hours to become an acupuncturist (which is not enough time to learn all the points, but that is another story). The business of producing drugs depends on keeping patients, not necessarily healing them. Studies that are funded by those companies present with outcomes that show their product in a positive light, or they are done again and again until the desired result is acheived. 
Consider if acupuncture were proven to be effective in curing many diseases more effectively and with less side effects than pharmeceuticals - insurance companies would need to start covering acupuncture, and the reliance on drugs would be greatly diminished. An entire industry would start losing money. This cannot be allowed to happen.
If we were really concerend about health, we would integrate both Western medicine and CAM for the most comprehensive treatment. They are two extremes that can be seen from the micro and macro levels - that is, that drugs work on the cellular level while acupuncture works on the "wholistic" level. 
The article on acupuncture in this encyclopedia presents the practice of acupuncture for the layman in terms that are easily understandable; however, it first takes the point of view that acupuncture does not work and then cites sources presenting both sides of the argument, having first already taken a side. It is unfitting for such an encyclopedia that presents drugs from a neutral perspective.
:Please sign your postings. I learned to do so after aggressively attacking something that it later turned out I had written myself. ;-)
:You are quite right about beginning an article with a POV judgment on the value of whatever is being discussed.  The correct way to handle things, assuming that we are going to cover the subject at all, is to describe the subject in terms of its own theory, its own ideas on how it is supposed to work.  Once readers have been given an unbiased view of the subject they can be referred to secondary articles that deal with criticisms, alternative takes on the question, etc.
:For instance, it would be correct to say that Newtonian physics has been proven false. But it would not be helpful to readers who want to understand what Newton succeeded in figuring out about the Universe to tell them that they should ignore Newtonian physics and direct their attention immediately to Quantum physics and Relativity.  The appropriate thing to do is to explain how Newton conceptualized the Universe, how he created a model of the Universe that explained most things so well that we still use it today for almost all purposes, and then go on to inform the reader that the theory broke down under certain exptreme conditions of size and speed, and that those failures led to both reconceptualizations of the subject matter and to new formulas that express reliably the new discoveries made in the course of working out all of the consequences of Newtonian Physics.
:The problem for the general reader in trying to understand accupuncture is that the conceptual system by which the entire Universe is undersood is incompatible with the Western view at the same fundamental level at which Newtonian physics is founded.  The Western reader wants to talk about matter and energy, unconsciously having in mind the very sophisticated Newtonian concepts, when the Chinese theoretician wants to talk about qi theory. 
:Neither the Newtonian nor the Qi theory can be assumed to be true.  Both are models for understanding processes that go on in the Universe. Ask somebody who has a well founded understanding of both systems how to translate an observation made in terms of one theory into the terms of the other theory and the right answer will be, "You can't get there from here."  
:Both theories talk about the same Universe and, more-or-less, the same entities. To put that observation in simpler language, both a Western doctor and a traditional Chinese doctor can look at the same patient. What is available to each of them is presumably the same. I.e., the patient doesn't change colors or anything depending on which doctor is looking at him or her.  But the two doctors are looking at the patient through two different sets of colored glasses, metaphorically speaking.  The Chinese doctor says something is going on with the patient's triple burner and the Western doctor asks where in hell the patient's triple burner is, trying to find a proper anatomical term for it. But the Chinese doctor is dealing with systems of function, not with physically discrete organs.  
:The productive way to handle the fact that the Chinese doctor and the Western doctor are using different models to understand their patients and their problems is to keep firmly in mind that the patient comes first and the rational systems come afterwards and are used to codify insights, to put insights into what is going on with the individual patient into terms that another "speaker" of the same conceptual system can understand.  So if something is going on with a patient and a Western doctor happens to notice it, that information may not be readily codified in terms of the Chinese doctor's model. I have no idea of how Chinese medicine understands stomach ulcers, but let's say that some Chinese doctor has been treating ulcers by accupuncture points that have nothing to do, ostensibly, with the stomach.  The points are on the patient's ears, feet, and other places totally "remote" from the patient's stomach.  The Western doctors have been telling patients to drink milk, stay away from pepper, etc., etc. for generations. Some patient tells them that milk does nothing for his ulcer but yogurt is almost a miracle cure. The doctors all scoff at this idea and ask him which little witch lady in which health food store he got that idea from.  Then somebody notices that ulcer patients have unusual bacterial colonization of the stomach. The other doctors find polite synonyms for quack and idiot. The doctor drinks a culture of the bacteria, immediately comes down with an intense stomach ulcer problem, and then cures himself with a good dose of antibiotics (and hopefully saves himself a long recovery period by taking homemade yogurt).  Now the Western doctor tells the Chinese doctor that ulcer patients have microbes in their guts that are physically attacking the stomach lining. Maybe that gives the Chinese doctor the idea that ways useful to treating infected wounds might be applicable to treating ulcers -- even though his theory might not have predicted that connection.  And maybe it turns out that the ways that the Chinese doctor has been treating ulcer patients do indeed not having anything to do, directly, with the stomach, i.e., if you put all sorts of instrumentation to work look at the patient's stomach while he was being treated for ulcers, the stomach might not show any changes at all.  But the Chinese doctor may have been doing things that do make changes that the Western doctor could observe in the "discrete" organs that the Western doctor identifies with the immune system.  So the Western doctor learns that rather than using drugs to perk up the immune system, drugs that have side effects that nobody should ever want, perhaps, he can stimulate accupuncture points and get the same beneficial results with virtually no undesirable side effects.
:Maybe the new contributor can help us see how to boil the stuff in Manfred Porkert's book down to encyclopedia size. He's the only one I know of who has tried to put the Chinese conceptual system, as it pertains to medicine, into English. It's a good book, i.e., responsible and thoroughly grounded in the Chinese systems, but it's several hundred pages and pretty rough going for the non-medical and non-Chinese philosophy crowd. P0M 18:54, 4 December 2005 (UTC)
thread_title:  Why acupuncture cannot be proven to be effective 

message: I just added some minor new material to the risks section, but did not add sources. Both of my sources are already listed in 'external links.' FYI if anyone was curious. --User:Jeffmedkeff | Talk 00:59, 2 December 2005 (UTC)
thread_title:  New Material in Risks 

message: Why is there no pseudoscience tag on this page?! It's core belief is in Meridian and Qi (Chi) which has no basis in Science, cant be verified yet is passed off in Acupuncture as a practical reality, that is psuedoscience. Qi can be more closely aligned to an element of Chinese myth or religion, something cant be considered science if it is based on such a principle, this is pseudoscience for the same reason Feng Shui is. - UnlimitedAccess 18:45, 2 January 2006 (UTC)
replies: text: It isn't pseudoscience because its underlying theory doesn't pretend to scientific validity. It underlying theory predates the scientific method by 2,000 years, at least, so it cannot pretend to be a scientific approach even if it wanted to. Science may certainly describe traditional Chinese medicine and the culture it grew from, from many different angles (archaeology, anthropology, linguistics, chemistry, biology, etc.), but as a subject to be studied, not a scientific theory. Theories may indeed be drawn about it, but those theories would be outside of TCM. The pretension to scientific validity is a necessary part of the definition of the term pseudoscience for use at Wikipedia. Some prefer protoscience for this sort of thing. There are many acupuncturists etc., especially in the West, who pretend to be scientific (especially the many medical doctors who now perform acupuncture in their clinics), but for us to paint the entire theory by the recent actions of some of its adherents in the article is proscribed by our original research policy. --Fire Star 19:23, 2 January 2006 (UTC)
replies: text: Good point, Fire Star.  I think "prescientific" is a better term for TCM theory, and prescientific or not, it's also clinically useful!  And even elegent, depending on the eye of the beholder.  The NIH consensus statement itself notes that TCM theories "are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture."  How much clearer can it be?  The validity of acupuncture manifests in, and must be measured by, clinical efficacy.  This is true irrespective of the culturally-conditioned ideas (which are, in effect, ancient and pragmatic mnemonic devices) that predict such efficacy.  TCM theory is therefore an alternative, but still useful, lens through which to view the human organism.  -Backin72 (n.b.) 01:15, 15 February 2006 (UTC)
replies: text: Should acupuncture be called an art?  Each practitioner's mastering of the skill is different.  Some masters achieve great result with their patient.  Some get no result at all.  Like a Western doctor drawing blood, some get it right the first time, but some give the patient bruises all over the arm.  When blood does not come out, can one jump to conclusion that blood is not there?  Blood vessles are visible so practice would improve the skill.  It would be hard to master the same with acupuncture.  Kowloonese 02:21, 15 February 2006 (UTC)
replies: text: I wouldn't call acupuncture only an art, but I agree there is definitely an element of art to it.  A lot of doctors say that biomedicine is both art and science.  One could say something similar about TCM.  It's not a science in the Western sense, but the theory is certainly systematic and internally consistent.  I think it's fine for the article to call it a therapeutic technique or healing modality, and maybe say that as with other healing modalities, there is an art to doing it effectively. -Backin72 (n.b.) 03:28, 15 February 2006 (UTC)
thread_title:  Pseudoscience 

message: This article on acupuncture is truly quite appalling. There are several barriers that I see in cleaning this up:
# There are a large number of people who insist on talking about all the hype and propaganda about the validity of acupuncture rather than sticking to the facts. This is not a new system of medicine, but it is new as far as western medicine is concerned. The research is still being done, therefore quoting statistics from the late 80's aint gonna cut it if there is more recent research from this century that proves otherwise. People more interested in fuelling the political debate rather than positively contributing to publishing knowledge of the topic on this wiki should do so in an informed and reasonable way in a separate article rather than taking up space in the main page. Perhaps the title of that page could be "The debate about the validity of acupuncture" or something similar. 
# The page NEEDS to be seriously reworked. The headings listed above seem to be quite good for a start. If no one can suggest anything better, perhaps it might be worthwhile to make a start on those headings. Unless someone can come up with some good reasons otherwise within the next week or two, I'll make a start.
# There is an absolute truckload of scientific studies done into acupuncture, and I don't think we really need to have a synopsis of all of them on this page. We need to work out a way to either a) get rid of them b) put them in an entirely separate article possibly titled "research related to acupuncture" Piekarnia 09:50, 12 January 2006 (UTC)
thread_title:  Let's clean up the page 

message: An FDA Guide to
Choosing Medical Treatments
by Isadora B. Stehlin
FDA Consumer June 1995 
http://www.fda.gov/oashi/aids/fdaguide.html
said re acupuncture "at this time their safety and effectiveness are still unproven."
so until another updated FDA source is provided I'll remove the claim from the article Mccready 01:40, 21 February 2006 (UTC)
replies: text: Actually, in 1996 the FDA did change acupuncture needles from Type 3 devices (experimental) to Type 2 (safe and effective when used according to certain standards, i.e. sterilized, etc.).  Google for "fda acupuncture safe effective" and you'll find it.  I'll fix it later. -Backin72 (n.b.) 21:55, 24 February 2006 (UTC)
thread_title:  fda 

message: I haven't been able to substantiate the claim that the Australian Victorian system has been used elsewhere. In fact the system is a mess as any examination of the law or their website will show. After six years they are still working on a FAQ for the general public, their findings that some practioners were lying in the statment of claim as to English competency have not been properly pursued, the board is aware (see decisions) that practioners are achieving registration by fraud but .....  Mccready 02:21, 21 February 2006 (UTC)
thread_title:  victorian board 

message: Why is it necessary to say anything in the example of practice section about Cochrane, or anything else?  This is why I took out all of the statements about efficacy, pro or con.  As far as I can tell, this section is meant more to describe what a visit to an acupuncturist is like.  The article is clear enough elsewhere on claimed and proven efficacy, standards of proof, study design etc.  -Backin72 (n.b.) 25 February 2006 (UTC)
Hi Backin72, I think it useful for each section to be balanced and as comprehensive/encyclopediac as possible. If a section, standing alone, can be read as one sided then we have failed WP duty. Why not draw the readers' attention to all areas of controversy so that the reader can form their judgement? Mccready 04:58, 26 February 2006 (UTC)
replies: text: Yes, that is a good principle to keep in mind.  I would say that we need to balance it with another principle, namely:  avoiding redundancy across sections, on the assumption that the reader is intelligent enough to read the whole article.  However, on this edit, since the section in question does mention the treatment of a specific condition, I can see the value of mentioning observations of efficacy.  I'll leave the EBM cite in there and restore the stuff I deleted about clinical observation of tenderness to palpation and so on.  Actually, I just noticed that Cochrane's conclusions were more nuanced than the one-line summary you inserted, so I'll clarify that as well.  Thanks!  I'm enjoying the collaboration here, and I think the article is improving quite a bit as a result. -[[[User:Backin72|Backin72]] (n.b.) 04:30, 27 February 2006 (UTC)
thread_title:  Example of Acupuncture Practice 

message: Thanks again Backin72
yes I edited a bit quickly, trying to get the "cochrane doubts list" under one rubric. I'm not sure sufficient effort has gone into blinding in acupuncture research. Single blind with assessment not being made by practioner is simple and even blinding the practioner inserting needles to patient identity is feasible. In other words the EMB problem is not as tough in acupuncture as it is in fusion treatment of lower back pain.
On your FDA edit, I'm concerned that as it stands it implies FDA approval of acupuncture when in fact they were looking at whether inserting needles per se was dangerous. Would you like to consider a rewording? Kevin Mccready 08:46, 27 February 2006 (UTC)
replies: text: I think we should report exactly what the FDA said/did and what it meant.  What they did was reclassify acupuncture needles from Class III to Class II medical devices, which means exactly what the article says (cf. refs; like the NIH consensus statement, this caused a lot of consternation in some quarters , but nonetheless that's what they said).  I do think it's appropriate to add a statement re the reclassification thing; it should probably also be mentioned under "Potential Risks". -Backin72 (n.b.) 04:46, 28 February 2006 (UTC)

text: sounds good, will you go ahead and do it? Mccready 05:46, 28 February 2006 (UTC)
replies: text: I sure will - within a day.  Cheers! -Backin72 (n.b.)  06:30, 28 February 2006 (UTC)
thread_title:  EMB and FDA 

message: Mccready, no offense, but your last batch of edits are without merit.
*Bandolier is 1998, which is way out of date for obvious enough reasons:  since then there have been 23 RCT's on acupuncture and headache.  Cochrane (2006) supersedes.  
*On Empire, it's insane for the article to start listing the views of every insurance company on acupuncture.  It would be pages long if we did so.  There are some in the US that cover it for anything, and some that cover it for nothing.  The reasons for such coverage vary.
*On the Huang Di Nei Jing, give me a break, the entire second section of that text (Ling Shu) is about acupuncture.  Googling or checking any basic introduction to acupuncture and TCM shows this.  
Sorry if I seem testy here, but I'm getting a little tired (cf. your distortion of what Cochrane said about headache) of editors shooting first and asking questions later.  Thanks. -Backin72 (n.b.) 22:56, 1 March 2006 (UTC)
thread_title:  reversions March 1 2006 

message: The history section has a few minor problems. I'd fix them but I don't know enough about the subject to correctly edit. The section seems a mixture of facts about its history, some conjecture and edits to discredit acup. Could someone knowledgeable editor help me resolve these issues:
#What does (Ma-wang-tui graves 68 BC)' mean? 
#Later in Chinese history, 365 points along the meridians were spoken of, not because they were anatomically identified, but because there are 365 days in a year. Could we get a cite for works that talk about 365 points? Is it an old idea that is no longer accepted? Is the points=days thing accepted or one user's POV?
#Some hieroglyphics... Which hieroglyphics? Where were they found? What are they called?
#Bian stones...not directly related to acupuncture Is it accepted that they aren't related to acupuncture or is this, again, one editor's POV? If they aren't related to acupuncture, they shouldn't be in the article
Regards,Ashmoo 04:38, 3 March 2006 (UTC)
replies: text: Hi Ashmoo:  (1) Ma-Wang-Tui refers to ancient medical texts; see Unschuld's Medicine In China.  (2) I deleted this; it's not a central theory in acupuncture.  (3) No idea.  (4)  I fixed this; there is some debate.  BTW good idea to add the new section on accreditation and controls.  regards, -Backin72 (n.b.) 07:55, 5 March 2006 (UTC)
thread_title:  History section 

message: Hi, here's an article (sorry don't have the full text or a link, just an abstract) comparing a sham acupuncture needle has more of an effect than a sham pill
Kaptchuk TJ. Stason WB. Davis RB. Legedza AR. Schnyer RN. Kerr CE. Stone DA. Nam BH. Kirsch I. Goldman RH.
 
Institution Osher Institute, Harvard Medical School, Boston, MA, 02215 USA. ted_kaptchuk@hms.harvard.edu
 
Title Sham device v inert pill: randomised controlled trial of two placebo treatments.
 
Source BMJ. 332(7538):391-7, 2006 Feb 18.
 
Abstract OBJECTIVE: To investigate whether a sham device (a validated sham acupuncture needle) has a greater placebo effect than an inert pill in patients with persistent arm pain. DESIGN: A single blind randomised controlled trial created from the two week placebo run-in periods for two nested trials that compared acupuncture and amitriptyline with their respective placebo controls. Comparison of participants who remained on placebo continued beyond the run-in period to the end of the study. SETTING: Academic medical centre. PARTICIPANTS: 270 adults with arm pain due to repetitive use that had lasted at least three months despite treatment and who scored > or =3 on a 10 point pain scale. INTERVENTIONS: Acupuncture with sham device twice a week for six weeks or placebo pill once a day for eight weeks. MAIN OUTCOME MEASURES: Arm pain measured on a 10 point pain scale. Secondary outcomes were symptoms measured by the Levine symptom severity scale, function measured by Pransky's upper extremity function scale, and grip strength. RESULTS: Pain decreased during the two week placebo run-in period in both the sham device and placebo pill groups, but changes were not different between the groups (-0.14, 95% confidence interval -0.52 to 0.25, P = 0.49). Changes in severity scores for arm symptoms and grip strength were similar between groups, but arm function improved more in the placebo pill group (2.0, 0.06 to 3.92, P = 0.04). Longitudinal regression analyses that followed participants throughout the treatment period showed significantly greater downward slopes per week on the 10 point arm pain scale in the sham device group than in the placebo pill group (-0.33 (-0.40 to -0.26) v -0.15 (-0.21 to -0.09), P = 0.0001) and on the symptom severity scale (-0.07 (-0.09 to -0.05) v -0.05 (-0.06 to -0.03), P = 0.02). Differences were not significant, however, on the function scale or for grip strength. Reported adverse effects were different in the two groups. CONCLUSIONS: The sham device had greater effects than the placebo pill on self reported pain and severity of symptoms over the entire course of treatment but not during the two week placebo run in. Placebo effects seem to be malleable and depend on the behaviours embedded in medical rituals.
 
Publication Type Journal Article. Randomized Controlled Trial.
Conclusion is that there may be a difference, but it is not scientifically significant.
Mar 13 2006
: If taking a phony aspirin pill produces some benefit in the reduction of, e.g., headache pain, then taking an aspirin pill also produces some benefit in the reduction of pain due to whatever factors are active in the case of the inert pill. We do not know exactly how the placebo effect works. There are also therapies that involve the deliberate mobilization of the bodies own resources without the trickery or manipulation involved in the use of placebos.  One of the differences between placebo pills and placebo needles is the specificity of the mental stimulus provided. If a phony aspirin pill is administered, the psychological message implied is, "feel less pain."  Expectation of the relief of pain may facilitate the relaxation of muscles constricting the blood vessels or otherwise causing head pain, but it also may facilitate the release of endorphins out of the same sense of relief because "someting is being done."  Theories abound, but nobody really knows why the use of needles, heat, and accupressure are efficacious, but each of these methodologies can cause the mind of a conscious patient to focus very sharply on one point in the body.  To an extent, the more powerful the stimulus, i.e., the greater the pain or the greater the felt pressure, the more strongly one's attention may be focused on these points.  But the applicaiton of a phony needle, especially to a naive subject, may be equally productive in causing intense attention to be directed to those points.P0M 01:07, 17 March 2006 (UTC)
replies: text: With regard to the abstract above, I don't have the full text either, but it does state that there were significant differences between the sham needle and placebo pill groups on certain measures during the study's full course (i.e., greater than a 2-week period).  Those observations, and the conclusions given by the authors in the abstract, are not the same as the editor's comment: "Conclusion is that there may be a difference, but it is not scientifically significant".  Patrick, I agree the issues are complicated and not fully understood.  I also think the article (as of  this moment, with the references to double-blinding issues and NIH on sham) summarizes and caveats the issues adequately. Thanks. -Backin72 (n.b.) 08:05, 17 March 2006 (UTC)
replies: text: It occurred to me earlier today that if we really want to know whether something like aspirin works the best way to find out would be to administer it without the experimental subjects being aware of it.  It's easy to vary the input into an intravenous drip without alerting a patient. But it would be much more difficult to stimulate acupuncture points without letting the patient know what is going on.  Maybe low voltage, low amperage currents to be delibered to probes attached at various points on patients' bodies without letting them be aware that they were being zapped.  That might be a plan in the case of hospital patients suffering conditions that force them to remain bedridden and relatively immobile anyway.  Maybe with miniaturized controls other patients could serve as test subjects without their having to be immobilized.P0M 02:12, 20 March 2006 (UTC)
replies: text: I just noticed your reply here; sorry for delay.  Yes, I agree, that would be an interesting experiment.  Quite creative. -Backin72 (n.b.) 23:22, 25 March 2006 (UTC)
thread_title:  Placebo effect 

message: I have still not gotten my answer for the (Question not answered) thing!  Please answer...I am very curious!
:Imagine you asked a similar question about how Asperin worked back in the 5th century BC.  You won't get an answer until a couple thousands years later.  Back then the willow bark would have been called pseudoscience because no body could explain how it worked.  Many discoveries were by accident and people made up a model to explain them. Most of the time, the model was inaccurate and only explained some cases but not all cases.  I remember sometimes ago, "scientists" believed atoms look like swiss cheese, but the model changed overtime.  Back then, they called that science though we would call it cheesy science now. :-) Nowadays, scientists believes atoms are made up of subatomic particles, waves etc., who can be sure the current model would be the same 200 years from now?  I'll bet my lunch it will change, though you won't want to eat my lunch 200 years from now.  There was a guy called Li Shizhen (李時珍) who chewed all kind of herbs and see if he would die from it.  He survived and wrote a book about the medicinal properties of all kind of herbs based on his body's reaction to them.  Many Chinese herbal doctors still base their prescriptions on this guy's book.  Is that book 100% accurate?  Probably not. One person's reaction can never be reliable. Is it totally worthless?  Not so either.  Asperin was discovered in similar way too.  Many well known Chinese medicinal receipes had gone through clinical tests.  The Chinese University of Hong Kong had done many scientific researches with Chinese medicines. I don't know how acupuncture was invented.  However, I guess someone was kneading his own body and found that certain points had different sensation when pressed. When he squeezed those points very hard, his body had some reactions.  If surface pressure caused a reaction, then what would happen if you poke it with a needle?  Millions of trial and errors later, someone documented and classified the effect of each response.  Someone drew a conclusion and formed a model trying to explain what was going on.  The model is as good as the swiss cheese atoms model.  It works in some cases, but not in others.  In current state, acupuncture is an art, it is not science until some scientists found a good model to explain what is going on.
:If you are interested in acupunture, sequeeze around your own body. Take note of all the places that give you a special sensation when squeezed.  Then buy a book on acupuncture and read about what the Chinese found out about those spots through experiments in the past thousand years.  You don't have to believe those emperical results because they are only as good as what conclusion is drawn from them, but you will be amazed that those acupressure points are not random locations, they were found based on your body reactions to pressure.  There are several famous acupressure points: try sequeezing the flesh between your thumb and index finger, there is a spot near where the two bones join which give you a numbing feeling when squeezed.  How about rubbing your temples, the base of your skull etc.?  There are many spots on your body that are different from the rest.  Experiment with them and report the result here.  Kowloonese 08:31, 24 March 2006 (UTC)
replies: text: Sorry, I agree this is an interesting subject, but what does it have to do with how we edit the article?  It still has to present all relevant POV's in a balanced way, whatever anyone feels from the exercise you suggest. -[[[User:Backin72|Backin72]] (n.b.) 08:57, 25 March 2006 (UTC)
thread_title:  HELP 

message: Since we may have an edit war brewing over this NIH/EBM business, I think we should try to isolate which issue(s) are contentious.  The discussion will benefit from third parties as well.
I understand that some editors, like Kevin, feel that acupuncture is pseudoscientific and/or that scientific consensus is that it is not more than a placebo.  These are issues that potentially affect the very structure of the article itself owing to NPOV guidelines regarding pseudoscience  and undue weight.
On pseudoscience, it is important to distinguish between acupuncture theory and practice.  Ironically, even though TCM theory is arguably pseudoscientific, its predictions still guide modern research and have predicted positive results in RCT's , .  The value of TCM theory in a vacuum (with its bodily humors and medieval sounding-stuff) is quite a different matter from TCM's value (even if informed by that theory) in practice.  In other words, modern, scientifically-literate TCM clinicians believe that there is some valuable information encoded in the culturally-determined models used by the old doctors.  (Where do you think the researchers got the idea to use P6 for nausea?)  As one EBM advocate points out, evidence is more important than power (i.e., the political legitimacy of a modality of healing).
The question of evidence naturally arises, and leads to the issue of majority POV and undue weight.  Scientific consensus is indeed that EBM is the "gold standard", but it is wrong to infer from EBM's lack of support for acupuncture that the scientific consensus is that acupuncture is a placebo.  I can't cite any definitive source for the scientific consensus on acupuncture's efficacy (and challenge others to find something explicit), but to my view what actually follows from EBM is that acupuncture's efficacy is for the most part unproven.  EBM's support (or lack thereof) for acupuncture is a function of at least two things:  (1) the criteria for top-tier evidence, and (2) the application of the decision tree for lower-tier evidence (cf. evidence is more important than power above).  There is substantive debate over the former (double-blinding issue), and the application of the latter is a matter for the individual clinician and therefore (as Kevin seems loathe to consider) is something that depends on the individual doctor and patient.  Thus, when Cochrane summarizes its top-tier evidence, they are careful to say whether there is pretty much no evidence (e.g. for smoking), or that evidence is mixed but inconclusive (low back pain), etc.  They are also careful to note varying results among RCT's.  This is so that doctors can make their own calls, rather than just blindly follow some one-size-fits-all EBM "bottom line".
The issue of individual judgement among clinicians may be a factor in the finding that a polled majority of doctors state that acupuncture is (in general) at least somewhat effective .  This is a significant divergence from what Kevin presumes (reasoning only from top-tier EBM data and ignoring the rest) must be a skeptical scientific consensus on acupuncture.  I suspect that Kevin's view is really a straw man.  Let's remember that we haven't really established what is the consensus of scientists on acupuncture: Kevin is assuming that absence of evidence = evidence of absence = most scientists think it's bogus, but we don't know that's true.  However, if we were to assume that it were true, then we'd have an interesting situation wherein the majority POV would be a function of the community polled, and surely the weight of doctors' views on such a matter has some bearing.  Of course, if you poll doctors a majority will say they believe in a Judeo-Christian God too, but it would be difficult to argue that their belief in acupuncture reflects Judeo-Christian cultural conditioning.  :-)  And of course clinical decision-making is a somewhat different matter than belief in a deity.
Anyway, enough said, but I hope I've added something to the debate here.  Bottom line, there is no obvious majority POV on acupuncture's efficacy among scientists, and among doctors, the evidence presented so far sways towards favoring efficacy.  The inferences in terms of our edits (sympathetic tone, weight, NIH) should be clear enough. -Backin72 (n.b.) 09:11, 28 March 2006 (UTC)
replies: text: Whatever the defects and problems in "Western" medicine (and there are PLENTY), the nonsense of Acupuncture gains no iota of validity from that. It is basically akin to witchcraft and astrology. I once got up from an acupuncture table (I am openminded to try something before dismissing it completely) to discover that the practitioner had left a needle in my foot. 66.108.4.183 12:21, 16 August 2006 (UTC)
replies: text: A needle left in your foot?  Wow.  I heard a surgeon left a scalpel inside someone's abdomen once.  I'll have to make a mental note to avoid surgery too, at all costs. ;-)  Your view of the science behind acu differs from the sources in the article, which is worth a careful read.  thx, Backin72 (n.b.) 18:52, 29 August 2006 (UTC)
thread_title:  More on science and EBM 

message: Hi Kevin, I just read the New South Wales report you mentioned.  It's a good example of a well-considered regulatory proposal, and notably has useful summaries of regulation of acu worldwide.
Above you said "Many practitioners believe that regulation = approval. It does not and we need to cover this also."  I don't read regulation as endorsement, but as ensuring both freedom of consumer choice and safety.  These issues arise with any modality or practice that has the potential to harm.  In any case we should stick close to sources and use fair tone.
The safety issues raised that were acu-specific had to do with unsterilized needles, linguistic competency of practitioners, and patients' potentially not seeing warranted biomedical intervention.  (Issues of toxicity were mentioned with regard to herbal TCM.)  These are issues frequently raised in regulating acu and CAM; they are covered somewhat in the Safety & Risks section (to which the Legal and Political Status section should refer).  Were those the things you wanted to add?  thx, Backin72 (n.b.) 19:13, 21 April 2006 (UTC)
replies: text: Hi Kevin; thx for adding AMA.  On NIH, perhaps you hadn't noticed that I'd already moved the safety-specific stuff to that section?  The rest was about research, efficacy and suggestions for clinical use, and is better left under the Research section.  It is too POV to edit the article such that positive statements by scientists are left out of the Science section and thereby subtly spun as unscientific.  (I don't know whether that was your intention or not; just commenting on the way it reads.)  edit: On bias, I don't think that any of the quoted commentators (Bandolier, NIH Consensus Comittee, AMA) are without some degree of bias, though none of it appears extreme; readers can infer a/o sources can be cited on this issue.  (If no one finds a source, I'll remove tagged statement on NIH being outdated in a few days).  Have a good weekend, and thanks, -Backin72 (n.b.) 01:14, 23 April 2006 (UTC)
replies: text: About the AMA reference, don't mean to be picky, but it's a pretty dodgy reference. It's a report that was commissioned a number of years ago that contains two references to acupuncture: 1) a digest article from AMA from 1992 2) an article written by our friend S Barrett (recognised biased writer).  There are no primary sources stated, no direct references to any trials. Are these the only two things they read before writing the report? Other material available from the AMA website shows that the opinion stated in the 1997 article is outdated. In fact, in a 50 page report on pain management from 2005 , they discuss the role of acupuncture and quote real research. They state that many benefits are based on empirical observations with only a few studies done to back up. On their site they quote NIH 1997 and their link to acupuncture tells a very different story  to the one currently listed on wiki. Can we please remove the statement and replace it with something more current and representative? Cheers Piekarnia 05:58, 26 April 2006 (UTC)

text: Agree that the AMA report is pretty underwhelming; they have some boilerplate citations and don't even purport to analyze RCT's.  But AMA is a relevant POV, and I'd tend to err on the side of inclusion.  Googling, I couldn't find anything better from them. thx,Backin72 (n.b.) 06:08, 27 April 2006 (UTC)

text: Hi Piekarnia.  "Medical acupuncture" is basically Joseph Helms' synthesis of various schools.  I think it should probably be treated in the same way as Japanese, Korean, Worsley, TCM, etc. -- either merged or having its own page, but being clear on what it is and isn't (it is valuable, but it's not more "scientific" or "rigorous" just because docs are doing it).  I like your original idea of having a "science and acu" page that covers emerging scientific research in more detail, and would naturally be updated more frequently than a TCM page.  I think we also should try and distinguish between China's "offical" TCM and the larger body of material that's sometimes called "traditional Oriental medicine".  Lot of work to do.  Wish I had more time, but I'm happy to help incrementally. best, Backin72 (n.b.) 06:04, 27 April 2006 (UTC)
thread_title:  New South Wales report; AMA and NIH