From Abracadabra to Zombies
reader comments: acupuncture
23 Aug 1999
I hope I'm not misunderstanding you, but you seem to be attacking Chinese
metaphysical explanations of acupuncture as improvable, on the basis that
even if all the predictions made by acupuncture were proven that still
would not prove the claims about meridians and blocked chi.
reply: Your hope is vanquished! Indeed, that is exactly what I am saying.
That position makes as much sense as saying "Just because all
the predictions of atomic theory are correct, that doesn't mean that atoms
exist." And, if we presume that all the claims of acupuncture as to
its medical effectiveness were scientifically proven (though they most
likely never will be), how would chi be
different from atoms? You can't see chi or meridians, but nor can you see
atoms or electromagnetic fields. Yet we accept their existence, because
what would happen if they did exist is what actually happens. Why should
not the same apply to chi, meridians, yin, yang,
etc.?
Simon Kissane
reply: You want me to explain the senseless to the hopeless? Well, I'll bite. Let's say, for example, that while Western medicine believes diabetes is caused by a malfunctioning pancreas, the actual cause is chi being blocked in some set of meridians. The pancreas does release insulin but only when yin and yang are unbalanced and a chi adjustment is needed. When insulin is taken (one Western remedy for many cases of diabetes), the chi is unblocked. If the patient does not take the insulin, the patient gets very ill and may die. We can say that that is because the chi remains blocked. We give the insulin, the patient recovers; we don't and the patient suffers. Do we need chi for our understanding of what is going on? No. We use Occam's razor to reject the chi hypothesis. It is unnecessary, a superfluous bit of metaphysics.
Can we test chi? Chi is not only not observable, it has no objective measurable effects. Chi can only be measured by subjective feeling. Can we do a test to demonstrate that this subjective feeling may have nothing to do with chi? Perhaps. It seems that little Emily Rosa did demonstrate this in her experiment with nurses who believe they can feel prana or energy when they wave their hands over a patient. The obvious implication of the experiment is that the nurses' feelings are purely subjective and not a measure of a real entity (chi, prana, energy, whatever) existing outside of their minds.
What we can measure are such things as the effect on blood pressure of sticking needles in particular parts of the body. If acupuncture can lower blood pressure, we might say that the needle pricks unblock chi in meridians. We might also say that James Van Praagh contacts dead persons unconsciously and requests them to open a spiritual valve in people who have the faith to undergo acupuncture for circulatory problems. Neither hypothesis is testable or useful. Western medicine will look to see if there is some physical response to the physical act of sticking a needle into a person. If it finds that acupuncture stimulates endorphin release, which in turn lowers blood pressure, it has a testable hypothesis. Are there other less inconvenient or more efficient ways to stimulate the endorphin system? Perhaps not. Then, let's use acupuncture to lower blood pressure where appropriate. Do we have to assume the existence of chi and meridians? No. These parallel universes of chi and meridians or spirit mediums and dead souls can't be proved or disproved, but they are superfluous to scientific explanation.
Your analogy between chi and atoms is a false one. The measurable effects of atoms is not purely subjective. Furthermore, there are conceivable scenarios which would be inconsistent with atomic theory. There are no conceivable scenarios that would be inconsistent with a belief in chi. Finally, our concept of the atom changes as we learn more about the world. Metaphysical concepts such as chi never change and never lead to any new discoveries about the world. The concept of chi is akin to the concept of creationism, a theory which begins with the assumption that it knows the absolute truth and will measure all experience by that truth. The concept of the atom is akin to the concept of evolution, a theory which tries to explain observable facts without presuming that those facts must fit a preconceived notion of what is true.
15 Jan 1999
Congratulations on your Skeptic's Dictionary. A welcome candle in the
darkness. I'd like to make a small comment on your Acupuncture article. I have no axe to
grind regarding acupuncture and have never used it. What interests me is your connection
between acupuncture and the chi/yin/yang model.
Certainly the model is metaphysical but it is only a model. I don't see how the unscientific nature of the model affects whether acupuncture "works", that is whether it has any effects which are quantifiable, reproducible, clinically useful or whatever. One might, for example, postulate a Renaissance doctor prescribing a foxglove-based medicine for a heart patient to bring the body's humours back into balance. The model may be wrong and/or metaphysical but the digitalis will still be effective.
It seems to me, therefore, that your (correct) debunking of the chi model is a bit
of a furphy. It really has no relevance as to whether acupuncture "works" or
not.
Stephen Hart
reply: Acupuncture is not just sticking needles into people and noting reported effects, which is what most people probably think of when they say it "works." Needles were stuck in my ear and after that I quit smoking. Or needles were stuck in my foot and after that my ear ache went away. Acupuncture is a process for unblocking chi, and that cannot be measured empirically.
I don't know what a furphy is, but I assume it is not good. But, since those who practice acupuncture claim they are unblocking chi and helping to balance yin and yang, to avoid comment on those concepts when evaluating acupuncture would be unforgivable.
If acupuncture accidentally turn out to be an effective medical tool either by stimulating the release of endorphins, etc., or by taking advantage of the placebo effect, that would have no relevance as to whether acupuncture "works". As I mention in my entry, to test these types of effects of needle pricking is not the same as testing acupuncture.
You seem to think that as long as an explanatory model "works" it is irrelevant to criticize it. If you want to avoid illness, avoid evil spirits. That is good advice. It works. I guarantee it, even if it is a furphy.
11 Feb 1998
I find it enormously sad that someone who is intelligent enough to have a web page is
so unwilling to be open minded about acupuncture. The fact that it has been used for
4,000 years in China as the primary system of health care seems to be of no concern to
you.
Intelligence is being open minded and considering possibilities. Not deciding
that you know everything and closing yourself off to possibilities.
Deborah
reply: Deborah, if you do much surfing on the internet you should know that it doesn't take much intelligence to have a web page. To be open-minded, I suppose, means being willing to believe in ch'i and energy blockages as the real cause of illness according to some ancient metaphysical system. The fact that acupuncture is 4,000 years old counts against it in my book. Who is likely to know more about the human body, someone who lived 4,000 years ago or someone who is living today? Acupuncture is still practiced in China, but none of their many medical journals make any reference to it. If a man in China has blockage in his left coronary artery, he will choose an an angioplasty over acupuncture any day....if it is available to him and he doesn't want to have a heart attack.
Intelligence is knowing how to evaluate evidence and information. Don't let your desire for something to be true get in the way of the evidence. It is much more intelligent to evaluate the evidence than it is to wax poetic about "possibilities."
22 Jan 1997
I was interested to see the Skeptic's Dictionary. I have always
considered myself a sceptic (Nb, this is not a spelling mistake, I am British) and you
have engaged my interest. I hope I can engage yours.
From what I have seen so far you are not as sceptical as I am about doctors. I try never to lose sight of the fact that the AMA and the BMA exist not to promote science, but to promote doctors. Asking these organisations about the effectiveness of other therapies is like asking IBM whose computers are the most reliable.
reply: I'm not as skeptical of medical science as I am of alternative medical practices. Doctors are human beings and as a group are no better or worse than the rest of us when it comes to being trustworthy, competent, etc., within their field of medicine. I am not as skeptical of the medical fields as I am of the alternative fields.
Most alternative therapies seem to me to be junk. But that is an intuitive feeling, I haven't tried most of them. What you include about chiropractic is a complete revelation to me. I suspect that chiropractic as taught in the US is utterly different from the therapy of the same name in the UK. In the UK it is very similar to osteopathy, but, in my experience, more effective. My experience relates to just a handful of practitioners, and may reflect individual competence not the differences between the disciplines. I have never met a chiropractor who believes that all, or even the majority, of conditions can be treated by manipulation of the spine. Their case is more reasonable: that problems of the musculo-skeletal system can be treated by manipulation of the musculo-skeletal system. This is something doctors in the UK have a problem with. They think backache is cured by painkillers. I am told that in a five year degree course a doctor will study the back for just four weeks - though the majority of patients suffer back pain at some point in their life. This oversight in the education of British doctors is more than apparent to me, and many of their patients.
I don't believe in acupuncture. I have told my acupuncturist this many times, and as soon as it stops working, I will stop going.
reply: There really is something distinct about British humour!
I can't tell you that acupuncture is more effective than a placebo, but I can tell you that it is far more effective than the drugs I was on before, which had presumably been trialled against placebos. Prior to seeing an acupuncturist I was on three different drugs, five times a day, for asthma. One was a steroid based inhaler, which taken in excess can over-stimulate the heart. To avoid over-dependence on that, I was prescribed two prophylactic drugs. One was mildly addictive, the other highly addictive. (Though not relevant to the effectiveness of the drugs, per se, I will mention that my doctor did not advise me that the drugs were addictive). With addiction discounted, I'm not sure whether these prophylactics helped me or not - I still needed the steroid daily. They did not address the causes of my asthma, and barely controlled the symptoms.
One session of acupuncture approximately every quarter controls my asthma far more effectively than the drugs used to.
Could acupuncture work as described by acupuncturists? This seems impossibly unlikely to me: yin and yang may be interesting philosophical concepts, but they are not physical substances. Could it be psycho-somatic? Intuitively this seems unlikely, as I don't believe in acupuncture, but yes it could. Asthma can be caused psycho-somatically, in which case a psycho-somatic cure would seem appropriate. Ultimately I don't really mind how it works, or why it works. That might be interesting to a scientist, but as a customer, I merely need to be satisfied that it works. If I find something better, I will use it, and if it stops working, I will stop going.
I still require ongoing treatment by acupuncture. I carry with me my Ventolin
(steroid) inhaler, but use it very rarely, say every couple of months compared with daily
when I was using drugs. When I need the Ventolin it is normally in response to a specific
negative stimulus such as high
levels of atmospheric dust or vigorous exercise in very cold weather.
Quentin Langley
reply: I don't mind how anything works, either, but I do mind when people claim they know how and their explanations are metaphysical couched in the language of science. I also mind when people claim something "works" and they use the word 'works' in such a vague way as to be practically useless.
Perhaps the most frequently offered defense of acupuncture by Western patients is
this pragmatic defense: acupuncture works! What does this mean? It certainly does not
mean that sticking needles into one’s body opens up blocked chi or restores the
balance of yin and yang. At most, it means that it relieved some medical burden. The
latter is an empirical matter and here I am skeptical because of the lack of control
studies which are necessary to remove doubts that the effects observed or felt are really
due to acupuncture rather than to some other cause. Many individuals who swear by
acupuncture (or therapeutic touch, meditation, mineral supplements, etc.,) often make
several changes in their lives at once, thereby making it difficult to isolate significant
causal factors. Control studies could also determine whether any effects of acupuncture
are short-term or long-term.
10 Feb 1997
What does it mean when you say that acupuncture cannot be proven?
reply: It means that the claim that acupuncture unblocks chi to allow yin and yang to flow in harmony is a metaphysical claim and no empirical study can prove or disprove a metaphysical claim.
The study that your website mentions sounds like a good start. I don't see your problem with the study of acupuncture using sham acupuncture points compared to real acupuncture. Although I don't know the details of this study you give the impression that it confirms the usefulness of acupuncture, but you state "of course not" (it doesn't confirm acupuncture), and go on to say that the study is a waste of money. You don't make any specific objections to the validity of the study, such as a claim that it was not controlled well enough. Why is it a waste of money to try to determine whether a commonly used therapy works or not?
reply: I would have no objection to testing whether sticking needles in people can ease pain or cure asthma, etc. Before tests are done on pseudo vs. real acupuncture points, there should be tests done which demonstrates that needle sticking can do any good. Then we can work out the right versus the wrong points.
Would you take the same attitude (that empirical studies are a waste of money) if
they were testing a new drug? It's true that the theory behind acupuncture (removal of chi
blockages) cannot be proved or disproved, but if I go for treatment I don't really care if
the theory behind the treatment is metaphysically accurate. I care if it WORKS, and this
study supports the claims that acupuncture does. Of course the effectiveness of
acupuncture can be proved or disproved empirically. I hope I misunderstood you. BTW, I've
noticed that skeptics say believers are a bunch of mushy brained fools and believers say
skeptics are closed-minded. I think both sides are right.
RPS
reply: Well, I hope I've misunderstood you, too.
23 Feb 1998
The pro-acupuncture comments from various people is an excellent summation of why
"alternative"/non Western/traditional medicine is so popular, at least among
industrial countries where there's a choice.
Acupuncture client #1. "It's 4,000 years old, there must be something in it." Never having experienced a lifestyle so poor that the only affordable health care is what can be bartered for with the local wise man or woman, these people can't conceive of a place where western-style doctors are so rare (and work so well) that an office visit may be a year's earnings. These people also have no historical grounding. People in the tropics have been using folk medicine for malaria for thousands of years and still use them. And malaria is still the #1 killer in the world. Same goes for the #2 killer: TB. Desperate people will try anything: just read some historical accounts of the Black Death. plague, cholera, typhoid, polio, etc.
Acupuncture client #2. "The AMA, BMA, NHS,CDC, etc. are out solely to protect their own interests so you can't believe what they say." This is to some extent true. Medicine is a profession as well as a calling, and it pays to protect one's financial interests. Sometimes, such as in the great tobacco debacle of the '60s, corruption will win the day. However, it's naive to think that acupuncturists, chiropractors, herbalists, homeopaths, etc. aren't in business to make money. The difference is that medical doctors have recognized the need for external and internal regulation of their profession.
Acupuncture client # 3. "My asthma medication had possible side effects; my
other medications were potentially addictive... " This entry is a bit confusing
because Ventolin is mentioned as a steroid when it is a bronchodilator. (Steroids
inhalers work by changing the make up of the cells they contact and must be used for weeks
or months before any benefits are seen.) As the side effects stated in the message
are consistent with Ventolin, I assume it's the medication referred to in
the opening paragraph. These individuals have invested a great deal in their
afflictions emotionally. Asthma is good for this as is fibromyalgia, lupus, ulcers,
low back pain. They're all chronic, some are very dramatic, and just dangerous
enough to be romantic. (Obviously we're not talking about those rare individuals for
whom asthma is a daily chance with death -- those people take their medication and are
glad to get it.) Unfortunately, living with and/or being cured of these problems
is often unpleasant and boring. Like doing your back exercises, or taking your
medication that gives you diarrhea for the first two weeks These people find
acupuncture (or garlic capsules, or 8 grapes soaked in gin, or whatever) works better than
all that nasty doctor stuff.
Acupuncture client #4: "Would you take that same attitude toward testing a new drug?" Took "Chemistry for Social Workers" at the local liberal arts college. Doesn't understand what a double blind study is. Never heard of a protocol. Thinks new drugs are developed by the Andy Hardy method. "Hey everybody! Let's cure cancer ourselves! We'll collect some Satureja montana!" Thinks cancer is one disease. Believes whatever Newsweek/Time/60 Minutes tells them.
Sorry about the length of this. Just had to get it off my chest.
Cheryl Hoffman
acupuncture
