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reader comments: acupuncture

27 Nov 2008
I resonate with the "skepticism is a virtue" idea, as I've always been one, particularly in the realms of modern medicine, religion, and government. It's forced me to go beyond what we're told in school, to research things a little more. I've uncovered things.

But I have to say, the few things I find written here on your site is more crap then I'd ever wish to digest.

My interests are particularly in things Chinese, especially acupuncture. What I find you writing is incredibly presumptuous and naive. It's easy for me to say because I see it work EVERY day, but why would I tell you that, you're not exactly a prospective client. It's just that people like you, who know SO little about it but write as if you're an expert, hurt the perception of this ancient art. My testimonials speak for themselves, I won't divulge them upon you. I've somehow talked some of the deepest skeptics into getting on the treatment table. And they come back shattered as if their whole paradigm is crumbling. I love the look on their face, why (?), because I've opened them up to the gleaming fact that there is something else going on beyond their understanding and THAT is enlightening. Some people, in the past including my brother, a surgeon, think it's placebo. Well? Why does it work on animals, why on children? Why on skeptics?

It's easy for a skepdick [clever!] like yourself to say something is fallacy because you have little to no exposure to it. This is a complex form of medicine, we train for 4+ years to be licensed to practiced. The last thing the world needs is another jackass of all trades and master of none.

My harsh words come not from the fact that you are a skeptic, rather from the fact that you actually put this bullshit out on the web.

Rex McCann

reply: Thank you for inspiring me to revise the acupuncture entry. I don't doubt that you have studied many complex things for many years to get your license to practice. I sincerely hope that my rewrite will help you understand why acupuncture works on animals, children, and skeptics. All can be conditioned to respond to needles, doctors in white coats and fancy gadgets, attention, etc. Robert Imrie, the veterinarian, can give you a more complete understanding on why it works on animals. I'll only add that part of the problem with evaluating animal responses to acupuncture is that we must rely on our own biased and hopeful observations to do the evaluations. And, as you no doubt know from your understanding of Pavlov's work with dogs, physiological responses can be conditioned in animals. Shots of morphine will make a dog salivate, too. Any shots, even of saline solution, after that will make the dog salivate. But I'm sure you have a better understanding of classical conditioning than I do, so I won't bother you with any more details.

I also owe thanks to Philip Stokes, whose criticism of the acupuncture entry as "worthless ranting," even though more ad hominem than substantive, also inspired me to rewrite the acupuncture entry.

Rex replies:

Well, you've missed my point entirely, Bob. To simplify, that was if you know little about a subject, refrain from "educating" the masses. Become an expert of SOMETHING, then maybe you can become an educator. Then maybe this can turn into a dialogue about how acupuncture works. You're so behind the times!!!! The thought in the modern medical world is not, "does acupuncture work?", it's "WHY does acupuncture work?"!!!!!!

reply: Maybe you didn't read the entry carefully. That's the question I answer: it works because of conditioning and placebo effects. That's what the science shows. My guess is that you don't read the science because you know from experience and training that it works for some other reasons. If you read my article, you'd understand why experience is not the most unbiased way to know things.

If you truly looked at this scientifically, or anything for that matter, you'd approach it WITHOUT bias. Bias skews your hypothesis (obviously), it skews your investigation, it skews your outcome! Try approaching it with an open mind! What feeds you exactly to do this work????

reply: Understanding the problem is the first step toward solving it, Rex, and you've got that covered. Recognizing that you're the one with the closed mind isn't as easy. Unlike you, I have no horse in this race, and don't care one way or another how acupuncture works.

If you're filling a niche then so be it. I can understand how it will be for you to look at this critically because your whole identity is so wrapped up in this skeptic crap. I'm just happy to turn someone like yourself on your heels, because, after all, it's you that's playing defense, not us.

reply: Now you're just blowing air, Rex. I can see that it doesn't take much to build up your confidence or make you happy. You must walk around with a perpetual grin. I'm sure you have a fine sense of humor.

Norman Paterson responds to Rex:

Rex -

The testimonials you are so proud of are of little value. You can get testimonials of any treatment you like; do you believe every testimonial you hear? If so, then let me know, as I have some very efficacious substances to sell you at a good price - all backed by authenticated testimony. If not, then why do you think yours are different? That's not a rhetorical question: what, specifically, have you done to determine the effectiveness of your treatment? What are your statistics, hypotheses, populations, controls, criteria, sampling strategies and quantitative results? What steps did you take to deal with your own bias and the biases of your colleagues and patients?

I suspect that you have done none of these things. Instead, you have carried out your treatments as you were taught, and found them to be effective, just like that. It's very convincing. Your patients improved. They were convinced too - even the skeptics. For you, that seems to be the end of the matter: case closed. Your questions ("why does it work on animals?") show that you have not researched this matter at all deeply. People are animals too. Animals - including people - are extremely complex, and we don't have anything like a complete understanding of the range of responses that even simple stimuli can bring out.

The evidence on acupuncture is not complete because it is hard to devise a complete control (i.e., one that won't let our biases get in the way). The evidence that can be relied on says that acupuncture works by the placebo effect. Perhaps you, Rex, could design an experiment to test the acupuncturist claims that have so far eluded objective examination. Whatever the result of the experiment, you'd be doing everyone a tremendous favour - reliable knowledge is the most precious of humanity's resources. Meantime, you are simply shooting the messenger.

Norman Paterson
Senior Scientific Officer
The University of St Andrews

More from Norm to Rex:

Thanks for taking the trouble to reply - I appreciate that.  It will take me a little time to read all that you have sent.  I'll comment in-line for the first part so you can see where I'm coming from and where I've got to.

On 2008-12-16, at 17:23, Rex McCann wrote:


First of all, I never said I liked Bob's website, I just said that I've challenged things from a young age, trying to relate with the skeptic in him.  It gives me hope that you are now both annoyed, because that is the breaking point from which you may look at this critically and perhaps exit the dinosaur kingdom where you now live.


Dinosaur kingdom - I like that.  My view is that you are in cloud cuckoo land.  This should make the exchange interesting.

There are great cultural obstacles when we compare mindsets East & West.  The greatest pitfall is that we take the high horse that modern (sometimes called Western) science is the pinnacle of all discovery and validation [...]

I just call it "science" and "medicine" without any qualification like "western".  One of the interesting features of science is that it is emphatically not divided into major schools in the way religions, say, are.  Scientists disagree about all sorts of things but usually only at the cutting edge.  These disagreements are resolved by experiment, and the sum of human knowledge grows.  Big disagreements yield big discoveries.


[...] and not rediscover Chinese Medicine from the inside out, looking at it ON IT'S OWN TERMS.

Now that's a problem.  Do I have to believe in acupuncture for it to work?  I don't have to believe in gravity or quantum mechanics or maths.  Perhaps you mean something else.


Norman, you describe "quantitative results", yet there is nothing quantitative about acupuncture.  It's all based on relationships, thus it is a QUALITATIVE science.


The clouds and cuckoos are getting closer.  If a hundred people visit a hundred acupuncturists for, say, lower back pain, it's not possible to count how many are cured?

The World Health Organization composed a study and a report, Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials, and here's what they find acupuncture is useful for so far:

low back pain neck pain sciatica tennis elbow knee pain periarthritis of the shoulder sprains facial pain (including craniomandibular disorders) headache dental pain tempromandibular (TMJ) dysfunction rheumatoid arthritis induction of labor correction of malposition of fetus (breech presentation) morning sickness nausea and vomiting postoperative pain stroke essential hypertension primary hypotension renal colic leucopenia adverse reactions to radiation or chemotherapy allergic rhinitis, including hay fever biliary colic depression (including depressive neurosis and depression following stroke) acute bacillary dysentery primary dysmenorrhea acute epigastralgia peptic ulcer acute and chronic gastritis


An impressive list, but neither Bob nor I has questioned that people use acupuncture because they get a benefit.  What is of interest is "what is going on when people get a benefit from acupuncture?"  Why ask this?  Several reasons.  Perhaps we will learn something new about people/animals.  There may be new forces, new concepts.  Anything is possible.  If we find out how acupuncture works, perhaps we can do something even better.  (Or do you think that Chinese medical science is the pinnacle of all discovery and validation?)

I'd like you to note that the aim is not to "disprove" acupuncture.  There is no preconception about what is or is not possible.

Basically they have 2 groups, one receiving an acupuncture protocol specific to the complaint, while the other group receives random needles stuck anywhere.  They find much more consistently that it's the first group claiming good results.  Yet there is a problem with this already.  We acupuncturists don't use protocols.  The results could be MUCH better!!!  Protocols are basically teaching tools.  We are more concerned with treating the individual and NOT the symptom.  Our initial assessment takes in all aspects of a person's health, and to create balance in the system we must find the root of their problem.  You may have heard acupuncture as a holistic medicine.  The constellation of symptoms for one person is different than another's, even though they're coming for the same chief complaint.  Example: western-trained doctor may prescribe patient antacids for acid reflux; Chinese-trained doctor may treat the liver if that's the underlying root.  We call it root & branch.  Twenty people come in for rheumatoid arthritis and receive twenty different treatments.  We find that if we focus treatment more on the individual as a whole our results last longer.  The small-minded doctor works to isolate symptoms, the level-minded doctor finds the root underneath all of those symptoms.  This is why someone may have little or no results with one acupuncturist and then later find great results with another.  The choice of points and skill at administering the treatment is different.  

Do you understand why quantification is difficult here?  I've attached an article here that further elaborates upon this, the great divide between Eastern and Western sciences, how we may bridge the divide and preserve knowledge that could help us.  It points out that Eastern & Western science use different criteria, in the East qualitative measures and in the West quantitative measures.

The difficulty is, how to study something like acupuncture and be sure we are not deluding ourselves.  What western-trained MDs do is irrelevant.  Whether 20 acupuncturists do 20 different things is not an insurmountable problem in principle: we just change the terms of the enquiry to include them all.  It's no more an issue than taking 20 different cars to 20 different garages for a tune-up to decide if tune-ups are cost effective.  Do you understand that it's not an issue?  Each car is different, each garage is different, and yet ... it is possible to come to a conclusion.

Shakespeare wrote "There are more things in Heaven and Earth, Horatio, than are dreamed of in your philosophy."  Some clever fellow turned it around and said he was concerned that there should not be more things in his philosophy than there are in Heaven and Earth.  The point is, it's easy to dream stuff up, including stuff that cannot be disproved.  I can argue that the universe was created last Tuesday, complete with all its apparent past and your memories.  You can't disprove this.  In general these propositions are a waste of time, because by definition they don't make any difference in the world.  If they did make a difference, we could do an experiment to see if they were real or not.

So when you claim that acupuncture cannot be examined, for whatever reason, I say you are shooting yourself in the foot.  Either it makes a measurable, objective difference in the world, or it does not.  Take your pick.

I'll stop here - time for brandy and bed.  Good night to all!

Yet it's not only the criteria as a lens through which to view the natural world that are different.  For the Chinese, there was not the order of hypothesis, experiment, and then observation.  They started with PURE OBSERVATION.  Not once, but literally millions of times.  Why does this point do this?  Because we've seen it work in this manner for millennia.  This is an empirical science.  And, having practiced acupuncture for some years now, I can attest to this.  Again we fall into the dilemma of our argument - on the one hand you stand with the theory that there is no reason why acupuncture can work; on the other hand you have myself, with the experience of administering this modality to thousands of patients, knowing that this is obviously way beyond the workings of placebo.  Placebo is an insulting word, if you delved a little deeper into this you would understand why.  The system of acupuncture is EXTREMELY complex.  Two of my mentors - who were surgeons before acupuncturists - say it is far more difficult to understand Chinese Medicine than it is Western Medicine.  Yet now they use surgery only as a last resort.

The attached article also speaks to the dilution of Chinese Medicine - in most circles it's not practiced to it's optimum level!  [Bob Carroll chimes in: please read Janet Plummer's reply to the article Rex is fond of.] This is greatly due to the influence of the West, and what I believe to be an inferiority complex that the Chinese still latch to.  Now, sadly, many doctors ARE acting according to protocol.  The patients' true needs are put aside for the treatment of disease.  The roots of Chinese Medicine, meanwhile, are buried in the virtues of prevention of disease and longevity!!!

A route which may gleam more understanding the mechanism through which acupuncture works is the findings of modern physics, the forces of electromagnetism, strong nuclear force, gravity, and weak nuclear force.  The unifying theory fits in there somewhere.  Bjorn Nordstrom was a man who discovered the acupuncture channels WITHOUT looking or them in a book he published, Biologically Closed Electric Circuits.  

If you all should entertain more dialogue, I am here. 

Rex McCann


Rex responds to Norm Paterson

Okay, Norm, I get your game, now time to pick you apart.

"One of the interesting features of science is that it is emphatically not divided into major schools in the way religions, say, are."

That is exactly the high horse I'm speaking of, are you too blind to see that? I have no hang-up with modern science and its criteria for viewing the world. Amazing discoveries are made through it. It is one lens through which to view the world. But if you can't agree that it has methodology - a language if you will - that is only different (not better or worse) from other ways of viewing nature's course, then we've got a serious hang-up here. I am not giving you a solution to how you're going to test and validate that acupuncture works. That work, as you said yourself, has already been done. What I am merely pointing out is that quantitative means towards discovery will yield nothing of real benefit, and may in fact serve to dilute the amazing science that it already is!

"Do I have to believe in acupuncture for it to work?" No, but to understand how it works you will have to be open and learn another means to look at the body. It's not like we're looking at some mystical thing here! It's the same body everyone else is looking at! In our case the body-mind, no separation.

Norman, you describe "quantitative results", yet there is nothing quantitative about acupuncture. It's all based on relationships, thus it is a QUALITATIVE science.

"The clouds and cuckoos are getting closer. If a hundred people visit a hundred acupuncturists for, say, lower back pain, it's not possible to count how many are cured?"

I tell you, your argument is crumbling. You will really have to look at this quantitative/qualitative thing more closely. I don't think we're getting anywhere. We're talking about the science itself, not the number of people that get better. Did you even read the article? I mean if you want to really have a dialogue here listen to what I'm saying, pay attention to the context!

"An impressive list, but neither Bob nor I has questioned that people use acupuncture because they get a benefit. What is of interest is "what is going on when people get a benefit from acupuncture?"

Ummm..... I thought you were interested in "how many are cured"...... I reiterate, perhaps in different vocabulary, open yourself to a new paradigm of thought, cuckoo land or whatever it is. I mean, you seem interested....

"If we find out how acupuncture works, perhaps we can do something even better."

Good boy, you're on to something there...

I'm having trouble understanding whether you're hung up on the results thing or the mechanism thing. Of course it couldn't at this point be the results, because studies have already shown that it works. I think I've already given you enough leads to put you in the right direction as far as finding the mechanism through which acupuncture works, so if you want to make an exit of the dinosaur kingdom you definitely could do so. It's whether you want to. To do so you will have to leave the western-mechanistic-quantitative mindset behind. We're talking the equivalent of a shift from Newtonian physics to Einsteinian physics. Otherwise you're doomed to skepticism the rest of your days.

Rex McCann

p.s. take your time, do a little more digging, relax, I'll be here

p.p.s. can energy and mass be the same thing, exhibit qualities of both??? At the close of the 19th century, the case for atomic theory, that matter was made of particulate objects or atoms, was well established. Electricity, first thought to be a fluid, was now understood to consist of particles called electrons, as demonstrated by J. J. Thomson who, led by his research into the work of Ernest Rutherford, had discovered using cathode rays that an electrical charge would actually travel across a vacuum from cathode to anode. In brief, it was understood that much of nature was made of particles. At the same time, waves were well understood, together with wave phenomena such as diffraction and interference. Light was believed to be a wave, as Thomas Young's double-slit experiment and effects such as Fraunhofer diffraction had clearly demonstrated the wave-like nature of light. But as the 20th century turned, problems had emerged. Albert Einstein's analysis of the photoelectric effect in 1905 demonstrated that light also possessed particle-like properties, and this was further confirmed with the discovery of the Compton scattering in 1923. Later on, the diffraction of electrons would be predicted and experimentally confirmed, thus showing that electrons must have wave-like properties in addition to particle properties. This confusion over particle versus wave properties was eventually resolved with the advent and establishment of quantum mechanics in the first half of the 20th century, which ultimately explained wave–particle duality. It provided a single unified theoretical framework for understanding that all matter may have characteristics associated with particles and waves, as explained below. By the very end of the 20th century extremely precise results were obtained quantifying this duality, in the form of the Englert-Greenberger duality relation.

It's true - It's both!!!!!

Bob Carroll chimes in: apparently Rex thinks the ancient Chinese understood E=mc2 and the medicine he practices is more in tune with "real" Chinese medicine, a "qualitative" science he says, rather than the bastardized version I know and write about. Rex sees that 100 different acupuncturists with provide 100 different diagnoses and perform 100 different treatments for the same patient who will be satisfied no matter who treats him or how. What he doesn't see is that this fact does not mean that we can't test acupuncture scientifically. It means that we are probably dealing with placebo medicine.

Rex has created an impenetrable shield around his beliefs. I'll just reiterate and be out of here: scientific methods, which the ancient Chinese did not have, were developed to avoid being deceived and deluded by what we think we've observed.


14 May 2008

Much of what I read on your site I believe highlights legitimate skepticism towards questionable beliefs and practices. However, it seems to me you are extremely resistant to empirical evidence. I believe you may carry this to a fault.

Much of what is documented in science starts with empirical evidence. Oftentimes, empirical observations are far ahead of science's ability to test their correctness. For example, until the 20th century it was probably not possible to scientifically prove cigarette smoking was bad for your health. Would you have labeled a "quack" someone who suggested people not smoke due to its dangers? How many would need to die before you would be willing to consider the value of the empirical evidence? At some point empirical evidence provides a "common sense" basis for guiding our actions, even without the "scientific" proof to back it up. Science often lacks the tools to validate correctly observed cause and effect relationships.

As you correctly point out in your acupuncture article, meridians and chi have never been proven to exist and seem to defy any sort of measurement. Does this guarantee they do not exist? Of course not. Given the several thousands of years of empirical evidence, it is just as likely science has simply not advanced to the point of being capable of detecting or measuring their existence.

On a final note, on your feedback page your write "If it makes you feel good to write an insulting letter...". Because someone disagrees with you does not justify them writing you an insulting letter. One does not deserve to be insulted for expressing their views. However, you slyly sidestep this by sprinkling condescending and insulting remarks throughout your writing.

Apparently you request others to "do as you say, not as you do". If you don't enjoy being insulted, don't insult others that may disagree with you. Hypocrisy is not an admirable trait.

Kind Regards,

reply: I agree with you about the note on my feedback page. It is unnecessary, so I removed it. I will say, though, that I try to reserve my insulting comments for those who insult me first. That said, I know from years of experience that even when I don't intend to insult someone, some people read what I say as insulting. Anyway, to me the more important issue you raise is the one about not giving due respect to empirical evidence and your example of acupuncture.

I assume you have read my posts on acupuncture and my essay on evaluating personal experience. If not, then your comments are made in ignorance because in those writings I make it crystal clear that one must not ignore empirical evidence but one must be open to the possibility that the explanation you favor is not the only one and may not be the best one.

If, on the other hand, you have read my articles on evaluating acupuncture claims and studies, and on evaluating experience, then I don't understand your criticism. All the empirical evidence strongly supports the claim that acupuncture works by the placebo effect. Science will never have tools to measure chi or meridians because they are metaphysical concepts, not empirical realities. These concepts were developed long before any empirical understanding of health and disease entered the Chinese medical tradition. But science does have the tools to tease out placebo effects from non-placebo effects. Studies that have done this are reviewed in my writings on acupuncture.

Finally, if you find my response insulting, I don't know what to say except that it is not intended to be so.

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