Originally published January 25, 2010 at midnight, updated January 25, 2010 at midnight
The merit of ancient wisdom is glorified in literature, movies, and music; the words of our elders and ancestors are accepted as sacred and unquestionably true. However, when it comes to health, ancient wisdom fails to provide a true benefit, miring us instead in a failed tradition. The modern practice of acupuncture is the best example of such an unfortunate appeal to antiquity.
Acupuncture, developed thousands of years ago in China, was based on the philosophy that meridians corresponding to the body’s “qi”, or life energy, run throughout the body. According to acupunctural medicine, when a needle penetrates points along these meridians, the functions of bodily systems and organs can be precisely manipulated.
Practitioners of this ideology claim to be able to treat a huge variety of illnesses this way, from headaches to infertility.
Today, there is a clear lack of scientific evidence demonstrating the presence of such meridians, or even “qi” in general. This destroys any scientific plausibility for acupuncture, making its consideration a leap of faith.
Biomedical research has ventured to unprecedented depths. It has evaluated the function of organs on a cellular, biochemical, and even atomic level. In contrast, the philosophical grounds for acupuncture remain without scientific foundation. Acupuncture simply rests on an unobserved, unsupported, and unlikely phenomenon.
The ultimate question is whether acupuncture is truly effective in treating disease. The scientific attempt to answer this question, however, has proven complicated and difficult.
Since the practice of acupuncture claims an influence over the function of the entire body and offers treatment for a huge number of diseases, it is exceedingly challenging to pinpoint a single measure of acupuncture’s efficacy as representative of the practice as a whole.
Such variety has made it problematic to compare studies and standardize the data.
Furthermore, the actual procedure of inserting needles is extremely difficult to control.
In any clinical study, the practitioner should not know whether he or she is administering the true treatment or the placebo treatment, known as “blinding.” But, in the case of acupuncture, it is very clear to the acupuncturist (and often the patient) if they are asked to perform a sham treatment or no treatment at all.
This unfairly biases the data and has allowed for some smaller clinical studies to have falsely positive results, largely due to the placebo effect of the patient being offered a novel treatment.
Despite these limitations, there have been some consistent results in the scientific research behind acupuncture. Particularly over the last few years, the controls for these studies have improved. This includes better sham procedures, more reliable practitioner blinding, and larger groups of patients to study.
In these well-controlled studies, the gap between the supposed effectiveness of the treatment and the placebo group has shrunk accordingly, leaving the two statistically indistinguishable. When put under scientific scrutiny, acupuncture was shown to be just an ineffective ideology.
Considering the recent flux of dependable data, it appears that acupuncture truly has little use in modern medicine today. Its philosophy is ancient, and while some translate that to mean “wise”, the truly wise know it to more accurately mean “outdated.”
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Comments
Folmsbee: No evidence for acupuncture
Man, this is something I've always felt iffy about. On one hand, I fully accept that there is very little science to acupuncture and that qi is just an analogy. On the other hand, it's saved my life before, which makes me think that it may be actually working. :|
As a random note, there's a syncretic movement in East Asia--or at least in Korea--which is trying to unify eastern and western medical methodologies. Since I don't know much about medicine, I don't know what they are doing for sure, but I think it's worth looking into for people interested in keeping people alive. The opinions regarding acupuncture seem to be always polarized to the extremes, so it might offer some new takes on the issue.
Also: Is that a pun there? Puns are always bad, Mr. Folmsbee. You'll get stabbed for that for sure.
Folmsbee: No evidence for acupuncture
Nice to see it happen... a lovely, clear-cut exposure of a "crock" (i.e., acupuncture) that has bamboozled everyone all the way upo the line for generations. Keep us the good work. People like you are a major protection for the rest of us from having to pay for this idiocy with our taxes and high insurance premiums.
L
Folmsbee: No evidence for acupuncture
Dear Mr. Folmsbee, The world should be saved from dumbells like you who publish these unresearched and opiniated articles. A lot of research has been done in China, and also in France and England,but, I suppose that is too much effort for you to check into. Plus, if it saved your life, we probably wouldn't have to be submitted to your ignorant hate mail. GG
Folmsbee: No evidence for acupuncture
The Acupuncture community is actively engaged in research. The big problem of course is the lack of quality large scale trials and the issue of sham treatment and blinding. Although attempts are being made to develop sham devices, to my knowledge there isn't anything yet that is fully acceptable.
Traditional Chinese Medicine (TCM) places a lot of emphasis on the patient-practitioner relationship which is also a problem within research, if this is regarded as part of the therapeutic process. We know from studies that patients feel better if their GP has actively listened to them or if they have been 'touched in a professional manner'.
In drug trials, if the control group feel no physiological effect from their 'sugar pill' they will pretty much deduce they are not getting the real drug. Where does placebo fit in here? There are trials of anti-depressants showing no statistical difference between 3 groups: 1. 'sugar pill' with no distinguishable effect. 2. Random medication that had some minor side effects and 3. an anti-depressant. The whole placebo phenomena is a minefield for the researcher and I believe the topic of a number of very interesting current studies.
I put together a group of points that I know will have a specific effect and see the benefit that my patients have. I make no grandiose claims but I can usually improve someone's sleep, alleviate their PMT, dysmenorrhea or indigestion, migraines and many more.
I will continue with my acupuncture research and welcome the ongoing debate.
Folmsbee: No evidence for acupuncture
Excellent article and great comment from lbrick. And yes, a lot of "research" has been done in China, France and England, but when the research is positive for acupuncture, you can be assured that the study was of poor quality, poorly controlled, would never be repeated and would be found in an obscure journal. Acupuncture has never been proven to cure anything. Supporters of acupuncture must rely on outdated, often ancient information. I doubt that any of them have read the most important , recent books on acupuncture and alternative medicine - Snake Oil Science by R. Barker Bausell and Trick or Treatment by Simon Singh and Edzard Ernst. These books are classics and should be read by anyone contemplating any alternative medicine treatment.
Folmsbee: No evidence for acupuncture
Quote:
"...when the research is positive for acupuncture, you can be assured that the study was of poor quality, poorly controlled, would never be repeated and would be found in an obscure journal."
Love the objectivity, CJ. Way to keep an open mind.
As for research, here you go:
http://www.webmd.com/breast-cancer/news/20091231/acupuncture-may-help-ease-hot-flashes
Hmm. A randomized, controlled trial on acupuncture, conducted by a licensed American medical doctor in an American hospital and published in an American medical journal ... and whaddya know? The results were positive for acupuncture.
Looks like I can "be assured" that CJ is both ignorant AND arrogant.
MD
Folmsbee: No evidence for acupuncture
Arrogance is as bad as ignorance in this matter. Folmsbee attacks acupuncture at its root, suggesting that the qi has not been "discovered" by Western science so therefore cannot exist. I would challenge Mr. Folmsbee to (1) describe in precise, Western scientific terms how it is that living things are able to move fluids against gravity. Give several examples (e.g. water in plants, blood in the foot, mucous). Then (2) describe with similar precision how the nervous system processes information. In both cases, avoid reductionism and "leaps of faith." (With regard to the latter, I have no research, but it is my experience that neurologists are generally more accepting of acupuncture than are their colleagues in other Western medical disciplines, maybe because they know enough about the bodily systems with which they deal to know that they don't know everything. Good science is open, not closed.)
Folmsbee: No evidence for acupuncture
Dear CKbartecchi, you are misinformed.
http://www.jcm.co.uk/catalogue.php?catID=196&opener=0-196
This is just fraction of the modern literature that most well trained Acupuncturists will have at their disposal. During our 3-4 years of training, we have a large amount of both Chinese and Western medical literature to study.
My w/e's are often spent at events such as this:
http://www.etcma.org/component/option,com_eventlist/Itemid,51/func,details/did,11/
a research symposium. I'm personally, a big fan of Professor Ernzt!
Karen - Acupuncturist
Folmsbee: No evidence for acupuncture
What is the scientific basis of MODERN acupuncture ? Do you still focus on the "qi" energy in the body or do you have something real that you work off of now?
Folmsbee: No evidence for acupuncture
Yes we still deal in "Qi". Qi crudely translates as 'energy' or 'breath of life' if you like but is seen as more of a metaphor or physiological abstraction which expresses the dynamic processes of the body. 'Gu Qi' relates to food & how this is processed.... 'Wei Qi' relates to our immune system... and so on.
A nice overview of what stimulation of a acupuncture point does:
http://www.itmonline.org/arts/zusanli.htm
if you scroll down, there is some info on the modern understanding of it's mechanisms. You can also check out myofascial/anatomy trains which relate to the communication between connective tissue cells although I think acupuncture meridians/channels relate more to neurological pathways as MRI scanning shows areas of the brain activated with the stimulation of points.
While we can use modern scientific techniques to update and refine our knowledge, there is a lot to be learnt from 'The yellow emperor's cannon of medicine' 400-300 BCE.
Huangdi Neijing
Where it lacks 'scientific' knowledge (although it was standard practice in those days to perform autopsy and they did have their own form of 'research') it makes up for in it's insights into human behaviour and our place in the natural world. I particularly like the comment about the 'youth of today' (that's 300 BCE). They are described as being loud, imbibing with alcohol and disrespectful to their parents! ;)
Where healthy scepticism is...er...healthy, so is keeping an open mind. Be careful not to discount things completely just because they do not fit comfortably into your current understanding.
Folmsbee: No evidence for acupuncture
In its original meaning, I have been told, qi is defined as "that which moves fluids and organizes information." These are two physiological processes (see my post above) that cannot be fully explained by modern medicine. The error of modern science is its arrogance, its stubborn belief that it is the sole sorce of knowledge and truth. If one can allow that there are things that we do not fully understand about physiological (and, for that matter, botanical) processes, then we can be open to say, well, perhaps something else is going on even if I can't see it. The Chinese can't see the qi with their microscopes any more than Western doctors can, but they evolved a system of medicine that is based on a plausible theory about what is unseen. (That is what the scientific method is.) They tested their hypothesis and refined it over thousands of years and the end result is that you can use needles or pressure to reduce stomach acid, reduce or eliminate pain, reduce nausea, heal insomnia, speed up normal healing, reduce opiate and other drug withdrawal, and ten thousand other things. Most practitioners of Chinese medicine (like the people posting here) are humble in their practice, because they are scientists who know that they don't know everything, and because they respect the enormous healing powers of the body. (I myself am not a practitioner - just an interested and respectful observer!)
Folmsbee: No evidence for acupuncture
A "synchrotron," which uses super-powerful X-rays to resolve the structure of matter down to the level of atoms, has detected evidence that acupuncture points differ from other parts of the body.
http://news.xinhuanet.com/english2010/china/2010-02/01/c_13159050.htm
Folmsbee: No evidence for acupuncture
That's fine... except that I have NEVER seen a study that has been able to "measure" qi. If it's energy, then it can be measured by the laws of physics.
People, keep in mind that this "ancient Chinese medicine" was being used at a time when the Chinese were living to be... what, thirty, forty years old?
If we're going to trust in the in the wisdom of the ancient Chinese, then are you willing to live in a house built in China a thousand years ago? Eat food farmed using a one-thousand year old technique? Learn physics as it was understood one thousand years ago?
All the studies I've seen indicate that there is no such thing as a "standardized" acupuncture site. When tested, practitioners pretty much went into completely different parts of the body, even when confronted by the same patient with the same problems. I'll have to track that study down...
And... if you're interested as to WHY it's a bad idea to encourage this sort of tripe...
http://www.battlefieldacupuncture.com/
If any of you are in the military, be prepared, if attached with a battlefield acupuncturist, to have your earlobes poked with fingernails instead of getting a nice dose of Valium when injured...
Folmsbee: No evidence for acupuncture
Alexgb:
Using a synchotron on human tissues seems like a bad idea. Synchotrons are used in X-ray crystallography to get the structure of proteins and other teeny tiny molecules. How would one use x-ray diffraction to read anything at the level of tissue? How would one crystallize tissue?
However, if the Chinese propaganda machine of Xinhua News pushes an idea I'm sure it's honest.
Folmsbee: No evidence for acupuncture
Connerm:
Good point (no pun intended). I think the article said it was rabit tissue, not human. By the way, it is interesting to note that one of the most wide-spread uses of acupuncture is by veterinarians. The highest paid ones treat race horses. Guess the blue grass owners don't mind the hype :-)
Tin man: If I were under battle conditions I would prefer the relaxed alertness of the aftermath of an ear acupuncture treatment to being whacked out by valium.
Folmsbee: No evidence for acupuncture
Relaxed alertness is kind of a contradiction by definition, but I digress.
Understand that when we're talking about battlefield medicine, we're treating acupuncture as a medicine, not as a state of readiness. Which means that, since the acupuncturists believe that acupuncture is a valid therapy for pain management, the pain from getting shot or shrapnel would be dealt with by punching the ear lobes.
There's a certain point where not even a placebo is going to help much. This is one of those cases. Yet, this is exactly what is advocated, instead of proven, scientifically-validated treatments.
Even better yet, with a belief that the source of all disease is a misalignment of qi, then what use is there to use sterile technique? As described by the paper below, even a wood splinter or rock will do the trick for acupuncture...
http://insidesurgery.com/2010/01/battlefield-acupuncture-niemtzow-technique-needle-battlefield-acupressure-marcucci-technique-pain-control-acute-traumatic-injury-haiti/
It's one thing to believe that there are energies out there we don't understand, yet can manipulate for healing purposes. It's quite another to completely ignore accepted and validated science (ie, germ theory and neuronal pathways) in a vain attempt to make a questionable practice more marketable.
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