As hard as it is to believe, there was once a time when I didn't think that acupuncture was quackery, an ancient "Eastern" treatment that "evolved" from bloodletting not unlike bloodletting in ancient "Western" bloodletting. This time was, hard as it is to believe, less than eight years ago, right around the time just before I got involved with my not-so-super-secret other blog. I figured that, because acupuncture involves sticking needles into the body, maybe there might be something to it. That doesn't mean that I thought that there was something to it, only that back then I was a lot more open to the possibility that there might be something to it than I am now. What changed that was actually learning something about acupuncture, studying the literature, and coming to the inevitable conclusion that, as Steve Novella and David Colqhoun put it, acupuncture is no more than a theatrical placebo, without compelling efficacy of evidence for pretty much anything.
I also learned how traditional Chinese medicine (TCM), of which acupuncture is the most famous component among "Western" people, was basically no more than the retconning of Chinese folk medicine by Chairman Mao in order to justify its use because he didn't have enough doctors trained in scientific medicine to take care of all of his people and to sell it to the West as the "integration" of Chinese and "Western" medicine. Yes, TCM was the first example in modern times of "integrating" quackery into scientific medicine, courtesy of Chairman Mao, the real inventor of TCM. Moreover, what passes for TCM today bears little resemblance to what Chinese folk medicine was even a hundred years ago, much less 2,000 years ago. Just ask yourself this: A couple of millennia ago, did anyone have the technology to produce those tiny thin needles that are used for acupuncture today—or anything like them? Of course not. Yet, acupuncture is frequently promoted by its adherents as being more than 2,000 years old. Again, even a hundred years ago, it looked much different.
So I reacted with a fair amount of alarm and annoyance when a good friend of my wife's sent me a link to a children's book by an acupuncturist, Samara White, and Troy White, who illustrated the book. The book is entitled Maya and Friends Visit the Acupuncturist. It features Maya, who is described thusly:
Maya loves trying new things! She goes on adventures with her friends, exploring and learning about the world around her. There’s a lot to know about her own body as well, and Maya is starting to understand how to stay healthy, and what to do when she isn’t feeling well. She wants to be able to rest and get better, so she has energy to dance, play, and discover new things.
She's accompanied by her friends Bobby Bear and Ellie Elephant to visit Dr. Meow, described as a "very wise acupuncturist," who apparently alleviates her fear of getting turned into a pincushion with acupuncture needles:
Owner of Purrr-fect Acupuncture, Dr. Meow knows all about Chinese medicine. She loves explaining it to new patients and friends. Dr. Meow takes great care with each of her patients, and is always figuring out how to best use her wisdom and techniques to help everyone feel their best.
If there's one thing that irritates me more than pseudoscience and quackery itself, it's books like Maya and Friends Visit the Acupuncturist that are clearly designed to indoctrinate children into a pseudoscientific world view, such as the prescientific world view of TCM. As I like to say, why is "ancient Eastern medicine" so favored? Today, we laugh at "ancient Western medicine," with its four humors, "imbalances" of which were once thought to be the cause of all disease. Yet what is TCM based on? Five elements, with imbalances between things like heat, cold, damp, and dry (among other things) posited as the cause of all disease. That's considered believable, while humoral theory is a joke, a historical oddity that was believed for many centuries, right up until as recently as a couple of hundred years ago. In any case, White offers not just acupuncture in her clinic, but craniosacral therapy, which is one of the silliest forms of pseudoscientific medicine in existence based on nonexistent physiology and someone seeing a similarity between cranial sutures and fish gills. (Seriously, the longer I discuss such treatments, the less surprises me.) More disturbingly, White also offers craniosacral therapy to infants, which is useless.
So what, exactly, is the story in Maya and Friends Visit the Acupuncturist? Fortunately for you (or maybe not), there is a preview video on YouTube to answer just this question:
The video starts with Maya coming down with the symptoms of a cold or the flu, with sneezing and chills, with runny nose and a sore throat. As Bobby Bear expresses concern, Ellie Elephant's first suggestion is to call Dr. Meow, a TCM practitioner, to get acupuncture, herbs, and "natural medicine." So Bobby, Ellie, and Maya head to Dr. Meow's office, where Dr. Meow subjects Maya to the prescientific and unvalidated method of pulse diagnosis. At that point the video ends, and the narrator urges viewers to follow Maya's story by buying the book, to read about Dr. Meow teaching Maya and her friends about qi, acupuncture, yin and yang, and herbs.
To get the idea of what this book is about (besides propaganda for TCM for children), Samara White wrote a guest blog at a pediatric (!) acupuncture website, entitled Helping Children be at Ease with Needles.. Now, no doubt there is utility to teaching children to be at ease with needles for when they receive science-based care such as vaccinations or when they require blood draws. To make them "at ease" with acupuncture needles? Not so much. Not that that stops White:
In the book, a young girl named Maya takes the initiative to go to the acupuncturist along with her animal friends. In doing so, she takes her health into her own hands. It was important for me to illustrate to kids that acupuncture can be something that they would want to try, and that it can even be an exciting adventure.
In the story, getting to the acupuncture office itself is fun—it’s not a chore and it’s not compared to going to a typical doctor’s office. The acupuncture office itself, Dr. Meow’s office, is full of fun items and interesting things to learn about.
Maya’s perspective of the world around her and her place in it shifts as a result of everything she learns at the acupuncturist’s office. She realizes she is connected to the world around her, and her body is connected to itself in surprising ways, like how a point on her hand can affect her nose, or how an acupuncture needle touching a channel pathway running down her legs can help her belly feel better.
Dr. Meow demonstrates acupuncture for Maya and Bobby Bear.
Again, acupuncture is theatrical placebo. It has no effect beyond placebo. So, unlike sticking needles in the skin for vaccination (for example), sticking them through the skin has only the potential to do bad things, albeit generally a small one unless the acupuncturist is one prone to collapsing a lung by sticking a needle too deep in the chest. Be that as it may, White really irritates me when she intentionally tries to contrast acupuncture to getting shots at the doctor's office:
Needles and shots are not the same!
And, the book does not compare acupuncture needles to shots. Not because we’re hiding anything, but because acupuncture needles really aren’t anything like hypodermic needles, so no need to ever mention shots and acupuncture in the same sentence!
Actually, I agree. Acupuncture needles and shots are not the same thing. Shots (such as vaccines) will actually do something therapeutic or protective to the child. Acupuncture needles are just needles being stuck into the body and do nothing useful. This appears to be a classic case of wanting to have it both ways. If, as White argues, acupuncture really is medicine, really does something, then acupuncture needles are like shots, only smaller and a lot more of them. It's also a distasteful denigration of real medicine to children. White is willing to paint shots as being scary as a way to try to portray acupuncture as somehow being fun, even though both involve sticking needles in the body, and, in fact, acupuncture involves sticking far more needles into the body than shots.
Oh, and there's a portrayal of Ellie Elephant getting cupping, which is certainly among the sillier bits of quackery considered part of TCM.
You know, looking over the promotional materials and excerpts from this book, I can't help but be reminded of another children's book, Melanie's Marvelous Measles.
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Stay tuned for the inevitable sequels: "Maya Visits Brian Clement's Clinic" and "Maya Gets A Bleach Enema".
So, about as medically plausible as George's Marvellous Medicine, but worse, it comes across as propaganda for kids, without the sense of fun in that book. Hopefully it's poorly written enough that it'll backfire.
Owner of Purrr-fect Acupuncture, Dr. Meow
Our own cats' acupuncture techniques leave much to be desired.
TCM was the first example in modern times of “integrating” quackery into scientific medicine, courtesy of Chairman Mao
It would be interesting to see a time-line comparing the Maoist invention of time-honoured traditions against the Indian adoption of homeopathy and the invention / synthesis of Ayurveda.
I especially liked the bit where Dr Meow carefully butchers Maya's friends for their bile and horn. Teach your kids TCM, because species extermination is fun!
D'oh! I wish I had remembered that aspect of TCM. Bobby Bear would appear to be in some trouble, wouldn't he?
I found it interesting that most of the positive reviews of this book on Amazon (and they were all 5 starts when I looked), are not "verified purchase" reviews. And, that they all have a similar tone. Not that I'm accusing anyone of loading the reviews, I just found it interesting.
re has
Whew! Knowing that, I'm very glad that Maya didn't bring Terence Tiger along.
If it's any consolation, books like this are rarely very effective, mostly because writing for children is a lot harder than writing for adults. You can't just dumb everything down. It's hard to judge from the snippet provided, but it doesn't really impress me from a writing standpoint. The attempt at poetry grates on my nerves because it's so badly done. Why is it that so many writers think "oh, I'm writing for kids; I'd better put in cute animals and make some of the words rhyme, because those things are fun!"
"Needles and shots are not the same!"
Infinitesimally thin needles are efficient against tetanus.
Wherein they fell into a trap of their own making, and it couldn't be better:
In Buddhism and Hinduism, the word 'Maya' means 'the state of illusion or incorrect perception of reality.'
Per the quote from the book, 'Maya loves trying new things.' Right!, and some of them, like acupuncture and Maoist Medicine, are pure humbug. But that doesn't deter Maya, because she's in a constant state of Maya! Then one day, a friendly scientist has a chance to teach her empirical and logical methods, critical thinking, and other useful skills...
Anybody interested in writing a sequel?
Another reason I think this book will be ineffective is the illustration. The characters are downright creepy.
Owner of Purrr-fect Acupuncture, Dr. Meow knows all about Chinese medicine.
I suspect the Whites were unaware of this, but that name has some unfortunate implications. Miáo (Pinyin spelling, pronounced "meow") is the Chinese term for certain ethnic groups (the Chinese consider them a single ethnic group, but they themselves do not, and they speak several distinct languages) located in mountainous regions of southern China (Guizhou and surrounding provinces) and adjacent parts of Southeast Asia. The most prominent subgroup, at least to Westerners, is the Hmong, many of whom emigrated to the US and other western countries after the Vietnam War. The similarity of the Chinese ethnic designation and the Western onomatopoetic representation of the sound cats make is not accidental; it's similar to the derivation of "barbarian", whose speech sounded to the ancient Greeks like "bar bar bar". I don't think the Whites were intentionally racist here, but a reasonable person with a bit of knowledge of China might take the character name that way.
Man, some of those pictures are trippy. Who knew that acupuncture needles glow white as they make everything right? I'm not sure if that would have made me more or less into the idea of getting stuck with needles as a kid. I mean, there is a certain Star Wars vibe going on there.
The names of the characters are really dumb and lazy, though. I mean, "Ellie the Elephant?" Come on.
I followed the link to SBM you provided. I thought I'd copy the quote from there about acupuncture about a century ago.
"Chinese doctors own that they know nothing at all of surgery. They cannot tie an artery, amputate a finger or perform the simplest operation. The only mode of treatment in vogue which might be called surgical is acupuncture, practised for all kinds of ailments. The needles are of nine forms, and are frequently used red-hot, and occasionally left in the body for days. Having no practical knowledge of anatomy, the practitioners often pass needles into large blood vessels and important organs, and immediate death has sometimes resulted. A little child was carried to the dispensary presenting a pitiable spectacle. The doctor had told the parents that there was an excess of fire in its body, to let out which he must use cold needles, so he had pierced the abdomen deeply in several places. The poor little sufferer died shortly afterwards. For cholera the needling is in the arms. For some children’s diseases, especially convulsions, the needles are inserted under the nails. For eye diseases they are often driven into the back between the shoulders to a depth of several inches. Patients have come to us with large surfaces on their backs sloughing by reason of excessive treatment of this kind with instruments none too clean."
There might not be any takers if this is what was on offer in the West today.
I notice that Dr. Meow is handling the needles with her bare hands, as do all those quacks. I guess there are no germs in TCM.
It is in all probablity coincidence, but the choice of name for TCM practicioner in the book reminds me of old picture pardoying maoist propaganda poster with "Chairman Meow". Seems oddly fitting.
Who would buy this book for their children? Or is the target audience other acupuncturists to keep in their offices? Reminds me a lot of Melanie's Marvelous Measels.
JP@13
But it's Qi, not Force. Dragonball Z might be a closer match.
Johnny@15
It's good for their immune system. Same reason junkies who reuse/share needles are known for their outstanding health.
TBruce those who promote pseudocience are great for creating creepy looking characters.Go to YouTube,and do a search for "Doctor Calvin".
As a cancer surgeon,ORAC might be interested in how cupping is used on cancer patients.
Treatment of cancer based on Cupping and Pure Salt therapy essentially comprise of :
1. Aggressive cupping (see my website or details) which is painful and each cupping session will last 1 to 1-1/2 hours per day and it can take up to 60 days to complete. The purpose is to clean the cancer patient's blood which is starved of oxygen and nutrients (food, vitamins, etc) that feed the red blood cells and white blood cells (immune system cells) therefore strengthening their function to supply oxygen and fight germs/cancer cells respectively. Aggressive cupping will leave dark marks (not scars) on the cupped area for up to 1-1/2 years which is why it is recommended for serious disease like cancer.
2. Pure salt therapy begin with initial cleansing of gastro-intestinal tract involving half-day fasting (no food) followed by drinking in 1/2 hour a total of 1-1/2 litres of pure salt solution (made up of 5 packets of 15-hours pure salt dissolved in 1-1/2 litres of distilled water). Cleansing to continue for five consecutive days with the aim to clean up the gastro-intestinal tract and improve absorption of pure salt during treatment phase. The treatment phase involves consumption of at least 30-hours pure salt (normally 200-hours pure salt for cancer but too expensive) which start with 2 packets per day (drink salt solution made-up of 1 packet in 1 glass of distilled water twice per day) and gradually increasing by 1 packet every other day. i.e. 2 packets day1, 3 packets day 2, 4 packets day 3 and so on until the patient start to purge. Once purging start the patient to reduce by 1 packet and continue the same number of packets everyday . So if the patient start to purge after 10 packets then the patient should continue to drink 9 packets everyday from then on. Cancer patients have been known to consume up to 20 packets per day and the pure salt consumption can last up to 1 year.
3) Bowing exercise (sujud for Muslims) start with 30 times a day and gradually increase to 500 times per day.
4) Drink at least 2 litres of distilled water per day.
5) Avoid oily/fatty food , junk food, no meat, no sugar, and eat lots of fresh vegetable/fruits.
6) Have positive thoughts that cancer can be cured and posses a strong desire to live. Mind-body interaction is very important to good health. In this regard prayers does help cancer patient to recover.
http://www.bestcuppingtreatment.com/files/1997008/uploaded/Cancer_treat…
ORAC,I never read your retcon post at SBM until now.You are not alone.A lot of us longtime comic geeks who got hooked in the 50s,60s or 70s,got very disenchanted with the direction comics were headed from the mid 90s and 2000s on,and just sort of drifted away.
Vile concept. Especially in light of this happening this week in Sydney:
http://m.perthnow.com.au/news/did-chinese-medicine-contribute-to-the-de…
"POLICE are investigating whether traditional Chinese medicine treatments from a southwestern Sydney medical centre may have contributed to the death of a seven-year-old boy with diabetes"
I prefer Chairman Meow myself.Obey the kitty.
I hear bags of glass are also very popular for kids.
The Smith @ 16: I was just about to say the same thing.
A few snippets for whoever wants to write that sequel:
Sign on the door: 'Dr. Meow's Meowist Medicine,' picture of the Chairman depicted as a cat.
'I can use a special needle, that's very thin and light!
Unlike the one your best friend used, to shoot up dope last night.
That one's a shot, but this one's not, so learn the proper terms
The only thing that they both share, is lots of nasty germs!'
Ending: Ellie the Elephant discovers a jar in the Meowist Medicine Herbothicary labeled 'Elephant horn' and whispers to Maya, 'They're killing my people to make this, I'm getting out of here!' Ellie finds a phone box and dials 999, and the Met swoop down and arrest Dr. Meow for trafficking in material made from endangered species.
This stuff practically writes itself. What we need is an illustrator and then someone can put up a web site with the satire version.
---
'Melanie's Marvellous Measles' deserves a sequel of its own. Perhaps 'Peter's Powerful Pertussis,' or maybe 'Derek's Delightful Diarrhea'?
What exactly is meant by this claim?
What is a "placebo" in this context?
A placebo is defined as having its effect via the mind - i.e., brain - not peripheral nerves.
Sticking needles in people does have an effect via the peripheral nerves. A study on mice showed that acupuncture released adenosine, which stimulated adenosine A1 receptors, and that was the mechanism for pain relief in that case.
Assuming acupuncture alleviates pain by a similar mechanism in people - what is meant by the claim that it's "just a theatrical placebo" for pain relief?
That you could achieve similar pain relief by purely mental means? Something like that?
Did you bother to read the paper linked to in that passage?
The author of Melanie's Marvelous Measles has written a number of books, including "Sarah Visits A Naturopath".
Here's the book's blurb:
I really find the irony in these acupuncture nuts. My wife is Chinese and she would trust an acupuncturist about as far as she could throw one. Most Chinese see them no better than fortune tellers or massesses.
kruuth@24
In my admittedly limited experience I've never met a Chinese TCM practitioner. They all love to talk about how they learned from some wise master though.
Also, the electroacupuncture researcher Luis Ulloa said
How does this square with the skeptical claim that it doesn't matter where you stick the needles?
If it doesn't matter where you stick the needles, as skeptics claim - then why would acupoints have been chosen to be near major nerves?
@Orac #24
No, I haven't read that paper. I have read things written about it by skeptics, and I still don't see how you would interpret the results of that paper to mean that acupuncture is just a theatrical placebo.
@Orac #24
I mean, I read what Steve Novella wrote about that paper, and one other skeptical assessment, on SBM or RI, I don't remember exactly where.
And you seriously expect me to take your objections seriously if you haven't even bothered to read the paper? It's not as though it's very long.
@Mike
At least she's explicit that naturopathy is all about blaming the patient. "If you're sick, it's your own damn fault."
Lurker @22
Among the sequels Ms Messenger has written to "Melanie’s Marvellous Measles",is "Sarah Visits A Naturopath".
This is a woman who believes SIDS is caused by vaccines.
Owner of Purrr-fect Acupuncture, Dr. Meow
Our own cats’ acupuncture techniques leave much to be desired.
I have to disagree here. In my experience the cats' acupuncture skills are incredibly effective in achieving their treatment goals. Now, their goals in using their little "needles" might not correspond to your goals, but this is another point entirely.
Can we write a skeptical children's book about the importance of science based medicine? I suggest, "Vickie's very valuable vaccination." Or "Arnie's awesome acetaminophen." Or, "How Holly hates hilarious homeopathic hype."
@Orac #31
I was asking you what you mean by the claim that acupuncture is just a theatrical placebo for pain relief - if it works in people via adenosine release acting on A1 receptors?
A "placebo" is supposed to act top-down, by mental processes. What do you mean by acupuncture "being a theatrical placebo" in this context?
Were the mice experiencing a placebo effect in that study? What would that mean?
I don't necessarily disagree with what you said - I just want to know what exactly you mean.
Search for "acupuncture" and "adenosine." I have written about those studies before. And I mean what I said: Acupuncture is a theatrical placebo with no compelling evidence that it does anything for anything above nonspecific placebo effects.
Har! Massive Fail as kiddie book.Dunning-Kruger: "Of course I can write a children's book!" May sell to acu-quack offices, but kids will be bored stiff. Probably a sign sbm is winning against the needlers, who have actually written this as re-enforcement to the 'inner child' of adult patients who need to be comforted in their retreat from reality into woo-magic.
Yup, the jokes write themselves. If I got started writing them down, I probably couldn't stop... OK, just one: Maya's world is shattered when Chairman Dr. Meow turns against Bobby Bear as a member of the Gang of Fur.
And 'I've got a special needle that makes everything feel right when it touches your body.'? Sounds more pedophilic than pediatric to me.
It glows white when you use it, that's how you know it's real.
Many Chinese acupuncturists here, with bi-lingual ads in the phone book, and offices in heavily Asian neighborhoods... More of these practitioners look to be immigrants or first generation than not.
I wonder if there's tension between the 'authentic' Chinese needlers and the Whities who've appropriated their thang. ?
@ Bpeth
Err, no. That you are describing here is something like Reiki or psionic healing.
The placebo effect is what happens when nothing is being done save natural healing, and having the feelings of being sick fading into the background.
In other words, it's a mix of baseline healing and being distracted away from your worries. For the latter, it helps if someone has been pretending to help you, like mom kissing your boo-boo.
capnkrunch@27
There's a TCM shop directly beneath my office. Latest window sign offers an "MOT for the whole body" using their modern new "Quantum Resonance Magnetic Analyzer" diagnostic machine. I'm tempted to complain it's exacerbating my electrosmog allergies.
I've wondered the very same thing myself.
@Bpeth
I recommend this post on acupuncture by Dr. Mark Crislip. Of especially significant interest, I'd point to the bit about the rubber arm.
@Orac #37
OK, I re-read your blog post on the Goldman et al paper.
Is your statement that acupuncture is nothing more than a theatrical placebo, based on your claim that it doesn't matter if you stick the needles in, or where the needles are stuck?
I don't see how those two things equate - because if you are sticking needles in near the site of pain, or even stimulating with a toothpick, it still has an effect via the peripheral nervous system. But a placebo acts top-down, by mental means.
Also, you write
So it did matter where the mouse was acupunctured, at least to that extent. It seems that you can't just acupuncture a mouse anywhere on its body and have that same effect on local pain.
Again, I don't see how all that equates to acupuncture having only a non-specific placebo effect.
I have an account on Nature but I still couldn't download the full text. So I'm relying on your summary of this study.
"It is no coincidence that all acupoints but one—360 of 361 described in humans—are located in the proximity of a major nerve"
What defines "proximity" to a major nerve, or for that matter "major" in reference to a nerve? You could probably insert needles at random into the human body and nearly always be within millimeters of some important-sounding nerve.
Kind of like when real estate agents promote a property as being "minutes from downtown". ;)
Roger Kulp:
Re. your #18, that Doctor Calvin is either practicing sans license, or is a lethally dangerous fraud who needs to be struck before he can strike again. Someone needs to ring the authorities straightaway and report him.
Re. 33: 'Sarah Visits a Naturopath' needs a sequel: 'And Sarah is Not Impressed.'
Bend @ 35: Splendid idea! 'Vickie's Valuable Vaccination': There's a measles outbreak in her school and the kids who didn't get their jabs are all falling behind, whilst VIcki and her friends keep coming to school and get ahead. Good opportunity to throw in a 'maths are fun' message too.
For Holly, I'd suggest 'Holly Heckles a Homeopath,' where the homeopath comes to town to give a speech about homeopathy, and Holly stands right up and tells everyone exactly how homeopathy is done (dilute below Avogadro's number) and winds up by asking 'if water has memory, why doesn't it remember when it was mixed with poo in the sewer?' Everyone breaks out laughing and walks out on the homeopath.
Instead of Paracetomol, why not aspirin? 'Arnie's Awesome Aspirin' can also tell the story of the Native Americans discovering it first as willow bark tea, and then make the point that if an 'herbal remedy' does anything at all, it can be tested scientifically and the active ingredients isolated and purified. And I'd bet you could even teach kids how RCTs are done.
This isn't a skeptical claim but instead a reproducible observation: studies examining efficacy find no differences in outcomes between 'genuine' acupuncture ( where the needlesare inserted at 'correct' meridian points) and sham acupuncture controls where they are deliberately inserted at the wrong meridian points--or for that matter, between genuine acupuncture and acupuncture performed with retracting needles that do not pierce the skin.
Check out charts of human nervous and venous systems--you'll see that major arteries, veins and nerves often are in close proximity. Because acupuncture was originaly a form of bloodletting, with the points the lancets inserted placed close to veins, when it was retconned by Mao the points where thin needles were inserted were shifted slightly to from the points where lancets were traditionally used for bloodletting, in order to minimize bleeding, but the slight shift still left them close to nerve pathways .
By the way, exactly how many "major nerves" are there in a person's ear (a frequent site for many acupuncture insertions)?
@Helianthus #41
Yes, that sort of thing is what I mean by top-down effects, via the mind.
The presentation to the FDA on placebo effects has a good diagram of that "top-down" vs "specific pharmacodynamic component" which differentiates a treatment effect from a placebo effect.
What I have been asking Orac is how is stimulating adenosine release to block pain reception, a "top-down" placebo effect?
It sounds more like a treatment effect, according to that definition.
Given that Cheng Dan'an moved them there and away from the veins, no, it's not much of a coincidence.
@JGC #48
It certainly is a skeptical claim, and some researchers claim that
I have no particular opinion on acupoint specificity. Maybe the researchers claiming that it exists, are completely biased.
But when you can easily find these opposing claims, it becomes a murky issue.
@Bpeth
Oh, and you seem to have a misunderstanding about placebos. A placebo is simply everything other than the thing that has an objective effect on the body. So it may be personal perceptions influenced by belief, the doctor's demeanor, whether you got enough sleep, if you're hungry, etc.; artifacts due to the design of the study; biases on the part of the person recording the data; and so on.
The most important thing to remember is that if there is some perceived placebo effect, the effect is subjective, not objective.
Maya want's help with her cold? I'm thinking Maya and her friends need help with their anorexia :mg:
Bpeth:
Like Todd explained, you misunderstand. A placebo does not act top-down, by mental means. It does not act at all, or at least, you cannot distinguish its action from chance and/or wishful thinking.
The placebo effect is widely misunderstood. It doesn't mean mind over matter. It's a recognition of observer bias. And that applies to all observers: the patient, the doctor, anyone collating the data, etc. All of them can be subject to unconscious bias, because the human tendency is to seek confirmation and then stop looking. Which is probably a more efficient way of getting answers, just not a more reliable one.
This, by the way, is why the placebo effect even exists in veterinary medicine, and even in nonliving things -- it's not mind over matter, it's the observer's bias. If we are looking for a dog to respond to a medication, we're more likely to notice positive results, even if they're just due to chance, or to interpret the dog's condition more favorably even if it hasn't changed at all. It's also why we come to believe that pushing the button for the elevator makes it come faster, even though quite definitely it does not, and intellectually we probably all know that perfectly well.
Scote @ #53: I was just thinking that little Maya's parents might want to get help for that little girl's eating disorder.
Our own cats’ acupuncture techniques leave much to be desired.
Of course I can't find it now, but a year or so ago there was a LOLCAT showing a cat crouching on a human's back (my surviving cat does likes to do this at 6am), doing the kneading bit.
The caption, if I remember correctly, reads "AltMed Cat: Specialties Massage and Acupuncture."
Roger Kulp:
Doctor Calvin? Shudder.
That's a real accomplishment, to make a Muppet rip-off look so utterly non-cute.
Do you also find the question of whether or not the earth is flat versus an oblate spheroid a murky issue?
Or that the sun orbits it, rather than the earth orbiting the sun?
How about the question of whether or not the universe and all it contains was created by spoken incantation over a seven day period roughly 600 yearas ago?
After all, a two second google-search will point you easliy to these opposing claims.
Bpeth,
Since the analgesic effects of acupuncture are small and barely clinically significant, the causes of those small effects are somewhat academic. I suspect that stomping on someone's foot or biting one's tongue would have effects of a similar magnitude. You could describe this as distraction or counter-irritation rather than placebo, I suppose, but the bottom line is that it is of no real use.
JP #39 wins the internetz for today, though I don't think I want to know how she came up with that link so quickly...
Hey, JP, how about a kiddie book kink series? Betty visits Bobby Bare's Bondage Boutique? Dot goes to Dierdre's Den of Doms?
Learn to count to Fifty with Mr, Gray? We could make a mint!
@ Scote:
@ Candy;
My thought exactly. Also Dr Meow.
HOWEVER perhaps it's the *artist* who has a problem if that's how he envisions
Ooops!
how he envisions women and girls.
Altho' she's really more of a cat than a woman..
So that would be 'Cathexia/ cat-arexia"' not anorexia.
By the conventions of caricature, Maya's not anorexic, she just hasn't grown into her body yet. Dr. Meow's physique, on the other hand, is genuinely frightening, and in combo with the gray skin tone makes her look like the last creature you'd ever want to consult for health advice. That's just one example of the surplus DK evident in these folks thinking they can create a kiddie book. The Whites must have a skinny gray kitty they can't imagine anyone wouldn't love! Had the Whites actually, you know, researched cat iconography they'd have gone with orange for lovability or white for 'goodness'.
Sadmar,you mean the guy that sang "500 Miles" and "Detroit City" had a bondage fetish? I never knew. ;)
ORAC,your "retcon" post at SBM,and the links in it,make for some very interesting reading.From Harriet Hall's post that you link to.
https://www.sciencebasedmedicine.org/the-reality-of-ancient-wisdom-acup…
Dugald Christie was a Scottish surgeon who served as a missionary doctor in northeastern China from 1883 to 1913. He wrote the book Thirty Years in Moukden. 1883-1913. Being the Experiences and Recollections of Dugald Christie, C. M.G. In providing medical care to Chinese patients, he initially met with strong resistance. People were suspicious of foreigners and spread vicious rumors about their evil doings. After he cured the blind with cataract surgery and helped patients the local doctors had failed to help, the community gradually realized he had something to offer that was far superior to what they were used to. Not just patients; people started flocking to his hospital to learn how to do what he did, and he eventually established the Mukden Medical College (still operating today under another name) to train Chinese doctors in Western medicine. During his 30 years in China he had ample opportunity to observe the practice of TCM.
The book is available online for free, but I’ll save you the trouble of reading it and describe the illuminating historical account of TCM in its pages. It serves as a reality check to those who believe in acupuncture, in “ancient wisdom,” and in the efficacy of non-Western medical practices.
Acupuncture
Chinese doctors own that they know nothing at all of surgery. They cannot tie an artery, amputate a finger or perform the simplest operation. The only mode of treatment in vogue which might be called surgical is acupuncture, practised for all kinds of ailments. The needles are of nine forms, and are frequently used red-hot, and occasionally left in the body for days. Having no practical knowledge of anatomy, the practitioners often pass needles into large blood vessels and important organs, and immediate death has sometimes resulted. A little child was carried to the dispensary presenting a pitiable spectacle. The doctor had told the parents that there was an excess of fire in its body, to let out which he must use cold needles, so he had pierced the abdomen deeply in several places. The poor little sufferer died shortly afterwards. For cholera the needling is in the arms. For some children’s diseases, especially convulsions, the needles are inserted under the nails. For eye diseases they are often driven into the back between the shoulders to a depth of several inches. Patients have come to us with large surfaces on their backs sloughing by reason of excessive treatment of this kind with instruments none too clean.
How is this "excess of fire" any different from the "toxins" and "metals" so many alt-med quacks say are to blame for autism or cancer?
I encountered a website on the "history of medicine" from the London Science Museum.
http://www.sciencemuseum.org.uk/broughttolife/themes/traditions/china.a…
If they leaned over any further to be non-judgmental and sympathetic towards 'alternative modalities' they would be flat on their backs.
There was a memorably night a couple months back when I had taken a mild dose of a certain chemical and was then summoned to a drinking establishment by a certain ex-Yugoslav of whom I very fond. We ended up trolling Craigslist for giggles at some point in the evening - the link is not our own work, however, but some of our inspiration. It has since become a running inside joke.
Man, then I'd never get a job with the CIA. Oh wait, never mind, I never will anyway.
^ "memorable," of course.
The reality:
https://m.youtube.com/watch?v=I3DVN7XMiQk
Shay @56
As a slight aside (but we are at least at post #61 here!), one of the most obscene things I have read about fake-medicine recently was when an - otherwise it seems genuinely caring - 'cat blogger' took her new kitten that was suffering from physiological digestive problems for acupuncture sessions...
I crap you not.
Honestly... she took the little cat to have pins stuck in her... It left me simultaneously enraged and distraught. I cannot read her posts anymore.
Hand? Heck, there's a point on my finger that clears my breathing right up!
I've got shpilkes in my genecktigazoink.
Oops, shoulda been this clip.
Man, then I’d never get a job with the CIA. Oh wait, never mind, I never will anyway.
NSA, on the other hand, these days they'll hire just anyone.
herr doktor bimler@73
A while back I remember reading that the NSA was having g trouble recruiting because all the skilled hackers out of highschool/college were too fond of the marijuana.
To be fair, Bpeth@51 does link to a very sciency looking paper published in a peer-reviewed sciency looking journal, with all the trimmings and considerable claims:
Feynman on cargo-cult science comes to mind. But to the uninitiated, it all looks pretty much the same as any real science findings.
Lurker@10: " In Buddhism and Hinduism, the word ‘Maya’ means ‘the state of illusion or incorrect perception of reality.’"
The elephant (we are seeing) is pink.
@davep
One wonders if the elephant is one of a number on parade.
I guess that if the girl is hearing animals talking to her, the cold is the least of her problem. She need some psychiatrist.
Well the short answer is 'yes'. It is extremely likely that a technelogiically advanced civilistion such as China was in roughly 15 AD could easily produce thin [metal] needles.
Probably, the Roman Empire, the Persian Empire too.It is far to easy to underestimate the levels of technology that existed before the internet.
I don't see that this is neccessarily an issue, however. It might have been perfectly feasible to use bamboo or wooden splinters.
Acupunture in China seems to have been around for at least 3,000 years though it sounds more like divination than medicine in the earlier centuries. No idea what happened recently, say since 15th C. (Lu, G.-D., & Needham, J. (2002). Celestial Lancets: A History and Rationale of Acupuncture and Moxa (1 edition). London: Routledge.)
TCM as it seems to be pushed in North America seems to think that there was some Golden Age of Chinese Medicine, instead there has been perhaps 3,000 or 3,500 years of evolution in medicine in China. I wonder what Tradition is followed? The one the Bank of Chinese Medicine likes?
I have never actually seen a reasoned discussion of how effective/ineffective various bits and pieces of Chinese practice are/have been. Somehow, I would have to suspect that some were at least as effective as early 19th C Western medicine, that is the odds were slightly in favour of your doctor killing you rather than curing you.
I really was surprised that Dr Christie in his memoir states that Chinese medicine did not know anything about amputations, etc. so it may well be true but this seems like the type of very basic battlefield medicine that one would have.
However, there was a regression in Chinese science and technology (and engineering?) from the early 16th Century into the 19th so it is possible that earlier skills and knowledge were not available.
Well don't forget NSA was likely offering civil-service levels salaries and the excitment of getting to take a lie-detector test once a year to prove you were not a communist, terrorist, or a member of the ACLU or possibly were cheating on your partner.
Have any such needles survived?
If acupuncture was around, it wasn't around in anything resembling its current form. Rather, it was more akin to what we would call bloodletting, with a heavy dose of astrology added on.
https://www.sciencebasedmedicine.org/astrology-with-needles/
https://www.sciencebasedmedicine.org/the-reality-of-ancient-wisdom-acup…
https://www.sciencebasedmedicine.org/retconning-traditional-chinese-med…
jrkrideau,
None of the photos of ancient acupuncture needles I have seen remotely resemble modern acupuncture needles. The ancient ones more closely resemble the lancets used for lancing boils, bloodletting and general poking purposes in medieval Europe, for example this set of ancient Korean needles. That does indeed seem to have been their purpose until the 1930s, when a clever Chinese pediatrician called Cheng Dan’an relocated the points away from blood vessels and introduced the fine needles.
Perhaps you are unfamiliar with just how fine acupuncture needles are - here's a photo showing how many can fit inside an 18 gauge hypodermic needle, which has an internal diameter of less than a millimeter. I doubt that the technology to make needles this fine existed millennia ago.
The 7 year old boy who died after suspected TCM treatment in Sydney - it's about as bad as it gets. Poor little fella.
http://www.dailytelegraph.com.au/news/nsw/aidan-fenton-7-was-made-to-fa…
Janerella @83: That article is behind a paywall, and I can't find anything on the BBC - do you have another link/article?
JustaTech@84
http://www.dailymail.co.uk/news/article-3062792/Police-investigate-slap…
janerella@83
Could not agree with you more. What's the harm indeed?
"I really was surprised that Dr Christie in his memoir states that Chinese medicine did not know anything about amputations, etc. so it may well be true but this seems like the type of very basic battlefield medicine that one would have. "
-As Christie points out in his account of the First Sino-Japanese War, there was nothing remotely battlefield-ready about the Qing homeland.
As the mother of a three year old I have to say the book sucks on a lot of levels. One I would never expose my kid to such nonsense, and two the woman who wrote it is no Dr. Seuss. (Small child is obsessed with Dr. Seuss books right now) I really don't think you're going to have a lot of luck convincing many children to line up to have a bunch of needles stuck in them. Though my child did thank the phelebotomist after she took his blood. Maybe he just thanked her for stopping. These books are probably being written for woo-y parents trying to get them to bring all their kids in for 'healing'. Sadly, they probably are.
However, there was a regression in Chinese science and technology (and engineering?) from the early 16th Century into the 19th
This would never happen in Western cultures. [/sarcasm]
@82 Krezaban
I had not realized that TCM (today) would insist on such small needles. Do they or should ask, “Do all of them since I doubt there is a ISO ... “! Bloody hell there IS an ISO standard (ISO 17218:2014) for acupuncture needles--single use!
It may be that 2,000 years ago that one could not meet this standard (which I have not read) but without some real knowledge of early Chinese metal-working and metallurgy I'd not discount it and as I mentioned there is no reason to even think that originally metal was used though by the time it was reliably documented I imagine they were.
I may have misinterpreted Orac's statement, he seemed to be dismissing earlier civilizations abilities to produce a thin needle and implying that acupuncture could not have existed in roughly 1 A.D. and this seemed unreasonable.
@86 E. Harding
Given the general decrepitude of the Qing dynasty by the time of the First Sino-Japanese War, I am not surprised there was “nothing remotely battlefield-ready about the Qing homeland”. Unfortunately I have not gotten that far in the memoir.
His report does not mean that such things may not have existed. The British death toll in the Crimean War suggest that.
What is rather more convincing to me of the general lack is the reports of individuals whom he treated on a regular basis.
It is more that China reportedly has some decent surgical techniques in earlier times and while they seemed to have declined it just seems unlikely that such useful techniques would have died out completely when China has as far as I can tell never been all that peaceful let alone the need to treat industrial accidents and so on.
It is possible that 3,500 years of medicine (well combined with superstition--sound a lot like Western medicine--did not figure out how to carry out basic surgical procedures or if it did, managed to let them lapse.
Certainly possible but seems strange. Unfortunately my local resources don't seem to have much available on Chinese medicine (I meant what look like scholarly hard-copy materials--I'd not trust googling here:) so I don't know.
jrkrideau in comment #89, replying to #82 Krebiozen (not krebazan):
There is no evidence for modern style ultra-thin acupuncture needles before the 20th century. All available evidence points to real traditional Chinese medicine using hollow needles for bloodletting, in their very own texts and materials. If you think there is evidence for ultra-thin needles being used in modern methods, then it is up to you to prove your assertion. Arguing "there could have been" is not reality-based, it's just wishful thinking.
You consider it plausible that the Calgons could reliably produce 26–32 ga. needles that were strong enough for reuse (or, for that matter, insertion into the skin) during the Han dynasty? What was this all about?
The thing is, putting needles into someone's epidermis has been shown time and time again to do nothing for the condition supposedly being treated, besides that of making the patient think they're being taken care of. It's no better than giving them injections of saline solution and calling it a powerful drug. Oh, except that the saline solution will at least aid their hydration level . The needles just open holes for bacteria to lodge in, and don't even connect with nerves, but with made-up "Meridians" that are supposed to heal you when poked with a needle. In short; it's all a sham! don't spend a cent on it.
@93 JerryA
@ JerryA
Sorry bad wording on my part now that I reread it when I am awake.
I did not mean to claim that early Chinese tech would match the current ISO standard ,just that I suspect it would be quite capable of producing [i]very[/i] thin needles.
Of course, maybe they could match it. :)