BBC Programme to show acupuncture deactivates brain

[andycal]

I only caught a bit of this program. The part I saw was the use of acupuncture to stop smoking. They apparently 'tested' this by telling the participant exactly what to expect (nausea after smoking) then standing around with cameras rolling and several doctors as well as the presenter looking on to see if she produced the expected response. This was presented as if it was evidence that acupuncture works; if valid, then nausea, nausea, therefore valid.



In order to NOT produce the expected response, the participant would not only have to be non-suggestible, but willing to brave the disapproval of everyone watching.

There was a good example of the stop smoking thing on the telly recently. In "How to pay your mortgage off in two years" (stay with me, there's a link here somewhere!), one of the participants was a 'hypnotist'. He sat in a quiet room and told a smoker that after the treatment he'd smell rotten fish whenever he wanted to light up. Sure enough, he did. Not a needle in sight.

Again, it's not the treatment but the surroundings and the suggestibility of the participant.

 

[bridgy]

The program certainly left me with more questions than answers.

With regards the heart operation in China, people here have raised serious questions regarding validity of the whole thing , but I can't really comment on this as I don't have the expertise - perhaps someone with some specialist knowledge could ask the programme makers via http://www.open2.net/alternativemedicine/feedback.html ?

The thing that struck me about the heart surgery was that no one bothered to say what the acupuncture itself was meant to be doing in this context - the impression given was that it was providing pain relief, but if this is the purpose then what was the point of numbing the chest with anaesthetic

I did do a quick Google search on Open Heart Surgery without general anaesthetic and came across this - http://www.expresshealthcaremgmt.com/20040331/innews03.shtml describing such an operation in India - I don't know if this sheds any more light on things for the medically trained amongst us? NOTE - no mention of a requirement for acupuncture in the article!

I can't help feeling that the whole heart operation thing was at worst a sham as suggested by some here, or at best a massive red herring where acupuncture is concerned.

Did anyone else notice that short section in the program where Kathy Sykes discussed those fake, retracting needles to be used as a control in acupuncture studies. They looked quite nifty, but then the program moved straight on to the study in America which didn't use them as a control, and then their own experiment which I don't think used them either - so what was the point of discussing them?

I too was dissapointed that their own experiment:
1. didn't test random points rather than just acupuncture points
2. was conducted by an acupuncture practitioner who (as was pointed out in the programme) knew his profession would be undermined if there was no affect shown, and who also knew who he was applying the real and fake acupuncture to (albeit only at the last minute).

Doesn't bode well for the next 2 programmes...

 

[Rolfe]

Yeah, she was really sceptical of the open heart surgery was'nt she!!! As Rolfe so rightly pointed out at the start of this thread, it is impossible to open the chest cavity whilst the patient is concious. IMPOSSIBLE!!!

Kathy Sykes just lapped this up, if she was half the scientist she claims she would imediatly see why this operation was a fake. And this woman is supposed to be a professor of public engagment in science!! pah!

I have to say that it appeared to me that they were opening that girls torso just below the liver in a horizontal incision - isn't heart surgery usually performed with a vertical section - hence the 'zipper club'?

This is the confusing thing. When we saw the open heart stuff, I'm sure I could see the heart pumping away like a good 'un. Now if it was heart was being worked on, don't they have to stop it and put her on a machine?

And then when she skipped out the hospital a few days later, she had a whopping great scar down her chest - the zipper club you mention?

I've been trying to figure this out from what I saw, and I can't really see that it was anything other than some sort of trick.

I wish I'd videoed it, but I didn't so there you go. As we saw the scalpel cut I did get the impression that the incision was being made laterally, but that could have been an illusion created by the drapes, I can't be sure. Certainly the operation site showed a midline thoracotomy with the sternum bisected, and when the girl left the hospital she did have an extremely ugly vertical midline chest incision.

The shots of the surgery clearly showed the intact heart beating away good-style, in an open chest. There was no mention of how the patient was being ventilated, and she was clearly not intubated. I saw some tubes that looked as if they might be for gas transport, but I couldn't see in what way they were connected to the patient. Someone in an earlier post mentioned a heart-lung bypass, something I have to say I know little about, as it's not a procedure performed in veterinary medicine. It seems reasonable that a heart-lung machine may be part of the solution to this mystery, but I can't really see how it solves it.

I would have thought they would have had to stop the heart in order to do the surgery described, but perhaps they did and we just didn't see that part. However, if there was a heart-lung machine, how was it connected?

The shots of the patient leaving the hospital showed an incision which seemed to go no higher than the thoracic inlet. There was no sign of any incision in the throat area, so apparently no tracheotomy at that level. I was wondering if the trachea was accessed directly within the thorax, and it may be that was what was done. Perhaps (ignorance showing, sorry) that's standard when a heart-lung bypass is in place. Nevertheless, how would you get the patient to that stage?

Normally, you would induce general anaesthesia and enough muscle relaxation to let you do what you pleased, and intubate the patient. Anaesthesia would be stabilised and the patieht ventilated before going into the chest cavity. The chest would then be opened, and the surgeon would have time to sort out and position whatever fancy equipment was needed. Perhaps at this stage a direct air line into the trachea at a point within the chest is feasible, perhaps even routine, I don't know. But what I do know is that getting to that stage would inevitably require intubation and ventilation, I just can't see how it would be possible otherwise without severely endangering the patient's life.

This could have been a total fake with the connivance of the television crew - in that case we could have been seeing bits of a number of different operations all cut together to give the desired impression. However, I wouldn't have suspected a BBC crew of such duplicity, and it seems more likely that the crew itself was deceived. I suspect there must have been a period of the process where they were excluded from the theatre. Either the girl was fully anaesthetised and intubated while the chest was opened and the heart-lung apparatus set up, then allowed to surface a bit and de-intubated after that, or there was a mad scramble to get a heart-lung bypass in place in a spontaneously breathing patient before she asphyxiated. Both of these possibilities sound dangerous to the point of madness to me.

It might also explain why the actual incision we saw being made looked as if it was in a different site entirely - being excluded from the theatre at that point, they just cut in a bit of stock footage?

Maybe there's another more reasonable explanation that I'm missing here, and hey, do we have anyone with any experience in human anaesthesia who could comment further? However, this is really quite obsessing me, because I feel we have been shown a conjuring trick and invited to believe there really is a bisected lady in the box under the drapes.

Other questions that spring to mind are, how come this is a safer procedure? Modern general anaesthesia is not high-risk, and I know how I'd prefer a patient who had its chest open and a lot of complicated tubing attached - unconscious! Just imagine if she had surfaced enough to panic! And how come the recovery was so fast? It's not the anaesthesia that's going to hold you back after a procedure like that, it's the fact that you've had your breastbone sawn open. And yet she was seen leaving the hospital apparently very soon afterwards. Hey, is it possible that her breastbone wasn't sawn open? (Back to the possibility of some very devious trickery.) And how come it was so much cheaper? Given all the paraphenalia and the extent of the surgery, I wouldn't have thought that the cost of a general anaesthetic would have added nearly as much to the price (proportionately speaking) as they claimed. Didn't they say the cost was halved? This is just ridiculous.

And note, this really has nothing at all to do with the acupuncture. Whatever was done to that girl, prestidgitation aside, could have been accomplished with deep sedation and local anaesthesia, which were admittedly used. What was the acupuncture supposed to be doing again?

I think it's an insult to the intelligence to be left with doubts and questions of that nature after what was supposed to be a scientific investigation, and frankly I'm disgusted.

Rolfe.

 

[sophia8]

How about the OA "test"?

I was extremely annoyed by the way she gleefully said that "acupuncture clearly works, at least for OA of the knee".
The only result we were presented with was that 33% of those receiving real acupuncture reported "some imporvement". No mention of how many reported the same from the (rather shoddily controlled) placebo group. And besides, it's obvious that at only 33% this could easily still be a placebo effect anyway. I could go on about how shot full of holes this single test was, but you're the converted and I'm no preacher.

I didn't see this program, but I have OA of the knees and I can state from experience that my perception of the discomfort is subject to placebo effects. If I'm depressed, they HURT and I can barely get up and down the stairs; if I'm in a happy mood, I can skip along until my knees lock suddenly.
If I was convinced that acupunture works, and I had a nice chatty acupuncturist visit every week and stick a few needles in my knees while he gossiped, I'm sure would feel a lot of improvement. But I doubt if the actual condition would be any different.

 

[DreadNiK]

As far as I'm concerned, they provided evidence only to support that sticking needles into someone has some a discernible effect, both on pain perception and the activity of the brain, and that the effect on pain perception is greater when the needles actually penetrate (the placebo trial), and that the activity seen in the brain is different when the needles are pushed further in and the 'deichi' sensation is caused.

What they claimed was that 'acupuncture works (+ qualifier)'. Totally lacking any definition of acupuncture as opposed to sticking needles in yourself anywhere you like and twisting. Potentially, there could be some biological/neurological phenomenon that could be explored to benefit, but she was far too unguarded in her speech. You'd think someone with her job would realise that the majority of people out there are illogical and credulous and the claims made in the program WILL be misinterpreted and misused to support unsupported positions about the effects of acupuncture.

As many have said, I would like to see needles stuck into random or non-acupuncture places. I would also like to see the effect of different widths of needles, multiple different depths, and also the effects of other similar activities, such as minor cuts, burns and the like.

That program was BBC science all over. Stretch what little solid evidence is presented to support whatever position they feel like.

 

[alock]

My wide had open abdominal surgery last year without a general anaesthetic. Her ability to cope with this had nothing to do with quack medicine.

(Hint: Think of a caesarean with an epidural)

 

[Asolepius]

Actually I was after the names of the scientists in the MEG/MRI study at the end of the program.

One of them was the ubiquitous George Lewith from Southampton. He who has published a load of negative studies in homeopathy (eg this one)but still runs a nice little private practice with it. Well actually a big practice.....

There's an important point here. It seems that a study was planned, conducted and reported on TV. Where was the critical independent review of the protocol? Was there ethics approval? And most importantly, where was the peer review? It is reprehensible to release research results to the lay media without peer review - and I'll wager it's a breach of the respective universities' codes of practice. If it was peer reviewed, why did the BBC not say so, and tell us where it was published? There is nothing on PubMed resembling this study within the last 2 years.

 

[Interesting Ian]

Yeah, she was really sceptical of the open heart surgery was'nt she!!! As Rolfe so rightly pointed out at the start of this thread, it is impossible to open the chest cavity whilst the patient is concious. IMPOSSIBLE!!!

What do you mean "impossible" What sort of impossible are we talking about here??

Kathy Sykes just lapped this up, if she was half the scientist she claims she would imediatly see why this operation was a fake.

Scientists can no longer be authorities in all aspects of science. She's probably a physicist or something, in which case if it is indeed impossible then she might not know it. I certainly did not know it is impossible. I would like you to substantiate this assertion though. If it is so obviously impossible this begs the question of why the BBC should show it at peak viewing times on one of their mainstream channels! Obviously they don't know it's absolutely impossible either

And this woman is supposed to be a professor of public engagment in science!! pah!

Infinitely better than that complete idiot called Dawkins. Her questioning and scepticism were impeccable.

 

[Interesting Ian]

Thanks Ian, you're a credit to whatever you are.

Anyhoo,

I was massivily dissapointed with the program. I taped it and there are a few things I need to check over, but on the face of it, it was just a standard "let's try to keep things balanced" type of blandness that the BBC generally throws out.

I disagree entirely. I would also have disagreed entirely if they had concluded that it was entirely due to the placebo effect. The presenter was really intelligent and excellent. Superb viewing! Wish they had some more high quality programmes on like that.

However it did look like open heart surgery, but based on what some people have been saying here, that's just not possible. I'm no doctor so I'm hoping someone who is will be able to throw light on it.

You mean you cannot be conscious while it's happening? But why??

 

[Interesting Ian]

Well I thought the program to be more balanced than I had expected. Kathy Sykes DID say (in voiceover) that the acupuncturist in China who was saying she should relax, and think less (lol) could have made the same observation to almost anyone...

I did not think she came across as overly credulous -

Of course she wasn't credulous! To suggest she was is quite frankly absurd. And to call her a airhead like Rolfe did is insulting in the extreme. She kept presenting the sceptical point of view. She kept questioning everything. It was a good sceptical programme. This is true scepticism as in the original meaning of the word. Not a knee jerk reaction that something is absolutely impossible!

 

[Interesting Ian]

Point taken. In fairness if the data is from the 3T MRI the acupuncturist would have to shout very loudly his disbelief as the patient must wear ear defenders. I have never used MEG. But I agree that there could be non verbal cues. However it's hard to think of a way of double blinding it effectively unless the points are in a mass of non-descript flesh [insert your own joke here].

I noted that they didn't say "local anaesthetic" they said that her "chest was numbed". I found that a little strange. If people know what a general anaesthetic is I would assume they would be au fait with "local anaesthetic". Choices of word like this make me suspicious as to what the program is trying to do.


I thought the start (operation aside) was fairly good although a bit more reference to suggestion and placebo wouldn't have gone amis. What I am particularly annoyed at is the build-up culminated in the complete failure to present the results in a transparent manner. I agree that the program makes the suggestion (to the viewers) that there is "something to acupuncture" if that's what you meant. But how one can reach that conclusion from the barely presented experiment is beyond me - if you disagree please explain exactly what you think this experiment demonstrated.

However I do agree that there is something (an analgesic effect) to acupuncture (using the laymans' definition: sticking needles in people at random). The danger is that unless you state precisely what the experiment shows, people take away the conclusion that the entire body of acupuncture theory is correct.

So for "public engagement in science" I'd say this was a success. For "public understanding of science" I think it left a lot to be desired.

I mean an an analgesic effect. Not proves it, but strongly suggests it. I mean it seems as if does relieve pain. The question is whether it is merely a placebo, and the research seems to strongly suggest that it's not merely a placebo.

I don't know about the ancient Chinese theory behind it. I have absolutely no idea if that is true or not and have no opinions on the matter.

 

[dogbite666]

What do you mean "impossible" What sort of impossible are we talking about here?? .

Opening the chest cavity of a patient whilst they are concious and not intubated is impossible. Please tell me how this girl was breathing whilst the doctors had her chest cavity open???????????? could you do that for me Ian?

Scientists can no longer be authorities in all aspects of science. She's probably a physicist or something, in which case if it is indeed impossible then she might not know it.

So she is authoritive enough to make an hour long TV program on the subject? This woman is a professor for goodness sake! being a professor means that you are an authority on science, and yet she wasn't even clever enough to know that a patient with an open chest cavity cannot breath unaided.

Infinitely better than that complete idiot called Dawkins. Her questioning and scepticism were impeccable.

Now your just trolling Ian. Go play with Dr MAS.

 

[Interesting Ian]

I'll still be interested to see the next programme. It does seem that there may be something to acupuncture, after all (even though it's nothing like what proponents claim - which won't stop them using this programme to shout "Acupuncture works!" and miss out the qualifiers).

It's nothing like what the proponents claim?? How on earth do you know this??

 

[Lothian]

I disagree entirely. I would also have disagreed entirely if they had concluded that it was entirely due to the placebo effect.

Why does your agreement or disagreement depend on the conclusion as opposed to the means of reaching it.

 

[Interesting Ian]

Originally Posted by Interesting Ian :
What do you mean "impossible" What sort of impossible are we talking about here?? .

dogbite666
Opening the chest cavity of a patient whilst they are concious and not intubated is impossible. Please tell me how this girl was breathing whilst the doctors had her chest cavity open???????????? could you do that for me Ian?

I know absolutely nothing whatsoever on this topic. I never even did biology at school after the age of 14. I don't understand the question. We can breath normally, so what is preventing people breathing in this sort of situation?

dogbite666
Scientists can no longer be authorities in all aspects of science. She's probably a physicist or something, in which case if it is indeed impossible then she might not know it.

dogbite666
So she is authoritive enough to make an hour long TV program on the subject? This woman is a professor for goodness sake! being a professor means that you are an authority on science,

Ummm . .science is a vastsubject. You cannot expect a physiciust, or a cosmologist, or a geologist, or a social scientist or a parapsychologist etc etc to necessarily have intimate details regarding the human body and how it works.

and yet she wasn't even clever enough to know that a patient with an open chest cavity cannot breath unaided.

It has absolutely nothing to do with being clever. I don't know it eitehr, yet I'm a damn site more clever than just about everyone who contributes on here.

dogbite666
Infinitely better than that complete idiot called Dawkins. Her questioning and scepticism were impeccable.

Now your just trolling Ian. Go play with Dr MAS.
.

I'm not "trolling", I'm stating very obvious facts. Dawkins is a moron.

 

[Interesting Ian]

Why does your agreement or disagreement depend on the conclusion as opposed to the means of reaching it.

It doesn't, and it shouldn't. That's what I'm complaining about. If the result of the programme had been that acupuncture doesn't exist, then most people on here would have been crowing how wonderful the programme was and how clever Kathy is.

 

[richardm]

It's nothing like what the proponents claim?? How on earth do you know this??

The proponents claim that acupuncture can do everything from cure disease to make you quit smoking. All that the programme demonstrated is that it may have a role to play in reducing pain, which is just a very tiny subset of what acupuncturists reckon they can do.

 

[dogbite666]

I know absolutely nothing whatsoever on this topic.

And obviously, judging by the content of this programme, niether does Kathy Sykes! You thought being a professor and all she might have had the intelligence to go to the libary and look in a book about the respiratory system!

I never even did biology at school after the age of 14. I don't understand the question. We can breath normally, so what is preventing people breathing in this sort of situation?

The chest is a closed cavity conating, among other things, the lungs. The bottom end of the chest cavity is closed by the diaphram. When we breath we make the diaphram move down which expands the chest cavity volume and hence lowers the pressure. The lungs, being open to the air by the mouth, expand and fill with air. When you open the chest cavity it is no longer closed and moving the diaphram no longer changes the pressure in the cavity which means the lungs do not inflate. The only way to get air into the lungs is by feeding a tube down the throat into the brochical tube, (not sure about the spelling), and pump the lungs with air. To get a tube down that far you need the patient to be unconcious otherwise the gag relex will push it out. Even so, this girl didn't have any tubes going into the lungs from the throat, and therefore cannot have had her chest cavity opened.

I believe this was a collection of films put together, rather than a fake operation. As Rolfe said, if her chest was opened they would have had to break her breast plate. There is no way she would be up and walking about in 2 days, as Kathy Sykes, said if this was the case.

Hope this answers your question Ian, and puts your mind to rest about the matter. As for sticking needles into people, well I agree it may have some effect on easing pain in other parts of the body.

 

[dogbite666]

I'm a damn site more clever than just about everyone who contributes on here.

Troll!

 

[Rolfe]

I know absolutely nothing whatsoever on this topic. I never even did biology at school after the age of 14. I don't understand the question. We can breath normally, so what is preventing people breathing in this sort of situation?

I thought I had explained this in an earlier post, but perhaps I was assuming too much basic physiology knowledge.

When you breathe, you draw air into your lungs by negative presure. The lungs are tighly encased in the chest cavity (chest wall and diaphragm), and when the chest wall expands and the diaphragm contracts the volume of this cavity is increased. This forces the lungs to expand (passively) to fill up the cavity, and in doing this air is drawn in through the nose and mouth.

This process depends absolutely on there being no air in the pleural space, that is the space between the outside of the lungs and the inside of the chest cavity. If there is air there, then when the chest expands, instead of the lungs expanding and taking air in from outside, the air in the chest will simply expand. And the patient will not be able to breathe. Look up "pneumothorax" and you'll probably find a better explanation.

Thus, the minute you open the chest, normal breathing simply isn't going to work. Something else has to be done. The usual thing is to put a tight cuffed tube down into the patient's trachea (windpipe), and attach this to an anaesthetic machine. This blows air into the lungs under positive pressure, and incidentally will deliver anaesthetic gases as well. You might dispense with the need for anaesthetic gases by using sedation and local anaesthesia, but you cannot dispense with the need for artificial ventilation. And the endotracheal tube cannot be passed in a conscious patient. The cough/gag reflex prevents it.

There are possible ways round this. Theoretically, you could consider doing a tracheotomy and intubating that way, bypassing the larynx where the gag reflex happens - much in the way Christopher Reeve was ventilated, because of his paralysed chest muscles and diaphragm. I'm very hazy on the practicalities of this, how would you overcome the breathing reflex in a conscious patient for example, but this is academic anyway, because the patient on the programme did not have a tracheotomy - there was no incision at the appropriate place.

Again theoretically, you could somehow attach the ventilator to the trachea within the chest, after the chest was opened. However, how would you get to that point without asphyxiating the patient? Or there may be a complete heart-lung bypass, which is something I don't know much about because it's not used in veterinary medicine, but again I don't understand how you could get something like that positioned and operating in a non-ventilated patient.

I wish we had an anaesthetist here to clarify some of the details, but I simply cannot see how this could have been achieved as it was portrayed on TV. Every possible scenario I think of involves a lot of convoluted and unnecessarily dangerous manipulation of the patient.

It really was like sitting watching a lady being sawn in half, and an allegedly sceptical scientist oohing and aahing and quite failing to notice that ladies aren't usually still alive after they've been bisected.

Rolfe.