“Alternative medicine doesn't exist and acupuncture is useless”

[Blue Wode]

…so says Wallace Sampson (clinical professor emeritus of medicine at Stanford University and editor in chief of the Scientific Review of Alternative Medicine) in today’s San Francisco Chronicle.

"It doesn't exist," he says. "We've looked into most of the practices and, biochemically or physically, their supposed effects lie somewhere between highly improbable and impossible."

-snip-

There are two major misconceptions about acupuncture, Sampson says, and both contribute to the misunderstanding of its worth as medical treatment. First, most people assume that it's an ancient Chinese cure that has existed, unchanging, for centuries. Not so, says Sampson, noting that "acupuncture was formalized in a complex way over the past 100 years, mostly in Europe and France and after the Communist takeover in China. Before that time there was no consistent formalization of acupuncture points or what each place was supposed to do. It was largely regional, and the thinking varied from city to city."

The other mistake people make about acupuncture, Sampson says, is that it offers specific cures. "It is nonspecific," Sampson says. "If it has the effect of, say, releasing endorphins through the application of needles, well, many things release endorphins -- a walk in the woods, a 5-mile run, a pinch on the butt."

More…
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/08/31/NSGDOIM5RJ1.DTL&type=health

For any JREF readers living in San Francisco, Wallace Sampson will be holding forth on acupuncture at 5.15pm today, at the Commonwealth Club at 595 Market St., S.F. (415) 597-6700 ($15 entry fee).

Great to see an article like this in the press.

 

[Deetee]

I agree there is no such thing as alternative medicine - if it works it is medicine, if it doesn't it isn't.

I thought acupuncture (which does have measurable effects) was not mediated through the release of endorphins, however.

 

[Ririon]

I agree there is no such thing as alternative medicine - if it works it is medicine, if it doesn't it isn't.

I thought acupuncture (which does have measurable effects) was not mediated through the release of endorphins, however.

So acupuncture is medicine? It had better beat some placebo first.

Until then, the butt-pinching therapy seems more interesting.

 

[RichardR]

I thought acupuncture (which does have measurable effects) was not mediated through the release of endorphins, however.

It's a hypothesis and there may be some weak evidence for it, but it's not been confirmed.

 

[Skeptic Ginger]

I said this a while back. In fact I started a thread on it. We need to stop distinguishing between alternative medicine and Western medicine (aka modern med, regular med, etc.). Evidence based medicine is a better term and incorporates both. Either there is evidence or there isn't no matter what the origin of the practice.

The words we choose to describe, label and express concepts have an impact separate from the thing you are describing and it pays to choose the words you use based on that impact.

Why do you think the Discovery Institute changed the name for Creation Theory to Intelligent Design? They didn't get what they wanted from the name change but they took great care choosing it and took great pains to disseminate the term.

Calling medicine 'alternative' implies it has a different quality and/or is measured by a different standard than other medicine. If we adopted the term, 'non-evidence based' rather than 'alternative' we would be conveying a stronger message. People might even start to ask why we didn't consider the time a practice or remedy has been in use and random anecdotes as evidence.


Re the acupuncture, I just did a lit search on this the other day. There are a few studies with some positive results including one where the effect was observed when the needles were inserted both before and after anesthesia induction. Compared to controls there was significantly less post op nausea. There was one recent case of a documented surgery under acupuncture anesthesia done at Oregon State University Hospital. Most of the research though has either been of poor quality or showed no results according to Quackwatch and most of the claimed use of acupuncture for anesthesia was likely supplemented with pain medication. The links to these are in another thread, here, and here.

I would favor more research on acupuncture before dismissing it out right. That would be the objective approach given there has been some evidence of various effects.

 

[Flange Desire]

snip
The words we choose to describe, label and express concepts have an impact separate from the thing you are describing and it pays to choose the words you use based on that impact.
snip

Great post - your words about words are spot on!
I think I may use the term 'evidence based medicine' from now on.

It has great impact as it sounds very positive, and has the bonus effect of immediately bringing to mind the alternative ('non-evidence-based medicine') - and dragging along with it, all the negative conotations of that alternative.

please excuse my clunky words - it is so difficult to discuss thought processes

 

[Skeptic Ginger]

Thank you Flange. As you can see, I have been interested in this for a while.

This thread is in a similar vein.

 

[Euromutt]

I said this a while back. In fact I started a thread on it. We need to stop distinguishing between alternative medicine and Western medicine (aka modern med, regular med, etc.). Evidence based medicine is a better term and incorporates both. Either there is evidence or there isn't no matter what the origin of the practice.

Personally, I make a conscious effort to refrain from referring to any form of CAM as "medicine," reserving the latter term for, well, actual medicine. Instead, I use terms like "alternative health care" or, better yet, "alternative (forms of) treatment." That said, it certainly can't hurt to use the term "evidence-based medicine" in preference to "western" or (puke) "allopathic medicine." As was pointed out in the earlier thread, it rightly implies that the alternatives are not evidence-based.

[writes mental note to self]

 

[Cuddles]

So acupuncture is medicine? It had better beat some placebo first.

Until then, the butt-pinching therapy seems more interesting.

http://www.newscientist.com/channel...unctures-effects-are-not-all-in-the-mind.html

It does appear that stikcing needles in people produces more brain response, and in different places, than just the placebo effect. Unfortunately for the acupunturists this happens if you just stick the needles in random places. IMHO it wouldn't be at all surprising if needling could produce a pain response and even an immune response due to breaking the skin. Clearly this doesn't mean that it will magically cure anything, but it does seem at least worth further research.

 

[Bronze Dog]

Personally, I make a conscious effort to refrain from referring to any form of CAM as "medicine," reserving the latter term for, well, actual medicine. Instead, I use terms like "alternative health care" or, better yet, "alternative (forms of) treatment." That said, it certainly can't hurt to use the term "evidence-based medicine" in preference to "western" or (puke) "allopathic medicine." As was pointed out in the earlier thread, it rightly implies that the alternatives are not evidence-based.

[writes mental note to self]

I don't mince words: I refer to the "alternative" stuff as quackery or sCAM.

I also make an effort to say "evidence-based medicine."

 

[Skeptic Ginger]

Another person brought up the term faith based medicine. This was my reply:

"Faith based medicine" is an accurate and very interesting concept, Triple. Were I to use that term, I would want to be careful of the context.

Say I started referring to alternative medicine as faith based. If it was in the context of treatments in use, it would likely imply faith based medicine was valid. If it were in the context of, alternative medicine for which there is no evidence of its effectiveness, or, faith based medicine essentially means there is no evidence it works, it would imply it wasn't valid.

If you belief faith is valid, you hear the message, "faith based medicine is valid". If you consider 'faith' a synonym for 'no evidence' you hear the message, "faith based medicine is not valid". This particular name, while true, may not be the best choice if we wish to promote evidence based medicine. But the term is an excellent example to illustrate the power of word choices in communication. And it illustrates why calling a category of medicine 'alternative' implies some medicine is valid despite there being no evidence it works. (BTW, This is not the equivalent of a placebo effect, so don't confuse the two issues.)

 

[Yahzi]

Great to see an article like this in the press.

Especially in San Francisco!

I was so happy I sent the journalist a nice email.

 

[Ririon]

http://www.newscientist.com/channel...unctures-effects-are-not-all-in-the-mind.html

It does appear that stikcing needles in people produces more brain response, and in different places, than just the placebo effect. Unfortunately for the acupunturists this happens if you just stick the needles in random places. IMHO it wouldn't be at all surprising if needling could produce a pain response and even an immune response due to breaking the skin. Clearly this doesn't mean that it will magically cure anything, but it does seem at least worth further research.

Sticking a needle somewhere halfway between acupuncture points or in the "wrong" acupuncture points IS the appropriate placebo in my book. If not, then acupuncture is reduced to sticking needles in your body at random places. (Which, again, it already is reduced to in my book... )

 

[Cuddles]

Sticking a needle somewhere halfway between acupuncture points or in the "wrong" acupuncture points IS the appropriate placebo in my book. If not, then acupuncture is reduced to sticking needles in your body at random places. (Which, again, it already is reduced to in my book... )

I believe there have been trials that show that sticking needles in people at random does have the same effect as acupuncture, but also that sticking needles in anywhere has a bigger effect than retractable needles where people think they are having acupuncture. This implies there could be a real effect over and above the placebo effect.

Having written the above I just found this : http://www.ncbi.nlm.nih.gov/entrez/...ve&db=PubMed&dopt=Abstract&list_uids=16691086, which says that even those with no knowledge of acupuncture can tell the difference between fake needles and real ones, so possibly a placebo effect is all there is to it.

 

[Blue Wode]

This New Humanist article by David Ramey seems to echo Wallace Sampson’s views:

There is a proposed link between the purported pain–reducing effects of placebos and the internal secretion of opioids, although the association between placebo interventions and the role of various neuropeptides is far from understood. The situation is made even more confusing in light of the fact that endogenous opioid release is postulated as a mechanism of action for acupuncture. Accordingly, it may be that acupuncture and placebo effects are inseparable. And, in fact, current large trials in Germany seem to indicate that acupuncture reduces pain in the same amount of patients as does a credible placebo. Still, it is no surprise that therapies that affect the mental state can stimulate the secretion of endogenous opioids and other mediators. And the fact remains that known methods of increasing endogenous opioids, for example, exercise, which is inarguably beneficial for health, are generally not the primary method of treating disease, nor are special therapeutic claims made for such methods.

There is also, of course, the pain element, referred to as ‘diffuse noxious stimulus’. If you have a headache, have someone kick you in the shin; your head might not feel so bad afterwards. A noxious stimulus at one site interferes with the perception of pain at another site. In that regard, while one study found that acupuncture suppressed the pain response to a cutaneous prick or electrical stimulation of a rat’s tail, the most effective suppression was obtained by a simple pinch.

http://www.newhumanist.org.uk/volume120issue1_more.php?id=1221_0_34_0_C

 

[Ririon]

...so possibly a placebo effect is all there is to it.

 

[thomps1d]

5-mile run, a pinch on the butt.

A pinch on the butt, eh?

*cracks knuckles*

OK...the Doctor is in the house...who's up for a little endorphine releasing action?

If I can videotape it, I won't even charge for the session!