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|Be Wary of Acupuncture, Qigong, and "Chinese Medicine", 12/1/2011|
|Be Wary of Acupuncture, Qigong, and "Chinese Medicine"|
Be Wary of Acupuncture, Qigong,
"Chinese medicine," often called "Oriental medicine" or "traditional Chinese medicine (TCM)," encompasses a vast array of folk medical practices based on mysticism. It holds that the body's vital energy (chi or qi) circulates through channels, called meridians, that have branches connected to bodily organs and functions. Illness is attributed to imbalance or interruption of chi.. Ancient practices such as acupuncture, Qigong, and the use of various herbs are claimed to restore balance.
Traditional acupuncture, as now practiced, involves the insertion of stainless steel needles into various body areas. A low-frequency current may be applied to the needles to produce greater stimulation.
Other procedures used separately or together with acupuncture include: moxibustion (burning of floss or herbs applied to the skin); injection of sterile water, procaine, morphine, vitamins, or homeopathic solutions through the inserted needles; applications of laser beams (laserpuncture); placement of needles in the external ear (auriculotherapy); and acupressure (use of manual pressure).
Treatment is applied to "acupuncture points," which are said to be located throughout the body. Originally there were 365 such points, corresponding to the days of the year, but the number identified by proponents during the past 2,000 years has increased gradually to about 2,000 . Some practitioners place needles at or near the site of disease, whereas others select points on the basis of symptoms. In traditional acupuncture, a combination of points is usually used.
Most acupuncturists espouse the traditional Chinese view of health and disease and consider acupuncture, herbal medicine, and related practices to be valid approaches to the full gamut of disease. Others reject the traditional approach and merely claim that acupuncture offers a simple way to achieve pain relief.
The diagnostic process used by TCM practitioners may include questioning (medical history, lifestyle), observations (skin, tongue, color), listening (breathing sounds), and pulse-taking. Six pulse aspects said to correlate with body organs or functions are checked on each wrist to determine which meridians are "deficient" in chi. (Medical science recognizes only one pulse, corresponding to the heartbeat, which can be felt in the wrist, neck, feet, and various other places.) Some acupuncturists state that the electrical properties of the body may become imbalanced weeks or even months before symptoms occur. These practitioners claim that acupuncture can be used to treat conditions when the patient just "doesn't feel right," even though no disease is apparent.
The conditions claimed to respond to acupuncture include chronic pain (neck and back pain, migraine headaches), acute injury-related pain (strains, muscle and ligament tears), gastrointestinal problems (indigestion, ulcers, constipation, diarrhea), cardiovascular conditions (high and low blood pressure), genitourinary problems (menstrual irregularity, frigidity, impotence), muscle and nerve conditions (paralysis, deafness), and behavioral problems (overeating, drug dependence, smoking). However, the evidence supporting these claims consists mostly of practitioners' observations and poorly designed studies. A controlled study found that electroacupuncture of the ear was no more effective than placebo stimulation (light touching) against chronic pain . In 1990, three Dutch epidemiologists analyzed 51 controlled studies of acupuncture for chronic pain and concluded that "the quality of even the better studies proved to be mediocre. . . . The efficacy of acupuncture in the treatment of chronic pain remains doubtful." They also examined reports of acupuncture used to treat addictions to cigarettes, heroin, and alcohol, and concluded that claims that acupuncture is effective as a therapy for these conditions are not supported by sound clinical research .
Acupuncture anesthesia is not used for surgery in the Orient to the extent that its proponents suggest. In China physicians screen out patients who appear to be unsuitable. Acupuncture is not used for emergency surgery and often is accompanied by local anesthesia or narcotic medication .
How acupuncture may relieve pain is unclear. One theory suggests that pain impulses are blocked from reaching the spinal cord or brain at various "gates" to these areas. Another theory suggests that acupuncture stimulates the body to produce narcotic-like substances called endorphins, which reduce pain. Other theories suggest that the placebo effect, external suggestion (hypnosis), and cultural conditioning are important factors. Melzack and Wall note that pain relief produced by acupuncture can also be produced by many other types of sensory hyperstimulation, such as electricity and heat at acupuncture points and elsewhere in the body. They conclude that "the effectiveness of all of these forms of stimulation indicates that acupuncture is not a magical procedure but only one of many ways to produce analgesia by an intense sensory input." In 1981, the American Medical Association Council on Scientific Affairs noted that pain relief does not occur consistently or reproducibly in most people and does not operate at all in some people .
In 1995, George A. Ulett, M.D., Ph.D., Clinical Professor of Psychiatry, University of Missouri School of Medicine, stated that "devoid of metaphysical thinking, acupuncture becomes a rather simple technique that can be useful as a nondrug method of pain control." He believes that the traditional Chinese variety is primarily a placebo treatment, but electrical stimulation of about 80 acupuncture points has been proven useful for pain control .
Many trials were published as short reports. Most trials claimed that the tested treatments were effective, indicating that publication bias may be common; a funnel plot of the 49 trials of acupuncture in the treatment of stroke confirmed selective publication of positive trials in the area, suggesting that acupuncture may not be more effective than the control treatments.
Two scientists at the University of Heidelberg have developed a "fake needle" that may enable acupuncture researchers to perform better-designed controlled studies. The device is a needle with a blunt tip that moves freely within a copper handle.
When the tip touches the skin, the patient feels a sensation similar to that of an acupuncture needle. At the same time, the visible part of the needle moves inside the handle so it appears to shorten as though penetrating the skin. When the device was tested on volunteers, none suspected that it had not penetrated the skin .
In 2004, a University of Heidelberg team proved the worth of their "sham acupuncture" technique in a study of postoperative nausea and vomiting (PONV) in women who underwent breast or gynecologic surgery. The study involved 220 women who received either acupuncture or the sham procedure at the acupuncture point "Pericardium 6" on the inside of the forearm. No significant difference in PONV or antivomiting medication use was found between the two groups or between the people who received treatment before anesthesia was induced and those who received it while anesthetized .
A subgroup analysis found that vomiting was "significantly reduced" among the acupuncture patients, but the authors correctly noted that this finding might be due to studying multiple outcomes. (As the number of different outcome measures increases, so do the odds that a "statistically significant" finding will be spurious.) This study is important because PONV reduction is one of the few alleged benefits of acupuncture supported by reports in scientific journals. However, the other positive studies were not as tightly controlled.
Harriet Hall, a retired family practitioner who is interested in quackery, has summed up the significance of acupuncture research in an interesting way:
Acupuncture studies have shown that it makes no difference where you put the needles. Or whether you use needles or just pretend to use needles (as long as the subject believes you used them). Many acupuncture researchers are doing what I call Tooth Fairy science: measuring how much money is left under the pillow without bothering to ask if the Tooth Fairy is real.
Improperly performed acupuncture can cause fainting, local hematoma (due to bleeding from a punctured blood vessel), pneumothorax (punctured lung), convulsions, local infections, hepatitis B (from unsterile needles), bacterial endocarditis, contact dermatitis, and nerve damage. The herbs used by acupuncture practitioners are not regulated for safety, potency, or effectiveness. There is also risk that an acupuncturist whose approach to diagnosis is not based on scientific concepts will fail to diagnose a dangerous condition.
|Unnaturalistic Methods: A, 25/3/2007|
|acu-point therapy: Mode of counseling psychology based partly on acupuncture theory and promoted by Mitchell J.|
acupuncture (acupuncture therapy, Zhenjiu): The practice of pricking or otherwise puncturing a living organism to relieve or eliminate disease, pain, or lethargy in that organism. Acupuncture typically involves inserting needles of various shapes into the skin with the purported aim of stimulating acupoints, which supposedly enable direct influence of the flow of Qi (chi). Practitioners may be called "acupuncturists" or "acupuncture therapists." Most forms of acupuncture are unnaturalistic.
Neuro-electric acupuncture and New Scientific ElectroAcupuncture--and, apparently, osteopuncture--are naturalistic.
acupuncture anesthesia (acupuncture analgesia, acupuncture assisted anesthesia, anesthetic acupuncture): Use of acupuncture to relieve pain during surgery wherein the patient is conscious, either in conjunction with or instead of analgesics or chemical anesthetics. It was introduced in 1958 in the People's Republic of China.
acupuncture cupping method: Combination of acupuncture and cupping.
acupuncture energetics (core acupuncture energetics): Practice of acupuncture with the intention of treating acupoints so that they "resonate" with "archaic pathways" of the "bodymind." It involves acupuncture imaging.
acupuncture imaging: Part of acupuncture energetics wherein the practitioner simultaneously palpates an acupuncture "zone" and describes it to the client in "energetic" terms. Joint focusing on "affected" zones supposedly enables channeling of the client's "true healing intention" to "appropriate" zones, which purportedly effects "bodymind integration."
"Acupuncture Osteopathy": A purported "meridian acupuncture" approach to releasing myofascial "body constitutions," advanced by author Mark D. Seem, Ph.D.
acu-yoga: Combination of self-applied acupressure and a group of yogic postures and stretches. It supposedly activates the points and "energy pathways" of acupuncture.
Akabane: Apparently, a form of acupuncture developed by Kobei Akabane. Akabane points are the terminal points of "meridians."
Goodheart, Jr., developed the first AK procedure (the origin and insertion technique) in 1964. He theorized that muscle groups share "energy pathways" with internal organs and that, therefore, every organ dysfunction is discoverable in a related muscle. Testing muscles for relative strength and tone supposedly taps the body's "innate intelligence" and enables practitioners to detect specific dysfunctions. AK encompasses: "clinical nutrition"; CranioSacral Therapy; "dietary management"; homeopathy, including classical homeopathy; meridian therapy (see "Ching Lo"), especially acupressure and acupuncture; and reflexology.
Ap-Bong Method: A mode of hand acupuncture that combines acupressure and acupuncture. It involves the fixing of small, thornlike pieces of metal on acupuncture points.
aqua acupuncture (aqua acupuncture therapy, aquapuncture, the injection therapy): Form of acupuncture that involves the hypodermic injection of substances (e.g., vitamin preparations or liquid herbal extracts) at acupuncture points, purportedly to "stimulate" them by pressure from the injected substance.
Asian medicine: Group of "Eastern" methods that includes acupuncture, panchakarma, and shiatsu.
auricular acupuncture (auricular acupuncture therapy): Alleged stimulation of acupoints on the auricle (the outer portion of the ear). Practitioners may base their choice of points on clinical experience, "modern medicine," the site of the disease, or the TCM theories of "Organs" and meridians.
auricular analgesia (auricular analgesic acupuncture, auricular acupuncture analgesia): Form of Chinese auricular therapy whose apparent design is to alleviate pain in fully conscious patients.
auricular point injection: Component of Chinese auricular therapy that is a form of aqua acupuncture.
auriculotherapy (auricular acupuncture, auricular therapy, ear acupuncture): Form of homuncular acupuncture developed by Dr. P.F.M. Nogier of France. Its theory depicts the auricle (the outer portion of the ear) as an upside-down fetus with points that correspond to bodily parts. Such points number more than two hundred. Ostensible diagnosis involves examining the ear for tenderness or for variations in electrical conductivity. Treatment consists in the acupuncturing or supposed electrical stimulation of the auricular acupoint that "corresponds" to the anatomical site of the malady.
Ayurvedic Acupuncture (Bhedan Karma, traditional Indian acupuncture): Subject of The Lost Secrets of Ayurvedic Acupuncture: An Ayurvedic Guide to Acupuncture (1994), by Frank Ros, "A.M.D." (probably "Doctor of Ayurvedic Medicine"), D.Ac. Ayurvedic Acupuncture is a form of Marma Chikitsa. The basis of Ayurvedic Acupuncture is the Suchi Veda. "Bhedan Karma" means "piercing-through therapy."
Ayurvedic Acupuncture (Bhedan Karma, traditional Indian acupuncture): Subject of The Lost Secrets of Ayurvedic Acupuncture: An Ayurvedic Guide to Acupuncture (1994), by Frank Ros, "A.M.D." (probably "Doctor of Ayurvedic Medicine"), D.Ac. Ayurvedic Acupuncture is a form of Marma Chikitsa. The basis of Ayurvedic Acupuncture is the Suchi Veda. "Bhedan Karma" means "piercing-through therapy."
|Miniglossary of "Alternative" Methods, 23/6/2004|
|Each of the following approaches has at least one of the following characteristics: (1) its rationale or underlying theory has no scientific basis, (2) it has not been demonstrated safe and/or effective by well-designed studies, (3) it is deceptively promoted, or (4) its practitioners are not qualified to make appropriate diagnoses. This article covers traditional Chinese medicine, acupuncture, ayurvedic medicine, clinical ecology, colonic irrigation, craniosacral therapy, herbalism, iridology, macrobiotics, naturopathy, orthomolecular therapy, and therapeutic touch. Full-length articles on aromatherapy, chelation therapy, chiropractic, and homeopathy are available elsewhere on Quackwatch.|
It holds that the body's vital energy (chi or qi) circulates through 14 hypothetical channels, called meridians, that have branches connected to bodily organs and functions. Illness is attributed to imbalance or interruption of chi. Ancient practices such as acupuncture and Qigong are claimed to restore balance by removing the interruptions.
Traditional acupuncture, as now practiced, involves the insertion of stainless steel needles into various body areas. A low-frequency current may be applied to the needles to produce greater stimulation.
Acupressure (shiatsu) is a technique that uses finger pressure instead of needles. Some states restrict the use of acupuncture to physicians or persons operating under the direct supervision of physicians, while others permit laypersons to practice without medical supervision.
The treatment is applied to "acupuncture points," which are said to be located throughout the body. Originally there were 365 such points, corresponding to the days of the year, but the number identified by proponents during the past 2,000 years has increased gradually to over 2,000 . Some practitioners place needles at or near the site of disease, while others select points on the basis of symptoms. In traditional acupuncture a combination of points is usually used. However, the existence of "meridians," "acupuncture points," or chi
Some acupuncturists reject Chinese medicine's trappings and postulate that pain relief occurs through mechanisms such as the production of endorphins (chemicals similar to narcotics). Although acupuncture may relieve pain, such relief tends to be short-lived.
The evidence supporting claims that acupuncture is effective consists mostly of practitioners' observations and poorly designed studies.
Acupuncture has not been proven to influence the course of any organic disease.
The adverse effects of acupuncture are probably related to the nature of the practitioner's training. A survey of 1,135 Norwegian physicians revealed 66 cases of infection, 25 cases of punctured lung, 31 cases of increased pain, and 80 other cases with complications.
A parallel survey of 197 acupuncturists, who are more apt to see immediate complications, yielded 132 cases of fainting, 26 cases of increased pain, 8 cases of pneumothorax, and 45 other adverse results . However, a 5-year study involving 76 acupuncturists at a Japanese medical facility tabulated only 64 adverse event reports (including 16 forgotten needles and 13 cases of transient low blood pressure) associated with 55,591 acupuncture treatments.
The National Council Against Health Fraud has concluded: (a) acupuncture is an unproven modality of treatment, (b) its theory and practice are based on primitive and fanciful concepts of health and disease that bear no relationship to present scientific knowledge, (c) research during the past 20 years has not demonstrated that acupuncture is effective against any disease, (d) perceived effects of acupuncture are probably due to a combination of expectation, suggestion, counter-irritation, conditioning, and other psychologic mechanisms, (e) the use of acupuncture should be restricted to appropriate research settings, (f) insurance companies should not be required by law to cover acupuncture treatment, (g) licensure of lay acupuncturists should be phased out, and (8) consumers who wish to try acupuncture should discuss their situation with a knowledgeable physician who has no commercial interest .
They state that diseases are the body's effort to defend itself and that cures result from increasing the patient's "vital force" by ridding the body of waste products and "toxins." Like some chiropractors, many naturopaths believe that virtually all ailments fall within the scope of their practice. Naturopathic treatments can include "natural food" diets, vitamins, herbs, tissue minerals, cell salts, manipulation, massage, exercise, diathermy, colonic enemas, acupuncture, and homeopathy. Although naturopaths claim that they stress prevention of disease, they tend to oppose immunization procedures.
Skrabanek P. Acupuncture: Past, present, and future. In Stalker D, Glymour C, editors. Examining Holistic Medicine. Amherst, NY: Prometheus Books, 1985.
Norheim JA, Fennebe V. Adverse effects of acupuncture. Lancet 345:1576, 1995.
Yamashita H and others. Adverse events related to acupuncture.
Sampson W and others. Acupuncture: The position paper of the National Council Against Health Fraud.
|Newsweek's Misleading Report on "Alternative Medicine", 16/10/2006|
|Geoffrey Cowley, one of Newsweek's reporters, refers to acupuncture as credible. But reviews of clinical studies of acupuncture do not support claims that acupuncture is effective for a wide variety of conditions. Beneficial effects have been reported for some types of acupuncture in treating symptoms such as pain and nausea. However, these effects may result from distraction, expectation, suggestion, conditioning, and characteristics of the client-practitioner relationship rather than anything special about acupuncture. Acupuncture has not been proven to alter the course of any disease.|
Another reporter, Anne Underwood, wrote about traditional Chinese medicine (TCM) practitioner Nan Lu examining her tongue and "pulses"—one for each organ of her body—to diagnose "energy leak" from her heart and then recommend acupuncture, qigong (described misleadingly as Chinese yoga), meditation, dietary modifications, and herbal remedies containing green orange peel, sour-date seed and licorice root along with dozens of exotic ingredients. She describes Lu's activities as sounding unscientific to "the Western mind." She fails to acknowledge that Lu's activities also sound unscientific to real scientists in Asia. TCM tongue and pulse examination lack validity and a rational basis for making diagnoses and recommending treatments. The diagnosis of "energy leak" in TCM is subjective and has no scientific basis. Modern physics recognizes energy as a material entity, as signified by Einstein's famous equation E=mc2, and explained by quantum theory. Energy is not an immaterial spirit as suggested by promoters of TCM and many other sCAM practices.
Underwood suggests that acupuncture relieves pain by boosting the body's own opiates called endorphins. But some studies have shown that blocking endorphin receptors using an opiate antagonist does not reverse pain relief following acupuncture. Besides, it is not necessary to apply needles to specific points, as in acupuncture, to release endorphins. The release can be stimulated without needles.
Underwood cites one study presented at a conference in China suggesting that acupuncture with low-level electrical stimulation can reduce drug cravings and the relapse rate among heroin addicts. But she does not mention that reviews of studies of acupuncture treatment for addiction have not supported claims that acupuncture improves addiction treatment outcomes. And running electrical current through tissues isn't "acupuncture."
Underwood claims that "Chinese medications tend to have fewer side effects than Western pharmaceuticals" and that "Western medicine is riskier." She provides an unsound argument for this generalization. She writes that a 1996 survey of the most populous Australian states found one adverse event from both herbs and acupuncture for every eight to nine months of a doctor's full-time practice, or one problem per 633 consultations. She compares this survey data with the results of a study published in JAMA in 1998 that used a totally different methodology: a meta-analysis of prospective studies. The authors of the 1998 paper estimated (not "found" as Underwood writes) that more than 100,000 drug reactions occurred among patients in U.S. hospitals in a single year. It is not reasonable to draw conclusions about the relative risks of all prescription drug treatments versus all herbal treatments by comparing adverse event data from hospitalized patients (who are often in weakened and uncertain conditions) with data on patients who visit doctors. The authors of the meta-analysis caution that their "results must be viewed with circumspection because of heterogeneity among studies and small biases in the samples." Underwood's comparison is also faulty because it only considers adverse events following treatments and not benefits offered by the treatments. She does not consider what widespread adulteration of Chinese herbal treatments with synthetic drugs indicates about what developers of these products think their herbs have to offer in terms of benefits. (Other potential adulterants and contaminants of herbal products include botanicals, microorganisms, microbial toxins, pesticides, fumigation agents, and toxic metals.) And, as reported in the journal Science, "According to a 1999 survey by the Hong Kong government, only 22% of outpatient medical consultations in the city were provided by Chinese medicine practitioners. Officials think the percentage is even lower, and they believe that safety concerns are driving people away from TCM." Herbal products are prone to misbranding because of difficulties in correctly identifying plant species, chemical variations within plant species, lack of standardization, additions of chemicals, and intentional substitution of one plant for another. Some traditional Chinese herbs have been found to contain aristolochic acid which has been linked to kidney destruction and urinary tract cancers. In June 2002, Health Canada warned consumers not to take seven products marketed as traditional Chinese Medicines because they were found to contain undeclared prescription drugs. In January 2003, the Director-General of Health for New Zealand warned consumers to stop taking eleven traditional Chinese medicines sold as herbal remedies after investigation and testing revealed they contain prescription medicines and toxic substances.
Underwood discusses the increasing demand of Westerners for Chinese medicine services without mentioning the increasing demand of people in China for modern medicine . Underwood offers a testimonial about a research scientist who said she had "serious dizzy spells" after suffering from West Nile virus. The scientist said treatment from "Western specialists" did not make her spells go away, but her dizziness, allergies, and chronic shoulder problem were "gone" after an acupuncturist diagnosed "stagnant liver qi" and administered acupuncture and herbal remedies. Underwood quotes the scientist as saying: "This doesn't make sense, but there's something there." Underwood concludes: "If Chinese medicine can help complications of West Nile virus, can it work for insomnia? The jury is out, but I'm optimistic." Underwood's unjustified conclusion about Chinese medicine and her failure to explain to readers why testimonials are unreliable as evidence of a treatment's efficacy is egregious journalism.
David Noonan's article on various methods promoted as "complementary and alternative medicine" or "CAM" for children mentions a three-year NIH-funded study of acupuncture treatment of cerebral palsy in which some patients showed improvements in some areas of functioning and others did not. Although Noonan provides no description of the study design, including whether the study included a control group, he describes the investigator, Burris Duncan, as "a member of a small but growing cadre of researchers who are subjecting pediatric CAM therapies to the rigors of traditional, randomized, controlled clinical trials." Rigorous studies should give clear answers, but Noonan quotes Duncan as saying: " all changed in different ways so it's very difficult to know what to make of this." Noonan raises additional questions about the rigor of Duncan's work by writing: "Determined not to raise false hopes, Duncan says the only thing he knows for certain is that more research is needed, and he plans to continue his work." Noonan also mentions that Duncan conducted the study because he was impressed with what he observed in China of acupuncture and other treatments of cerebral palsy. Although Noonan's article includes Duncan's subjective impressions, it does not address the superstitious basis for acupuncture treatment, the implausibility of acupuncture having special benefits for children with cerebral palsy, and the importance of focusing scientific resources on testing plausible rather than implausible treatments.
... believe in this characterization of medicine; otherwise, why would they prudently recommend childhood vaccinations? And, apparently, the authors themselves have that "don't just stand there, do something attitude," especially in treating self-limited conditions. They write: "In most cases, the therapies we recommend have at least some supportive research evidence and always have anecdotal evidence of efficacy." But it's easy to come up with cheery anecdotes for just about any nostrum. And it's easy to meet the lenient standard of "at least some supportive research evidence" by citing poorly designed, mostly irrelevant, or anomalous research studies providing far less than extraordinary evidence for extraordinary hypotheses. A molehill of supportive evidence would meet the authors' standard even when a mountain of conflicting scientific evidence and knowledge is available. Based on preliminary findings and/or anecdotes, the authors are quick to jump to conclusions that treatments work: "If a potentially effective therapy is safe and relatively inexpensive, we don't feel a need to wait for further research to explain how it works—it's enough for us to know that it works." . Thus, they recommend various dubious treatments including: (a) cranial osteopathy for ear infections, headaches, sinus or respiratory problems, learning disabilities, and attention deficit disorder; (b) homeopathic products to treat sore throats, colds, and other self-limiting conditions; and (c) acupuncture for acute sinusitis. The title of their chapter on traditional Chinese medicine is an example of the "everybody says so" fallacy: "A Billion People Can't Be Wrong." If a billion people rely on anecdotes to conclude that a treatment has therapeutic value, then they can be just as wrong as Ditchek, Greenfield, and Willeford. Regarding so-called "energy medicine" methods, they write: "We have seen promising anecdotal or research evidence for some of them and others are simply too wacky for ...
Another book the sidebar recommends is The Holistic Pediatrician by Kathi J. Kemper, MD, MPH. Kemper's book is, for the most part, a useful resource for parents. The vast majority of healthcare methods recommended in the book are rational and fit right in the medical mainstream. The book also provides prudent warnings to consumers about herbal products available to consumers in the United States. And Kemper does not rely on anecdotes as evidence. The main problem with the book is that Kemper embraces studies finding various "CAM" treatments as effective without considering whether the results make sense, are clinically significant, or are attributable to research design problems. For example, she cites a paper by Jennifer Jacobs and her colleagues in support of her suggestion to consider seeing a homeopathic practitioner to administer homeopathic remedies (which probably contain none of the supposedly active ingredients) for childhood diarrhea. But, as pointed out in a published critique, the study showed no clinically significant benefits of homeopathic treatment, no benefits were demonstrated for most measured outcome variables, different homeopathic products were used on different subjects, and the subjects did not have diarrhea severe enough for treatment, rather than monitoring, to be indicated. Based on similarly shaky evidence, Kemper, suggests trying: (a) "therapeutic touch" for burns or fever; (b) visiting a TCM practitioner who can recommend an herbal tea for eczema treatment; (c) homeopathic remedies containing "pulsatilla" to treat ear infections (followed, if the infections don't clear up in 24 hours, by seeing a physician); and (d) acupuncture treatment for allergies, asthma, bedwetting, headache prevention, and nausea/vomiting. According to a description of Kemper in the second edition of the book, she was recruited in 1998 by Harvard Medical School to become the first director of the Center for Holistic Pediatric Education and Research. In his foreword to the second edition of Kemper's book, her colleague Herbert Benson, MD, President of the Mind-Body Medical Institute wrote: "On the other hand, hucksterism and quackery are alive and well. Con men manipulate millions via mass media and the Internet; and it takes a physician experienced in both traditional and alternative medicine to keep perspective in the face of sales tactics appealing to nature, forgotten mysteries, and forbidden fruits." Benson is mistaken. "Alternative medicine" is a mere marketing label promoted as if it were a medical speciality. Consumers need the perspectives of experts in healthy skepticism.
|Unnaturalistic Methods: C, 3/7/2009|
|C.A.R.E. (Chakra Armor Release of Emotions): System advanced by author Raphael Rettner, D.C. Apparently, its postulate is that emotions are "involved in" four "energy pathways": acupuncture meridians, chakras, "polarity elements," and "armor" (a muscle spasm due to an unexpressed emotion).|
Chinese auricular therapy (Chinese auricular acupuncture, traditional Chinese auricular acu-points therapy, traditional Chinese auricular acupuncture, traditional Chinese auricular therapy): Group of TCM "techniques" whose "channel theory" differs from that of body acupuncture.
Chinese medicine (Traditional Chinese Medicine, TCM): Ancient "holistic" system whose basics include herbology, nutrition, and the concepts of acupuncture meridians, the Five Elements (Five Phases), and yin and yang. TCM theory posits both "Organs" (the Triple Burner, for example) and "Substances" (such as Shen, or "Spirit") for which scientific evidence is absent.
(chi) and "Blood" in diverse ways, including acupressure, acupuncture, cupping, moxabustion, scraping, and application of "acu-powder," electricity, herbs, or magnets.
German naturopath Peter Mandel, who developed Esogetics, created and named Color puncture. "Treatment" involves application of colored light, with a device that resembles a penlight, to "acupuncture receptors" in the skin. Ac cording to Colorpuncture theory, color is "life energy" that carries "healing information," and acupuncture meridians convey this information to the cells and organs that need it.
cosmic energy chi kung (Buddha palm, Cosmic Chi Kung, Cosmic Healing Chi Kung): Group of "techniques" that purportedly develops "healing hands" and the capacity for absent healing. It is a form of channeling, and its theory posits acupuncture meridians, "Cosmic energy," and "Universal energy."
The above description relates to fire cupping (the fire cupping method), which has several forms. Other forms of cupping include the acupuncture cupping method, the air pumping cupping method, and the water cupping method.
curanderismo (curanderismo healing system): Mexican-American "healing" tradition. It encompasses acupuncture and homeopathy. Its theory posits natural and supernatural sources of illness; alleged supernatural sources include evil spirits and brujos (practitioners of antisocial magic).
cymatic therapy (cymatic medicine): Form of "vibrational bioenergetics medicine" developed by Sir Peter Guy Manners, M.D., D.O., Ph.D., of England. It is an acupressure-like method wherein devices send "beneficial" sound through the skin. This sound purportedly reestablishes "healthy resonance" in "unhealthy" tissues. Cymatics theory posits acupuncture meridians and holds that "life is sound" and that every part of the body vibrates at a unique audible frequency.
|Rebuttal of Timothy N. Gorski, M.D., 17/12/2005|
|The NCCAM is the only division of the NIH that is oriented toward a particular class of therapeutic methods, as vague and confused a concept as "CAM" may be. As such, it is the only center that is oriented primarily to the needs, desires and inclinations of practitioners -- whether of acupuncture, homeopathy, "energy medicine" or some other belief system -- instead of the needs, problems and circumstances of patients. Wallace Sampson, MD, Editor of the Scientific Review of Alternative Medicine and Clinical Professor of Medicine at Stanford University who taught a course there on "alternative medicine" for 22 years, has called the NCCAM "a full employment program for pseudoscientists and poor quality physicians." Funding decisions at the NCCAM reflect these assessments, as I will shortly show.|
"Qi" is the traditional Chinese counterpart to psychic "life energy," the "flow" of which is said to be modified by acupuncture and which advocates claim can be "absorbed" and "emitted." Chow claims to cure illness and boost the psychic powers of individuals by transmitting "qi" to them by telephone . She employs typical stage magic tricks to "prove" the existence of "qi" energy.
"Dr." David Bresler is also an acupuncturist. Like Chow, he is not a physician but holds a PhD. He is credited by the White House with being "one of the first contemporary American scientists to study and research acupuncture, guided imagery, and other mind/body approaches." But the only two published clinical trials of which he is a co-author involve acupuncture, one of which showed no benefit in asthma. Another article purported to show scientifically that the whole human body is mapped out on the ear .
Xiao Ming Tian is a Beijing-trained physician-acupuncturist who runs the Academy of Acupuncture and Chinese Medicine at his Wildwood Acupuncture Center in Bethesda. There he offers acupuncture, acupressure, Chinese herbal remedies, and Qi-Gong "treatments," qi-gong being the vitalistic "energy" medicine of the prescientific Orient .
Tian has been a consultant to the NIH and was involved in producing the NIH Consensus Statement on Acupuncture that deliberately excluded critics of the method. The biographical information on Tian released by the White House indicates that he received government funding for "many research projects on the use of Chinese herbal medicine and dietary supplements," none of which appears to have resulted in published work available by search on PUBMED. According to the White House press release, Tian is also "President of the American Association of Chinese Medicine," as well as "Honorary Director of the China Association of Traditional Chinese Medicine and Vice President of The International Academy of Medical Qigong, both in Beijing, China."
American Specialty Health Plans and American Specialty Networks "provide chiropractic and acupuncture managed-care services." Acupuncture Today calls him the "president of one of the largest acupuncture HMOs in the nation." DeVries'efforts seem to be devoted primarily to getting employers and insurance companies, and, it would now appear, taxpayers, to pay for unproven methods.
Oleson TD, Kroening RJ, Bresler DE "An experimental evaluation of auricular diagnosis: the somatotopic mapping or musculoskeletal pain at ear acupuncture points." Pain
|Analysis of the Final WHCCAMP Report: Chapter 2, 28/3/2002|
| Traditional Chinese Medicine (e.g., acupuncture, Chinese herbal medicine) |
Beginning in the 1950s, the whole foods and dietary supplement movements began to change Americans' view of food as not only something they needed to stay alive but also as potential therapeutic agents. In the late 1960s and early 1970s, Americans were increasingly exposed to a variety of traditional health care systems from foreign and indigenous cultures, many of which dated back to antiquity . New York Times writer James Reston's account of his emergency appendectomy in a Chinese hospital during then Secretary of State Henry Kissinger's visit to China in 1971 was particularly influential in this process . Reston's article described how his postoperative pain and discomfort were relieved by acupuncture and herbs. For most Americans, this was their first glimpse of Traditional Chinese Medicine and its potential uses.
The late 1970s saw the emergence of the holistic health care movement in this country. Holistic practice (holism comes from the Greek word "holos" or "whole") emphasized an attention to the whole person, including the physical, spiritual, psychological, and ecological dimensions of healing. Holistic health care incorporates practices and concepts of Eastern philosophy and diverse cultural traditions, including acupuncture and the use of herbs, massage, and relaxation techniques as well as conventional medical practices . It gained its greatest following among nurses . However, many physicians, particularly those in the new specialty of family medicine, also became interested in this movement. The American Holistic Medical and Nurses Associations were formed, large professional and public conferences held, and a number of holistic medical clinics and holistic health centers opened.
Surveys of rheumatology patients have found similarly high CAM utilization rates, ranging between 19 and 63 percent, depending on the type and severity of their condition . Other studies have documented that people with painful chronic conditions, including arthritis and headache, and psychological problems (insomnia, depression, and anxiety) are frequent users of CAM therapies, particularly massage, chiropractic, and acupuncture .
Evidence suggests that a growing number of physicians already use some CAM practices and consider them safe and effective in offering them to their patients. A comprehensive review of 25 surveys of physician practices and beliefs regarding five commonly used CAM practices -- acupuncture, chiropractic, homeopathy, herbal medicine, and massage -- found that about half of the surveyed physicians believed in the efficacy of these five CAM practices . This study found that a significant proportion of conventional physicians were both referring patients to CAM practitioners and/or offering some of these CAM treatments in their practice.
Acupuncture in the management of low back pain and recurrent headaches
In addition to these Cochrane systematic reviews, an NIH scientific review panel concluded that acupuncture is a plausible option for treating several conditions, including nausea associated with chemotherapy and anesthesia, acute dental pain, headaches, temporomandibular joint dysfunction, fibromyalgia, and depression . [That panel, like this Commission, was stacked with advocates who wrote a loosely worded and poorly reasoned report. Its exact words were that "acupuncture may be useful.
van Tulder MW, Cherkin DC, Berman B, Lao L, et al. The effectiveness of acupuncture in the management of acute and chronic low back pain. A systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 1999;24(11):1113-1123.
Melchart D, Linde K, Fischer P, White A, et al. Acupuncture for recurrent headaches: a systematic review of randomized controlled trials. Cephalalgia 1999 Nov;19(9):779-786.
National Institutes of Health, Office of the Director. NIH Consensus Statement: Acupuncture Volume 15 (5): November 3-5, 1997.
|Analysis of the Final WHCCAMP Report: Chapter 7, 25/3/2002|
|Today, coverage of CAM is evolving in benefit design, type and number of interventions offered, and availability. Consumers and health care providers may use available coverage for a CAM therapy as a principal intervention or as an integral part of the treatment of certain health conditions, such as acupuncture for management of chronic pain. The direction taken by health plan coverage of CAM in the future will shape consumer access to CAM services, the degree of integration of CAM and conventional medicine, and the philosophical foundation of the nation's health care system. |
In the last several years, a number of health plans have begun to cover certain CAM services, although the prevalence of this coverage is relatively low, compared to coverage of conventional therapies. Information on this trend is available from an annual survey of employer-sponsored health plans that recently began to include questions regarding a few specific CAM services offered in benefit packages. In 1998, 49 percent of survey respondents indicated that chiropractic was covered; by 2000, the number had risen to 70 per cent. Over the same time period, coverage of acupuncture rose from 12 per cent to 17 percent, and coverage of massage therapy increased from 10 percent to 12 percent. The survey also found that large employers (those with more than 20,000 employees) were more likely to offer CAM benefits than medium and smaller employers. PPOs and indemnity insurers were more likely than HMOs to offer health plans that include CAM benefits .
For example, the CAM benefit may cover only one or a few CAM services as the data above indicates. Other limitations include ceilings on the number of visits covered, restrictions on clinical applications, and fixed qualifications for the type of practitioner; for example, ten acupuncture visits might be covered for pain management provided by a medical doctor, and thus would not be covered if provided by a professionally-trained acupuncturist.
As a defined, core benefit. This benefit is managed by limiting the type of CAM services covered (e.g., only chiropractic, or only chiropractic and acupuncture), requiring a preauthorization or a referral by a primary care physician, or setting visit or dollar limits and higher co-payments than for routine physician visits.
At the operational level, government agencies like the Centers for Medicare and Medicaid Services (CMS), insurers, and managed care organizations invest significant time and resources to determine which benefits are covered, for how long, which practitioners are authorized to perform the services, and how payment will be made. Except for chiropractic and, increasingly, acupuncture and massage therapy, much of CAM is not covered. The services that are covered are often accompanied by limitations, such as global visit limits that are unrelated to individual patient needs or course of treatment.
Government agencies, insurance companies and managed care organizations use uniform coding systems -- such as the International Classification of Disease to denote diagnosis, Common Procedural Terminology (CPT) to denote medical procedures, dental codes for dentistry, national drug codes for prescriptions, and the CMS/HCFA Common Procedure Coding System for supply items and some procedures -- as part of the electronic record of information about items and services used. Because coding has evolved along with conventional health care, including reimbursement trends, these systems have limited capability to capture CAM practices and products. For example, CPT codes, a set of more than 8,000 procedure codes developed by the American Medical Association for use throughout conventional health care, provides for a few CAM services including two codes for acupuncture.
For example, it has 37 codes reflecting acupuncture services.
necessary in the current situation? For example, a health insurance company may decide to add acupuncture to its benefit, but may limit coverage to situations in which acupuncture is no longer considered investigational, such as control of nausea during cancer treatment and treatment of certain pain conditions. In addition, the company will review each request to approve or pay for the service on a case-by-case basis to determine whether acupuncture was indeed medically necessary in that situation.
The Internal Revenue Code allows employers and other health plan sponsors to deduct the costs of providing accident and health insurance. Although the Federal code includes chiropractic and acupuncture as deductible medical expenses, the current policy approach is weighted heavily toward conventional medical care and physician direction of services. This approach could be modified to allow purchasers, health insurers, and managed care companies to develop health benefit packages that include safe and beneficial CAM interventions that qualify fully for favorable tax treatment under the law and regulations. In addition, Federal policy-makers are encouraged to monitor evidence on the benefits and cost-effectiveness of CAM interventions and health promotion programs with an eye to possible modifications of the tax code in the future.
|Unnaturalistic Methods: E, 4/6/1997|
|electroacupuncture (electric acupuncture, electric acupuncture therapy, electrical acupuncture): Application of electricity to acupoints, with or without needles.|
electroacupuncture biofeedback: Pseudodiagnostic method developed by Reinhold Voll, M.D., of Germany, in the 1940s. Its theory posits the meridian sys tem of acupuncture. In "biological dentistry," electroacupuncture biofeedback involves application of an electrical current to a tooth. Al legedly, abnormal readings indicate an infection or "disturbance" near the tooth and, possibly, in the organ that supposedly shares a meridian with the tooth.
electrodiagnosis (bioelectric testing, electrodermal screening, electrodermal testing): Localizing of "imbalances" along acupuncture meridians with galvanometric devices.
electromagnetic healing: Form of "acupuncture without needles" involving the use of products that allegedly focus "tachyon energy" ("life energy"). In physics, the tachyon is a hypothetical superluminal particle. Evidence thereof is absent.
endo-nasal therapy: Form or variation of acupuncture that supposedly involves the stimulation of acupoints inside the nose.
Esogetics: System developed and named by German naturopath Peter Mandel and practiced at the Mandel Institute, in Bruchsal, Germany. It reportedly boils down to the "science of bio-energy," whose "levels" range from the material to the esoteric. One of the premises of esogetics is that colored light transmitted by acupuncture meridians tends to heal specific forms of disease and dysfunction. The name "Esogetics" derives from the words "esoteric" and "energetics."
|Analysis of the Final WHCCAMP Report: Chapter 4, 4/8/2004|
|Since the public utilizes both conventional health care and complementary and alternative medicine (CAM), the Commission believes that this reality should be reflected in the education and training of all health practitioners. [Appropriate education would inform students that homeopathy is worthless, chiropractic "subluxations" are delusions, the flow of "chi" through "acupuncture meridians" is a nonsensical concept, and chelation therapy doesn't work.|
Required and elective courses included acupuncture, herbal medicine, homeopathy, meditation, manual healing techniques, nutritional supplement therapy, and spirituality, according to the questionnaire.
In a study of an allopathic medical school with no formal or elective courses in CAM, third-year medical students were found to have insufficient knowledge about the safety of 10 common CAM modalities . These modalities included massage therapy, herbal medicine, meditation, chiropractic, hypnosis, spiritual healing, acupuncture, homeopathy, reflexology, and naturopathy.
Georgetown University School of Medicine plans to integrate CAM into the entire medical school curriculum as part of a recent grant from the National Institutes of Health's (NIH) National Center for Complementary and Alternative Medicine (NCCAM). Other innovative efforts to integrate CAM with existing medical school curricula are already underway; however, these efforts are geographically dispersed, not well known, and not systematically studied. They range from informal CAM seminars, such as brown bag lunches with CAM practitioners sponsored by student groups, to formal symposia or debates of controversial CAM issues by authorities with opposing views. While survey and other lecture courses are efficient ways of presenting a large volume of information, CAM is being integrated into a variety of courses. For example, information on acupuncture is being integrated into basic science courses, such as anatomy or physiology, as well as clinical courses, such as neurology, while herb-drug interactions are being included in pharmacology.
10.5 Expansion of eligibility of CAM students at accredited institutions for existing of loan programs should be explored.
In an attempt to provide some uniform guidance, the Federation of State Medical Boards' Special Committee for the Study of Unconventional Health Care Practices has begun to develop guidelines for the use of CAM. These guidelines address education, but they focus on the scientific basis of treatment methods without delineating any specific education or training requirements. Simultaneously, nascent efforts by physician organizations to standardize CAM education and training for allopathic and osteopathic physicians have emerged. The American Board of Holistic Medicine, for example, has administered a board certification examination covering 13 areas of holistic medicine, including exercise medicine, nutritional medicine, environmental medicine, biomolecular medicine, behavioral medicine, spiritual medicine, energy medicine, social medicine, manual medicine, homeopathic medicine, botanical medicine, ethnomedicine including acupuncture, and conventional medicine. For physicians practicing medical acupuncture, the American Board of Medical Acupuncture has developed and administered a board certification examination.
Traditional Chinese acupuncture, therapeutic massage, and naturopathic medicine perhaps have moved closer than other CAM professions to establishing national education and training standards. Because of their progress, these CAM professions are appropriate candidates for conferences convened by DHHS and other Federal Departments and Agencies, although CAM professions and disciplines that are still in the process of developing standards should be included as well. Such conferences would assemble the leadership of CAM, conventional health, public health, evolving health professions, and the public; educational institutions; and appropriate organizations to facilitate establishing CAM education and training guidelines. Subsequently, these guidelines would be made available to the states and professions for their consideration.
|The Eisenberg Data: Flawed and Deceptive, 20/6/2004|
| Acupuncture |
The authors acknowledge that "Some forms of unconventional therapy typically involve a provider (for example, a chiropractor or acupuncturist)." But there is no attempt to explain or account either for the 30% of chiropractic use that people were practicing on themselves or the more curious finding that 9% of users of acupuncture had apparently been practicing on themselves.
Again, "Some users of unconventional therapy may visit a provider less often than once a year but may continue to use the prescribed unconventional therapy." Was this the case only with imagery, "spiritual healing," and commercial weight loss programs, or also with a third of those who said they had used chiropractic and nearly a tenth of those who said they had used acupuncture?
The authors go on with their finding that "fewer than 3 in 10 users of unconventional therapy mention its use to their medical doctors," ignoring the fact that some of this "unconventional medicine" may even have been supplied by or at the recommendation of medical doctors. Moreover, the importance of visits to "unconventionals" is variable. A physician may not attach much importance to whether a patient had a massage, attended a Weight Watchers' meeting, or even seen a chiropractor in the previous 12 months. No one study is expected to answer all questions about an investigated matter. But what would be useful to know is how many people, given a serious diagnosis by a physician, seek out acupuncture, homeopathy, or a brown rice diet in lieu of appropriate medical or surgical treatment, or use substances that interfere with prescribed drugs? How many unnecessarily use ineffective methods for disorders that are self-limited?
Dr. Eisenberg was the keynote speaker, and he used his time to review his 1990 data. He admitted that much of the "unconventional medicine" considered in the survey was essentially "extended self-care." He then, without further explanation, began referring to "alternative medicine" and focused on herbs, acupuncture, and homeopathy. There was no discussion of "relaxation techniques," which accounted for the largest use of "unconventional medicine" in his 1993 article. There was no consideration of chiropractic, massage, imagery, or "spiritual healing" or of commercial weight-loss programs. Dr. Eisenberg, at this same conference in 1997, ridiculed critics of homeopathy as having taken the position that, "it can't work, so it doesn't work?"
We have known for several years that approximately 1 in 3 adults in the United States uses chiropractic, acupuncture, homeopathy, or one of many other treatment modalities.
In 1996, under pressure from organized acupuncturists, the FDA reclassified acupuncture needles as Class II "medical devices," which permitted their use and associated claims of various health benefits. In 1997 the OAM, in association with its former interim Director, carefully orchestrated a seemingly biased panel that issued a consensus statement in favor of acupuncture.
The 1998 Eisenberg article mentioned none of these things, while marveling at the public's alleged demand for "alternative medicine." The impression remains that acupuncture and "natural" products are safe, effective, and even constitute "cutting edge" medical science.
|Analysis of the MACCAH Draft: Regulation of CAM, 27/6/2003|
|Statutory regulation is most often applied to higher-risk CAM modalities. These include modalities that use interventions such as spinal manipulation (eg, chiropractic, osteopathy), invasive techniques (eg, acupuncture) or ingested substances (eg, herbal medicine). Products such as dietary supplements and herbal remedies may also be regulated by statute.|
The House of Lords Select Committee on Science and Technology recommended in 2000 that acupuncture and herbal medicine should be regulated by statute. They also suggested that statutory regulation for non-medical homoeopaths might eventually be appropriate. The Select Committee recommended that the various voluntary bodies representing other CAM professions come together to form a single, voluntary, self-regulatory body for each modality. It cautioned against the establishment of multidisciplinary bodies (House of Lords Select Committee 2000).
The herbal medicine and acupuncture professions in the UK are currently preparing to apply for statutory regulation. Such regulation is also expected to encompass traditional practitioners who use acupuncture or herbalism as part of their practice (eg, practitioners of Ayurvedic and traditional Chinese medicine). In the future, CAM professions who apply for statutory regulation in the UK will be able to do so under Section 60 of the Health Act 1999, rather than through the time-consuming process of pursuing their own Act of Parliament. In this way the Health Act 1999 resembles New Zealand's Health Practitioners Competence Assurance bill.
Some states have developed regulatory or licensing arrangements for some CAM practitioners. For example, many regulate acupuncture and require practitioners to be trained to a specified standard.
The National Certification Commission for Acupuncture and Oriental Medicine plays a role in setting standards in individual states. Some states limit the practice of acupuncture to medical practitioners or to those under a medical practitioner's supervision. Naturopathic medicine is also recognised and licensed in several states.
In April 2002 the federal government granted five CAM practitioner associations $A100,000 each to assist in the development of 'national uniform registration systems for suitably qualified practitioners in acupuncture, herbal medicine and naturopathy'. This is to enable practitioners to achieve registration before the introduction of goods and services tax (GST) in June 2003. After this date only 'recognised professionals' will be able to practise these modalities without charging GST. This is a one-off initiative and is not intended to replace the regulatory functions of the states and territories.
Traditional Chinese medicine (TCM) is a complete diagnostic and treatment system dating back thousands of years. Its main tools are acupuncture and herbal medicines. China relied entirely on TCM until Western medicine was introduced at the end of the 17th century. By the end of the 19th century Western biomedicine had almost displaced TCM in urban areas. Although the Communist Party was originally committed to eradicating TCM, which they regarded as a legacy from imperial times, Chairman Mao felt that integration of the old and the new was the best way forward for the health of the nation. At the First National Health Conference in 1950 it was decided that TCM and Western medicine should be integrated into a universal health system (Fulder 1996). Today approximately 95 percent of general hospitals in China have traditional medicine departments (Bodecker 2001).
|Unnaturalistic Methods: T, 4/6/1997|
|TCM acupuncture (New Acupuncture): Form of acupuncture that arose in the People's Republic of China during the Cultural Revolution. Symptoms or syn dromes ("patterns of disharmony") are its focus. "TCM" stands for "Traditional Chinese Medicine."|
thirty-day energetic workout: Exercise program designed by Richard M. Chin, M.D., O.M.D., author of The Energy Within: The Science Behind Every Oriental Therapy from Acupuncture to Yoga (Paragon House, 1992) and coauthor of The Martial Arts. It is a purported aid to balancing both one's "body energy" and one's "mind energy," and an alleged way to "balance out" all twelve major meridians ("primary energy channels"), in crease the flow of "energy," and remove and prevent minor "energy blockages."
Tibetan medicine encompasses acupuncture and moxibustion and purportedly heals both the physical and the psychic "being." Its theory posits reincarna tion, evil spirits, tutelary gods, and three physiological principles: "wind," "bile," and "phlegm." The terms "Tibetan medicine" and "Tibetan Buddhist Medicine" appear synonymous.
tracing: "Technique" akin to Therapeutic Touch. It involves moving the hand or fingers along acupuncture meridians.
traditional acupuncture (Traditional Chinese acupuncture): Form of acupuncture based on the meridian theory of, and usually practiced in the context of, TCM.
|Applied Kinesiology: Phony Muscle-Testing for "Allergies" and "Nutrient Deficiencies", 23/8/2014|
|The practicing AK is a graduate chiropractor who can explain to you how your glands and organs appear to be functioning with specific muscle tests. He can suggest nutrition to help improve various conditions, and he can demonstrate with your muscles that you probably need particular nutrients. He can correct problems in your spine and in joints, and can stretch or compress muscles to improve your structural condition. He may massage certain junctures of nerve, lymph, blood, and acupuncture meridians to stimulate glandular or systemic activity. He can advise you on how to stay healthy and he will pay particular attention to your posture and your feet. He can offer an excellent second opinion if you are under a physician's care, are seeing a chiropractor who is not an applied kinesiologist, or if you have been in an accident .|
Goodheart states that AK techniques can also be used to evaluate nerve, vascular, and lymphatic systems; the body's nutritional state; the flow of "energy" along "acupuncture meridians"; and "cerebro spinal fluid function." The 70-page chapter on "meridian therapy" in a leading AK textbook advises that subluxations influence the status of meridian system and vice versa .
Health Kinesiology (HK), founded by Jimmie Scott, is said to use "muscle testing/monitoring to to identify the priority order of the energy balancing that needs to be done with his/her client, exactly what stresses are interfering with well being, and which energy balancing methods to use for that individual." According to Scott, it can "eliminate allergies, release physical toxicity, emotional traumas, overcome learning blocks, & perform at your best, among other things!" In one technique—the Allergy Tap—the practitioner "places the offending substance over a specific acupuncture point on the belly and taps eight pairs of specific acupuncture points."
Jaffe-Mellor Technique (JMT) involves muscle-testing while the patient holds a small glass vial containing the test substance. If weakness occurs, the practitioner taps along the spine while the patient holds the vial. Then acupuncture or acupressure are used to "balance the energy throughout the body." In 2002, the directory on the JMP Web site listed more than 300 practitioners in the United States.
Nambudripad's Allergy Elimination Technique (NAET) is based on the notion that allergies are caused by "energy blockage" that can be diagnosed with muscle-testing and permanently cured with acupressure and/or acupuncture treatments. Its developer, Devi S. Nambudripad, D.C., L.Ac., R.N., Ph.D., is described on her Web site as an acupuncturist, chiropractor, kinesiologist, and registered nurse who practices in California.
Thought Field Therapy and several other varieties of "emotional acupressure" are said to be rooted in ancient Chinese medicine and applied kinesiology. Their advocates claim that negative emotions are caused by a disruption in the body's "energy system" and that correcting "energetic disturbances" can often correct emotional problems. The treatment is performed by tapping on "acupuncture points" while the patient thinks about a problem. These practices are claimed to be effective against a long list of emotional and physical problems.
BodyTalk is said to "combine the wisdom of advanced yoga and advaitic philosophy, the insights of modern physics and mathematics, the energy dynamics of acupuncture, the clinical findings of Applied Kinesiology, and western medical expertise." The International BodyTalk Association, which lists hundreds of "certified" practitioners in its directory, states:
|Some Notes on Joyce K. Anastasi, Ph.D., R.N., F.A.A.N., L.Ac., 19/6/2013|
| IOM Description (2003): Joyce K. Anastasi, Ph.D., R.N., F.A.A.N., L.Ac. is the Helen F. Pettit Associate Professor of Clinical Nursing at Columbia University School of Nursing, and Director of both the Center for AIDS Research, and the Integrative Therapies in Primary Care Subspecialty Program. She also maintains a private acupuncture practice and received her degree in Oriental Medicine and Acupuncture from the New York College of Wholistic Health, Education and Research. She holds a PhD in Nursing from Adelphi University, as well as a MA in Nursing from New York University. Dr. Anastasi has written several articles on symptom management and CAM therapies in HIV/AIDS and has been awarded many research grants including one from NCCAM titled, Acupuncture and Moxibustion: A Randomized Controlled Trial for Chronic Diarrhea in Persons with HIV.|
Acupuncture has been practiced for more than 2,000 years. It involves inserting very fine needles into specific points on the body to reduce pain and produce balance in order to create physiologic changes. The concept of Qi is the central focus of acupuncture. Qi is a vital life force that moves through energy pathways called channels. Acupuncture points are selected for stimulation on the basis that when the flow of Qi is blocked, imbalance can result in pain and dysfunction. Thus acupuncture can restore the balanced flow of Qi and promote health. . . .
As an acupuncturist, I assess the patient by making a tongue diagnosis, and pulse diagnosis. The tongue provides a geographic map of the organ systems and the pulse provides important information about specific organ networks as they relate to Chinese medicine. Specific information about each patients’ excess or deficiency condition(s) and areas of imbalance is identified. Next, a TCM diagnosis and treatment plan is made. I identify and record the necessary acupuncture points to stimulate and the techniques and methods that will be implemented during the session.
|Stay Away from Adrenal Cortical Extract (ACE), 9/8/2006|
|This disconnect persists despite scientific data about modern biomedicine's obvious objective benefits. Worthless and harmful traditional remedies are rationalized as being just "different," "alternative," "traditional," "unorthodox." Acupuncture, for example, is rationalized by saying "if it has worked for three thousand years, there must be something to it." But "worked" is never quantitatively defined. Of course, the same could be said for tiger parts used for male potency. Decimation of wild animal species for imagined effects of their parts does enter the perceived benefit equation. Cultural relativism results in this peculiar blindness to folkways' untoward consequences in favor of "nonjudgmental" description. |
Private foundations fund many "AM" activities and may be the largest source of "AM" funding. The $300-million Fetzer Foundation funded the Bill Moyers PBS TV series Cancer and the Mind and the 1993 Eisenberg New England Journal of Medicine "AM" study. It still funds the Beth Israel/Harvard and other medical school courses, postgraduate physician education courses, departments, and research projects. The Laing Foundation (>$1 million) funded the University of Maryland acupuncture (pain) program and other activities. The Rosenthal Foundation funds Columbia University's "AM" program to at least $750,000. The Templeton Foundation gives annual awards, funds research, and supports other nonprofit organizations for millions of dollars for support of spirituality and religion in medicine. Ten million dollars went to the University of California this year from the Osher Foundation for an "altmed" service. Endowments are in the hundreds of millions of dollars, with annual funding exceeding the $14-20 million per year of the Federal Office of Alternative Medicine.
The July 3, 1998, San Jose Mercury News bore a small Washington Post article about rural China's 70% infestation rate by various parasites, most commonly worms, resulting in malnutrition, decreased intelligence, and general weakening of the workforce. The article was buried on page DD5. The previous week's acupuncture article was on page 1B, complete with half-page photo. This kind of editorial treatment is typical.
The press is also often scammed. In the August 16, 1998, issue of Parade magazine, there appeared an article about the marvels of acupuncture, including a smiling woman undergoing chest surgery with only ear acupuncture for anesthesia. The photo appeared to be a fake, as did the story (chest surgery without intubation and heart bypass or cooling?). Such scams or cons—or variants on them—are widespread, and the press frequently falls for them.
So where are acupuncture and moxibustion when we need them? The worm infestation above apparently does not respond to "AM." The failure of traditional Chinese medicine in China and its maximum 18% usage there is a testimonial to modern biomedicine's success. But this is assumed not to interest the public; at least it seems not to interest the press.
Pressure groups from the "CAM" community support these policies and contribute funds toward their passage. The primary pressure for AMTs comes from "chelation therapy" physicians. (Chelation is a worthless "alternative" therapy for heart and vascular disease.) Political pressures, not public need or scientific validity, were behind the rise of chiropractic, acupuncture, and other methods.
One quick test for the usefulness of an "alternative" therapy is to ask oneself, what would happen if this therapy were tomorrow no longer available? How much would acupuncture and homeopathy be missed? How about antineoplastons, immunoaugmentive therapy, laetrile, and unsupervised megavitamins? If the public had never heard of them, the common health would not suffer a bit. On the other hand, how would the public handle absence of antibiotics, X-rays, anesthesia, and major operations?
|Some Notes on Sherman Cohn, J.D., LL.B., LL.M., 15/1/2005|
| IOM Description (February 2003): Sherman Cohn has been a professor at Georgetown Law Center since 1965. He specializes in the fields of civil procedure, professional responsibility and legal issues of alternative and complementary medicine. Before joining the Law Center faculty, he served as a clerk for Judge Charles Fahy of the D.C. Circuit and in the Appellate Section of the Civil Division of the Department of Justice. He is a member of the D.C., Maryland, and Virginia bars and is also a member of the American Law Institute, the American Judicature Society, and the Society of American Law Teachers. He served for eleven years as the first national president of the American Inns of Court. He is a member of the Charles Fahy American Inn. He served as the Administrator of Preview of U.S. Supreme Court Cases from 1976-79 and as Director of Continuing Legal Education at the Law Center from 1977-84. From 1982-93, he served as chair of the National Accreditation Commission for Schools and Colleges of Acupuncture and Oriental Medicine. From 1998 to 2002 he was President of the Jewish Law Association. Professor Cohn has also served as the Chair of the Board of Trustees of the Tai Hsuan Foundation, and is presently a member of the Board of Overseers of the Traditional Acupuncture Institute, the National Acupuncture Foundation, Acupuncture and Oriental Medicine Alliance, and is on the Board of Visitors of John Marshall Law School.|
"Oriental medicine," often referred to as "traditional Chinese medicine (TCM)," encompasses a vast array of folk medical practices based on mysticism. It holds that the body's vital energy (chi or qi) circulates through channels ("meridians") that have branches connected to bodily organs and functions. Illness is attributed to imbalance or interruption of chi. The diagnostic process used by TCM practitioners may include questioning (medical history, lifestyle), observations (skin, tongue, color), listening (breathing sounds), and pulse-taking (claimed to determine which meridians are "deficient" in chi). Treatment with acupuncture and herbs is claimed to "restore balance."
These concepts are not based on the body of basic knowledge related to health, disease, and health care that has been widely accepted by the scientific community. Moreover the scope and quality of acupuncture education do not prepare most practitioners to make adequate diagnoses and provide appropriate treatment.
The Traditional Acupuncture Institute makes the following claims about its services:
Traditional acupuncture, proven effective over thousands of years, is directed toward good health, vitality, balance, longevity, and alleviation of stress. . . .
|Quack "Electrodiagnostic" Devices, 7/11/2013|
|The first EAV devices were developed by Reinhold Voll, a West German physician who had been engaged in acupuncture practice in the 1950s . In 1958, he combined Chinese acupuncture theory with galvanic skin differentials to produce his EAV system.|
Proponents claim that these devices measure disturbances in the body's flow of "electro-magnetic energy" along "acupuncture meridians." Some are claimed to measure "vibrations," "resonance," or "stresses" associated with body tissues and/or organs. Actually, most devices are little more than fancy galvanometers that measure electrical resistance of the patient's skin when touched by a probe. The device emits a tiny direct electric current that flows through a wire from the device to a brass cylinder covered by moist gauze, which the patient holds in one hand. A second wire is connected from the device to a probe, which the operator touches to "acupuncture points" on the patient's other hand or a foot. This completes a low-voltage circuit and the device registers the flow of current. The information is then relayed to a gauge or computer screen that provides a numerical readout on a scale of 0 to 100 . According to Voll's theory: readings from 45 to 55 are normal ("balanced"); readings above 55 indicate inflammation of the organ "associated" with the "meridian" being tested; and readings below 45 suggest "organ stagnation and degeneration." However, if the moisture of the skin remains constant—as it usually does—the only thing that influences the size of the number is how hard the probe is pressed against the patient's skin. Some devices have all of their wires connected to the patient or generate their responses randomly so that the practitioner does not influence the results.
In the earlier devices, the number was indicated by a needle that moved over a dial gauge. Later versions, such as the Interro pictured below, make sounds and provide the readout on a computer screen. The treatment selected depends on the scope of the practitioner's practice and may include acupuncture, dietary change, and/or vitamin supplements as well as homeopathic remedies.
Capital University of Integrated Medicine, a nonaccredited postgraduate school that closed in 2005, offered a three-day course in "Electro Dermal Resistance Analysis." The course was said to provide "assessment of health and the treatment of imbalances of the immune system through the resistance characteristics of specific acupuncture meridians on the body" and how to "locate the systemic roots of immune system weakness and to provide stimulation to strengthen the weakness."
American Association of Acupuncture and Bio-Energetic Medicine. Basic explanation of the electrodermal screening test and the concepts of bio-energetic medicine. AAABEM Web site, 1998.
|Biography Magazine Interview of Dr. Stephen Barrett, 19/11/1999|
Barrett: There are two separate issues here. One is the theory and practice. And the other is what actually happens when you go to see a practitioner. The acupuncture universe is divided into two groups. One thinks of acupuncture in terms of a physical process that causes the body to produce pain-relief compounds like endorphins, or that works by distracting a person so that when you pinch one part of the body, another might relax.
They're trained in Chinese medicine, which involves pulse diagnosis, where they feel the pulse for 6 or 12 or 24 characteristics, on the basis of which they tell you what's wrong with your "chi" and what herbs and what type of acupuncture you should have. It is complete insanity.
Barrett: I did, following a lecture in my local community. After listening to my pulse, he looked at my tongue and told me I had "congestion of the blood" and "stress." I don't have congestion of the blood, and he had no concept of whether or not I'm under stress. As for the lady standing in line behind me, he said she had premature ventricular contractions, which is an irregular heartbeat. I then took her pulse, which was completely normal. This guy was a medical lunatic. But he represents the acupuncturist majority. The bottom line is that acupuncture may have some usefulness in relieving certain kinds of discomfort. For instance, acupuncture may be able to relieve postoperative nausea, but it may not be cost-effective. I don't want to spend $90 and get a needle when I can take a pill for a fraction of the price that would do the same thing.
Biography: Yet we have come to regard the Chinese practices of acupuncture and herbal medicine highly. Think of the five-part Bill Moyers series on PBS, "Healing and the Mind."
|Unnaturalistic Methods: B, 4/6/1997|
|Bi-Digital O-Ring Test Molecular Identification Method (Bi-Digital O-Ring Test, O-Ring technique): Means of determining internal-organ "representation areas" on the human tongue. Theoretically, this enhances tongue acupuncture and TCM tongue diagnosis. Yoshiaki Omura, M.D., Sc.D., developed the method in New York City. It includes the Direct Bi-Digital O-Ring Test Method and the Indirect "Bi-Digital O-Ring Test." Omura has promoted the method worldwide, and there are "O-ring societies" in Europe and Japan.|
Bindegewebsmassage (bindegewebsmassage system, connective tissue massage): Form of bodywork developed in Germany in the 1930s by Elisabeth Dicke. Its theory resembles that of traditional acupuncture, positing a "powerful association" between particular areas of connective tissue (e.g., cartilage) and specific "paths" of the nervous system and internal organs.
body acupuncture: Apparently, "ordinary" acupuncture, i.e., any form of acupuncture whose "channel theory" is that of TCM and whose scope is the entire human body (e.g., not just the ears).
bodywork (Bodywork Therapy, bodywork therapies): A potpourri of methods typified by exercising, manipulating, and/or manually (especially digitally) touching the body. It overlaps with energy field work. The expression "bodywork" is generally interchangeable with "hands-on healing" and "hands-on health." The major categories of bodywork are: (a) massage therapy, (b) body-centered psychotherapy, and (c) touch therapy. Its major foci are: (a) body structure (e.g., chiropractic), (b) "body armor" (e.g., Reichian Therapy), (c) chi or "vital energy" (e.g., acupressure massage, acupuncture, and jin shinn), (d) relaxation (e.g., lomi-lomi and Swedish massage), and (e) the alleged "subtle body" (e.g., Reiki and Therapeutic Touch). The word "bodyworkers" apparently refers to practitioners of any form of bodywork that is not categorizable as acupuncture, chiropractic "adjustments," osteopathy, body-centered psychotherapy, touch therapy, or energy field work.
|Some Notes on Susan Folkman, Ph.D., 15/1/2005|
|The site also states: "UCSF has been among the leaders in the field of alternative medicine education, offering major elective courses for ten years: an introductory course on complementary modalities, such as acupuncture, herbal medicine, manual therapies and Ayurvedic medicine; a course on homeopathy; a class called 'the Healer's Art'; and a lecture series on the history of alternative medicine. UCSF seeks to build upon this foundation in the hope of transforming the current model of medical education in this country." The key question in evaluating any "CAM" educational program is whether it promotes critical thinking of merely regurgitates the claims of "CAM" proponents.|
An article in the June/July 2000 issue of San Francisco Medical Society magazine notes that two of of the center's faculty members were sent for training in an "intensive two-year course in five-element acupuncture." This form of acupuncture is based on nonsensical theories. The center's clinical staff includes two practitioners of reiki, which is based on the notion that "healing energy" can flow from the practitioner's hands to the patient's body.
Public lectures sponsored by the center include: "Traditional Chinese Medicine: Acupuncture Meridians and CHI," "Breath Therapy: How We Breathe Affects Health & Wellness," "Biofeedback: Taking Control to Optimize Health and Healing," "Energy Healing: Meridians, Shiatsu, and Reiki," "Acupuncture: For More than Pain," and Acupuncture: The Wisdom of Traditional Chinese Medicine." Neither these talks nor the others in the series appear to criticize anything that might be considered "CAM."
|Analysis of the MACCAH Draft: Integration of CAM into Mainstream Medicine, 27/6/2003|
|ACC currently subsidises the cost of treatment for acupuncture, chiropractic and osteopathy services provided by specified providers.|
Acupuncture and some 'relaxant' therapies have been integrated into some pain clinics.
Acupuncture and occasionally aromatherapy have been integrated into some obstetric and cancer services, palliative care, rehabilitation and care of the elderly.
Within primary care, a survey of GPs in Victoria found that over 80 percent of respondents had referred patients to CAM practitioners and 20 percent of respondents practise a complementary therapy themselves (Pirotta et al 2000). Acupuncture is the CAM most commonly adopted by GPs for inclusion within mainstream general practice (Australian Medical Association 2001). Around 15 percent of Australian GPs practise acupuncture. The Royal Australian College of General Practitioners now has special interest groups for members who practise acupuncture or nutritional medicine.
|A Kushi Seminar for Professionals, 8/1/2015|
|East West Journal, which has a circulation of about 100,000, contains more than 100 pages per issue. Its news and feature articles cover health, nutrition, psychology, and environmental issues-from the macrobiotic viewpoint. Its editorial philosophy is antagonistic toward scientific medicine and certain public health measures, including fluoridation. Fringe systems, such as acupuncture, chiropractic, homeopathy, naturopathy, Christian Science, and past-life therapy, are promoted in uncritical articles.|
The relationship between macrobiotics and Chinese ying-yang theory is not clear-cut. While macrobiotics distinguishes according to structure, the Chinese theory-which includes acupuncture theory-distinguishes by function. For example, macrobiotics classifies the earth (compact) as yang and the heavens (diffuse) as yin, while yin-yang theory does the opposite. Thus, as Kotzsch notes, "while Ohsawa purports to present an ancient Oriental way of thinking, in practice his does not correspond to the classical Chinese system."
The next morning, at 7:00 A.M., we commenced our daily exercise class in the library. Our instructor, Michael Joutras, said the exercises affected the flow of energy ("ki" or "Ch'i") through body channels ("meridians"), sharing the same system on which acupuncture and shiatsu (finger pressure at acupuncture points) are based. He instructed us to rub our palms together.
Postscript 1/8/15: The Web site of the Kushi Institute states that its flagship Way to Health Program "has helped thousands of individuals and families prevent or relieve cancer, heart disease, arthritis, osteoporosis, anxiety, depression and other chronic conditions." However, Kushi and his first wife (Aveline) both died of cancer. Aveline succumbed in 2001 at the age of 78 following a 9-year battle. A family spokesperson said that Aveline underwent standard radiation therapy when the her was discovered, but when it spread to her bones and she was told there was no other conventional treatment available, she relied on acupuncture and other "Eastern" methods. Michio died of pancreatic cancer in 2014 at the age of 88.
|Homeopathy: The Ultimate Fake, 23/8/2009|
|Proponents claim these devices measure disturbances in the flow of "electro-magnetic energy" along the body's "acupuncture meridians." Actually, they are fancy galvanometers that measure electrical resistance of the patient's skin when touched by a probe. Each device contains a low-voltage source. One wire from the device goes to a brass cylinder covered by moist gauze, which the patient holds in one hand. A second wire is connected to a probe, which the operator touches to "acupuncture points" on the patient's foot or other hand. This completes a circuit, and the device registers the flow of current. The information is then relayed to a gauge that provides a numerical readout.|
The treatment selected depends on the scope of the practitioner's practice and may include acupuncture, dietary change, and/or vitamin supplements, as well as homeopathic products. Regulatory agencies have seized several types of electroacupuncture devices but have not made a systematic effort to drive them from the marketplace.
During 1988, the FDA took action against companies marketing "diet patches" with false claims that they could suppress appetite. The largest such company, Meditrend International, of San Diego, instructed users to place 1 or 2 drops of a "homeopathic appetite control solution" on a patch and wear it all day affixed to an "acupuncture point" on the wrist to "bioelectrically" suppress the appetite control center of the brain.
|Unnaturalistic Methods: M, 26/1/2005|
|macroreflexology: Any form of reflexology that concerns "reflex areas" throughout the body. Acupressure and acupuncture exemplify macroreflexology.|
MediPatch Healthcare System (MediPatch system): Spinoff of homeopathy developed by Dr. Robert Jordan and characterized by the use of MediPatch Homeopathic Remedy Kits. Its theory posits a "chakral energy system" and twelve "acupuncture meridian pulse points."
meridian energy diagnosis: Purported way to "determine" the "flow of energy" throughout acupuncture meridians and whether "blockages" or "imbalances" exist.
moxabustion: Adjunct to acupuncture characterized by the burning of moxas -- preparations of dried leaves from the common mugwort (Artemisia vulgaris) or the wormwood tree (Artemisia chinensis) -- at acupoints to stimulate chi.
Practitioners attach moxas to acupuncture needles, place them directly on the skin in the form of small cones, or place the cones on a layer of ginger.
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