¡¡
....I
bet when they go in for a root canal the only needle they want to see is a
shot of novocaine. --Cecil
Adams
Acupuncture is a traditional Chinese
medical technique for unblocking chi
(ch'i or qi) by inserting needles at particular points on the body to
balance the opposing forces of yin
and yang. Chi is an energy
that allegedly permeates all things. It is believed to flow through the body
along 14 main pathways called meridians. When yin and yang are in harmony,
chi flows freely within the body and a person is healthy. When a person is
sick, diseased, or injured, there is an obstruction of chi along one of the
meridians. Traditional Chinese medicine has identified some 500 specific
points where needles are to be inserted for specific effects.
Acupuncture has been practiced in
China for more than 4,000 years. Today, the needles are twirled, heated, or
even stimulated with weak electrical current, ultrasound, or certain
wavelengths of light. But no matter how it is done, scientific research can
never demonstrate that unblocking chi by acupuncture or any other means is
effective against any disease. Chi is defined as being undetectable by the
methods of empirical science.
A variation of traditional
acupuncture is called
auriculotherapy or ear acupuncture. It is a method of diagnosis and
treatment based on the unsubstantiated belief that the ear is the map of the
bodily organs. For example, a problem with an organ such as the liver is to
be treated by sticking a needle into a certain point on the ear that is
supposed to be the corresponding point for that organ. (Similar notions
about a part of the body being an organ map are held by those who practice
iridology [the iris is the map
of the body] and reflexology
[the foot is the map of the body].) Staplepuncture, a variation of
auriculotherapy, puts staples at key points on the ear hoping to do such
things as help people stop smoking.
Traditional Chinese medicine is not
based on knowledge of modern physiology, biochemistry, nutrition, anatomy,
or any of the known mechanisms of healing. Nor is it based on knowledge of
cell chemistry, blood circulation, nerve function, or the existence of
hormones or other biochemical substances. There is no correlation between
the meridians used in traditional Chinese medicine and the actual layout of
the organs and nerves in the human body. The
National Council Against Health Fraud (NCAHF) claims that of the 46
medical journals published by the Chinese Medical Association, not one is
devoted to acupuncture or other traditional Chinese medical practices.
Nevertheless, it is estimated that somewhere between 10 and 15 million
Americans spend approximately $500 million a year on acupuncture for
treatment of depression, AIDS, allergies, asthma, arthritis, bladder and
kidney problems, constipation, diarrhea, colds, flu, bronchitis, dizziness,
smoking, fatigue, gynecologic disorders, headaches, migraines, paralysis,
high blood pressure, PMS, sciatica, sexual dysfunction, stress, stroke,
tendinitis, and vision problems.
Empirical studies on acupuncture are
in their infancy. Such studies ignore notions based on
metaphysics such as
unblocking chi along meridians and seek to find causal connections between
sticking needles into traditional acupuncture points and physical effects.
Even so, many traditional doctors and hospitals are offering acupuncture as
a "complementary" therapy. The University of California at Los Angeles
medical school has one of the largest acupuncture training courses in the
United States for licensed physicians. The 200-hour program teaches nearly
600 physicians a year. According to the
American Academy of Medical
Acupuncture, about 4,000 U.S. physicians have training in acupuncture.
In March 1996, the Food and Drug
Administration (FDA) classified acupuncture needles as medical devices for
general use by trained professionals. Until then, acupuncture needles had
been classified as Class III medical devices, meaning their safety and
usefulness was so uncertain that they could only be used in approved
research projects. Because of that "experimental" status, many insurance
companies, as well as Medicare and Medicaid, had refused to cover
acupuncture. This new designation has meant both more practice of
acupuncture and more research being done using needles. It also means that
insurance companies may not be able to avoid covering useless or highly
questionable acupuncture treatments for a variety of ailments. Nevertheless,
Wayne B. Jonas, director of the Office of Alternative Medicine at the
National Institutes of Health in Bethesda, MD, has said that the
reclassification of acupuncture needles is "a very wise and logical
decision." The Office of Alternative Medicine is very supportive (i.e.
willing to spend good amounts of tax dollars) on new studies of the
effectiveness of acupuncture.
The most frequently offered defense
of acupuncture by its defenders commits the
pragmatic fallacy. It is
argued that acupuncture works! What does this mean? It certainly does
not mean that sticking needles into one's body opens up blocked chi. At
most, it means that it relieves some medical burden. Most often it simply
means that some customer is satisfied, that is, feels better at the moment.
The NCAHF issued a position paper
on acupuncture that asserts, "Research during the past twenty years has
failed to demonstrate that acupuncture is effective against any disease" and
that "the perceived effects of acupuncture are probably due to a combination
of expectation, suggestion, counter-irritation, operant conditioning, and
other psychological mechanisms." In short, most of the perceived beneficial
effects of acupuncture are probably due to mood change, the
placebo effect, and the
regressive fallacy. Just
because the pain went away after the acupuncture doesn't mean the
treatment was the cause. Much chronic pain comes and goes. An alternative
treatment such as acupuncture is sought only when the pain is near its most
severe level. Natural regression will lead to the pain becoming less once it
has reached its maximum level of severity. Also, much of the support for
acupuncture is anecdotal in the form of
testimonial evidence from
satisfied customers. Unfortunately, for every anecdote of someone whose pain
was relieved by acupuncture there may well be another anecdote of someone
whose pain was not relieved by acupuncture But nobody is keeping track of
the failures (confirmation
bias).
Nevertheless, it is possible that
sticking needles into the body may have some beneficial effects. The most
common claim of success by acupuncture advocates is in the area of pain
control. Studies have shown that many acupuncture points are more richly
supplied with nerve endings than are the surrounding skin areas. Some
research indicates sticking needles into certain points affects the nervous
system and stimulates the body's production of natural painkilling chemicals
such as endorphins and enkephalins, and triggers the release of certain
neural hormones including serotonin. Another theory suggests that
acupuncture blocks the transmission of pain impulses from parts of the body
to the central nervous system.
There are difficulties that face any
study of pain. Not only is pain measurement entirely subjective, but
traditional acupuncturists evaluate success of treatment almost entirely
subjectively, relying on their own observations and reports from patients,
rather than objective laboratory tests. Furthermore, many individuals who
swear by acupuncture (or therapeutic
touch, reiki,
iridology,
meditation, mineral
supplements, etc.) often make several changes in their lives at once,
thereby making it difficult to isolate significant causal factors in a
control group study.
Some of the acupuncture studies
supported by the Office of Alternative Medicine at the National Institutes
of Health try to mimic traditional control group studies, but no control
study will reveal if chi was unblocked or if yin and yang are in or out of
harmony. Control studies using objective measurements of treatment success
could determine, however, how much of the success of acupuncture is due to
nothing more than subjective assessment by interested parties. Such studies
could also determine whether any effects of acupuncture are short-term or
long-term.
Finally, acupuncture is not without
risks. There have been some reports of lung and bladder punctures, some
broken needles, and some allergic reactions to needles containing substances
other than surgical steel. Acupuncture may be harmful to the fetus in early
pregnancy since it may stimulate the production of adrenocorticotropic
hormone (ACTH) and oxytocin, which affect labor. There is always the
possibility of infection from unsterilized needles. And some patients will
suffer simply because they avoided a known effective treatment of modern
medicine.
See related entries on
alternative health practices, chi
control study,
iridology,
placebo effect,
reflexology,
therapeutic touch, and
reiki. and
yin-yang.
¡¡
further reading
reader comments
Barrett, Stephen and William T. Jarvis. editors.
The Health Robbers: A Close Look at Quackery in America, (Amherst,
N.Y.: Prometheus Books, 1993).
Barrett, Stephen and Kurt Butler.
editors.
A Consumers Guide to Alternative Medicine : A Close Look at Homeopathy,
Acupuncture, Faith-Healing, and Other Unconventional Treatments
(Buffalo, N.Y. : Prometheus Books, 1992).
Huston, Peter. "China, Chi,
and Chicanery - Examining Traditional Chinese Medicine and Chi Theory,"
Skeptical Inquirer, Sept/Oct 1995.
Raso, Jack.
"Alternative" Healthcare: A Comprehensive Guide (Amherst, NY:
Prometheus Books, 1994).
Information resource:
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