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Our article says
”Kalichman and Vulfsons' 2010 clinical review confirmed that "ah shi" points are what are now referred to as "MtrP points”.
MtrP points are of questionable validity, based primarily on work by one person, and are on fringe in science, mainstream in alternative medicine. But that aside, maybe I am mistaken and missing something, but where do Kalichman and Vulfson say that their “review confirmed” that? PPdd ( talk) 04:12, 28 January 2011 (UTC)
It doesn't matter how many acupuncture points existed in the Chinese system - we're really only referring to the Chinese system at this point, let's not forget there are at least a half-dozen other methods - the point is they have never established a scientific basis for acupuncture points to be taken seriously that I'm aware of. It is verifiable that in at least on peer reviewed opinion, acupuncture's original points were based on a form of astrology and sympathetic magic. Though we should describe the fact that people believe acupuncture points exist, we should also describe the POV that they were historically not based on rational precepts, and that the empirical investigation of acupuncture has not resulted in any specific point being found to correspond to any specific effect. Middle 8, one of your points has long been that acupuncture can't be simply dismissed. Point taken. However, a point that must also be recognized is that after several decades of investigation, the evidence base of acupuncture has become quite narrow, supporting only two columns - nausea and pain. Just because lots of people believe in something, doesn't mean we report that in exclusion to what science has actually found. We should juxtapose the two points whenever possible - "people believe X about acupuncture, but when investigated the evidence base is Y". And generally, that evidence base is not very good. WLU (t) (c) Wikipedia's rules: simple/ complex 02:33, 4 February 2011 (UTC)
Note that I've removed some material from the lead. There are a couple problems with the edit in question.
Keep in mind this is coming from an editor that thinks acupuncture is utter shit - this edit was against my personal POV, that's how damned strongly I feel about it. A good article that will be defended by everyone interprets the P&G fairly for all sources and edits. I notice the article has been used elsewhere in the page, I plan on looking at it there as well and expect to re-remove it.
The other edits I have no problem with so far, they do remove a lot of unsourced information which is perfectly valid per WP:PROVEIT. Having fresh eyes on a page helps clean up stuff like this and usually leads to new, more reliable sources being added. WLU (t) (c) Wikipedia's rules: simple/ complex 17:17, 4 February 2011 (UTC)
I have a childhood based fear of doctors with needles. Does acupuncture ever hurt? PPdd ( talk) 03:26, 2 February 2011 (UTC)
(undent) I'm an acupuncturist with a previous career in pharmaceutical research. Information needs to be considered in context; some drugs that are considered safe enough to sell without a prescription are far more dangerous than acupuncture ( tylenol, for example). Even aspirin kills a few people each year; the total of 86 reported for acupuncture (over every year of recorded history!) is thus relatively quite low. Bicycles and soccer balls are far more of a menace. Compared to virtually all drugs and therapies, acupuncture is quite safe [1]; the references in the article all support that conclusion. How well acupuncturists are trained makes a huge difference: in the U.S., for example, they receive thorough education on safety (including all the issues mentioned above) and are required to use sterile, one-time-use, disposable needles in almost every state. Middle 8 ( talk) 15:58, 3 February 2011 (UTC)
As for pain, just google; acupuncture needles are much smaller than hypodermic needles, and generally don't "hurt" as much as cause a "twinge" initially which then fades into a pleasant, relaxing feeling. The large majority of the time, the places in the body that were needled don't even bleed when the needle is removed. Just tell your acupuncturist if a needle hurts too much, and she'll remove it and insert another in a slightly different position. No two people are exactly alike, and some may have small nerves near the skin that are too close for comfort to the textbook point location. -- Middle 8 ( talk) 15:58, 3 February 2011 (UTC)
"Two patients terminated study participation, complaining that acupuncture was too painful to continue." [2]
"acupuncture is a painful and unpleasant treatment" [3]
"Japanese acupuncture needles are much finer than their Chinese counterparts, and hence far less painful." Acupuncture Today, Southern Medical Journal, July 1988 - Volume 81 - Issue 7 - ppg 885-887, Yasuo Yshida
PPdd ( talk) 04:38, 4 February 2011 (UTC)"For the purpose of pain relief, the choice of non-acupuncture points as a sham treatment is also a problem because of the existence of diffuse noxious inhibitory control (DNIC) phenomena; it is well established that painful stimulation inhibits pain, and DNIC has been proposed as a physiological basis of acupuncture analgesia." [4]
(outdent) The best source for adverse effects in acupuncture (including pain from needle insertion) is this Ernst review, which puts the total number of adverse events at 11.4% and notes that they are mostly minor. PPdd, you could have found this by reading the article. -- Middle 8 ( talk) 08:01, 4 February 2011 (UTC)
Note that "painfulness of treatment" is different from "adverse effects" as commonly used. For example, getting an injection of morphine in one's buttox may be painful, but it is not listed as an "adverse effect" of morphine (which has plenty of adverse effects: addiction, constipation, etc.). The pain in treatment is likely responsible from the minute effects detected via the diffuse noxious inhibitory control (DNIC) phenomena, as speculated in the source above. PPdd ( talk) 14:51, 4 February 2011 (UTC)
I notice references to Cheng are being removed (i.e. [5]). This is debatable. Though only "Cheng, 1987" is given, this is still a valid, if imprecise source. When the reference number is clicked on, it takes you to the reference itself. This reference should be hyperlinked to take the reader to the "References" section, specifically the line with Cheng, 1987 on it (Cheng, X (1987). Chinese Acupuncture and Moxibustion (1st ed.). Foreign Languages Press. ISBN 7-119-00378-X.) If the google books link had a preview I'd link to this.
I don't know how reliable the book is for medical claims, but for basics of Chinese acupuncture (number of points, meridians, typical treatment, etc.) it is probably adequate.
Remember that while all information should be sourced, commonly-accepted knowledge or knowledge no-one objects to does not need a citation. We don't need a refernce after the sky being blue, the capital city of a country, the roundess of the Earth or that cancer is conventionally treated with chemotherapy and surgery. The big flaw in many sources is the lack of page numbers; that could be addressed by finding the page numbers in the original text. Probably easier would be finding the same information in another source - for instance, this one which has a preview option and allows for searching inside. Though further references are invariably a boon to the page, removing unsourced information is not always the best action to take. If the information is basic (acupuncture involves needles; acupuncture exists in China) then wikipedia and our readers are not helped by removing this sort of thing. I'm not saying replace all the information and references, but be judicious and ask if the information removed really needs a source, and if the page is better for even unsourced information being present. WLU (t) (c) Wikipedia's rules: simple/ complex 19:42, 4 February 2011 (UTC)
Here's the Cheng material I deleted -
"In the clinical practice of acupuncturists, patients frequently report one or more of certain kinds of sensation that are associated with this treatment:
- Extreme sensitivity to pain at the points in the webs of the thumbs.
- In bad headaches, a feeling of nausea that persists for roughly the same period as the stimulation being administered to the webs of the thumbs.
- Simultaneous relief of the headache. [2]"
I would have tried to check the ref, but it was 1987, and totally incosistent with a claim of nausea relief. I outlined this problem below, where "acupuncure" keeps shifting meaning, e.g., treatment for nausea may cause pain, and treatment for pain may cause nausea. But both treatments are called "acupuncture". So (assuming it actually has efficacy in both), does it cause or relieve nausea? The logical error causing the problem is called the fallacy of four terms.
I have a big problem with medical articles that claim efficacy without saying HOW effective. For example, if Rogaine was 100% effective at growing ONE hair, it would be called '100% effective", and people who buy it would still get about nothing. Similarly, even if there was endorphin release from needling, does the needling cause more pain than it relieves? All these are important questions which seem to be ignored. (They get deliberately obfuscated like this by pharmaceutical companies, too.) PPdd ( talk) 02:22, 5 February 2011 (UTC)
This article uses fallacy of four terms reasoning in that it is constantly shifting definitions of acupuncture to imply false things.
This article needs alot of work!
PPdd (
talk) 16:28, 5 February 2011 (UTC):Not a bad start on a todo list, though by neglecting to provide links you've left your meaning rather ambiguous. I've added a {{
todo}}
at the top of the page, I'd suggest moving these points there so they don't disappear into talkpage archives before they're addressed. After that, I'd suggest you add links to clarify the article sections you are referring to at each point.
LeadSongDog
come howl!
22:39, 4 February 2011 (UTC)
I added the list to the "to do" list at top, but comments on how to fix all of this should go in this section. PPdd ( talk) 16:28, 5 February 2011 (UTC)
The NIH, with appointments made by political considerations, has always blended milk toast political caution with science, as its director is a political appointment, not a nomination by peers.
One wonders what statistical methods they used to conclude “likely”, given that the areas referred to have not been tested. Shame, shame. PPdd ( talk) 23:58, 4 February 2011 (UTC)“Further research is likely to uncover additional areas where acupuncture interventions will be useful.”
The cochrane study cited says
"There was no clear difference in the effectiveness of P6 acupoint stimulation for adults and children; or for invasive and noninvasive acupoint stimulation."
So invasively sticking needles in someone had no extra effect. The lede says otherwise. "Noninvasive acupuncture" is oxymoronic. This is another case of moving the goalpost defining acupuncture. PPdd ( talk) 15:15, 5 February 2011 (UTC)
The "efficacy" findings are misleadingly stated in article. The article does not state "how much" pain relief, even if there was 100% pain relief. Using another example, if a remedy for baldness caused one hair to grow 100% of the time, it would have 100% efficacy, but be useless. Similarly, if sticking needles into someone always caused a very minute amount of the body's natural pain relievers to be released, it would have 100% efficacy, but be worthless. PPdd ( talk) 21:02, 5 February 2011 (UTC)
"One of the major challenges in acupuncture research is in the design of an appropriate placebo control group."
Am I the only one who finds this to be a silly statement? It would be EASY. 200 people with kidney problems (or some other problem over which acupuncture claims efficacy and is not obvious by simple observation.) The patients are seated in the room and the acupuncturist walks in and treats the patient. Half the time the acupuncturist is told to treat kidney problem and half the time he is told to treat something else (placebo.) They aren't allowed to speak so the acupuncturist does not know what ailment the person truly has and the patient does not know acupuncture so he doesn't know what is really being treated. This is a perfectly double blind experiment, is it not? Then the patients rate the efficacy of the treatment (or it is measured scientifically if possible). You compare the percentages of success of the real treatment and the placebo. Easy experiment design, right?
The truth is that these kind of experiments have been done, but acupuncture does not usually fare well - most of its claims do not hold up in scientific study while a fraction seem to. Like most pseudo sciences, rather than roll back their claims when confronted with science, they attack the scientific method or claim that it doesn't apply. For years, ESP people have claimed that they can't perform in labs because of electrical fields and psychics claim they can't be tested because of the negative energy of the testers. Similarly, acupuncture is trying to claim that it can't be tested because it can't fit into basic experiment design.
"In trials of new drugs, double blinding is the accepted standard, but since acupuncture is a procedure rather than a pill, it is difficult to design studies in which both the acupuncturist and patient are blinded as to the treatment being given."
Again, ridiculous - countless medical procedures are tested every year. This just sounds like a closed tautology speaking. —Preceding unsigned comment added by Ksjazzguitar ( talk • contribs) 18:25, 28 September 2010 (UTC)
Primary somatosensory cortex homunculus, anybody?
The upper lip of the lateral sulcus, an inch or so either side of the central sulcus, is called the Rolandic operculum. The swallowing section of the primary somatosensory cortex (S1) is located in the portion of the Rolandic operculum posterior to the central sulcus. S1 is green in the top left image here. As you follow that cortex into the lateral sulcus, it becomes part of the ceiling of the lateral sulcus, embodying the secondary somatosensory cortex (S2, green in the top right image). The (brown) wall at the end of the lateral sulcus is the insula. Sorry if that's too much information.
If the real acupuncture activated the Rolandic operculum, as the authors report, that is spooky. The Rolandic operculum on the outer surface is normally not involved in generic pain processing, so it's not an artifact of that. Actually, on further thought, the "swallowing" section of S1 is adjacent to S2, and S2 is active in both hemispheres in response to oddball somatosensory stimulation. [10] So the activity located in the Rolandic operculum in this study could simply be S2 registering the shift of attention to the sensation. All depends on the precise location of the activity, I guess. But if that's what is happening, it doesn't explain the lack of activity in the sham punctures, which would have been equally oddball. I give up. Anthony ( talk) 22:13, 28 September 2010 (UTC) Addendum. 05:50, 29 September 2010 (UTC)
apparently gets round that, although not all results have been as clear cut as this particular one. Wilfridselsey ( talk) 07:14, 29 September 2010 (UTC)
Undent. Care would have to be taken for avoiding POV forking, particularly given the fact that both the underlying basis for acupuncture and its clinical efficacy are both heavily contested. There shouldn't be one article saying "This is acupuncture and how it works" (which assumes it works) followed by "this is the conditions acupuncture works on, but note that the reason why it works is heavily contested". Though I'm sure most people would agree that the current page needs a re-write and general clean-up, segregation would have to be done very, very carefully (if at all) to avoid one page discussing the "mechanisms" of acupuncture (which is both false since there is no actual agreed-upon mechanism, and deceptive since it assumes that acupuncture "works") and another discussing clinical evidence and uses. It's probably better to clean up the current page than split it, there's a lot of minor, tangled discussions about different aspects. WLU (t) (c) Wikipedia's rules: simple/ complex 16:21, 29 September 2010 (UTC)
Sorry, but I'm not convinced.
"Designing a good placebo for acupuncture is actually quite difficult - altering the points needled addresses only one aspect of what 'acupuncture' incorporates, and you also have to distinguish between 'acupuncture', 'dry needling' and 'Traditional Chinese medicine' - each is a separate test."
Fine, then each can be tested. The fact that there is more than one system is not an argument against a double blind experiment.
"You have to control for nonspecific affects - the acupuncturist's own beliefs, which can leak through body language, duration of treatment, care, etc."
Yes, but (in my suggested experiment) if the patients have already been evaluated by other acupuncturists to determine the "correct" action, then the acupuncturist in the test does not have to do an evaluation. If the treatment is dependent on the beliefs of the practitioner, then it is not science, it is supernatural. If a doctor determines that a patient needs the shock paddles to restart the patients heart and asks another doctor to do it, it is irrelevant whether the second doctor believes in the procedure. This is how real treatments work.
The acupuncturists "body language" would be irrelevant in my example experiment; he would believe it is the right treatment.
"Many systems of acupuncture claim a need for a lengthy diagnosis based on the TCM approach, and practitioners will claim it's not 'real' acupuncture if you don't spend an hour taking pulses, interviewing, looking at the tongue, etc."
Fine, different systems can be tested differently. But this is sounding more and more like the arguments other pseudo-sciences make - when an experiment doesn't go their way, they blame the experiment or those being tested, saying that they weren't the real deal. I hear astrology proponents say the same thing all the time - when an experiment goes against them they ague that the test wasn't testing "real" astrology, ignoring that many do and it still fails. A couple centuries ago, phrenology proponents made the same claims. And the fact that in 5000 years they have failed to develop a unified approach is NOT an argument in their favor.
"But as far as this page goes, talk pages are not meant to be forums for discussion. We base the page on a neutral summary of what reliable sources say."
My point is that I think that it is NOT neutral. To me it reads like acupuncture apologetics. I am not trying to argue acupuncture, but the slant of this article. This article would give me the impression that there is very little evidence against acupuncture's efficacy, contrary to what I have seen in the literature. Contrast this article with the CSICOP position paper: http://www.csicop.org/uploads/files/Acupuncture_Paper.pdf.
For something as controversial and that has failed so often in experiments to produce clear results better than control groups, this article is painfully shy of contradictory arguments - it reads like something written by an acupuncture enthusiast who has put in a few token arguments against. I do agree that the article show show both sides, but it is hard to build a "con" when the "pro" makes its claims unfalsifiable by saying that science is incapable of testing it (claim it shares with other pseudo-sciences.) Really, the "con" portions of this article could be summed up as, "Well, there is 'some' (lets pretend its not 'a lot') but it doesn't count because acupuncture can't be effectively tested by science." Would that argument be accepted for any medical procedure? Would it be acceptable in any other wikipedia article?
While I do agree that there is some data suggesting that acupuncture has some mild effects in some isolated situations, that in no way justifies the claims made by acupuncturists and in no way supports the bias of this article. unsigned comment added by Ksjazzguitar ( talk • contribs) 00:39, 30 September 2010 (UTC)
I don't have the standing on this subject and I don't have the energy to get into an edit war so I will not be the one to change this. But this is in no way a neutral article - it is an advertisement for acupuncture masquerading as a wikipedia article. I hope that someone fixes it.—Preceding unsigned comment added by Ksjazzguitar ( talk • contribs) 00:39, 30 September 2010 (UTC)
(de-indent) As a rule, statements by expert bodies, including practice guidelines, are good MEDRS's and should be included. It doesn't take much space to include them. They help show the present-day sphere of usage and degree of acceptance. -- Middle 8 ( talk) 09:37, 22 January 2011 (UTC)
I suggest that the lede be organized as follows - First sentence definition, First pragraph:very general objective definition, Second paragraph: Description of beliefs, Third paragraph: Science and criticism; Fourth paragraph: Reception (e.g., affect on threatened and endangered species, world prevalence) PPdd ( talk) 02:46, 27 Januar 2011 (UTC)
I am wondering if you are all aware that the first section has a lot of typos and run on sentences and ideas. It also does not present a succint intro of the field. TCM and acupuncture are not separate, acupuncture is included in TCM (Traditional Chinese Medicine). It does not incorporate it, it is the other way around, acupuncture is a branch of TCM. Also, more than half is criticism, which should typically be in the criticism section, or not in intro. Am I wrong about this? Please excuse any lack of wikiquette, some of my comments should be more questions, than comments. Soll22 ( talk) 21:09, 7 February 2011 (UTC) Also, issues with the sentence "Acupuncture's effectiveness for other than psychological effects is denied by the science based medicine community." The sentence is innacurate. There is no consensus about the effectiveness of acupuncture in the "science based medicine community". Also, define science based medicine community. Psychological treatment is actually the most controversial facet of acupuncture in the "science based medicine community" that you mention, and it is far more commonly accepted for musculo-skeletal pain disorders. Mental health (psychological effects, as is stated in the second sentence, first paragraph) is generally considered outside the scope of practice of acupuncture in most states. Does this statement really belong as a intro to the Acupuncture entry? Soll22 ( talk) 21:19, 7 February 2011 (UTC)
At right is a motor cortex map of the body. TCM has a toungue map of the body. Does anyone know where a pic of such a map is? PPdd ( talk) 04:05, 27 January 2011 (UTC)
If you are in a city with a TCM college in it, you can use their library to get an image. Tongue Diagnosis by Giovanni Maciocia is a basic book. Tongue diagnosis is complex, and is NOT based on "chew marks". There is specific language to discuss tongue topography and it relates to a complex of issues in the organ systems in Chinese Medicine. Soll22 ( talk) 04:06, 7 February 2011 (UTC)soll22
Alright I will look into it. Just getting used to all the rules and regs of wikipedia. Soll22 ( talk) 21:04, 7 February 2011 (UTC)
I noticed that the lede has drifted away from using sources (a stylistic preference that is conducive to POV-drift) and toward the inclusion of unsupported assertions and OR. I did a pretty massive revert, per WP:BOLD, to the lede, restoring one iteration of a pretty longstanding, stable version from 22 October 2010.
Most of us probably know that one needs a REALLY good source to say it is that way as opposed to saying that X source says it's that way. PPdd, try to find a source of unimpeachable stature saying that scientists and historians are now certain that the location of acupuncture points was determined only metaphysically and had nothing to do with empirical observation.
Additionally, the dichotomy between "alt-med" and "EBM" is not one that is generally used (e.g. Ernst doesn't, nor does Institute of Medicine); "alternative" can denote sphere of usage. See sources in first part of alternative medicine. I also removed another unsourced sentence asserting that TCM's points are based solely on metaphysics and the like. This isn't Skptical.Inquirer.Pedia. Again, we need sources, and really good ones, to speak in the encyclopedic voice and say that "X is the case" rather than "according to source Y, X is the case".
Whoever stripped the sources out of the lede did a disservice to the article; I'm just going to revert to an earlier version that had them, because otherwise some editors tend to tweak prose to fit their assumptions without strict adherence to sources. What is the advantage of a lede section that omits sources, diverges from the article and reads like a generic skeptical criticism? The version to which I reverted at least has sources and fairly depicts the various issues in the article, rather than drifting into more and more variations on "it's metaphysical, not EBM". BTW, the definition in this version implicitly takes into account Hk's note about non-TCM needling being called acu. -- Middle 8 ( talk) 14:59, 27 January 2011 (UTC)
I still see primary research being used. Eliminate the whole section (all three sentences). The latest one doesn't even mention acupuncture (at least the abstract). Note that needling without meridians isn't acupuncture. Neither is electroacupuncture. We're not supposed to engage in our own OR or promote OR found elsewhere, and primary research is essentially OR. -- Brangifer ( talk) 04:09, 28 January 2011 (UTC)
Hi Hk - re your reply to the thread-starter above (beginning with the phrase " Middle 8, I undid your revert of the multi-editor created..."), here are a couple of points to consider (also relevant to some of the discussion above, e.g. regarding the merits of fertilizer):
(1) A minor point: The version to which I had reverted was just as much a "multi-editor"-authored lede as the present one, so I have no idea why you bring that up as if it were some sort of advantage.
(2) A major point: If you believe that the version to which I reverted is (quote) ""pro-"acupunture is not nonsense"" (unquote), and that that's bad, then you do not understand the topic or NPOV. There is no scientific consensus that acupuncture is nonsense, bullshit, horseshit, or whichever pejorative you think is the most hilariously trenchant. None. In fact, it's not even a majority opinion. What I just said is easily falsifiable by the citation of a source ( WP:BURDEN). Provide that source, please, or if you can't, please stop editing as if it were true. What we can say is that there exists *a* view along the lines that acupuncture is "nonsense", and a spectrum of opinion between that and something like the WHO report (cite in article here), or the NCCAM, or the AAMA, etc. There is no single majority view on acupuncture, let alone a consensus one. If I'm wrong, all it takes is an adequate source that is a sufficiently powerful RS to illustrate scientific majority and/or consensus view, along the lines of what we require for category:pseudoscience (summary of current consensus on WP, as I understand it, here: User:Middle_8/Pseudocat).
(3) Speaking of the WHO report, the text is better in the article (compared to the wordy version before), but the attribution still needs to be changed to the WHO, period, and not "Zhu-Fan Lee". 2/0 and Brangifer, it's good to have objective eyes here; you might have a look at this (a good summary, referencing this higher up on the page) in the archives, and see if you don't agree that the misattribution of the WHO report to one of its contributing authors wasn't classic wikisophistry (and perhaps, heaven forbid, a bad-faith attempt to reduce its weight). Ernst himself noted, in his criticism of the WHO report on homeopathy, that it indeed carries a great deal of weight; it should be treated accordingly, per WP:TRUTH. Ernst quoted [23]: “Any report WHO puts out will have an impact”, says Ernst, who says in debates supporters of acupuncture will counter his evidence by simply citing the claims backed in the WHO report. “Who am I against the WHO?”, he asks. “What better name could you think of but WHO?” Ernst is not speaking ironically or asking a rhetorical question. He is stating, correctly, that the WHO carries a great deal of weight, and that it's a damn shame that such a weight-y source wrote a report that he believes, with no small amount of justification, to be biased (as attributable views on controversial subjects frequently are). I imagine we can handle the weight issue more gracefully than by falsifying the source's attribution, don't you? We can have a robust, informative article about acupuncture that doesn't have, as a unifying and primary subtext, "acupuncture is nonsense". We also should, per NPOV, VER and OR. regards, Middle 8 ( talk) 06:24, 2 February 2011 (UTC)
WLU's newly installed lede pic is quite beautiful. The drawing "balances" the hollow empty space at left with a solid figure at right, just like in acupuncture theory, and even looks like a picture of yin and yang. Note that although the belly button is misplaced, the true center of gravity is over the subjects supporting left ankle (to the viewers right), just as in Michaelangelo's drawings. PPdd ( talk) 18:21, 4 February 2011 (UTC)
Please help find RS for
"Risk of terminating pregnancy with the use of certain acupuncture points that have been shown to stimulate the production of adrenocorticotropic hormone ( ACTH) and oxytocin, and with unsterilized needles and lack of infection control: transmission of infectious diseases. (such as hepatitis B, hepatitis C, HIV I remember seeing confirmed cases of hepatitis B ... needs a ref, though)"
, which I removed from the article as NRS. PPdd ( talk) 22:11, 7 February 2011 (UTC)
the article is still POV but this time it is overly skeptical. three quarters of what is written should be moved to the criticism section. it is fine to be critical and skeptical of acupuncture but the article should be written in the same neutral format as other controversial subjects. — Preceding unsigned comment added by Metabradley ( talk • contribs) 21:42, 5 February 2011 (UTC)
the sources used are obviously not versed in chinese history or medicine and make broad, inaccurate claims. historically there are only two major rivers with any relevance in china (yellow river and yang river) not twelve. qi is not a "mystical" substance but a philosophical one, which arguable still has no place in medicine. the point locations are very much derived from human anatomy and take into account such things as muscle bodies, tendons and ligaments, bones, fossa (bone and soft tissue), foramen, nerve bundles and plexus. not using western terminology, of course. the name of many of the points reference the anatomical location. when the point system was brought to the west the points lost their anatomical names and were replaced with numbers. also, from the list of acupunture points wiki page ( http://en.wikipedia.org/wiki/List_of_acupuncture_points): "Medical texts describe the location and indications of more than 400 acupuncture points." not the 365 astronomically derived points listed on this page. i am sure that there are wonderful articles that critique acupuncture; the ones used should not be listed among them. also when in the editing mode it is highlighted that the page is already too long so the burden should not be on people to add more material which balances out the POV but rather the POV should be removed in order to make the article neutral and shorter. plenty of pages have a criticism section, i read a lot of wikipedia articles and this is one of the few that includes the criticism in the introduction of the article. as well this article already has the criticism section so it would seem reasonable to put the criticism there. — Preceding unsigned comment added by Metabradley ( talk • contribs) 19:27, 6 February 2011 (UTC)
if you removed <365>, which was the exact number stated to be derived from astrological means, why didn't you remove the rest of the statement? i will look at the RS. mb. —Preceding unsigned comment added by 204.187.140.30 ( talk) 21:46, 6 February 2011 (UTC)
It has no real significance in clinical practice. NO ONE refers to this in the clinical practice of acupuncture. This article seems to be written with a few exceptions by people only tangentially familiar with acupuncture in it's clinical form. — Preceding unsigned comment added by Soll22 ( talk • contribs) 01:18, 7 February 2011 (UTC)
Also, the lede contains a lot of criticism of acupuncture which there are several sides. I feel that while this is definitely one side, there are several other sides that should be represented, not in the lede. This should be a separate criticism section. As it reads now, the lede is THE criticism section, not a NPOV lede. Clearly the editors expressed their point of view in the talk page - acupuncture is pseudo-science, I hate acupuncture etc, obviously, not NPOV, and this is what comes through in the lede. There is no consensus in the medicine community, and this should be the NPOV of the CRITICISM section. I think the whole content of the lede, besides the typos and lack of logic of the statements, needs to be discussed. In the meantime, I disagree that it should be left as is. Soll22 ( talk) 12:47, 9 February 2011 (UTC)
Two sentences were removed as NRS (and POV)
Many other countries do not license acupuncturists or require them to be trained. Most European countries with the exception of Spain, Portugal, Holland and Poland, require a medical license prior to acupuncture licensing, thus placing acupuncture under the domain of the medical profession.
Please help out by finding RS so these edits can go back in. PPdd ( talk) 22:07, 7 February 2011 (UTC)
The following section was removed from the lead. WP:LEAD requires us to either provide sources for all information in the lead, or none depending on the page. Having a wall of text with no sources following several paragraphs full of sources is inappropriate. If this is a "draft" section, I would suggest composing that draft on a user subpage rather than on a main page. WLU (t) (c) Wikipedia's rules: simple/ complex 12:04, 8 February 2011 (UTC)
There are various definitions of “acupuncture”, "effectiveness", and "need for further research", causing confusion about claims of acupunture proponents and confusing debates. First, in most cases “acupuncture” refers only to insertion of needles in traditionally determined acupuncture points. In this case, it is contrasted with randomly inserting needles, which is called a “sham treatment” or “ placebo for acupuncture”, which is referred to as “needling”. Second, in some cases the very opposite is the case - “acupuncture” refers to this random needling, and this random needling is compared to pressing needles against the skin at the same points but not puncturing the skin, which is called "the placebo for acupuncture". So in the first case "needling with penetration" is called "the placebo for acupuncture", and in the second case "needling is with penetration" is the same as "acupuncture", but "nonpenetrating needles" is "the placebo for acupuncture". Third, sometimes, but less often, “acupuncture” refers to “ acupressure”, which is applying pressure to traditional acupuncture points. Another reversal of definitions is that sometimes "stimulation" by pressing acupuncture points without penetration is called "acupuncture", not "placebo", and is compared to some other placebo treatment or "control". Another ambiguous usage is that some claim that acupuncture is "effective", and mean that it is effective for all of its claims, such as prevention of disease. Others might mean by a claim of "effectiveness" that it treats psychological states such as pain or nausea, but not necessarily other conditions. Some may mean by a claim of "effectiveness" for pain relief that the relief is dramatic or significantly large enough to justify study. Others may mean that it is only barely detectable but still measurable. Different definitions of “acupuncture” are combined with different definitions of "effectiveness" and this causes still more confusion about its claims. There is also ambiguous usage of "need for further research". Some may mean by this that spending money on additional research is a good expenditure of highly limited medical research funds, while others mean by it that, if conclusions are to be drawn, more research funds would have to be spent, even if they might not think doing so is a good place to spend limited research funds.
Please forgive my writing into the text with grievances. I found this page after, and was troubled by the loss of 1 hour's work. Anyway, the information in the lede is very problematic. I found my information to be both more accurate to acupuncture theory and better sourced (journal of pocket guide for instance). Though in that case I am willing to accept the poor quality of the source (NIH) but not willing to accept the quality of a pocket dictionary.
My discussion of point theory was far more accurate than the ridiculous river based statements, and my discussion of organs was intended to show the underlying anatomical basis for some of acupucnture theory. If you are going to say there is no evidence and then you are going to erase the evidence then we are looking not at a group of consensus finding and intelligent editors.
Here is my edit of the lede, please let me know what the problems with it are — Preceding unsigned comment added by Luke643 ( talk • contribs) 18:26, 8 February 2011 (UTC)
"Acupuncture is an alternative medicine that treats patients by insertion and manipulation of needles in the body. In the 2004 NIH Consensus Paper on Acupuncture, it was determined that therapies that had undergone the most successful clinical trials were for postoperative and chemotherapy care, particularly for nausea and vomiting, postoperative dental care, low-back pain, headache, and tempero-mandibular disorder. Promising results in a handful of other therapies were discussed, with recommendation of further clinical trials..[1] Acupuncture typically incorporates traditional Chinese medicine (TCM) as an integral part of its practice and theory. The term “acupuncture” is sometimes used to refer to insertion of needles at points other than traditional ones, or to applying an electric current to needles in acupuncture points.[2][3]
Acupunture dates back to prehistoric times, with written records from the second century BCE.[4] Different variations of acupuncture are practiced and taught throughout the world.
The theory of pathology in Chinese medical practice(CM) differs from the modern trending of Western medical practice(WM). Rather than focusing on infectious agents (known in CM by various names, simply grouped under the term 'climatic factors'), disease pathology is believed to advance due to an imbalance of the correlative metaphor system based on early Chinese correlative Cosmology, including concepts such as yin and yang, the wu xing, (known as the Five Phases) and psycho-physical imbalance caused by "blockage" or "stagnation" of qi, a word variously translated as 'energy', 'breath', 'vital energy'[5]. These “systematic correspondences”[6] explain much of the phenomena of the persistence of health and illness in the human body. The system is not dissimilar to the Milieu intérieur theory of Claude Bernard.
Point location is based on sets of primary and secondary jingluo 經絡, or 'warp threads', 'winding channels', commonly called 'meridians' in the west. The channels each correspond and putatively interact with correlated internal Zangfu, often translated as 'Organs'. 10 of the 12 correlated organs correspond exactly with western anatomical organs, the Heart, Lungs, Kidneys, Pericardium (considered to have functionality equal to the major organs), Liver, Gall Bladder, Stomach, Large Intestine, Small Intestine, and Bladder. The final two, the 'spleen' and 'triple burner' refer to the spleen/pancreas and three vertical fibrous myo-fascial areas of the chest and abdomen (Upper, Middle and Lower), respectively.
The pioneering work of Dr. Helene Langevin, at the University of Vermont has given us clues as to how to explain Acupuncture points in bio-medical terms. She found that needles are 'grasped' differently at Acupuncture points then at non-acupuncture points. Based on her research, Langevin proposed a bio-medical mechanism based on "connective tissue planes" that explains the theoretical/metaphorical constructs of points, meridians, blockages, needle grasp, and sensation of 'qi', concepts that underpin the whole of acupuncture practice.[7]"
I am happy to put this info lower down into the body of the text.
the comments below are relavent. I fail to see how "correlative cosmology" is not plain english when "chinese astrology" is. But whatever. the important thing is that the practice of acupuncture is NOT based on astrology in terms of sourcing for points and channels. I will approach this in my revisions to the page. Luke643 ( talk) 05:16, 9 February 2011 (UTC)Luke643
Soll22 ( talk) 02:55, 9 February 2011 (UTC)
Explain "apparently has not provided a scientific basis and revolution for the existence of acupuncture points or meridians". Soll22 ( talk) 02:55, 9 February 2011 (UTC)
Why is a primary source not acceptable?? I agree that the term "pioneering" was a bit strong. But it seems ridiculous to me that a peer reviewed article would be unnacceptable when a pocket medical dictionary is being used to determine what "practitioner's claim"
Famousdog - it is precisely that which occurred in her study. CT bound differently at acupuncture points then at non-points. But as I said, I am cool with not using it. Luke643 ( talk) 17:05, 9 February 2011 (UTC)luke643
Ok, I am reposting what I worked on yesterday. Again, the Lede should not include criticism of acupuncture theory, methods, or beliefs, as that information all must come in lower sections. The lede should state concisely what the practice is only. does this make sense to everybody? Luke643 ( talk) 17:05, 9 February 2011 (UTC)Luke643
thanks for that, I have fixed the lede to include the summary of criticism. Luke643 ( talk) 17:29, 9 February 2011 (UTC)luke643
Additionally, I should clarify why the rivers/astrology statements are false. First, the lingshu (the Warring States text that the Matuk quotes) does not suggest that the points and channels come from rivers or the days of the year, and certainly do not suggest that they come from astrological incantations or rituals. Peter Deadman's analysis of the mawangdui text on acupuncture and physiology suggests that the formation of points was quite the opposite: unsystematic and based on points of tenderness in massage and exercise. Parralellisms are very common in classical chinese texts, and this one is no different. That there are 12 channels that correspond to 12 rivers in China (they certainly knew there were more than 12!) and points to the days of the year was a rhetorical device used to verify the 'natural' and cosmological significance of the points. But there is simply no suggestion in the literature that the pionts and channels originate in the rivers and stars. If my Columbia MA in Pre-modern Chinese History is not enough to convince the wiki world of the veracity of my reading of the lingshu, then I throw my hands in the air. Luke643 ( talk) 17:23, 9 February 2011 (UTC)Luke643
deleted following sentence: "Acupuncture's effectiveness for other than psychological effects is denied by the science based medicine community.Ernst_2006-02" The citation does not in any way prove that the science based community as a whole makes such a statement. Citation is also about a discussion which selects certain studies and not others, and draws certain conclusions. Mr. E. Ernst opinions can by no means be considered the unanimous opinion of the entire science based medicine community. "Science based medicine community" must be defined. It is a vague general term without a specific meaning. Numbers, members? If one person in the science based medicine community dissagrees, your statement is false. If you qualify your statement by "some" in the science based community, you are introducing a topic that belongs in the controversy or criticism section and misplacing it in the intro section. — Preceding unsigned comment added by Soll22 ( talk • contribs) 02:08, 9 February 2011 (UTC) oh i forgot to sign Soll22 ( talk) 02:15, 9 February 2011 (UTC)
The way the article is worded, it makes acupuncture sound like it significantly relieves nausea. As an uninsured purchaser of antiemetics in the hospital, I recall thinking that the antiemetics sold by pill-pushing pharmaceutical companies were about as useful as buying Rogaine to grow hair. A more objective and NPOV article edit on this would be, "Systematic reviews have found acupuncture to be as useless for treating nausea as antiemetics sold by pill pushing pharmaceutical companies." The existing POV article wording on this makes me sick to my stomach. (This is actually a serious request for a suggestion for rewording.) PPdd ( talk) 15:08, 9 February 2011 (UTC)
Why can't the principles of TCM be researched like anything else in "allopathic" medicine? If an intervention is effective, that effect should survive blinding, randomization, large numbers of patients, statistical analysis and placebo controls. If it's not, we should see drops in "effectiveness" with every application of a test designed to remove a particular bias. Research is indifferent to paradigm, if something works, it works, and it should work irrespective of who is doing it and where it is being done. To think otherwise seems like special pleading. How do you know patients aren't simply getting better due to the passage of time and natural healing? Why do you attribute that healing to acupuncture? This is specifically problematic for back pain, which has essentially no evidence-based treatment beyond "avoid bed rest". Comparing acupuncture to "regular care" isn't setting the bar very high since "regular care" isn't particularly effective. That's like carrying a rabbit's foot because it's just as effective as reading your horoscope. You are correct in noting that something can work without us understanding the mechanism - but that's a reason to research the mechanism. But first we should check to make sure it actually works rather than assuming it does. You don't have to know how an SSRI works in order to demonstrate that it helps with major depression. Again, research and empirical evidence properly gathered are indifferent to the beliefs of the researcher.
Was the ice research based on TCM principles? Are all TCM principles equally supported? Why does conventional research "work" for that finding, but not for others - like acupuncture? Again, this looks like special pleading - research is great as long as it confirms something we already believed - otherwise let's ignore it. Has this work been replicated in humans, who aren't mice (the subjects of this particular study)? And since TCM is primarily a 'physical' treatment - aimed at disease and disability rather than mental illness, isn't your invocation of psychiatry an inappropriate comparison? Why is TCM less risky? Particularly given things like contamination [29], [30], adulteration, [31], as well as delays in treating serious conditions. TCM may, or may not cure you, but if something carries risks but doesn't work, why use it? If it carries risks but it is uncertain whether it works, why prescribe it before confirming it works? If something carries no risks, why believe that it works - all effectively demonstrated interventions have predictable dose-response curves that at the extreme top-right end in toxicity. An intervention that has no adverse effects at any dose suggest it has no effect period.
PPdd, TorT does indeed address many of these points. I got my copy from the library. It's time well spent. WLU (t) (c) Wikipedia's rules: simple/ complex 03:20, 10 February 2011 (UTC)
Famousedog wrote, "the plethora of acupuncture systems means that pretty much any point on the body has some 'significance'." Famousdog's "point" ("ambiguous points?") is a good one, and if anyone has RS on this, it certainly belongs in the article, since it will bring MOS consistency to the various sources cited, and make the article readable. PPdd ( talk) 14:40, 10 February 2011 (UTC)
Just wanted to say that although I may not agree with all the content in the EBM section, I do think that it's much better written than the lede or the recently proposed lede. IMO any subject can be discussed if it's well written, and I do see a real effort in the EBM section, at any rate more than I can put into it these next few days. Soll22 ( talk) 21:12, 9 February 2011 (UTC)
PPdd, when you find out this information please write it in the book that you are clearly compiling. There is simply not the space in the article to detail or debunk acupuncture on this level. Famousdog ( talk) 14:05, 10 February 2011 (UTC)
Also keep in mind that there may not be a definition that is universally accepted or agreed-upon. Again, we are dealing with a prescientific concept from a culture that did not practice dissection and did not test the claims made using empirical research. Exact definitions are necessities for scientific research (and good scholarship in general) but we are not dealing with a technique which evolved through scientific research - it may have been simple bloodletting, and after the revolution in the 40s it went through a substantial political filter. This is not an excuse to impose a definition or even point out that one is lacking - unless you can find a source to substantiate it. Again, it is simply the reality of wikipedia and acupuncture research in general. WLU (t) (c) Wikipedia's rules: simple/ complex 02:53, 11 February 2011 (UTC)
I agree with Famousdog's edits' implied perspective that the article is very long and can use alot of paring down of dupicated content. So please get out your knives and cut away anything that is not evidenced by reliable sources, or just excess fat. PPdd ( talk) 16:04, 10 February 2011 (UTC)
"Blood is a red liquid circulating in the vessels, and is a vital nutrient substance in the body." - Cheng, 1987, p. 48.
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Our article says
”Kalichman and Vulfsons' 2010 clinical review confirmed that "ah shi" points are what are now referred to as "MtrP points”.
MtrP points are of questionable validity, based primarily on work by one person, and are on fringe in science, mainstream in alternative medicine. But that aside, maybe I am mistaken and missing something, but where do Kalichman and Vulfson say that their “review confirmed” that? PPdd ( talk) 04:12, 28 January 2011 (UTC)
It doesn't matter how many acupuncture points existed in the Chinese system - we're really only referring to the Chinese system at this point, let's not forget there are at least a half-dozen other methods - the point is they have never established a scientific basis for acupuncture points to be taken seriously that I'm aware of. It is verifiable that in at least on peer reviewed opinion, acupuncture's original points were based on a form of astrology and sympathetic magic. Though we should describe the fact that people believe acupuncture points exist, we should also describe the POV that they were historically not based on rational precepts, and that the empirical investigation of acupuncture has not resulted in any specific point being found to correspond to any specific effect. Middle 8, one of your points has long been that acupuncture can't be simply dismissed. Point taken. However, a point that must also be recognized is that after several decades of investigation, the evidence base of acupuncture has become quite narrow, supporting only two columns - nausea and pain. Just because lots of people believe in something, doesn't mean we report that in exclusion to what science has actually found. We should juxtapose the two points whenever possible - "people believe X about acupuncture, but when investigated the evidence base is Y". And generally, that evidence base is not very good. WLU (t) (c) Wikipedia's rules: simple/ complex 02:33, 4 February 2011 (UTC)
Note that I've removed some material from the lead. There are a couple problems with the edit in question.
Keep in mind this is coming from an editor that thinks acupuncture is utter shit - this edit was against my personal POV, that's how damned strongly I feel about it. A good article that will be defended by everyone interprets the P&G fairly for all sources and edits. I notice the article has been used elsewhere in the page, I plan on looking at it there as well and expect to re-remove it.
The other edits I have no problem with so far, they do remove a lot of unsourced information which is perfectly valid per WP:PROVEIT. Having fresh eyes on a page helps clean up stuff like this and usually leads to new, more reliable sources being added. WLU (t) (c) Wikipedia's rules: simple/ complex 17:17, 4 February 2011 (UTC)
I have a childhood based fear of doctors with needles. Does acupuncture ever hurt? PPdd ( talk) 03:26, 2 February 2011 (UTC)
(undent) I'm an acupuncturist with a previous career in pharmaceutical research. Information needs to be considered in context; some drugs that are considered safe enough to sell without a prescription are far more dangerous than acupuncture ( tylenol, for example). Even aspirin kills a few people each year; the total of 86 reported for acupuncture (over every year of recorded history!) is thus relatively quite low. Bicycles and soccer balls are far more of a menace. Compared to virtually all drugs and therapies, acupuncture is quite safe [1]; the references in the article all support that conclusion. How well acupuncturists are trained makes a huge difference: in the U.S., for example, they receive thorough education on safety (including all the issues mentioned above) and are required to use sterile, one-time-use, disposable needles in almost every state. Middle 8 ( talk) 15:58, 3 February 2011 (UTC)
As for pain, just google; acupuncture needles are much smaller than hypodermic needles, and generally don't "hurt" as much as cause a "twinge" initially which then fades into a pleasant, relaxing feeling. The large majority of the time, the places in the body that were needled don't even bleed when the needle is removed. Just tell your acupuncturist if a needle hurts too much, and she'll remove it and insert another in a slightly different position. No two people are exactly alike, and some may have small nerves near the skin that are too close for comfort to the textbook point location. -- Middle 8 ( talk) 15:58, 3 February 2011 (UTC)
"Two patients terminated study participation, complaining that acupuncture was too painful to continue." [2]
"acupuncture is a painful and unpleasant treatment" [3]
"Japanese acupuncture needles are much finer than their Chinese counterparts, and hence far less painful." Acupuncture Today, Southern Medical Journal, July 1988 - Volume 81 - Issue 7 - ppg 885-887, Yasuo Yshida
PPdd ( talk) 04:38, 4 February 2011 (UTC)"For the purpose of pain relief, the choice of non-acupuncture points as a sham treatment is also a problem because of the existence of diffuse noxious inhibitory control (DNIC) phenomena; it is well established that painful stimulation inhibits pain, and DNIC has been proposed as a physiological basis of acupuncture analgesia." [4]
(outdent) The best source for adverse effects in acupuncture (including pain from needle insertion) is this Ernst review, which puts the total number of adverse events at 11.4% and notes that they are mostly minor. PPdd, you could have found this by reading the article. -- Middle 8 ( talk) 08:01, 4 February 2011 (UTC)
Note that "painfulness of treatment" is different from "adverse effects" as commonly used. For example, getting an injection of morphine in one's buttox may be painful, but it is not listed as an "adverse effect" of morphine (which has plenty of adverse effects: addiction, constipation, etc.). The pain in treatment is likely responsible from the minute effects detected via the diffuse noxious inhibitory control (DNIC) phenomena, as speculated in the source above. PPdd ( talk) 14:51, 4 February 2011 (UTC)
I notice references to Cheng are being removed (i.e. [5]). This is debatable. Though only "Cheng, 1987" is given, this is still a valid, if imprecise source. When the reference number is clicked on, it takes you to the reference itself. This reference should be hyperlinked to take the reader to the "References" section, specifically the line with Cheng, 1987 on it (Cheng, X (1987). Chinese Acupuncture and Moxibustion (1st ed.). Foreign Languages Press. ISBN 7-119-00378-X.) If the google books link had a preview I'd link to this.
I don't know how reliable the book is for medical claims, but for basics of Chinese acupuncture (number of points, meridians, typical treatment, etc.) it is probably adequate.
Remember that while all information should be sourced, commonly-accepted knowledge or knowledge no-one objects to does not need a citation. We don't need a refernce after the sky being blue, the capital city of a country, the roundess of the Earth or that cancer is conventionally treated with chemotherapy and surgery. The big flaw in many sources is the lack of page numbers; that could be addressed by finding the page numbers in the original text. Probably easier would be finding the same information in another source - for instance, this one which has a preview option and allows for searching inside. Though further references are invariably a boon to the page, removing unsourced information is not always the best action to take. If the information is basic (acupuncture involves needles; acupuncture exists in China) then wikipedia and our readers are not helped by removing this sort of thing. I'm not saying replace all the information and references, but be judicious and ask if the information removed really needs a source, and if the page is better for even unsourced information being present. WLU (t) (c) Wikipedia's rules: simple/ complex 19:42, 4 February 2011 (UTC)
Here's the Cheng material I deleted -
"In the clinical practice of acupuncturists, patients frequently report one or more of certain kinds of sensation that are associated with this treatment:
- Extreme sensitivity to pain at the points in the webs of the thumbs.
- In bad headaches, a feeling of nausea that persists for roughly the same period as the stimulation being administered to the webs of the thumbs.
- Simultaneous relief of the headache. [2]"
I would have tried to check the ref, but it was 1987, and totally incosistent with a claim of nausea relief. I outlined this problem below, where "acupuncure" keeps shifting meaning, e.g., treatment for nausea may cause pain, and treatment for pain may cause nausea. But both treatments are called "acupuncture". So (assuming it actually has efficacy in both), does it cause or relieve nausea? The logical error causing the problem is called the fallacy of four terms.
I have a big problem with medical articles that claim efficacy without saying HOW effective. For example, if Rogaine was 100% effective at growing ONE hair, it would be called '100% effective", and people who buy it would still get about nothing. Similarly, even if there was endorphin release from needling, does the needling cause more pain than it relieves? All these are important questions which seem to be ignored. (They get deliberately obfuscated like this by pharmaceutical companies, too.) PPdd ( talk) 02:22, 5 February 2011 (UTC)
This article uses fallacy of four terms reasoning in that it is constantly shifting definitions of acupuncture to imply false things.
This article needs alot of work!
PPdd (
talk) 16:28, 5 February 2011 (UTC):Not a bad start on a todo list, though by neglecting to provide links you've left your meaning rather ambiguous. I've added a {{
todo}}
at the top of the page, I'd suggest moving these points there so they don't disappear into talkpage archives before they're addressed. After that, I'd suggest you add links to clarify the article sections you are referring to at each point.
LeadSongDog
come howl!
22:39, 4 February 2011 (UTC)
I added the list to the "to do" list at top, but comments on how to fix all of this should go in this section. PPdd ( talk) 16:28, 5 February 2011 (UTC)
The NIH, with appointments made by political considerations, has always blended milk toast political caution with science, as its director is a political appointment, not a nomination by peers.
One wonders what statistical methods they used to conclude “likely”, given that the areas referred to have not been tested. Shame, shame. PPdd ( talk) 23:58, 4 February 2011 (UTC)“Further research is likely to uncover additional areas where acupuncture interventions will be useful.”
The cochrane study cited says
"There was no clear difference in the effectiveness of P6 acupoint stimulation for adults and children; or for invasive and noninvasive acupoint stimulation."
So invasively sticking needles in someone had no extra effect. The lede says otherwise. "Noninvasive acupuncture" is oxymoronic. This is another case of moving the goalpost defining acupuncture. PPdd ( talk) 15:15, 5 February 2011 (UTC)
The "efficacy" findings are misleadingly stated in article. The article does not state "how much" pain relief, even if there was 100% pain relief. Using another example, if a remedy for baldness caused one hair to grow 100% of the time, it would have 100% efficacy, but be useless. Similarly, if sticking needles into someone always caused a very minute amount of the body's natural pain relievers to be released, it would have 100% efficacy, but be worthless. PPdd ( talk) 21:02, 5 February 2011 (UTC)
"One of the major challenges in acupuncture research is in the design of an appropriate placebo control group."
Am I the only one who finds this to be a silly statement? It would be EASY. 200 people with kidney problems (or some other problem over which acupuncture claims efficacy and is not obvious by simple observation.) The patients are seated in the room and the acupuncturist walks in and treats the patient. Half the time the acupuncturist is told to treat kidney problem and half the time he is told to treat something else (placebo.) They aren't allowed to speak so the acupuncturist does not know what ailment the person truly has and the patient does not know acupuncture so he doesn't know what is really being treated. This is a perfectly double blind experiment, is it not? Then the patients rate the efficacy of the treatment (or it is measured scientifically if possible). You compare the percentages of success of the real treatment and the placebo. Easy experiment design, right?
The truth is that these kind of experiments have been done, but acupuncture does not usually fare well - most of its claims do not hold up in scientific study while a fraction seem to. Like most pseudo sciences, rather than roll back their claims when confronted with science, they attack the scientific method or claim that it doesn't apply. For years, ESP people have claimed that they can't perform in labs because of electrical fields and psychics claim they can't be tested because of the negative energy of the testers. Similarly, acupuncture is trying to claim that it can't be tested because it can't fit into basic experiment design.
"In trials of new drugs, double blinding is the accepted standard, but since acupuncture is a procedure rather than a pill, it is difficult to design studies in which both the acupuncturist and patient are blinded as to the treatment being given."
Again, ridiculous - countless medical procedures are tested every year. This just sounds like a closed tautology speaking. —Preceding unsigned comment added by Ksjazzguitar ( talk • contribs) 18:25, 28 September 2010 (UTC)
Primary somatosensory cortex homunculus, anybody?
The upper lip of the lateral sulcus, an inch or so either side of the central sulcus, is called the Rolandic operculum. The swallowing section of the primary somatosensory cortex (S1) is located in the portion of the Rolandic operculum posterior to the central sulcus. S1 is green in the top left image here. As you follow that cortex into the lateral sulcus, it becomes part of the ceiling of the lateral sulcus, embodying the secondary somatosensory cortex (S2, green in the top right image). The (brown) wall at the end of the lateral sulcus is the insula. Sorry if that's too much information.
If the real acupuncture activated the Rolandic operculum, as the authors report, that is spooky. The Rolandic operculum on the outer surface is normally not involved in generic pain processing, so it's not an artifact of that. Actually, on further thought, the "swallowing" section of S1 is adjacent to S2, and S2 is active in both hemispheres in response to oddball somatosensory stimulation. [10] So the activity located in the Rolandic operculum in this study could simply be S2 registering the shift of attention to the sensation. All depends on the precise location of the activity, I guess. But if that's what is happening, it doesn't explain the lack of activity in the sham punctures, which would have been equally oddball. I give up. Anthony ( talk) 22:13, 28 September 2010 (UTC) Addendum. 05:50, 29 September 2010 (UTC)
apparently gets round that, although not all results have been as clear cut as this particular one. Wilfridselsey ( talk) 07:14, 29 September 2010 (UTC)
Undent. Care would have to be taken for avoiding POV forking, particularly given the fact that both the underlying basis for acupuncture and its clinical efficacy are both heavily contested. There shouldn't be one article saying "This is acupuncture and how it works" (which assumes it works) followed by "this is the conditions acupuncture works on, but note that the reason why it works is heavily contested". Though I'm sure most people would agree that the current page needs a re-write and general clean-up, segregation would have to be done very, very carefully (if at all) to avoid one page discussing the "mechanisms" of acupuncture (which is both false since there is no actual agreed-upon mechanism, and deceptive since it assumes that acupuncture "works") and another discussing clinical evidence and uses. It's probably better to clean up the current page than split it, there's a lot of minor, tangled discussions about different aspects. WLU (t) (c) Wikipedia's rules: simple/ complex 16:21, 29 September 2010 (UTC)
Sorry, but I'm not convinced.
"Designing a good placebo for acupuncture is actually quite difficult - altering the points needled addresses only one aspect of what 'acupuncture' incorporates, and you also have to distinguish between 'acupuncture', 'dry needling' and 'Traditional Chinese medicine' - each is a separate test."
Fine, then each can be tested. The fact that there is more than one system is not an argument against a double blind experiment.
"You have to control for nonspecific affects - the acupuncturist's own beliefs, which can leak through body language, duration of treatment, care, etc."
Yes, but (in my suggested experiment) if the patients have already been evaluated by other acupuncturists to determine the "correct" action, then the acupuncturist in the test does not have to do an evaluation. If the treatment is dependent on the beliefs of the practitioner, then it is not science, it is supernatural. If a doctor determines that a patient needs the shock paddles to restart the patients heart and asks another doctor to do it, it is irrelevant whether the second doctor believes in the procedure. This is how real treatments work.
The acupuncturists "body language" would be irrelevant in my example experiment; he would believe it is the right treatment.
"Many systems of acupuncture claim a need for a lengthy diagnosis based on the TCM approach, and practitioners will claim it's not 'real' acupuncture if you don't spend an hour taking pulses, interviewing, looking at the tongue, etc."
Fine, different systems can be tested differently. But this is sounding more and more like the arguments other pseudo-sciences make - when an experiment doesn't go their way, they blame the experiment or those being tested, saying that they weren't the real deal. I hear astrology proponents say the same thing all the time - when an experiment goes against them they ague that the test wasn't testing "real" astrology, ignoring that many do and it still fails. A couple centuries ago, phrenology proponents made the same claims. And the fact that in 5000 years they have failed to develop a unified approach is NOT an argument in their favor.
"But as far as this page goes, talk pages are not meant to be forums for discussion. We base the page on a neutral summary of what reliable sources say."
My point is that I think that it is NOT neutral. To me it reads like acupuncture apologetics. I am not trying to argue acupuncture, but the slant of this article. This article would give me the impression that there is very little evidence against acupuncture's efficacy, contrary to what I have seen in the literature. Contrast this article with the CSICOP position paper: http://www.csicop.org/uploads/files/Acupuncture_Paper.pdf.
For something as controversial and that has failed so often in experiments to produce clear results better than control groups, this article is painfully shy of contradictory arguments - it reads like something written by an acupuncture enthusiast who has put in a few token arguments against. I do agree that the article show show both sides, but it is hard to build a "con" when the "pro" makes its claims unfalsifiable by saying that science is incapable of testing it (claim it shares with other pseudo-sciences.) Really, the "con" portions of this article could be summed up as, "Well, there is 'some' (lets pretend its not 'a lot') but it doesn't count because acupuncture can't be effectively tested by science." Would that argument be accepted for any medical procedure? Would it be acceptable in any other wikipedia article?
While I do agree that there is some data suggesting that acupuncture has some mild effects in some isolated situations, that in no way justifies the claims made by acupuncturists and in no way supports the bias of this article. unsigned comment added by Ksjazzguitar ( talk • contribs) 00:39, 30 September 2010 (UTC)
I don't have the standing on this subject and I don't have the energy to get into an edit war so I will not be the one to change this. But this is in no way a neutral article - it is an advertisement for acupuncture masquerading as a wikipedia article. I hope that someone fixes it.—Preceding unsigned comment added by Ksjazzguitar ( talk • contribs) 00:39, 30 September 2010 (UTC)
(de-indent) As a rule, statements by expert bodies, including practice guidelines, are good MEDRS's and should be included. It doesn't take much space to include them. They help show the present-day sphere of usage and degree of acceptance. -- Middle 8 ( talk) 09:37, 22 January 2011 (UTC)
I suggest that the lede be organized as follows - First sentence definition, First pragraph:very general objective definition, Second paragraph: Description of beliefs, Third paragraph: Science and criticism; Fourth paragraph: Reception (e.g., affect on threatened and endangered species, world prevalence) PPdd ( talk) 02:46, 27 Januar 2011 (UTC)
I am wondering if you are all aware that the first section has a lot of typos and run on sentences and ideas. It also does not present a succint intro of the field. TCM and acupuncture are not separate, acupuncture is included in TCM (Traditional Chinese Medicine). It does not incorporate it, it is the other way around, acupuncture is a branch of TCM. Also, more than half is criticism, which should typically be in the criticism section, or not in intro. Am I wrong about this? Please excuse any lack of wikiquette, some of my comments should be more questions, than comments. Soll22 ( talk) 21:09, 7 February 2011 (UTC) Also, issues with the sentence "Acupuncture's effectiveness for other than psychological effects is denied by the science based medicine community." The sentence is innacurate. There is no consensus about the effectiveness of acupuncture in the "science based medicine community". Also, define science based medicine community. Psychological treatment is actually the most controversial facet of acupuncture in the "science based medicine community" that you mention, and it is far more commonly accepted for musculo-skeletal pain disorders. Mental health (psychological effects, as is stated in the second sentence, first paragraph) is generally considered outside the scope of practice of acupuncture in most states. Does this statement really belong as a intro to the Acupuncture entry? Soll22 ( talk) 21:19, 7 February 2011 (UTC)
At right is a motor cortex map of the body. TCM has a toungue map of the body. Does anyone know where a pic of such a map is? PPdd ( talk) 04:05, 27 January 2011 (UTC)
If you are in a city with a TCM college in it, you can use their library to get an image. Tongue Diagnosis by Giovanni Maciocia is a basic book. Tongue diagnosis is complex, and is NOT based on "chew marks". There is specific language to discuss tongue topography and it relates to a complex of issues in the organ systems in Chinese Medicine. Soll22 ( talk) 04:06, 7 February 2011 (UTC)soll22
Alright I will look into it. Just getting used to all the rules and regs of wikipedia. Soll22 ( talk) 21:04, 7 February 2011 (UTC)
I noticed that the lede has drifted away from using sources (a stylistic preference that is conducive to POV-drift) and toward the inclusion of unsupported assertions and OR. I did a pretty massive revert, per WP:BOLD, to the lede, restoring one iteration of a pretty longstanding, stable version from 22 October 2010.
Most of us probably know that one needs a REALLY good source to say it is that way as opposed to saying that X source says it's that way. PPdd, try to find a source of unimpeachable stature saying that scientists and historians are now certain that the location of acupuncture points was determined only metaphysically and had nothing to do with empirical observation.
Additionally, the dichotomy between "alt-med" and "EBM" is not one that is generally used (e.g. Ernst doesn't, nor does Institute of Medicine); "alternative" can denote sphere of usage. See sources in first part of alternative medicine. I also removed another unsourced sentence asserting that TCM's points are based solely on metaphysics and the like. This isn't Skptical.Inquirer.Pedia. Again, we need sources, and really good ones, to speak in the encyclopedic voice and say that "X is the case" rather than "according to source Y, X is the case".
Whoever stripped the sources out of the lede did a disservice to the article; I'm just going to revert to an earlier version that had them, because otherwise some editors tend to tweak prose to fit their assumptions without strict adherence to sources. What is the advantage of a lede section that omits sources, diverges from the article and reads like a generic skeptical criticism? The version to which I reverted at least has sources and fairly depicts the various issues in the article, rather than drifting into more and more variations on "it's metaphysical, not EBM". BTW, the definition in this version implicitly takes into account Hk's note about non-TCM needling being called acu. -- Middle 8 ( talk) 14:59, 27 January 2011 (UTC)
I still see primary research being used. Eliminate the whole section (all three sentences). The latest one doesn't even mention acupuncture (at least the abstract). Note that needling without meridians isn't acupuncture. Neither is electroacupuncture. We're not supposed to engage in our own OR or promote OR found elsewhere, and primary research is essentially OR. -- Brangifer ( talk) 04:09, 28 January 2011 (UTC)
Hi Hk - re your reply to the thread-starter above (beginning with the phrase " Middle 8, I undid your revert of the multi-editor created..."), here are a couple of points to consider (also relevant to some of the discussion above, e.g. regarding the merits of fertilizer):
(1) A minor point: The version to which I had reverted was just as much a "multi-editor"-authored lede as the present one, so I have no idea why you bring that up as if it were some sort of advantage.
(2) A major point: If you believe that the version to which I reverted is (quote) ""pro-"acupunture is not nonsense"" (unquote), and that that's bad, then you do not understand the topic or NPOV. There is no scientific consensus that acupuncture is nonsense, bullshit, horseshit, or whichever pejorative you think is the most hilariously trenchant. None. In fact, it's not even a majority opinion. What I just said is easily falsifiable by the citation of a source ( WP:BURDEN). Provide that source, please, or if you can't, please stop editing as if it were true. What we can say is that there exists *a* view along the lines that acupuncture is "nonsense", and a spectrum of opinion between that and something like the WHO report (cite in article here), or the NCCAM, or the AAMA, etc. There is no single majority view on acupuncture, let alone a consensus one. If I'm wrong, all it takes is an adequate source that is a sufficiently powerful RS to illustrate scientific majority and/or consensus view, along the lines of what we require for category:pseudoscience (summary of current consensus on WP, as I understand it, here: User:Middle_8/Pseudocat).
(3) Speaking of the WHO report, the text is better in the article (compared to the wordy version before), but the attribution still needs to be changed to the WHO, period, and not "Zhu-Fan Lee". 2/0 and Brangifer, it's good to have objective eyes here; you might have a look at this (a good summary, referencing this higher up on the page) in the archives, and see if you don't agree that the misattribution of the WHO report to one of its contributing authors wasn't classic wikisophistry (and perhaps, heaven forbid, a bad-faith attempt to reduce its weight). Ernst himself noted, in his criticism of the WHO report on homeopathy, that it indeed carries a great deal of weight; it should be treated accordingly, per WP:TRUTH. Ernst quoted [23]: “Any report WHO puts out will have an impact”, says Ernst, who says in debates supporters of acupuncture will counter his evidence by simply citing the claims backed in the WHO report. “Who am I against the WHO?”, he asks. “What better name could you think of but WHO?” Ernst is not speaking ironically or asking a rhetorical question. He is stating, correctly, that the WHO carries a great deal of weight, and that it's a damn shame that such a weight-y source wrote a report that he believes, with no small amount of justification, to be biased (as attributable views on controversial subjects frequently are). I imagine we can handle the weight issue more gracefully than by falsifying the source's attribution, don't you? We can have a robust, informative article about acupuncture that doesn't have, as a unifying and primary subtext, "acupuncture is nonsense". We also should, per NPOV, VER and OR. regards, Middle 8 ( talk) 06:24, 2 February 2011 (UTC)
WLU's newly installed lede pic is quite beautiful. The drawing "balances" the hollow empty space at left with a solid figure at right, just like in acupuncture theory, and even looks like a picture of yin and yang. Note that although the belly button is misplaced, the true center of gravity is over the subjects supporting left ankle (to the viewers right), just as in Michaelangelo's drawings. PPdd ( talk) 18:21, 4 February 2011 (UTC)
Please help find RS for
"Risk of terminating pregnancy with the use of certain acupuncture points that have been shown to stimulate the production of adrenocorticotropic hormone ( ACTH) and oxytocin, and with unsterilized needles and lack of infection control: transmission of infectious diseases. (such as hepatitis B, hepatitis C, HIV I remember seeing confirmed cases of hepatitis B ... needs a ref, though)"
, which I removed from the article as NRS. PPdd ( talk) 22:11, 7 February 2011 (UTC)
the article is still POV but this time it is overly skeptical. three quarters of what is written should be moved to the criticism section. it is fine to be critical and skeptical of acupuncture but the article should be written in the same neutral format as other controversial subjects. — Preceding unsigned comment added by Metabradley ( talk • contribs) 21:42, 5 February 2011 (UTC)
the sources used are obviously not versed in chinese history or medicine and make broad, inaccurate claims. historically there are only two major rivers with any relevance in china (yellow river and yang river) not twelve. qi is not a "mystical" substance but a philosophical one, which arguable still has no place in medicine. the point locations are very much derived from human anatomy and take into account such things as muscle bodies, tendons and ligaments, bones, fossa (bone and soft tissue), foramen, nerve bundles and plexus. not using western terminology, of course. the name of many of the points reference the anatomical location. when the point system was brought to the west the points lost their anatomical names and were replaced with numbers. also, from the list of acupunture points wiki page ( http://en.wikipedia.org/wiki/List_of_acupuncture_points): "Medical texts describe the location and indications of more than 400 acupuncture points." not the 365 astronomically derived points listed on this page. i am sure that there are wonderful articles that critique acupuncture; the ones used should not be listed among them. also when in the editing mode it is highlighted that the page is already too long so the burden should not be on people to add more material which balances out the POV but rather the POV should be removed in order to make the article neutral and shorter. plenty of pages have a criticism section, i read a lot of wikipedia articles and this is one of the few that includes the criticism in the introduction of the article. as well this article already has the criticism section so it would seem reasonable to put the criticism there. — Preceding unsigned comment added by Metabradley ( talk • contribs) 19:27, 6 February 2011 (UTC)
if you removed <365>, which was the exact number stated to be derived from astrological means, why didn't you remove the rest of the statement? i will look at the RS. mb. —Preceding unsigned comment added by 204.187.140.30 ( talk) 21:46, 6 February 2011 (UTC)
It has no real significance in clinical practice. NO ONE refers to this in the clinical practice of acupuncture. This article seems to be written with a few exceptions by people only tangentially familiar with acupuncture in it's clinical form. — Preceding unsigned comment added by Soll22 ( talk • contribs) 01:18, 7 February 2011 (UTC)
Also, the lede contains a lot of criticism of acupuncture which there are several sides. I feel that while this is definitely one side, there are several other sides that should be represented, not in the lede. This should be a separate criticism section. As it reads now, the lede is THE criticism section, not a NPOV lede. Clearly the editors expressed their point of view in the talk page - acupuncture is pseudo-science, I hate acupuncture etc, obviously, not NPOV, and this is what comes through in the lede. There is no consensus in the medicine community, and this should be the NPOV of the CRITICISM section. I think the whole content of the lede, besides the typos and lack of logic of the statements, needs to be discussed. In the meantime, I disagree that it should be left as is. Soll22 ( talk) 12:47, 9 February 2011 (UTC)
Two sentences were removed as NRS (and POV)
Many other countries do not license acupuncturists or require them to be trained. Most European countries with the exception of Spain, Portugal, Holland and Poland, require a medical license prior to acupuncture licensing, thus placing acupuncture under the domain of the medical profession.
Please help out by finding RS so these edits can go back in. PPdd ( talk) 22:07, 7 February 2011 (UTC)
The following section was removed from the lead. WP:LEAD requires us to either provide sources for all information in the lead, or none depending on the page. Having a wall of text with no sources following several paragraphs full of sources is inappropriate. If this is a "draft" section, I would suggest composing that draft on a user subpage rather than on a main page. WLU (t) (c) Wikipedia's rules: simple/ complex 12:04, 8 February 2011 (UTC)
There are various definitions of “acupuncture”, "effectiveness", and "need for further research", causing confusion about claims of acupunture proponents and confusing debates. First, in most cases “acupuncture” refers only to insertion of needles in traditionally determined acupuncture points. In this case, it is contrasted with randomly inserting needles, which is called a “sham treatment” or “ placebo for acupuncture”, which is referred to as “needling”. Second, in some cases the very opposite is the case - “acupuncture” refers to this random needling, and this random needling is compared to pressing needles against the skin at the same points but not puncturing the skin, which is called "the placebo for acupuncture". So in the first case "needling with penetration" is called "the placebo for acupuncture", and in the second case "needling is with penetration" is the same as "acupuncture", but "nonpenetrating needles" is "the placebo for acupuncture". Third, sometimes, but less often, “acupuncture” refers to “ acupressure”, which is applying pressure to traditional acupuncture points. Another reversal of definitions is that sometimes "stimulation" by pressing acupuncture points without penetration is called "acupuncture", not "placebo", and is compared to some other placebo treatment or "control". Another ambiguous usage is that some claim that acupuncture is "effective", and mean that it is effective for all of its claims, such as prevention of disease. Others might mean by a claim of "effectiveness" that it treats psychological states such as pain or nausea, but not necessarily other conditions. Some may mean by a claim of "effectiveness" for pain relief that the relief is dramatic or significantly large enough to justify study. Others may mean that it is only barely detectable but still measurable. Different definitions of “acupuncture” are combined with different definitions of "effectiveness" and this causes still more confusion about its claims. There is also ambiguous usage of "need for further research". Some may mean by this that spending money on additional research is a good expenditure of highly limited medical research funds, while others mean by it that, if conclusions are to be drawn, more research funds would have to be spent, even if they might not think doing so is a good place to spend limited research funds.
Please forgive my writing into the text with grievances. I found this page after, and was troubled by the loss of 1 hour's work. Anyway, the information in the lede is very problematic. I found my information to be both more accurate to acupuncture theory and better sourced (journal of pocket guide for instance). Though in that case I am willing to accept the poor quality of the source (NIH) but not willing to accept the quality of a pocket dictionary.
My discussion of point theory was far more accurate than the ridiculous river based statements, and my discussion of organs was intended to show the underlying anatomical basis for some of acupucnture theory. If you are going to say there is no evidence and then you are going to erase the evidence then we are looking not at a group of consensus finding and intelligent editors.
Here is my edit of the lede, please let me know what the problems with it are — Preceding unsigned comment added by Luke643 ( talk • contribs) 18:26, 8 February 2011 (UTC)
"Acupuncture is an alternative medicine that treats patients by insertion and manipulation of needles in the body. In the 2004 NIH Consensus Paper on Acupuncture, it was determined that therapies that had undergone the most successful clinical trials were for postoperative and chemotherapy care, particularly for nausea and vomiting, postoperative dental care, low-back pain, headache, and tempero-mandibular disorder. Promising results in a handful of other therapies were discussed, with recommendation of further clinical trials..[1] Acupuncture typically incorporates traditional Chinese medicine (TCM) as an integral part of its practice and theory. The term “acupuncture” is sometimes used to refer to insertion of needles at points other than traditional ones, or to applying an electric current to needles in acupuncture points.[2][3]
Acupunture dates back to prehistoric times, with written records from the second century BCE.[4] Different variations of acupuncture are practiced and taught throughout the world.
The theory of pathology in Chinese medical practice(CM) differs from the modern trending of Western medical practice(WM). Rather than focusing on infectious agents (known in CM by various names, simply grouped under the term 'climatic factors'), disease pathology is believed to advance due to an imbalance of the correlative metaphor system based on early Chinese correlative Cosmology, including concepts such as yin and yang, the wu xing, (known as the Five Phases) and psycho-physical imbalance caused by "blockage" or "stagnation" of qi, a word variously translated as 'energy', 'breath', 'vital energy'[5]. These “systematic correspondences”[6] explain much of the phenomena of the persistence of health and illness in the human body. The system is not dissimilar to the Milieu intérieur theory of Claude Bernard.
Point location is based on sets of primary and secondary jingluo 經絡, or 'warp threads', 'winding channels', commonly called 'meridians' in the west. The channels each correspond and putatively interact with correlated internal Zangfu, often translated as 'Organs'. 10 of the 12 correlated organs correspond exactly with western anatomical organs, the Heart, Lungs, Kidneys, Pericardium (considered to have functionality equal to the major organs), Liver, Gall Bladder, Stomach, Large Intestine, Small Intestine, and Bladder. The final two, the 'spleen' and 'triple burner' refer to the spleen/pancreas and three vertical fibrous myo-fascial areas of the chest and abdomen (Upper, Middle and Lower), respectively.
The pioneering work of Dr. Helene Langevin, at the University of Vermont has given us clues as to how to explain Acupuncture points in bio-medical terms. She found that needles are 'grasped' differently at Acupuncture points then at non-acupuncture points. Based on her research, Langevin proposed a bio-medical mechanism based on "connective tissue planes" that explains the theoretical/metaphorical constructs of points, meridians, blockages, needle grasp, and sensation of 'qi', concepts that underpin the whole of acupuncture practice.[7]"
I am happy to put this info lower down into the body of the text.
the comments below are relavent. I fail to see how "correlative cosmology" is not plain english when "chinese astrology" is. But whatever. the important thing is that the practice of acupuncture is NOT based on astrology in terms of sourcing for points and channels. I will approach this in my revisions to the page. Luke643 ( talk) 05:16, 9 February 2011 (UTC)Luke643
Soll22 ( talk) 02:55, 9 February 2011 (UTC)
Explain "apparently has not provided a scientific basis and revolution for the existence of acupuncture points or meridians". Soll22 ( talk) 02:55, 9 February 2011 (UTC)
Why is a primary source not acceptable?? I agree that the term "pioneering" was a bit strong. But it seems ridiculous to me that a peer reviewed article would be unnacceptable when a pocket medical dictionary is being used to determine what "practitioner's claim"
Famousdog - it is precisely that which occurred in her study. CT bound differently at acupuncture points then at non-points. But as I said, I am cool with not using it. Luke643 ( talk) 17:05, 9 February 2011 (UTC)luke643
Ok, I am reposting what I worked on yesterday. Again, the Lede should not include criticism of acupuncture theory, methods, or beliefs, as that information all must come in lower sections. The lede should state concisely what the practice is only. does this make sense to everybody? Luke643 ( talk) 17:05, 9 February 2011 (UTC)Luke643
thanks for that, I have fixed the lede to include the summary of criticism. Luke643 ( talk) 17:29, 9 February 2011 (UTC)luke643
Additionally, I should clarify why the rivers/astrology statements are false. First, the lingshu (the Warring States text that the Matuk quotes) does not suggest that the points and channels come from rivers or the days of the year, and certainly do not suggest that they come from astrological incantations or rituals. Peter Deadman's analysis of the mawangdui text on acupuncture and physiology suggests that the formation of points was quite the opposite: unsystematic and based on points of tenderness in massage and exercise. Parralellisms are very common in classical chinese texts, and this one is no different. That there are 12 channels that correspond to 12 rivers in China (they certainly knew there were more than 12!) and points to the days of the year was a rhetorical device used to verify the 'natural' and cosmological significance of the points. But there is simply no suggestion in the literature that the pionts and channels originate in the rivers and stars. If my Columbia MA in Pre-modern Chinese History is not enough to convince the wiki world of the veracity of my reading of the lingshu, then I throw my hands in the air. Luke643 ( talk) 17:23, 9 February 2011 (UTC)Luke643
deleted following sentence: "Acupuncture's effectiveness for other than psychological effects is denied by the science based medicine community.Ernst_2006-02" The citation does not in any way prove that the science based community as a whole makes such a statement. Citation is also about a discussion which selects certain studies and not others, and draws certain conclusions. Mr. E. Ernst opinions can by no means be considered the unanimous opinion of the entire science based medicine community. "Science based medicine community" must be defined. It is a vague general term without a specific meaning. Numbers, members? If one person in the science based medicine community dissagrees, your statement is false. If you qualify your statement by "some" in the science based community, you are introducing a topic that belongs in the controversy or criticism section and misplacing it in the intro section. — Preceding unsigned comment added by Soll22 ( talk • contribs) 02:08, 9 February 2011 (UTC) oh i forgot to sign Soll22 ( talk) 02:15, 9 February 2011 (UTC)
The way the article is worded, it makes acupuncture sound like it significantly relieves nausea. As an uninsured purchaser of antiemetics in the hospital, I recall thinking that the antiemetics sold by pill-pushing pharmaceutical companies were about as useful as buying Rogaine to grow hair. A more objective and NPOV article edit on this would be, "Systematic reviews have found acupuncture to be as useless for treating nausea as antiemetics sold by pill pushing pharmaceutical companies." The existing POV article wording on this makes me sick to my stomach. (This is actually a serious request for a suggestion for rewording.) PPdd ( talk) 15:08, 9 February 2011 (UTC)
Why can't the principles of TCM be researched like anything else in "allopathic" medicine? If an intervention is effective, that effect should survive blinding, randomization, large numbers of patients, statistical analysis and placebo controls. If it's not, we should see drops in "effectiveness" with every application of a test designed to remove a particular bias. Research is indifferent to paradigm, if something works, it works, and it should work irrespective of who is doing it and where it is being done. To think otherwise seems like special pleading. How do you know patients aren't simply getting better due to the passage of time and natural healing? Why do you attribute that healing to acupuncture? This is specifically problematic for back pain, which has essentially no evidence-based treatment beyond "avoid bed rest". Comparing acupuncture to "regular care" isn't setting the bar very high since "regular care" isn't particularly effective. That's like carrying a rabbit's foot because it's just as effective as reading your horoscope. You are correct in noting that something can work without us understanding the mechanism - but that's a reason to research the mechanism. But first we should check to make sure it actually works rather than assuming it does. You don't have to know how an SSRI works in order to demonstrate that it helps with major depression. Again, research and empirical evidence properly gathered are indifferent to the beliefs of the researcher.
Was the ice research based on TCM principles? Are all TCM principles equally supported? Why does conventional research "work" for that finding, but not for others - like acupuncture? Again, this looks like special pleading - research is great as long as it confirms something we already believed - otherwise let's ignore it. Has this work been replicated in humans, who aren't mice (the subjects of this particular study)? And since TCM is primarily a 'physical' treatment - aimed at disease and disability rather than mental illness, isn't your invocation of psychiatry an inappropriate comparison? Why is TCM less risky? Particularly given things like contamination [29], [30], adulteration, [31], as well as delays in treating serious conditions. TCM may, or may not cure you, but if something carries risks but doesn't work, why use it? If it carries risks but it is uncertain whether it works, why prescribe it before confirming it works? If something carries no risks, why believe that it works - all effectively demonstrated interventions have predictable dose-response curves that at the extreme top-right end in toxicity. An intervention that has no adverse effects at any dose suggest it has no effect period.
PPdd, TorT does indeed address many of these points. I got my copy from the library. It's time well spent. WLU (t) (c) Wikipedia's rules: simple/ complex 03:20, 10 February 2011 (UTC)
Famousedog wrote, "the plethora of acupuncture systems means that pretty much any point on the body has some 'significance'." Famousdog's "point" ("ambiguous points?") is a good one, and if anyone has RS on this, it certainly belongs in the article, since it will bring MOS consistency to the various sources cited, and make the article readable. PPdd ( talk) 14:40, 10 February 2011 (UTC)
Just wanted to say that although I may not agree with all the content in the EBM section, I do think that it's much better written than the lede or the recently proposed lede. IMO any subject can be discussed if it's well written, and I do see a real effort in the EBM section, at any rate more than I can put into it these next few days. Soll22 ( talk) 21:12, 9 February 2011 (UTC)
PPdd, when you find out this information please write it in the book that you are clearly compiling. There is simply not the space in the article to detail or debunk acupuncture on this level. Famousdog ( talk) 14:05, 10 February 2011 (UTC)
Also keep in mind that there may not be a definition that is universally accepted or agreed-upon. Again, we are dealing with a prescientific concept from a culture that did not practice dissection and did not test the claims made using empirical research. Exact definitions are necessities for scientific research (and good scholarship in general) but we are not dealing with a technique which evolved through scientific research - it may have been simple bloodletting, and after the revolution in the 40s it went through a substantial political filter. This is not an excuse to impose a definition or even point out that one is lacking - unless you can find a source to substantiate it. Again, it is simply the reality of wikipedia and acupuncture research in general. WLU (t) (c) Wikipedia's rules: simple/ complex 02:53, 11 February 2011 (UTC)
I agree with Famousdog's edits' implied perspective that the article is very long and can use alot of paring down of dupicated content. So please get out your knives and cut away anything that is not evidenced by reliable sources, or just excess fat. PPdd ( talk) 16:04, 10 February 2011 (UTC)
"Blood is a red liquid circulating in the vessels, and is a vital nutrient substance in the body." - Cheng, 1987, p. 48.