Like it? Share it!

Sign up for news and updates!






Enter word seen below
Visually impaired? Click here to have an audio challenge played.  You will then need to enter the code that is spelled out.
Change image

CAPTCHA image
Please leave this field empty

Login Form



We Should Be Insulted PDF Print E-mail
Swift
Written by James Randi   

The "complimentary and alternative medicine" business brings in some $34 billion a year in direct out-of-pocket spending from American consumers.  The budget of the US National Institutes of Health - a major Federal agency - is not available to the average person, it seems.  Looking in on the Internet for a simple dollar figure produces no results that I can find.  A direct search for a "$" sign reports no hits...

My attention has been brought to this strange situation since I recently came into possession of a 62-page full-color booklet produced and distributed by the National Cancer Institute, part of the National Institutes of Health. This comprehensive publication - in its "Words To Know" glossary, begins with a definition of what is possibly the only form of quackery that outranks homeopathy for idiocy: acupuncture. It reads:

Acupuncture (AK-yoo-PUNK-cher): The technique of inserting thin needles through the skin at specific points on the body to control nausea, vomiting, and other symptoms.

Other literature issued by the NCI runs on and on about how ancient this idea is, that it is used in China, and how it's administered. Does it work? Well, the agency doesn't quite say. Their entry under "Nausea and Vomiting" in connection with chemotherapy refers to pharmaceuticals which are known to work, and ends with:

Acupuncture may also help... You may also ask your doctor or nurse about acupuncture, which can relieve nausea and vomiting caused by cancer treatment.

Note the "may" and "can" provisional language.  That's not what I want from the US National Institutes of Health. I want the best, latest, dependable, professional findings, not vapid guesses and "feel good" statements. From the "Quackwatch" site of Dr. Stephen Barrett, M.D., at www.quackwatch.com/01QuackeryRelatedTopics/acu.html I give you this - typical - finding from expert medical observers who have looked into this subject scientifically:

A study published in 2001 illustrates the absurdity of TCM practices. A 40-year-old woman with chronic back pain who visited seven acupuncturists during a two-week period was diagnosed with "Qi stagnation" by six of them, "blood stagnation" by five, "kidney Qi deficiency" by two, "yin deficiency" by one, and "liver Qi deficiency" by one. The proposed treatments varied even more. Among the six who recorded their recommendations, the practitioners planned to use between 7 and 26 needles inserted into 4 to 16 specific "acupuncture points" in the back, leg, hand, and foot. Of 28 acupuncture points selected, only 4 (14%) were prescribed by two or more acupuncturists. The study appears to have been designed to make the results as consistent as possible. All of the acupuncturists had been trained at a school of traditional Chinese medicine (TCM). Six other volunteers were excluded because they "used highly atypical practices," and three were excluded because they had been in practice for less than three years. Whereas science-based methods are thoroughly studied to ensure that they are reliable, this appears to be the first published study that examines the consistency of TCM diagnosis or treatment. I would expect larger studies to show that TCM diagnoses are meaningless and have little or nothing to do with the patient's health status. The study's authors state that the diagnostic findings showed "considerable consistency" because nearly all of the practitioners found Qi or blood stagnation. However, the most likely explanation is that these are diagnosed in nearly everyone. It would be fascinating to see what would happen if a healthy person were to be examined by multiple acupuncturists.

Acupuncture is only a notion, a colorful way of looking at the human condition, a mystical and primitive concept of how the human body works and survives. It has no basis in fact or in observation. It is a dangerous myth. For the US National Institutes of Health to support it - though in an uncertain, luke-warm fashion - is farcical. The JREF has consistently offered its million-dollar prize to any and all acupuncturists, but in the more than 667 recorded applications we've received, and tests we've done - as seen at this Excel file - none are from acupuncturists.  Note: this does not prove that the notion doesn't work, but from the tens of thousands of practitioners, common sense would suggest that at least one would step forward...

Offering mythology and false hope to the American public is not a proper function of the US National Institutes of Health.  I object strongly to official pandering to ignorance and encouraging it.

Trackback(0)
Comments (26)Add Comment
Well said...
written by Michael K Gray, August 01, 2009
We need to create a groundswell of reason against these theatrical placebos.
Especially when our taxes are paying either to subsidize them, or investigate them AGAIN and AGAIN.

Your $1m Challenge is quite the most effective stick that I am able to employ with which to demand that these promoters of patent piffle 'put up or shut up'.
I am personally very glad that the JREF has decided to continue it.
report abuse
vote down
vote up
Votes: +22
...
written by MadScientist, August 01, 2009
I think it's outright criminal to give people the impression that acupuncture and such nonsense may work (rather than may have short-lived positive psychological effects). I think it ranks with religions promoting the nonsense that intercessory prayer works - the nonsense is deadly and people do suffer a lot for it.
report abuse
vote down
vote up
Votes: +7
Nitpick...
written by Marcus Hill, August 01, 2009
Is one of the "Words to Know" not "complEmentary"? Or is this the kind of "medicine" that actually admits that all it does is say nice things to make us feel better?
report abuse
vote down
vote up
Votes: +0
Excel file proves psychic powers!
written by Dave8675309, August 01, 2009
I checked out that Excel file... lots of interesting stuff in there... some of those claims sure are amazing - making wine age with the power of thought?, talking to animalssmilies/wink.gif, can predict roulette wheel ball fall (why's he after this paltry million?), etc.

But the most amazing fact I learned was that someone at the JREF can predict the future... somehow they know that some guy will claim cold reading abilities in about thirteen years! Maybe whoever wrote that entry should apply for the million.
report abuse
vote down
vote up
Votes: +1
...
written by Skeptigirl, August 01, 2009
The bottom line is rational thinkers just don't have a loud enough voice to counter the idiocy. Many of the political leaders in this country are following popular demand rather than making science based decisions. We need to make science based medicine speak louder.
report abuse
vote down
vote up
Votes: +12
...
written by Firionel, August 02, 2009
I think in all fairness two points should be noted: Acupuncture may not perform better than a placebo acupuncture, but in some people that can still be a rather marked effect, especially if one is trying to relieve pain, anxiety or sickness. And for somebody who is in serious pain or suffering (maybe because he is undergoing cancer treatment) or who is suffering chronically from 'unspecific symptoms' (which may well be caused by something akin to placebo effect) any relieve is welcome. We shouldn't be too picky about where it comes from. Of course acupuncture is not exactly an effective treatment, but on the other hand it seems to have been carefully designed over many years to maximize the psychological impact on those who believe in it. For patients in really desperate situations they can still be of help.
report abuse
vote down
vote up
Votes: -7
acupuncture and public health
written by pakeha, August 02, 2009
Thanks for pointing out the strange silence of USgovernmental statistics on the subject of acupuncture.
Why hasn't this practise been thoroughly investigated by the FDA?
Out of respect for ethno/cultural heritages and religious beliefs?
I'm admittedly still in shock from the case of the parents who refused to take their dying daughter to hospital, choosing rather to have prayer sessions over the child, alleging they didn't know she was 'so badly off'.
And then defending their decision in court.
As did the homeopaths responsible for their daughter's death in Australia just recently.

Surely it can be considered a governmental responsibility to have the general population informed about quackery or at least have the information available to the general public.
Wasn't that the original purpose of the AMA and the DFA in their beginnings?
report abuse
vote down
vote up
Votes: +9
...
written by Rustylizard, August 02, 2009
As tourists in Guilin, China, my wife and I were surprised when our guide took us to a local clinic. We did not know it was part of the tour.

A Chinese Dr. greeted us in a waiting room, where shelves full of folk cures such as rattlesnake wine, animal parts, and herbs were on display - comforting. The good Dr. entered the room holding a light bulb in his hand. He muttered something, and the light bulb lit up without the benefit of wires or an apparent source of current. It was the type of gimmick you can find in US magic shops – the bulb contains a small internal battery, and you close the circuit with any ring worn on your finger. Our guide was clearly impressed.

Then, we were offered an acupuncture session – why I do not know, since neither of us had complained of any malady - preventative medicine, I suppose. We politely declined, not wanting to promote this quackery and not wanting to subject ourselves to the risk of contaminated needles.

The magic trick was a clear deception. If the Dr. believed in acupuncture, I can not say. But most Chinese certainly do, and the greater the number of believers, of course, the more it must be true. It probably amplifies the power of the placebo effect – understandable in China, where many cannot obtain good treatment. Perhaps the same “crowd mentality” is taking over in this country – the 34 billion spent on alternative medicine seems to attest to that. When goofy convictions convince some folks to refuse proven treatments, it truly is a sad state of affairs. Let's hope alternatives don't gain enough clout to worm their way into national health care.
report abuse
vote down
vote up
Votes: +1
...
written by Google-fu Master, August 02, 2009
The budget of the US National Institutes of Health - a major Federal agency - is not available to the average person, it seems. Looking in on the Internet for a simple dollar figure produces no results that I can find. A direct search for a "$" sign reports no hits...

http://www.google.com/search?q=NIH+budget gives http://www.nih.gov/about/budget.htm which says
"The NIH invests over $30.5* billion annually in medical research for the American people."

Rather sad that's less than what's spent on complimentary and alternative medicine.
report abuse
vote down
vote up
Votes: +3
...
written by Google-fu Master, August 02, 2009
It seems the NIH is also spending some 443 million on research in complementary and alternative medicine itself (http://report.nih.gov/rcdc/categories/) But it's not as bad as that sounds, considering what they count among CAM. For example a lot of studies about the effect of nutritional compounds. There are still a few projects involving acupuncture though. (http://report.nih.gov/rcdc/cat...e Medicine)
report abuse
vote down
vote up
Votes: +3
historical acceptance?
written by Diverted Chrome, August 02, 2009
Chiropractic battled its way into mainstream acceptance through political lobbying and millions of dollars in PR campaigns (rather than through scientific proof). The older posters will remember when it wasn't very accepted. I haven't googled this, but, did acupuncture follow this? Is it going through it right now?
report abuse
vote down
vote up
Votes: +0
...
written by Walk, August 02, 2009
My mother-in-law got quite upset with me when I questioned the effectiveness of having acupuncture done on her DOG, when I mentioned that there's no scientific evidence for it's efficacy. She said, "Well, she had trouble walking, but right after her treatments she has much less trouble."

When I asked if the "treatment" included anything else, she said, "Oh, ya, he gives her some shots." When I asked if she had ever tried having the vet perform JUST the acupuncture without the shots, to see if that worked, she angrily changed the subject. The real shame is that on a fixed income, she could ill-afford the extra cost.
report abuse
vote down
vote up
Votes: +8
practical issues
written by melusine, August 02, 2009
This article raises the question: what to do in your doctor's everyday life?
I agree about the points above
1- Homeopathy and acupuncture are no better than any other placebo
2- The funding such ideas is not a priority and should not be encouraged by public fundings
3- Governement agencies should properly inform people

However, I am often facing patients using some kind of placebo. It can be almost anything from homeopathy, acupuncture to special homemade recipies… And they benefit from it. When a patient is better with his placebo, why should I change this? Does it benefit him? What should I replace it with?

Of course, we can try to the best of our abilities to inform them on what is actually working and how (even though the understanding of the placebo effect remains limited). But then what happens?
In the ideal case, they listen, say yes and don't need any placebo anymore… but that's a dream.
In the worst case they are offended and you get a "you mean it's all in my head?" or "you are saying I'm crazy?" or worse "you think I fake it? You think I'm not in pain?". Or any version or mix of these answers… sadly that's not a nightmare and happens quickly and easily.

But in most cases, you end up with nothing. The patient talks, you explain, he talks again, forgets what you said and you've achieved nothing.

So yes, most patients use placebo in their everyday life. And yes it works for them (no more and no less than expected of course). And for now, we keep using them to treat patients. Because not everyone can understand the placebo effect and accept it, even in the face of evidence. Because patients don't reason their illness, they feel it. There is no denying of the pain whatever its source.
report abuse
vote down
vote up
Votes: +6
...
written by kraut, August 02, 2009
To piss some off - just some personal anecdotal medical history.

I had severe backpain after heavy lifting when 24 for years. I was laid up at regularly once a year for 11 years till one year, after a sneeze while in bed with severe backpain my sciatic nerve got squeezed and as a consequence I was not able to get out of bed anymore.
Painkillers helped me to get to a doctor at the local med. clinic.
I told him that pills given by a differnt Dr. did not work, ao he asked me if I would try accupuncture.
I did, and after the first session 50% of the pain was gone - I could at least go to the toilet on my own again, and sit at the table for minutes at a time.
After the second session I went back to work, after the third session backpain did not reoccur for 12 years.
Then I damaged it again, again through job related heavy lifting.
This time accupuncture only helped on a day to day basis, so I gave the treatment up.
What cured the problem were three sessions on the stretch table.
No backpain and very careful for three years walking.
report abuse
vote down
vote up
Votes: +2
...
written by Skeptigirl, August 02, 2009
written by pakeha, August 02, 2009
Thanks for pointing out the strange silence of USgovernmental statistics on the subject of acupuncture.
Why hasn't this practise been thoroughly investigated by the FDA?
Out of respect for ethno/cultural heritages and religious beliefs?

It's more than just a little cultural PC. Many of our elected officials are themselves believers in bad medicine. Senator Tom Harkin of Iowa, for example, boasts on his web page that he helped establish the branch of the NIH for alternative medicine. They recently reported that after 2.5 billion dollars spent researching alternative medicine, they have only found one success, ginger for nausea has mild success. Harkin is oblivious to the fact his efforts have only proved how ineffective alternative medicine really is.

And the NIH committee on alternative medicine is just as oblivious. Their response to the total failure to find anything useful other than ginger for nausea after expending that much money? It supposedly only shows more studies are needed.
report abuse
vote down
vote up
Votes: +8
...
written by Skeptigirl, August 02, 2009
written by kraut, August 02, 2009
To piss some off - just some personal anecdotal medical history.

There's nothing wrong with anecdotal evidence. The problem is only when we draw unsupported conclusions from this evidence.

If a treatment such as acupuncture works, it will be detected in a well designed study. Despite anecdotal reports by the thousands, when you actually look for an effect, it is not there. The ONLY conclusion one can draw from this (because thousands of studies have been done so we can draw a valid conclusion) is that people who think acupuncture resulted in their improvement are wrong. They got better and they would have even without the acupuncture.
report abuse
vote down
vote up
Votes: +5
Here's my anecdote, take it for what it is worth.
written by Skeptigirl, August 02, 2009
I had some significant TMJ (jaw) pain that went on for months. One dentist recommended a $400 nighttime bite guard. Another recommended round the clock anti-inflammatories.I took the anti-inflammatories for a month and was still not getting better.

My GP set me up for a referral at a TMJ clinic at the U of WA Dental School. The appointment was 3 weeks off. I kept taking the anti-inflammatories.

Finally, about a week before the appointment, the pain started getting better. I kept the appointment but I shouldn't have. They made it worse stretching my jaw open to measure my range of motion. So it got worse, but because it had finally started improving, I kept taking the anti-inflammatories and canceled the follow-up appointment.

After a couple more weeks I've finally gotten better and while it flares up a tad and I am taking less but I'm still taking some anti-inflammatories, I feel the problem is resolved. I have something akin to an arthritic jaw joint. I can live with it. Surgical outcomes are not promising. The bite guard doesn't really make sense to me, I'm not worse in the morning. I don't wake up grinding my teeth.

The point of this story is, sometimes things take several months to heal. Had I gotten the bite guard I may have falsely attributed my recovery to it. Just because pain lasts a long time and finally goes away is not evidence the last thing you tried is the thing that fixed it. If that thing we think worked actually did, then research would not contradict that conclusion.
report abuse
vote down
vote up
Votes: +8
...
written by Skeptigirl, August 02, 2009
written by melusine, August 02, 2009
This article raises the question: what to do in your doctor's everyday life?
I agree about the points above...
However, I am often facing patients using some kind of placebo. It can be almost anything from homeopathy, acupuncture to special homemade recipies… And they benefit from it. When a patient is better with his placebo, why should I change this? Does it benefit him? What should I replace it with?

I consider the circumstances in my practice. One needn't fight against alternative medicine every minute of the day.

When I teach classes to employees, I include in the introduction an explanation that science based medicine is successful and science is a process of testing what we know rather than a set of facts. I point out the billion dollar false advertising schemes and I educate employees to note if the outcome measured in the study is really meaningful or not. For example, killing germs doesn't measure infections prevented. Most germs by far are not pathogens.

If I am discussing false beliefs with a friend, I will get into discussions about why anecdotes are not good evidence. You cannot just tell them they are wrong. You have to bring up things that demonstrate your point without addressing their specific false conclusion. For example, I point out that if there was the effect they believe occurred, it would show up when double blind studies were done. But it doesn't. I discuss how experience is powerful evidence. That acknowledges their belief, but I go on to say how common it is for us to infer causal relationships when only associations are evidenced.

If I'm talking to a patient, I won't encourage the use of bad medicine just because the patient believes it makes them feel better. But I may just not comment at all if I think it might interfere with their trust of me or if they are getting some good from a placebo.

I will however, point out the evidence against some alternative medicine if the opportunity arises. For example, I will definitely tell patients there is evidence now that products like Airborne and Echinacea do not work. That area of patient education is not interfering with any placebo effect. It is instead interfering with the waste of resources which could be better spent.

I see no reason one size fits all here addressing the serious problem society has with bad medicine.
report abuse
vote down
vote up
Votes: +8
...
written by Skeptigirl, August 02, 2009
written by Google-fu Master, August 02, 2009
It seems the NIH is also spending some 443 million on research in complementary and alternative medicine itself (http://report.nih.gov/rcdc/categories/) But it's not as bad as that sounds, considering what they count among CAM....
The main problem with using research funds this way is we are letting popular demand rather than evidence drive the direction of the research. Think of how much we might know about the real causes of autism had evidence driven the research direction instead of the manufactured controversy that began with falsified data.
report abuse
vote down
vote up
Votes: +2
...
written by Skeptigirl, August 02, 2009
written by Rustylizard, August 02, 2009
Let's hope alternatives don't gain enough clout to worm their way into national health care.
I'm afraid you are too late on that one. We need to get it out of the plans rather than simply not letting it in.

My state is one of the worse offenders. They passes several laws already mandating insurers cover alt med. They banned Thimerosal in any vaccine for pregnant women or kids 3 and under which resulted in a flu vaccine shortage for those groups as enough preservative free vaccine was not available.
report abuse
vote down
vote up
Votes: +1
errata
written by Skeptigirl, August 02, 2009
They passed several laws...
report abuse
vote down
vote up
Votes: +0
FDA and acupuncture
written by Todd W., August 03, 2009
@pakeha

Why hasn't this practise been thoroughly investigated by the FDA?


The practice of acupuncture does not fall within the FDA's jurisdiction. The needles used do fall under the purview of FDA, though, as Class II devices. Unfortunately, acupuncture needles have been around since before 1976 (when the medical device amendment was passed), and so marketers just need to show substantial equivalence to those predicate devices (i.e., not significantly different in safety or efficacy from the pre-1976 needles). They don't need to go the more lengthy PMA route (actually doing clinical trials and such to show they actually do stuff).

According to regulations (21 CFR 880.5580), an acupuncture needle is defined as: "a device intended to pierce the skin in the practice of acupuncture. The device consists of a solid, stainless steel needle. The device may have a handle attached to the needle to facilitate the delivery of acupuncture treatment."

FDA is suppose to review all pre-1976 medical devices at some point to determine which devices need to be re-evaluated (i.e., force all manufacturers to perform clinical trials for S&E), but given their budget situation, I don't see them making a concerted effort to review acupuncture needles anytime soon. There are other pre-1976 devices on which they would probably focus their efforts and resources, as they could pose a greater risk to patients.
report abuse
vote down
vote up
Votes: +0
What acupuncture is
written by garyg, August 03, 2009
A few things should be noted in this discussion:

1) There's Chinese acupuncture and there's Indian acupuncture (ayurvedic medicine). As in their respective
astrologies, the body maps differ
2) Traditional Chinese acupuncture also includes moxibustion (burning herbs), yet this is usually omitted in the West.
3) Some studies have shown that sticking pins in a patient randomnly produce the same results as "real" acupuncture.
Thus there may be something here, call it counterirritation or whatever.

Pinch yourself somewhere until it hurts. Now pinch yourself somewhere else. The first site doesn't hurt, does it?
report abuse
vote down
vote up
Votes: +1
shamcupuncture
written by Todd W., August 03, 2009
@garyg

3) Some studies have shown that sticking pins in a patient randomnly produce the same results as "real" acupuncture.
Thus there may be something here, call it counterirritation or whatever.


Yep, and there were also studies that showed the same effect as "real" acupuncture using, IIRC, toothpicks that did not pierce the skin.
report abuse
vote down
vote up
Votes: +0
placebos okay?
written by jer, August 03, 2009
I have to say I take strong issue with the idea of placebos being useful. I know several people who, being involved with CAM, make regular use of placebo treatments. Though these "treatments" may at times make some symptoms feel better, they also train the patients to self diagnose based on feelings/suggestion until the've let their imaginations run away with them and - down to nearly every single person - become the biggest hypochondriacs you've ever seen. They get into a cycle of either imagining every little thing is wrong with them or imagining the placebo helped them - feeding complete dependency on their favorite quack and his "cures." If you're feeling a little achy, a little tired, or a little lonely - or maybe just don't quite want to go to work today - what could be better than getting attention from a personable "healer" who feeds into your fantasy that something is uniquely wrong with you and tells you he has the cure. It rewards people for dreaming up illnesses by giving them attention.

What people really need is to develop the maturity to deal with the daily ups and downs, cope with things they don't need treatment for, and become educated on how to approach things they do need medicine for. Failing to do that can consume your life with nonsense.
report abuse
vote down
vote up
Votes: +1
...
written by Skeptigirl, August 03, 2009
written by garyg, August 03, 2009
1) There's Chinese acupuncture and there's Indian acupuncture (ayurvedic medicine). As in their respective
astrologies, the body maps differ
2) Traditional Chinese acupuncture also includes moxibustion (burning herbs), yet this is usually omitted in the West.
3) Some studies have shown that sticking pins in a patient randomnly produce the same results as "real" acupuncture.
Thus there may be something here, call it counterirritation or whatever.
Unless you add a no treatment arm to your study and conduct the research properly, you cannot say whether sticking needles randomly in your body does a darn thing, even a placebo effect.

In addition, besides the fact placebo effect may occur with acupuncture, there is so much bad research in the pool we really have no idea what if anything acupuncture can accomplish. Unfortunately there is a cultural aspect in China which results in face saving when research fails to produce positive results. We have a similar problem here in the West that results indicating failed hypotheses are not published as often as those studies with positive results. But it is even worse in China. (See the book, "Snake Oil Science" for supporting citations.

Pinch yourself somewhere until it hurts. Now pinch yourself somewhere else. The first site doesn't hurt, does it?
Since acupuncture needles don't generally hurt, this is a meaningless analogy. In addition, pinching ceases to hurt as soon as you stop pinching.
report abuse
vote down
vote up
Votes: +0

Write comment
This content has been locked. You can no longer post any comment.
You must be logged in to post a comment. Please register if you do not have an account yet.

busy