Archive for the ‘Acupuncture’ Category
The following gem was included in an Australian Broadcasting Corporation report on the recent identification by University of Minnesota researchers of specific spinothalamic tract neurons implicated in the sensation of itching and shut down by the act of scratching. The researchers, whose study is published as a Brief Communication in the April issue of Nature Neuroscience, express hope that now that this pathway has been discovered, it may eventually pave the way for treatments, pharmaceutical or involving electrical stimulation, that replicate the phenomenon and render scratching obsolete. For folks with certain conditions associated with chronic itching, which can be debilitating for some, this would be a welcome advance.
“Professor Marcello Costa, a neuroscientist at Adelaide’s Flinders University, says a pain treatment like acupuncture could be developed for itching.
“The acupuncture is not damaging, it’s a little bit invasive but it works very well because it activates much better than just rubbing,” Professor Costa said.
“So we all discovered rubbing by ourselves, just like we discovered scratching; we have a scientific rubbing which is called acupuncture but we don’t have a scientific scratching. So I expect this paper will generate interest in developing such a scientific scratcher.””
In the article, it is implied that Costa was one of the scientists or doctors in Australia excited by the team’s findings, and he appears to have no connection with the research. In reading the full text of the paper, I can find no mention of acupuncture so it would seem that Costa came completely out of left field with this comment, which makes not a lick of sense. How does one develop a new acupuncture treatment? Does a new acupuncture point, where there exists yet another mysterious blockage of “energy” as it courses along its equally enigmatic meridian, need to be discovered? One that impacts this specific spinothalamic tract pathway?
Clearly Costa already knows that acupuncture “works very well” for itching because it “activates much better than rubbing”. But activates what? Regardless, I’m sure we will soon be reading about a landmark study proving that acupuncture cures itching. It will involve a small number of unblinded subjects with no control group naturally but that won’t matter to the people that already know it works.
Making the rounds last week was another example of the poor quality medical and science reporting that has come to saturate the mainstream media. The article in question, on the benefits of acupuncture for animals, is fairly typical. The situation appears to be rapidly worsening as more dedicated science reporters are being replaced with generalists, although as a skeptic I must recognize that a certain degree of selection bias may be coming into play. I do tend to go out and look for this sort of fluff pseudojournalism. But as I continue to read report after credulous and poorly researched report on topics like vaccine safety, alternative medicine, and even ghost or UFO sightings my expectations continue to steadily decline. If not for blogs like Science-Based Medicine and Neurologica, I feel I would have very few places to turn. I do like to tell myself, in an attempt to feel just a little better about the current state of affairs, that the blame falls primarily on inexperienced journalists, but even seasoned reporters with significant exposure to scientific topics are dropping the ball, as was the case in E.J. Mundell’s March 3rd HealthDay News report.
According to his bio, Mundell, the Senior Assigning Editor for HealthDay News, has 10 years of experience writing (among other things*) on health related topics for a variety of outlets such as Reuters Health and The Scientist. At one point he was even the managing editor for the consumer health news division for Reuters. Yet despite this experience, he penned a sloppy piece of pseudojournalism entitled Animals Respond to Acupuncture’s Healing Touch.
In the article, it is clear that Mundell did not seek out the scientific or skeptical viewpoint on acupuncture or its use in animals. But instead of the more common error made by journalists who, because of some seemingly pathologic need to provide a sense of balance, write as if there were two legitimate sides to a scientifically one-sided issue, Mundell has written what reads more like a press release from The International Veterinary Acupuncture Society. A vet who teaches one of their certifying courses is quoted in the piece along with a pro-acupuncture private vet and a “skeptical” pet owner who is amazed by her animal companion’s miraculous turnaround. There isn’t even the typical misquoted straw man one-liner from a skeptic included so that a believer might easily shoot it down. The two vets in the piece are allowed to spread blatant misinformation unchallenged. Why would Mundell write such thoroughly false information as if it were gospel truth and pass along such worthless anecdotes and testimonials?
There is so much wrong with this story that it is difficult to know where to begin. I think I’ll start, as so many reports on alternative medicine miracles do, with the standard anecdote about how a suprising therapy changed a patients life. In the article, Mundell cleverly describes the medical problems of a patient named Nelly in a way that is meant to fool readers into thinking she is human. Status post spine surgery, weak, lethargic and with poor appetite, Nelly’s friend takes her to a specialist for a seemingly last resort attempt at recovery. After just a few sessions, Nelly the dog is restored to her vibrant former self, all thanks to acupuncture. That’s right, animal acupuncture.
“Almost immediately after the first treatment, Nelly’s energy went from zero to 100,” recalled that friend, Annie Washburn, who works as a community organizer in New York City. Nelly became more mobile, ate more and resumed regular bowel movements. “She bounced back in a way that seemed miraculous,” Washburn said.
This anecdotal experience is unreliable and unable to effectively establish that Nelly truly experienced any improvement secondary to the acupuncture. In the many months that have passed since those initial treatments, Washburn’s memory could easily have been altered over time by multiple retellings of the anecdote. Also, humans tend to exaggerate positive outcomes over time. In reality, the actual events could have been very different than what we are being told without Washburn actually lying. All memories, even those that have evolved over time or were implanted by another person, feel real to us. And the more dramatic a so-called flashbulb memory is to us, the less likely it is going to be accurate weeks, months, and years down the road. This is why we are such poor medical historians and a big part of why properly designed studies are necessary to answer questions regarding efficacy of treatments.
What is more plausible is that the dog improved slowly over time and would have recovered eventually regardless of what therapy was being provided. Many proponents of inert therapies make a fuss over animals as patients because of their supposed inability to be effected by placebo. This notion is entirely false, however, as the placebo effect does have an impact on animals as well as on the owner’s perception of their pet’s recovery. The primary error is in thinking of the placebo as a single entity, that being some kind of mind-over-matter effect stemming from the expectation of the patient. If that were the case, then I would agree that animals are not susceptible to placebo. But that is a straw man manifestation of it. Instead of simply being mind-over-matter, the placebo effect consists of a number of different components, some of which are pure artifact, which can lead to the appearance of a true improvement. Among these components are the tendency for symptoms to regress to the mean, which is probably the largest component of any placebo effect, investment justification, a novel therapy or more complicated therapy effect, or the desire to please an authority figure to name just a few. None of these have anything to do with an actual physiologic effect from the intervention and they only require the pet owner’s biased and subjective personal experience.
It is easy to imagine how a dog lover might interpret their pet’s behavior differently secondary to a placebo effect. It usually takes Rosco a whole week to get over his flare ups but with acupuncture it only takes 7 days. In addition to pet owners and the potential for biased evaluations, it is equally easy to see how an animal might act differently because of how their owner interacts with them. Rosco might actually act more energetic and appear to be feeling better simply because his owner is paying more attention to him in anticipation of a postive therapeutic result. Perhaps other changes, like an improved diet or a new and more interesting location, may lead to positive changes in behavior that do not stem from any new therapy. It is foolish to think that the placebo effect can’t be applied to animals, particularly our doting animal friends.
The article is overflowing with misinformation and contains the expected pseudohistorical mention of how acupuncture is an “ancient healing technique.” Perhaps I employ too narrow a definition of the word, but I would not consider a therapy that has in reality only been practiced for at most a few hundred years as ancient. It is a commonly accepted myth that acupuncture as we know it has existed for thousands of years. I’ve even read one source which claimed that acupuncture dated back to the dawn of man. I have to wonder where our primitive primate ancestors would have acquired not only the steel used to fashion such thin needles but also the paper upon which to bill insurance companies for their use. According to Mundell,
“Experts point out that animals have been treated with acupuncture therapy from the very beginning. In fact, Chinese records that go back thousands of years describe the use of healing needles on horses and other livestock.”
This is simply false. Needle like instruments considerably larger than what are used today were used to drain pockets of infection in animals but there is no historical record from that time period of the placing of thin needles in special areas of the body in order to remove obstructions to a mystical healing energy force. This concept, as mentioned above, is probably only a few hundred years old and did not even become popular in China until the 1960’s when it was forced on the public by their government. And it has become steadily less popular as scientific medicine has come to play a larger role in Chinese society.
Mundell further reveals his ignorance of the subject, or perhaps his purposeful covering up of the rather silly underlying mechanism claimed by acupuncture believers, in the following explanation.
“The points, referred to as loci, represent important locations for nerves and blood vessels that, when manipulated, somehow aid healing, experts say.”
Acupuncture, as it is promoted by the near totality of practitioners and patients, involves the shoving of thin needles into specific points on the body in order to relieve the obstruction of a vital, yet undetectable by any modern scientific techniques, energy force. There is no legitimate evidence, anatomic or otherwise, that these loci have any special relationship to nerves or blood vessels. They are, in fact, completely arbitrary. There isn’t even agreement over the number or location of these loci, or over which should be focused on. Some proponents claim that only the ear requires needling while others only care about the bottom of the feet.
One of the experts in the article reveals that “veterinary acupuncture has proven effective in healing or easing the symptoms of arthritis, acute injuries, hip dysplasia, respiratory disorders, immune system ailments and a host of other problems” This is also entirely false. There have been, over the years, a number of small and poorly designed studies, typically unblinded and uncontrolled, that have shown a weakly positive effect. But, as is the case with inert therapies, as larger and better designed studies are performed, particularly studies that are appropriately blinded and have a placebo control group, it becomes increasingly evident that there is no effect. This is certainly the case with acupuncture.
Animal acupuncture is only one very small step above pet psychics on the list of the most absurd jobs in the pseudosciences or the paranormal.
* E. J. Mundell was the production secretary for 1990’s Prom Night III: The Last Kiss