Re: Alternative Medicine (was Re: Skepticism - its uses and abuses)

On 12/22/05, jack syme <drsyme@cablespeed.com> wrote:
>
> If patients were given acupuncture according to the meridian theory by a
> capable practitioner, and another group of patients was given sham
> acupuncture (same types of needles, same number of sticks, but in different
> places) by the same practitioners, but the patients didnt know which
> treatment they got, and, the people that were evaluating the responses didnt
> know which treatment the patients got (the evaluators do not have to be the
> same as those that are doing the procedure), wouldnt this qualify as double
> blind placebo controlled?
>

I'm not sure it would qualify as placebo controlled. The problem is that
the practitioner giving the sham treatment would know that it was a sham and
thus might unwittingly give psychological cues to the patients. My
understanding of double blind procedures is that e.g. in drugs, the doctor
prescribing the drug must not know which patient gets the placebo and which
gets the drug.

My friend who claims to be "electrosensitive" cites an oft-quoted case of
the Norwegian Prime Minister who claims she is affected by mobile phones,
even when they are not in use - (when they don't emit radio waves except
about once an hour to give a homing signal). The basis of the Norwegian
Prime Minister's claim is that she'd had friends come into the room with a
mobile phone concealed in their bag, either switched on or off. She says
she can tell when the phone is switched on. My objection to this procedure
is that the person carrying the bag in knows the state of the phone, and
will unwittingly give the game away. This effect was noted in the 19th
Century with the horse called "Clever Hans" who could do arithmetic. You'd
ask it a question and it would stamp its feet the correct number of times to
give the right answer. It was found that it didn't have to be the horse's
trainer who asked the question - it would work with anyone, provided the
horse could see the "questioner", and the "questioner" knew the answer.
Otherwise the horse couldn't get the right answer. The explanation was that
the horse picked up on the tension, or facial expression of the
"questioner", when it had stamped its feet the right number of times.

Hence, with these effects so well established, I think it would not work to
give a sham acupuncture if the practitioner knew it was a sham.

 Iain

----- Original Message -----
> *From:* Iain Strachan <igd.strachan@gmail.com>
> *To:* jack syme <drsyme@cablespeed.com>
> *Cc:* Michael Roberts <michael.andrea.r@ukonline.co.uk> ; chmorl@wm.edu ; D.
> F. Siemens, Jr. <dfsiemensjr@juno.com> ; asa@calvin.edu
> *Sent:* Thursday, December 22, 2005 8:57 AM
> *Subject:* Re: Alternative Medicine (was Re: Skepticism - its uses and
> abuses)
>
> Jack,
>
> This does raise some interesting points. After reading Michael's post, I
> checked out acupuncture on Skepdic.com http://skepdic.com/acupunc.html
> and found that they argued that it was most likely to be a placebo effect.
> The whole problem with any medical treatment is that the claim "it works for
> me" (it worked for Michael) is not scientific - acupuncturists claim it
> works by unblocking chi energy (or whatever), a concept that has no
> scientific backing. The fact it works for you is just as easily explained
> by the placebo effect as it is by saying it's directly the acupuncture (cf
> my earlier experiences with the Buteyko method for asthma, which I now put
> down to placebo).
>
> However, it's been around for thousands of years, and Jack's point that
> maybe we don't know why it works is a good one. It _might_ be placebo, but
> it could be due to an as yet to be discovered phenomenon. I think David's
> point is also valid, that traditional remedies are likely to be superior to
> wacky modern techniques. Although these remedies may work for unknown
> reasons, I guess the principal of natural selection applies here. Ancient
> people may have tried all sorts of random weird ideas to cure people (like
> waving chicken entrails over someone), and there is a chance that some
> random things tried will work, and those are the ones that are still with us
> today.
>
> I think that maybe "skeptics" perhaps overlook this possibility - they
> tend to write off everything that doesn't have tested scientific evidence
> (double-blined trials etc), when in fact it _could_ be that something that
> has stood the test of time works for an unknown reason.
>
> It struck me that there could be a blinded trial that might demonstrate if
> acupuncture is down to placebo, however. As I understand it, acupuncture
> has to be done (according to tradition) by putting in the needles at
> "meridian" points, something that has little scientific backing. So suppose
> you had a trial where the "placebo" was to insert needles into places that
> weren't meridian points, and the other half used the known meridian points.
> Then if those on the placebo fared just as well as the others, it would
> conclusively disprove the meridian theory. The difficulty of doing this
> would be to make it "double-blinded"; the person sticking in the needles
> would have to be unaware of whether it was a meridian point or not. You
> would have to train up volunteers from scratch to administer acupuncture on
> a number of points, some of which were meridians, and some of which weren't
> & then assign randomly who used which points. I would have thought it could
> be done though in a carefully controlled way.
>
> Iain
>
> On 12/22/05, jack syme <drsyme@cablespeed.com> wrote:
> >
> >
> >
> > > On chinese medicine I am convinced by acupuncture. I have a bad
> > neck - I
> > > can hear grinding when
> > > I turn my head! It's been stretched massaged but acupuncture helped. I
> > > only tried it as nothing worked. However there are good reasons why it
> >
> > > works.
> > >
> >
> > This is exactly the issue I struggle with. Yes acupuncture can
> > work. But
> > why does it work? What are the good reasons why it works? As far as I
> > know
> > there is no anatomical correlate for meridians, and no physiological
> > correlate for qi.
> >
> > My professional opinion of acupuncture is that it works by some
> > mechanism
> > that is not at all well understood. And most likely has nothing to do
> > with
> > qi and meridians. There might be a real effect on neuropeptides, some
> > unkown effect on nervous system function, or it might all be placebo
> > effect.
> > But, the risk of being needled is very small. So if someone can find
> > relief
> > from a chronic ailment such as headaches, neck and back pain, without
> > side
> > effects then just because its mechanism is not well understood is no
> > reason
> > not to recommend it.
> >
> > But, is the fact that the underlying philosophy of acupuncture Taoist a
> > reason not to recommend it to Christians? And should I as a Christian
> > physician not recommend it for those reasons? Similar questions can be
> > raised about kundalini yoga, vedic medicine, meditation techniques,
> > etc. I
> > have up to this point taken the approach that the underlying worldview
> > that
> > acupuncture is based on is so far removed from the practice of it, that
> > there is little reason to believe that undergoing acupuncture was
> > sinful.
> > And it is likely that the traditional explanation of how acupuncture
> > works,
> > is in fact false.
> >
> >
>
>
> --
> -----------
> After the game, the King and the pawn go back in the same box.
>
> - Italian Proverb
> -----------
>
>

--
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After the game, the King and the pawn go back in the same box.
- Italian Proverb
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