You are currently browsing comments. If you would like to return to the full story, you can read the full entry here: “Chinese Medicine Demystified (Part I): A Case of Mistaken Identity”.
- Chinese Medicine Demystified (Part II): Origins of the “Energy Meridian” Myth The idea that Chinese medicine is a psychic, metaphysical medicine is based on gross mistranslations...
- Chinese Medicine Demystified (Part III): The “Energy Meridian” Model Debunked Historical evidence and modern research indicate that the Chinese medicine has nothing to do with...
- Chinese Medicine Demystified (Part IV): How Acupuncture Works Modern research demonstrates that acupuncture can relieve pain, reduce inflammation and restore homeostasis. In this...
- Chinese Medicine Demystified (Part VI): 5 ways acupuncture can help you where drugs and surgery can’t Five reasons acupuncture beats western medicine as a primary healthcare modality....
- Chinese Medicine Demystified (Part V): A Closer Look At How Acupuncture Relieves Pain Research continues to shed light on how acupuncture relieves chronic pain and inflammation without significant...
Tags: chinese, demystified, doctor, history, medicine, meridian, qi, western
Interesting! I look forward to reading what you have to say on this topic, as all I’ve heard is the Western version, which is easily dismissed.
Though to address your final question, people are easily fooled by placebos and such when they lack the objectivity of the scientific method to help determine what works. Consider how what you call the Western version of Chinese medicine persists. So it might be possible for the real version to persist too.
I look forward to that series!
That’s a good point about people being skeptical of acupuncture. I would hypothesize that if acupuncture were solely placebo, then most of the people who went in with skepticism would not continue very long, and that most of those that did continue treatment would have started out expecting it to work. It would be interesting to see a survey address that question.
You said, “I’ll end by suggesting the possibility that the placebo effect is not something to be derided and avoided. It’s something to be respected and cultivated.”
Depending on what you mean, I agree. It’s a good idea to encourage healing by making the treatment environment and experience as positive and hopeful as possible. On the other hand, if you’re suggesting dishonesty, telling patients that a treatment works when you know it doesn’t except in their heads, I don’t think that would turn out well in the end. I’m sure you agree.
Also, it’s sometimes possible to distinguish between perceived improvement and actual improvement, objectively measured. For example, if a person’s arm is injured and he receives treatment, it is possible to test the efficacy of the treatment in two ways: by asking him if he is getting better, and by testing the function of the arm, say with strength tests or something, to see if it is improving. A perception of improvement is valuable, of course, but if the person perceives he is getting better but isn’t actually getting better, the treatment may not be truly effective. When possible, it seems like a good idea to distinguish between the two possibilities. I’m just talking generally here, about what should be done when evaluating treatments.
Like I said, I am eager to read your future posts.
Oh, thank you for writing this. I am looking forward to your next part of the piece.
“Let me ask you this. Do you think Chinese medicine would have survived for more than 3,000 years and spread to every corner of the globe if it wasn’t a powerful, complete system of medicine?”
Er, yes, actually, I do. I guess the biggest example of an idea which has survived despited there being zero evidence in its favour is religion. Seems pretty popular still, doesn’t it?
I’ll certainly return to see what you have to say, but it’s fair to put me on the sceptical side of the fence at the moment!
that’s interesting.. that was really a great post.. it seem really nice to read that.. that’s great…
It is indeed a big mistake to think that only “energy” flows through the meridians. Chinese books say Qi and Blood flow through them, and my understanding of Qi and Blood indicate form and function.
Now how were these meridians mapped? I’ve performed acupuncture on patients (obviously, since I am an acupuncturist and MD) and they will testify that they can feel a propagation of “qi sensation” (proven by studies by Pomeranz et al to be stimulation of a-delta fibers) along the pathways of the meridians. Hence, it is erroneous to assume that meridians are anatomic structures – they’re physiologic.
I forgot to add that it is my belief, which I’m sure you’ll concur with, that the cultural use of language is important here. I tend to tell my residents that I believe that Chinese medicine will be easier to understand if we look at it from a “what were the ancients trying to say when they chose to use a particular word or term?” instead of using our own understanding of a word or term in our attempt to comprehend their ideas. I am quite sure that you know what I mean and will definitely expound on that more. I can’t wait to see if your ideas on “fire”, “cold”, “wind”, etc concur with mine. Looking forward to your next posts.
The world is a complicated place. There is more than one version of Chinese medicine, and beyond duration, for validation, try head-count: 1.3 billion Chinese thrive in conditions that might challenge the average American. The good doctor (M.D.) Ted Kapchuck wrote a delightful tome: The Web that Has No Weaver, in which he introduces west to east. It turns out that the Chinese have no descriptive principle that corresponds to the endocrine system, an entire specialty here in the west, and the west has nothing close to the triple warmer, that explanatory principle that discusses how the digestive fires are cooking (middle burner) or the sexual fires (lower burner)burn or blow out.
There are various forms of proof. Geometry has proofs. Science can confirm an hypothesis and generate a Theory… which is not a proof. But have your life saved, (so you feel, determine, experience) by some modality, be it western or eastern, and that is proof enough for most human beings.
My opinion is that the school, spreadsheet, cookie cutter method of teaching acupuncture here is not very good. Apprenticeship is so much better. I believe that many folks in the US of a may experienced poor examples of the art.
I imported acupuncture needles to the US from China during the previous millennium and I had to do so under an “experimental” license, for this 3 – 8,000 year old modality, Chinese Medicine. The medical guild does not appreciate friendly competition. Good luck in De-mystifing this subject. I have studied it with interest, in English, for twenty-five years and I am still mystified.
Old Chinese Proverb: A doing is worth a thousand showings, a showing is worth a thousand tellings.
Good acupuncture is a blessing.
Poor acupuncture is…. the hokey pokey.
The best acupuncturist uses no needles. Best medicine is least medicine.
@Friend of Matt:
Agreed, The best acupuncturist uses no needles. I think I have a brief explanation to the seeming lack of an “endocrine” system in Chinese medicine. What is the endocrine system but the relationship between organs, between different parts of the body, as signified by hormones? In that sense, the entirety of Chinese medicine, with it’s emphasis on harmonization of the different aspects of anatomy and physiology, can be seen as a correspondence to the endocrine system, can it not? Also, isn’t Ted Kapchuk an oriental medicine doctor? I know he teaches at Harvard medical school.
1. Anecdotes are the only evidence that acupuncture has been curing “common conditions” for thousands of years. If that’s all you need then fair enough
2. the Chinese were way behind western doctors in dissecting human bodies (that’s why they invented 12 meridians based on China’s 12 great rivers as a proxy explanation)
3. comparing the lifespan of Chinese emperors to western hoi polloi is hardly fair now is it?
PS I much preferred your article on the myth of chemical imbalances.
@ gordie w
1) it’s not just anecdotes. Even in the old days, people didn’t just treat one patient then wrote down the results – they’d make sure what they wrote was relatively consistent before having the guts to put their reputation on the line via a book. One anecdote isn’t good enough for me. Several thousand patients’ worth of clinical experience is
2) Not that far behind, based on the descriptions of the anatomical organs (average size and weight, general shape) described in the Huangdi Neijing. Also, Chinese didn’t just “invent” 12 meridians. The earliest texts actually combined the Heart and Pericardium, making a total of 11 source points.
Chris, I’ve blogged several times on how Big Pharma manipulates data so that the results of such randomized clinical trials can be made to say what Big Pharma wants. About the placebo thing, a colleague of mine who is a chiropractor and acupuncturist once taught me how to respond to accusations that what I do (acupuncture and other TCM modalities) is just placebo. He told me to reply, “My placebo works better than your placebo.”
Mmmmm … before we dismiss qi flow etc. Science – medicine, physics, mechanics – flourished in China for many centuries from around the 3rd or 4th century BCE. Just look in Needham’s Science & Civilisation in China, or indeed – more briefly – any book on inventions. We find that Chinese inventions often predate their discovery/adoption in the West by up to 1500 years.
It is not unreasonable, both scientifically and philosophically, to accept that the microcosm of the human body might reflect the macrocosm of the universe … that there are parallels between the structure, energies and laws governing both. So how does the universe work? Basically – as far as I can tell – no-one knows. I watched a TV programme the other day which proposes the existence of ‘dark flow’, dark matter of course, and multiple universes (incidentally early Daoism in the 5th century BCE posited a universe that came into existence through no divine intervention from a pre-existing condition of nothingness – damn right as far as we know!). In the light of this its’s not – in my opinion – wise to dismiss either the ideas of early Chinese science (qi flow), nor the seemingly fuzzy science that is so easily dismissed by hard-edged know-it-alls.
OK can I add this and check the ‘Notify me’ box ….
*fanboy reaction* PETER DEADMAN. *kowtows* You’re one of my heroes! I refer to your Manual of Acupuncture all the time! I don’t think Chris is trying to debunk qi flow but rather look at it from a western point of view. I basically agree with what Chris says except for the idea that the meridians as we know it were a result of De Morant’s childhood connect-the-dots.
@Chris, of course acupuncture works better than placebo. Otherwise it would not work on animals or young children. While it is obvious that acupuncture has better effects on people with a positive outlook, it also works on those who come in skeptics and just want to “see what it can do.” It’s like Lourdes (I’m catholic) – people come in skeptics and leave as believers.
Philip: ah the old “animals and children” fallacy.
*speaking er, writing as a former member of my high school debating team* and how exactly is it a fallacy, sir? (just so that I don’t use that logic again in the future)…
Hm, that Moffet paper is interesting. There were many things I hadn’t heard of before. Do lasers, capsicum bandaids, and electro-stimulation really count as acupuncture?
The paper also concluded: “In short, acupuncture can affect outcomes but might not depend on specific points, locations, or techniques.” Weren’t you saying that the traditional acupuncture points were supposed to work because they had the largest concentrations of nerves or something?
That’s a good point about drugs though. I hadn’t considered that I could investigate the efficacy of drugs I might be prescribed.
@jesse and Chris
Yes, I believe that different traditions also depend on the practitioner. I know someone who just loves scalp acupuncture for some reason. I prefer five transporting points and combining Yuan Source and Luo Connecting Points as needed. Our choice of “style” reflects practitioner preference.
It’s true that lack of evidence for one method over another doesn’t mean there isn’t a better method.
Are you aware of this more recent paper by Moffet? It concludes, from my reading of the abstract, that acupuncture points that were specifically selected as either the wrong points or not points at all (as opposed to just points selected with a different method) give as much effect as true acupuncture points. What do you think?
philip: because the placebo effect encompasses more than just “feeling a bit better because the doctor was nice to us”. It also includes regression to the mean (i.e. getting better naturally) and observer bias (i.e. having faith in some treatment and as a result imagining that your baby’s condition has improved when it hasn’t). Presumably if your baby is sick you wouldn’t rely solely on acupuncture etc. You would feed him differently, you would keep him warm or make sure he slept more. Who’s to say this isn’t what helped him? It is even possible that, because you have so much faith in a treatment, your child feels better as a result of recognising your own confidence. All of these are well established problems with relying on anecdote, not just in alt med but in mainstream medicine too.
Non-specificity does seem like it could be an advantage. It strikes me though, that if the positioning of the needles doesn’t seem to make a significant difference, couldn’t I get some sterile needles and stick myself in random places, rather than paying someone to do it for me?
Ah, I see. I can see how that would be the case. Thanks.
Chris, I believe you’re correct about acupuncture outperforming placebo for some conditions – even sceptics grudgingly admit that. I still wonder if that is to do with selection bias (i.e. only positive trials being published) but this is as much, or more, of a problem with mainstream medicine, as we all know. I wish acupuncture worked, I hope it does. I did end up here after searching for “chemical imbalance myth” and have had my own dreadful experiences with psychiatrists.
@ Gordie. Good point: I will answer with a question: can it be considered placebo effect when an infant with spastic paralysis due to cerebral palsy can have his limbs relaxed, even temporarily, by an intervention such as putting acupuncture needles into select points?
Also, you are right in mentioning multifactorials. I myself am a father of a five year old and my main method for treating her would depend on the disease. In one case of bronchitis I referred to her pediatrician for appropriate antibiotics. In some cases of common cold I relied on massage. I recall only two instances of using acupuncture needles on her and both were to quickly lyse a fever (both due to viral infections.) Diet and massage are actually the most important tcm modalities for children. Again this reinforces what Chris is saying about having many tools at one’s disposal.
Chris: yes, for some reason sticking needles to yourself doesn’t quite have the same effect.
General comment: one tragic error among many western MDs who study acupuncture (like myself) is that they end up only using acupuncture much to the detriment of patients who could benefit more from another modality like tui na or herbal medicine. I myself learned that the hard way.
This is one hell of an article. I have a close friend who came from China to practice medicine in America. He has a western MD degree and a degree in Traditional Chinese Medicine from Shanghai, earned in 1963. I couldn’t agree more with the lack of understanding for this system. The arrogance of modern western medicine refuses to entertain that there could be knowledge that is unknown and misunderstood by them even as they look through their microscope hunting for answers to complex diseases. Arrogance ends in failure. Traditional Chinese Medicine employs herbs, massage, pulse and tongue diagnoses, stress reduction, Chi Gung, , cupping, laughter and needles.
What impresses me most about my Chinese colleague is that he cares about his art and science and he actually works on your body for an hour or two when you come to see him. I know of no medical doctor who does the same thing. Instead, they see you for two minutes, write you a prescription and don’t care to listen to a word you have to say.
Loved your series, especially your explanation of Qi. I usually describe the character for Qi as being made up of two radicals: one is for things that are in the air, the other is grain. Air and Grain make Qi….
I am on point with a lot of what you say in this series. But let me clarify one thing are you saying that the nomenclature by which we define meridians is wrong, or that the whole concept of meridians is erroneous? If it is the later, you are making a bold statment indeed!
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