(This piece is a guest post written by resident Saintgasoline.com alternative medicine and health expert Dr. Deepsack Woo-Hands.)

In a recent study performed in my basement with a number of bewildered dogs and unwilling children, I uncovered a wide assortment of efficacious uses for acupuncture.  While skeptics continually criticize acupuncture, calling it mean names like placebo and scrawling its name and number onto bathroom stalls while promising it will deliver a good time, the research nevertheless continues to truck along, showing more and more advantages to acupuncture.  The study I performed in my basement, for instance, revealed that a variety of forms of acupuncture can be quite useful, from problems ranging from the treatment of pain to training dogs not to soil your couch.

As the ever skeptical Dr. Ziztur has even admitted in her own anti-alternative medicine blog, ”electroacupuncture” can sometimes be effective.  Regular acupuncture needles lacking electricity, however, lack any real efficacy. It is thus strange that combining the needles with electricity would make them so effective. Nevermind that transcutaneous electrical nerve stimulation is already a proven therapy.

Naturally, the novel practice of adding electricity to acupuncture needles has led me to introduce even more ingenious methods of acupuncture that show great promise in treating various ailments.  Such research indicates that acupuncture can serve a useful purpose in medicine and should be practiced by all doctors immediately, provided that the acupuncture needles are combined with something else that already works.

Specifically, my own research showed positive therapeutic value for four forms of acupuncture.  Each form of acupuncture was assessed in comparison with an adequate placebo and a control group receiving no treatment.  The placebo consisted of dropkick therapy, in which case I told the terrified children or confused dogs locked in my basement that I would attempt to cure their ailments by kicking them in the face with a stunning, professional wrestling-style dropkick.  In the end, my research showed that all four acupuncture groups performed significantly better than this placebo group, experiencing less jaw and head pain and receiving fewer concussions.  Strangely, the group receiving no treatment also fared better than the placebo, which has led me to conclude that not treating people can be an effective modality for various medical problems.  Indeed, I have found that not treating my colds, itches, and headaches often leads to their relief within a few days or hours.  For doctors to overlook the amazing health benefits that can result from doing absolutely nothing is simply appalling.

At any rate, the four acupuncture arms of my study proved helpful for a number of different problems, depending on the form of acupuncture used.  What follows, then, is a brief description of the various forms of acupuncture used, followed by the evidence of its efficacy, proposed explanatory mechanisms, and possibly brief digressions about ponies, as my five-year-old niece did the final proofread for this piece and she frickin’ loves ponies.

Tube Acupuncture
In this acupuncture group, patients were treated with specialized acupuncture needles fitted with plastic tubes that had plungers at the top.  The tubes were filled with various ingredients, and the plungers were pressed down upon administering the acupuncture treatment.  (The acupuncture needle looked something like this.) Depending on the ingredient, this form of acupuncture proved immensely effective for a variety of common medical problems.  When the acupuncture tube was loaded with morphine, for instance, it proved tremendously effective at relieving pain and inducing constant pleas for more among the increasingly fidgety children receiving this therapy.  When loaded with killed or attenuated microorganisms, they proved almost as effective as vaccines at preventing infectious disease and boosting immune system responses.  Of course, my research does not yet explain why tube acupuncture should be so effective against such a variety of problems.  It seems, however, that this form of acupuncture could one day become quite mainstream, taking the place of the traditional and outmoded western medicine use of syringes, vaccines, and so on.  Were I to hazard a guess, I would assume the mechanism of action of this form of acupuncture is that, upon releasing the substance’s energy in the tube, the various meridian channels of the body become activated with qi, which subsequently boosts immunity to pain, disease, and so on.

Dental Acupuncture
My research also surprisingly showed many beneficial dental uses for acupuncture.  When modified by applying a curve to the acupuncture needles, they served very well as dental probes.  When modified by adding motors that would rotate the needle, acupuncture proved amazingly effective at preventing tooth decay.  In this form of acupuncture, the needle would be rotated by the motor in such a way that it would drill into the tooth, at which point the decayed tooth material could be removed and replaced with a restorative material.  The proposed mechanism of this dental acupuncture is entirely speculative.  The evidence suggests, however, that because meridians do not travel through teeth, there must be some as yet unobserved force or energy that transfers the energy from nearby meridians to the tooth.  I suspect the answer is tiny, invisible, metaphysical leprechauns, but more research is needed.  Also, ponies are awesome and beautiful and amazing and I want one for my birthday.

Dog Acupuncture
One wouldn’t expect it, but poking dogs with sharp needles after they’ve urinated on your couch can provide amazing dog-training benefits.  In my study, the many dogs in my basement (who constantly urinated on my couch) were treated with standard acupuncture.  Whenever they urinated on the couch, I would immediately treat them with acupuncture, causing them to yelp, cry, whine, and squeal in joy.  (They love acupuncture!)  After only a few treatments, the dogs stopped urinating on the couch.  In fact, the treatment was so effective that the dogs almost stopped urinating completely, refusing to go at all until after they had eyed me suspiciously for at least an hour, smelling me warily and contenting themselves that no needles were present.  The only explanation for this effect, obviously, is that dogs have souls and when they urinate on couches, their souls become tainted with bad karma, and only through eastern mystical practices like needle-poking can the bad karma be lifted.  Also, ponies.

Chair Acupuncture
If I were to say that acupuncture can help restore the mobility of quadriplegics and paraplegics, most western medical doctors would scoff at me with derision and pelt me with rotten eggs and scorn and maybe even rotten eggs that they’ve injected with their scorn.  But their closed-mindedness shuts them out to the true power of acupuncture.  For in this fourth and final arm of my acupuncture study, my research demonstrated improved mobility for patients with spinal cord injury.  These acupuncture needles were specially designed, attached to a chair with wheels.  The acupuncture needles were put on the arm rest and inserted into the side of the patient, who then sat in the seat with the wheels.  (The chair acupuncture device looked something like this, but with needles.)   After receiving treatment, patients often moved about by turning the wheels on the chair, only occasionally wincing from the needles, and I instantly recognized that acupuncture had improved their mobility significantly.  Previously the paraplegics had been lazily lying about, not walking or running or jumping or moving much at all, and now, suddenly, acupuncture had given them the ability to roll around in the special chair acupuncture device I had given them.  Clearly, the meridians were at work here.  The patients’ meridians had been disrupted by a blockage of their qi, which led to their paralysis.  The chair acupuncture helped divert the flow of qi into a new path, allowing better mobility.  Acupuncture had been vindicated once again.

Conclusion
As can be seen, my new research reveals that continued skepticism of acupuncture is baseless and foolish.  More and more, acupuncture is proving to be effective in treating a number of medical problems.  When you combine it with electricity it helps to relieve back pain.  When you combine it with plungers and tubes and morphine it relieves pain.  When you combine it with chairs with wheels on them it helps improve mobility.  To deny acupuncture in the face of these successes is thus ludicrous.  Who knows what acupuncture may accomplish in the future, after all, when it is combined with many more outlandish things?  What will the skeptics say when acupuncture allows people to travel to the moon by attaching rocketships to the needles?  What will the skeptics say when acupuncture uncovers fundamental theoretical particles like the Higgs boson when Large Hadron Colliders are attached to the needles?  Obviously, they will remain skeptical regardless of how many things acupuncture proves capable of accomplishing when attached to other things that can accomplish these things.  And this is why skeptics will never, ever be welcome in my practice as a licensed acupuncturist.  And they can never ride my pony.

—Dr. Deepsack Woo-Hands

Skeptics universally fear illogical claims and asinine assertions, but this fear is not reasonable.  Such a fear is rooted in a Western way of thought that sees skepticism as totally opposed to credulousness.  But it is high time skeptics embraced a more mystical, Eastern way of thinking:  The Tao of Skepticism.

Modern skeptical techniques simply do not work.  For example, in light of the recent libel case against Simon Singh brought about by the British Chiropractic Association (BCA), skeptics have been ranting and raving about the lack of research showing any efficacy for chiropractic techniques on various childhood conditions like colic and asthma. This skeptical approach, however, is totally unreasonable—even bogus.

The promoters of medical nonsense and quackery have been winning the popularity contest for years, as evidenced by lumbering, well-funded organizations like the National Center for Complementary and Alternative Medicine (NCCAM), which are being funded by respectable organizations like the National Institutes of Health (NIH).  Alternative medicine skeptics, naturally, unwaveringly stick to their traditional techniques of logical argument, continually pointing out logical fallacies and demanding evidence, blind to the fact that this approach does not win over the public.  But to the average layperson, skeptics just seem whiny, demanding, and closed-minded.  Such arguments are not convincing.

Therefore, I propose that skeptics should borrow the tactics of the believers, performing a sort of mental judo throw and using the weight of the believers against themselves. After all, for every yin, there is a yang; for every summer, there is a winter; and for every nut, there is a nutcracker.  Sometimes what is dark leads us to light, and sometimes what is wrong can be right, and sometimes the long-winded and rambling can seem poetic.  There is a time for killing and a time for healing, and a time for skepticism and a time for being credulous fucktards.  As such, we must embrace what I call the Tao of Skepticism, realizing that we must reign in our passion for critical thinking and occasionally act like raging fucktards to win over the masses to our side.  What follows, then, is a brief survey of these new, mystical, Eastern tactics we could use to battle medical nonsense and other woo.  (The focus on chiropractic is courtesy of the BCA, as bullying lawsuits against fine science writers like Simon Singh will not be tolerated by the blogosphere, and will guarantee you all sorts of bad press.  Let this be a lesson to you fuckwits.)  In the mystical, ancient technique known as the Tao of Skepticism, these tactics are known as The Sevenfold Ways of Woo:

The Way of the Big
Complementary and alternative medicine (CAM) is a huge, big-money industry.  It is composed of large organizations and groups, like the British Chiropractors Association (BCA), that drown out individuals, swelling to gargantuan proportions like some sort of malignant tumor or radioactive lizard that breathes fire and terrorizes the Japanese.  Using the Tao of Skepticism, naturally, we can use this knee-jerk dislike of large, corporate entities to our skeptical advantage.  For, as anyone knows, huge organizations and corporations are uniformly evil.  Those who dispute such a claim need only look toward Walmart, that giant of the retail industry, whose low, low prices come at the cost of pissing on the souls of puppies and eating the desires and dreams of little children everywhere.  Given people’s aversion to anything large, and their overwhelming desire to characterize organizations and groups as soul-less corporate husks, a simple tactic for skeptics to fight against woo is to simply refer to alternative medicine as BIG.  No argument is needed.  The next time someone tries to say anything positive about chiropractic, just sneer, “Oh, you mean Big Chiro…” and watch as your opponent withers away, unable to counter this claim.  The beauty of this argument is that it is not an argument at all.  Thus, no one can argue against a sneer of “Big Chiro”—for how do you logically refute an emotionally laden word devoid of argument?  You can’t.  Beware, though, for there is one area in which this argument won’t apply, and that is in regards to woo-woo “penis pills” that claim to offer “male enhancement” (i.e., penis enlargment).  For whatever reason, criticizing anything else as Big always seems to work wonders, but calling penis pills Big Penis only encourages people to buy more.  I don’t yet understand why this should be the case.

The Closed-Minded Way
Skeptics are not the only closed-minded people out there.  The Tao of Skepticism shows us the yin to this yang, as chiropractors and other alternative medicine practitioners, for example, are so closed-minded that they put even skeptics and atheist fundamentalists to shame.  If one innocently asserts that chiropractic is a bunch of foolish, ignorant bullshit, for instance, chiropractors will universally jump to the defensive, arguing at lenth that this isn’t true!  Of course, this is exactly how closed-minded people react.  How dare these loud-mouthed assholes be so bold as to deny that chiropractic is complete bullshit!  Are they really so closed-minded that they can’t even conceive of chiropractic as a foolish and flailing alternative medicine modality that shares many qualities with the feces of bulls?  Why can’t they open their minds and embrace skepticism, or open their minds to the fact that maybe, just maybe, cracking the spine has no fucking effect on asthma?  What arrogant, unflinching swine these chiropractors are for being closed to these possibilities!  Alternative medicine practitioners are thus arrogant and rude to so quickly deny that their treatments are bullshit nonsense that fare little better than placebos.

The Way of the Quantum Skeptic
As most skeptics know, believers who promote bunk and nonsense frequently invoke quantum physics as justifications for their nonsensical claims.  But skeptics have failed to utilize this amazing tactic, which can be used to justify almost anything, provided you have enough ignorance of the real physics.  The Tao of Skepticism, thankfully, is wholly ignorant of any physics, be it quantum or classical!  For instance, did you know that Schrodinger’s cat argues against chiropractic, because it shows that our backs are always in a superposition of alignment and misalignment, and that when we are lying on a chiropractor’s table—like a half-dead, half-alive cat—we could wind up dead after an observation collapses the wave function?  Also, Heisenberg’s Uncertainty Principle proves that chiropractic cannot work, because a chiropractor cannot know the position of a vertebrae if he knows the velocity at which he will manipulate it, and therefore he cannot find it, and on the other hand he cannot know the velocity at which he will manipulate a vertebrae if he knows its position, and therefore he could manipulate it at too great a velocity, causing injury and/or stroke.  Thus, the chiropractor cannot possible manipulate the spine, because the Uncertainty Principle shows that he’d either manipulate it at too great a velocity or be unable to locate the spine.  Clearly, the Tao of Skepticism puts quantum woo-woo on the side of the skeptics.

The Way of the Unnatural and Wrong
Most any skeptic has encountered the naturalistic fallacy, or the claim that something is not right because it is not natural.  Of course, though this is a logical fallacy, that does not mean we skeptics cannot co-opt it for its effectiveness.  Chiropractors, for instance, are highly unnatural people who do unnatural things to the spine.  You do not, after all, go into the wild and see elephants and badgers cracking each other’s spines, or paying other animals pretending to be doctors to fuck with their neck.  (The only natural correlate to the chiropractor in the wild is the duck, which is also a type of quack.)  This defense can even be used against those alternative remedies that thrive on implications that they are “all natural”, like herbal medicine—the Tao of Skepticism, after all, can show us how even natural things are unnatural, and unnatural things are perfectly natural.  For example, one can simply remark that it is not natural to buy strange herbs from weird hippies in jars riddled with fake chinese calligraphy in the case of “natural” herbal medicine.  Clearly, what is most natural is to not use any of these alternative practices at all, whether it be sticking yourself full of needles, eating a bunch of strange, foreign herbs, or fucking around with your vertebrae.  Better to just die alone and miserable, or be eaten by a predator, which is the natural way of doing things.

The Way of Cheapness (Never Mind Efficacy)
One positive aspect to alternative medical modalities like Therapeutic Touch, herbal medicine, or homeopathy is that these treatments are generally cheaper than “Western” cures, like surgery.  Therapeutic Touch, of course, is cheap because it requires about one millionth of the skill it takes to be a surgeon.  Even a frickin retarded bonobo could pretend to move your nonexistent “energy” by randomly waving its arms six inches over your body.  Herbal medicine, likewise, is generally cheaper than western medicine because these products don’t attempt to isolate the active ingredient or supply it in fixed amounts.  You just get the whole damned herb, regardless of how much of the active ingredient is present, because isolating the chemically relevant portion of the herb would be costly!  Of course, skeptics can counter the cheapness of alternative medicine by inventing their own cheap “treatments,” using the Tao of Skepticism.  For instance, the next time someone remarks that homeopathy is cheaper than chemotherapy for treating cancer, simply reply that you have an even cheaper treatment called “trout slapping,” wherein you slap someone with a trout, and you will perform said therapy for only the cost of the trout.  Obviously, if alternative medicine is so cheap, skeptics can envision countless therapies that would be even chaper (and thereby more effective, in the mind of the believer)—and that includes doing absolutely nothing.  Why take homeopathy when sitting on your ass eating Fritos is cheaper!?  Why go to a chiropractor for a long, arduous process of spinal manipulation when I can simply “treat” you with Pudding Sock Therapy, wherein I soak my socks in pudding and then stick them in your ear?  It’s cheaper!  And if Western medicine hasn’t worked, and has cost you so much money, you have nothing to lose by trying it (except possibly your ability to hear)!  After all, if that chemotherapy isn’t curing your cancer, you may as well let me piss on you for a little piss therapy, or fart into your butthole for reverse fart therapy, as I only charge a few dollars for it.

The Way of Ancient Wisdom
It is unseemly to disrespect one’s elders.  The elderly and ancient, even those who have degenerative neurlogical diseases and are incapable of remembering how to put on pants, are universally more intelligent and wise than the young.  As such, traditional, ancient wisdom always trumps modern advances.  This is why traditional chinese medicine is seen as so effective, and why practices like blood-letting and burning witches are as effective today as they were in the past.  (This is true, by the way—they are as ineffective today as they were back then!)  Given these facts, skeptics must emphasize the ancient historicity of their claims.  Did you know that peer-reviewed medical journals were present in neolithic caves, painted on the walls with the blood of yaks, complete with P values of less than or equal to 0.001 in regards to the efficacy of yak blood as a pigment?  Did you know that ancient chinese men sitting on top of mountains believed that homeopathy is bunk and vaccines should be administered to children?  It’s true!  And we have to accept it, because it is old.  Just as we must accept it when our racist grandfather starts talking about “the Japs.”  Judging from his wrinkles, after all, he must be correct.  Skeptics, of course, have a useful resource in the form of James Randi, a man in his eighties, with a long enough beard to look like something out of the 18th century.  No one can deny HIS traditional wisdom.  Once again, the Tao of Skepticism shows us that the path of the skeptic can intersect the path of the believer, becoming one with it in a process of self-annihilation and renewal.  Indeed, the Tao of Skepticism itself is based on ancient, mystical wisdom (I swear it is not something I just made up a few hours ago!), and so therefore it, too, must be correct.

The Way of Implausible Conspiracy Theories
By now, everyone knows that doctors are secretly members of a ritualistic cabal that requires them to take an oath never to cure cancer, AIDS, or any other disease, as doing so would significantly reduce their profits.  What would doctors do, after all, if they were not continually receiving more and more patients with AIDS and cancer?  They’d all be out of business, playing golf, and never dying from cancer or AIDS!  Why would anyone want that?  Clearly, there is no incentive for doctors to cure diseases.  But on the other hand, the skeptic should note, is the fact that there is no incentive for chiropractors to cure asthma, back problems, and so on.  After all, if a chiropractor can cure a back problem in a single visit, there will be no need for the patient to return.  Clearly, if you want to have your AIDS cured, you will have to continually return to the Chiropractor, naturopath, or homeopath, except when you die, in which case the alternative medical practioner has “healed” you by sending you back to Heaven or something.  (Perhaps the oddest thing about this defense for the skeptic, of course, is that it is largely true!  Chiropractors really do try to get repeat customers by emphasizing that constant manipulations are required, even in the absence of any supporting evidence for this.)

Conclusion
There are many more tactics skeptics could adopt to counter the forces of magical thinking and alternative medicine, but there is not room enough here to detail all of them.  The Tao of Skepticism, after all, is all-encompassing.  It is contradictory and incoherent, but very well, because like Walt Whitman it contains multitudes.  What is clear, however, is that skeptics need to abandon the current course, in which they use only reason, logic, and science.  With alternative medicine infiltrating government health organizations, medical schools, pharmacies, and hospitals the world over, skeptics can easily recognize that science-based medicine is losing ground.  The irrational, ridiculous tactics of the alternative medicine movement, even in spite of their irrationality and ridiculousness, have won over countless adherents.  As such, skeptics should learn from the successes of alternative medicine and embrace a more pragmatic approach, using the same idiotic defenses of alternative medicine in support of skepticism and scientific thinking.  In the end, this is the only way in which we can conceivably gain ground.  By appeasing the believers with low-brow thinking and horrid argument, we can win the day by converting even the most hard-nosed skeptic into a bumbling idiot, which would instantly garner such skeptics newfound respect among idiots all over the world, and in effect guarantee them spots on Larry King Live, Oprah, and the Huffington Post, where they could spout their skeptically oriented idiocy ad nauseam.  Then, when the dust settles, the skeptics will have won the battle of witlessness, and they could finally return to the enclaves of science, reason, and evidence-based thinking, weary of the long, hard road they have traveled.  Sometimes, in order to defeat your enemy, you must become your enemy; you must embrace the yin in your yang; and you must become stupid if you wish to remain smart.  Such is the Tao of Skepticism.

Most complementary and alternative medicine (CAM) modalities are complete bunk. Among the most mind-numbingly stupid modalities are therapeutic touch (a misleadingly named “therapy” in which a practitioner does not actually touch the patient at all and instead manipulates the “energy field” that hovers about six inches from the patient’s body), homeopathy (a “medicine” that consists of pure water—the “active” ingredient is removed by repeated dilutions), and ear-candling (a therapy that actually works just like it sounds—you stick a freakin’ candle in your ear). Such silly, insane, and utterly astonishing alternative treatments are so little removed from claims about magic and fairies with pixie dust that they warrant the same amount of dismissive derision and should be brushed aside as worthless without even attempting to investigate them. Unfortunately, because we live in a society in which CAM is increasingly becoming incorporated into mainstream medicine, researchers are often forced to investigate such tripe to finally reveal the surprising, scientifically-supported conclusion that drinking plain water is no more beneficial than, say, drinking Aquafina, and that sticking candles in your ear doesn’t do much of anything except present a risk of setting your hair on fire or getting hot wax in your face. It is relieving to see that science is investigating such pressing, eminently worthy research questions based solely on the fact that this crap has saturated our culture through ingenious marketing and political clout. After all, why should science let plausible mechanistic explanations and scientifically-feasible hypotheses generate research when they can simply waste resources on foolish, faddish nonsense promoted by charlatans and funded by the gullible and the desperate?

Homeopathy, therapeutic touch, and ear-candling are easy targets, of course. Other CAM treatments are not nearly as implausible. Herbal medicine, for instance, is highly plausible on the face of things, although it can be implemented in a dangerous fashion. St. John’s wort, for instance, is an herbal remedy commonly used to treat depression, but if it is mixed with other common antidepressant medications (medications a depressed person is likely to be taking), it can lead to adverse side effects like serotonin syndrome, which can be deadly. Of course, herbs and other medicines based on plant products are not outside the realm of western medicine. It is well-known that plants can generate various chemicals that can be used to treat ailments; aspirin, for example, is derived from the bark of the willow tree. What makes herbal medicine dangerous is that, unlike modern pharmaceuticals, the herb’s active ingredient is not isolated for more effectiveness, many of the herbs are not efficacious at all or in certain contexts in which they are marketed, and as I mentioned above they can have serious interactions with other drugs. And it goes without saying that many people forego more effective treatment in favor of these nearly worthless alternatives, setting themselves up for worsening medical conditions. So while it is true that not all CAM treatments are complete bunk, the large majority of them are, and those that aren’t complete bunk can still be characterized as semi-bunk or half-bunk for the unreasonable dangers they can present.

Besides herbal remedies, of course, acupuncture is probably one of the most highly touted alternative remedies. When initially described—acupuncture involves inserting needles into certain specific “meridian” points on the body through which life energy supposedly travels—acupuncture seems almost as crazy and absurd as a practice like ear-candling. However, a few studies have shown that acupuncture may be efficacious for treating various pain problems, and even more have tried to dubiously argue that acupuncture is effective even when its pain-relief results fared no better than placebo.

To get an idea how prevalent ideas about acupuncture’s efficacy have become, one need only peruse the popular press or simply Google the term “acupuncture.” As an example, here is a quote from Natalie Angier’s pop-science book The Canon:

When patients with lower back pain reported pain relief from bona fide needling but not from sham acupuncture, even the most skeptical Western doctors had to concede that the 5,000 year-old practice might have its limited uses. (p. 33)

Et tu, Brute? To be credulously stabbed in the back with acupuncture needles by a fine science journalist like Natalie Angier shows just how well such alternative modalities have saturated the healthcare industry. But though Angier is normally a fine journalist, she is certainly in err here. In the book, she refers to a study that tested traditional acupuncture (where needles were inserted into the “official” acupuncture nodes that harness the energy or qi or whatever) against sham acupuncture (in which the needles were inserted into “sham” spots not traditionally used in traditional acupuncture). The results, she said, showed that traditional acupuncture outperformed the sham acupuncture. Now, I am not certain what study she is referring to, but it has been widely demonstrated that traditional acupuncture does not outperform random needling. Even before the publication of her book in 2007, there were many studies that showed such results. As an example, a study by Brinkhaus et al published in February of 2006 showed that, among 298 patients assigned to acupuncture, minimal acupuncture, and a waiting-list control group that received no treatment, there was no significant difference between the acupuncture group and the minimal acupuncture group in relieving chronic low back pain. (“Minimal acupuncture” in this study consisted of superficial needling in non-acupuncture points.) Thus, for Angier to claim that “even the most skeptical” had to concede that acupuncture worked was an amazing overstatement. One medical study, much less a study of pain that could easily be marred by placebo effects, is not nearly enough to convince a skeptic, as the quality of the study could be poor, the interpretation could be misleading, and at any rate, studies like these must be replicated to be accepted without question.

As I said, though, Angier made her remarks concerning acupuncture in 2007. Has time and further research vindicated acupuncture? Not a chance. Acupuncture studies have actually been quite numerous since then, and most of them show that acupuncture performs no better than placebo. On top of that, the placebo form of acupuncture in many of these studies has improved significantly. In the studies mentioned previously, the placebo form of acupuncture consisted of needling non-acupuncture areas of the body. Later acupuncture placebos went even further, of course, and these forms of “sham” acupuncture did not consist of needling at all. Instead, a shaft would be placed on the patient’s body and produce the sensation of a needle without any sort of skin penetration at all. Thus, these placebos controlled not only for the specific placement of acupuncture needles, but also for the act of needling itself.

One such placebo-controlled trial using this form of sham acupuncture (it involved a blunt needle touching the skin and then being immediately retracted into the shaft) ironically showed that the sham performed better than the true acupuncture (Goldman et al). This study followed 123 patients who experienced persistent arm pain from overuse injuries, and the sham acupuncture group experienced more pain relief than the true acupuncture group during treatment (without the attendant pain and soreness of having a needle jammed into one’s self). Thus, this study showed that the placement of the needles and the mechanism of needling itself have no effect on pain.

As I mentioned earlier, though, scientists must be wary of studies, especially those involving pain, and the results must be replicated. Of course, many more studies have shown that acupuncture performs only as well as sham acupuncture and other placebo forms. After one analysis of 13 studies about acupuncture’s effects on pain (involving nearly 3,000 patients), the authors concluded:

Our findings correspond with several Cochrane reviews on acupuncture for various types of pain, which all concluded that there was no clear evidence of an analgesic effect of acupuncture.

Clearly, the evidence for acupuncture grows shakier with more research, and conveniently the higher quality research tends to show more negative results for its effectiveness. This makes sense given the initial implausibility and the seeming insanity of the treatment modality. But if acupuncture doesn’t work, how is it that some studies manage to show a positive result?

While I lack the resources to do an exhaustive examination of the literature, it seems that those studies that purport to show a positive effect stemming from acupuncture either do so through misleading interpretations of much less compelling data or else through poor study methodology.

As an example of poor study methodology, consider the “positive” results attained in a study by Carlsson and Sjölund: They showed that two acupuncture groups had greater pain relief from low back pain than a placebo group receiving treatment with a fake transcutaneous electrical nerve stimulation (TENS) device. The study is even featured on the Acupuncture Today website, which exclaims that acupuncture shows “significant” pain relief for low back pain after 1, 3, and 6 months. (The abstract for the actual study, interestingly, only claims “significant” pain relief for months 1 and 3.) Why are there scare quotes around “significant”? Because it is being used in a statistical sense. When a person off the street says they feel a significant reduction in pain, that usually means the pain has decreased by quite a bit. In statistical medical journal jargon, of course, “significant” pain relief can mean as little as having minimal change. Looking at a graph of the data for this study, it appears the the difference in pain amounts to about 10 mm on a 100 mm pain scoring scale—which translates into “minimal” pain relief. (I don’t have access to the actual numbers, but it appears from the graph that the pain relief at 6 months may have just missed the “significant” cutoff at just under 10 mm.)

So yes, the study showed that acupuncture caused “significant” (that is, minimal) pain reduction in the lower back. Where’s the flaw in the methodology? Well, the flaw is that they included a form of acupuncture in which the needles are electrified (called electroacupuncture) and then combined that with the “true” acupuncture group. Obviously, the traditional Chinese healers from 5,000 years ago were not using electrified needles. But perhaps this shows that electroacupuncture works. Once again, this line of reasoning is flawed. As you may have noticed, the “placebo” group of this study involved the use of a fake TENS device. TENS devices are frequently used in the treatment of low back pain. Their mechanism of action is to stimulate nerves with electricity. That is, the standard, Western treatment of low back pain involves electrical stimulation, which is exactly what the electroacupuncture does. It is reasonable to assume, then, that the actual acupuncture needling has no effect whatsoever, and the limited pain relief is the result of the electrical stimulation. And given that other studies have isolated needling as a variable and shown it no better at pain relief than sham acupuncture with no needle penetration, it would appear that this study demonstrates nothing whatsoever about acupuncture, and at best shows that standard treatment with an electrical stimulation device is beneficial. Remember, kids: If you’re going to do medical research, isolate your goddamn variables. If the only way to legitimize your alternative, 5,000 year-old treatment is to haphazardly vivisect it and sew its corpse onto standard medical treatments like transcutaneous electrical nerve stimulation, then it would seem patients would be better off with the standard care without the elaborate, ritualized nonsense attached to it.

Naturally, when the data itself can’t be manipulated into showing a positive result through poor methodology, many study authors and journalists instead prefer to interpret the results in a stunningly incompetent manner.

Now, if I were researching the efficacy of a certain drug and compared it with a placebo sugar pill in a study, subsequently finding that the placebo sugar pill and the drug both improved outcomes, it would be highly unreasonable for me to exclaim that the drug—and placebo sugar pills—work. Obviously, the purpose of a placebo control is to account for the placebo effect. If a treatment does no better than a placebo, that means the treatment doesn’t work—the pain relief may be caused primarily by psychological effects like self-reporting biases and so on. In the acupuncture world, of course, a study that shows true acupuncture performing only as well as the placebo acupuncture is reason to go about proclaiming a success, that both the placebo acupuncture and the regular acupuncture work! When this sort of nonsense is tried by drug researchers it seems stupid and crazy, but for whatever reason acupuncture researchers and credulous journalists routinely get away with making such claims about the placebos in acupuncture trials.

In a study by Cherkin et al, for example, the researchers studied pain-reducing effects of acupuncture for low back pain in three acupuncture groups versus a group receiving standard care (the acupuncture groups also received standard care in addition to being needled, though). The acupuncture groups consisted of a group receiving “individualized” acupuncture care, a group receiving standard acupuncture, and a group receiving superficial acupuncture that consisted of toothpicks that didn’t penetrate the skin. Not surprisingly, all three acupuncture groups performed better than the standard care group in terms of pain improvement. This was expected, naturally, because the acupuncture groups also received standard care, and the slight improvement could easily be attributed to the placebo effect, a conclusion tacitly acknowledged in the last sentence of the abstract. The important comparison is between the placebo “toothpick” acupuncture and the “real” forms of acupuncture, though. All of these performed the same, which just goes to show, once again, that the placement of the needles in certain spots does not matter and that the actual needling through skin also does not matter in terms of pain relief. If the placebo acupuncture performs as well as the real versions, this is no success to crow about. And yet headlines read, “Acupuncture, Real or Fake, Helps Aching Back,” while the researchers themselves often make similar claims. The interpretation of these results in the media is simply ignorant and stupid, enforcing the misconception that acupuncture actually works.

Thus, the initial gut-reaction to poking oneself with multitudes of needles turns out to be correct: Acupuncture is a nonsensical waste of time, producing health benefits only on par with a placebo and certainly not warranting the time, money, and effort that go into such a treatment. More and more, studies show that acupuncture does not work compared with sham treatments and other placebos, and those studies that do show benefits are severely flawed, either by using crazy hybrid acupuncture needles incorporating traditional Western treatments (like the electroacupuncture needles that mimic TENS devices) or just using bad methodology in general. In the end, the positive results of acupuncture studies are largely illusory, created either by the media, as they whore for attention with a catchy headline, or created by the patients themselves as a placebo effect.

References:

Angier, N. The Canon: A Whirligig Tour of the Beautiful Basics of Science. Houghton Mifflin Harcourt. 2007.

BMJ-British Medical Journal (2009, January 29). Pain relieving effects of acupuncture are limited. ScienceDaily. Retrieved June 4, 2009, from http://www.sciencedaily.com­ /releases/2009/01/090127202048.htm.

Brinkhaus B, Witt CM, Jena S, et al. Acupuncture in patients with chronic low back pain: A randomized controlled trial. Arch Intern Med 166(4):450-457, 2006.

Carlsson CP, Sjölund BH. Acupuncture for chronic low back pain: A randomized placebo-controlled study with long-term follow-up. Clin J Pain 17(4):296-305, 2001.

Cherkin DC, Sherman KJ, Avins AL, et al. A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Arch Intern Med 11;169(9):858-866, 2009.

Devitt M.  Acupuncture provides long-term relief of low back pain. Acupuncture Today 3(3), 2002. Retrieved June 4, 2009, from http://www.acupuncturetoday.com/archives2002/mar/03lowbackpain.html.

Goldman RH, Stason WB, Park SK, et al. Acupuncture for treatment of persistent arm pain due to repetitive use: A randomized controlled clinical trial. Clin J Pain 24(3):211-218, 2008.

Steenhuysen J. Acupuncture, real or fake, helps aching back: Study. ABC News Health, May 11, 2009. Retrieved June 5, 2009, from http://abcnews.go.com/Health/PainNews/wireStory?id=7560289.

(This post is dedicated to the recent commenter who claimed alternative medicines work, specifically citing acupuncture. Thanks for making me waste hours of my time writing this lengthy reply.)

Last Thursday, ABC premiered the first episode of a quirky, moralising legal drama that is arguably the bastard child of Ally Mcbeal, Boston Legal, and a bunch of new age hippies. Such a deformed monstrosity of a show could only be the mutated amalgam of three parents, eschewing the normal process of sexual intercourse to create new life by simply chopping off the worst aspects of each (not that new age hippies have any good aspects, mind) and haphazardly throwing these chunks together in a semi-coherent form.

I don’t hate the show just because I abhor the show’s blatant moralising in favor of idiotic new age bunk and “alternative” medicine, though. No, even in spite of these faults, the show is just plain bad, even absent these affronts to my sensibilities. The dialogue tries entirely too hard to be snappy and witty, coming across like that ass at your job who is always trying to make jokes and usually failing. And its quirks are hardly endearing or entertaining. Weird, unnecessary musical moments pop up for no apparent reason, often featuring washed-up, homosexual pop stars from the ’80s. It’s like Ally Mcbeal’s infamous dancing baby, except somehow more irrelevant and hardly as memorable. And don’t even get me started on the plot; it’s formulaic, predictable, and incredibly cheesy. If the first episode is a sign of things to come, then viewers have good reason to tune out, and I suspect the large majority of viewers, like me, were only the residuals of Lost’s season priemer, which Eli Stone had the luck of following. I’m saddened that I did not immediately change the channel.

Naturally, the show’s transparent new-age agenda is the one thing that really stirred up my gastric juices. I can pardon a bad show, but I cannot and will not forgive a bad show that pushes insane bullshit as somehow factual. Indeed, the first episode did not merely make one or two awkward endorsements of pseudoscience; instead the whole show is founded upon pseudoscience. The premise of the show, for instance, revolves around the main character’s attempts to change the world as a “prophet” of God. Apparently, having visions of George Michael makes one a prophet, now. There is even a character on the show whose sole purpose is to dispense worthless new-age platitudes. And, get this, the character is a practitioner of “alternative” chinese medicine. That’s right, the show features the unholy trinity of woo: faith, antivaccination nonsense, and alternative medicine. (I can already sense Orac’s head exploding in rage.) The first episode appeals endlessly to the power of faith with the help of George Michael singing the song of the same name, foolishly advertises the long falsified claims of hysterical mothers that ingredients found in vaccines cause autism, and features the quack alternative medicine practitioner dispensing sage spiritual advice while poking him endlessly with needles. Although, if I had to choose between being stabbed with needles and watching this tripe, I’d go with the needles, hands down.

The first episode is saturated with nonsense like this. Ultimately, it relies less on substance and more on appeals to emotion (and blatant lies) to get its point across. How can anyone root against Eli Stone when he helps the mother of an autistic boy to prevail against a towering legal firm and monolithic vaccine maker? It doesn’t matter that Eli suffers from delusional hallucinations; that the mother doesn’t understand causality, medicine, or science; or that the cause they’ve decided to champion is ridiculous and unsupported by any evidence. What matters is that the little guy won. The delusional, idiotic, little guy.

At heart, the show is simply trying to convey that faith can prevail over science and “facts”, and so can alternative medicine. Of course, no facts of any sort support the claims of alternative medicine practitioners or new-age gurus. Alternative medicinal practices are just a method for impatient pseudo-doctors to pretend to be practicing medicine without the effort or accountability, and new age spirituality just takes all the worst reasoning of established religions and removes it from ritual. Of course, Eli Stone ultimately fails to show that faith can transcend science. By siding with the antivaccination crowd, the show has opened itself up for criticism based on the implications of this unthinking support, and Eli Stone unwittingly refutes its new-age, feel-good ideology by advocating such nonsense. Authoritative and legitimate medical institutions like the World Health Organization and Centers for Disease Control and Prevention universally recognize that vaccines are safe and effective. What we find in Eli Stone is that faith does not trump reason. Instead, faith leads to horrible injustices and the endorsement of idiotic, unproven claims that ultimately cause more harm than good. Now we must fear for the mothers or potential mothers who watch this show and try to prevent their children from being vaccinated. We must fear for those who will refuse modern medical treatment in favor of worthless and futile reliance on alternative medicine, medicine that doesn’t have to live up to reasonable safety standards, whose efficacy is unsupported by evidence, and whose side effects can be dangerous and deadly, particularly in relation to other drugs or overuse. Eli Stone means well, but its faith causes more harm than good. To paraphrase Steven Weinberg, Eli Stone proves once and for all that though good people do good things and bad people do evil things, it takes faith for good people to do evil things.