[Marxism] "Acupuncture has been validated"

[Nigel Irritable]

Nick Fredman said:

> "Barrett is wrong. According to World Health Orgnisation:

> "While evidence [i.e. evidence from clinical double blind trials] shows 
> that acupuncture, some herbal medicines and some manual therapies (e.g. 
> massage) are effective for specific conditions, further study of products > and practices is needed"
http://www.who.int/mediacentre/factsheets/fs134/en/print.html

This is true in a sense, but means much less than advocates of CAMs generally imply.

It is true that some herbal medicines have an actual medical effect. This is because some herbal medicines contain active ingredients that happen to occur naturally. It's a clearly scientifically understood process and applies to some herbal medicines in some circumstances and does not present a challenge to any of the precepts of scientific medicine. It is unfortunate however that these medicines are often prepared and sold by people who don't understand what they are doing and who sell them alongside various "medicines" and "remedies" that contain no such active ingredients.

The answer is fairly straightforward: Treat substances containing naturally occurring active ingredients exactly as we do manufactured medicines. Test them and if one works, regulate it and dispense it through pharmacies and other outlets where dosage, concentration, interaction with other medications and the like can be properly regulated. If it doesn't work, treat selling it as fraud.

The issues surrounding acupuncture and certain massage therapies are a little more complicated. Both tend to be surrounded by reams of mysticism and general idiocy. They do not work as their proponents claim they work. However, both have certain observable benefits, in a very limited range of settings.

Massage therapies can benefit certain muscular and other similar problems for reasons that are fairly obvious and have nothing to do with the mysticism that surrounds massage as a CAM. It is possible that sticking needles into the skin has certain benefits for certain types of pain relief. Again this has nothing whatsoever to do with the mysticism surrounding acupuncture or the accumulated "wisdom" of its practitioners - in studies where acupuncture has been shown to have some benefits for pain relief, there has been no statistically significant benefit from using the methods and beliefs of acupuncturists as opposed to shoving the needles in at random.

In fact, the main benefit of acupuncture as a treatment is closely connected to the placebo effect. Ben Goldacre, the writer of the Guardian's Bad Science column, deals with this issue in a very fair and interesting article here:

http://www.badscience.net/2007/09/542/

Goldacre explains, using perhaps the most famous study that found benefits for acupuncture (in treating chronic back pain), that what was found in the study on close examination:

A) May show pain relief benefits for sticking needles into the skin.
B) Shows no greater benefit for following acupuncturist's methods than for doing so entirely at random.
C) Certainly shows the power and complexity of the placebo effect, particularly when dealing with a problem like chronic back pain which is understood to be as much a psychosocial problem as a biomedical one.

In this study, 27% of the patients showed improvement from a conventional medical approach. This is, in Goldacre's view, itself an indication of the power of the placebo effect as many of these same subjects had shown no improvement from a similar approach before taking part in the trial. 47% of the acupuncture group reported improvement. However 44% of the group undergoing treatment which they were told was acupuncture and was approached similarly but which actually involved sticking pins into the body at random themselves reported an improvement.

Essentially, saline injections have a more powerful placebo effect than sugar pills. Something involving a lot of reassurance and "ceremony" and the like can have a greater placebo effect again. There may possibly be some physiological process which allows sticking needles into people at random to cause some pain reduction in sufferers of some kind of pain. Those two statements together account for the entirety of the measurable medical benefits of acupuncture.

And acupuncture, certain types of massage, and certain types of herbs (within the strict limits outlined above) are the only types of CAMs that have ever been reliably shown to have any kind of positive effect on any kind of illness or ailment. No other CAM has ever beaten the expected placebo effect in any properly held trial. None of them. For any ailment. In any trial. At this point in time that's pretty damning.