Talk:Acupuncture/Archive 2

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We seem to be entering a edit war

Backin72, Kevin and others. It's clear from the multiple reverts that are going on here with regard to the lead section that we are in the beginning stages of an edit war. Kevin, you have simply reverted the edits of 4 separate editors with regard to the same sentence, which clearly shows that you are the only contributer on this page who seems to think that the sentence belongs there with no modification. There are 4 who think it doesn't belong there. Wiki three revert rule guidelines strongly recommend reverting a change only once. Because Kevin, you obviously feel very strongly about this issue and are prepared to continually revert and make no changes to the sentence, there are several options available.

1. We can get some third party wikipedians to review our article and make suggestions about the lead section.

2. We can get dispute resolution

3. You can accept that the sentence you insist on inserting to the lead section is not appropriate and attempt to enter discussion about possible alternatives.

Continuing to revert changes made by multiple users does not constitute an option. It is obvious that your opinion with regard to this lead section does not represent the majority of editors on this page. Wiki three revert rule guidelines also state that as an alternative to reverting, a reword is often more appropriate. Obviously this is the easiest one to organise, and we hope that Kevin will be happy to discuss this before proceeding with further editing on this sentence.

Wiki guidelines state WP:LEAD that any specialist terminology that is ESSENTIAL to describing the topic needs to be defined in the lead section itself. A link is not sufficient. If it absolutely needs to be there, it needs to be defined in the lead section. The majority concensus is that reference to scientific debate is sufficient for the lead section. Making reference to cochrane collaboration and EBM brings into use non-essential specialist terminology in the lead section. Simply adding a link to the cochrane/ebm stuff is not enough, it either needs to be defined in the lead section or removed. My suggestion was to remove said sentence until it was rephrased to be more "layperson friendly". Kevin, you have not responded to my suggestions in this regard. Did you read my talk contribution before you reverted my changes the other day? Also, Kevin, if we're quoting EBM in general, we need to say that the findings are minimal and disputed (or similar). If we're quoting Cochrane as a standard for EBM, they have stated their P6 findings. You have not provided a reference to where the Cochrane collaboration dispute their own findings on P6. It is incorrect and inaccurate to quote the sentence as it stands regardless. Despite your anti-acupuncture sentiment on your personal home page, it is important to remember that you need to maintain NPOV at all times on this website. Piekarnia 02:38, 6 May 2006 (UTC)

Hi Piekarnia -- please see my remarks to Kevin just above as well. I think the best resolution is to proceed as you originally suggested, and expand the lead section. Rather than trying to simplify a bunch of POV's and stuff about research, efficacy and safety into a brief, general sentence, we can be NPOV by being inclusive. Kevin seems to have come around to this perspective with regard to leaving in NIH and WHO in the article alongside Cochrane and Bandolier, so it doesn't seem like a big stretch to work them all into a two- or three-paragraph lead. It's too late for me to wrap my mind around summing it up concisely right now; feel free, and I'll pitch in later as well. thx, Backin72 (n.b.) 07:33, 6 May 2006 (UTC)

Hi,

My suggestion to an alternative in that lead sentence is simply to state both meanings on the matter. Like on the german wikipedia. I'm trying to accomplish this on the dutch version. We're having the same discussion there at this moment. The french version is also a little bit fuzzy about it.

johanna(excuses for bad english)

Thanks for your comments Piekarnia. I hope you would be the first to agree that this issue is about logical and rational editing, not numbers. Four editors don't disagree with me. In fact Backin72 prefers to say most of the claims don't meet EMB or science. Backin72 also prefered to have EMB and cochrane in the lead. If memory serves correctly, he put them there and his remark above says he prefers to expand the lead. If you object to the statement I propose you will need to provide evidence that any claim for acupuncture is agreed on by the scientific community. I'm happy to consider a mediator you propose, but I would prefer you to provide the evidence first, or consider a form of words we can all agree on. You haven't quite quoted WP:LEAD correctly. It says "Where uncommon terms are essential to describing the subject, they should be succintly defined within the introduction." The question is twofold; whether EMB is uncommon and whether it "describes" acupuncture. Describing and commenting on are two separate issues. I searched the talkpage for "layperson" friendly and only found one instance in your message above. What form of words would you proposed to describe EMB in such a manner? I'm not sure what you mean by "mininmal" findings. The ref to P6 is in the body of the article. Thanks for looking at my website. I hope it was informative. Mccready 07:59, 8 May 2006 (UTC)

Hi Kevin. Thanks for your response, it's nice to be able to discuss this issue with you. I feel that there is actually a lot of agreement with what needs to go in and what should be left out, but that it's just a matter finding the right phrasing. It was my suggestion to expand on the lead section and I think it is appropriate to have a representative paragraph on the scientific stuff. I also said that "none of the evidence" should be removed in the meantime because it is inaccurate and misleading. When I said that four editors disagree with you, I meant that four separate editors have reverted the same sentence that you kept adding back in. I stated my particular objection to the sentence as two-fold:

1. That one sentence on the topic is too little, and that it should be adequately explained in the lead section itself without the need for a link. Two or three sentences describing EBM in lay terms is better than a brief sentence that readers will only understand once following a link. One sentence describing what evidence based medicine is, one sentence outlining the key players, one sentence outlining the relevant opinions. The topic of EBM in the lead section will sound more relevant if it's in context. Previously it just sounded too weird and specific, because it was tacked on at the end of a bunch of unrelated stuff. Let's give it a few sentences to do it justice. It seems quite obvious to me that the concept of evidence-based medicine is not a common term that the average reader would be familiar with. There are some deductions that one could make from the terminology, but I think it is important to properly describe it in a few sentences, don't you?

2. My objection is to the word "none". The inference is that scientific evidence for acupuncture doesn't exist. That statement is incorrect, because there is a meta-analysis that supports the use of acupuncture for P6 (Cochrane) that is disputed by another group (Bandolier). It means that there is some evidence that has been reviewed and found effective by one group, but these findings are disputed by another group. It doesn't mean there is no evidence. Stating that there is no agreement is different to stating that there is no evidence. I'm not sure which part of my rationale you don't understand, I feel that I have adequately explained my perspective several times already. Are you questioning where the Cochrane collaboration sit on the hierarchy and proposing that Bandolier sits higher? Do you consider the Bandolier findings to negate and erase the Cochrane findings? I'm not sure why you want to put "none" in the introduction despite it not accurately representing the body of the article. That is why I object to "none" and changed it to "most". The relevant evidence is already in the article and you and I are both very familiar with it, I felt no need to site it again. Let me know if it's still not clear to you. Cheers, Piekarnia 01:51, 9 May 2006 (UTC)

I agree with your take, Piekarnia. In terms of EBM controversy, don't forget headache, besides P6. I moved the Cochrane commentary there and added some links.

Kevin, please stop putting words in my mouth. Of course I disagree with your original wording. What wasn't clear about what I said above? Please either read more carefully, or quit being disingenuous; either way, it's an insult to editors' intelligence and a waste of time. I don't agree with your spin on my views. (i.e., "In fact Backin72 prefers to say most of the claims don't meet EMB or science." -- I've explained already why the "is it scientific?" question isn't very meaningful.)

You avoid the central question I raised about your edit: "Is your version, which basically summarizing Bandolier's take on EBM, a fair and accurate summary of what the article says on these matters?" You want to place the burden on other editors to "provide evidence that any claim for acupuncture is agreed on by the scientific community," as if the issue were simply a test of your statement's truth value rather than its adequacy as a summary of the article. The lead must fairly summarize all the POV's covered and not only the view of a single group of EBM reviewers. If you disagree, explain why?

Piekarnia's longer version is an improvement, imo. thx, Backin72 (n.b.) 07:50, 9 May 2006 (UTC)

Thanks P. Good comments again. Yes it's good to discuss (unlike my experience on some other pages). I'm happy to compromise with you and flesh out EBM in the lead, though as you will see from my earlier post, I don't think this is the place for a brief history of EBM. ie your points in 2 and 3 would seem better on EMB page. On "none", my wording was specific. It talked about "proof". There is no scientific proof for any of the claims of acupuncture. See Hafner and see Taub on this. It's also a question of the use of the word "evidence" - some see evidence in the entrails or clinical experience (ie the tautological anecodtal evidence) while others take it to mean something closer to proof. Supporting is also quite different to proof. Given all this I would be happy to compromise again if you prefer the wording "there is no scientific agreement about any of claims for the efficacy of acupuncture". I don't rank Cochrane versus Bandolier - I look at the evidence. I must say though that some of the Cochrane group are acupuncturists and this can be seen as a conflict of interest. As to Backin72's edit above. Gee keep cool. Am I wrong that the statement beginning "most" was left there by you for ages? Backin72, we are creating an encyclopedic article. Yes I know you disagree with my wording, I was referring to the wording about "most". Also the reader would like to know, I think, what science has to say about acupunture. Is the "single group of EBM reviewers" any scientist who says acupuncture is bunk such as Taub? Anyway, hopefully the two compromises I've suggested will meet with your approval. Please keep calm and assume good faith. Mccready 08:54, 9 May 2006 (UTC)

"What science has to say about acupuncture" -- no consensus on this in terms of efficacy, so can't refer to "science" as if it's a single voice. (Your desire to "look at the evidence" is one we certainly share, but your effort to extrapolate an undocumented majority view is contrary to all three pillars of Wikipedia -- you can't verify it, it's original research and it's POV.) Disagreement exists over what counts as evidence and how to interpret it (including the threshold for "proof") and how to apply it clinically. -Backin72 (n.b.) 19:25, 9 May 2006 (UTC)

Merge with Acupuncturist

The page Acupuncturist has not been mentioned here, it makes sense to merge the two as with Osteopath redirecting to Osteopathic medicine to avoid duplication. apers0n 09:49, 6 May 2006 (UTC)

Good idea. Mccready 08:03, 8 May 2006 (UTC)

Agree. The only caveat is article length. There has been discussion of splitting the article, and one possibility for a daughter article is the section entitled "legal and political status", which covers issues including the training of L.Ac.'s. Even so, agree "acupuncturist" should be merged and that the term should redirect here for now. Backin72 (n.b.) 01:16, 9 May 2006 (UTC)

Merger completed, added Acupuncture is practised by "Licensed Acupuncturists" and other healthcare professionals. All the rest is duplicated in the current article.

Interestingly there is also a proposal to split the Osteopathic medicine article to deal with legal and political status. apers0n 10:52, 9 May 2006 (UTC)

Pasted the following text from acupuncturist into 'legal and political status' pending splitting the article

An Acupuncturist is a healthcare professional who practices acupuncture. Acupuncture is a therapy in which thin needles are inserted into points on the body, and then gently manipulated. Acupuncturists may also practice other modalities such as herbal medicine or tui na, or may be medical acupuncturists, who are trained in allopathic medicine but also practice acupuncture in a simplified form. Acupuncturists who are not Western medical practitioners usually complete three years of acupuncture school, with a fourth year often required for those who wish to practice herbal medicine. License is regulated by the state or province in many countries, and often requires passage of a board exam.

In the United States, acupuncturists are generally referred to by the professional title "Licensed Acupuncturist", abbreviated "L.Ac.". The abbreviation "Dipl. Ac." stands for "Diplomate of Acupuncture" and signifies that the holder is board-certified by the National Certification Commission for Acupuncture and Oriental Medicine. Professional degrees are usually at the level of a Master's degree and include "M.Ac." (Master's in Acupuncture), "M.S.Ac." (Master's of Science in Acupuncture), "M.A.O.M." (Master's of Acupuncture and Oriental Medicine). "O.M.D." signifies Oriental Medical Doctor, and may be used by graduates of Chinese medical schools, or by American graduates of postgraduate programs. (However, the OMD degree is not currently recognized by the Accreditation Commission for Acupuncture and Oriental Medicine, which accredits American educational programs in acupuncture).

- needs looking at apers0n 11:22, 9 May 2006 (UTC)

Scientific Review of Alternative Medicine

This journal is cited as an example of debate over P6's efficacy for nausea and vomiting[1]. I think it's highly likely that this journal is biased against acupuncture. Its full title is: "The Scientific Review of Alternative Medicine And Aberrant Medical Practices". Its editor is Wallace Sampson, co-founder of Quackwatch and NCAHF, with Stephen Barrett. Here is what a court found in a lawsuit that the NCAHF brought and lost against a manufacturer of homeopathic remedies (emphasis added):

Furthermore, the Court finds that both Dr. Sampson and Dr. Barrett are biased heavily in favor of the Plaintiff and thus the weight to be accorded their testimony is slight in any event. Both are long-time board members of the Plaintiff; Dr. Barrett has served as its Chairman. Both participated in an application to the U.S. FDA during the early 1990s designed to restrict the sale of most homeopathic drugs. Dr. Sampson's university course presents what is effectively a one-sided, critical view of alternative medicine. Dr. Barrett's heavy activities in lecturing and writing about alternative medicine similarly are focused on the eradication of the practices about which he opines. Both witnesses' fees, as Dr. Barrett testified, are paid from a fund established by Plaintiff NCAHF from the proceeds of suits such as the case at bar. Based on this fact alone, the Court may infer that Dr. Barrett and Sampson are more likely to receive fees for testifying on behalf of NCAHF in future cases if the Plaintiff prevails in the instant action and thereby wins funds to enrich the litigation fund described by Dr. Barrett. It is apparent, therefore, that both men have a direct, personal financial interest in the outcome of this litigation. Based on all of these factors, Dr. Sampson and Dr. Barrett can be described as zealous advocates of the Plaintiff's position, and therefore not neutral or dispassionate witnesses or experts. In light of these affiliations and their orientation, it can fairly be said that Drs. Barrett and Sampson are themselves the client, and therefore their testimony should be accorded little, if any, credibility on that basis as well.[2]

The review in question uses dubious criteria to contest some of the RCT's, such as the fact that one was done in Taiwan, irrespective of its methodology. -Backin72 (n.b.) 08:07, 9 May 2006 (UTC)

Further notes on AMA

Kevin, your latest addition to the AMA section was without reference, therefore I removed it. Until you can provide a source for your statement, and explain why you added that statement and not another statement of theirs in favor of acupuncture, then I see no reason to put it back in. There are plenty of examples of the AMA saying all kinds of stuff about acupuncture (some discussed in previous AMA section), but they have not issued a policy or report that is specific to acupuncture as far as my searches have concluded. Please enlighten the rest of us if you have found such a source before putting such derogatory statements on the page. Please remember NPOV. AMA have not ONLY published unsupportive material about acupuncture, so reporting only negative comments does not accurately represent their opinion, nor is it representative of NPOV to only publish one sided arguments. Thanks. Piekarnia 05:38, 10 May 2006 (UTC)

The reference was at the beginning of the section. The words are AMA's. I've restored and put the citation. If you wish to cite other AMA material please do so. Please assume good faith. Mccready 06:20, 10 May 2006 (UTC)

Hi Kevin, thanks for putting the reference. I didn't realise it was from the same article. The phrase you quote doesn't actually relate to acupuncture practice at all, but to the practice of injecting pharmaceuticals and/or anesthetic into parts of the body surrounding autonomic nerves. This is Prolotherapy, not acupuncture, nor is it related to Traditional Chinese medicine. Perhaps such a link would be more relevant on that page instead. Cheers, Piekarnia 08:10, 10 May 2006 (UTC)

Thanks P, it be the case that some acupuncturists do it would it not? And the Prolotherapy doesn't mention acupuncture and does mention the notion of irritants, which is not the rationale apparent from the AMA quote. I have tried to craft words you may be in agreement with. Mccready 13:20, 10 May 2006 (UTC)

I do appreciate the reword, it's a good gesture on your behalf. Yes, some acupuncturists may also practice prolotherapy, but that does not make it acupuncture. Some acupuncturists also use crystal healing, that does not make crystal healing part of acupuncture. Some dentists may inject anaesthetic into an area of the body that just happens to be an acupuncture point, but that does not make what they practice acupuncture. Some gps also practice reiki, but that does not make reiki part of the standard practice of being a gp. I think you get what I mean here. Prolotherapy is not part of standard acupuncture practice, therefore has no place on this page - especially when it's described as acupuncture. With the hundreds of acupuncture points on the body, many of them near to nerve plexuses, a lot of injections are going to be into "acupuncture points". But I think you're missing the "point" by quoting this particular phrase, and as much as you would love to put the words "health fraud" and "acupuncture" in the same sentence and context, I'm afraid it's too much of a stretch for this article. Prolotherapy is not acupuncture. I would appreciate removing the references. The prolotherapy article doesn't mention acupuncture - because it's not acupuncture. Simple. They do mention the notion of irritants, and they list a few examples, one of which is lidocaine (a local anesthetic) which is inferred from the AMA quote. You're already at your three-revert limit for this 24 hour period, why don't you sit on it and think about it before re-editing. Backin72, your thoughts and contribution to this topic would be welcomed. Piekarnia 23:08, 10 May 2006 (UTC)

Agree, this is at best very peripheral to acu, deleted. Backin72 (n.b.) 06:29, 11 May 2006 (UTC)

Happy to join consensus on this, enjoyed P's wry digs too. Mccready 18:30, 12 May 2006 (UTC)

Cool; thanks for fleshing out the Tonelli too. Backin72 (n.b.) 20:39, 12 May 2006 (UTC)

Glad to provide some light entertainment for you, Kevin :) Piekarnia 06:51, 13 May 2006 (UTC)

Linkspam?

This user's only two contributions to Wikipedia consist in placing this link California State Oriental Medical Association to a website in progress on the TCM page and acupuncture page. I'd rather see it removed at this stage, at least until their website is fixed.Mccready 06:23, 14 May 2006 (UTC)

There doesn't seem to be anything wrong with the webpage now, seemed fine when I visited it. Provides basic info on tcm plus a link to the Californian Journal of Oriental Medicine. Piekarnia 12:24, 14 May 2006 (UTC)

CSOMA is the practitioners' organization in California, where the profession is well-established. Actually one of the better sites of its kind (representing Western TCM practitioners), and the FAQ section works. I finally went ahead and reworked the External Links section; please let me know what you think. Haven't got the Spleen Qi to take on the bibliography just yet. ;-) thx, Backin72 (n.b.) 04:29, 15 May 2006 (UTC)

Lead section, again

Kevin suggests:

Acupuncture (from Lat. acus, "needle" (noun), and pungere, "prick" (verb) or in Standard Mandarin, zhēn jiǔ (針灸) is a Traditional Chinese medicine whereby needles are inserted and manipulated into "acupuncture points" on the body in order to restore health and well-being.

That sentence is awkward and not technically correct, unlike the original:

Acupuncture (from Lat. acus, "needle" (noun), and pungere, "prick" (verb) or in Standard Mandarin, zhēn jiǔ (針灸) is a broad term covering techniques for inserting and manipulating thin needles into "acupuncture points" on the body in order to restore health and well-being.

Kevin suggests:

Acupuncture theory is not based on health knowledge accepted by the scientific community.

True for the most part, but not an adequate summary of what the article says about theory. If the lead section is going to discuss theory, it should say what it is (TCM, etc.) as well as what it isn't, and do so in proportional correspondence to what the article says about it. WP:LEAD is quite clear that the criteria for sentences in the lead section are not just that they be true, but that they adequately summarize the article. Given that, how is it justifiable to say about acu theory only that it's not scientific?

Kevin suggests:

Proponents of various acupuncture traditions throughout the world (Japanese, Korean, and classical Chinese) disagree on locations of acupuncture points for treating a given condition.

Source please? Extent of disagreement? Also see comments above re adequacy of summary -- those comments apply even more here. Currently there is no discussion of disagreement over point location in the article at all. So what's it suddenly doing in the lead?

Reverted/edited subsequent sentences in first paragroah to:

Acupuncture is practised by "Licensed Acupuncturists" and other healthcare professionals. In the West, it is sometimes considered a branch of Traditional Chinese medicine (TCM) along with herbal medicine and tui na. Other types of acupuncture, notably Japanese, Korean, and classical Chinese acupuncture, are practiced and taught throughout the world.

Backin72 (n.b.) 06:37, 17 May 2006 (UTC)

Hi Backin72, I took out the licensing stuff becuase it contains an inaccuate implication. In many parts of the world, for example in most of Australia, there are no licensing requirements. The tui na stuff may be relevant but not in the lead, likewise for herbal medicine. Of course the proponents of different schools disagree. How would you have product differentiation otherwise. But here are some links for you.

On Korean belief, a quick google finds 'Korean Hand Acupuncture is a popular subset of Korean Acupuncture where the hands are considered a microsystem of the entire body. Within this system you may diagnose and treat conditions anywhere in the body by treating just the hands.' Similarly on the Japanese belief To contrast with TCM, Japanese acupuncture typically uses thinner needles, less points and less stimulation by using more shallow needle insertions even to the point of just touching the needle to the skin. Additionally, while not entirely unique to Japanese acupuncture, practitioners tend to use the abdomen as a diagnostic tool more often than other styles of acupuncture. [3] Here's another link among hundreds [4]. And the Japanese style resembles next to nothing of TCM and on Korean The first school believes the middle (3rd) finger is the torso and head, with the arms being the 2nd and 4th fingers, and the legs being the 1st and 5th. The second school thought the thumb (1st) the head, the palm the torso, the 2nd and 5th fingers the arms, and the 3rd and 4th the legs.[5] Here's a nice piece of product differentiation Japanese acupuncture today is different from Chinese, though it originated in China and came to Japan about 14 centuries ago. Japanese acupuncture, generally speaking, involves thinner needles and a shallower needle insertion, making a treatment more relaxing and less uncomfortable. It relies on moxibustion (heat therapy) as much as it does on acupuncture needles in treating people. This combination is very effective at giving the patient a well-rounded gentle, yet, powerful treatment. and Traditional acupuncture associates each point with a list of symptoms that it treats, and then the practitioner chooses points accordingly. However, the Traditional style takes the individuality out of a treatment, treating each patient suffering from the same illness with the same points. The very important thing left out of the Traditional style is treating both the symptoms and the cause of your condition.

Classical style, on the other hand, targets both symptoms and cause. By doing so, your ailments will resolve and your constitutional health will be boosted. With this type of treatment your digestion, sleep, stress level, etc, will also change for the better and so your overall health will be greatly improved. That is why our clinic is called Classical Acupuncture clinic.[6] Do I need to provide further evidence? I don't need to provide links on Five Element Acu do I?

We don't need to say in the lead what TCM is. That's what the link is for.

Hope you can reconsider your revert in the light of this. Mccready 07:34, 17 May 2006 (UTC)

Added US qualifier for LAc.

Just providing a link to TCM doesn't address this central issue: "True for the most part, but not an adequate summary of what the article says about theory. If the lead section is going to discuss theory, it should say what it is (TCM, etc.) as well as what it isn't, and do so in proportional correspondence to what the article says about it. WP:LEAD is quite clear that the criteria for sentences in the lead section are not just that they be true, but that they adequately summarize the article."

Your references discuss different styles of acu, and the only mention of point location disagreements are in Korean Hand acu (which is in fact incorporated into O'Connor and Bensky's translation of Shanghia U of TCM's teaching text). There are also systems of ear, foot, face and nose acu. Except for ear acu, these systems aren't widely used in the West. They aren't the same as standard body acu. Your references on different styles would be good to put in the article, but there is in fact little disagreement over body acupuncture points (the main channel points and extra points, like Yintang). It's misleading to suggest that there is unless you have a good ref that says so. I'm fine with changing if you can show sources and congruence with policies on the lead. Haven't seen this demonstrated yet. thx, Backin72 (n.b.) 08:56, 17 May 2006 (UTC)

The only other disagreements over the location of points that comes to mind is a collection of points called the "ghost points" that were initially described by sun-si miao in 1200AD (or whenever he was alive), but that has more to do with translation than anything else.

I agree with the removal of "Licensed acupuncturist" because not all acupuncture practitioners are "licensed" some are registered, some are qualified. The term acupuncturist is fine, and I think it is important to state that acupuncture is also practiced by people who aren't qualified as acupuncturists. We should keep that sentence and remove "Licensed".Piekarnia 09:16, 17 May 2006 (UTC)

Backin72, Let's take this one step at a time. 1. The prominence now given to US licensing practices in the lead is misplaced. Why do you think the point belongs in the lead ahead of other issues? Or are you happy with P and I to join the consensus 2. The Korean hand school is definitely an example of different needling points believed to have differing effects. This needs to be in somewhere. And I hope you can concede this point. 3. On the issue of Japanese acu, I'm happy to concede you are correct and we are talking styles not acu points. In that case the article needs to make the point about differing styles. Mccready 11:39, 17 May 2006 (UTC)

Agree no reason to weight toward US terminology; removed sentence entirely for now. One accepted definition of "acupuncturist" is anyone who practices acupuncture (irrespective of their training), so it seems tautological and odd to say something like "acu is practiced by acu'ists and others". Not sure it's necessary for the lead to mention the issue of who practices and how they are licensed at all, since it varies so much by locality, so we'd just have a vague statement not conveying much useful info. Also removed mention of tuina and herbal medicine from lead.

Kevin wrote: "The Korean hand school is definitely an example of different needling points believed to have differing effects. This needs to be in somewhere. And I hope you can concede this point." Sure, please feel free to add a section to the article on Korean Hand Acu that mentions this and other salient points about that system. If that section grows into its own article, then your point could go in its lead section.

Kevin wrote: "On the issue of Japanese acu, I'm happy to concede you are correct and we are talking styles not acu points. In that case the article needs to make the point about differing styles." Yes, it would be good if the article also had good, NPOV coverage of Japanese, French, Five-Element, and other non-TCM acu's. thx, Backin72 (n.b.) 17 May 2006 (UTC)

Reversions May 26 2006

Recent edits to the "Safety and risks" section by Mccready are (as is often the case) misleading; these refer to malpractice by unregulated pracitioners and that needs to be clear. Article should accurately convey the degree of safety when regulated and risks of lack of regulation.

NIH cites surveys showing safety, which accord with restored sentence in first para. Need to cite reliable and unbiased source for assertion otherwise. thx, Backin72 (n.b.) 21:45, 26 May 2006 (UTC)

You're way out of line here Backin72. Whether an acupunturist is regulated or not is not the point. These people are practising acupuncture. In fact they are regulated by health and saftey provisions of local councils and by other ordinances, a fact you would have gathered if you had read the report properly. This is a government report about a serious health and safety issue. It contains concerns of "legitmate" practioners. It was povish of you to delete it, ESPECIALLY as we had already discussed it and you had already welcomed its inclusion. If you are reluctant to see your industry cleaned up, please don't bring that reluctance to your editorial attempts on this article. Mccready 01:52, 27 May 2006 (UTC)

Show me where I agreed on including those things out of context. What I did agree to is given above. This is an encyclopedia -- would an encyclopedic article on hand surgery include horror stories about hand surgeries gone wrong and omit the notable fact that the practitioners were unlicensed? Doubt it. And again you're engaging in careless editing: The second quote, from Li, is from Chapter 3, subsection entitled "The Case For Regulation", and is explicitly about unregistered practitioners. The first quote is from the same section, which outlines the harms of having inadequate regulation. Nowhere do you make this clear. If you want to include the issues raised in that article, do so less POVishly. I don't think other editors should have to keep cleaning up after your careless edits. I'm not the one whose user discussion page is covered with these complaints; you are. Fixing this is incumbent on you, not me. thx,Backin72 (n.b.) 02:37, 27 May 2006 (UTC)

In the time you wrote this you could have made your little edits. It is against WP policy to delete material as you have done. There are NO LICENSED acupuncturists in NSW. They ARE regulated. I have edited again to try to meet YOUR needs. Please edit the material to suit yourself rather than deleting again. Your attitude is tiresome. Mccready 02:54, 27 May 2006 (UTC)

Come on, you should know better than to accuse me of violating WP policy for deleting POVish stuff. These issues are handled by consensus. Safety section needs some work and I'll do so soon. thx, Backin72 (n.b.) 09:03, 30 May 2006 (UTC)

So I'm back after a short break (and dosed up with some Xiao Yao San). Kevin, I read the report that you linked to, and failed to see the relevance of the quotes you selected. The people referred to were in breach of the law and not representative of acupuncturists as a whole. I think it's important to state that single-use disposable needles should be used wherever available and disposed of properly. Just because a handful of practitioners - who probably aren't qualified - choose to break the law by not complying with the skin penetration act, doesn't mean it should find its way into an encyclopedia. It is an argument for more stringent regulation - which is happening. When acupuncture is practiced by competent and educated professionals in compliance with appropriate regulations it is quite safe. When the guidelines aren't followed, problems ensue - just like they would if a gp decided not to comply with such regulations. But it is not relevant on a general encyclopedic page about acupuncture. Cheers Piekarnia 09:38, 5 June 2006 (UTC)

Hi Piekarnia, good to see you back. I did think that those quotes were a bit undue-weight-ish as well, but since they are referring to things being done today by unlicensed/ill-regulated practitioners, they should go in -- same as if unlicensed midwives were failing to wash their hands, etc. As long as the section tells it like it is across the board, giving due weight to settings where acu'ists have to meet licensing standards and use standard precuations, I think it's fine. I've been meaning to get around to reorganizing that section. cheers, Backin72 (n.b.) 22:08, 5 June 2006 (UTC)

References removed from main page until verified

The following were removed because they lacked crucial information required by Wikipedia Guidelines for Citing Sources.

• Zhen Jiu Xue/ Tai-zhong Association of Chinese Medical Doctors, the Publishing Committee on Acupuncture, 1976. (Chinese characters for all of this to follow)

Article is biased

Who wrote this, AMA shills? Acupuncture is highly efficacious. I am skeptical and not at all fond of New Age things, but acupuncture doesn't fall into that category at all. Nor am I a vegetarian or crank--I eat everything and I fully subscribe to Western medicine for everything. I would not go to an acupuncturist to cure a massive infection, for example. But acupuncture works beautifully for nervous conditions, stress, anxiety and a whole raft of non-specific complaints especially when the etiology can't be established. bamjd3d 03:10, 7 June 2006 (UTC)

It would be good to include stuff along the lines of what Western acu'ists tend to see in the clinic. I'd agree re the conditions you mention, along with a wide range of pain complaints. That's much more representative than the WHO list, IME. Let's see if we can find a solid source along these lines. thx, Backin72 (n.b.) 08:06, 7 June 2006 (UTC)

What about acupuncture for weight loss and allergies? Does it really work? (Jada) 12 June 2006

Your question is a little like asking whether sspirin will work for headaches. If a person is suffering from a tension headache, taking an aspirin or two may first relieve the symptoms of pain, and relieving the pain may let the blood vessels go back to their normal status. So the headache will be cured. But if the person has a brain tumor, then the aspirin probably will not even be effective in pain relief.

In other words, the theoretical answer to your question would depend on what the causes for the overweight condition are, and what the causes for the allergies are. If the person is overweight because of his/her desire to gain weight to be able to play a certain character in a movie, or because some evil dude has hypnotized this person and given him/her a compulsion to eat -- in other words if the person is overweight because of some strange environmental factor, then there would be no reason to believe that acupuncture would help.

If somebody is becoming overweight because of some kind of malfunction of the mind/body system, then the question would be whether there is a doctor who can figure out what is actually causing the problem, and whether that doctor can figure out how to manipulate the mind/body system with needles, finger pressure, or whatever needed in order to restore normal function.

Allergies are reactions of the immune system to something coming into the system from the outside that is associated with damage. So if you get a dose of some nasty microbe in your nose and you begin to have a runny nose, to sneeze, and to cough, then that's a good thing. What seems to happen with conditions like hay fever is that something that is essentially innocuous gets into the system and gets treated as though it were a harmful micro-organism. Our bodies tolerate all kinds of microbes without objection, so it is a little odd that the body would fail to tolerate something that is not doing any harm. Possibly what happens is that (1) the individual is rather more trigger-fingered that are most people, and (2) something bad happens to the body while the pollen is present so that it suffers a kind of guilt by association.

One way of treating an allergy is the chemical analog for the treatment of phobias. One waits until the body is not reacting to the allergen (e.g., winter time if the problem is with a plant pollen), and then one introduces a very small amount of a very dilute preparation of the allergen. If that dose is tolerated, then a few days later a slightly higher dose is given. As long as no allergic reaction occurs, the dosage in increased. By the time the flowers bloom, the body is already tolerating high levels of the allergen.

N.B. This procedure is potentially dangerous. A little overdose (e.g., going up the next step even though the previous step was not well tolerated) can produce a reaction at the injection site like a bee sting. A large overdose could be deadly. When I had the treatment in the 50s, they started by evaluating the sensitivity test for intensity. Then they ordered the prepared serum from a specialty pharmaceutical house. After the injection I had to hang around the doctor's office for 20-30 minutes just in case something might go wrong.

Any treatment that involves subjecting a person to allergens to which s/he is sensitive can be very dangerous. Accidental ingestion of minute quantities of peanut can be deadly to some people.

There are all kinds of supposed acupuncturists in the world. I once went for treatment to a person who had been trained as a chiropractor. He dropped a needle on the carpet, picked it up, and used it on me anyway, saying that acupuncture needles could not transmit disease. I was a fool not to have stopped him from using the needle. At least I had the sense to not go back to a supposed doctor who did not understand or accept the germ theory of disease. In that case he at least had credentials displayed on his wall.

Just be careful who you give control of your body. If you had a million dollar sports car, would you let me drive it? :-) P0M 17:53, 15 July 2006 (UTC)

Treatment by acupuncture, if it can be done, would work by calming to allergic response in the presence of the allergen. As far as I know, there would be no other way of safely and effectively doing allergy reduction. You don't just want to knock the immune system out. It's not good to catch tuberculosis just to avoid hay fever.

Assuming that somebody knows how to calm down the immune system, then the next question would be whether the patient can find a therapist who can actually figure out the patient's body and can actually program the patient's treatment.

It would be interesting to see a good study of treatments of these conditions. But one would have to rate the physicians, rate the severity of the problems, and also have a large enough study for it to be statistically valid. I think there has not been such a study. P0M 03:53, 15 July 2006 (UTC)

Category:Pseudoscience

An editor recently added this category (with the highly misleading edit summary that he was "reverting vandalism": I did remove the tag from two related articles, but it had never been on this one. Also, good faith edits should never be called vandalism). I just removed the tag, and here's why.

There really is no compromise between having the cat tag or not, so we have to look to WP policy. The NPOV default is not to have it, because it endorses a POV (cf. WP:CG, which says not to use categorizations unless they're obvious, straighforward and uncontroversial). The WP:V default is to place burden of proof on editors who want the tag to stay. If that POV isn't demonstrably widely accepted, we shouldn't use the tag, but rather present relevant POV's in the article.

There is no evidence for scientific consensus that acupuncture is pseudoscientific. A range of views exist, and if there is consensus it's that we don't know and need to study it. See the EBM reviews in the article, which show that debate about efficacy is taking place among mainstream scientists. Also see this talk from Prof. Edzard Ernst.

I have no problem with the article discussing the skeptical view that acu is pseudoscience. I recently wrote the section on "Criticisms of Traditional Theory" in the spirit of "writing for the enemy". It's a significant view, well worth presenting, but not a demonstrably majority view. From a good faith POV, which approach improves the article more: adding a section presenting criticism, or insisting without discussion that the pseudoscience tag be present?

Vocal hardline skeptics don't necessarily speak for all scientists. Skeptics undermine their own credibility by arguing from authority ("X says it's pseudoscientific, so it must be so"). The fact that there is debate among EBM reviewers shows that multiple, credible POV's exist among scientists. Let's get back to NPOV and present all views, but endorse none. Thanks, Backin72 (n.b.) 17:22, 10 July 2006 (UTC)

Just removed again. Happy to discuss. Any response to arguments above? See esp. WP:CG and WP:V. Thanks, Backin72 (n.b.) 00:15, 18 July 2006 (UTC)

I do not believe that it is pseudoscience either. The herb lady who prepared infusions of foxglove for heart patients was not a pseudoscientist because she had made a simple empirical discovery. Due to the openmindedness of a traditionally trained M.D., her discovery was recognized for what it was. She could just as easily have been called a quack. As far as I know, she was not interviewed, so we do not know how she made her discovery or how she would have defended her choice of therapy. Perhaps she was in the habit of trying various things on herself, noting their effects, and then trying them cautiously on people who displayed symptoms that seemed to her likely to be helped by the medication. Maybe she kept written record, maybe she just had a very good memory, but somehow she figured out how to calculate dosages.

It would be really interesting to discover cases in which a standard acupuncture treatement was abandoned because people noticed that it did not work

It seems to me that pseudoscience is typically an explanation that begins with a conclusion and seeks evidence to support it -- frequently with little between the "primal truth" and the "theoretical" conclusion. P0M 03:08, 18 July 2006 (UTC)

Robert Carrol and Pseudo science

Why not remove the confusing bit attributed to Robert T. Carroll. The quote given in the WP acupuncture article is from his web site -which is to encourage critical thinking. Reading through his preface ( http://skepdic.com/preface.html) it is clear that he is not stating any of what is on there as 'gospel,' nor, that he agrees with all of it. He even includes the resent positive findings by Professor Professor Sykes at the very end (and not a reference but the full newspaper article). http://skepdic.com/acupunc.html

Therefore, is it not wrong to use the 'Septidic' web site 'definition' as a 'criticism.' This leads me to consider it's not suitable for inclusion in an encyclopaedic article. The WP Acupuncture article already goes to some length not to confuse the reader into thinking acupuncture is something that it is not. The Robert Todd entry just reinforces the confusion in those that are already confused.--Aspro 14:18, 18 July 2006 (UTC)

I don't agree with Carroll's logic, but his view does appear to be shared by some vocal "skeptical" types and therefore seems OK as a significant minority view. He doesn't say it's gospel, just an opinion, which the world is full of ... cheers, Backin72 (n.b.) 02:46, 19 July 2006 (UTC)

Kevin added category:pseudoscience with the edit summary "agree/disagee is not the point. significant people say so. Manheimmer refuses to show the data ernst quotes!!)". I added Template:Disputed-category and asked "Which 'significant people', + how is that sufficient to use cat given WP:CG?" It's been a few days since then, and no replies, so in the spirit of bold, revert, discuss I'm now removing both the cat and the template if that's what it takes to get discussion going.

There is unfortunately no compromise between having a topic be in a cat or not. I argue that it's misleading to use this cat because the reader will think scientific consensus is that acu is bogus, whereas in fact some scientists say there is evidence for acu's efficacy and take it seriously enough to study it. We should discuss different views in the article, but WP shouldn't "categorically" endorse one POV. See WP:CG. Also, "significant people say so" isn't enough to justify using the cat (and who are these people, btw?). WP:NPOV#Undue_weight says that quotes from "prominent adherents" are fine to establish something as a significant minority POV, but those don't necessarily suffice to prove popular or scientific consensus. For scientific consensus, we look to reer-reviewed literature, and that shows evidence-gathering and argument over evidence, not dismissal as pseudoscience. --Backin72 (n.b.) 06:27, 27 July 2006 (UTC)

Backin72 there are enough people saying it's PS to justify the label. Data from the key paper is being withheld by Manheimer. I don't agree that this is how science should be conducted. I'm replacing the label. Mccready 06:53, 27 July 2006 (UTC)

"Enough key people" (who?) doesn't cut it per the reasons I gave above referring to WP:CG and WP:V. You're repeating yourself but not answering those arguments. Manheimer's conditions for sharing the data (i.e. w/ other academics) are entirely acceptable. Besides, other people incl. Ernst himself co-authored that review, and in any case Cochrane's review (different dataset, all but Berman differant authors) reaches the same conclusion. See WP:OR; if your criticisms are good, someone will get around to publishing them; until or unless you publish them, they can't be used for editing WP. You can't categorize something because "some people say so" or because of an email exchange you had, and I doubt most editors would support such logic. thx, Backin72 (n.b.) 15:28, 27 July 2006 (UTC)

You missed my earlier point Backin72. It doesn't matter whether acupuncture turns out to work or not; confusing what is 'logically possible' and 'physically possible' is such a basic error of critical thought that: either the significant authority has been misquoted or it indicates he cannot be of any 'significance' to start with. It automatically follows on: the same must be true for anyone else who makes the same error. So Robert Carroll's nonsense ought to be removed as it confuses the issue. --Aspro 12:57, 27 July 2006 (UTC)

I just do not follow you here, Aspro. Carroll is not making the error of logic you presume. He is saying that acu is pseudoscientific because its TCM theory predict things using concepts like "flow of qi" which are scientifically untestable. Agree it's a bit of a straw-man argument since scientists can still test predictions of efficacy irrespective of the metaphors used to make them. But Carroll has been quoted directly, as you can see from clicking through. Bottom line, I have no special attachment to that quote and just wanted to include a notable person from the critical end. Please substitiute a better quote if you like. thx, Backin72 (n.b.) 15:28, 27 July 2006 (UTC)

The answer I have just given to Backin72 addressees or covers part of your point too Mccready. However, you come across as so passionate at getting things in boxes you will no doubt need to understand more before being prepared to accept this, as your employing compounded errors, (ie. inferior boxes being able to enclose their superior boxes simply because some people mix up rhetoric, logic and the meaning words in the hope that others wont notice.). Suggest you start of at Critical thinking and go though it slowly, (be patient; at night-school it would take three months, just as crash course introduction to the subject). Though it, you will discover how to compare attributes and classify correctly etc. --Aspro 12:57, 27 July 2006 (UTC)

For guidance on the use of categories, we may also look to the NPOV FAQ: Wikipedia:NPOV_tutorial#Categorisation. That refers to Wikipedia:Categorization_of_people, which says:

Not all categories are comprehensive: For some "sensitive" categories, it is better to think of the category as a set of representative and unquestioned examples, while a list is a better venue for an attempt at completeness. Particularly for "sensitive" categories, lists can be used as a complement to categorization.

This is the same idea as presented in WP:CG, which says:

Categories appear without annotations, so be careful of NPOV when creating or filling categories. Unless it is self-evident and uncontroversial that something belongs in a category, it should not be put into a category. ....

Whatever categories you add, make sure they do not implicitly violate the neutral point of view policy. If the nature of something is in dispute (like whether or not it's fictional or scientific or whatever), you may want to avoid labelling it or mark the categorization as disputed.

Thus, NPOV doesn't trump WP:CG at all, as some have argued (See Category Talk:Pseudoscience; rather, WP:CG and other category guidelines provide guidance on how to use categories within NPOV.

Acupuncture has been said by some to have pseudoscientific aspects (i.e., TCM theory, if taken literally rather than as metaphor). But this is neither a demsonstrably majority view, nor does the PS criticism apply to every aspect of acupuncture (its claims of efficacy are testable, etc.). Thus using the category is inappropriate in this case. However, it's fine to include acu on a list, with proper sourcing and annotation, as in pseudoscience. Because lists can be sourced and annotated (see WP:LIST), the threshold for inclusion of a topic is lower for a list than for a category. All of this follows from the guidelines linked from the NPOV FAQ. cheers, [[[User:Backin72|Backin72]] (n.b.) 20:18, 9 August 2006 (UTC)

Overly commercial links

I am concerned about the links under Advocacy and discussion. They seem to be doing little more than funneling people to non informative sites primarily selling herbs, books, and other such garbage. The one I am most concerned about is http://www.chinesemedicinetimes.com/. All sides of the page are lined with ad's. The "research" they have is scanty at best and only qualifys as research under the most broad of definitions. I am removing it and it is my opinion that many others should be removed. Does anyone else have any thoughts on this? Foolishben 18:09, 21 March 2007 (UTC)

External link citing studies

Since someone removed the page I added--a collection of published scientific articles about the medical uses of acupuncture--I added it back. Although the page is within a larger site with commercial purposes, no products are listed for sale on this page, so it is similar to other organizations in this section which take money. Since the section is clearly marked advocate sites, readers are alerted to the potential for bias. Moreover, the fact that these are full-length scientific articles published in reputable journals adds distinct value to readers. They can read the articles and judge the research for themselves.--Azzazz

Threshold for inclusion of individual studies?

Ryanjo recently added a summary of a German study on knee osteoarthritis[7]. It was added to the "Evidence-based medicine" section, but since EBM by definition is concerned with reviews and not individual studies, I thought it best to move the study to a separate, new section entitled "examples of controlled studies"[8]. However, hundreds of studies exist and this could quickly get both overpopulated and POV-ish as some editors will inevitably attempt to cram in as many positive or negative studies as they can, depending on their POV. Suggestions on how to handle this issue? inclusion is good, but I'm not sure what the criteria should be for individual studies. It could get pretty wild. I've tended to believe it's best to quote significant groups commenting on research (NIH, AMA), along with EBM reviews. So maybe better to delete it, even though I prefer to err on the inclusionist side, and continue to keep EBM updated, since EBM reviewers will inevitably take into account this and other studies systematically. Thoughts? reagrds, --Backin72 (n.b.) 04:08, 9 August 2006 (UTC)

I don't know the answer either, but I'll give you my thoughts to see if combined with yours they are strong enough to throw light into dark corners.

It is the quality of the trials and the quality of the reviews that are important, rather than whether they are positive or negative.

It is newspaper hacks that go for giving both sides 'equal ink' rather than explaining the quality of each argument - not expected in an encyclopaedia.

Further: there is a misconception in some folks, that because 'scientific scepticism' seems to 'refute' all the time that this is how scientists works. Research is more of a 'hard slog' to 'confirm' that something agrees with what has already been established (other facts) and then see if another labs agree or fails to agree. If they disagree, then modify to make good any weakness in the protocol that peer review found wanting and perform a new trial. Bad hypotheses -just fad away in the process. They don't usually get to the point of being refuted. (Gosh!.. Don't I make it sound simple!)

So, I would look out for (i) individual studies (pos & neg; strong and week) that have been reviewed by other research peers. (ii) For reviews of several trials (using tunnel analysis etc) look again at the credentials of the reviewers. In other words don't burden yourself with trying to judge trials which is really the job for the individuals with the relevant experience who are more familiar with the mathematical and other faux pas which can come about in science.

Therefore: I would strongly go for asking that only peer reviewed research get listed.

Perhaps a box at the top of the talk page can state this? Perhaps also have a box on the talk page for new research releases that sound promising but which has not yet been properly reviewed (e.g.. The Sykes BBC trials)

The next problem is that 'any' medical treatment were the outcomes will differ widely from person to person (due to when symptoms are due to multiple possibilities of different gene expression) is not best suited to this form of medical trials, be it acupuncture or psychiatric medication etc. but it's all there is (clarification: until modern genetics came alone it was heresy to suggest the same set of signs and symptoms may have different underling causes -because it was / is the signs and symptoms that are used to confirm the disease.) So, it is not surprising perhaps -with the benefit of hindsight- that this method has only shown 'promising' positive results in pain control -suggesting that it is a 'specific' set of genes that have their expression changed in the CNS (by acupuncture) and that this 'set' is the same for 'most' individuals. Therefore, it may be worth explaining the limitations of this type of approach to determine existence -or otherwise- benefit of treatment. The general reader may not appreciate where the strengths and weaknesses of medical trials lay. It needs to be spelt out for them. Not because their stupid but because most humans have areas of high specialisation and understanding and other areas which they find -just bore them silly. Might also be worth asking a child: read this, then tell me: what else would you like the article to tell you.

They wont have any preconceived ideas to call upon to fill in for any short comings in the text, so if bits don't make sense to them they will tell you.--Aspro 18:58, 12 August 2006 (UTC)

Thanks for your perspective on this, Aspro, and sorry about the slowish reply. Certainly agree that quality of studies ought to be the criterion as opposed to outcome. I agree that it could be useful to discuss some individual studies that well-credentialed reviewers have cited, or that are of comparable quality (e.g. above-mentioned knee osteoarthritis study, which Cochrane or some reviewer should get around to soon). On the issue of individual variation, I agree this is relevant, but wouldn't sufficiently large and randomized populations account for this factor? (Assuming that the studies are adequately controlled, which is non-trivial when studying any procedure as opposed to a pill....) Cheers, --Backin72 (n.b.) 05:41, 17 August 2006 (UTC)

Whilst I would like to think that sufficiently large cohort would pull out the signal (if any) from the noise, I expect that that such a trial would be prohibitively too expensive to perform.

Also, I think it is using the wrong approach.

To call upon an analogy:

Watching children messing around in dinghies, one observers how quickly they learn to judge just how far off the centre line the Center of Buoyancy can go before capsizing (and colder the water the quicker they seem to acquire the skill). They do this without recourse to: pencils, paper, calculator or text book on naval architecture. To load a cargo ship (well) by calculation takes a lot of time (or so I was once informed). Yet, a child can instinctively move themselves or a mass or many masses to a position to keep his/her boat in the best of trim. Therefore, with so many possible variables to unbalance on organism it would take a very large cohort for each physical and mental complaint that is compared against orthodox treatments.

(When I first started work, digital computers where too slow to do mathematical modelling so boffins often used analogue computers. Therefore, I suppose because of my background: when I read the traditional theory of acupuncture etc., I do not see 'a theory' at all but possibly a 'narrative' built up of observations - I'm not claiming that it is- but just possibly - a narrative- formed from many trials and errors - that helps a dynamic system to regain balance. Maybe a 'prescience' is a better name for it than 'theory'. Also, for an 'armchair philosopher' not to be able to probe the shadows beyond this point is to demonstration enough to me: that he or she has reached their personal level of incompetence. See: the Peter Principle) As a further aside: Today though, with faster computers and a large body of software know-how to call upon, it may be time for pursuing a 'systems approach' to medicine.

It is interesting to note that when I looked up the work on this approach to managing diabetes, I see that it was the idea of Complementary and Integrative Medical Therapies department of Harvard Medical School. However, the idea is now 'old hat' in some of the sciences such as engineering.

Shucks...! Another aside. My college (who has been looking over my shoulder) has just pointed out that the theory of naval architecture is absolutely and unequivocally pseudoscience !!! His reason: you can not 'see' a ships center of buoyancy nor X-ray it! Nor whip out a tape and measure the Metacentric height. Nor cut out the center of gravity and put it on a set of scales and weigh it. Yet all these things are supposed to be influence by all the other parts of the ship and yet he (nor I -now I come to think about it) have ever seen any lines or ropes -or anything at all- that this force of buoyancy can travel along. Think we had all better stick to 'firm' dry land from now on... Cheers --Aspro 10:44, 17 August 2006 (UTC)

Good & interesting stuff Aspro... I knew someone who studied naval architecture and that is a very good analogy on self-regulation. I certainly don't mind such comparisons either. Yes, speculation and metaphor do not automatically a pseudoscience make. And pointing out that there's stuff we don't know about the human organism isn't mere appeal to ignorance. IME, acupuncture is pretty amazing at helping people "reset their course" and reduce stress. There are studies that back this up, but it's hard to measure general well-being as opposed to particular symptoms and signs, or absence thereof. best, --Backin72 (n.b.) 06:13, 18 August 2006 (UTC)

Edits by User:Acupuncturist

Hello Acupuncturist! As a fellow L.Ac., I appreciate your contributions and perspective here. In changing your edits, I'm not saying that they aren't the "truth" as you suggested in your edit summary, but I am urging that we attend to WP guidelines which recognize multiple "truths" about topics. Please understand that the page in its current form represents consensus carefully developed over time among multiple editors, and significant changes (like in the lead section) should be discussed here first. You are adding some good points that I attempted to work into the article, although some do need citation (per WP:V), and some seem a bit too "pro-acupuncture" in tone (see WP:NPOV). Not everything needs to be in the lead section. In a couple of cases, and please don't take offense, I felt that the same basic idea was more clearly or concisely conveyed in the original text. Look forward to your thoughts, and welcome to Wikipedia! best regards, --Backin72 (n.b.) 02:25, 25 August 2006 (UTC)

I am not a computer user. Mostly I am a healer. After one has heard it from literally hundreds of people I think one has earned the right to the title. I think that there are hired "experts" out there who are gainfully engaged in distorting the truth about this nonpatented not elitist form of medicine. It seems easier to establish credibility with one source citing multiple studies aginst acupuncture. It is grossly unfair that the Gerac study did not appear. Does a study have to be performed by disinterested doctors to be considered legit on this site... My uncle was in one of these so-called studies and the doc was very rude, always used the same points never asked any questions of him and whaddya know after a couple of treatments he didnt feel any different. Acupuncture is a medical art, something which corporate medicine can do without, as it interferes with the bottom line.

By the way my uncle, years later got a treatment for 2 week old, bent- over back pain that went away after one time with me. He said the experience was completely different.

COMMON ADVERSE EVENTS??? are you guys crazy? Who does your acupuncture a gorilla? (the preceding unsigned comment was left by User:Acupuncturist) 23:53, 28 August 2006 (UTC)

Hi Acupuncturist. It's always good to have the contributions of practicing acupunturists. Several others have contributed here as well, including Piekarnia (who is missed) and myself. An important thing you'll find on WP is that editors of all backgrounds follow the basic policies of WP:NPOV, WP:VER and WP:OR. Whether you're an experienced computer user or not, you'll find those are good ones to review.

Some comments:

• I agree with you about the importance of bedside manner and your caveats about study design. NIH mentions a bit of the latter.
• Thanks for adding the material on tongue diagnosis; I expanded the diagnosis subsection of Traditional Theory in line with Cheng.
• In your editing, please be careful of punctuation and that you don't cut off other references (scroll down to LIne 218, [here].)
• "Common, minor adverse events" is what the article says. Let me capitalize MINOR there to emphasize that.  :-) Ernst is pretty accurate about occasional bleeding, etc.
• "Evidence-based medicine" refers specifically to reviews according to particular protocols. The research on efficacy and observable effects that you added is fine; I just moved it to other sections. Gerac.de is in German; English Wikipedia strongly prefers English-language subjects.
• Excellent references on safety; thank you!
• Finally, I've removed this for now: it doesn't have anything to do with acupuncture, but could be included in another article.

"Antibiotic overuse leads to resistant super-bacteria. 'The prevalence of antibiotic -resistant bacteria in Taiwan is due to the heavy use of antimicrobial agents in both animal husbandry and clinical practice over the past decades'" Int J Antimicrob Agents 2001 Sep.

OK, thanks! best regards, --Backin72 (n.b.) 06:24, 29 August 2006 (UTC)

I still haven't had the time to read how to work this stuff correctly, I work an hour from my clinic and currently work long hours to maintain a cash based practice. gerac used to have an English tranlation. the Acupuncture Today article is archived at www.acupuncturetoday.com/archives2002/jul/07gerac.html. Also Brian Carter has a great site for Acupuncture resarch archives at www.pulsemed.org. I'm determined to make it home before 10 tonight. peace. acup.. 23:41, 29 August 2006 (UTC)

Oh, OK, I know what GERAC refers to now and had just forgotten the name. Good stuff; I'll add the Acu Today link. I wonder what type of sham acupuncture they used? all the best, --Backin72 (n.b.) 06:07, 30 August 2006 (UTC)

Proposed merge of Electroacupuncture according to Voll

No vote on merge; it's much more far-out than plain-vanilla acupuncture, plus the article is already too long and is ripe to have stuff spun off (some candidates that come to mind are meridian theory, TCM diagnostics and aspects of scientific studies). Electroacupuncture according to Voll would probably be better merged with bioresonance therapy or some related thing. thanks, --Backin72 (n.b.) 07:29, 31 August 2006 (UTC)

No also.- This page is already too long and more sub-pages are needed for this topic. Thanks for suggesting changes in the discussion page! --Travisthurston 03:47, 2 September 2006 (UTC)

No on merging. In fact, it should be splitted because it is way too long and full of peripheral issues. It is not concise enough. I suggest that "acupuncturist" should not be merged either, and revert it back to its own entry. Each keyword should stand on its own, otherwise it loses its focus to the reader. 4 September 2006 (UTC)

agreed - most of the articles on wikipedia would be better if there were less redirections and more sub-articles for topics. I also agree with the suggestion that acupuncturist have its own entry. --Travisthurston 03:40, 5 September 2006 (UTC)

Major revision is needed to split and trim out political and non-essential opinions of the efficacy of acupuncture

It deviated from the spirit and guidelines of what Wikipedia is WP:5P and what Wikipedia is not WP:NOT. It did not subscribe to principles of Neutral Point of View WP:NPOV. Specifically, it should not be a "Critical Review" nor "Opinions of Current Affairs."

loserThe opinions and skepticisms should be moved to Discussion or other relevant places. It distracts from describing what acupuncture is. It doesn't even describe what acupuncture does or how it works!

Specific Recommendations for Revision:

• Acupuncture#Legal_and_political_status section should belong to a separate entry for acupuncturist because it falls into the category of the "practice of acupucture," not the description of what acupuncture is or is not!
• A separate entry of acupuncturist should be restored from the previous stand-alone keyword, and should not be merged or redirected. (For instance, medicine and medical doctors (physicianas) are totally different things, they should not be lumped together, so are acupuncture and acupuncturists.)

• Acupuncture#TCM_perspective_on_treatment_of_disease is an "Opinions of Current Affairs" and is too broad a viewpoint unrelated to acupuncture in specific. It should be linked to Traditional_Chinese_Medicine but should not be discussed here. It is beyond the scope of acupuncture.
• Acupuncture#Criticism_of_TCM_theory is a "Critical Review," violating the guidelines of Wikipedia WP:NOT.

• The entire section on Acupuncture#Scientific_research did not subscribe to the principles of Neutral Point of View. It is about "Opinions of Current Affairs" as seen from the viewpoint of the United States (very US-centric). Just because it is describing evidence-based research according to the Western approach, it does not mean that it is not "evidence-based" as defined by the Oriental approach where it is time-tested for thousands of years.
  • The entire section should be moved to the Discussion or a link because it is about "Opinions on Current Affairs" which becomes obsolete when more studies are concluded.
• The section is so biased that it is not even a Western viewpoint, nor representative of the view from other English-speaking countries. If you read any of the other entries of acupuncture in other languages in wikipedia, including other Western European language's entries, none of them have this US-centric viewpoint.
  • (To make a point for the discussion, FDA approval does not mean a treatment/drug is necessarily effective; it just means that it is sanctioned by the US officials, a very country-dependent seal of approval. Just because a treatment or a drug is not approved by FDA, it doesn't mean it is not effective, because they can be approved by other countries such as Europe or Canada long before it is approved in the US. Just because specific studies were not conducted in the US until recently, it does not mean that scientific research on acupuncture were not done elsewhere. There is a volume of scientific literature published in Chinese and Western European countries, which are totally discounted in the section. US is not the only authority in scientific research. That's why the entire section is not Neutral Point of View.]
  • Please review the history of thalidomide before you start ranting about how narrow and "country-dependent" FDA approval is. Apollo 16:29, 24 July 2007 (UTC)
• The section has left out the wealth of knowledge from the oriental sources (where acupuncture has been practiced for thousands of years), which shows how biased it is. Just because the US is a new-comer in the field, it does not mean nothing is known about it, nor is it not researched scientifically elsewhere. For those skeptics, it just shows their naivety. They do have every rights to doubt and question the effectiveness, but that does not belong here in a wikipedia entry.
  • The National Center for Complementary and Alternative Medicine in NIH was only created 10 years ago in the US to study alternative medicine such as oriental medicine, showing how immature the US is in this field of medicine. Nonetheless, the US scientific community is finally open to see what is true out there other than the traditional medical practices. But traditional medical practice as defined by the West is new to the East, and vice versa, the traditional medical practice as defined by the East is new to the West. So, it's just because it is new to the West, it does not mean it is not effective or valid medical practice. That's why it is not neutral, and merely a viewpoint.

• The entire section on Acupuncture#Safety_and_risks is so negative that it is all about harmful effects, there is nothing positive nor mentioning any safe or beneficial effects. It is so biased that is only one-sided, no balance at all. It violates Neutral Point of View guidelines.
• The section on Acupuncture#Risks_from_omitting_orthodox_medical_care is entirely an opinion of a belief system subscribed by some doctors, but not true for all western doctors. It is extremely biased and negative, violating the Neutral Point of View principle of Wikipedia. It should be deleted.

In sum, the majority of description is biased, narrow-minded, one-side, US-centric, anti-acupuncture and politically motivated. It is totally not neutral. This is not what Wikipedia is for. Coladie 16:23, 5 September 2006 (UTC)

Hi Coladie. Thanks for your recent edits on WHO standard points and NCCAM. (Note that the "controversial" bit about points was from the NIH report.) On your objections about bias, I have to disagree. The article is well-sourced. Ephemeral "current affairs" are not the same as "best scientific evidence available today", and the article does and should cover the latter. As research changes, we update the article, but we shouldn't be silent about it and just have some puff about how great it's been in Asia for thousands of years, and pretend that suffices. Research on acu is ongoing, isn't being done just by people wanting to disprove acu, and deserves coverage. Also, evidence-based medicine has a specific meaning; check it out.

On US- and Western-centric bias, that's an inevitable problem with English WP; the solution is to find and add more verifiable material about acu in other countries. That would be welcome. The article does say acu has been used in the East for centuries. However, accumulated clinical experience, while important to mention, isn't the same as controlled research. We should note both.

There is nothing misleading about "Safety and Risks", as it says very clearly that minor bleeding or bruising are "common, minor" adverse events, which is how the study cited describes them. "Risks from omitting orthodix medical care" is indeed Western med POV, but it's a significant POV, and should be included (and it's also a valid point, imo: American L.Ac.'s aren't adequately trained to recognize more than cursory signs of biomedical disease, and ought to make sure patients have been evaluated by doctors as well. I say this as an L.Ac. myself.)

So I'd strongly urge against deleting material here. The article reflects a great deal of give-and-take between acupuncturists and skeptics and I think does a good job of conveying facts about various opinions. best regards, --Backin72 (n.b.) 18:54, 5 September 2006 (UTC)

Backin72, let's assume a general neutral standpoint for a second, in the spirit of Wikipedia, an article entry should describe what the keyword is to inform the reader to gain more knowledge of the term described. If you re-read the article as a 3rd person, you will notice that 2/3 of this particular article is about political issues rather than acupuncture per se.

Yes, although it appears it described some scientific references, nonetheless is political in the sense that it subscribes to a party-line, in this case, the party-line of a US-based viewpoint. I don't believe it is even a Western-bais because many other Western countries do not subscribe to the same viewpoint. That is my point.

Yes, I know what evidence-based medicine is, but that does not mean it is the only approach you can prove things scientifically. The overwhelming majority of the scientific research results are actually based on laboratory-controlled experiments done on laboratory animals before any clinical trials. Thus, large-controlled clinical trials of double-blinded experiments are not the only way to prove the efficacy of a drug or treatment. It is merely one of many scientific research approaches. To say that it is the only metric to measure the effectiveness of a treatment is too one-sided and not neutral. That's why when the wealth of knowledge based on other scientific studies on acupuncture are either ignored or discounted, it gives the readers the impression that all the rest of scientific studies are not scientific or proven. That is just not objective.

Many of those peripheral issues as a skeptics or warnings can be condensed, addressed as a footnote or a link to the discussion. It shouldn't take up 2/3 of the article.

As I said before, unorthodox is totally relative. What is unorthodox in the West is traditional in the East, and vice versa. Who is right is a matter of opinion. As such, it is a non-neutral viewpoint that failed the WP:NOT guideline test. I know someone has spent some time on writing it, but they are better belong to the external reference, not part of the description of the term itself.

I would raise the same objection to other articles that are non-neutral, so I'm not against this article per se. I understand the intent was noble to warn people, but there is a place for it as a footnote or a link. In other words, if you find someone spends 2/3 of the article on questioning the effectiveness of surgery because it is not scientific and there are no evidence-based research done on double-blinded clinical trials for surgery, and all those side-effects of cutting up people, leaving people bleeding, and worst yet, some surgeons forgot and left scissors inside the patient's body, do you think it is objective?

By the same token, surgery had not gone through any of the evidence-based medicine clinical trials just as much as acupuncture, does it mean surgery is non-scientific, unproven or ineffective technique for treatment? Do you not accept the time-tested evidence of real-world patient results as evidence? Would you enter this skeptism into the Wikipedia term "surgery" to question the effectiveness and risks of surgery the same way? I'm not defending the East here, just a point for argument of what belongs in a Wikipedia term and what shouldn't be. peace Coladie 20:35, 5 September 2006 (UTC)

By the way, NIH is very biased. It is an arm of the government, as such, it is always political. It is very "politically-correct" in all its public statements and public reports. That's why it is so controversial. They may try to be neutral, but that is not the reality. NIH used to be much more independent as a scientific agency, but not anymore. If you read any of their public statements in their websites, they always put forth what public wants to hear rather than what the true scientific facts are. I wouldn't be surprised to see them endorsing faith-healing as a legit treatment too, given that this administration has funded so many faith-based initiatives already. But should this be included as part of Wikipedia term too, certainly not. Coladie 21:34, 5 September 2006 (UTC)

Hi Coladie. You're making some unwarranted assumptions about what the article says and what I think. The article doesn't say EBM is the only way to know whether something is effective, but it does accurately say that consensus among scientists is that EBM is the way to go. The article also raises caveats about blinding procedures. Acupuncture is a large topic, so naturally a range of social issues are going to be covered, including licensure. I agree that spinning off acupuncturist, and covering licensing issues there, could be a good approach.

Again, there's a lot of material here that represents the cumulative efforts of a number of editors, so I suggest we take this section by section. Please select one section, find some verifiable sources that meet WP:V and WP:RS and then let's discuss ways to edit accordingly. regards, --Backin72 (n.b.) 23:51, 5 September 2006 (UTC)

Coaldie, I have to agree with Backin72 here (makes a nice change). You appear to be unlcear about the difference between evidence and anecdote. It is important that you do some research to become familiar with it. What people "report" may not be what is happening. The "thousands of years" argument is not strong - for thousand of years people said the earth was flat and that humans couldn't fly. Also the placebo is a very powerful and little understood effect. Good luck with your research. Mccready 12:50, 6 September 2006 (UTC)

Wow! Coladie you make so much sense here that I just want to thank you for taking the time to try to clear up this article. If it stays too opinionated I am going to suggest mobilization of patients and students as "editors". If all of the meticulous scientific research on acup. carried out by TENS OF THOUSANDS over the centuries, (all with just as much nobility of cause as the Quackwash folks), were to become the sole priority of English language tranlators today we could NOT EVEN KEEP UP WITH THE ARTICLES WRITTEN EVERY DAY ABOUT THE EFFICACY OF ACUPUNCTURE,. As a matter of fact the Russians,Chisese and Japanes don't even waste time trying to "prove it works" anymore, instead opting for research on curing paralysis, Parkinson's and Alzheimer's disease and finding a blood test to assist in point selection.Acupuncturist 20:05, 6 September 2006 (UTC)Acupuncturist

Thank you Acupuncturist. It's good to see the diversity of opinion. But let's not forget about objectivity and neutrality. Distant yourself from it for a second and really see what I tried to say:

• Let's use another article entry to illustrate what a clean Wikipedia entry should be:
• Surgery is a good example. It is what a good Wikipedia article because it is neutral, clean, concise and informative without muddling with any politics or opinions or biases.
• The surgery topic is very similar to acupuncture.
  • It has history dated back a couple thousands years similar to acupuncture.
  • Both originated from the Orient and practiced in the East before the West picked it up.
  • Both are time-tested in the field.
  • Both had been studied and research in the laboratory using well-controlled scientific methods.
  • But both did not go through any of the double-blinded placebo studies. (Evidence-based medicine is a very misleading term to imply that all other scientific methods are not based on evidence, so I avoid using such a misleading term.)
  • Yet why isn't there any of these controversal political opinions about surgery?
  • Why do you think surgery is evidence-based whereas acupuncture is not?
  • How is surgery "proven" while acupuncture isn't?

What I suggested was reorganize it and condense it and use footnotes/external links to make the same point without losing any of the content so it remains clean without cluttering. You have to see it from the point of view of the reader to keep things simple, not as an author to push any viewpoint. That is objectivity and neutrality.

Acupuncture is definitely evidence-based in that there are volumes of published scientific laboratory and field research studies. Lab and field research is the core in scientific and medical research. These are all evidence-based, i.e., based on factual, objective, verifiable scientific research, published in peer-reviewed scientific journals. Double-blinded placebo studies are only a small part of the bigger scientific research methodologies. It is misleading to say that it is the only way to prove the effectiveness of any treatment, and all the other research are not evidence-based or scientific.

I can list all the scientific literature references here, but Wikipedia is not the place to list point-counterpoints arguments, and it would escalate into a battleground, which is not my intent.

My point is: keep it simple and concise (as in the surgery example) for the sake of the readers. The controversies can be cited as external references or footnotes. That is adhering to the spirit and policies of Wikipedia. It is easy to get emotional after vesting on a project, but an objective person would welcome critics and doesn't mind being edited for the bigger good. Wikipedia isn't own by one person, it is for everyone! Coladie 02:25, 7 September 2006 (UTC)

I'm unable to edit much till next week, but a quickie: Since WP is for everyone, all verified, significant POV's are included. That doesn't mean deleting (or relegating to footnotes) material that some readers believe is controversial. Per WP:NPOV:

The neutral point of view is a means of dealing with conflicting views. The policy requires that, where there are or have been conflicting views, these should be presented fairly, but not asserted. All significant published points of view are presented, not just the most popular one. It should not be asserted that the most popular view or some sort of intermediate view among the different views is the correct one. Readers are left to form their own opinions.

As the name suggests, the neutral point of view is a point of view, not the absence or elimination of viewpoints. It is a point of view that is neutral - that is neither sympathetic nor in opposition to its subject.

peace, --Backin72 (n.b.) 03:31, 8 September 2006 (UTC)

Good that we strike a balance. I think part of the controversy lies in mixing the specific treatments that acupuncture are effective (i.e., "indications,"a pharmacological term to mean what the medicine is for) with those that were never intended for acupuncture (i.e., "contraindications," a pharmacological term to mean what the medicine is not indicated/intended for).

Just like surgery, it is not a cure-all treatment because there are diseases that are inoperable. By the same token, acupuncture is not cure-all for everything, and there are ailments that are inacupuncturable. Neutrality is separating out the facts from myths, and not throw the baby out with the bath water by discounting the entire acupuncture practice wholesale. Coladie 21:58, 9 September 2006 (UTC)

Hi Coladie, am back but busy, so please forgive my brevity. No disagreement with what you say just above, and in fact I strongly agree with your second paragraph. I do understand the problem of "how to frame acupuncture", and I guess the best we can do is talk about different paradigms and say when we are speaking from them, if that makes sense.

Very nice work on scientific theories on acupuncture! Hope you don't mind that I moved it to be beside sci research section; no POV implications, just flow. Some of the stubs sound a little unusual and you may get flack from some editors, but as long as verifiable sources can be found, no problemo. best regards, --Backin72 (n.b.) 19:52, 12 September 2006 (UTC)

Neutrality review?

I saw a while back now that you were asking for a neutrality check, and so I did some source checking on this; hope you find it useful. I think that this would be a better article if it were more concise and better referenced. Length without close referencing offers many opportunities for unconscious POV. The following are specific examples of problems I came across

1. Claim in WP. "However, there is no evidence that those tattoos were used as acupuncture points or if they were just decorative in nature".

Comment: This statement is referenced to a Lancet article, and seems to be wrong. The Lancet says: "A treatment modality similar to acupuncture thus appears to have been in use long before its previously known period of use in the medical tradition of ancient China. This raises the possibility of acupuncture having originated in the Eurasian continent at least 2000 years earlier than previously recognised."

2. Claim in WP "Acupuncture has been used to treat a number of conditions ...Classically, "in clinical practice, acupuncture treatment is typically highly-individualized and based on philosophical constructs, and subjective and intuitive impressions" and not on controlled scientific research."

Comment The quote is given correctly, but is not really representative of the conclusions of the paper, which state "Despite their different foundations and weighing of information, TCM and EBM are not mutually exclusive. Both share a commitment to providing the best possible treatment for patients based on individual experience and the best available external evidence. Single-case experimental design studies, expanded into large-scale RCTs if they merit allocation of substantial resources, may be a valuable tool for clinical investigation as well as a source of credible evidence supporting the practice of conscientious acupuncture practitioners."

3. WP In the section on critics: "Philosopher Robert Todd Carroll deemed acupuncture a pseudoscience because it "confuse(s) metaphysical claims with empirical claims".[7]...

Comment Carroll teaches at a community college, and the source is not peer reviewed, so the threshold for notability as a critic seems low.

The Sampson/Bayerstein quote. This simply recounts the opinions of a few unnamed Chinese scientists. It would be better to recount the opinions/conclusions of the authors themselves. e.g. "It seems that the practice of TCM and the concepts of internal and external Qi place China in a dilemma. Advancement of these ideas, especially overseas, increases China's prestige and is a matter of cultural pride. Yet the inherent mysticism and magical thinking in these notions are an embarrassment to the Marxist rationalism of the government and to the scientific community as a whole."

Neither Barrett’s comments nor Kaptchuk’s either seem particularly critical or informative. Are there really no more notable critics who say more pithy things? I suspect that there are. (see Domar AD. Acupuncture and infertility: we need to stick to good science. Fertil Steril. 2006 May;85(5):1359-61)

I added a priceless quote from 1694 to the Meridian (Chinese Medicine) page on this topic. Check it out - perhaps it would fit better on this page. Kaptchuk has some much better quotes I think, and no doubt anyone with a copy of Needham's Science and Civilisation in China volumes would be able to fish out some more pearls. -- Mugwumpjism 21:46, 11 May 2007 (UTC)

WP claim "According to the NIH consensus statement on acupuncture: Despite considerable efforts to understand the anatomy and physiology of the "acupuncture points", the definition and characterization of these points remains controversial. Even more elusive is the basis of some of the key traditional Eastern medical concepts such as the circulation of Qi, the meridian system, and the five phases theory, which are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture."

Comment It is not clear that this is a criticism at all, although it is cited as though it were. The same NIH statement concludes: "Findings from basic research have begun to elucidate the mechanisms of action of acupuncture, including the release of opioids and other peptides in the central nervous system and the periphery and changes in neuroendocrine function. Although much needs to be accomplished, the emergence of plausible mechanisms for the therapeutic effects of acupuncture is encouraging." In context, WP appears to be mis-citing the NIH statement to promote a POV

Later in the WP article, is this assertion "The statement was not a policy statement of the NIH but rather the assessment of a panel whose impartiality has been questioned by members of the The National Council Against Health Fraud (NCAHF)."

Comment This seems to equate the authority of NIH with that of NCAHF, and does so having already quoted the same NIH statement without reservation for an apparently critical comment. The NCAHF does not have the same standing as NIH.

5. WP claim on scientific research into efficacy "For the following conditions, the Cochrane Collaboration concluded there is insufficient evidence that acupuncture is beneficial, often because of the paucity and poor quality of the research and that further research would be needed to support claims for efficacy":(and gave a list of conditions).

Comment. An editorial in the British Medical Journal in 2006 (BMJ 2006;333:611-612) said, of the same evidence base,: "The Cochrane review found evidence from high quality randomised controlled trials that acupuncture reduces pain in the short and intermediate term compared with sham (placebo) acupuncture.11 This implies that treatment has real effects over and above a placebo response."

6. WP claim on Risks "Some western doctors believe that receiving any form of alternative medical care without also receiving orthodox western medical care is inherently risky, since undiagnosed disease may go untreated and could worsen."

Comment This has no reference attached. However, in the BMJ, same editorial as above: "The new research in this week's BMJ means that acupuncture for persistent lower back pain has been clinically researched more thoroughly than many orthodox medical treatments. Healthcare decision makers should consider acupuncture as an adjunct to usual care for patients with persistent low back pain or migraine: the best evidence shows that the associated health gain represents good value."

Overall comments The section on legal and political status seems to be long for the purpose simply of validating the claim that acupuncture is carefully regulated part of the health systems of many countries, and involves professional training and licensure. These are important points, but not at this length. The section on Scientific theories is under development so I wouldn’t want to be critical at this stage, but

WP claim "Many scientific theories have been proposed to address the physiological mechanisms of action of acupuncture. To date, more than 10,000 scientific research studies have been published...."

Comment .... but this is a belied by assertions that there hasn’t been enough research and much more is needed. In fact in the NIH literature base, most are tests of efficacy or case reports, not studies of mechanism etc, and there have been few studies in mainstream science journals.

This section seems overlong and weak in its sources. I suggest focussing on a) the Gate Theory and b) endogenous opioids as a framework of explanation that is well supported and in high regard. There is a danger that writing at length on weakly supported theories diverts attention from the strong ones, and a danger that with length comes errors or confusions. Perhaps some of the other theoretical discussions should be hived off into specialist articles?

Gleng 15:45, 10 October 2006 (UTC)

Gleng, I'm glad you posted this. I've now looked them over and generally agree. Will have a go at implementing them soon. --Backin72 (n.b.) 06:38, 12 October 2006 (UTC) Update: Have put in lots of work tonight on other aspects of the article, but haven't forgotten the above. cheers, --Backin72 (n.b.) 08:00, 14 October 2006 (UTC)

Issue #1 (Otzi in Lancet) fixed.--Backin72 (n.b.) 05:54, 15 October 2006 (UTC)

Recent edits by User 206.57.90.87

Hi 206.57.90.87. I see some NPOV and VER problems with your recent addition and breaking off of a new section called "Efficacy of acupuncture"[9]. You include unsourced generalizations ("To date there is no conclusive scientific evidence indicating that the procedure has any effectiveness beyond that of a placebo") and assert sig POV's about efficacy instead of presenting them. Please note also that there already exists a section entitled Acupuncture#Scientific_research_into_efficacy and material on efficacy should go there alongside the other sig POV's presented. Material already in that section, and stuff cited just above in talk from Gleng, clearly show that there is debate about efficacy among scientists.

I also see you deleted quite a bit of material, and I'm not sure why, though it may not be notable or sufficiently V RS.

What I've done is move your additions pending further discussion. Thanks and best regards, --Backin72 (n.b.) 02:46, 13 October 2006 (UTC)

P.S. ChrisDas (are you 206.57.90.87 creating a screen name? thanks if so) -- let's try and keep close to V Rs's and avoid OR, and per Wikiquette discuss here on talk, not in the article's body[10]. We need to hammer out consensus here and I agree with Pursey's reverting[11]. Cochrane is above reproach and clearly shows legit sci POV that acu is efficacious. So let's do the NPOV thing and cover all views, not assert a single one. best, --Backin72 (n.b.) 04:41, 13 October 2006 (UTC)

PPS - ChrisDas, also please read Help:Edit summary and WP:DR and try to leave helpful, substantive edit summaries, thanks, it really helps. cheers, --Backin72 (n.b.) 04:48, 13 October 2006 (UTC)

Material added by User 206.57.90.87 on efficacy (includes expansion of existing stuff in lead)

The World Health Organization (WHO), the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institute of Health (NIH), the American Medical Association (AMA), the National Council Against Health Fraud (NCAHF) and various government reports have studied and commented on the efficacy of acupuncture. Whether acupuncture is efficacious or a placebo has been the subject of ongoing scientific research. Scientists have conducted reviews of existing clinical trials according to the protocols of evidence-based medicine; some have found efficacy for headache, low back pain and nausea, but for most conditions have concluded that there is insufficient evidence to determine whether or not acupuncture is effective. There is no evidence that the needles have any affect on the pathogenesis of viruses and microorganisms, or on human physiology, with the exception of the neurological pathways associated with the nerve cells that were stimulated by them. Thus, the most promising clinical application of acupuncture is in the area of pain control.

Empirical data on acupuncture, gathered through scientific experiment and analysis, focuses on biochemical and psychological mechanisms because the existence of "qi "and the balance of "yin" and "yang" (described below) are by definition undetectable. To date there is no conclusive scientific evidence indicating that the procedure has any effectiveness beyond that of a placebo. Studies on acupuncture that meet scientific standards of experimentation have concluded two things: acupuncture is usually more effective than no treatment or a placebo in pill form, and that there is no significant difference in the effectiveness of acupuncture and “sham” acupuncture (superficial needling at non-acupuncture sites), which is often used as a control. This indicates that the effect is either caused by the tendency of extended, invasive procedures to generate more powerful placebo effects than pills or by the general stimulation of afferent nerve endings at the surface of the skin, causing the release of pain relieving biochemical compounds such as endorphins (this can also be done with jalapeno peppers, electricity, and various other form of stimulation). It may also be a combination of these two effects.

The vast majority of research on acupuncture is conducted by researchers in China, and extensive reviews of this research by scientists in other countries consistently find major flaws in the design of the experiments, as well as selective reporting of results and conclude that no conclusions can be drawn from them

Numerous experimental difficulties have prevented the conclusive establishment of a causative relationship (if it exists) between pain relief and the administration of acupuncture. These include the subjective nature of pain measurement and the pervasive influence of psychological factors such as suggestion, confirmation bias, and the distraction of being poked by a needle. Also, the tendency of chronic pain to ebb and flow on its own without any external intervention leads people to falsely perceive that the last measure they took before the pain subsided was the cause of the relief. Despite these concerns, there is general agreement that acupuncture is safe when administered by well-trained practitioners, and that further research is warranted.

While an article in the American Journal of Acupuncture in 1999 admits that "Thirty years of active acupuncture research have failed to unequivocally demonstrate its clinical efficacy", some supporters and practitioners of acupuncture contend that since it is based on a philosophical model, its effectiveness cannot be proven or disproved with scientific tests.

I have never edited an article on wikipedia before and apologize for the apparent breach of protocol

The current article is very misleading and does not reveal the current lack of evidence for acupuncture. It includes numerous studies and theories (from the 50s and 60s) that have been thoroughly discredited by scientific analysis. The writer clearly believes that this technique based on energy fields that can’t be detected is a valid alternative to scientific medicine for people who have real illnesses and need actual care. Only one of the scientific theories he lists is remotely scientifically sound (the one I left in) The rest have absolutely no basis in biology. They simply use scientific terminology to confuse people into thinking that an actual biochemists or microbiologists agree with it. When subject to peer review they quickly breakdown and can be debunked by information in an undergraduate textbook. The references I gave are publications from pubmed related to acupuncture that have the highest degree of credibility among their peers. As a scientist, I understand and applaud your demand for more proof, which is readily available. However, I encourage you to investigate the many claims made by the author of the article and the reason it is suspected of bias. Under criticism he states "TCM theory predates use of the scientific method, and has received various criticisms on that basis" It is not criticized because it is old but because it makes no sense and has no evidence to support it. The thoery was proposed 2000 years ago, when humans had no awareness of the existance of viruses, eukaryotic cells, and bacteria and possessed no real knowledge of what causes disease. Ancient peoples in China, like physicians in the middle ages (who believed that disease was caused by spirits and demons), were unaware of chemistry, biology and physiology, tissue organization, organs and organ functionality, the circulatory and endocrine systems, the function of the brain, the existence of genetics, proteins and countless other discoveries made over centuries and tested repeatedly using logical experimentation and empirical analysis. However, I have resrticted my assertions to those which can be referenced by scientific publications, although there is a very wide spectrum of credibility among scientific papers dealing with the subject of acupuncture. This means that an advocate of TCM can easily quote an extremely biased study funded by the PROC or western organizations that benifit financially from the multibillion dollar buisiness of acupucture. It is irresponsible to promote medical fraud in an online encyclopedia. I would not be surprised if the author of the article is one of the many people who make a lot of money by convincing sick people that this actually works. I am a graduate student in molecular and cell biology and have nothing to gain except the awareness that fewer sick people might be ripped off if the public understands that there is no observable, reality based evidence that acupuncture works. However, I understand the importance of neutrality in an encyclopedia and recognize that even statements that have the highest probability of accuracy, such as the fact that the people who came up with the idea of "qi" had no knowledge of genetics, anatomy, eukaryotic cells, and microscopic organisms(no microscopes), and therefore had very limited awareness of the causes of disease, appear biased in certain contexts. I look forward to your responses and hope you understand that I was not trying to “vandalize” the article in any way, but have a genuine desire to inform people of the most probable explanation for this phenomenon based on the available body of evidence. I also feel the the article on homeopathic medicine is id need of revision=) Sincerely, chris —the preceding comment is by ChrisDas - 07:01, 13 October 2006: Please sign your posts!

Hi, and thanks for dropping by the talk page to chat about the changes you've been making :) Your input is valuable, but generally if they are big or controversial changes to an article, you'll want to have a chat to the other editors on an article's talk page first and reaching a consensus. :) Personally, I have no real input on this topic other than to say thanks for participating in discussion. :) Pursey 03:27, 14 October 2006 (UTC)

The most important basis of science and scientific integrity is to allow and provide alternate hypotheses and alternate theories. As such, deleting and making claims that alternative theories are invalid and have no scientific basis is not only subjective and non-scientific, but also a disservice to the community. A person may sit in one camp and disagree with the other camp, but that does not mean that the alternate theories are bogus or dubious.

For example, in physics there are both Newtonian theory and Relativity theory, both can co-exist without shooting the other one down. Both are scientifically valid to explain the same thing in different ways. Similarly, in physics there is particle theory and wave theory in the duality of physics, that matters and light can be considered as wave (electromagnetic wave) or particle (photons). This is scientific and objective way of doing science -- to acknowledge alternative point of views.

By the same token, if you don't believe in acupuncture, it is your belief system, which is subjective and non-objective. If you are a true scientist, you would acknowledge that there are alternative theories that explain acupuncture that counters your intuition, but that does not mean they are not scientific. There are scientific published literature supporting the alternate explanation in acupuncture that are published and cited in PubMed, and your claim that they were invalided is unsubstantiated without any scientific evidence that they are disproved, except your own claim. To completely delete them, and claimed that your view is the only valid view and the rest is invalid based on your own opinion is counter the to open-mindedness in science, and is a disservice to the community by limiting the community to see only your point of view. The community does have the right to see both sides of the story, and make up their own mind. When you make up the mind for them, you simply become an agent of propaganda..

The published scientific results were funded by government funding agencies, not private commerical enterprises, contrary to your assertions. They have no finanical stakes in acupuncture except to understand natural phenomena for the sake of understanding. I have to tell you that information in an undergraduate textbook is obsolete and not current or up-to-date. To believe that undergrad textbook is the bible of knowledge is very typical of a graduate student, but that is far from the truth. In fact, undergrad textbook only tells you about the scientific dogmas, the party-line in science. But Nobel prize is won by disspelling these dogmas.

This is why there is a place for alternate theory. Alternate explanation is what drives science forward, rather than entrenched into the traditional, obsoleted thinking. In particular, the thinking that western medicine is the only scientific valid medicine while eastern medicine is quackery or non-scientific is living in the Middle Age. NIH (National Institute of Health) has just started the Complementary Medicine Branch only in the last 5 years or so, so the world is waking up to the reality and acknowledge the scientific validity of eastern medicine. You may want to stick your head in the sand, but please don't stick other people's head in the sand by deleting and suppressing the alternate scientific evidence and blind the public from seeing them. I'm an expert scientist in the field with no stake in acupuncture. I know have expert knowledge in both eastern and western neuropharmacology and neurobiology. To give you an example, people would laugh at electromagnetic stimulation in medicine as quackery in eastern medicine 5 years ago, nowadays hospitals are spending millions of dollar to acquire powerful pulsed magnetic stimulator not only in medicine, but also alter the brain process. Who is laughing now?

Last, but not least, it seems that you have very little knowledge of what acupuncture is, except for the blanket opinionated point-of-view that it is quackery. That does not sound very objective, scientific or neutral. Coladie 19:00, 25 January 2007 (UTC)

Reply to Chris

Hi Chris. WP encourages bold edits, so no worries, and welcome aboard. It's great to have more editors who have scientific backgrounds (I happen to as well). However, it's possible to be "too bold", and WP also asks that we collaborate. While your recent edit[12] addresses my and Pursey's concerns in part, it is largely a revert of a previous edit with a minor reorg[13], and I still see POV and VER problems in how it is presented. In general, I prefer to err on the side of inclusion, and once we agree on the basic interpretation of WP's content-guiding policies (as Pursey cited on your user talk page), I'm sure we can hammer out something mutually agreeable and appropriately encyclopedic. It comes down to "saying who says what, and why", and sourcing same.

BTW, if I lapse into WP jargon below, it's not meant to obfuscate; it's just that the shorthand becomes a habit. By "V RS" I mean "verifiable, reliable source" (cf. WP:V and WP:RS).

First, I don't think your reorg of the section on efficacy was a net improvement, for a couple of reasons: (1) Moving the rest of the material from that section to another is unwarranted. All of it presents sig sci POV's on efficacy. I've moved them back together. (2) The lead section ought to include discussion of efficacy and research; see WP:LEAD. (3) On placing the section first, I don't have a strong opinion, but I think a comprehensive lead section followed by history, classical theory, and then the rest flows well.

Second, on material you removed:

I agree that much of the section comprising what was in the section entitled "Scientific theories and mechanisms of action" may be dubious, as you as you stated in your most recent edit summary[14]. Another editor (Coladie) recently added most of it, and I simply haven't set aside the time to look at it closely till now, so it's good you brought it up. In all honesty, I'm not sure what should be done with it. It appears to be quite a baby-bathwater mix of potentially interesting material, possible OR, and fringe, outdated, and plausible material. I certainly agree with your NPOV rewording regarding endorphins. Deleting the rest outright goes too far, but as it stands, there are significant problems with NPOV, VER and OR. For now I think the section should be tagged, and the rest moved to a subsection of talk for further editorial attention. (I've done the same, for similar reasons, with some comments that followed GERAC under "Examples of controlled studies".)

Removal[15] of the sectons entitled "TCM perspective on treatment of disease" and "Indications according to acupuncturists in the West" appears unwarranted. Maybe you did so in haste, given your (imho more justifiable) objection to the material mentioned above. How are these not sig POV's, and what's the matter with the sourcing? Please explain your objections.

You removed the sentence "In practice, EBM does not demand that doctors ignore research outside its "top-tier" criteria [16]." Was that unintentional?

You also removed both an image and POV-check tag, which I assume was unintentional.

Third, on material you added or changed (which I moved to the section entitled "A note on scientific methodology and acupuncture", assuming it represents sig POV's not cited above in that section):

You apparently added NCAHF to the lead section. They're not nearly as notable as the other groups cited. Fine to cite them in body of article, but undue weight (in the sense of poor parallelism) to put them in lead.

In an earlier edit[17], you added a reference from Linde et. al. to the last sentence in the lead re efficacy. Can you elaborate on what that ref says?

You made the following change:

"Scientists ... for most conditions have concluded that there is insufficient evidence to determine whether or not acupuncture is effective."

changed to

"Scientists ... for most conditions have concluded that acupuncture is no more effective than a placebo."

As you know, these statements are not identical. The latter statement (a) requires a higher burden of evidence than the former, and -- probably for that reason -- (b) is not demonstrably a majority scientific POV, per EBM reviews.

You wrote: There is no evidence that acupuncture has any affect on the pathogenesis of viruses and microorganisms, or on human physiology, with the exception of the neurological pathways associated with the nerve cells that were stimulated by them.

I assume you can provide a V RS that says this, so I fact-tagged it. However, asserting this as fact is going too far, given what Cochrane et al say about efficacy (i.e., there is evidence for efficacy, but the mechanism isn't clear). Please use "X says.. " language, per NPOV's framing of "facts about opinions".

Thus, the most promising clinical application of acupuncture is in the area of pain control. - this is OR unless you can cite a V RS. Fact-tagged.

Empirical data on acupuncture, gathered through scientific experiment and analysis, focuses on biochemical and psychological mechanisms because the existence of "qi "and the balance of "yin" and "yang" are by definition undetectable. - Actually, empirical data focuses also on clinically observable outcomes, irrespective of mechanism. The sentence also manages to be both POV and tautological, cf Talk:Vitalism.

To date there is no conclusive scientific evidence indicating that the procedure has any effectiveness beyond that of a placebo. - According to whom? Evidently not the EBM reviewers cited earlier. What is the threshold for conclusive evidence? Needs NPOV wording and V RS, as does the material that follows (I've seen the "noxious stimulus" argument made elsewhere, I believe on the blog "Confessions of a Quackbuster", whose author I respect; still, I'd like to see a V RS for it.)

Acupuncture in patients with tension-type headache: randomized controlled trial, Copyright © 2005, BMJ Publishing Group Ltd - please expand this source, i.e. which publication?

The vast majority of research on acupuncture is conducted by researchers in China, and extensive reviews of this research by scientists in other countries consistently find major flaws in the design of the experiments, as well as selective reporting of results and conclude that no conclusions can be drawn from them - "extensive reviews ... consistently find" is a broad claim, and I've changed the wording to accord with your citation of a single source pending further clarification of what Ernst says and to whom he attributes it. Does your Ernst source really make the criticism about Chinese studies that you are claiming? I'd be surprised if he wholly dismisses them, and categorically, because I recall that some Chinese studies are included in EBM reviews, including the one Ernst coauthored on low back pain[18] (which he mentions here, which your source predates by six years, which suggests it may be outdated for this citation).

Finally, while an article in the American Journal of Acupuncture in 1999 admits that "Thirty years of active acupuncture research have failed to unequivocally demonstrate its clinical efficacy", some supporters of acupuncture contend that since it is based on a philosophical model, its effectiveness cannot be proven or disproved with scientific tests. The latter assertion needs a source, and framing it in terms of the former citation is POV and (if itself an unsourced formulation) OR.

OK -- I hope you take all of my work here in good faith, Chris, and I certainly extend the same.

best regards, --Backin72 (n.b.) 07:55, 14 October 2006 (UTC)

Template:ActiveDiscuss at Scientific theories and mechanisms of action

I've moved parts of this section to a subpage /scimech for further discussion. (Please note that this is the first time I've used this template on WP, and I apologize if I've used it improperly. I also don't mean to devalue the work of the editors who added the material I've moved, but rather to attract further editorial input that may improve it.)

thanks, --Backin72 (n.b.) 07:55, 14 October 2006 (UTC)

Template:ActiveDiscuss at Examples of controlled studies

Likewise, I've moved parts of this section to a subpage /dblblind for further discussion. Please note the disclaimer above. --Backin72 (n.b.) 07:55, 14 October 2006 (UTC)

I don't know how long it's appropriate to leave these templates on the page, given the apparent lack of editorial interest... thx, --Backin72 (n.b.) 06:08, 1 November 2006 (UTC)

Efficacious and Placebo

This seems a little contradictory, efficacious means achieiving the desired result, so even if something was a placebo and did what it was intended to, couldn't it be categorized as efficacious? —The preceding unsigned comment was added by The snare (talk • contribs) 01:14, 23 October 2006.

Apparently "Efficacious" is a term of art and used correctly here.... ----Backin72 (n.b.) 06:11, 1 November 2006 (UTC)

For a method to be considered efficacious and meaningful in any medical sense, it would have to make an objectively measurable biological difference above and beyond subjective effects (the placebo effect is primarily a subjective effect caused by expectation). Subjective effects can produce shortlived bodily reactions (example: embarrassment can cause blushing, goose bumps, enlarged pupils, racing pulse, etc.), but have no lasting real effect on any serious illness.

A treatment method that exploits the placebo effect may itself be harmless (like homeopathy), but in real life can have dangerous consequences, because it produces a false sense of security, leading the sufferer to place their trust in a method that has no real chance of changing the course of their disease. This can be a fatal delusion, hence the placebo effect can just as well be called the placebo illusion, which is why it is used in clinical research, where measuring the consequences of beliefs in illusions is vital. One must therefore be very careful how one defines "efficacious," because it can cause the death of patients, while it increases the profits of the unethical practitioner who is exploiting the placebo effect. Definitions have consequences. -- Fyslee 20:26, 14 November 2006 (UTC)

Well-said. Fyslee, do you see any inappropriate usage of the term in the article in its present form, e.g. "Whether acupuncture is efficacious or a placebo has been the subject of ongoing scientific research", etc.?

One caveat: to the extent that subjective effects are important in reducing stress, might they not have lasting and real effects on illnesses of all kinds? Acupuncture is a case in which the boundary between subjective and objective effects (cf. trigger point release) is poorly understood, but patients still rate it highly, and it's quite unlikely to do harm as long as appropriate biomedical approaches are concurrently pursued. best, --Backin72 (n.b.) 22:11, 14 November 2006 (UTC)

I would say that the statement "Whether acupuncture is efficacious or a placebo has been the subject of ongoing scientific research" is both accurate and written in an NPOV style, so it's good enough.

Stress relief can certainly make it easier to bear the burden of having a serious illness. This gets to the core of the meaning of quackery -- the claims made. If a method makes honest and reasonable claims, then no problem. Let's take massage for example. If a massage therapist (or a physical therapist, like myself....;-) claims that massage can cure cancer, or even improve recovery rates, they are guilty of quackery and deception. If they claim that massage can relieve tense muscles, provide some stress relief, and relieve some forms of musculoskeletal pain, then there is no problem. Claims should be reasonable and backed up by research when possible. When research is lacking or inconclusive, then it's best to stick to the "milder" claims, since "extraordinary claims demand extraordinary evidence." Normal and uncontroversial claims won't normally raise an eyebrow. -- Fyslee 19:50, 15 November 2006 (UTC)

Agreed again. (Homeopathy is a case where even "mild" claims of efficacy are weird. If it really does work beyond placebo, I'll be damned if I know how. I remember back in grad school when the whole Benveniste thing went down.) cheers, --Backin72 (n.b.) 00:30, 16 November 2006 (UTC)

Comments

Hi. I have a scientific background with degrees in Biology and Animal Science and am currently in veterinary school. I have had accupuncture done on myself and I have seen it done on dogs, cats, and horses. I truly believe that it works. Most acupuncture points correspond to points on the body with increased nerve endings, etc. Acupuncture is NOT just a bunch of boloney. It really does work. . . although acupuncture does work better for some things than others. . . acupuncture is not a cure for all ailments, and I believe that acupuncture can be incorporated with Western Medicine. —The preceding unsigned comment was added by Eqvet4christ (talk • contribs) 19:08, 1 November 2006.

The following quotes by Felix Mann are some of the most pejorative statements in this page and obviously put there by someone with inordinate bias. Felix Mann, whom I knew personally, was NOT an expert on acupuncture. For example, his book on the points of acupuncture, which happened to be one of the first done in english, is perhaps the worst and most innacurate atlas of acupuncture ever published. The quotes from Mann are also extremely subjective and non-informative.

"The traditional acupuncture points are no more real than the black spots a drunkard sees in front of his eyes." (p. 14)

and…

"The meridians of acupuncture are no more real than the meridians of geography. If someone were to get a spade and tried to dig up the Greenwich meridian, he might end up in a lunatic asylum. Perhaps the same fate should await those doctors who believe in [acupuncture] meridians." (p. 31)[13] —The preceding unsigned comment was added by Acudoc27 (talk • contribs).

This article is overloaded with anti-acupuncture references, and I will not tolerate it.

(A comment was removed by editor acupuncturist, which in part referred to ashi points) The article calls de qi (the actual crucial electrical connection of the needle to the qi) "historical", and says some patients actually "claim" to experience it. If you are writing about acupuncture and you have not experienced de qi, it is to me like writing about Baseball and never connecting ball with bat! —The preceding unsigned comment was added by Acupuncturist (talk • contribs) 23:14, 6 November 2006.

(1) "Ashi" points are, as you know, tender points. "Ouch" is one loose translation that my professors (who were graduates of med schools in Shanghai, Beijing etc.) used, and it doesn't contradict "that's it" in context, but rather clarifies the idea. See this link, for example: www.acupuncturenewyork.net/ashi.htm. (2) Qi is not defined as electricity. (3) Nothing wrong with citing what studies say; what's important is to explain study design and results. NIH covers this well, explaining caveats about blinding etc. Suggest you have a look at WP:NPOV and WP:VER, as well as WP:CONSENSUS, before lashing out too much at fellow editors who are trying to help make this the best article available online that covers all significant views on the subject. best regards, Backin72 (n.b.) 00:26, 7 November 2006 (UTC)

Backin72 you were right I am a Wikipedia Single Purpose Account. Through the use of acupuncture and massage I have helped hundreds if not a thousand patients with "real illnesses" and "real pain" and my empathy goes out to anyone who would read this article and decide based on what they saw that acupuncture is phony. I apologive for lashing out at other users. I am sure there are charlatan practitioners out there, as well as inept acupuncture mimics, but that does not mean editors here should feel obligated to turn away interested average readers who may, as so many have through my practice, finally have some relief. as for the qi not being scientifically defined as being electrical, it depends on who you ask. The rest of the world's research on acupuncture is busy finding physical structures of the meridians, while we in the USA can't even agree on the electrical properties of points even in light of the fact that a fifty dollar machine with a nine volt battery can find them based on electrical resistance. Its easier for naysayers to say its a "philosophical concept" and support it with ancient theories of TCM, that way it simply cannot exist in the "real world". Acupuncturist 15:53, 13 November 2006 (UTC)

Hi Acu'ist. I wasn't accusing you of bad faith by bringing up WP:SPA, just cautioning againt soliciting multiple SPA edits[19]. I certainly wouldn't want to article to advance a single POV on acupuncture. On qi, the article on that topic covers its subtleties fairly well, and I'd rather incorporate that breadth a bit than POVishly define it as a "current". Rving for now and suggest expanding later. Some may see qi as electrical current (if so, we should source this; measurable resistance alone doesn't suggest it's a current), but it's not even close to the breadth and nuance seen at qi or, e.g., what Bensky and O'Connor say in their translation of the classic Shanghai UTCM text. best regards, Backin72 (n.b.) 22:33, 14 November 2006 (UTC)

When people look at acupuncture on wiki and they go to theory they are looking for the answer to a question of why do people use needles for treatment. What's the theory?

BALANCING IS FOR CIRCUS CLOWNS AND HAS NO MEANING RELATIVE TO THE THEORETICAL QUESTION OF USING METAL NEEDLES! BALANCING YIN AND YANG IS for a conversation about yin and yang not one about acupuncture theory. Don't you see how demeaning it is to use the term in that segment?

DEADMAN, Al-Khafaji, Baker: point selection methods: local, distal, adjacent, proximal, above/below, front/back, center/extremities, int/ext, pairing, crossing, chain/lock, empirical, combination, alternation but NO BALANCING AT ALL! O'Conner, BENSKY: Moving/Circulating, Benefitting/ reinforcing, Draining, BUT NO BALANCING!

Now about De-qi, ARRIVAL OF QI (by the way i think if you are calling it obtaining the qi you are giving yourself a little too much credit, you may try to "obtain the qi", but in actuality it arrives. Xinnong: quoting Miraculous Pivot... acup therapy does not take effect until the arrival of qi. The description: soreness, numbness or a distending feeling around the needle - things you woul imagine that the PATIENT WOULD FEEL!!!

Again, by the way, why does it have to be "meridian system" why use a French term for Chinese medicine? 'cause a lot of Americans don't like the French? cause its sounds intellectual? what happened to Channels and Collaterals. The network vessels are important and again I suggest that any acup. ignoring them is sharply limiting their ability to resolve chronic complaints.

Now about QI... How nice that you have an are to talk about qi, Even as an acup'st I am not interested in it. FOR ACUPUNCTUR TREATMENT WE ONLY WORK WITH ONE KIND OF QI. MISUNDERSTANDING THIS CAN BRING ABOUT CONFUSION IN THE READERS OF THE ARTICLE THE DAMAGE FROM WHICH WILL BE IRRECONCILABLE! qi is Source, Nourishing, Proctecting, Ancestral, Pectoral, Organic, AND CHANNEL QI... Channel qi "FLOWS THROUGHOUT THE CHANNELS AND COLLATERALS" like a... let's see like a... current. yeah that's it... metal needles, electrical resistance, biological current, huh... I think I am starting to find a way to communicate the Theory of acupuncture (NOT TCM, but just acupuncture) to the article readers.—The preceding unsigned comment was added by Acupuncturist (talk • contribs) 15:45, 16 November 2006.

Would it help to have a couple of pentagrams? One showing the five elements (and their ability to selectively create to and destroy) and a pentagram for the organs to show the relationship of the direction whereby they can tonify or subjugate. Have hesitate to suggest this before because I know nothing about this type of therapy.--Aspro 18:47, 16 November 2006 (UTC)

Pentagrams are for acupuncture students. To they layperson in America they are equated with witchcraft. I am saying that in the early part of the article acupuncture should be defined in simple realistic terms that dont conjure up images of flower children, space cadets, or witches. Acupuncture has gotten enough of a bad image from the time tahat a French doctor went to China for a bit and started training collegues without consideration for the image that would be created by the nomenclature eg. ACUS Needle = RIGID BODY WITh A POINT DESIGNED TO TEAR TISSUE IN ITS PATH - PUNCTURE TO CUT OPEN... No one uses needles anymore, they are filiforms. Puncturing is rare and should not be in the name of the procedure. This articLe cant even decide whether acupuncture is a procedure or a philosophy or a psudoscience or a system. POINTS are not POINTS aT ALL THEY ARE holes, AT LEAST THE ARTICLE GETS THAT RIGHT. iT JUST NEEDS TO BE SIMPLE AT FIRST, THEN EVERYONES KOOKY SLANTS CAN BE ELUCIDATED.Acupuncturist 14:56, 17 November 2006 (UTC)

Hey guys, just a note for people new to Wikipedia; using all caps is considered by many to indicate yelling something and is seen as trying to shove one's opinion on others regardless of arguments. I'm not saying that is going on, but I'm giving a heads up as to how people who do that have been historically treated at Wikipedia. --Fire Star 火星 15:04, 17 November 2006 (UTC)

i'll use my e e cummings voice, then... i am yelling, but i don't want to shove anything on others. historically acupuncturists are a bit passive and the problems i see in this article are due to my collegues not speaking up and allowing acupuncture to be marginalized and disparaged in the public opinion. Acupuncturist 20:36, 20 November 2006 (UTC)

Dear Friends - well, we acupuncturists are full of spunk. Just a quick comment that the criticism of acupuncture by Drs. Ulett and Han (the younger) are self-serving and therefore biased. Their entire book is an attempt to replace all of acupuncture with: their own little machine. Tragic, especially given the brilliant research of the elder Han, Ji-Sheng, whose work is well worth mentioning. 216.99.199.222 04:57, 6 February 2007 (UTC)Roger Lore (DAOM, LAC) Oregon College of Oriental Medicine rlore@ocom.edu www.ocom.edu

Are these links still needed?

Wikipedia:Dead_external_links/404/a lists these documents as lost and still needed for the Acupuncture article:

1. http://dsc.discovery.com/convergence/iceman/evidence/tattoos.html
2. Acupuncture: Review And Analysis Of Reports On Controlled Clinical Trials, World Health Organization, 2002

However, I can not find any references to either in the article. Can these two links just be stricken out of the link rot list?
Just happened to pass by on link patrol... --Ronja Addams-Moring 17:02, 1 December 2006 (UTC)

Physically verifiable points

Thanks for your efforts to bring neutrality to this article. The opening leaves me with a perception the article is somewhat biased against acupuncture. In the intro the article states "There is no physically verifiable anatomical or histological basis for the existence of acupuncture points or meridians." If you mean, existance like the skeletal system or circulatory, I understand, however I am able to locate some points associated with bone and tissue indentations (e.g. middle of eye brow).

I suggest including a statement of how it IS verifiable. This info comes later, but should be reflected in the intro for neutrality. Such as "...but can be measured electrically, thermally and as a physical sensation." (e.g. http://www.medicalacupuncture.org/aama_marf/journal/vol16_2/article_5.html

I'm not an expert, so will leave the wording to those who can be technically accurate.

Keep up the good work! D1doherty 13:06, 9 January 2007 (UTC)

I think the statement in question is OK but should be balanced with a statement that the validity of acupoints depends on their clinical efficacy in practice, and that this is a matter scientists are studying (see acupuncture point and EBM section). Will add. Backin72 (n.b.) 06:24, 29 January 2007 (UTC)

Hi, colleagues! I recently added a review of the lirature showing that there is a reality to acupuncture points as demonstrated by magnetic resonance imaging and PET scans of the brain. I aknowledge that my placing it in the "History" section was bold (http://en.wikipedia.org/w/index.php?title=Acupuncture&oldid=113256841) , but it appeared fair to me, however, considering that in the same section we can read the opening remark: "There is no physically verifiable anatomical or histological basis for the existence of acupuncture points or meridians." (As if we were now, at this point in History, finally awakening from the nightmare of pseudoscience...)I believe that this "absence of evidence=evidence of absence" claim is now outdated as it is contradicted by scientific research. I thank you, Backin72 for your appreciative remarks and constructive criticism and I aknowledge that the quality of the article would suffer from the structure changes I made. However, I believe it is a disservice to this great scientific review to put it in "5.5. Other research", especially when we consider that the preceding points 5.2, 5.3, give a little too much weight to institutions' opinions (NIH, AMA) and not enought to research in itself, which continues at his own quick pace. I would propose that, instead of reading those facts after the opinions of prestigious institutions, we provide the facts first, and the opinions after. This would read:

1. 5 Scientific research into efficacy

   * 5.1 Evidence-based medicine

==> * 5.2 Evidence from neuroimaging studies

   * 5.2 NIH consensus statement
   * 5.3 American Medical Association statement
   * 5.4 Examples of controlled studies
   * 5.5 Other research

The other, preliminary research using neuroimaging (also in 5.5. Other research) should then go with it, since it provides interesting details and a good feel of what evidence-based acupuncture will probably look like in a near future: "Acupuncture at LI.4 and ST.36 resulted in significantly higher scores for De-Qi and in substantial bradycardia. Acupuncture at both acupoints resulted in activation of the hypothalamus and nucleus accumbens and deactivation of the rostral part of the anterior cingulate cortex, amygdala formation, and hippocampal complex; control stimulations did not result in such activations and deactivations."

Pierre-Alain Gouanvic

Sounds like a fine idea to me; weight should go to good research and this appears to be a review of very good quality. I very much appreciate your finding it, Pierre-Alain, and putting it in. I didn't want to bury it, just move it to the section w/ the rest of the research, so, let's go for it. I also added mention of this research to the lead section, and we should add it to the acupuncture point article as well. Regarding distal points, I've heard of some research (I think from China) that St36 increases B cells; will try and find that. Thank you again! best regards, [[[User:Backin72|Backin72]] (n.b.) 18:32, 7 March 2007 (UTC)

Oops, I did not notice this crucial addition in the lead section. I have quite a bit to learn about WP editing! Sorry if I appeared a little upset: I hope that it will be possible to deal with other parts of the article which state an "absence of evidence". I'll be back soon. Thanks for the good work. Regards, Pierre-Alain Gouanvic 20:14, 7 March 2007 (UTC)

Yes, I can see how it might have appeared that I was burying the neuroimaging stuff; I had not made the change to the lead at that point. Your comment above was entirely civil and well-reasoned. On the "absence of evidence" issues, getting the wording right and consistent with WP:NPOV and WP:ATT presents a challenge in a great many articles where various scientific views (including significant "agnostic" views) exist. I'm delighted that you're editing this article, and hope you stick around. best regards, Backin72 (n.b.) 01:08, 8 March 2007 (UTC)

I added it to the acupuncture point article. I also created articles for the two distal acupoints that have been studied (and quoted here: Nei guan & Zhi yin); please see the talk page of acupuncture point for more details. It is my fondest hope that each progress in the scientific validation of acupoints be registered and that, in parallel, each validated point receives its own article. Those acupoint pages should get their own anatomic pictures; any ideas how to do this in conformity with copyright regulations? Does WHO allow it? When you find the reference for St36, I invite you to create a page! I'll have a look on this point myself. Let me tell you that picturing that WP could have most of the relevant acupoints explained and demonstrated (as much as possible) in dedicated articles is very motivating. After 3-4 millenia, it should be in the public domain!... ;-) I also think that those pages should have their chinese WP mirrors (and generous chinese translators to contribute to English WP (and French WP; I'm an EN-to-FR translator)). Pierre-Alain Gouanvic 07:52, 9 March 2007 (UTC)

Great! I'll keep an eye out for open-source anatomical diagrams we can use (or modify, then upload). Bravo on your vision for WP and acupuncture! regards, Backin72 (n.b.) 07:32, 11 March 2007 (UTC)

I just created the page for the Shenmen point. I quote an animal study (thereby preventing placebo effects) which shows clear effects on dopamine and hyperactivity in the context of drug addiction. Certainly a point with important public health significance. I also created the acupoints category. Regards, Pierre-Alain Gouanvic 03:20, 13 March 2007 (UTC)

Coladie, please remember WP:V

Nothing personal, Coladie, but the reason I removed large sections of the stuff you wrote on mechanisms is that vast amounts of it don't meet WP:V (and probably WP:OR). I know that WP encourages editors to improve edits rather than deleting stuff, but there is a practical limit on that, borne out by something that I've repeatedly seen on WP: it's not good for an editor to add material that contains a high ratio of "bathwater" to "baby" and thereby demand other editors to sort out the good stuff. This is something you should do yourself. All I can say is please read WP:V carefully, do your best to understand what a V RS is for science and medicine, and then edit accordingly. As your edits stand, they won't stay, I can guarantee you that (based on what I know about the views of other editors of this page).

Also, the Mann citation is fine for what Mann says (since he's a notable source), but he's not a V RS for what consensus is among "doctors and scientists". I'll restore and fix. thx, Backin72 (n.b.) 06:24, 29 January 2007 (UTC)

Empirical schmerical. The Chinese used the Filter: Dialectic Marxist Materialism to get rid of any non material scientific based theory from the use and study of Chinese Medicine. All it did is muddy the water. In practice, even in Chinese Colleges of Chinese Medicine, Teachers spoke politically correct and used old classical ideas in practice. In Vietnam the Classics were not filtered. The Trung E Hoc was rewritten based upon Hospital experience, pragmatic based science, under the leadership of Dr. Van Nghi. So Called Scientists baised to a materialistic point of view leave out much of theoretical physics in their discussion. At the Dusseldorf Conference in 1988 it was agreed by a world wide group of Clinical practitioners and Researchers that there could be no (western form) of Scientific study of Acupuncture. One POV cannot use its validity system to study another system (POV). Until we agree on the concept of Harmony vs the concept of contradiction we remain, on the part of the contradictionists, irreconsilable. I agree Backin72. (User talk: m connelly)18:30, monday 29 Jan 2007

Hi m connelly; I agree that the classical Chinese paradigm on which TCM is based is different from the Western paradigm. However, I don't agree that (at least a large number of) TCM's (clinical) predictions can't be tested with intelligently-designed studies. The idea of harmony vs contradiction is an interesting one that needs a V RS for citation in the article. regards, Backin72 (n.b.) 05:48, 30 January 2007 (UTC)

hi Bakcin72, Harmony vs Contradiction, Lecture, Indiana University, to the Faculty and Guests of the Department of Philosophy of Science. 1971 Michael Connelly. (User talk: m connelly) 21:10 Jan 30 2007

Hi MC -- sounds OK if it's available at a library, source is reliable (see WP:RS, and it's used as an e.g. of a significant POV rather than presentation of fact. (See also WP:NPOV and WP:V) cheers, Backin72 (n.b.) 22:23, 30 January 2007 (UTC)

Aren't any of the editors real acupuncturists? If so, don't you want to clear the difference between needles and filiforms right away? I am, and I don't need the WHO to decide where a point is and where it's not-how about you? Don't any of you work with the qi, or are you just poking fibers until people say ouch?Acupuncturist 22:10, 23 March 2007 (UTC)

Lead section

Sorry, another incomplete edit summary (accidentally hit return button while composing). Revision should read: rm sentence I added awhile back -- seems redundant, and pipelink to "protoscience" is probably misleading. What remains in the lead is, I hope, a fair and concise summary of sourced debate. thx, Backin72 (n.b.) 00:23, 31 March 2007 (UTC)

Additional informal comments by User: acupuncturist

There is a reason this site has been nominated to checked for its neutrality. First it starts with the words needle and prick, not health, relief or medicine... It goes on to talk about placebo, insufficient evidence and safety. A picture shows a dumpy man in a diaper with Chinese writing. Then it talks about no known...basis, etc. (Getting the impression yet?) Next we have loose associations, the triple heater and the jargon section which I edited to include many omitted diagnostics. We finally arrive at the actual mechanism by which acupuncture works QI, and it's not even explained tha its electrical current, natural to living entities. The point catagories fail to represent the most important ones- the ashi points (explained in a different area).I'm just saying... How about this line "acupuncture has been used to treat a number of conditions" Really, over thousands of years, millions of practioners- a number? History... I learned in school that needles were discovered from the bronze age 3-4,000 y.a. I also learned the Yellow Emperor destroyed artifacts of prior dynasties, including those relating to acup. whatev- 2,500 or 5,000 years... Next up... Critisism. First we start with some out of context quotes by an insightful medical doctor and some from a college professor and the quackwatch founder. Treatment #121 billion by acupuncturist 999,000, the medical doctors' list of uses. And more sophisticated jargon... Then more criticism and a few statements from organizations in competition with acupuncturists and a list of bad things that can happen from acupuncture. Oddly the 66,000 and 55,000 individual patient studies appear at the very end... Not included are some of the most important studies, like GERAC.de of some 40 thousand patients and 7,000 practitioners, where reported significant relief was like 89.9%. Acupuncturist 17:25, 31 March 2007 (UTC)

Is Energy a Good Translation For Chi (Qi)...???

Is Energy a Good Translation for Chi…?

At the beginning of our time, the ancient Chinese once thought that Chi was the micro-substance which made up all the matter in the universe. Thus the term Chi has a great influence in the Tradition Chinese Medicine (TCM). The term Chi has many meanings depends on the context. For example, Chi by itself means air. However, in Chi Kung, it is involved in breathing methods, therefore, Chi means breathing here. Hence, Chi Kung is an ultimate breathing method.

In TCM, the term Chi was used very loosely. In my native acupuncture book described Chi as follows: Chi is the functional activities of the internal organs. In order for our body to be in the state of homeostasis, the organs must interact with each other. One organ produced a product and passed on to another. For example, the liver converts the glycogen into glucose and carried by the blood inside the body. It is considered that Chi is flowing properly; because the liver is performing its function, which is part of the somatic activities. If the liver stop functioning, not able to convert glucose to keep the Chi flow, it is considered that Chi is clogged.

The TCM practitioner might say that the Chi is weak in one’s body. It simply means that some of the organs are not functioning properly. This is how Chi is expressed in the Chinese society. Among the Chinese people, they just know the term Chi, but cannot explain it explicitly.

There is an old Chinese proverb says: If something is not named correctly, then it cannot be described properly. In the case of Chi, translated as Energy. The original meaning has been changed completely. As we can see, Energy does not match the meanings as described above. Unfortunately, scientists tried to conduct experiment on this imaginary Energy theory and still have not come to any conclusion. Why, it is because due to the mistranslation of the term Chi as Energy. We are abided by the limited definition of Energy; and went off tangent of the right track.

If we treated Chi as Chi, then we may find a way to prove it as energy. If we cannot prove it as Energy, then we still have Chi to work with. In fact, Chi is not Energy; it has to be something else. Now, Chi is still an open item to be investigated. In the other word, if we insist Chi as Energy, it will be a dead end.

In conclusion, the mistranslation of Chi as Energy is due to the language barrier between two cultures. Chi was never meant as a form of energy in the Chinese society. Calling Chi as Energy is totally mistranslated. Mistranslation will cause misinterpretations and misleading. The imaginary Energy is causing the scientific investigation come to a co-de-sac. That is why, up until now, modern science still cannot come up with a scientific explanation. So, people lets wake up, stop trying to catch the shadow of the wind. Chi is not energy. Lets break this language barrier.ChiDragon 22:13, 31 March 2007 (UTC)

I applaud wholeheartdely your intervention. As an ex-medical translator and terminologist, I think I can appreciate how important your question is. Or perhaps not, because I'm not a sinologist!! I am going to send everything I find here. And enrich the Chi page. And try to understand how "energy" is misleading. Bravo, ChiDragon!!! (BTW, I am aware that many people in the field understand that currents running through the skin or other phenomena we might not know well yet, because they are so tenuous, are weak simply because they fulfil a different role; that they are not powerlines. I think that a better analogy would be "web of information" and that network theories (such as Castell's, and other's (systems biology)) could be a good start). In any case, to make sense of the oh-so-many scientific theories (I hope some purists won't mind if I put those two words together; lol) about Chi, we must come up with a temporarily definitive definition that IS NOT misleading. ;) Pierre-Alain Gouanvic 03:45, 27 July 2007 (UTC)

--

Satisfaction of one's curiosity is one of the greatest sources of happiness in life.

Linus Pauling

Refs added to lead

...but I still need to format them. thx, Backin72 (n.b.) 17:34, 12 April 2007 (UTC)

Y DC

Under legal (blah blah)...what is Y DC? They do not mention. Gargoyle123 01:26, 16 May 2007 (UTC)

Scientific theories and mechanisms of action is Unreferencedsection

I put an Unreferencedsection-template on the Scientific theories and mechanisms of action, because it seems to exaggerate the effects of acupuncture. I'm really curious to know from where that information is taken, but no sources are available. The directions to that there might be something in the National Library of Medicine isn't enough. Mikael Häggström 10:48, 19 June 2007 (UTC)

There seem to be no other references than that one critizising the whole section. Therefore, I removed that section from the artice, because it's unreferenced. Furthermore, I think it's bullshit. However, it can still be found in the page history, for those who are really admirers of acupuncture. Mikael Häggström 10:54, 20 June 2007 (UTC)

History of Acupuncture

Does the following passage make sense to people? Either 68 BC is before 305-204 BC or the Yellow Emperor's Classic of Internal Medicine does not qualify as a Chinese medical text.

The earliest Chinese medical texts (Ma-wang-tui graves, 68 BC) do not mention acupuncture. The Chinese medical text that first describes acupuncture is the Yellow Emperor’s Classic of Internal Medicine (History of Acupuncture), which was compiled around 305–204 B.C.

Good catch. Changed it:

• Acupuncture's origins in China are uncertain. The earliest Chinese medical text that first describes acupuncture is the Yellow Emperor’s Classic of Internal Medicine (History of Acupuncture) Huangdi Neijing, which was compiled around 305–204 B.C. However, the Chinese medical texts (Ma-wang-tui graves, 68 BC) do not mention acupuncture.

-- Dēmatt (chat) 04:09, 8 September 2007 (UTC)

Bibliography - relevant ?

I'm suspicious of the Bibliography section - references are poorly cited, often with 1st and 2nd authors switched over (see these edits) and there are loads of non-specific links to "Academic Search", "EBSCO" and "<http://search.epnet.com>".

The enties and issues about them are identical to the list at http://www.ibiblio.org/chineseculture/contents/heal/p-heal-c02s01.html Now that may just be a copy of a previous version of wikipedia's own artcle, in which case it is failing to acknowledge wikipedia, otherwise this article has had a list of sources copied and pasted into it with the sources not having been used as references whilst the article was written (if so, then they should be removed).

The "EBSCO" and "<http://search.epnet.com>" series of links - can they be cited better and are they useful at all given they required a subscription to access ? David Ruben ^Talk 02:32, 20 July 2007 (UTC)

New page for an important acupoint

Hi,

for those who are interested by the pages made about acupuncture points, after neiguan, shenmen and a few others (see those that are in blue in "list of acupuncture points" or those that appear under the "acupuncture points" category), I created zusanli, which is a very much studied point. I invite you to visit the page and provide feedback. Pierre-Alain Gouanvic 05:06, 26 July 2007 (UTC)

See article history for explanation of my edits

See the header of this entry for why I posted it. Mikael Häggström 08:31, 1 August 2007 (UTC)

The Takeshige experiment

For the following text:

Similar results were also obtained in experiments with animals showing that the analgesic effect is not due to subjective psychological placebo effect, but real physiological phenomena.

, I couldn't find the PubMed article. It describes a scientific phenomenon, so there must be a presentation of methods and results somewhere. Please provide that before reinsertion into the article. Mikael Häggström 10:12, 1 August 2007 (UTC)

Neutrality Discussion

Hello all! When I saw the tag for neutrality, I was expecting to see a specific discussion section for it on the talk page, but didn't really, so here we go.

While my belief "system" is at it's most basic based on real science and skepticism, I have come to believe in a number of possibilities, mysticisms and spiritual views that most would consider well outside the realm of science. I see no inherent contradiction between these two worlds, while remaining skeptical of anything that I have not investigated for myself.

This is my first investigation into acupuncture, and I found this article quite informative and compelling. While overall it does seem a touch pro-acupuncture, the evidence for it is really pretty good, and there is plenty of opposing POV included as well, so I think that is pretty okay. Some of the later sections are a bit more messy, and particularly I think the "Other Injury" section is pretty ridiculously biased against; It's obviously infinitely easier to accidentally kill someone with a scalpel or drugs than with a tiny needle. I'd be tempted to remove that kind of reactionary propaganda unless there were any kind of significant statistics to back it up. I mean, how many people (especially per procedure) have DIED as a direct result of acupuncture? While not receiving necessary conventional treatment is a concern, there is a section on that as well right there, and this article is great at not in any way endorsing such ideas.

I definitely think that keeping the scientific and practical info SEPARATE from the metaphysical stuff is absolutely KEY to anyone with an understanding of science reading this article with an open mind, and you have done an EXCELLENT job there! I also must say that you have the most civil, understanding, constructive talk page of any article that I've ever checked out, and you get mad props for that, especially considering how contentious the issue is. There are obviously some great, level-headed people working on this article, and I thank you.

One concern I do have is the random (or worse, not) mixing of research claims from very different eras. Acupuncture research has obviously come a long way, and I would expect some research from earlier times to be biased and poorly executed. I therefore find it quite misleading and confusing to follow a claim by one study immediately with a contradiction from another significantly older one, as here:

For headache, Cochrane concluded (2006) that "(o)verall, the existing evidence supports the value of acupuncture for the treatment of idiopathic headaches. However, the quality and amount of evidence are not fully convincing. There is an urgent need for well-planned, large-scale studies to assess the effectiveness and cost-effectiveness of acupuncture under real-life conditions." [6]. Bandolier (1999) states: "There is no evidence from high quality trials that acupuncture is effective for the treatment of migraine and other forms of headache. The trials showing a significant benefit of acupuncture were of dubious methodological quality. Overall, the trials were of poor methodological quality."

This leads me to believe that the second statement is an amendment to the first, when in fact it took place 7 YEARS earlier, which seems like a long time to me in this context.

Otherwise, keep up the great work. And to those who are new here, PLEASE respect the people, customs, and rules of Wikipedia; these are GREAT people here and they deserve it. Please remember, while acupuncture may be the whole world to you, it is just one tiny part of the vast world of Wikipedia, and everyone, including you, needs to work together along with everyone else and according to the rules and customs of this world to produce a resource of consistent reliability for everyone. Elgaroo 13:37, 25 September 2007 (UTC)

As one of the folks who has actively edited and discussed here, let me thank you very much, both for your perceptive comments and well as the nice compliments! I agree with pretty much everything you say about the article. Will have a go when I have time. best regards, Backin72 (n.b.) 21:48, 28 September 2007 (UTC)

Popping in to say that, while the article has a lot of sources, I believe the "Migraine Study" (whereupon, crudely summarized, it was found that there was no difference between "guided" acupuncture and "sham" acupuncture) needs to be given more weight. As it stands, the article goes on for kilobytes and kilobytes about this system versus that system, while evidence that strongly suggests there is no practical difference or "correct" system to follow is buried in a tiny blurb. I certainly won't dispute that there is a measurable result from sticking needles in a patient's skin, but as it stands, the current revision of the article's lead-in is rather misleading in its selective presentation of the evidence. --Badger Drink (talk) 01:50, 19 December 2007 (UTC)

One caveat there is that sometimes the "sham" or "control" conditions may be closer to an "active" treatment condition than one realizes, giving a false negative result. See this comment (which was cited in an earlier version of this article). Since there are thousands of studies, editors have lately agreed to keep discussions of evidence focused on reviews rather than risk WP:WEIGHT issues by focusing on one or two studies. I agree the results of the studies you cite are interesting and provocative, but I would strongly caution against framing the whole article in terms of their results. Better to go with high-quality reviews. I don't have a problem citing individual studies, in theory, but in practice tt gets very tendentious with each editor wanting to put in their favorite study, which balloons to dozens of studies... isn't this why graduate texts and review articles are preferred by WP (cf. WP:MEDRS)? regards, Backin72 (n.b.) 18:55, 19 December 2007 (UTC)

External Link providing collection of FAQs pertaining to acupuncture

The following link, [20], provides an excellent collection of frequently asked questions related to acupuncture. It also includes some historical evidence of acupuncture's potential origins outside of China, but does not discredit China's significant role in the advancement of acupuncture. Curioustrip 00:09, 22 October 2007 (UTC)

Evidence that it works

Evidence that it works: http://www3.interscience.wiley.com/cgi-bin/fulltext/116838594/HTMLSTART —Preceding unsigned comment added by 66.27.116.89 (talk) 03:04, 12 November 2007 (UTC)

Animals

Recent news reports have surfaced that in the USA, some animals have responded positively to acupuncture. Once sufficient sources can be found, this information should be included. This is the newslink I came across. Well to be sure I'm not suggesting this is a new phenomenon, but what are people's thoughts on this? Manderiko (talk) 10:49, 6 December 2007 (UTC)

Thanks for bringing that up. Agreed. Will try and find some sources (the article above is ok but not that informative). Backin72 (n.b.) 23:12, 7 December 2007 (UTC)

Neurohormonal theory: effects not unique to acupuncture

I feel that this section in its current state is somewhat misleading because it fails to state other instances in which endogenous opiates are released. Specifically, research has demonstrated that placebo's may create pain reduction through endogenous opiates: Amanzio, M., Pollo, A., Maggi, G., Benedetti, F. (2001). Response Variability to Analgesics: a Role for Non-specific Activation of Endogenous Opioids. Pain, 90(3), 205-215. There is also overlap in the neural areas activated: Wagner, T.D., Rilling, J.K., Smith, E.E., Sokolik, A., Casey, K.L. et al. (2007). Placebo-Induced Changes in fMRI in the Anticipation and Experience of Pain. Science, 303(5661), 1162-1167. This research is also not mentioned on the Scientific theories regarding acupuncture page. I believe this research bears mention on both pages as these observed effects following accupuncture treatment could easily be attributed to placebo effects. In fact until 5 minutes ago that article stated "Similar results were also obtained in experiments with animals showing that the analgesic effect is not due to subjective psychological placebo effect, but real physiological phenomenon". I doubt the very existance of the supporting article (see talk on that page) and the interpretation so it cannot be used as evidence against my suggestions, at least until the article is found. JamesStewart7 (talk) 08:55, 23 December 2007 (UTC)

James, I have no objection to reworking the section discussing the above research. It seems that most of the research into mechanisms is pretty vague. The strongest seems to be the neuroimaging stuff and the EBM reviews. As for the other article, Scientific theories regarding acupuncture, it's just a mess, too much "baby and bathwater" mixed together, and I've decided I just don't have the time to edit that one. The editor who started it has WP:OWN issues, so be warned it may not be fun. regards, Backin72 (n.b.) 16:52, 23 December 2007 (UTC)

Ok I will make the edits to this page as soon as I have timeJamesStewart7 (talk) 03:18, 24 December 2007 (UTC)

NCCAM classifies acupuncture as an energy therapy.

Quoting directly from NCCAM's web page on Energy Medicine: An Overview:

"Practitioners of energy medicine believe that illness results from disturbances of these subtle energies (the biofieldAn energy field that is proposed to surround and flow throughout the human body and play a role in health. Biofields have not been measured by conventional instruments. Reiki and qi gong are examples of therapies that involve biofields.). For example, more than 2,000 years ago, Asian practitioners postulated that the flow and balance of life energies are necessary for maintaining health and described tools to restore them. Herbal medicine, acupuncture: A family of procedures that originated in traditional Chinese medicine. Acupuncture is the stimulation of specific points on the body by a variety of techniques, including the insertion of thin metal needles though the skin. It is intended to remove blockages in the flow of qi and restore and maintain health., acupressureA type of acupuncture that stimulates specific points on the body using pressure applied by the hands., moxibustionIn traditional Chinese medicine, the use of heat from burning the herb moxa on or near the skin at an acupuncture point. Intended to stimulate the flow of qi and restore health., and cupping, for example, are all believed to act by correcting imbalances in the internal biofield, such as by restoring the flow of qi through meridians to reinstate health. Some therapists are believed to emit or transmit the vital energy (external qi) to a recipient to restore health. ...

Energy Medicine Involving Putative Energy Fields The concept that sickness and disease arise from imbalances in the vital energy field of the body has led to many forms of therapy. In TCM, a series of approaches are taken to rectify the flow of qi, such as herbal medicine, acupuncture (and its various versions), qi gong, diet, and behavior changes.

Acupuncture Of these approaches, acupuncture is the most prominent therapy to promote qi flow along the meridians. Acupuncture has been extensively studied and has been shown to be effective in treating some conditions, particularly certain forms of pain.1 However, its mechanism of action remains to be elucidated. The main threads of research on acupuncture have shown regional effects on neurotransmitter expression, but have not validated the existence of an "energy" per se." [21]

Substantial changes proposed to mechanisms page

I am placing a note here to inform people that I have proposed some very substantial changes to the Scientific theories regarding acupuncture page, including the deletion of large parts of the article. I have made these propositions in response to the long standing totally disputed and cleanup tags. If we can get that page cleaned up to a suitable standard we may be able to include more information about hypothesized mechanisms of accupuncture into the main article, and imporove what is already in the present article. Please see Talk:Scientific theories regarding acupuncture for more details (place comments on that page).JamesStewart7 (talk) 03:18, 24 December 2007 (UTC)

I just thought I'd let people know that I have carried out the proposed changes on this page. As no one commented on the proposed changes after almost two weeks I'd appreciate it if people discussed the changes before reverting them. I am aware a lot of information was removed and some of what was removed was referenced, however, in the case that referenced claims were present the relevance to acupuncture (how this theory explains how acpuncture works) was often not referenced. In other cases a hypothesis was presented like there had been evidence found for it and I was able to find a RS saying no evidence has ever been found for this theory - see talk on that page. In short, please don't revert without a reliable source for every statement. I'm posting this here because I'd really like to see the page cleaned up and the information merged into this article. Currently three theories are presented on that page. One is presented, in full, on this page and the other two have limited references so the content is now fairly somewhat similar. I wouldn't want to merge a whole bunch of unreferenced information into this article so I think more references would need to be found first. I read the AfD page and it seems I have not been the only one to suggest a merger.

Speaking of unreferenced claims, it seems several of the unreferenced claims that were present on the scientific theories regarding acupuncture page have been creeping into the related section of this article. I just removed a few that are perhaps oversimplifications of the truth. I think people have included some of these because they sound accurate but they are not really eg Yes morphine and endorphins do activate the same opiod receptors but "receptor" is inaccurate as there are a few types of receptors involved and I the profile of activation is probably slightly different. In any case a reference is required. Secondly although say the amygdala may be proporitionally more responsible for the control of the emotional aspect of pain perception this is false "Each of these brain structures processes a different aspect of the pain — from experiencing emotional pain, to the perception of what the pain feels like, to the recognition of how harmful the pain is, to localizing where the pain is coming from." as it is an integrative process. As it turns out, phrenologywas wrong. Also I'm about to change this "This can be proven scientifically by blocking the action of endorphins (or morphine) using a drug called naloxone." Given naltroxone and observing an increase in pain perception does not mean that the effect is "proven scientifically" to be a result of endogenous opiates. This requires interpretation and no scientist uses the term "proven". Here, "Some studies suggest that the Analgesic (pain-killing) action of acupuncture is mediated by stimulating the release of natural endorphins in the brain" I will be changing mediated by to associated with. All the studies can establish is an association. They are not sufficient to establish causality. JamesStewart7 (talk) 10:08, 5 January 2008 (UTC)

Reasons Why the Largest Acupuncture Study in History is Ommited from ths Article

I think it would be nice to hear about why the two anti-altenrative medicine groups have such a prominent voice in this article, while every time I check it all mention of the GERAC study (GERAC.DE) is erased. READER BEWARE. Acupuncturist (talk) 23:50, 29 December 2007 (UTC)

I am unfamiliar with this study but am I to take it from the .DE that this study is not in english. Non english sources are mentioned here Wikipedia:V#Non-English_sources JamesStewart7 (talk) 05:03, 30 December 2007 (UTC)

Which two "anti-alternative medicine groups are you referring to?

Re the GERAC study, please find link to abstract here, if that's the same one you had in mind (GERAC did a series of trials, AFAIK). I don't mind including it, since it is large and recent, but as I mentioned above, going with individual studies over reviews is a slippery slope. Good meta-analyses will properly weight particular studies, avoiding WP:WEIGHT issues (and contentious edit warring over whose favorite studies to include).

It is interesting that in that study, acupuncture was approximately twice as effective as guideline-based conventional therapy ("a combination of drugs, physical therapy, and exercise"). That result "led to acupuncture being adopted as a covered benefit for chronic LBP treatment under statutory health insurance plans"[22]. At the same time, sham acupuncture ("superficial needling at nonacupuncture points") was almost as good as verum acupuncture! It's an interesting result, and raises questions over how active "acupuncture points" are in various conditions, and how exactly studies using "sham" acupuncture should be designed. Were the "non-acupuncture points" in this study's sham group local, i.e. in the low back region? If so, they may have been "active" after all. Or were they adjacent or distal points with no indications, TCM or biomedical for back pain? (We should get a copy of the whole article, and cite well-sourced commentary if possible.)

These questions will undoubtedly be hashed out in the scientific community in future studies and reviews. I'd repeat that for WP, the latter are better sources. But we can include some studies that reviews haven't gotten to yet, as long as we use a little dash of informed discretion and don't just start cherry-picking. Backin72 (n.b.) 03:56, 31 December 2007 (UTC)

I haven't given the study an extensive reading (although reading the abstract it looks ok) but, Acupuncturist, it doesn't look like you read it too well if you think the anti-alternative medicince groups want to block it to make acupuncture look bad, "Differences among groups were as follows: verum vs sham, 3.4% (95% confidence interval, –3.7% to 10.3%; P = .39);" p = 0.39 means the result is not significant (no difference between the groups). So the study found real acupuncture is no better than fake acpuncture (the placebo). Hardly convincing evidence that acpuncture is effective. Also Backin72, pain is perhaps the one condition where placebo effects have been reliably demonstrated. Even a rather damning (and quite well conducted imo) review of the placebo effect found evidence for the placebo effect in reducing pain "https://content.nejm.org/cgi/content/abstract/344/21/1594". The fact that sham acupuncture was "effective" does not mean it is not a true placebo. Placebo's of all sorts (even sugard pills) produce a reliable reduction in pain scores especially when the patient thinks it will work eg greater effects when the patient is not told there is a placebo group in the trial. I'm sure someone, somewhere along the line, someone has suggested sugar pills (basically small amounts of lactose I think) are active medicaitons. JamesStewart7 (talk) 07:55, 31 December 2007 (UTC)

Latest university research on acupuncture Dec 2007

Here's a link detailing some interesting research from the University of Manchester concerning acupuncture and reducing the side-effects of cancer chemotherapy. http://www.newsmonster.co.uk/acupuncture-relieves-side-effects-of-cancer-chemotherapy.html Danny85.210.174.17 (talk) 09:58, 31 December 2007 (UTC)

There is no sham acupuncture group (only sham accupressure) so it can only provide weak evidence for the efficacy of acupuncture at best. JamesStewart7 (talk) 10:16, 31 December 2007 (UTC)

I don't think there is yet scientific consensus over whether sham is the best control for acupuncture, or if it is, where to put the (quasi-)needles. (See here.) Per my comments elsewhere on this talk page, that judgment is best left to reviewers, on whom we should rely more than individual studies. --Backin72 (n.b.) 00:15, 3 January 2008 (UTC)

Infobox

The large font size used looked wrong and is not used by other infobox templates. Is it already used on other alternative medicine articles and would we wish it to be used ? If people agree worthwhile, then I can help out at the infobox proposal page (WP:IB/Proposed) - effectively a sandbox to collaboratively work up a template before going live with multiple articles which then would be using a fixed set of named parameters. :-) David Ruben ^Talk 14:51, 31 December 2007 (UTC)

I knew it looked awful. Thanks so much for fixing that. Happy New Year, David -- Backin72 (n.b.) 22:47, 31 December 2007 (UTC)

Category:Pseudoscience (again)

For McCready: the ArbCom addressed this issue, and their ruling is now part of official WP policy. WP:NPOV is now clear about when to use Category:Pseudoscience. Per WP:NPOVFAQ#Pseudoscience, attributable evidence of scientific consensus is necessary to use Category:Pseudoscience, while evidence of a sig POV that the topic is pseudoscientific is necessary to mention PS in the article. For many articles such as acupuncture, we do have sig POV's saying pseudoscience. However, to use the category, we need to show evidence of a scientific majority. (See WP:RS: "Claims of consensus must be sourced. The claim that all or most scientists, scholars, or ministers hold a certain view requires a reliable source. Without it, opinions should be identified as those of particular, named sources.") An example of such consensus would be a statement by a group such as an Academy of Science. Please stay in line with what is now official WP policy and provide such a source if you wish to place the pseudoscience category on any article. Thanks. Backin72 (n.b.) 22:49, 31 December 2007 (UTC)

More on lead section

1. Agree with this edit. Undue weight to cite a source a flawed as Quackwatch in lead, and indeed to use it at all in an article on a notable topic, per reasons already discussed at Talk:CAM. Quackwatch is a questionable source per WP:SOURCES, and the Arbcom referred to it as an unreliable and partisan source. No reason whatsoever to use it when better sources expressing the same POV exist.

2. Am reverting this change to the lead because it is sloppy and misleading, per WP:LEAD as well as WP:WEIGHT. (a) for back pain, saying "so and so has reported" without discussing the contents of the report is not informative. (b) omitting nausea is not appropriate given that good sources say there is moderate efficacy. (c) for neck pain, saying "there is a report of moderate evidence" suggests a single study rather than a meta-analysis from an excellent V RS. Cochrane Collaboration is vastly more a V RS than the Scientific Review of Alternative Medicine, which is sort of the flip side of, e.g., a Journal of Scientific Exploration: peer-reviewed, but virtually self-published by a self-selected group and no small whiff of publication bias. That is my opinion, but it is backed up by Pubmeds's declining on at least three occasions to index SRAM[23]. (Boo-hoo - what a conspiracy. Seems like those darned extremists are everywhere these days. Almost makes those Real Skeptical Knowers Of The Truth seem like a shrill minority or something. See last comment here.) SRAM is at the lowest tier of peer-reviewed reliability.

If "skeptics" really want to have their voices taken seriously, they should be grownups and get their stuff through peer-review just like everyone else. When they do that, as here (pdf) or here, their stuff is considered a good V RS and given appropriate weight on WP. When they don't, as with self-published stuff like Quackwatch, it's not. Backin72 (n.b.) 22:28, 2 January 2008 (UTC)

Scientific Method and the Assessment of Chinese Medical Theory and Techniques sections

I think both the "Views of proponents" and the "Views of critics" subsections (ie the whole section) should be removed. The sections are almost entirely unreferenced and perhpas unreferenceable and there are major POV concerns as a lot of opinion is being presented as fact eg "Clinical trials are still a valuable exercise, but they are not sufficient to determine conclusively whether either the individual constituents of the medical theory (e.g. acupuncture points), or the medical theory as a whole, are valid" is just an opinion that has not been attributed to anyone. Also some strange things have been done with these sections. This is in the criticism of acupuncture section "Tonelli, a prominent critic of EBM, argues that complementary and alternative medicine (CAM) cannot be EBM-based unless the definition of evidence is changed". That reads more like a criticism of EBM to me. What is referenced in this section is either not directly relevant to accupuncture eg the information about CAM in general or is repeated below in the "Scientific research into efficacy" section. This reference "acupuncture is usually more effective than no treatment or a placebo in pill form, and that there is no significant difference in the effectiveness of acupuncture and “sham” acupuncture, which is often used as a control.[47] is also problematic as we have admitted a primary source where all the other scientific evaluations are meta-analyses (secondary sources). This is the only referenced statement that warrants keeping "The vast majority of research on acupuncture is conducted by researchers in China, and Ernst et al. argue that there exist major flaws in the design of the experiments, as well as selective reporting of results, and conclude that no conclusions can be drawn from them" and it may be moved elsewhere. This whole section is a violation of WP:RS which is inexcusable due to the sheer number of RS available on this topic. JamesStewart7 (talk) 05:02, 6 January 2008 (UTC)

Evidence from neuroimaging studies

I think there is some selective quoting going on with the reference here. The reference does state this
We have systematically researched and reviewed the literature looking at the effect of acupuncture on brain activation as measured by functional magnetic resonance imaging and positron emission tomography. These studies show that specific and largely predictable areas of brain activation and deactivation occur when considering the traditional Chinese functions attributable to certain specific acupuncture points. For example, points associated with hearing and vision stimulates the visual and auditory cerebral areas respectively
However it also states this
However, Gareus et al. (10) throws some doubt on Cho's findings. Therefore, while it appears that it is probable that acupuncture-like stimulation of UB67 triggers specific activation of the occipital cortex, it is by no means a uniform and consistent finding.
...
However, activation was not seen in the left inferior frontal gyrus and it is also clear that not all acupuncturists would agree that these points are related to language
...
They suggest that these different patterns may be related to specific therapeutic effects, although it is difficult to justify this based on data obtained from healthy volunteers receiving one acupuncture treatment.
...
It appears that there are substantial overlaps between the pain matrix that have already been identified within the brain and its response to placebo acupuncture and pain
I don't think the results are nearly as clear cut as that one included quote would make it seem. JamesStewart7 (talk) 05:59, 6 January 2008 (UTC)

Yes, the reference does suggest that our knowledge in this area is still very much evolving, and caveats pain, but also points to much clearer-cut findings such as PC6 for nausea. I've revised the quote striving to more accurately reflect the source. regards, Backin72 (n.b.) 08:12, 8 January 2008 (UTC)

Comparisons

This is just not a fair comparison
This is in comparison to 2,216,000 serious adverse drug reactions that occurred in hospitals 1994. (Lazarou J, Pomeranz BH, Corey PN., JAMA. 1998 Apr 15;279(15):1200-5.) So to compare indirectly, Acupuncture has a 0.2% chance of causing a minor adverse effect compared to prescription medications having a 6.7% chance of causing a serious adverse event in a hospital setting. Firstly, that is only drug reactions that occur in hospitals. There are many, many drugs taken outside of hospitals and I would argue that over-the-counter medications are much safer than prescription drugs so by restricting the sample to hospital patients, the data is already really skewed, especially when you consider that the bulk of accupuncture treatments are probably not performed in hospitals. Secondly, drugs are prescribed for a lot of conditions. You cannot compare say an accupuncture treatment for lower back pain to the use of immunosuppressants as part of a heart transplant. Furthermore, I believe these sort of indirect comparisons where an editor takes two seperate studies and compares the results qualifies as OR which is grounds for removal on its own. JamesStewart7 (talk) 06:10, 6 January 2008 (UTC)

Agree, I'd noticed that too and thought it was OR. Just removed it. regards, Backin72 (n.b.) 08:02, 8 January 2008 (UTC)

Changing the introductory paragraphs

I have just submitted a change to the introductory paragraphs. The original sentence relating to needling "acupuncture points" did not take into account the treating of Ashi points. My clarification, although quite lengthy, added this element. This is my first post so I hope that I have not transgressed in any way. Llj444 (talk) 16:44, 18 January 2008 (UTC)

Welcome aboard. I appreciate the spirit of your edit. If "ashi points" are not defined as "acupuncture points", they are certainly part of TCM theory... and researchers claiming to do "sham" acupuncture by needling "non-acupuncture-points" may be doing verum treatment if the "sham" points are also "ashi" points. That's an actively debated topic and should be mentioned. However, I'm not sure the lead section is the place to jump right into the specific meridians. Will think it over. Welcome! Backin72 (n.b.) 21:42, 18 January 2008 (UTC)

For McCready: you asserted "bulk of scientists saying ac is crap." Source please? Also: "page needs to be 50kb max." Yes, your attempts at WP:GAME are duly noted[24][25]. (Assume good faith isn't a suicide pact.) You've been blocked in the past for such behavior. Suggest you disengage a bit. --Backin72 (n.b.) 10:20, 27 January 2008 (UTC)

Good the talk begins. But you are wrong in your allegation that I have been blocked for gaming. Pls apologise and pls answer for the third time, should the article be 30-50kb? Mccready (talk) 10:27, 27 January 2008 (UTC)

(1) Pls answer my question: "bulk of scientists saying ac is crap." Source please?

(2) You were blocked for tendentious editing. You're doing it again, and you ought to be blocked again for it, IMO. You're the one who owes an apology to the various editors whom you've stressed out.

(3) No, I don't see any reason to be rigid about article size, per other comments at Wikipedia talk:Article size. Also, I think the best way to go about reducing article size is discussion and splitting, not chopping out well-sourced material that you don't happen to like. --Backin72 (n.b.) 10:41, 27 January 2008 (UTC)

1) Don't be silly. I suppose you'd want a cite that most scientists don't think the moon is made of blue cheese. 2) Not gaming. Don't be silly again. Editors are responsible for their own emotional state, not me. 3) Pls answer question. Do you agree or not that the article should be limited to 30-50kb? I'm quite happy for you to split away. A lot of the material is repeated elsewhere as I have said. Mccready (talk) 08:10, 28 January 2008 (UTC)

On (1), we've been over this before: see WP:NPOVFAQ#Pseudoscience and WP:RS#Claims_of_consensus. Prove your claim. The moon being made of blue cheese not a serious claim. Acu's effifacy for various things is, and is studied as such. On (3), what part of "no" didn't you understand? --Backin72 (n.b.) 09:00, 28 January 2008 (UTC)

I return after a long break to comment on this article (which I was editing back in 2006). First let me make it clear that I have no interest in engaging into debate with McCready over the same content that was argued about 2 years ago, and seems to be still argued about now. It is interesting to see how the page has developed, but I must admit it is a shame to see how skewed the article is towards discussion of the scientific validation of acupuncture, at the expense of giving readers an understanding of what acupuncture actually is. Also unfortunate to note is that McCready seems to still not make the distinction between what acupuncture is and what it claims to be able to achieve). He has successfully wasted many people's time and effort on argument over a sub-topic, at the expense of the same time and effort being spent on making the article more complete with information about all subtopics of acupuncture.

I am giving my opinion based on a break of 18months from editing this page, and the fresh perspective this gives. Summarised below:

1. Of the four paragraphs in the lead, only one describes what acupuncture is, and it does so poorly. I'm not sure that people know what filiform needles are, and the link to wiktionary doesn't enlighten the reader any further. I think it is important to disambiguate this, also I'm not sure how you would achieve this. I am happy to give you some further ideas on this Bakcin72 (or others) if you require.

2. The other 3 paragraphs are centred on the topic of the efficacy of acupuncture. Such a series of paragraphs would be better suited to an article entitled "the efficacy of acupuncture". For an article titled "acupuncture" one paragraph is enough. McCready, be concise and fair in what you wish to say about the efficacy of/debate surrounding acupuncture and summarise it into one paragraph. There is no need to repeat yourself for theatrical purposes, especially in the lead paragraph. Leave it in the section that it belongs to, and summarise appropriately in the lead. (I am only naming you McCready because I see you as the primary spokesperson for this subtopic and main person responsible for such a series of paragraphs being in the lead in the first place).

3. Suggestions for other subtopics that I think could suitably replace the space left by removing 2 of 3 paragraphs would be:

   a. use of the words qi and meridian, as any discussion on acupuncture is kinda pointless 
      without referencing key ideas behind its use by acupuncturists etc.
   b. reference to "gate theory" and other medical references to the western medical ideas 
      behind the use of acupuncture by doctors etc.
   c. acupuncture points are located all over the body, and are chosen according to a number 
      of theories: TCM, Japanese acupuncture, ashi points, scientific reasons etc.

These are just suggestions, however I think it is VITAL to give more of an idea about what acupuncture actually is in the lead section of an article entitled acupuncture- before launching into debate about scientifically verifiable efficacy.

4. McCready, please go ahead and create a page for your pet topic of efficacy of acupuncture and put yours and others well researched content in there. Be sure to link to it at the head of the section titled "Scientific Research into Efficacy" and summarise appropriately. I think that you have spent a lot of time and effort putting this view across that your efforts should be displayed in an article of their own. There is certainly more than enough material. Your strong command of written english will allow you to effectively summarise such material into two paragraphs or so on the main acupuncture page, whilst leaving an entire page for the full extent of yours and Backin72's previous posts on the subject. Note, this is not an attempt at "muddying the waters" as you commonly cite, simply a pragmatic way of keeping the article on topic. At the moment, if I were marking a paper titled "Acupuncture" that contained what is written on the acupuncture page, it would receive an E at best due to a lack of information about the topic and a seemingly strong bias to one of the many sub-topics. Other sub-topics don't receive nearly as much weighting and space on this page, which I think is very unfortunate. I'm sure both yourself and Backin72 would agree with me on this.

I'll pop back in a month or so to see how things are going, and to see if either McCready, Backin72 or others have responded to my suggestions and comments. Who knows, I may even dare to edit again. Until then... Happy editing! Piekarnia (talk) 01:45, 9 March 2008 (UTC)

Hi Piekarnia, long time no see. Generally agree about reworking the lead, and since another editor (DavidRuben) has suggested something similar, I think we should go ahead. BTW, I would not favor a separate article on efficacy as that could be seen as a POV fork (or at least, I would favor retaining a significant amount of stuff about efficacy in this article, just not so much in the lead).

I've kind of given up on this article though. WP's fundamental assumptions (that lack of peer review can result in a decent article) are too flawed. So forgive me if I keep an eye on it so it doesn't get worse, while not putting in hours to make it better. Rather like bailing a leaky boat. regards, Backin72 (n.b.) 02:31, 14 March 2008 (UTC)

Piekarnia, your personal attacks on me do you no credit. Please desist. The culture of wikipedia has changed since you were last here. Try to address yourself to the issues not the person. Such bad behaviour on your part is clampled down on much more rigorously now. Please check civility and assume good faith. I agree with Backin72 that a fork would be inappropriate. I agree with you on filiform. I agree with you that the top is too long and some of the history stuff could be addressed below. I think we need to say much more strongly up top what science says on acupuncture's efficacy on the various diseases acupuncturists treat. The statement "according to a review by Edzard Ernst and colleagues in 2007, which found that the body of evidence was growing, research is active, and that the "emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions". is a wishy washy unscientific one (seems???,imply???) that acupuncturists would love. ie the subtext is "we know it works, just give us time and research money and we'll prove it." There are plenty of more punch statements on efficacy. Who cares, for the purposes of the lead, if the research is growing. The "body of evidence" growing phrase can be read as "evidence that acupuncture works is mounting". It can also be read strictly that this is not the case. In either case the phrase should go because it allows ambiguity, does it not? Acupuncture points are hotly debated by various schools of acupuncture - undermines the whole claim. So I don't agree with where you are coming from in this.

The WHO and NCCAM stuff need not be in the lead. They there serve the purpose of puffery. They've reported on it. So what was the outcome? And once again we have the altmed cry for more reseach.

Yes the article is a long long dog's breakfast. Mccready (talk) 13:42, 17 March 2008 (UTC)

We already have a list of diseases. We simply need to present them in a table with a column for the efficacy of acupuncture.

Stuff to add

This is interesting, re mechanism. --Backin72 (n.b.) 05:19, 31 January 2008 (UTC)

And here is a link that (currently) provides free full access to the text and PDF version: Acupuncture Anesthesia and Analgesia for Clinical Acute Pain in Japan. MeekMark (talk) 11:36, 31 January 2008 (UTC)

I would hardly consider that journal to be reliable. And basically, they're saying that acupuncture treats every pain ever known. I would be opposed to using it. I'm not at all a supporter of junk science, so I've added some very reliable references to this article. I intend to be as neutral as I can to balance both sides of this story. But this article doesn't even entice me to look beyond it. Unsupported claims always makes me yawn. OrangeMarlin ^{Talk• Contributions} 03:19, 2 February 2008 (UTC)

Agree it is fairly underwhelming as a review, but as for the journal itself, Ernst and Kaptchuk are pretty studly and are on the review board. Not sure though about the general quality of articles or publication bias. --Backin72 (n.b.) 06:47, 2 February 2008 (UTC)

• Good one re sham acu and placebo effects: Kaptchuk et. al., BMJ 2006;332:391-397. Article about it in Science News. --Backin72 (n.b.) 06:47, 2 February 2008 (UTC)

Added. --Backin72 (n.b.) 07:58, 3 February 2008 (UTC)

Maybe more stuff

This research was published yesterday in the British Medical Journal. It includes meta analysis, which is something that never gives me any feeling of confidence. However, the paper suggests a NNT of 17:1 so it is note worthy from that point of view. Manheimer, Eric; et al. (7 February 2008 ).Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ. doi:10.1136/bmj.39471.430451.BE.--Aspro (talk) 16:55, 8 February 2008 (UTC)

I saw that reported too, yes, agree. cheers, Backin72 (n.b.) 06:27, 9 February 2008 (UTC)

Williams

Good; undue weight to cite that guy in lead anyway. --Backin72 (n.b.) 04:15, 2 February 2008 (UTC)

Cleanup

If all goes well, I'm hoping to clean up the article and prune/merge some stuff into Traditional Chinese medicine, Meridian (Chinese medicine), Zang Fu, etc. --Backin72 (n.b.) 04:18, 2 February 2008 (UTC)

It may take awhile, since edits like this are nontrivial and I haven't edited a couple of the above articles before. But the result will be a shorter, tighter article. --Backin72 (n.b.) 05:29, 2 February 2008 (UTC)

I made a small but significant change to the lead, in accordance with the sources we have in the article (AAMA etc), which list mainly pain and other symptoms. --Backin72 (n.b.) 07:57, 3 February 2008 (UTC)

Lead-in discussion on verification

Clearly Mccready's steady drastic reduction of the lead-in's discussion of the research and verification basis for acupuncture is not agreed with by several editors who have reverted it back (warning issued re risk being seen as edit warring). However I do have issues with the lead-in concentration on this:

• The leadin should really explain what something is and its historical & social background before getting too heavily into criticism & proofs.
  • The leadin current is sparse on history and even less mention of social/society issues. The first date mentioned in the leadin is not some estimate of when the practice first started (or a referrence to first written record to at least give a minimum timeframe) but "2007" for an American Journal publication.
  • The leadin needs give a little more description of history and uses. NB this should be noncontentious to indicate what it has been/is used for, which is quite distinct from an assertion of effectiveness - cf antibiotics often given for sore throat in the UK (true) but this not the same as whether blanket prescribing helps (contentious and certainly less clear-cut than the previous generation of doctors thought, and I certainly prescribe in well under half of cases as most are clearly self-resolving viral infections). Some mention also should be made of spread of practice into Western World (we surely all agree that acupuncture more prevalently available and practised in UK & US than say 100 years ago, but precisely what was this process (NB needs citing of course)
• Given I do not dispute that acupuncture is widely practised in the Far East, acupuncture is clearly not a trivial-minority opinion. Therefore the leadin should at least make some better mention of TCM viewpoint on disease and how acupuncture is thought to aid health. Likewise, given there are some positive scientific studies, how modern science (which does not see evidence for Qi) suspects acupuncture might exhibit its effects (ie pain-gate model, neuro-immunological effects or whatever).
• Of course given the alternative/complimentary aspect of how acupuncture is perceived, the leadin needs cover the evidence supporting or refuting claims of effectiveness, but this should not I think form the largest part of the leadin (relocate details to the "Scientific research into efficacy" section).

So, IMHO, the material Mccready has removed and paraphrased was overly harsh with the scythe, but I agree currently unduely long and needs some triming with expansion of other more straight forward encyclopaedic description aspects. David Ruben ^Talk 12:02, 7 February 2008 (UTC)

Thanks David. Good finally to get the discussion started properly. The diehard defend acu at all costs acus who inhabit this page have refused to discuss properly despite an outward appearance. The points you made are valid on the whole. But the overwhelming evidence is that acu is BS. Even the one metastudy on P6 that Backin72 likes to tout has been criticised by scientists. Bakcin72 operates, as do most altmeders, by 1) muddy the waters by saying it's controversial and scientists can't agree (we've seen it classically in the tiny minority of global warming deniers among scientists) 2) suggesting their fav altmed as soln, 3) crying that they are cut off from research fund which would soon prove the moon is green cheese (thus Backin72 likes to quote any source he can that concludes more research is needed) 4) wikilawyering to prevent any sensible analysis or presentation of facts unsullied by UNDUE weight (thus a sensible conclusion is labelled OR and out of court, or a syllogistically correct statement is also thus labelled.

The facts are 1) most of the "science community" pays no attention to altmed because they've got b better things to do. Therefore statements about what the community thinks are fraught and need to be carefully verified. 2) the huge bulk of papers conclude acu is BS 3) this article's LEAD gives UNDUE weight to the minority of studies finding acu may have a point. The current statement in the lead "For most conditions acupuncture has no effect." is a huge compromise as it is. But Backin72 doesn't even accept that compromise. He can name no condition for which acu has unequivocally, to the satisfaction of the science community, been shown to have effect. There are even editors here who claim to be skeptics but have stated on their pages that they think acu has a demonstrated analgesic effect. Show me the studies proving that I say. Looking forward to sensible discussion. Mccready (talk) 00:53, 8 February 2008 (UTC)

(Further repeated blanking of section being discussed was disruptive and your block warranted). Whilst above indeed probably the views of majority established "conservative" conventional medical doctors, your points are merely items that the acupuncture criticism section might cover. Rather what I am trying to generate is discussion that the lead-in should have more information describing what acupuncture is, its historical context and views of claimed modality of effect, rather than be so heavily dominated by just the modern scientific verification/justification. The problem, I see, is over balance of spread of covered aspects, not a POV desire to downplay the veracity of the technique (of which I am an intrigued sceptic), so could some pro-acupuncture editors help here by suggesting how the verification discussion in the lead-in might be summarised down just a little and the other items I mention be more fully covered. The article's tone as set in the lead-in should really be a positive affirmation of what acupuncture is, and not what might be seen as an apologetic justification piece. David Ruben ^Talk 01:02, 9 February 2008 (UTC)

David - I think your idea on moving forward with the lead is great, and the only reason I haven't responded sooner is I am time-poor and was asked to resolve a BLP problem elsewhere. Will work on this as soon as I can, certainly this weekend.

BTW, for Mccready, I'd appreciate being referred to by my handle here, and not nicks like (redacted) and the like. This isn't a political campaign, and as I mention on my user page, I prefer not to label people based on a single attribute, and in the spirit of the Golden Rule ask that others refrain from doing so with me. Also, WP:NPA comes into play.

As for Mccready's other comments... I feel that acu should be held to the same standards as anything else in medicine, and there is plenty already cited in the article (just go to Pubmed and read the studies cited in the reviews from Cochrane, Ernst etc.). However, Mccready seems to have a double standard for acupuncture, doubting any result and questioning the motives of the researchers. Not unlike his approach to wikiquette[26][27], interestingly. So, I'm not sure if there's anything else I can say to address his concerns. regards, Backin72 (n.b.) 06:27, 9 February 2008 (UTC)

Backin72, please stop your slurs on me. Other editors have agreed the article has UNDUE weight and length problems. The UNDUE weight in the lead is by mentioning a purported condition that acu is useful for but not mentioning the huge bulk of conditions it is useless for. You have already ack'd this and therefore I have edited accordingly. How then do you propose we address the remainder of the issues of undue weight and length? I have to disagree with DR about criticism in the lead. One persons crit is another's fact. If the bulk of people believe acu may be useful, it might be good to point out up front that it largely isn't. Mccready (talk) 08:13, 10 February 2008 (UTC)

(1) I'm sorry if you believe I've slurred you. Please show me where. I believe it's calling a a spade a spade to cite your edit and block history. (2) Per WP:DR, please take care not to misrepresent my views. I don't recall ever there were undue weight problems such that therefore you should go ahead and edit as you have. I do agree with DavidR that we should refocus the lead on historical use and devote a shorter section to scientific research, but not in the biased way you suggest. (3) Your edit conflates the jury being out with outright dismissal of acu by the sci community. A great many of of our Cochrane reviews say "not enough evidence to determine efficacy". Some do say "no evidence of efficacy", but based on what we have, you're going too far. That's why I (and a bunch of other editors) think the original stable version is preferable. More work on lead to come. --Backin72 (n.b.) 09:51, 10 February 2008 (UTC)

P.S. My ES here should have read (emphasis added on omitted matl'l): "(rv- "most conditions no effect" not supported by sources, which frequently cite a need for more/better studies - conflates positions of agnostic and disbelief - and reword to attrib Ernst)" --Backin72 (n.b.) 09:56, 10 February 2008 (UTC)

For Davidruben et. al. - well, I wanted to work on the lead this weekend, but other stuff came up, both on and off wiki. Still a priority. Am also interested in improving the history section, and have some good books (including Unschuld, one of the best) at hand. regards, Backin72 (n.b.) 20:41, 11 February 2008 (UTC)

Fact or Crit

I have copied this from my talkpage to here. Mccready (talk) 05:48, 11 February 2008 (UTC)

In regards to my Acupuncture revert, it was done to restore the introduction. The article simply didn't make sense starting out with a criticism of acupuncture without first defining the term.Asher196 (talk) 05:43, 11 February 2008 (UTC)

Asher, the fact it that the material you removed was factual. Whether you personally regard it as critical is not the point. Even if I concede your point, please show me the wikipedia policy which says we cannot have such material in the lead. Mccready (talk) 05:48, 11 February 2008 (UTC)

I want to Wikipedia to be encyclopedic, and your version of the lead-in is confusing. Simple as that.Asher196 (talk) 05:56, 11 February 2008 (UTC)

You have now changed your story. Now you need to explain why you are confused. Otherwise will you please replace my version? Thanks. Mccready (talk) 06:18, 11 February 2008 (UTC)

I'm not saying your material shouldn't be in the article, I'm saying your material shouldn't be the lead. I came to the article by clicking the "Random article" button. The first thing I read was "Many Cochrane reviews of acupuncture say there is not enough evidence to determine its efficacy. Others say there is no evidence of efficacy. A review by Edzard Ernst and colleagues in 2007 said that the "emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions." Well, that's fine, but what is acupuncture? Look at it from the perspective of someone with no knowledge of the subject and maybe you will see my point.Asher196 (talk) 06:41, 11 February 2008 (UTC)

Fine.Yes I concede your point. But as it now stands it conveys the idea that there is controversy. This a classic altmed tactic. In fact the overwhelming bulk of evidence is that it has no effect. I'm happy to edit to take out the possibly confusing reference to Cochrane in the lead. Mccready (talk) 07:37, 11 February 2008 (UTC)

Lead

I really am getting sick of the fact that bold editing is regarded as disruptive. And it needs to be seriously noted that edit warring alone is an impossibility. I am also getting sick of the fact that some editors refuse to conduct discussion properly despite numerous attempts on my behalf. So let's try again. Could you please address three points one by one.

1. Backin72 has acknowledged multiple times that for the great bulk of conditions acupuncture has no effect. His words are "A great many of of our Cochrane reviews say "not enough evidence to determine efficacy". Some do say "no evidence of efficacy"" He believes then that my preferred formulation goes too far. My latest formulation, reverted by him without adequate discussion, despite his edut summary, was "Many scientific reviews of acupuncture say there is not enough evidence to determine its efficacy or that there is no evidence of efficacy. However, a review by Edzard Ernst and colleagues in 2007 said that the "emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions"." On 30 January Backin72 said "For many more conditions, there is not enough evidence to determine efficacy. That's what the sources say." Then on 10 February he writes, after he reverts me again (and remember he doesn't edit war - only me) in contradiction to his earlier claims "rv- "most conditions no effect" not supported by sources". He also says "Of cource acu is used clinically for conditions where EBM support is lacking" then he tries to excuse this by saying "but that is also true for some biomedical modalities, including most surgical techniques." Why don't we just stick to the facts and let other article handle issues the way they will? On 3 February Backin72 says "The list of conditions that a particular compound or technique cannot treat is endless." Then he refuses to list any of them in the lead (a position I'm comfortable with) while listing nausea in the lead because this throws a possible positive light on acu.

So point 1. Why cannot the lead say "Many scientific reviews of acupuncture say there is not enough evidence to determine its efficacy or that there is no evidence of efficacy. However, one review by Edzard Ernst and colleagues in 2007 said that the "emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions".

2. UNDUE weight. A typical altmed tactic is to muddy the waters. Altmeders love to say science doesn't know or scientists are divided etc. Thus Backin72's preferred formulation of the lead says there is scientific controversy. And Backin72 stoutly defends (but I edit war apparently) his preferred formulation that "Scientists are studying the mechanisms and efficacy of acupuncture." Again a typical altmed tactic to gain legitimacy - scientists are studying it so it must be worthwhile. It's a bit like the global warming "controversy" - only existing in the minds of a tiny minority of outliers. In fact most scientists, if they bother to look at CAM or acu at all, conclude it is utter rubbish. To drum up a supposed controversy is Original Research and UNDUE weight. Likewise to use the term "scientific community" which Backin72 also defends. Despite being asked, Backin72 has refused to name even one condition for which acu has unequivocally, to the satisfaction of the science community, been shown to have effect. Likewise, it's a typical altmed tactic to say further research needs to be done. So whenever Backin72 gets the chance he likes to quote any source he can that says so. This is undue weight.

So point 2. Why do we not delete reference in the lead to scientific controversy and scientific community.

3. Nausea. Given the above can we please delete reference to nausea in the lead. It is one of the tiny shreds of research that acupuncturists can still hold onto to give them faith that there must be something to acu after all. Needless to say there is strong disagreement by other researchers about the validity of the nausea study Bakcin72 stoutly defends in the lead (but I only edit war, remember?). By all means discuss it, for and against, but why in the lead? And for the record, my personal view is that yes there may be something in it, but so far it certainly doesn't look like it.

So point 3. Can we delete nausea in the lead?

Finally I might add that Backin72's clever attempt to sideline me, while consistently refusing to discuss properly, does indeed appear self-serving. It's about time the wikipedia community looked beyond my bold comments in edit summaries and on talk pages and looked at the facts of my editing and my consistent attempts to get sensible discussion. And before even the self-styled skeptics start another attack, let me assure you I have learnt a lesson from my recently block and that my edit style and gosh yes to some extent my wiki personality have undergone a change for the better. Over to you :-) Mccready (talk) 23:59, 11 February 2008 (UTC)

Hi Mccready -- I'd like to applaud your recently taking to heart criticism that was meant as constructive. I think Fyslee, a self-identified chiro-skeptic, had it right when he said (paraphrasing) that there's not much point in revert warring, because if others agree with one's edits, they'll make sure the edits stick. If not, why bother? Even if one doesn't think others are making sensible arguments, all one can do is keep a cool head, discuss, and accept that sometimes others may disagree. That's WP, for better or worse. If you want expert oversight, Citizendium is the place for that (and of course, some will feel that those experts are probably all biased too.... e.g., only Joseph Mercola, or Stephen Barrett, has it right...can't please everyone.)

I acknowledge that I've reverted a number of your edits, but the thing to remember is that at least four other editors have agreed (and reverted along) with me, whereas you've been the only one arguing for and rv-ing to your edits. IOW, while bold editing is good, repeated bold editing against consensus is bad. See WP:BRD. But, that's the past. Looking ahead, we should be pragmatic and try to collaborate.

The other thing that's important to keep in mind is that all CAM's are not the same. Some are taken more seriously than others as shown by the volume of peer-reviewed studies. Acupuncture is in the top tier of that class, and perhaps has the greatest number of RCT's of any so-called CAM therapy. Comparing it to global warming skepticism, or saying that the moon is made of green cheese, is fallacious. Scientists have spoken en masse against the former, and do not take the latter seriously enough to submit it, time and time again, to peer review.

I would also, once again, gently request that you not misrepresent my views, as you did when saying that I have "acknowledged multiple times that for the great bulk of conditions acupuncture has no effect." False. Not so. In a field with active research, I don't read absence of evidence as evidence of absence. This is a case where the jury is out, and is actively deliberating. Ernst is no alt-med sympathizer; he's very EBM about everything, and if anything is an acu-skeptic, but even he acknowledges research is active and the issue is controversial. (I'd add that in my view, and per several V RS's, the issue of proper study design is critical and not well-settled.)

I disagree re omitting nausea and other positive findings from the lead. The idea that it's "undue weight" to cite it, if we talk about evidence or lack thereof for other things in the lead, makes no sense to me. Am I the only one who feels this way? Chime right in, ya'll.

And BTW, you can keep on repeating your demand for RCT's all you like, but I already replied above, and to clarify, double-blind is never gonna happen properly for a procedure as opposed to a compound, so if anything the meta-analyses are too conservative. Start with Pubmed, search terms "acupuncture pain", limits "Clinical Trial, Randomized Controlled Trial, Review, Core clinical journals." Or ask OrangeMarlin, who reputedly is able to decipher such things ;-)

Regarding your last edit, I have some issues with it:

• The statement that "the exact location of acupuncture points (is) not agreed by acupuncturists" is not supported by the source, which instead says "the definition and characterization of these points remain controversial". I've read lots and lots of point location texts, and compared them, and there is little disagreement over the location of the major channel and extra points on the body (Liv-8 is about the only one I can think of); only in subsystems like hand and ear acupuncture (which often involve mapping a homunculus onto those respective body parts; TCM loves systematic correspondence) can one find significant variance.
• The second and second-to-last sentences are virtually identical.

Anyway, I would prefer to move forward from here with DavidR's suggestion and reorient the lead, and generally improve the article as I've talked about above. I'd really rather write than argue, especially if I'm in the minority and arguing is fruitless. Does that seem like a sensible approach? Pouring you a cold beer now (if that's your thing ... substitute recreational beverage of choice). regards, Backin72 (n.b.) 10:27, 14 February 2008 (UTC)

Partially reverted, for reasons above: (a) source didn't meet the claim re point location. (b) it's redundant to say Many studies say there is not enough evidence to determine its efficacy while others say there is no evidence of efficacy ... For most other conditions reviewers have found either a lack of efficacy ...or have concluded that there is insufficient evidence to determine if acupuncture is effective". Apart from removing the claim re (a), my edit doesn't change the meaning of the lead at all, just yet (pondering how to do that re history, migration to the West etc.). Also, I'm not sure whyquit.com is a V RS, and in any case, I'd like to suggest a guideline for new stuff like that: first edit the article, then synthesize the lead from that. That's per WP:LEAD. regards, Backin72 (n.b.) 10:27, 14 February 2008 (UTC)

---

(sorry been busy in real world last couple days) OK, above looks more promising being a discussion on how to approach further editing. I'll make a few observations (ignore as you see fit)

• "contentious" or similarly implied phrase needs including: western medicine has obviously not (yet) wholeheartedly included this into its own practice and does not accept the traditional proposed underlying mechanism of action of Qi, conversely (until recently) the Chinese would have relied exclusively upon TCM. So what is common experience & approaches taken in health care are very different for large fractions of the world's population, there is a discrepancy and therefore some degree of tension between the viewpoints. As Wikipedia should not be US/UK centric, the practice of approx 1/4 of the worlds population is highly notable.
• Backin72 and Mccready are clearly more familiar with literature on acupuncture than most wikipedians, so I'll refrain from commenting on any single paper or how firmly various viewpoints identify with that paper.
• Point about lack of evidence for efficacy is not the same as evidence that lacks efficacy is a good one and all too often forgotten. However given that studies generally can only confirm a positive rather than a negative, not unreasonable that an extensive practice acquires a body of supportive evidence - and conventional medicine is also guilty of this. Example: one might suppose that use of bath oil emollients for patients with dry skin and eczema is a good thing, but a surprising lack of evidence for this (vs. just apply full-on creams after a bath) - and a recent Cochrane review was highly critical of the practice not so much that this of disproved effectiveness, but rather that such a common and expensive practice lacked support and so needed to be questioned.

But might I suggest you take a step back from concentrating on these few sentences of the lead-in. As you two are exploring ways to work better together, can I suggest a few wikidiversions (aka some lateral thinking):

1. Firstly put on the back burner current discussion on that paragraph, and find some parallel parts of the article that need improving. Select a dull, dry, most matter-of-fact points you can find and see if it can be better written (i.e. good English rather than necessarily great expansion or clarification) and better sourced. There must be some points you can happily agree with (how about representation in Chinese art, or role of acupuncture as forming part of Chinese self-identity). If you can work together on such aspects this will help regain trust and AFG.
2. Be really brave and rather than trying to edit in a style that is shifted from your personally held viewpoint to that of NPOV, instead agree to edit only as if from your opposing view point trying to approach the NPOV. I promise you it is much harder than you might think, but does wonders from being a good encyclopaedic copywriter, rather than a participant in a discussion forum arguing out a case. Consider what makes a good competitive Debater: being given an unprepared bizarre untenable proposition to have to earnestly debate and defend :-)
   Hence (following points of course would need references to cite) Backin72 try adding something about how western medicine has traditionally rejected or felt threatened by acupuncture (perhaps seen as vanguard opening the way for all other CAMs diverting limited resources/spending to what is/was seen as "unproven" treatments) and Mccready add something on scope of acupuncture use in China (NB factual usage, not whether proven effectiveness). Likewise Backin72 on perhaps unrealistic claims made for acupuncture (surely some less scrupulous practitioners may make wild claims for treating conditions for which wider acupuncture/TCM community would view as unjustified) and Mccready on the "professionalisation" of practitioners in the west, from just a few practicing enthusiasts to voluntary organisations to official legislated bodies - I'm guessing here but presumably: addressing clinic sterilisation protocols, continuous training and reaccredidation, financial propriety, personal propriety such as move here in UK to have everyone who works intimately with members of the public to be required to have undergone a police criminal check (i.e. not on a Sex Offenders register).

There is only one thing better than a good edit, and that is a good edit that makes one feel virtuous and gains one kudos :-) I'm not going to suggest that you two become each other's best friend, but if you could agree to flip roles and form a team, then as such knowledgeable people on the subject, that would be an incredibly strong team to move this article forward from B-class to Featured Article status. Hence Backin72 be the proactive one to (disappointingly) add a major study that fails to confirm acupuncture effect in a condition (rather than Mccready gleefully adding this and risk being seen to push the conventional medicine POV) and conversely where a good paper finds some positive effect a (somewhat surprised) Mccready adds this (rather than Backin72 needing to fly the flag). Before anyone argues impossibility of this as acupuncture does/does not work, reflect that we all know that it is a statistical certainty that in research with multiple studies at least some will report positive findings and some negative so there will opportunities on both sides (irrespective of where one personally thinks the balance of papers will prove to be).

So foster exemplary super-civility, scrupulous AFG thanking each other for valid points, time & effort in contributing and going out of you way to ensure your personal counter-viewpoint is fairly described (I’ll coin the terms "wikihiatus", "wikiparallel", "wikireciprocate"). This is an article/topic that should easily warrant Feature Article status and eventual inclusion as article of the day on the Main Page, work to that goal, not whether can be resolved as absolute proof/disproof. If you can move the article forward (and bring a fresh spring clean to this talk page), then consider seeking Wikipedia:Peer review (a copyediting, not expert academic, process), to gain some outside views on what this artcle lacks and what, as leading contributors to this article, you can help do. David Ruben ^Talk 15:40, 14 February 2008 (UTC)

Excellent general advice. Re "writing for the enemy", note that I was doing that 18 months ago,[28][29] as well as recently[30]. --Backin72 (n.b.) 19:07, 19 February 2008 (UTC)

Pain

I noticed that on 3 Feb Backin72 inserted the reference to pain in the LEAD. The reference is unsourced. The use of acupuncture for pain relief is also highly controversial. For these two reasons the statement on pain in the LEAD implying perhaps some efficacy should be removed. Please comment. Mccready (talk) 02:09, 15 February 2008 (UTC)

The wording ("with the aim of") is already adequately NPOV, but I added a ref nonetheless. --Backin72 (n.b.) 05:30, 15 February 2008 (UTC)

Hi Mccready. Why are you trying to add Quackwatch to the lead again when you've already tried twice [31][32] and have been reverted by two different editors[33][34]? The second rv was very clear in the ES as to why, and I also discussed the reasons in archived talk. So, I've reverted, both because QW is not a good source here and also because the definition uses aforementioned "aims to..." language that invokes no scientific evidence (which we go on to cover in detail anyway).

It's really good that you're trying to turn over a new leaf in terms of wikiquette, but repeated bold editing with which most or all other editors disagree is still disruptive, even if it stays within 1RR, cf. feedback from admins here. thanks, Backin72 (n.b.) 21:38, 15 February 2008 (UTC)

My tuppence worth: I personally find Quackwatch useful for some of the more bizare internet claims one sees - often commented by QW already. However it has been debated previously at wikipedia how much of an individual blog vs open peer-reviewed process it is (this is not the place to rehash that debate), but consensus was that did not form a reliable source as per our (wikipedia) guidelines (WP:RS) or that it constituted more of a tertiary source (which is not allowed). So whilst I personally might find QW articles interesting (if sometimes a little over-the-top), they should not generally be used as a citation to support material here in wikipedia. Whilst I have sympathy with the idea that if a majority-opinion body decides not to comment on a minority's views, that may leave an absence of sources to cite from, there is merit in WP's assessment of QW usefulness; instead more direct primary or secondary sources need be found. David Ruben ^Talk 22:00, 15 February 2008 (UTC)

I agree; I think where can be good is as a counter to vanity claims in fringe topics. But for well-known areas that have attracted plenty of V RS commentary, it's gratuitous. best, Backin72 (n.b.) 22:08, 15 February 2008 (UTC)