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the Mattuck quote seems overly esoteric/obscure and certainly not a theory that is accepted by most practitioners --maybe it would be appropriate for another page on esoteric acupuncture? also it is not covered within the main article so it should not be in the lede. <small><span class="autosigned">— Preceding [[Wikipedia:Signatures|unsigned]] comment added by [[User:Metabradley|Metabradley]] ([[User talk:Metabradley|talk]] • [[Special:Contributions/Metabradley|contribs]]) 02:02, 20 February 2011 (UTC)</span></small><!-- Template:Unsigned --> <!--Autosigned by SineBot--> |
the Mattuck quote seems overly esoteric/obscure and certainly not a theory that is accepted by most practitioners --maybe it would be appropriate for another page on esoteric acupuncture? also it is not covered within the main article so it should not be in the lede. <small><span class="autosigned">— Preceding [[Wikipedia:Signatures|unsigned]] comment added by [[User:Metabradley|Metabradley]] ([[User talk:Metabradley|talk]] • [[Special:Contributions/Metabradley|contribs]]) 02:02, 20 February 2011 (UTC)</span></small><!-- Template:Unsigned --> <!--Autosigned by SineBot--> |
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:Then I have no idea what "theory" you're referring to above. The word "theory" isn't used anywhere in the second paragraph. Also, please sign your comments with four tildes (<nowiki>~~~~</nowiki>). Hitting edit conflicts with SineBot every time I respond to you can get a bit tiresome. |
:Then I have no idea what "theory" you're referring to above. The word "theory" isn't used anywhere in the second paragraph. Also, please sign your comments with four tildes (<nowiki>~~~~</nowiki>). Hitting edit conflicts with SineBot every time I respond to you can get a bit tiresome. — [[User:Mann_jess|<b>Jess</b>]]<span style="margin:0 7px;font-variant:small-caps;font-size:0.9em">· [[Special:Contributions/Mann_jess|Δ]][[User_talk:Mann_jess|♥]]</span> 02:07, 20 February 2011 (UTC) |
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== we all agree this is POV, right? == |
== we all agree this is POV, right? == |
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What? Why can't they design a good experiment?
"One of the major challenges in acupuncture research is in the design of an appropriate placebo control group."
Am I the only one who finds this to be a silly statement? It would be EASY. 200 people with kidney problems (or some other problem over which acupuncture claims efficacy and is not obvious by simple observation.) The patients are seated in the room and the acupuncturist walks in and treats the patient. Half the time the acupuncturist is told to treat kidney problem and half the time he is told to treat something else (placebo.) They aren't allowed to speak so the acupuncturist does not know what ailment the person truly has and the patient does not know acupuncture so he doesn't know what is really being treated. This is a perfectly double blind experiment, is it not? Then the patients rate the efficacy of the treatment (or it is measured scientifically if possible). You compare the percentages of success of the real treatment and the placebo. Easy experiment design, right?
The truth is that these kind of experiments have been done, but acupuncture does not usually fare well - most of its claims do not hold up in scientific study while a fraction seem to. Like most pseudo sciences, rather than roll back their claims when confronted with science, they attack the scientific method or claim that it doesn't apply. For years, ESP people have claimed that they can't perform in labs because of electrical fields and psychics claim they can't be tested because of the negative energy of the testers. Similarly, acupuncture is trying to claim that it can't be tested because it can't fit into basic experiment design.
"In trials of new drugs, double blinding is the accepted standard, but since acupuncture is a procedure rather than a pill, it is difficult to design studies in which both the acupuncturist and patient are blinded as to the treatment being given."
Again, ridiculous - countless medical procedures are tested every year. This just sounds like a closed tautology speaking. —Preceding unsigned comment added by Ksjazzguitar (talk • contribs) 18:25, 28 September 2010 (UTC)
- You may find more details in the references appended to that statement, but this is a good popular summary that touches on some of the issues faced. Designing a good placebo for acupuncture is actually quite difficult - altering the points needled addresses only one aspect of what "acupuncture" incorporates, and you also have to distinguish between "acupuncture", "dry needling" and "Traditional Chinese medicine" - each is a separate test. You have to control for nonspecific affects - the acupuncturist's own beliefs, which can leak through body language, duration of treatment, care, etc. Many systems of acupuncture claim a need for a lengthy diagnosis based on the TCM approach, and practitioners will claim it's not "real" acupuncture if you don't spend an hour taking pulses, interviewing, looking at the tongue, etc. Designing a test of "verum" acupuncture is actually quite tricky for many, many reasons - location of the needles, modality, whether electricity is used or not, whether the skin is penetrated, etc. I would suggest Trick or Treatment as a good place to look into this, but there's lots of places where this kind of thing is discussed - I like Sciencebasedmedicine.org and Respectful Insolence. Snake Oil Science is also a good book that focuses on methodology.
- But as far as this page goes, talk pages are not meant to be forums for discussion. We base the page on a neutral summary of what reliable sources say. And one of the big criticisms of acupuncture is that it is actually quite difficult to do a fair test of "real" acupuncture rather than placebo and expectation effects. That's pretty easy to verify and therefore should remain - if you find the point confusing after reading the lead and body text on this topic, that suggests we need to do a better job of explaining it though. WLU (t) (c) Wikipedia's rules:simple/complex 18:50, 28 September 2010 (UTC)
- The paradox with acupuncture, is that in most trials the acupuncture fairs no better than the placebo, but for a limited amount of conditions, when the acupuncture is combined with some conventional therapy, then it performs better than the conventional therapy alone. Wilfridselsey (talk) 19:04, 28 September 2010 (UTC)
- What's the difference between "true" and "sham" acupuncutre really? Basically the system of TCM behind it. The fact that "real" and "sham" acupuncture produce the same response should be taken as a substantial indication that the theory behind it - qi, meridians, Blood, etc. - are essentially worthless and it is the process of stabbing people with needles that is effective. It doesn't matter where you stab them, it doesn't matter if you really use needles (versus toothpicks, or retracting needles that don't pierce the skin), what does matter is that the person believes they are being stabbed and that it is effective. The next step to take is to try to tease out whether the actual stabbing with needles is worthwhile, or if it's also useless. If stabbing people with needles has a true effectiveness beyond placebo and expectation, you should still see an effect when you have a well-designed trial that controls for all variables except "skin penetration". They've managed to do some of those trials by modulating the demeanour of the therapist (higly suggestive that acupuncture is effective versus a very neutral practitioner) and found that the more enthusiastic the practitioner, the better the results. This is highly suggestive of a placebo effect. When you combine acupuncture with actual medical treatment, it's very, very arguable that all you are adding to the treatment is a strongly suggestive placebo effect - particularly since it is an unusually effective placebo as it combines theatricality (needles!), exoticness (from the mysterious Orient!), injections (needles again!), nonspecific effects (lengthy diagnosis interview!) and expectation (newspapers love this shit and report positive studies all the time with nary a mention of alternative explanations!) into a single dramatic package. Ben Goldacre has some neat stuff on this [1]. The fact that "real" and "sham" turn out to be very, very similar in effectiveness, irrespective of the type of sham (varying location, retracting needles, toothpicks, fake TCM theory) reinforces the idea that acupuncture could very well be nothing more than a form of autointoxication via endogenous opioids or a redefinition of pain by the CNS. This is further reinforced by the fact that the two symptoms it is most effective on - pain and nausea - are both subjective events that are among the most susceptible to the placebo effect. Meanwhile, it's pretty much useless for drug withdrawal, smoking cessation, weight loss and actual treatment of any disease. The fact that "true" and "sham" acupuncture are indistinguishable in results is highly suggestive of the idea that there's no real benefit to acupuncture itself, merely that the ritual is effective at evoking natural pain-relieving and pain-redefining mechanisms. WLU (t) (c) Wikipedia's rules:simple/complex 19:27, 28 September 2010 (UTC)
- Probably, the most interesting experiments are those using functional MRI. They stick a needle in and see what reaction there is in the brain essentially, this one is probably closest to your 'kidney problem scenario: [2] Wilfridselsey (talk) 19:55, 28 September 2010 (UTC)
- I don't understand the excitement at the finding jamming needles into a person lights up an MRI. If I'm reading the study correctly, the sham acupuncture point, at a part of the body far less sensitive to stimulation than the hand, didn't light up the same areas as the "true" acupuncture, and either didn't light up any areas at all ("Nor did it elicit any other activation or deactivation detectable at this threshold") or did light up a different area and they didn't report it ("In addition, activation was detected in the medial frontal gyrus"). It would be interesting to map these points to the Cortical homunculus, where the distance between the finger and wrist is, neurocortically, far further apart than it is in the body. The difference in saliva production is also statistically significant, but I wonder if it is clinically significant? And it's hardly a wonder that presenting an irritating stimuli causes the mouth to water. Results like this would be suggestive, but they're not, in my mind, paradigm-breaking by any means. WLU (t) (c) Wikipedia's rules:simple/complex 20:43, 28 September 2010 (UTC)
- What's the difference between "true" and "sham" acupuncutre really? Basically the system of TCM behind it. The fact that "real" and "sham" acupuncture produce the same response should be taken as a substantial indication that the theory behind it - qi, meridians, Blood, etc. - are essentially worthless and it is the process of stabbing people with needles that is effective. It doesn't matter where you stab them, it doesn't matter if you really use needles (versus toothpicks, or retracting needles that don't pierce the skin), what does matter is that the person believes they are being stabbed and that it is effective. The next step to take is to try to tease out whether the actual stabbing with needles is worthwhile, or if it's also useless. If stabbing people with needles has a true effectiveness beyond placebo and expectation, you should still see an effect when you have a well-designed trial that controls for all variables except "skin penetration". They've managed to do some of those trials by modulating the demeanour of the therapist (higly suggestive that acupuncture is effective versus a very neutral practitioner) and found that the more enthusiastic the practitioner, the better the results. This is highly suggestive of a placebo effect. When you combine acupuncture with actual medical treatment, it's very, very arguable that all you are adding to the treatment is a strongly suggestive placebo effect - particularly since it is an unusually effective placebo as it combines theatricality (needles!), exoticness (from the mysterious Orient!), injections (needles again!), nonspecific effects (lengthy diagnosis interview!) and expectation (newspapers love this shit and report positive studies all the time with nary a mention of alternative explanations!) into a single dramatic package. Ben Goldacre has some neat stuff on this [1]. The fact that "real" and "sham" turn out to be very, very similar in effectiveness, irrespective of the type of sham (varying location, retracting needles, toothpicks, fake TCM theory) reinforces the idea that acupuncture could very well be nothing more than a form of autointoxication via endogenous opioids or a redefinition of pain by the CNS. This is further reinforced by the fact that the two symptoms it is most effective on - pain and nausea - are both subjective events that are among the most susceptible to the placebo effect. Meanwhile, it's pretty much useless for drug withdrawal, smoking cessation, weight loss and actual treatment of any disease. The fact that "true" and "sham" acupuncture are indistinguishable in results is highly suggestive of the idea that there's no real benefit to acupuncture itself, merely that the ritual is effective at evoking natural pain-relieving and pain-redefining mechanisms. WLU (t) (c) Wikipedia's rules:simple/complex 19:27, 28 September 2010 (UTC)
- The paradox with acupuncture, is that in most trials the acupuncture fairs no better than the placebo, but for a limited amount of conditions, when the acupuncture is combined with some conventional therapy, then it performs better than the conventional therapy alone. Wilfridselsey (talk) 19:04, 28 September 2010 (UTC)
Primary somatosensory cortex homunculus, anybody?
The upper lip of the lateral sulcus, an inch or so either side of the central sulcus, is called the Rolandic operculum. The swallowing section of the primary somatosensory cortex (S1) is located in the portion of the Rolandic operculum posterior to the central sulcus. S1 is green in the top left image here. As you follow that cortex into the lateral sulcus, it becomes part of the ceiling of the lateral sulcus, embodying the secondary somatosensory cortex (S2, green in the top right image). The (brown) wall at the end of the lateral sulcus is the insula. Sorry if that's too much information.
If the real acupuncture activated the Rolandic operculum, as the authors report, that is spooky. The Rolandic operculum on the outer surface is normally not involved in generic pain processing, so it's not an artifact of that. Actually, on further thought, the "swallowing" section of S1 is adjacent to S2, and S2 is active in both hemispheres in response to oddball somatosensory stimulation. [3] So the activity located in the Rolandic operculum in this study could simply be S2 registering the shift of attention to the sensation. All depends on the precise location of the activity, I guess. But if that's what is happening, it doesn't explain the lack of activity in the sham punctures, which would have been equally oddball. I give up. Anthony (talk) 22:13, 28 September 2010 (UTC) Addendum. 05:50, 29 September 2010 (UTC)
- I think that the studies using fMRI on humans and animals have been the most interesting. A lot of the studies into acupuncture have been subject to the Hawthorn effect. fMRI
apparently gets round that, although not all results have been as clear cut as this particular one. Wilfridselsey (talk) 07:14, 29 September 2010 (UTC)
- Considering the Hawthorne effect is a mental reaction to a situation, I don't see how an fMRI would get around it since the brain does the thinking. But irrespective, what is needed to include this information in the page is a secondary source. Brain imaging is mentioned here but a newer study would be better. I've looked on pubmed but the abstracts are pretty vague and more than a little gushy. It'd be interesting to see what happens when a skeptic looks at the same data. I'll look a bit more on pubmed and see if I can find a full text version. WLU (t) (c) Wikipedia's rules:simple/complex 10:40, 29 September 2010 (UTC)
- WLU - lets face it, nothing is going to convince you. One of the biggest health providers in the world are rejected as a mere insurance company. Germany, UK and Europe recommend acupuncture as part of the treatment for chronic lower back pain, this is rejected by you you know better. You request authoritaive information on acupuncture research I offer a peer reviewed database of 1900 odd articles, you offer publications who provide opinion in return. The American College of Physicians and the American Pain Society have issued joint clinical practice guidelines recommending that clinicians consider acupuncture as one possible treatment option for patients with chronic low back pain who do not have a response to self-care. Furthermore, the North American Spine Society recently concluded that acupuncture provides better short-term pain relief and functional improvement than no treatment and that the addition of acupuncture to other treatments. The fact that the treatment is past the study stage and is provided by mainstream health organisations is not important as far as you are concerned? Recent studies with fMRI on humans and animals can demonstrate that verum acupuncture effects the brain cortex differently to sham or placebo, and you want me to provide you with more information? You have quoted wp guidelines to me all the time. I will respond with wp:npov. Wilfridselsey (talk) 11:21, 29 September 2010 (UTC)
- What would be required to un-convince you? If some of my questions about the brain imaging study could be answered, if they could be consistently replicated by various research groups, if they had different placebo conditions which addressed my criticisms about the current placebo condition and all converged on a common finding, then I would be convinced. It's the rare phenomenon that is established by a single study, particularly one that is ambiguous. The Milgram experiments were conducted over years, in various situations, with lots of consistent replications despite changing circumstances, with deliberate manipulation and testing of the independent variable that showed a dose-response effect. That's convincing. This is a single study, and though suggestive, it is not convincing. That is why we insist on a secondary source for these things, not a single study. You haven't responded to my, and Anthony's criticisms of the "1900 studies" nor the fact that this information is actually included in the article. You don't have to convince me, you have to provide reliable sources to substantiate your point - the problem is, there are more reliable sources that contradict your belief in the efficacy of acupuncture. It's not my fault much of the research on acupuncture is shoddy, and as the research and placebo gets better the efficacy drops off - but that is the reality of the situation and one that, per WP:NPOV, should be discussed. It is disingenuous to portray acupuncture research as a slam-dunk when there are a variety of sources that criticize the research base as biased, poorly-controlled, old and inconsistent. Is it really surprising that acupuncture is better than no treatment? No. Can that easily be explained by acupuncture being a dramatic placebo? YES.
- Acupuncture is a contested topic in the medical literature, with lots of criticism that shouldn't be written off. The page lists numerous conditions for which acupuncture is supported, but also, appropriately, lists the reasons why the research isn't necessarily as simple to interpret as one might think. So in response to your citation of NPOV, I will respond right back with NPOV, as well as MEDRS which insists on review articles rather than primary sources. I've linked some, we need to look into the full texts and see what they say. There is a section on brain imaging which can be expanded, so the next step is to stop wasting time on primary research results and start looking into literature reviews - often promising, just as often inconclusive. WLU (t) (c) Wikipedia's rules:simple/complex 11:50, 29 September 2010 (UTC)
- WLU - lets face it, nothing is going to convince you. One of the biggest health providers in the world are rejected as a mere insurance company. Germany, UK and Europe recommend acupuncture as part of the treatment for chronic lower back pain, this is rejected by you you know better. You request authoritaive information on acupuncture research I offer a peer reviewed database of 1900 odd articles, you offer publications who provide opinion in return. The American College of Physicians and the American Pain Society have issued joint clinical practice guidelines recommending that clinicians consider acupuncture as one possible treatment option for patients with chronic low back pain who do not have a response to self-care. Furthermore, the North American Spine Society recently concluded that acupuncture provides better short-term pain relief and functional improvement than no treatment and that the addition of acupuncture to other treatments. The fact that the treatment is past the study stage and is provided by mainstream health organisations is not important as far as you are concerned? Recent studies with fMRI on humans and animals can demonstrate that verum acupuncture effects the brain cortex differently to sham or placebo, and you want me to provide you with more information? You have quoted wp guidelines to me all the time. I will respond with wp:npov. Wilfridselsey (talk) 11:21, 29 September 2010 (UTC)
- No you don't get away that easy. I am willing to accept Anthony's point that the Pomeranz citation is out of date. But as you recall my request was very narrow. I repeat, in the statement by the National Health service, we should say: " The National Health Service of the United Kingdom states that there is "reasonably good evidence that acupuncture is an effective treatment" for chronic lower back pain, nausea, vomiting, osteoarthritis etc.. as that was in their statement and they are now offering acupuncture for CLBP. I also suggested that we put something along these lines somewhere:
- "There has been some evidence to suggest that acupuncture maybe effective in the treatment of chronic lower back pain when used with a regime of conventional therapy, including exercise and manipulation. Several major health organisations now recommend a combination of conventional treatment and acupuncture for chronic lower back pain."
- You assume that I am an acupuncture advocate, I am not, however this is an important development as it's a recognition by major health organisations that acupuncture is effective in this SINGLE case Wikipedia should reflect that. I do not think that it requires comment as you have qualifications about the efficacy of acupuncture for chronic LBP in other places, but this was reported widely on the media, so is another reason to include it. As far as the 1900 odd articles are concerned. NHS Evidence is a medical search engine, all the articles come from a variety of sources and are peer reviewed, so you will find some of the papers that you cite listed. But not on vet. medicine.
- No you don't get away that easy. I am willing to accept Anthony's point that the Pomeranz citation is out of date. But as you recall my request was very narrow. I repeat, in the statement by the National Health service, we should say: " The National Health Service of the United Kingdom states that there is "reasonably good evidence that acupuncture is an effective treatment" for chronic lower back pain, nausea, vomiting, osteoarthritis etc.. as that was in their statement and they are now offering acupuncture for CLBP. I also suggested that we put something along these lines somewhere:
- I do not think that my request is unreasonable? Wilfridselsey (talk) 14:45, 29 September 2010 (UTC)
- Not unreasonable, but I would say redundant. Have you actually read any of the sections I pointed to where your points are essentially already addressed?
- I do not think that my request is unreasonable? Wilfridselsey (talk) 14:45, 29 September 2010 (UTC)
- The page is already quite long (see WP:LENGTH and WP:SS). Singling out the NHS' recommendation on LBP is unnecessary, particularly when it is dealt with at greater length above. Acupuncture has been found effective for many types of pain and nausea, I see no need to further single out lower back pain more than it already is, particularly when it is heavily qualified to indicate the difficulties faced in trying to treat it and design an adequate placebo. Redundant, unnecessary, adding length to the page for little reason I can see. Put another way, why is it so necessary to single out lower back pain versus dental pain, pain during endoscopy and headaches? And should we note that it's not effective for addictions, asthma, chronic pain, depression, insomnia, neck pain, sciatica, shoulder pain, stroke and tinnitus? Particularly when this is a single recommendation paper from a single national health authority and there are over a hundred countries in the world? Why not Health Canada, Australian health services, New Zealand, and those just being off the top of my head for English-speaking countries? Arguably the entire mention is redundant to the actual evidence base the article draws from. Since we're obviously going to disagree, we have a couple opitions - wait for more editors' input, asking for a WP:3O if we don't get any, or a formal WP:RFC. WLU (t) (c) Wikipedia's rules:simple/complex 15:35, 29 September 2010 (UTC)
- I repeat in the case of LBP it stands out because it has been generally accepted, not just as a principle but also in practice. BTW- note 62 leads to a dead link probably because it is out of date. This article is from July 2010, [7] , which points to a paper in the New England Journal of Medicine. Note that the article gives current recommendations from the American College of Physicians, the American Pain Society and the North American Spine Society for incorporating acupuncture into a treatment plan.
- I don't think that resolving our little dispute will fix the main article it's way too long and rambling. It could do with either blanking half of it, or splitting in two, one with how the practice of acupuncture works, and the other the arguments for and against.Wilfridselsey (talk) 16:04, 29 September 2010 (UTC)
Undent. Care would have to be taken for avoiding POV forking, particularly given the fact that both the underlying basis for acupuncture and its clinical efficacy are both heavily contested. There shouldn't be one article saying "This is acupuncture and how it works" (which assumes it works) followed by "this is the conditions acupuncture works on, but note that the reason why it works is heavily contested". Though I'm sure most people would agree that the current page needs a re-write and general clean-up, segregation would have to be done very, very carefully (if at all) to avoid one page discussing the "mechanisms" of acupuncture (which is both false since there is no actual agreed-upon mechanism, and deceptive since it assumes that acupuncture "works") and another discussing clinical evidence and uses. It's probably better to clean up the current page than split it, there's a lot of minor, tangled discussions about different aspects. WLU (t) (c) Wikipedia's rules:simple/complex 16:21, 29 September 2010 (UTC)
- Wilfrid, regarding your comment to WLU above, "Recent studies with fMRI on humans and animals can demonstrate that verum acupuncture effects the brain cortex differently to sham or placebo..." Are you aware of an authoritative review of these studies? I've only seen the primary study you mentioned earlier in this thread. [8] Anthony (talk) 17:30, 29 September 2010 (UTC)
- This was the one I was looking at [9] and a more recent study [10] and this on humans[11] (talk) 17:45, 29 September 2010 (UTC)
- Thank you. Anthony (talk) 18:18, 29 September 2010 (UTC)
- No probs. I would like to hear your views on them. Regards Wilfridselsey (talk) 18:24, 29 September 2010 (UTC)
- Both of those are primary sources, one on rats. They are not the secondary sources required by WP:MEDRS. Anthony, I linked some review articles in an earlier post on this thread - [12]. Just below the image above. WLU (t) (c) Wikipedia's rules:simple/complex 19:35, 29 September 2010 (UTC)
- I think I've given this one to you already, Investigating Acupuncture Using Brain Imaging Techniques:The Current State of Play is a general review but does cite one of the papers (talk) 20:33, 30 September 2010 (UTC)
- No probs. I would like to hear your views on them. Regards Wilfridselsey (talk) 18:24, 29 September 2010 (UTC)
- Thank you. Anthony (talk) 18:18, 29 September 2010 (UTC)
- This was the one I was looking at [9] and a more recent study [10] and this on humans[11] (talk) 17:45, 29 September 2010 (UTC)
Sorry, but I'm not convinced.
"Designing a good placebo for acupuncture is actually quite difficult - altering the points needled addresses only one aspect of what 'acupuncture' incorporates, and you also have to distinguish between 'acupuncture', 'dry needling' and 'Traditional Chinese medicine' - each is a separate test."
Fine, then each can be tested. The fact that there is more than one system is not an argument against a double blind experiment.
"You have to control for nonspecific affects - the acupuncturist's own beliefs, which can leak through body language, duration of treatment, care, etc."
Yes, but (in my suggested experiment) if the patients have already been evaluated by other acupuncturists to determine the "correct" action, then the acupuncturist in the test does not have to do an evaluation. If the treatment is dependent on the beliefs of the practitioner, then it is not science, it is supernatural. If a doctor determines that a patient needs the shock paddles to restart the patients heart and asks another doctor to do it, it is irrelevant whether the second doctor believes in the procedure. This is how real treatments work.
The acupuncturists "body language" would be irrelevant in my example experiment; he would believe it is the right treatment.
"Many systems of acupuncture claim a need for a lengthy diagnosis based on the TCM approach, and practitioners will claim it's not 'real' acupuncture if you don't spend an hour taking pulses, interviewing, looking at the tongue, etc."
Fine, different systems can be tested differently. But this is sounding more and more like the arguments other pseudo-sciences make - when an experiment doesn't go their way, they blame the experiment or those being tested, saying that they weren't the real deal. I hear astrology proponents say the same thing all the time - when an experiment goes against them they ague that the test wasn't testing "real" astrology, ignoring that many do and it still fails. A couple centuries ago, phrenology proponents made the same claims. And the fact that in 5000 years they have failed to develop a unified approach is NOT an argument in their favor.
"But as far as this page goes, talk pages are not meant to be forums for discussion. We base the page on a neutral summary of what reliable sources say."
My point is that I think that it is NOT neutral. To me it reads like acupuncture apologetics. I am not trying to argue acupuncture, but the slant of this article. This article would give me the impression that there is very little evidence against acupuncture's efficacy, contrary to what I have seen in the literature. Contrast this article with the CSICOP position paper: http://www.csicop.org/uploads/files/Acupuncture_Paper.pdf.
For something as controversial and that has failed so often in experiments to produce clear results better than control groups, this article is painfully shy of contradictory arguments - it reads like something written by an acupuncture enthusiast who has put in a few token arguments against. I do agree that the article show show both sides, but it is hard to build a "con" when the "pro" makes its claims unfalsifiable by saying that science is incapable of testing it (claim it shares with other pseudo-sciences.) Really, the "con" portions of this article could be summed up as, "Well, there is 'some' (lets pretend its not 'a lot') but it doesn't count because acupuncture can't be effectively tested by science." Would that argument be accepted for any medical procedure? Would it be acceptable in any other wikipedia article?
While I do agree that there is some data suggesting that acupuncture has some mild effects in some isolated situations, that in no way justifies the claims made by acupuncturists and in no way supports the bias of this article. unsigned comment added by Ksjazzguitar (talk • contribs) 00:39, 30 September 2010 (UTC)
This article is POV
I don't have the standing on this subject and I don't have the energy to get into an edit war so I will not be the one to change this. But this is in no way a neutral article - it is an advertisement for acupuncture masquerading as a wikipedia article. I hope that someone fixes it.—Preceding unsigned comment added by Ksjazzguitar (talk • contribs) 00:39, 30 September 2010 (UTC)
- Notice how little the surgery articles talk about double-blind, sham studies. --Middle 8 (talk) 10:12, 22 January 2011 (UTC)
- There is a big difference between surgery and acupuncture as far as double blind and placebo. First, results of surgery are dramatic beyond any possible placebo. If they are not, the surgery should not be done. Second, surgery has indirect support when it is inferred from other empirically based knowledge. Acupuncture is entirely different, since there are no corresponding known anatomical structures corresponding to it to indirectly infer it from empirical information, unlike surgery, which is based on anatomy. (In fact, anatomy means "to cut up".) PPdd (talk) 01:14, 26 January 2011 (UTC)
- Three points. One, surgery generally has a much more obvious outcome - death, increased cardiac output, the removal of a tumour, the reattachment of a limb, massive weight loss after stomach stapling versus a lower score on a subjective instrument to measure pain or nausea (again, two symptoms incredibly susceptible to the placebo effect). Two, surgery has been tested and found to be an exceedingly effective placebo, indicating that the placebo effect is not unitary and that perhaps yes, it is important in some cases to use placebos in surgeries designed to improve quality of life and other subjective outcomes. Three and most important - the failings of one discipline does not justify another. The fact that surgery could certainly improve its research methodology in many cases does not automatically validate the use of shoddy research methodology in acupuncture, and certainly doesn't demonstrate it is effective. If you wish to criticize the methodology of surgical research, then go to the appropriate talk page, which is not here. This page is to discuss acupuncture. WLU (t) (c) Wikipedia's rules:simple/complex 03:31, 25 January 2011 (UTC)
- @WLU: Your comment about talk pages is solemnly noted. My point is simple: both science and Wikipedia should strive to avoid double standards. Statements made about lack of evidence should be consistently applied across the board, as should qualifying statements about the difficulty of designing studies for procedures. Of course it should be easier to control for the variables in acupuncture compared to surgery, but that doesn't mean that it's easy in absolute terms. A procedure is, obviously, qualitatively different from a compound. Acupuncture is closer to surgery than it is to drugs in terms of the challenge in controlling variables. --Middle 8 (talk) 00:59, 26 January 2011 (UTC)
- Surgery is often a product sold by surgeons to make money, just as MDs push drugs for pharmaceutical companies to get repeat patients. Acupuncture is, however, from an even lower level of hell. PPdd (talk) 05:45, 25 January 2011 (UTC)
- @HkFnNGA: Yes, surgeons who oversell their "product" are in dire ethical territory. OTOH, acupuncture (done with clean needle technique and standard safety precautions) is orders of magnitude safer than drugs or surgery. Ethically, the unnecessary use of acupuncture is far less harmful than the unnecessary use of drugs or, FSM forbid, surgery. I'm not sure how you reckon hellishness. --Middle 8 (talk) 00:59, 26 January 2011 (UTC)
- The goal of medicine is to establish procedures with a high degree of effectiveness and a low degree of risk - where the benefits of the procedure offset the risks. Acupuncture may be safer than some surgeries and drugs, but its benefit has not been established and it does carry risks - punctured lungs, fainting, bleeding, infection, even with clean needles. That is my objection, in addition to its impact on science and critical thinking in general. Positing a form of magic as an explanation for a phenomenon is corrosive to empirical investigation. If a procedure has no true benefit, it should not be undertaken. If it has benefits only as a placebo, then the risks taken should be zero (i.e. nonpenetrating needles). And finally, the treatment should not be used as a substitute for actual medical care for even minor problems. One of the worst effects of CAM procedures is the badmouthing and downplaying of actual, effective interventions by practitioners - antivaccination advocacy, drugs are always bad, cancer treatment is just cut, burn or poison. This applies to acupuncture, where again, the benefits are not established, the risks are present, and it is predicated and promoted by most practitioners as a form of magic. Ethically, acupuncture should not be promoted for actual use until it has been clearly established whether there is a placebo-independent effect. That is the standard we apply for drug trials - until they are proven effective, they are used for research purposes only. That would be ethical. WLU (t) (c) Wikipedia's rules:simple/complex 12:08, 26 January 2011 (UTC)
- @HkFnNGA: Yes, surgeons who oversell their "product" are in dire ethical territory. OTOH, acupuncture (done with clean needle technique and standard safety precautions) is orders of magnitude safer than drugs or surgery. Ethically, the unnecessary use of acupuncture is far less harmful than the unnecessary use of drugs or, FSM forbid, surgery. I'm not sure how you reckon hellishness. --Middle 8 (talk) 00:59, 26 January 2011 (UTC)
- I find it amusing that on one hand the page is claimed to be NPOV for not being critical enough, and on the other it is too critical. If you're pissing off both sides, usually that means the page is going OK.
- KS, I sympathize with your points, and agree with most - most studies don't properly distinguish between true versus nonspecific effects, and acupuncture has been proven useful only in the treatment of the highly psychogenic symptoms of pain and nausea. But neutrality is determined by sources, and there are so many sources that report acupuncture uncritically that we're limited in what we can say. If you are truly interested in this, you need to start reading the scientific literature - books and articles - and finding ones that substantiate your points. The CSICOP is a reasonable parity source for fringe points of view (on this page, the "theory" behind acupuncture would count) but we can't rewrite the article based solely on that one document. Particularly not a document that is not a peer reviewed article. It can be integrated throughout with attribution, but can not form the core of the whole page.
- WP:UNDUE states that we depict the page and topic in a manner equivalent to that existing in reliable sources. Until the scientific community comes to a united stance on acupuncture, we must portray the roughly-comparable sides. Fortunately there are papers like this which point out some of the issues involved in conducting research and in particular how that research is interpreted to give undue emphasis on its apparent efficacy. But there's still a limit. We aren't Quackwatch, but we can use it as a source. WLU (t) (c) Wikipedia's rules:simple/complex 10:39, 30 September 2010 (UTC)
- Don't include me as pissed off because I think that you or the main article are anti acupuncture. My concern is that you have not reflected the fact that mainstream medicine has accepted acupuncture for one type of problem. It is a significant milestone for acupuncture. In the future it maybe discarded as bunkum. It does not mean that trials of acupuncture have been good science in the past or that it works. We all know that acupuncture is controversial, but you need to keep up with the latest developments positive and negative. Wilfridselsey (talk) 19:50, 30 September 2010 (UTC)
- WLU - I have to support u for a change . Check this out [13]. Wilfridselsey (talk) 21:50, 30 September 2010 (UTC)
- You have to reflect and substantiate the mainstream opinion through reference to reliable, secondary sources. That is how we show the mainstream opinion. If you have a concern, cite a mainstream, current, secondary source. Just claiming the article is biased is meaningless - you have to demonstrate it by reference to the literature. And I will repeat myself yet again - it is well acknowledged that acupuncture has been tested against low back pain. This is in the article. It's not unproblematic research, which is also acknowledged. The criticisms of acupuncture are easy to find, make eminent sense and neatly tailor with a possible explanation of possible results. So there's the argument that it is effective, and the argument that its effectiveness draws exclusively from placebo effects rather than the very act of inserting needles has some non-placebo effect. The "latest developments" include both positive and negative results and discussions, with (still) better controlled studies showing little effect that's can't be accounted for by placebo. WLU (t) (c) Wikipedia's rules:simple/complex 23:01, 30 September 2010 (UTC)
- I accept your argument on sources etc. I have provided you with reliable secondary sources, and I see that Anthony has cited them in the main article. That is not my point of contention. I know that the efficacy of chronic lower back pain is discussed in the main article. My request, was not really about whether acupuncture works or not. Perhaps I have not made myself clear enough, by getting side tracked on an area that does interest me (fMRI). What I am saying is that mainstream healthcare providers and professional organisations have accepted that acupuncture plus conventional treatment as best practice for the treatment of chronic LBP. This was reported widely in the media worldwide, but obviously not important enough for Wikipedia? Whether you are for acupuncture or against, it is an important story and groundbreaking. I have provided you with the up to date policy of a variety of organisations. There are citations to news organisations that reported it in this paper, Interpretive bias in acupuncture research? which coincidently is against acupuncture, I think that it is a better paper than the CSICOP one, and the authors are quite authoritave, but I do not believe that it is peer reviewed so we can not cite it. Wilfridselsey (talk) 10:14, 1 October 2010 (UTC)
- Clinical Guidelines Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. - Recommendation 7. There's also quite an interesting news article on NPR here [14] Wilfridselsey (talk) 21:45, 2 October 2010 (UTC)
(de-indent) As a rule, statements by expert bodies, including practice guidelines, are good MEDRS's and should be included. It doesn't take much space to include them. They help show the present-day sphere of usage and degree of acceptance. --Middle 8 (talk) 09:37, 22 January 2011 (UTC)
Suggestion to preserve current organization of article, but work on some of the subsection paragraph organization and content
- Three short-paragraph introduction and summary, using ordinary English as much as possible, First very general summary, Second (article sections 1-4) theory, history, and practice, Third (article sections 5-7) science and reception.
- Well organized hierarchical article sections and subsections, listed in the article contents box, with general opening paragraphs, so a specific purpose user can quickly go to the content they are looking for, with specificity increasing as the section or subsection develops.
- Most of the article sections and subsections are well organized, and flow well from general and simple, to detailed and technical, but some of the article subsections need some more work.PPdd (talk) 21:43, 27 December 2010 (UTC)
- That seems like a good plan to me. Do you want to put here what you have in mind for the lead section? The guideline covering the lead is WP:LEAD. The table of contents is automatically generated from the ==Section== and ===Subsection=== headings. As far as the structure of the body of the article is concerned, although this is an article about an elaborate placebo, it makes claims about health and efficacy, so should follow WP:MEDMOS; but your strategy looks good to me.
- If you need a pay-per-view review article, I can access most journals indexed on PubMed and would be happy to email to you. If you can make the whole thing more concise, and use fewer references (by citing the same textbook or review for several claims, rather than a different reference for each claim), that would be fantastic... but that's a huge job. Good luck. --Anthonyhcole (talk) 12:04, 17 January 2011 (UTC)
Suggested lede paragraph structure
I suggest that the lede be organized as follows - First sentence definition, First pragraph:very general objective definition, Second paragraph: Description of beliefs, Third paragraph: Science and criticism; Fourth paragraph: Reception (e.g., affect on threatened and endangered species, world prevalence) PPdd (talk) 02:46, 27 Januar 2011 (UTC)
- Can you propose some text? --Anthonyhcole (talk) 03:22, 27 January 2011 (UTC)
- @PPdd: "effect on threatened and endangered species" -- You might be thinking of some TCM "herbal" compounds (which can also include animal parts), but there's nothing about that germaine to acu. Sounds like just another way to try to depict acu in a negative light. --Middle 8 (talk) 14:59, 27 January 2011 (UTC)
I am wondering if you are all aware that the first section has a lot of typos and run on sentences and ideas. It also does not present a succint intro of the field. TCM and acupuncture are not separate, acupuncture is included in TCM (Traditional Chinese Medicine). It does not incorporate it, it is the other way around, acupuncture is a branch of TCM. Also, more than half is criticism, which should typically be in the criticism section, or not in intro. Am I wrong about this? Please excuse any lack of wikiquette, some of my comments should be more questions, than comments. Soll22 (talk) 21:09, 7 February 2011 (UTC) Also, issues with the sentence "Acupuncture's effectiveness for other than psychological effects is denied by the science based medicine community." The sentence is innacurate. There is no consensus about the effectiveness of acupuncture in the "science based medicine community". Also, define science based medicine community. Psychological treatment is actually the most controversial facet of acupuncture in the "science based medicine community" that you mention, and it is far more commonly accepted for musculo-skeletal pain disorders. Mental health (psychological effects, as is stated in the second sentence, first paragraph) is generally considered outside the scope of practice of acupuncture in most states. Does this statement really belong as a intro to the Acupuncture entry?Soll22 (talk) 21:19, 7 February 2011 (UTC)
Tongue map of the body
At right is a motor cortex map of the body. TCM has a toungue map of the body. Does anyone know where a pic of such a map is? PPdd (talk) 04:05, 27 January 2011 (UTC)
- Chances are one has not been uploaded to wikipedia or the Wikimedia Commons. The best way to acquire such an image is normally to make it yourself - take a picture of your tongue and map it using image manipulation software based on a reliable source. Alternatively, you can contact people who have one on a website and ask for permission to use it. Unfortunately this is subject to rather stringent conditions. My suggestion is to read up on our image use policy and go from there. Personally I hate trying to work with images I don't take myself. WLU (t) (c) Wikipedia's rules:simple/complex 11:49, 27 January 2011 (UTC)
- Thanks, but I don't know where to find such a map. The tongue-body relation is so fundamental in figuring out where to stick needles in the body (e.g., based on chew marks on the tongue) that thre must be ancient or otherwise unprotected images all over the place. I just don't know where to find them. PPdd (talk) 14:54, 27 January 2011 (UTC)
If you are in a city with a TCM college in it, you can use their library to get an image. Tongue Diagnosis by Giovanni Maciocia is a basic book. Tongue diagnosis is complex, and is NOT based on "chew marks". There is specific language to discuss tongue topography and it relates to a complex of issues in the organ systems in Chinese Medicine. Soll22 (talk) 04:06, 7 February 2011 (UTC)soll22
- We can't use other people's images at Wikipedia witout a written authorization. (I don't know the exact rules, see WP:Commons.) If you are in the field, perhaps you might be able to draw one, or get written permission, and we can use that. PPdd (talk) 04:25, 7 February 2011 (UTC)
Alright I will look into it. Just getting used to all the rules and regs of wikipedia. Soll22 (talk) 21:04, 7 February 2011 (UTC)
Lede reverted to earlier, sourced, better version
I noticed that the lede has drifted away from using sources (a stylistic preference that is conducive to POV-drift) and toward the inclusion of unsupported assertions and OR. I did a pretty massive revert, per WP:BOLD, to the lede, restoring one iteration of a pretty longstanding, stable version from 22 October 2010.
Most of us probably know that one needs a REALLY good source to say it is that way as opposed to saying that X source says it's that way. PPdd, try to find a source of unimpeachable stature saying that scientists and historians are now certain that the location of acupuncture points was determined only metaphysically and had nothing to do with empirical observation.
Additionally, the dichotomy between "alt-med" and "EBM" is not one that is generally used (e.g. Ernst doesn't, nor does Institute of Medicine); "alternative" can denote sphere of usage. See sources in first part of alternative medicine. I also removed another unsourced sentence asserting that TCM's points are based solely on metaphysics and the like. This isn't Skptical.Inquirer.Pedia. Again, we need sources, and really good ones, to speak in the encyclopedic voice and say that "X is the case" rather than "according to source Y, X is the case".
Whoever stripped the sources out of the lede did a disservice to the article; I'm just going to revert to an earlier version that had them, because otherwise some editors tend to tweak prose to fit their assumptions without strict adherence to sources. What is the advantage of a lede section that omits sources, diverges from the article and reads like a generic skeptical criticism? The version to which I reverted at least has sources and fairly depicts the various issues in the article, rather than drifting into more and more variations on "it's metaphysical, not EBM". BTW, the definition in this version implicitly takes into account Hk's note about non-TCM needling being called acu. --Middle 8 (talk) 14:59, 27 January 2011 (UTC)
- Middle 8, I undid your revert of the multi-editor created NPOV lede to a pro-"acupunture is not nonsense" lede. The sources for the lede should be in the article body, which is summarized in the lede. Acupuncture is not a very complicated subject. It is a superstition based ancient practice, like blood letting, which survived by tradition and authority, but is now believed to be nonsense because it's occult foundations and their predictions about locations of points has been demonstrated to be inconsistent with anatomy and physiolgy. I had put in RS on these numerological bases, and inconsistencies with anatomy and physiology, but I guess they were deleted. Brangifer may also have put some RS on these in some talk page remark somewhere, but I don't remember where right now. PPdd (talk) 16:26, 27 January 2011 (UTC)
- There is bound to be some overlap between tender points, trigger points, and acupuncture points, but coincidental overlap doesn't justify equating them. In some cases there are bound to be some points discovered through experience, which Middle8 correctly points out. While the first two will have some biomedical/histological basis, and if an acupuncture point corresponds to one of the first two, a biomedical explanation may exist. Acupuncture points have no consistently reproducible histological basis since they are a metaphysical construct from ancient times. As Felix Mann, founder and past-president of the Medical Acupuncture Society (1959–1980) and the first president of the British Medical Acupuncture Society put it: "...acupuncture points are no more real than the black spots that a drunkard sees in front of his eyes." There is some poor quality research produced by believers and published in poor quality journals (instant access for publicizing your own work online) which is used to make a connection, but again, coincidental overlap doesn't justify equating them. This is a typical pseudoscientific attempt to use the trappings of science to boost the reputation of unknown or dubious matters.
- We even have a two-sentence section here ( Acupuncture#Myofascial trigger points correspond to acupuncture points ) which has a heading that very boldly proclaims they "correspond" in a manner that would lead readers to believe they are identical. It's very questionable to use primary research from believers in this way. That needs fixing. This error has been duplicated in other articles. -- Brangifer (talk) 00:39, 28 January 2011 (UTC)
- I agree with Brangifer's comment about coincidental overlap and metaphysical basis. In fact, I am surprised that there have been aby studies at all given the metaphysical basis (which was completely removed from the Traditional Chinese Medicine article lede first paragraph, after which I put it back in, only to have it removed again by another editor). The coincidental overlap phonomenon is similar to "shopping statisticians", where if a researcher get no results from a statistician using one method of data analysis, the researcher keeps going around until they get a statistician whose emethods show some minute effect. As far as I read, the "overlap" is based on one particular definition of "near", which can be shopped from set of points and level of nearnesses to another set of this pair. PPdd (talk) 01:12, 28 January 2011 (UTC)
- Can we find a better term than "correspond to"? Perhaps "substantially correlate to" would be less misleading. Or we could give the more detailled numbers. We must not, though, presume the paper is badly done, simply because we dislike its conclusions. LeadSongDog come howl! 01:41, 28 January 2011 (UTC)
- We should use plain English when possible, and accurately state journal conclusions, as well as conclusions of other studies and analyses. Most studies hav found no correspondence, just the one sort of whacky fringe science tirgger points paper (the existence of trigger points is not widely accepted in medicine, only widely used in alternative medicines) which is based on the work of just one now dead other scientist trying to be the president's physician.
- Metaphysical basis dispositive - The fact that the points are determined by the "number" of rivers (what counts as a river is arbitrary) in one Chinese Empire (what counts as an empire boundary is arbitrary) and the "number" of days in a year (which is not even 365, but only close to that) should be dispositive. Science shows that there is no correspondence between the human body and the numbers of rivers/earth spin cycles per revolution about the sun. And what this has to do with all of the snake oil/sea horse nonsense actually prescribed by acupunturists, and consumed all over is another whacked out belief (reasoning to tiger's penis for virility?). PPdd (talk) 01:56, 28 January 2011 (UTC)
I still see primary research being used. Eliminate the whole section (all three sentences). The latest one doesn't even mention acupuncture (at least the abstract). Note that needling without meridians isn't acupuncture. Neither is electroacupuncture. We're not supposed to engage in our own OR or promote OR found elsewhere, and primary research is essentially OR. -- Brangifer (talk) 04:09, 28 January 2011 (UTC)
- I've removed several primary sources and all of the headings but one. Sections should not be two sentences long and headings should not make definitive statements like that. Also removed some unsourced sections which would be good if sourced but as is fall under WP:PROVEIT and without proper attribution and sourcing read too much like POV-pushing. And that's coming from someone who thinks acupuncture is a steaming pile of bullshit. WLU (t) (c) Wikipedia's rules:simple/complex 20:37, 1 February 2011 (UTC)
- I agree with your NPOV edit, but acupuncture is BS? BS has a nonplacebo effect as a fertalizer for plants. Don't overrate acupuncture. PPdd (talk) 03:24, 2 February 2011 (UTC)
- Though I appreciate your comment, I must point out that your analogy only works if we are discussing acupuncture for plants. As yet, I have never seen a medical application of bovine feces on human subjects. Though given alternative medicine's approach to...everything, it's pretty amazing they haven't tried colonic irrigation with actual bullshit. WLU (t) (c) Wikipedia's rules:simple/complex 12:10, 3 February 2011 (UTC)
- Analogy-shmalogy, it turns out that flying feces is literally part of TCM[15]. WLU, once again you are essentially correctin your prognostics. Your forecasts indicate that you have your finger right on the pulse of TCM... and its tongue, in this case. I am part Native American (Apache), and I had some very strong maté, a traditional native south american medicine which was said to promote my “general health and well being”, and it tasted just like the fresh bovine product smells. PPdd (talk) 15:25, 10 February 2011 (UTC)
- Though I appreciate your comment, I must point out that your analogy only works if we are discussing acupuncture for plants. As yet, I have never seen a medical application of bovine feces on human subjects. Though given alternative medicine's approach to...everything, it's pretty amazing they haven't tried colonic irrigation with actual bullshit. WLU (t) (c) Wikipedia's rules:simple/complex 12:10, 3 February 2011 (UTC)
- I agree with your NPOV edit, but acupuncture is BS? BS has a nonplacebo effect as a fertalizer for plants. Don't overrate acupuncture. PPdd (talk) 03:24, 2 February 2011 (UTC)
Nonsense, BS? Say who (or WHO)?
Hi Hk - re your reply to the thread-starter above (beginning with the phrase "Middle 8, I undid your revert of the multi-editor created..."), here are a couple of points to consider (also relevant to some of the discussion above, e.g. regarding the merits of fertilizer):
(1) A minor point: The version to which I had reverted was just as much a "multi-editor"-authored lede as the present one, so I have no idea why you bring that up as if it were some sort of advantage.
(2) A major point: If you believe that the version to which I reverted is (quote) ""pro-"acupunture is not nonsense"" (unquote), and that that's bad, then you do not understand the topic or NPOV. There is no scientific consensus that acupuncture is nonsense, bullshit, horseshit, or whichever pejorative you think is the most hilariously trenchant. None. In fact, it's not even a majority opinion. What I just said is easily falsifiable by the citation of a source (WP:BURDEN). Provide that source, please, or if you can't, please stop editing as if it were true. What we can say is that there exists *a* view along the lines that acupuncture is "nonsense", and a spectrum of opinion between that and something like the WHO report (cite in article here), or the NCCAM, or the AAMA, etc. There is no single majority view on acupuncture, let alone a consensus one. If I'm wrong, all it takes is an adequate source that is a sufficiently powerful RS to illustrate scientific majority and/or consensus view, along the lines of what we require for category:pseudoscience (summary of current consensus on WP, as I understand it, here: User:Middle_8/Pseudocat).
(3) Speaking of the WHO report, the text is better in the article (compared to the wordy version before), but the attribution still needs to be changed to the WHO, period, and not "Zhu-Fan Lee". 2/0 and Brangifer, it's good to have objective eyes here; you might have a look at this (a good summary, referencing this higher up on the page) in the archives, and see if you don't agree that the misattribution of the WHO report to one of its contributing authors wasn't classic wikisophistry (and perhaps, heaven forbid, a bad-faith attempt to reduce its weight). Ernst himself noted, in his criticism of the WHO report on homeopathy, that it indeed carries a great deal of weight; it should be treated accordingly, per WP:TRUTH. Ernst quoted[16]: “Any report WHO puts out will have an impact”, says Ernst, who says in debates supporters of acupuncture will counter his evidence by simply citing the claims backed in the WHO report. “Who am I against the WHO?”, he asks. “What better name could you think of but WHO?” Ernst is not speaking ironically or asking a rhetorical question. He is stating, correctly, that the WHO carries a great deal of weight, and that it's a damn shame that such a weight-y source wrote a report that he believes, with no small amount of justification, to be biased (as attributable views on controversial subjects frequently are). I imagine we can handle the weight issue more gracefully than by falsifying the source's attribution, don't you? We can have a robust, informative article about acupuncture that doesn't have, as a unifying and primary subtext, "acupuncture is nonsense". We also should, per NPOV, VER and OR. regards, Middle 8 (talk) 06:24, 2 February 2011 (UTC)
- Of course, Ernst is making this statement in light of the lack of evidence for acupuncture and makes this statement to detract from the weight the WHO should carry in this case. For this suspect therapy the WHO is a political document as much as it is a scientific one, and it is one that has been criticized. Appropriate weight means writing the summary of the WHO document as well as any criticisms. I still don't have a problem with noting the author, and frankly don't think that most readers would notice if we changed the author to S. F. Adams. WLU (t) (c) Wikipedia's rules:simple/complex 12:10, 3 February 2011 (UTC)
- We aren't too far apart on this. Yes, politics are involved. It remains the case that the critics are less weight-y than the WHO; they should be cited, but the WHO remains the stronger source (which is Ernst's exasperated point -- their is truth in both our takes on this). We do need to make sure the article reflects the lack of consensus rather than an imagined consensus that it's all nonsense, and that we give adequate weight to the view that acupuncture is valuable for certain conditions. That is a view compatible with EBM: lacking higher-quality evidence such as meta-analyses of RCT's, one looks at the evidence at lower rungs of the ladder. That was what Sackett said about it, anyway. --Middle 8 (talk) 16:11, 3 February 2011 (UTC)
- Of course, Ernst is making this statement in light of the lack of evidence for acupuncture and makes this statement to detract from the weight the WHO should carry in this case. For this suspect therapy the WHO is a political document as much as it is a scientific one, and it is one that has been criticized. Appropriate weight means writing the summary of the WHO document as well as any criticisms. I still don't have a problem with noting the author, and frankly don't think that most readers would notice if we changed the author to S. F. Adams. WLU (t) (c) Wikipedia's rules:simple/complex 12:10, 3 February 2011 (UTC)
Will it hurt?, and "death by acupuncture"
I have a childhood based fear of doctors with needles. Does acupuncture ever hurt? PPdd (talk) 03:26, 2 February 2011 (UTC)
- Wikipedia is not a how-to manual and does not give advice. If you can find a reliable source discussing this, it's probably worth adding to the aritcle but wikipedia editors aren't the kind of people to ask about this sort of thing. WLU (t) (c) Wikipedia's rules:simple/complex 20:42, 2 February 2011 (UTC)
- I couldn't find RS. But it would be information about acupuncture. Tatoos hurt and cause bleeding. Does acupuncture? Does deep dry needling of Mftp? Maybe someone else has RS on this. PPdd (talk) 20:48, 2 February 2011 (UTC)
- Read Singh and Ernst's book Trick or Treatment. Acupuncture is not "harmless". Injuries and at least one death have been linked to it. Famousdog (talk) 12:16, 3 February 2011 (UTC)
- Death by acupunctue? What a way to go. I think I will expand this section header. (I always wondered about what kinds of historic experiments on people might have led to acupuncture's development.) PPdd (talk) 14:10, 3 February 2011 (UTC)
- An Austrian patient was killed when a needle penetrated her sternum and pierced her heart. Minor infections from dirty needles are common. Hepatitis and pneumothorax are a potential risk. You say you're scared of needles? Then expect side effects related to anxiety such as nausea, vomiting, fainting, etc. The biggest lie in all creation is that alternative medicine is "harmless rubbish". Its not. Rubbish? Yes. Harmless? Not necessarily. Famousdog (talk) 14:30, 3 February 2011 (UTC)
- Death by acupunctue? What a way to go. I think I will expand this section header. (I always wondered about what kinds of historic experiments on people might have led to acupuncture's development.) PPdd (talk) 14:10, 3 February 2011 (UTC)
- Read Singh and Ernst's book Trick or Treatment. Acupuncture is not "harmless". Injuries and at least one death have been linked to it. Famousdog (talk) 12:16, 3 February 2011 (UTC)
- I couldn't find RS. But it would be information about acupuncture. Tatoos hurt and cause bleeding. Does acupuncture? Does deep dry needling of Mftp? Maybe someone else has RS on this. PPdd (talk) 20:48, 2 February 2011 (UTC)
(undent) I'm an acupuncturist with a previous career in pharmaceutical research. Information needs to be considered in context; some drugs that are considered safe enough to sell without a prescription are far more dangerous than acupuncture (tylenol, for example). Even aspirin kills a few people each year; the total of 86 reported for acupuncture (over every year of recorded history!) is thus relatively quite low. Bicycles and soccer balls are far more of a menace. Compared to virtually all drugs and therapies, acupuncture is quite safe [17]; the references in the article all support that conclusion. How well acupuncturists are trained makes a huge difference: in the U.S., for example, they receive thorough education on safety (including all the issues mentioned above) and are required to use sterile, one-time-use, disposable needles in almost every state. Middle 8 (talk) 15:58, 3 February 2011 (UTC)
- I am no big fan of pharmaceutical industries and surgeons pushing their products to line their pockets, so this does not argue for acupuncture being harmless. PPdd (talk) 16:27, 3 February 2011 (UTC)
As for pain, just google; acupuncture needles are much smaller than hypodermic needles, and generally don't "hurt" as much as cause a "twinge" initially which then fades into a pleasant, relaxing feeling. The large majority of the time, the places in the body that were needled don't even bleed when the needle is removed. Just tell your acupuncturist if a needle hurts too much, and she'll remove it and insert another in a slightly different position. No two people are exactly alike, and some may have small nerves near the skin that are too close for comfort to the textbook point location. --Middle 8 (talk) 15:58, 3 February 2011 (UTC)
- So it does sometimes hurt? I googled, but just got NRS stuff, and it was all about relieving pain, not causing it. Can you point me to RS on this? PPdd (talk) 16:27, 3 February 2011 (UTC)
- See, this is another example of a facetious rhetorical question that wastes time. One might as well say "hey, surgery is supposed to relieve pain; why do they have to use anesthetics then, HUH?". For RS, see "Contemporary Chinese Medicine and Acupuncture" or any book on delivery of acupuncture care, or, if you like, patient FAQ from professional organizations such as the AAAMA. Just google. And anyway, where is RS needed in the article? --Middle 8 (talk) 18:25, 3 February 2011 (UTC)
- Its not a facetious question. I can't get a straighforward answer to it. I would never get a tattoo if only because of the pain. Acupuncture makes ridiculous claims about "healing", totally unsupported by any study. And undergoing pain for what is at best a barely detectable effect according to ALL studies makes not sense. Can it be painful and cause bleeding? PPdd (talk) 18:48, 3 February 2011 (UTC)
- Note that many people may die from taking aspirin or tylenol. That should be appropriately noted on those pages. Note that people have died from acupuncture, that should be noted here. Note that tylenol and aspirin both have well-established risks, and unequivocal benefits. Note that acupuncture has well-established risks, but its benefits are far, far more questionable. That is the difference, and that is why there is such debate on the topic. Acupuncture points have never been reliably demonstrated to correlate to any meaningful anatomical structures, nerves or otherwise. As for this being a good example of something, this section is a good example of a large number of talking points and a few sources (only one). So my ultimate comment is - if you want to include information about acupuncture being painful, look for a reference on it. Try google books. All this discussion is giving Middle 8 a platform to repeat him/herself, and wasting a lot of time. Sources people, sources then content. If it's a review article or reliable book, it's valid for inclusion. If the point has been criticized in the same, it's also valid. We are not a forum for discussion. PPdd, I answered your original question in a manner appropriate to a wikipedia talk page - we shouldn't try to establish the truth of whether acupuncture hurts, we should establish if the sensation of acupuncture can be verified. Stop baiting each other. WLU (t) (c) Wikipedia's rules:simple/complex 02:42, 4 February 2011 (UTC)
- @WLU: your complaint that I repeat myself on this talk page is about as striking an example of WP:KETTLE as any I've seen; the evidence is right there in the edit history. --Middle 8 (talk) 07:58, 4 February 2011 (UTC)
- That would sting a little more coming from someone who wasn't a SPA and equally guilty. I will note, however, that I have supported a referenced methodolgy and history section, and that the best sources tend to support my points. WLU (t) (c) Wikipedia's rules:simple/complex 12:33, 4 February 2011 (UTC)
- @WLU: your complaint that I repeat myself on this talk page is about as striking an example of WP:KETTLE as any I've seen; the evidence is right there in the edit history. --Middle 8 (talk) 07:58, 4 February 2011 (UTC)
- I am not intending to bait anyone. I just wondered if it hurt. I don't think my question has not been asked by almost enyone who ever got acupuncture, so it is certainly article material. The problem I had with RS on this was that searches for "pain" produced "pain relief references. I was hoping someone might already have RS on this. I don't even know who Middle8 is. I agree with "many people may die from taking aspirin or tylenol. That should be appropriately noted on those pages", but add it should also be noted on the box of the product. The blight of overprescription and overuse of pharmaceuticals and surgeries is terrible. PPdd (talk) 03:01, 4 February 2011 (UTC)
- WLU, thank you for taking the time to track down a source, but it is not MedRS. It is not peer reviewed and says, for example, “modern science has measured the electrical charge at these (acupuncture points), corroborating the locations of the meridians.” I will use your (implicit) idea of using "painful" instead of "pain" at google scholar. PPdd (talk) 03:17, 4 February 2011 (UTC)
- Note that many people may die from taking aspirin or tylenol. That should be appropriately noted on those pages. Note that people have died from acupuncture, that should be noted here. Note that tylenol and aspirin both have well-established risks, and unequivocal benefits. Note that acupuncture has well-established risks, but its benefits are far, far more questionable. That is the difference, and that is why there is such debate on the topic. Acupuncture points have never been reliably demonstrated to correlate to any meaningful anatomical structures, nerves or otherwise. As for this being a good example of something, this section is a good example of a large number of talking points and a few sources (only one). So my ultimate comment is - if you want to include information about acupuncture being painful, look for a reference on it. Try google books. All this discussion is giving Middle 8 a platform to repeat him/herself, and wasting a lot of time. Sources people, sources then content. If it's a review article or reliable book, it's valid for inclusion. If the point has been criticized in the same, it's also valid. We are not a forum for discussion. PPdd, I answered your original question in a manner appropriate to a wikipedia talk page - we shouldn't try to establish the truth of whether acupuncture hurts, we should establish if the sensation of acupuncture can be verified. Stop baiting each other. WLU (t) (c) Wikipedia's rules:simple/complex 02:42, 4 February 2011 (UTC)
- Books are perfectly acceptable sources for even medical opinions. MEDRS does not apply blindly to the entire page. For basic information like "what does acupuncture feel like" we don't need a Cochrane review. Further, I wouldn't expect it. There's a reason I went to google books for this. The fact that it is published by Cengage Learning, an academic publisher, means it is reliable enough. However, the fact that it makes blanket statements that better sources do not support means I would suggest not using it for that purpose. But it's fine for "acupuncture normally isn't painful".
- The blight of modern pharmaceuticals and overprescription is terrible, but irrelevant for this page except to note that it is used as a red herring to validate the use of acupuncture. And in that case, only if a reliable source makes the point for us. If you want warnings for acupuncture to appear on a box somewhere, you're in the wrong place. We're an encyclopedia, not a soapbox, crystal ball or publisher of original research. If you're really interested in how acupuncture feels, play around with some search terms and dig a bit in google and google books. You don't need an international review panel to note that acupuncture has been described as painful, odd, warm, electric, numbing or whatever - you just need a source that doesn't say something outrageous. This would be fine, so would this one. We're not talking about heart transplants, it's a fine needle being stuck into the body. If that's our substantive concern, I think most people would agree to something said in one of these sources. WLU (t) (c) Wikipedia's rules:simple/complex 03:35, 4 February 2011 (UTC)
- Thanks again. I found MEDRS for “acupuncture is a painful and unpleasant treatment”[1] using google scholar. But this opens up a can of worms as to how acupuncturists hide this information so well. I also found MEDRS that twisting the needles is extremely painful. An endorphin release that relieves a headache would be expected in such cases, not be surprising. I am still looking. PPdd (talk) 03:43, 4 February 2011 (UTC)
"Two patients terminated study participation, complaining that acupuncture was too painful to continue." [18]
"acupuncture is a painful and unpleasant treatment" [19]
"Japanese acupuncture needles are much finer than their Chinese counterparts, and hence far less painful." Acupuncture Today, Southern Medical Journal, July 1988 - Volume 81 - Issue 7 - ppg 885-887, Yasuo Yshida
PPdd (talk) 04:38, 4 February 2011 (UTC)"For the purpose of pain relief, the choice of non-acupuncture points as a sham treatment is also a problem because of the existence of diffuse noxious inhibitory control (DNIC) phenomena; it is well established that painful stimulation inhibits pain, and DNIC has been proposed as a physiological basis of acupuncture analgesia." [20]
(outdent) The best source for adverse effects in acupuncture (including pain from needle insertion) is this Ernst review, which puts the total number of adverse events at 11.4% and notes that they are mostly minor. PPdd, you could have found this by reading the article. --Middle 8 (talk) 08:01, 4 February 2011 (UTC)
- This review of acupuncture you refer to , is only about acupuncture at points used to treat pain and only in Germany for that, and does not discuss how painful it is during treatment (in the abstract on the linked page you provided). You still have not answered my question in a straightforward way, does it hurt? It seems like there must be an attempt to cover this basic question. In fact, as far as I can tell, any minimal nonplacebo effect observed is thought by scientists to be a result of the body's DNIC reaction to the painfulness of treatment. PPdd (talk) 13:32, 4 February 2011 (UTC)
- PPdd, that represents original research. If you want to know if the "jamming the needle in" part of acupuncture hurts, you've got your answer - it can, but a variety of sensations are reported. Middle 8, PPdd's original question was about pain. Ernst's review of adverse events should be included as well. Though pain should be noted, so should the fact that it doesn't always hurt and a variety of sensations have been reported. That's about it. WLU (t) (c) Wikipedia's rules:simple/complex 12:33, 4 February 2011 (UTC)
- I don't understand how quoting three MEDRS on a talk page is OR. From WP:OR - "To demonstrate that you are not adding original research, you must be able to cite reliable published sources that are both directly related to the topic of the article, and that directly support the material as presented." I have not even yet proposed content. Apparently the practice varies widely worldwide and the painfulness level varies with practitioner, the level of pain depends on where the needles are inserted for different treatments, the level of painfulness ot treatment varies with how the needles are manipulated, some people do not mind or get used to the pain of insertion, some people do not mind or get used to the pain of manipulation, and some people find the pain intolerable. A futher question is whether it hurts more for 1st timers, as compared to people who have developed a tolerance for it over their life. This is discussed in another clearly MEDRS article I found. PPdd (talk) 13:26, 4 February 2011 (UTC)
- PPdd, that represents original research. If you want to know if the "jamming the needle in" part of acupuncture hurts, you've got your answer - it can, but a variety of sensations are reported. Middle 8, PPdd's original question was about pain. Ernst's review of adverse events should be included as well. Though pain should be noted, so should the fact that it doesn't always hurt and a variety of sensations have been reported. That's about it. WLU (t) (c) Wikipedia's rules:simple/complex 12:33, 4 February 2011 (UTC)
Note that "painfulness of treatment" is different from "adverse effects" as commonly used. For example, getting an injection of morphine in one's buttox may be painful, but it is not listed as an "adverse effect" of morphine (which has plenty of adverse effects: addiction, constipation, etc.). The pain in treatment is likely responsible from the minute effects detected via the diffuse noxious inhibitory control (DNIC) phenomena, as speculated in the source above. PPdd (talk) 14:51, 4 February 2011 (UTC)
- Three sources synthesized on the talk page is OR, but it doesn't really matter since OR is only an issue on the actual main page. On the talk page it falls more under misuse of the talk page (which we've all been doing for quite a while). So long as you don't port these sources and their conclusion to the main page, it's not really an issue. This is still a synthesis ("acupuncture is painful") because none of the sources focus specifically on whether acupuncture causes pain. We're better off citing sources which discuss the myriad ways acupuncture can feel. Clearly it is not a unitary sensation or phenomenon. That getting stuck with a needle is painful falls under the heading of "well duh" but the fact that it is consistently described as something other than painful is something worth noting. Certainly we should not push the POV that acupuncture is just painful without a convergence of sources on the topic. WLU (t) (c) Wikipedia's rules:simple/complex 18:33, 4 February 2011 (UTC)
Yin and yang in article's lede pic
WLU's newly installed lede pic is quite beautiful. The drawing "balances" the hollow empty space at left with a solid figure at right, just like in acupuncture theory, and even looks like a picture of yin and yang. Note that although the belly button is misplaced, the true center of gravity is over the subjects supporting left ankle (to the viewers right), just as in Michaelangelo's drawings. PPdd (talk) 18:21, 4 February 2011 (UTC)
- I just think the last one sucked. WLU (t) (c) Wikipedia's rules:simple/complex 18:24, 4 February 2011 (UTC)
- Sucked for a lede, but not for a picture in the practice section. I loved your "brothel" comment. I didn't notice it on first viewing. I once got a moxibustion treatment from a stripper friend. PPdd (talk) 18:38, 4 February 2011 (UTC)
- Note that Michaelangelo's figure's buttox points left to the west, and the TCM drawing's figure's buttox points right to the east, with the Americas in the middle, in keeping with the "spirit" of yin/yang. So, let the qi flow freely in art. (That was a normative statement, so is neither true nor false.)PPdd (talk) 15:13, 8 February 2011 (UTC)
- Sucked for a lede, but not for a picture in the practice section. I loved your "brothel" comment. I didn't notice it on first viewing. I once got a moxibustion treatment from a stripper friend. PPdd (talk) 18:38, 4 February 2011 (UTC)
Cheng citation
I notice references to Cheng are being removed (i.e. [21]). This is debatable. Though only "Cheng, 1987" is given, this is still a valid, if imprecise source. When the reference number is clicked on, it takes you to the reference itself. This reference should be hyperlinked to take the reader to the "References" section, specifically the line with Cheng, 1987 on it (Cheng, X (1987). Chinese Acupuncture and Moxibustion (1st ed.). Foreign Languages Press. ISBN 7-119-00378-X.) If the google books link had a preview I'd link to this.
I don't know how reliable the book is for medical claims, but for basics of Chinese acupuncture (number of points, meridians, typical treatment, etc.) it is probably adequate.
Remember that while all information should be sourced, commonly-accepted knowledge or knowledge no-one objects to does not need a citation. We don't need a refernce after the sky being blue, the capital city of a country, the roundess of the Earth or that cancer is conventionally treated with chemotherapy and surgery. The big flaw in many sources is the lack of page numbers; that could be addressed by finding the page numbers in the original text. Probably easier would be finding the same information in another source - for instance, this one which has a preview option and allows for searching inside. Though further references are invariably a boon to the page, removing unsourced information is not always the best action to take. If the information is basic (acupuncture involves needles; acupuncture exists in China) then wikipedia and our readers are not helped by removing this sort of thing. I'm not saying replace all the information and references, but be judicious and ask if the information removed really needs a source, and if the page is better for even unsourced information being present. WLU (t) (c) Wikipedia's rules:simple/complex 19:42, 4 February 2011 (UTC)
- I would have tried to improve the ref, but the material seemed to make medical claims, e.g., that acupuncture (always) causes nausea and (always) cures headaches, which seemed inconsistent with other material in the article, like relieving nausea. What do you think on these points? PPdd (talk) 20:06, 4 February 2011 (UTC)
- You removed a lot of stuff, I don't recall seeing Cheng refer to pain and nausea specifically. For pain and nausea, I would definitely suggest using better quality, more recent sources rather than Cheng. For basics of acupuncture however, I would think it's fine.
- Note that even conventional, well-proven medication does not always cure whatever it is prescribed for, so that's a bit unfair. Acupuncture has, to the best of the ability of research to tell to date, been proven to improve pain and nausea. It's still not perfect, it could still be placebo, this is noted, but we shouldn't be unfairly critical. WLU (t) (c) Wikipedia's rules:simple/complex 02:09, 5 February 2011 (UTC)
Here's the Cheng material I deleted -
"In the clinical practice of acupuncturists, patients frequently report one or more of certain kinds of sensation that are associated with this treatment:
- Extreme sensitivity to pain at the points in the webs of the thumbs.
- In bad headaches, a feeling of nausea that persists for roughly the same period as the stimulation being administered to the webs of the thumbs.
- Simultaneous relief of the headache.[2]"
I would have tried to check the ref, but it was 1987, and totally incosistent with a claim of nausea relief. I outlined this problem below, where "acupuncure" keeps shifting meaning, e.g., treatment for nausea may cause pain, and treatment for pain may cause nausea. But both treatments are called "acupuncture". So (assuming it actually has efficacy in both), does it cause or relieve nausea? The logical error causing the problem is called the fallacy of four terms.
I have a big problem with medical articles that claim efficacy without saying HOW effective. For example, if Rogaine was 100% effective at growing ONE hair, it would be called '100% effective", and people who buy it would still get about nothing. Similarly, even if there was endorphin release from needling, does the needling cause more pain than it relieves? All these are important questions which seem to be ignored. (They get deliberately obfuscated like this by pharmaceutical companies, too.) PPdd (talk) 02:22, 5 February 2011 (UTC)
Moving the goalpost definitions of acupuncture, and recommendations that "more studies are needed" - in this article
This article uses fallacy of four terms reasoning in that it is constantly shifting definitions of acupuncture to imply false things.
- "Acupuncture" defined as "12rivers/365days acupuncture" is compared to "randomly sticking needles" as placebo;
- Then "randomly sticking needles" is called "acupuncture" to compare to "nonpenetrating needles" as placebo.
- Then "acupuncture" is comared to no treatment, as "control", with it being left unspecified as to which "acupuncture" definition is used.
- "Acupuncture" definition is then broadened include "stimulation without needles", e.g., in the NIH nausea relief claim, which concludes that "noninvasive stimulation" of one of 365 points is the same as sticking in needles, and it is said that there is evidence that "acupuncture" relieves nausea (even though no needles are needed.
- The concept of "point" (which occupies zero area) is never defined, leaving "an area of unspecified nearness to one of 365 points" stimulated to be a new definition of "acupuncture points".
- Then some version of one of these "acupuncture" definitions is found to have some efficacy for pain or nausea relief, without specifying which definition of acupunture, or whether there was a placebo or "control" used for the conclusion.
- Then "acupuncture" is declared effective, even though only one of the various "acupuncture"s may have had efficacy, as if this shows efficacy for all definitions of acupuncture.
- Then "12rivers/365days acupuncture" is declared effecitive because "acupuncture" is, and implicit in declaration is that 12 rivers and 365 days has to do with efficacy!!!
- Then "accupuncture", without specifying which definition is used, is said to relieve nausea.
- Then "acupuncture" is said to relieve headaches, but cause nausea. (Cheng 1987 entry)
- Then poor placebo construction leads to meaningless systematic reviews, which thus conclude "more research is needed to reach conclusions", which is then changed to "the review says more reasearch is needed", to imply they are reccommending wasting still more money on studies!
- Then these various definitions and ambiguities are combined to create still greater ambiguities.
- An example of this abuse is WHO findings, which do not even compare to placebo in some cases. Another example is findings by bodies about pain relief when compared to no treatment, then concluding a statement about "acupuncture" in general, under which definition not being specified.
- This violates the basic "consistency" requirement at WP, e.g., as stated in MOS.
- A result is an article that reads like an advert for "acupuncture".
This article needs alot of work! PPdd (talk) 16:28, 5 February 2011 (UTC):Not a bad start on a todo list, though by neglecting to provide links you've left your meaning rather ambiguous. I've added a {{todo}}
at the top of the page, I'd suggest moving these points there so they don't disappear into talkpage archives before they're addressed. After that, I'd suggest you add links to clarify the article sections you are referring to at each point. LeadSongDog come howl! 22:39, 4 February 2011 (UTC)
- I will start cleaning up the article, e.g., starting with AMA. The AMA was very critical, calling acupuncture "astrology based".[22]. The article says "the American Medical Association (AMA) Council on Scientific Affairs produced a report in 1997, which stated that there was insufficient evidence to support acupuncture's effectiveness in treating disease, and highlighted the need for further research."[23]. What they really did is say, not that there was such a need, but http://www.ama-assn.org/ama/no-index/about-ama/13638.shtml [Much of the information currently known about these therapies makes it clear that many have not been shown to be efficacious. Well-designed, stringently controlled research should be done to evaluate the efficacy of alternative therapies.”]", i.e., if you want to waste your money on a study, then at least do the study correctly". Quite a shift of meaning, with similar shifts repeatedly done. PPdd (talk) 23:16, 4 February 2011 (UTC)
I added the list to the "to do" list at top, but comments on how to fix all of this should go in this section. PPdd (talk) 16:28, 5 February 2011 (UTC)
NIH, politic milk-toast, or junk science?
The NIH, with appointments made by political considerations, has always blended milk toast political caution with science, as its director is a political appointment, not a nomination by peers.
- But in the report cited in the article, it ventures into pure junk science futurology It made findings that can only be classified as being pseudoscientific futurology, making predictions about what “future” studies in areas not yet tested will “likely” uncover - =
One wonders what statistical methods they used to conclude “likely”, given that the areas referred to have not been tested. Shame, shame. PPdd (talk) 23:58, 4 February 2011 (UTC)“Further research is likely to uncover additional areas where acupuncture interventions will be useful.”
- None the less, it is still a widely-respected organization and a reliable source. It should be included, and only criticized if a reliable source can be found. WLU (t) (c) Wikipedia's rules:simple/complex 01:59, 5 February 2011 (UTC)
Claim of nausea reduction "noninvasive acupuncture"
The cochrane study cited says
"There was no clear difference in the effectiveness of P6 acupoint stimulation for adults and children; or for invasive and noninvasive acupoint stimulation."
So invasively sticking needles in someone had no extra effect. The lede says otherwise. "Noninvasive acupuncture" is oxymoronic. This is another case of moving the goalpost defining acupuncture. PPdd (talk) 15:15, 5 February 2011 (UTC)
Please help find RS and restore pregancy termination content to article
Please help find RS for
"Risk of terminating pregnancy with the use of certain acupuncture points that have been shown to stimulate the production of adrenocorticotropic hormone (ACTH) and oxytocin, and with unsterilized needles and lack of infection control: transmission of infectious diseases. (such as hepatitis B, hepatitis C, HIV I remember seeing confirmed cases of hepatitis B ... needs a ref, though)"
, which I removed from the article as NRS. PPdd (talk) 22:11, 7 February 2011 (UTC)
- Points for terminating pregnancy, i.e., specific points that do a specific thing? Perish the thought! Point specificity is moose poopie! Well, for "efficacy", anyway. For "risks", by all means, source it up at all costs! LOL --Middle 8 (talk) 22:35, 5 February 2011 (UTC)
- Middle 8, don't undervalue moose poopie!! It can be used as fuel, or as an air freshener (depending on one's preferences), or as dinner (depending on one's biological kingdom)... not like that darned acupuncture, which can only, say, stop pregnancies (and only as a "risk" -- please, do not file under "efficacy" or my paradigm might start shifting, which would hurt worse than a wedgie since I have a pseudo-skeptical stick so far up my ass!) --Evil twin of Middle 8 (talk) 22:35, 5 February 2011 (UTC)
- You meant bull moose poopie. I deleted it from the article, but put it here to give whatever editor put it in a chance to find RS, if any exist. It seemed specific enough to have come from some source. PPdd (talk) 22:11, 7 February 2011 (UTC)
- Middle 8, don't undervalue moose poopie!! It can be used as fuel, or as an air freshener (depending on one's preferences), or as dinner (depending on one's biological kingdom)... not like that darned acupuncture, which can only, say, stop pregnancies (and only as a "risk" -- please, do not file under "efficacy" or my paradigm might start shifting, which would hurt worse than a wedgie since I have a pseudo-skeptical stick so far up my ass!) --Evil twin of Middle 8 (talk) 22:35, 5 February 2011 (UTC)
"Efficacy" findings are misleadingly stated in article
The "efficacy" findings are misleadingly stated in article. The article does not state "how much" pain relief, even if there was 100% pain relief. Using another example, if a remedy for baldness caused one hair to grow 100% of the time, it would have 100% efficacy, but be useless. Similarly, if sticking needles into someone always caused a very minute amount of the body's natural pain relievers to be released, it would have 100% efficacy, but be worthless. PPdd (talk) 21:02, 5 February 2011 (UTC)
End run around MEDRS: Misleading by quoting medical conclusions by alternative organizations
Is The American Academy of Medical Acupuncture MedRS? Per WP:PARITY, "Note that fringe journals exist, some of which claim peer review. Only a very few of these actually have any meaningful peer review outside of promoters of the fringe theories, and should generally be considered unreliable." In the quoted material with AAMA, there is no indication of whether their conclusoins about "acupuncture" are compared to a sham treatment of random intrusive needle insertion. I don't think quoting their conclusion should be in the article under WP:Parity. I am holding off deletion as NRS to give time to discuss. PPdd (talk) 21:08, 5 February 2011 (UTC)
- What source and statement are you specifically talking about in the main page? In general it is hard to make broad-strokes statements. The AAMA would be considered a reliable source for discussing what acupuncturists believe and a mainstream (particularly American) summary of the material. I wouldn't say it is a MEDRS, for that I would defer to journal articles. WLU (t) (c) Wikipedia's rules:simple/complex 23:36, 6 February 2011 (UTC)
- I agree with you, and the matter you refer to was just dealt with at talk:homeopathy. But this is a bit trickier. The article says[24], "The American Academy of Medical Acupuncture (2004) states: 'In the United States, acupuncture has its greatest success and acceptance in the treatment of musculoskeletal pain.' " The problem is that a typical reader would read this as what sounds like an authority is making the declaration. This is a more subtle MEDRS problem, since the sentence is true as stated, but it will likely mislead almost all readers. Most readers would think it means "a medical authority of national stature says that acupuncture is successful in general, but has great success in the treatment of pain". That is how I first read it, thinking it was a national science based "Medical" authority (that's why they choose such names). This is exactly the kind of inference MEDRS was designed to aviod. PPdd (talk) 23:50, 6 February 2011 (UTC)
I have raised this as a general question about the subtle problem of "misleading by quoting medical conclusions by alternative organizations that have assumed titles of authority" at MEDRS here[25]. Continued discussion specific to acupuncture can continue in this section, but please contribute your ideas on the more general question at MEDRS. PPdd (talk) 15:12, 7 February 2011 (UTC)
- I am inserting another topic here that has to do with MEDRS and acupuncture.
- I have another perspective altogether, based on scanning the MEDRS page. Please feel free to correct my approach, but I would appreciate it if we could really discuss the content.
- It seems that MEDRS rules apply to medical fields. Acupuncture is not considered a medical field, according to it's national regulatory board,NCCAOM and to all state licensing agencies. Acupuncture is defined as a health care profession whose specifics vary slightly from state to state. The diagnostics are based on it's own traditional concepts. Acupuncturists are not allowed to diagnose or treat according to medical diagnoses. It is against our scope of practice. Health Care and Medicine are two different concepts. Health Care is all encompassing term for a diversity of fields, medicine is specific to those trained in the medical profession and designated as such. I believe that MEDRS such as JAMA do not directly apply to Acupuncture.
- A discussion about medical research of acupuncture is worthwhile, it does not pertain directly to the field of acupuncture, but to the interaction of acupuncture and the medical field. Like I said before, I think this a very interesting topic to explore, but it should be given its own section but not mixed with the main body of the entry, since it does not pertain to the actual topic of acupuncture. It's more of a "perspective on acupuncture" from a medical POV.
- From theNY Office of Professions site: "An acupuncturist is a licensed health care professional who, based on the concepts of oriental medicine, maintains the health of patients and evaluates and treats their illness and pain. Using the principles of oriental medicine, the acupuncturist will examine you by looking, listening, asking questions, and touching."
- It is a healthcare profession, but there is no mention of medical profession. The medical professions are clearly described as such. NY State Office of Profession - Medicine. Medical doctors and acupuncturists are both health care providers, but medicine is it's own independent field, as is acupuncture. Medicine does not describe the entirety of health care professions. Acupuncture has a bio-medical component, whose main function is to facilitate communication between members of all healthcare professions as a common language. Thus a Dr. can communicate with an acupuncturist about a patient, and an acupuncturist will understand both the language and the medical concerns but will not treat them as such. Acupuncture diagnoses are sometimes parallel to allopathic diagnoses but they are generally of a different nature. All acupuncture treatments are based on TCM diagnoses, which you can find in the industry standard manuals of Giovanni Macciocia, the Foundations of Chinese Medicine, The Practice of Chinese Medicine, and Yan Wu, Practical Therapeutics of Chinese Medicine. It is in fact illegal to treat according to a medical diagnosis. All acupuncturists and patients sign forms stated as much in the beginning of every patient/clinician interaction because of the common confusion between the two (fields of health care and diagnoses).
- Please let me know your thoughts on this. Soll22 (talk) 22:02, 16 February 2011 (UTC)
POV article
the article is still POV but this time it is overly skeptical. three quarters of what is written should be moved to the criticism section. it is fine to be critical and skeptical of acupuncture but the article should be written in the same neutral format as other controversial subjects. — Preceding unsigned comment added by Metabradley (talk • contribs) 21:42, 5 February 2011 (UTC)
- The reason for this is that much of the theory and practice content was NRS, and was moved to this talk page (above sections) to find RS. The science material was mostly RS, but that which was not was also moved out of the article to this page below. You can help out by finding RS for this content and moving it back to the article. PPdd (talk) 22:06, 5 February 2011 (UTC)
- A couple points. First, per WP:STRUCTURE it is somewhat preferable to stitch POVs throughout the article and appropriate sections. It's not prohibited to have a "criticisms" section, but the ideal solution is to form a coherent narrative in which the criticisms are logically included in the appropriate section. Second, "neutral" does not mean "complimentary". There is a great deal of controversy regarding acupuncture in the scientific and medical community. Though practitioners think acupuncture "works", numerous researchers contest what good research on acupuncture is, and what is actually "working". That being said, we should fairly and accurately describe what acupuncture practitioners believe about acupuncture - and note in the appropriate sections where there is evidence to support these beliefs. We should justify this with reference to reliable sources - in the case of most things but efficacy, that means a scholarly book on the practice of acupuncture.
- I do agree with Metabradley that the tone of the page is drifting towards in an overly critical direction. Personally I believe acupuncture is bunk, but that doesn't mean I think the page should be purged of an accurate description of what believers believe. I also agree with PPdd that the best way to address this is finding the best sources to depict these beliefs. As I said above, I'm not averse to using Cheng, I thought it was acceptable.
- Also, as a top-level article it needs to address Japanese, Tibetan, Korean and Thai acupuncture as well. WLU (t) (c) Wikipedia's rules:simple/complex 22:29, 5 February 2011 (UTC)
the sources used are obviously not versed in chinese history or medicine and make broad, inaccurate claims. historically there are only two major rivers with any relevance in china (yellow river and yang river) not twelve. qi is not a "mystical" substance but a philosophical one, which arguable still has no place in medicine. the point locations are very much derived from human anatomy and take into account such things as muscle bodies, tendons and ligaments, bones, fossa (bone and soft tissue), foramen, nerve bundles and plexus. not using western terminology, of course. the name of many of the points reference the anatomical location. when the point system was brought to the west the points lost their anatomical names and were replaced with numbers. also, from the list of acupunture points wiki page (http://en.wikipedia.org/wiki/List_of_acupuncture_points): "Medical texts describe the location and indications of more than 400 acupuncture points." not the 365 astronomically derived points listed on this page. i am sure that there are wonderful articles that critique acupuncture; the ones used should not be listed among them. also when in the editing mode it is highlighted that the page is already too long so the burden should not be on people to add more material which balances out the POV but rather the POV should be removed in order to make the article neutral and shorter. plenty of pages have a criticism section, i read a lot of wikipedia articles and this is one of the few that includes the criticism in the introduction of the article. as well this article already has the criticism section so it would seem reasonable to put the criticism there. — Preceding unsigned comment added by Metabradley (talk • contribs) 19:27, 6 February 2011 (UTC)
- I don't beleive in critcism sections, but rather sections by topic, with specific criticisms being enmeshed with claims and beliefs for each topic. For example, a reader might want only to read about pratices and criticisms point by point, and might be totally uninsterested in theory or criticisms of the theory. It is a matter of style.
- The "balance" (yin yang) of the article will soon be restored, with RS for the theory material which was massively removed as NRS. But the material was not lost, just moved to this talk page in sections above, so RS can be found. Please help out finding RS.
if you removed <365>, which was the exact number stated to be derived from astrological means, why didn't you remove the rest of the statement? i will look at the RS. mb. —Preceding unsigned comment added by 204.187.140.30 (talk) 21:46, 6 February 2011 (UTC)
- yes, multiple pov are wonderful, however, the idea is to have INFORMED pov, not someone skimming the covers of an acupuncture manual or treatise placing a misinformed concept in the wiki entry and critiquing. The idea that the channels correspond to the rivers of China is a minor part of a huge treatise, and also mainly discussed as a conceptual metaphor.
It has no real significance in clinical practice. NO ONE refers to this in the clinical practice of acupuncture. This article seems to be written with a few exceptions by people only tangentially familiar with acupuncture in it's clinical form. — Preceding unsigned comment added by Soll22 (talk • contribs) 01:18, 7 February 2011 (UTC)
- Soll22, you must have reliable sources to instert claims of efficiency. For example, you made this[27] edit, saying "It relieves pain, treats infertility, treats disease, prevents disease, promotes general health, or can be used for therapeutic purposes." You cannot simply state your belief that "it... prevents disease" like you did in that edit, unless you meet the standards at WP:MEDRS for such a claim. PPdd (talk) 01:34, 7 February 2011 (UTC)
- Yes, I understand. I have to get through the rules & regs of wikipedia editing. However, there are a lot of misinformed and truncated statements that give a misleading view of acupuncture in this article. In my edit above, I was only experimenting. I simplified the sentence from "Practitioners claim it does etc etc." to "It does etc etc". I will be getting familiar with the rules, with real, acceptable edits to follow.. sorry about any current mix-ups. Soll22 (talk) 18:36, 7 February 2011 (UTC)
- (Aside - Soll22, if you put colons before your comment, it indents the comment. So take the number of colons of the comment you are responding to and add one colon more; this will indent your comment one additional indent to the comment you are responding to, and other editors can tell it is a response to the last comment.)
- Soll22, we clearly have different POV's ("POV" stands for "point of view"). But if you click here[28], you can see that I worked with editors with POV's that were the opposite of mine, and everyone ended up being very happy. I suggest you start a new section on this talk page listing things you think are innacurate or omitted from the article. I will then try to find MEDRS for them ("MEDRS" stands for the rules at WP:MEDRS), and help you get them in the article in a way that follows WP rules ("WP" stands for "Wikipedia"). MEDRS is tricky for both beginners and experienced editors, so just because you don't understand the rules, does not mean your ideas do not merit placement in the article, so if you put your suggestions on this talk page, I (or another editors) can help find WP:RS or WP:MEDRS for your suggestions, or help reword them so they can go in the article.
- The first section of an article (before the table of contents) is called the "Lede" or "Lead". I suggest you do not try to change the lede in your first edits, because there are tricky rules for it, and it is strictly based on what has generally already been agreed to be in the article "body" (the part after the lede). It is best to add things with MEDRS to sections of the body, or delete things that do not have MEDRS. Please never delete things with MEDRS just because you do not agree with them.
- Incidentally, there is a list of "edit summaries" on the "view history" tab of the article page. When you make an edit, it is best etiquette to put an edit summary, so editors can see why you made an edit. You can see what changes were made by comparing the diffrences of edits (called "diffs") by checking the little circles next to the two edits you are interested in comparing. PPdd (talk) 19:03, 7 February 2011 (UTC)
- (This page is called a "talk page", or "talk", even though the tab says "discussion", so an edit summary that says "see talk" means "click the discussion tab and discuss in the relevant section".)
- Abbreviations you will see in the "edit summary" on the history page include "rv" for "revert" or "undo", "sp" for spelling, and "gm" for grammer.
- One last thing. New editors almost always get very frustrated and discouraged because they may do alot of work over a period of time, then suddenly someone comes along and deletes the whole bunch of work citing an obscure WP guideline. This is likely to happen to you, too, and happen again and again. Never take it personally, no matter how mad or frustrated you get. Your work is never lost, since it is on the history page ("view history" tab), and the information you gathered can always be accessed and fixed, if it belongs in the article.
- Yes, I understand. I have to get through the rules & regs of wikipedia editing. However, there are a lot of misinformed and truncated statements that give a misleading view of acupuncture in this article. In my edit above, I was only experimenting. I simplified the sentence from "Practitioners claim it does etc etc." to "It does etc etc". I will be getting familiar with the rules, with real, acceptable edits to follow.. sorry about any current mix-ups. Soll22 (talk) 18:36, 7 February 2011 (UTC)
- Soll22, you must have reliable sources to instert claims of efficiency. For example, you made this[27] edit, saying "It relieves pain, treats infertility, treats disease, prevents disease, promotes general health, or can be used for therapeutic purposes." You cannot simply state your belief that "it... prevents disease" like you did in that edit, unless you meet the standards at WP:MEDRS for such a claim. PPdd (talk) 01:34, 7 February 2011 (UTC)
- Again, if an editor thinks this article is anti-POV, please find RS for material in sections with theory and practice content awaiting RS for insertion back in the article body. PPdd (talk) 19:18, 7 February 2011 (UTC)
- There's not really such a thing as "anti-POV", which implies that there is somewhere a single "right" POV and also POVs that are "against" it. There are multiple POVs, we try to represent all the major ones using reliable sources.
- Soll22 - you can't merely assert something is wrong. If a statement is in your opinion wrong, but unsourced, it can be removed. If it is sourced, you must figure out if it is reliable, particularly for medical claims. If it is reliable, you must figure out if it is accurately summarized. If a source is reliable, accurately summarized, current/a contemporary opinion - the only "option" is to find out if the point has been criticized or "countered" by another reliable source. Information is not removed because an editor thinks it is wrong. WLU (t) (c) Wikipedia's rules:simple/complex 18:42, 8 February 2011 (UTC)
- PPdd I appreciate your taking the time to point out rules and regs. I will do my best to get a hang of things. My personal point of view, not to be confused with the POV of the entry is that as a member of a licensed profession, this article does not in any way represent the community or official (legislative) view of acupuncture. Therefore I am over eager to "straighten" things up, just as you guys seem to be. The pov is simply different. The reason why I jumped into the lede is because it seems to me the most not NPOV section of the wiki entry, plus it's the first one you see. There are statements such as the location of the acupuncture meridians which are based on the number of rivers, which doesn't even make logical sense. A location of several things cannot be based on a number of things. The majority of acupuncture literature includes no reference to the correspondance of meridians to the rivers in China. It is a philosophical metaphor that is not really part of the clinical literature. Yet the lede contains a marginal statement it's only statement about the channels. It is very POV.
Also, the lede contains a lot of criticism of acupuncture which there are several sides. I feel that while this is definitely one side, there are several other sides that should be represented, not in the lede. This should be a separate criticism section. As it reads now, the lede is THE criticism section, not a NPOV lede. Clearly the editors expressed their point of view in the talk page - acupuncture is pseudo-science, I hate acupuncture etc, obviously, not NPOV, and this is what comes through in the lede. There is no consensus in the medicine community, and this should be the NPOV of the CRITICISM section. I think the whole content of the lede, besides the typos and lack of logic of the statements, needs to be discussed. In the meantime, I disagree that it should be left as is. Soll22 (talk) 12:47, 9 February 2011 (UTC)
Model of POV cooperation in alternative medicine articles
- The Anthroposophic medicine article was subject to edit wars and back and forth claims of POV from both sides. But it ended up with what appears to be unanimous consensus on both POV sides that they are all happy[29].
- In a comment in one of repeated "comlaint-POV" sections above, an editor commented that since both POV sides were unhappy, this was a sign of a good balance.
- I propose that the best sign of good balance is when both sides are happy, not unhappy.
- Much of the disputes can be resolved by working on the to-do list at the top of this page, since most criticisms on both sides seem to involve a shift in definitions to make a point.
- Further balance can be arrived at by working on finding RS for the massively deleted NRS theory and practice material, moved to the talk page above to find RS.
- Let's balance our yin/yang the right way in a path to happiness, not unhappiness. PPdd (talk) 22:43, 6 February 2011 (UTC)
- Seems like this ideal is turning out more like a "model of mono-operation". What happens when nobody else is playing along? Do you vote amongst yourself? Seriously, please don't stop -- this is the greatest thing that I've seen on WP in a long time. By "this" and "greatest", of course, I mean the tragicomic, obdurate refusal of others to *collaborate!*, not your own abundant and balanced labors. Carry on. Please. If you won't, who will? The future of the article is in your hands! You must allow nothing to deter you. I want this article to be a model that shows how amazing Wikipedia can be, and you are the best hope yet for shepherding it to a yet-undreamt-of state. DO. NOT. STOP. EVER. Sincerely, Middle 8 (talk) 11:29, 8 February 2011 (UTC)
- I'm allowing my silence to represent support for most of PPdd's edits. Middle8, if you've got a problem with PPdd's edits, you need to object, and refer to reliable sources saying why they are problematic. This pointless baiting doesn't help anyone. WLU (t) (c) Wikipedia's rules:simple/complex 11:50, 8 February 2011 (UTC)
- Middle8, what I did in the anthroposophical medicine article was to be asked to come in as an outsider to a highly edit-warred article about a "spritually and supernaturlly based, homeopathy using, 'medical'" practice. I deleted almost the entire article's pro-anthrop-med-POV material as NRS, which was yelled and screamed at. I then found sources for the material and put it back in with RS, deleting the entire "criticism section", and distributing the criticisms topic by topic with the now RS pro-POV material. This was not a "mono operation" because I could not have done it witout the many greater "mono operations" put in to the article before I came in, and I only used WP policies in my edits of the many pre-existing "mono operations" of others. You also should know that I am a critic of all profit-driven-medicine and profit-driven-studies, alternative or not. Also, I was once giving a lecture at Stanford, lambasting the abuse of the word "energy" in alt meds, but then I called a coffee break as I had used up all of my "energy". Radical skepticism should be turned on itself, and be accompanied by radical open-mindedness. I actually believe (without MEDRS to put it in the article) that there is an "anatomic structure" corresponding to general needling, which is the body's system for reacting to mild pain or mild trauma, and that this system might have a greater effect on conscious psycholological states like pain and nausea than the consious effects of the mild pain and mild trauma. I also believe that traditional acupuncture might have, by trial and error, randomly happened across at least some locations that stimulate this body- wide structure more than just random needling. But I have no MEDRS on this belief to put it in the article.
- I believe my main contribution to the acupuncture article is in the fourth lead paragraph, which sorts out enought ambiguitites in the article body to stop symantic debates on the talk pages, and limit debate only to MEDRS on objective facts about medical conclusions, and objective RS facts about beliefs and practices.
- My other main contribution was to delete all of the NRS material I could find, from all POVs, and move it all to talk to find RS so it can go back in if it should. This is not a "mono operation", it is Wiki policy.
- Middle8, please help find RS for content I deleted on theory and practice and this will help balance the yin and yang in the article. PPdd (talk) 14:59, 8 February 2011 (UTC)
- I'm allowing my silence to represent support for most of PPdd's edits. Middle8, if you've got a problem with PPdd's edits, you need to object, and refer to reliable sources saying why they are problematic. This pointless baiting doesn't help anyone. WLU (t) (c) Wikipedia's rules:simple/complex 11:50, 8 February 2011 (UTC)
"Anatomical structures"? Wikipedia:Writing for the opponent
- Is a bodywide subcutenous stimulatable type of cells at non-acupuncture points that generates neurotransmitters an "anatomical structure"? PPdd (talk) 23:28, 6 February 2011 (UTC)
- If so, is stimulation of it with needles "acupuncture", or is it a "placebo to test acupuncture against"? PPdd (talk) 23:30, 6 February 2011 (UTC)
Acupuncture Practice in Chinese Hospital/Clinical discussion of Acupuncture
Sorry, this is a new heading with a short text. The discussion are very long, most of them don't include ANY references from and by the Chinese Medical Community. You all don't seem to understand that in China, Acupuncture and Herbology are established branches of medicine, which co-treat alongside allopathic medicine, with clinical studies and proven results. This article and discussion does not, to my mind, include the point of view of a chinese medical clinician. It is a very one-sided debate, and I will do my best to bring more qualified theoreticians in it. Most of the statements regarding the theory of acupuncture are without any depth, laughable. It is easy to dismiss acupuncture based on statements which are basically ignorant of the field. Please at least attempt to study the topic you are writing about. Study of commentaries of a topic are poor substitutes for knowledge of the field itself. Imagine if this kind of outside commentary was applied to other fields.
-soll22 — Preceding unsigned comment added by Soll22 (talk • contribs) 01:28, 7 February 2011 (UTC)
- I agree. Please help out by finding RS for practice in China (and Japan). PPdd (talk) 22:08, 7 February 2011 (UTC)
- Soll22, I find your comments to be in extreme bad faith, ignorant and personally offensive. "You all don't seem to understand..." Please do not smear other editors as not knowledgeable. "...that in China, Acupuncture and Herbology are established branches of medicine..." Not quite. I understand that during the cultural revolution in China, the new Communist Party was stuck for ways to provide state healthcare to its massive population. The Party's solution was to use "barefoot doctors" and traditional medicine to treat those with minor ailments and free up the rest of the healthcare system for more serious issues. "...which co-treat alongside allopathic medicine, with clinical studies and proven results." Please read the article and attached citations for point-by-point dismissals of most of this so-called "evidence". "It is a very one-sided debate," No it isn't. You're here aren't you? Start debating instead of insulting us. Convince us of your superior knowledge of the subject. "and I will do my best to bring more qualified theoreticians in it." Please do. I'd like to test myself against these geniuses. "Most of the statements regarding the theory of acupuncture are without any depth, laughable." Which ones? Tag them if you find them incorrect or biased. Provide evidence to rebuff them. Otherwise, stop complaining. "It is easy to dismiss acupuncture" Yes, it is, isn't it? "based on statements which are basically ignorant of the field." Oh sorry, I thought you'd finished. Thanks for calling us all ignorant again, Great High One. "Please at least attempt to study the topic you are writing about." I've studied it in great depth actually. It sounds like you've been too busy fleecing the gullible to study it. "Study of commentaries of a topic are poor substitutes for knowledge of the field itself." So reading widely about a topic, studying the entire evidence base and weeding out poorly-performed studies, downright fraudulent research and concluding that acupunture is (mostly) bunkum is not "knowledge", but going to an acupuncturist and coming out thinking "hmm, I feel a bit better now that nice man's stuck needles in my chakras" (whoops, wrong belief system) is? "Imagine if this kind of outside commentary was applied to other fields." It is. That's how science works. Clever, eh? Famousdog (talk) 12:29, 8 February 2011 (UTC)
- Famousedog, you are correct, but Soll22 is a brand new editor with an apparently extreme POV background re acupuncture. I have been directing him to basic WP methods (like putting edit summaries, and discussing on talk) and policies, and he is improving and communicating more. It took me a while to begin to understand WP:Civility and WP:GF. Also "fleecing the gullible" sounds like the written version of my own thoughts about "science based medicine", which in practice is really a "science based profit-generating-machine, that utilizes scientific-marketing, supported by profit-driven scientific studies designed to make more money using scientific methods in its profit-driven studies", while acupuncture is more like "primitive-profit-generating-machine based on superstitions, to take what it can from the gullible, without using well developed scientific marketing methods", but I am sure that acupuncture's its profit generating methodology will improve and catch up to "science-based-profit-machine based on marketing science (especially with the insurance industry now subsidizing, and thus indirectly promoting, acupunture practice).
- SOL22, Famousdog is correct, but since you are new, you might not totally get what he is saying. I suggest you read WP:Civility, WP:GF, and WP:MEDRS. You don't have to read it all at first, but at least skim over them to get the main ideas. One of the main things to get from these is that you should assume editors are trying to make the article better, even if they delete things you agree with (because they are NRS (not RS), or put in things you disagree with, but which have MEDRS. Another thing to remember is that to put in a claim about medical effects, you must have sources that are "secondary" (See WP:MEDRS) sources from established mainstream major medical sources, not from sources in the field (like acupuncture journals). Otherwise, you might still be able to use major acupuncture journal sources, but only to source claims about what acupuncturists believe or how they practice. I also suggest you very carefully read the article's fourth paragraph, which was derived from RS (reliably sourced with inline citations) content in tha article body (the part after the table of contents). When you start to edit, it is probably best to add or deleted things in the article body, not the lead (the part before the table of contents), which summarizes salient things in the article body. PPdd 14:09, 8 February 2011 (UTC)
- I appreciate your efforts to educate Sol22 in the Ways of Wikipedia, but your characterisation of mainstream medicine as some sort of scientifico-medical Axis of Evil is very naive. You say "science-based medicine ... is just a science based profit-generating-machine". What about all the people who, oh, I don't know, get better thanks to it? Case in point: Radiation therapy, vilified by alternative medicine ignoramuses as "curing by harming", has an 80% survival rate after 5 years in the treatment of prostrate cancer.[30] If some people make money by selling machines and isotopes that save 80% of people treated with them, then more power to them! Damning the whole of evidence-based medicine because a few companies make a profit is a failure to see the wood for the trees. Famousdog (talk) 09:37, 9 February 2011 (UTC)
- I'm just happy that all acupuncturists give away their labour for free, all manufacturers of acupuncture needles produce supplies voluntarily for no money, and therefore there is never any financial conflict of interest involved. Yeah, all interventions except research cost money. Bitching and moaning that companies and individuals make money off of medicine is hypocritical. Yes, money causes bias, but it causes bias in all groups - not just pharmaceutical manufacturers and doctors. Acupuncturists get paid too. Research, at least in the US, must be provided free of charge. In fact, often test subjects are paid for their time and risk. Damn those evil, greedy companies for giving away all that free testing, just so they can make money off of it later! Seriously, Big Pharma has done some shitty things in the name of the almighty dollar, but they don't have a lock on making money from treatment, and they still need profits to develop new compounds, fund research on it, and ultimately produce effective drugs to treat and cure diseases. Sometimes they even give it away for free! Other times they fund pseudo-journals. That's why we need the NIH and other research funding agencies. WLU (t) (c) Wikipedia's rules:simple/complex 03:27, 10 February 2011 (UTC)
- I appreciate your efforts to educate Sol22 in the Ways of Wikipedia, but your characterisation of mainstream medicine as some sort of scientifico-medical Axis of Evil is very naive. You say "science-based medicine ... is just a science based profit-generating-machine". What about all the people who, oh, I don't know, get better thanks to it? Case in point: Radiation therapy, vilified by alternative medicine ignoramuses as "curing by harming", has an 80% survival rate after 5 years in the treatment of prostrate cancer.[30] If some people make money by selling machines and isotopes that save 80% of people treated with them, then more power to them! Damning the whole of evidence-based medicine because a few companies make a profit is a failure to see the wood for the trees. Famousdog (talk) 09:37, 9 February 2011 (UTC)
- PPdd thanks, and yes, I am trying to get to all these wiki rules as time allows. As you can see I am not jumping into any more corrections as I realize that doing so without the proper wikiquette is a waste of time (yours and mine) space, making both the talk page and the actual entry a nightmare for readers, and energy. Famousdog, my statements are not based on historical fact, but on clinical experience of my professors, many of which have had lengthy clinical stays in Beijing, Shanghai, Guangdong, Taipei and other cities. I do realize that a personal perspective is not the way wikipedia functions, but I am over enthusiastic about the field so I do apologize for any past ramblings about personal experience or opinions or any future ones. I do appreciate any touches of personal input in this discussion, for ex. PPdd description of a personal experience with an acupuncturist. I can better understand what each editor's foundation is, and try to find common ground, as I am sure there is even between the most unlikely edits. There are a lot of issues under discussion here that worth exploring, and I am looking forward to doing that. famousdog, did I really say science-based medicine is just a science based profit-generating-machine? please refer me to that section, I honestly don't ever remember saying that, because I rarely discuss the profitability of medicine - it's tricky topic, much trickier than establishing efficacy, and one that I would not be likely to jump into.
- I would also encourage you to do a bit of research on "survival rates" after radiation or chemotherapy. I do remember being part of a discussion at a workshop, at Sloan-Kettering Memorial Cancer Center about what survival rates mean in these studies. Survival rate in a study about cancer treatment, means "not succumbing to the original cancer". However, several of these tx may cause other problems( chemotherapy can cause kidney failure, or sever liver dysfunction and radiation has caused cancers in other areas of the body - bone cancer or leukemia after radiation for prostate cancer for example) and survival rates for illness generated by the treatment or another type of cancer that can be clearly linked to the treatment is never part of the official survival rate. A number of patients of chemotherapy or radiation do succumb to fatal illnesses 10-15 years after the original cancer. I do not know the statistics, I am just bringing up a point that statistics need to be also examined in some detail. Just because something is analysed in percentages does not mean it is a thorough and definitive study. I am just saying - hang in there, and give things a second look. Secondly, I don't want to critique allopathic treatments at all, and I don't want to go into the subject since this talk page is about acupuncture.
- And famousdog, basically the point of that paragraph which I wrote the first day when I found this page, was based on statements about the theory of the field of acupuncture which had no relation with anything in the clinical texts, studies or current discussions within the field of acupuncture. It was also an acupuncturist's first encounter with, what to most people inside the field would appear as an anti-acupuncture POV. I distinguished reading commentaries about acupuncture rather than critiquing with an inside knowledge of the field. It's easy to critique the channels as being astrological poo-poo, but it's not really fair since they are not thought of, used, discussed or taught from that perspective.
- I know now that the folks here are serious about wiki rules, and that is important to me also, and I think now that we can all profit from our interaction. Anyhow, gotta split now, but will be back in the discussion asap.Soll22 (talk) 19:53, 14 February 2011 (UTC)
- Personal experience, irrespective of it is yours or another practitioner, is not allowable as a source. If your professors have published journal articles on the topic, we can cite them - provided they are the reliable, secondary sources required of articles.
- Chemotherapy survival rates are irrelevant here, the failings of other areas of research do not matter since this is the page on acupuncture. We do not examine statistics in detail, but we can cite sources that do so. It is not statistics that determines if a paper can be cited - it is the reputation of the publisher for fact checking and its status as a secondary source - review article or meta analyses. This is why Cochrane reviews are our best sources, as they combine both. WLU (t) (c) Wikipedia's rules:simple/complex 17:54, 15 February 2011 (UTC)
- I agree WLU, personal experience is not allowable as a source, and that other areas of research are irrelevant. I was answering famousdogs incursion into the statistics of chemotherapy survival. That being said, I did enjoy your rant on big Pharma. I was speed reading last time, didn't realize the last paragraph was yours.24.215.187.94 (talk) 17:29, 16 February 2011 (UTC)
removal of NRS POV and POV material - please help find RS
Two sentences were removed as NRS (and POV)
Many other countries do not license acupuncturists or require them to be trained. Most European countries with the exception of Spain, Portugal, Holland and Poland, require a medical license prior to acupuncture licensing, thus placing acupuncture under the domain of the medical profession.
Please help out by finding RS so these edits can go back in. PPdd (talk) 22:07, 7 February 2011 (UTC)
- Um. You're using the terms "anti-POV" and "pro-POV" a lot, but I'm not sure I understand your definition, and if I do, whether I think its helpful. Famousdog (talk) 12:39, 8 February 2011 (UTC)
- I just meant that each of the sentences looked like they were from opposites POVs, and I was hoping editors would help with both POVs at the same time to encourage cooperation. I just changed the wording since you point out that it might have the opposite effect of my intent. (I changed the size of your comment and mine so we don't distract from the section purpose of getting RS. Please change size back if you disagree. PPdd 13:49, 8 February 2011 (UTC)
- I don't agree, and it throws off the threading. If you're simply removing unsourced material, all you really need to refer to is WP:PROVEIT; whether a summary is POV or not is a separate, and much more difficult issue. If a source is lacking or inadequate (i.e. it's someone's blog) then simply remove it and worry about whether the information is POV or not if and when it is replaced. WLU (t) (c) Wikipedia's rules:simple/complex 18:36, 8 February 2011 (UTC)
- I just meant that each of the sentences looked like they were from opposites POVs, and I was hoping editors would help with both POVs at the same time to encourage cooperation. I just changed the wording since you point out that it might have the opposite effect of my intent. (I changed the size of your comment and mine so we don't distract from the section purpose of getting RS. Please change size back if you disagree. PPdd 13:49, 8 February 2011 (UTC)
Unsourced information from lead
The following section was removed from the lead. WP:LEAD requires us to either provide sources for all information in the lead, or none depending on the page. Having a wall of text with no sources following several paragraphs full of sources is inappropriate. If this is a "draft" section, I would suggest composing that draft on a user subpage rather than on a main page. WLU (t) (c) Wikipedia's rules:simple/complex 12:04, 8 February 2011 (UTC)
There are various definitions of “acupuncture”, "effectiveness", and "need for further research", causing confusion about claims of acupunture proponents and confusing debates. First, in most cases “acupuncture” refers only to insertion of needles in traditionally determined acupuncture points. In this case, it is contrasted with randomly inserting needles, which is called a “sham treatment” or “placebo for acupuncture”, which is referred to as “needling”. Second, in some cases the very opposite is the case - “acupuncture” refers to this random needling, and this random needling is compared to pressing needles against the skin at the same points but not puncturing the skin, which is called "the placebo for acupuncture". So in the first case "needling with penetration" is called "the placebo for acupuncture", and in the second case "needling is with penetration" is the same as "acupuncture", but "nonpenetrating needles" is "the placebo for acupuncture". Third, sometimes, but less often, “acupuncture” refers to “acupressure”, which is applying pressure to traditional acupuncture points. Another reversal of definitions is that sometimes "stimulation" by pressing acupuncture points without penetration is called "acupuncture", not "placebo", and is compared to some other placebo treatment or "control". Another ambiguous usage is that some claim that acupuncture is "effective", and mean that it is effective for all of its claims, such as prevention of disease. Others might mean by a claim of "effectiveness" that it treats psychological states such as pain or nausea, but not necessarily other conditions. Some may mean by a claim of "effectiveness" for pain relief that the relief is dramatic or significantly large enough to justify study. Others may mean that it is only barely detectable but still measurable. Different definitions of “acupuncture” are combined with different definitions of "effectiveness" and this causes still more confusion about its claims. There is also ambiguous usage of "need for further research". Some may mean by this that spending money on additional research is a good expenditure of highly limited medical research funds, while others mean by it that, if conclusions are to be drawn, more research funds would have to be spent, even if they might not think doing so is a good place to spend limited research funds.
Proposed conventions for using the term "acupunture" in the article
- Per MOS, the lede fourth paragraph is straight out of the line cited RS material in the body.
- To eliminate talk page arguments over semantics, I propose never using the term "acupuncture" in the article body; instead always qualify it with its usage per the RS inline citation.
- (1) Use "traditional TCM acupunture" to refer to TCM based points.
- (2) Use "penetrating needling" to refer to random points.
- (3) Use "nonpenetrating needle stimulation of TCM acupuncture point" when the RS uses "acupuncture" in this qualified usage.
- (4) Use "nonpenetrating needle stimulation of random points" when the RS talks about this.
- (5) Use "placebo for traditional TCM point needling" for "random penetrating needling" as placebo, per the RS.
- (6) Use "placebo random nonpenetrating needling as placebo for randon penetrating needling" per the RS.
- (7) Use "placebo non-needling control" per the RS.
- (8) Use "efficacy for all TCM claims" when appropriate.
- (9) Use "efficacy for relief of (this specific kind of nausea)" for that specific kind of nausea.
- (10) Use "efficacy for relief of (this specific kind of pain)" for that specific kind of pain.
- (11) Use "significant efficacy" to distinguish from "minor efficacy".
- (12) Never use "further study is needed".
- Instead use "have an opinion that expenditure of limited medical research funds is merited" when the cited entity expresses a subjecive opinion and thinks further research funding is a good idea for limited available medical research funding.
- Use "further study would have to be funded to draw conclusions" to express an objective fact from a MEDRS entity, when there is no opinion on the merits of spending limited medical research funding, but when no conclusions can be objectively drawn from what has been spent so far.
- That is alot of conventions, but there are at least that many ambiguous semantic abuses in the article itself, which both misleads the reader, and causes meaningless debates over semantics at talk.
- I further propose that this list become a FAQ answer at the top of talk.
- Please suggest modifications to the list by number, or add to the list other ambiguities you have found in the article, which I have overlooked. PPdd (talk)
Luke643 on february 8 1:26pm
today's attempts and writing into the page with grievances
Please forgive my writing into the text with grievances. I found this page after, and was troubled by the loss of 1 hour's work. Anyway, the information in the lede is very problematic. I found my information to be both more accurate to acupuncture theory and better sourced (journal of pocket guide for instance). Though in that case I am willing to accept the poor quality of the source (NIH) but not willing to accept the quality of a pocket dictionary.
My discussion of point theory was far more accurate than the ridiculous river based statements, and my discussion of organs was intended to show the underlying anatomical basis for some of acupucnture theory. If you are going to say there is no evidence and then you are going to erase the evidence then we are looking not at a group of consensus finding and intelligent editors.
Here is my edit of the lede, please let me know what the problems with it are — Preceding unsigned comment added by Luke643 (talk • contribs) 18:26, 8 February 2011 (UTC)
"Acupuncture is an alternative medicine that treats patients by insertion and manipulation of needles in the body. In the 2004 NIH Consensus Paper on Acupuncture, it was determined that therapies that had undergone the most successful clinical trials were for postoperative and chemotherapy care, particularly for nausea and vomiting, postoperative dental care, low-back pain, headache, and tempero-mandibular disorder. Promising results in a handful of other therapies were discussed, with recommendation of further clinical trials..[1] Acupuncture typically incorporates traditional Chinese medicine (TCM) as an integral part of its practice and theory. The term “acupuncture” is sometimes used to refer to insertion of needles at points other than traditional ones, or to applying an electric current to needles in acupuncture points.[2][3]
Acupunture dates back to prehistoric times, with written records from the second century BCE.[4] Different variations of acupuncture are practiced and taught throughout the world.
The theory of pathology in Chinese medical practice(CM) differs from the modern trending of Western medical practice(WM). Rather than focusing on infectious agents (known in CM by various names, simply grouped under the term 'climatic factors'), disease pathology is believed to advance due to an imbalance of the correlative metaphor system based on early Chinese correlative Cosmology, including concepts such as yin and yang, the wu xing, (known as the Five Phases) and psycho-physical imbalance caused by "blockage" or "stagnation" of qi, a word variously translated as 'energy', 'breath', 'vital energy'[5]. These “systematic correspondences”[6] explain much of the phenomena of the persistence of health and illness in the human body. The system is not dissimilar to the Milieu intérieur theory of Claude Bernard.
Point location is based on sets of primary and secondary jingluo 經絡, or 'warp threads', 'winding channels', commonly called 'meridians' in the west. The channels each correspond and putatively interact with correlated internal Zangfu, often translated as 'Organs'. 10 of the 12 correlated organs correspond exactly with western anatomical organs, the Heart, Lungs, Kidneys, Pericardium (considered to have functionality equal to the major organs), Liver, Gall Bladder, Stomach, Large Intestine, Small Intestine, and Bladder. The final two, the 'spleen' and 'triple burner' refer to the spleen/pancreas and three vertical fibrous myo-fascial areas of the chest and abdomen (Upper, Middle and Lower), respectively.
The pioneering work of Dr. Helene Langevin, at the University of Vermont has given us clues as to how to explain Acupuncture points in bio-medical terms. She found that needles are 'grasped' differently at Acupuncture points then at non-acupuncture points. Based on her research, Langevin proposed a bio-medical mechanism based on "connective tissue planes" that explains the theoretical/metaphorical constructs of points, meridians, blockages, needle grasp, and sensation of 'qi', concepts that underpin the whole of acupuncture practice.[7]"
- We can't see the sources in this version, please include the relevant ones as [http://www.example.com hyperlinks] (see WP:LINK for more info on the technical aspects). You may want to dig your version up from the history tab. Note that "pioneering" is a peacock term that should be avoided. Also, unless Dr. Langevin's work has been reported in a secondary source (in this case that would be a review article - not a primary study where she actually jabbed people with needles and measured stuff) then it is not appropriate for the page. There are lots of studies on the effectiveness of acupuncture - most are negative with pain and nausea being the exceptions. This should be noted, as should the fact that the results for these symptoms are themselves equivocal. The comparison to "western" medicine (terrible term - modern medicine placing its emphasis on empirical evidence rather than folk beliefs may have originated in Western Europe but it is applied with great effectiveness throughout the world) may be unwarranted. The sentence starting with "The systemic correspondences" is essentially unsourced, and waaaaaaayyyy oversteps appropriate. Too much detail on the theory as well, historically a notification of the points, qi and meridians was enough. And then we've got my previous comments about Dr. Langevin - really need to see the sources for this, a bare assertion is not enough. WLU (t) (c) Wikipedia's rules:simple/complex 18:53, 8 February 2011 (UTC)
I am happy to put this info lower down into the body of the text.
- Luke, without checking the sources for RS, I put your edits in the article body, so you did not lose your work. MOS says to use plain English, not to use jargon, to avoid specifics (like a report of a single political body which reports by political "consensus", not by scientic peer review) in the lede; the lede generally summarizes in an objective manner, what is in the article body. A first comment on your edit (which I put unchanged without checking the sources) into the article body is that writing "based on early Chinese correlative Cosmology" instead of "a belief that heavenly bodies affect the body, known as Chinese astrology" is not plain English, and is known as weasel words for what is commonly called Chinese astrology in plain English, and is POV because of that. You must also state medical conclusions in the most objective manner, based on findings by secondary medical sources (see WP:MEDRS). PPdd (talk) 19:05, 8 February 2011 (UTC)
the comments below are relavent. I fail to see how "correlative cosmology" is not plain english when "chinese astrology" is. But whatever. the important thing is that the practice of acupuncture is NOT based on astrology in terms of sourcing for points and channels. I will approach this in my revisions to the page. Luke643 (talk) 05:16, 9 February 2011 (UTC)Luke643
- Chinese Astrology is undefined - Correlative Cosmology is a specific term that involves multiple correlations between the trajectories of astronomical objects, natural phenomena, meteorological events, historical events, political events. It is a field that is part of chinese cultural studies, it is metaphorical in nature and involves concepts that are blended with what you might call "scientific". Astrology is typically the Western concept for the Western pseudo-science which has existed since antiquity for the first few hundred year, it was inseparable from Astronomy and Physics.
Soll22 (talk) 02:55, 9 February 2011 (UTC)
- The Langevin article is apparently this one from 2002. This is a primary source, and thus essentially can not be used on the page. It is also nearly 9 years old, and apparently has not provided a scientific basis and revolution for the existence of acupuncture points or meridians. WLU (t) (c) Wikipedia's rules:
Explain "apparently has not provided a scientific basis and revolution for the existence of acupuncture points or meridians". Soll22 (talk) 02:55, 9 February 2011 (UTC)
Why is a primary source not acceptable?? I agree that the term "pioneering" was a bit strong. But it seems ridiculous to me that a peer reviewed article would be unnacceptable when a pocket medical dictionary is being used to determine what "practitioner's claim"
- I see no reason why Langevin article should not be included. Age of the article is irrelevant. However, the basic premise that acupuncture points/meridians correspond with any anatomical structure is easily dismissed by the fact that the plethora of acupuncture systems means that pretty much any point on the body has some "significance". Secondly, there is "connective tissue" all over the body, increasing the likelyhood of a correlation. In addition, why on earth would sticking pins in connective tissue do anything? Famousdog (talk) 09:56, 9 February 2011 (UTC)
Famousdog - it is precisely that which occurred in her study. CT bound differently at acupuncture points then at non-points. But as I said, I am cool with not using it.Luke643 (talk) 17:05, 9 February 2011 (UTC)luke643
- Note - Chinese astrology based acupuncture is not all from "on earth". PPdd (talk) 15:24, 9 February 2011 (UTC)
- The Langevin article is a primary source Famousdog, that is why in my opinion it should not be included. It has also not led to a widespread acceptance of the idea that acupuncture points are related to connective tissue, making it a minority (of one) opinion (IMO). Soll22, primary sources are not acceptable based on WP:PSTS and WP:MEDRS. A primary source for a scientific statement is an original study - someone reporting on an experiment. Primary sources are not used because they are easily abused, can be cherry-picked to support specific conclusions, may be refuted by later experiments, may be freak or unusual occurrences, may involve small groups, improper blinding, poor statistics and other methodological failures that make it easier to discover spurious results, and generally are poor choices for medical or scientific points, particularly when it is merely a hypothesis that would substantiate a major and contentious issue like the existence of acupuncture points. Note that many studies, reported in secondary sources (that would be review articles) have found that sham needling of non-acupuncture points is just as effective as needling traditional acupuncture points, which suggests that Langevin's results are spurious. Put another way, primary sources are not acceptable because it is a policy on wikipedia. The reason itself matters less than the fact that community consensus has determined that primary sources are inappropriate. WLU (t) (c) Wikipedia's rules:simple/complex 12:18, 9 February 2011 (UTC)
Ok, I am reposting what I worked on yesterday. Again, the Lede should not include criticism of acupuncture theory, methods, or beliefs, as that information all must come in lower sections. The lede should state concisely what the practice is only. does this make sense to everybody?Luke643 (talk) 17:05, 9 February 2011 (UTC)Luke643
- Please see WP:LEAD. The lead section very much should include criticisms because a) acupuncture makes medical claims, and b) the criticisms are very much part of the contemporary dialogue regarding acupuncture. The lead section should summarize the entire article, and that includes criticisms. Please review WP:LEAD. WLU (t) (c) Wikipedia's rules:simple/complex 17:19, 9 February 2011 (UTC)
thanks for that, I have fixed the lede to include the summary of criticism.Luke643 (talk) 17:29, 9 February 2011 (UTC)luke643
Additionally, I should clarify why the rivers/astrology statements are false. First, the lingshu (the Warring States text that the Matuk quotes) does not suggest that the points and channels come from rivers or the days of the year, and certainly do not suggest that they come from astrological incantations or rituals. Peter Deadman's analysis of the mawangdui text on acupuncture and physiology suggests that the formation of points was quite the opposite: unsystematic and based on points of tenderness in massage and exercise. Parralellisms are very common in classical chinese texts, and this one is no different. That there are 12 channels that correspond to 12 rivers in China (they certainly knew there were more than 12!) and points to the days of the year was a rhetorical device used to verify the 'natural' and cosmological significance of the points. But there is simply no suggestion in the literature that the pionts and channels originate in the rivers and stars. If my Columbia MA in Pre-modern Chinese History is not enough to convince the wiki world of the veracity of my reading of the lingshu, then I throw my hands in the air. Luke643 (talk) 17:23, 9 February 2011 (UTC)Luke643
- While we value expertise in a subject here, we value compliance with policies even more. As a newbie here you need to be very cautious and not restore content that has been deleted. That's called edit warring and can get you blocked before you've even learned how things are done here. That would be shame. Solo editing is dangerous. We do things by consensus here. Take your new content and place it on this talk page first. We can then discuss it, tweak and revise it, and then, MAYBE, it might be acceptable as new content.
- As I've written below, editing the lead is a rather dangerous thing, especially for a newbie. First make your concerns known here. Discuss them with other editors. Then, if a consensus emerges, changes can be made. Don't restore your deleted content without reaching such a consensus. There are reasons, in this case many, for why your additions are deleted. (They aren't really gone. They can be recovered and worked on, so your time hasn't really been wasted.) We have all been through this process of getting our first attempts rebuffed, often many times. Don't take it personally. It's part of the learning experience, and if you learn from it rather than getting upset, you'll show a positive learning curve and that will create a good reputation for you. That will be your capital here. It will help you when you really need help.
- Also, as explained on your own talk page, please start to indent your comments, and always sign with four tildes, no more and no less. -- Brangifer (talk) 18:33, 9 February 2011 (UTC)
- Luke643, when I started editing, I got very frustrated by all the rules, deletions, etc. This went on for months. After making about 4,000 edits, I still get frustrated, and am still learning and I still edit like a newbie. Other eidtors, including on this page, took their time and helped me out alot on this. If you have any questions, I will gladly return these favors to you, so just post a note (or frustration) on my talk page, and I will try to help, or refer you to someone if I can't. PPdd (talk) 18:46, 9 February 2011 (UTC)
RS needed for system table
Flow of qi through the meridians | ||
Zang-fu | Aspect | Hours |
Lung | taiyin | 0300-0500 |
Large Intestine | yangming | 0500-0700 |
Stomach | yangming | 0700-0900 |
Spleen | taiyin | 0900-1100 |
Heart | shaoyin | 1100–1300 |
Small Intestine | taiyang | 1300–1500 |
Bladder | taiyang | 1500–1700 |
Kidney | shaoyin | 1700–1900 |
Pericardium | jueyin | 1900–2100 |
San Jiao | shaoyang | 2100–2300 |
Gallbladder | shaoyang | 2300-0100 |
Liver | jueyin | 0100-0300 |
Lung (repeats cycle) |
Does anyone have RS for this table I deleted as NRS? PPdd (talk) 20:49, 8 February 2011 (UTC)
- PPdd, keep in mind that not everything needs a source. If no editors are challenging it, then there's no reason to remove it. If there is no reason to believe that it is inaccurate, then there's no reason to remove what is probably a fairly helpful summary of beliefs. I myself made that table and didn't remove the information because I didn't see anything controversial - it's a reasonable summary of what practitioners believe and was placed in a section that made it clear it wasn't actually supported by research. You are still within your rights to remove it, but keep in mind you don't have to. If you are really concerned about a source, it's worth looking for one before deleting. You could try google books for instance. If anyone has Essentials of Chinese Medicine volume 1 by Z. Liu, it may have some information on page 334 (my preview cuts off for that section).
- Of course, if no-one can provide a source and no-one, not even the acupuncturists active on this page believes this, then I will eat my words and you were totally justified. I hope you're not, I hate eating my words. Makes me seem less omniscient. WLU (t) (c) Wikipedia's rules:simple/complex 12:28, 9 February 2011 (UTC)
- The main reasons I removed it was that I was trying to remove everything that had specific information, both scientific and about beliefs. Also, I did not understand the terms in the table, and I was hoping someone would explain them. I did not know how to put {{Citation needed}} tags on a table (I tried). Finally, I found it too coinidential that Chinese divisions of the day into 24 hours, which is entirely a convention, happened to coincide with western European division into 24 hours. It would be like Chinese weeks being seven days long, because God happened to take a rest after 6 days when he created China, just like he did after creating the middle east. I have been mad at God ever since, because 7 is not a very good number, as it is too prime for a nice division. A non-prime number like six for the number of days a week would have been much better (and also allowed for a shorter work week). But like you, maybe God is not omniscient, and failed to think about this when he took his 7th day rest in both China and the middle east. PPdd (talk) 14:43, 9 February 2011 (UTC)
- I just realized that God might not be as stupid as I thought. Since a menstrual cycle is 28 days, 7 divides nicely into it, so maybe He was trying to throw women a bone, after having made them from one (adam's rib). And He clearly made the moon go round the earth for this reason, which explains why there are 12 months in both western and Chinese calendars (the article attributes it to a lunar calendar, not a menstrual calendar). PPdd (talk) 14:55, 9 February 2011 (UTC)
- The main reasons I removed it was that I was trying to remove everything that had specific information, both scientific and about beliefs. Also, I did not understand the terms in the table, and I was hoping someone would explain them. I did not know how to put {{Citation needed}} tags on a table (I tried). Finally, I found it too coinidential that Chinese divisions of the day into 24 hours, which is entirely a convention, happened to coincide with western European division into 24 hours. It would be like Chinese weeks being seven days long, because God happened to take a rest after 6 days when he created China, just like he did after creating the middle east. I have been mad at God ever since, because 7 is not a very good number, as it is too prime for a nice division. A non-prime number like six for the number of days a week would have been much better (and also allowed for a shorter work week). But like you, maybe God is not omniscient, and failed to think about this when he took his 7th day rest in both China and the middle east. PPdd (talk) 14:43, 9 February 2011 (UTC)
- My point (with my intended humor removed) is that the table should be in the article, but is not yet well explained in the article body, and it would help if it was so explained, with RS. Since you edited in the table, perhaps you could do a brief addition to the article body explaining what the Chinese terms in the table mean, and what the "hours" mean (and maybe so an additional RS statement on how the definition of what "hour" is, is entirely a matter of "convention", so it cannot serve as a basis for a medicine.) PPdd (talk) 18:40, 9 February 2011 (UTC)
Corrections
deleted following sentence: "Acupuncture's effectiveness for other than psychological effects is denied by the science based medicine community.Ernst_2006-02" The citation does not in any way prove that the science based community as a whole makes such a statement. Citation is also about a discussion which selects certain studies and not others, and draws certain conclusions. Mr. E. Ernst opinions can by no means be considered the unanimous opinion of the entire science based medicine community. "Science based medicine community" must be defined. It is a vague general term without a specific meaning. Numbers, members? If one person in the science based medicine community dissagrees, your statement is false. If you qualify your statement by "some" in the science based community, you are introducing a topic that belongs in the controversy or criticism section and misplacing it in the intro section. — Preceding unsigned comment added by Soll22 (talk • contribs) 02:08, 9 February 2011 (UTC) oh i forgot to signSoll22 (talk) 02:15, 9 February 2011 (UTC)
- There are plenty of citations to that effect, so I am putting it back. Please tag unreferenced statements with {{Citation needed|date=February 2011}} before removing them, to give other editors a chance to provide refs. Now I have to trawl through the edit history to find out where the f*** that sentence was removed from. Famousdog (talk) 10:07, 9 February 2011 (UTC)
- I do apologize for not using the correct tags. However, the point is that the statement was made as a general accepted statement from the point of view of an entity, the science based medicine community, that simply does not function as an entity. The science based medicine community has many members, each one of them with their own opinions.
- The fact that Mr. Ernst suggests something in an article is by no means a license to draw conclusions that are stated as facts about the entire science based medicine community. Ernst himself made no such statement. The citation was misleading. The only acceptable conclusion from that article was the following: E. Ernst suggests that evidence effectiveness for the effectiveness of acupuncture in treating pain based issues is lacking, or debatable, based on the studies used in the article. And this sentence would belong in a section about E. Ernst, not acupuncture. Certainly his work is debatable, not saying without merits, but certainly up for discussion. If you wish to do so, kindly start an E. Ernst entry and enjoy yourselves over there.
- I also deleted the sentence again 5 minutes ago, since it was inserted as a free standing sentence right after the first paragraph, which also has to do with the structure.
- One of my criticisms about the sentence was that is was placed in the middle of a descriptive paragraph, not in the criticism section, where it obviously should be.
- The sentence was also modified with frequently, as in frequently denied. That qualifier places the statement in the debate category. Some people deny, some people accept it, it is still up for grabs. Thus it should not be a blanket statement about how acupuncture is seen. The intro section is more than half criticism which is not acknowledged by the writers here.
- This is definitely not NPOV. Just the fact that an opinion had been mentioned without being credited as an opinion but passed along as fact is a violation of NPOV. Soll22 (talk) 12:27, 9 February 2011 (UTC)
- Please space your posts per the talk page guidelines as it makes it easier to read.
- Edzard Ernst is seen as one of the primary critics of CAM and proponents of rigorous, science-based evaluation of the practices. His opinion carries weight, but if a sentence is justified solely through reference to one of his articles, it may be worth noting it as his opinion. That may be a strong statement to make, but it should not be removed - the article itself should be reviewed to ensure it is accurately summarized in the page. Sentences should also not be removed merely because they are dangling and not part of a paragraph - move it, integrate it, but don't remove it. I replaced it, and note that it was sourced to three citations, not merely one. Please do not remove it unless you can demonstrate that it is actively misrepresenting the sources it cites. Unless Ernst is publishing something in a non-peer reviewed venue like a blog, we do not necessarily need to single it out as his opinion - by publishing in a reliable source or scientific publisher, it carries the weight of the publisher itself. You have to demonstrate the publisher failed their due diligence, not Dr. Ernst. WLU (t) (c) Wikipedia's rules:simple/complex 12:46, 9 February 2011 (UTC)
Pill pushin' POV
The way the article is worded, it makes acupuncture sound like it significantly relieves nausea. As an uninsured purchaser of antiemetics in the hospital, I recall thinking that the antiemetics sold by pill-pushing pharmaceutical companies were about as useful as buying Rogaine to grow hair. A more objective and NPOV article edit on this would be, "Systematic reviews have found acupuncture to be as useless for treating nausea as antiemetics sold by pill pushing pharmaceutical companies." The existing POV article wording on this makes me sick to my stomach. (This is actually a serious request for a suggestion for rewording.) PPdd (talk) 15:08, 9 February 2011 (UTC)
- well it seems like that kind of NPOV edit deals with a comparison of the two, not with one. There are fields of comparative science discussions which are defined as such. Discussing one particular field is not the same as a comparative discussion. The comparison elements must be agreed upon by everyone - acupuncture/pharmaceuticals, acupuncture interventions/surgery, etc. I also suggest, in the name of establishing a clear discussion, get an acupuncture treatment for the same complaint that you were attempting to treat with pharmaceuticals. I would assume that if you call up an acupuncturist and explain you are doing a personal experiment to establish the efficacy of an anti-emetic vs acupuncture treatment, they might give you a discount or even a free treatment. Otherwise most acupuncture schools offer discounted treatments in the school clinic, in most cities, under $30 a treatment, especially for financially disadvantaged, senior citizens or students. At the very least, most patients report a feeling of calm and relaxation by just being in an acupuncture office compared to an emergency room. I really do think that a personal experiment is in order, so YOU can have a clear idea. Since you know the inefficiency of some pharmaceuticals from personal experience, you can freely discuss it from that perspective. Your discussion of acupuncture does not have the same credibility because you freely mix sources and pov.Soll22 (talk) 15:41, 9 February 2011 (UTC)
- I did go to an acupuncturist for pain, because a friend would not shut up until I did. I had pain due to a masively ruptured L5/S1 disc from my falling down a 100 verticle foot landslide, for which I received two neural surgeries for pain relief, after which I still had pain. You are right, the relaxed music and atmosphere was much better than an emergency hospital, as well as the time spent with me. But the honest acupuncturist told me that acupuncture's effects were, at best, very small, and would not help my severe pain, and referred me to a medical pain clinic for pharmaceutical treatment, without giving me acupuncture. PPdd (talk) 16:44, 9 February 2011 (UTC)
- This discussion should be settled by sources. What are the best sources that exist for acupuncture relieving nausea? Have they been criticized? Pulling in personal experience as patient or acupuncturist is invalid. PPdd, I am getting increasingly concerned that the page is taking a perspective that acupuncture is completely ineffective. The first section raises great concerns that personal opinions and definitions are being applied to the article. There are certainly valid points that should be raised in the appropriate section - that virtually any point on the body could be an acupuncture point depending on the system should be noted, but I would place it in the TCM section. Issues with placebo treatments and sham acupuncture should go in research in my opinion. The first section of the page is a self-reference when it says "This article's meaning..." The inclusion of the phrase "or lack thereof" is problematic. The sentence "There are various definitions of “acupuncture”, "placebo treatment", "effectiveness", and "need for further research", causing confusion about claims of acupuncture proponents and confusing interpretation of scientific reviews." is unsourced and asserts an opinion. The page is being pushed closer to an entry of The Skeptic's Dictionary and this concerns me. Our first job is to have a neutral, accurate description of what acupuncture is generally believed to be, then move into issues of efficacy, placebos, theory, etc. The continuous shaving of meanings, even if sourced, can still be inappropriate if it pushes the idea that acupuncture is known to be nonsense. I am quite certain it is nonsense, but the scientific community at large is not and there is still large amounts of sincere (but in my mind credulous) research being done on the subject. Journal articles still talk about qi, acupuncture points, meridians and the like. We should as well - and note the dissenting opinions in the appropriate section rather than with the "voice" of the article.
- Note that we do have a style guideline for medical articles, WP:MEDMOS. I believe the most applicable section would be drugs because there is no "treatment" section. Anyway, since this is a borderline article it's not settled. My personal preference was to put the history section first. This isn't a certain thing, I'm mostly noting it for reference if useful. WLU (t) (c) Wikipedia's rules:simple/complex 17:17, 9 February 2011 (UTC)
- (I think )I corrected defects in the definitions section, removing NRS stuff and my own oipions I had not noticed I was inserting.
- Re- "completely ineffective", see my section below "Proposed NPOV theme to keep in mind when editing this article". I have not yet read a skeptic article on acupuncture. I started reading a couple, but found that they argued using various ambiguities in the terms from the outset, so I decided not to bother reading any further. Before reading this article and sources cited in it, my "knowledge" about acupuncture came from MD's re consulting about data analysis at Stanf, and from an extensive talk with the smart and honest acupuncturist/osteopath that my friend insisted I go to.
- Re - comparisons to antiemetics, I have some knowledge about this from numerous and extended discussions with high end GI and pain doctors, both post-op after surgery, and re nausea as a side effect of pain and of pain meds. The upshot is that state of the art medicine has little understanding of nausea, but many drugs have been proposed, mostly in the context of dealing with side effects of AIDS meds. I have not yet read the systematic reviews of acupuncture studies on this, but I wonder at the outset if in some of the reviewed studies, how there could not be a confounding of side effets of pain meds and nausea meds. To do a proper study withou such confounding, a post-op antiemetic would have to be given to a patient deprived of pain meds, which would be unethical. Similarly, acupuncture might have been given for pain control and nausea control at the same time, so there was no nausea from pain meds, and then this was compared with pain and nausea meds given at the same time. I cannot think of an ethical study being done in another way, but I may be wrong. PPdd (talk) 19:19, 9 February 2011 (UTC)
- Your changes move too quickly for me to track given the limited amount of time I can spend on this, but I'll try to give the page a thorough read-through when I find the time. I will point out the fact that much of your comment is about your experience with acupuncture, pain and nausea when it should be what your sources say. Have you read Trick or Treatment? I see that as a good, evidence-based perspective on acupuncture and one that certainly informs my understanding of the topic. It points out the criticisms but honestly summarizes the results of research that gives acupuncture credit where it is due (even while pointing out that the evidence base still needs improvement). Reliable sources criticizing the evidence base are valuable, our own criticisms are not. I really, really suggest that you spend some time reading even the abstracts of the papers you are citing as the summary must follow from the source, not our opinion. Good review articles should discuss and evaluate primary sourcse on the basis of their methodology including controls - but those opinions must again come from sources. Note for instance, how I try to deal with this information - it's a passive-voice (less than ideal!) note regarding the evidence base for acupuncture, that says it has been questioned and improvements are needed. It doesn't say there is no evidence or that research is flawed, or go through a very finely-sliced analysis. We don't get to be adamant about things until the scientific consensus is clear and the only believers are true believers (like astrology or flat earthers).
- I realize I'm repeating myself, but these points bear repeating as they lead to a better page with a more solid consensus supporting it. WLU (t) (c) Wikipedia's rules:simple/complex 20:27, 9 February 2011 (UTC)
- I only put my experience here responding to Soll22" suggestion that I go to an acupuncturist. None of my edits are other than RS (except regarding confusion and ambiguity, which I deleted). Thanks for recommendation to Trick or Treatment, which I can not access yet. When that book uses the expression "acupuncture", does it refer to penetrating needles at TCM points, any penetrating needles, nonpenetrating stimulation of TCM points? Does credit due when it is due refer to credit for some kind of stimulation of one TCM point but not necesarily others, a credit of passing a .05 p-value in systematic review, no matter how tiny the .05 effect, or lasting releif compared to short-lived relief although not long eneough to matter much for outpatient treatment? Since I have heard good things about this book, I assume it clarifies all of these ambiguities. Similarly, I assume you mean by improvements are needed" that they are needed to make conclusions, not that you are suggesting a pressing need to spend money on improvements. Since I learned about MEDRS from you, I would like to get your take on my highly qualified wording designed to pass MEDRS in the "does it hurt" section. There are no secondary sources, but I worded it to pass MEDRS anyway, as the comments on painfulness are not primary studies, as the studies were not on painfulness, but were incidental to what the article is about. Peer medical and acupuncturist reviewers appear to let these comments be in the articles as if it is undisputed common knowledge, so did not edit the incidental comments out. PPdd (talk) 21:04, 9 February 2011 (UTC)
- PPdd, I do appreciate you sharing your experience on the talk page, it gives me a better idea of where you are coming from. I myself am an L.Ac., and have treated several people with severe back pain who had already been in consultation with surgeons for vertebral fusion or other procedures. My patients got better, some slowly, some quickly, and after several months of weekly or biweekly treatments now only come for maintenance treatments once a month or less, and have regained 80% mobility. They have not been under any other kind of care with the exception of occasional ibuprofen & such. Acupuncture is notoriously difficult to calibrate as far as efficacy, since the points work in combination with each other and different points are therapeutic for different individuals with the same condition. I do respect the acupuncturist who referred you to a medical doctor. There are some conditions which are extremely severe that can greatly benefit from allopathic medicine. However this is a general statement.
- I do know acupuncturists who would gladly take you on with your ruptured disc, and I believe that without a doubt you would at the very least have 50% improvement in the pain, if not some actual modification and healing of internal structures. To give you an example of how tricky it is to "prove" principles of chinese medicine and acupuncture, western medicine for example has always advocated ice for controlling inflammation. Acupuncture and Chinese Medicine always firmly sustained that ice slows down healing. Finally, a study was completed by Zhou Lan at the Cleveland Institute Neuroinflammation Research that showed modifications in the biochemistry of inflammation which supports the Oriental Medicine approach to trauma. Developed inflammation which develops uncontrolled by ice or cold applications actually stimulates a particular subset of growth hormone IGF-1 which improves healing speed and quality of tissue growth. This directly supports indications in Chinese Medicine of treating injuries, even in acute stages with warm applications, and contraindicates the usage of ice. [31] I can get a copy of the faseb jouranal if you like I cannot link to it here.
- The fact that the priniciples of chinese medicine are not easy to research in clinical studies based on the existing paradigms does not mean that they are unproveable or false. Chinese medicine has only, in the past 10 years begun to establish research methodology that aligns it with the "hard science" areas of western research. Remember that efficacy is not the exclusive domain of hard science. Many western medical areas such as psychiatry and psychiatric medications are still a crap-shoot for most physicians. Many psychiatric meds work after random empirical observation of efficacy, where the patients improve under medication without any clear understanding of the pharmacological mechanism. Since clinical trials in certain situations are blocked by ethical considerations as you stated above, even certain branches of western medicine proceed without the rigour that you seem to imply it always does. Chinese Medicine has the advantage of being less risky than an unproved or under-proved western modalities, either pharmaceutical or surgical. While Chinese Medicine may not cure you, in most cases it will not harm you, which is more than you can say for allopathic treatments gone wrong.Soll22 (talk) 22:37, 9 February 2011 (UTC)
- I only put my experience here responding to Soll22" suggestion that I go to an acupuncturist. None of my edits are other than RS (except regarding confusion and ambiguity, which I deleted). Thanks for recommendation to Trick or Treatment, which I can not access yet. When that book uses the expression "acupuncture", does it refer to penetrating needles at TCM points, any penetrating needles, nonpenetrating stimulation of TCM points? Does credit due when it is due refer to credit for some kind of stimulation of one TCM point but not necesarily others, a credit of passing a .05 p-value in systematic review, no matter how tiny the .05 effect, or lasting releif compared to short-lived relief although not long eneough to matter much for outpatient treatment? Since I have heard good things about this book, I assume it clarifies all of these ambiguities. Similarly, I assume you mean by improvements are needed" that they are needed to make conclusions, not that you are suggesting a pressing need to spend money on improvements. Since I learned about MEDRS from you, I would like to get your take on my highly qualified wording designed to pass MEDRS in the "does it hurt" section. There are no secondary sources, but I worded it to pass MEDRS anyway, as the comments on painfulness are not primary studies, as the studies were not on painfulness, but were incidental to what the article is about. Peer medical and acupuncturist reviewers appear to let these comments be in the articles as if it is undisputed common knowledge, so did not edit the incidental comments out. PPdd (talk) 21:04, 9 February 2011 (UTC)
- I did go to an acupuncturist for pain, because a friend would not shut up until I did. I had pain due to a masively ruptured L5/S1 disc from my falling down a 100 verticle foot landslide, for which I received two neural surgeries for pain relief, after which I still had pain. You are right, the relaxed music and atmosphere was much better than an emergency hospital, as well as the time spent with me. But the honest acupuncturist told me that acupuncture's effects were, at best, very small, and would not help my severe pain, and referred me to a medical pain clinic for pharmaceutical treatment, without giving me acupuncture. PPdd (talk) 16:44, 9 February 2011 (UTC)
- well it seems like that kind of NPOV edit deals with a comparison of the two, not with one. There are fields of comparative science discussions which are defined as such. Discussing one particular field is not the same as a comparative discussion. The comparison elements must be agreed upon by everyone - acupuncture/pharmaceuticals, acupuncture interventions/surgery, etc. I also suggest, in the name of establishing a clear discussion, get an acupuncture treatment for the same complaint that you were attempting to treat with pharmaceuticals. I would assume that if you call up an acupuncturist and explain you are doing a personal experiment to establish the efficacy of an anti-emetic vs acupuncture treatment, they might give you a discount or even a free treatment. Otherwise most acupuncture schools offer discounted treatments in the school clinic, in most cities, under $30 a treatment, especially for financially disadvantaged, senior citizens or students. At the very least, most patients report a feeling of calm and relaxation by just being in an acupuncture office compared to an emergency room. I really do think that a personal experiment is in order, so YOU can have a clear idea. Since you know the inefficiency of some pharmaceuticals from personal experience, you can freely discuss it from that perspective. Your discussion of acupuncture does not have the same credibility because you freely mix sources and pov.Soll22 (talk) 15:41, 9 February 2011 (UTC)
Why can't the principles of TCM be researched like anything else in "allopathic" medicine? If an intervention is effective, that effect should survive blinding, randomization, large numbers of patients, statistical analysis and placebo controls. If it's not, we should see drops in "effectiveness" with every application of a test designed to remove a particular bias. Research is indifferent to paradigm, if something works, it works, and it should work irrespective of who is doing it and where it is being done. To think otherwise seems like special pleading. How do you know patients aren't simply getting better due to the passage of time and natural healing? Why do you attribute that healing to acupuncture? This is specifically problematic for back pain, which has essentially no evidence-based treatment beyond "avoid bed rest". Comparing acupuncture to "regular care" isn't setting the bar very high since "regular care" isn't particularly effective. That's like carrying a rabbit's foot because it's just as effective as reading your horoscope. You are correct in noting that something can work without us understanding the mechanism - but that's a reason to research the mechanism. But first we should check to make sure it actually works rather than assuming it does. You don't have to know how an SSRI works in order to demonstrate that it helps with major depression. Again, research and empirical evidence properly gathered are indifferent to the beliefs of the researcher.
Was the ice research based on TCM principles? Are all TCM principles equally supported? Why does conventional research "work" for that finding, but not for others - like acupuncture? Again, this looks like special pleading - research is great as long as it confirms something we already believed - otherwise let's ignore it. Has this work been replicated in humans, who aren't mice (the subjects of this particular study)? And since TCM is primarily a 'physical' treatment - aimed at disease and disability rather than mental illness, isn't your invocation of psychiatry an inappropriate comparison? Why is TCM less risky? Particularly given things like contamination [32], [33], adulteration, [34], as well as delays in treating serious conditions. TCM may, or may not cure you, but if something carries risks but doesn't work, why use it? If it carries risks but it is uncertain whether it works, why prescribe it before confirming it works? If something carries no risks, why believe that it works - all effectively demonstrated interventions have predictable dose-response curves that at the extreme top-right end in toxicity. An intervention that has no adverse effects at any dose suggest it has no effect period.
PPdd, TorT does indeed address many of these points. I got my copy from the library. It's time well spent. WLU (t) (c) Wikipedia's rules:simple/complex 03:20, 10 February 2011 (UTC)
- Libraries are second only to deserts and botanical gardens as my favorite places. Used book stores smell pretty good, too. PPdd (talk) 03:42, 10 February 2011 (UTC)
Famousdog's plethora
Famousedog wrote, "the plethora of acupuncture systems means that pretty much any point on the body has some 'significance'." Famousdog's "point" ("ambiguous points?") is a good one, and if anyone has RS on this, it certainly belongs in the article, since it will bring MOS consistency to the various sources cited, and make the article readable. PPdd (talk) 14:40, 10 February 2011 (UTC)
Proposed NPOV theme to keep in mind when editing this article
After reading some of the vast talk page discussions, I have found an underlying theme for the article that will likely make most, if not all, POV’s happy. The following is, for the most part, solely based on RS from the article.
- Acupuncture is a medical practice of inserting needles.
- It was founded before the scientific method and discoveries in medical related sciences such as human anatomy, human physiology, cell biology, and physics.
- Like other pre-scientific medical systems aroung the world, it was based on astrological and other supernatural beliefs, and possibly empirical anecdotal evidence and trial and error evidence.
- It has survived in large part, due to a cultural respect for authority and tradition in China.
- It may also have survived in par, by having some effectiveness, and some acupuncturists point to its survival for so long as possible evidence of this claimed effectiveness.
- The efficacy is small or short-lived enough that, if it exists, it has been difficult to detect using scientific methods.
- Any medical practice that goes on for thousands of years may evolve further by successful trial and error, but this evolutoin has been hampered by a cultural resistance to change in China, as with science in Europe under the authority of the church.
- It is not unreasonable to believe that such trial and error evolution, however slow, might stumble upon some real cause and effect relationship.
- Huge debates have occurred due to the supernatural initial basis, lack of scientific methodology, lack of clear anatomical basis for acupuncture points, and ambiguous and shifting meaning of “acupuncture” and terms related to testing its efficacy.
- Additional debates are about how to scientifically and ethically design rigorous studies, and whether it is worth spending limited medical research funding searching for an effect.
- One scientific basis proposed by believers in acupuncture is that stimulation of one or more points on the body might have effects through a body wide anatomical neurotransmitter release or similar extended structure, and that thes points might have been stumbled upon by trial and error, over thousands of years of very slow evolution of acupuncture methods.
- A question for further research is whether, if such a structure exists, new methods, or points triggering the structure can be found that increase the level of efficacy.
- Whether or not expenditure of limited medical research funds is justified, is highly disputed.
- Just as some skeptics scoff at the superstitious, mystical, or prehistoric basis of acupuncture, some acupuncturists scoff at contemporary science's narrowminded and egocentric views about the possiblity of nonphysical "energies" not yet detected at our time, simlilar to behaviorists' narrowminded rejection of the existence of a "mind", now effectively utilized in cognative psychology.
I think most, if not all, POVs will agree with everything in the above summary. As far as I can tell, there is not much else going on in the article. PPdd (talk) 17:34, 9 February 2011 (UTC) Note- So as not to take up alot of space, I am modifying the above as comments come in, responding to them, so if I incorporate your good comment, your comment might look inane to new comers when in fact it was the opposite.
- Please be cautious. Keep in mind that a lead here isn't the same as an introductory section or paragraph elsewhere. It follows strict rules and is based on the content of the article, regardless of how stupid that might make the lead appear. Read WP:LEAD. If a lead looks dumb, then it may not be written properly, or the article may not cover the subject properly. Fix the article first, then tweak the lead, never the other way around. Each word, phrase, and sentence in a lead should have a parallel in the body of the article, preferably in the same order they appear in the article. While not absolutely necessary (it would be nice to avoid it...), references are often necessary in the lead. I like to keep the main ref (long version) in the body and only use the short "name" version (<ref name=blabla/>) in the lead. This basically demonstrates the primacy of content in the body, and that the lead is only following and copying content and refs from the body. It should ALWAYS be in that order.
- I have a subpage that gives some tips: How to create and manage a good lead
- Trying to completely redo a lead is more often than not a very controversial thing to do and usually not worth it. It is better to tweak it according to new content that's been added to the article, or if one finds that very significant matter in the article isn't mentioned in the lead, then add short mention in the lead. Otherwise try to refrain from rewriting leads unless there is extremely good reason for doing so. This is one of the most common mistakes made by newbies who read the lead and think "that's not good enough" or "that's not true" or "that doesn't describe or sum up the topic completely". The last one is based on an erroroneous understanding of the definition of a "lead" here at Wikipedia. The lead isn't supposed to sum up or define the topic. It is supposed to sum up the content of the article, and should include a definition that is based on the content, not on definitions found elsewhere. IOW we create our own definitions here. Yes, we should include definitions in the body from other RS (thus justifying using them in the lead), but we often end up with our own definitions that are a combination of other definitions and facts from the article. On very comprehensive and well-written articles, because of our NPOV policy our own definitions end up being the best on the internet because they define the subject from all notable angles. -- Brangifer (talk) 18:08, 9 February 2011 (UTC)
- You are likely correct, so I withdraw suggesting a change in lede (and deleted this from my section title above so noone else wastes time reading that part.) However, I believe that the themes in the above are a good NPOV approach to further editing the article, as edits they will likely be acceptable to all POVs and not be contested at talk if it is kept in mind. PPdd (talk) 18:29, 9 February 2011 (UTC)
- I do not read that as a good lead and it is one that exemplifies what I see as not-so-subtle POV push. PPdd, I really mean this as a constructive criticism, not a blank criticism - on articles like this it is hard to avoid letting bias creep in, and the policy in question, NPOV, is not an obvious beastie. Acupuncture is the practice of inserting needles for medical purposes. Flatly, that's your opening sentence. The one you propose is already loading in what the points are based on, that it's not based on science, that it's only based on superstition, that it's only kept because people are stupid and dislike change, that there's no anatomy and the subtext really comes across as "ONLY STUPID PEOPLE BELIEVE IN ACUPUNCTURE!!!!!!!" You're putting far, far too much emphasis on the scientific aspects and basis of a cultural practice. Science is important, but it is an aspect of acupuncture, not the whole of it. The previous version was 1-3 pagaraphs on what acupuncture was, and one paragraph on the research behind it. That is a good balance for me, it makes sense, is encyclopedic, and fairly describes the process before going on to bash the evidence base. If you look at blatant quackery like homeopathy, it still gives lots of descriptive information. If you look at historical practices like bloodletting - again it focuses on description. The difference between the two is one is a historical curiosity, while the other is still being used today. But no matter what, an encyclopedic entry describes rather than debunks. Your efforts to improve the page are appreciated and obviously sincere, but in my opinion as an experienced editor, you are going too far in one direction. WLU (t) (c) Wikipedia's rules:simple/complex 20:17, 9 February 2011 (UTC)
- I am in agreement with WLU. There are major problems with the approach that all stem from the building of Acupuncture as a straw man waiting to be flamed by biomedicine. The tone of the article as a whole is far more inveighed than the corresponding page on Chiropractic, which is a CAM that is equally poorly researched. And it is not even a distant relative of the french wiki page. Can we please use these as templates for the future of the Acu page? Was not the "previous version" the one I had drawn up? If so, can somebody please resurrect that and properly format it? I have been appropriately warded off editing the main page. Luke643 (talk) 21:32, 9 February 2011 (UTC)
- Luke643, try editing in the article body, and not the lede, and your edits that meet MEDRS will likely stick, and then be incorporated into the lede, which is supposed to sum up things in the article body. The above comments were utilized and incorporated in the proposal above, which was changed accordingly. PPdd (talk) 22:07, 9 February 2011 (UTC)
- To be clear - I think PPdd's edits and what is essentially commentary on acupuncture would be incredibly valuable to any research study or review article regarding acupuncture. I just think they're inappropriate here. Think of it this way - imagine you know nothing of acupuncture. What would you want to know? Would you want to know, immediately, that it's not scientifically mainstream or supported? Or would you want to know what it is, where it comes from, and that its scientific status is contested? Example - I know essentially nothing of Chinese opera. When I go to the opera page, I want to know what Chinese opera is, what is its history, and at the end, I would be interested in reading about its reception in other cultures. I know essentially nothing of calculus. When I go there, I want to find out what branch of math it is in, its purposes and uses, and at the end, that's when I want to know whether there are significant disputes over its uses or theories. Always remember we are an encyclopedia - we inform and reflect the contemporary. We do not outpace it. We are not a crystal ball. WLU (t) (c) Wikipedia's rules:simple/complex 02:53, 10 February 2011 (UTC)
- I am trying to write for what someone would like to know, other than me. Personally I skip to the history section of articles, because I like history. I am also in the 10% minority who reads the yellow pages phone book alpabetically (before internet, at least), and don't read the ads (I am guessing, WLU, you are in that same 10% minority.) But 90% just read the ads and look at the pictures. Per MEDRS, "Wikipedia's articles, while not intended to provide medical advice, are nonetheless an important and widely used source of health information". I think a typical reader of a medical article, is probably a person ignorant enough of medicine to bother considering acupuncture (after reading 2009 Cochrane, I would even try it for post op nausea, now.) Also ignorant enough to go first to Wiki (Just kidding, as everyone gripes about "anyone can edit", yet goes to Wiki first, like I do.) I expect a typical user would want to first know how much it hurts, then how much it costs, then would want to read only a short paragraph about what it is, then read another short paragraph about what the medical community thinks of its effectiveness, and if still interested, read about how significant its effects are. Then if I was still interested, I would want details about its effect on my particular condition. This does not typify WP users of articles other than medical ones. PPdd (talk) 03:24, 10 February 2011 (UTC)
- To be clear - I think PPdd's edits and what is essentially commentary on acupuncture would be incredibly valuable to any research study or review article regarding acupuncture. I just think they're inappropriate here. Think of it this way - imagine you know nothing of acupuncture. What would you want to know? Would you want to know, immediately, that it's not scientifically mainstream or supported? Or would you want to know what it is, where it comes from, and that its scientific status is contested? Example - I know essentially nothing of Chinese opera. When I go to the opera page, I want to know what Chinese opera is, what is its history, and at the end, I would be interested in reading about its reception in other cultures. I know essentially nothing of calculus. When I go there, I want to find out what branch of math it is in, its purposes and uses, and at the end, that's when I want to know whether there are significant disputes over its uses or theories. Always remember we are an encyclopedia - we inform and reflect the contemporary. We do not outpace it. We are not a crystal ball. WLU (t) (c) Wikipedia's rules:simple/complex 02:53, 10 February 2011 (UTC)
- Luke643, try editing in the article body, and not the lede, and your edits that meet MEDRS will likely stick, and then be incorporated into the lede, which is supposed to sum up things in the article body. The above comments were utilized and incorporated in the proposal above, which was changed accordingly. PPdd (talk) 22:07, 9 February 2011 (UTC)
- I am in agreement with WLU. There are major problems with the approach that all stem from the building of Acupuncture as a straw man waiting to be flamed by biomedicine. The tone of the article as a whole is far more inveighed than the corresponding page on Chiropractic, which is a CAM that is equally poorly researched. And it is not even a distant relative of the french wiki page. Can we please use these as templates for the future of the Acu page? Was not the "previous version" the one I had drawn up? If so, can somebody please resurrect that and properly format it? I have been appropriately warded off editing the main page. Luke643 (talk) 21:32, 9 February 2011 (UTC)
This may be part of the problem. By writing to yourself rather than to the WP:P&G (and WP:MOS) you are constructing an article that is more meaningful to you, but you are moving it away from it's purpose as an encyclopedia. It's becoming more like Yahoo answers than Brittanica. Put another way, wikipedia is an encyclopedia, and not a how to manual. A typical user may want to know that stuff - but we are not aimed at a user. We are aimed at someone seeking knowledge of a topic. Think more in terms of someone who encounters the topic in a novel, and wants to understand what's going on. Think in terms of an alien, discovering a printed copy of the article 1,000 years after all human life has been eliminated. Think less like someone trying to prove something, and more like someone trying to explain something. Though information like "does it hurt" is important, it is not section-heading important. It's something you integrate into a description of a typical session, or perhaps adverse effects (along with the myriad other ways acupuncture feels). Remember that our audience is as broad as possible - not just users. The information should be organized rationally, to develop over time. For me, that means history to typical treatment to research - and not front-loading a whole bunch of information on why research is hard and why definitions are slippery into the first section after the lead. Acupuncture is essentially the insertion of needles according to tradition. The fact that there are many traditions that come later and that tradition and science do not match up and that you can really define half-a-dozen different types of "acupuncture" from a research-perspective specifically is useful and appropriate, but it should come later. The fact that efficacy has multiple meanings in research alone is interesting, but less relevant here. The fact that the efficacy of acupuncture in research can be defined differently is also interesting - but clearly, in my mind, goes in the research section. Immediately after the lead - should you really see a section on placebos? If you were writing an article about aspirin, would you start with placebos? I would start with willow trees. Medical acupuncture that ignores all traditional theory is quite new, and nowhere near as well-known as traditional acupuncture. Even most doctors would be hard-pressed to say what the difference is and why it is important. Maybe later it will form a substantial potion of the page, but that is for later.
I realize I keep harping on this with a large amount of italics, but that is because I strongly, strongly believe the current setup is not helping readers, it is inserting them directly into a very complicated and nuanced view of the research on acupuncture before the discussion of what it actually is. All my experience as an editor keeps reading the section order as wrong, as listing everything that is wrong with acupuncture and acupuncture research well before it ever talks about simple acupuncture. Even read the current lead - it discusses what it is and traditional beliefs before going into medical efficacy. TCM may put the cart (it works) before the horse (so why test it), this puts the bridle, reins and blinders six feet in front of the horse with the cart still in the barn and everyone is walking to town. WLU (t) (c) Wikipedia's rules:simple/complex 04:30, 10 February 2011 (UTC)
- I wish I had more time to devote to this. I think it is absolutely right that the acupuncture page not be dominated by criticism. But I think it is even more important for the actual discussion of the defined (in acupuncture texts) contents of acupuncture be accurately represented. The concept that I have harped on - rivers and astrology - is just one. When I have more time I will begin - incrementally - approaching some of the other incorrect information. Again, let's use either the chiro page in english, or the french Acu page as guidelines to a truer encyclopaedic entry.Luke643 (talk) 04:58, 10 February 2011 (UTC)
- Agreed that the "definitions" section should be broken up into small pieces, with each parts to go into sections just before the terms are first used. It came out as a chunk because I made a list as I read each of the different usages in the article, trying to make sense of things, originally assuming MOS consistency, but not finding it.
- Agreed "does it hurt?" should go into the practice section. It also needs RS for claims that it does not usually hurt, or that people get used to it, or find it relaxing, All the MEDRS sources cited in the article on this were from proponents, and so not MEDRS, for this medical assertion.
- I moved the history to the bottom only because it was less about acupuncture than about its history. I actually like reading history first. But I speculate that most who want to know what acupuncture is, either want to know about its practices and theory, or about what it is from an objective science perspecive.
- Agreed the lede structure is good, and the article structure should follow it.
- Regarding "all my experience as an editor", you have made 45,000 edits in 4.5 years. Whew! PPdd (talk) 05:15, 10 February 2011 (UTC)
- I'm in agreement with WLU here. I think PPdd is being far too prescriptive. At the end of the day, this is an encyclopedia article, not a feckin' book about acupuncture. We simply can't cover all sub topics of this already very broad topic. Something has to give. Famousdog (talk) 14:00, 10 February 2011 (UTC)
- Luke, there are sources to support the contention that acupuncture is based at least in part on geography and astrology, and not on an objective examination of human anatomy. I believe the Chinese forbade the dissection of cadavers. If you have other sources that substantiate another origin to acupuncture points and meridians, feel free to integrate them as an alternative explanation that can share space. Keep in mind that when popular versus scholarly sources "compete", scholarly always wins. In this case, historical reviews of the topic would take precedence over even medical journals. With a topic like acupuncture, with a prescientific and ideological rather than empirical base, there will almost certainly be divergence in sources and opinions. There is no "one" acupuncture and we should do our best to summarize all of them honestly. Unfortunately, that diversity makes the page harder to work with.
- Also, please stop comparing this page to other pages. Unless it is a featured article, other pages are irrelevant. Always look to the policies and guidelines instead. Unfortunately there are a lot, but any good editor should be able to point you to some sort of guidance (if you have questions, you may try edior assistance).
- PPdd, it's reasons like this that I suggested working on a subpage, and still do think that is a good idea to take. Keep in mind that all changes are live, so if you have made a change to the main page that substantially worsens it, it shouldn't be there. Sub pages, you can have works in progress, utter shit, scratchpad ideas or a roughly-polished gem and it doesn't matter. If you tell other editors about it, they can edit there as well to work towards a consensus version while keeping the previous flawed but at least more polished version in mainspace. If you are making any substantial changes to a page, particularly if it is in content or tone rather than structure, and doubly-particularly if it is a busy or high-profile page, a sub-page may be the way to go. You've made probably close to a hundred changes of major and minor nature, with singificant impact. It's probably too late to do so for this page, but in the future it is something to think about. Subpages are easy to set up and work just like a regular page with an edit history, full ability to implement codes and use templates, etc. Once you've got a final version you can simply cut and paste.
- Yes, we do need a source for the rather surprising fact that stabbing someone with a needle doesn't necessarily hurt. The history of acupuncture is integral to the overall context of acupuncture, I would still prefer it coming immediately after the lead but we can always do a more formal section on the page order. I agree that it is a judgement call whether history comes before practice and theory. You've got it backwards regarding the lead though - lead always follows body. If your lead and body are out of synch, the lead should be changed to reflect the body. It should be the last section of a page you edit.
- As far as my experience, I've never successfully broken the top 500. WLU (t) (c) Wikipedia's rules:simple/complex 15:24, 10 February 2011 (UTC)
- WLU - anatomy and points/channels: The source that is most important is the Lingshu (2nd part of huangdi neijing) and as I have explained it says nothing about the origins of the points at all, let alone basing them on geography. In warring states writing style (the style of the lingshu) the forming of logical argument was based on correlation and similarity joining seemingly unrelated phenomena. So, in the lingshu, which is absolutely the text that must be used to determine such concepts, as it is the fundamental text on the practice, we only are told that there is a neat correspondence to the 'natural' land forms (not just rivers, but mountains as organs, etc) and the flow of the calender year (not astrological, but temporal). So again, using this rhetorical device to suggest origin is patently wrong. If you use later astrological suggestions from other sources (where are these sources?) then they must be trumped by the Lingshu. And I assure you they are outliers. Nowhere in the training grounds of american acupuncturists will it be taught that the points/channels are based on rivers/astrology. It is definitely a straw man setup for discrediting the practice based on naive (and incorrect) translation/analysis of the lingshu.
- as for dissection - i have to find my sources, but there was a some surgery going on in the warring states period. It was not proscribed until much later. The important part of the anatomical discussion here is that points and channels developed from palpation and massage practice, not from basis on cosmological models. The cosmological models of the lingshu didn't exist until late warring states period anyway, therefore the anatomical position of the points of acupuncture well precede these models.
- Lastly, I brought those pages in as comparisons in form. Why is it not useful to compare? A side note: the dutch and german acu pages resemble the french closely. It is my feeling that our lede therefore is not consistent with common practice in europe.Luke643 (talk) 17:05, 10 February 2011 (UTC)
- Sources are required, not assertions. An actual ancient Chinese text would be for one thing illegible for most readers and for another a primary source. If there is a source regarding acupuncture and astrology (a quick look says there is, but I'm not sure about the quality), it stays in. Merely being old isn't sufficient to discount later ideas, since ideas develop over time. If an actual analysis could be found, if it notes that the original beliefs about acupuncture didn't use astrology but later beliefs did, that is the information we put in. But overall - sources. If you want to say the astrology and geography relations to acupuncture were meant to be metaphorical or rhetorical, source it. My guess would be American acupuncturists aren't trained regarding the astrological and geographic significance of acupuncture points because a) it's far more obvious superstition than qi and b) much of that was purged when the book on acupuncture was literally rewritten by Mao's medical teams.
- Note that surgery isn't the same thing as dissection. Barbers in Europe undertook much surgery, but that didn't really help them discover much about the body. If points and meridians developed out of massage - source it.
- Note as well that other language wikipedias may have different policies, and almost certainly different sources, than English wikipedia. Here we follow the policies and guidelines, not examples of other pages or other wikis. WLU (t) (c) Wikipedia's rules:simple/complex 03:13, 11 February 2011 (UTC)
- @WLU: Your reply is simply straw man. Other-language wikis (if the articles are good) can help avoid WP:UNDUE violations, which only topic expertise can accomplish. This is useful for editors, like you and PPdd and most others here, who have no topic expertise but forge ahead anyway, making the article worse and worse IMO, almost comically so (which is why I have encouraged you both to continue, as performance art). Matuk below doesn't even warrant mention: s/he is not an expert on the subject. Ever heard of Paul Unschuld? He's the foremost scholar of the history of medicine in China. Much better than that joke of a source from Matuk. --Middle 8 (talk) 14:02, 12 February 2011 (UTC)
- No, other language wikis have different rules than us, and therefore can not serve as a model - we always use the policies and guidelines. Despite being linked through the Wikimedia Foundation the individual rules and guidelines are generated by the editors, and bar legal restrictions exerts no oversight role - certainly not regarding content. Other wikis, being user-generated content, are not reliable sources and therefore can't be used as references. Topic expertise on the other hand, is indeed a red herring. Topic experts should have access to sources, thus their expertise is unnecessary except for being able to provide and interpret them in plain language - which any editor can do given time and a library. Please also see the Essjay controversy. In addition, while independent scholars may look at an entire field, even while specializing in a sub-section, practitioners like yourself and Luke are more likely to specialize in one type of acupuncture and have far less information on the history (and in particular historical controversies) in addition to having an ideological and financial stake in the argument. Also note that reliability doesn't come in the form of expertise, it comes in the form of reputation for fact checking. Unschuld and Matuk are both eligible for use as sources based on their ability to publish in peer reviewed journals and scholarly books, not on the basis of name recognition. The only time name matters is when we are citing an opinion from a nonreliable source where the expertise of the person makes their opinion relevant, but that generally will not occur on something like acupuncture because of the large number of actually reliable sources available. Opinions from personal webpages are generally only used for fringe topics. Mainstream topics require actually reliable sources. If Unschuld has something to say, feel free to cite him. WLU (t) (c) Wikipedia's rules:simple/complex 18:09, 12 February 2011 (UTC)
- @WLU: Your reply is simply straw man. Other-language wikis (if the articles are good) can help avoid WP:UNDUE violations, which only topic expertise can accomplish. This is useful for editors, like you and PPdd and most others here, who have no topic expertise but forge ahead anyway, making the article worse and worse IMO, almost comically so (which is why I have encouraged you both to continue, as performance art). Matuk below doesn't even warrant mention: s/he is not an expert on the subject. Ever heard of Paul Unschuld? He's the foremost scholar of the history of medicine in China. Much better than that joke of a source from Matuk. --Middle 8 (talk) 14:02, 12 February 2011 (UTC)
- In determining the origin of the points, the Lingshu is the source, so a proper reading is important. Secondary sources, such as the Deadman Manual of Acupuncture back up my assertions, mentioning absolutely nothing of astrology, and suggesting instead that the points were unsystematically developed, based on massage and other physical practices. Moreover, the secondary source that is used on the page currently is the piece by Camilla Matuk, (who has a graduate degree in biomed comm). Her statements are underpinning the assertion that points and channels are BASED on astrology and geography, and they are based on her reading of the Lingshu (page 6 of her paper). She uses no other source, and there is no other source for this stuff on our page. Matuk is clearly not qualified to be reading classical chinese, nor assess the meaning of classical chinese texts. Additionally, the piece is about illustration of western and chinese medicine! Therefore at the very least this information should be removed, or re-sourced by an acceptable source, preferably written by a specialist in Chinese Medical history. I have presented you with my own expertise in terms of the lingshu, and that should be enough to remove the matuk info. If I cannot use my reading of the Lingshu as a basis for putting content onto the page (which I am entirely in agreement with), neither should the user of Matuk, whose sole source for the statements are, you guessed it, the Lingshu.
- I'm in agreement with WLU here. I think PPdd is being far too prescriptive. At the end of the day, this is an encyclopedia article, not a feckin' book about acupuncture. We simply can't cover all sub topics of this already very broad topic. Something has to give. Famousdog (talk) 14:00, 10 February 2011 (UTC)
As far as replacing it with more accurate content on the origin of the points, I point you to the Deadman, as I said it is the industry standard for point and channel theory in America.
- fair play on surgery vs. dissection. And I simply do not have time to look into this part. and fair play on the different guidelines and such. and your recent changes have brought us far closer to the Chiro page, so I am much happier with the state of the lede in form, if not content. Luke643 (talk) 06:40, 11 February 2011 (UTC)
- I found a reference to dissections in China, page 144 of this -
- John Z. Bowers, Proceedings of the American Philosophical Society, Vol. 117, No. 3 (Jun. 15, 1973), pp. 143-151, Published by: American Philosophical Society, Article Stable URL: http://www.jstor.org/stable/986539
- Bowers also discusses the origins and theory of the channels and points. He mentions nothing of astrology or geography, also page 144. The piece is hardly friendly toward Acupuncture, but it is very well researched for the time. This should be sufficient to eliminate the Matuk-sourced information.
- Given the date on that paper I'm not hugely surprised. China was just starting to open up to the West at that point, there would have been minimal access to most historical sources, and acupuncture had gone through Mao's "barefoot doctor" revolution less than 20 years before. The fact that this one source does not mention this hypothesis is not reason to remove it. This source can be used to supplement the information in the page, but since it does not specifically discuss the relationship between acupuncture and astrology, it doesn't impact that aspect of the page. There are other sources that make the point. I wouldn't use that source to reference the page, but I would use this one, if I can get my hands on it. WLU (t) (c) Wikipedia's rules:simple/complex 12:06, 11 February 2011 (UTC)
- His source is a book on Chinese Astrology for one reference, and his second is an article on pulses in early chinese documents which says "it is commonplace understanding that the acupuncture body is a microcosm of the known universe, a metaphor for structures that early Chinese found in Heaven and Earth." Surely this language is clear enough to support my reading and not the current page's reading. The Chinese Astrology book should not be considered as a useful source on Acupuncture. Again, Acupuncture texts should be considered as the theoretical basis for Acupuncture. If we use another of Kavoussi's references as our source, L'Acuponcture Chinoise by Georges Solie De Morant, another foundational western text, we find no statements as to the origiin of points, other than a reference to the Lingshu correlation with the days of the year (correlation, not origin from) and reference to another text which only had 338 points. He then goes on to say on page 21, in a subsection titled "What do the Points connote to the Chinese?" in which he quotes a chinese encyclopedia which calls the points, that the points are "important, sensitive areas of the human body." Another encyclopedia he quotes says this, "energy and blood circulate in the body through the meridians and secondary vessels by moving across hollow spaces;" There is no suggestion in his sources of astrology or geopgraphy.Luke643 (talk) 15:52, 11 February 2011 (UTC)
- Also, the Houvassi excerpt has a sub-heading "science based medicine", with a keyword association titled "quackary exposed." This is problematic, as I have explained. Building up the origin of the points and channels as astrological and geographical is a rhetorical device designed to discredit the practice by attributing to it language that is considered superstition. Why are we giving this bias such a prominent voice on the page? — Preceding unsigned comment added by Luke643 (talk • contribs) 16:02, 11 February 2011 (UTC)
- His source is a book on Chinese Astrology for one reference, and his second is an article on pulses in early chinese documents which says "it is commonplace understanding that the acupuncture body is a microcosm of the known universe, a metaphor for structures that early Chinese found in Heaven and Earth." Surely this language is clear enough to support my reading and not the current page's reading. The Chinese Astrology book should not be considered as a useful source on Acupuncture. Again, Acupuncture texts should be considered as the theoretical basis for Acupuncture. If we use another of Kavoussi's references as our source, L'Acuponcture Chinoise by Georges Solie De Morant, another foundational western text, we find no statements as to the origiin of points, other than a reference to the Lingshu correlation with the days of the year (correlation, not origin from) and reference to another text which only had 338 points. He then goes on to say on page 21, in a subsection titled "What do the Points connote to the Chinese?" in which he quotes a chinese encyclopedia which calls the points, that the points are "important, sensitive areas of the human body." Another encyclopedia he quotes says this, "energy and blood circulate in the body through the meridians and secondary vessels by moving across hollow spaces;" There is no suggestion in his sources of astrology or geopgraphy.Luke643 (talk) 15:52, 11 February 2011 (UTC)
- Given the date on that paper I'm not hugely surprised. China was just starting to open up to the West at that point, there would have been minimal access to most historical sources, and acupuncture had gone through Mao's "barefoot doctor" revolution less than 20 years before. The fact that this one source does not mention this hypothesis is not reason to remove it. This source can be used to supplement the information in the page, but since it does not specifically discuss the relationship between acupuncture and astrology, it doesn't impact that aspect of the page. There are other sources that make the point. I wouldn't use that source to reference the page, but I would use this one, if I can get my hands on it. WLU (t) (c) Wikipedia's rules:simple/complex 12:06, 11 February 2011 (UTC)
- Bowers also discusses the origins and theory of the channels and points. He mentions nothing of astrology or geography, also page 144. The piece is hardly friendly toward Acupuncture, but it is very well researched for the time. This should be sufficient to eliminate the Matuk-sourced information.
- John Z. Bowers, Proceedings of the American Philosophical Society, Vol. 117, No. 3 (Jun. 15, 1973), pp. 143-151, Published by: American Philosophical Society, Article Stable URL: http://www.jstor.org/stable/986539
- I found a reference to dissections in China, page 144 of this -
Who is "he" in these cases, Kavoussi or the references he is citing? Also, no source claims exclusive rights to determine a page's contents - though comprehensive and respected sources are extremely useful, can be used dozens of times in an article and can be the reference for the majority of a page, that doesn't mean it is the only source and all information included in the page must respect or duplicate it. If it is a minority opinion, we can note a minority opinion.
If the Chinese astrology book is a reliable source (solid publisher) and explicitly mentions acupuncture, it is a valid inclusion. The fact of the matter is, as a prescientific intevention we would not expect to see correspondence to objective facts. It's natural to anticipate multiple explanations for various features of the intervention. I would not support saying acupuncture points are only based on astrology, provided there are sources stating the points are based on something other than astrology. I have to gather and read the sources before I can give an opinion on specific issues, but you must realize that "netural" does not mean "favourable" and merely because a source presents a strong opinion does not mean it can't be used. If it is a minority opinion it should be attributed, not removed. WLU (t) (c) Wikipedia's rules:simple/complex 19:10, 11 February 2011 (UTC)
- @WLU - "The fact of the matter is, as a prescientific intevention we would not expect to see correspondence to objective facts" - that's a really good point! That's why, prior to the scientific revolution, people had no idea how agriculture worked, or how to make tools, or how to use medicinal herbs (especially that, since they didn't have controlled studies, so herbs didn't work back then), or really, ANYTHING. It sure was a drag that people couldn't "see correspondence to objective facts" or pass any knowledge on to subsequent generations, since subsequent generations are objective. It's sad, but without the Flying Spaghetti Monster's frequent interventions, humans would have gone extinct repeatedly until His Noodly Monsterhood decided to invent Newton, Pascal, Joule, and all the other SI units (SI meaning "Science is Invented!", by FSM, of course). Your insight is certainly.... a remarkable one, and any conclusions that editors derive from it should be treated accordingly. By the way, just because I'm sometimes sarcastic doesn't mean I'm not constructive (cf. your mean removal of my comment). What is the rebuttal of silly, illogical ideas if not constructive? Well, I admit it's not very constructive in wikiality-land. Sorry about that, for any adherents. --Middle 8 (talk) 14:02, 12 February 2011 (UTC)
- That's a straw man. People could use tools without knowing how they worked, science allows you to determine how they work and how to make them work better. Witness the massive explosion in food production, the existence of effective medicine and treatments for things such as infections, cancer, pain control and nutritional deficiencies, versus the salination of the soil in Mesopotamia, the massive die-off of New World Indians after the appearance of smallpox, and the fact that we had to develop antibiotics and vaccination because herbs were, at best, marginally effective if they worked at all. Many of those herbs were chosen because they looked like the organ they were supposed to treat. Humans were no smarter or dumber than we are now, but we now have a methodology that places emphasis on data and bias-correction. Previously, much of that "smartness" was turned towards unprovable religious ideas and attempting to justify the wisdom of ages past.
- When your comments are solely dedicated to baiting and mocking other editors, and not towards improving the page, then no, your comments are not constructive. Frankly, I'd spend less time on this page pointing out the flaws in the reasoning presented if editors actually used sources rather than arguments. I dislike having to deal with edits to the main page justified by nothing more than "that's not what acupuncture/homeopathy/herbal medicine is". The only reason I spend time doing this is because it tends to result in fewer edits to mainspace by editors who come in convinced of the efficacy of their particular intervention having never considered the actual evidence for it or possible explanations for said evidence.
- So yes, I am justified in removing the last in a series of sarcastic comments. If you are frustrated by editing wikipedia and your inability to substantiate your points through reference to reliable sources, that's not my problem. But when you waste time and storage space on cute, annoying little comments that can never improve the main page, that is my problem. Wikipedia is not therapy. Stick to the topic at hand, provide specific references, cite specific problems, and above all, accept that a pro-acupuncture page is not necessarily a good acupuncture page. There is debate, there's not much good evidence, and this should be recognized. If you don't like wikipedia, feel free to start Acuwiki, move over to Citizendium or complain all you want at Wikipedia Review. Just don't do it here. WLU (t) (c) Wikipedia's rules:simple/complex 18:09, 12 February 2011 (UTC)
- @WLU: your comment about therapy is strange. The most therapeutic moment I ever had with WP was realize that the less time I spent with it, the better. The only evidence its proponents can point to that it matters is the same argument that astrology columns and superstitious scriptures use: "N million readers who don't know any better can't be wrong", in effect. My comments are just as relevant as anything here; if you don't like what I write, go start an organized whine about it. --Middle 8 (talk) 05:32, 13 February 2011 (UTC)
- Allow me to be clearer - if you find editing wikipedia frustrating, then rather than making sarcastic jibes please take a break. Your substantive comments may be relevant, but comments like these don't help anyone. They are not relevant, they add to the acrimony of the page, they are uncivil and they are very much not in keeping with the talk page guidelines. WLU (t) (c) Wikipedia's rules:simple/complex
- Hi WLU (I think) - No, I don't find editing WP frustating; I find WP itself amusing and silly (except for TV shows and stuff like that, where it's really good). I think my comments that you diff'd above actually are helpful, though I think we can agree that they are not helpful to you. And that's OK; you should definitely ignore my comments if you don't like them. I'm not that active anyway, so there's not much "there" there. Enjoy your editing. (90% of Satanic ritual abuse? Wow! That's a lot of work.) --Middle 8 (talk) 04:05, 14 February 2011 (UTC)
- You are very active on this page, and your comments are aggravating, frustrating and make the talk page more acrimonious. I find your comments diffed above to be uncivil, baiting, and serve no purpose in the improvement of the page, and doubt anyone else finds them helpful, though I am sure it feels very satisfying to write them. But that is not the purpose of the talk page, or wikipedia. I fail to see how sarcasm and false praise helps anyone. Please stop it. WLU (t) (c) Wikipedia's rules:simple/complex 18:03, 15 February 2011 (UTC)
- Hi WLU (I think) - No, I don't find editing WP frustating; I find WP itself amusing and silly (except for TV shows and stuff like that, where it's really good). I think my comments that you diff'd above actually are helpful, though I think we can agree that they are not helpful to you. And that's OK; you should definitely ignore my comments if you don't like them. I'm not that active anyway, so there's not much "there" there. Enjoy your editing. (90% of Satanic ritual abuse? Wow! That's a lot of work.) --Middle 8 (talk) 04:05, 14 February 2011 (UTC)
- Allow me to be clearer - if you find editing wikipedia frustrating, then rather than making sarcastic jibes please take a break. Your substantive comments may be relevant, but comments like these don't help anyone. They are not relevant, they add to the acrimony of the page, they are uncivil and they are very much not in keeping with the talk page guidelines. WLU (t) (c) Wikipedia's rules:simple/complex
- @WLU: your comment about therapy is strange. The most therapeutic moment I ever had with WP was realize that the less time I spent with it, the better. The only evidence its proponents can point to that it matters is the same argument that astrology columns and superstitious scriptures use: "N million readers who don't know any better can't be wrong", in effect. My comments are just as relevant as anything here; if you don't like what I write, go start an organized whine about it. --Middle 8 (talk) 05:32, 13 February 2011 (UTC)
- @WLU - "The fact of the matter is, as a prescientific intevention we would not expect to see correspondence to objective facts" - that's a really good point! That's why, prior to the scientific revolution, people had no idea how agriculture worked, or how to make tools, or how to use medicinal herbs (especially that, since they didn't have controlled studies, so herbs didn't work back then), or really, ANYTHING. It sure was a drag that people couldn't "see correspondence to objective facts" or pass any knowledge on to subsequent generations, since subsequent generations are objective. It's sad, but without the Flying Spaghetti Monster's frequent interventions, humans would have gone extinct repeatedly until His Noodly Monsterhood decided to invent Newton, Pascal, Joule, and all the other SI units (SI meaning "Science is Invented!", by FSM, of course). Your insight is certainly.... a remarkable one, and any conclusions that editors derive from it should be treated accordingly. By the way, just because I'm sometimes sarcastic doesn't mean I'm not constructive (cf. your mean removal of my comment). What is the rebuttal of silly, illogical ideas if not constructive? Well, I admit it's not very constructive in wikiality-land. Sorry about that, for any adherents. --Middle 8 (talk) 14:02, 12 February 2011 (UTC)
- The He was Morant I believe. If you were looking at the bit about morant. The astrology book, along with a mis-reading of the lingshu, is currently dominating the lede's statements about the theory of channels and points. And I disagree that articles based on these two things are reputable in discussing acupuncture. If these sources and their content were used on a page entitled Astrological Acupuncture then I would give full credit. But they are not. I have presented two credible sources, foundational texts to the study of Acupuncture in America that have no reference to astrology or geography. And I have explained in detail why the sources you cited were poor/purposefully mis-leading/based on a primary text neither author had any authority to analyze. Additionally, one of the sources that houvassi uses as evidence of belief in astrological origins of points and channels explicitly states that these things are mere correlations, and their likening is metaphorical. This should be sufficient to change the lede information. If the astrological and geographical info is to be in the page it should both be re-written as "correspondance" and not an originating element, and it should be farther down the article as a minority opinion. The problem is that it is a minority opinion based on an article on medical illustration, and on one written with the expressed agenda of discrediting acupuncture.Luke643 (talk) 19:59, 11 February 2011 (UTC)
- Also, I just read over some comments by WLU about practitioners, with my name included. I should explain that I am not a practicing acupuncturist, though I have been trained as one. So I don't have any financial horses in this race. I am far more interested in History (which was precisely what you said we acupuncturists are not especially interested/trained in), and I will complete a MA in Chinese History in a few months. What is bothering me about the page (which must be obvious!) is the poor content concerning what the sources of chinese history actually suggest it to be. What I am reading a lot of is what poor biomed oriented scholarship considers it to be. But the delivery method of that scholarship supporting this orientation- journals - is trumping both reasoned argument against, and other source material that disagrees. It should not. As I have illustrated in the two points I have been hammering away at, the sources underpinning the CORE material in the lede are not just poor, but in fact ridiculously poor. Yet they are being held up as equal to the fundamental source material I have presented. The lede should reflect the theory of acupuncture as currently understood in America by both scholars and those who teach acupuncture, only after this is established should critical information be presented, which is the format we have now gotten to on the page. The problem is no longer the format, but rather the content. We have a Pocket Dictionary telling us what practitioners of acupuncture think, we have an illustrator's discussion of medical illustrations telling us what the theory of acupuncture is, and it is backed up by a text designed to discredit the field of acupuncture, using incredibly poor sources (book on astrology), and insisting that a correlation is actually a cause, the most fundamental of errors in argument and experiment. So...can we finally fix this lede? Seriously.Luke643 (talk) 03:06, 13 February 2011 (UTC)24.188.2.0 (talk) 20:36, 12 February 2011 (UTC)
- Luke643, you keep bashing an "illustrator" publishing a medical history article in The Journal of Biocommunication. That is a major peer reviewed medical journal. Histories published in peer reviewed medical journals are peer reviewed by medical historians. One problem that kept TCM so primitive is an attitude of disdain for anatomy and its sister - anatomical illustration, without which scientific medicine would not have advanced. A big part of the history of medicine is the study of medical illustration. Without medical illustration, medical texts would be almost useless. The purpose of the illustration is not just to show anatomy, but to draw or image it in a way which leads to an understanding of physiology. One area I have expertise in is xerophytic field botany, and I recently posted twice at talk WikiPoject plants about how the Wiki articles and glossaries of botanical terms lack anatomical illustrations, not just "photos", and so are practically useless. If you think the peer review panel and editors made an error, email Journal of Biocommunication with your evidence, and they will almost certainly print a retraction. PPdd (talk) 04:15, 13 February 2011 (UTC)
- this is willful obfuscation. The illustrations of acupuncture points have no indications that they are based on astrology and geography. Matuk uses the lingshu as source. This must be changed. It is just wrong. What more can I possibly say? I have given sources, reasoned argument, and more sources. I know you want to believe in the anachronism of China's stagnation and inferiority, but this is getting in the way of progress on the page.184.239.126.166 (talk) 16:44, 13 February 2011 (UTC)"
- Sorry, that was me. Was writing from my phoneLuke643 (talk) 18:23, 13 February 2011 (UTC)
- I've read the article in question and think that its use in this page overstates its actual contents. I will try to re-read and examine its specific uses in the near future. I will also try to find the time to take out Needles, herbs, gods, and ghosts from the library to see what it has to say. This again underscores my previous point, said many, many times. To do a good job editing the article, you need to find and read sources. Please stop debating personal experience, stop bringing up the alleged failings of modern medicine, red herrings about big pharma and "allopathic" anything. I feel an irritating need to correct these many logical and factual fallacies, and that burns up time on the talk page with absolutely no improvement to the actual acupuncture page. Please instead spend time finding and reading sources. WLU (t) (c) Wikipedia's rules:simple/complex 18:03, 15 February 2011 (UTC)
- Luke643, re illustrators publishing in Biocommunication, see medical illustration. If you think that author made an error, please provide an RS secondary source medical historian article to add a dissenting opinion to the article. PPdd (talk) 18:51, 15 February 2011 (UTC)
- WLU, I don't think I did any of those things that you were complaining about. I have only brought in sources. PPdd, the opinion is not mainstream, and therefore I do not need to produce a 'dissenting opinion' from the medical history field. However, I have provided multiple sources for the mainstream opinion from the field itself, not the biomed history field. If we are to present the theory we must present the theory, not the poorly sourced, loaded, anti-quack, or simply adjunctively related sources (matuk and houvassi). I plan to use Unschuld, Deadman, and Ellis/Wiseman to source my brief theory discussion.Luke643 (talk) 20:54, 16 February 2011 (UTC)
- Luke643, re illustrators publishing in Biocommunication, see medical illustration. If you think that author made an error, please provide an RS secondary source medical historian article to add a dissenting opinion to the article. PPdd (talk) 18:51, 15 February 2011 (UTC)
- I've read the article in question and think that its use in this page overstates its actual contents. I will try to re-read and examine its specific uses in the near future. I will also try to find the time to take out Needles, herbs, gods, and ghosts from the library to see what it has to say. This again underscores my previous point, said many, many times. To do a good job editing the article, you need to find and read sources. Please stop debating personal experience, stop bringing up the alleged failings of modern medicine, red herrings about big pharma and "allopathic" anything. I feel an irritating need to correct these many logical and factual fallacies, and that burns up time on the talk page with absolutely no improvement to the actual acupuncture page. Please instead spend time finding and reading sources. WLU (t) (c) Wikipedia's rules:simple/complex 18:03, 15 February 2011 (UTC)
- Sorry, that was me. Was writing from my phoneLuke643 (talk) 18:23, 13 February 2011 (UTC)
- this is willful obfuscation. The illustrations of acupuncture points have no indications that they are based on astrology and geography. Matuk uses the lingshu as source. This must be changed. It is just wrong. What more can I possibly say? I have given sources, reasoned argument, and more sources. I know you want to believe in the anachronism of China's stagnation and inferiority, but this is getting in the way of progress on the page.184.239.126.166 (talk) 16:44, 13 February 2011 (UTC)"
- Luke643, you keep bashing an "illustrator" publishing a medical history article in The Journal of Biocommunication. That is a major peer reviewed medical journal. Histories published in peer reviewed medical journals are peer reviewed by medical historians. One problem that kept TCM so primitive is an attitude of disdain for anatomy and its sister - anatomical illustration, without which scientific medicine would not have advanced. A big part of the history of medicine is the study of medical illustration. Without medical illustration, medical texts would be almost useless. The purpose of the illustration is not just to show anatomy, but to draw or image it in a way which leads to an understanding of physiology. One area I have expertise in is xerophytic field botany, and I recently posted twice at talk WikiPoject plants about how the Wiki articles and glossaries of botanical terms lack anatomical illustrations, not just "photos", and so are practically useless. If you think the peer review panel and editors made an error, email Journal of Biocommunication with your evidence, and they will almost certainly print a retraction. PPdd (talk) 04:15, 13 February 2011 (UTC)
- Also, I just read over some comments by WLU about practitioners, with my name included. I should explain that I am not a practicing acupuncturist, though I have been trained as one. So I don't have any financial horses in this race. I am far more interested in History (which was precisely what you said we acupuncturists are not especially interested/trained in), and I will complete a MA in Chinese History in a few months. What is bothering me about the page (which must be obvious!) is the poor content concerning what the sources of chinese history actually suggest it to be. What I am reading a lot of is what poor biomed oriented scholarship considers it to be. But the delivery method of that scholarship supporting this orientation- journals - is trumping both reasoned argument against, and other source material that disagrees. It should not. As I have illustrated in the two points I have been hammering away at, the sources underpinning the CORE material in the lede are not just poor, but in fact ridiculously poor. Yet they are being held up as equal to the fundamental source material I have presented. The lede should reflect the theory of acupuncture as currently understood in America by both scholars and those who teach acupuncture, only after this is established should critical information be presented, which is the format we have now gotten to on the page. The problem is no longer the format, but rather the content. We have a Pocket Dictionary telling us what practitioners of acupuncture think, we have an illustrator's discussion of medical illustrations telling us what the theory of acupuncture is, and it is backed up by a text designed to discredit the field of acupuncture, using incredibly poor sources (book on astrology), and insisting that a correlation is actually a cause, the most fundamental of errors in argument and experiment. So...can we finally fix this lede? Seriously.Luke643 (talk) 03:06, 13 February 2011 (UTC)24.188.2.0 (talk) 20:36, 12 February 2011 (UTC)
EBM section
Just wanted to say that although I may not agree with all the content in the EBM section, I do think that it's much better written than the lede or the recently proposed lede. IMO any subject can be discussed if it's well written, and I do see a real effort in the EBM section, at any rate more than I can put into it these next few days.Soll22 (talk) 21:12, 9 February 2011 (UTC)
- Per WP:MOS, the lede sums up what is in the article body using plain English, and does not have jargon or too much specificity (like lisitng individual entities). If you make significant RS edits in the article body, they will likely be summed up in a general way and put in the lede. Beginning to edit can be frustrating, because of all the guidelines and policies causing deletions, so if your edits get deleted, WP:Be bold and keep making them, but always WP:assume good faith and have WP:Civility. (If you click on the links I just provided, there are guidlines and policies. Your work is never lost, and can be easily recovered by clicking the article's history tab, looking for your name and edit summary (which lets others know the reason for an edit, and also lets you find it easily), and clicking on the dated link to the left of your name. Then click edit, and you can recover your exact edit there. PPdd (talk) 23:38, 9 February 2011 (UTC)
2 dimensional points, and 3 dimensional surfaces; How deep does it go?
- Another shifting definition is confusing me. A point has no dimensions. My edits have been almost solely based on RS already in the article. But something I cannot figure out from the content or cited RS that I have read, is how broad an area does the word "point" encompass, according to TCM or medi-acupuncturists, and how deep does the "point" go down into the body. There are a few acupuncturist editors here. Can anyone explain this, and maybe put it in the theory section with RS? PPdd (talk) 02:26, 10 February 2011 (UTC)
- The points have varying depths, and different styles use different depths. The japanese often needle very superficially (<.3"), but the chinese will often needle far more deeply (up to 3") but it depends upon the point, the desired manipulation and the feel of the tissue below and around the needle upon insertion. A basic idea: Upper abdomen points are typically needled superficially (<.5"), but points on the gluteals and mid-thigh/knee area are often needled deeply (1-3"). However, it is important to remember that needle depth varies tremendously from practitioner to practitioner. Hope this helps. Luke643 (talk) 05:16, 10 February 2011 (UTC)
- Good info. Can you find some verifiable sources for what you just wrote so you can put it in the practice section? PPdd (talk) 05:44, 10 February 2011 (UTC)
- The points have varying depths, and different styles use different depths. The japanese often needle very superficially (<.3"), but the chinese will often needle far more deeply (up to 3") but it depends upon the point, the desired manipulation and the feel of the tissue below and around the needle upon insertion. A basic idea: Upper abdomen points are typically needled superficially (<.5"), but points on the gluteals and mid-thigh/knee area are often needled deeply (1-3"). However, it is important to remember that needle depth varies tremendously from practitioner to practitioner. Hope this helps. Luke643 (talk) 05:16, 10 February 2011 (UTC)
PPdd, when you find out this information please write it in the book that you are clearly compiling. There is simply not the space in the article to detail or debunk acupuncture on this level. Famousdog (talk) 14:05, 10 February 2011 (UTC)
- I got the idea about locating points and how broad and deep they are from your own "plethora" comment, which I thought was critical information lacking in the article which would make it readable. I actually shortened the lengthy "booklike article" by massively deleting all NRS material (except for disambiguating useages throughout the article, which I put in with RS so the article met MOS internal consitency requirements and became readable). But my deletion left the clinical practice and theory sections relatively empty. Four questions will make the science and other sections readable, since as it stands, the definition of where a point is and how it is located, how wide an area it covers, how deep it is, and how variable it is , seems to change all over the article, which throws the word "acupuncture" around, but with changing definitions, an inconsistency prohibited by MOS. When I came to the article, I could not read it because of all the shifting definitions and ambiguities. PPdd (talk) 14:34, 10 February 2011 (UTC)
- Note that if you can't find it in a book, you should either remove it, or at the least not change it. Rather than Luke giving us the information and us having to trust him, we need a source to verify the information. Whatever the source says, that is the information we include. PPdd, this is again related to your approaching this as a puzzle to be solved, a research paradigm to be explored and a concept to be debunked (or at least examined critically). If you have questions about what a point is, that is something you look for off-wikipedia and if you find an answer, then you put it in. Most disputes can be settled by sources and you should be getting the details from books and articles in order to integrate them here. Editing articles really well takes a considerabl amount of time, simply because you need to read a lot of sources. I essentially wrote about 90% of the satanic ritual abuse article. It took me over a year, and I read all 15 books in the references section from cover to cover (or for the ones that didn't focus exclusively on SRA, the sections that did). Not to mention all the journal articles, and the crappy journal articles that got brought up on the talk page and were so shoddy or out of date that they never made it to the front page. When working on topics, I binge on information for months, gradually integrating what I can as I go along. To do this well takes considerable time, and I would suggest reading at least the abstracts of most of the articles before working with or summarizing them. Perhaps you have, if that's the case then you are a quick reader because your edits occur in extremely rapid succession and you've been keeping it up for days. Your intention is laudable, your efforts to work with other editors, accept criticism and respond is also laudable, but the normal hierarchy for page changes is always sources, policies, guidelines, manual of style, essays, then discussion and consensus on the talk page. WLU (t) (c) Wikipedia's rules:simple/complex 15:35, 10 February 2011 (UTC)
- Understood. I tried not to make any changes except to clarify things already in the article, based on the cited RS. I think I only added a handful of new MEDRS and actual content additions, much less than I deleted as NRS. If Luke643 had provided a link to RS I could have read, I would have put in these minor additional content items to balance what I massively deleted as NRS, but I am wating to see RS on it first. I think this information with RS, and RS for Famousdog's comment in another section that locations of points vary so much that the whole body is effectively an acupuncture point would go a long way to making widely varying statements in the article more intelligable, at least it would for me. PPdd (talk) 15:51, 10 February 2011 (UTC)
- I hope you do find RSs for this, PPdd, because clearing up this fundamental ambiguity would be useful. When I was researching chronic pain, every source seemed to have a different definition for the term, or didn't bother to define it. It took me several months to locate an RS that laid out the ambiguity, explaining the various usages. --Anthonyhcole (talk) 16:44, 10 February 2011 (UTC)
- Yes, we share frustration. Reading the literature is very difficult because of all the abuse of ambiguities. Ambiguity of usage is the meat of alternative medicine. Never let a practicitioner hold the goal post for you. PPdd (talk) 17:08, 10 February 2011 (UTC)
- point depths and locations are always defined anatomically. All the info on their location and depths, as practiced by most american acupuncturists, are laid out in this book: http://www.amazon.com/Fundamentals-Chinese-Acupuncture-Paradigm-title/dp/091211133XLuke643 (talk) 00:07, 11 February 2011 (UTC)
- Yes, we share frustration. Reading the literature is very difficult because of all the abuse of ambiguities. Ambiguity of usage is the meat of alternative medicine. Never let a practicitioner hold the goal post for you. PPdd (talk) 17:08, 10 February 2011 (UTC)
- I hope you do find RSs for this, PPdd, because clearing up this fundamental ambiguity would be useful. When I was researching chronic pain, every source seemed to have a different definition for the term, or didn't bother to define it. It took me several months to locate an RS that laid out the ambiguity, explaining the various usages. --Anthonyhcole (talk) 16:44, 10 February 2011 (UTC)
- Understood. I tried not to make any changes except to clarify things already in the article, based on the cited RS. I think I only added a handful of new MEDRS and actual content additions, much less than I deleted as NRS. If Luke643 had provided a link to RS I could have read, I would have put in these minor additional content items to balance what I massively deleted as NRS, but I am wating to see RS on it first. I think this information with RS, and RS for Famousdog's comment in another section that locations of points vary so much that the whole body is effectively an acupuncture point would go a long way to making widely varying statements in the article more intelligable, at least it would for me. PPdd (talk) 15:51, 10 February 2011 (UTC)
- Note that if you can't find it in a book, you should either remove it, or at the least not change it. Rather than Luke giving us the information and us having to trust him, we need a source to verify the information. Whatever the source says, that is the information we include. PPdd, this is again related to your approaching this as a puzzle to be solved, a research paradigm to be explored and a concept to be debunked (or at least examined critically). If you have questions about what a point is, that is something you look for off-wikipedia and if you find an answer, then you put it in. Most disputes can be settled by sources and you should be getting the details from books and articles in order to integrate them here. Editing articles really well takes a considerabl amount of time, simply because you need to read a lot of sources. I essentially wrote about 90% of the satanic ritual abuse article. It took me over a year, and I read all 15 books in the references section from cover to cover (or for the ones that didn't focus exclusively on SRA, the sections that did). Not to mention all the journal articles, and the crappy journal articles that got brought up on the talk page and were so shoddy or out of date that they never made it to the front page. When working on topics, I binge on information for months, gradually integrating what I can as I go along. To do this well takes considerable time, and I would suggest reading at least the abstracts of most of the articles before working with or summarizing them. Perhaps you have, if that's the case then you are a quick reader because your edits occur in extremely rapid succession and you've been keeping it up for days. Your intention is laudable, your efforts to work with other editors, accept criticism and respond is also laudable, but the normal hierarchy for page changes is always sources, policies, guidelines, manual of style, essays, then discussion and consensus on the talk page. WLU (t) (c) Wikipedia's rules:simple/complex 15:35, 10 February 2011 (UTC)
Also keep in mind that there may not be a definition that is universally accepted or agreed-upon. Again, we are dealing with a prescientific concept from a culture that did not practice dissection and did not test the claims made using empirical research. Exact definitions are necessities for scientific research (and good scholarship in general) but we are not dealing with a technique which evolved through scientific research - it may have been simple bloodletting, and after the revolution in the 40s it went through a substantial political filter. This is not an excuse to impose a definition or even point out that one is lacking - unless you can find a source to substantiate it. Again, it is simply the reality of wikipedia and acupuncture research in general. WLU (t) (c) Wikipedia's rules:simple/complex 02:53, 11 February 2011 (UTC)
- I found some RS on needle size and depth from Luke643's partially online source, and put it in practice sectoin. But you are likely correct that there is no totally uniform codes. I qualified the edits with "in U.S." PPdd (talk) 02:57, 11 February 2011 (UTC)
Lede
So the lede urgently needs revision. 1. Dorland is not a valid source for the claims of acupuncture practitioners of what they can treat. For those claims see the NIH paper - which of course has been cited as problematic, but in determining what acu pract's suggest they can do it is perfect. 2. The rivers astrology thing has got to go. It is just wrong as I have explained above. Please review my version of the origins section. My source for the origin of points and channels is the Peter Deadmen Manual of Acupuncture, which itself is based on extensive research of the Mawangdui texts, which are the earliest known extant texts on acupuncture. The Deadman is the industry standard. Also, discussing it's difference with biomed is a construction of a loaded argument designed to discredit acupuncture, thus revealing a very strong POV. Save that stuff for the criticism portion of the intro. Also, the lede criticism is far too strong. Notice the french version:
- L’acupuncture1 est une des branches de la médecine traditionnelle chinoise, basée sur l’implantation et la manipulation de fines aiguilles en divers points du corps à des fins thérapeutiques.
L'acupuncture traditionnelle est un art thérapeutique qui élabore son raisonnement diagnostique et thérapeutique sur une vision énergétique taoïste de l'homme et de l'univers : l'homme, microcosme, organisé à l'image du macrocosme universel, s'en trouve donc soumis aux mêmes règles, qui devront inspirer son mode de vie, et serviront de trame à l'élaboration de l'acte médical. Son efficacité ainsi que son substrat scientifique restent discutés. L'acupuncture a été inscrite au patrimoine culturel immatériel de l'humanité de l'UNESCO le 16 novembre 20102.
- Here is my origin paragraph. I will leave the criticism section for others.
I hope this can generate some positive change on the pageLuke643 (talk) 05:12, 10 February 2011 (UTC)
- I added a partial link to your ref. You do not need to have an online source, just pagge numbers, but it will might cause problems with some editors if it cannot be viewed and contradicts another online reliable source. PPdd (talk) 06:04, 10 February 2011 (UTC)
the second paragraph from the lede (which i have examined below) is inaccurate, overly POV and sounds like it was written by a high school student making stuff up to get a paper done.
- Ideas of what constitutes health and healing sometimes differ from concepts used in scientific, evidence based medicine.
--> of course, it is an entirely different medical system created by different culture before the modern scientific system existed. maybe it could be said minus the POV which slants the rest of the paragraph.
- Acupuncture was developed prior to the science of human anatomy and the cell theory upon which the science of biology is based.
--> channel and meridian theory is an anatomical system, created and used in china. it is not the same as the biomedical system but nonetheless it is a valid anatomical system used in referencing the body.
- Disease is believed to be caused by an imbalance of yin and yang (a metaphysical balance) caused by a "blockage" or "stagnation" of metaphysical energy known as qi, not by infectious agents.
-->external pathogens have been included in TCM since its inception and biomedical concepts, including infectious agents, have been incorporated into TCM since first contact with western systems (17th century). imbalance or stagnation makes one more susceptible to pathogens.
- Location of meridians is based on the number of rivers flowing through an ancient Chinese empire,
-->this part of the sentence literally makes me laugh "a number of rivers", "an ancient chinese empire" --overly vague and really not true. i would agree that the concept of channels is related to the flow of rivers (much like how biomedicine teachers will make an analogy between rivers and veins) but not the number of channels. this has been debunked twice by two different people i have no idea why it is still there.
- and the location of acupuncture points on the meridians are derived from Chinese astrological calculations,
-->original there was a number here (365), which claimed to be the number of acu-points derived through astrological means, which was proven to be inaccurate (by another wiki page no less!). making the statement more vague by removing the number does not increase the overall accuracy of the statement; it just makes it more absurd. i would love to see how the locations of the points on the body were derived by astrology without somehow referring to anatomy. i have read over the names of many of the points and i can't seem to find any that correspond to chinese constellations or astrology.
- and do not correspond to any anatomical structure.
--> they absolutely do; each point has a very specific location which corresponds to anatomical structures. several even have anatomical landmarks in the name: Lu-5 is called chi ze, which is translated as cubit marsh. it is located on the cubital crease, in the depression (marsh) on the radial side of the tendon m. biceps brachii. St-43, Xian Gu (sunken valley) is located in the depression (valley) distal to the junction of the 2nd and third metatarsal. these are only two points chosen at random, there are a tonne of examples.
- No force corresponding to qi (or yin and yang) has been found in the sciences of physics or human physiology.[6][7][8][9][10]
--> seems reasonable but i am not sure if this is the best location for the sentence. it would probably be better to have introduced qi, yin and yang more thoroughly before critiquing them.
also the lede above by luke643 (?) seems pretty NPOV and more inline with what i think of as a reasonable well written encyclopedia article.
metabradley mb (i forgot to sign in first) —Preceding unsigned comment added by 204.187.140.30 (talk) 20:24, 13 February 2011 (UTC)
I agree, starting the lede about a health care profession which is not a bio-medical with a sentence derived from a bio-medical source is not appropriate and creates an immediate bias towards a medical POV, which in this case is also a direct question of the validity of the acupuncture field, therefore a non NPOV. The lede does not accurately summarize the body of the entry, is loaded with bio-medical references and uses minority POV's that do not agree with mainstream POV's regarding clinical and historical aspects of acupuncture, which are present in the entry.Soll22 (talk) 18:39, 18 February 2011 (UTC)
Acupuncture and evidence based surgery
I agree with Famousdog's edits' implied perspective that the article is very long and can use alot of paring down of dupicated content. So please get out your knives and cut away anything that is not evidenced by reliable sources, or just excess fat. PPdd (talk) 16:04, 10 February 2011 (UTC)
Evidence for acupuncture as a treatment for nostalgic delusions
In the good old “golden days” of a few weeks ago before I came to the acupuncture article, I used to think I knew what a “consistent definition” was, what “placebo” was, what a “need for further research” meant, what a “point” or “location” was, and what MOS said about defining in the first lede paragraph, or section lede paragraphs. Even MOS has only recently become only a guideline for using colons and apostrophes, not about defining for consistency of usage and organization of content... ah for the golden days. I am making a point in a humorous style, but editors should edit the acupuncture article with this point in mind. PPdd (talk) 17:55, 10 February 2011 (UTC)
- Can you make your point directly, without all the allusions? I have no idea what you're saying. Are you making some point along the lines of: "it's wikiality to even come close to the view that acupuncture is anything other than fantasy?" You were saying stuff like "acupuncture is garbage? No way, even garbage has its uses" recently. Are you reaffirming that point, modifying it, or saying something entirely different? thanks, Middle 8 (talk) 05:54, 14 February 2011 (UTC)
- The direct point is that there is much unnecessary fighting on this talk page with both sides replying on ambiguities. The ambiguities need to be kept in mind so as to have WP:Consistency in the article, and this will also stop much bickering over semantics. PPdd (talk) 18:17, 15 February 2011 (UTC)
- OK, I see. Thanks for clarifying. I don't see any examples of that particular problem offhand; it would help if you would flag any that you do see. On an unrelated but equally "meta" note, I see your comments going in a lot of directions at once; it might be good to pick a single issue or section (or two or three at most), work on that, and move through the article in that way. --Middle 8 (talk) 02:32, 17 February 2011 (UTC)
- The direct point is that there is much unnecessary fighting on this talk page with both sides replying on ambiguities. The ambiguities need to be kept in mind so as to have WP:Consistency in the article, and this will also stop much bickering over semantics. PPdd (talk) 18:17, 15 February 2011 (UTC)
Secondary sources citing possible physical correlates to TCM concepts
The article as it stands now states and implies that there is no physical correlation to TCM ideas at all, placing TCM on the same scientifically-improbable tier as homeopathy. A couple of generalized, pejorative quotes are used to support this assertion, but there is a good secondary source -- an Ernst review -- that does not support it.
Ernst mentions Langevin's research on connective tissue planes (and their correspondence to meridians) in his review article "Acupuncture - A Critical Analysis", currently source #11 in the article, here (pdf). quote:
- "There is some tantalizing [e.g. 32, 33], but no compelling scientific evidence for the existence of either meridians or acupuncture points [29]."
Reference 33 is a review article by Langevin et. al. discussing her research on conective tissue planes: Ahn AC, Wu J, Badger GJ, Hammerschlag R, Langevin HM. "Electrical impedance along connective tissue planes associated with acupuncture meridians." BMC Complement Altern Med 2005; 5: 10. This means that we can cite the primary source Langevin (the germaine body of work), with care not to contradict the basic thrust of secondary source Ernst. (Update - Both Ernst's review and Langevin's are citeable. --11:35, 19 February 2011 (UTC))
The paper most relevant to a possible physical basis for meridians is this one (pdf): Langevin HM, Yandow JA, "Relationship of acupuncture points and meridians to connective tissue planes", The Anatomical Record (New Anat.) 269:257–265, 2002.
Langevin's papers, and Ernst's citation of her research, are sufficient to put something like this in the article (quotes are from the paper above):
- research by Langevin et. al. suggests, but does not prove, that there exists an "anatomical relationship of acupuncture points and meridians to connective tissue planes". Langevin hypothesizes that this relationship is relevant to acupuncture’s mechanism of action.
BTW, in that same review article Ernst[36] says: "Health is seen by traditional acupuncturists as a balance of two opposites, Yin and Yang, sometimes likened to the sympathetic and parasympathetic nervous systems [30]." His reference 30 is in German, but his summary of it, being in English, is citeable. (It's not clear whether the correspondence is seen as metaphorical or if it gets down deeper into TCM therapies having particular effects on the nervous system, but a simple mention will do for now, and will buttress the older NIH statement along similar lines.)
So we have a secondary source supporting scientifically plausible correspondence of meridians with connective tissue planes, as well as a correspondence between yin/sympathetic- and yang/parasympathetic-nervous systems. The article has been too one-sided for too long in citing only glib denials and ignoring sources that suggest TCM ideas may have biomedical correlates. Such correlations are not settled, but they are legitimate hypotheses that are verifiable and adequately weighted (cf. Ernst), and it's misleading to cite Mann as the last word on the subject. It's plainly time to include these well-sourced hypotheses or ideas. Acupuncture is not a priori scientifically improbable in the same way homeopathy is; good sources have said as much; it's time for WP to include them. regards, Middle 8 (talk) 22:12, 12 February 2011 (UTC)
- No, that means we should put in Ernst's actual statement - citing Langevin directly is not appropriate per WP:MEDRS which prohibits the use of primary sources unless there is good reason. We cite secondary sources, we don't use them as evidence that primary sources are citable. The overall thrust of Ernst's statement is that there is no compelling evidence for the existence of acupuncture points, the best way to summarize the statement in my mind would be with a direct quote. Calling it plausible is incorrect, "tantalizing" isn't the same thing as "plausible".
- Stringing together two Ernst statements is WP:OR. His statement about the sympathetic/parasympathetic is about him saying acupuncturists have claimed a link. He's not saying there's a correlation, he's saying other had claimed it. Such correlations (and it's not a correlation, it's a supposition) are not settled, but that doesn't mean it's proven. WLU (t) (c) Wikipedia's rules:simple/complex 00:08, 13 February 2011 (UTC)
- Sure we quote Ernst. Obviously, the good reason for also quoting Langevin is to clarify what he means when he means by "some ... evidence".
- What you refer to as "(t)he overall thrust of Ernst's statement" is not just the part you like. You don't get to excise "tantalizing" out of personal preference.
- Citing two Ernst statements from the same review isn't OR; Ernst is already talking about possible TCM-biomedical correspondences in the brief overview in the intro. I agree that the second statement is probably not on the order of the first, but if Ernst's mention of that poor-quality Matuk article justifies citing it in the article, then the same goes for his citation of the opinion of some acupuncturists a/o doctors a/o scientists. CSICOP already makes a similar point (or used to; not sure if it's even still in the article). --Middle 8 (talk) 05:20, 13 February 2011 (UTC)
- I see utterly no reason to cite Langevin, that seems like little more than an attempt to shoehorn an unnecessary primary source into the article when we have a secondary source that is perfectly acceptable. His overall point is the lack of evidence, no reason to go into detail on what that tantalizing, unreplicated, 10 year old evidence is. we cite Matuk because it is a reliable source, not because Ernst mentions her. WLU (t) (c) Wikipedia's rules:simple/complex 14:37, 13 February 2011 (UTC)
- Ernst at a minimum; Langevin's research is an ongoing program and is nontrivial, and most importantly, not fringe. Readers will have heard all sorts of stuff about acupuncture, and deserve to know (in a sentence or two) the nature of the research Ernst cites, and not just the fact that Ernst says it is tantalizing but not compelling. Most readers will, I think, be curious as to what is tantalizing, and MEDRS certainly allows enough latitude with citing primary sources to allow it here.
- I just noticed that the particular paper Ernst mentions is itself a review article[37] and that it cites Langevin, 2002 (pdf). I don't have access to it, but I'm pretty sure it passes MEDRS, and deserves more coverage than it's getting in the article. As I recall, one or more editors on the "acupuncture is bullshit" spectrum only wanted to cite the "not conslusive" part and not the "suggestive" part. I'm pretty sure that there's a policy or two on WP having to do with adequately citing sources -- oh yes, NPOV and VER.
- I just read the conclusions. The authors found their sources to be inconclusive on the whole, but suggestive for meridians, and suggested further, better research was needed to follow up on these 'suggestive' results. Here is an interesting line from the article: "Preliminary interpretation of the data suggests that deeper, subcutaneous tissue layers may be an important component in the increased capacitance and decreased resistance reported at acupuncture meridians."Luke643 (talk) 05:00, 14 February 2011 (UTC)
- Many thanks for having a look at the full version. That line you mention sounds like it's quotable, along with sufficient caveats. The article is certainly a MEDRS and a sentence like that one is a good summary of the "suggestive" parts. Wikipedia doesn't only cite "definitive" material; in fact I would say that the majority of articles on scientific topics that are any good do, in fact, mention topics that aren't settled but are presently being explored in the field, including notable hypotheses such as the one here. regards, Middle 8 (talk) 05:51, 14 February 2011 (UTC)
Langevin's articles are six and nine years old respectively, and haven't been replicated by independent groups. Again, this is "tantalizing" but flawed evidence with no real support. Put another way, if this were the generally accepted explanation for acupuncture points, demonstrating they are real and have an objective existence that is accepted and researched by at least a substantial number of people, then I would expect to see this rationale invoked in articles, rather than qi, meridians, or any other competing explanations. There are multiple competing explanations for meridians, acupuncture points and acupuncture's effectiveness - historical (qi), biochemical (adenosine from the Nature paper), psychogenic (placebo and ritual), biomechanical (Langevin's connective tissue planes hypothesis). In both regular research articles and review articles, which are mentioned? Normally qi is the dominant one, the rest are competing and the competition is ongoing - primarily because no single set of research studies has been successful in demonstrating, unequivocally, repeatedly and across reserach groups, that X is the ultimate. Though Langevin's hypothesis is one possible explanation, and makes more biological sense than magical energy that can't be measured, it's still not the explanation.
The line quoted from Langevin is not quotable, it gives undue weight to a primary source that is the per Ernst equivocal evidence for a possible explanation of a phenomenon that is not the widely held explanation for how, why or whether acupuncture works. It may not be trivial, but it's certainly not widely accepted. MEDRS supports the citation of primary sources only in limited situations: "Controversies or areas of uncertainty in medicine should be illustrated with reliable secondary sources describing the varying viewpoints. The use and presentation of primary sources should also respect Wikipedia's policies on undue weight; that is, primary sources favoring a minority opinion should not be aggregated or presented devoid of context in such a way as to undermine proportionate representation of expert opinion in a field." Whether meridians and qi exist, whether acupuncture points are a prescientific representation of a real phenomenon, this is controversial, unsettled, and one or even two studies with a total of less than 100 subjects should not be presented as if they were the most compelling argument. I'll be arguing against the adenosine paper for exactly the same reason. Ernst doesn't even discuss the hypothesis, merely mentioning that some researchers believe it. It is yet another explanation offered for acupuncture points, meridians and qi that hasn't been demonstrated sufficiently yet. WLU (t) (c) Wikipedia's rules:simple/complex 19:19, 15 February 2011 (UTC)
- WLU, please see Luke's comment a little bit above (dated 05:00, 14 February 2011 (UTC)). It turns out that there is also a secondary source with Langevin as co-author, so we don't have to worry about primary sources. It's actually already used in the article (or recently has been; it's hard to keep up) for the "not proven" bit but not the "suggestive" bit; the latter should be mentioned as a fair depiction of the paper's central thrust. Luke mentions a quotable quote from that review in the comment I pointed to above. On your argument: Yes, there are multiple, competing explanations, but which of the biomedically-based ones besides placebo have made it into a secondary source? Just Langevin's connective tissue hypothesis. --Middle 8 (talk) 02:25, 17 February 2011 (UTC)
- An article with Langevin as an author appears three times on the acupuncture page. In each case it is to say no anatomical correlates have been identified. We have discussed this source before - it's negative. It's about electrical properties. The concluding sentences of the abstract are "The studies were generally poor in quality and limited by small sample size and multiple confounders. Based on this review, the evidence does not conclusively support the claim that acupuncture points or meridians are electrically distinguishable. However, the preliminary findings are suggestive and offer future directions for research based on in-depth interpretation of the data." Lots of biomedical explanations have been proposed. None have produced fruitful, replicable, high-quality evidence that supports the hypothetical constructs of TCM and acupuncture. Tantalizing, promising and preliminary evidence is not support, it's suggestive of future research. Even Langevin says this. If I am missing the source being quoted or summarized, please let me know. So far none of the ones I have looked at have supported any assertion that there is a widely-accepted, evidence-based explanation for TCM or acupuncture. Placebo unites much data, but that's still a minority opinion and still being tested - though passing most tests to date. WLU (t) (c) Wikipedia's rules:simple/complex 04:59, 17 February 2011 (UTC)
- @WLU: Above you agreed with putting in Ernst's ""tantalizing but no(t) compelling" remark even though it's not about rock-solid evidence. You were correct, because Wikipedia doesn't require our sources to report only rock-solid evidence. Hypothesis are acceptable as long as they pass our content guidelines, and both Ernst's and Langevin's reviews do. Langevin's review article is not only negative, despite being portrayed in the article as such. Luke has cited a sentence from its conclusion (not the abstract; full paper requires access) that we might use, along with Ernst: "Preliminary interpretation of the data suggests that deeper, subcutaneous tissue layers may be an important component in the increased capacitance and decreased resistance reported at acupuncture meridians." The only other objection you've expressed, WP:WEIGHT concerns about Langevin as a primary source, have been met with a secondary source from Langevin to go along with Ernst. Langevin's fascia hypothesis is the only biomedical explanation, besides placebo, to make it into recent secondary sources, as far as I know. So there's no NPOV/weight problem with citing them, and in fact there is one if we don't. --Middle 8 (talk) 11:35, 19 February 2011 (UTC)
- An article with Langevin as an author appears three times on the acupuncture page. In each case it is to say no anatomical correlates have been identified. We have discussed this source before - it's negative. It's about electrical properties. The concluding sentences of the abstract are "The studies were generally poor in quality and limited by small sample size and multiple confounders. Based on this review, the evidence does not conclusively support the claim that acupuncture points or meridians are electrically distinguishable. However, the preliminary findings are suggestive and offer future directions for research based on in-depth interpretation of the data." Lots of biomedical explanations have been proposed. None have produced fruitful, replicable, high-quality evidence that supports the hypothetical constructs of TCM and acupuncture. Tantalizing, promising and preliminary evidence is not support, it's suggestive of future research. Even Langevin says this. If I am missing the source being quoted or summarized, please let me know. So far none of the ones I have looked at have supported any assertion that there is a widely-accepted, evidence-based explanation for TCM or acupuncture. Placebo unites much data, but that's still a minority opinion and still being tested - though passing most tests to date. WLU (t) (c) Wikipedia's rules:simple/complex 04:59, 17 February 2011 (UTC)
Blood flow, stagnation, blockage, flow channels
"Blood is a red liquid circulating in the vessels, and is a vital nutrient substance in the body." - Cheng, 1987, p. 48.
- If "Blood" is "blood", then (1) why is it capitalized? This appears to be a MOS violation. I have read varioulsy that (2) Blood "propels itself", (3) Blood can "stagnate" and acupuncture treats this, (4) Blood vessels can suffer "blockage" and acupuncture treats this, (5) Blood can flow in the wrong "vessel" and acupunture treats this. In the context of the Cheng quotation, (6) is (2)-(5) believed to be literally true? PPdd (talk) 16:58, 13 February 2011 (UTC)
- I keep reading about blockage of the flow of blood, and stagnation of blood flow, or blood flowing in the wrong channels. Is this a metaphoric flow? PPdd (talk) 00:56, 13 February 2011 (UTC)
- Corrected title spelling, hope you don't mind.
- It is more properly Blood, with a capital "B" but irrespective is not the red, physical blood that flows when a person is cut. I either read it in a source, or on acupuncture itself, but Blood is not physical blood, it is an energetic opposite to something. Might be the opposite of qi. So it's "energetic", but has nothing to do with actual energy (heat, electricity, light, kinetic impact, sound, radiation, magnetism, chemical, gravitational or any I've missed), it's related to the CAM concept of "energy". Which isn't talked about as if it were a real thing but is probably closer to metaphor than any other concept. WLU (t) (c) Wikipedia's rules:simple/complex 02:26, 13 February 2011 (UTC)
- That definitely needs clarifying in the article. In TCM articles I have read, TCM "B"lood, has properties or something like "b"lood, then its back to anti-chi "B"lood, or something like that. Its very confusing. PPdd (talk) 02:37, 13 February 2011 (UTC)
- "Blood is a red liquid circulating in the vessels, and is a vital nutrient substance in the body." - Cheng, 1987, p. 48. (Cheng is one of the main books that the NCCAOM exam is based upon; most states that acupuncturists pass the test in order to be licensed.) Blood is yin in nature and Qi is yang. So TCM Blood is physical but has TCM-esque functions. You'll find that other introductory TCM texts say the same thing. "Blood Stagnation" frequently refers to two distinct concepts (one being pain that is fixed in location, the other palpable masses in the body that shouldn't be there in a healthy body). Sloppy translation is often a problem.
- PPdd, why are you biting off so much more than you can chew in attempting to coordinate a major rewrite in an area about which you know little? Relying on other editors who don't know how little they know won't help. --Middle 8 (talk) 05:05, 13 February 2011 (UTC)
- Thank you for the clarification. One should not have to have a belief in supernatural forces to read an article, so clarification or disambiguation is needed. If "Blood" is "blood", then (1) why is it capitalized? This appears to be a MOS violation. I have read varioulsy that (2) Blood "propels itself", (3) Blood can "stagnate" and acupuncture treats this, (4) Blood can suffer "blockage" and acupuncture treats this, (5) Blood can flow in the wrong "vessel" and acupunture treats this. In the context of the Cheng quotation you provide, (6) is (2)-(5) believed to be literally true? PPdd (talk) 13:04, 13 February 2011 (UTC)
- That definitely needs clarifying in the article. In TCM articles I have read, TCM "B"lood, has properties or something like "b"lood, then its back to anti-chi "B"lood, or something like that. Its very confusing. PPdd (talk) 02:37, 13 February 2011 (UTC)
- @PPdd: TCM's "xue", or "Blood", is capitalized as a convention to distinguish it from anatomical blood. Some authors have tried to just call it "xue" and leave it untranslated (like yin, yang and qi), but the capitalization as "Blood" (along with capitalization of the zang-fu, even the "Spleen" which has nothing to do with the anatomical spleen) is near universal in the English-language TCM literature. Why not read The Web That Has No Weaver, at a minimum, before trying to coordinate a massive rewrite? Do you really think that TCM is so useless that it doesn't matter whether you get it right as long as you manage to portray it as wrong?
- Answering your other questions is like being an unpaid TCM tutor, and that's not my thing, sorry. Good luck; there are other editors you can ask. OK, so you may not get a correct answer, but no big deal; Wikiality goes with the territory. Have fun! And don't let your faith in your mission to improve the article (by Wikipedia's special standards) waver! --Middle 8 (talk) 14:36, 13 February 2011 (UTC)
- Being "unpaid" at Wikipedia is part of the process. Being a "tutor" providing RS is helpful and much better than interminable long winded talk page discussions arguing semantics because of ambiguities, which has resulted in a massive archive for this article, with the same discussion over and over. PPdd (talk) 16:58, 13 February 2011 (UTC)
- @PPdd: Sorry, I'm not trying to be a dick, but answering your questions properly involves more typing than I have time for, *and* I certainly can't keep up with your rapid-fire approach, *especially* with the persistent subtext of "TCM is complete and utter bullshit" and the "gotcha" tone of some of the questions you've asked in other sections. Just check out Kaptchuk's "Web" or Maciocia's "Foundations of Chinese Medicine" or Wiseman et. al.'s "Fundamentals of Chinese Medicine" (Paradigm Publications; it uses a consistent translation system [38]) or something like that. I'll give you some brief answers to your questions on Blood that may need further unpacking. Basically, Blood is Yin in nature and Qi is Yang. Qi moves the Blood, but Blood is also "mother of the Qi", i.e., necessary in making more Qi from food and air. So stagnation of Blood can result from a blockage or from not enough Qi (think of Qi as gasoline and Blood as tanker trucks that deliver it; now imagine a gasoline shortage so severe that the tanker trucks run out of gas on the freeway, causing a traffic jam: that is Stagnation due to Deficiency. Note how all I'm tending to capitalize other English translations of specific TCM terms; that again is a convention that predates Wikipedia'a MOS.)
- So, the answer to your (2) above is no, Qi propels the Blood. (3): yes, to an extent. There are two kinds of "stagnation"; one refers to fixed pain and the other to fixed, palpable masses i.e. tumors. Acupuncture can't treat all of those, obviously. (4): I suppose yes; again, translation gets messy. I'd need to know whicb translation system was being used; ideally Nigel Wiseman's. (5) I need more context and reference to original Chinese terms to answer that.
- I hope that helps. PPdd, would you mind answering my question that you didn't answer above, and I'm not being ironic: why are you biting off so much more than you can chew in attempting to coordinate a major rewrite in an area about which you know little? (Relying on other editors who don't know how little they know won't help.) regards, --Middle 8 (talk) 20:41, 13 February 2011 (UTC)
- I am qualified to write on medical articles. I was at Stanford for 11 years doing medical study data analysis and philosophy of science. I was recently asked to help on anthroposophical medicine, which I had never heard of. I essentially blanked the entire arrticle as NRS, to yells and screamsfrom all sides. Then I put in science stuff from journals with MEDRS... and half the yells and screams went away. Then I got cooperation from people who believed in and had studied the AM field, and I added more on theory and practices and beliefs of practioners. I ended up with this[39], and then from an anthro med practitioner this[40], and the article has basically been stable and essentially unchanged ever since. So I ask that you please assume WP:GF, have patience, help with disambiguating and RSing proposed content, and help with the to-do list at the top of this page. Most of these talk page discussions are about avoidable ambiguities, and a lack of cooperation finding RS to add more into the article about theory and practice. PPdd (talk) 22:21, 13 February 2011 (UTC)
- I hope that helps. PPdd, would you mind answering my question that you didn't answer above, and I'm not being ironic: why are you biting off so much more than you can chew in attempting to coordinate a major rewrite in an area about which you know little? (Relying on other editors who don't know how little they know won't help.) regards, --Middle 8 (talk) 20:41, 13 February 2011 (UTC)
- Well, I wish you luck, and no kidding, I'm glad you have something to work on that you enjoy. If I were you I'd channel it toward something different, but that's a matter of preference. I don't have faith in Wikipedia, and less time to be editing, so I can't commit to anything significant. But if I can find a way to help, and things seem to be moving in a good direction, I'll try to improve it. On a meta-level, I think your attitude is positive, and I agree that it is much better to try to make involved parties happy rather than annoyed. I'm not sure it's possible, especially with some of the "skeptic" types who are among the most wildly bad-faith-assuming, and WP:CIVIL and WP:HARASS, violators in town. Could be their cynicism toward some editors has rubbed off on me: I don't think Wikipedia is, in general, an environment conducive to what you are trying to attempt. All it takes is a few bad apples. Anyway, good luck, and I salute your idealism, with no irony -- it's Wikipedia itself that I scorn, and I believe that it takes advantage of people like you (follow the money; there are obvious conflicts of interest with for-profit Wikia). But maybe you'll at least enjoy yourself here. Put it this way: on WP, it takes a lot of "enthalpy" (editorial attention) to overcome the "entropy" (tendency toward wikiality, and the related issue of problem editors tending to drive away good ones). cheers, Middle 8 (talk) 03:29, 14 February 2011 (UTC)
Adenosine A1 receptor study in Nature Neuroscience
LINK: http://www.nature.com/neuro/journal/v13/n7/abs/nn.2562.html
I was surprised that there was ABSOLUTELY no mention of this highly relevant article in this wiki entry. This is probably one of the only scientifically rigorous animal models used to provide a possible mechanistic basis for acupuncture. To summarize:
- Acupuncture triggers an increase in the extracellular concentration of ATP, ADP, AMP and adenosine.
- Mice that are adenosine A1 receptor deficient fail to exhibit an analgesic effect after acupuncture.
- Inhibition of adenosine breakdown potentiated an increase in the analgesic effect of acupuncture.
The latter two points are especially important, as it demonstrates that a) acupuncture stimulates the release of some factor, and b) enhancement or inhibition of that factor modulates downstream pain response. Controls like that are critical for scientifically rigorous studies, as opposed to just saying "Oh look, acupuncture causes Y, and so Y must be the casual factor", or "A doctor stuck some needles in me and my pain went away, thus acupuncture works".
That said, the study is not conclusive, because a control for "proper" vs sham acupuncture was not performed.
I'd say at least this warrants inclusion in the article. Jimhsu77479 (talk) 22:49, 13 February 2011 (UTC)
- Not usable since MEDRS primary source. Also all mild trauma or causing of mild pain triggers biochemical releases, so not about acupuncture in humans, even if it was not a primary source study under WP:MEDRS. PPdd (talk) 23:01, 13 February 2011 (UTC)
- Well, added a blurb in possible mechanisms. Correct for POV if desired. Since there IS a section in the article about possible mechanisms (otherwise, delete that whole section), that's where it would go, not in any clinical justification of efficacy. Jimhsu77479 (talk) 23:18, 13 February 2011 (UTC)
- I could easily find a review citing that article such as http://www.springerlink.com/content/e4733559013331h1/ , but I assume that wouldn't make you happy, right? — Preceding unsigned comment added by Jimhsu77479 (talk • contribs) 01:05, 14 February 2011 (UTC)
- The whole section should be deleted as someone's speculations about the "possible", or at best a proposal to do a primary source study, which is even less than a primary source study. PPdd (talk) 03:43, 14 February 2011 (UTC)
- That's a primary source that has not been validated through replication and as yet, applies only to animals and not humans. We require secondary sources that demonstrate this in humans, in order to note this. To portray it as accepted theory or even as a promising note is not yet demonstrated through evidence it is accepted by the scientific community. I've removed it. The secondary source presented is about the possible mechanisms through which acupuncture could possibly be useful for oncology. There's no mention acupuncture is useful in the treatment of cancer, and only one mention that it may be useful for the treatment of nausea during chemotherapy - sourced to the Cochrane Collaboration, among the best sources available on wikipedia. The best evidence you could get out of that is "it has been suggested there may be mechanisms through which it might be useful in oncology". Actual review articles suggest acupuncture may be useful for dry mouth, pain, and generally the symptoms but certainly not the cause. Even these results have issues - the final article states that recent RCT have mixed results and only pointed to a potential role. Not proof, not acceptance. Adenosine may be the causal mechanism, but it is far from settled. We are not the news and should not be reporting new results merely because they are new. WLU (t) (c) Wikipedia's rules:simple/complex 19:31, 15 February 2011 (UTC)
- The whole section should be deleted as someone's speculations about the "possible", or at best a proposal to do a primary source study, which is even less than a primary source study. PPdd (talk) 03:43, 14 February 2011 (UTC)
finding consensus on the theory of points and channels
So, can we find some consensus on this please? My position: For the lede, particularly the stating of the basic theory of acupuncture points and channels, the language of rivers and astrology as origin of points and channels should not be used. The sources behind the statement are unrelated to Acupuncture theory, and themselves are based on a)misread primary source material, and b)a book on Chinese Astrology. I have presented several sources for acupuncture theory, an explanation of the systematic correspondance theory (as elaborated by Unschuld in his book [41]) that helps us understand the parralellisms of the lingshu, and an alternative (and sourced) version of the theory of acupuncture section of the lede. The theoretical description I have written above (somewhere) is simple, strait-forward, and consistent with the four major American acupuncture texts (Deadman, Maciocia, CAM, and Ellis/Wiseman), and suggests nothing of scientific efficacy, or lack thereof. It is entirely NPOV. Whereas the current lede is tilted toward the highly skeptical biomed view on acupuncture, and is full of inaccuracies as to the theory of acupuncture. So please, let's all weigh in.Luke643 (talk) 05:24, 14 February 2011 (UTC)
- Agree with essentially all of this. The Matuk source is very weak. I'm trying to find my copies of Unschuld; do you have "Medicine In China" by chance? He talks about some early superstitious ideas that predate even medicine, stuff along the lines of bad juju, but I don't remember his saying (a) how early "witch doctor" stuff evolved into Chinese medicine (maybe bloodletting to let out xie aka "evils"?), or (b) anything about astrology. And I don't recall any other reliable source mentioning it either. Just because Matuk is published doesn't make it correct, as MEDRS mentions. "Skeptical" websites like to repeat the astrology claim to make TCM look as pseudoscientific as possible, but as I said, it's not the sort of thing I've seen in any scholarly source outside of Matuk (sp.). Agree with your take. --Middle 8 (talk) 06:06, 14 February 2011 (UTC)
- as WLU pointed out, the Houvassi article also mentions it, but uses the Lingshu quote as source (which only says "correspond" anyway) and a chinese astrology book to back it up, then uses another paper as source for the astro stuff, a paper which explicitly calls all correspondances in early medical theory "metaphors." This is just rehashing what I said above...sorry.Luke643 (talk) 13:40, 14 February 2011 (UTC)
- If you can edit the talk page, you can edit the article. The only difference is you don't sign your name, something that I'm guessing won't bother you. ;-) Go ahead and give it your best shot; I or someone else can fix any problems such as formatting issues. Or, suggest text and let's do it (see WP:SILENCE; lack of stated objection usually means lack of significant disagreement). And if anyone objects but has been snoozing through talk page discussion, they'll revert, or (if they're creative) "improve" a.k.a. modify it, and (if they're good "citizens" of this site) discuss their reasons here in more than a cursory manner.
- One thing that has discouraged me in the past is the some editors are very rude and think it's OK to revert with little or no discussion (and sometimes rely on meatpuppets to take their side). Having a critical mass of good editors -- I'd say at least five, whatever their view on the topic -- makes it easier to call out that kind of poor wikiquette and make clear that it won't be tolerated. We would have achieved that by now if not for those same editors succeeding in driving away good editors (note that some have come right out and said that this is their goal; in theory, such an admission should result in a ban). So, not leaving is one way of improving the article, along with the satisfaction of seeing the ideals of WP actually followed. But it does take more than 2 or 3 good ones. Sadly there are editors here who prefer to get their way by making your on-wiki life miserable. So, there is strength in numbers of good editors willing to confront asshole editors by saying, in effect, "have you no sense of decency?" en masse. We've had that in the past, from time to time. regards, Middle 8 (talk) 07:44, 15 February 2011 (UTC)
- AHH! the silence thing makes sense, it was just confusing me up until now. I will get started when I have some time, in the next few days.Luke643 (talk) 14:27, 15 February 2011 (UTC)
- Luke643, if you start a new section with the same topic of an ongoing discussion in another section, or referring to an ongoing discussion in another section, then silence at the new section is not WP:Silence. It is best not to start a new section identical with an ongoing section, but rather, if you like, to continue discussing in the ongoing section, or start a new subsection if you think that would be helpful. I note that other editors have responded to you regarding this topic in the other section, but you did not respond back, but instead created a new section on the same topic. PPdd (talk) 18:13, 15 February 2011 (UTC)
- Yes, essentially WP:BOLD. I haven't read the discussion here, but if you do anything crazy to the article, I (or another editor) will either fix it or revert. Generally speaking, if you see something you'd like to change, just do it. If another editor objects, he'll say so. Pre-emptive discussion usually isn't necessary unless you expect your changes to be controversial. — Jess· Δ♥ 17:38, 15 February 2011 (UTC)
- WP:Bold should only be used in compliance with WP's other policies and guidelines, otherwise it might be interpreted as WP:Vandalism if they are blatantly violated. PPdd (talk) 18:13, 15 February 2011 (UTC)
- WP:VAND is an inappropriate policy to mention here - it's a deliberate attempt to worsen wikipedia. Much as we might disagree about page content, none here are trying to make the page worse. WP:CPUSH or WP:EW would probably be more appropriate to point to. No-one here is a vandal, despite any acrimony that might develop. WLU (t) (c) Wikipedia's rules:simple/complex 20:56, 15 February 2011 (UTC)
- Actually PPdd, I started this new one because of the silence in the old one. I had responded to all points on the above stuff in a previous talk thread, then when I got silence I got confused and started this one.Luke643 (talk) 20:26, 16 February 2011 (UTC)
- I tried to make some changes. And PPdd killed them, with the suggestion that I look at the MOS for leads. Well I did, and nothing on RS is listed about sources. Here is what is listed: Citations: "Further information: Wikipedia:Verifiability and Wikipedia:Citing sources
- Actually PPdd, I started this new one because of the silence in the old one. I had responded to all points on the above stuff in a previous talk thread, then when I got silence I got confused and started this one.Luke643 (talk) 20:26, 16 February 2011 (UTC)
- WP:VAND is an inappropriate policy to mention here - it's a deliberate attempt to worsen wikipedia. Much as we might disagree about page content, none here are trying to make the page worse. WP:CPUSH or WP:EW would probably be more appropriate to point to. No-one here is a vandal, despite any acrimony that might develop. WLU (t) (c) Wikipedia's rules:simple/complex 20:56, 15 February 2011 (UTC)
- WP:Bold should only be used in compliance with WP's other policies and guidelines, otherwise it might be interpreted as WP:Vandalism if they are blatantly violated. PPdd (talk) 18:13, 15 February 2011 (UTC)
- AHH! the silence thing makes sense, it was just confusing me up until now. I will get started when I have some time, in the next few days.Luke643 (talk) 14:27, 15 February 2011 (UTC)
The lead must conform to verifiability and other policies. The verifiability policy advises that material that is challenged or likely to be challenged, and quotations, should be cited. Because the lead will usually repeat information also in the body, editors should balance the desire to avoid redundant citations in the lead with the desire to aid readers in locating sources for challengeable material. Leads are usually written at a greater level of generality than the body, and information in the lead section of non-controversial subjects is less likely to be challenged and less likely to require a source; there is not, however, an exception to citation requirements specific to leads. The necessity for citations in a lead should be determined on a case-by-case basis by editorial consensus. Complex, current, or controversial subjects may require many citations; others, few or none. Contentious material about living persons must be cited every time, regardless of the level of generality." PPdd, I am not really clear on what you are doing here. The sources I used far outweigh the flimsy sources on the lead. The Acupuncture Today link included. Please explain what you are doing. RS in stating the THEORY of acupuncture should not be dominated by MEDRS sources, as the theory was outlined 2000 years before biomedicine existed, and the MEDRS sources are ridiculous. I am really tired of arguing this point. Unschuld is one of three or four of the top scholars in the field of Chinese Medical History. Deadman is the first source listed in the bottom of our page, and the most important american book on points and point theory. The very basic theory in the lead should reflect the best scholarship on the theory of acupuncture. Clearly your POV is overpowering your reason. I think my changes should be resurrected and relieved of technical errors at the very least.Luke643 (talk) 00:33, 17 February 2011 (UTC)
- Deadman is a source for what acupuncturists may think or practice, but is not a historian, so is only marginal at best as a source for history, and his book is not peer reviewed. The Journal of Biocommunications source that you do not like the findings of is a secondary source in a major medical journal, peer reviewed by historians. See WP:MEDRS. You also knocked out about 10 sources for 2-3 sentences, and moved one source to the wrong sentence. The lede is the worst place to learn WP policies and guidlines, and MEDRS is about the most strict RS policy. Also see WP:SUA. 01:13, 17 February 2011 (UTC)
- Those things should have been fixed, not removed. PPdd is more than capable of fixing them. MEDRS is trumping RS on this page with absurd results.Luke643 (talk) 01:56, 17 February 2011 (UTC)
- "Trump" is the wrong word. MedRS and RS should both be followed. MEDRS is more strict than RS for the reasons stated at MEDRS. PPdd (talk) 02:23, 17 February 2011 (UTC)
- I have posted this in another entry, but scanning through MEDRS, it seems that it is only applicable to bio-medical information, as per the Wiki MEDRS. Acupuncture ONLY crosses into biomedical territory in the context of bio-med clinical studies when an attempt is made to correlate acup. diagnosis and treatment with allopathic. Acupuncture applications per se are NOT bio-medical, it treats solely through it's own diagnostic system which is not based on bio-medicine. This is the law in the United States and the nature of the profession. Most of acupuncture practice is not considered bio-medical as per state legislation and national regulatory board, NCCAOM. Acupuncturists do not treat bio-medical diagnosis nor do they make them. Therefore MEDRS should only be applicable when discussing crossover into biomed which is a joint endeavor of med/acupuncture. Bio-med sources should only be required when discussing acu/medical interaction, which is only a small percentage of all acupuncture activity in the USA. CF my entry in nr. 16 "End run around MEDRS: Misleading by quoting medical conclusions by alternative organizations" scope of acupuncture is diagnosis and treatment according to tcm principles. Soll22 (talk) 02:47, 17 February 2011 (UTC)
- Well-put, Sol. I think you and Luke643 are correct; MEDRS doesn't apply to every aspect of alt or traditional medicines (or any medicine for that matter if we're talking about things like history or anthropology). Maciocia, Deadman, Cheng and others are verifiably good sources based on the NCCAOM and other certifying bodies citing them; they are more than fine in the article, as long as we're not trying to use them for something like efficacy. Even for efficacy, evidence-based medicine considers evidence in a tiered manner; Cochrane-type reviews are the best, but there are lower levels that EBM doesn't disregard. --Middle 8 (talk) 02:49, 17 February 2011 (UTC)
- I have posted this in another entry, but scanning through MEDRS, it seems that it is only applicable to bio-medical information, as per the Wiki MEDRS. Acupuncture ONLY crosses into biomedical territory in the context of bio-med clinical studies when an attempt is made to correlate acup. diagnosis and treatment with allopathic. Acupuncture applications per se are NOT bio-medical, it treats solely through it's own diagnostic system which is not based on bio-medicine. This is the law in the United States and the nature of the profession. Most of acupuncture practice is not considered bio-medical as per state legislation and national regulatory board, NCCAOM. Acupuncturists do not treat bio-medical diagnosis nor do they make them. Therefore MEDRS should only be applicable when discussing crossover into biomed which is a joint endeavor of med/acupuncture. Bio-med sources should only be required when discussing acu/medical interaction, which is only a small percentage of all acupuncture activity in the USA. CF my entry in nr. 16 "End run around MEDRS: Misleading by quoting medical conclusions by alternative organizations" scope of acupuncture is diagnosis and treatment according to tcm principles. Soll22 (talk) 02:47, 17 February 2011 (UTC)
- "Trump" is the wrong word. MedRS and RS should both be followed. MEDRS is more strict than RS for the reasons stated at MEDRS. PPdd (talk) 02:23, 17 February 2011 (UTC)
- Those things should have been fixed, not removed. PPdd is more than capable of fixing them. MEDRS is trumping RS on this page with absurd results.Luke643 (talk) 01:56, 17 February 2011 (UTC)
Is Nan-ching as linked in the starting comment a translation of an original text? If so, it should be used very judiciously and we should rely on the commentary sections rather than the original text. It's also from 1986 so new discoveries, new translations and new interpretations can make it obsolete. It is also one opinion among many, and can be used only to represent what historical people thought, not what is real.
Regarding WP:SILENCE, the initial comment was posted two days ago, on a talk page that is absurdly long. Don't consider silence to be consent, and in particular don't consider it to be consensus. Also keep in mind that "good" editors are in many ways a matter of opinion.
Regarding the 'theory' of acupuncture, we must be careful. What is described about acupuncture can be noted, we should have a well-sourced section discussing how acupuncture is explained. However, claiming this is an accurate description of how the body works is quite something else. Among the TCM claims not supported by science are: acupuncture points; meridians; qi; tongue diagnosis; pulse diagnosis; acupuncture being effective for anything beyond pain, nausea, and if you're really stretching, fertility (though those studies are questionable and questioned); yin; yang; astrological diagnosis and treatment; moxibustion; herbs. There's probably more. The issue faced is that there is a short step from "acupuncturists believe X" and "X is true". This is problematic for claims not supported by actual research, and is normally addressed by stitching the "X" part together with the scientific reply - Acupuncturists believe acupuncture points exist, but no acupuncture point has been demonstrated to be specifically effective for the treatment of a specific condition (unless it has, but you better have a damned good source). Qualified statements like 'X may occur, Y may be treated, Z research may be promising' which are extremely common in the literature, is not a reason to say X occurs, Y can be treated, or Z is promising research.
Acupuncture also strays into biomedical territory when it makes biological claims - I'm going back again to acupuncture points, meridians and other statements about anatomy and physiology. Making diagnostic claims is also medicine and therefore MEDRS would apply - acupuncturists may believe X, may believe in diagnosing using the tongue - but scientific, evidence-based medicine supports the use of the tongue to diagnose only a small number of conditions and does not believe there is a homunculus of the body. And if acupuncture isn't making biomedical claims, what is it actually saying? If it's actually useful and effective, why can't this be demonstrated, particularly as the quality of trials gets better?
Please don't use the term "allopathic", it's a red herring often used by CAM advocates to make vague claims by presenting themselves as its opposite. It's offensive to doctors, and quite meaningless - not to mention hypocritical since acupuncture is based on symptoms even if the attribution of cause is different. WLU (t) (c) Wikipedia's rules:simple/complex 04:06, 17 February 2011 (UTC)
- TCM does not claim anything. It lays out a system and works according to it. Please check my paragraph in section 16. I don't know what you mean when you say "acupuncture also strays into biomedical territory when it makes biological claims" pls. explain and let's discuss. It does absolutely not make diagnostic claims. Like I said, it treats according to tcm principles, and acupuncturists are required to note any medical diagnostic that a patient comes with in quotation marks and mark the source of the diagnostic. They do NOT work according to those diagnostics, they are simply required to master the language with which to understand them. TCM diagnostics are something like: Liver Fire, Liver Qi invading SP, Heart Fire etc etc. These DO NOT directly correspond to their western counterparts and are not meant to do so within current lawful acupuncture practice.Soll22 (talk) 04:23, 17 February 2011 (UTC)
- The system used is a set of claims - qi exists. It is manipulated through herbs, needles and tai chi. Perhaps there are sources that say this is metaphorical, but do most depict them as metaphorical? When an acupuncture practitioner says "you suffer from stagnant qi", that sounds like a diagnosis. "Stagnant qi is stimulated by acupuncture", that sounds like a treatment. TCM very much does make claims, like all medical systems do - TCM, ayurveda, homeopathy, traditional Native American healing, they all make claims and attribute disease to causes, and treatments to cures. Put another way, your statements would suggest no TCM practitioner should bother with a diagnosis - if they're just using words with no meaning and no treatment implications, why waste that time? Why claim that fire rises through the liver into the greater burner and this causes fevers? These statements do not correspond to evidence based medicine because they are prescientific, while EBM is based on science (biology, chemistry and physics) and medicine (randomized, controlled trials). The diagnosis and other concepts may have no equivalent in EBM, and that should be noted. That's why it's important to have sources that state things like "no anatomical or physiological correlates have been found for acupuncture points or meridians"; "stagnant qi has no biological correlates". If a correlate has been found, if a reliable and consistent association can be identified between what most, or even one practitioner consistently identifies as "qi" (or whatever) and a repeatable effect that has been replicated, extended and verified, that should be noted if an appropriate source exists. As discussed above - there is tantalizing suggestions of evidence, but nothing that is universally, or even significant minority acceptance as an anatomical equivalent to a TCM concept. Claiming acupuncturists don't actually believe what they are saying is more than a little horrifying - it suggests that thousands of practitioners are essentially lying to their patients, a practice EBM discarded as unethical decades ago. WLU (t) (c) Wikipedia's rules:simple/complex 05:01, 17 February 2011 (UTC)
- WLU, the Unschuld text is both a translation and some commentary. His interpretation of the text and discussion of systematic correspondances is hardly a new idea, and is based on the bedrock interpretation of early chinese thought in the Sinological field. See the Cambridge History of Early China, The Ambivalence of Creation, by Michael Puett, The Construction of Space in Early China, by Mark Edward Lewis, the work of David Keightley... I could give you more if I had some time. All these sources in one way or another touch on the correlative cosmology of Yin, Yang, the Five Phases, and the rest of the basic correspondances considered to be the foundation of the earth, man and the cosmos. Medical theory is part and parcel of this philosophical discourse. It is a system that is varyingly considered in the early sources, some finding it to be real and powerful, others finding it to be metaphor. Unschuld was therefore not uncovering new territory theoretically, nor is his work outdated, the field has understood these very simple pieces of the philosophical puzzle very well for a very long time. This is why it was simply shocking for me to read in the Matuk, and echoed on the page here such a fundamentally ignorant reading of the Lingshu. You do not see this misreading anywhere else of course, Matuk, not a sinologist, made a simple and entirely forgivable mistake. To elevate her mistake to the LEAD can only be interpreted as entrenched and ridiculous dissent. Hiding behind it stinks of cowardice. This is an immense waste of my time. The frustration I have trying to improve this page is only surpassed by the frustration I have thinking about the millions of people reading it as it currently is written. At the very least we need to remove this odious line suggesting that points and channels come from rivers and astrology. It is bunk. It is ridiculous. It is keeping me up at night. There is the massive stink of Orientalism on this page, and I cannot get it out of my nose.Luke643 (talk) 05:21, 17 February 2011 (UTC)
“There are 365 days in the year, while humans have 365 joints [or acupoints]... There are 12 channel rivers across the land, while humans have 12 channel” – Ling Shu, and there are many more examples of “numerology to needles” quoted from classic texts in this book. PPdd (talk) 05:44, 17 February 2011 (UTC)
- WLU tcm does not make claims. It is a pre-existing system that is, whether you agree with it or not, a functioning and legal health care field in the United States. The "claims" you state it makes have been resolved legally nationally with the accrediting boards and licensing boards in each state. So perhaps it's not up to us to reinvent the wheel on wikipedia and go against mainstream views that acupuncture is a valid, legal and accepted field in health care, even by organizations that are listed in MEDRS. Acupuncture is a Health Care field, just as medicine is a Health Care field. You cannot apply medical research directly to acupuncture AS AN ENTIRE field because they are not in some kind of hierarchal relationship, they are independent of each other. The diagnoses it makes within it's field are proven every day by it's own guidelines. Not all Health Care fields are subject to medical analysis and approval, although some are easier to correlate to medical topics and some are harder. An EBM perspective, which you do not provide any references for - as a whole, since you are talking about the entire field, is simply a EBM POV which should be clearly stated as such. The EBM POV about acupuncture is x or y or z.
- You cannot however mistake that for an NPOV, or a mainstream POV. While the medical profession is large, it is by no means the majority of the population, or even the majority of health care. An Matuk is not a mainstream industry text or a mainstream text about the profession of acupuncture. I believe we should be focusing on texts which are professionally used and only bring in RS that support the mainstream texts. An article like Mattuck's is not from the clinical acupuncture perspective, it's not even a mainstream historical interpretation. If you want to us RS, I don't believe that her writing is an RS for this entry.Soll22 (talk) 12:14, 17 February 2011 (UTC)
- Something being a health care field does not make it actually effective - tooth fairy certification is still certification on an unsubstantiated topic. Reiki and therapeutic touch are both accredited, and they are little more than hand waving and happy thoughts - literally. Accreditation in tooth fairy science still makes it tooth fairy science. Acupuncture may be a legal field, with all sorts of accretions of administrative approvals - but it's actual effectiveness in treating symptoms and diseases is under dispute within the medical field, as is its rationale for how it works. I've never advocated for removing any information on accreditation - I've advocated for a depiction of the clash between medical claims made by acupuncturists and researchers versus the actual evidence. Claiming sticking needles into a person can relieve pain is a medical claim, and must be supported with the best medical evidence we have - Cochrane reviews usually. There is support for acupuncture relieving pain, though there is also evidence this is due to placebo rather than the effectiveness of the actual intervention. Claiming the body survives through the flow of magical energy through specific pathways and can be manipulated to improve health by needling specific points is a claim as well, that can be evaluated by science. It has been, and was found wanting in nearly every measure with a variety of articles published that were "tantalizing", or "promising" or "possible" but never clearly demonstrated. The opinion of the majority of individuals on acupuncture is meaningless and of little interest - it is the opinion of experts that determines a topic. What encyclopedia would be worth reading if it were based on what the average citizen believed? None. You go to experts. Doctors for medical claims, biologists for biological, and historians for historical. Matuk, who I have yet to re-read and examine in detail, has already been attributed as a minority opinion - but it is still a relevant opinion that should be included. Other opinions should be included as well. If better sources than Matuk can be found, they should be used. But Matuk still remains, as far as I can tell, a peer reviewed journal article. WLU (t) (c) Wikipedia's rules:simple/complex 12:40, 17 February 2011 (UTC)
- I propose we use the following, at least as a start, as the RS for field of clinical acupuncture. For the historical aspects, Luke643 probably has an better idea of what constitutes industry standard bibliography, but Unschuld is cited as a reference in man of these texts, so I would personally go ahead and base the whole historical aspect on Unschuld as the mainstream POV in anglo-nations about the historical background of acupuncture. This is the bibliography for the national board exam for acupuncture which is the national standard for licensing, NCCAOM. Cheng, Xinnong, ed. Chinese Acupuncture and Moxibustion. 2nd ed. Beijing: Foreign Languages Press, 2005.,Deadman, Peter, Mazin Al-Khafaji, Kevin Baker. A Manual of Acupuncture. East Sussex, England: Journal of Chinese Medicine Publications, 2001. ; ---. A Manual of Acupuncture. 2nd ed. East Sussex, England: Journal of Chinese Medicine Publications, 2007.; National Acupuncture Foundation. Clean Needle Technique Manual for Acupuncturists. Guidelines and Standards for a Clean and Safe Clinical Practice of Acupuncture. 6th ed. Chaplin, CT: National Acupuncture Foundation, 2009.; O’Connor, John, and Dan Bensky, trns. and ed. Acupuncture: A Comprehensive Text. Shanghai College of Traditional Medicine. Seattle, WA: Eastland Press, 1996.
- Secondary Sources: Connelly, Dianne M. Traditional Acupuncture: The Law of the Five Elements. 2nd ed. Traditional Acupuncture Institute, 1994. Kaptchuk, Ted J. The Web That Has No Weaver: Understanding Chinese Medicine. 2nd ed. © 2-1-2011 NCCAOM® Acupuncture Study Guide59 New York: McGraw-Hill, 2000. ; Maciocia, Giovanni. The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists. 2nd ed. New York: Churchill Livingstone, 2005. ---. The Practice of Chinese Medicine: The Treatment of Disease with Acupuncture and Chinese Herbs. 2nd ed. New York: Churchill Livingstone, 2007. Wiseman, Nigel, and Andy Ellis. Fundamentals of Chinese Medicine. Revised Edition. Brookline, MA: Paradigm Publications, 1995. Worsley, J. R. Traditional Chinese Acupuncture: Meridians and Points. 2nd ed. Element Books, 1991. Zhang, Ting Liang, and Bob Flaws. trns. A Handbook of Traditional Chinese Gynecology. 3rd ed. Boulder, CO: Blue Poppy Press, 1987. Soll22 (talk) 12:45, 17 February 2011 (UTC)
- WLU you are talking about experts in a DIFFERENT field. They are not experts on acupuncture. This tooth fairy conversation I am sure violates several wiki rules, plus it is disrespectful towards several editors here. How about the wiki civility rules? Why would you include a minority opinion Mattuck, when it is not from any kind of standard perspective. It is a curiosity, a selective historical, and not well researched perspective on a clinical field. It does not coincide with rs on the history of acupuncture. It is not appropriate and it is not stated as a personal historical and literary interpretation of an otherwise standardized field. If it's not noted as such, it does not belong in the entrySoll22 (talk) 12:54, 17 February 2011 (UTC)
- Matuk is a secondary peer reviewed history of medicine source published in a preeminent medical journal, backed up by multiple other RSs for the assertions in the article that cite Matuk. That's as good as it gets at Wiki. Furthermore, the Ling Shu agrees with all these sources - “There are 365 days in the year, while humans have 365 joints [or acupoints]... There are 12 channel rivers across the land, while humans have 12 channel” – , and there are many more examples of “numerology to needles” quoted from classic texts in this book. PPdd (talk) 16:52, 17 February 2011 (UTC)
- Matuk is an acceptable source in a rather specific journal - I wouldn't call it "preeminent" and I wouldn't support it being used as the final word. I think it's very much a minority opinion and should be phrased as such (as it is currently on the page). That book would probably be OK, but it's pretty close to being a primary source (i.e. a translation of the old texts) and would have to be used judiciously. I don't think it's a source that should be excluded, but neither should it be ignored.
- Why am I being uncivil? Because I refuse to accept that acupuncture is as effective as claimed by practitioners? That's just critical thinking and the important thing is whether I can substantiate it by reference to reliable sources. Civility means I don't call other editors names but we certainly don't have to agree. I've expressed my opinion, referenced sources and policies/guidelines, pointed out flaws in both sides and have limited my editing to the main page. Not a single edit war have I started that I'm aware of. If my comments about tooth fairy science and acupuncture violates a rule here, please point it out - the fact is, there are a substantial number of researchers and skeptics who are deeply, deeply critical of the claims made about acupuncture and the quality of the research conducted on the subject. They have pointed out, rightly, that there is no good evidence for many of the claims of acupuncture's efficacy beyond placebo, for the mechanism it claims to work on, for the history that has been attributed to it, and so forth. I've got a reprint of an article discussing this, I'll read through it when I find the time to try to flesh the idea out more. We can use essentially any reliable source to expand the history - if there are reliable sources criticizing or refuting specific statements (i.e. the idea that acupuncture is the same now as it was 2000 years ago is false - Kim Taylor has written a book on the substantial revisions made to acupuncture during the decades following Mao's revolution in China; there are sources supporting the idea that acupuncture was essentially second-tier peasant medicine that was dying out in China until the Communists rose to power and used it as a form of surrogate medicine while they were trying to train medical doctors - I've read it, I need to find the source and cite it). The fact that many books are published on one side of the debate doesn't mean that is the only side of the debate. In cases like that, so long as the sources are reliable we spin it thus: "Acupuncture was traditionally believed to be X, and Y happened, and Z happened. This interpretation has been challenged due to Q." Depending on the challenge, the details involved, the weight it carries among historians of science and China, it may get more or less text. Unschuld is certainly a good starting point and can form the backbone of the history section. But he doesn't overwrite dissenting opinions. Regarding the clinical sources - those could be used to briefly describe, say, the conditions that acupuncture is claimed to be effective for. However, in those cases a Cochrane review will carry more weight, get the final word and essentially represent the mainstream opinion on the use of acupuncture to treat that particular conclusion. For medical claims, we use MEDRS and Cochrane reviews are specifically identified as among the best sources we have for that sort of information. WLU (t) (c) Wikipedia's rules:simple/complex 18:53, 17 February 2011 (UTC)
- WLU I appreciate your clear writing style and your effort to have a clear discussion. I did not accuse you of starting an edit war, I haven't gotten to that part of wiki rules.....yet! The only thing I object to, as editing colleagues here, is calling the subject of the wiki entry toothfairy science or suggesting that it is toothfairy science or in the category of toothfairy science.
- What I am trying to point out is that acupuncture is not a bio-medical field and should not be discussed "primarily" from that perspective. I see any discussion from the point of view of bio-medical studies to be biased in interpreting acupuncture in language and concepts not specific to it's scope of practice. I will be back with more. I wrote a larger section with a couple of links under section 16. It would be great if you could comment on that. About Mattuck, I don't mind including it but with the qualifier of it being a particular take on the historical aspect, not as the prevailing view, which, with a few days work, we can clarify that it is not. 12 hour work days don't allow for a lot of wiki time. Soll22 (talk) 01:43, 18 February 2011 (UTC)
- Matuk is a secondary peer reviewed history of medicine source published in a preeminent medical journal, backed up by multiple other RSs for the assertions in the article that cite Matuk. That's as good as it gets at Wiki. Furthermore, the Ling Shu agrees with all these sources - “There are 365 days in the year, while humans have 365 joints [or acupoints]... There are 12 channel rivers across the land, while humans have 12 channel” – , and there are many more examples of “numerology to needles” quoted from classic texts in this book. PPdd (talk) 16:52, 17 February 2011 (UTC)
section break
Acupuncture claims to be a biomedical intervention. It can be tested as such, and has been. The tests have not supported the theory of acupuncture, and I'm still not sure why you would expect it to - why would China be the only prescientific culture in the world to manage to understand human health and anatomy before the invention of a microscope, before dissection, before the germ theory of disease? The medical aspects of acupuncture should be discussed from a medical perspective, the historical from a historical. I may call something tooth fairy science, but it's not a problem until I try to put it on the page. I don't object to you believing in something I consider nonsense - just the logical and sourcing flaws that may impact the page. My point is that acupuncture can't be assumed to work without a comparable investigation of how it works, and all those investigations have been less than fruitful.
Matuk is already used on the page, and the information is clearly attributed to her rather than being a blanket statement. Wikipedia is about verifiability, not truth. It's not about what acupuncture truly is, it is what sources can be found to verify text. WLU (t) (c) Wikipedia's rules:simple/complex 18:45, 18 February 2011 (UTC)
- Please cite the sources that state that acupuncture claims to be a bio-medical intervention. Going by exact definitions: Merriam-Webster: 1. of or relating to biomedicine 2. of, relating to or involving biological, medical or physical science. I think you are confusing terms.
- Like I said, by legislation under point 16 of the talk page which I have been asking you to read, acupuncture is a HEALTH CARE field, MEDICINE is a HEALTH CARE field, (excuse the caps, I am not shouting I would have preferred italics, which I am trying to put in but am unable to.) Medicine is a subfield of health care. Acupuncture is a subfield. Not everything that is health care is biomedical. That something can be tested as such does not by any means imply that that field makes such a claim. There are "investigations" going on to determine whether or not it can be stated that acupuncture has efficacy in bio-medical diagnosis and treatment. That is a separate issue from the actual definition of the field. The field of acupuncture is defined by it's own paramaters which take special care to exclude biomedical terms.
- Mattuck does not belong in the lede, she is a minority, specialized view point that does not accurately SUMMARIZE (again not shouting but bolding in absence of italics) either a clinical or historical perspective on acupuncture. The lede is supposed to be a summary or conclusion of different paragraphs in the body. Please explain how it is that the Mattuck summarizes anything and belongs in the lede.Soll22 (talk) 21:42, 18 February 2011 (UTC)
- I also checked out the body of the text, she also does not belong in the section she was in without a specific mention of a "minority" POV, as per wiki NPOV page. Please do not reinsert without defining the mainstream POV and discussion the particulars Mattuck's minority POV as well as stating the provenance of the POV.Soll22 (talk) 22:38, 18 February 2011 (UTC)
- I just read the article cited, finally, trying to find the sentence cited. I find it cited out of context and misleading. This is the paragraph from Mattuck:
- "The Chinese drew mystical numerical associations, called the Da shu, or “great numbers.” It was no coincidence to the ancient Chinese, for example, that our four limbs matched the number of seasons and directions, and that in the one record of a human dissection on the body of the rebel Wangsun Qing, the hired butchers of his captor, Wang Mang, reported finding five zang (liver, gall bladder, heart, spleen, kidneys) corresponding to the five planets; 12 vessels circulating blood and air corresponding to the 12 rivers flowing toward the Central Kindgom; and 365 parts of the body, one for each day of the year (Lingshu 13/311 )."
- The statement that you propose as a defining theoretical background for the Acupuncture channels and points, is actually described in Mattuck's article as a mystical numerical association typical for the ancient Chinese. This is not a "founding principle" upon which the acupuncture channels and points are based but a parallel association, such as comparing the numbers of limbs on the body to the 4 seasons and directions. The wiki entry states the following: "Acupuncture points are located based on a belief that the body is related to the number of rivers flowing toward an ancient Chinese kingdom (believed to be exactly 12), and the number of days in the year (believed to be exactly 365)." I find this a false conclusion from the article." Soll22 (talk) 23:58, 18 February 2011 (UTC)
- The Mattuck source in fact implies that the 12 channels existed previously and independently, and the correlation was made from these preexisting channels to the number of rivers in china. Plus, the 365 days of the year are associated with the 365 body parts, not with acupuncture points, which is simply a mistake in citation.Soll22 (talk) 00:07, 19 February 2011 (UTC)
- Claiming acupuncture can treat anything makes it a medical claim - even for what it has actually been proven to work for. Making claims about biology - i.e. that qi and meridians exist - falls under the same guidelines. Please review how Matuk is actually used in the article, particularly the lead if you are going to complain about it. Her use as a minority POV is dealt with by attributing the opinion to her specifically. WLU (t) (c) Wikipedia's rules:simple/complex 02:15, 19 February 2011 (UTC)
- I did review it and I actually quoted it above. Please re-read and explain how it is that even though there is no mention of a correspondance between 365 days and acupuncture points, that is taken from the article? And that there is no causal relationship between the 12 channels and the 12 rivers of china. Please explain, this does not make sense aside from any ideological issues. It's simply not a logical conclusion.Soll22 (talk) 02:25, 19 February 2011 (UTC)
- Claiming acupuncture can treat anything makes it a medical claim - even for what it has actually been proven to work for. Making claims about biology - i.e. that qi and meridians exist - falls under the same guidelines. Please review how Matuk is actually used in the article, particularly the lead if you are going to complain about it. Her use as a minority POV is dealt with by attributing the opinion to her specifically. WLU (t) (c) Wikipedia's rules:simple/complex 02:15, 19 February 2011 (UTC)
Wikiproject?
Seems like there's some editorial energy collecting here, and there may be hope for getting a good article if we gather enough input. If hgilbert says PPdd did a good job, I'm willing to AGF, retract my earlier expressions of cynicism (which PPdd took in good humor, much as I intended them) and welcome his enthusiasm and philosophy (expressed above) which is quite AGF and big-picture-smart: if WP is going to work, imo, it should be a classy place conducive to intellectual endeavor. I have sources and a background that can help. Maybe we should start a wikiproject and invite some editors who have commented previously, and sort of build the sub-community editing the page, with more AGF, better understanding of what other editors are good at, etc. --Middle 8 (talk) 06:16, 14 February 2011 (UTC)
I’m having trouble with pooping
Acupuncture is used to treat constipation and diarrhea, which are related to flow problems (of qi). I can find good RS for the TCM beliefs about this flow, but I have yet to find simplified good MEDRS for what is believed to really be going on. MEDRS at google scholar is about highly specialized studies, and basic MEDRS med texts are not available online. My only available hard cover resource is this[42], which may not be MEDRS, but I thought mentioning it might help lighten the load on this talk page, without having to get a more expensive needle poke (or non-penetrating stimulation) for the problem. (Believe it or not, that was actually a serious request.) PPdd (talk) 21:05, 14 February 2011 (UTC)
- Re MEDRS – Some can be dug out of here[43], flushed out of here[44], and this is flowing with them[45].
- Why do we have to describe the biomedical etiology & pathology of every condition for which TCM indicates acupuncture? Just wikilink to them, imo, as has been done in earlier versions of the article. --Middle 8 (talk) 23:11, 14 February 2011 (UTC)
- I am going off the WHO statement and studies indicating what may acturally work, or on what there have been studies with at least a minimal asstempt to apply scientific methodology. These seem, from my reading, to be what most modern practitioners focus on. They are mostly psychological effects, and hard to measure without the vagueness of psychological questionaires about "what level is your pain on a scale of 1-10?". But constipation, vomiting, and diarhea cross the line from measuring just psychological effects like pain relief and nausea, to something physically measurable on an objective physical puke-ometer or poop-ometor. (PS - LOL on your edit summary for this particluar section, "too much information"!) :) PPdd (talk) 23:37, 14 February 2011 (UTC)
- You could try two things - google books (if you have a google account, gmail or otherwise, that seems to help you get more preview per book) and when undertaking pubmed searches, use the "reviews" filter (on the right side of the screen). Acupuncture has no generally accepted reason for why it works (and there's still questions about if it works). An appropriate action is simply to find what you can and cite it. However, you often turn up mushmouth stuff like this where "may work" is the main theme, not "has been shown to work". Like a lot of acupuncture, it is assumed that it must work, and therefore research will inevitably find the desired results, so there's really no reason to bother researching it, let's just implement it. The pages for diarrhea, enema and constipation don't mention acupuncture at all. Note that the WHO report is seen as a problematic source at best. WLU (t) (c) Wikipedia's rules:simple/complex 20:54, 15 February 2011 (UTC)
- I am going off the WHO statement and studies indicating what may acturally work, or on what there have been studies with at least a minimal asstempt to apply scientific methodology. These seem, from my reading, to be what most modern practitioners focus on. They are mostly psychological effects, and hard to measure without the vagueness of psychological questionaires about "what level is your pain on a scale of 1-10?". But constipation, vomiting, and diarhea cross the line from measuring just psychological effects like pain relief and nausea, to something physically measurable on an objective physical puke-ometer or poop-ometor. (PS - LOL on your edit summary for this particluar section, "too much information"!) :) PPdd (talk) 23:37, 14 February 2011 (UTC)
- Why do we have to describe the biomedical etiology & pathology of every condition for which TCM indicates acupuncture? Just wikilink to them, imo, as has been done in earlier versions of the article. --Middle 8 (talk) 23:11, 14 February 2011 (UTC)
Treatment of bacterial infections
WlU, I didn't understand your edit summary for deletion from practices sectin of
"TCM practitioners believe acupuncture cures some bacterial infections, which they believe are caused by problems in the flow of qi, based on examination of the tongue, pulse, and other symptoms; science based medicine believes bacterial infections are caused by bacteria, and treats with specific antibiotics targeted to kill the specific bacteria, and base diagnosis on a laboratory analysis to determine the type of bacteria.[4][5][6][7][8]"
This was to round out the practices section description of what is practiced. There is little in the article about nonpsychological illness treatment practices, and psychological effects are notoriously difficult to measure. PPdd (talk) 23:36, 15 February 2011 (UTC)
- At the most basic level, those aren't reliable sources in general. At best, they represent what those specific practitioners believe about acupuncture or sell acupuncture to treat them. They're what I call "random website", the kind of thing that pops up when you type "infection acupuncture" into google. The first, Cinnabar Acupuncture, is nothing more than a spa's website. Even information like what practitioners think acupuncture can treat should verified by reliable sources, which would again be scholarly books and journals. These sites are particularly problematic because they claim to be able to genuinely treat and cure these conditions. Let me put it another way - if acupuncture is claimed to be able to treat infections, you should be able to justify this relatively easily with a quick pubmed search without having to resort to what are mostly sales sites. With so many high quality sources, we shouldn't be using sites like these. And even to portray these claims as justified or something practitioners believe, we need actual journal articles. There should be studies to demonstrate it being effective or ineffective. WLU (t) (c) Wikipedia's rules:simple/complex 00:02, 16 February 2011 (UTC)
- OK. I couldn't find anything at google scholar (I tried), and I figured the main websites represented what was actually practiced. But I like a hard line on sourcing, so I will keep looking. This addition to the article, if RS can be found on beliefs, would round out the overly psychological treatment orientation. PPdd (talk) 00:42, 16 February 2011 (UTC)
- The sources are better, but I've adjusted. First off per MOS:TITLE, you don't repeat the heading title in the subsections. Second, while the clinical manual is a good source, the Thieme manual is not. The clinical manual has a specific section on infection, a whole chapter dedicated to infection in general. The Thieme manual has individual mentions stitched throughout, and isn't really a purportedly medical book in the first place. What you want is specific references dedicated to a topic, not throwaway sentences on books aimed at totally different ideas. An ideal source is one that focuses, at length, on a specific condition. I've removed the section on bleeding through the nose and mouth - first it's way too specific, second, it had the same sourcing problem. If you want to replace something similar, then the same sort of sourcing should apply - scholarly books (check the publisher) with an entire chapter or at least several-page subsection on the topic. What a single practitioner believes on their website isn't really a good source.
- I also have an issue with the section on bacterial infection, which illustrates a general irk I have with the page. It places the TCM concepts on an equal footing with actual science - as in, "according to acupuncture, infections are caused by a dark qi. Science has demonstrated that infections are caused by micro-organisms provoking an inflammatory reaction." You've got magic on one hand, and, you know, reality on the other. Wikipedia does not give medical advice, and also should contain accurate information. The idea that qi causes infection is, well, pretty much wrong. A section that makes it look like acupuncture and scientific research are somehow on the same footing is flat-out wrong. Prescientific vitalism can not, does not, will not, should not compete with real knowledge. How to deal with it I'm less sure, because practitioners do genuinely believe in this nonsense. Right now my inclination is to list the conditions acupuncture is alleged to treat, with a broad overview statement of "and they think everything is caused by stagnation of the blood" or whatever, and essentially leave it at that. Once such a section was developed, it may be worth rolling it into the same section as the actual science, perhaps in a table:
- OK. I couldn't find anything at google scholar (I tried), and I figured the main websites represented what was actually practiced. But I like a hard line on sourcing, so I will keep looking. This addition to the article, if RS can be found on beliefs, would round out the overly psychological treatment orientation. PPdd (talk) 00:42, 16 February 2011 (UTC)
Stagnation of blood|Not supported |
Congestion of blood and qi in the zhang fou|Some support with questions about the placebo effect |
Overactive spleen|Symptom (pain) relief only |
Astrologically inauspicious birth|Symptom (pain and nausea) relief only |
- Did you mean "SHOUT" at your screen?
- I should have my head examined for starting to edit on alt med articles, but I can't since my phrenologist is on vacation. And I was afraid there would be criticism since the infection section made acupuncture look ridiculous, never thinking it would make it appear somehow on par with reality.
- I agree it needs to be made clear what is a belief and what is a fact, and the second sentence could simply have said "bacterial infections are caused by bacteria", which appears to be a tautology, like "water is H2O", but even the latter may not be a tautology, since homeopathic water is believed by practitioners to be "H2O Plus".
- I agree with another editor that it is neither appropriate nor feasible to list every claim of acupuncture, but a small number of brief descriptions for general categories of claims, like "infection, reproduction, bleeding, vomiting, excrement, and psychological maladies", is feasible, somewhat comprehensive, does not take up too much space, and well illustrates thinking, beliefs, and subsequent practices common in the field.
- Your proposed "long way off" structure proposal is good. An eleboration of it is "category: practitioner belief -> practitioner reasoning -> practitioner practice; fact -> basis of fact -> science based practice as comparison", which only needs 2-4 sentences per category.
- (Uh, oh, either my liver fire just went up and scorched my lungs, causing my stomach to react (as would reasonably be expected to follow), or I have been reading too much alt med theory things.) PPdd (talk) 13:30, 16 February 2011 (UTC)
Blood and bleeding; Deadman and acupuncture.com
Blood is a central concept in acupuncture, and without a traumatic physical injury, is rarely seen other than in menstruation or coming from the mouth or nose. Sourced by Peter Deadman’s summary at Acupuncture.com, the following illustrates the kind of reasoning in TCM acupuncture, and illustrates how incommensurable it is with western ideas –
”It is believed that liver fire rushes upwards and scorches the lungs, injuring the blood vessels and causing severe bleeding from the mouth and nose, and that acupuncture treats bleeding from the mouth or nose.[9] It is believed that vomiting of blood is caused when heat in the lung causes qi to flow to the stomach, which is also treated with acupuncture.[9]”
Deadman wrote a text on acupuncture, A Manual of Acupuncture which has these are typical comments about it, “The Bible of Acupuncture!”, “The Deadman text is required by most TCM schools.”, and “This book is not a manual of acupuncture, it is THE manual.” Deadman also wrote The Journal of Chinese Medicine, described as “The premier English language journal in the field of Chinese medicine”. Since Deadman writes for Acupuncture.com, which is easily accessable to users with a link, I propose that, in the case that content at Acupuncture.com is by Deadman, that Acupuncture.com be considered RS (not just a "random website" when Deadman is the author there) about practices, beliefs, and reasoning of some English speaking practitioners when the material posted there is from Deadman. PPdd (talk) 13:41, 16 February 2011 (UTC)
- Luke643, I note above that you also find Deadman authoritative as a spokesperson for TCM and acupuncture position. PPdd (talk) 22:04, 16 February 2011 (UTC)
- Not sure if you are asking more than one question. Yes, the concept of blood in western terms, and that in TCM is very different. Go to Macciocia, Foundations of Chinese Medicine, p.60. All terms that also exist in western medicine are capitalized in tcm so as to avoid confusion. Liver with a capital L is not the same as the organ liver, Blood is different that blood, etc. They are all defined and discussed in textbooks I have listed above. As far as Deadman's writings on the website being considered an RS, I have no idea, WLU seems to be the person to answer this. I still need to get the hand of what exactly an RS is. Are books, that are not available on the internet a RS? Also, is there a clear directory where one can look up more in depth wiki rules? I see all the links you are posting for helping me out with wiki rules are not in one directorySoll22 (talk) 22:57, 16 February 2011 (UTC)
- There is no central directory that I know of, but there are hundreds or thousands of policies and guidelines. Try WP:MEDRS, WP:RS, WP:MOS, and WP:OR for starters. These are some of the most commonly referred to. I created the directory to WP:MOS specialized guidelines which appears at the top of WP:MOS (which is called a WP:HAT). I called the directory Wikipedia:Manual of Style (list of specialized Manual of Style articles). As you can see if you click on it, there are hundreds or more sub-guidelines just for this one MOS guideline! People who read all this stuff are called WikiLawyers. WikiLawyers are generally ignored under the Doctrine of Absurdity, and are about as well liked as regular lawyers. There is also WP:IAR, which, if you use it, everyone will ignore your arguments. PPdd (talk) 00:02, 17 February 2011 (UTC)
- Not sure if you are asking more than one question. Yes, the concept of blood in western terms, and that in TCM is very different. Go to Macciocia, Foundations of Chinese Medicine, p.60. All terms that also exist in western medicine are capitalized in tcm so as to avoid confusion. Liver with a capital L is not the same as the organ liver, Blood is different that blood, etc. They are all defined and discussed in textbooks I have listed above. As far as Deadman's writings on the website being considered an RS, I have no idea, WLU seems to be the person to answer this. I still need to get the hand of what exactly an RS is. Are books, that are not available on the internet a RS? Also, is there a clear directory where one can look up more in depth wiki rules? I see all the links you are posting for helping me out with wiki rules are not in one directorySoll22 (talk) 22:57, 16 February 2011 (UTC)
Back to the original question, is Deadman, when he writes @ acupuncture.com, RS for some beliefs and practices? PPdd (talk) 02:30, 17 February 2011 (UTC)
- @PPdd - yes, certainly. The situation is similar to the one described in WP:RS (or a related page) where an expert writes something on a blog. Deadman is reliable for TCM theory and practice, yes. Not for stuff like history or biomedicine. --Middle 8 (talk) 02:54, 17 February 2011 (UTC)
- The total list of policies and guidelines can be found at WP:P&G. WP:SIMPLE is probably a good starting point. Both are linked in my signature. The essential criteria for a reliable source is the reputation of the publisher for fact checking and accuracy. Specific questions and disagreements can be addressed to the larger community at the reliable sources noticeboard. For any medical claims, WP:MEDRS applies. Wikipedia should be based on secondary sources - primary sources are first-hand accounts (the standard examples are witness statements, and for scientific papers, a single, or set of experiments reported in an article). Secondary sources summarize primary sources to come to a conclusion (review articles, books, meta-analyses, probably most non-scientific peer-reviewed articles would count, but would be more limited in scope than, say, a scholarly book). Tertiary sources are things that summarize secondary sources - encyclopedias. They are useful for extremely basic information, but otherwise are generally not considered a good place to seek more detailed information. Individual experts publishing on website and other areas where they are the sole arbiters of the content are not normally seen as reliable sources because of the lack of oversight. The exception is for fringe claims, things like "UFOs are real", "HIV doesn't cause AIDS", "the world was created in seven literal days by YHWH and dinosaurs were placed by the devil to lead Christians astray". For FRINGE articles, web postings are more acceptable, particularly from reputable scholars. I would consider it extremely unlikely that on this page a personal website, even of Edzard Ernst, would be considered appropriate or even useful. Expertise is seen as localized or focused - historians and history journals tend to carry more weight for history, doctors and medical journals for health, and for criticisms of fringe concepts like much of CAM there are specific journals that critically examine the issues. CAM is itself problematic because there are a large number of "peer reviewed" journals whose standards are low and there is no challenge to much of the credulous baggage that tends to accompany CAM.
- It doesn't matter if a book or article is freely available or not (see, for instance, WP:PAYWALL). Information must be reliably sourced, not easily accessible. For many of these points and sources, a trip to a university library may be required. I do most of my book reading in physical books, and if I can find a google books preview, I like to include the page number and url as part of the page = field in the {{cite book}} template.
- There are not hundreds of guidelines, but there are a lot of them. Many do not apply because of the nature of this article. The core polices and guidelines of WP:V, WP:RS, WP:MEDRS, WP:NPOV, WP:ENC and WP:NOT are "must reads" for this page, and the secondary of WP:FRINGE, WP:REDFLAG, WP:PSTS would probably help. Acupuncture is not as simple as many pages because it is based on unsubstantiated mysticism, but is taken seriously by medical researchers. There are always ways to mediate disputes - there are noticeboards, requests for comments, actual mediation, even arbitration. There is a lot of wasted space spent on debate here, when it should be about sources. However, if someone comes up with an unsourced, illogical propaganda point - i.e. "big pharma, therefore acupuncture works" - I make a point of illustrating that it is stupid and wrong. But we would save much time by not having those debates - instead, contested points should be identified, the sources reviewed, the wording adjusted to ensure it is fair and accurate, and then move on. Rarely would it be acceptable to remove a source for "ideological reasons" (i.e. an editor doesn't like it), but they can be qualified, supplemented, and in rare cases eliminated because further information renders the point moot (i.e. research from the 1980s is often irrelevant because newer information is available). I quote as many policies as I think apply when I post on the talk page, I do this for a reason - it should save time if ultimately everyone is working from the same understanding of how wikipedia functions. Please refer to them and base arguments on them, and on sources.
- No, a website even written by Deadman would not be a reliable source in my opinion (per WP:SPS). The thing about experts is, they tend to get their information from sources, and write about them. If Deadman believes something enough to write a blog article about it, he has probably written a book or journal article about it. If a webpage can be replaced by a book, it should nigh-always be replaced by a book. WLU (t) (c) Wikipedia's rules:simple/complex 03:41, 17 February 2011 (UTC)
- @WLU -- WP:SPS has an explicit exception for authorities like Deadman: "Self-published expert sources may be considered reliable when produced by an established expert on the topic of the article whose work in the relevant field has previously been published by reliable third-party publications." I don't think that could be any clearer: Deadman, writing on a website, is an RS for TCM. Besides, the page in question says at the bottom: "The material presented in this article is taken from the textbook A Manual of Acupuncture and originally appeared in The Journal of Chinese Medicine." So, yeah, he did write a book about it, and ideally we should cite the book, plus the website as a convenience link. --Middle 8 (talk) 12:09, 19 February 2011 (UTC)
- The deadman book is authoritative for the theory of Acupuncture in Chinese Medical terms, and for how Acupuncture is taught in America. What was the question though?Luke643 (talk) 04:49, 17 February 2011 (UTC)
- What are reliable source and can a webpage be used. Deadman's book is probably OK. Reviewing the actual webpage, it's making medical claims about how to treat nosebleeds, coughing blood, irregular menstruation, vomiting blood, blood in the stool. You need a better source for that, and to claim effectiveness, you need actual research. WLU (t) (c) Wikipedia's rules:simple/complex 12:45, 17 February 2011 (UTC)
- What about for what it believes it treats, and the theory of why it believes so (e.g., "liver fire shcorches lungs, and that's why some acupuncturists think you get nosebleeds, or are vometing blood", if Deadman wrote it, but put what he wrote at a major website like acupuncture.com? PPdd (talk) 16:45, 17 February 2011 (UTC)
- To me, and this is a personal opinion based on experience, not something I can justify through a clear reference to a policy, that comes across far too much as an implied "look how stupid practitioners are" example. Irrespective, the website would be insufficient even if it's called acupuncture.com. There's no world-wide authority or governing body that establishes universally-recognized, authoritative guidelines that I'm aware of (how could you when your practice is not evidence based?) meaning we're stuck with books. That's also a lot of detial on one particular condition or set of conditions. Acupuncture may have a set of diseases it thinks it can treat, that doesn't mean we should note every single one of them and the specific explanation for each. Particularly since the explanation makes them look bad, makes no sense in terms of knowledge of modern anatomy, and is just justified by reference to a webpage. I think it reads like nonsense, reflects badly on the person saying so, is excessive detail, is an unreliable source, but overall I can not point to a clear rule that forbids it. I would much rather leave it out. WLU (t) (c) Wikipedia's rules:simple/complex 18:27, 17 February 2011 (UTC)
- By not putting things in the article that describe standard thinking practices, one is left with a misleading air of scientific legitimacy after reading the article (I was when I first read it). When I read the article, then read the following in the Journal of Chinese Medicine, I was surprised, indicating a defect in the Wiki article in describing the thinking that goes on in TCM acupuncture. "Liver fire rushes upwards and scorches the Lung, injuring the blood vessels and giving rise to reckless pouring of blood from the mouth and nose." The wiki article as it is gives a reader the impression that acupuncture is 95% about treating psychological conditions like pain or nausea, that there have been a huge number of (poorly designed) scientific oriented studies on acupuncture, yet no conclusion can be drawn about whether acupunture works. In the literature, there are two classes of claims, one psychological, the other physical, and the latter is much more commonly treated. Also, blood seems to be the central objective term universally appearing in each diagnosis (unless one translates qi as "breath"). Breath, blood, food, and excrement are about all one can objectively see going in or out of the body. In the absense of of dissection, about the only things left to look at are pulse, breath, skin, in the mouth (toungue), eyes (which do not change much), and behaviour. I think the practices section should be kept concise, but include objective and easily measured physical claims and their bases, in addition to the overwhelming discussion on psychological pain, or things that are among the most difficult things in medicine to measure. PPdd (talk) 21:37, 17 February 2011 (UTC)
- I've got to admit, I'm making the best case I can but it's not unambiguous. In my mind we should illustrate what is scientifically legitimate by citing reliable sources that support, and fail to support or criticize TCM and acupuncture. I still think that webpage is not reliable. If you can find an alternative, better source I would have less problem, but again, overall it's a case of editorial judgment. If we are the only ones who feel strongly, we can seek a third opinion. WLU (t) (c) Wikipedia's rules:simple/complex 00:41, 18 February 2011 (UTC)
- I found a much better source, as good as can be found for a modern source, and I highly qualified the sentence as to where the quote was coming from, and I did not bog things down with a new section for it. PPdd (talk) 01:39, 18 February 2011 (UTC)
- PPdd and WLU, I cannot find the page you are talking about at acupuncture.com, and PPddclicking on your citation does not give me a link. In any case discussing something that is not directly linked to the wiki entry seems to be filling up space and making this harder and harder to navigate. I think Deadman's personal contributions to one website or another should not automatically be a RS. Even experts can write poorly or from a personal standpoint, which is not necessarily what you want as an RS. Deadman's book which is actually co-authored by two others, Kevin Baker, and Mazin Al-Khafaji (the guy whose name no one can remember or pronounce) is industry standard teaching manual for master's level courses, therefore should clearly be RS, as per wiki RS, or even MEDRS.Soll22 (talk) 22:15, 18 February 2011 (UTC)
- The link works fine for me. Try going to the journal itself, the then to its free sample articles, then a few pages into the lists of sample articles. Note that all articles in that journal either support acupuncture, or conclude that further research should be done, never that it did not work. And that confirmation bias to the hilt selectivity is the kind of study base Cochrane includes, if it asserts proper placebos or controls, there being such a paucity elsewhere. PPdd (talk) 01:14, 19 February 2011 (UTC)
- PPdd and WLU, I cannot find the page you are talking about at acupuncture.com, and PPddclicking on your citation does not give me a link. In any case discussing something that is not directly linked to the wiki entry seems to be filling up space and making this harder and harder to navigate. I think Deadman's personal contributions to one website or another should not automatically be a RS. Even experts can write poorly or from a personal standpoint, which is not necessarily what you want as an RS. Deadman's book which is actually co-authored by two others, Kevin Baker, and Mazin Al-Khafaji (the guy whose name no one can remember or pronounce) is industry standard teaching manual for master's level courses, therefore should clearly be RS, as per wiki RS, or even MEDRS.Soll22 (talk) 22:15, 18 February 2011 (UTC)
- I found a much better source, as good as can be found for a modern source, and I highly qualified the sentence as to where the quote was coming from, and I did not bog things down with a new section for it. PPdd (talk) 01:39, 18 February 2011 (UTC)
- I've got to admit, I'm making the best case I can but it's not unambiguous. In my mind we should illustrate what is scientifically legitimate by citing reliable sources that support, and fail to support or criticize TCM and acupuncture. I still think that webpage is not reliable. If you can find an alternative, better source I would have less problem, but again, overall it's a case of editorial judgment. If we are the only ones who feel strongly, we can seek a third opinion. WLU (t) (c) Wikipedia's rules:simple/complex 00:41, 18 February 2011 (UTC)
- By not putting things in the article that describe standard thinking practices, one is left with a misleading air of scientific legitimacy after reading the article (I was when I first read it). When I read the article, then read the following in the Journal of Chinese Medicine, I was surprised, indicating a defect in the Wiki article in describing the thinking that goes on in TCM acupuncture. "Liver fire rushes upwards and scorches the Lung, injuring the blood vessels and giving rise to reckless pouring of blood from the mouth and nose." The wiki article as it is gives a reader the impression that acupuncture is 95% about treating psychological conditions like pain or nausea, that there have been a huge number of (poorly designed) scientific oriented studies on acupuncture, yet no conclusion can be drawn about whether acupunture works. In the literature, there are two classes of claims, one psychological, the other physical, and the latter is much more commonly treated. Also, blood seems to be the central objective term universally appearing in each diagnosis (unless one translates qi as "breath"). Breath, blood, food, and excrement are about all one can objectively see going in or out of the body. In the absense of of dissection, about the only things left to look at are pulse, breath, skin, in the mouth (toungue), eyes (which do not change much), and behaviour. I think the practices section should be kept concise, but include objective and easily measured physical claims and their bases, in addition to the overwhelming discussion on psychological pain, or things that are among the most difficult things in medicine to measure. PPdd (talk) 21:37, 17 February 2011 (UTC)
- To me, and this is a personal opinion based on experience, not something I can justify through a clear reference to a policy, that comes across far too much as an implied "look how stupid practitioners are" example. Irrespective, the website would be insufficient even if it's called acupuncture.com. There's no world-wide authority or governing body that establishes universally-recognized, authoritative guidelines that I'm aware of (how could you when your practice is not evidence based?) meaning we're stuck with books. That's also a lot of detial on one particular condition or set of conditions. Acupuncture may have a set of diseases it thinks it can treat, that doesn't mean we should note every single one of them and the specific explanation for each. Particularly since the explanation makes them look bad, makes no sense in terms of knowledge of modern anatomy, and is just justified by reference to a webpage. I think it reads like nonsense, reflects badly on the person saying so, is excessive detail, is an unreliable source, but overall I can not point to a clear rule that forbids it. I would much rather leave it out. WLU (t) (c) Wikipedia's rules:simple/complex 18:27, 17 February 2011 (UTC)
- What about for what it believes it treats, and the theory of why it believes so (e.g., "liver fire shcorches lungs, and that's why some acupuncturists think you get nosebleeds, or are vometing blood", if Deadman wrote it, but put what he wrote at a major website like acupuncture.com? PPdd (talk) 16:45, 17 February 2011 (UTC)
- What are reliable source and can a webpage be used. Deadman's book is probably OK. Reviewing the actual webpage, it's making medical claims about how to treat nosebleeds, coughing blood, irregular menstruation, vomiting blood, blood in the stool. You need a better source for that, and to claim effectiveness, you need actual research. WLU (t) (c) Wikipedia's rules:simple/complex 12:45, 17 February 2011 (UTC)
Regarding questions about whether or not TCM is biomedical: obviously there is some overlap, but a fair treatment certainly involves delving into TCM-specific ideas to a far greater degree than we do on other pages. This would be true even if TCM acupuncture was only of historical interest, and is an issue that has come up with homeopathy and other alt-med topics that need to be properly depicted with respect to (bio)medicine. The second paragraph under WP:WEIGHT is key:
- "In articles specifically about a minority viewpoint, such views may receive more attention and space. However, these pages should still make appropriate reference to the majority viewpoint wherever relevant and must not represent content strictly from the perspective of the minority view. Specifically, it should always be clear which parts of the text describe the minority view. In addition, the majority view should be explained in sufficient detail that the reader can understand how the minority view differs from it, and controversies regarding aspects of the minority view should be clearly identified and explained. How much detail is required depends on the subject. ..."
The whole thing is a good read, but that's probably the most relevant part. --Middle 8 (talk) 12:09, 19 February 2011 (UTC)
- Middle 8, I am not sure that treating common symptoms, such as back pain, headache and nausea is enough to qualify tcm treatment as overlapping into biomedical. I don't think these are specifically biomedical conditions they are symptoms. I believe that a biomedical diagnosis, and a claim to treat biomedical diagnosis refers to a specifically medical diagnosis such as: herniated disc, impeded cerebrovascular flow, gastritis, etc. Headache is a symptom, not a diagnosis. It's very important that we clarify terms here through objective sources. TCM diagnostics as they are charted can include symptoms, but are never defined by symptoms. A TCM diagnostic is strictly described in terms of the organ/channel affected (the organ/channel as defined in TCM terms and Capitalized so as to not be confused with the biomedical term with the same name) and the pathology of the organ/channel also in TCM terms (vacuity, excess, Fire, Heat, Damp, Cold, Wind). TCM always treats the tcm diagnosis, and the same symptoms, such as headache can correspond to different diagnoses. Therefore TCM does not treat biomedical conditions. This is clearly stated in the scope of practice under licensing laws of each state.Soll22 (talk) 16:12, 19 February 2011 (UTC)
On "beliefs"
There are no reliable sources that establish what someone believes. People lie, even to themselves. They also change their minds, usually without making any public pronouncement. This is particularly the case when they have a large vested interest. A priest may lose faith yet continue to offer mass. An lawyer may doubt his ability to find justice while continuing to practice law. We can speak with evidence as to what the doctrine of TCM accupuncture is, but not to what the beliefs of practioners are. We should confine ourselves to that for which we can show evidence. LeadSongDog come howl! 18:17, 16 February 2011 (UTC)
- I couldn't agree with you more - see Bad faith article for more on what you just said re "people lie, even to themselves", etc.
- I will add to "to do" list - change "practices" or "beliefs" to something like "TCM doctrine says", but wait for further comments before I do. PPdd (talk) 18:46, 16 February 2011 (UTC)
- which aspect of the page are we talking about here? For what Acupuncture texts old and new suggest TCM treats, the answer is that they don't say it treats any biomedical pathologies, but rather a wholly different set of syndromes, that may or may not encompass biomed pathology. See Maciocia for extensive discussion of this. But again, what are we talking about in terms of page content?Luke643 (talk) 20:30, 16 February 2011 (UTC)
- I will add to "to do" list - change "practices" or "beliefs" to something like "TCM doctrine says", but wait for further comments before I do. PPdd (talk) 18:46, 16 February 2011 (UTC)
Subpages Question
Can we, I mean is it possible, to create subpages with all the separate topics and use the main talk page as an index?
It's doubled in size in one week.Soll22 (talk) 22:32, 16 February 2011 (UTC)
:No, there is some policy or guideline about that, but I forgot which. You can create a subpage at your own userpage and put almost anything you want there, however, and anyone at Wikipedia can see it. PPdd (talk) 23:52, 16 February 2011 (UTC) I misread your question to be about a subpage of the article, not abuot this talk page. PPdd (talk) 03:13, 17 February 2011 (UTC)
- If we can avoid posting in older threads, the bot will archive them pretty soon; I suggest starting a new thread if the existing one is very long. --Middle 8 (talk) 02:56, 17 February 2011 (UTC)
- It might be best to start a subsection about anything unresolved in the section, rather than starting a new section, as the prior context might go out of sight in an archiving. PPdd (talk) 03:15, 17 February 2011 (UTC)
- How do you start a subsection? aren't most of them unresolved, though?Soll22 (talk) 03:19, 17 February 2011 (UTC)
- Start a subpage by adding a slash to the page you are making a sub-page of: for instance, [[Acupuncture/subpage]]. Once you've created the link to the page, simply click on it and start editing. A related talk page also becomes available. Please do so as a user subpage though, not as a subpage to an article. More information can be found at WP:SP. WLU (t) (c) Wikipedia's rules:simple/complex 03:43, 17 February 2011 (UTC)
- How do you start a subsection? aren't most of them unresolved, though?Soll22 (talk) 03:19, 17 February 2011 (UTC)
- It might be best to start a subsection about anything unresolved in the section, rather than starting a new section, as the prior context might go out of sight in an archiving. PPdd (talk) 03:15, 17 February 2011 (UTC)
- If we can avoid posting in older threads, the bot will archive them pretty soon; I suggest starting a new thread if the existing one is very long. --Middle 8 (talk) 02:56, 17 February 2011 (UTC)
Science's inherent POV problem
Here is an edit someone did -
"A review by Edzard Ernst and colleagues in 2007 found that research is active and that the "emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions".[10] Researchers using evidence-based medicine have found good evidence that acupuncture is moderately effective in preventing nausea.[11][12]"
- That is about all that is said in that article's science section.
- But acupuncture is used for thousands of things or more. By devoting much time to a barely detectable treatment for one kind of pain that is no better than a nonstimulating placebo treatment (which may be no better than another placebo for that placebo, stimulating another point, or point nearby), and postoperative vomiting and nausea (I am still dubious that Cochrane did not miss some confounder, like giving acupuncture for pain and nausea, vs., e.g., antiemetics and nauseating opiates), it makes a reader think that there is some kind of balance between conditions acupuncture treats and those it does not - "acupuncture is effective for some but not all conditions". What sloppy use of language! The wiki article suffers from the same problem, in that the science section is all about the minute number of conditions that Cochrane looked at, which leaves acupunctures generally utter uselessness for almost all of its claims unstated, or unemphasised, in the science section. If most scientific sudies are on pain, a small part of acupuncure, there is an inherent POV that "acupuncture" usually means "pain treatment", when it does not. I have no suggestion to deal with this, and its no one's fault, but maybe someone has ideas how to balance the science section out, while maintaining scientific objectivity. PPdd (talk) 01:57, 18 February 2011 (UTC)
Moxibustion Edits
PPdd, I did not remove the source or add any wording that was not in the source. Let's be specific with criticism of edits. I actually summarized the source in a short paragraph. The original sentence, if you checked at all, stated that moxibustion was a technique that burns the skin. In fact the source cited stated that the majority of the moxibustion is indirect moxibustion that does not burn the skin and that there are two types of moxibustion, direct and indirect. I found the sentence to be misleading of the cited source. Please check sources and different edits before reverting. The source also states several facts about a JAMA published study which I included in the paragraph, since you guys are so happy to sprinkle bio-med references througout the article. If otherwise, please explain. — Preceding unsigned comment added by Soll22 (talk • contribs) 21:55, February 18, 2011 (UTC)
- I also disagreed with those edits - if a medical claim is made, then it is appropriate to note where medicine and science in general contradicts this.
- The JAMA article was a primary source, an article describing the results of an experiment. They are very easy to cherry pick and thus must be used with caution - not to support one particular point that one particular editor liked (see WP:MEDRS, which have pointed to many, many times. I am adding my opinion to the consensus started by 2over0 and PPdd. If a sentence does accurately summarize part, but not all of a source, then the appropriate thing to do is expand, not remove. If a source states a fact that was part of a research study - we go to the research study. While acupuncture.com might be an adequate source for moxibustion, it's not for claims of medical effectiveness. For that, we need secondary sources from peer-reviewed journals. WLU (t) (c) Wikipedia's rules:simple/complex 02:11, 19 February 2011 (UTC)
- The edit PPdd reverted appears to have been made by WLU here, not Sol. It seems he probably hit "cur" to check the summation of Sol's edits, and so missed that WLU had contributed one edit in the middle. I've reverted because of this, and because WLU's summary seems to be adequate. — Jess· Δ♥ 02:22, 19 February 2011 (UTC)
- Please explain why a sentence is a better summary than a short paragraph. I have no problem with WLU summation I also find it accurate, however I don't see why my summation had to be corrected. Like I said, no problem on my part with taking out the JAMA mention.Soll22 (talk) 02:28, 19 February 2011 (UTC)
- WLU's edit summary stated that he was removing a primary source and unsourced content. Personally, I prefer the paragraph over the sentence, and that could be returned if we just get a source for it. I only reverted PPdd because his edit summary indicated he might have been confused over why the change was made, and not having looked into acupuncturetoday.com, I'm willing to assume good faith on WLU's part and accept that it is not reliable for our purposes here. Do you perhaps know of a secondary source we could use to describe moxibustion in more detail? — Jess· Δ♥ 03:39, 19 February 2011 (UTC)
- For sure, I can get a better source for moxibustion description. It would be one of the clinical textbooks of acupuncture practice. Is that ok? Can't get to it until Monday, but glad to be having the discussion.
- My paragraph was sourced from the exact same source that PPdd's sentence was, and that WLU's sentance is. I simply developed a paragraph. Maybe it turned out unsourced if I deleted some link material accidentally, but it was supposed to be linked to the same source. I am happy to leave out the mention of the JAMA article (sourced from the same article in acupuncturetoday.com) which is the only one WLU objected to as being inapropriately sourced. However, it was unnecessary to delete my whole paragraph if the only objection was the JAMA mention which was a separate sentence. WLU could have deleted the JAMA study mention, which was separate from the summary of moxibustion and not the entire paragraph.Soll22 (talk) 04:38, 19 February 2011 (UTC)
- Soll22 removed the clear RS statement in the acupuncture journal article that moxibustion directly burns the skin, either causing blistering and scarring, or being taken off before blisters appear, here[46]. Soll22 then moved the source for the original correct summing of the “blister and scar” journal article to a sentence reporting a primary source study here[47], leaving the first sentence with no source. WLU then saw Soll22’s second sentence reporting a primary source study, and did not have to bother checking the source Soll22 incorrectly put on it, but WLU simply and CORRECTLY deleted Soll22’s second sentence as well as the misplaced source Soll22 put on it[48].
- Soll22, if you don’t like what a journal specifically says, like “burn, blister, and scar”, you can’t replace this with “warm”, and remove the citation from that sentence. You cannot move a reference from the sentence it supports to another sentence that you want in the article, a source that has nothing to do with the sentence you are moving the source to. You also can’t put in primary source study sentences, which is why WLU removed your sentence. WLU did not have to bother to check the source you put on the primary source study, because even if the source supported it, the sentence could not go in. And you can't add your own unsourced sentence in front of a source that has nothing to do with your sentence. Many editors check the sources against the content of the sentence, so it will always get delete3d. The purpose of a source is to back up a sentence, not to look like there is a source to the sentence. PPdd (talk) 04:51, 19 February 2011 (UTC)
- @PPdd, I checked your diffs, and I still don't see anywhere that Sol "removed" a source, or indeed even moved one. I see that Sol changed "burned" to "warmed", and that he added another sentence to the section, but no other changes to the refs at all. WLU is the one who removed the ref (which you reverted, attributing it to Sol). I haven't read the citation, so I can't comment on the content, but I see no reason not to AGF for anyone here, particularly newer editors. — Jess· Δ♥ 05:14, 19 February 2011 (UTC)
- Sol removed the ref from the sentence it went with, then put it at the end of an unrelated primary source study sentence Sol put in the article, a sentence with unsupported by the ref appended to it, and which is a primary source study sentence. So WLU corrrectly removed that sentence Sol put in, and what appeared to be an unrelated ref appended to it. I would have done exactly as WLU if I saw it, without following line by line Sol's edits. — Preceding unsigned comment added by PPdd (talk • contribs)
- There's a miscommunication happening here... and I'm not sure what to do about it at this point. You are defending WLU's edit... but that's the edit you reverted. (Compare WLU's change to your revert). Sol didn't change the ref at all; He only added new content, which you restored after it was removed. — Jess· Δ♥ 05:56, 19 February 2011 (UTC)
@Soll22 A clinical textbook would still be a primary source, but I think it would be acceptable in this case, since we're describing the practices of acupuncture, and not its efficiency. As long as the textbook represents a fairly mainstream view of acupuncture practices, I think that would definitely be a nice addition to the article. Good suggestion! — Jess· Δ♥ 05:18, 19 February 2011 (UTC)
- Here is what the secondary source journal article says –
” How does moxibustion work? Does it hurt? - In direct moxibustion, a small, cone-shaped amount of moxa is placed on top of an acupuncture point and burned. This type of moxibustion is further categorized into two types: scarring and non-scarring. With scarring moxibustion, the moxa is placed on a point, ignited, and allowed to remain onto the point until it burns out completely. This may lead to localized scarring, blisters and scarring after healing. With non-scarring moxibustion, the moxa is placed on the point and lit, but is extinguished or removed before it burns the skin. The patient will experience a pleasant heating sensation that penetrates deep into the skin, but should not experience any pain, blistering or scarring unless the moxa is left in place for too long.
- To rewrite that as “warming the skin” is not POV, it is misrepresentation.
- Note also that this POV pro-acupuncture journal does not even answer its own question, which should have been, “Yes, repeatedly burning the skin at various points until it blisters so much it leaves scars hurts like hell! What did you think, stupid?” PPdd (talk) 05:27, 19 February 2011 (UTC)
- yes, and this is the rest of the article:
- Indirect moxibustion is currently the more popular form of care because there is a much lower risk of pain or burning. In indirect moxibustion, a practitioner lights one end of a moxa stick, roughly the shape and size of a cigar, and holds it close to the area being treated for several minutes until the area turns red. Another form of indirect moxibustion uses both acupuncture needles and moxa. A needle is inserted into an acupoint and retained. The tip of the needle is then wrapped in moxa and ignited, generating heat to the point and the surrounding area. After the desired effect is achieved, the moxa is extinguished and the needle(s) removed."
- Scarring moxibustion is not legal without a patient's written consent in the USA, and generally not practiced in the United States, or in most countries outside East Asia.
- I think that skewing the entry to the idea that moxibustion consists only of the burning of the skin is a misuse of the source. The source clearly states the Indirect moxibustion is currently the more popular form and that even direct moxibustion that is non-scarring generates a "pleasant heating sensation etc etc."
- I also object to your general language when discussing this topic Soll22 (talk) 05:49, 19 February 2011 (UTC)
Recent Copyedit
I'm doing a fair amount of copyediting, including linking unlinked terms, removing overlinking, rewording some sections, clarifying ideas, and so forth. I just reverted this change to cut down on overlinking and because the latter term ("supernatural") is shorter and more precise than "metaphysics (beyond natural law)", and is also the title of the target page. I just wanted to clarify the reason for my revert, PPdd, since the edit summary is too short to really get that idea across.
On another note, there is a substantial amount of seemingly POV wording throughout the article, which I'm mostly not trimming down since I'm not well read on the sources. One such example was on the painfulness of acupuncture, where a paragraph was littered with "incidentally", "isolated cases", and other qualifying terms wholly unsupported by the sources. As it is, the sources we're using for that section are probably less than ideal anyway... but not being familiar with the literature myself, it's hard for me to track down more appropriate ones. If anyone else is more familiar with the topic offhand, that section really should be entirely reworded to convey actual studies on the topic, and actual consensus (to the extent that it exists), rather than synthesizing unrelated studies to draw original conclu:sions. All the best, — Jess· Δ♥ 17:29, 19 February 2011 (UTC)
- Thanks for the civility. I agree with all your edits so far. I fully agree that something like qi, that is above (super) natural laws of physics is best and most preciedly described as supernatural, and metaphysical is a weasel word (like "complimentary" or "alternative"). I did all the overqualification in the "does it hurt?" section only because at that time, there had not yet been consensus at MEDRS to allow peer reviewed remarks on generally accepted things, but published as incidental remarks in a primary source study about something unrelated to the incidental secondary remark, in this case "it may be painful". There has been consensus at MEDRS that this is OK, so all my admittedly excessive qualifiers can be removed. PPdd (talk) 18:56, 19 February 2011 (UTC)
supernatural is not shorter than metaphysical; they both have 12 letters in them. supernatural is way less precise. lets not boil Chinese metaphysics and philosophical theory down to supernatural just because you don't like it. — Preceding unsigned comment added by Metabradley (talk • contribs) 00:05, 20 February 2011 (UTC)
Mattuck Reference, please discuss.
This is the exact text from the Camilia Matuck article which is cited:
"The Chinese drew mystical numerical associations, called the Da shu, or “great numbers.” It was no coincidence to the ancient Chinese, for example, that our four limbs matched the number of seasons and directions, and that in the one record of a human dissection on the body of the rebel Wangsun Qing, the hired butchers of his captor, Wang Mang, reported finding five zang (liver, gall bladder, heart, spleen, kidneys) corresponding to the five planets; 12 vessels circulating blood and air corresponding to the 12 rivers flowing toward the Central Kindgom; and 365 parts of the body, one for each day of the year (Lingshu 13/311 ) ."[49], p6, paragraph 1
To my reading, in plain english and to paraphrase, this means the following: "The [ ancient] Chinese made mystical number associations. The four limbs matched the number of the seasons. The five organs were found to correspond to the five planets. The 12 vessels (of qi and blood) correspond to the 12 rivers flowing toward the Central Kingdom."
Here is the text adjusted by PPdd in the entry:
"Acupuncture points are located based on what historian of science Camilla Matuk calls "mystical numerical associations", in that "12 vessels circulating blood and air corresponding to the 12 rivers flowing toward the Central Kingdom; and 365 parts of the body, one for each day of the year".[7] No research has established any consistent anatomical structure or function for either acupuncture points or meridians."
I cannot see the correlation between the article and the causal relationship in the wiki entry which states that the acupuncture points are based on mystical number associations. The acupuncture points are not mentioned in the citation, only channels. The channels are not are based on but are used as part of a numerical number association. There is no mention of a location in the cited text, only numerical associations. There is no mention of the location of the rivers serving as a base for the channels. There is only a correlation which states: there are 12 channels just as there are 12 rivers flowing towards the Central Kingdom.
This is the text in the lede:
"The location of meridians are based on the number of rivers flowing through the ancient Chinese empire, and acupuncture points were originally derived from Chinese astrological calculations.[7][8]"
Same issue: the cited text states, does not make, an existing correlation, not a causal relationship between either the number of the rivers in China and the acupuncture channels. The location is not even mentioned in the citation.
The statement about acupuncture points being originally derived from Chinese astrological calculations comes from the website www.cancer.org, which is does not seem to be an RS for acupuncture information since it does not give direct citations for the information it reports. Not sure how websites are designated RS or not. Happy to hear any input pro, or anti. ThanksSoll22 (talk) 20:11, 19 February 2011 (UTC)
- You forgot to mention that the www.cancer.org site you say is not reliable is the American Cancer Society. I added two refs inline for the sentence following the Matuk quote.
- No, I did not notice that the site is the American Cancer Society. I was browsing through wiki source definitions to find out what makes a website RS. Would you mind giving me a def for that? Is it automatically an RS because it belongs the the American Cancer Society? Also, what makes the American Cancer Society an RS for acupuncture historical information? I am not trying to be provocative, I simply do not know how RS for one topic or another is established. I could not find info related to reliability of websites as a source. I also see some anonymous edits in the main entry related to the phrases I just discussed here. Aren't anonymous edits supposed to be deleted?Soll22 (talk) 21:07, 19 February 2011 (UTC)
- MEDRS rules do not apply to non biomedical information, as per wiki MEDRS. This is an exact comment about historical provenance that does not have a direct citation, albeit from a potentially MEDRS source. That is my question. Is this correct according to RS? I also do not find an exact discussion of websites.Soll22 (talk) 21:22, 19 February 2011 (UTC)
Just guessing here, but it's probably because it's a lot to work with all at once. Often, editors have time (or energy, motivation, etc) to work on only specific or smaller issues... so his not responding doesn't necessarily mean he's avoiding anything. In any case, I'll give my input as best I can. I'm working just from what you have written here, not from having read the sources in question myself... but I'm having trouble following your objection. From what I've gathered, you're saying that the source doesn't develop a casual relationship between, say, the 12 rivers and the acupuncture channels. Is that right? However, what you've quoted above does appear to say that by using the word "corresponding". That the 12 channels correspond to the 12 rivers in China does indicate that the former is based on the latter. Perhaps I've misunderstood something here, and you can clarify for me. I'll read through the sources in more detail if necessary and when I have a chance. — Jess· Δ♥ 23:27, 19 February 2011 (UTC)
- Soll22, I have responded, when you participated in this exact discussion above. I responded again,
- “There are 365 days in the year, while humans have 365 joints [or acupoints]... There are 12 channel rivers across the land, while humans have 12 channel” – Ling Shu, and there are many more examples of “numerology to needles” quoted from classic texts in this book. PPdd (talk) 05:44, 17 February 2011 (UTC)
- And again,
- Matuk is a secondary peer reviewed history of medicine source published in a preeminent medical journal, backed up by multiple other RSs for the assertions in the article that cite Matuk. That's as good as it gets at Wiki. Furthermore, the Ling Shu agrees with all these sources - “There are 365 days in the year, while humans have 365 joints [or acupoints]... There are 12 channel rivers across the land, while humans have 12 channel” – , and there are many more examples of “numerology to needles” quoted from classic texts in this book. PPdd (talk) 16:52, 17 February 2011 (UTC)
- And those are not the only two places where the exact same thing came up.
- Soll22, after repeatedly responding to you and Luke643 on this, you simply ignored my response and started a whole new section on the same question to which I twice responded. Pretending that Matuk is talking about a different 365 and 12 than the points and meridians on which they are located can’t be sincere, and pretending that I did not respond by starting a new section is also not very sincere. PPdd (talk) 00:39, 20 February 2011 (UTC)
- i believe the whole second paragraph is garbage. i have tried to make it less POV for weeks now but with no success. this is by no means an accepted theory. something more acceptable would be the theories included in the deadman text as included in the alternate lede by Luke643. — Preceding unsigned comment added by Metabradley (talk • contribs) 00:12, 20 February 2011 (UTC)
- @Metabradley I don't know what "theory" you're referring to. The second paragraph seems good enough to me. Are you talking about biology? Or, perhaps, that bacteria can cause health problems? Both of these are strongly accepted within the scientific community, and we definitely have to report that.
- @PPdd, In fairness, I suggested on my talk page that Sol start a new section to discuss any refs he felt were being treated improperly. I definitely do not think he's trying to do anything but edit in good faith; He was simply following my suggestion. — Jess· Δ♥ 01:02, 20 February 2011 (UTC)
- Jess, if you read the paragraph carefully, it says that as there are four limbs to the body, there are four seasons in the year. There are 12 channels as there are 12 rivers in China. This does not imply a causal relationship, the number of channels was not based on, or selected according to the number of rivers in China. It is an observation of correspondence which the author makes, and states as such. The number of channels cannot in any case be attributed to the number of rivers in the China, as China's geography in the period during which the Nei Jing was codified varied from a small state to unified China back to multiple warring states. Also, there the Nei Jing is believed to be a compilation of many sources, and contains 162 chapters many of which offer information that does not necessarily agree. The astrological or river correspondance is in 1 out of 162 chapters. Soll22 (talk) 01:15, 20 February 2011 (UTC)
- @Sol Are we talking about the same source, which says: "It was no coincidence..... 12 vessels circulating blood and air corresponding to the 12 rivers"? This seems fairly clear to me that one is based on the other. I don't know how else to translate "corresponding to" except that there's a casual relationship between the two. You seem to be familiar with the source... is there another section (or another source entirely) which states that the numbers are based on something else? — Jess· Δ♥ 01:57, 20 February 2011 (UTC)
@ppdd: what are the names of the 12 rivers? --the link (which makes it seem so official) goes to a list of over 130 rivers in china. and what ancient chinese empire is the quote referring to? it all seems so ambiguous. i felt that the quote should have been removed when it was shown that there was a different number than 365 points and that they all have specific locations on the body, idicating a systematic analysis of the body (aka anatomy --but admittedly different that the one you are accustomed to) — Preceding unsigned comment added by Metabradley (talk • contribs) 01:58, 20 February 2011 (UTC)
@Jess· Δ♥ haha. funny. if you notice i referenced Deadman's Manual of Acupuncture and Luke643, neither of which are disputing biology. — Preceding unsigned comment added by Metabradley (talk • contribs) 01:48, 20 February 2011 (UTC)
the Mattuck quote seems overly esoteric/obscure and certainly not a theory that is accepted by most practitioners --maybe it would be appropriate for another page on esoteric acupuncture? also it is not covered within the main article so it should not be in the lede. — Preceding unsigned comment added by Metabradley (talk • contribs) 02:02, 20 February 2011 (UTC)
- Then I have no idea what "theory" you're referring to above. The word "theory" isn't used anywhere in the second paragraph. Also, please sign your comments with four tildes (~~~~). Hitting edit conflicts with SineBot every time I respond to you can get a bit tiresome. — Jess· Δ♥ 02:07, 20 February 2011 (UTC)
we all agree this is POV, right?
So why is it written with such an obvious POV? Not only are over half of the sentences and references in the lede critical or inaccurate. The tone of the lede creates a very POV reading experience. Even the parts which are supposed to be describing the practice of acupuncture are actually a (ever so slightly) veiled criticism. The lede does not represent the rest of the article.
It seems the lede is getting more POV rather than less even though it has been pointed out many times that the lede is POV and multiple non-POV ledes or alterations have been suggested. it seems anti-acupuncture POV edits are allowed directly into the article while NPOV edits are left to hang in the discussion page where only a few will see them.
Does anyone moderate changes to this article? What is their POV about acupuncture? —Preceding unsigned comment added by 204.187.140.30 (talk) 21:59, 19 February 2011 (UTC)
- Hello, yes, I agree. I appreciate your comments. It would be great if you could sign up as a user. I'm not sure anonymous comments go over very well. User name does preserve privacy, and your email is not necessary. You sound like you know your way around though.. so I probably don't need to tell you what to do..Yes, this is definitely POV and thanks for joining the discussion. Soll22 (talk) 22:25, 19 February 2011 (UTC)
Lede opening sentences
I just created two new sentences for the lede based on the definitions from the National Library of Medicine, and the licensing agencies of two of the states most prominent in establishing acupuncture legislation, California and New York. I hope no one will find issue with this. I slightly modified the existing opening sentence which contained the descriptor "alternative medicine" which has just today been objected to as belonging to the category of "weasel words". I assumed no one would object to removing something that potentially belongs to that category. Aside from removing "alternative medicine", I expanded the first sentence according to the exact description at Medline Plus, the National Library of Medicine Online. Please discuss before making any changes, I am available.Soll22 (talk) 22:44, 19 February 2011 (UTC)
- PPdd, I see you reversed my expansion on the lede. Please explain, like I said I am available for discussion. I absolutely did not delete any sourced material. I fully explained my changes in the paragraph above.Soll22 (talk) 22:53, 19 February 2011 (UTC)
- I'm not sure what you mean by your comment about alternative medicine being weasely. If our reliable sources describe it that way (which they do fairly consistently) then we definitely should be representing that. Perhaps you're referring to something elsewhere on the site which I haven't seen? In any case, I re-reverted the changes to the lead because they go against the MOS. We need to begin the article with a definition per WP:LEAD#Introductory text. In other words, we need to begin with "Acupuncture is", and not with "X group says Y about acupuncture". To be honest, I sort of like the way the article starts out right now. Of course there's always room for improvement, but it concisely sums up the topic, covering the definition, history, scientific reception and so forth all in compliance with WP:LEAD and other policies. I'm not convinced that some of the new information introduced really should come before all of that (such as, for instance, the scope of licensure. Is there a broader issue you're trying to address? — Jess· Δ♥ 23:17, 19 February 2011 (UTC)
- I think Sol is referring to where on another page I cited a source (Science Based Medicine, maybe?) ctriticising the introduction of the expressions "alternative medicine" and "complementary medicine", in order to make it appear to be real medicine, or to complement real medicine. That critic (I think he is at Yale medicine) was complaining about the new expression "integrative medicine", and he cited another critic who said it is better called "quackademic medicine", especially as its leading national proponenent just published in New England Journal of Medicine that the most resent systematic review showed acupuncture no better than a sham treatment, yet then recommended that it be used as a "complementary treatment", essentially recommending lying to patients in order to get a placebo effect, and this recommendation got through the peer reviewers and editor of NEJM and was published. I was in email correstpondence with the chief editor of NEJM for a while, and he never bit the bullet and admitted the mistake, instead weaseling around and saying "yes, it was a controversial subject, when the real complaint wasn't about whacky CAM, but about NEJM publishing a recommendation to lie to patients with a placebo treatment. PPdd (talk) 23:32, 19 February 2011 (UTC)
good job on the first paragraph! now lets see if we can remove the POV from the second one, it is full of crap. — Preceding unsigned comment added by Metabradley (talk • contribs) 23:26, 19 February 2011 (UTC)
- oh, it has been changed back again. — Preceding unsigned comment added by Metabradley (talk • contribs) 23:30, 19 February 2011 (UTC)
- (edit conflict)Yes, I reverted this edit as well. This edit is better (as it doesn't have the MOS concerns), but I think there are still a few issues. For instance, we already state earlier in the sentence that acupuncture is an alternative medicine, and that it treats patients. Because of that wording, saying again "to improve health and wellbeing" is redundant. More troublesome is that it also gives the impression of efficiency; What you're trying to say is that the goal is to improve health, but it instead comes off as the result. I'm also seeing an issue with the wording of "inserting needles into specific body points", since this article also covers random needling, which that def doesn't include. As far as I can tell, the current def encompasses all forms of acupuncture that this article contains, so it should be sufficient. Again, is there a broader issue you're trying to address? We might be able to go about tackling it a different way. — Jess· Δ♥ 23:41, 19 February 2011 (UTC)
- I have no problem with the alternative medicine label. PPdd just described it as weasel word earlier today on the talk page, which is why I thought no one would object. Yes there are other issues, but will discuss at a later time, it's more complex. Would you mind taking a look at above entry about the Matuck citation? This is an small but insidious issue that I have brought up several time as a direct comment to both WLU and PPdd and neither will make a comment about the information I am discussing. PPdd seems to deflect by repeatedly bringing up the cancer.org citation. That is not the main point of my inquiry. Thx..Soll22 (talk) 23:32, 19 February 2011 (UTC)
i preferred the opening paragraph before <alternative medicine> was added, i have no idea how many edits ago it was, changes happen so fast i can't keep up! — Preceding unsigned comment added by Metabradley (talk • contribs) 00:24, 20 February 2011 (UTC)
the sentence: "Its practitioners variously claim that it relieves pain, treats infertility, treats disease, prevents disease, promotes general health, or can be used for therapeutic purposes." seems too narrow. people other than practitioners (non-tcm medical professionals that recommend acupuncture, and patients that have received it and felt it worked for them) assert these things too. maybe it could be broadened? also, the implication of the word <claims> doesn't sit too well with me, maybe <assert> instead? — Preceding unsigned comment added by Metabradley (talk • contribs) 00:34, 20 February 2011 (UTC)
- It seems to me that "its practitioners" adequately sums up the topic without being weasly. If we were to change that section, it would have to be more specific, not less (i.e. "The X Institute claims", not "Some people claim"). I also think the word "claim" is perfectly appropriate here... "Asserts" tends to imply less evidentiary backing than "claims" does, so changing it would do the opposite of what it seems you're trying to. With that said, I see no reason to make a distinction between the two, and "claim" flows better and is more common than the alternative. — Jess· Δ♥ 01:08, 20 February 2011 (UTC)
- I would like to preserve or use the final part of the sentence that Jess deleted, coming from Medline Plus. This is the reason why, which I have been trying to present previously in various headings on the talk page:
Acupuncture, as I quoted before, through legislation, is a health care profession. Restoring health is not the exclusive domain of biomedical fields. Health is defined in many ways, emotional health, mental health, physical health, not all of which are treated exclusively through biomedical intervention. Counseling, social work, and other therapies are not defined in biomedical terms, yet they are considered health care professions. In acupuncture and tcm, health is achieved through treatment according to chinese medicine principles. This is in the wording of the law, therefore it is an accepted term and not subject to debate. Whether or not acupuncture can prove it's efficacy in medical trials is another thing. But acupuncture is effective within it's own parameters of establishing health. Acupuncture does not need validation from clinical trials to continue existing in it's current form. It is already approved as a health care profession. What clinical trials are trying to establish is the usefulness of acupuncture in a biomedical context, which is not the only context in which the human race defines health. Whether or not acupuncture will be approved as a sister to biomedical treatment in biomedical institutions is up for grabs. That acupuncture restores health under principles of chinese medicine is already established. I find that the entire entry is skewed to the sense that acupuncture's entire validity as a health care field is dependent upon proof in biomedical trials. This is untrue. Acupuncture as it stands now is an accepted health care field. It is important to state this in the lede, as this is the current accepted standing of acupuncture, and to distinguish the biomedical claims from claims of efficacy according to it's own parameters.Soll22 (talk) 01:57, 20 February 2011 (UTC)
- ^ Acupuncture compared with placebo in post-herpetic pain, Pain, Volume 17, Issue 4, December 1983, Pages 361-368, George T. Lewith , a, Jennifer Fielda and David Machina
- ^ Zhen Jiu Xue, p. 177f et passim.
- ^ a b c Deadman, Peter; et al. (2006). A Manual of Acupuncture. Journal of Chinese Medicine Publications. p. 11. ISBN 0951054678.
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(help) | Cite error: The named reference "Deadman" was defined multiple times with different content (see the help page). - ^ ”infectiousrhinitis caused by acute or chronic bacterial infection”, Cinnabar Acupuncture,[50]
- ^ ”effective treatments for urinary tract infections…using acupuncture and herbal treatments that are still in use today… findings on how germs cause disease revolutionized scientific theories about infectious diseases, including urinary tract infections. Antibiotics have been prescribed since… a yellow-sticky tongue coating; and a rapid, "soggy" pulse”, TAKING CONTROL OF URINARY TRACT INFECTIONS, Traditinal Chinese Medicine Information Page, TCM Page.com, [51]
- ^ ”Acute diarrhea is most commonly caused by bacterial, viral or parasitic infection, by intolerance to foods or by a reaction to certain medicines. Allopathic practitioners tend to use antibiotics to treat”, TCM For Diarrhea, Altmed.com, [52]
- ^ What Acupuncture Can Treat, Acufinder.com, [53]
- ^ What Can Acupuncture Treat, Ageless Herbs, [54]
- ^ a b Some Acupuncture Points Which Treat Disorders of Blood, Peter Deadman and Mazin Al-Khafaji, [55]
- ^ Ernst E; Pittler MH; Wider B; Boddy K (2007). "Acupuncture: its evidence-base is changing". Am. J. Chin. Med. 35 (1): 21–5. doi:10.1142/S0192415X07004588. PMID 17265547.
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ignored (help) - ^ Lee A; Done ML; Lee, Anna (2004). "Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting". Cochrane database of systematic reviews (Online) (3): CD003281. doi:10.1002/14651858.CD003281.pub2. PMID 15266478.
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ignored (help) - ^ Dibble SL; Luce J; Cooper BA; Israel J; Cohen M; Nussey B; Rugo H (2007). "Acupressure for chemotherapy-induced nausea and vomiting: a randomized clinical trial". Oncol Nurs Forum. 34 (4): 813–20. doi:10.1188/07.ONF.xxx-xxx. PMID 17723973.
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