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: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, [[User:Middle 8|Middle 8]] ([[User talk:Middle 8|talk]]) 11:29, 8 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, [[User:Middle 8|Middle 8]] ([[User talk:Middle 8|talk]]) 11:29, 8 February 2011 (UTC) |
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::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. [[User:WLU|WLU]] <small>[[User talk:WLU|(t)]] [[Special:Contributions/WLU|(c)]] Wikipedia's rules:</small>[[WP:SIMPLE|<sup><span style='color:#FFA500'>simple</span></sup>]]/[[WP:POL|<sub><span style='color:#008080'>complex</span></sub>]] 11:50, 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. [[User:WLU|WLU]] <small>[[User talk:WLU|(t)]] [[Special:Contributions/WLU|(c)]] Wikipedia's rules:</small>[[WP:SIMPLE|<sup><span style='color:#FFA500'>simple</span></sup>]]/[[WP:POL|<sub><span style='color:#008080'>complex</span></sub>]] 11:50, 8 February 2011 (UTC) |
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::::@WLU -- Say what? I love this guy's edits! They somehow epitomize Wikipedia - hence my encouragement. --[[User:Middle 8|Middle 8]] ([[User talk:Middle 8|talk]]) 10:16, 10 February 2011 (UTC) |
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:::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. |
:::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. |
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:::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. |
:::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. |
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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)
- Note - I put in my tongue map request in the section below before reading this section. PPdd (talk) 15:20, 8 February 2011 (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)
- You have made my case for me. I don't need to respond. Wilfridselsey (talk) 12:04, 29 September 2010 (UTC)
- Good, I'll consider the current page adequate then, and the discussion closed. WLU (t) (c) Wikipedia's rules:simple/complex 14:01, 29 September 2010 (UTC)
- You have made my case for me. I don't need to respond. Wilfridselsey (talk) 12:04, 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)
- @WLU -- sure there are lots of national health authorities. There are lots of journals too. We need not cite them all, but the ones that are about acupuncture are good candidates, eh? :-) --Middle 8 (talk) 10:12, 22 January 2011 (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)
- 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)
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)
- I agree, it reads like an advert for acupuncture. PPdd (talk) 05:41, 25 January 2011 (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)
- Continuing this discussion is pointless because I have seen no references cited and therefore there is no justification for changing the page. WLU (t) (c) Wikipedia's rules:simple/complex 12:08, 26 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)
- Wilfrid, can you link to The American College of Physicians and the American Pain Society joint clinical practice guidelines? Anthony (talk) 20:01, 2 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)
- Thanks for that. Anthony (talk) 12:18, 4 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)
Category:Pseudoscience (still) doesn't belong here? Let's try to finally reach consensus on this.
User:Yworo was correct to undo User:Badger Drink's revert that restored category:pseudoscience. The relevant policies are WP:FRINGE/PS and WP:RS/AC. To meet the threshold in the former, we need a source of the caliber described in the latter. No one has presented such a source, and until someone does, the category should not be used here. --Middle 8 (talk) 03:47, 1 December 2010 (UTC)
- Also, I've followed this content dispute for several years and have never seen anything like consensus emerge on it. Please point me to the specific, archived discussion if I may have missed it. thx, Middle 8 (talk) 08:17, 1 December 2010 (UTC)
- The argument mostly went that the traditional chinese medicine approach/explanation was pseudoscientific, the fact that acupuncture relieves pain possibly through the placebo effect is not. I don't feel that strongly either way and haven't seen a sufficiently reliable source to definitively label all or part of it as pseudoscience and the scientific consensus isn't clear yet. There are several sources that use the word, but I don't think it's there yet. WLU (t) (c) Wikipedia's rules:simple/complex 01:44, 3 December 2010 (UTC)
- Editors should be able to be reach consensus by applying these fundamental criteria of what constitutes a pseudoscience, since these are factual criteria, not matters of editors' opinions.69.199.196.246 (talk) 21:12, 27 December 2010 (UTC)
- If acupunture claims to be a "science", but uses only tradition and authority to make just SOME of its claims (possible e.g., the number "365" based on the "number" of days in a year, or "12" based on the "number" of "major" rivers in China), then it is a pseudoscience, even if attempts to apply other sciences or scientific methodology in other areas. The basic idea of pseudoscience is that some science is used in some parts, but non-science is used in others, or in combination with science.
- Here[15] is an easy read for editors who are still making up their mind on this, a publication from Northwestern, containing, e.g., “…mystical numerical associations, called the Da shu, or “great numbers”… 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 abosolutely highest caliber source on this is the Ling Shu, considered to be the "Canon of acupuncture", which has also stuff like this[16], which smacks of numerology. This might even put acupuncture in the “occultism” category, but at a minimum, when combined with any claims of scientific evidence, argues for categorization as “pseudoscience". Since this satisfies the high caliber source requested by Middle 8 above, and so satisfies the relevant policies WP:FRINGE/PS and WP:RS/AC, I will restore User:Badger Drink's revert that restored category:pseudoscience, but I am still open to other perspectives.69.199.196.246 (talk) 22:29, 27 December 2010 (UTC)
- The category does not get placed on article based on original research. It gets placed only when a majority of scientific sources agree on the designation. There's been an WP:ARBCOM decision about this, and acupuncture has not been shown to meet the criteria required by ArbCom for the application of this category. In particular, you are using your own judgment about the contents of primary sources. That's right out as a method for determining whether the label is applicable. Yworo (talk) 23:18, 27 December 2010 (UTC)
- The Arbitration ruling may be found here. According to the guidelines there, acupuncture would be classified under the heading "Questionable science" because it has a large following and because there is not a broad and general agreement that it is pseudoscience (i.e. research continues to be done on it by qualified medical researchers). According to the ArbCom decision, the category does not get placed on articles about questionable science, only on for subjects for which there is a broad and citable opinion that most or all of the scientific community considers it such. You may also want to note that not following the outlines of this arbitration decision can lead to sanctions. Yworo (talk) 23:27, 27 December 2010 (UTC)
- Yworo, thank you for alerting to the ArbCom decision, and coming back to provide a link.
- The arguments given in the previous paragraph (e.g., "research continues to be done on it by qualified medical researchers") would also apply to the pseudoscience of homeopathy, which has the category "pseudoscience", following arbitration. I only found out about acupuncture points being based on "the 12 rivers flowing toward the Central Kindgom [at some arbitrary time in the past]; and 365 [365 and about 1/4?] parts of the body, one for each day of the year" after reading this Wiki article, which entirely changed my POV as to the "pseudoscience" issue.
- It would be good to put a permanent warning at the top of the talk page about ALL ArbCom rulings on this article, so editors do not waste time responding to what appears to be an ongoing attempt at reaching consensus by editors. I do not know how to do this, or I would put one there.69.199.196.246 (talk) 00:08, 28 December 2010 (UTC)
The "ArbCom ruling" just cited by Yworo is NOT about acupuncture. Acupunture IS called a "pseudoscience" by the scientific community, e.g., on the Science-Based Medicine website here[17]. It does not work any more than a placebo, as per the multiply referenced year 2010 meta analyses here[18] and here[19]. Take a theoretical foundation based on locating points using the "number" of rivers in the Chinese empire and the "number" of days a year (it would have been more accurate to find 365 1/4 accupuncture points to "scientifically" test), add a "force" that has been overlooked by physics, and add scientific studies on top, and you have the paradigm of pseudoscience. This is using the definition that is the true outcome of the above cited ArbCom ruling. I will put the category header back in. Please do not remove it without citing a reliable source that contradicts the Science-Based Medicine article calling it "pseudoscience" here[20]. Middle 8said "we need a source of the caliber described in the latter, explaining his revert. This[21] is such a cite. Please do not delete the category without a RS that contradicts this, explicitly stating that it is not a pseudoscience.69.199.196.246 (talk) 08:38, 28 December 2010 (UTC)
- I don't like acupuncture. I think it's stupid, pseudoscientific nonsense fetishized in the West into something it never was. But I don't think we've met the threshold for it to be called pseudoscience just yet. TCM maybe (probably) but not acupuncture, which consistently has found effects for pain and nausea (probably due to placebo rather than penetration, but still). SBM, a site which I love, is unfortunately not a reliable source and is at an extreme of the continuum (this is tacitly acknowledged on the site itself by its many posts decrying new and credulous studies - those studies are still being published, therefore the medical community still has a large number of people who don't think acupuncture is pseudoscience). What we need is a large number of peer-reviewed secondary sources from mainstream medical journals that indicates acupuncture has lost its shine and is considered pseudoscience. WLU (t) (c) Wikipedia's rules:simple/complex 15:21, 30 December 2010 (UTC)
- WLU, how can you say "TCM maybe (probably) but not acupuncture"? Acupuncture is part of TCM, so "TCM maybe (probably)" implies "acupuncture maybe (probably)". PPdd (talk) 01:12, 25 January 2011 (UTC)
- It depends on how you define acupuncture. If you define it as "the use of fine needles to penetrate the skin to alleviate symptoms", acupuncture has some merit based on the best studies. If you say "the use of fine needles to modulate the yin and yang of qi based on time of day and colour of the tongue in order to treat disease", acupuncture is pseudoscientific nonsense based on prescientific reasoning (mostly bloodletting and astrology). Acupuncture (needles through the skin without attention to anatomical structure or location beyond safety) has some evidence base supporting its use in the treatment of pain and nausea. The use of TCM methodologies and diagnostic tools (observing the tongue, measuring multiple pulses, selecting specific acupuncture points on specific meridians, choosing the points based on the time of day, the use of moxibustion) is pretty obvious pseudoscience. There is reasonable evidence for poking needles into the skin to alleviate pain and nausea. There's none to support the crap and ritual surrounding it. That's the distinction I'm trying to make. Eventually we may call one dry needling and the other acupuncture, and draw a distinct line between the two, but I don't think we're there yet. WLU (t) (c) Wikipedia's rules:simple/complex 03:40, 25 January 2011 (UTC)
- I agree that a problem with pseudoscience is shifting the definition around. Randomly sticking needles should not be called acupunture, since it does not rely on the meridians based on the twelve rivers of a Chinese empire, and does not locate points based on the number of days in a year. But if it is found to be effective it will be called acupuncture, and acupuncturists will all say they are confirmed. I recently read an article whereby some neurotransmitter associated with pain relief was measured as being increased by sticking needles, but I can't find it. Can you direct me to it? PPdd (talk) 05:59, 25 January 2011 (UTC)
- This is the most recent one I can think of that might come close, with this analysis by Orac. You might be thinking of a different one, but I can't think of any that involve neurotransmitters (adenosine in this study was measured outside of the central nervous system. In mice). WLU (t) (c) Wikipedia's rules:simple/complex 11:26, 25 January 2011 (UTC)
- I agree that a problem with pseudoscience is shifting the definition around. Randomly sticking needles should not be called acupunture, since it does not rely on the meridians based on the twelve rivers of a Chinese empire, and does not locate points based on the number of days in a year. But if it is found to be effective it will be called acupuncture, and acupuncturists will all say they are confirmed. I recently read an article whereby some neurotransmitter associated with pain relief was measured as being increased by sticking needles, but I can't find it. Can you direct me to it? PPdd (talk) 05:59, 25 January 2011 (UTC)
- It depends on how you define acupuncture. If you define it as "the use of fine needles to penetrate the skin to alleviate symptoms", acupuncture has some merit based on the best studies. If you say "the use of fine needles to modulate the yin and yang of qi based on time of day and colour of the tongue in order to treat disease", acupuncture is pseudoscientific nonsense based on prescientific reasoning (mostly bloodletting and astrology). Acupuncture (needles through the skin without attention to anatomical structure or location beyond safety) has some evidence base supporting its use in the treatment of pain and nausea. The use of TCM methodologies and diagnostic tools (observing the tongue, measuring multiple pulses, selecting specific acupuncture points on specific meridians, choosing the points based on the time of day, the use of moxibustion) is pretty obvious pseudoscience. There is reasonable evidence for poking needles into the skin to alleviate pain and nausea. There's none to support the crap and ritual surrounding it. That's the distinction I'm trying to make. Eventually we may call one dry needling and the other acupuncture, and draw a distinct line between the two, but I don't think we're there yet. WLU (t) (c) Wikipedia's rules:simple/complex 03:40, 25 January 2011 (UTC)
- WLU, how can you say "TCM maybe (probably) but not acupuncture"? Acupuncture is part of TCM, so "TCM maybe (probably)" implies "acupuncture maybe (probably)". PPdd (talk) 01:12, 25 January 2011 (UTC)
- A comment on one of the SBM articles: It seems pretty clear from the substance of the author's comments and his aggrieved tone that he feels his "side", i.e. the extremely dismissive view toward acupuncture, is losing. He says "One of the things that disturbs me the most about where medicine is going is the infiltration of quackery into academic medicine. ... Probably the most common form of pseudoscience to wend its way into what should be bastions of scientific medicine is acupuncture. Harvard, Stanford, Yale, M. D. Anderson, and many others ... I never expected it to show itself in one of the Nature journals, as it did in the study I just mentioned. I also never expected it to show up in that flagship of clinical journals, ...(NEJM)...". These are comments from a guy pissed at the widespread acceptance of acupuncture. Perhaps this source can serve as guidance with respect to "undue weight": excessive deference to the SMB guy's view should be avoided if it's dwarfed by mainstream acceptance. Ernst expressed a similar view with respect to the WHO: paraphrasing, "they're the great big WHO; critics like me are isolated individuals; how can we get our views heard?" Don't worry, Eddzie Baby -- Wikiality can help ya toot your horn! LOL --Middle 8 (talk) 14:14, 11 January 2011 (UTC)
- Dr. Gorski is annoyed that the NEJM is buying into the magic that practitioners and believers use to explain acupuncture. We can detect the action of a single atom, even a single photon, yet somehow acupuncture manipulates an "energy" that behaves nothing like any other energy we've ever found, that can't be measured, and most strangely, can't be reliably agreed-upon even by its advocates. Science produces a convergence of opinion based on evidence and investigation regarding real phenomenon. This is worse than pathological science because even believers can't reproduce results. We know a lot about the body, yet we've never managed to detect a meridian, acupuncture point or qi (and why would you considering the former two are based on astrology rather than biology). That is SBM's overall critique of alternative medicine including acupuncture - it ignores all the knowledge we have in order to arrive at a pre-concieved conclusion. I'm sure Dr. Gorski would be one of the first to say that his side is not "losing" but is upset the way the pendulum is swinging away from evidence and towards politics and opinion. The mainstream opinion has actually shifted substantially away from acupuncture in the past couple years. It has discarded the belief that it's useful for nearly anything except pain and nausea; now the focus is on these two symptoms, which are extremely vulnerable to expectation and placebo. Excessive deference to beliefs should be avoided until it is clear that those beliefs have some sort of root in reality.
- However, since SBM is not being considered as a source for the page, this is all so much chatter. WLU (t) (c) Wikipedia's rules:simple/complex 18:06, 12 January 2011 (UTC)
- Gorsi is annoyed at a lot more than NEJM, as he makes plain in the excerpt I quoted.
- WLU wrote: "The mainstream opinion has actually shifted substantially away from acupuncture in the past couple years" -- according to which sources? Designing studies properly remains a challenging problem, and care should be taken that "sham" controls do not introduce falsely negative results (see this commentary). It shouldn't be surprising that docs and scientists who recognize this caveat, and understand that the map (e.g. TCM theory) is not the territory (e.g. what happens to patients when they are needled in a certain way), would not dismiss acupuncture. --Middle 8 (talk) 10:29, 15 January 2011 (UTC)
- According to meta-analyses using adequate placebos, thanks. Which have consistently found that acupuncture is only effective for placebo-susceptible pain and nausea. That commentary makes the false assumption that all placebos are equal. They are not. Two pills are more effective than one, pill colour affects its "effectiveness" for different conditions, injections are more effective than pills, elaborate placebos are more effective than simple ones, exotic, foreign, novel and "sciencey" placebos are more effective than plain ones, high practitioner confidence and faith in the placebo (in both verbal and nonverbal forms) increases effectiveness, and those with rituals involved are more effective than those without. Acupuncture is an injection preceded by an elaborate, lengthy, nonsense-babble-filled "diagnosis" that comes from exotic China. It's hardly surprising that it's more effective than a simple "take this pill". Not all placebos are equal and simply assuming they are, as that commentary appears to, does not make it so. If a sham control introduces "negative" results, that suggests that either the sham isn't a sham, or the treatment isn't a treatment. Every placebo control used with acupuncture - varying the point stabbed, using sham needles, not using needles at all, they've come out equal to real acupuncture in properly designed trials. And invariably the result has been "sham acupuncture is as good as real" rather than "real acupuncture isn't real". These trials are useful in demonstrating how worthless TCM "diagnosis" and treatment is for everything except enhancing the placebo effect. You should read the full set of articles on acupuncture at SBM, you'd find most of these ideas explored at length and it would inform you on just how difficult it can be to design a good acupuncture trial - and that most trials simply aren't that good. I also find it anecdotally interesting that the two scientists I am aware of who attempted to apply stringent scientific controls to CAM research (Ernst and R. Barker Bausell) both came away unconvinced. WLU (t) (c) Wikipedia's rules:simple/complex 13:57, 15 January 2011 (UTC)
- I have been in email correspondence with the editor of NEJM about this. There seems to be a misunderstanding by some Wiki editors above of the basis of the uproar that the article caused. The problem was that acupuncture was found to be equivalent to a sham, then the author recommended it as a complimentary treatment. In effect, NEJM editors let slip a recommendation of lying to patients and then administering placebos. The fact that acupuncture was the particular placebo was incidental to the editorial (and peer reviewers') error of letting this clause slip into the conclusion.PPdd (talk) 09:31, 16 January 2011 (UTC)
- According to meta-analyses using adequate placebos, thanks. Which have consistently found that acupuncture is only effective for placebo-susceptible pain and nausea. That commentary makes the false assumption that all placebos are equal. They are not. Two pills are more effective than one, pill colour affects its "effectiveness" for different conditions, injections are more effective than pills, elaborate placebos are more effective than simple ones, exotic, foreign, novel and "sciencey" placebos are more effective than plain ones, high practitioner confidence and faith in the placebo (in both verbal and nonverbal forms) increases effectiveness, and those with rituals involved are more effective than those without. Acupuncture is an injection preceded by an elaborate, lengthy, nonsense-babble-filled "diagnosis" that comes from exotic China. It's hardly surprising that it's more effective than a simple "take this pill". Not all placebos are equal and simply assuming they are, as that commentary appears to, does not make it so. If a sham control introduces "negative" results, that suggests that either the sham isn't a sham, or the treatment isn't a treatment. Every placebo control used with acupuncture - varying the point stabbed, using sham needles, not using needles at all, they've come out equal to real acupuncture in properly designed trials. And invariably the result has been "sham acupuncture is as good as real" rather than "real acupuncture isn't real". These trials are useful in demonstrating how worthless TCM "diagnosis" and treatment is for everything except enhancing the placebo effect. You should read the full set of articles on acupuncture at SBM, you'd find most of these ideas explored at length and it would inform you on just how difficult it can be to design a good acupuncture trial - and that most trials simply aren't that good. I also find it anecdotally interesting that the two scientists I am aware of who attempted to apply stringent scientific controls to CAM research (Ernst and R. Barker Bausell) both came away unconvinced. WLU (t) (c) Wikipedia's rules:simple/complex 13:57, 15 January 2011 (UTC)
The irony is this: Wikipedia is a "pseudo-encyclopedia", a crap source according even to its own standards. It doesn't really matter what is written at Wikipedia except to those who make a hobby of writing here. 173.73.6.136 (talk) 06:44, 31 December 2010 (UTC)
- Wikipedia DOES matter. It is usually the first article listed in a Google search, indicating that a huge number of people read it. That said, I loved your "pseudo-encyclopedia" coinage.PPdd (talk) 09:35, 16 January 2011 (UTC)
- Glad you liked the "pseudo-encyclopedia" coinage. :-) Yes, Wikipedia is important in the sense that it's popular. Lots of things are popular, but that doesn't mean they're useful or worth improving. Fundamentalist religion is popular and (therefore) important too, but that doesn't mean one should look to it for truth or devote a bunch of time to "improving the project". I suppose that non-fundamentalists—humanists for example—could improve the world by joining fundamentalist churches and trying to steer them toward a less crazy course. But there are other ways of improving the world without having to play within such crazy, dysfunctional systems. I trust that the analogy is taken. :-) --173.73.6.136 (talk) 00:40, 25 January 2011 (UTC)
- Like it or not, Wikipedia is defining what counts as knowledge in the 21st Century. I refrained from editing for years becuase of defects with it. But people read it more and more, an even seasoned academisians and skeptics are known to read it in their closet. It matters what is in it, and reading it gives the reader a kind of knowlege. It has problems, but so does the peer review process and statistics-ignorant scientics do a terrible job at experimental design and data analysis, but the results get published anyway, and publication bias and the file drawer effect worsen what is already bad statistics work. Its what we have, and improvements should be made at Wikipedia. So, 173.73.6.136... get a name. PPdd (talk) 01:02, 25 January 2011 (UTC)
- Glad you liked the "pseudo-encyclopedia" coinage. :-) Yes, Wikipedia is important in the sense that it's popular. Lots of things are popular, but that doesn't mean they're useful or worth improving. Fundamentalist religion is popular and (therefore) important too, but that doesn't mean one should look to it for truth or devote a bunch of time to "improving the project". I suppose that non-fundamentalists—humanists for example—could improve the world by joining fundamentalist churches and trying to steer them toward a less crazy course. But there are other ways of improving the world without having to play within such crazy, dysfunctional systems. I trust that the analogy is taken. :-) --173.73.6.136 (talk) 00:40, 25 January 2011 (UTC)
- Wikipedia DOES matter. It is usually the first article listed in a Google search, indicating that a huge number of people read it. That said, I loved your "pseudo-encyclopedia" coinage.PPdd (talk) 09:35, 16 January 2011 (UTC)
- And we acknowledge this by categorizing wikipedia as a non-reliable source and can not be used as a reference on wikipedia. WLU (t) (c) Wikipedia's rules:simple/complex 16:16, 1 January 2011 (UTC)
- That comment entirely misses the import of my first sentence above. It doesn't matter whether or not Wikipedia somehow acknowledges that it's a crap source; the point is that it quite simply is one. 173.73.6.136 (talk) 09:54, 8 January 2011 (UTC)
- Can't let this stand. It's a crap source because it is often written by amateurs who sometimes misunderstand the subject, is occasionally vandalised, and is sometimes written by people with no understanding of the scientific method or the peer-review process. If you read it with this in mind, it is an excellent source because you can follow up its assertions in the sources it cites and see if the article reflects current mainstream scholarship. Anthonyhcole (talk) 10:43, 8 January 2011 (UTC)
- So Wikipedia is good because, while articles may suck, readers can use the sources cited by those articles (which may suck at any level, including poorly-chosen sources) to verify whether they suck or not? :-) This exercise is circular reasoning, and sounds like no advantage over using Google and more specific indices like PubMed, Readers' Guide, etc. Of course, people are lazy and gullible and will accept all kinds of nonsense: superstition, pseudoscience, and now pseudo-encyclopedias... --173.73.6.136 (talk) 00:40, 25 January 2011 (UTC)
- Oh. Of course. I see. Thanks. --Anthonyhcole (talk) 02:09, 25 January 2011 (UTC)
- The fact that "people accept... pseudo-encyclopeidias" is a reason to do work to make Wikipedia better. Early on, I never really used it because of its "pseudo" problems. Now, after much work by many have improved it, it is usually the first thing I use. And if I come across an article I think has problems, I try to spend time to fix them. User:173.73.6.136, you should get a name and help out, too. Your contributions would be helpful and welcome. And you never get to experience the emotions of an edit-war until you do. Nor the even better feeling you get as you gradually begin to WP:assume good faith, which carries over nicely into real world encounters with people. PPdd (talk) 02:57, 25 January 2011 (UTC)
- Oh. Of course. I see. Thanks. --Anthonyhcole (talk) 02:09, 25 January 2011 (UTC)
- So Wikipedia is good because, while articles may suck, readers can use the sources cited by those articles (which may suck at any level, including poorly-chosen sources) to verify whether they suck or not? :-) This exercise is circular reasoning, and sounds like no advantage over using Google and more specific indices like PubMed, Readers' Guide, etc. Of course, people are lazy and gullible and will accept all kinds of nonsense: superstition, pseudoscience, and now pseudo-encyclopedias... --173.73.6.136 (talk) 00:40, 25 January 2011 (UTC)
- Can't let this stand. It's a crap source because it is often written by amateurs who sometimes misunderstand the subject, is occasionally vandalised, and is sometimes written by people with no understanding of the scientific method or the peer-review process. If you read it with this in mind, it is an excellent source because you can follow up its assertions in the sources it cites and see if the article reflects current mainstream scholarship. Anthonyhcole (talk) 10:43, 8 January 2011 (UTC)
- That comment entirely misses the import of my first sentence above. It doesn't matter whether or not Wikipedia somehow acknowledges that it's a crap source; the point is that it quite simply is one. 173.73.6.136 (talk) 09:54, 8 January 2011 (UTC)
- Pseudoscience - Acupuncture is based, in part, on occult ideas like a correspondence between the number of rivers in a particular Chinese empire, the number of days in the year, and various astrological ideas. Layered on top of these occult foundations are pretended scientific ideas and scientific claims. That is archetypical of a pseudoscience.PPdd (talk) 01:34, 15 January 2011 (UTC)
- Comment The map is not the territory. Just because a prescientific culture explains an observation in terms peculiar to their culture does not moot the observation itself. For example, Western herbs whose activity was once explained using humoral theory are found to have some active ingredient. Another example is eclipses: some ancient culture might have explained these in mythological terms while creating a calendar that predicts eclipses (perhaps not perfectly, but better than chance). Similar questions should be kept in mind when evaluating TCM: one should not discard a traditional framework if valid observations are entrained in it along with nonscientific or antiscientific ideas. --Middle 8 (talk) 10:29, 15 January 2011 (UTC)
- Just because a prescientific culture made an observation, doesn't mean it's real. And many of those beliefs about herbs were wrong. Echinacea consistently fails adequately controlled tests. It's the reality that determines whether a treatment works, not its age, and holding on to the ancient technique when there is a scientific alternative is simply stupid. If acupuncture actually has specific effects, TCM should be discarded in favour of scientific investigation that validates its use in multiple groups, in appropriate circumstances. Traditional frameworks should be discarded once a scientific explanation is validated. The whole point of scientific investigation is to determine what aspects of the traditional approach have objective value, and discard the rest. To think otherwise means a presumably emotional attachment to the worthless, possibly harmful prescientific aspects. If you don't need to penetrate the skin to get the effects of acupuncture, it's unethical and just stupid to keep jamming needles into the skin when it can cause, say, death. If acupuncture does help with pain and nausea but the TCM "diagnosis" is worthless because the location of the needle is irrelevant, you are wasting time and money by putting clients through that diagnostic procedure. If acupuncture works and can be delivered quickly and safely without a lot of voodoo nonsense, it will be adopted by medicine. If it's benefits are dubious and placebo-based, it should justifiably be discarded. WLU (t) (c) Wikipedia's rules:simple/complex 13:57, 15 January 2011 (UTC)
- "Just because a prescientific culture made an observation, doesn't mean it's real." - as the saying goes, "duh"; most of what you say goes without saying. My point is just that a lot of sources say or imply that because yin and yang and qi don't exist, acupuncture can't be real. (You appear to make this straw man argument above when you say "We can detect the action of a single atom, even a single photon, yet somehow acupuncture manipulates an "energy" that behaves nothing like any other energy we've ever found, that can't be measured, and most strangely, can't be reliably agreed-upon even by its advocates.") There are aspects of TCM, like tongue diagnosis and other signs, that are externally verifiable. A patient with "Spleen qi deficiency" will have certain signs and symptoms, even though one will never find "spleen qi" (although one may eventually settle on biomedical correlates, such as Langevin's hypothesis that fascial tissue planes correspond to meridians). To the extent TCM makes useful predictions that aren't explainable biomedically, it's useful -- also a "duh" statement. If and when they figure what is going on beyond placebo, sure, no need for the archaic framework. --Middle 8 (talk) 10:51, 22 January 2011 (UTC)
- The guts of research is teasing out the placebo from the real. The "magic" parts of acupuncture, the lengthy diagnosis and fake, complicated-sounding babble probably serve to enhance the placebo effect and that's it. There's no reason to give the TCM practitioners any extra weight just because their prescientific nonsense is old, or comes from far away. If there's a real relationship between tongue diagnosis and disease, it should be easy to demonstrate when broken down into its basic components. That's science. It certainly shouldn't be taken as a give. WLU (t) (c) Wikipedia's rules:simple/complex 03:51, 25 January 2011 (UTC)
- As you pointed out below, the jury remains out on whether TCM is mere pseudoscience. That's partly because scientists have yet to rule out the possibility that there are clinically useful aspects of TCM, cf. Langevin & meridians. The question is not whether to be scientific about acupuncture; the question is how to do it properly, and that question is not settled in the literature. --Middle 8 (talk) 00:20, 26 January 2011 (UTC)
- The guts of research is teasing out the placebo from the real. The "magic" parts of acupuncture, the lengthy diagnosis and fake, complicated-sounding babble probably serve to enhance the placebo effect and that's it. There's no reason to give the TCM practitioners any extra weight just because their prescientific nonsense is old, or comes from far away. If there's a real relationship between tongue diagnosis and disease, it should be easy to demonstrate when broken down into its basic components. That's science. It certainly shouldn't be taken as a give. WLU (t) (c) Wikipedia's rules:simple/complex 03:51, 25 January 2011 (UTC)
- "Just because a prescientific culture made an observation, doesn't mean it's real." - as the saying goes, "duh"; most of what you say goes without saying. My point is just that a lot of sources say or imply that because yin and yang and qi don't exist, acupuncture can't be real. (You appear to make this straw man argument above when you say "We can detect the action of a single atom, even a single photon, yet somehow acupuncture manipulates an "energy" that behaves nothing like any other energy we've ever found, that can't be measured, and most strangely, can't be reliably agreed-upon even by its advocates.") There are aspects of TCM, like tongue diagnosis and other signs, that are externally verifiable. A patient with "Spleen qi deficiency" will have certain signs and symptoms, even though one will never find "spleen qi" (although one may eventually settle on biomedical correlates, such as Langevin's hypothesis that fascial tissue planes correspond to meridians). To the extent TCM makes useful predictions that aren't explainable biomedically, it's useful -- also a "duh" statement. If and when they figure what is going on beyond placebo, sure, no need for the archaic framework. --Middle 8 (talk) 10:51, 22 January 2011 (UTC)
- Just because a prescientific culture made an observation, doesn't mean it's real. And many of those beliefs about herbs were wrong. Echinacea consistently fails adequately controlled tests. It's the reality that determines whether a treatment works, not its age, and holding on to the ancient technique when there is a scientific alternative is simply stupid. If acupuncture actually has specific effects, TCM should be discarded in favour of scientific investigation that validates its use in multiple groups, in appropriate circumstances. Traditional frameworks should be discarded once a scientific explanation is validated. The whole point of scientific investigation is to determine what aspects of the traditional approach have objective value, and discard the rest. To think otherwise means a presumably emotional attachment to the worthless, possibly harmful prescientific aspects. If you don't need to penetrate the skin to get the effects of acupuncture, it's unethical and just stupid to keep jamming needles into the skin when it can cause, say, death. If acupuncture does help with pain and nausea but the TCM "diagnosis" is worthless because the location of the needle is irrelevant, you are wasting time and money by putting clients through that diagnostic procedure. If acupuncture works and can be delivered quickly and safely without a lot of voodoo nonsense, it will be adopted by medicine. If it's benefits are dubious and placebo-based, it should justifiably be discarded. WLU (t) (c) Wikipedia's rules:simple/complex 13:57, 15 January 2011 (UTC)
- Pseudoscience - There are no anatomical structures corresponding to meridians and points, based on the 12 rivers of the Chinese empire, or 365 days of the year. These bases of acupuncture directly contradict developmental biology. Piling a bunch of scientific rituals on top of these nonexistent "structures" is archetypical pseudoscience.PPdd (talk) 20:29, 15 January 2011 (UTC)
- Yes, I agree. But your statement is original research that states the painfully obvious. Until a sizable minority of the scientific community agree that it is pseudoscience, we can not place the category on the page. Given an ostensibly medical topic like acupuncture, we need several high-quality journals proclaiming it to be nonsense. And given the journals publishing shoddy, poorly-interpreted research as if it justified acupuncture, we may be waiting a while for that. I understand your frustration, I see how ridiculous the claims are, and if this were my encyclopedia it would clearly state that acupuncture is nonsense and pseudoscience. But because we must give due weight to the scholarly opinion, we can't put it up yet. I'm sure it will come, but it will take time. WLU (t) (c) Wikipedia's rules:simple/complex 01:06, 16 January 2011 (UTC)
- WLU, thank you for explaining how Wikipedia works. Mission accomplished. I have provided the scholarly opinion you said is needed, with direct statements like "acupuncture is a pseudoscience", below. You said "it will take time". You were right, it took time... my time, and a waste of it. But that's the way the Wiki works.PPdd (talk) 09:19, 16 January 2011 (UTC)
- Yes, I agree. But your statement is original research that states the painfully obvious. Until a sizable minority of the scientific community agree that it is pseudoscience, we can not place the category on the page. Given an ostensibly medical topic like acupuncture, we need several high-quality journals proclaiming it to be nonsense. And given the journals publishing shoddy, poorly-interpreted research as if it justified acupuncture, we may be waiting a while for that. I understand your frustration, I see how ridiculous the claims are, and if this were my encyclopedia it would clearly state that acupuncture is nonsense and pseudoscience. But because we must give due weight to the scholarly opinion, we can't put it up yet. I'm sure it will come, but it will take time. WLU (t) (c) Wikipedia's rules:simple/complex 01:06, 16 January 2011 (UTC)
- "ACUPUNCTURE IS A PSEUDOSCIENCE." - John P. Jackson[22], the physicist who led the team to debunk the Shroud of Turin myth.
- "Let’s be clear: acupuncture is pseudoscience"[23]- Steven Salzberg, Director of the Center for Bioinformatics and Computational Biology and professor at the University of Maryland - [24]
- “Acupuncture research… characteristic of pseudoscience” [25] - Wallace I. Sampson, MD, FACP, clinical professor emeritus of medicine at Stanford University and editor-in-chief at the Scientific Review of Alternative Medicine.
- “Acupuncture: Nonsense with Needles”[26] - Arthur Taub, M.D., Ph.D., Yale University professor of Neurology, American Board of Neurology and Psychiatry
- Acupuncture’s “theory and practice are based on primitive and fanciful concepts of health and disease that bear no relationship to present scientific knowledge.” – National Council Against Health Fraud [27]
- The Science-Based Medicine executive editor specifically refers to acupuncture as a "pseudoscience"[28], in an article titled "Acupuncture Pseudoscience in the New England Journal of Medicine" - Steven Novella, MD, Yale University professor of neurology, and Founder and Executive Editor of Science Based Medicine website. Other editors are here[29]. 135 supporting comments on this article by science based medicine community, and not one single objection to calling it "pseudoscience" in all of the comments . That should be pretty conclusive and resolve this once and for all.PPdd (talk) 09:05, 16 January 2011 (UTC)
No one has commented since I quoted the editor of Science-Based Medicine yesterday. The above quotes by the most senior and leading scientists who have examined acupuncture, from Stanford to Yale to the German are dispositive. I will add the category "pseudoscience", and add a paragraph to the lead summarizing them, and a paragraph to the body quoting each of them, unless some no-nonsense argument is presented by tomorrow.PPdd (talk) 09:13, 16 January 2011 (UTC)
- Does the profession claim its practice is derived from or based on science? If so, it is, by my understanding of the term, pseudoscience. But I haven't seen evidence of that. Is there a consensus statement from the International Association for the Study of Pain or similar professional body declaring it to be pseudoscience? I haven't seen evidence of that. All you have provided above is a smattering of individuals using the term. The last example, an essay published on a website controlled by its author, is in fact accusing the authors of a 2010 review of acupuncture studies, of pseudoscience. That is, he is slamming the quality of their work, not saying acupuncture is pseudoscience.
- Be patient. It is not yet appropriate for Wikipedia to be pronouncing on this. --Anthonyhcole (talk) 13:43, 16 January 2011 (UTC)
- Agreed. Compare those sources to the sources used on the page. The majority of the sources are peer-reviewed journals, scholarly books, and statements from prominent medical organizations. The parity of the sources is not equal. Some of these sources could be included, perhaps acuwatch and the UK skeptics links, but none are peer reviewed journals and thus can't be taken as evidence of the opinion of the scientific community as a whole (in the form of the article's peer reviewers and the editors of the journals). Every single one of these sources would need to be attributed to the author, and the author's qualifications must also be spelled out (X person, a Y from Z institution, has stated that...) Some could be integrated, probably not all, and they can't be taken as high-impact, mainstream opinion. I would not recommend putting them in the lead. WLU (t) (c) Wikipedia's rules:simple/complex 13:54, 16 January 2011 (UTC)
- Both Anthony and WLU have got this exactly right, IMO; kudos to you both for the cogent explanations. The policies WP:FRINGE/PS and WP:RS/AC are the foundation for these conclusions. I wrote up my rationale on the subject here and may move it outside userspace since the issue seems to come up from time to time. Other editors' thoughts, if any?--Middle 8 (talk) 10:51, 22 January 2011 (UTC)
- Scientific Review of Alternative Medicine, American Board of Neurology and Psychiatry, Center for Bioinformatics and Computational Biology, National Council Against Health Fraud, and Science-Based Medicine are certainly prominent medical organizations. It appears that some editors are not acting in good faith, but have a POV to mislead readers of Wikipedia as to what acupuncture is, and “balance” true facts with false pseudoscientific statements.PPdd (talk) 18:17, 16 January 2011 (UTC)
- They aren't the American Medical Association, the WHO, the FDA or the like. SBM in particular is a blog, NCAHF is a skeptical organization, not a mainstream medical one. Dr. Salzburg is speaking as a skeptic, not as a representative of his lab. They may be legitimate organizations, but they are not large mainstream players. WLU (t) (c) Wikipedia's rules:simple/complex 18:24, 16 January 2011 (UTC)
- They are RS by Wiki standards. They are not contradicted by any other mainstream science based medicine organization. There is no basis for excluding them by any Wiki standard.PPdd (talk) 18:41, 16 January 2011 (UTC)
- Wikipedia is not going to slap a label like "pseudoscience" on this before a review in a peer-reviewed medical journal, or an authoritative umbrella body does. Saying it is pseudoscience in the encyclopedia's voice (by adding it to category:pseudoscience) based on some magazine article, YouTube comment, blog or anti-CAM site, will be opening the gates for no end of assertions citing similar quality sources from both sides of the debate.
- But why don't you follow WLU's suggestion and say "Dr X of 123 and Prof. Y of 456 have described the theory and practice of acupuncture as pseudoscience" and see if that floats? --Anthonyhcole (talk) 11:08, 17 January 2011 (UTC)
- Sounds reasonable; will do.PPdd (talk) 19:43, 17 January 2011 (UTC)
- They are RS by Wiki standards. They are not contradicted by any other mainstream science based medicine organization. There is no basis for excluding them by any Wiki standard.PPdd (talk) 18:41, 16 January 2011 (UTC)
- They aren't the American Medical Association, the WHO, the FDA or the like. SBM in particular is a blog, NCAHF is a skeptical organization, not a mainstream medical one. Dr. Salzburg is speaking as a skeptic, not as a representative of his lab. They may be legitimate organizations, but they are not large mainstream players. WLU (t) (c) Wikipedia's rules:simple/complex 18:24, 16 January 2011 (UTC)
- Agreed. Compare those sources to the sources used on the page. The majority of the sources are peer-reviewed journals, scholarly books, and statements from prominent medical organizations. The parity of the sources is not equal. Some of these sources could be included, perhaps acuwatch and the UK skeptics links, but none are peer reviewed journals and thus can't be taken as evidence of the opinion of the scientific community as a whole (in the form of the article's peer reviewers and the editors of the journals). Every single one of these sources would need to be attributed to the author, and the author's qualifications must also be spelled out (X person, a Y from Z institution, has stated that...) Some could be integrated, probably not all, and they can't be taken as high-impact, mainstream opinion. I would not recommend putting them in the lead. WLU (t) (c) Wikipedia's rules:simple/complex 13:54, 16 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)
- 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[30]: “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)
Edit about MtrP points, Astrology
Our article says
”Kalichman and Vulfsons' 2010 clinical review confirmed that "ah shi" points are what are now referred to as "MtrP points”.
MtrP points are of questionable validity, based primarily on work by one person, and are on fringe in science, mainstream in alternative medicine. But that aside, maybe I am mistaken and missing something, but where do Kalichman and Vulfson say that their “review confirmed” that? PPdd (talk) 04:12, 28 January 2011 (UTC)
- By all means, rephrase to more accurately reflect the review's finding.LeadSongDog come howl! 23:44, 1 February 2011 (UTC)
- I can't see anything in the link comparing to placebo, or the level or significance of the effect. PPdd (talk) 08:44, 2 February 2011 (UTC)
- Just to be sure, are you reading the paper or just the abstract? LeadSongDog come howl! 13:40, 2 February 2011 (UTC)
- While not usable in the article, this rapid response to that paper is somewhat illuminating. LeadSongDog come howl! 13:51, 2 February 2011 (UTC)
- I was reading the abstract. The link for the paper says - "Cummings and White, 10 in their systematic review of 23 RCTs of needling therapies (dry needling or injections), stated that direct needling of MTrPs seems to be an effective treatment, but the hypothesis that needling therapies have efficacy beyond placebo is neither supported nor refuted ... low methodologic quality of original studies... most recent systematic review included 7 RCTs of acupuncture and dry needling for the management of MTrPs.24 Evidence from one study suggested that direct MTrP needling was effective in reducing pain compared with no intervention. Two studies provided contradictory results when comparing direct needling of MTrPs versus needling elsewhere in muscle; the evidence from another 4 studies failed to show that needling directly into an MTrP is superior to various nonpenetrating sham interventions... We agree with Cummings and White's conclusion"
- While not usable in the article, this rapid response to that paper is somewhat illuminating. LeadSongDog come howl! 13:51, 2 February 2011 (UTC)
- Just to be sure, are you reading the paper or just the abstract? LeadSongDog come howl! 13:40, 2 February 2011 (UTC)
- I can't see anything in the link comparing to placebo, or the level or significance of the effect. PPdd (talk) 08:44, 2 February 2011 (UTC)
- It seems like inclusion in the article should not occur because it is basically reporting that there are no research conclusions and "further research is required", with the latter being an opinion (which I disagree with). That two reviewers have an opinion that more research is needed does not belong in a medical article as WP:Undue (there are many more high end-scientists who think more research is a waste of money). PPdd (talk) 18:03, 2 February 2011 (UTC)
- I think you may have missed the point. Your own thoughts, like mine, are irrelevant here, as we are pseudonymous editors and hence our readers should treat us as being both unreliable and unverifiable. We instead must reflect the balance and range of the best quality recent reliable medical sources that we can find on the subject. In this case those sources are essentially telling us that studies to date have had weak methodology and small sample sizes, and therefore the cumulative results have been inconclusive. However, if we can cite a recent high quality review saying that "more research is a waste of money", we should do that too. I haven't found such a source to cite as of yet. LeadSongDog come howl! 19:21, 2 February 2011 (UTC)
- You are right that my opinion does not matter. But the existence of an inconclusive review due to poor experimental designs, does not meet standards for inclusion in an encyclopedia, or WP:MEDRS and WP:Undue. And the fact that there are two individuals who think more research needs to be done (especially given a vast majority who think otherwise), does not merit mention in an encycopedia article. Similarly, if every study on astrology was poorly designed, and so a systematic review was inconclusive, yet two researchers said they thought more research was needed, this opinion would not merit mention in an encyclopedia, even with a vast number of poorly designed studies on astrology. PPdd (talk) 20:13, 2 February 2011 (UTC)
- The existence of an inconclusive review that does meet the standards laid out in MEDRS (and this one does) is a reliable source for stating "results have to date been inconclusive". I believe that's what it is used for in this article. That's not undue weight IMO since it's not like there is a consensus within the field and this is a tiny minority. We're not noting that there is no correlation or whatever, only that there is no answer yet. The fact is, the question has been examined and the conclusion was we don't know enough to say yea or nay. Though others may think that research may not need to be done, but this opinion is reported as part of a systematic review based on evidence and experiment and not an off-the-cuff opinion. The point is the question is not settled, and the opinion of these two researchers based on their review of the evidence is that it can't be settled - at least not on the basis of the current evidence. That's worth noting.
- Astrology is not really a fair comparison since it's not taken seriously by anyone. Acupuncture is taken seriously though whether it is pure placebo or there's something happening independent of placebo is still a question. WLU (t) (c) Wikipedia's rules:simple/complex 21:07, 2 February 2011 (UTC)
- Agree with WLU and LeadSongDog. --Middle 8 (talk) 16:01, 3 February 2011 (UTC)
- "Astrology is not taken seriously by anyone"? TCM and its acupuncture are both based on astrology (see Traditional Chinese medicine on this, and 365 days for for determining location of acupuncture points). Ronald Reagan made presidential decisions based on his wife's astrologer. "What sign are you?" is a serious question for many.
- I am still not convinced that putting "studies to date on one aspect of acupuntures many, many claims for types of eficcacies have poor methodologies, and these two people have an opinion as to whether more being done is merited" belongs in this article, or any article, such as astrology. PPdd (talk) 16:40, 3 February 2011 (UTC)
- @PPdd: TCM probably *originally* had 365 points based on days of the year, but that number changed over centuries, and about 400 points are taught today in standard TCM courses. Yes, astrology is taken seriously by many, and while articles do note that, WP policy is to give preference to scientific opinion; this is all spelled out in WP:NPOV and related pages. Likewise, it is common for review articles to state the need for further research when the evidence base is small (i.e., lacking in conclusive evidence pro or con). WP's treatment of astrology and acupuncture, respectively, reflect science's opinion of them. Your approach here is becoming disruptive: e.g., changing headers to absurdities; facetious rhetorical questions; WP:IDHT on basic questions of science and WP policy. Most editors don't want to waste time on that level of things. Please see WP:TPG and content policy pages. And if you were going to say you're writing absurdities because you think acupuncture is absurd, your point was taken some time ago. You may remove your rhetorical needle from it now. Thanks. --Middle 8 (talk) 18:17, 3 February 2011 (UTC)
- Agree with WLU and LeadSongDog. --Middle 8 (talk) 16:01, 3 February 2011 (UTC)
- You are right that my opinion does not matter. But the existence of an inconclusive review due to poor experimental designs, does not meet standards for inclusion in an encyclopedia, or WP:MEDRS and WP:Undue. And the fact that there are two individuals who think more research needs to be done (especially given a vast majority who think otherwise), does not merit mention in an encycopedia article. Similarly, if every study on astrology was poorly designed, and so a systematic review was inconclusive, yet two researchers said they thought more research was needed, this opinion would not merit mention in an encyclopedia, even with a vast number of poorly designed studies on astrology. PPdd (talk) 20:13, 2 February 2011 (UTC)
- I think you may have missed the point. Your own thoughts, like mine, are irrelevant here, as we are pseudonymous editors and hence our readers should treat us as being both unreliable and unverifiable. We instead must reflect the balance and range of the best quality recent reliable medical sources that we can find on the subject. In this case those sources are essentially telling us that studies to date have had weak methodology and small sample sizes, and therefore the cumulative results have been inconclusive. However, if we can cite a recent high quality review saying that "more research is a waste of money", we should do that too. I haven't found such a source to cite as of yet. LeadSongDog come howl! 19:21, 2 February 2011 (UTC)
It doesn't matter how many acupuncture points existed in the Chinese system - we're really only referring to the Chinese system at this point, let's not forget there are at least a half-dozen other methods - the point is they have never established a scientific basis for acupuncture points to be taken seriously that I'm aware of. It is verifiable that in at least on peer reviewed opinion, acupuncture's original points were based on a form of astrology and sympathetic magic. Though we should describe the fact that people believe acupuncture points exist, we should also describe the POV that they were historically not based on rational precepts, and that the empirical investigation of acupuncture has not resulted in any specific point being found to correspond to any specific effect. Middle 8, one of your points has long been that acupuncture can't be simply dismissed. Point taken. However, a point that must also be recognized is that after several decades of investigation, the evidence base of acupuncture has become quite narrow, supporting only two columns - nausea and pain. Just because lots of people believe in something, doesn't mean we report that in exclusion to what science has actually found. We should juxtapose the two points whenever possible - "people believe X about acupuncture, but when investigated the evidence base is Y". And generally, that evidence base is not very good. WLU (t) (c) Wikipedia's rules:simple/complex 02:33, 4 February 2011 (UTC)
- @WLU - you say "We should juxtapose the two points whenever possible" - only to the degree that RS's support doing so. Otherwise, you're grinding your own axe, or in WP terms, engaging in a combination of OR and violating NPOV by giving excessive weight to a synthesis that exists in some places but becomes original when unduly repeated. The evidence base for acupuncture has remained small because of the lack of EBM-gold-standard studies; its direction pro- or con- various conditions has never been striking due to the lack of such studies. The reason such studies are lacking is not for want of effort, but due to the difficulty in controlling for all the variables in the procedure. This is why virtually all Cochrane reviews say that more research is needed. If you are saying that the evidence base is consluviely negative for a number of conditions, you are on a different page than Cochrane reviewers. Your view is on the skeptical side of a spectrum of views; it should not be taken as the only one. --Middle 8 (talk) 07:55, 4 February 2011 (UTC)
- If two reliable sources note two points that are polar opposites, we should note both. If multiple reliable sources converge on a point with a small number dissenting, we note both but give more weight to both. In acupuncture, there is plenty of criticism, few high-quality review and meta-analyses saying anything good, and a lot of theory inherited from tradition. All of which we note. And we also note that in most cases, the reviews are inconclusive - acupuncture, in a well-controlled experiment, normally produces no effects beyond placebo. The exceptions are pain and nausea. The best studies I've seen all discuss this, and this is what the page says. The fact that practitioners want to believe in magic (i.e. the "methodology" of acupuncture) is noted, but the evidence must also be noted. This is why we keep arguing over the use of "pseudoscience". The methods of acupuncture are nonsense, little more than wishful thinking and folk reasoning you can find in any culture. The results do have some evidence - for pain and nausea. Little more.
- The characterization of the actual evidence base for acupuncture has been steadily narrowing - this is discussed in Trick or Treatment. As controls got better, the evidence supporting acupuncture got worse. That's noted in the last paragraph of the section on evidence-based medicine. WLU (t) (c) Wikipedia's rules:simple/complex 12:29, 4 February 2011 (UTC)
- There is no general agreement that controls have gotten better. They have changed, yes: generally in the direction of reducing false positives while increasing false negatives. --Middle 8 (talk) 21:10, 4 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)
- Rubish? Rubish is usually easy to get rid of. Don't overrate acupunture by equating it to the much more manageable "rubish". PPdd (talk) 16:27, 3 February 2011 (UTC)
- You made the exact same observation above about "bullshit". Repetition of a triviality that is not germaine to the article wastes space and other editors' attention. Kindly stop, per WP:TPG and WP:POINT. --Middle 8 (talk) 18:28, 3 February 2011 (UTC)
- Rubish? Rubish is usually easy to get rid of. Don't overrate acupunture by equating it to the much more manageable "rubish". PPdd (talk) 16:27, 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 [31]; 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)
- (Note: Please don't break up other editor' comments; again, see WP:TPG.) As I said, the issue is one of relative risk. --Middle 8 (talk) 18:25, 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 - yes, I know; only on Wikipedia is it considered bad to volunteer in one's own area of expertise. Have fun keeping this PPdd guy in check. It would be funny to let him just write whatever he wants, though, wouldn't it? --Middle 8 (talk) 10:03, 5 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." [32]
"acupuncture is a painful and unpleasant treatment" [33]
"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." [34]
(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)
Edit to lead
Note that I've removed some material from the lead. There are a couple problems with the edit in question.
- The source used is a primary source aimed at evaluating the effectiveness of a specific intervention on a specific group. Per WP:MEDRS, primary sources should be used with caution and only to substantiate essentially the main point of the primary source. In order to propose a mechanism, particularly in the way proposed in the removed section, a review article or scholarly book from a well-respected publisher should be used.
- The specific wording used makes it sound like the article specifically addressed acupuncture's effects on pain and nausea via this mechanism. Even if the introduction or discussion section made these points explicitly, this is still a primary source. The wording was very, very original research-sounding to me, synthesizing several citations to make a specific conclusion. Difuse noxious inhibition of stimulus is one potential mechanism through which acupuncture works, and the science is not settled. There are many strong opinions and we should not be depicting the discussion as if it were settled.
- On a purely technical level, we should be citing the pubmed link and using a citation template (that's not really technical, but it matches the sourcing to the style of the rest of the page). If this article is replaced in the page (which I would strongly urge it not be, for any reason), we should use a citation template. I would suggest {{cite pmid | 16618043 }} since it's pretty much the fastest way to include pubmed-indexed articles. It autofills the citation and therefore avoids things like saying this is a "ham-controlled trial", an incredibly amusing typo On another technical note, we should have used the <ref name = whatever> tags to cite this article twice, not repeating the same citation. PPdd, for that sort of stuff feel free to ask me or any other experienced editor about those sorts of tricks. That's not a big deal at all, it's just something you have to see a couple times to know how to use.
Keep in mind this is coming from an editor that thinks acupuncture is utter shit - this edit was against my personal POV, that's how damned strongly I feel about it. A good article that will be defended by everyone interprets the P&G fairly for all sources and edits. I notice the article has been used elsewhere in the page, I plan on looking at it there as well and expect to re-remove it.
The other edits I have no problem with so far, they do remove a lot of unsourced information which is perfectly valid per WP:PROVEIT. Having fresh eyes on a page helps clean up stuff like this and usually leads to new, more reliable sources being added. WLU (t) (c) Wikipedia's rules:simple/complex 17:17, 4 February 2011 (UTC)
- Your removal of my primary source material was appropriate. PPdd (talk) 17:41, 4 February 2011 (UTC)
- The remaining lede still makes it look like acupuncture's trivial effectiveness for nausea and pain is a big part of acupuncture (WP:Undue), that it has a strong effect when it is very minor, that this effect is inexplicable or surprising enough to merit mention in the lede (one would expect sticking needles in a body would cause release of the body's natural pain relievers, just as in tattooing), etc.
- I deleted not only NRS proPOV material, but also NRS antiPOV material. I delete all NRS stuff everywhere I see it if I do not already believe it, and add a cit needed tag if I do already believe it, no matter what my POV. One thing I deleted was a reference to acupuncute causing nausea, but the source cited only had a last name, Cheng, and date (1987?), with no title, full name, or way to check it. This directly contradicts that acupuncture treats nausea.
- So I suggest removing the nausea and pain specifics from the lede (using these reasons and MOS "no specifics inthe lede", WP:consistency, and WP:Undue), but leaving it in the body.
- I will read up on citations and referencing and ask you if I can't figure it out without wasting your time on me. Thanks for the offer.
- I am not convinced that acupuncture is utter shit. (You can get rid of shit by flushing the toilet, but not acupuncture.) More seriously, I believe that it might be possible to relieve larger pain by causing smaller pain (e.g., by causing release of natural pain relievers or by distraction. In grad school, I was dating a psychology grad student who studied cognitive coping strategies and their effects on the immune system under Linus Pauling in his last years, and her study is still carried out by at UCSF dental school 15 years later, where you can get free dental care by foregoing anasthetics - gotta be some poor people out there somewhere to experiment on.) I try to balance radical skepticism with radical open-mindendness. I know people with tattoos who like getting them, because, they say, it causes a state of euphoria. (Don't you just love people who italicize every other word?) PPdd (talk) 18:13, 4 February 2011 (UTC)
- Wasn't Pauling a nutter basically after 1975?
- If we want to indicate that acupuncture's effectiveness is trivial (something I'm not convinced of, the placebo effect can be quite strong, even if it is transitory - and that assumes acupuncture is nothing but a placebo effect which is still up for debate irrespective my thoughts on the matter) then we need a better source. I would agree to such a commentary given an appropriate source, but sometimes we have to live with stuff like this pending new research and review articles. Wikipedia is not done so no need to come to a conclusion. Remember, the lead is meant to be a broad overview, and we should only note that acupuncture's effectiveness is "trivial" if there is strong indication that this is the scientific mainstream opinion - I don't think it is. That acupuncture is effective for pain and nausea should remain in the lead in my opinion, particularly given the sources. I don't know if it's worthwhile to parse the sources to determine whether they give an indication of how effective.
- I really don't mind giving suggestions on referencing, templates, tables and the like, it's one of the more gratifying parts of editing a collaborative work. If you are planning to be here for a while, you really need to know about diberri's template generator, particularly with a pubmed number or ISBN. The pubmed template generator is particularly useful if you plan on editing anything that's medicine or biology-related. You can also look into adoption or editor assistance for quick replies to specific questions. {{Helpme}} is also a handy template to use if you need a quick reply. Oh, and don't try to use an ampersand in your auto-signature. Doesn't work. WLU (t) (c) Wikipedia's rules:simple/complex 18:24, 4 February 2011 (UTC)
- Nutter? Yes. But he had the best free immunology lab near Stanford in the early 90's. I owned the building across the street from it (where Hewlett and Packard first started up) then. I was also doing philosophy of data analysis at the time, and after talking to all his grad students and post docs about his Vitamin C studies and claims, he ended up banning me from his building. PPdd (talk) 18:32, 4 February 2011 (UTC)
- I think acupuncture's effect is beyond (unpainful) placebo, due to release of the body's pain inhibitors from its painfulness (whether conscious pain, or a body response to trauma). I don't think it is merited in the lede, however, or at least without huge qualifications. The nausea thing definitely does not merit lede placement, especially as this is not consistent with the partially sourced material I deleted. PPdd (talk) 18:36, 4 February 2011 (UTC)
- There is a strong "moving goalpost" thing going on in the article, or implied by its wording. Acupuncture is found to have some effect for pain, but this is often used to imply that acupuncture has an effect, in general, as in "56 % of doctors think acupuncture works". Also, there is a shift between using "acupuncture" to describe reandomly sticking needles, vs. "acupuncture" as sticking only in "12 rivers/365-days" points, then shifting back again. Doing a correct study is very ethically problematic, because the "victim" of the study is being offered two painful placebo treatments to "relieve" pain. PPdd (talk) 18:45, 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. [35]). 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".[36]. 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."[37]. 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)
- Unfortunately, I agree. PPdd (talk) 02:00, 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[38], "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[39]. 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)
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)
- All that being said - edits like this are strongly, strongly inappropriate POV ones. You don't address neutrality by removing reliable sources. WLU (t) (c) Wikipedia's rules:simple/complex 22:31, 5 February 2011 (UTC)
- The PDF file in the right columb here[40] is a pro-POV and Japanese acupuncture perspective RS (it boasts Japanese is better than Chinese acupuncture because it is much less painfull). PPdd (talk) 22:36, 5 February 2011 (UTC)
- All that being said - edits like this are strongly, strongly inappropriate POV ones. You don't address neutrality by removing reliable sources. WLU (t) (c) Wikipedia's rules:simple/complex 22:31, 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.
- PS, don't foget to sign (some people find "twiddling" to be a form of relaxation). PPdd (talk) 20:39, 6 February 2011 (UTC)
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[41] 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[42], 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[41] 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[43].
- 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.[44] 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.[44] 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)
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)
- indeed, thanks brang. as I said, I will be only working from this page now.Luke643 (talk) 21:23, 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. [45] 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 [46], [47], adulteration, [48], 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 "ambigous definitions" section at the top of the article body. PPdd (talk) 15:17, 9 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)
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)
- How are the "points" located? Are superficial anatomical structures used, and measurements from them taken, like "midway between such and such bone in the thumb, and so and so bone in the index finger? PPdd (talk) 05:44, 10 February 2011 (UTC)
- How broad an area is allowed to be considered being on a "point"?
- How does this vary from country to country? PPdd (talk) 05:44, 10 February 2011 (UTC)
- How broad an area is allowed to be considered being on a "point"?
- How are the "points" located? Are superficial anatomical structures used, and measurements from them taken, like "midway between such and such bone in the thumb, and so and so bone in the index finger? PPdd (talk) 05:44, 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)
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)
- ^ 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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