AcupunctureValidMedicalTechniqueOrLucrativeHoax?HistoryofAcupuncturePracticedinChinaforover4,000yearsTraditionalChinesemedicaltechniqueforunblockingchiAcupunctureistheinsertionofneedlesinspecificpointsonthebodyTheseinsertionpointsarebelievedtocorrespondwith14mainpathwayswithinthebodycalledmeridiansOriginsofAcupuncturePhilosophyOriginatesinTaoisttradition(specificallymeditation)FuHisdiscovered/createdideaofyinandyangbyobservingabrokenlineandanunbrokenlineWhatexactlyisChi?Chiisanenergythat,accordingtoancientChinesebeliefs,permeatesallthingsChimustbeabletoflowfreelythroughoutthebodyinorderforapersontomaintainoverallhealthChiflowsalongthemeridiansofthebodyWheredoyinandyangfitin?AcupunctureneedlesareinsertedinanattempttobalancetheopposingforcesofyinandyangYinandyangarebalancedwhenapersonishealthyandchiisthereforeabletoflowfreelyInjuryorillnesscauseyinandyangtobecomedistressedandunbalancedOriginallytherewere365acupuncturepoints,butthroughtheyearsthisnumberhasincreasedtoover2,000EachpointisbelievedtocorrespondwithaparticularillnessorinjuryWhatisacupunctureusedtotreat?DepressionArthritisKidneyproblemsFluFatigueChronicpainMigrainesParalysisHypertensionTendonitisVisionproblemsSexualDysfunctionAndmanyothers…Isthereamedicalbasistoacupuncture?AcupunctureisnotbasedonmodernmedicalscienceThereisnoobviouscorrelationbetweenthe14identifiedmeridiansandtheactuallocationoforgansandnerveswithinthebodySomeproponentsofacupuncturehaveattemptedtoexplainitsmedicalfunctionStimulationofnaturalpainkillingchemicalssuchasendorphinsNeedlesblockthetransmissionofpainimpulsestotheCNSPossiblemedicalexplanationsResearchonAcupunctureManyscientificstudiesonacupuncturearestillintheearlystagesSubjectivityOnecontrolledstudydonebyMelzackandKatzcomparedelectroacupunctureoftheeartoplacebostimulationThisstudyfoundacupuncturetobenomoreeffectivethanlightlytouchingtheearinrelievingchronicpainMoreResearchThreeDutchepidemiologistsanalyzed51controlledstudiesofacupuncturein1991Theirconclusion:“…thequalityofeventhebetterstudiesprovedtobemediocre…Theefficacyofacupunctureinthetreatmentofchronicpainremainsdoubtful.”(Kleijnen,etal)ResearchContinuedAstudypublishedin2001exposedtheinconsistencyofthediagnosisandtreatmentofacupunctureDiagnosesaswellastheprescribedtreatmentsvariedwidelyOf28pointsselected,only4(14%)wereprescribedby2ormoreacupuncturistsWhyuseacupunctureifithasbeenprovenineffective?Manyhospitalsanddoctorsthatuseacupunctureuseitonlyascomplementarytherapyor“lasthope”therapyExample:DUMCWhydopeoplepersistinusingacupuncture?Althoughnotsupportedbyempiricalevidence,acupunctureisoftensupportedbyanecdotalevidence(whichcanalsoleadtoconfirmationbias)PlaceboeffectRegressionfallacyPragmaticfallacyConfoundingtreatmentsWhycan’twedisproveacupunctureasavalidhealingtherapy?AcupuncturetheoryisflawedatthecorebythefactthatitisvirtuallyimpossibletofalsifyChinesebeliefsdefinechiasbeingundetectablebythemethodsofmodernscienceIfitmakespeoplefeelbetter,doesitmatterthatwecan’texplainwhy?LucrativeIndeed!AccordingtotheAmericanAcademyofMedicalAcupuncture,approximately4,000physiciansintheUnitedStateshavereceivedtraininginacupuncturetherapy10-15millionAmericansspend~$500millionperyearonacupuncture1in10AmericanshavetriedacupunctureButtherearerisks…BladderorlungpunctureAllergicreactiontoneedlesInfectionfromunsterilizedneedlesFaintingConvulsionsNerveDamagePuttingofftreatmentsthatareknowntobeeffective