Some of my attraction to study Traditional Chinese Medicine (TCM) was due to the early 1990′s popularity of “Quantum Mysticism.” Books such as _The Tao of Physics_ by Fritjof Capra, _The Holographic Universe_ by Michael Talbot, and _The Dancing Wu Li Masters_ by Gary Zukav made a convincing connection between Taoist philosophy, modern physics, and thus acupuncture and TCM. Many of these speculative connections were over-generalized and incorrect, however there are some interesting parallels that usually go back to the basic mathematical structure of the universe. The fact that atoms have a positive and negative aspect in the proton and electron does not mean that every idea about Yin and Yang is accurate.
Finding good scientific research about acupuncture has been a bigger journey than I expected. It has also been more controversial. I’ve become more aware of the “Anti-Science” sentiments which some natural medicine proponents share with creationists. They often claim that their subtle, spiritual truths cannot be approached by science.
When it comes to medical interventions I offer to patients in my clinic, it is my duty to find out to the best of my ability how well they work and which treatments are most plausible. An extreme example I’ve written about at length is the nutritional deficiency disease beriberi, from the lack of thiamine. Some acupuncture texts list beriberi as an indication for multiple acupuncture points. I certainly hope no acupuncturists take this literally, and recommend food or supplements containing B-vitamins in the rare instance they may see a patient with beriberi. It is completely implausible that acupuncture can effectively treat a nutritional deficiency, and it is not worth doing any research to test this claim. However, it is still plausible that acupuncture can be a treatment of value for many painful conditions, from shingles to headaches to musculoskeletal pain.
It is a bit more complicated to test the claims of Chinese acupuncture than treating “headache,” as it involves the realm of TCM “energetic diagnosis.” In this practice, a traditional diagnosis is made such as “Liver Qi Stagnation” which could be manifesting as irritability, headaches, and digestive upset. Points are selected not based on the symptoms of “headache” or “loose stools” but to resolve the underlying energetic pattern of Livery Qi Stagnation (i.e. the points “Free and Smooth the Liver”).
In TCM, headaches may be attributed to several patterns other than Liver Qi Stagnation, such as Liver Fire, Gallbladder Damp-Heat, and Blood Deficiency. Because TCM theory posits several patterns which can cause various symptoms, some acupuncturists feel that it is difficult or impossible to do scientific research to test TCM acupuncture. This isn’t the case, but instead of trying to understand research design, some acupuncturists have confounded their anti-science stance with quantum mysticism. Here is an example an acupuncturist I know posted on Facebook:
in case you were thinking that the interest in acupuncture is ‘new’…in the US, it actually started in the 70s, after Nixon visited China (and the vulcan saying is “only Nixon could go to China”). Keep in mind that the sicence that will yield “evidence based” data is not biology for acupuncture…it’s quantum physics. Which has yet to be applied to modern medicine in the west.…The Western Life Sciences have always been about picking apart the biological world to answer questions; quantum physics knows that all things in the universe change in mysterious and magical ways. And Chinese Medicine knew it too, thousands of years ago….
I bolded the key statement that caught my attention and made me shake my head (a Qi Gong technique for repelling pathogenic thinking).
The basic fact is that people who have problems for which they seek medical intervention want those problems to be resolved. For most patients, especially of alternative medicine, theories are secondary to results. Researchers, scientists, doctors, and acupuncturists should be interested in both the reliability of results and which theory best explains them. Quantum physics has very little to do with any of this.
Let’s say were are going to do research on acupuncture for headaches. We have plenty of money and people with headaches, so we can design a really good trial. Here are some of the groups we can have:
- TCM acupuncture: a team of traditionally trained TCM acupuncturists does individualized TCM diagnosis and chooses points based on the underlying energetic pattern.
- Japanese acupuncture: a team of highly regarded Japanese acupuncturists uses channel-based point selection and needling technique on their group.
- Massage group: it will be interesting to compare the results from a group who gets a similar amount of touch-based attention from a massage therapies.
- Placebo acupuncture: using the best non-puncturing credible placebo needles and similar attention and communication, this group will think they had some acupuncture needles put in, but didn’t.
- Formula acupuncture: a standard group of points is put in to every headache patient, without regard to their individualized diagnosis. However, a similar intake and amount of attention should be given to give them the idea that the practitioner is doing individualized treatment.
- Waiting list: This group is told they will eventually get treatment, and their headaches are tracked.
- Standard care: This group may get recommended to take aspirin or something similar.
Do you see how this trial, if there are enough patients (like 1000 per group), would yield useful data? This is the direction that good acupuncture research is going. I wrote about a Chinese study which looked at 3 styles of acupuncture and 1 placebo group and found the 3 styles did about the same and were only slightly better than the sham treatment.
Even more groups could be added to this, such as External Qi Gong, Sham Energy Treatment, Tai Chi, Yoga, gluten-free diet, etc.
One important factor is that the patients be randomized. This means that each group will have a similar spectrum of patients (i.e. on average, they will have had similar duration and frequency of headaches). Also, with proper screening, extreme cases should be filtered out (i.e. brain tumors, undiagnosed diabetes, etc.) as we don’t want patients who need more advanced treatment to end up in a sham or control group.
This sort of clinical research only looks at how effective the treatments are, not why they work. The scientific data generated is not “biology” and certainly not “quantum physics,” it is based on clinical results.
If one of the groups shows remarkably better results than another group, then other sciences can look at the mechanisms which are involved. However, if the true (“verum” to be fancy) acupuncture doesn’t do any better than the placebo acupuncture groups, there is no reason to go looking for the mechanism of its effect.
This is where acupuncture is at today in regards to scientific research–most good research shows no difference between a standardized set of points and a carefully selected set of points based on TCM theory. This approach has even been integrated into the Community Acupuncture movement via Miram Lee’s 10 points she wrote about in _Insights of a Senior Acupuncturist_ (subtitled “one combination of points can treat many diseases”). Yet there are many systems, schools, and seminars which promote their point combinations as being more effective than everyone else’s.
It is these acupuncture systems and TCM schools which should be most interested in showing their acupuncture to be more effective than the competing systems by doing good research. There isn’t much good research on acupuncture, but the best research so far shows little if any difference between traditional acupuncture and placebo acupuncture. Dismissing this with “anti-science” or “quantum mysticism” isn’t in the best interest of patients or those who want to know the truth (as in reliable, reproducible scientific evidence).
Attacking the validity of the scientific method in general is indeed similar to the ploy used by religious fundamentalists who cling to creationist beliefs despite ample evidence that they are incorrect. While it may reassure fellow “true believers,” appealing to mystical ignorance is unlikely to win many new converts as the information age progresses.