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Apr 24 2013

Cupping is a thing? Really?

Taslima points to celebrities who are actually getting cupping done. It makes me wonder if they’re also getting bled, and whether they prefer leeches or the lancet. It’s medieval nonsense and total quackery.

I was wondering if there were any good analyses of this stuff, though, and my search turned up an unsurprising fact: WebMD, that popular website for Americans who can’t afford to go to a real doctor, is embarrassingly uncritical of cupping. In fact, they’re generally very woo-ish — I am once again made conscious of my class privilege, because when I feel sick I walk down the street to see a real doctor at nominal cost, because I’ve got good health insurance. Which makes me wonder some more — maybe universal health care would be a more effective means of curbing quackery than trying to educate everyone to be good skeptics. Sometimes, being skeptical is only an option when you can afford to question.

122 comments

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  1. 1
    WharGarbl

    @PZ

    maybe universal health care would be a more effective means of curbing quackery than trying to educate everyone to be good skeptics.

    In Taiwan, they have fairly good universal healthcare (a doctors visit for anything cost just about $3, a bit more if you got some illness you need to actually treat). Their healthcare insurance system actually covers treatment with Chinese herbal medicine and acupuncture.

  2. 2
    Amused

    As a child, I was cupped on many occasions. Very unpleasant, and the bruises last for several weeks. I’ve had mustard papers applied, too.

  3. 3
    DLC

    I’ve seen photos of various hollywood personalities who have marks on them from cupping. I wasn’t sure if I should laugh at them being bilked or be angry at yet more people subjecting themselves to woo scams.
    perhaps both.

  4. 4
    traversedavies

    I do wish I could agree, but cupping is done here in Canada as well. I think that cupping is fine… when it’s part of the fetish community (it is) but as a medical procedure it’s pretty dubious.

  5. 5
    pascale68

    Unfortunately, I know plenty of affluent people who go for this kind of thing, with the argument that it is more “natural” than taking something from “Big Pharma”. ugh

  6. 6
    kemist, Dark Lord of the Sith

    maybe universal health care would be a more effective means of curbing quackery than trying to educate everyone to be good skeptics.

    Sadly, no, it doesn’t.

    Here in Canada we have universal health care and some people are still getting into woo.

    Even though they’ve got to pay for it, whereas they don’t have to pay to see a doctor. Even if real drugs are way cheaper than crap like homeopathy.

    Some even use the same arguments as US quacks against “allopathic medicine” even though they make no freaking sense in a single-payer system.

    I’m afraid there’s no good substitute for critical thinking.

  7. 7
    Amused

    Just to add to my previous comment — I grew up in Soviet Russia, which had universal healthcare (doctors’ visits were free, and in fact, you could have a doctor visit you AT HOME for free). However, pharmacies still sold those special cups and doctors advised patients to have both cupping and mustard papers done in the event of a URI.

  8. 8
    Charly

    I am not sure about the influence of universal healthcare on quackery. I live in EU, in two states (Germany and CZ) which both have very good universal healthcare. In both states, AFAIK, quackery thrives – homeopathy, acupuncture, you name it – and there are still serious debates, whether this “alternative” medicine should or should not be included in the universal health care system, and significant amount of people say “YES” to that question.

  9. 9
    blf

    maybe universal health care would be a more effective means of curbing quackery

    No idea if it cuts the amount or not, but it still happens. Here in France, homopathetic shite is all over the place (even in pharmacies for feck’s sake!), and there’s a feckton of anti-vaxers in the UK (to the extent there is a serious problem in Wales (Swansea) right now, with several hundred cases of measles and emergency vaccination programmes). And numerous other examples…

  10. 10
    richardelguru

    Paging Drs Bald and Cild
     
    Drs Bald and Cild to the Surgery
     
     
     
    see Medicinale Anglicum (Bald’s Leechbook)

  11. 11
    AJS

    I have just one question for you Americans.

    Who the hell voted against free medicine?

    I mean, free medicine ….. the right to see a doctor anytime, without payment ….. who would vote against that?

  12. 12
    raven

    OT but vaguely related.

    Second Child Of Philadelphia Faith-Healing Couple Dies
    NPR (blog) ‎- 22 hours ago

    A Philadelphia couple whose infant son died last week reportedly told police, “Our religion tells us not to call a doctor.” They were on probation …

    I’ve seen this before. It isn’t that unusual in faith healing families to lose (kill) not just one but two children. To easily treatable medical conditions.

    “Our religion tells us not to call a doctor.” So what. You religion is wrong and you are idiots then.

    This is just a fundie xian ritual, human child sacrifice.

  13. 13
    WharGarbl

    @Amused
    #7

    I grew up in Soviet Russia, which had universal healthcare (doctors’ visits were free, and in fact, you could have a doctor visit you AT HOME for free). However, pharmacies still sold those special cups and doctors advised patients to have both cupping and mustard papers done in the event of a URI.

    Growing up in Taiwan, it’s the same thing.
    Perhaps I’m biased, but I think Taiwan have a fairly good reason on continuing to offer acupuncture and Chinese herbal medicine. It’s deeply ingrained part of the Chinese culture, and when administered correctly, are not harmful.

  14. 14
    roro80

    “Getting into woo” is a lot better than being forced into woo because you have no access to real doctors. I would definitely agree that universal quality healthcare would not erase the existence of the woo-prone, but it would certainly reduce the way poor, desperate, sick people are outright scammed by unscrupulous assholes. Honestly, I feel a lot less bad that Gwenyth is a dumb-ass and being scammed by suction cup cleansing than I feel about, for example, an uninsured, uneducated person getting sold a massage chair that will “cure their cancer” for $500 they can’t afford. I know that scam was being pulled on a large number of non-English-speaking immigrants by an unlicenced “doctor” a few years ago in my area. These are people who would *of course* go to a real doctor for real medical treatment if they could, but they most certainly aren’t able to do so.

  15. 15
    michaeld

    Yeah I must concur with the other comments. There are some roads in Ottawa here where there’s a different quack every block or 2. Universal health care does little to curb them.

  16. 16
    Marcus Ranum

    It’s good kink play.

  17. 17
    Edward Haines

    Rather than WebMD when searching for information on a form of quackery, may I suggest http://www.sciencebasedmedicine.org/ ? This site provides quite extensive description and analysis of all sorts of CAM (alternative healing techniques). They have a search box so it is easy to look up any particular form in which one is interested. I searched on “cupping” just now and came up with a number of articles. See http://www.sciencebasedmedicine.org/?s=cupping

  18. 18
    Jethro

    Who the hell voted against free medicine?

    Politicians who are in the pocket of the insurance lobby or have constituents who care very deeply about their tax money not helping “the undeserving poor” (or both).

  19. 19
    Marcus Ranum

    It’s deeply ingrained part of the Chinese culture, and when administered correctly, are not harmful.

    It’s been deeply ingrained as an alternative to real medicine because it’s cheap and you don’t have hoi polloi cluttering up the real hospitals so that they can serve the elite. Sure, it’s not at all harmful to fob nostrums off on the lumpenproles while your leaders fly to the Mayo Clini or get treated in state of the art medical facilities by doctors who trained in Europe and the US. Sure.

  20. 20
    PZ Myers

    Damn. Well, it was just a hopeful thought.

    I should have guessed, though: does anyone think Gwyneth Paltrow has any trouble seeing a doctor, or paying for one? Yet there she is, getting some barbarically stupid maltreatment, and probably paying a pretty penny for it, too.

  21. 21
    Marcus Ranum

    does anyone think Gwyneth Paltrow has any trouble seeing a doctor, or paying for one?

    Nope. She’s just an unwitting marketing shill for big alt.

  22. 22
    WharGarbl

    @Marcus Ranum
    #19

    It’s been deeply ingrained as an alternative to real medicine because it’s cheap and you don’t have hoi polloi cluttering up the real hospitals so that they can serve the elite. Sure, it’s not at all harmful to fob nostrums off on the lumpenproles while your leaders fly to the Mayo Clini or get treated in state of the art medical facilities by doctors who trained in Europe and the US. Sure.

    Learn about the situation about mouthing off, jackass.
    1. The cluttering up REAL hospital doesn’t make sense because BOTH treatments options occurs in the SAME FUCKING HOSPITAL.
    2. At least we have a universal healthcare system that works pretty well compared to the US. Granted, comparing healthcare systems to whatever system the US has is like trying to compare anything to turd.

  23. 23
    shoshidge

    Everyone has beat me to it, in Canada we are just as plagued with alt-med as the States and everything I read on the subject tells me that western Europe is worse.
    Based on my experience, the more exotic and silly therapies like cupping are a hobby of left wing, educated affluent people, the working classes don’t seem too interested, even when it’s covered by insurance.

    One more point, nobody voted against ‘free’ health care, it’s not free, you just pay for it a different way.
    I’m a believer in the Canadian system, but universal health care does have its shortcomings, and many Americans would see their quality of health care decrease if a more socialized system were adopted.

  24. 24
    Alexandra (née Audley)

    AJS:

    I mean, free medicine ….. the right to see a doctor anytime, without payment ….. who would vote against that?

    The gullible voters who don’t want their money going to treat people who don’t deserve it.

    True story: I worked with a dude who could not afford the health insurance plan offered by our company, so he did without. After his wife had a bout with cancer and he had a minor out-patient surgery, he found himself in tens of thousands of dollars of debt.

    When the debates over the Affordable Care Act started, he was right at the front lines… fighting against it. Because other people didn’t deserve to benefit from the money he had earned.

    It’s selfishness, purely and simply.

  25. 25
    Orac

    Which makes me wonder some more — maybe universal health care would be a more effective means of curbing quackery than trying to educate everyone to be good skeptics. Sometimes, being skeptical is only an option when you can afford to question.

    Actually, the exact opposite can also happen. You see, when a form of universal health insurance becomes a government program (or, in the case of Obamacare, a program heavily subsidized and regulated by the government), it becomes a political issue. When that happens, patient groups lobby and woo-friendly legislators can write mandates to cover woo into the law, such as efforts to make the feds include acupuncture as an “essential health benefit.” Look at the NIH. You’d think its rigorous science would keep the woo at bay, but we have NCCAM because a powerful Senator (Tom Harkin) believes that bee pollen cured him and he wants the government investigating so-called CAM.

  26. 26
    Argle Bargle

    AJS @11

    Who the hell voted against free medicine?

    But socialism…and death panels…and the government controlling our health…and CEOs thrown out of work and begging in the streets…and socialism…and government inefficiency…and…and…and SOCIALISM!!1!one!

  27. 27
    Marcus Ranum

    Learn about the situation about mouthing off, jackass.

    I like you when you’re all feisty.

    1. The cluttering up REAL hospital doesn’t make sense because BOTH treatments options occurs in the SAME FUCKING HOSPITAL.

    I’m confused. Are you saying that the cupping is being performed in a hospital, using trained doctors, and taking up facility space? Really? It’s not being done on the cheap? Huh. It sure is cheaper to give someone a cupping than to give them an MRI, huh?

    At least we have a universal healthcare system that works pretty well compared to the US

    I’m sure my perspective is heavily influenced by the various lies I’ve been fed. I recall one interview on NPR where there was a doctor discussing how antibiotics are treated like nostrums (handed out for viral infections, etc) and some articles on sciencebasedmedicine about how Mao strongly pushed “traditional chinese medicine” as an alternative to real medicine during the cultural revolution, because a lot of the real doctors were killed. Those are the points that stick in my mind. Ben Goldacre’s comments on how “complimentary” medicine is infiltrating into the UK’s medical system – as a low-cost alternative for the health service to offer as a sop to the ignorant – also are in my mind.

    Lastly, can you show me where I said anything nice about the US medical system? I have a good friend who is a nurse who tells me blood-curdling stories that convince me that I’ll probably prefer to die than step foot in a hospital other than for getting wounds sewn back together if I can’t get the duct tape to stick…

  28. 28
    Rob Grigjanis

    I’d barely heard of this, but if it’s medieval nonsense and total quackery, why are clinical studies being done with apparently positive results, and further studies proposed?

  29. 29
    busterggi

    For a good demonstration of cupping check out Roman Polansky’s classic ”The Fearless Vampire Killers of Pardon Me but Your Teeth are in My Neck’.

  30. 30
    Marcus Ranum

    Who the hell voted against free medicine?

    In the US it would be politiicans – politicians who have taxpayer-provided “free” medical care.

  31. 31
    Bronze Dog

    My first instinct was to agree with the hopeful thought. It’d still probably be a net good for cutting down on quackery. A lot of the quacks would have a harder time competing on price, since they’re largely profit driven, and having cheap or free healthcare as their primary competitor would make that more visible.

    Thinking about it, one adaptation I suspect we’d see is a change in the marketing of quackery. Instead of Big Pharma overcharging and doctors being 100% profit-driven businessmen with no emotions whatsoever, they’d depict the government program as cutting corners to save money at the expense of people’s lives, too bogged down in bureaucracy to see what’s really wrong with you, or in bed with the Illuminati with the goal of ruling the world by shrinking your unmentionables. Therefore, the quacks will argue, it’s in your best interest to pay extra for their profit-driven quackery because they’re motivated by the invisible hand of the market to fix everything that’s wrong with you. Along with everything that isn’t wrong with you. (Why only profit from sick people?)

  32. 32
    Larry

    Getting a hickey is now considered to be medicinal?

  33. 33
    Xaivius (Formerly Robpowell, Acolyte of His Majesty Lord Niel DeGrasse Tyson I)

    I’d like to see a complete moratorium on the term “Alternative Medicine,” as it is a fucking lie. There is medicine, and there is bullshit. Period. If a leafy poultice helps with healing and can pass significance testing, then we don’t just tell people “Put these leaves on it!” We distill down the active ingredients, do clinical trials, and after checking for side effects, we have medicine.

    and when administered correctly, are not harmful.
    WharGarbl@13

    Incorrect. Acupuncture as ‘medicine’ means that it is supposed to treat some form of malady. When people die because they tried to use acupuncture to cure their HIV in place of actual medicine, then we lay part of that blame on allowing acupuncture to be treated as medicine.

    Examples of issues

    It’s deeply ingrained part of the Chinese culture…

    Bleeding wounds and drinking Urine to cure disease were traditions of Europe. Now? not so much. Culture is a poor justification for allowing scams to prey on people looking for help.

  34. 34
    The Mellow Monkey

    “Getting into woo” is a lot better than being forced into woo because you have no access to real doctors. I would definitely agree that universal quality healthcare would not erase the existence of the woo-prone, but it would certainly reduce the way poor, desperate, sick people are outright scammed by unscrupulous assholes.

    This. Maybe the woo doesn’t go away with better access to healthcare, but it does cut down on the number of disadvantaged people who only turn to woo because they had no other options. And those people end up propping up the woo and helping perpetuate it, while also not getting any real medicine.

    Ask me how many ear infections I had growing up that led to garlic rubbed in my ear and tea instead of antibiotics. Not because that was preferable, but because nothing else could be afforded.

  35. 35
    fmitchell

    AFAIK, cupping ~= accupuncture << aspirin.

    (For math-phobic folks, "cupping is about equal to accupuncture and much less effective than aspirin" … and read a book by Danica McKellar for Leibniz's sake.)

    As for "Who the hell voted against free medicine?", you might as well ask "Who the hell voted against background checks for firearms?" Our representative democracy is getting less representative and less democratic every year. In another 20 years we'll probably see representatives from 50 states replaced by representatives from the NRA, Humana, Monsanto, and other corporations elected by market cap.

  36. 36
    OptimalCynic

    I always thought cupping was a BDSM thing. I was astonished to learn people believe it has medicinal benefits.

  37. 37
    roro80

    Who the hell voted against free medicine?

    Why give it out for free when huge numbers of people can make bucks hand over fist by witholding medicine from those who need it?

    I was talking about this this morning with my mom, in regards to education. Public education was doing too good a job in the majority of the country, and nobody was getting rich off of it. Enter Dubya, who sees this as a very, very big problem and comes up with No Child Left Behind, which simultaneously allows for federal and state money to go to private for-pay schools while making public school suck. Double extra points because “higher standards” (teaching kindergarteners what should be taught in 2nd grade!) sounds so lovely to people who don’t know what they’re talking about. Triple extra good points for these assholes because now the rich white people will be able to send their white, well-fed, kids to school without any of those poor brown kids. They can offer art and music and physical education and extra tutoring and school-sponsored educational trips and nap-time for kindergarteners. Let’s guess which schools get higher scores, shall we? Now we are seeing the public schools fail, as they were designed to do, and huge numbers of students fleeing to private school, where those who can afford it (and many who can’t) now pay $25k per kid to get what they were getting in public school a few decades ago. Money!

    The exact same thing is happening with healthcare. Way fewer people were getting rich off healthcare 20 years ago when Blue Cross and Blue Shield were not-for-profit. Now we’ve jacked the prices way, way up on every piece of medical equipment and every moment of medical time. We’ve made insurance companies un-navagatable. Doctors have to carry enormous amounts of malpractice insurance because they have to see too many patients every day and only spending 15 seconds with a very sick person means you’re going to make mistakes, and when those mistakes cost 1000x what they used to to fix, it’s a much, much bigger deal when you make one. Everyone is making the mulah like crazy now, to the very real detriment of the consumers of health care. Double extra points because the “lazy” people without jobs can’t afford to the go doctor, nor can those brown people the wealthy love to look down on.

    The whole thing sucks so much, and it’s fucking reprehensible that it was designed specifically to suck this much.

  38. 38
    Thumper: Who Presents Boxes Which Are Not Opened

    This is relevant.

    A faith-healing Philadelphia couple serving probation for the death of their two-year-old son are in trouble again following the death of another of their children.

    *sigh*

  39. 39
    roro80

    Ugh — wall of text and html failure. Sorry.

  40. 40
    Xaivius (Formerly Robpowell, Acolyte of His Majesty Lord Niel DeGrasse Tyson I)

    why are clinical studies being done with apparently positive results, and further studies proposed?
    Rob Grigjanis@28

    This study being from the ‘BMC Complementary and Alternative Medicine Journal,’ I would kind of think that was their schtick. Haven’t we gone over this?

  41. 41
    kemist, Dark Lord of the Sith

    they’d depict the government program as cutting corners to save money at the expense of people’s lives, too bogged down in bureaucracy to see what’s really wrong with you, or in bed with the Illuminati with the goal of ruling the world by shrinking your unmentionables. Therefore, the quacks will argue, it’s in your best interest to pay extra for their profit-driven quackery because they’re motivated by the invisible hand of the market to fix everything that’s wrong with you. Along with everything that isn’t wrong with you. (Why only profit from sick people?)

    That’s not very far off from the reasoning you see here.

    Then you also get people speculating wildly about why rich and famous people get treated elsewhere – sometimes in highly reputable clinics in the US, but also occasionally in wretched hives of quackery like the Burzynski clinic. It never enters their logic-impaired minds that the reason might be linked to a desire for privacy in the first case, and to bog-standard gullibility in the second.

  42. 42
    Thumper: Who Presents Boxes Which Are Not Opened

    Ah, I see Raven beat me to it…

  43. 43
    roro80

    @Mellow Monkey #34

    Ask me how many ear infections I had growing up that led to garlic rubbed in my ear and tea instead of antibiotics. Not because that was preferable, but because nothing else could be afforded.

    Exactly, Mellow Monkey. Something tells me that, as the price of basic medicine like antibiotics has gone up by such huge amounts in the last couple of decades, and as the wealth gap has increased, the incidence of these home remedies has skyrocketed. Being perfectly able to afford real doctors and medicine and consciously choosing woo is one thing, but being forced into goofy fake treatments because real medicine is basically impossible to access for so many millions of USians is quite another. The latter of these problems is solvable.

  44. 44
    w00dview

    The gullible voters who don’t want their money going to treat people who don’t deserve it.

    This whole concept of linking income to morality is one of the most fucked up aspects of US culture. CEOs who get billions in subsidies are wonderful, benevolent great leaders job creators whilst a single mother scraping by on food stamps is just a lazy slut trying to leech of the taxpayer and does not deserve to be supported by the government. It is horrifically puritan in its outlook.

  45. 45
    The Vicar (via Freethoughtblogs)

    Aha! I actually knew about this one before — there’s a discussion of cupping in Harold Klawans’ books on neurology. (He uses it to illustrate the connection between biochemistry and symptoms, in particular fever.)

    @AJS, #11:

    Who the hell voted against free medicine?

    One of the big forces against it the previous time around (in the 1990s) was the American Medical Association, whose membership is approximately (IIRC) a quarter to a third of all doctors in the U.S.. They did all sorts of lobbying and were a key source of talking points for the Republicans (who are, of course, the party which forms the face of the resistance to the whole idea). I seem to recall that their worry was that the medical profession would cease to be profitable with government-mandated bidding and prices. (You know, like the way the defense industry ceased to be profitable because it sells to the government.)

    This time around, from what I saw and read, the official A.M.A. stance was still anti-universal healthcare, but there was enough dissent among the membership that they kept fairly quiet. Most of the dissent is generated by the fact that medical practices now essentially have to employ more clerical staff than medical staff, just to deal with private insurers.

    Instead, the opposition this time came from the Republicans, partially because the reforms involved were being presented by the Democrats (although Obama himself was actively working against universal healthcare), but primarily for ideological reasons. It is axiomatic to the right that rich people are rich because they are virtuous and deserving and hardworking. Thus it follows that poor people are poor because they are not virtuous or deserving or hardworking. Thus, aid should be withheld from the poor because they are morally flawed; if aid is given to them, they will lose their only motivation to work — sheer economic hardship — and become indolent.

    Not only is this the basic economic theory of the right wing (and, increasingly, the center, which means the Democrats), it was essentially the attitude of Victorian Britain, so don’t you Brits get all huffy at us; you already made these same mistakes in the past.

  46. 46
    Nick Gotts

    Rob Grigjanis@28,

    From the study you link to:

    CONCLUSION:

    In this exploratory study dry cupping with a pulsatile cupping device relieved symptoms of knee OA compared to no intervention. Further studies comparing cupping with active treatments are needed.

    You see that “compared to no intervention”? That tells you they didn’t even try to exclude placebo effects.

  47. 47
    Xaivius (Formerly Robpowell, Acolyte of His Majesty Lord Niel DeGrasse Tyson I)

    You see that “compared to no intervention”? That tells you they didn’t even try to exclude placebo effects.
    Nick Gotts (formerly KG)@46

    Which in any decent medical journal would have never made it out of editing, if it even got accepted. Yay alt med journals!

  48. 48
    eveningchaos

    I was talking to a coworker who swears by “alternative medicine”. I asked her, “Do you know what they call alternative medicine that has been proven to work through peer review and clinical trials?” She asked, “No, what?” I replied, “Medicine.”

  49. 49
    lamaria

    When massaging I sometimes use cupping to prepare the ground. I don´t leave the cups on to create bruises, just slide them over the back to losen up the tissue. Saves quite a bit of strain on my hands.

  50. 50
    Rob Grigjanis

    Nick Gotts @46:

    That tells you they didn’t even try to exclude placebo effects.

    Fair enough.

  51. 51
    roro80

    eveningchaos #48 — In fairness, I think there is a case to be made that there are only certain things that get to the stage of peer review and clinical trials. For example, there are almost no good studies on using cranberry juice or cranberry pills to prevent UTIs, just a bunch of tiny crap-science studies with inconclusive results. I spent about 12 years of my life with chronic UTIs that I would get every 6-8 weeks no matter what I did. Round after round of antibiotics, then finally going on daily low-dose antibiotics, cured the UTIs but left me with a bunch of other problems. The solution was daily cranberry pills, and now I’m down to less than 1 a year for the past 3 years. I know they work for prevention. So: why no real studies on cranberry pills? My best guess: who would pay for such a study? I get 60 pills for $4.95 online, with shipping free if I order a few bottles at a time. How are the people doing the trial going to make up their investment? The cranberry industry isn’t set up for clinical trials, I’m guessing.

    This is not, of course, an endorsement of alternative medicine, just a suggestion that “medicine” has another crucial factor besides studies and trials, in the US at this time at least, and that factor is money. I do find that very unfortunate.

  52. 52
    WharGarbl

    @Marcus Ranum
    #27

    I’m confused. Are you saying that the cupping is being performed in a hospital, using trained doctors, and taking up facility space? Really? It’s not being done on the cheap? Huh. It sure is cheaper to give someone a cupping than to give them an MRI, huh?

    Just because someone’s getting a cupping doesn’t mean they don’t get MRI. My experience in Taiwan healthcare system is that stuffs like acupuncture, cupping, Chinese herbal medicine are generally used to deal with chronic issues (such as pain control). It generally follows when getting treatment by western medicine (for example, my aunt got prescribed a regimen of Chinese herbal medicine AFTER a fairly high-dose treatment of antibiotics to fight a particularly nasty salmonella infection).

    Those are the points that stick in my mind. Ben Goldacre’s comments on how “complimentary” medicine is infiltrating into the UK’s medical system – as a low-cost alternative for the health service to offer as a sop to the ignorant – also are in my mind.

    I’m not sure about conditions in the UK, so I must apologize for the harsh tone since your experience came from there. In Taiwan, Traditional Chinese medicine (a bit of interest, for some people in Taiwan, western medicine is considered “alternative” to the more “well-established” Chinese medicine) as used in hospital is more or less a compliment to normal treatments. They will still use relevant treatment for diseases (for example, antibiotics for salmonella). But afterward, they’ll also prescribe you Traditional Chinese medicine to combat side-effect of drugs.
    As for Mao, well, the West weren’t exactly… popular in China due to imperialism… Also note that Taiwan and China were very different around that time (China is Communist, Taiwan is more Capitalist).

  53. 53
    Gregory Greenwood

    w00dview @ 44;

    This whole concept of linking income to morality is one of the most fucked up aspects of US culture. CEOs who get billions in subsidies are wonderful, benevolent great leaders job creators whilst a single mother scraping by on food stamps is just a lazy slut trying to leech of the taxpayer and does not deserve to be supported by the government. It is horrifically puritan in its outlook.

    It gets even better than that – don’t forget that it is an increasingly popular trope that these billionaire CEOs are really victims… ‘Victims’ of the jeolous hatred of those with less ‘vision’, less ‘capacity for hard work’, less committment to the ideals of that toxic old lie, the ‘American Dream’.

    ‘Victims’ of ‘witch hunts’ by progressive liberals and Leftwing politicians and everyone else that the Right claims wants to ‘destroy the American way of life’.

    You see, being accurately identified as corrupt one-percenters who accrued their wealth by means of exploiting the hardship of average citizens is the single greatest injustice in the history of humanity, naturally. Far worse than little things like people being rendered homeless or even dying for want of decent medical insurance, for instance. Why, to even suggest such a parallel is clearly an insult to the poor, oppressed, richest and most politically powerful segment of society. I mean, next you will be saying that affirmative action isn’t evidence of the boot of the establishment firmly planted on the neck of the mistreated white man, or that the criminalisation of rape doesn’t clearly demonstrate that the state is under the control of a bunch of pee-pee hating feminazis…

    Welcome to the worldview of the Republican party. Nauseating, isn’t it?

  54. 54
    owenjohn

    Of course it’s rife in the Islamic world probably because Muhammad gave it the thumbs up… now im off to get some magic black cumin.

    http://www.guidedways.com/book_display-book-71-translator-1-start-10-number-591.htm

    http://en.wikipedia.org/wiki/Hijama

  55. 55
    WharGarbl

    @Xavius
    #33

    Incorrect. Acupuncture as ‘medicine’ means that it is supposed to treat some form of malady. When people die because they tried to use acupuncture to cure their HIV in place of actual medicine, then we lay part of that blame on allowing acupuncture to be treated as medicine.

    We don’t say antibiotic shouldn’t be used as medicine when people misuse it to treat viral diseases and made things worst. The harm of acupuncture came from people misusing it to displace known valid treatment.
    In Taiwan (at least my experience with it), acupuncture is prescribed in compliment for western medicine. It’s used as part of the pain management if the patient cannot tolerate the pain medication given.

    @fmitchell

    AFAIK, cupping ~= accupuncture << aspirin.

    Not if you’re allergic to aspirin or it’s chronic pain.

  56. 56
    Alexandra (née Audley)

    w00dview:

    This whole concept of linking income to morality is one of the most fucked up aspects of US culture.

    “Socialism never took root in America because the poor see themselves not as an exploited proletariat but as temporarily embarrassed millionaires.” John Steinbeck

    It’s just an example of why the “American dream” is such a fucked up concept. I mean, one day I could be part of the 1%†, so we shouldn’t “punish” “job creators” with higher taxes. Let’s face it, when I’m a billionaire, I’m going to be greedy as all get-out. Wouldn’t you?

    †With enough pluck, hard work, and grit, natch.

  57. 57
    Matthew Stief

    i’d only ever heard of it in the context of BDSM, where it is definitely “a thing.” haha

  58. 58
    Xaivius (Formerly Robpowell, Acolyte of His Majesty Lord Niel DeGrasse Tyson I)

    We don’t say antibiotic shouldn’t be used as medicine when people misuse it to treat viral diseases and made things worst. The harm of acupuncture came from people misusing it to displace known valid treatment.
    In Taiwan (at least my experience with it), acupuncture is prescribed in compliment for western medicine. It’s used as part of the pain management if the patient cannot tolerate the pain medication given.
    WharGarbl@55

    Acupuncture has been shown repeatedly to have no significant effect from placebo. In the United States, it has zero standing as a medical treatment, being lumped in with other “alternative medicines.” Much like homeopathy. As a note, due to it’s status as “not medicine,” it can be expensive to obtain, while doing nothing. It is explicitly harmful by pretending to be medicine.

    The difference, in this case, between Misprescribed Antibiotics and acupuncture, is that antibiotics actually have an effect on the body.

  59. 59
    WharGarbl

    @roro80
    #51

    This is not, of course, an endorsement of alternative medicine, just a suggestion that “medicine” has another crucial factor besides studies and trials, in the US at this time at least, and that factor is money. I do find that very unfortunate.

    I think you made a good response to Xavius #33: “We distill down the active ingredients, do clinical trials, and after checking for side effects, we have medicine.”
    It takes a lot of money to make medicine, and if something isn’t “profitable” enough.
    Put it this way, what profit is there to “distill’ down the active ingredient, do clinical trials, and make it into the medicine if after the above steps boils down to “So, you confirmed that chewing this leaf has similar effect? And it’s a lot cheaper than your drug?”
    Unless, of course, we start letting pharmaceutical company patenting plants.

  60. 60
    lamaria

    O, and of course there´s an old Scandinavian text where the devil is ill and gets cupped by witches…

  61. 61
    WharGarbl

    @Xavius
    #58

    Acupuncture has been shown repeatedly to have no significant effect from placebo.

    Considering that when performed by license technicians, acupuncture has very low risk and no side-effects. I would say that just having placebo effect is enough (as compared to drug based pain relief, which can problematic depending on your physical).

    In the United States, it has zero standing as a medical treatment, being lumped in with other “alternative medicines.” Much like homeopathy. As a note, due to it’s status as “not medicine,” it can be expensive to obtain, while doing nothing. It is explicitly harmful by pretending to be medicine.

    As you said, in the US. In Taiwan, it’s regulated by licensing and training. It’s not more expensive than other treatment on account that it’s just poking patients with needles in the right places.

    I would give an anecdotal case regarding my uncle, who has chronic back pain. He first elected to go for western medicine (you get to choose whether to see doctors practicing in western medicine or Chinese medicine). He was prescribed some sort pain killer and some sort of stomach pill (I don’t remember the name, but it’s something that’s always prescribed with medication that has “potential harm to stomach” as their side effect). After two weeks, pain did go away but he got stomach problem (he had stomach problem before). Doctors tweaked the dosage, same problem. Doctor referred him for acupuncture, pain reduction was not as great as medication, but no stomach problem for him.

  62. 62
    Jafafa Hots

    I can give you anecdotal evidence of my psychic powers, because I predicted the Challenger explosion months ahead of time. (I actually did.)

    So… how much can I charge you now for a reading?

    A far as placebo effect, if that’s all you can offer then I might as well pray instead – it’s free.

  63. 63
    The Vicar (via Freethoughtblogs)

    @WharGarbl, #61:

    The problem with that scenario is that as soon as you admit the efficacy of clinical studies, then you also admit that anyone charging for acupuncture at all is necessarily overcharging. You don’t even have to stick the pins in any particular spots to get the placebo effects; as I recall, the most recent big study on the subject actually showed that people stuck in totally random spots ended up with slightly better results than “genuine” acupuncture. So the whole licensing, administration by doctors, etc. is just a gigantic ripoff.

  64. 64
    Dalillama, Schmott Guy

    I mean, free medicine ….. the right to see a doctor anytime, without payment ….. who would vote against that?

    Bigots. There’s a significant chunk of the (white) U.S. population who can’t stand the thought that POCs might receive government services, and are willing to shoot both their own feet off, if only it means that a black person loses their whole leg.

  65. 65
    Xaivius (Formerly Robpowell, Acolyte of His Majesty Lord Niel DeGrasse Tyson I)

    “So, you confirmed that chewing this leaf has similar effect…”
    WharGarbl@59

    Are you seriously using ‘argumentum ad Big Pharma?” REALLY?! Fucking hell…

    Alright. Fine. Let’s do this. Same shitty argument that has been used a thousand fucking times. Let’s use the real example: Willow bark, aka acetylsalicylic acid, aka FUCKING ASPIRIN.

    Willow bark relieves pain. This has been known for a very long time, right down to Hippocrates. It is somewhat abundant. It also has fucking HORRIFIC side effects, such as gastrointestinal bleeding at high rates. Distillation of acetylsalicylic acid from this reduced side effects, AND allowed for more controlled dosing, which improves efficacy.

    So:
    1) Au natural medicines have SEVERE dosing issues, as well as a cornucopia of undesired effects.
    2) distillation allows for proof of efficacy, as well as reduction of side effects.

    As for big pharma: If they can find something that they can convince the FDA of that cures or treats something, they’ll do it. Medical patents expire quickly, which is why companies like Pfizer throw BILLIONS at R&D.

    To hear blatant, Woo bullshit arguments like this just right pisses me off. What’s next? Big Pharma doesn’t want us to get well so they can make more money off us?

  66. 66
    chigau (違う)

    Xaivius may be more likely to respond if you spell xis ‘nym correctly.

  67. 67
    Michael

    My wife ended up getting some kind of special deal at a local “clinic” and gave me a few free sessions. While massage was one of those, which I had no problem with, cupping was another. I’d never had it, didn’t know much about it, and experienced it with no noticeable effects – not surprisingly. However, it did leave several unusual circular marks on my back, so I had some fun at work the next day or so when I claimed I’d been attacked by a squid (or octopus, I can’t remember). When my victim’s replied, “Yeah, right.”, I showed them some of the marks on my back and left them very confused…

  68. 68
    chigau (違う)

    never mind

  69. 69
    The Vicar (via Freethoughtblogs)

    @ Xaivius, #65:

    The problem with your argument is that Big Pharma is so big, and has its profits so well guaranteed by U.S. law and the medical establishment in general, that the amount they spend on research and development is piddling compared to what they spend on executive compensation or stock dividends. (I’m too lazy to go look it up, but there was an investigative article on Salon.com a few years back, and they found that the ratio of executive compensation to research spending was 10 to 1 or so.) The “we need these profit margins so we can come up with new advances” thing is a canard, and so is “we will investigate any possible source of revenue because we are so desperate”.

  70. 70
    Xaivius (Formerly Robpowell, Acolyte of His Majesty Lord Niel DeGrasse Tyson I)

    The Vicar (via Freethoughtblogs) @65:

    The entire point of my post is that Evidence-Based Medicine works, with a corollary that the pharmaceutical industry is usually willing to jump on anything to make a buck, largely because they are greedy, and also the people working there are usually, y’know, actually trying to make people’s lives better. I have no doubt about the failings of Pfizer et al, and would much prefer to see more transparent methodologies used by, preferably, a state-run organization with mandated reporting. But that’s beside the point I want to make.

    I feel the need to repeat this:

    Evidence-Based Medicine WORKS

    Acupuncture is not Evidence-Based Medicine. Neither is Cupping. Or ear-candling.

  71. 71
    truthspeaker

    AJS

    24 April 2013 at 10:56 am (UTC -5)

    I have just one question for you Americans.

    Who the hell voted against free medicine?

    I mean, free medicine ….. the right to see a doctor anytime, without payment ….. who would vote against that?

    As another commenter pointed out, it was politicians, not voters, who voted against free medicine. A majority of Americans favor it (depending on how the poll question is phrased), but both Senator Baucus and President Obama declared it “off the table”.

    It’s important to remember that the USA was founded by affluent people who didn’t want to pay taxes. Modern politicians are adept at convincing middle and even working class voters that the tax burden for any new spending will fall on them, not on rich people – and to a certain extent they’re right. Even when progressive politicians decide to raise revenue to pay for spending (usually spending enacted by previous politicians without a revenue stream), somehow the tax burden ends up on the affluent, middle, and working classes but not the very rich.

  72. 72
    Amphiox

    WharGarbl;

    If acupuncture is pure placebo then acupuncture should NEVER be used, period. Because acupuncture involves the penetration of the body by foreign objects and that is a non-zero harm, however small. And since a good counseling session with a physician is also pure placebo and does not involve violation of the body by a foreign object, there is thus no circumstance in which the former can be justifiably preferred over the latter.

    If acupuncture is pure placebo then acupuncture is a violation of all medical ethics. You can justify the use of acupuncture only if it is more than just placebo.

    Also, do not presume that only drugs have side effects and “complimentary” placebo therapies do not. The nocebo effect is just as real as the placebo effect. Adverse events are documented even in the placebo arms of trials.

    As for chronic pain, evidence based medicine to date has pretty much no good answer whatsoever for chronic pain. Into this vacuum of ineffectiveness complimentary therapies have been stuffed, partly because there are no other options and partly because of the human instinct to do something, anything, rather than nothing. But we must never fool ourselves into thinking that these things are actually any good for chronic pain. Their use is in fact an admission of impotency, a counsel of despair. We may as well add prayer to that pool of options.

  73. 73
    Xaivius (Formerly Robpowell, Acolyte of His Majesty Lord Niel DeGrasse Tyson I)

    Eloquent, succinct words that make sense
    Amphiox@72

    This is far better stated than I. I am too angry to discuss this further. Don’t peddle woo, kids.

  74. 74
    truthspeaker

    As has happened before I left the racism component out of my political explanation, and someone else added it. It really can’t be underestimated. There’s plain old vilifying of poor people, and then there’s vilifying poor people as code for vilifying people of color. There’s a lot of overlap between the two.

  75. 75
    WharGarbl

    @Xaivius
    #65
    Not arguing against big pharma, but more that, as @roro80 #51, certain set of remedies do not get studied due to a combination of.
    1. The stuff they’re treating is fairly minor.
    2. They have no significant side-effects already.
    3. They’re cheap.
    In short, they’re not studied because their weaker capability is sufficient for people while having comparatively low side-effect. Pharmaceutical company has the important role of developing medicine, but the cost of development is such that they have to balance risk/reward of developing a drug. If they’re not confident enough that they can improve a drug’s effectiveness or its side-effect enough to justify the cost of research, they’re likely not going to do it.

    The problem with all the “alternative medicine” is that people market them as some sort of miracle cure when they’re not.

    @The Vicar
    #63

    The problem with that scenario is that as soon as you admit the efficacy of clinical studies, then you also admit that anyone charging for acupuncture at all is necessarily overcharging. You don’t even have to stick the pins in any particular spots to get the placebo effects; as I recall, the most recent big study on the subject actually showed that people stuck in totally random spots ended up with slightly better results than “genuine” acupuncture. So the whole licensing, administration by doctors, etc. is just a gigantic ripoff.

    Sticking needle in random spots could get people seriously injured or killed. Acupuncture training at least teach practitioner where to stick those needles to NOT seriously injured or killed.

    @Jafafa Hots
    #63

    I can give you anecdotal evidence of my psychic powers, because I predicted the Challenger explosion months ahead of time. (I actually did.)

    So… how much can I charge you now for a reading?

    If I ran out of all other options, THEN I might try out for your reading.
    Then again, I don’t see any reason why I need a psychic reading at all. Unlike, say, chronic pain.
    Heck, if you’re good with the skill of cold-reading, I would toss $5 your way just for some entertainment values.

  76. 76
    w00dview

    Gregory Greenwood:

    Welcome to the worldview of the Republican party. Nauseating, isn’t it?

    Ugh, you said it. Terrifying that these heartless assholes make up one of the most powerful mainstream party in the states.

    Dr Audley Z. Darkheart, PhD, MD, DDS, Esq:

    It’s just an example of why the “American dream” is such a fucked up concept. I mean, one day I could be part of the 1%†, so we shouldn’t “punish” “job creators” with higher taxes.

    As a way of shutting down any discussion about the injustice of economic inequality, the American Dream is a fantastically effective piece of propaganda. Earning 2 dollars an hour for waiting tables? OBVIOUSLY your own fault, if you were brilliant and hard working like our corporate overlords, you would be a billionaire by now. The American Dream basically teaches the lower classes to roll on their back and submit to their “betters”. It is why Republicans try their damnedest to destroy public education. An ignorant populace can put up with a lot more crap from their employers than an educated one which know when they are being screwed with.

  77. 77
    Rich Woods

    @WharGarbl #52:

    It generally follows when getting treatment by western medicine (for example, my aunt got prescribed a regimen of Chinese herbal medicine AFTER a fairly high-dose treatment of antibiotics to fight a particularly nasty salmonella infection).

    And which do you think helped her the most?

    I’ve only once seen Chinese herbal medicine in action. When in Hong Kong a friend asked me to accompany him when he went to see a traditional Chinese doctor regarding a problem he had (my friend had little knowledge of medical terminology; I have some, thanks to my parents, but I certainly won’t claim it amounts to much). My friend didn’t speak Cantonese and the doctor only spoke a dozen words or so of English. The consultation consisted of the doctor pointing to pre-printed diagrams of the human body and to sheets of bi-lingual phrases describing various symptoms and possible histories (I helped out with explaining these medical terms where I could; there was only one which had me baffled, and obviously I recognise that I could have been wrong with others). The doctor did also examine my friend for signs, once he had some idea where to look.

    I certainly don’t doubt the doctor meant well and did his best under the circumstances, but it was what he prescribed my friend which struck me the most. There was a small closet off the consulting room, containing a couple of pots bubbling away and upon the wall a few shelves of jars of assorted ointments and pills. Various dried plants and herbs hung down from hooks on the ceiling. The doctor took one bottle of what looked to me like small, hairy black pills and gave it to my friend. He then drew diagrams of clocks and a calendar to indicate how often a pill should be taken, followed (understandably enough) by a charge in HK dollars.

    I know all this is only anecdote, but the pills didn’t help my friend. A month later he gave up and paid for antibiotics which did clear up his problem.

  78. 78
    Jafafa Hots

    Then again, I don’t see any reason why I need a psychic reading at all. Unlike, say, chronic pain.

    What if I can predict when you’ll get your desired placebo effect? It may not be a real psychic power, but if you believe me then maybe I can cause a placebo effect to help induce your acupuncture’s placebo effect.

  79. 79
    WharGarbl

    @Rich Woods
    #77

    And which do you think helped her the most?

    Antibiotics got rid of the salmonella, gave her nasty diarrhea and stomach pain. Chinese herbal medicine part was to alleviate the diarrhea and stomach pain.
    Granted, I don’t know if she would’ve gotten better without the herbal medicine part.

  80. 80
    WharGarbl

    @Jafafa Hots
    #78

    What if I can predict when you’ll get your desired placebo effect? It may not be a real psychic power, but if you believe me then maybe I can cause a placebo effect to help induce your acupuncture’s placebo effect.

    So, like hypnotist and physician counseling?

  81. 81
    Krasnaya Koshka

    Amused @ 7: I live in Russia now and doctors still make free house calls. Before I had health insurance that I paid for ($132 a year) but now that I’m an official resident, it’s free for me. (I did pay $30 for the cardiologist, though, when I was having heart troubles.)

    My gf’s sister recently had an extreme bout of hypertension and it was recommended she see a “specialist”. It was a leech and cup doctor. I was very surprised when she told me about it. She suffered it for a few months but then decided it was doing nothing for her. And the feeling of the leeches made her creeped out. Poor thing.

  82. 82
    WharGarbl

    @Xaivius
    #70

    and also the people working there are usually, y’know, actually trying to make people’s lives better.

    Even without greed, it doesn’t defeat the fact that the resources needed to research drugs are expensive. Short of government funded research programs, a “non-profit” drug company would still need to find drugs that can sell well enough to recover the research cost.

    Evidence-Based Medicine WORKS

    I agree with you on that point. But as many said, people will flock to alternative medicine to find anything that works. Especially for Taiwan, where a lot of people believe in Chinese medicine (heck, it worked for them for 2000+ years). Good regulation reduce/eliminate problems of malicious scamming of patients.

    @Amphiox
    #72

    If acupuncture is pure placebo then acupuncture should NEVER be used, period. Because acupuncture involves the penetration of the body by foreign objects and that is a non-zero harm, however small. And since a good counseling session with a physician is also pure placebo and does not involve violation of the body by a foreign object, there is thus no circumstance in which the former can be justifiably preferred over the latter.

    Perhaps we differ regarding the “never”. But if it benefits the patient, even if its a placebo effect, if the potential harm is less than the placebo effect. I don’t see why not. Counseling is another option, but what would you have them do if it didn’t work either?

    The nocebo effect is just as real as the placebo effect. Adverse events are documented even in the placebo arms of trials.

    Using Taiwan system as example, traditional Chinese medicine is optional, as in you choose to see a Chinese doctor. If you choose it, more than likely you believe that it’s going to help (hence unlikely for nocebo effect to occur).

  83. 83
    timdiaz

    My dad grew up in a tiny village in Spain, they had a lot of old wives tales about medicine. He told me about this when I was 10 and I knew it was bullshit.

    Though I guess I shouldn’t be too harsh on the celebs. I’m sure they were sold on it by someone very charismatic and slick.

  84. 84
    Endorkened

    Exactly! I’m a hypnotist, and I can promise you there’s nothing your needles can do that my voice can’t. The difference is that I’m consciously and deliberately invoking the placebo effect, so I can also do things you can’t–like creating sensory hallucinations, or even treating short-term memory loss associated with post-concussion syndrome.

  85. 85
    Kevin

    Well, I think both accupuncture and cupping result in the same thing…a pain signal that results in the body producing a flood of endorphins. So, is that a “placebo” response, or something else? It’s pretty close — if not identical to — BDSM play. Would not surprise me in the least to see it in that community as a “toy”.

    I would not use either for anything other than “entertainment purposes only”. Particularly in lieu of other allopathic solutions to whatever problem you’re seeking to redress.

    Of course, celebrities like Paltrow are fond of “cleansing toxins” and other woo-woo nonsense. So, if cupping is for “cleansing toxins”, then it’s perfectly harmless. Except to her wallet. And perhaps her vanity. And perhaps if she gets a skin infection…that wouldn’t be harmless.

    Of course, there is also such a thing as “wet cupping”, which is cupping with blood letting. Which isn’t harmless at all.

  86. 86
    WharGarbl

    @Krasnaya Koshka
    #81
    I think leeches do have some benefits regarding circulation (something about the chemical in there saliva). Not sure how well it does against hypertension.
    Actually, an interest response to @Xaivius #33

    Bleeding wounds and drinking Urine to cure disease were traditions of Europe. Now? not so much. Culture is a poor justification for allowing scams to prey on people looking for help.

    Leech therapy is a form of blood-letting therapy. Supposedly it improves blood circulation to the “blood-letting” area (obviously, balanced by the fact that too much blood-lost is a serious problem).

    My general view on alternative medicine is that when in conflict, evidence-based medicine should take precedence when deciding treatment. “Established” alternative medicines may be valid options if evidence-based medicine cannot treat it or evidence-based medicine caused to much side-effect to the patient.

    The “established” part basically means medical practices that had been used by culture worldwide for a LONG time. Some of those might be sham, but some others may actually have their intended effect, even if their underlying theory on how those intended effect occurs. For no other reason that if they have been doing it that long, there MAY have been a connection between said treatment and the symptom/disease they’re trying to treat.

    Case in point, London’s sewage system was created on the belief that miasma causes cholera, and removing miasma by removing dirty water would eliminate/reduce cholera. While now we know that cholera is not caused by miasma, it turns out that the sewage system does solve the cholera problem by removing the environment that cholera causing bacterium can thrive.

  87. 87
    WharGarbl

    @Johnathan
    #84

    Exactly! I’m a hypnotist, and I can promise you there’s nothing your needles can do that my voice can’t. The difference is that I’m consciously and deliberately invoking the placebo effect, so I can also do things you can’t–like creating sensory hallucinations, or even treating short-term memory loss associated with post-concussion syndrome.

    I’m pretty sure getting poked with a few needle by professionals who knows where to stick those needle without causing permanent harm is better than a bat to the head.

  88. 88
    eveningchaos

    roro80 #51 – I too have heard that cranberry juice has a positive effect on UTIs. If the simple and cheap remedy seems to work for you, by all means, continue with it. I’m sure if a study were conducted, there would be empirical evidence to support its benefits. It sounds like there is definitely something at work in this cheap and readily available home remedy.

    What I was referring to in my previous post was the fact that quacks make a lot of money off gullible and desperate people. Most of the effects of these “remedies” offer what you would expect from the placebo effect. I think a good rule of thumb is follow the money. If it’s lining some quack’s pocket, best be skeptical. If Ocean Spray makes a few extra dollars on tasty juice, no real harm done.

    Dawkins has a great series called, “The Enemies of Reason”, where he investigates and confronts alternative medicine practitioners. I just question the ethics of certain people who willingly mislead the ignorant public for there own benefit. Some are probably convinced that what they do is helping. It doesn’t change the fact that they are peddling snake oil.

  89. 89
    eveningchaos

    roro80 – I’m also from Canada so my perspective might be a lot different with how I view medicine being practiced. I really take for grated that we have a pretty good system here. I just hope Stephen Harper doesn’t go and strip that fundamental Canadian value as he has with many others since his reign began. Thank you for bringing a differing perspective on this vital human issue.

  90. 90
    Krasnaya Koshka

    WharGarbl @ 86 – I’m not a leech expert but I think in this case it was a bad idea as it didn’t help.

    To be fair, I think Russian medicines are all placebos. When I went in for heart arrhythmia, I was given four medicines that were all basically alcohol. Some with a pine-y taste. (This is why I’m the main Advil supplier in SPb. They have no actual pain relief pills. I thought I’d die of menstrual cramps here until I went “home” and picked up Advil. Now I’m the supplier.)

    So, for countries with crappy medicines, perhaps Kevin’s response is best. “a pain signal that results in the body producing a flood of endorphins.

  91. 91
    Amused

    @WharGabl

    I think leeches do have some benefits regarding circulation (something about the chemical in there saliva). Not sure how well it does against hypertension.

    I remember a Madventures episode where one of the presenters got a “treatment” of leeches in Russia, at one of those spa-like, fancy-schmancy alternative medicine clinics. The guy couldn’t stop bleeding for two days afterwards. Blood just kept seeping out of him into this enormous maxi-pad-like thing he had to wear around his torso all the time. After a few comments, the show kinda just let that issue fade away without any closure — which leads me to believe (or at least hope) the poor thing eventually went to a REAL doctor and got some medicine to stop hemorrhaging.

    Leech saliva contains anticoagulant enzymes. Depending on how many leeches you get (and that Madventures guy got a lot simply because he’s big and has a lot of “surface area”), those things can put a lot of hirudin into your blood stream. And that’s the same if you just took an unspecified quantity of anticoagulant medication. One obvious danger is intracranial hemorrhage and stroke. And since the homeopaths who administer leeches have no training in medicine, biology or chemistry, they can’t be trusted to give you the “right” number of leeches to prevent a significant quantity of anti-clotting enzymes from entering your body.

    To the extent that leeches are used to relieve high blood pressure, hell, even good old-fashioned medieval-style bleeding from the wrist is probably safer.

  92. 92
    Pteryxx

    Perhaps we differ regarding the “never”. But if it benefits the patient, even if its a placebo effect, if the potential harm is less than the placebo effect. I don’t see why not.

    To toss another anecdote out there regarding the placebo effect…

    When I was in single digits of age and constantly getting sick, I disliked cold medicines. Nasty-tasting, didn’t work very well, and dispensed only by parental authority, meaning I either had to beg and persuade them that I really did feel sick, or they’d inflict doses on me when I felt well enough to not need any. Therefore I decided to invent my own ‘medicine’, reasoning that if it tasted horrible enough, I could convince myself to feel better because of the taste alone. I remember carefully selecting edible components only, rather than risk the side effects or overdoses of real medicines. The final recipe involved orange soda, dill pickle juice, and a dash of chocolate syrup. For several years, if I started to run a fever, I’d secretly mix a cup or a whole glass of this brew and choke it down before my parents could catch me getting sick and interfere with my life thereby. And most of the time, the fevers did resolve in a day or so, versus three or four days on only standard, parent-dispensed medication. (And as a proto-scientist, I did test it by sometimes drinking only the orange soda.)

    Obviously I knew at the time that my secret fever drink was just a trick – played on myself, no less – and couldn’t have any real medicinal effect. The whole point was to come up with something nasty and unusual enough, something used in no other situation, so that the trick would be plausible (in the storytelling sense) and thus effective. I learned the concept of a placebo effect some years later, in high school.

    There’s research showing the placebo effect can be moderated by how expensive a medication is (a high price tag makes a placebo more effective), the color and shape of pills, the practitioner’s explanation and manner, unrelated tastes or side effects which convince the patient that something is happening, and yes, anecdotal evidence. Placebos basically work through the power of storytelling… something humans will pay for and be affected by, even when they know the story isn’t real.

  93. 93
    Pteryxx

    Using leeches in reconstructive surgery

    Today’s plastic surgeons usually call upon them once other methods to decrease venous congestion, such as pricking the skin with a needle or using nitropaste (a cardiac drug that dilates blood vessels), have been exhausted. “We don’t want to use them unless we have to,” said Ronald M. Friedman, M.D., a plastic surgeon in private practice in Plano, Texas. “It’s a salvage situation.”

    Reattaching a digit and reconnecting its blood vessels is painstaking work that is often carried out under the microscope. Problems with reestablishing blood flow occur about 10% of the time when “we can get the artery hooked up, but not the vein,” explained Louis P. Bucky, M.D., a plastic and reconstructive surgeon at the University of Pennsylvania in Philadelphia.

    Similarly, a tram flap, abdominal tissue used to create a new breast after a mastectomy, may also become engorged with blood that cannot find its way out of the affected area. Leeches work by “removing extra venous blood and increasing blood flow” to the region, according to Ira D. Papel, M.D., a plastic surgeon in private practice in Owings Mills, Md., and associate professor at John Hopkins University, Division of Facial Plastic Surgery, in Baltimore.

  94. 94
    Ichthyic

    It’s used as part of the pain management if the patient cannot tolerate the pain medication given.

    this is nothing more than a rationalization, based on a TINY TINY statistical minority.

    no WAY is that the real reason for why these practices are not only maintained, but PROMOTED within the medical communities in Taiwan and China.

    sorry, your “experience” seems to have really amounted to you rationalizing your own healthcare system!

    sad.

  95. 95
    Amphiox

    Perhaps we differ regarding the “never”. But if it benefits the patient, even if its a placebo effect, if the potential harm is less than the placebo effect. I don’t see why not.

    Your argument is only valid if there was a binary choice between acupuncture and some non-placebo medical treatment and NOTHING ELSE. But that is not the case the real world. In the real world you almost always have more than 2 choices.

    What we have here is:

    Option 1: Placebo benefit offset by small risk harm – this would be analogous to acupuncture
    Option 2: Placebo benefit offset by NO risk harm – this would be counseling or any number of other NONINVASIVE strategies
    Option 3: Real benefit offset by moderate risk of harm

    If Option 3 cannot be pursued because the moderate risk of harm is too great, then so long as option 2 exists and it ALWAYS does, then Option 1 CANNOT be chosen, or it is a violation of medical ethics.

    Option 2 is always superior to Option 1. Even if Option 1 provides a benefit greater than the risk of harm it does not matter, because Option 2 provides the same benefit with no risk of harm. Option 1, therefore cannot be ethically chosen over Option 2.

    Counseling is another option, but what would you have them do if it didn’t work either?

    Something that does not involve penetrating the body with a foreign object. INVASIVE procedures must pass a higher bar.

    If acupuncture is pure placebo, then it is no different from a sham surgery procedure, and nearly all sham surgeries are unethical, even in the setting of a well controlled clinical trial. (That is one reason by placebo controlled trials for surgical procedures are so rare – the experimental design can almost never pass ethics review).

    If acupuncture is pure placebo, then it cannot be more effective than counseling, or any other equivalent non-invasive placebo, and is NOT, ethically, allowable as an alternative to them. If it IS more effective than those, then it is NOT pure placebo, but you better have the evidence to back that claim up.

  96. 96
    Amphiox

    no WAY is that the real reason for why these practices are not only maintained, but PROMOTED within the medical communities in Taiwan and China.

    They are promoted for cultural, political and historical reasons.

    The placebo effect may even be enhanced by the same cultural, political, and historical reasons.

    But it is politics, not science.

  97. 97
    Amphiox

    Leeches in the setting of reconstructive plastic surgery is not alternative medicine. It is evidence based medicine.

    Similarly, maggots in the setting of some necrotic open wounds.

    In any other setting, these two ARE alternative medicine.

  98. 98
    Christian

    Whew, for a second I thought this had something to do with S. E. Cupp.

  99. 99
    cm's changeable moniker (quaint, if not charming)

    Ben Goldacre’s comments on how “complimentary” medicine

    Awesome! “Do help yourself to a sugar pill on the way out; they’re terribly good for you!”

    is infiltrating into the UK’s medical system – as a low-cost alternative for the health service to offer as a sop to the ignorant

    Sort of.

    The fun thing though, is that placebo actually works and now the race is on to find the most effective placebo! (If you’ve read Bad Science you’ll remember the fake-gore-surgery …)

  100. 100
    Pteryxx

    Amphiox: what’s up with “INVASIVE” being a bright line for inherently unethical procedures, w.r.t. acupuncture? Massage and chiropractics don’t penetrate the skin at all, but carry a lot more risk than acupuncture does. (And sham surgery’s not even close to cleanly done acupuncture, as far as I know. Not to mention the very real danger of predatory counseling…) Would acupuncture be fine if the needles only rested on the skin, so the recipient could feel the pricking? Or if the needles were electrified to cause the sting without penetration?

  101. 101
    John Horstman

    Cupping is a thing? Really?

    This was my exact reaction when I found out about it from a friend of a friend (with whom I hung out exactly once, as she was apparently deeply offended my utter contempt for New Age quackery; one of the reasons I like Minchin’s Storm so much is that I’ve had several similar experiences, though I doubt I was as rhetorically engaging as Minchin’s character) who operates a woo-heavy spa.

  102. 102
    Amphiox

    Pteryxx: Invasiveness is a line. Not the only line. There are multiple parallel lines.

  103. 103
    Ichthyic

    But it is politics, not science.

    exactly.

  104. 104
    yazikus

    Or ear-candling

    I lived in a town once where there was a large population of hippie granola types, and everyone was into ear candling, and I just couldn’t stop the inner chuckle when I think of someone holding a tube of flaming paper to their ear to suck out ear wax! One- gross! Two- isn’t that super dangerous? How often do you think they catch their hair on fire?

  105. 105
    Crissa

    I think it’s more an example of how vast the demand for medicine is, and why no amount of ‘market’ can contain it. Because as long as someone is suffering, or thinks they are, they have ‘demand’.

    On the other hand, I don’t think a bunch of photos really shows anything about whether they’re paying alot for it, what they’re using it for, etc. For all I know they’re paying nearly nothing for a meditative experience.

  106. 106
    Crissa

    Re: 92 Pteryxx 24 April 2013 at 4:42 pm (UTC -5)
    Obviously you need to write a paper on sugar-rush as a treatment of low-intensity fevers.

  107. 107
    Ogvorbis: Still failing at being human.

    When I was in high school, the mother of one of my friends was diagnosed with breast cancer. The doctor recommended chemotherapy and surgery. She said no. Instead, she had the tumour ‘sucked’ out of her breast through a knife cut into a Mason jar. Somehow they produced a vacuum in the jar and it pulled something out of her breast. Unfortunately, it was not the tumour and she died within six months. Cupping the tumour out was good enough for her dead mother and her dead father, her dead grandparents, and her dead aunt, two uncles and one cousin was good enough for her because ‘Traditional medicine works sometimes but modern medicine never does.’

  108. 108
    yazikus

    @Ogvorbis

    ‘Traditional medicine works sometimes but modern medicine never does.’

    What a sad sad story. Sad for your friend’s mother, and for your friend, who lost a mother, and all of the mother’s friends who lost a companion. Awful.

  109. 109
    Tethys

    They must have had an excess of black bile, which as any medieval physician knows, creates bad humours. Of course you should pull those out of your body, lest they lodge and create hysteria. /sarc

    On the plus side, I remembered a scene involving cupping at the end of Dangerous Liaisons and discovered that I can watch the entire excellent movie on youtube.

  110. 110
    No One

    Misfired penis pump.

  111. 111
    The Vicar (via Freethoughtblogs)

    @Tethys, #109:

    In the section of the book I referenced above which talks about cupping, the history of the practice is mentioned, and I seem to recall that it really did start as a “humours” thing. I’ll see if I can go dig it up. (I remember that the chapter was titled “as useful as cupping a corpse”.)

  112. 112
    The Vicar (via Freethoughtblogs)

    Oh, and incidentally, what the heck happened to the layout and stylesheets/scripts for FTB? Suddenly today it’s all different, and massively inconvenient to leave comments because some idiot javascript closes up the comment list and the “leave a comment” section after the page loads.

  113. 113
    Alethea Kuiper-Belt

    Cranberry juice is also no use: http://www.sciencebasedmedicine.org/index.php/cranberry-the-alt-med-zombie/ That one never made sense to me anyway. My preferred alt-med (*) for UTIs is alkaline, because surely neutralising the acid makes more sense for pain relief than further acidifying it.

    (*) Carb soda. And lots and lots of water. Until I can get to a doc for real drugs.

  114. 114
    chrislawson

    Apologies for the very long post…

    I’m late to the party, but there are quite a lot of statements made in the article and the comments above that really niggle at me.

    1. Alt-med tendencies have nothing to do with lack of universal health care. Every country in the world has a large alt-med industry, including the UK, Canada, and Australia.

    2. As someone pointed out above, in some of these countries the alt-med industry has used regulatory capture (Google the term + Saturday Morning Breakfast Cereal for an excellent cartoon explanation) to get their nostrums injected into the public health system. The UK has publicly funded homeopathic hospitals. In Australia, where the various states have just merged their medical boards into a national body, there is now a push by that body to include Chinese medical practitioner registration alongside medicine, nursing, physiotherapy and other evidence-based professions.

    3. Despite its well-manicured image as a cottage industry, alt-med is a massive enterprise — a study from about 10 years ago in Australia showed that consumers were spending *twice* as much on alt-med formulations as they were on prescription medications. Remember that next time someone uses the argumentum ad Big Pharma.

    4. Despite popular conception, most users of alt-med are not uneducated — most are, like anti-vaxxers, tertiary-educated and have acquired a form of Kruger-Dunning incompetence. That is, because they are educated, they think they know more than experts in the field without actually doing the work to acquire their own expertise. It’s similar to the MBA fallacy (the idea that if you have an MBA you know enough to run a business in any industry), or those people who think a martingale betting system is the way to win big at casinos.

    5. There is a big difference between placebo effects and psychological effects, even if they feed into each other. A placebo effect is when an inactive intervention has a measurable effect on an outcome. While we tend to think of this as psychological, it can in fact refer to any number of causes, including bias in study design, statistical error, sampling variations, and so on. This is why even completely non-psychological tests should have controls.

    6. Despite numerous assertions in the comments, there have been many studies into cranberry juice for UTI. If ever anyone wants to find out about the actual research base for a treatment, even an alt-treatment, a good place to look is the Cochrane Collection (its own pages describe it better than I have space for here, but essentially its a collection of systematic reviews by groups of people with a shared research interest). Cranberry juice for UTIs has its own Cochrane Review which turned up numerous studies, several of which were good enough quality to include in the review. It’s also worth noting that Cochrane Reviews are usually updated every few years, so that early conclusions (in 2008 it was reported that cranberry juice seemed to have a modest effect in reducing UTIs) can change (by 2012, the addition of a further 14 studies changed the conclusion to “it is unlikely that cranberry in its juice form is going to be an acceptable and effective intervention”). Anyway, my major point here is that despite a lack of drug company interest, there is still a lot of research being done by interested practitioners with non-Pharma research funding. Don’t just assume that because something is alt-med that it has no relevant research base.

    7. Despite being a hardcore evidence-based medicine doctor, I do sometimes refer people for acupuncture. Contrary to what has been stated earlier, acupuncture *does* have a big research base — sadly most of it is of appalling quality and should be ignored, but again if you check out Cochrane you can find dozens of reviews of evidence for acupuncture for a wide range of pain conditions. Most of these reviews conclude that there is little evidence for acupuncture, but several find modest benefits *even over sham acupuncture*. As such, I find it completely reasonable to refer patients for acupuncture when other, more mainstream methods of pain relief have failed or are inappropriate. I don’t really have a lot of time for acupuncture (and no time at all for its non-pain related uses) and I only recommend it to 2 or 3 people a year, but it is cheap and safe (certainly safer than anti-inflammatory medications) and frankly, even if there is a huge placebo component, for the treatment of a subjective experience like pain I really don’t care.

    8. On the other hand, “traditional Chinese medicine” should be avoided at all costs even if it does have a placebo effect because it is known to be manufactured with little QA with many “treatments” containing dangerous levels of heavy metals and other toxic components. (And as Marcus Ranum says, one of the reasons for the heavy use of traditional medicines in China is that Mao had millions of intellectuals killed, which included science-based doctors, so it was a cheap and supposedly proletarian way of providing medical services, even if those services were largely useless. The idea that we should continue to support Chinese medicine because it is traditional is about as viable as supporting witch-burning in Europe, crucifixion of criminals in Rome, and mass human sacrifice in Mexico.)

    9. Oh, and although nobody has mentioned it yet, the NCCAM was a good idea when it was started, but after many years of work and many billions of dollars in funding without uncovering a single unequivocal benefit for alt-meds, it has now degenerated into a political exercise in milking positive results for alt-meds (including potentially dangerous chelation therapy for inappropriate causes) in order to justify its continued existence.

  115. 115
    Amphiox

    Some Traditional Chinese Medicine (and other traditional medicines too, of course) have real physiological effects.

    And those physiological effects play right into the placebo effect.

    “This herb will melt your tumor and allow you to pee it out”

    You take the herb and lo! you start urinating more, because the herb has an actual diuretic in it. You notice that and think aha! The tumor is coming out! Huzzah!

    Sometimes a painful or noxious or harmful physiological effect can amplify the placebo effect too. You think that because you’re paying a cost in pain and suffering, you must be getting a benefit in return. A lot of ritual has been historically based on that principle. You humble yourself and debase yourself in prayer, and in return you get your prayer answered. Or you sacrifice your prized goat….

    Couple those real physiological effects with a complete lack of control or oversight regarding dosaging and potency, and the mind just shudders….

  116. 116
    The Vicar (via Freethoughtblogs)

    To answer my own question at 112 above: turns out my browser was somehow being served the mobile version of this site for no good reason (I certainly didn’t click on any links to trigger that).

  117. 117
    chigau (違う)

    A few days ago I had my ear power washed syringed.
    This produced a lump of petrified ear wax about the size of a pea which the medtech was sure was decades old (she seemed to be impressed).
    I think the warm-water-jet was more useful than STICKING SOMETHING BURNING INTO MY EAR.
    I hear better in that ear now.

  118. 118
    embertine

    Hey, don’t knock leeches. When I had a blood donation go a bit wrong and ended up with a haematoma the length of my arm, they had to keep the needle in for ages to drain the blood out, while I bit the side of the bed to keep from screaming and scaring all the other donors.

    I could have done with a few of our friendly little bloodsuckers then, although it’s true that the leeched tend to keep bleeding for quite a long time afterwards due to the anti-clotting saliva.

  119. 119
    Nick Gotts

    if you check out Cochrane you can find dozens of reviews of evidence for acupuncture for a wide range of pain conditions. Most of these reviews conclude that there is little evidence for acupuncture, but several find modest benefits *even over sham acupuncture*. – chrislawson

    Wouldn’t you expect to find a few suggesting “modest benefits” just by chance? Particularly given the well-known tendency for negative results to go unpublished.

    I’m currently suffering from tennis elbow, a condition whose pathogenesis is not known, and for which there are a number of treatments but (as far as I can discover) poor evidence that any of them is better than no treatment other than time – most cases resolve in months, although recurrence is common. I am being treated by an NHS physiotherapist, but I’m continuing this only because if the condition gets worse, it would be better to be already under treatment rather than having to start again with self-referral. Oddly enough, this physio wanted to stick an acupuncture needle in my elbow. He says it’s “not really acupuncture” – I assume he means it doesn’t rely on the “chi” woo-woo, but that may be because he’s picked up on my scepticism. The idea, as with a number of tennis elbow treatments, is explicitly to “restart the healing process” by causing fresh damage!

  120. 120
    Dr Marcus Hill Ph.D. (arguing from his own authority)

    cm @99: Nah, “complimentary medicine” is really quite effective. The practitioner tells you that no ailment could continue to afflict someone as intelligent, good looking, nattily dressed and fragrant smelling as you. All these compliments have a pronounced placebo effect. It works just as well as complementary medicine.

    Although it’s not really complementary medicine, something I heard on the news yesterday does serve to illustrate that universal healthcare doesn’t reduce poor medical consumer decisions, it merely shifts them from desperate resorts of those who can’t afford EBM to ill informed choices of people with money to spare on bollocks. The current wave of measles among those not vaccinated 10 to 15 years ago in the wake of Wakefield has led to a programme of free MMR catchup vaccinations for any child who missed one or both shots in early childhood. The main outbreak has been in Swansea (Wales), but a company from the NW of England has opened up a centre in Swansea offering single measles shots for money, despite the fact that these are less effective against measles than MMR (and don’t protect at all against mumps or rubella, and there is no available single shot for rubella) and have more side effects. The company has been forced to take down some claims and links to old and discredited news articles from their website, but they were (and, to the extent that they can push the advertising laws, still are) playing on the “vaccine overload” myth. The reason this demonstrates who the victims of CAM are in a country with universal healthcare is that this initiative is being successful – people are paying to get a vaccine which is worse than the one they could get for free because they are making poorly informed decisions. There were even people interviewed on the news piece who were getting MMR only because they couldn’t afford the single shot.

  121. 121
    blf

    Wouldn’t you expect to find a few suggesting “modest benefits” just by chance? Particularly given the well-known tendency for negative results to go unpublished.

    Interesting point (about “the well-known tendency for negative results to go unpublished”). How do Cochrane Reviews deal with this tendency?

    I’m very much outside my area of expertise here, but am under the impression Cochrane Reviews, among other aspects, look for independent confirmations of the results reported in the studies reviewed, in an attempt to rule out the “by chance” aspect. That is, the Reviews look for proven replicability.

  122. 122

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