Prince Charles’ Foundation for Integrated Health (FIH) is listened to by many in our Government as a sound source of information on complementary medicine. It has been given large sums of money over recent years by the Department of Health to set ways of regulating CAM sellers. The result has been the moribund Ofquack: the Complementary and Natural Healthcare Council.
FIH has been regularly criticised for being hopelessly naive and uncritical of alternative medicine. FIH likes to call quackery ‘ Integrative Medicine’ and sound like it is calling for the integration of ‘natural’ ways of healing with modern healthcare. In reality, it does little but uncritically promote bonkers charlatanism.
The latest promotion comes in the form a news item on their web site telling us that “Dr Richard Niemtzow has developed a form of ‘Battlefield acupuncture’ which will be used by the US Air Force in Iraq and Afghanistan.” We are told that,
This method of acupucture [sic] involves inserting very tiny semi-permanent needles into very specific acupoints in the skin on the ear to block pain signals from reaching the brain. This method can lessen the need for pain medications that may cause adverse or allergic reactions or addiction.
…
‘This is one of the fastest pain attenuators in existence,’ said Dr. Niemtzow ‘The pain can be gone in five minutes.
Remarkable stuff. Niemtzow is the Editor in Chief of Medical Acupuncture, the journal of the American Academy of Medical Acupuncture. Are we seeing the integration of ancient Chinese practices into modern battlefield care? Of course not. The whole thing is a fanciful charade.
Auricular Acupuncture, or Ear Acupuncture, or even auricolotherapy, is indeed part of what is called ‘Traditional Chinese Medicine’. It was included into Mao’s re-invention of Chinese medicine as part of the Cultural Revolution’s Barefoot Doctors’ repertoire. However, the roots of ear acupuncture do not lie in ancient Chinese medical beliefs but in 1950’s France. Yes, like its auricular cousin, Hopi Ear Candling – also found in your High Street Chinese Medicine Shop, it has roots that are thoroughly western. Ear Candling is a recent invention and nothing to do with the Hopi Tribe – who are hopping mad about the appropriation of their name to Western quackery.
The UK Auricular Acupuncture College tell us that it “is an ancient Oriental therapy using acupuncture on points of the ear to treat specific parts of the body”. This looks like it is simply untrue. In a 2007 review, published in Evidence Based Complement Alternative Medicine, Luigi Gori and Fabio Firenzuoli tell us that ear acupuncture was invented by Lyon based doctor, Dr Paul Nogier, who is now known as the “Father of modern auricolotherapy”.
The son of Paul Nogier, Raphaël Nogier, tells us,
1951, Paul NOGIER received in his consultation a patient, who explained to him that he was relieved from a sciatica pain by a cauterisation on the ear carried out by a quack in Marseille, Madame BARRIN
Nogier’s remarkable ‘insight’ was to realise that the ear was a little homunculus – a man in the ear – in the form of a foetus. Thus, sticking a pin in the right part of the ear could somehow heal the corresponding part of the body. It turns out that Dr Nogier was a homeopath and so we do not need to concern ourselves too greatly about the battiness of these ideas.
Nogier’s son, Raphaël, continues the pace of invention admirably and has developed this science to even greater extents. From Madame Barrin’s humble quackery has grown a mighty and imaginative worldwide quackery. Electrical instruments are used to detect the appropriate points on ears to stick pins in. Furthermore, Nogier developed “auriculomedicine” – a technique for diagnosing problems by measuring the pulse whilst putting pressure on various parts of the ear.
It would appear that the French ear pin therapy quickly spread via Japan back to China where it was re-interpreted in terms of Chinese acupuncture:
The discovery of the system spread to China and led to intensive research by the Chinese medical authorities at a time of renewed interest in Traditional Chinese Medicine. After learning about the Nogier ear charts in 1958, a massive study was initiated by the Nanjing Army Ear Acupuncture research Team. This Chinese medical group verified the clinical effectiveness of the Nogier approach and assessed the conditions of over 2000 clinical patients, recording which ear points corresponded to specific diseases. The outcome of that research was very positive and resulted in the utilization of this therapy by the ‘Barefoot Doctors’ of the Cultural Revolution. In China was published an Ear Chart remarkably similar to that of Dr Nogier in 1958.
So, from the Chinese Army to the US Air Force. Richard Niemtzow, MD, PhD, MPH appears to have been developing his own version of ear acupuncture using tiny needles that you leave in your ear until they drop out. We are told,
Using ancient Chinese medical techniques, a small team of military doctors here has begun treating wounded troops suffering from severe or chronic pain with acupuncture.
In a deviation from the Nogier philosophy, Niemtzow believes that the “ear acts as a “monitor” of signals passing from body sensors to the brain. Those signals can be intercepted and manipulated to stop pain or for other purposes.” A remarkable scientific discovery. Give that man a Nobel Prize.
The clincher for me is that he calls on the Wisdom of Pirates. Niemtzow says” Even 18th-century pirates were convinced of the value, piercing their lobes with earrings ‘to improve their night vision'”. Did the British ever tell the US that eating carrots improved the night vision of Royal Air Force pilots during the Battle of Britain?
This French, Chinese and Pirate wisdom is proving very useful apparently as “Battlefield acupuncture has been especially effective among patients suffering from a combination of combat wounds, typically a brain injury or severed limbs, burns and penetrating wounds along with severe disorientation and anxiety.”
So, we shall see. It has yet to be deployed into Iraq battlefield operations and has to “overcome skepticism within the ranks of military doctors”. I doubt it ever will be. What we do know is that the organisation that Niemtzow works for does quite a good job of promoting acupuncture in the US. For an academic institution, it is quite surprising to find on their home page that the American Academy of Medical Acupuncture says that it can “Find an Acupuncturist Near You”.
Well done to the Foundation for Integrated Health for uncritically carrying this story. I am sure the acupuncturists of the USA are very pleased.
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If you want to know more about Niemtzow, the excellent blog Science Based Medicine takes him apart here.
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Note: Due to a technical error when this blog was moved from one platform to another, the comments were not properly imported. What follows is a text archive of the discussion. Please feel free to add to the discussion in the normal way.
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19 Comments:
SVETLANA PERTSOVICH said… - O-o-o-h! Wow!
Pirates – it is cool! 😀
At last we have understood Prince’s vast scheme! 😉 One day just the pirates had turned Britain into great land power, which owned 25% Earths surface. Evidently, Prince decided to repeat the feat of his ancestors and to turn Britain into great power again, using the quacks instead of pirates 😉
Oh, what a giant idea! 😀
Yes, wise people say rightly that the History repeat twice – at first – in the form of high tragedy, and then – in the form of low fars… - 11 January, 2009 23:17
Exdoc said… - Great post. I would be v interested in finding out more about historical aspects of Chinese medicine (I am sure that there are many more examples of recent treatments being attributed to an ancient wisdom to give it ‘credibility’).
Do you know of a book/article objectively documenting the history of Chinese medicine esp regarding Mao’s role in recreating it?
Thanks. Exdoc - 12 January, 2009 05:58
- Nash said…
- Pirates wore ear rings to pay for their funneral and a mass.
- 12 January, 2009 10:43
- Le Canard Noir said…
- Suckers: How Alternative Medicine Makes Fools of Us All By Rose Shapiro gives a good overview of the rise of TCM under Mao. This book is available from my bookshop. 😉 Shapiro has a good index and set of references for further reading.
The main source is the academic book Chinese Medicine in Early Communist China, 1945-1963 (Needham Research Institute) by Kim Taylor. This is a more academic work and hence more expensive.
Taylor describes how the rise of TCM was one of simple pragmatism for Mao. Being able to recruit all the various forms of ‘witchcarft’ (as Mao called it) and unite it under a banner, he was able to declare that there was no doctor shortage in China and hence celebrate one more success for the communist revolution. Although in decline in China now, TCM appears to have found its home in the decadent shopping malls of the capitalist pig dogs. - 12 January, 2009 10:49
- John H said…
- Exdoc – for a quick online version have a look at:
http://www.sciencebasedmedicine.org/?p=252
This points to a good presentation on the history (or lack thereof) of acudoodah.
Orac crucifies this military woo in his Respectful Insolence site:
http://scienceblogs.com/insolence/2008/12/battlefield_acupuncture_revisited_only_t.php
I would imagine that battlefield woo would be a remarkably dangerous thing for field medics to practice. I think a soldier who has just lost a limb courtesy of traumatic amputation would prefer morphine rather than acupuncture needles. He also has the weaponry at hand to back up his drug of choice.
Andy – A post without any reference to the wreck of the Helvetia. I look forward to finding them. It’s a sort of modern version of “Spot The Wally”. - 12 January, 2009 15:50
- Stuart van Onselen said…
- Ms Pertsovich – You may be on to something there, but I think it’s not as simple as that: The truth is thatthe lack of pirates is causing global warming.
As an island nation, Britain is particularly vulnerable to flooding from the melting icecaps. As a royal defender of his homeland, it is only natural that HRH would do everything in his power to re-introduce pirates to the world’s seas.
Of course, Pirate Bay and other P2P distribution sites are also playing their part, enabling anyone to be a pirate, and do his/her bit to fight the scourge of global warming. And get to wear those natty vision-enhancing ear-rings. - 12 January, 2009 17:25
- SVETLANA PERTSOVICH said…
- This post has been removed by the author.
- 13 January, 2009 01:41
- SVETLANA PERTSOVICH said…
- “…the lack of pirates is causing global warming…”
Ha-ha-ha!
Wow! What a fantastic statistics! 😀
And bear in mind – it is only a half of whole truth 😉
If you try to compare the dynamics of decreasing of number of monarchies in the world and global warming, you will see positive correlation too. And the correlation coefficient will be equal almost 1.0. The lack of monarchs is causing global warming too! Oh, poor, poor Charles! We are cursing him up hill and down dale here, and, as it turns out – he is our only hope in the face of incoming new Flood. And star-crossed prince doesn’t know even about his great role in our world.
Still worse! He deludes himself in another question. If you try to find a correlation between the increasing of number of quacks and global warming, you will find very strong correlation too! But it will be negativecorrelation – the excess of quacks is causing tremendous global warming! Do you see now real sense of quackery danger, eh?
But our fair monarch is not to blame – simply he doesn’t know statistics. But if anyone dared to come and explain him it – surely he would scatter his quacks to the devils. And instead of it he would turn all quackbusters into his own team of Royal pirates.
What? Do you think it is not possible? No problem. Only look at our lads! It is heroes! Gimpy, Dr. Aust, John H. … We could go without traditional pirate parrot. Add Andy Lewis as a sailing-master, Ben Goldacre as a boatswain, me myself as a cook (ah, I am a good cook, I can even roast cutlets. And they don’t even burn sometimes – though very rarely…), Prof. Ernst as a ship doctor. Oh, it will excellent team! Sir Francis Drake will pivot as a propeller with envy in his grave.
And if we also elected David Colquhoun as our captain, then no traces would remain of the problem of global warming! We would rescue the world. Though I can’t guarantee that under Prince’s alive supervision the problem would not turn into its antipode – global icing….
😀 😉 - 13 January, 2009 01:46
- mugsandmoney said…
- Once upon a time I was an acupucturist. Please note:
a) There are at least two different – and conflicting – versions of the ear atlas.
b) the standard ear bears very little resemblance to the real ear – the topology is highly variable.
c) Some of the points are apparently less than a millimetre apart
d) The practical difficulties of holding and inserting a needle mean that it’s very difficult indeed to get it sensibly near the spot which you were aiming for.
On the couple of occasions when I tried to administer ear acupuncture, it was effectively random.
On the couple of - 13 January, 2009 21:57
- SVETLANA PERTSOVICH said…
- Andy, today is Old New Year – old Russian feast 🙂
Happy New Year!
I wish you new victories in new 2009 year!
Be happy and healthy! - 13 January, 2009 23:35
- SVETLANA PERTSOVICH said…
- http://jackofkent.blogspot.com/2009/01/reforming-english-law-of-libel.html
- 15 January, 2009 12:01
- hakkers23 said…
- It appears that the words ‘unbiased’ and ‘educated’ are missing from your life. Many old texts of chinese medicine have reference to points in the ears. Nogier’s experiments used points that he wanted to disprove could have an effect on the partsd of the body the points were said to represent. What he did was actually help prove their efficacy. Really just because someone says Nogier did it, doesn’t mean its true! I wouldn’t like to be in court with you on the jury. Forget the evidence, you just assume on someone elses opinion regardless of the facts. To call something quackery without a real study of the facts leave you open to the same charges of quackery you wish to put on others. But I’m sure that you will rant/or ignore this comment as it doesn’t fit in with your biased opinion.
- 17 March, 2009 11:03
- Le Canard Noir said…
- hakkers23 – perhaps you would like to supply references to any pre 1950 book or paper that discusses ear acupuncture as a specific discipline and, while you are at it, supply references to any research reviews that show the efficacy of ear accupuncture for any condition?
- 26 March, 2009 11:41
- Anonymous said…
- How about this?
http://acudetox.com/about/
What is the evidence base for acupuncture detoxification?
A wide variety of controlled clinical trials, outcome summaries and anecdotal reports about the use of acupuncture in addiction treatment have been appearing since the 1970s in journals specializing in addictions, mental health, public health, criminal justice and acupuncture. These reports differed vastly in terms of methodology, populations studied, statistical sophistication and clinical relevance as well as in their findings about the value of acupuncture. A sub-category of this published work has focused specifically on the NADA protocol. Within this sub-category is found strong evidence for the effect of the NADA protocol in improving patient outcomes in terms of program retention, reductions in cravings, anxiety, sleep disturbance and need for pharmaceuticals. Regular updates on ongoing publications and reports about relevant clinical outcomes are found in Guidepoints. Many of the basic items in the literature of the field appear in the list of NADA reference materials. A bibliography of relevant publications is available in the Members area.
————————-
And here’s a suggestion: instead of basing your entire lives on “evidence”, clinical trials, double-blind testing and the like, why not experience the real world and go and see a good acupuncturist and have a few sessions? Otherwise you come across like eunuchs telling everyone how terrible sex is. Only you won’t, because it’s easier to sit in judgment from the safety of your website than to go and find out for yourselves. - 26 March, 2009 23:16
- Anonymous said…
- I’ll save Hakkers23 the trouble. Here you are:
http://ukpmc.ac.uk/articlerender.cgi?artid=1116070
Taras Usichenko, Anesthesiology and Intensive Care Medicine Department, University of Greifswald, Germany, presented results of a randomized, sham acupuncture-controlled study on intraoperative analgesic effects of auricular acupuncture (AA). The authors analyzed the intraoperative analgesic requirement in 57 patients during total hip arthroplasty (THA) performed under general anesthesia with previous application of permanent AA needles. AA was safe and effective in reducing intraoperative fentanyl requirement for analgesia during THA in comparison with control group (P = 0.005). - 26 March, 2009 23:23
- Le Canard Noir said…
- Ha Ha Ha. You quacks kill me. “Instead of basing your entire lives on “evidence””. Evidence is such a bad thing isn’t it? Especially when you are claiming to treat sick people.
Let’s say I did try acupuncture (how do you know I haven’t)? How would I know it worked. If I was sick, how could I tell apart a) just getting better on my own, b) placebo-like feelings that I am ‘better’, even if the course of illness has not changed and c) acupuncture works? Of course, you can’t. if you believe you can, you are simply delusional.
So, no pre-1950 books on AA? Thought not.
And so to your ‘evidence’. The Usichenko paper on ear acupuncture is quite interesting (have you read the paper? I bet you haven’t). Whilst they claim that group that had ‘real’ ear acupuncture took less analgesics, the paper is quite clear in noting that the amount of pain felt by ‘real’ and sham acupuncture was the same. The authors conclude “We hesitate to make a final conclusion concerning the analgesic effects of AA based on the widely spread data of this initial study”. The difference in analgesic usage could be simple explained by the fact that there were big sex differences between the AA and control groups. Not the best evidence in the world.
But this is typical. I bet most acupuncture research is on subjective and placebo responsive conditions – mostly pain. Acupuncture is very hard to create true placebos for – hence, trials can easily give false positives due to incomplete blinding. All the trials show is a placebo response. Acupuncture tests are rarely done on conditions with objective measurement points and with measureable disease end-points. To hard to fake. Hence, all the guff on addiction too. Simple placebo treatment. - 27 March, 2009 00:17
- Anonymous said…
- ‘Evidence is such a bad thing isn’t it? Especially when you are claiming to treat sick people.’ Definitely: The biggest killer after heart disease and cancer is Western, evidence-based medicine, largely based on randomised, placebo-controlled, double-blind studies, and correctly administered. And that’s according to official government statistics. Surely you know that?
And the first tenet of medicine is supposed to be ‘primum nil nocere’: ‘Most important of all, do no harm.’ We have strayed a long way from the path of healing, which is primarily an art, not a science.
Why do you call me a quack when you know nothing about me? That is jumping to a conclusion and an insulting one at that. Based on no ‘evidence’. I am someone who is pretty sceptical about the validity of the opinions you express on your site, which is very different. Apologise, you pustulent fool. You see? I’m doing it now. I called you a pustulent fool based on no evidence whatsoever, whereas in reality you probably are of average intelligence and have reasonable skin to accompany your mundane and tiresome views. And, yes, that is my subjective opinion.
Secondly, how do you objectively define or measure ‘sick’? You can’t. If you feel a bit muzzy-headed on the way to getting the flu, are you ‘sick’? In which case, how can you bring it up (as it were) in a ‘scientific’ discussion on health.
The difference between us is that I don’t actually care whether acupuncture has any evidence that you find acceptable to back it up. I will try it, and if I like it, I’ll keep having it. Just like sex or a cheese sandwich.
Thirdly, there are no such things as ‘placebo-like feelings’. There are only feelings. The placebo effect was invented/postulated in the 1950s complete with some pretty flawed and possibly faked data. And yet, it is wheeled out at every turn as an explanation for every mystery by those who are uncomfortable with uncertainty. By those who lack the humility to say, “I don’t know. Let’s wait and see. Maybe we’ll never know.” And in any case ‘placebo’ appears to be as powerful if not more so than the active factor in pretty much any Western medicine, not to mention a damn sight cheaper and without any ‘side-effects’ (i.e. poisoning).
I have a strong suspicion that you have never tried acupuncture because you appear to have a strong antipathy towards it and a great deal of ignorance on the specifics. I wasn’t suggesting you tried acupuncture to prove or disprove it, merely that it might be good for you and you might enjoy it.
Moreover, your general thrust appears to be this: ‘Produce evidence/clinical trials/double-blind studies etc., so that I can tell you why they’re flawed and how clever and superior I am.’ Like a toddler who has just discovered how to say the word ‘no’ and uses it at every opportunity. Which is a pretty boring game after the first no doubt hilarious but doomed attempt to give you what you ask for.
If you say that acupuncture can’t be proven, the corollary is that it can’t be disproven either. In which case your website is a pretty rickety and pointless platform. - 27 March, 2009 14:37
- Le Canard Noir said…
- Good grief. The idea that evidence based medicine is the third largest killer in the world is an absurd, offensive, willfully ignorant and stupid made up piece of nonsense. A moment’s thought would quickly demolish this absurdity. The ‘fact’ is touted around by deeply malicious quacks intent on promoting their hogwash fantasies of money spinning quackery.
This idea has come about from some deeply flawed and one-sided propaganda masquerading as research. Now, medicine is a human activity, and as such, mistakes are made. Furthermore, when presented with illness, treatments very often carry a balance of benefits and risk. All the quacks do is focus on risks and mistakes and then propose that medicine is a killer. If you can show me evidence that takes into account both benefits and risk and still comes up with scientific medicine being a killer the nyou will have won. But you will not be able to. I have written about this terrible canard before. I dare you to read it all…
I quote:
An analogy: ambulances are responsible for many accidents, injuries and deaths every year. They charge at high speed through populated areas, ignoring road conventions and distracting other drivers. If you were to publish a table of injuries and deaths due to ambulances, they would look quite starting. In fact, one source reports an average of one collision each day involving an ambulance in the UK. Not all result in death of course, but still a big number.
Would you ban ambulances and set up alternative, low pollution, holistic and carbon neutral cart and horse emergency transport? How about bicycle ambulances? Of course not. There is no such thing as alternative and complementary ambulances. Even quacks get in the ambulance after a bad road accident. The reason is that by taking appropriate risks, ambulances save thousands of lives every year. Seconds counts when hearts and lungs are failing or you are bleeding badly. The lives saved vastly outweigh the iatrogenic injuries caused. It is up to society to balance the benefit and risks and choose how ambulances should behave.
To answer some of your questions:
I call you a quack because you promote unproven or disproven medical treatments. It is that simple.
Define ‘sick’? I have no idea what your point is. I guess you might be under the misunderstanding that scientific medicine cannot take into account subjective feelings. Of course it can. Trials ask patients about subjective experiences all the time.
Are you denying or confirming placebo effects? I am not sure if you are being coherent here. And, for the record, I think placebo effects are vastly overstated reasons for explaining how alt med ‘works’. I would guess most if the time, people get better and then attribute success to whatever magic bones they were rubbing at the time. Its called ‘regression to the mean’ and ‘post hoc reasoning’ if you want to look it up.
You accuse me of just pointing out flaws in the paper. If you wish to reply, can you answer me this? Did you read the ear acupuncture paper on post operative analgesia? I bet my cotton socks you did not. You quoted it as evidence without the slightest idea of what the paper actually said. I call that plain daft. If you did read the paper, why did you cherry pick your conclusions from it and ignore the vital author’s comments?
“If you say that acupuncture can’t be proven, the corollary is that it can’t be disproven either. In which case your website is a pretty rickety and pointless platform.”
Another supremely daft assertion. No, I cannot prove there are not elephants in my kitchen either, but that does not stop me from coming to rational conclusions about the possibility of their being elephants in there. The same with ear acupuncture. It looks like daft, made up nonsense. It has no evidence base to suggest there is anything to it. It flies in the face of all that we do know about anatomy. The only meaningful conclusion to come to is that it is horseshit designed to dupe the gullible. N’est-ce pas? - 27 March, 2009 15:33
Your ignorance regarding auricular medicine makes you look pretty silly. If you had any true experience or medical knowledge of it you would think otherwise.
Please tell us, Joan.