AcupunctureBMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7215.973 (Published 09 October 1999) Cite this as: BMJ 1999;319:973
All rapid responses
"I would seriously question the existence of "advanced"
acupuncture. The techniques themselves are fairly simple and
easily learned; what matters is clinical judgement about
whom and what to treat. Success in acupuncture depends
rather little on acquiring esoteric knowledge but is
generally proportionate to the practitioner's existing
clinical skill and competence."
We have a problem here in the US, where Chiropractors with
less than 100 hour training and MD's and DO's with 50 hours
and 150 hours of video are doing terrible quality work,
showing por results and injuring patients. Part of this
could be because of their poor memory of anatomy courses 30
years ago and part due to a form of arrogance learned in
medical school here in the US.
Primary trained acupuncturists (I am of course only speaking
of the US acu's) do "advanced" acupuncture because they have
much more didactic and clinical training in acupuncture and
a sound basis for understanding how the system works.
Unfortunately, a Conventional medicine training does little
more than provide training in how to do Conventional medical
science research, which can only prove or disprove what is
killed or not because is if something is killed, it is easy
There are cracks in the wall, however, and I am hopeful that
research methodology for metaanalyses of clinical data
regarding the use of the Oriental Medicine paradigm on an
individualized basis will show its efficacy in a way that is
quantifiable even to the corrupt (a 1 trillion dollar
pharmaceutical industry can indeed lead to academic
corruption) scientific system that presently exists.
It is systemic corruption and hopefully there are ethical
doctors aware enough to start addressing it. My question on
ethical guidelines for doctors relates as much to telling
their patients exactly what their training is when they are
doing "alternative" care in their normal practices, and how
long they have been doing so. There is a big difference
between treating a knee or an elbow and treating gastric or
reproductive disorders, and the tendency to fall back on
pharmaceuticals, for liability reasons or otherwise, always
interferes with their ability to do a proper job.
Acupuncturists have consistently had referral to
Conventional physicians as a major part of their training,
because we recognize their capability at heroic measures to
save lives with radical proceedures. The trouble is the
continuing arrogance of the Conventional practitioners who
feel their ability to understand anything is so great that
they can't see the trees for the woods.
I am hopeful that the next 20 years will find a reduction in
the rudeness we are seeing from both sides as we start to
Competing interests: No competing interests
You've finally withdrawn after enough manoevering to confuse Field
The merits of EB will continue to be debated well into the next
millennium I have no doubt; acupuncture and moxibustion, and the
doctrine under which it should be used - Traditional Chinese Medicine - is
gradually becoming better understood as it's peculiarities are seen to
equate clearly to the evolving 'medical paradigm' we know so well in the
West. Dedicated researchers in China and internationally are opening the
minds of even the most (objectively) skeptical individuals as they use
modern techology to unlock the age-old secrets which have served billions
of people so well up to the present day. We who work with TCM , and our
patients who benefit from the system, do not delude ourselves but wait for
the rest of the modern medical fraternity to join with us in recognising
the immense benefits possible as East meets West in medicine.
All the best
Competing interests: No competing interests
I see nothing in your most recent correspondence that warrants
furhter discussion. I'm perfectly satisfied to let readers of eBMJ decide
for themselves, on the basis of material already posted, whose views are
grounded in demonstrable fact and whose are grounded in self-serving
Best to all,
Competing interests: No competing interests
I think it's time we returned to the original theme set by Vickers
and Zollman - Acupuncture. In my first response to you I recognised and
was intrigued by your focus, not on the debate about the contents of their
article or my comments re. that but on my observation that probably less
than 20% of WM is EB. After providing more than adequate statistics and
bibliographic evidence for those observations - which to date you have
avoided tackling unlike I who spent considerable time and effort
effectively dismantling your 'references' - I realise that you're unable
to dismantle my scientific and statistical provision so had to shift the
emphasis of the debate, this time to 'folklore'.
Your statement that "you've not detected a trace of this evidence"
says much for your observation and objectivity witness your
misrepresentation of my EBM and folklore arguments.
You've ignored or avoided almost all relevant facts I've supplied -
conveniently changing the basis, or subject, of the argument each time
you're overwhelmed with logic. This seems to be a common ploy used by
'international Skeptics' who are unable to sustain a debate using
scientific analysis. The response becomes a change of subject, change of
emphasis to avoid the real issues or the blanket "we advocates (meaning
Skeptic colleagues) of the subject have decided - scientifically - that we
advocates are right and everyone else (according to meta-analyses of all
our own published studies)is wrong". This 'conclusion' to a debate is then
published widely through friendly media as being "scientifically valid".
Facts you've ignored include:-
1. All discussion and information I supplied apertaining to
'acupuncture & moxibustion' in our modern world.
2. All bibliographical and analytical data I provided apertaining to
the conclusion that only 1-20% of WM is EB, if that.
3. Analysis of the serious problems associated with ADR-reporting, an
international problem, and one which cannot be 'excised' from the debate
"is WM EB?".
Instead you've slipped from one topic to the next when confronted
with scientific argument, dismantling of your "EB studies" list, and
direct and circumstantial evidence I have produced to support my
You proposed using a 'statistician' and 'others with experience' to
verify my figures re. '1-20% of WM is EB' yet when I reproduced them you
changed the subject!
You failed even to attempt to dismantle my specific argument, based
on analysis of my, AND YOUR, references preferring to take up the
'clallenge' of a debate on legend and folklore.
You've been found out.........so accuse me of 'misinformation' about
legend and folklore as if to try to reduce the impact of my analytical
arguments about the validity of TCM, acupuncture & moxibustion, EBM
and serious problems with ADR-reporting which affects the value of any EB
for WM; all exceptionally important issues in modern medical provision as
far as the public is concerned.
You fail to respond directly to the realities of a scientific
argument by introducing conjecture as opposed to fact :--
eg. Virtually ignoring my extensive bibliography, analysis of that,
statistics and deductions about the 1-20% EBM, you introduced 'therapeutic
phlebotomy and 12th century medicine' as an 'argument'.
eg. When faced with Dr Braithwaite's facts that fraud is very
widespread in the multinational pharmaceutical industries' "scientific
method", thus seriously undermining genuine attempts at producing a
definitive EB for WM, you can only respknd with "what's the
point"!!....then again change the argument to "well what about herbal
medicine" as though this somehow impacts on the EB of WM??
eg When Dr Neville Goodman, examiner for the Royal College of
Anaesthetists (and Healthwatch 'Skeptics' member) is shown to question the
value of RCT (particularly when RCT supported homeopathy) as an important
instance of a medic whose opinions are valued (by Skeptics?) yet who
detracts from the assumed value of RCT and is therefore in opposition to
Prof. of CAM of Exeter University Edzard Ernst(another 'Healthwatcher')
who has claimed that CAMs must be shown to have RCT as EB before becoming
'scientifically valid' you move the argument to one about homeopathy!
Your latest piece of 'La-La' qualifies my ponts admirably:-
1. You argue that the 'Huang Di Nei Jing' is little more than about
1500 years old, then finding reference to a 'Huang Di Nei Jing' over 2000
years old (that may refer to this text quoted as being over 4000 to 5000
years old when Huang Di ruled) you say it may be a text with different
content! I suppose "The Yellow Emperor's Canon of Internal Medicine" could
have been confused with another of the same name!!
2. You say that if I wrote in a 1999 version of the Travels of Marco
Polo claiming interaction with aliens (why would I invent that?)it could
be misconstrued by future historians - I doubt this could happen as
Skeptics would refute my assertion and future historians would have that
information also; whereas in the case of TCM, the Nei Jing, acupuncture
& moxibustion what references do you have from even 2,000 years ago
that refute the claims for the validity of those?
3. Sealed texts from a small part of China, as Chang Sha is, are
probably specific to that region with perhaps some reflection on other
areas (like the 'Miami texts' may refer to the cultural variations of
Alaska). China is vast, with many peoples, cultures, languages and
dialects from the White Russian and Mongolian North to the Cantonese and
Vietnamese South. The Nei Jing specifies different modalities for
different regions - the Bian Shi or stone needles being specified for
Eastern and coastal (fish eating) areas. Chang Sha is a 'lake and river
dwellers' location East of South where stone pressure could have been most
4. You quote Sima Qian for records of therapeutic needling as c 90BC,
even c 90BC is known to be questonable let alone his data. He was a
historian, not a physician, and may have had little idea of the
differences between 'stone needling', bamboo/porcelain needling and
'therapeutic needling' - he was already part of the 'metal age'. He did
say "Those who remember the past will be the masters of the future" so
wasn't all that bad - unless he was merely speaking up for historians! I'm
quite surprised you (a Skeptic) quoted references from 'the Court
Astrologer of Emperor WU TI of the HAN Dynasty!
5. If Qi Po was Hippocrates perhaps Hippocrates was Chi Po, the
Yellow Emperor's physician!
6. I said "there is no concensus on what IS EBM". Your 'rebuttal' was
the intriguing "yes there is a concensus on what IS NOT EBM"?!
7. You say little is under discussion 'among EBM advocates' except
the relative emphasis to be placed on different types of evidence yet in
your list you omit those inferred by David Isaacs & Dominic Fitzgerald
at 'Seven Alternatives to EBM' above (e-BMJ letter BMJ 1999;319:1618 18th
I suspect there are many 'advocates of EBM' who are more than
selectively objective when confronted with the question 'just what is EBM,
do we already have it, and what value is imposed on the various modalities
associated with WM?'
I DO AGREE with your final sentence "misinformation ultimately does
no one any good" and would cite the following references from your
statements as of the 'misinformation' cateogory:-
a. "a concensus has been reached as to what is EBM"
b. "the only issue under discussion among EBM advocates is the
relative emphasis that should be placed on the various types of objective
evidence such as RCT...."
c. "that I insist on venturing into the realms of fantasy, myth and
wishful thinking in order to support my acupuncture/TCM beliefs"
d. "that you cast the light of scholarship and reality on my
fantasies" or indeed much else we have discussed...
e. "that you are capable of dismantling my bibiolgraphy-supported
analysis of the current dismal state of EBM"
and finally, an extra piece of mythology.....
"that you have anything constructive to introduce into the discussion
that TCM is an ancient, yet ultra-modern, and fundamental doctrine for the
safe and efficacious use of acupuncture & moxibustion".
Competing interests: No competing interests
While I agree that one of us has “slipped from the main issue,” (if
not “from the pale of reality”), I hasten to point out that I’m not the
guilty party. If, when asked to substantiate your claim to knowledge of
Neolithic Chinese medical beliefs, you insist on citing books about the
“Lost Continent of Mu,” “alleged secret knowledge of the Ancient
Egyptians,” and other such nonsense, I have little choice but to respond
to said nonsense.
You suggest that, perhaps, “we” have ventured into this intellectual
“La-La Land,” because you’ve “produced abundant evidence for the points
you made, leaving little more but ‘folklore’ to query.” I’ve not detected
a trace of this alleged evidence. To the contrary, it’s quite clear
you’ve taken to citing irrelevant nonsense because, while you haven’t a
shred of evidence to support your claims, you are for whatever reason
unwilling or unable to concede that they are baseless.
Once again, you disparage “skeptics” – this time for “disputing the
validity of folklore.” (I’m not sure what “invalid” folklore, fables, or
legends might even look like. Perhaps you could define “invalid folklore”
for us?) The truth is that, far from finding folklore “invalid” (whatever
that means), I find it fascinating. In fact, some of my skeptical
colleagues are even professional folklorists. Moreover, I agree that
folklore can and sometimes does suggest avenues of productive scientific
investigation. Consider the Iliad and Schliemann’s excavations at
Hissarlik, and the Norse sagas leading to Ingstad’s discoveries at L’Anse
aux Meadows. (But, to be fair, we must also consider Ponce de Leon’s quest
for the “Fountain of Youth,” and the pervasive quest among early European
explorers for the folkloric “Christian Kingdom of Prester John” – alleged
to lie variously in India, Africa and Central Asia)
It seems that the only “deficiency” my skeptical colleagues and I are
guilty of, at least from a credulous perspective, is that we appreciate
the distinction between myth and objective evidence. We hesitate to trot
out tales of “Paul Bunyan and his blue ox, Babe,” or “Aesop’s Fables,” or
“Saint Nicholas and his flying reindeer,” or even the story of “St. George
and the Dragon” in support of our historical or archeological hypotheses.
After blaming me for your having resorted to the “folklore as
objective evidence” argument, you immediately propose that we “now
entertain the 'folklore' debate.” My suggestion is: let’s not. You
obviously feel your folkloric conjectures support your claim to special
knowledge of Neolithic Chinese medical thought, and I obviously think the
notion is ridiculous.
You tell us “it was recorded in the Nei Jing that during the reign of
the Yellow Emperor (2690-2590BC) Bian Shi (stone probes) were already
being used to adjust people's Qi circulation. Now we are talking approx.
4,600 years ago.”
This is yet another example of “fable” masquerading as “historical
fact.” (“Recorded” by whom? You conveniently forget to tell us. And
where is the “record” of which you speak?) If you take the time to check
the Sinological literature, as distinct from the acupuncture/TCM advocate
literature, you’ll find the following.
1. As I pointed out earlier, the earliest existing copies of (the
three constituent parts of) the Huang-de nei-jing date only from the 5th
to the 8th centuries A.D.
2. There is a bibliographic reference to a book by the name of “Huang
-di nei-jing” in Han times (200 B.C. to 200 A.D.), BUT there are many
examples from Chinese literature wherein an early text with a particular
name turns out to have nothing, whatever, to do with later texts bearing
the same name. It was common practice for subsequent authors to enhance
the prestige of their own ideas and their own writings by “borrowing” the
title of older and highly venerated texts (much as alt advocates routinely
do today). The Han text bearing the name “Huang-di nei-jing” has not
survived. Therefore, we simply do not know if it had anything whatever to
do with the versions that have survived to the present.
If you were to write the “John Heptonstall, 1999 version” of “The
Travels of Marco Polo,” and if you were to claim that Marco was abducted
by space aliens, taken to Vega Five and then returned, would future
historians, in your view, be obliged to construe your work as an objective
part of the historical record regarding 13th century Marco Polo? Just
3. So far as I’m aware, the earliest references to “qi” in what might
be construed as a medical or physiological sense date to the writings of
Meng-tsu and Tsou-yang in the 4th century B.C. – more than 20 centuries
later than the legendary reign of the Yellow Emperor. If you can cite
primary sources that indicate otherwise, please do so.
4. The earliest Chinese medical texts known today were discovered in
1973 at the Mawangdui graves, which were sealed in 168 BC. These
documents, a total of fourteen medical texts written on silk and wood,
provide a unique and apparently comprehensive picture of Chinese medicine
as it existed during the third and early second centuries BC. They are of
particular interest, not only because of their extreme antiquity, but
because they are the only such comprehensive medical texts to have
descended through the ages totally untouched and unmodified by subsequent
editors and revisers. Moxa-cauterization, compresses, fumigations,
medicinal baths, minor surgery, magical incantations, magical ritual
movements, massage, cupping, steaming, pressure with stones, and some 217
pharmaceutics are described. Although they record a broad spectrum of
therapeutic procedures available in China at the time, acupuncture is not
mentioned even once in these texts. If acupuncture were a significant
part of Chinese medical practice at the time, how could any rational
person reasonably explain this fact?
5. The earliest literary reference to any kind of therapeutic
“needling” (zhen) is found in the Shiji, [Records of the Historian], of
Sima Qian, written circa 90 BC. No known Chinese source prior to this
time refers unequivocally to any such technique. Sima Qian mentions
“needling” in passing three times, once in the biography of Bian Que, and
twice in the biography of Chunyu Yi. He offers no indication that these
practitioners were aware of a system of insertion points or that they were
acquainted with the fundamental system of conduits (described in later
centuries) whose “qi” flow might be influenced by “needling.”
6. No serious Sinologist or historian of medicine I’m aware of views
the Yellow Emperor as a real, flesh-and-blood, individual, much less one
who lived in the 24th or 25th centuries B.C (the traditional “folkloric”
dates ascribed to his reign). If you know of any Sinologist or historian
of medicine who holds such a belief, please name them and cite their
published statements supporting your claim.
7. Sinologist and historian of medicine, Prof. Paul Unschuld,
apparently has “in press” a book offering compelling argument that what
we, today, construe as the Huang-di nei-jing was compiled between 100 B.C.
and roughly 1,000 A.D. In any case, the consensus view among serious
historians and Sinologists today is that the Huang-di was not compiled
earlier than the first century B.C. (References upon request.)
8. You mention the Yellow Emperor’s physician, Qi Bo, but apparently
fail to realize the genuine significance of this figure. Qi Bo and his
commentaries raise the fascinating possibility that information presented
in the Huang-di nei-jing may not even be Chinese in origin. Scholars have
advanced the hypothesis that Qi Bo, the most important interlocutor of the
Yellow Emperor in The Inner Cannon of the Yellow Emperor, is none other
than Hippocrates of Cos.
The figure Qi Bo has no background in Chinese history or mythology, and
this fact, together with the Han-period pronunciation of his name [G'ieg
Pak], suggests that the fame of the Greek physician may have reached China
two centuries or more after his death. In any case, the “commentaries of
Qi Bo,” (extant copies of which are only 1,200 to 1,500 years old), in no
way support your wild conjecture that “Beijing Homo erectus practiced a
form of TCM-herbalism (and possibly acupuncture) all those years ago in
ancient China (half a million years ago) selecting local flora and fauna
You insist that, based on “numerous publications, especially the ones
you [I] provided, no consensus has yet been reached as to what is EBM.”
This is essentially a false claim. All advocates of evidence-based
scientific biomedicine I’m aware of agree emphatically that “anecdote,”
“patient/client testimonial,” and practitioner/patient/client “experience”
count for nothing in discerning the “objective evidential basis” for
medical claims. This certainly constitutes a “consensus” by any reasonable
standard, and it certainly excludes the beliefs, claims, and “anecdotal
gold standard” promoted by most advocates of “alternative” medicine.
The only issue under discussion among EBM advocates is the relative
emphasis that should be placed on various types of objective evidence such
as RCTs, systematic reviews, prospective vs. retrospective studies, and so
on. I’m unaware of a single EBM advocate who holds that “anecdotes,”
“medical fables,” “patient satisfaction,” or “practitioner experience”
should be ascribed equal weight to any of these things. If you can name
one, and can offer supporting documentation, please do so.
As I pointed out in my previous post to this forum, your absurd claim
is exactly analogous to the claims of U.S. “Creationists” when they assert
that “there is no consensus among scientists regarding the theory of
evolution.” The truth, of course, is that virtually all competent bio-
scientists agree that evolution has taken place and is, therefore “a
fact”: they only dispute the precise mechanisms and means by which it
works. The fact is that advocates of evidence- and science-based medicine
have, indeed, reached a “consensus” as to what does and does not
constitute “objective evidence.” Unfortunately for you and other “highly
invested” alt med advocates, they have, for very good reason, excluded the
highly subjective, arbitrary and demonstrably unreliable “standards” you
obviously hold dear.
If you steadfastly insist on venturing into the realms of fantasy,
myth, and "wishful thinking" in order to support your acupuncture/TCM
beliefs, it's difficult to see the point in continuing this dialog. On
the other hand, so long as you insist on mis-representing the facts in
support of your "acupuncture, TCM and/or alternative medical" beliefs,
I'll do my best to continue "casting the light of science, scholarship,
and reality" on your fantasies.
In any case, for your sake, and the sake of all those fated to read
what you write, I hope you'll eventually
learn to "do your homework" much more carefully before committing
additional misinformation to the public record. Misinformation ultimately
does no one any good.
Best to all,
Bob Imrie, DVM
Competing interests: No competing interests
You've slipped quietly from the main issue - acupuncture &
moxibustion, via 'evidence-based medicine' to a 'legend and folklore'
debate; I assume this is because I have produced abundant evidence for the
points I made on the other issues and there is little but 'folklore' to
Your latest letter brings new meaning to the word 'skeptic' -
'disputing the validity of folklore'.
Nevertheless let's now entertain the 'folklore' debate:-
Churchward's works were not cited 'to support my claims regarding the
medical beliefs of the ancient Chinese...' but in response to your
inference that the 'neolithic age' was unlikely to have experienced
developments such as Traditional Chinese Medicine as 'there is no written
evidence for such'. Seeing as the origins of 'writing' are suggested by
historians to be less than a few thousand years old, clearly 'neolithic
man' must have used other means to communicate over the ages - why even
stone age man has managed to tell us a bit about his era through cave
drawings! The Naacal tablets and Niven's South American tablets told
similar tales according to those explorers, and as Solon recounted - that
ancient civilisations called Atlantis and Mu were destroyed by cataclysm.
When, where are how is still a matter of conjecture but nevertheless
cannot be disproved - or proved. Sumerian scripts tell tales of the times,
folklore and legend, along with ritual, dance and stories, also provided
the ancients with the means to keep their cultural heritage alive.
Prof. LO and Dr. Tsui never claimed to know the legend to be true,
nor did I expect them to, one usually attributes to legend a state of
'perhaps' as opposed to never or ever. However, it was recorded in the Nei
Jing that during the reign of the Yellow Emperor (2690-2590BC) Bian Shi
(stone probes) were already being used to adjust people's Qi circulation.
Now we are talking approx. 4,600 years ago. It is said that the Nei Jing
author was the Yellow Emperor (may or may not be true), the Ling Shu being
part of the Nei Jing covered aspects of acupuncture & moxibustion. The
Emperor's physician Qi Po, during the long commentaries, does speak of
even earlier 'sages' taking responsibility for public health and spending
much time on disease prevention through the transfer of knowledge and
education to their charges - just as we do in 'modern TCM', isn't that
therefore TCM practice? TCM modalities include herbals, I suspect even
Beijing Homo erectus practiced a form of TCM-herbalism all those years ago
in ancient China (half a million years ago) selecting local flora and
fauna for health, possibly a bit of acupressure as well!
I never said that 'legend' should be construed as a type of
objective evidence - they are a valuable resource from which to set off an
inquiry. Ignoring legend precludes such inquiries. Nor did I say that
'qualifications' or 'authority' ensure accuracy of fact; just look at a
prime example - biochemical medicine with less than 20% EB yet holding
positions of 'qualification' and 'authority' by law.
The Egyptians were referred to in response to your "one wonders how
much anyone, including Europeans, knew about mathematics and
physics...during the Mesolithic period (10,000 to 3,000 BC)"; I told you
who did, using Egyptians as examples of pretty good maths users of the
c3000-c2500BC period). I note you use the 'Egyptologists' data when
declaring dates - are you not putting rather a lot of trust in these
'authorities' when other investigators such as Bauval and Gilbert ('The
Orion Mystery') have questioned, with useful argument, so much of their
It seems that the 'Egyptian pyramid builders', or their predecessors may
have been utilising mathematical and astronomical concepts dated to 10,000
years earlier. No one has proved that the great pyramid was Egyptian
built, or how it was built, and you're using conjecture to argue against
I would repeat - from numerous publications, especially the ones you
provided, no concensus has yet been reached as to what is EBM; how can you
say this statement is false? The few references you provided, from a
veritable sea of data, failed even to agree on a protocol to assess EB, or
what EB means, or what an EB should be; they took no account of fraud
which is said to be widespread in the prescribed drug industry, nor
inconsistencies in results achieved by pharmacists for the same population
as physicians shown in other studies to occur; nor the obvious improvment
in reporting of critical data (such as ADRs) when financial inducement was
provided to the medics involved; etc. etc.
You try to avoid the inevitable conclusion that, NO interventions
could be specified by the pharmaceutical industry, with or without bias or
fraud or commercialism, as truly EB because inherent in the system of drug
appraisal is the need for accurate ADR-reporting by physicians - an
essential part of the follow up process to confirm the EB of any
prescribed drug for patients. Generally all that is used 'to provide an
EB' (which will appear as data in the MIMs or BNF) is a drugs trial, often
on healthy recipients, of a few weeks duration and it is the drugs
performance within the greater populaton that completes that EB study. We
see from the Bordeaux study (Moride Y et al, Br J Clin. Pharmacol 1997
Feb;43(2):177-81; 'Under-reporting of ADRs in General Practice') that GPs
may be under-reporting ADRs as much as 24,000 times so a major part of the
'EB proving' fails through the inadequacies of the ADR-reporting system.
So what are the 'fine details' you say are still up for discussion
while 'the basic tenets of EBM are well-established'? Perhaps you could
advise the veritable 'sea' of researchers who are avidly trying to find
that holy grail 'the protocol for the perfect EB system' that you and your
'advocates of science-based medicine' have found! Will residents in the
year 2,100 hear tell of 'the legend of the search for the lost protocol in
1999' and the advocates who then believed in its existence?
Competing interests: No competing interests
I think it speaks volumes that, when challenged to provide hard
evidence to support your claims regarding the medical beliefs of the
ancient Chinese thousands of years before the invention of writing, the
best you can do is to cite “Colonel” James Churchward (ca. 1850 – ca.
1936), the “Father of Crank Archeology,” and author of those “seminal
scientific works,” “The Lost Civilisation of Mu” (1926), and “The Children
The “Colonel,” himself, tells us “All matters of science in this work
are based on the translations of certain ancient Naacal tablets which I
discovered in India many years ago.” Unfortunately, these “Naacal
tablets,” which “Hindu priests” taught him (and him alone) to translate
sometime during the 1870s, somehow managed to vanish into thin air soon
thereafter. (Funny how that always seems to happen whenever self-
described visionaries secretly discover and learn to interpret all the
evidence for a “lost continent” or a “lost civilization.” See the
histories of Theosophist, Madame Blavatsky, and Mormon patriarch, Joseph
Smith, to name just two examples.) So, basically, the “evidence” we’re
left with for the existence of the “lost continent of Mu” is the word of
James Churchward – which you obviously find highly compelling. I think
it’s worth pointing out here that Churchward not only claimed to be a
“Colonel, late of the Bengal Lancers,” but something of a “steel tycoon”
as well. Of course, no evidence seems to exist in support of these claims
either. Some folks will believe literally anything.
You tell us you were “taught by Prof LO Chi-kwong and his assistant
Dr TSUI Sui- king, (who both have “oodles of experience” and are very
highly regarded) … that the 'evolutionary theory of 'acupuncture &
moxibustion' tells of how thousands of years ago ancients located body
points which assisted in symptom removal through finger pressure … then
stone pressure was used, then 'puncture' was found to work…” Apparently,
you believe that, because these individuals are very experienced surgeons
and very highly regarded in China, what they taught you must be true.
(This, by the way, is what skeptics and scientists refer to as “an appeal
to authority in lieu of fact.”) Did you ever think to ask the good
doctors how they could possibly know what “ancient Chinese healers”
believed “thousands and thousands of years ago” when no written records
exist to support such claims? The core issue here seems to be your
apparent inability to distinguish between what someone with impressive
credentials has “taught you” or “told you” and objective evidence.
As though to illustrate this point, you proceed to tell us “the
Taoists have their own legend[s] which [are not] dissimilar to the legends
of the Olmecs and other ancient peoples.” In other words, “legends,” in
your view, are to be construed as a type of objective evidence. (If this
is not your view, why are you citing legends in response to a request for
objective evidence?) Even if you were somehow able to demonstrate that
they vaguely reflect objective reality, what in the world would modern
renditions of these “Olmec legends,” or even Taoist ones, have to say
about your claimed knowledge of Chinese medical beliefs from the third
millennium BC? (Answer: nothing.)
The final irrelevancy you toss on the heap of imaginary evidence
offered in support your claim to knowledge of Neolithic Chinese medical
beliefs is that “the Egyptians seem to have known much about maths [sic]
and astronomy.” What in the world do you believe this has to do with
Chinese medical theory/philosophy/knowledge of the third millennium B.C.?
(By the way, you ask the irrelevant question: “Are they [the Great
Pyramid of Khufu] not currently dated at somewhere between about 10,000
and 3,000BC?” My irrelevant answer is “No. They [the Great Pyramid] are
not ‘dated to between about 10,000 and 3,000 BC.’ The Great Pyramid is
dated to the early Fourth Dynasty of the Old Kingdom – specifically, to
the reign of King Khufu [ca. 2591 to ca. 2568 B.C.]. The very earliest
pyramid in Egypt, the Step Pyramid of King Djoser, dates to roughly 2685 -
2680 B.C. Claiming that they [the Old Kingdom pyramids of Egypt] date to
‘between 10,000 and 3,000 B.C. is akin to claiming that the Apollo moon
landings ‘date to between 8,000 B.C and 1,650 A.D.)
You tell us that it’s “clear from the numerous publications that no
consensus has yet been reached as to E[vidence] B[ased Medicine],” but, as
the multiple references I’ve already posted here amply demonstrate, this
is simply false. (Your claim does, however, have much in common with the
arguments “Creationists” often advance against “Evolutionists.”) While
the fine details are still up for discussion, the basic tenets of evidence
-based medicine are well-established and agreed upon – at least among
advocates of science-based medicine.
Finally you ask: “Need I say more to refute your 'ancients were
pretty dumb' theory?”
No. You need not “say more,” John. I think you’ve said enough. I
hold no such “theory.” On the other hand, I confess I do hold in contempt
those “modern revisionists” who arrogantly take it upon themselves to
“speak on behalf of the ancients” rather than allowing the “ancients” to
speak for themselves by means of the objective literary, historical, and
archeological records. While I believe in nothing even remotely resembling
the “ancients were dumb” theory to which you refer, I would be delighted
to further discuss my “some modern folks are fools” hypothesis, if you’d
Best to all,
Competing interests: No competing interests
And I thought you were getting to grips with the complexities of my
We seem to have got stuck on the less relevant (to the part of
Vickers and Zollman's paper the ABC of CM - acupuncture which I was
debating) subject of EB-Western Medicine and I did say I was intrigued why
you have chosen to focus on this topic as opposed to allowing me to
venture lots of data supportive of 'acupuncture & moxibustion' as a
modality for TCM. Nevertheless, I now respond to your latest, may I say
rather irrational resposnse to my last input!
I'll answer your points as I read them:-
My reply to the question of 1-20% is reasonable and highlights just
how easy it is for any statistician to use a group of papers, of which
there are many (including the 10 you chose to try to make your point), to
assert whatever they wish to do. I rechecked my figures and could not find
any errors - perhaps you could use a stats. expert to reassess them? It is
clear from the numerous publications that no concensus has yet been
reached as to the EB of WM; the reasons are as I already explained and:-
1. No concensus has been reached as to what constitutes EB; yet Prof.
Ernst decided, as evidenced by his publications with others, that CAMs
cannot be deemed EB unless RCTs have been performed. (I gave you the
refs.). Dr Goodman, another 'Healthwatch' er stated that ( and using
successful homeopathy RCTs as a case in point) "RCTs are no gold standard
at all". If RCT HAS to be a basis for EB, then this must apply to ALL
medicines, and medical modalities not just CAMs.
2. I think the 'science based' medical training is valuable BUT drugs
change all the time and one needs to be a biochemist to really understand
their actions so the GP has to depend on pharmaceutical input to 'get it
right' when applying drug theory to the human animal. In order to keep up
with the rate of change, the best option is for the GP to vet research
trial data; where does one vet this if not Medline, Cochrane database,
medical publications etc. The problem is then application, interest, time
and appreciation of what is available and where it is. (BMJ 1998 Jan.
31;316(7128):361-5 McColl A et al reminds you of the problems involved)
for any EB WM to find its way into the GPs - and then patients' - regime.
The paper by MacAuley D 'The integration of EBM and personal care in
family practice' (Ir J Med Sci 1996 Oct-Dec;165(4):289-91) provides
another level of concern in that EBM cannot always find the GP, then
patient, because "It is difficult to find evidence supporting many
clinical management decisions, it may be difficult to interpret evidence
when it is available, and it may be difficult to apply this evidence in
the consultations. Clinical decisions may be influenced at many levels
through health policy, audit, protocols and guidelines but the individual
doctor patient relationship remains at the core of general practice.
Developing a culture of EBM in general practice must integrate
quantitative and qualitative research, epidemiology and psychology and the
skills of public health and family medicine". I note he says 'developing a
culture of EBM' not 'the culture of EBM already developed'. Saad ED,
Grunspun H "Evidence-based Medicine" (Rev Hosp Clin Fac Med Sao Paolo 1996
Jan-Feb;51(1):34-6) say "EBM has been described as a new approach to
teaching and practicing clinical medicine.....Through its method, EBM
places less value on clinical experience, the study understanding of
pathophysiology, and common sense;instead it emphasizes observation,
levels of evidence, and critical interpretation of original literature".
They seem to disagree with you and agree with me?!
3. I am not trying to 'go to any lengths to mis-represent and
distort fact to cast 'scientific biomedicine' (your description of WM) in
a bad light. How can you call WM 'scientific biomedicine' when clearly it
is not yet entitled to that label, but with the recent advent of a desire
to create an EB for ALL medicines one expects ALL medicines which pass
muster as EB to eventually be 'safe' for patients and be entitled to be
I think this is a must for the dedicated and hard-working physicians who
need to be sure that the intervention they make is right, let alone their
There is little 'scientific' about practices which
a. Fail to provide an EB for more than 1-20% of their interventions
b. Are criticised as having a high level of opportunity for fraud and that
fraud is widespread
c. Have only recently decided that an EB is a necessary basis for their
d. Cannot show that an EB treatment actually reaches a patient most of the
I think that the current trend for researchers to identify and
develop the means to provide EBM to patients is laudable, indeed
essential, and one hopes that they will eventually work out which methods
(RCT, anecdote, cohort studies etc.) suit which modalities the best. New
standards can then be applied to ensure an EB for ALL medicines as that is
what the patients' want (unfortunately I suspect many patients already
think, inaccurately, that is what they have been receiving for years when
clearly it is not).
Also, forms of medical intervention currently referred to as CAMs
will be able to be assessed using similar EB protocols (which have been
designed/modified where necessary and as appropriate for each CAM). The
insistence, usually by those who denigrate CAMs, that CAMs are worthless
unless based on RCTs can then be laid to rest.
4. Phlebotomy, or blood-letting, has much to do with extraction of
blood from veins - is that not what leeches do? Ergot was mentioned as an
example of an 'old remedy' retained by WM. I've never heard of Chinese
vets extracting pints of blood from animals, or TCM espousing such methods
with humans - the references would be useful - I have heard of Western
medics doing this not so long ago. 'Blood letting', especially in the form
of 'pricking therapy' (I already referred you to several research items)is
still practiced in China for the successful treatment of various diseases.
5. I was taught by Prof LO Chi-kwong and his assistant Dr TSUI Sui-
king, both graduates of Hangchow Medical College 1959; Prof LO having
spent 15 years in surgery before moving to Hong Kong and Dr. TSUI in
residence, that the 'evolutionary theory of 'acupuncture &
moxibustion' tells of how thousands of years ago ancients located body
points which assisted in symptom removal through finger pressure (as we do
now eg. pressing each inner canthus for frontal headache), then stones (
called BIAN ) pressure was used, then 'puncture' was found to work more
effectively so first bamboo was used to puncture the skin, then porcelain,
until eventually with the arrival of metals acupuncture evolved into the
modality we know today; silver and gold needles were referred to as
providing a 'sedating' and a 'tonifying' effect respectively and finally
we now have stainless steel 'needles' in the current age. Sounds quite a
plausible 'evolutionary theory'.
However, the Taoists have their own legend which I described in
short. It is not dissimilar to the legends of the Olmecs and other ancient
peoples of the world. I don't like to think of such practices as
'obsolete' when I find that the ancients appear to have used similar
methods to those now used. Lack of 'evidence' in material form does not
prove ancient practices are obsolete. Many ancient practices are carried
forward through the spoken word, and some had to be due to political 'book
burning' we hear so much about nowadays.
6. The Egyptians seem to have known much about maths and astronomy
witness the three pyramids at Giza having an unusual alignment rather like
that of Orion's belt; along with the unexplainable exactitude built into
the great pyramid of Cheop's (Khufu's, described as more like a
geometrical mountain than a building) structural dimensions. Are they not
currently dated at somewhere between about 10,000 and 3,000BC? Does the
great pyramid of Khufu not have almost exact alignment with the four
cardinal compass points (with average discrepancy of only 3 mins of arc, a
variation of <0.06%, in any direction), and four base sides almost
exactly equal in length to within 0.08%, yet it was constructed with
approximately 2.5 million limestone blocks. Need I say more to refute your
'ancients were pretty dumb' theory?
7. For Colonel Churchward's work I suggest you read some of his
publications such as 'The Children of MU' and others where the Hindu
tablets'inscriptions are explained - with his literal translations. He
provides much evidence for the origins and existence of MU.
As for skepticism, I thank God for rational sceptics as without them
there would be far less reasoned debate. 'Incurable' skepticism can also
be healthy if, once proved beyond reasonable doubt, a point is taken.
Competing interests: No competing interests
I’m a bit disappointed that when I ask you to explain your straight-forward
claim that as little as 1% of standard medicine is evidence-based, you
respond with a veritable mountain irrelevant conjecture that fails to even
address the question. Instead of showing us the hard data and meticulous
analysis that would be required to prove your point, you offer a pointless
mish-mash including platitudes and homilies about statistics being “damn
lies,” “skeptics asking God for an ID card,” and various irrelevancies such
as “Only 40% of GPs know of [the] Cochrane database, and few use it, only
20% have surgery access to bibliographic databases…” and so on ad nauseam.
So what?! Do you suppose it's possible that some GPs may have learned
something about science- and evidence-based medicine from a source other
than the Cochrane database?… such as their science-based medical training?
In order to come up with your imaginary 1-20% figure, you’ve had to resort
to an absurd definition of “evidence-based interventions” as “only those
administered by physicians who are familiar with the Cochrane database
and/or the tenets of EBM.” Is it reasonable to assume that, if a GP who has
never heard of the Cochrane database prescribes an antibiotic to treat a
susceptible bacterial infection, his/her “ignorance of the database”
somehow renders said treatment “non-evidence-based”? The issue at hand is
“how much of standard medicine is evidence-based”: not “how many GPs or MDs
have utilized the Cochrane database,” or “how many physicians have accessed
EB-checking facilities.” Your responses seem designed to obfuscate this
You’ve offered us several prime examples of how alt advocates will go to
almost any lengths to mis-represent and distort the facts so that they
appear to cast scientific biomedicine in a “bad light.” They seem to feel
that maligning science and scientific biomedicine somehow bolsters the case
for acupuncture, homeopathy, and various other unproven and “evidence-free”
medical belief systems. This pathological process is somewhat akin to the
person who, when asked to prove that he’s smart, responds with a diatribe
accusing everyone else in the world of being stupid.
How many flaws, real or imaginary, will have to be “exposed” in standard
medicine in order to “validate” acupuncture, homeopathy, phrenology,
psychic surgery, chiropractic, or any other unproven therapeutic wannabes?
The only reason I can think of for one to doggedly believe in the “only 1
to 20% of standard medicine is evidence-based” fantasy is that they feel it
somehow bolsters the case for the various “0% evidence-based alternative”
therapies the alt med community is providing on a fee-for-service basis to
When you tell us that RCTs (Randomized Controlled Trials or CCTs –
Controlled Clinical Trials) have “never really been performed” because “the
theoretical requirements are unrealistic and unscientific,” what is your
point? Because no RCT is perfect, are you seriously suggesting that we
abandon this standard? In your view, we should abandon RCTs in favor of
It’s not too difficult to imagine the “standards” some folks might prefer
as an alternative -- the same “ancientness,” “anecdotal,” “testimonial,”
“patient/practitioner satisfaction” standards that scientific biomedicine
has painfully and inexorably struggled to discard over the last several
centuries. Of course, there is a certain convoluted (if pathological) logic
to this position. If one is heavily invested -- financially, emotionally,
and professionally -- in the efficacy of unproven modalities, these
medieval standards are the ONLY ones that will justify the continued use of
such modalities in the 20th and 21st centuries. Therefore, in the
“tail-wag-the-dog” world of alternative medicine, these “standards” MUST be
You tell us that prominent scientist and ethicist “Senator Edward Kennedy”
noted that IF only 10% of the data from on-going CCTs is defective the
problem is enormous." Of course, you seem to have overlooked the
all-important word “if.” You tell us: Dr. John Braithwaite, states that [in
view of] international bribery, corruption,... fraud in the testing of
drugs, [and] criminal negligence in the unsafe manufacture of drugs, the
pharmaceutical industry has a worse record of law breaking than any other
industry.” So, again, what is your point?
Does Kennedy go on to say that "controlled clinical trials are, thererore,
not worth conducting"? What does Braithwaite have to say about the
entirely unregulated manufacturers of “herbal medications,” or the
manufacturers of “homeopathic” remedies, or other “alternative” therapeutic
agents? (Answer: nothing.) Is your point that, since “bribery and
corruption” sometimes come into play in the application of scientific
biomedicine, that the tenets of science and scientific biomed are somehow
invalid? Sometimes potent antibiotics are ineffective in the face of
resistant bacterial infection. Does it follow that we should abandon
antibiotics in favor of “homeopathic water therapy” or “cow dung
poultices”? I don’t think so. It seems that the very best argument some alt
advocates can advance in support of the various unproven therapies they’re
selling the public is that “scientific biomedicine is fraught with
You are mistaken with regard to therapeutic phlebotomy and TCM. Therapeutic
phlebotomy has nothing whatever to do with the “leeches” or “ergot” you
mention. You tell us: “Yes the Chinese do still use 'pricking' as a form of
intervention, usually to lower BP, or temperature, or to reduce the effects
of shock.” The fact is that, in China, modern veterinary acupuncturists
advocate the letting of “a half-liter or more” of blood in the treatment of
some maladies.” I’d be happy to provide references if you wish. As
Kuriyama, Unschuld and other Sinologists and historians of medicine have
observed, two thousand years ago the Chinese, like the ancient Greeks
before them, often performed therapeutic phlebotomy, and in intriguingly
similar ways. The practice was eventually abandoned in human TCM, but it is
still very much a part of veterinary TCM as practiced in China.
You refer to “HealthWatch personality Dr. Neville Goodman, examiner for the
Royal College of Anaesthetists” and you immediately dismiss all his
straight-forward criticisms of homeopathy on the basis that “he doesn't
believe in it,” even though “RCTs supports it!” The hard fact is that the
highest quality RCTs and meta-analyses do NOT support homeopathy. I suspect
you know as well as I do that the highest quality (most tightly controlled,
adequately randomized, and statistically significant studies) show
precisely the opposite of what you suggest. See:
I also suspect you’re well-aware that, even when meta-analyses of extant
homeopathy trials are conducted by dyed-in-the-wool homeopathy advocates
such as Wayne Jonas, the authors are forced to concede that “we found
insufficient evidence from these studies that homeopathy is clearly
efficacious for any single clinical condition” See:
If, after 200 years of investigating homeopathy, that’s the case, why in
the world should we waste any more of our precious and limited time and/or
research funding on homeopathic “research”? How many more centuries of
investigation will we have to suffer through before we can reasonably say
“Enough is enough! We’ve examined homeopathy up and down and it obviously
doesn’t work”? And, more to the point, when will it become “medical fraud”
to persist in selling homeopathic therapies to a gullible but trusting
You respond to one of my queries with the comment: “How can I refer to
5,000 years of 'acupuncture and moxibustion'? The simple answer is that I
didn't.” And my simple retort is, “I never asked the question to which
you've responded here." It seems you’ve gone out of your way to distort
both my words and your own prior comments in order to obscure the facts.”
Let’s take a quick look at what I actually said, and what you actually said
in your previous messages.
You claimed “'Inflammation of the liver'/'excessive bile production' …
retains the same symptomatology and possible differential diagnoses as it
did 5,000 years ago… the same emotions are involved … same acupoints
effective … similar modes of stimulation (needles, massage, herbs) - the
main change is how it may have developed in the patient; 5,000 years ago it
may be due to drinking excessive alcohol or a particular pathogen, nowadays
it may also be due to that, but may also be caused by our toxic
environment/food. 5,000 years ago it may have been treated with eg.
peppermint and nowadays may also be treated with that. 5,000 years ago
acupoints LIV2 or LIV3 would be effective, same today” And I responded “I’m
curious to know exactly what you believe “Chinese medicine" had to say
about “acupuncture, moxibustion” and various other things “5,000 years ago”
(3,000 BC.) I’d very much like to know the identity of the specific Chinese
medical and/or literary sources upon which you base your beliefs and claims.”
My question still stands: what sources from the Chinese historical record
allow you to make such claims? The fact is, you have no idea what TCM
really had to say about these things “5,000 years ago,” because there are
no surviving Chinese medical texts that even come close to being 5,000
years old. Therefore your claims are based on nothing more than your
imagination and your fervent “belief” that the tenets of 20th century TCM
are “thousands and thousands of years old” (and, therefore, somehow
“venerable” rather than merely obsolete).
You then proceed to regale us with the “evolutionary theory” for the
development of the "Theory of Ching Luo" or Channels and collaterals that
holds that the Chinese "started in some way using hands, then stones (BIAN
stone), then graduated to bamboo, then porcelain, and finally metals
through the ages to stimulate acupoints.”
I’t seems you haven’t “done your homework” in this regard. (Can you imagine
performing “acupuncture” with sharpened stones (bian) – ouch! -- or with
“porcelain” needles? -- snap!) If you’re interested in learning what
contemporary Sinologists and historians of medicine (as distinct from
acupuncturists and TCM advocates) actually believe regarding the probable
uses of "bian" and the development of acupuncture, I suggest you find a
copy of: The Origins of Acupuncture, Moxibustion, and Decoction, by YAMADA
Keiji, Nichibunken Monograph Series No. 1, International Research Center
for Japanese Studies, Kyoto, Japan, 1998. Various books by Sinologist and
historian of medicine Paul Unschuld cast the issue in an even more
You tell us “The Taoist theory I am familiar with is that 10,000 years ago
the Chinese were visited by a group of Caucasians they called 'The Son's Of
the Reflected light' who taught them physics, mathematics, astronomy,
peaceful living, and bio-electric body therapy.” My immediate response is:
“What a charming story. Why in the world would you assume it’s true?” What
textual material or objective evidence exists to support it? You’ve
provided yet another prime example of precisely the sort of “imaginary
historical TCM reference” to which I alluded earlier. (One wonders how
much anyone, including "Europeans," knew about mathematics and physics,
much less "bio-electricity," during the Mesolithic period [10,000 to 3,000
Please keep in mind that Scientologists advance similarly evidence-free
“theories” about super-beings having populated Earth several tens to
thousands of years ago. Likewise, followers of “Chariots of the Gods”
advocate Eric von Daniken advance similar “visiting space alien theories.”
19th century “Atlantis” advocate Ignatius Donally, and his various
supporters, advanced similar beliefs, and so do any number of other
“lunatic fringe” groups. Of course, advocates of science, reason, and
historical scholarship respond as they must: with the question “where is
the hard, objective evidence?” The answer always seems to be: There is none.
Your musings regarding “enlightened beings” visiting South America and
“teaching advanced subjects which led to rapid evolutionary development”
provide yet another embarrassing illustration of the utterly credulous and
entirely “evidence-free” basis for some "pop" historical and medical
You tell us: “anthropologists are still trying to explain Col. James
Churchward in his books on the legendary civilisation of MU taken from
ancient tablets discovered in Hindu temples late last century [which tell]
of an advanced civilisation which was destroyed by a cataclysm probably
involving flood. His story fits the various cultures and the period of the
'flood' is within the last 12,000 years. Prior to that he states that the
MU civilisation lasted about 100,000 years. Their teachings have a great
similarity to TCM philosophy and cosmology…” Do they? Can you provide for
us transcriptions from, or a literal translations of, any of these magical
“Hindu tablets”? Of course, even if such accounts exist, we know they
can't be "first person accounts" of events taking place 12,000 years ago,
because writing, itself, is less than 6,000 years old. "Can you name a
single “anthropologist” who states they are “still trying to explain” any
of this evidence-free rubbish? Can you provide a single scrap of
documentary evidence substantiating either the existence of “MU” or the
presence of any civilization on “MU” dating to ANY epoch, much less dating
to “100,000 years ago”? I don’t think you can do any of these things.
Finally, you tell us “5,000 years may have been too conservative [a
figure]” (without having provided a single tangible, verifiable reference
to support your far-fetched beliefs regarding medical practice in Neolithic
China.) Then you ask me “Are you convinced yet, or is Skeptic [sic] an
incurable trait?” My answer is that “healthy skepticism is an inherent and
essential part of a ‘scientific world-view,’ so, yes, I suppose it's an
“incurable trait” – at least among those who chose not to be gullible
and/or those who value a scientific perspective on reality. Of course,
those who’ve emotionally, financially and professionally “committed”
themselves to the provision of various unproven and highly unlikely medical
“therapies” without waiting for “hard supportive evidence” need not fret
over the matter, since they're obviously not afflicted with this "incurable
Kindest regards to all,
Robert Imrie, DVM
Competing interests: No competing interests
Thanks for your most recent discourse. I appreciate the effort but
realise the need to help release your apparent confusion. I'll try keep it
simple as space (and time) are at a premium.
There are 7 points puzzling you:-
1. How do I find 1 - 20% of 'scientific biomedicine' ( your words) to
Whilst acknowledging that 'lies damn lies and statistics' is about
right, I can play the same game:-
Using only the RCT figures you supplied with the ten studies (for
reasons I've already stated and which will become more apparent when you
read my responses to your 2. to 7. points) and taking
a. the highest of 30.7% ( Gill et al, Leeds University, BMJ 1996 ) with
b. study for general practise which is where patients generally attend
first for their 'diagnosis' and initial intervention with
c. the study by McColl A et al, BMJ 1998, about GPs access and inclination
towards utilising the concept of EB in their patient intervention, we find
Only 40% of GPs know of Cochrane database and few use it, only 20%
have surgery access to bibliographic databases, only 17% have WWW
access for Medline etc. so we choose the rough estimate that 17-20% of
GPs are able to access EB data for patients (most said they probably
wouldn't have the time to access such data having only 4 to 6 minutes
per patient per consultation but I'll allow for the whole 100% of the
17-20% GPs as having used those EB-checking facilities!) so we have
18.5% (half way between 17 and 20%) of GPs able to access said data, and
a maximum of 30.7% RCT data available to the average general
practitioner - 18.5% of 30.7% is 5.68% (of RCT data available for GP to
use per patient if time allows); IF his diagnosis is accurate, IF the
RCT data is true and not falsified to any extent (and that's a big
IF as you'll see when you read on ), and IF the RCT has an intrinsic
value as a research mechanism (another big IF) your average patient has
a 5.68% maximum chance of gaining an EB treatment. Of course we all know
that the three IFs are not 100% satisfactory, so they would be reduced
by factors associated:- for example, say a GP on average gets 50%
diagnoses correct, his patients have 2.9% chance of an EB treatment. If
the trial integrity is about 30% valid on average, then the EB reduces
to 0.87%. If RCTs are intrinsically unsound say 20% of the time, the
final EB would be about 0.70% available to his patient). Not far off 1%.
Of course I'm playing with figures as many of the variables are
unknown, and EB varies with practice, doctor, patient, drugs, surgery,
trial data, integrity of trial etc. etc. and all EB data must be highly
suspect as I will explain later. But it may be that for most GPs their EB
value is close to 0% as far as a patient is concerned, perhaps an
anaethetist has a higher value as may a specialist or surgeon as their
practices, interventions and procedurtes are generally less complex with
a. Harris L. Coulter PhD, author of 'The Controlled Clinical
Trial: an Analysis'
argues that the CCT 'Gold Standard' HAS NEVER ACTUALLY BEEN PERFORMED
"because the theoretical requirements are unrealistic and
unscientific. How can you test a drug on 12 or 100 or 1000 identical or
homogeneous people all with the same thing wrong with them? Allopaths
can't even find 5 homogenous patients....you'll always find things that
are different between people, because we are all chemically,
physically, structurally and emotionally unique.. the CCT can never tell
a doctor how a given patient will react to a given drug at any given
time.. the findings from the so-called CCT are useless in one-to-one
b. Senator Edward Kennedy, conducting a hearing of the Senate Health
Sub-commitee, noted that if only 10% of the data from on-going CCTs is
defective the problem is enormous "when you consider the potential
cumulative effect of faulty animal data coupled with faulty human data you
have the elements of a regulatory nightmare".
.......'Reviews' of "The Controlled Clinical Trial: an Analysis" at
c. Dr. John Braithwaite, now a Trade Practices Commissioner, wrote
the devastating expose 'Corporate Crime in the Pharmaceutical Industry
(1984)'. In this 440 page book he states:-
:- that international bribery and corruption, fraud in the testing of
drugs, criminal negligence in the unsafe manufacture of drugs - the
pharmaceutical industry has a worse record of law breaking than any
:- his study is based on extensive international research including
interviews of 131 senior executives of pharmaceutical companies in the
USA, UK. Australia, Mexico and Guatemala.
:- he shows how pharmaceutical multinationals defy the intent of those
regulating safety of drugs by bribery, false advertising, fraud in
safety testing, unsafe manufacturing processes, smuggling and
international law evasion strategies.
:- data fabrication is so widespread that it is called 'making' in the
Japanese pharmaceutical industry, graphiting' or 'dry labelling' in the
:- the book reports that between 1977 and 1980 the USA FDA discovered
62 doctors who had submitted manipulated or downright falsified clinical
data. A study conducted by the FDA has revealed ONE IN FIVE DOCTORS
investigated, who carry out field trials of new drugs, had invented the
data they sent to drug companies, and pocketed the fees. "The problem
is that most fraud in clinical trials is unlikely ever to be detected..
most cases which do come to public attention do so because of
extraordinary carelessness by the criminal physician" Braithwaite says.
d. Dr Judith Jones, Director of the Division of Drug Experience of
the FDA says that if the data by a clinician proves unsatisfactory towards
the drug being investigated it is quite in order for the company to
continue trials elsewhere until satisfactory results and testimonials are
achieved. Unfavourable results are very rarely published.
Some doctors can earn up to $1 million per year, at $1000 per patient, and
if they don't produce the desired results they lose the work.
2. How do I account for the obvious efficacy of treatments, eg. drugs
such as antibiotics, surgery, transfusions etc.?
I don't really have to as we know that many interventions can be
efficacious, the problem is whether the patient is availed of a
correct, EB based one, and statistics suggest this may not often be the
case. To date most of the research seems to look at whether a treatment
has been trialled as opposed to whether a patient is likely to get the
correct one for their disorder. In surgery or anaesthesia one is
expected to be more likely to get an EB, but in general practice one is
faced with much less than 20% probability of a patient getting an EB
response. For example, if the trial data was falsified, any assumed EB
becomes false. If the RCT was inadequate, the EB is of less value. If
the doctor did not give the first choice treatment because of budget,
time or other constraints (eg. works in the real world) the EB is
lacking. etc. Hence your assumed 'high' efficacy of biochemical medicine
is incorrect due to that daily 'reality'.
In TCM we see every patient as a new individual, we live with
reality every day, a reality based on thousands of years of anecdote,
evolution, empiricism (especially this last 50 years in modern
'scientific' China) and a relatively unchanging, and integrity-based low
budget medical model. We start from scratch with every patient, we're
not tied to prescribing Prozac for every alleged depression, or
erythromycin for every chest infection, or paracetamol for every slight
temperature etc. We take into account their environment, constitution,
lifestyle, potential pathogens, emotions, internal disharmonies,
external influences, cosmology, etc. until we KNOW that the treatment we
mete out fits THAT patient to a tee. We may be wrong at times, but every
time we reassess and re-prescribe, reassess and re-prescribe according
to the medical model we follow that has stood the test of time, requires
time and effort on every patient's behalf without skimping (and insists
upon first doing no harm ). That is what WM must aspire to.
a. Dr Vera Scheibner, retired Principal Research Scientist for the
NSW Government with a Doctorate in Natural Sciences, who has published
3 books and some 90 scientific papers, after studying some 30,000 pages
of medical papers dealing with vaccination, found 'no evidence that
vaccines are safe or effective'. Her book "Vaccination: The Medical
Assault on the Immune System" of 264 pages describes her findings. She,
as other prominent anti-vaccine spokespersons have concluded, believes
that vaccination does not confer immunity against a pathogen but
suppresses our immunity against that pathogen leading to an increase in
disorders such as auto-immune diseases, diabetes, cancer, asthma and
neurological problems amongst many others. The 'wild pathogen' may have
been displaced by the attenuated or mutated pathogen and we see diseases
like polio being replaced with eg. MS and/or ME, measles with atypical
measles, whooping cough with asthma etc. whilst the medical system
appears to be in denial about these potential effects.
The AIDS debate has unleashed a medical dilemma which involves
theory - how can the condition 'HIV +ve' be a precursor for AIDS and yet
'measles +ve' or 'meningitis +ve' are said to be a protective state due
to the presence of antibodies to the attenuated or dead virus? Do our
children now have numerous (vaccine-induced) serious 'antibody states'
which actually represent 'pre-disease' rather than protection?
This illustrates another problem of EB-medicine; what science is the
EB based on, and is the science correct?
Is modern medicine causing most of the illness we see invading the
lives of virtually every family in the 'modern world'? Should we be
looking at the statistics more closely, perhaps 1%-20% is over generous
and the true 'EB effect' results in a negative status where WM induces
MORE disease than the lack any medical intervention would in general?
What's the old saying, "if all the prescriptions were collected together
and thrown into the sea, only the fish would die?" or words to that
I remember hearing of a Medical School Professor telling his
students that about half the medicine he would teach them about was
useful and the other half was of little use - the only problem was
nobody knows which half is which.
"No amount of experimentation can ever prove me right: a single
experiment can prove me wrong". Albert Einstein.
"We have to live today by what truth we can get today and be ready
tomorrow to call it falsehood". William James.
"But I have seen the science I worshipped and the aircraft I loved
destroying the civilisation I expected them to serve". Charles A.
3. How can I dispute the 40 authors in the 10 studies you supplied?
"If all mankind minus one were of one opinion, and only one person
were of the contrary opinion, mankind would be no more justified in
silencing that one person than he, if he had the power, would be justified
in silencing mankind" John Stuart Mill (1806-1873)
I think they're avoiding, or perhaps ignoring, many variables.
4. What calculatons did I use for my 1-20% EB?
See answer at Q. 1. above.
5. Where does 'therapeutic phlebotomy' fit into it?
Not sure why you selected that, after all leeches are still bred
use in Wales, UK, with great demand for their services I'm told...
something stood the test of time in WM after all... and look at
ergot, still a favourite for migraine after 400 years...
Yes the Chinese do still use 'pricking' as a form of intervention,
usually to lower BP, or temperature, or to reduce the effects of shock.
The technique has been extensively studied over the millennia but here
are a few recent examples of its use and efficacy:-
a. "The Examples of Clinical Application of Pricking Blood Therapy".
SHANG Xiukui, LIANG Chunyu; The Department of Acupuncture and Moxibustion
of Tianjin College of TCM, Tianjing 300193, China.
Using tri-edged needle to bleed several drops of blood at selected
acupoints they describe the traditional techniques and provide their own
case histories of how it is suitable for cases due to Stagnation of wind
and fire evils, and oedema due to kidney insufficiency. These may include
arthritic effects, infantile acute convulsions, furuncle, mumps, swellng
and pain of throat, conjunctivitis, influenza, prostatic hypertrophy etc.
b. "Study on mechanism of pricking blood at 'twelve well points of
the hand' in resisting experimental cerebral ischemia in rabbits". ZHON
Guoping, DENG Changqing; Hunan College of TCM, Changsha, 410007.
The technique was observed in 31 rabbits, randomly divided into 3 groups
(control 10, ischaemia 11, ischaemic plus blood letting group 10). Two
hours after occlusion of rabbit bilateral common carotic arteries contents
of Ca2+, lipid peroxide and cAMP of brain tissues all increased
significantly but activity of superoxide dismutase and glutathione
peroxidase lower evidently indicating overload of intracellular Ca2+ and
increase in oxygen free radicle, After blood letting of '12 well points'
contents of Ca2+, malonyldialdehyde and cAMP lowered significantly while
the activity of SOD increased considerably. Results suggested that blood
letting of 12 well points could resist cerebral ischaemic-induced overload
of intracellular Ca2+ of the brain tissues and prevent the toxic action of
oxygen free radical.
c. "Treatment of Acute Diseases of Pharynx and Larynx with Blood-
Pricking therapy". TIAN Ling; College of Chinese Traditional Medicine,
Hebei Medical University, 050091, China.
A group of 79 patients with acute diseases of pharynx and larynx were
treated with blood-pricking therapy, using either acupoint pricking or
local scattered pricking. "A good result was achieved suggesting that
blood pricking therapy can replace antibiotics and alleviate the
sufferers' pain and economic burden. It is a simple and easy process to
carry out". Of the 79, 56 sufferers recovered, 14 effective, and 9 felt
better. Total effective rate 100%, average treatment times was 2.
6. Why do I focus on RCT for EB evidence when there are reviews,
cohort studies, anecdote and other non-experimental types of evidence?
As I said I am treating WM the same as CAMs have been treated,
especially by your UK counterparts in the 'Campaign Against Health
Fraud' (now HealthWatch) - the specified requirement being CCT/RCT
before any study is deemed useful or even 'SCIENTIFIC'. I use CAHF and
HealthWatch personalities publications as references to prove this point
thus answering another of your questions:-
a. Professor Edzard Ernst, Professor of CM at Exeter University
'HealthWatch' medical member wrote in The Independent 2.6.1998 a full
article entitled 'Hidden Truths Behind Healing Hands' in which he says
"Historically, in medicine, we have struggled to get away from
testimonials or anecdotes. Exactly 50 years ago, the RCT was introduced
as the gold standard to find out whether a given therapy is effective
or not. With this tool we are now able to differentiate between specific
therapeutic effects and non-specific (eg. placebo effects, natural
history of disease) effects and can furthermore determine whether one
particular treatment is better than another... If, in the present
context, science means the evaluation of treatments through RCT, the
notion that science cannot be applied to CM is false..." He then lists a
number of CAMs where he assigns the titles effective, ineffective,
inconclusive or insufficient evidence - the basis being ONLY RCT - and
under the heading "The Diagnosis is.. Misleading".
b. Another (SKEPTIC) HealthWatch personality Dr. Neville Goodman,
examiner for the Royal College of Anaesthetists, wrote an article
entitled "Homeopathy studies stir up a storm" in the HealthWatch
Newsletter April 1998 ( www.biochem.ucl.ac.uk/~dab/nlett29.html).
He states about homeopathy "I could not accept a RCT favouring
homeopathy (and I hasten to add, would decline the opportunity to
peer review any such research). I regard that sort of result as an
important demonstration that RCT are no gold standard at all, there are
all sorts of problems with them....": (and all because he doesn't
believe in homeopathy, even if RCT supports it!), very scientific.
c. Prof. Ernst, White and Resch 'Searching for Acupuncture Trials:
which database'; Acupuncture in Medicine Nov 1995, Vol 13, No.3.
state that "EB medicine depends on sensitive, precise and informative
searches for references to CCTs"
d. Ernst, Resch; 'The Clinical Trial - Gold Standard or Naive
reductionism'; Eur J Physmed rehabil 1996; 6 No 1. state "Yet, when it
comes to conclusively verifying the effectiveness of therapeutic
interventions, only one design will lead to an unbiased answer, the
intervention study better known as THE CLINICAL TRIAL".
e. Prof Ernst. 'Complementary Medicine Common Misconceptions'
Holistic Health No 50 Summer 1996 states that "To be a useful treatment
each Complementary remedy must be demonstrated to be clinically
effective in defined conditions through RCT, and these are still a
rarity in CM".
f. Ernst, Eialka; Forsch Komplementarmed 1994;1:226-232. 'The
Clinical Effectiveness of Massage Therapy - A Clinical Review' says
that "The methodology of each study had to fulfil further basic criteria
of validity (adequate sample size, preferably randomised patients,
allocation, description of massage techniques, and consistent
therapies). Most importantly the study had to be controlled - as we felt
that UNCONTROLLED TRIALS PROVIDE LITTLE OR NO RELIABLE INFORMATION ABOUT
EFFECTIVENESS (Anderson B, 1990)".
7. How can I refer to 5,000 years of 'acupuncture and moxibustion'?
The simple answer is that I didn't. I said "TCM acupuncture and
moxibustion... has maintained an unbroken record... for thousands of
years". I then said "Inflammation of the liver/excessive bile..... same
symptomatology and possible differential diagnosis as it did 5,000 years
ago..." and "5,000 years ago it may be due to drinking excessive
alcohol.... may have been treated with peppermint.... acupoints LIV2 or
LIV3 would be effective, same today".
The 'evolutionary theory' for the development of the "Theory of Ching
Luo" or Chamnnels and collaterals is that the Chinese started in some way
using hands, then stones (BIAN stone), then graduated to bamboo, then
porcelain, and finally metals through the ages to stimulate acupoints.
The Taoist theory I am familiar with is that 10,000 years ago the
Chinese were visited by a group of Caucasians they called 'The Son's Of
the Reflected light' who taught them physics, mathematics, astronomy,
peaceful living, and bio-electric body therapy. It is a similar story
to the South American and other cultures who speak of 'enlightened
beings' visiting them and teaching advanced subjects which led to the
rapid evolutionary development anthropologists are still trying to
explain. Colonel James Churchward in his books on the legendary
civilisation of MU taken from ancient tablets discovered in Hindu
temples late last century tells of an advanced civilisation which was
destroyed by a cataclysm probably involving flood. His story fits the
various cultures and the period of the 'flood' is within the last 12,000
years. Prior to that he states that the MU civilisation lasted about
100,000 years. Their teachings have a great similarity to TCM philosophy
and cosmology, but who really knows?
So 5,000 years may have been too conservative.
Are you convinced yet, or is Skeptic an incurable trait?
They do say "A skeptic would ask God for his ID card"... or at least
Edgar A. Shoaff did.
"There is a superstition in avoiding superstition"... Francis
"The farce is finished, I go to seek a vast perhaps"...
Competing interests: No competing interests