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Science, People and Politics. Issue five, September - October, 2009, volume i, Volume II.

An acupuncturist writes to the editor about the book Alternative Medicine, Trick or Treatment, by Simon Singh and Edzard Ernst.

TO THE EDITOR
One of my concerns with the current scientific analysis of alternative medicine is the obsession with "proof": in other words can we find a scientific explanation for it? If we can't, claims science, then it can't work. This book exemplifies this attitude.

As a practising acupuncturist I am not qualified to comment on the attempted demolition of the validity of other alternative medicine disciplines, so will limit my critique to the section on acupuncture.

I have treated patients for nearly 20 years, and most of them have "got better". Rheumatoid arthritis has dramatically receded (as evidenced by blood tests that puzzle the specialist, as well as by the patients' subjective experience), IBS has vanished, migraines have stopped, women struggling with supposed infertility for years have got pregnant, intransigent musculo-skeletal problems have resolved, panic attack have ceased....

The authors focussed a great deal on the placebo effect. By altering needle insertion depth from some supposed optimum depth, and then creating guide tubes that adhere to the skin and retractable needles so there is no puncture at all, they claimed to prove that any effects of the treatment are "simply" the placebo effect. However, the basis for these trials is nonsense, because acupoints can be stimulated from the skin surface - in some cases that is all that is required - and there is no "correct" depth for needle insertion: it varies with the point, the person, the condition being treated, the patients' age, and many other factors. They conclude by saying that "Acupuncture works only because the patients have faith in the treatment" (p112). This is belied by the successful treatment of animals with acupuncture. I have treated dogs, cats, horses and human sceptics with equally positive outcomes.

The placebo effect can be described as "a positive response showing no obvious pharmacological or transformative cause". This does not necessarily mean that it does nothing, rather that its action is not detectable or measurable by scientific methods.

All bodies have self-healing properties, for example the clotting mechanism, antibody production systems, enzymes which check for RNA transcription errors to prevent mutations being expressed etc... One view of acupuncture is that it works as a catalyst, somehow stimulating the body's self-healing mechanisms. If this is the case, then surely any system which promotes self-healing is equally as valid as sending in the pharmacological storm-troopers, and it creates much less collateral damage? However, the authors call this "sham" acupuncture, and accuse practitioners of conning their patients out of money.

I have my own theories about the way that acupuncture works, which relate to the fact that all matter is fundamentally composed of atoms, in other words mostly space with electrons and other sub-atomic particles spinning around nuclei. Everything that happens to us, every action, every movement, every ailment, is at root due to energetic reactions at this atomic or sub-atomic level. I believe acupuncture acts at this energetic level. I don't need or want to know the precise mechanisms, merely that if the correct points or channels are stimulated, as ascertained by thousands of years of practise, the desired effects usually result.

Much was also made of the apparent withholding of negative outcome results in some of the Chinese trials. Is there any treatment in any system of medicine anywhere or at any time that has a 100% success rate? I doubt it. Certainly we hear more and more of pharmaceutical companies suppressing or ignoring negative outcomes (and dangerous side-effects) in their drug trials. So the Chinese are human and fallible and greedy for recognition too. They only reported the positive outcomes. It didn't work for everybody. But it did work for some, which in slating the truth-bending of the Chinese, the authors seem to have ignored.

In conclusion, I understand that the authors have bought into the modern worlds' deification of the scientific paradigm. However, science is not "the truth". It is a paradigm that provides an extremely useful model for explaining and understanding a lot of things, but there are many other things that cannot be explained within its' framework. Attempting to apply the scientific rationale to these things is like using the wrong tool - like trying to dismantle a car to see how it works using a laser gun.

Sadly this book could deter many people who could benefit from alternative medicine from trying it.
Carrie Clare, BSc(hons), Dip Ac, MBAcC, Sowerby Bridge, West Yorkshire, UK.
Editor: Helen Gavaghan