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#26 2017-03-11 07:43:05

millededge
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Re: A "How to" on ways governments can kill commercial activity

Each has its place and those in western medicine in this country lobby hard to prevent this to the detriment of people seeking treatment for conditions.

At the risk of upsetting you, can you defend this assertion? If acupuncture is that great, why is nobody grabbing it with both hands after "5000 years"?

Are we all thick?

Maybe, like blood letting and leeches in the West, acupuncture isn't that helpful.

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#27 2017-03-11 07:45:15

millededge
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Re: A "How to" on ways governments can kill commercial activity

And governments should kill government-subsidised acupuncture if there is no good evidence it works better than exisiting treatments.

This is a loaded issue, especially for pain, where I do think, if acupuncture has a role, it is in pain.

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#28 2017-03-11 09:18:54

millededge
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Re: A "How to" on ways governments can kill commercial activity

My take on it is Chinese superstition and bluster. This is hard for some Chinese, for it involves loss of face.

Unfortunately, these issues exist. It is just the same in our own culture in Australia, in a different way.

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#29 2017-03-11 10:34:56

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Re: A "How to" on ways governments can kill commercial activity

millededge wrote:

And governments should kill government-subsidised acupuncture if there is no good evidence it works better than exisiting treatments.

As this is back on topic of the thread I shall respond to this point  - I whole heartedly agree with the above but can you name any backed with evidence of non efficacy that fall into this category and are provided by qualified acupuncturists?

In so saying they should also kill any government subsidised treatment via western methods/pharma where acupuncture (or any alternative to western) is better than existing treatments and then subsidise the better option - eg Allergic Rhinitis - search for recent paper by Dr John McDonald.

mmm..shiney might even say we shouldn't subsidise any?...not a bad idea for leveling the playing field.

Can't have your cake and eat it too.

Your last point just verifies your narrow mindedness, lack of education in this field of medicine and shows as an example to all the dismissiveness displayed by a large number of those involved with western medicine towards any other form of treatment. Unfortunately these issues exist. wink .
As I said each has their place, a point you, with unlearned arrogance seem to be unable to accept.

You should research UB67 and its function if you have aspirations of becoming a half decent practitioner in your chosen field of obstetrics, might save you having to resort to your "healing knife" for caesarians so often...take the blinkers off and jump down the rabbit hole Alice.

Again - If you want to keep on about East v West medicine start a new thread but consider yourself warned that I clearly know more about western medicine than you do about eastern.

Edit to add - I couldn't be less Chinese if I tried so saving or losing face from a cultural standing is not an issue.

Last edited by Stoic Phoenix (2017-03-11 21:46:13)


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#30 2017-03-12 02:05:11

millededge
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Re: A "How to" on ways governments can kill commercial activity

Stoic Phoenix wrote:
millededge wrote:

And governments should kill government-subsidised acupuncture if there is no good evidence it works better than exisiting treatments.

As this is back on topic of the thread I shall respond to this point  - I whole heartedly agree with the above but can you name any backed with evidence of non efficacy that fall into this category and are provided by qualified acupuncturists?

In so saying they should also kill any government subsidised treatment via western methods/pharma where acupuncture (or any alternative to western) is better than existing treatments and then subsidise the better option - eg Allergic Rhinitis - search for recent paper by Dr John McDonald.

mmm..shiney might even say we shouldn't subsidise any?...not a bad idea for leveling the playing field.

Can't have your cake and eat it too.

Your last point just verifies your narrow mindedness, lack of education in this field of medicine and shows as an example to all the dismissiveness displayed by a large number of those involved with western medicine towards any other form of treatment. Unfortunately these issues exist. wink .
As I said each has their place, a point you, with unlearned arrogance seem to be unable to accept.

You should research UB67 and its function if you have aspirations of becoming a half decent practitioner in your chosen field of obstetrics, might save you having to resort to your "healing knife" for caesarians so often...take the blinkers off and jump down the rabbit hole Alice.

Again - If you want to keep on about East v West medicine start a new thread but consider yourself warned that I clearly know more about western medicine than you do about eastern.

Edit to add - I couldn't be less Chinese if I tried so saving or losing face from a cultural standing is not an issue.

A little lesson for an acupuncturist. Mistakes happen in real life, tragic ones. You may have experienced this personally. If not, considering your quip about C-sections, here is a story close to home.

A close relative chose to have a vaginal delivery though was already overdue. She did this with the best of intentions, thinking as many do, bad things don't happen. She chose not to have a caesar. Her child aspirated meconium at parturition. A child with an airway full of its own sh!t, in lay terms. This is a reason why caesar is offered in postterm pregnancy. The problem with neonates in this situation is the downtime for oxygen delivery is worse than for an adult, way worse. This is compounded by issues related to airway instrumentation. The airway is tiny. The child was left with a hypoxic brain injury and is mentally retarded. This is something the child and family have to live with. The burden of care will continue throughout the life of the parents, who are quite bright university graduates.

The next child was born by caesar.

Lesson: being anti-caesar is no comfort when things go wrong.

This is a good example of why caesars are done and had I or any of the treating specialists pushed hard maybe a different decision would have been made by the relative, instead of one she now lives with everyday, for the rest of her life.

I'll get to the issue of government subsidy for acupuncture in the next post.

Last edited by millededge (2017-03-12 04:49:03)

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#31 2017-03-12 02:38:21

millededge
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Re: A "How to" on ways governments can kill commercial activity

The Australian government provides funding via the Therapeutic Goods Administration presently on the basis of scientific evidence.

That evidence, as applied to acupuncture, has a contemporary "gold standard", which is the multi-centre double-blind placebo-controlled randomised trial (DBPCRT)

The evidence for acupuncture is not robust. The Cochrane database lists only a few studies in favour and for pain, one of which involved "idiopathic headache".

Idiopathic, I remember being informed many years ago, as a diagnosis, means "idiotic and pathetic", ie a non-diagnosis.

A German study in back pain fits the mold for the DBPRCT.

Findings are linked here:
https://www.painscience.com/articles/ac … r-pain.php

What is interesting in the German study is that sham acupuncture was as effective as acupuncture, but BOTH were more effective than usual treatment.

This is called the Hawthorne Effect in academic medicine.

Also, I found this interesting from the same site:

One of the most acupuncture-damning experiments in recent history was the one that showed that acupuncture can "work" even when the needles are stuck into a rubber hand.
...
Subjects had their brains scanned while acupuncture was performed on a "phantom limb," by tricking the brain into perceiving a rubber hand as if it was real.

In this scenario, the needling cannot possibly be the cause of a biological response, because rubber hands do not have cells or nerves. And even if people have qi flowing in meridians, clearly rubber hands do not. And so this experiment neatly eliminates two of the major common explanations for how acupuncture might work (as measured by brain scans, anyway).

The results identified the same kind of perceptions and brain activity that previous studies have found with needling of genuine limbs. This (strongly) suggests that the explanation for any perceived benefit of acupuncture is psychological: the brain can obviously respond to the idea of needling. Real needling not required to elicit the same response that has been touted as a specific therapeutic effect. If true, belief is the active ingredient in acupuncture, not the manipulation of qi.

I am not an obstetrician or midwife btw, the ungodly hours and extreme risk (carried for 20+ years postpartum) are for truly dedicated people.

Acupuncture in obstetrics fascinated me back in the day. As a student I presented the case for acupuncture in labour. This is an acute pain situation, quite different to that of chronic pain, where if acupuncture has a role, it is surely there.

Acupuncture, to my understanding, is based on a cosmological pre-scientific worldview, rather similar to Galenic-Western and as I have learned from the link below, also Islamic theory. Energy, if you like, was viewed more in terms of the vasculature and circulation in ancient times. It involved bloodletting with a lancet, much as it did in the West and near East. It fell out of favour for some time and was banned in China in 1929. It was reformulated by a Chinese paediatrician in the 1930s, to involve points located away from blood vessels, using needles rather than lancets.

A fascinating read is here, whichever side of the fence you sit:
http://sciencebasedmedicine.org/astrology-with-needles/

And the recollections of a Scottish missionary doctor in 19th century China here:
https://sciencebasedmedicine.org/the-re … -so-great/

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#32 2017-03-12 12:23:27

Stoic Phoenix
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Re: A "How to" on ways governments can kill commercial activity

millededge wrote:

The Australian government provides funding via the Therapeutic Goods Administration presently on the basis of scientific evidence.

That evidence, as applied to acupuncture, has a contemporary "gold standard", which is the multi-centre double-blind placebo-controlled randomised trial (DBPCRT)

Randomized double blind placebo control (RDBPC) studies are considered the "gold standard" of epidemiologic studies.
You of all people should know many procedures you can not double blind.
You can't accurately or effectively double blind trial a surgical procedure any more than you can double blind an acupuncture procedure. IE - the cards are stacked and you being from a medical background should know that. (more on this further down)

I also again put it to you to name even just one example of medicare cover for acupuncture via a licensed acupuncturist that shouldnt be funded due to lack of evidence of efficacy....just one. (This is a trick question my friend as I know it is impossible for you to find one)

Never said I was anti C section, I just know it is often used when not required. There are also many cases where this procedure is a no brainer.

"Your take", and "your understanding", - not much you have put forward about Eastern medicine is factual...lancets were and still are used for very few things but to think only lancets were used pre 1929 is just not factual and I have no idea how you came to that conclusion. Also saying points were moved away from blood vessels????? got a link to this claim from what I would deem a  reputable source?
As for getting information from 7 year old links with "astrology by needles"...no bias there at all, science...western science as I have said repeatedly now, hasnt fully grasped the full extent of the benefits of anything that they dont understand and worse dont want or try to understand (due to fear of viable competition?) and cant measure - it would be great to have a little machine that went "bing" to verify what it does...but because western science hasn't/won't/can't invent one to do this doesn't mean acupuncture doesn't work.

If you are genuinely interested in the latest comprehensive review of acupuncture clinical trials completed only this year send me a PM and I will forward you the 81 page document.
(McDonald J, Janz S. The Acupuncture Evidence Project: A Comparative Literature Review (Revised edition). Brisbane: Australian Acupuncture and Chinese Medicine Association Ltd; 2017.)
NB - Dr J McDonalds original background is in Western Medicine

Some excerpts -
"Bottom Line
Our study found evidence for the effectiveness of acupuncture for 117 conditions, with stronger evidence for acupuncture's effectiveness for some conditions than others. Acupuncture is considered safe in the hands of a well-trained practitioner and has been found to be cost effective for some conditions. The quality and quantity of research into acupuncture's effectiveness is increasing."

"Placebo-controlled clinical trials consistently underestimate the true effect size of acupuncture (which means that acupuncture is more effective than the type of trials used in this review show), yet they have still demonstrated National Health and Medical Research Council (NHMRC) Level I evidence for the effectiveness of acupuncture for 117 conditions."

"It is no longer possible to say that the effectiveness of acupuncture is because of the placebo effect, or that it is useful only for musculoskeletal pain."

You can not win this debate with me sorry Milled because you are grasping at straws and admit your responses are based on opinion which has no grounding in reality whereas I have a degree in the subject matter along with evidence and actual research backing any assertion I make.

I have no doubt you are knowledgeable in your field but you are clearly far from qualified to make any assertions one way or the other on Eastern Medicine and as such I don't understand your steadfast stance against it.

Now...if you aren't finished with this topic which is taking away from the aim of this thread for the third and last time I say start a new thread as I won't be discussing this subject further on this one.


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#33 2017-03-13 04:29:40

millededge
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Re: A "How to" on ways governments can kill commercial activity

Actually, double blind placebo controlled trials are 100% about *intervention* not the incidence and prevalence of a variable.

I'm not saying that to discredit acupuncture, it just is.

I'm not even anti-acupuncture. I just see the evidence base as not that great and that afaik is the reality sculpted by well designed studies, meagre as they are in number.

To be clearer, and maybe a shade Machiavellian, but if it has an effect, even if it isn't due to a diagnosis based on examination of the tongue and prescientific conceptions of the pulse (ie Traditional Chinese Medicine), even if there is no anatomical evidence of chinglo channels (so called meridia) or Qi, I'm ok with that, if it works.

The problems I have with it are the evidence base is weak and its theoretical underpinnings are not verifiable. That is not exactly "anti-acupuncture". I have no axe to grind against it, truthfully and no great reason to bear its standard either.

I still think gating is logical in terms of contemporary understanding of pain. I think also if there are studies of the effect of acupuncture in non-nociceptive pain issues, ie higher order neuronal network organisation of the pain experience such as hyperalgesia and allodynia, I would like to know, as these are common problems.

You've alluded to this somewhat (maybe) in reference to allergic rhinitis. I know this well and think the idea of being cured from allergy to cat dander by acupuncture interesting (if unlikely), from the point of view of higher order neuronal desensitisation, but from the idea of the theory behind acupuncture, pure quackery.

That said, I think if acupuncture worked as good as or better than densensitisation (a bone fide homeopathy, if not actually called that), then the only issue I would have with it is cost, which might be ok as densensitisation is expensive. Nasal corticosteroids and antihistamines are relatively inexpensive so I expect the typical person seeking acupuncture is not the typical person with allergic rhinitis.

Last edited by millededge (2017-03-13 06:06:41)

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#34 2017-03-13 04:36:21

millededge
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Re: A "How to" on ways governments can kill commercial activity

You just know C-section is done when it is not required. Actual quote

I just know it is often used when not required.

Well, maybe Dr Stoic should don his phoenix outift, race to the local operating theatre and tell them what's what tongue

Last edited by millededge (2017-03-13 05:20:09)

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#35 2017-03-13 04:54:24

millededge
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Re: A "How to" on ways governments can kill commercial activity

This is a randomised trial, single blind so not quite so impactful as the double blind trial, but still interesting, from the Annals of Internal Medicine.

WHEELING, W.Va., May 11 — Acupuncture was more effective than conventional treatment for relieving lower back pain in a randomized trial, but performed no better than poking patients gently with toothpicks.

http://scienceblogs.com/insolence/2009/ … terpreted/

The conclusion - acupuncture is no better than a toothpick.

Now that may raise hackles. But bear in mind, maybe even Chairman Mao wasn't in favour of Traditional Chinese Medicine (TCM), but promoted it for political reasons.

I mean, rhino horn and bear's gallbag juice is reminiscent of eye of newt and bone of shark in the mediaeval European apothecary. But still, these things exist in "5000 years old" TCM.

It is said that Chairman Mao himself preferred Western medicine. His personal physician quotes him as saying "Even though I believe we should promote Chinese medicine, I personally do not believe in it. I do not take Chinese medicine.

http://journals.lww.com/anesthesia-anal … e=Fulltext

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#36 2017-03-13 05:59:42

millededge
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Re: A "How to" on ways governments can kill commercial activity

"Your take", and "your understanding", - not much you have put forward about Eastern medicine is factual...lancets were and still are used for very few things but to think only lancets were used pre 1929 is just not factual

There is a clear association with the lancet and needle. The shift was away from lancets to needles, after the ban. Needles existed before 1929 and so did lancets in a significant way. They were used and probably they were used a lot like they were in the West, often and very much the progenitor of what you accept as acupuncture. If you are unfamiliar with the association to the lancet, that is unfortunate and I would expect better if it was my degree.

One of the first major authors on acupuncture is the Yellow Emperor himself, Huang Di in his Neijing. This shares a canonical reverence with other texts of the same vintage in a manner and potency I feel is understood by our present mass media overlords.

The conceptualisation of acupuncture points in terms of the five elements of chinese astrology - fire, water, wood, metal and earth, not to mention their relationship with the cosmos, is the spiritual heart of acupuncture, not biology. There is no anatomical evidence for the existence of acupuncture points.

Last edited by millededge (2017-03-13 06:40:37)

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#37 2017-03-13 07:25:53

millededge
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Re: A "How to" on ways governments can kill commercial activity

Chapter 54 Explanations on the Needles 54-281-6 Huang Di asked: "I should like to hear an explanation of the 'nine needles' and the Way of depletion and repletion." Qi Bo responded: "As for 'when piercing a depletion, then replenish it,' [that is, pierce until] there is heat below the needle. {When the qi is replete, then heat is present.} As for 'when there is fullness, then discharge it,' [that is, pierce until] there is cold below the needle. {When the qi is depleted, then cold is present.} As for 'what is densely compacted and old, eliminate it,' [that is,] let the bad blood.   The following phrases ending with the character 者 may be quotations from a larger text named 九鍼 Jiu zhen,"The Nine Needles."This text appears to have also been the basis of Ling shu 1, titled 九鍼十二原. From 刺虛則實之者 to 九針之名各不同形 者these phrases are to be found in Ling shu 1 without commentary. A large part of Su wen 54 is a commentary to this text (see also note 15 below).   Zhang Jiebin: "  'There is heat below the needle' is: the cold turns into heat. When [the re-gion below the needle] is hot, then the proper qi has arrived and the depletion has been replenished. Hence, this is a supplementation."   Zhang Jiebin: "  'There is cold below the needle' is: the heat turns into cold. When [the re-gion below the needle] is cold, then the evil qi has arrived and the repletion has been depleted. Hence, this is a drainage."   Wang Bing: "菀 is 積, 'accumulation.' 陳 is 久, 'old.' 除 is 去, 'to remove.'That is to say, when blood has accumulated in the network vessels for a long time, one pierces [these vessels] with a needle and removes it." 971/56: "This makes it very clear that the phrase 去宛陳 (in Su wen 14) is a therapy whereby blood is let by piercing the network vessels."

http://muse.jhu.edu/chapter/962045

Physical appearance and qi are opposed to each other; hence, a disease emerges. 氣 is to say: the qi in the vessels; 形 is to say: the physical appearance of the body."   Wang Bing: "The vessels constitute the palace of the blood. Hence, depletion and repletion appear in both [the vessels and the blood] alike. When [the states of vessels and of the blood] oppose each other, then this constitutes a disease."

http://muse.jhu.edu/chapter/962044

Chapter 50 Discourse on the Essentials of Piercing 50-273-2 Huang Di asked: "I should like to hear about the essentials of piercing." Qi Bo responded: "The diseases include [those] at the surface and [others] in the depth; piercing includes shallow [piercing] and deep [piercing]. Always go to the respective structures; never go too far on this way. If one goes to far on this [way], then [this results in] internal harm; if one does not reach it, then [this] generates external congestion. Once there is a congestion, then evil will follow there. When [the proper measure of] shallow or deep [piercing] is not achieved, contrary [to one's intentions] this will cause severe injury and excites the five depots inter-nally. This will generate a serious disease subsequently.

http://muse.jhu.edu/chapter/962036

These are just a few referenced quotes to assist. Bloodletting is tied to acupuncture.

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