Talk:Scientific theories regarding acupuncture

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This is an entry for the scientific description of the theories and models underlying the mechanisms of action in acupuncture therapy. It provides objective, neutral and scientific information on the research studies of acupuncture. Please go to other wikipedia entry of acupuncture for discussion of any controversies or politiccally biased views of eastern vs. western medicine. Coladie 18:13, 1 March 2007 (UTC)

Contents

[edit] {{totallydisputed}}

This POV fork of the acupuncture article is cherry-picking amongst the published research article to promote the POV that there is scientific evidence for acupuncture.

Contrary to some voices heard in the AfD the number of references for an article is unrelated to following WP:ATT. Citing single research article instead of review articles and textbooks is actively discouraged, see WP:SCIENCE and WP:RS.

Pjacobi 21:33, 15 April 2007 (UTC)

I find no support in WP:RS or WP:SCIENCE for the contention that articles published in peer reviewed journals aren't good sources for scientific articles. Indeed, the revision as of 23:20, 15 April 2007 of Wikipedia:Reliable sources describes the following as an "[aspect] of reliability": "The material has been thoroughly vetted by the scholarly community. This means published in peer-reviewed sources, and reviewed and judged acceptable scholarship by the academic journals." Clearly, then, articles in peer reviewed journals are considered to be reliable sources per WP:RS. That is not to say, of course, that the findings of every published study are true, or should have their truth asserted in Wikipedia articles. However, because Wikipedia is built upon information contained in reliable sources, properly citing a study published in a peer reviewed journal in support of a claim creates a rebuttable presumption that the claim is true, and is acceptable for inclusion in an article. The burden of evidence is then shifted to the editors who wish to have a claim removed -- such editors would need to produce reliable sources of their own, which provide sufficient evidence against the claim to outweigh the source(s) cited in support.
So, rather than placing a {{totallydisputed}} tag on this article, on the basis of a completely unreferenced assertion that the information it contains is not accurate, it might be more advisable to produce some reliable sources (if any) which claim that there is a lack of scientific evidence for the efficacy of acupuncture. Such material (if any) could then be incorporated into the article, in the interest of neutrality. John254 02:14, 16 April 2007 (UTC)
I'm not sure what Pjacobi means by the phrase "scientific evidence for acupuncture". With regard to evidence that acupuncture is effective, Acupuncture#Scientific_research_into_efficacy may be a good read. As for theories about acupuncture's mechanism(s), it's fine with me if editors want to use this article to summarize hypotheses and research from the literature. Probably all kinds of WP:WEIGHT and WP:OR problems will abound, but have fun. --Jim Butler(talk) 04:26, 16 April 2007 (UTC)
John254 and Jim Butler fortunately agree that the reports presented should be balanced by reports casting doubt upon their findings. But in order to do this within the bounds of an article in a general encyclopedia, some selectivity is necessary. A good way of doing this is to rely primarily upon review articles, including only landmark primary research. One way of selecting primary articles for the purpose is the repute of the journals. WP is not a bibliography. PubMed covers this subject for those who want to go further. . DGG 01:55, 17 April 2007 (UTC)

Ok I've removed some sections that are not referenced and I consider doubtful. I'm probably going to be criticized for the amount of claims I have removed, but I have only removed unreferenced claims. The reason I have taken such an aggressive stance in removing claims is that this article, titled SCIENTIFIC THEORIES regarding acupuncture is largely laking in scientific references and contains much pseudoscience. It's not like people would not have realised things needs sources or required time to source information either. There has been a totally disputed tag on this article since April (the bot marked it December but look at past revisions) which should suggest references are necessary. So if anyone wants to reinclude things please include a reference. Also seeings as this article was considered for deletion and requires a cleanup, I hardly think deleting unreferenced will hurt it and there is always the original acupuncture article that explains all the non-scientific ideas. The following is why I doubt and have removed specific unreferenced claims in the article:

Firstly I took out the explanation of a cramp as a feedback loop gone awry, where the muscle keeps tightening and tightening. This stands in apparent contrast to the cramp article: "There are five basic causes of cramping: hyperflexion; inadequate oxygenation; exposure to large changes in temperature; dehydration; or low blood salt.". Hyperflexion appears to be similar to what is stated in the article but I understand the problem as an antagonist muscle failing to contract as an agonist muscle contracting or contracting past the safe range in one movement, not continuing steps of greater contraction, each caused by the last as explained in the article. In any case, even if I'm wrong, the article needsa reference for reinclusion.

"At the spinal cord level, pain transmission via the pain fibers can be blocked by surround inhibition of the neighboring nerve fibers that merge at the substantia gelatinosa in the spinal cord" Surround inhibition has been observed in vision and perhaps hearing and some forms of touch (proprociception?) but I am unaware of any evidence for surround inhibition in pain. You can't apply information from one area to another without a reference. Please note that the sense of touch is distinct from pain and follows seperate spinal pathways.

I have also noticed a lot of words like "proven" and "confirmed" being used. Scientists do not use these words in their papers (see philosophy of science and they shouldn't be used here. Also I've seen topics related to areas where things have supposedly been confirmed eg. "[analgesia]] associated with acupuncture administration are also confirmed to be mediated through the thalamus" been hotly disputed. It is important to realise that when studying the brain and perhpas science in general, conclusions are made through inferences only, thus nothing is ever proven and the results are only as good as the scientific procedures used.

"where emotional pain/suffering is processed" the thalamus basically gates, relays information. A lot of things happen there. The limbic system as a whole may be said to process emotion but to say the thalamus processes suffering alone is misleading and an oversimplification. This is also unreferenced so it was removed. "where cognitive feedback signal to the thalamus distinguishing whether the pain is noxious (painful) or innocuous (non-harmful)" pain is noxious by definition. Again, I think this is a misrepresentation of the role of the thalamus.

"modern-day powerful non-invasive" phrases like this add little to the content of the article and serve only to make the claims seem more reliable.

"Most cells in the body are electrically charged." Doubtful, unreferenced. I haven't heard of anything that is not a neuron being electrically charged. Many cells may carry a charge at some point but that is not their resting state. "These epithelial layers (that line the body surface or organs) maintain a 30-100 mV voltage difference across themselves (i.e., across cell layers, not across individual cell's membrane" The last sentence of the 1977 supporting article abstract: We present here a theory to support this hypothesis. They are presenting a theory only, not evidence. In the article it was presented like fact. Also, what happened since 1977? Did no one bother to test the theory or did the evidence show the theory was wrong? Since the reference in the entire section provides no evidence and almost every other statement is doubtful (except about neurons which is largely irrelevant) and unreferenced I have cut the section.

"often ignored by most casual observers" - unreferenced and inflammatory.

"This shows how cell growth and repair can be directed and re-directed by electric fields, following along the path of electric conductance and strong electric field strengths. The importance of electric field in cellular function leads to the identification of these crucial morphogenetic singular points in the body, as well as the understanding of why reversing the electrical polarity of the electrode in electroacupuncture can produce opposite effect in the body." - This unreferenced conclusion is the only tie back to accupuncture and does not follow from the claims at all. There is no mention of crucial morphogenetic singular points in the references. The article also fails to point out that the references concern in vitro tests or embryology and such effects have not been demonstrated in adulthood. They probably also occur in adult animals that can regenerate limbs but of course humans don't. There is also no evidence given for the claim that electroacupuncture actually produces these opposite effects.

"In 1950, Nakatani discovered that there is a series of points in which electroconductivity was higher than the surrounding area when he measured the skin resistance of edematous patient with nephritis (a kidney disorder).[1]" Fact tag- needs a source that is not associated with the therapy.

"He was the first person to measure the electrical activity of acupuncture points, and first to use electrical stimulation to stimulate acupuncture points." - I doubt there is any way to verify this at all. JamesStewart7 (talk) 10:43, 23 December 2007 (UTC)

[edit] Meridians

The section on meridians needs a major clean up as it makes no distinction between anatomical meridians and acupuncture meridians. As it stands now, it merits deletion. BatteryIncluded 18:40, 15 September 2007 (UTC)

What is an "anatomical meridian"? I've never heard the term used except in TCM, as a translation for (pinyin) jing-luo. Jim Butler(talk) 06:59, 11 November 2007 (UTC)

[edit] Removed non existantant or improperly referenced article

The quote "Similar results were also obtained in experiments with animals showing that the analgesic effect is not due to subjective psychological placebo effect, but real physiological phenomenon". I have two problems with this interpretation and the supporting article. Firstly I doubt the very existance of the supporting article, "Mechanism of individual variation in effectiveness of acupuncture analgesia based on animal experiment." I can't actually find this paper. I searched google scholar, medline, web of science, embase and various other directories for the title and I can not find it. Furthermore, the reference cites European Journal of Pain, volume 11, year 1990, which is highly suspicious because I looked up the European Journal of Pain in science direct (http://www.sciencedirect.com/science/journal/10903801) and volume 1 started in 1997. Secondly, I highly doubt that interpretation was present in the original study, if it exists, making that claim original research. For these reasons, I am removing the citation and interpretation.JamesStewart7 (talk) 08:58, 23 December 2007 (UTC)

You're a better man than I if you are willing to wade through all this stuff. I had various objections to most of this material when the creator of the article attempted to add it to acupuncture. Then that editor just created this article as a sort of POV-fork. IMO, it's all pretty dubious-looking. Thanks for your efforts toward improving it, if such is indeed possible. :-) Jim Butler(talk) 17:19, 23 December 2007 (UTC)

[edit] Sections I would like to see removed as part of article cleanup - place objections/thoughts here

The only way this article will be cleaned up is if unreferenced doubtful points are removed. I've already made some changes and as I wish to make much more substantial changes I thought I should give people notice of my plans so that they may voice objections. I know some of it is accurate from various biology and psychology courses I have taken that some of this information particularly the "Neurohormonal theory" is at least, plausible, even if these sections do contain some factual errors. I also know from these same courses much of this article is innnaccurate. This impression seems to be shared by many and many seem to be unwilling to touch this article because so much of it is misleading that they have deemed it not worth the effort. I can see their point. As little of the article is properly referenced and supported, you really need to have done some sort of biology/pain perception course to be able to seperate baby from bathwater. This makes a satisfactory peer review very difficult. So my aim is to remove unreferenced dubious claims and add references for plausible claims and get this article down to a point where others (particularly those who contribute to the main accupuncture article) are willing to edit it. Any help here, particularly from those with biology/medical knowledge would be much appreciated.

Here is my analysis for each section:

  1. Nerve-reflex theory - Warrants keeping if references can be found. Much of the information in this section is bs and it is all unrefferenced but the idea that sticking needles in someone creates stress (the HPA axis relates very closely to the stress response) is plausible at least. Of coruse the section should probably point out that there are a million ways to invoke the stress response and the section should speak in more plain english in general (all the jargon is not necessary and only confuses the reader). The section should prorbably also note that this theory is probably more of a scientific hypothesis that is yet to receive sufficient empirical support (if I'm wrong, prove it with a reference). The thoery should probably also get a better name - HPA axis involvement?
  2. Gate control theory - Keep but with modifications. Quick searches reveal little on gate control theory that is not 30 years old. There are, howeve, pain control mechanisms on a spinal level. I could probably find a neurobiology book to support this. Whether accupuncture actually activates these mechanisms, however, is another question altogether and the link is highly speculative.
  3. Neurohormonal theory - Keep. This theory features on the main accupuncture article and is probably the most plausible. However, it misses key points like placebos producting similar effects. I will amend this shortly.
  4. Electric conductance - Remove. The link back to accupuncture has already been cut as it was spurious and the whole section is now irrelveant.
  5. Role of electric field in directing growth and morphogenesis. Remove. Same deal as above.
  6. Morphogenetic singularity theory - Remove. I do not believe this idea meets the criteria for a scientific hypothesis, let alone theory. I will reverse this decision if someone can point out the testable predictions this theory makes and the independent research to support them (Reference is in Am J Chin Medicine). Also this section is largely incoherent and after reading it several times I can't work out what the theory actually states beyond electricity is unstable
  7. Electrical singular point and acupuncture points - Remove. The section has nothing to do with accupuncture. It only states that you can detect the magnetic field put out by neural outside the skull. I fail to see how this is a theory of accupuncture.
  8. Morphogenetic singularity theory and the meridian system - Undecided. Again the citation is Am J Chin Medicine and again it fails to clearly state its predictions. I will have to read the reference though before I can decide
  9. Mechanisms of action and subsections - Remove and place any reliable references in other sections. This section goes back on to talking about embryology. The problems are the same as in the morphogenetic singularity theory. The embryology may be accurate but even if it is, none of the links back to accupuncture are referenced and the relevance to accupuncture is never really established. The "Long-term biological effects of acupuncture" section may have some retainable references but these would be better placed with nerve-reflex theory or neurohormonal theory.
  10. Diagnostic vs. treatment models and subsections - Remove and place anything reliable in main accupuncture article. Nothing in this section remotely resembles a scientific theory.
  11. Recent advances - Remove. Section was originally written like it is just a matter of time till we find out accupuncture is effective and how it works. As it stands it is clearly not a scientific theory of accupuncture.

I realise if all my recommendations are followed we would be removing half the article but I see no problem with this. Wikipedia policy clearly states that unreferenced material can be removed. I know that I am suggesting the removal of a lot of referenced material, but what is referenced is not relevant to accupuncture. It does not make sense to leave a whole heap of irrelvenat embryology in an accupuncture article if the link to accupuncture is not properly referenced. The totally disputed tag has been long standing so something needs to be done. If anyone disagrees with my suggesting that a section should be removed I would like them to also show me a reliable source that details evidence for the theory AND its relevance to accupuncture. Sources from mainstream medical journals will of course be given higher consideration than, for example, Am J Chin Medicine. If enough verifiable information can be found on any section, it will then warrant inclusion.

In light of the scientific status of many of these "theories", I would also like to see the article title changed to "Scientific hypotheses regarding accupuncture". Many of these hypotheses are not complete or internally consistent enough to be considered scientific theories. Also any hypothesis must be falsifiable to be considered for inclusion on this page. Note that the criteria for inclusion on this page is not scientific truth, but simply a complete hypothesis that has had some research conducted on it and been published. I also see no reason that falsified theories cannot be included, if some note is made that they have been falsified, provided reliable sources are included. Given the extent of these proposed changes, I would like input from as many people as possible before I make these changes. I will be seeking consensus before making any changes to avoid the possibility of anyone reverting it after. I am also placing an note on the main accupuncture change to attract attention.JamesStewart7 (talk) 03:12, 24 December 2007 (UTC)

If no one comments on any of this within two weeks from the date I posted it, I'm just going to go ahead and make the changes. —Preceding unsigned comment added by JamesStewart7 (talk • contribs) 08:21, 29 December 2007 (UTC)

I looked at the papers for the "Morphogenetic singularity theory and the meridian system" about which I was previously undecided. The supporting papers seem to be presenting hypotheses only and both are by Shang who fails to provide any evidence that directly supports his theory. This article, "http://annals.highwire.org/cgi/content/abstract/136/5/374" touches on the hypothesis stating "Classic theory recognizes about 365 points, said to be located on 14 main channels (or meridians) connecting the body in a weblike interconnecting matrix. These channels are not detectable by ordinary scientific methods" so I can only conclude this is not the scientific theory it claims to be. After all how can you prove that something which is indetectable does not exist. JamesStewart7 (talk) 08:59, 5 January 2008 (UTC)