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Korean invented acupuncture

Chinese steal everything. Acupuncture was actually invented by Korean during Gojoseon era. Ancient Chinese doctors traveled to Korea and learn from Korean master. — Preceding unsigned comment added by 99.225.190.42 (talk) 06:20, 27 June 2013 (UTC)

If you actually had a reliable source to back that up, that would be interesting -A1candidate (talk) 20:54, 5 July 2013 (UTC)

Acupuncture usage in the US military and other military forces

Very sorry, but I just can't see the merit of those sections. Maybe it's because I'm European. Anyways, this is supposed to be an encyclopaedic article informing people on the topic of acupuncture; whether the US army or the Iranian mullahs or the German postal service like acupuncture is really irrelevant. A1candidate, if you think this army stuff is encyclopedic material, please create a proper article about it. Otherwise, I'd just delete it. Cheers, --Mallexikon (talk) 02:58, 27 May 2013 (UTC)

Im not sure why you claim that your European heritage should influence your judgement on my work, I thought the usage of acupuncture in armed military forces would probably be interesting for 99% of readers out there. What do other editors here think? -A1candidate (talk) 06:21, 27 May 2013 (UTC)

I'm ambivalent. "Battlefield Acupuncture" is certainly notable in the U.S., though it does not add to understanding Acupuncture on its own terms. However, the question of whether acupuncture is "mainstream" or not is often raised. For this reason, I would say it should be included.Herbxue (talk) 14:40, 28 May 2013 (UTC)

Reverted edits by Mallexikon

I've reverted edits by Mallexikon because there was no consensus for its removal. See discussion above. -A1candidate (talk) 06:33, 17 June 2013 (UTC)

I have to agree with Mallexikon. It's not relevant to the topic of this particular article. Dominus Vobisdu (talk) 08:12, 17 June 2013 (UTC)

Proposed New Mechanism of Action Section

I am not a very experienced editor, but have a background in biology and neuroscience. A number of editors have suggested modeling the Mechanism section on the antidepressants page. Here is my understanding of current literature:

The mechanism of acupuncture's effect is unknown. A number of theories have been suggested to explain it:

Placebo

There is some evidence that acupuncture's effect includes a placebo component but this effect incompletely explains acupuncture's effects on pain and eg nausea/vomiting.

Stimulation of Neurotransmitter Release

Acupuncture has been shown to stimulate release of a number of endogenous compounds, including opioids ie endorphins and enkephalins, monoamines, adenosine, ATP and the neurotransmitters involved in Diffuse Noxious Inhibitory Control. None has been definitely shown to be responsible for all of acupuncture's effects in humans.

Gate Control Theory of Pain

This is based on Ronald Melzack and Patrick David Wall's work, that acupuncture stimulates competing nerves which reduce or "gate" pain sensation in the spinal cord. It is not uniformly accepted and does not explain non-pain effects.

Interstitial Transmission Theories

These theories propose that the acupuncture signal is transmitted along non-neural, non-vascular meridian-like networks. These include Becker's bioelectric theory, the Primo Vessel theory and Langevin's Fascial theory. Although Langevin's work is supported by the most evidence, it has yet to be confirmed as the mechanism of acupuncture's effect on pain.

Autonomic Modulation

Originally described by Looney, this theory proposes that acupuncture results in release of various brain chemicals that modulate the autonomic nervous system, to influence a wide variety of organs and systems.

Viscero-Somatic and Somato-Visceral Reflexes Theory

This theory is based upon Felix Mann's work which proposes that acupuncture activates spinal reflexes, thus explaining its visceral effects. Mann has recently distanced himself from supporting acupuncture points and meridians.

Neural Deactivation

There has been recent work suggesting that acupuncture is not directly stimulatory, but, instead, blocks either peripheral nerves directly or blocks the release of brain stress chemicals.

I would appreciate the input of other editors, and, if they deem it appropriate, edit this and then paste into the page!--Tzores (talk) 01:33, 12 June 2013 (UTC)

Wow. Very bold, and very productive. I hesitated incorporating very much of it into the article, though, because when glancing over it it seemed to me there's a lot of primary sources here...? --Mallexikon (talk) 05:59, 13 June 2013 (UTC)

Thanks Mallexicon for great effort on the new Mechanisms of action section. Why have you omitted 4 of the sub-sections above? The Placebo effect has very wide support and incorporates tertiary evidence ie meta-analyses. Dr Langevin's work on fascia, although citing a primary source, is very widely supported, has been cited many hundreds of times and is included in a number of secondary sources elsewhere in the article. Dr Pomeranz's work on monoamimes also has much support as does Diffuse Noxious Inhibitory controls. Some of the neural deactivation work is also supported by secondary sources. Either way, given that this whole section talks about research and hypotheses, there is a good case for including primary sources here. If you go to Misplaced Pages's Antidepressants page you will see that every reference in the Mechanism of action section is supported only by primary reference sources. Does the acupuncture postulated mechanisms of action section require a higher level of evidence than that of antidepressants for inclusion? There is a good case for the whole section - as above - with all 7 sub-headings to be part of the article. I'd be interested to hear from Herbxue and Puhlaa on this.--Tzores (talk) 04:06, 14 June 2013 (UTC)

Well, you have a point about the primary sources... Why don't you insert the remaining sections into the article and see what the other editors think? Would be interesting to see what the sceptics have to say... --Mallexikon (talk) 13:08, 15 June 2013 (UTC)

Have made this a separate section to the Questionable validity of the acupuncture model section. I will work on finding more secondary sources and will then insert remaining into the Possible Mechanism of Action section.--Tzores (talk) 01:19, 21 June 2013 (UTC)

As suggested by Mallexicon, I have now incorporated this into the article to reflect current scientific thinking. Most of the sources are secondary/tertiary, but have included some primary sources too as the section is about theory. This is in line with the Antidepressants article's Mechanism section (I think originally suggested as a model for this by Herbxue??) which only has primary sources. For the sceptics (including me, although I have maintained NPOV), top of the list is Placebo which wasn't much in the article before, but has the most scientific community support! I'd appreciate some assistance please - the ref by Vickers has been cited elsewhere in the article and needs to be merged; also, there is a Diffuse Noxious Inhibitory Control Misplaced Pages article, but I can't seem to link to it - thanks--Tzores (talk) 23:42, 25 June 2013 (UTC)

Recent edit

I've restored related, non-medical content since there was no consensus for its removal as per Talk:Acupuncture#Acupuncture_usage_in_the_US_military_and_other_military_forces -A1candidate (talk) 13:26, 15 June 2013 (UTC)

Well as I wrote in my edit summary, there was consensus about this - in the Talk:Acupuncture#Suggestion: Current research and recommendations section. Cheers, --Mallexikon (talk) 07:40, 17 June 2013 (UTC)

I believe you are clearly misinterpreting the entire discussion. It was about medical claims/recommendations. As for its usage, I think Herbxue seems to agree that it should be included, see Talk:Acupuncture#Acupuncture_usage_in_the_US_military_and_other_military_forces. Lets hope this doesn't drag into an edit war -A1candidate (talk) 07:44, 17 June 2013 (UTC)

"Clearly misinterpreting"... hmmm. The part of the discussion I'm referring to says this:

"@Herbxue: I don't mind stating what agencies "tasked with making health care recommendations" have to say about acupuncture... The armed forces of the US and Germany hardly fall under that category, though. --Mallexikon (talk) 08:46, 29 May 2013 (UTC)

Ok thanks, I thought you meant all the proposed sources were irrelevant.Herbxue (talk) 14:13, 29 May 2013 (UTC)

I would agree with Mallexikon here, the recommendations of the WHO are clearly relevant as a body of medical experts while the opinions of the armed forces of some few (select) countries are hardly relevant for the article...()... Greetings --hroest 11:49, 29 May 2013 (UTC)"

As would I. I can't see any relevance to this article. Dominus Vobisdu (talk) 08:38, 17 June 2013 (UTC)

I'm sorry if I misinterpreted this as consensus to my position on Herbxue's side if there actually is none... I think hroest was pretty non-ambiguous, though. --Mallexikon (talk) 08:21, 17 June 2013 (UTC)

RfC: Should acupuncture in the military be included?

Acupuncture in the military

Usage in the United States military According to The Washington Times, the U.S. Military's first encounter with acupuncture occurred during the Vietnam War, when an Army surgeon wrote in the 1967 edition of Military Medicine magazine about local physicians who were allowed to practice at a U.S. Army surgical hospital and administered acupuncture to Vietnamese patients. In 1995, Dr. Richard Niemtzow, a retired U.S. Air Force colonel who had earlier practiced medicine as a radiation oncologist, began offering acupuncture to military personnel stationed at the McGuire Air Force Base in New Jersey. A few years later, Niemtzow became the first full-time military medical acupuncturist for the U.S. Navy. In 2009, the U.S. Air Force set up the Air Force Acupuncture Center at the Joint Base Andrews in Maryland to practice and teach "battlefield acupuncture" to physicians and other medical personal. That year, the Naval Medical Center San Diego reported that its pain management clinic had provided acupuncture to more than 2,600 beneficiaries. As of 2012, over a hundred medical professionals in the U.S. Air Force have been trained to use acupuncture techniques. While the pratice of acupuncture was mostly limited to the U.S. Air Force, it soon spread to other departments of the U.S. Military including the U.S. Navy and the U.S. Army. In late 2012, the Office of the Secretary of Defense officially approved a visit by U.S. military physicians to the Beijing University of Chinese Medicine in order to strengthen Sino-American military relations and to "exchange acupuncture information". Usage in other military forces Since 2010, acupuncture has been practised by the German Bundeswehr in several military hospitals. In the People's Republic of China, acupuncture has been used by the People's Liberation Army to aid in the treatment of battlefield injuries.

Would the section above, regarding acupuncture in the military, be a desirable addition? -A1candidate (talk) 08:39, 17 June 2013 (UTC)

Threaded discussion

• Oppose. What the armed forces or the postal services think about acupuncture is not relevant here. --Mallexikon (talk) 10:15, 17 June 2013 (UTC)
• Oppose: Irrelevant to the topic of this article and adds nothing to understanding the topic of this article. The fact that a scattering of military forces have tried out accupuncture is of trivial significance. Essentially OR based on Google trawling of non-MEDRS-compliant popular news articles. Dominus Vobisdu (talk) 17:40, 17 June 2013 (UTC)
• Oppose 1. Irrelevant. 2. synthesis of sources to advance a point. 3. Most of the sources are primary, IRWolfie- (talk) 00:25, 18 June 2013 (UTC)
• Oppose - I recommend a separate article on "Battlefield Acupuncture" (this is notable enough) which can be linked to from a brief mention of this somewhere in the acupuncture article. The main issue for me is it is too much about the U.S. military and not enough of a broad-based section on the prevalence of acupuncture use. I would support a section on prevalence to address the "mainstream or fringe" question. Herbxue (talk) 20:52, 21 June 2013 (UTC)
• Oppose as per the points above. Samwalton9 (talk) 14:18, 22 June 2013 (UTC)
• Oppose following Herbxue's reasons. Rex (talk) 20:46, 26 June 2013 (UTC)
• Comment: The article Usage of acupuncture in the military was created by A1candidate (talk · contribs) and I have nominated it for possible deletion: Misplaced Pages:Articles for deletion/Usage of acupuncture in the military.-- Brainy J ~✿~ (talk) 13:36, 28 June 2013 (UTC)
• Oppose. As per other arguments. Looks like someone trying to legitimize their favorite topic. NinjaRobotPirate (talk) 01:30, 9 July 2013 (UTC)

Medical procedure?

I wouldn't call its affiliated procedures (moxibustion, cupping etc.) medical, but acupuncture itself probably is... (it's also listed in WP's Medical procedure article). If no one objects I'd change the lead sentence accordingly. Cheers, --Mallexikon (talk) 06:09, 23 June 2013 (UTC)

I would object. While accupuncture is sometimes used by physicians, it is usually practiced by quacks, much like moxibustion and cupping. Calling the procedure medical would legitimize the practices of these quacks. Furthermore, the evidence for the effectiveness of accupuncture is limited and equivocal, and it still has not entered the medical mainstream. It is still more alternative medicine than medicine. Dominus Vobisdu (talk) 07:27, 23 June 2013 (UTC)

Push POV much Dominus? I don't care whether you call it a medical procedure or not, but cupping and moxa are typically practiced by professional acupuncturists, the Chinese term for acupuncture includes moxa (zhenjiu 针灸). I don't see a reason to differentiate, unless you are pointing out that MD's occasionally use acupuncture as a stand-alone therapy, separate from theory and associated techniques?Herbxue (talk) 19:41, 23 June 2013 (UTC)

Were you addressing me or Mallexikon? If me, you seem to have misread my comment. Yes, I do mean that "MD's occasionally use acupuncture as a stand-alone therapy, separate from theory and associated techniques". Nevertheless, it remains more alternative medicine that mainstream evidenced based medicine. Dominus Vobisdu (talk) 20:24, 23 June 2013 (UTC)

I was addressing Mallexikon. The article title "Acupuncture" could have very narrow or very broad meanings and I think different editors assume different things. Broad meaning would have acupuncture refer to the whole system of healing of which it is (usually) a part (which also could narrowly refer to "TCM" or broadly to Traditional East Asian Medicine) or narrowly to the insertion of needles into the body for therapeutic effect. I only mention this to explain my post above about "zhenjiu" including more than just needle insertion.Herbxue (talk) 21:00, 23 June 2013 (UTC)

So how about adding the word medical to procedures in the lede sentence? I kinda would, DV is against it... else opinions? --Mallexikon (talk) 02:13, 25 June 2013 (UTC)

I support using the term medical procedure. "Medicine" is not a term that exclusively applies to contemporary biomedicine, which itself is not exclusively evidence-based.Herbxue (talk) 03:32, 25 June 2013 (UTC)

Unqualified, "medicine" does indeed strongly imply modern medicine, and does exclude alternative "medicine" and traditional Chinese "medicine". We already have in the next sentence of the lede that the procedure is used in traditional Chinese "medicine", and shortly after that put its use in modern medicine in proper context. Adding "medical" to the first sentence of the lede is very misleading and would violate WP:GEVAL. Dominus Vobisdu (talk) 15:08, 25 June 2013 (UTC)

I think you go too far. "Medicine" is the diagnosis and treatment of disease. The idea that the word medicine is owned by conventional modern medicine is an opinion, not a fact. Herbxue (talk) 15:27, 25 June 2013 (UTC)

It is a very widespread opinion, and a very reasonable assumption. We use words according to common usage, and common usage is that medicne refers to modern medicine, and not alternative "medicine". See our article on Medicine. Quackery can call itself "medicine" to fool the gullible, but that does not make it medicine, as the article on Alternative medicine makes clear. The lede is fine as it is, and the proposed change would violate our policies. Dominus Vobisdu (talk) 15:56, 25 June 2013 (UTC)

If your point were stronger you wouldn't need ad hominem attacks. The definition of the word does not exclude practices outside of the mainstream. Even if it did, the argument presumes that no mainstream MD's use acupuncture, which is also not true.Herbxue (talk) 21:08, 25 June 2013 (UTC)

Again, you're confused. Read my post further up. And the fact that mainstream MD's occasionally use acupunture is, as I said, already mentioned in the lede in the appropriate context. You seem to misunderstand what an "ad hominem" is. I see none. Dominus Vobisdu (talk) 21:18, 25 June 2013 (UTC)

The question at hand - "Is acupuncture a medical procedure" - is not answered by your opinion that it is practiced by "quacks", you are labeling people with an insult in order to argue that the word "medical" is inappropriate. That is what I am calling ad hominem, acknowledging it is a group rather than a person you are attacking. I personally think many docs who take gifts in exchange for promoting certain medications are quacks and dangerous opportunists, but that does not mean that what they are doing is not an attempt at practicing medicine. The opinion on the group is irrelevant to the question at hand. Herbxue (talk) 21:44, 25 June 2013 (UTC)

The reason I'd tend to call it a medical procedure is the fact that we have evidence of efficacy (at least for some conditions). This would also be the reason why I'd oppose calling it "quackery". --Mallexikon (talk) 01:54, 26 June 2013 (UTC)

I'd like to see the sources we'd use to call it a "medical procedure". TippyGoomba (talk) 03:18, 26 June 2013 (UTC)

And high quality secondary WP:MEDRS sources only that confirm that it is widely considered a medical procedure within the medical community. Otherwise, it's OR or UNDUE. Dominus Vobisdu (talk) 19:44, 26 June 2013 (UTC)

I can't find any highly cited reliable sources referring to acupuncture as a medical procedure, these for example do not:

• K Streitberger, J Kleinhenz, MD. Introducing a placebo needle into acupuncture research. The Lancet, Volume 352, Issue 9125, 1 August 1998, Pages 364–365,
• Ji-Sheng Han. Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies. Trends in Neurosciences, Volume 26, Issue 1, January 2003, Pages 17–22,
• NIN Consensus Development Panel on Acupuncture. Acupuncture. JAMA. 1998;280(17):1518-1524,
• Ted J. Kaptchuk; Acupuncture: Theory, Efficacy, and Practice. Annals of Internal Medicine. 2002 Mar;136(5):374-383.

All of which have hundreds of citations each. (Sorry for the formatting) Samwalton9 (talk) 20:10, 26 June 2013 (UTC)

"There is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking. Whether a therapeutic practice is 'Eastern' or 'Western,' is unconventional or mainstream, or involves mind-body techniques or molecular genetics is largely irrelevant except for historical purposes and cultural interest. As believers in science and evidence, we must focus on fundamental issues - namely, the patient, the target disease or condition, the proposed or practiced treatment, and the need for convincing data on safety and therapeutic efficacy." - Fontanarosa P.B., and Lundberg G.D. "Alternative medicine meets science" JAMA. 1998; 280: 1618-1619. ... I'd like to point out that we have very good evidence for efficacy of acupuncture. Cheers, --Mallexikon (talk) 01:54, 27 June 2013 (UTC)

We're not exploring the evidence for acupuncture at the moment, we're talking about calling it a medical procedure. To do so, we need sources. Do you have any? Or are you now dropping your proposal to state that acupuncture is a medical procedure? TippyGoomba (talk)

Well, we have plenty of sources calling it alternative medicine... do you understand what I'm getting at? --Mallexikon (talk) 03:06, 27 June 2013 (UTC)

Draft a sentence or two complete with sources and we'll take a look. I predict we'll end up in WP:OR or WP:SYNTH land but I'm always ready to be surprised. TippyGoomba (talk) 03:29, 27 June 2013 (UTC)

As you wish... --Mallexikon (talk) 04:20, 27 June 2013 (UTC)

I wasn't suggesting you edit the article, clearly it would get reverted. I just wanted something concrete to discuss.

Two of the three references you give fail WP:RS. But this passes the smell test. It states Acupuncture is one of the oldest, most commonly used medical procedures in the world which it sources to nccam.nih.gov, which fails WP:RS. TippyGoomba (talk) 04:44, 27 June 2013 (UTC)

Careful with the quick reverts, man... this was sourced material, and not everybody is a fan of WP:BRD (luckily, I am)... anyway, the fact that Stanford sources an NIH statement means that they endorse it. So their credibility backs it up. Which makes this a reliable source. Cheers, --Mallexikon (talk) 04:58, 27 June 2013 (UTC)

Again, we're not looking for a single source or sporadic sources that call acupuncture a "medical procedue", but for a good source that acupuncture is WIDELY considered a medical procedure by the majority of the medical community. If it's just a minority position, that would violate WP:UNDUE. And that source has to be a reliable secondary source that conforms to WP:MEDRS, preferably an academically reviewed review article or book. Dominus Vobisdu (talk) 06:51, 27 June 2013 (UTC)

Well I don't know what you are looking for but your we certainly doesn't include me (so who are you talking about?)... And I'm not quite sure what you mean with secondary source when what we talk about are matters of terminology...? I'm also not quite sure why you are evoking WP:UNDUE since we're not dealing with a theory... But I can see where your unease is coming from... so for consensus' sake, how about calling it "alternative medical procedure" then? --Mallexikon (talk) 09:10, 27 June 2013 (UTC)

A secondary source would be something like a book or systematic review. Do you have a source for your new suggestion? TippyGoomba (talk) 15:20, 27 June 2013 (UTC)

The "we" of Dominus also does not include me. This seems like a pretty simple issue to me - do you also need a systematic review of RCT's to state that acupuncture is a "procedure"? No, its just a description not a medical claim of efficacy or safety. Really, its over the top what you are asking for to justify a simple and accurate description, and I think Mallexikon has satisfied your need for a source.Herbxue (talk) 15:53, 27 June 2013 (UTC)

Not even close. Sorry, but what you're proposing is OR and UNDUE. Ain't gonna fly. Dominus Vobisdu (talk) 00:38, 28 June 2013 (UTC)

I'm not proposing the edit, I'm supporting it - creating consensus.Herbxue (talk) 02:52, 28 June 2013 (UTC)

We don't count votes, we discuss, see WP:CON. So far your contribution the discussion has not even demonstrated an understanding of the objections raised, let alone addressed them. You are not supporting the edit, you are cheering for it. TippyGoomba (talk) 03:42, 28 June 2013 (UTC)

Tell me what I don't understand, please. I think my statements have been quite reasonable so I request that you assume good faith and address the content rather than make assumptions about me.Herbxue (talk) 05:24, 28 June 2013 (UTC)

My apologies, I assumed you'd read the entire thread. Essentially, we have no sources which support "acupuncture is a medical procedure" and to quote Vobisdu: we're not looking for a single source or sporadic sources that call acupuncture a "medical procedue", but for a good source that acupuncture is WIDELY considered a medical procedure. Mallexikon has since withdrawn his initial suggestion (I think) and is now suggesting "alternative medical procedure", sources pending. TippyGoomba (talk) 05:46, 28 June 2013 (UTC)

I don't have a lot of time right now, so I'll return to this discussion later... just wanted to point out that we've had quite a few editors banned from this article because of frequent ad-hominems... And thanks, Herbxue, for keeping your cool. Cheers, --Mallexikon (talk) 07:36, 28 June 2013 (UTC)

There was no ad hominem. Tippy was perfectly correct in pointing out that Herbxue has not addressed the policy-based objections raised and has apparently misunderstood what consensus means on WP. Dominus Vobisdu (talk) 07:42, 28 June 2013 (UTC)

@TippyGoomba: Even that proposal would be redundant, because of the next sentence in the lede. It already states that accupuncture is part of traditional Chinese medicine.

@Herbxue: What you are not understanding is the policies that are being cited in this argument, especially: WP:RS, WP:MEDRS, WP:NOR, WP:NPOV and WP:FRINGE. The bar is set VERY high on all medicine-related material, especially fringe-related material, here on WP. The sources have to be impeccable. Dominus Vobisdu (talk) 07:42, 28 June 2013 (UTC)

DV, I guess what you are not really understanding is the meaning of Misplaced Pages:No personal attacks. I suggest you read it again and change your tone. We're all very happy with discussing content here, but these ad-hominems gotta stop. Seriously. --Mallexikon (talk) 01:09, 30 June 2013 (UTC)

Are you still suggesting an edit? TippyGoomba (talk) 03:06, 30 June 2013 (UTC)

Yes. My suggestion is to change the first lede sentence to "Acupuncture is a collection of alternative medical procedures ..." Sources would be this Clinical UM Guideline, the NHS, the NIH, and the Stanford source we already discussed. Cheers, --Mallexikon (talk) 04:23, 30 June 2013 (UTC)

Not in sources. TippyGoomba (talk) 05:08, 30 June 2013 (UTC)

Quoting: 1.) "Acupuncture is one of the oldest, most commonly used medical procedures in the world..." 2.) "Acupuncture is a form of ancient Chinese medicine ... It is a complementary or alternative medicine.." 3.) "Acupuncture is one of the oldest and most commonly used forms of traditional medicine... " --Mallexikon (talk) 05:16, 30 June 2013 (UTC)

Looks good to me, clearly supported by the sources. I think TIppy is saying the "collection of...procedures" is not in the sources (correct me if I'm wrong). The statement in Mallexikon's proposed edit is accurate because acupuncturists typically employ at least several different "procedures" including cupping, gua sha, moxa, electrostimulation, etc.Herbxue (talk) 15:21, 30 June 2013 (UTC)

Mallexikon made three proposals, which are you referring to? IRWolfie- (talk) 15:34, 30 June 2013 (UTC)

No, that's a misunderstanding. I made an initial proposal and then altered it to this: change the first lede sentence to "Acupuncture is a collection of alternative medical procedures ..." Sources would be this Clinical UM Guideline, the NHS, the NIH, and the Stanford source we already discussed. Cheers, --Mallexikon (talk) 05:33, 1 July 2013 (UTC)

Nothing about "alternative medical procedures" in those sources. Furthermore, the statement is ambiguous. It has the potential to be read as "alternative (medical procedures)" as opposed to "procedures in (alternative medicine)". TippyGoomba (talk) 07:26, 1 July 2013 (UTC)

True... but we could avoid the ambiguity by wikilinking: alternative medical procedure. --Mallexikon (talk) 08:22, 1 July 2013 (UTC)

I take the lack of responses as a quiet agreement... About that "nothing about alternative medical procedures in the sources": no, not literally - that would be plagiarism. But the sources clearly say that acupuncture is alternative/traditional medicine, and that it is a procedure (one could argue that these two conclusions actually amount to common sense, but it's always nice to have sources anyway). Alternative medical procedure therefore is proper close paraphrasing. Cheers, --Mallexikon (talk) 01:30, 2 July 2013 (UTC)

No, there is still no consensus. What you are describing is classic WP:SYNTH. Furthermore, it adds nothing to the article that is not already in the second sentence. Your reading of plagarism is not correct, either. Dominus Vobisdu (talk) 06:50, 2 July 2013 (UTC)

Are you saying that going from "alternative medicine" to "alternative medical" is synthesis?Herbxue (talk) 14:47, 2 July 2013 (UTC)

How you came to that conclusion based on what I wrote above is beyond me. Dominus Vobisdu (talk) 15:01, 2 July 2013 (UTC)

Man, can't even ask you a simple question. I did not come to a conclusion, I asked you a question. Mallexikon presented sources calling acupuncture "alternative medicine", citing them to propose an edit calling it an "alternative medical procedure", then you said it is "classic synth" - now, I'm asking you, what is the synthesis you are referring to?Herbxue (talk) 15:50, 2 July 2013 (UTC)

See Mallexion's post immediately before mine. Then see Tippy Goomba's post last post to which Mallexion was replying. Cobbling something together that does not exist in the sources is the definition of WP:SYNTH. Furthermore, it's still superfluous. And ambiguous. Dominus Vobisdu (talk) 16:05, 2 July 2013 (UTC)

What you are saying is simply not true. The sources use the terms "alternative medicine" and "traditional medicine". Changing this to "alternative medical" is close paraphrasing, and where you see WP:SYNTH totally eludes me. Your concern about ambiguity has been addressed as well - we'll avoid it by using a wikilink... I got the feeling you just completely refuse to play ball here - you call for reliable sources, and as soon as I present them it's something else you don't like. Now you come up with a completely different issue, saying my proposed change was superfluous. I guess it's better to call for an outside opinion, so I'll take this to the DR/N (Talk:Acupuncture#Medical procedure?). Cheers, --Mallexikon (talk) 03:29, 3 July 2013 (UTC)

I've been saying the statement is redundant for over a week now, which you would know if you had taken the time to read my posts. It's always been one of my main objections. And I'm tired of this deadhorse discussion. I've been patient and considered your arguements and answered them fully. I remain unconvinced by them. As far as I'm concerned, there is no point in further discussion. Drop the stick already. Dominus Vobisdu (talk) 04:04, 3 July 2013 (UTC)

Unconstructive behaviour. Better to take this somewhere else. --Mallexikon (talk) 04:46, 3 July 2013 (UTC)

Medical procedure, part II

Since DR/N declined to deliver a judgement whether the sources I've contributed so far do or do not support the change I intended: let's start from scratch. I propose to change the lede sentence to: "Acupuncture is a medical technique involving..." My sources are:

1. Encyclopedia Britannica ("acupuncture, ancient Chinese medical technique for...")
2. The Skeptic's dictionary ("Acupuncture is a medical technique...")
3. Merriam-Webster dictionary ("Medical technique in which needles are inserted into the skin...")
4. Random House dictionary ("a Chinese medical practice or procedure...")
5. This Clinical UM Guideline & Stanford Hospital ("Acupuncture is one of the oldest, most commonly used medical procedures in the world...")

And no, trying to argue that "medical procedure" does not automatically imply "medical technique" will not fly. Cheers, --Mallexikon (talk) 10:43, 4 July 2013 (UTC)

If you're abandoning the WP:DR/N, please let them know. I don't think it's appropriate to start a separate but related discussion outside their framework while you have a case open there. TippyGoomba (talk) 15:56, 4 July 2013 (UTC)

Yes certainly, very thoughtful of you. --Mallexikon (talk) 02:04, 5 July 2013 (UTC)

I haven't been following this particular discussion, but this is a no brainer. Of course it's a medical procedure. It could also be qualified as a TCM medical procedure. Here are the current two first sentences, with TCM mentioned earlier:

• Acupuncture is a collection of traditional Chinese medical (TCM) procedures involving penetration of the skin with needles in order to stimulate certain points on the body. In its classical form it is a characteristic component of TCM, and one of the oldest healing practices in the world.

That could even be shortened to remove superfluous content that really says nothing:

• Acupuncture is a collection of traditional Chinese medical (TCM) procedures involving penetration of the skin with needles in order to stimulate certain points on the body, and is one of the oldest healing practices in the world.

How's that? Note that we're already calling it a "healing practice," which is far more dubious than just calling it a TCM procedure. -- Brangifer (talk) 16:57, 4 July 2013 (UTC)

BTW, is "collection of" really necessary? -- Brangifer (talk) 17:05, 4 July 2013 (UTC)

My objection to alternative is on the basis that it's a deceptive euphemism. TCM is descriptive, so I think it's fine. TippyGoomba (talk) 19:47, 4 July 2013 (UTC)

I see now (from above) that "alternative medical" is considered objectionable by some, even though it is the official classification by many notable sources. Why the objection? It's TCM and AM. Plenty of RS to support both. -- Brangifer (talk) 21:00, 4 July 2013 (UTC)

To me, it's just plain redundant. TCM is a subset of AM, so mentioning AM adds no new information. Dominus Vobisdu (talk) 21:05, 4 July 2013 (UTC)

"Medical procedure" makes it sound like it's part of medicine. Is prayer a medical procedure? Is prayer an alternative medical procedure? I'm fine with the term "alternative medicine" because that's the common name. It's locally redefined and not medicine. Without sources it's too much of a leap for me (ie WP:OR) to start using the locally defined term "alternative medicine" as an adjective. Sources which establish common use would change my mind. TCM is not a euphemism and it explicitly states the nature of the "medicine", so the same issues don't apply, in my opinion. TippyGoomba (talk) 22:20, 4 July 2013 (UTC)

I can see both points, so just mention TCM. How's my proposed wording sound to you? -- Brangifer (talk) 00:02, 5 July 2013 (UTC)

I have no objections. Thank you for the suggestion. TippyGoomba (talk) 00:53, 5 July 2013 (UTC)

Yes, thank you Brangifer. I'd like to stick to "Acupuncture is a medical technique involving penetration of the skin with needles in order to stimulate certain points on the body" though. Medical is a commonly used adjective regarding acupuncture (please see my sources above), and I'd like our wording to reflect that. --Mallexikon (talk) 02:04, 5 July 2013 (UTC)

??? "Medical" (alone) was not part of my suggestion. That could be misunderstood as making it a mainstream western medical technique that is not categorized as "alternative", which the categorization that makes it eligible for coverage by NCCAM. I'm seeking a compromise, and since it's a "traditional Chinese medical" procedure, that seems to qualify it enough to remove objections. That should be good enough, even for you. -- Brangifer (talk) 03:13, 5 July 2013 (UTC)

Well, as you said above: "...this is a no brainer. Of course it's a medical procedure." Tippy and Dominus have rejected my proposal of "alternative medical procedure", demanding that we have to stick very closely to what reliable sources say. So, I've consulted reliable tertiary sources (please see the beginning of this threat), and they are very clear about the usage of "medical technique" (or, "medical procedure"). So I guess that's what we should stick to. Tippy and Dominus can't have it both ways. --Mallexikon (talk) 03:48, 5 July 2013 (UTC)

Your sources mean diddly squat. as I wrote before "Again, we're not looking for a single source or sporadic sources that call acupuncture a "medical procedue", but for a good source that acupuncture is WIDELY considered a medical procedure by the majority of the medical community. If it's just a minority position, that would violate WP:UNDUE. And that source has to be a reliable secondary source that conforms to WP:MEDRS, preferably an academically reviewed review article or book." Claiming that acupuncture is a "medical procedure" is misleading and downright dishonest. Ain't going to happen. Dominus Vobisdu (talk) 05:52, 5 July 2013 (UTC)

Mallexikon, as I mentioned above, when I first commented on this thread I wasn't aware of the exact nature of the dispute, but when appraised of the situation I could see their point, which is not aligned with yours. It's a TCM procedure, which is already classified as an alternative medicine procedure. RS can be mustered for both POV. By using my description, we obviate the need for mentioning alternative medicine in the first sentence since TCM is a form of alternative medicine. -- Brangifer (talk) 05:55, 5 July 2013 (UTC)

Im the guy from DR/N, and the above proposal by brangifier looks like a reasonable compromise (and has wider acceptance amongst editors here). Ill close the DRN now -- Nbound (talk) 05:42, 5 July 2013 (UTC)

Can we decide whether we go with my version or not? -- Brangifer (talk) 06:50, 5 July 2013 (UTC)

Well, we're still discussing my version... @Dominus: As I already said above, my sources are:

1. Encyclopedia Britannica ("acupuncture, ancient Chinese medical technique for...")
2. The Skeptic's dictionary ("Acupuncture is a medical technique...")
3. Merriam-Webster dictionary ("Medical technique in which needles are inserted into the skin...")
4. Random House dictionary ("a Chinese medical practice or procedure...")
5. This Clinical UM Guideline & Stanford Hospital ("Acupuncture is one of the oldest, most commonly used medical procedures in the world...")

The majority of these are tertiary sources - and about the biggest heavyweights you can ask for when it comes to dictionaries. If you have a dissenting opinion from the Britannica, Webster's, and Random House, please show sources that prove that these dictionaries are wrong. --Mallexikon (talk) 06:57, 5 July 2013 (UTC)

None of those sources is acceptable per WP:MEDRS, and none of them support your position. Dictionaries and encyclopedias are worthless for determining what is medicine or not, and sporadic mentions are not equal to general opinion. Dominus Vobisdu (talk) 07:12, 5 July 2013 (UTC)

DM is correct. It's not a matter of them being wrong. It's a matter of giving a better description that can't be misleading, and it's based on the content of this article, as it should be. That's why we often create our own definitions which are better than those found anywhere else. Since your suggestion isn't getting any support, I have proposed a compromise, and it's gotten support. Why would you object to describing it more accurately as a "traditional Chinese medical procedure"? That cannot be misunderstood. -- Brangifer (talk) 07:18, 5 July 2013 (UTC)

As a TCM practitioner, I rather like the phrase "traditional Chinese medical procedure" - but it is problematic because not all "acupuncturists" use TCM theory for practice. I'd be ok with it on the grounds that the Chinese originated most, and utilize all techniques described as acupuncture - but I don't think Chiropractors, MD acupuncturists, or Japanese acupuncturists would agree with calling it a TCM procedure. "Medical procedure" or "alternative medical procedure" are more accurate and inclusive. Herbxue (talk) 18:38, 5 July 2013 (UTC)

Pretty much a moot question now. A solution has been achieved in the next section. Dominus Vobisdu (talk) 18:52, 5 July 2013 (UTC)

"Alternative medicine" in the lead

TippyGoomba objects to "alternative ... on the basis that it's a deceptive euphemism." While I agree that it's a misuse of the term (per the standard skeptical position expressed here), RS still use that descriptor, so we must do the same. I have now checked the article for use of the descriptor "alternative medicine" and find it is mentioned far too little in the article, and should be mentioned more prominently in the lead. It comes far too late there. How can we mention it earlier in the lead? -- Brangifer (talk) 05:55, 5 July 2013 (UTC)

It's already mentioned implicitly in the second sentence as TCM, which is a form of alternative "medicine". What need is there to mention it explictly? Dominus Vobisdu (talk) 06:23, 5 July 2013 (UTC)

I'm making this its own thread (by adding a heading) since it's not necessarily related to the previous thread. The reason I think it's a good idea to mention AM early is because editors know, but readers don't always know, that TCM is a subset of AM. We should make that explicit. There are plenty of good RS that document it. -- Brangifer (talk) 06:50, 5 July 2013 (UTC)

Ok, I see your point. What about simply mentioning AM in the second sentence as follows: "In its classical form it is a characteristic component of traditional Chinese medicine (TCM), a form of alternative medicine, and one of the oldest healing practices in the world." ? Dominus Vobisdu (talk) 07:05, 5 July 2013 (UTC)

A very simple and effective solution. I have to run now. -- Brangifer (talk) 07:12, 5 July 2013 (UTC)

Mentioning AM earlier is a good idea. Your suggestion works for me as well. TippyGoomba (talk) 14:31, 5 July 2013 (UTC)

There is no such thing as "alternative" medicine - Either something works as a true medical procedure or its simply a placebo-based sham procedure, and should be labelled as such. The reality is that researchers do not really know how acupuncture works and this should be acknowledged in the article. For millions of people across East and Southeast Asia, TCM is less of an "alternative" medicine and more like the only treatment that is affordable to them. -A1candidate (talk) 20:22, 5 July 2013 (UTC)

Damn right, "there is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking." Tippy is likening acupuncture to prayer, and DV calls it quackery... this is heavily POV, but worse than that, it's unscientific and dogmatic. There's plenty of MEDRS in our article documenting that acupuncture is effective for certain conditions - it's just unscientific to ignore that. Have you noticed at all that one of the sources for my "medical procedure" proposal isThe Skeptic's dictionary? (And I do recommend to read that article, it's very rational). If you automatically dismiss what is written in the Britannica, I think you should stop for a minute and ask yourself whether your dogmatism got the better of you. - However, I believe in consensus, so I'll settle for "Acupuncture is an alternative medical procedure..." as suggested by Brangifer. --Mallexikon (talk) 21:00, 6 July 2013 (UTC)

You are misrepresenting Brangifer's position. Do I understand correctly that you're still suggesting this edit/sources? The objections regarding sources have been repeated several times, you're firmly in WP:IDONTHEARYOU land now. Time to move on. TippyGoomba (talk) 03:03, 7 July 2013 (UTC)

I'll quote that article. "The evidence does not support the claim that acupuncture is a necessary treatment for a single ailment, however. If acupuncture is beneficial on its own or as a complement to scientific treatment for any condition, it is so because of conditioning and placebo factors such as patient expectation and confidence in the treatment. It's also clear that sticking needles in people is irrelevant for acupuncture to work, but appearing to do so is apparently necessary for it to work." IRWolfie- (talk) 12:06, 7 July 2013 (UTC)

I'm certainly not misrepresenting Brangifer's position . I'd settle for "Acupuncture is an alternative medical procedure..." as suggested by him. --Mallexikon (talk) 07:45, 8 July 2013 (UTC)

Per the diff you use to my comments, you are misrepresenting me. I agree with Dominus Vobisdu's suggestion above, or something like that. TCM gets the primacy, with AM added in there somewhere. Both are mentioned early. -- Brangifer (talk) 15:12, 9 July 2013 (UTC)

I'm implementing that suggestion now. Seems that no one has objected, except A1. Dominus Vobisdu (talk) 15:22, 9 July 2013 (UTC)

I prefer Mallexikon's more inclusive phrasing due to the fact that while acupuncture grows out of and is most common to Chinese medicine (itself a broader descriptor than the specifically 20th-century systematized "TCM"), it is not exclusively a TCM practice. Herbxue (talk) 18:00, 9 July 2013 (UTC) -Actually, the current wording is ok except for a couple things - most importantly the first sentence does not indicate that acupuncture is performed with a therapeutic/medical/healing intent, just that it is a procedure involving needles (which could imply things like tattoos or piercing). This is why I support Mallexikon's current proposal, even though I like "traditional Chinese medical procedures". Also, could we change "involving" to "including" - in most cases acupuncture does include moxa, cupping, electro, ion pumping, etc. Herbxue (talk) 21:08, 9 July 2013 (UTC)

Something worthy of mention regarding acupuncture's safety

According to the article, acupuncture "carries a very low risk of serious adverse effects." However, this does not seem to jibe with a review by Edzard Ernst, one of the most cited authors in this article, who was able to dig up 296 cases of traumatic events, and these are just in China. Furthermore, 201 of those were just from pneumothorax. Should we include mention of it here? Jinkinson (talk) 01:09, 20 July 2013 (UTC)

Theories?

We have a new section that implies that there are many "theories" that attempt to explain the mechanism of the alleged effects of acupuncture. My first concern is that, as presented, none of these could be called "theories" as they do not seem to present a cohesive, explanatory, widely supported synthesis of anything. Perhaps more important, they seem to have been presented many years ago and there is no mention about their current acceptance. I would either just remove this whole section, shorten it to a paragraph, or, at least, refer to these as "ideas" or "suggestions about mechanism of action". Do the sources refer to these as "theories"? Desoto10 (talk) 17:37, 2 August 2013 (UTC)

How about "hypothesis"? instead of "idea"? -A1candidate (talk) 17:50, 2 August 2013 (UTC)

Thanks for discussing - in my edit summary I said these are hypotheses that are supported by some evidence and not disproven by evidence. I thought that qualified as a theory per the WP article on theory. I am willing to admit being wrong, but what is the exact criteria? Dominus mentioned "lots" of evidence, or that a theory must be "widely" accepted. How do we determine that? It seems subjective. Nonetheless, these are important lines of inquiry into the physiologic effects of needle insertion so they belong in the article, regardless of whether we label them theories or hypotheses. Herbxue (talk) 17:51, 2 August 2013 (UTC)

A good test is whether something is widely discussed as a serious and supportive fashion in the secondary WP:MEDRS literature, that is, in several high-quality mainstream medical/scientific sources, and is backed up by a substantial amount of primary studies by different independent researchers who come to the same conclusions. By any measure, none of these come even remotely close to being a theory except for the placebo theory, and none are even quite at the hypothesis stage yet, so quibbling over the subjectivity of the words "a lot" is pointless. "Speculation" is probably the best word overall. For the best of them, "proposed explanations" may apply. For the rest, "clutching at straws" or "wild stabs in the dark" are even more accurate. Agree that the section should simply be removed. There's nothing really of encyclopedic interest here as far as we are concerned. If there were, it would have been substantially discussed in multiple independent reliable sources. Dominus Vobisdu (talk) 18:12, 2 August 2013 (UTC)

These probably all fail WP:MEDRS, but here you go:

• Medical textbook by Springer Publishing: "...Additional observations have implicated tissue release of nucleotides and adenosine in acupuncture analgesia, and shown analgesia results from peripheral actions at adenosine A1Rs... " (Source)
• Review article by Evidence-based Complementary and Alternative Medicine: "... These data strongly suggest that acupuncture-released ATP and its metabolite adenosine in local acupoint tissues block pain impulses from sites distal to needling point...." (Source)
• Review article by the Pflügers Archiv: European Journal of Physiology: ...In a separate study, the mechanistic action of acupuncture was observed by focusing on adenosine. It was found that insertion and manual rotation of acupuncture needles triggered a general increase in the extracellular concentration of purines, including the transmitter adenosine and ATP metabolites..." (Source)
• Review article by Neuropsychopharmacology (journal): "...In another recent study, Goldman et al. (2010) found that localized A1R activation underlies the antinociceptive effects of acupuncture. Manual stimulation of acupuncture needles resulted in localized extracellular increases in nucleotides (ATP, ADP, and AMP) and adenosine...'" (Source)
• The Lancet:"...After electroacupuncture in the patients with pain CSF β-endorphin levels rose significantly in all subjects, but met-enkephalin levels were unchanged. These results suggest that the analgesia observed after electroacupuncture in patients with recurrent pain may be mediated by the release into the CSF of the endogenous opiate, β-endorphin..."(Source)

• Peptides (journal):"..These data suggested that AVP (Arginine vasopressin) in the brain played a role in the process of acupuncture analgesia in combination with the endogenous opiate peptide system.." (Source)
• Radiology (journal):"...Results from human and animal studies (2,9–13) suggest that acupuncture acts as a neuromodulating input into the central nervous system (CNS) that can activate multiple analgesia systems and stimulate pain modulation systems to release neurotransmitters such as endogenous opioids..." (Source)
• The American Journal of Gastroenterology:"...The more remarkable modulation on the homeostatic afferent network, including the insula, ACC, and hypothalamus, might be the specific mechanism of acupuncture." (Source)

Obviously all these researchers are just trying to promote a form of pseudoscience that is based on nothing more than quackery -A1candidate (talk) 18:25, 2 August 2013 (UTC)

None even come close to being more than merely suggestive or speculative. Dominus Vobisdu (talk) 18:44, 2 August 2013 (UTC)

Theories do a lot more than "implicate" and "suggest", and the other two fail the correlation is not causation test. Aside form the placebo explanation, which is well supported, there are no other robust explanations. Dominus Vobisdu (talk) 18:34, 2 August 2013 (UTC)

Posted at WP:FTN. Dominus Vobisdu (talk) 18:41, 2 August 2013 (UTC)

Actually, the same can be said about the sources used to support the health risks of acupuncture at Acupuncture#Adverse_events. I dont have time to go through all of them but I'll just quote from the last references: "Acupuncture remains associated with serious adverse effects". Fails the "correlation is not causation test". Should it therefore be removed? -A1candidate (talk) 18:54, 2 August 2013 (UTC)

I think that the best solution would be to find a recent review article that actually summarizes the most significant current ideas about potential mechanisms and provide a summary of their summary in a paragraph. It would be best if these mechanisms had strong evidence from human studies, as opposed to animals or tissue-culture. Just for my own information, when they stick a needle in a mouse do they use a special "mouse acupuncture" needle, which would be much thinner than what is used for humans or do they just use a human needle? 66.201.49.79 (talk) 20:29, 2 August 2013 (UTC)Desoto10 (talk) 20:31, 2 August 2013 (UTC)

That's an interesting question. Acu needles come in a wide range of sizes. I assume they used thin needles on the mouse. A trial comparing results in humans using thin vs. thick needles would be interesting (I'm sure its been done in China).

Back to the question at hand, I am not interested in fighting about "theory". I do think hypothesis is supported by the definition of the work hypothesis. Regardless, we have already discussed the inclusion of the proposed mechanism section and consensus was that it was appropriate for the article as it describes the current status of the research. We should be careful not to extrapolate it into claims of medical efficacy, but we should also be careful not to eliminate useful information that is backed by RS and adds value to the article. Herbxue (talk) 21:08, 2 August 2013 (UTC)

It's been pointed out that the references given contain speculation rather than a explanatory framework. Adding this kind of speculation would violate WP:WEIGHT. Do you have better sources or an alternative edit? TippyGoomba (talk) 07:03, 3 August 2013 (UTC)

The same can be said about the sources used to support the health risks of acupuncture at Acupuncture#Adverse_events. I'll just quote from the last references: "Acupuncture remains associated with serious adverse effects". An association of acupuncture with serious adverse effects fails the "correlation is not causation test". Should it therefore be removed? -A1candidate (talk) 08:30, 3 August 2013 (UTC)

Hell, yes, it should be removed! And I was under the impression that you HAD removed it already. I've read the paper and that is not at all an accurate paraphrase of the original text, which states basically that sereious side effects are rare and rarely due to the treatment itself, but rather to the fact that practioners are often incompetent.

On the flip side, though, I'm removing the entire proposed mechanisms section, based on the same paper, which states that no plausible mechanisms have been proposed. As this is not only a top-notch secondary source, but, even better, a review of reviews, and is very recent, it carries a lot of weight. Far more than the inconclusive suggestive studies you mentioned above and currently used in the article. Dominus Vobisdu (talk) 09:22, 3 August 2013 (UTC)

Please don't do that. It is not appropriate to use one source to negate other's ongoing work. One paper's conclusion that there is no mechanism does not justify eliminating good sources that show the ongoing work to try to identify a mechanism. And by the way, the section is called "proposed" mechanisms, which they are. THis is important, ongoing research that adds to the article.Herbxue (talk) 19:25, 3 August 2013 (UTC)

What you are proposing would grossly violate a big bunch of our policies. WP is not the place to present "continuing research", especially if that research is at the speculative and suggestive stage. We are not a new service. Being a tertiary source, we are the third man on the match. The information we get is based on what secondary sources say, which are based on what the primary sources say. Which, in turn, are based on what the preliminary sources say, which are based on what the suggestive sources say, which are based on what the speculative sources say. The material you wish to include comes from too low down the food chain to be of any encyclopedic value. If ifs and buts were candy and nuts, it would be Christmas every day. Dominus Vobisdu (talk) 19:58, 3 August 2013 (UTC)

At what point does multiple violations of MEDRS to include tentative wordings from primary sources also constitute a violation of the whole idea behind WP:CRYSTAL? Seriously, we can't include guesswork about what the future holds, simply because so much (most?!) inconclusive research ends with wordings like "further research is needed". We really need to pare this down to what is actually known NOW, and use MEDRS compliant sources. -- Brangifer (talk) 19:51, 3 August 2013 (UTC)

If you take a closer look at the sources above, half of them are review articles and the first one is a medical textbook (not an acupuncture textbook). I don't see how MEDRS is being violated in anyway. -A1candidate (talk) 20:02, 3 August 2013 (UTC)

You already answered that question yourself. Speculation about possible connections is not acceptable regardless of the source. Even of the source meets our sourcing policy to a tee, as the above mentioned review of reviews does. That's why I deleted the sentence about acupuncture being asociated with deaths at your request. The problem is not the sources, but the type of material involved. Speculation is expressedly forbidden by WP:CRYSTALBALL. Dominus Vobisdu (talk) 20:08, 3 August 2013 (UTC)

If I may quote from the sources above: "In another recent study, Goldman et al. (2010) found that localized A1R activation UNDERLIES the antinociceptive effects of acupuncture. Manual stimulation of acupuncture needles RESULTED in localized extracellular increases in nucleotides (ATP, ADP, and AMP) and adenosine." This is not speculation but a direct cause and effect -A1candidate (talk) 20:26, 3 August 2013 (UTC)

Cherrypicking will get you nowhere. The sentence you picked is merely a summary of a primary study. Nothing more. Dominus Vobisdu (talk) 20:37, 3 August 2013 (UTC)

I support inclusion of a 'mechanism of action' section that can review the current theories. If we look at another controversial treatment, such as antidepressants, we see the mechanisms of action section start with an admission: "For depression, the mechanism of action of antidepressants is unknown.", before the section reviews current 'theories'. Note that primary sources and animal studies make up the basis of the discussion! Despite the low-quality sources, IMO it is still helpful for the reader to have access to current theories that are under investigation. Similarly, I think that including a discussion of the theoretical mechanisms of action behind acupuncture is appropriate and helpful - as long as it is qualified as theory (rather than fact) and not associated with any medical claims of efficacy. The section should also begin with a qualification, as does the antidepressant article.Puhlaa (talk) 21:05, 3 August 2013 (UTC)

If you want to be taken seriously, it would help if you took the time to learn what the word "theory" means before you carlessly bandy it about. After all, that's what this whole thread is about. It doesn't mean what you think it does. As for anti-depressants, WP:OTHERSTUFFEXISTS and is a not a very compelling argument, as is WP:ITSUSEFUL. Dominus Vobisdu (talk) 21:13, 3 August 2013 (UTC)

Acupuncture is based on the placebo effect. Period. End of discussion. (While there are studies that show otherwise, there's no point trying to reach a consensus on Misplaced Pages until consensus is first reached within the scientific community. All other discussion is futile) -A1candidate (talk) 21:32, 3 August 2013 (UTC)

Essentially, yes. By default. That is the only theory that has widespread support and is supported by the preponderance of the evidence, and data that contradict it are either inconclusive, tentative or unconfirmed, or originate from low-quality studies. Other explanations are not plausible or not supported by good evidence. Passing the "placebo" barrier is the first step that most alternative medicine methods, indeed all medicine methods, have to take, from homeopathy to zinc lozenges for colds. Passing the preliminary phases is relatively easy, as the experiments at that stage are designed to detect true positives at the cost of detecting false positives as well. Later stages are more rigorous. That's why we highly favor secondary studies over primary studies. Dominus Vobisdu (talk) 21:45, 3 August 2013 (UTC)

Attempts to recruit editors

Obviously, there's nothing wrong with asking other editors to give their opinions but please do it in a neutral manner and not like this , this, and this

-A1candidate (talk) 19:21, 2 August 2013 (UTC)

The guidelines on this are at WP:CANVAS. I don't see anything improper having happened. Alexbrn 19:27, 2 August 2013 (UTC)

Well, WP:CANVAS says:

This page in a nutshell: When notifying other editors of discussions, keep the number of notifications small, keep the message text neutral, and don't preselect recipients according to their established opinions.

My main concern is that statements like these aren't neutral -A1candidate (talk) 19:37, 2 August 2013 (UTC)

I don't think raising concerns which are tied to WP's core policies (as seems to be the case here) is not "neutral" - quite the opposite, surely? Alexbrn 19:42, 2 August 2013 (UTC)

the message presumes a violation of the policies, and encourages users to come redress those violations, and therefore is not neutral. Gaijin42 (talk) 19:46, 2 August 2013 (UTC)

It also preselects a population known to be looking for things to label as fringe, which could be an example of WP:Votestacking. Herbxue (talk) 20:22, 2 August 2013 (UTC)

The purpose of the fringe noticeboard is stated at the head of its page. This does not include "looking for things to label as fringe". In fact queries posted there are frequently resolved by determining that a topic in question is not subject to fringe guidelines. Posting to a noticeboard can never be an example of canvassing: they are specifically for "problems that editors encounter in writing and maintaining Misplaced Pages articles". Alexbrn 20:34, 2 August 2013 (UTC)

Sorry, you are accusing wikiproject medicine and science of being a group "looking for things to label as fringe"? IRWolfie- (talk) 22:38, 2 August 2013 (UTC)

No, it was also posted at the Fringe notice board. By its nature, that board seeks to identify what is or is not "mainstream", so alerting editors that monitor that page will naturally result in adding a bias towards discounting reliable RS because it is associated with, or used to help explain an alternative medicine subject. Herbxue (talk) 02:54, 3 August 2013 (UTC)

Absolute nonsense. Sources which are not reliable will be discounted. That is all. IRWolfie- (talk) 21:50, 3 August 2013 (UTC)

A couple years ago I was accused of sockpuppetry and page banned for a similar recruitment attempt. The fact that you assume an air of authority as part of a noticeboard does not mean that you seek out unreliable sources in an unbiased manner. I am not accusing you of doing so, but Dominus did not assume good faith of the active editors of this page and recruited like-minded people. You can save the "we follow sources" lecture - I perfectly understand it - I just don't agree that it serves the project to censor out interesting and valuable information in primary sources if they are not making a claim of efficacy. Drug articles, for example, are loaded with primary sources. So the term "cherry picking" goes both ways. Herbxue (talk) 15:33, 5 August 2013 (UTC)

I got one too. I was pretty surprised to see the canvassing, given how illformed the suggested edit is. I'd be interested to hear from an admin on how canvassing should be done for pseudoscience/fringe topics. I'm not sure I understand the issue in this case, was there some set of users or wiki projects that should have been notified that weren't? TippyGoomba (talk) 04:45, 3 August 2013 (UTC)

No, I don't think anyone was intentionally left out. In my opinion what happened was an editor in good faith changed "theories" to "ideas" and I (in good faith) reverted them because they changed established text and their edit was not sourced, and I thought "theories" was appropriate based on the WP definition of theory. I quickly established willingness to compromise on the terminology, but Dominus had already begun a drama-filled escalation of rhetoric at that point. A1Candidate shared RS that backed the inclusion of the sources in the article which were already well established after discussion and much work by other editors. In my opinion, Dominus is introducing theatrical drama in this situation to get support to remove well-sourced content on proposed mechanisms in order to push a POV that there is absolutely no basis for believing that needle insertion does anything to the human body. I think the whole thing has been blown way out of proportion and should have just been discussed here, instead of recruiting like-minded POV pushers at the fringe notice board. Herbxue (talk) 05:25, 3 August 2013 (UTC)

I guess that's one version. Perhaps it's best if we all get back to discussing changes to the article, rather than user conduct. TippyGoomba (talk) 06:59, 3 August 2013 (UTC)

"Its effects are due to placebo"

I have removed this statement from the effectiveness section because it is a definitive statement that is unproven, and only one of the 3 cited sources even suggests that its effects are due to placebo (the Ernst paper). None, even the Ernst, suggests that placebo is the only mechanism by which it works, therefore the statement is unsupported by the sources. Herbxue (talk) 19:42, 5 August 2013 (UTC)

Dominus keeps reverting the edit, so I proposed a compromise to the inaccurate blanket statement that is not supported by the sources cited. Herbxue (talk) 20:09, 5 August 2013 (UTC)

All three citations support the statement. Furthermore, it's the default position. Do you have more recent systemic reviews which demonstrate otherwise? TippyGoomba (talk) 05:28, 6 August 2013 (UTC)

Only one even comes close, and its the Ernst, which more than one other editor has expressed concerns about undue weight. Even his paper does not make the blanket statement "acupuncture's effects are do to placebo" - it is careful to say there is the evidence suggests acupuncture may be nothing more than placebo, which is an admitted speculation. Show me a quote in multiple reviews that support a sweeping generalization like that. Herbxue (talk) 06:17, 6 August 2013 (UTC)

You guys are still reverting me, returning to a version that is not supported by the sources. Its not even supported by Ernst, the man on a mission to discredit acupuncture does not even go so far as to say "it's effects are due to placebo" - if you ever intend to say "we follow the sources" with a straight face again, I suggest you read the fucking sources before reverting me, or propose and edit, supported by the sources. A1candidate made that edit erroneously and I have corrected it numerous times. Dominus and Tippy keep supporting the erroneous edit without actually reading the source that supposedly supports it, or intentionally misrepresenting what the source actually says. That basically means you are liars. Herbxue (talk) 03:15, 12 August 2013 (UTC)

no, u TippyGoomba (talk) 04:36, 12 August 2013 (UTC)

Looking at the sources again, I wonder if it is overstating their case to say the effects are due. Ernst's blog on the topic from earlier this year contains the wording: "the evidence from the most rigorous clinical trials seems to suggest that much, if not all of the effects of acupuncture might be due to placebo". Alexbrn 07:31, 14 August 2013 (UTC)

Since things have escalated, I've taken Herbxue to ANI, see WP:ANI#Herbxue. Please correct me there if I've missed something. TippyGoomba (talk) 03:20, 15 August 2013 (UTC)

IMO, Dominus Vobisdu and TippyGoomba have not AGF at all and have continuously focused on the editor here instead of the edits. Interesting that neither Tippy or Dominus has felt it necessary to comment on the sources that Herbexue is referring to, they just keep drive-by reverting to a version that is not supported by those sources. TippyGoomba and Dominus Vobisdu have repeatedly restored the text in the lead that says "the effects of acupuncture are due to placebo", yet the sources do not support this text. The body of our article also does not support this text in the lead; our article says:

"A 2012 meta-analysis found significant differences between true and sham acupuncture, which indicates that acupuncture is more than a placebo when treating chronic pain (even though the differences were modest). A 2010 systematic review also suggested that acupuncture is more than a placebo for commonly occurring chronic pain conditions, but the authors acknowledged that it is still unknown if the overall benefit is clinically meaningful or cost-effective."

As Alexbrn points out, even the well-known critic Ernst can only say that it "might be due to placebo". I would love to hear how Dominus or Tippy justify continuously restoring the text when it is not supported by the sources and refusing to engage in discussion here? and then have the nerve to report Herbexue to ANI? Puhlaa (talk) 04:47, 15 August 2013 (UTC)

Alt-med proponents love to take advantage of the public's lack of knowledge about what "placebo" is. Placebo is not something that has to be proved. It is the default conclusion of any medical trial, and remains true until it is disproved. The burden rests solely on alt med proponents to do so. They always try to shift the burden on scientists to prove that their method doesn't work, instead of providing credible evidence that it does work. So far, no convincing evidence has been produced. All of the studies to date have either been fundamently flawed because of faulty methodolgy or bias, or have produced weak, contradictory and non-reproducible evidence.

They also prey on the public's lack of knowledge about what "effectiveness" is. If the effectiveness of a method is no better than placebo, that means it is not more effective than holy water or beads and rattles.

None of the reliable studies performed to date have indicated that there is more at play than simple placebo efect, a fact that Ernst makes clear in his "review of reviews" www.dcscience.net/Ernst-2011-AcupunctAlleviatePainRiskReview.pdf‎, which has been removed from the article. The review of reviews states that recent high-quality studies indicate that the effects of accupuncure are due to "non-specific effects such as therapist conviction, patient enthusism, or receiving a treatment believed to be helpful", in other words, placebo. Or that "real" acupuncture works no better than sham (placebo) acupuncture. It goes on to state that if

The Madsen metastudy says very clearly that sham accupuncture (placebo} worked better than no treatment, and that the difference between "real" and sham accupucture (placebo) was not clinically relevant and could not be distinguished from bias ].

There is a quibble also on "may be due to placebo", another common ploy used by alt med proponents. In normal English, this means "may be due to causes other than placebo". It's a banal statement that is true in all medical trials, as it can never be disproved (it's unfalsifiable), only proved. This does not imply that it is caused by other causes, nor does it lend any credence to such conclusions. It's mere speculation that is inherent in the scienific method. Until credible evidence is produced that identifies other causes, it is basically a meaningless statement, and the conclusion that any effects are due to placebo remains the only valid conclusion. Dominus Vobisdu (talk) 02:41, 16 August 2013 (UTC)

1. Madsen, MV (2009). "Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups". BMJ. 338: a3115. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
2. Vickers, AJ (2012). "Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis". Arch Int Med. 172: 1444–1453. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
3. Han, JS (2004). "Acupuncture and endorphins". Brain Res. 361: 258–261.
4. Cheng, RS (1981). "Monoaminergic mechanism of electroacupuncture analgesia". Brain Res. 215: 77–92. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
5. Goldman, N (2010). "Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture". Nat Neurosci. 13: 883–888. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
6. Burnstock, G (2009). "A novel hypothesis for the involvement of purinergic signalling". Med Hypoth. 73: 470–472.
7. Morton, CR (1988). "Inhibition of nociceptive responses of lumbar dorsal horn neurons by remote noxious afferent stimulation in the ca". Pain. 34: 75–83. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
8. Melzack, R (1985). "Acupuncture and transcutaneous electrical nerve stimulation". Postgrad Med J. 60: 893–896. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
9. Ho, MW (1998). "The acupuncture system and the liquid crystalline collagen fibers of the connective tissues". Am J Chin Med. 26: 251–263. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
10. Jung, GH (2011). "Fine structure of extracellular fibers in primo-nodes and vessels". Connect Tiss Res. 52: 487–495. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
11. Langevin, HM (2002). "Relationship of acupuncture points and meridians to connective tissue plane". Anat Rec. 296: 257–265. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
12. Looney, G (1981). "Autonomic theory of acupuncture". Am J Chin Med. 2: 332–333.
13. Choi, W (2012). "Differential autonomic response to acupuncture at wood and metal of five-shu acupoints". J Altern Comp Med. 18: 969–964. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
14. Mann, F (1977). Scientific Aspects of acupuncture.
15. Silberstein, M (2013). "Is acupuncture "stimulation" a misnomer? A case for using the term "blockade"". BMC Comp Altern Med. 13: 68.
16. Asghar, AU (2010). "Acupuncture needling sensation: The neural correlates of deqi using fMRI". Brain Res. 1315: 111–118. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
17. Eshkevari, L (2013). "Acupuncture Blocks Cold Stress-Induced Increase in Hypothalamus-Pituitary-Adrenal Axis in Rat". J Endocrin. 217: 95–104. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
18. "File: 120216-N-PB383-282.jpg". United States Navy. Retrieved 26 May 2013. Description: Cmdr. Yevsey Goldberg conducts an acupuncture procedure on a patient aboard the amphibious transport dock ship USS New Orleans (LPD 18).
19. ^ "Acupuncture moving to war zones". The Washington Times. Retrieved 26 May 2013. {{cite web}}: Italic or bold markup not allowed in: |publisher= (help)
20. ^ Pellerin, Cheryl (Dec. 10, 2010). "Doctors Use Acupuncture as Newest Battlefield Tool". American Forces Press Service. Retrieved 2012-09-12. {{cite web}}: Check date values in: |date= (help)
21. Buzanowski, J.G. (2012-04-06). "Deployed doc has Airmen on pins and needles". United States Air Force. Retrieved 2012-09-12.
22. "NMCSD Provides an Alternative Medicine". United States Navy. Retrieved 26 May 2013. In 2009 NMCSD's pain management clinic provided acupuncture to more than 2,600 beneficiaries. The clinic provides therapeutic and non-invasive pain management therapy to patients of all ages with chronic illness.
23. "Deployed doc has Airmen on pins and needles". United States Air Force. Retrieved 26 May 2013.
24. "Air Force Medical Acupuncture Physicians Visit China". United States Air Force. Retrieved 26 May 2013. The visit was approved by the Office of the Secretary of Defense and Secretary of the Air Force/International Affairs Global Strategy. The purpose of the tour was to promote good will between our civilian and military Chinese colleague physicians and to exchange acupuncture information.
25. "Chinesische Medizin bei der Bundeswehr" (in German). Bundeswehr Joint Medical Service. Retrieved 26 May 2013. An den ausgewiesenen Akupunkturpunkten wurden Ansammlungen von feinen Nervenenden oder sonstigen Rezeptoren gefunden – diese Korrelate konnte man nachweisen. Dies bestätigt, dass sich die Akupunktur frei von jeder Einbildung auf den menschlichen Körper auswirkt – und nicht über den Placebo-Effekt.
26. "平衡针灸军训伤防治基地在内蒙某部建立" (in Chinese). Ministry of National Defense of the People's Republic of China. Retrieved 26 May 2013.
27. "What is CAM?". N.I.H. Retrieved 8 March 2013.
28. "What is CAM?". N.I.H. Retrieved 8 March 2013.

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