a bonobo humanity?

I tried to find a picture of the chi energy system online, but guess what, nothing to be found. Here’s a chi-reflexology map instead – from the Australian College of Chi-Reflexology, no less!

On the ever-reliable US-based NeuroLogica blog, Steven Novella reports on an interesting case of acupuncture promotion here in Oz, via Rachel Dunlop. As Novella reports, acupuncture has been studied many times before, and Cosmos, our premier science mag, did a story on the procedure a while back, reporting no evidence of any benefits except in the notoriously vague areas of back pain and headaches.

Not surprisingly, lower back pain was one of the conditions that supposedly benefited from acupuncture, according to media hype about the latest study. The trouble is, this study was being reported on before being published and peer reviewed, which, to put it mildly, is highly irregular and raises obvious questions. The Sydney Morning Herald is the offending news outlet, and Dr Michael Ben-Meir the over-enthusiastic researcher. As the article points out, Ben-Meir is already a ‘convert’ to acupuncture, having used it for some time in acute cases at two Melbourne hospitals. That’s fine, if a bit unorthodox, but it doesn’t accord with other findings, and there are therefore bound to be questions about methodology.

One of the obvious difficulties is that acupuncture can hardly be applied to patients without them knowing it. It’s a much more hands-on and ‘invasive’ experience than swallowing a tablet, and this will undoubtedly have a psychological effect. It seems to me, just off the top of my head, that acupuncture, with its associated rituals, its aura of antiquity and its oriental cultural cachet, would carry greater weight as a placebo than, say, a homeopathic pill. But in fact I don’t have to speculate here, as there is much clinical evidence that injections have a greater placebo effect than pills, and big pills have a greater placebo effect than small ones. So it doesn’t greatly surprise me that people will report a lessening, and even a dramatic lessening, of acute pain, after an acupuncture treatment, however illegitimate. I presume there are illegitimate treatments, because the ‘key meridional points’ where the needles are applied are precisely know by legitimate acupuncturists, and they apply their treatments with rigorous accuracy.

Well, actually there’s a big question as to whether or not there are any legitimate acupuncturists, because acupuncture is based on an energy system known as ‘chi’, which supposedly has meridional points at which needles can be inserted quite deeply into the skin, but there’s no evidence whatever that such an energy system exists, let alone about how such a system might function – for example, its mode of energy transmission (whatever ‘energy’ might mean in this case). Considering that we know a great deal about the autoimmune system and the central and peripheral nervous systems, it seems astonishing that this other bodily system has gone undetected by scientists for so long, and especially in recent times, with our ultra-sophisticated monitoring devices. When you look up ‘chi, sometimes spelt ‘qi’ or with other variants, you’ll find nothing more specific than ‘energy’, ‘life force’ or something similar – nothing corpuscular or in any sense measurable by modern medicine. Even so, researchers into acupuncture have come up with an attempt to measure its efficacy by comparing it to ‘sham acupuncture’ in clinical trials. Sham acupuncture uses the ‘wrong’ meridians and the ‘wrong’ depths to which the needle goes.

But herein lies an obvious problem. Sham acupuncturists insert needles only millimetres deep, while real acupuncturists put their needles between one and three or four centimetres deep: ‘Depth of insertion will depend on nature of the condition being treated, the patients’ size, age, and constitution, and upon the acupuncturists’ style or school’, according to an acupuncture site I visited at random. These are rather wide parameters, but the point that interests me is this. If you don’t put your needle in deep enough, you won’t make contact with the chi that needs to be stimulated or other wise modified to heal the patient. So goes the rationale, surely. It’s like, if you don’t put the needle for a standard vaccination in the right place, you’ll miss the vein. But veins are clearly real. If you go dissecting, you’ll find veins and arteries and nerves and muscle and fat and so on. But you won’t find chi. Yet, apparently it does have real existence. It’s between one and four centimetres down, according to real acupuncturists, depending on the above-mentioned variables (and no doubt many others).

So we can’t actually see it, or find it on dissection, but it’s locatable in space, vaguely. Or is it that chi is everywhere in the body but the right kind of chi, the bit that’s causing the pain and needs to be treated with needles at certain precise meridional points, is at a certain distance from the surface of the skin?

It all begins to sound a bit like theology, doesn’t it?

Here’s the ‘take-home’ for me. If you read about treatments that ‘work’ but you get virtually nothing about the mechanism of action, as is the case, for example, with homeopathy and acupuncture, be very skeptical. In the end I’m not impressed with clinical trials that show a ‘real effect’, even a startling one, because I know about regression to the mean, and I particularly know about the placebo effect. I want ‘proof of concept’. In this case proof of the concept of chi and of meridians. I’ve heard homeopaths defend their pills on TV recently by claiming that, ‘whatever the mechanism, clinical trials consistently prove that this treatment works’, and I can’t be bothered chasing up those clinical trials  and testing their legitimacy, I go straight to the concepts and processes behind the treatment – the law of similars, the law of infinitesimals, and don’t forget succussion. These concepts are so intrinsically absurd that we needn’t bother looking at the clinical data. If there are positive results, they haven’t been produced by homeopathy. The fact that homeopaths themselves are largely uninterested in the mechanisms is a dead giveaway. You’d think that the law of infinitesimals and the law of similars would surely have myriad applications far beyond their current ones. They would revolutionise science and technology, if only they were real (and they’d also render obsolete much that we currently know).

The same goes for acupuncture, and chi. If this bodily system were real, and chi could be captured in a test tube, and its constituents examined and isolated under a microscope, how revolutionary that would be. How transformative. Chi pills, chi soap, chi breakfast cereal…

Ah but I’m thinking like one of those limited westerners, so modern, so smug, so lacking in the insight of the ancients…