Naturopathy for the beginning Skeptic

Hello folks.  How have you guys been?  Its been a little jacked up here, mostly due to poor timing and various injuries.  The world of pseudoscientific bullshit keeps rolling along.  I am really starting to understand why James "The Amazing" Randi calls it all "Unsinkable Rubber Duckies".  And just so you know, I'm about to go on a rant, so if you want to skip over it, you may just want to skim past the rest of this paragraph, and the next one too.  I was in the Oklahoma City Bass Pro Shop the other day to kill some time between errands I had to do.  While I was walking through the store, looking at fishing equipment, clothing, and the wide variety of "stuff" they carry, 1) I saw something that pissed me off, which doesn't seem to take much these days, and 2) I had a realization.  What I saw were the damned Power Bands being sold to help with "Stability, Strength, " and I believe it said stamina.  It had the goofy little "hologram" in it and the cheap rubber bracelet. This is ridiculous.  The manufacturers of these things just seem to bounce them from retailer to retailer trying to find somewhere the skeptical community doesn't go.  With the large number of skeptics that don't own firearms, let alone hunt, I think they may have found a safe haven for the time being.  The question is, is it worth it? Would this be a fight worth the time and effort to take up, or would it be a fruitless venture?  Because they actually carry very few things that promote Woo, it may actually be a good thing to nip it in the bud before it has a chance to spread much farther.  I know that the backwoods skepticism seems to be my individual niche, and I may be the only one that cares that these things are being sold here, but on the other hand, if they are successful at Bass Pro Shop, what's to stop them from slowly leaking back out into the general market place again?
    And now for my realization, which is totally unrelated to the power band bracelets.  The realization I had is this: If you ever need a visual or physical representation of the concept of false choices, go through the fishing lure section in any sporting store.  Yes, they may have what looks to be hundreds of different types, but upon closer examination, you'll come to realize that, no, there are only a handful.  You have plastic lures, that while they come in hundreds of colors and various sizes, there are only a scant few designs such as worms, crawfish, fish, tubes, and a few that readily defy an easy description.  Then you have the hard lures (which ironically are plastic while I think the plastic lures are rubber) You can get ones that mimic crawfish, fish, grasshoppers, and mice, and some that are hard to define their general shape.  Once again, they come in a variety of colors and sizes, but for the most part, you only have a few things to choose from.  I know you can use stink bait, live baits, metal lures, and fishing flies, but still not a lot of choices.  So you have roughly 10, maybe 15 choices to make, yet you may see an area that takes up about 1/2 an acre with thousands of different colored packages with wildly promotive descriptions of how much better their product is than all the others.  Yet, in the end, you end up asking yourself do I want a worm or do I want a grasshopper?

First off, before I begin the topic, I would like to thank everyone that has responded to my call for help on the activism project I'm trying to do.  I am currently working on posts for their suggestions, and hopefully I will have them up soon.  I'm also trying to develop a title for the project, rather than continuing to use "New Skeptical Activism Project"  I originally wanted to call it "Project Bullshit", but I don't know how well people would respond to it, and I don't want Penn and teller to think I lifted one of their ideas.  Personally, I think it's to the point, but if you have a better suggestion, let me know.

Naturopathy
Todays topic is another one that the beginning skeptic is going to come across a lot.  You may see it and not actually realize it.  You may even have it in your house at this moment.  Basically any time you see the phrases "All Natural"  "Natural Ingredients" "No Chemical Additives" etc..., you are more than likely dealing with a form of naturopathy.  There are many different forms of alternative medicine that fall under the blanket term of naturopathy, and I'll discuss some of these later in the post.  The basic concept behind naturopathy is no chemicals (which is rather silly, if you think about it, everything is made up of chemicals) and no or minimally invasive surgery.
 The definition of naturopathy according to Wikipedia says:
Naturopathy, or naturopathic medicine, is a form of alternative medicine based on a belief in vitalism, which posits that a special energy called vital energy or vital force guides bodily processes such as metabolism, reproduction, growth, and adaptation.^[1] Naturopathy favors a holistic approach with non-invasive treatment and generally avoids the use of surgery and drugs.^[2] Among naturopaths, complete rejection of biomedicine and modern science is common.
It's actually a fairly long article, so I'm just putting the first paragraph here.

And for a laugh, Conservapedia says:

Naturopathy is a New Age alternative medicine. The practice of this medicine include vegetarianism, nutritional and exercise counseling, hydrotherapy, heliotherapy, thalassotherapy, manual therapy, herbalism, acupuncture, aromatherapy, electrotherapy, magnetotherapy, musictherapy, chromotherapy, homeopathy and chiropractic.

Some important names in naturopathy are: Vincent Priessnitz (1799-1852), Theodor Hahn (1824-1883), Arnold Rikli (1823-1906), Sebastian Kneipp (1824-1897), Tadeo Wiesent (1858-1926), Wilhelm Winternitz, Benedict Lust (1872-1945), Eduardo Alfonso, Manuel Lezaeta, Adrian van der Put, Nicolás Capo and José Castro.

In 1902, Benedict Lust organized the Naturopathic Society of America, which was reorganized as the American Naturopathic Association (ANA) in 1919. [1] In America, licensing and training requirements vary from state to state. In some countries the practice of naturopathic medicine is unregulated or the industry is self regulated.

Naturopathy is a whole medical system that originated in Europe. Naturopathy aims to support the body's ability to heal itself through the use of dietary and lifestyle changes together with therapies such as herbs, massage, and joint manipulation; the emphasis is on supporting health rather than combating disease.

A central belief in naturopathy is that nature has a healing power [2]

Like all New Age practices, reconciling it with Christianity can be problematic.
This is their entire article on the subject.  For once, there is no mention of atheists though.

And the American Naturopathic Association states:

Naturopathy is the oldest form of health care.  It means, essentially, "to follow the path of nature"... in healing.  And as such, naturopathy is directly based on observable scientific principles.  

Terminology:  The words "naturopathic" and "naturopath" are generic terms describing a process or person following the path of nature, generally in health care, but also in other reaches of life.

TITLES:  Traditional Naturopaths title themselves in various ways-  Naturopathic Doctor, Naturopath, Doctor of Natural Health, Natural Physician, Traditional Naturopath, Certified Traditional Naturopath, Naturopathic Practitioner.  This may vary by state/region and by the type of degree or diploma each School conveys.

This term - that of "naturopath"  is our western equivalent of "ayurvedic".  We do not, and encourage others not to buy into the false assumption that this term belongs to an elite few people- namely- the naturopathic medical practitioners.  It is a term that we must share, if we wish to use it at all.
This one seems to be a little more in depth than some of the other associations that I looked into, so for the naturopaths benefit, I am going to use them as the pro side of the article.

History
The history of naturopathy technically goes back to the beginning of human civilization.  The use of herbs has been documented by the Greeks, the Chinese, and even the Sumerians.  What we now call an herbalist was back then called a healer (or a witch when times were bad).  People have known for centuries that chewing on willow bark would help alleviate pain.  This is because willow bark contains salacin, which is basically the same ingredient you find in aspirin.  The term naturopathy was coined, according to Wikipedia, in 1895 by John Scheel and the term was bought by a man named Benedict Lust.  In 1901, the School of Naturopathy was founded by Benedict Lust in New York, which was dissolved in 1919.  Lust then formed the American Naturopathic Association, which survives to this day.  Interest in Naturopathy has had both high and low periods, but it has never completely disappeared.  Due to the fact that until the middle of the 19th century, there weren't really any chemists or doctors working to derive beneficial compounds, I am going to use the 1880's as the beginning of what we know call naturopathy.  Wikipedia is about the only reliable place I was able to find anything on the history of naturopathy, and I've hit most of the high points, so from here, we'll jump right into the practices.

Practices
Like I mentioned earlier, there are a many different alternative practices that can fall under naturopathy, and rather than write an individual post on each one, I am going to list them along with a brief definition.  In no particular order, they are:
Ayurveda- From the Indian sub-continent, it is a combination of herbal medicine and energy manipulation
Herbal medicine- Exactly like is sounds, medicine from herbs.
Homeopathy- Highly diluted substances that are supposed to treat the symptoms
Acupuncture- Needles stuck into "mapped" points on the body to help manipulate energy.
Chinese herbal medicine- Once again, exactly like it sounds, medicine made from herbs, from China.
Color Therapy- This is a new one to me.  It's basically using different colored light to "balance the energy".  I wonder how well it would work on a color-blind person like me?
Reflexology- A form of acupressure used on the feet, hands, or ears.
Manipulative therapy- This includes chiropractic, osteopathy, massage, and anything else that parts of the body are physically manipulated.
Unani-Another new one.  This is a Muslim form of medicine based on the 4 humours.
Yoga- A form of physical exercise from India
Nutrition and diet- A lot of naturopaths tend to lean towards vegetarian or vegan diets to cleanse the body;
Hydrotherapy- Baths.  They actually refer to it as healing with water.
Reiki- Sort of like faith healing.  Hands are placed on the patient and their "energy" or "aura" is manipulated

There are probably others that that I missed and are included, and some of the above are not included, depending on the school and training that the practitioner received. None of these practices have any scientific backing that shows they work any better than the placebo effect.  According to the American Naturopaths Associations website a true naturopath does the following:
Nutrition, Healing Diets, and Food Therapeutics, Healing programs,
Massage and Applied Bodywork Therapies
Naturopathic Physical Medicine
Energy Medicine/Energy Balancing Bodywork
Hydrotherapy
Iridology / Iris Analysis
Applied Natural Therapeutics and Treatments
Medicinal Herbal Practice
Botanical Applied Therapeutics
Herbal Pharmacy and Dispensary.  Apothecary Practice
Natural Physician Assessment Methods
Community Education and Counseling
Holistic Anatomy and Physiology
Parasitology
Microbial Balancing of Inner Ecology
Eastern /Oriental Therapeutic Approaches
Flower Essences Creation and Practice

Once again, little or no evidence that any of these interventions work, except, oddly enough parasitology.  This is the study of parasites and their environments.  I don't know how it made it onto their list.  But overall, the way that naturopathy is supposed to work is that the body heals itself.  In the words of Mark Crislip, host of the Quackcast podcast, "Why do something, just stand there."  And as a side note, I found several places advertising themselves as :Naturopathic Cancer Hospitals".  This disgusted me.  They have all these quack treatments for people that are literally fighting for their lives.  I've said in the past that placebo treatments for the truly terminal may be a good thing, but if someone has a chance to put their cancer into remission through chemo or surgery and live, why go to an alt -med practitioner?  A lot of these also fall under the umbrella term "Holistic", which has just come to mean "whole body"  So they try and treat mind. body and soul when trying to cure people of various ailments.  It's just another aspect of "Supplementary Complimentary Alternative Medicine".  (To borrow again from Mark Crislip, it's all S.C.A.M.)

Licensing and Regulation
There are only about 20 U.S. states and territories that require naturopaths to be licensed.  They are:

• Alaska
• Arizona
• California
• Colorado
• Connecticut
• District of Columbia
• Hawaii
• Idaho
• Kansas
• Maine
• Minnesota
• Montana
• New Hampshire
• North Dakota
• Oregon
• Utah
• Vermont
• Washington
• United States Territories: Puerto Rico and Virgin Islands

This list came from the American Association of Naturopathic Physicians
Looking through their list of licensing boards, I did not see any that did not have the word Naturopth in it.  Not a single one had the phrase "Medical Board" in it, like you would see with a regular M.D.  They appear to be largely self regulated, which in of itself is a scary thought.  South Carolina and Tennessee are the only states that actually prohibit naturopathic practices, and Utah is the only one to require a residency between graduation and beginning a practice.  Way to go Mormons!
As for actual U.S. regulation (and yes, I know I;m primarily discussing U.S. policies rather other countries.  This is because each country has their own views as to what constitutes a naturopath or traditional healer and what constitutes modern medicine.), there is very little regulation.  In most states, I could hang a sign out my front door and advertise myself as a naturopathic healer, with little fear of breaking any laws.   I could find no evidence of a regulatory board in the Department of Health and Human Services for chiropractic, hompeopathic, or any other alt-med practice. When it comes to herbal medicine, there is no regulation by the F.D.A.  All those bottles of herbal supplements lined up on the shelf at your local Wal-Mart, Target, WalGreens, or any other store, (which is the most common way people come into contact with this particularly invasive form of Woo) have no regulation.  There is no guarantee that what the bottle claims to contain is actually in it.  There is a good article on Slate.com about the lack of regulation over these supplements.  You can read it here.  Basically due to lobby groups, they were defined as dietary supplements, therefore not subject to the more rigorous F.D.A. regulation over food and drugs.  As a matter of fact, I pulled these examples straight from the F.D.A. F.A.Q. (damn, that's a lot of acronyms for one post) website concerning dietary supplements.  It states:

Where can I get information about a specific dietary supplement?

Manufacturers and distributors do not need FDA approval to sell their dietary supplements. This means that FDA does not keep a list of manufacturers, distributors or the dietary supplement products they sell. If you want more detailed information than the label tells you about a specific product, you may contact the manufacturer of that brand directly. The name and address of the manufacturer or distributor can be found on the label of the dietary supplement.

Who has the responsibility for ensuring that a dietary supplement is safe?

By law (DSHEA), the manufacturer is responsible for ensuring that its dietary supplement products are safe before they are marketed. Unlike drug products that must be proven safe and effective for their intended use before marketing, there are no provisions in the law for FDA to "approve" dietary supplements for safety or effectiveness before they reach the consumer. Under DSHEA, once the product is marketed, FDA has the responsibility for showing that a dietary supplement is "unsafe," before it can take action to restrict the product's use or removal from the marketplace. However, manufacturers and distributors of dietary supplements must record, investigate and forward to FDA any reports they receive of serious adverse events associated with the use of their products that are reported to them directly. FDA is able to evaluate these reports and any other adverse event information reported directly to us by healthcare providers or consumers to identify early signals that a product may present safety risks to consumers. You can find more information on reporting adverse events associated with the use of dietary supplements at Dietary Supplements - Adverse Event Reporting.

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Do manufacturers or distributors of dietary supplements have to tell FDA or consumers what evidence they have about their product's safety or what evidence they have to back up the claims they are making for them?

No, except for rules described above that govern "new dietary ingredients," there is no provision under any law or regulation that FDA enforces that requires a firm to disclose to FDA or consumers the information they have about the safety or purported benefits of their dietary supplement products. Likewise, there is no prohibition against them making this information available either to FDA or to their customers. It is up to each firm to set its own policy on disclosure of such information. For more information, see claims that can be made for dietary supplements

That is a scary thought!  You can read the rest of it here.  Like most other alternative medicines, they do not have to show efficacy before marketing their products.  Which leads us to the next point.  (I'm getting a bit better at segues)

Evidence
The evidence for the efficacy of any naturopathic intervention is nearly nil.  I trolled pub-med and couldn't find any trustworthy studies that showed any of the treatments were actually capable of helping.  I will allow one caveat though.  Many medicines we have today are indeed derived from natural products.  The main example is willow bark, which once it was analyzed, we were able to make aspirin.  Like all other alt-med treatments, the pro side constantly uses anecdotes and subjective measurements as evidence that their ideas work.  My personal favorite tactic they use, especially in the energy healing and manipulation group, is that science has no way to measure what they are doing, but they know they are doing it.  You will hear naturopaths use several arguments during debates.  The most common ones are:
The argument from antiquity- " People have been using this for thousands of years, so it must work."  People have also been sacrificing animals, babies, and virgins for centuries.
The argument from nature - "If it's natural, it must be good for you."  Well asbestos, hemlock, and uranium are all natural, so sit down and enjoy the soup.
The argument from conspiracy -"Big Pharma doesn't want people to be healthy or to know that this works because it will eat into their profits."  Bullshit asshole.  Last year, people spent about $34 billion on alt med.  When you figure these companies don't have to pay for research and development, licensing, years of testing, years of waiting for approval for sale, and yes marketing, it;s almost pure profit.  So much for the mom and pop market model..
Yes almost all alt-med practitioners will throw out the "Big Pharma" or "Big Government" conspiracy card at some point in a discussion.  As I said earlier, the scientific evidence for the efficacy of a naturopaths "treatments" is sorely lacking.

Conclusion
My personal conclusion when it comes to medical treatment is that I would rather go and get poked and prodded by someone that earned their white coat with years of education from a school with the word "medical" in it than chew on a piece of tree bark while someone tells me to eat more green and orange food and then gives me a bottle of saw palmetto.

I know this article wasn't as organized as the other 2 "Woo for the beginning Skeptic" posts were.  I didn't realize exactly how much the topic actually encompassed, and because of personal experience with some aspects of it, I kept finding myself getting frustrated and going off on rants that I had to come back and edit out later. (This one is very heavily edited.  It's taken me several weeks to write it.)  I still may come back and revisit some of the subdivisions later, if people request that or if there is a news article concerning one of them.   I know I cursed a bit more than usual, and I hope that impressionable young children aren't reading this.  If you are,I hope you learned something.  The lesson is "Don't do alt-med.  It's bad, mmmkay?"  And now we have my first promo as a matter of fact!  One of you lovely readers has written a book on homeopathy, which will hopefully be published soon, and was kind enough to let me know about it.  When it's published, I will give you all the details, where to get it, cost, formats, and where to send any letters of praise and appreciation.  Or at least as much info as they want me to put out. Until next time, be good, be reasonable, and be yourself.

The Skeptical Okie

Acupuncture for the beginning Skeptic.

Hello everyone, I hope that things have been going well.  It looks like things may be a little chaotic here at the Skeptical Okie Headquarters for a while.  While trolling some of the odder sites on the internet (no, not those sites), I came across a really weird article (dare I say misguided or blatantly wrong?) on Conservapedia.  Basically, it says that "Dinosaur skin discovery befuddle evolutionists.  Why?  The earth is only 6000 years old."  Urg!  I go on some of these sites for a laugh, but I have a strong interest in paleontology, so this really irked me.  I have been fighting the urge to write them and ask if they aren't really a front for The Onion.   You know, stories that they thought were too out there to put up on their own site.  Besides, who the hell really uses the word befuddle anymore.  But in the mean time, I am going to continue the Topics for Beginners series, which I hope has been helpful so far.  The reason I started with homeopathy is that it is more than likely one of the first of the pseudosciences that you will come across as you begin this wonderful, and at times stressful journey into the skeptical movement.

Now for a fun little thought trip.  You've noticed that lately you've been having asthma problems.  You call and make an appointment, and show up in a very cute little office.  You sit back, read the magazines, and finally get called into the exam room.  You sit down and tell the nice person your problems, and wait for their diagnosis.  They tell you that obviously you have blocked or disturbed chi, but they have just the thing.  They have you lay on a table, close your eyes, and tell you you might feel a little prick.  They then proceed to put anywhere from 15 to 100 very thin needles in various places.  At this point, they may ask you how you are feeling.  To be honest, if you are in a confined space with someone that basically just stabbed you with needles, are you going to tell them you feel worse?  This folks, is acupuncture (the key part of the word is puncture) and this:

is what you may look like.  Oops, sorry, wrong picture.  I meant this is what you might look like


(photo from acupuncturehoustoncity.com)

The basic breakdown of acupuncture is that it is a cross between acupressure points and a porcupine.  The practitioners have various charts that display where to place the very thin needles to help clear any blocked chi, usually along what is called a meridian line.  These are supposedly lines that travel the body and help the chi (usually pronounced key or chee) move throughout the body.  Just like with many other new age medical treatments, there are traditionalists and contemporary practitioners that have competing ideas concerning the placement of the needles and even the materials that they should be made of.  Before I devolve into a rant against untested, unfounded, and even dangerous pseudo-scientific bullshit, let's talk a bit about the history of acupuncture, shall we.

History:
The history of acupuncture is, of course, a little murky.  According to the RationalWiki, it dates back to about 300 BCE, while Wikipedia places its roots at possibly 1600-1100 BCE.  Acupuncture.com has the date roughly between 480-221 BCE for the beginning of acupuncture, but the wording of the article makes it a little difficult to be sure. According to them in another article, it may even go back as far as 4700 BCE.   In an article about the history of acupuncture, it seems to deal mostly with the political and philosophical development of China.  Conservapedia has a 2 sentence blurb, and yet they manage to make it sound as though it has been definitively proven to work.  Everyone does agree (except Conservapedia, which doesn't even mention it's origins) that it began in China a long time ago.  Most of the proponents for acupuncture will use this as a basis for their arguments concerning the efficacy if their treatments.  This is the logical fallacy known as "The Argument from Antiquity".   In this fallacy, you are stating that the concept is correct or it works because it's been around for a long time.   You can also call it the "Time tested appeal"  This is an argument used by many people that either use or practice alt-med.  They are saying that because the advancement of science hasn't completely eliminated their ideas, they must be onto something that modern medicine has missed, like chi, qi, chakras, meridians, etc.  You know, things that scientists don't understand because they can't be disproven or tested, (even though they have been many times) so they must be there and we just can't find them.  What is known concerning the history of acupuncture (and I am personally going to go with the 300 BCE figure due to several factors such as metallurgy and known written texts) is that it has been an aspect of Chinese health care for at least 2000 years.

Theory:
The theory behind acupuncture is actually rather intriguing.  It also sounds sort of like the ideas that the medieval european  healers had concerning illness.  From Acupuncture.com

As the basis of Acupuncture, Shen Nung theorized that the body had an energy force running throughout it. This energy force is known as Qi(roughly pronounced Chee). The Qi consists of all essential life activities which include the spiritual, emotional, mental and the physical aspects of life. A person's health is influenced by the flow of Qi in the body, in combination with the universal forces of Yin and Yang . (I will discuss Yin and Yang a little later). If the flow of Qi is insufficient, unbalanced or interrupted, Yin and Yang become unbalanced, and illness may occur. Qi travels throughout the body along "Meridians" or special pathways. The Meridians, (or Channels), are the same on both sides of the body (paired). There are fourteen main meridians running vertically up and down the surface of the body. Out of these, there are twelve organ Meridians in each half of the body (remember they are in pairs). There are also two unpaired midline Meridians.

(and no, I'm not linking to these people.  I view them to be nearly as bad a naturalnews, and I don't really want to be associated with them in anyway, except discussing their articles.)  Every article I've read says that there are either 12 or 14 meridian lines running through the body.  Why they can't agree, I really have no idea.  From RationalWiki you get :

Its theoretical basis is that health and sickness are caused by the good or bad flow of chi through the body, in particular along the twelve major meridians of the body (though some authorities list fourteen or even more) which run from head to toe along the body, and which are associated with the bladder, gallbladder, heart, large intestine, small intestine, kidneys, liver, lungs, spleen, stomach, pericardium, and "triple heater". It is necessary to translate this last term word for word from the Chinese because there is no such thing as the "triple heater".

The acupuncturist treats the ailments of these various parts by inserting needles at points lying on these meridians, known simply as "acupuncture points" and manipulating the needles to increase or decrease the flow of chi along that meridian.

So basically the idea behind acupuncture is "something's wrong with this person, let's jab a bunch of needles in them and see what happens."  I can only imagine the testing and trials they went through.  It probably went something like "You feel bad?  OK, lay down.  Um.... I know, tell me if this makes you feel better.   No?  How about when I put it here.  OK.....uh, that went badly.  Mental note, don't go very deep, especially there.   But, he doesn't feel bad anymore.  Next patient please."  I know that was sarcastic and a little goofy ( and I would love to see a Monty Python sketch based on the origins of acupuncture) but in all honesty, that may be close to what happened.  The thing is, no one knows how it came about.  Aside from the needles, the other basic premise of acupuncture is chi (this is the spelling I'm going to use for the rest of the article).  Chi is a persons life force.  And used to make the spirit bomb in Dragonball Z.  When it the balance of chi is altered, either by being concentrated or blocked in an area, illness occurs.  To help alleviate the problem, the flow of chi must be returned to proper levels.  An acupuncturist uses a chart based on acupressure points, which I'll discuss in a bit, to determine the best location to place the needles to help restore the flow.  Once placed and manipulated by the practitioner, I imagine it's like clearing a dam in a river.   Some practitioners also claim that the 5 elements are involved.  I don't mean carbon, nitrogen, hydrogen, oxygen, and copper.  I mean earth, wind, fire, water, and spirit (Go Planet!)  These forces need to be in balance with each other in order to preserve health.  If one comes to dominate the others, or one is entirely depleted, then illness will occur.  These forces can also be manipulated using acupuncture.  How you can manipulate air or fire with a metal needle, I have no idea.  I can't even begin to grasp how that would work.

Diseases:
Like any other alt-med practice, there are a wide range of diseases that acupuncturists claim to be able to treat.  From one article in Acupuncture.com:
The most common ailments currently being treated are: lower backache, Cervical Spondylosis, Condylitis, Arthritic Conditions, Headaches of all kinds (including migraine), Allergic Reactions, general and specific use for Analgesia (including surgery) and relief of muscles spasms. There have also been clinical trials in the use of Acupuncture in treating anxiety disorders and depression. Likewise, very high success rates have been found in treating addictions to alcohol, tobacco (nicotine) and "hard' drugs.Acupuncture can rid the body of the physical dependency, but can not rid the mind of the habit (psychological dependency). For this reason, Acupuncture treatment of addictions has not been fully successful.

And under the main pages Patients:Conditions A-Z you find :

Acne Addiction Allergies Alzheimer's Angina Anxiety Arthritis Asthma Back Pain (Self-Help) Back Pain (Chinese Medicine) Benign Prostatic Hyperplasia Breast Cancer Breast Lumps Cancer Candidiasis (Yeast Infection) Carpal Tunnel Syndrome Cholesterol, High Chronic Fatigue Syndrome Constipation Crohn's Disease Depression Dermatitis (Eczema) Diabetes Diarrhea Diverticular Disease

Ear Infection Endometriosis Eye Diseases Female Sexual Dysfunction Fibroids Fibromyalgia Flu (and Colds) GERD Glaucoma Gout Gum Disease Hayfever Headache Heartburn Hemorrhoids Hypertension Impotence Indigestion Infertility Irritable Bowel Syndrome Insomnia Kidney Stones Lung Cancer Male Infertility Memory Loss

Meniere's Disease Menopause Menstrual Cramps Multiple Sclerosis Muscle Strain and Sprain Osteoporosis Pancreatitis Parkinson's Peptic Ulcer Premenstrual Syndrome Preventative Medicine Psoriasis Rheumatoid Arthritis SARS Shingles Sinusitis Stress Stroke Tinnitus Trigeminal Neuralgia Ulcerative Colitis Urinary Incontinence Urinary Tract Infection Vitiligo

They don't claim all can be treated with acupuncture, such as gum disease, but they also promote chinese herbal medicine, which is a form of naturopathy.  I'm not going into this right now because it is going to be a blog post in the near future.  However, the number of diseases they claim can be treated with needles in the dermal layer is appalling.  Especially given that there have been no definitive studies that show acupuncture actually works.

The Tools:
Lets go back to the little example in the beginning.  While laying on the table, listening some new age music that's piped into the room, the kindly person that claimed they could help you would be sticking these into your skin

Pleasant, aren't they.  These are the acupuncture needle.  When I googled for them, I actually found a large number of varieties.  This really doesn't sound like a heavily monitored industry.  And yes, it is an industry.  Proponents of alt-med will normally utter the phrase "Big Pharma" at some point in their argument.  Alt-med makes billions of dollars each year, just like the pharmaceutical companies.  As a matter of fact, some pharmaceutical companies, like Merck,  have actual bought or created their own alt-med lines. Back to the tools of the trade.  Another tool they use are the all important meridian and acupressure point charts.  Here is where it gets a little odd.  There are many charts that show a lot of different points.  There are roughly 670 points, according to Acupuncture.com.  RationalWiki doesn't have a total, but Wikipedia gives a range from 160 to 670, stating that part of the last number is due to a number of pressure points on the ear.  Some of the charts they use look like these:

I don't know how your ear controls what goes on in your feet.

I did find many more, but they aren't shy about showing the human body, and in case there are small children looking at this, I didn't want to cause them to hit puberty early.  They even have charts for animals.

There are also charts for dogs, cattle, and horses.  And I don't know about you, but having been around these animals for most of my life, I would not want to be the person trying to stick a needle in them.

Alternatives:
There are some alternatives, aside from the exact placement of the needles and what the placement actually does.  One of the most common is is electro acupuncture, which like so many other pseudoscience claims, has been promoted by Dr. Oz/  Electro acupuncture is acupuncture with an mild electric shock.  Many traditionalists do not consider this true acupuncture.  Another alternative is whether they use wooden or steel needles.  Most practitioners use surgical stainless steel, but some are making a move back to a more traditional treatment.  There is also a needle-less acupuncture.  This is a combination of faith healing (another future topic) or psychic surgery and acupressure points.  Much like homeopathy, people claim that the effects of acupuncture are so strong that needles aren't really needed. (15 cool points to the first person to leave a comment as to what more than likely causing this).  There is also a form called Sonopuncture, which uses ultrasound instead of  needles to manipulate acupressure points.  There are probably more forms that I haven't heard of or been able to find.

Problems:
Once again, people often ask "What's the harm?"  Outside of the normal risks that come from opting for alternative medicine to treat life threatening illnesses, there is at least one additional danger from using acupuncture.  Much like a real doctor or a tattoo parlor, sterilization is of utmost importance.  Over the years, there have been reports of people contracting diseases such as hepatitis C from contaminated needles and improper sterilization techniques.  This is a risk anytime you are dealing with something that can break your body's first line of defense, you skin.  Anytime you are dealing with a procedure that involves piercing the skin, you can demand to watch them open a new, sterile package before proceeding.  an uncommon, but not unheard of problem, is the acupuncturist going too deep with the needle and piercing something such as an organ and causing even more problems.  Another problem associated with acupuncture is the actual efficacy of the treatment.

Testing:
Looking on PubMed.gov, there are numerous studies concerning the efficacy of acupuncture.  For the most part, they seem to lean towards that it may effective in treating some of the symptoms, but not the actual disease.  The reason acupuncture may be at least partially effective in treating various symptoms such as pain, fear, soreness and the like is due to the release of dopamin and serotonin, which help with both mood and pain receptors in the body.  This is the same idea as the best way to cure a headache is to drop a hammer on your foot.  The main problem with testing acupuncture is that it is incredibly difficult to develop a true blinded test with a reliable control with acupuncture.  This is mostly because either the person placing the needles knows if they are doing it correctly, or the person receiving the acupuncture knows when a needle is sticking out of their skin.

Conclusion:
My conclusion is, if I wanted to have sharp objects jabbed into my skin, I would fight a porcupine.  It would likely have the same effect, but a much cooler story.  I don't feel that the available evidence proves that acupuncture is effective, and the risks can easily out-weigh the possible benefits.  Go in for headaches, come out with hepatitis, or at least a much lighter wallet.

I hope that this article is helpful for anyone that is just starting to look at the world in a skeptical manner.  I'm not saying that alt-meds don't work, I'm just saying that the current evidence doesn't show many of them to be effective. Thanks for reading, and until next time, be good, be reasonable, and be home in time for dinner.

The Skeptical Okie

Homeopathy for the beginning skeptic.

Hello everyone. I hope that you're doing well.  I know it's been a while, and I apologize. There has been a lot going on that's prevented me from developing a post for your reading enjoyment.  But now that things have settled down a bit here at the Fortress of Logic, located in the secret basement of the Skeptical Okie Headquarters, I'm back in the saddle.  For the next few posts, I'm going to be covering a general theme, basically alternative (quack) medicine.  These will include homeopathy, acupuncture, reiki, faith healing, psychic surgery, and .......  you get the idea.  Some may be over more than 1 topic if they are closely related. Now, before you go "Oh hell, he's going to get technical on me.", no I'm not.  These are going to be a general knowledge posts over the history, what proponents and opponents say about it, what the risks are, possibly some case studies, and from there I'll let you use your critical thinking skills to come to a conclusion.  That's not to say I'm not going to be the normal snarky bastard that you've come to love, or at least like enough to spot me a five at lunch.  I'll probably mouth off when discussing some of the more outrageous claims, but you don't want me to keep that kind of stuff bottled up.  It wouldn't be pretty. (Like I'm ever pretty.)  And I'm still waiting for submissions and suggestions on my project.  If you know of a pseudoscience product that you want tested, let me know.  For more details, go back to post #31, New Skeptical activism project.  And let me know if I need to alter the submissions criteria.  Back to the topic at hand, these next few posts are going to be a sort of beginners guide for people new to the Skeptical movement.  I hope that you find them helpful.

Homeopathy
According to Wikipedia, homeopathy was started in 1796 by Samuel Hahnemann under the concept of "like cures like" also called "The Law of Similars".  Basically, if you have a condition, say sneezing, you would dilute pepper, because it causes the same condition, and take it as a medication.  This is supposed to cause the body to react, and cure itself  through your own immune system.  Since then, it has often been touted as a method to cure nearly anything from allergies to cancer.  The popularity of homeopathy has had its highs and lows over the last 200 years, but it has seen a steady increase over the last roughly 30 years.  (Like I said, this is sort of a beginners guide, so I'm not going to get too in-depth over the history) These days, you can walk into nearly any pharmacy or drug store and find something labeled "homeopathic cure".  WalGreens, CVS, Wal Mart, and most of your small mom and pop type places all carry something homeopathic.  (Sorry if I didn't list your favorite store, these are the only ones that are both well known and that I have actually been in.)  In the U.S., there is not really much regulation concerning homeopathic medicine, so I feel that any numbers I am able to find regarding the amount of homeopathy bought, the numbers of different treatments available, or even the number of practitioners are not reliable.  I do know if you open an Oklahoma City phone book (yes, I actually keep a hard copy phone book around.  Comes in handy when dealing with particularly adamant salesmen), you will find a number of listings for alternative and complimentary medicine.  4 in fact.  But, if you drive around OKC, you will see hundreds of signs promoting "all natural homeopathic cures" or some such variation of this drivel.  And you often see people entering the "place of business" (often, it's just a sign someone has stuck in their front yard) to buy something they either think or hope will help them. (I'm not going to make assumptions about the actual product or service they are purchasing, out side of they are buying something from someone in the building)

Methodology
From this point on, I'll be referencing several sources, so I'm going to abbreviate the ever popular Wikipedia to Wp, and as I use other sources, I will give an abbreviation with the first use of their name.
According to Wp, the process of creating a homeopathic medication is rather complicated and labor intensive.  After determining what you ailment is and what your cure should be, (most homeopaths say that to be truly effective there needs to be a one on one consultation to provide the proper remedy.  This is why a lot of them tend to dismiss the 10-23 campaign.  Look up the Merseyside Skeptics Society for more info on this.)  After the consultation with the patient, they consult a homeopathic materia medica, a book with a list of provings and studies.  I'll talk about provings in a bit.  Then the prep work begins.  There are primarily 2 different types of preparation, depending if the initial substance is water soluble or not.  If it is, then they begin the dilution straight away.  The initial dilution rate is 1 gram of the substance in 99 milliliters of liquid, either water or alcohol to make a total of 100 mL of liquid.  Homeopaths call this process either dynamisation or potentisation. (This article is going to kill my spell check)  At this point they dilute the substance with either alcohol or distilled water.  The comes everyones favorite part, the succussion.  They mix it up by hitting the bottle or vial 10 times against an object with an elastic surface. You can find videos of this on YouTube.  Some of them are pretty funny. (Some even use a bible, maybe for added strength?)  They do this because the founder of homeopathy believed that this would activate the "vital energies" of the substances.  Kind of like cutting the corner off of a roast because your mother always did, not realizing she had a small roaster pan. And the dilutions continue.  A quick note about the dilution scale used in homeopathy.  They use what they call the "C scale" or centesimal.  You should remember from you science class that the prefix "centi" means 1/100th.  The substance is diluted by a factor of 100 at each stage.  You will often see the dilution labeled like 6C.  This means that the process has been done 6 times.  So after doing the math, this means that 1 part in one trillion is the "active" ingredient at a 6C dilution.  They have dilution rates as high as 200C to treat the flu, using duck liver.  What effects a duck liver is supposed to cause to be able to treat the flu, I have no idea.  I couldn't find any information as to how they came up with that.   To give you an idea of how dilute the duck liver treatment is consider this:
 A popular homeopathic treatment for the flu is a 200C dilution of duck liver, marketed under the name oscillococcinum. As there are only about 10⁸⁰ atoms in the entire observable universe, a dilution of one molecule in the observable universe would be about 40C. Oscillococcinum would thus require 10³²⁰ more universes to simply have one molecule in the final substance.
You could treat the entire planet until the end of time a million times over from 1 duck.

Now if a substance is not soluble in either water or alcohol, then they use a process called "trituration"  They take the substance and mix 1 gram of it with 99 grams of usually lactose.  They grind them together, and just like the soluble substances, take 1 part and dilute it again, and again, and again, etc...  Then either way, the final product is added to a relatively inert substance that has been pressed into a pill.  The primary delivery agent used is a sugar pill.  Every site I looked at gave almost the exact same steps for preparing a homeopathic cure, and believe me, there are a lot of them out there.  There are a few differences.  Some try and stay pure to the roots and do everything by hand, others have updated the process.  A funny one is  WholeHealthNow.com (WHN) .  You can read a description of their process here .  It's funny because of the lengths they go in terms of machinery and tech, but try and remain traditional.  So that's the quick and dirty on dilutions in homeopathic preparations.  Now to look at how they determine what treatments are effective for what conditions.

Proving
According to RationalWiki (RW), :
A proving records the experiences of the "provers", usually a dozen or so people who consume the remedy over a period of time. Their thoughts, feelings, dreams and habits are then recorded in what is often termed the "Materia Medica" (from the Latin meaning "collected body of knowledge") and analysed.

According to the New York School of Homeopathy,:
A proving is the testing of a potentized substance to find out which symptoms that substance is capable of producing, and hence curing. A proving is conducted on volunteers who are in a reasonable state of health (provers), and who do not know what substance it is they are taking. Doses are repeated until provers start to experience symptoms of a change in state. The provers record everything they experience, whether physical, emotional, mental, or even spiritual, as long as the change in state persists. At the end of the proving all the records are compared to find the physical symptoms, states of mind, feelings, and experiences that the provers have had in common, which can reasonably be attributed to the emerging signature resonance of the substance. 

Basically what this means is that, given the other fundamental of homeopathy is "like cures like", they have people take a substance they want to test, and then self report how they feel over a period of time and compare to the symptoms they want to treat.  And at this point I must unfortunately give credit to the first homeopaths for actually developing what would one day become the clinical trial.  It's like alchemists developing chemistry.  They were soooooo close.  From these provings, they take the data and determine what conditions it will treat.  (I would have loved to see the looks on peoples faces when the guy said "I think this duck liver will treat the flu")  A little backwards from a clinical trial, but I'll give them a B- for effort.  Hahnemann, in the first provings used undiluted substances and went from there.  According to Wp, most modern practitioners tend to use ultra-dilute forms.  The problem with ultra dilute homeopathy is that it is highly improbable that any of the original substance is actually in the treatment.  This is where "water memory" and the placebo and nocebo effects come into play.  There are some exceptions to this.  On occasion, the makers of homeopathic medicine have been known to actually put real medicine in their products, and then claim that because shows to have an effect, all homeopathy works.

"Water Memory", and the Placebo and Nocebo effects
According to homeopaths, water has the ability to "remember" substances that have come into contact with it, hence the reason that they use distilled water for their dilutions.  Never mind the fact that every bit of water on the planet at some point or another has passed through the urinary tract of one creature or another.  Most research on this has basically shown it to be a false assumption.  One piece of research that got a lot of media attention and had the homeopaths claiming that they were right all along is a study by Luc Montagnier, the man that helped discover the HIV virus.  In a new study, he found that he could basically replicate a strand of DNA from electromagnetic signals in diluted water.  This study is unfortunately way above my pay scale, and the newest info I could find on it was from 2011.  I believe they are still trying to replicate his results.  Returning to homeopathy, there is no reason to assume that water can "remember" the traits of a substance that it has come into contact with, especially at the dilution rates that homeopaths prefer to use. If it can, why does anyone ever get sick?  hasn't all the water come into contact with all the things?  Shouldn't it have the memory of everything?  (There is also no reason to assume that just because something makes you cough violently that it can be used to treat a similar symptom.)  The placebo effect is often heard when discussing any medicine, the nocebo effect isn't talked about as much, but it is probably just as important.  The placebo effect, which translated from Latin means "I will please" is when you feel an improvement because you think you will.  Doctors have used it for ages.  The problem is trying to separate the effects of the medication and the placebo.  This is normally accomplished by using a double blind test.  This involves blinding the test subjects and the testers.  This prevents anyone from knowing who is receiving a sugar pill and who is receiving actual medication.  Given the fact that homeopathy uses sugar pills, it is really difficult to separate the two.   Nocebo, translated from Latin means "I will harm" and it is the exact opposite of the placebo.  You feel bad because you think you will.  Both of these, placebo and nocebo involve not only psychology but anatomy also, so they are much more complicated than I am making them out to be.  In simplest terms,  you feel the way you think you should.  If you look up studies concerning homeopathy, you will often see the phrase "no better than placebo effect.

Studies
When it comes to homeopathy, very few areas of medicine have had as many studies concerning their efficacy.  Of course, when searching for study results, they can be extremely biased.  Groups like Natural News, Whole Health Now, and other groups that tend to have the words Health or Natural in their name will tell you that the results show that homeopathy is more effective than placebo, with varying results.  If you look at groups like the NIH in England, WHO, or the CDC, they say either the effects are no better than placebo or that more studies are needed.  With the CDC, they actually recommend that people not take homeopathic anti-virals for malaria.  I was unable to find any studies that either definitively prove that homeopathic medicines work beyond the placebo effect.

Risks
Just like any other medical treatment, there are risks.  Unlike others, there aren't any directly related to homeopathy, which is part of the appeal.  The practitioners claim that there are no side effects from using their products, and this is the most factual claim that they make, unless you're diabetic.  The main risk, just like with other alternative medicines with a dubious efficacy, is when people with life threatening conditions use them instead of traditional western medicine (can I just say actual medicine?)  When someone uses homeopathy to treat cancer, malaria, HIV and AIDS instead of seeing a medical doctor, then they are effectively taking their life into their own hands.  To sum it up, the biggest risk for those with truly serious issues, not just a cold or itchy skin, is death.  For anyone else, the biggest risk is a lighter wallet, and sometimes an actual reaction to something in the medicine.

Conclusion
Given what I know of chemistry, biology, and even the water cycle, my opinion is that when it comes to homeopathy, all you are getting is a sugar pill labeled with scientific sounding names and an overly complicated manufacturing process.  That is my personal hypothesis, and you are free to make your own conclusions.  Honestly though, if I had a serious illness and was seeking treatment, someone that is following a 217 year old recipe for a sugar cube and believes that water knows what's been put in it is the last place I would go

I hope that this introduction to one of the major pseudosciences has been as entertaining to read as it was to research.  I couldn't fit nearly everything in a simple blog post, so I suggest you look into a few aspects yourself.  If you have any questions or comments, feel free to leave them in the comment section.  Until next time, be good, be reasonable, and be a good example.

The Skeptical Okie