Acknowledging the danger of turning this into a dialogue, I shall
endeavour to be short in my response:
when a man of 40 years of age, is faced with the problem of not being
able to achieve an erection, then he is perceiving himself as ill and
for that he seeks treatment. How productive is to face this man with the
attitude that he is not ill? If that man is 80, then you have a point
(although I may revisit this statement when I am 80!!).
a second point is to look at the literature: when acupuncture is used to
treat this 'non-illness' where do we stand:
Kho HG, Sweep CG, Chen X, Rabsztyn PR, Meuleman EJ.
The use of acupuncture in the treatment of erectile dysfunction.
Int J Impot Res. 1999 Feb;11(1):41-6.
PMID: 10098953 [PubMed - indexed for MEDLINE]
Yaman LS, Kilic S, Sarica K, Bayar M, Saygin B.
The place of acupuncture in the management of psychogenic impotence.
Eur Urol. 1994;26(1):52-5.
PMID: 7925530 [PubMed - indexed for MEDLINE]
Lets be frank with our attitudes: it is common to rejoice when
acupuncture is shown to be effective but also to be damning when a piece
of work contradicts our opinion. This is counterproductive for our
profession, our attitudes and obligations to our patients and to our
position as professionals who care for the wellbeing of other people. It
is our duty to be informed and objective, and apply this information
with care to people who trust us to help them with their plight.
Being damning of pharmaceutical companies is fashionable, and at times
justifiable. In the main however, modern healthcare would not have been
what it is without the significant advances in pharmaceuticals available
today. In addition, last I checked, most people practicing acupuncture
offer treatment of the symptoms of premenstrual tension and menopause.
Are they to be damned as well??
Daniel Schulman wrote:
> Point taken, but even your reply has multiple layers of complexity.
> You suggested that if one is seeking treatment for 'erectile dysfunction'
> and Viagara cures it, the discussion terminates at that point. In your
> words, I would respond with 'lets get serious folks'. As far as I can
> remember, there was, in fact, no such 'disease' as 'erectile dysfunction'
> until Viagara was developed - and that is an increasingly common phenomenon
> - that a medication is developed, a disease category is 'invented' to create
> the notion that the new medicine is a cure for a disease, and off we go.
> There is now a move to psychiatrically classify PreMenstrual syndrome as a
> psychiatric illness, for which there is suddenly a drug. and on and on it goes.
> And, I don't think a pneumothorax is trivial but its incidence rate when
> acupuncture administered by qualified practitioners certainly is.
> At 01:55 PM 12/1/04 +0000, you wrote:
> >Now, there's a point! Have we however, in this discussion lost the
> >essence of what healthcare is meant to be?
> >If one is seeking treatment for erectile dysfunction and Viagra cures
> >it, well, the argument is non-existent: he may further deplete his
> >kidney essence, but, boy is he going to have a good time doing it!!
> >On the other hand, if someone is going to receive acupuncture for
> >anything that may require needling a point in their thorax, a trivial
> >adverse effect such as pneumothorax, which requires hospitalisation and
> >the insertion of a tube down their chest, may negate the benefit of the
> >and I for one, know which of the two adverse effects above would
> >Lets get serious here guys, the safety of any treatment is paramount for
> >incorporation of this treatment to mainstream healthcare, safety is the
> >first condition this treatment has to show. Effectiveness is secondary.
> >Iatrogenesis as a cause of disease is well known (something like 70% of
> >cancer pain is iatrogenic for example), but the argument here is not
> >which method is more harmful. The argument is how harmful acupuncture
> >is. And the general consensus, despite such discussions as the one we
> >are having now, is that acupuncture is safe (McPherson et al, 2001;
> >White et al, 2001 both in the BMJ, free for all to access-www.bmj.com).
> >the issue becomes much more emotive, because the harmfullness of
> >acupuncture is far more widely advertised than is its effectiveness. And
> >effectiveness, is something that acupuncture has not established firmly.
> >going back to the points that Philip was raising in a previous posting
> >about the efficacy of acupuncture on migraine, the key point is that
> >people got better in the acupuncture group. Not the training of the
> >acupuncturist (which incidentally, was such that allowed the
> >physiotherapists Advanced Membership of the Acupuncture Association of
> >Chartered Physiotherapists. That means they needed to have more than
> >200hours training, and in the main, these practitioners had completed a
> >2-year course. Such courses would usually allow one to practice as an
> >acupuncturist in the UK).
> >Looking forward to your responses.
> >Daniel Schulman wrote:
> >> You Know the so-called 'adverse effect' debate is really infinitely complex
> >> if you think about it at all.
> >> I have always thought it would be interesting to fund a study assessing side
> >> effects of Western Med treatments FROM A CHINESE MED PERSPECTIVE.
> >> Just one example - how many men in their 60's are prescribed Viagara by
> >> their doctor and then become very sexually active when a chinese med
> >> diagnosis would indicate Kidney Vacuity and Essence Depletion (you know,
> >> things like ear ringing, weak knees, weak low back, frequent copious
> >> urination, pulse, tongue, etc, etc) and then proceed to ramp up Kidney
> >> depletion and develop all the sequelae of that much faster than had they not
> >> been given Viagara.
> >> Western Med would not see that as an adverse effect because they would not
> >> relate the two or even know to look for those connections, but a sort of
> >> Chinese Med Epidimiological perspective could well uncover monumental
> >> iatrogenesis in just that one case.
> >> So, if we are really going to have a serious discussion about adverse
> >> effects, we have to get far far more sophisticated than the silly and
> >> trivial obsession with things like pneumothorax from acupuncture!!
> >> Daniel SchulmanContent-Type: text/x-vcard; charset=us-ascii;
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> >Content-Transfer-Encoding: 7bit
> >Content-Description: Card for Dr. Panos Barlas
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> >Attachment Converted: c:\isn\eudora\attach\p1.vcf