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The everyday blog of Richard Bartle.


12:03am on Monday, 10th January, 2005:

Medical History

Rant

In an attempt to make history more interesting than history teachers would otherwise make it, the national curriculum requires part of it to be studied vertically. This means that the examiners pick a particular theme and the students look at how it has changed over time. One of the themes my elder daughter is studying is medicine. I'm actually quite in favour of this in principle.

What I'm not in favour of is the following extract from page 175 of her textbook (Medicine and Health through Time, by Ian Dawson and Ian Coulson) on a page headed "What is alternative medicine?":

Acupuncture

Acupuncture developed in ancient China 4,000 years ago (see page 23).

What is it?

Acupuncture involves the releasing of blocked energy by inserting fine needles on various pressure points of the body. Some modern acupuncture uses needles with a slight electric current. It has been used as an anaesthetic during major surgery.

How does it work?

Acupuncture charts the flow of energy around the human body. When energy paths become blocked or out of balance diseases can occur. Acupuncture allows the energy to flow again — thus relieving pain and stimulating healing.

Excuse me? Excuse me? What kind of claptrap is this?

OK, so of the various forms of alternative medicine there are kicking around, acupuncture is a little different in that it does appear to work for some ailments. However, it does not work by allowing "energy" to "flow again". This may be a useful metaphor that helps the practitioner visualise the processes involved (which are not actually understood yet), but it's just that — a metaphor. The processes can be described equally well in terms of an imaginary life-giving fluid flowing through the body, although normally the metaphor is "life force" (qi) — a consequence of the ancient Chinese's understanding of force being better than their understanding of energy.

The language is ambiguous, too. Diseases can indeed occur "when energy paths become blocked or out of balance", but then diseases can occur "when the sun goes down" or "when I hear music". Of course they can occur — there's no relationship between the diseases and event. So why say it? Because children (and most adults) reading it will think that it's saying this is why diseases occur. Well it's not. A blocked "energy path" doesn't invite bacteria into the body; the best that can be said is that it may indicate a lowering of immunity.

The last line is particularly annoying, in its use of the word "thus". Assuming that there were some mysterious energy flowing through the body which was blocked, why would unblocking it either relieve pain or stimulate healing? I'm not saying that acupuncture does neither of these things, I just want to know the basis of the "thus". The premise of the preceding sentence is that blocked energy paths cause diseases, therefore shouldn't removing the block remove the disease? What does that have to do with relieving pain or stimulating healing?

Even the history part is suspect. Leaving aside the fact that the word "ancient" is entirely superfluous in the opening sentence, there is some dispute as to whether it was created 4,000 years ago or more like 2,100. It sounds better if it's older, but making it almost twice as old as there is evidence for perhaps merits a caveat...

I'm moaning about this because my daughter, along with the rest of her student cohort, is going to come away with the impression that there's more science to acupuncture than is yet understood. I'm also moaning because that just happened to be the page I opened her history book at just now, and I've no idea what other poor reflections of reality or history are embedded within it elsewhere. To be fair, the description of homeopathy on the same page is couched in terms of "they say" and "they believe", but if anything that adds even more credence to the description of acupuncture as if the processes described were fact rather than metaphor.

OK, rant over. I'll go and lie down now...


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Copyright © 2005 Richard Bartle (richard@mud.co.uk).