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Editor's Correspondence
April 22, 2013

Acupuncture's Elephant in the Room

Author Affiliations

Author Affiliations: Quackwatch, Pittsboro, North Carolina (Dr Barrett); and Department of Public Health, California State University, Los Angeles (Dr London).

JAMA Intern Med. 2013;173(8):712-713. doi:10.1001/jamainternmed.2013.3743

The optimistic article by Vickers et al1 did not consider an important point. Research studies may not reflect what takes place in most acupuncturist offices. Most acupuncturists are graduates of “oriental medical schools,” where they learn about 5-element theory, “energy” flow through meridians, and other fanciful traditional Chinese medicine (TCM) concepts that do not correspond with scientific knowledge of anatomy, physiology, or pathology.2 Practitioners of TCM typically rely on inappropriate diagnostic procedures (pulse and tongue diagnosis) and prescribe herbal mixtures that have not been sufficiently studied.35 Diagnoses based on TCM such as “Qi stagnation,” “blood stagnation,” “kidney Qi deficiency,” and “yin deficiency” may not jeopardize patients who are treated in an academic setting, where they have received a medical diagnosed before entering the study. But what about people with conditions that TCM-trained acupuncturists are not qualified or inclined to diagnose? Real-world evaluations of acupuncture should also consider the cost of unnecessary treatment.

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