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Changing the introductory paragraphs

I have just submitted a change to the introductory paragraphs. The original sentence relating to needling "acupuncture points" did not take into account the treating of Ashi points. My clarification, although quite lengthy, added this element. This is my first post so I hope that I have not transgressed in any way. Llj444 (talk) 16:44, 18 January 2008 (UTC)

Welcome aboard. I appreciate the spirit of your edit. If "ashi points" are not defined as "acupuncture points", they are certainly part of TCM theory... and researchers claiming to do "sham" acupuncture by needling "non-acupuncture-points" may be doing verum treatment if the "sham" points are also "ashi" points. That's an actively debated topic and should be mentioned. However, I'm not sure the lead section is the place to jump right into the specific meridians. Will think it over. Welcome! Jim Butler 21:42, 18 January 2008 (UTC)

For McCready: you asserted "bulk of scientists saying ac is crap." Source please? Also: "page needs to be 50kb max." Yes, your attempts at WP:GAME are duly noted. (Assume good faith isn't a suicide pact.) You've been blocked in the past for such behavior. Suggest you disengage a bit. --Jim Butler 10:20, 27 January 2008 (UTC)

Good the talk begins. But you are wrong in your allegation that I have been blocked for gaming. Pls apologise and pls answer for the third time, should the article be 30-50kb? Mccready (talk) 10:27, 27 January 2008 (UTC)

(1) Pls answer my question: "bulk of scientists saying ac is crap." Source please?

(2) You were blocked for tendentious editing. You're doing it again, and you ought to be blocked again for it, IMO. You're the one who owes an apology to the various editors whom you've stressed out.

(3) No, I don't see any reason to be rigid about article size, per other comments at Misplaced Pages talk:Article size. Also, I think the best way to go about reducing article size is discussion and splitting, not chopping out well-sourced material that you don't happen to like. --Jim Butler 10:41, 27 January 2008 (UTC)

1) Don't be silly. I suppose you'd want a cite that most scientists don't think the moon is made of blue cheese. 2) Not gaming. Don't be silly again. Editors are responsible for their own emotional state, not me. 3) Pls answer question. Do you agree or not that the article should be limited to 30-50kb? I'm quite happy for you to split away. A lot of the material is repeated elsewhere as I have said. Mccready (talk) 08:10, 28 January 2008 (UTC)

On (1), we've been over this before: see WP:NPOVFAQ#Pseudoscience and WP:RS#Claims_of_consensus. Prove your claim. The moon being made of blue cheese not a serious claim. Acu's effifacy for various things is, and is studied as such. On (3), what part of "no" didn't you understand? --Jim Butler 09:00, 28 January 2008 (UTC)

UNDUE Weight

Acupuncture Jim wants to cherry pick the slight amount of dodgy evidence that may exist for efficacy of acu and put it at the top. This is unacceptable. We all know that acupuncture has no demonstrated effect for the huge range of conditions for which it is used. Shouldn't we put that at the top if this is the route you want to travel? Mccready (talk) 08:23, 28 January 2008 (UTC)

Cochrane Collaboration is dodgy, eh? Sounds like an opinion straight out of the fringes of anti-science. It looks like more editors agree the lead is well-weighted in the version you dislike. The sources are impeccable, like Ernst, and the wording is clear about where there is and isn't efficacy per EBM. --Jim Butler 09:03, 28 January 2008 (UTC)

Are you being deliberately obtuse? It's not about Cochrane, which has its share of altmed nuts infiltrated anyway. You, Acupuncture Jim, gather every bit of evidence in support and want it in the top but have none which says for heaps of conditions it's crap. POV or not? For chrissakes why do you insist on filiform???Mccready (talk) 09:28, 28 January 2008 (UTC)

Ah, I think I see what happened; a sentence I'd thought was there dropped out along the way. Restored. Better approach than just deleting good V RS's, I think. Filiform? Of course, to distinguish them from other needles the reader might know of in a medical context, like hypodermic needles. I think that's called accuracy, not undue weight. --Jim Butler 10:45, 28 January 2008 (UTC)

Fair enough. Accepted. Now we have to address undue weight. The top needs to ack that science shows the bulk of conditions acu purports to treat are not amenable to acu. Mccready (talk) 01:38, 30 January 2008 (UTC)

Hehe, hey I just had this same statement made on the Talk:Chiropractic page. Mccready, are you trolling? I agree the article is long, especially the lead, but any shortening needs to be NPOV. More likely, the article could be split up, but don't delete hard work from other editors, make a new page and move it. Also, you can't just cut out one POV and expect it to stick. See if you can shorten it and still be saying the same thing... and it needs to be reliably sourced. ---- Dēmatt (chat) 02:35, 30 January 2008 (UTC)

Well, I removed the unsourced POV statement that remained. ---- Dēmatt (chat) 14:51, 30 January 2008 (UTC)

Thanks Dematt; agree entirely that what you removed was OR. I went even further and reverted, since the earlier wording remains the most accurate depiction of the sources cited (Ernst 2007, and the rest of the EBM reviews). As Ernst explains, the body of evidence is growing, and that evidence is showing efficacy for some conditions and a lack of efficacy for others. For many more conditions, there is not enough evidence to determine efficacy. That's what the sources say. A good example is their review of acupuncture for depression. cheers, Jim Butler 20:14, 30 January 2008 (UTC)

Are you guys deliberately ignoring the topic. The topic is UNDUE weight. It's a wiki policy. Pls address the issue.Mccready (talk) 01:55, 31 January 2008 (UTC)

"Undue weight", "article length" -- anything to justify your pruning particular views from the lead. It's called "wikilawyering". Your edits speak louder than your talk-page rationalizations. Happy editing and hope you have a great day, but don't think others haven't seen through your approach. I agree there is some accumulated cruft in the article, but I don't think you possess the objectivity to identify it. --Jim Butler 03:24, 31 January 2008 (UTC)

Temper, tempers please :-) I've not delved into the recent edit history, but this is generally a well written and informative article. I would though tend to feel that description of what acupuncture claims to be should come before critisms etc. Hence should last paragraph of leadin ("Traditional Chinese medicine's acupuncture theory predates... ") come as the second paragraph of the leader? David Ruben 03:36, 31 January 2008 (UTC)

Hi David - we could, although that paragraph (fourth one in the lead, this version) actually contains criticism, unlike the neutral evidence in the second. Maybe can rearrange somehow. I think it does have good article potential. (Mea culpa on temper, but do check the edit history for certain editors' deletionism.  :-) cheers, Jim Butler 05:19, 31 January 2008 (UTC)

Acupuncture Jim, Your abuse doesn't hide the fact the you refuse to engage in sensible discussion. We both know that for a huge range of conditions that acus treat there is no evidence of effectiveness. Does this or not need to be referenced in the top. Mccready (talk) 09:03, 1 February 2008 (UTC)

The reason for my revert is that we already talk about evidence in the lead, and specifically say "For most other conditions reviewers have found either a lack of efficacy (e.g., help in quitting smoking) or have concluded that there is insufficient evidence to determine if acupuncture is effective (e.g., treating shoulder pain)." It's redundant then to list a bunch of conditions where evidence for efficacy is lacking or uncertain.

Of cource acu is used clinically for conditions where EBM support is lacking, but that is also true for some biomedical modalities, including most surgical techniques. The Institute of Medicine, one of the four Academies of Sciences in the US, also makes this point (see last paragraph here). If you edited the lead sections of arthroplasty, etc., to add a list like you want to here, how far would you get? Be realistic. If your edits aren't judicious and supported by other editors (it's not just me objecting), they aren't going to stick. regards, Jim Butler 21:16, 1 February 2008 (UTC)

If we aren't going to mention specific conditions in the lead where acu is ineffective, then pls explain, Acupuncture Jim, why we should mention specific conditions were it is claimed to be effective. If you want to edit an article on surgical techniques go right ahead. Your point is irrelevant here. Mccready (talk) 11:27, 2 February 2008 (UTC)

The list of conditions that a particular compound or technique cannot treat is endless. I don't believe we apply your logic to other articles on WP, and surgical techniques are a good comparison because similar blinding issues apply to RCT's. Use common sense, please. --Jim Butler (t) 07:35, 3 February 2008 (UTC)

We're getting closer now. Of course the list is endless, but as you have it now you present one person's view that acu relevance is expanding. What are we to do about this UNDUE weight? I reiterate, your comments on other articles are irrelevant. We are talking here about the acu article. Mccready (talk) 03:07, 5 February 2008 (UTC)

Read more carefully, please. Ernst doesn't say acu relevance is expanding; he says the evidence base is, which is a simple statement of fact: more RCT's are being done every year. Your attempt to add a list to the lead is tendentious, redundant and stylistically inappropriate. It's good in the article but ridiculous in the lead. The lead is a summary; we already say that evidence is equivocal or lacking for "most other conditions" in the lead, and I hold firm to my view that enumerating them in the lead is plain silly. And comparisons to other articles are entirely relevant: your edits would never stick in any other article either. How many things does aspirin not treat? Please, common sense applies. You've been blocked before for disruptive editing and I wouldn't be at all surprised to see it happen again. --Jim Butler (t) 05:34, 5 February 2008 (UTC)

Stuff to add

This is interesting, re mechanism. --Jim Butler 05:19, 31 January 2008 (UTC)

And here is a link that (currently) provides free full access to the text and PDF version: Acupuncture Anesthesia and Analgesia for Clinical Acute Pain in Japan. MeekMark (talk) 11:36, 31 January 2008 (UTC)

I would hardly consider that journal to be reliable. And basically, they're saying that acupuncture treats every pain ever known. I would be opposed to using it. I'm not at all a supporter of junk science, so I've added some very reliable references to this article. I intend to be as neutral as I can to balance both sides of this story. But this article doesn't even entice me to look beyond it. Unsupported claims always makes me yawn. OrangeMarlin 03:19, 2 February 2008 (UTC)

Agree it is fairly underwhelming as a review, but as for the journal itself, Ernst and Kaptchuk are pretty studly and are on the review board. Not sure though about the general quality of articles or publication bias. --Jim Butler (t) 06:47, 2 February 2008 (UTC)

• Good one re sham acu and placebo effects: Kaptchuk et. al., BMJ 2006;332:391-397. Article about it in Science News. --Jim Butler (t) 06:47, 2 February 2008 (UTC)

Added. --Jim Butler (t) 07:58, 3 February 2008 (UTC)

Maybe more stuff

This research was published yesterday in the British Medical Journal. It includes meta analysis, which is something that never gives me any feeling of confidence. However, the paper suggests a NNT of 17:1 so it is note worthy from that point of view. Manheimer, Eric; et al. (7 February 2008 ).Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ. doi:10.1136/bmj.39471.430451.BE.--Aspro (talk) 16:55, 8 February 2008 (UTC)

I saw that reported too, yes, agree. cheers, Jim Butler (t) 06:27, 9 February 2008 (UTC)

Williams

Good; undue weight to cite that guy in lead anyway. --Jim Butler (t) 04:15, 2 February 2008 (UTC)

Cleanup

If all goes well, I'm hoping to clean up the article and prune/merge some stuff into Traditional Chinese medicine, Channel (Chinese medicine), Zang Fu, etc. --Jim Butler (t) 04:18, 2 February 2008 (UTC)

It may take awhile, since edits like this are nontrivial and I haven't edited a couple of the above articles before. But the result will be a shorter, tighter article. --Jim Butler (t) 05:29, 2 February 2008 (UTC)

I made a small but significant change to the lead, in accordance with the sources we have in the article (AAMA etc), which list mainly pain and other symptoms. --Jim Butler (t) 07:57, 3 February 2008 (UTC)

Lead-in discussion on verification

Clearly Mccready's steady drastic reduction of the lead-in's discussion of the research and verification basis for acupuncture is not agreed with by several editors who have reverted it back (warning issued re risk being seen as edit warring). However I do have issues with the lead-in concentration on this:

• The leadin should really explain what something is and its historical & social background before getting too heavily into criticism & proofs.
  • The leadin current is sparse on history and even less mention of social/society issues. The first date mentioned in the leadin is not some estimate of when the practice first started (or a referrence to first written record to at least give a minimum timeframe) but "2007" for an American Journal publication.
  • The leadin needs give a little more description of history and uses. NB this should be noncontentious to indicate what it has been/is used for, which is quite distinct from an assertion of effectiveness - cf antibiotics often given for sore throat in the UK (true) but this not the same as whether blanket prescribing helps (contentious and certainly less clear-cut than the previous generation of doctors thought, and I certainly prescribe in well under half of cases as most are clearly self-resolving viral infections). Some mention also should be made of spread of practice into Western World (we surely all agree that acupuncture more prevalently available and practised in UK & US than say 100 years ago, but precisely what was this process (NB needs citing of course)
• Given I do not dispute that acupuncture is widely practised in the Far East, acupuncture is clearly not a trivial-minority opinion. Therefore the leadin should at least make some better mention of TCM viewpoint on disease and how acupuncture is thought to aid health. Likewise, given there are some positive scientific studies, how modern science (which does not see evidence for Qi) suspects acupuncture might exhibit its effects (ie pain-gate model, neuro-immunological effects or whatever).
• Of course given the alternative/complimentary aspect of how acupuncture is perceived, the leadin needs cover the evidence supporting or refuting claims of effectiveness, but this should not I think form the largest part of the leadin (relocate details to the "Scientific research into efficacy" section).

So, IMHO, the material Mccready has removed and paraphrased was overly harsh with the scythe, but I agree currently unduely long and needs some triming with expansion of other more straight forward encyclopaedic description aspects. David Ruben 12:02, 7 February 2008 (UTC)

Thanks David. Good finally to get the discussion started properly. The diehard defend acu at all costs acus who inhabit this page have refused to discuss properly despite an outward appearance. The points you made are valid on the whole. But the overwhelming evidence is that acu is BS. Even the one metastudy on P6 that AcuJim likes to tout has been criticised by scientists. AJ operates, as do most altmeders, by 1) muddy the waters by saying it's controversial and scientists can't agree (we've seen it classically in the tiny minority of global warming deniers among scientists) 2) suggesting their fav altmed as soln, 3) crying that they are cut off from research fund which would soon prove the moon is green cheese (thus AcuJim likes to quote any source he can that concludes more research is needed) 4) wikilawyering to prevent any sensible analysis or presentation of facts unsullied by UNDUE weight (thus a sensible conclusion is labelled OR and out of court, or a syllogistically correct statement is also thus labelled.

The facts are 1) most of the "science community" pays no attention to altmed because they've got b better things to do. Therefore statements about what the community thinks are fraught and need to be carefully verified. 2) the huge bulk of papers conclude acu is BS 3) this article's LEAD gives UNDUE weight to the minority of studies finding acu may have a point. The current statement in the lead "For most conditions acupuncture has no effect." is a huge compromise as it is. But AcuJim doesn't even accept that compromise. He can name no condition for which acu has unequivocally, to the satisfaction of the science community, been shown to have effect. There are even editors here who claim to be skeptics but have stated on their pages that they think acu has a demonstrated analgesic effect. Show me the studies proving that I say. Looking forward to sensible discussion. Mccready (talk) 00:53, 8 February 2008 (UTC)

(Further repeated blanking of section being discussed was disruptive and your block warranted). Whilst above indeed probably the views of majority established "conservative" conventional medical doctors, your points are merely items that the acupuncture criticism section might cover. Rather what I am trying to generate is discussion that the lead-in should have more information describing what acupuncture is, its historical context and views of claimed modality of effect, rather than be so heavily dominated by just the modern scientific verification/justification. The problem, I see, is over balance of spread of covered aspects, not a POV desire to downplay the veracity of the technique (of which I am an intrigued sceptic), so could some pro-acupuncture editors help here by suggesting how the verification discussion in the lead-in might be summarised down just a little and the other items I mention be more fully covered. The article's tone as set in the lead-in should really be a positive affirmation of what acupuncture is, and not what might be seen as an apologetic justification piece. David Ruben 01:02, 9 February 2008 (UTC)

David - I think your idea on moving forward with the lead is great, and the only reason I haven't responded sooner is I am time-poor and was asked to resolve a BLP problem elsewhere. Will work on this as soon as I can, certainly this weekend.

BTW, for Mccready, I'd appreciate being referred to by my handle here, and not nicks like "Acupuncture Jim" and the like. This isn't a political campaign, and as I mention on my user page, I prefer not to label people based on a single attribute, and in the spirit of the Golden Rule ask that others refrain from doing so with me. Also, WP:NPA comes into play.

As for Mccready's other comments... I feel that acu should be held to the same standards as anything else in medicine, and there is plenty already cited in the article (just go to Pubmed and read the studies cited in the reviews from Cochrane, Ernst etc.). However, Mccready seems to have a double standard for acupuncture, doubting any result and questioning the motives of the researchers. Not unlike his approach to wikiquette, interestingly. So, I'm not sure if there's anything else I can say to address his concerns. regards, Jim Butler (t) 06:27, 9 February 2008 (UTC)

Jim Butler, I have noted you prefer me not to use a nickname for you. For brevity I'll address you as JB and hope that is OK. Please stop your slurs on me. Other editors have agreed the article has UNDUE weight and length problems. The UNDUE weight in the lead is by mentioning a purported condition that acu is useful for but not mentioning the huge bulk of conditions it is useless for. You have already ack'd this and therefore I have edited accordingly. How then do you propose we address the remainder of the issues of undue weight and length? I have to disagree with DR about criticism in the lead. One persons crit is another's fact. If the bulk of people believe acu may be useful, it might be good to point out up front that it largely isn't. Mccready (talk) 08:13, 10 February 2008 (UTC)

(1) I'm sorry if you believe I've slurred you. Please show me where. I believe it's calling a a spade a spade to cite your edit and block history. (2) Per WP:DR, please take care not to misrepresent my views. I don't recall ever there were undue weight problems such that therefore you should go ahead and edit as you have. I do agree with DavidR that we should refocus the lead on historical use and devote a shorter section to scientific research, but not in the biased way you suggest. (3) Your edit conflates the jury being out with outright dismissal of acu by the sci community. A great many of of our Cochrane reviews say "not enough evidence to determine efficacy". Some do say "no evidence of efficacy", but based on what we have, you're going too far. That's why I (and a bunch of other editors) think the original stable version is preferable. More work on lead to come. --Jim Butler (t) 09:51, 10 February 2008 (UTC)

P.S. My ES here should have read (emphasis added on omitted matl'l): "(rv- "most conditions no effect" not supported by sources, which frequently cite a need for more/better studies - conflates positions of agnostic and disbelief - and reword to attrib Ernst)" --Jim Butler (t) 09:56, 10 February 2008 (UTC)

For Davidruben et. al. - well, I wanted to work on the lead this weekend, but other stuff came up, both on and off wiki. Still a priority. Am also interested in improving the history section, and have some good books (including Unschuld, one of the best) at hand. regards, Jim Butler (t) 20:41, 11 February 2008 (UTC)

Fact or Crit

I have copied this from my talkpage to here. Mccready (talk) 05:48, 11 February 2008 (UTC)

In regards to my Acupuncture revert, it was done to restore the introduction. The article simply didn't make sense starting out with a criticism of acupuncture without first defining the term.Asher196 (talk) 05:43, 11 February 2008 (UTC)

Asher, the fact it that the material you removed was factual. Whether you personally regard it as critical is not the point. Even if I concede your point, please show me the wikipedia policy which says we cannot have such material in the lead. Mccready (talk) 05:48, 11 February 2008 (UTC)

I want to Misplaced Pages to be encyclopedic, and your version of the lead-in is confusing. Simple as that.Asher196 (talk) 05:56, 11 February 2008 (UTC)

You have now changed your story. Now you need to explain why you are confused. Otherwise will you please replace my version? Thanks. Mccready (talk) 06:18, 11 February 2008 (UTC)

I'm not saying your material shouldn't be in the article, I'm saying your material shouldn't be the lead. I came to the article by clicking the "Random article" button. The first thing I read was "Many Cochrane reviews of acupuncture say there is not enough evidence to determine its efficacy. Others say there is no evidence of efficacy. A review by Edzard Ernst and colleagues in 2007 said that the "emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions." Well, that's fine, but what is acupuncture? Look at it from the perspective of someone with no knowledge of the subject and maybe you will see my point.Asher196 (talk) 06:41, 11 February 2008 (UTC)

Fine.Yes I concede your point. But as it now stands it conveys the idea that there is controversy. This a classic altmed tactic. In fact the overwhelming bulk of evidence is that it has no effect. I'm happy to edit to take out the possibly confusing reference to Cochrane in the lead. Mccready (talk) 07:37, 11 February 2008 (UTC)

Lead

I really am getting sick of the fact that bold editing is regarded as disruptive. And it needs to be seriously noted that edit warring alone is an impossibility. I am also getting sick of the fact that some editors refuse to conduct discussion properly despite numerous attempts on my behalf. So let's try again. Could you please address three points one by one.

1. Jim Butler has acknowledged multiple times that for the great bulk of conditions acupuncture has no effect. His words are "A great many of of our Cochrane reviews say "not enough evidence to determine efficacy". Some do say "no evidence of efficacy"" He believes then that my preferred formulation goes too far. My latest formulation, reverted by him without adequate discussion, despite his edut summary, was "Many scientific reviews of acupuncture say there is not enough evidence to determine its efficacy or that there is no evidence of efficacy. However, a review by Edzard Ernst and colleagues in 2007 said that the "emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions"." On 30 January Butler said "For many more conditions, there is not enough evidence to determine efficacy. That's what the sources say." Then on 10 February he writes, after he reverts me again (and remember he doesn't edit war - only me) in contradiction to his earlier claims "rv- "most conditions no effect" not supported by sources". He also says "Of cource acu is used clinically for conditions where EBM support is lacking" then he tries to excuse this by saying "but that is also true for some biomedical modalities, including most surgical techniques." Why don't we just stick to the facts and let other article handle issues the way they will? On 3 February Butler says "The list of conditions that a particular compound or technique cannot treat is endless." Then he refuses to list any of them in the lead (a position I'm comfortable with) while listing nausea in the lead because this throws a possible positive light on acu.

So point 1. Why cannot the lead say "Many scientific reviews of acupuncture say there is not enough evidence to determine its efficacy or that there is no evidence of efficacy. However, one review by Edzard Ernst and colleagues in 2007 said that the "emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions".

2. UNDUE weight. A typical altmed tactic is to muddy the waters. Altmeders love to say science doesn't know or scientists are divided etc. Thus Butler's preferred formulation of the lead says there is scientific controversy. And Butler stoutly defends (but I edit war apparently) his preferred formulation that "Scientists are studying the mechanisms and efficacy of acupuncture." Again a typical altmed tactic to gain legitimacy - scientists are studying it so it must be worthwhile. It's a bit like the global warming "controversy" - only existing in the minds of a tiny minority of outliers. In fact most scientists, if they bother to look at CAM or acu at all, conclude it is utter rubbish. To drum up a supposed controversy is Original Research and UNDUE weight. Likewise to use the term "scientific community" which Butler also defends. Despite being asked, Butler has refused to name even one condition for which acu has unequivocally, to the satisfaction of the science community, been shown to have effect. Likewise, it's a typical altmed tactic to say further research needs to be done. So whenever Butler gets the chance he likes to quote any source he can that says so. This is undue weight.

So point 2. Why do we not delete reference in the lead to scientific controversy and scientific community.

3. Nausea. Given the above can we please delete reference to nausea in the lead. It is one of the tiny shreds of research that acupuncturists can still hold onto to give them faith that there must be something to acu after all. Needless to say there is strong disagreement by other researchers about the validity of the nausea study Butler stoutly defends in the lead (but I only edit war, remember?). By all means discuss it, for and against, but why in the lead? And for the record, my personal view is that yes there may be something in it, but so far it certainly doesn't look like it.

So point 3. Can we delete nausea in the lead?

Finally I might add that Butler's clever attempt to sideline me, while consistently refusing to discuss properly, does indeed appear self-serving. It's about time the wikipedia community looked beyond my bold comments in edit summaries and on talk pages and looked at the facts of my editing and my consistent attempts to get sensible discussion. And before even the self-styled skeptics start another attack, let me assure you I have learnt a lesson from my recently block and that my edit style and gosh yes to some extent my wiki personality have undergone a change for the better. Over to you :-) Mccready (talk) 23:59, 11 February 2008 (UTC)

Hi Mccready -- I'd like to applaud your recently taking to heart criticism that was meant as constructive. I think Fyslee, a self-identified chiro-skeptic, had it right when he said (paraphrasing) that there's not much point in revert warring, because if others agree with one's edits, they'll make sure the edits stick. If not, why bother? Even if one doesn't think others are making sensible arguments, all one can do is keep a cool head, discuss, and accept that sometimes others may disagree. That's WP, for better or worse. If you want expert oversight, Citizendium is the place for that (and of course, some will feel that those experts are probably all biased too.... e.g., only Joseph Mercola, or Stephen Barrett, has it right...can't please everyone.)

I acknowledge that I've reverted a number of your edits, but the thing to remember is that at least four other editors have agreed (and reverted along) with me, whereas you've been the only one arguing for and rv-ing to your edits. IOW, while bold editing is good, repeated bold editing against consensus is bad. See WP:BRD. But, that's the past. Looking ahead, we should be pragmatic and try to collaborate.

The other thing that's important to keep in mind is that all CAM's are not the same. Some are taken more seriously than others as shown by the volume of peer-reviewed studies. Acupuncture is in the top tier of that class, and perhaps has the greatest number of RCT's of any so-called CAM therapy. Comparing it to global warming skepticism, or saying that the moon is made of green cheese, is fallacious. Scientists have spoken en masse against the former, and do not take the latter seriously enough to submit it, time and time again, to peer review.

I would also, once again, gently request that you not misrepresent my views, as you did when saying that I have "acknowledged multiple times that for the great bulk of conditions acupuncture has no effect." False. Not so. In a field with active research, I don't read absence of evidence as evidence of absence. This is a case where the jury is out, and is actively deliberating. Ernst is no alt-med sympathizer; he's very EBM about everything, and if anything is an acu-skeptic, but even he acknowledges research is active and the issue is controversial. (I'd add that in my view, and per several V RS's, the issue of proper study design is critical and not well-settled.)

I disagree re omitting nausea and other positive findings from the lead. The idea that it's "undue weight" to cite it, if we talk about evidence or lack thereof for other things in the lead, makes no sense to me. Am I the only one who feels this way? Chime right in, ya'll.

And BTW, you can keep on repeating your demand for RCT's all you like, but I already replied above, and to clarify, double-blind is never gonna happen properly for a procedure as opposed to a compound, so if anything the meta-analyses are too conservative. Start with Pubmed, search terms "acupuncture pain", limits "Clinical Trial, Randomized Controlled Trial, Review, Core clinical journals." Or ask OrangeMarlin, who reputedly is able to decipher such things ;-)

Regarding your last edit, I have some issues with it:

• The statement that "the exact location of acupuncture points (is) not agreed by acupuncturists" is not supported by the source, which instead says "the definition and characterization of these points remain controversial". I've read lots and lots of point location texts, and compared them, and there is little disagreement over the location of the major channel and extra points on the body (Liv-8 is about the only one I can think of); only in subsystems like hand and ear acupuncture (which often involve mapping a homunculus onto those respective body parts; TCM loves systematic correspondence) can one find significant variance.
• The second and second-to-last sentences are virtually identical.

Anyway, I would prefer to move forward from here with DavidR's suggestion and reorient the lead, and generally improve the article as I've talked about above. I'd really rather write than argue, especially if I'm in the minority and arguing is fruitless. Does that seem like a sensible approach? Pouring you a cold beer now (if that's your thing ... substitute recreational beverage of choice). regards, Jim Butler (t) 10:27, 14 February 2008 (UTC)

Partially reverted, for reasons above: (a) source didn't meet the claim re point location. (b) it's redundant to say Many studies say there is not enough evidence to determine its efficacy while others say there is no evidence of efficacy ... For most other conditions reviewers have found either a lack of efficacy ...or have concluded that there is insufficient evidence to determine if acupuncture is effective". Apart from removing the claim re (a), my edit doesn't change the meaning of the lead at all, just yet (pondering how to do that re history, migration to the West etc.). Also, I'm not sure whyquit.com is a V RS, and in any case, I'd like to suggest a guideline for new stuff like that: first edit the article, then synthesize the lead from that. That's per WP:LEAD. regards, Jim Butler (t) 10:27, 14 February 2008 (UTC)

(sorry been busy in real world last couple days) OK, above looks more promising being a discussion on how to approach further editing. I'll make a few observations (ignore as you see fit)

• "contentious" or similarly implied phrase needs including: western medicine has obviously not (yet) wholeheartedly included this into its own practice and does not accept the traditional proposed underlying mechanism of action of Qi, conversely (until recently) the Chinese would have relied exclusively upon TCM. So what is common experience & approaches taken in health care are very different for large fractions of the world's population, there is a discrepancy and therefore some degree of tension between the viewpoints. As Misplaced Pages should not be US/UK centric, the practice of approx 1/4 of the worlds population is highly notable.
• Jim Butler and Mccready are clearly more familiar with literature on acupuncture than most wikipedians, so I'll refrain from commenting on any single paper or how firmly various viewpoints identify with that paper.
• Point about lack of evidence for efficacy is not the same as evidence that lacks efficacy is a good one and all too often forgotten. However given that studies generally can only confirm a positive rather than a negative, not unreasonable that an extensive practice acquires a body of supportive evidence - and conventional medicine is also guilty of this. Example: one might suppose that use of bath oil emollients for patients with dry skin and eczema is a good thing, but a surprising lack of evidence for this (vs. just apply full-on creams after a bath) - and a recent Cochrane review was highly critical of the practice not so much that this of disproved effectiveness, but rather that such a common and expensive practice lacked support and so needed to be questioned.

But might I suggest you take a step back from concentrating on these few sentences of the lead-in. As you two are exploring ways to work better together, can I suggest a few wikidiversions (aka some lateral thinking):

1. Firstly put on the back burner current discussion on that paragraph, and find some parallel parts of the article that need improving. Select a dull, dry, most matter-of-fact points you can find and see if it can be better written (i.e. good English rather than necessarily great expansion or clarification) and better sourced. There must be some points you can happily agree with (how about representation in Chinese art, or role of acupuncture as forming part of Chinese self-identity). If you can work together on such aspects this will help regain trust and AFG.
2. Be really brave and rather than trying to edit in a style that is shifted from your personally held viewpoint to that of NPOV, instead agree to edit only as if from your opposing view point trying to approach the NPOV. I promise you it is much harder than you might think, but does wonders from being a good encyclopaedic copywriter, rather than a participant in a discussion forum arguing out a case. Consider what makes a good competitive Debater: being given an unprepared bizarre untenable proposition to have to earnestly debate and defend :-)
   Hence (following points of course would need references to cite) Jim Butler try adding something about how western medicine has traditionally rejected or felt threatened by acupuncture (perhaps seen as vanguard opening the way for all other CAMs diverting limited resources/spending to what is/was seen as "unproven" treatments) and Mccready add something on scope of acupuncture use in China (NB factual usage, not whether proven effectiveness). Likewise Jim Butler on perhaps unrealistic claims made for acupuncture (surely some less scrupulous practitioners may make wild claims for treating conditions for which wider acupuncture/TCM community would view as unjustified) and Mccready on the "professionalisation" of practitioners in the west, from just a few practicing enthusiasts to voluntary organisations to official legislated bodies - I'm guessing here but presumably: addressing clinic sterilisation protocols, continuous training and reaccredidation, financial propriety, personal propriety such as move here in UK to have everyone who works intimately with members of the public to be required to have undergone a police criminal check (i.e. not on a Sex Offenders register).

There is only one thing better than a good edit, and that is a good edit that makes one feel virtuous and gains one kudos :-) I'm not going to suggest that you two become each other's best friend, but if you could agree to flip roles and form a team, then as such knowledgeable people on the subject, that would be an incredibly strong team to move this article forward from B-class to Featured Article status. Hence Jim Butler be the proactive one to (disappointingly) add a major study that fails to confirm acupuncture effect in a condition (rather than Mccready gleefully adding this and risk being seen to push the conventional medicine POV) and conversely where a good paper finds some positive effect a (somewhat surprised) Mccready adds this (rather than Jim needing to fly the flag). Before anyone argues impossibility of this as acupuncture does/does not work, reflect that we all know that it is a statistical certainty that in research with multiple studies at least some will report positive findings and some negative so there will opportunities on both sides (irrespective of where one personally thinks the balance of papers will prove to be).

So foster exemplary super-civility, scrupulous AFG thanking each other for valid points, time & effort in contributing and going out of you way to ensure your personal counter-viewpoint is fairly described (I’ll coin the terms "wikihiatus", "wikiparallel", "wikireciprocate"). This is an article/topic that should easily warrant Feature Article status and eventual inclusion as article of the day on the Main Page, work to that goal, not whether can be resolved as absolute proof/disproof. If you can move the article forward (and bring a fresh spring clean to this talk page), then consider seeking Misplaced Pages:Peer review (a copyediting, not expert academic, process), to gain some outside views on what this artcle lacks and what, as leading contributors to this article, you can help do. David Ruben 15:40, 14 February 2008 (UTC)

Pain

I noticed that on 3 Feb Jim Butler inserted the reference to pain in the LEAD. The reference is unsourced. The use of acupuncture for pain relief is also highly controversial. For these two reasons the statement on pain in the LEAD implying perhaps some efficacy should be removed. Please comment. Mccready (talk) 02:09, 15 February 2008 (UTC)

The wording ("with the aim of") is already adequately NPOV, but I added a ref nonetheless. --Jim Butler (t) 05:30, 15 February 2008 (UTC)

Hi Mccready. Why are you trying to add Quackwatch to the lead again when you've already tried twice and have been reverted by two different editors? The second rv was very clear in the ES as to why, and I also discussed the reasons in archived talk.

It's really good that you're trying to turn over a new leaf in terms of wikiquette, but repeated bold editing with which most or all other editors disagree is still disruptive, even if it stays within 1RR, cf. feedback from admins here. thanks, Jim Butler (t) 21:38, 15 February 2008 (UTC)

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