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I am once again both surprised and dismayed by the striking contradictions between sections of your publication. On page 4 of the June 5 issue is the article "How Can Psychiatric Research Attract Top Minds?," an important, timely topic when the prestige of psychiatry, compared with other medical specialties, is at a many-decade nadir. On page 23 is a letter from Dr. George Ulette extolling "evidence-based acupuncture" as useful for the treatment of addiction, depression, and PTSD. He considers this so-called "advanced method" superior to old-fashioned acupuncture, which maintains that the body's vital energy (chi or qi) circulates through 14 channels, or meridians, that have invisible branches connected to body organs and their functions.
Dr. Block, a letter writer in the April 3 issue, maintains that twirling needles through these marvelous channels lowered his blood pressure, but Dr. Ulette considered Dr. Block's traditional technique to work through placebo effect alone. There is no current scientific evidence that electrical stimulation alone, stripped of a little mumbo jumbo, cures any condition outside of its power of suggestion, perhaps excluding electroconvulsive therapy, which requires electrical currents much larger than those possibly delivered by acupuncture needles.
The only competent study to demonstrate nonplacebo effects of acupuncture relates to nausea, and even here the evidence is debatable. The November 1997 Consensus Development Conference on Acupuncture, which modestly supported some claims, was dominated by proponents and marketers of this dollar-derivative of the ancient Qigong masters of prescientific China's approaches to medicine.
True, unlike the venipuncture and trepanning methods of our medical ancestors, acupuncture produces a few hematomas and a rare lung puncture rather than a lingering painful death. However, acupuncture-no matter which pseudoscientific explanations are proffered-shares with the above discredited methods magical thinking and a paucity of controlled studies that meet minimal standards of the psychiatric research extolled a few pages before Dr. Ulette's letter. To attract "top minds," psychiatry must not stray far from scientific legitimacy.
Peter Barglow, M.D.
Sacramento, Calif.