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pozorvlak ([personal profile] pozorvlak) wrote2010-10-27 02:14 pm
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The meaning of "Energy"

Last night a friend of mine retweeted this:
.@marzillk What energy!? Some completely unobservable thing? Energy is simply the ability to do work. Nothing more, nothing less.
-- rhysmorgan
It turned out that this was in response to the following:
@AlabasterC My sister recommends homeopathic aconite and tapping various energy points. It is helping a bit.
When questioned further marzillk usefully clarified:
@rhysmorgan Spleen meridian boosts immune system. It's under ribs on the left hand side - find the sore point, then tap while slow breathing

@rhysmorgan I know it sounds mental but I can genuinely feel it doing something.
Now, there's so much wrong with that that I don't know where to start. But I do know where not to start: by criticising her terminology. I fired off:
@rhysmorgan right now, @marzillk's making observations and you're bitching about terminology. Pop quiz: which is more scientific?
I want to expand on that a bit.

When I went off to university ten years ago, one of the questions I wanted to answer was "what is this thing called energy?" I still don't have a good answer to that, unfortunately; if asked now I'd mumble something about Noether's Theorem and Hamiltonians of closed systems, so I am at least confused on a higher level. But let's accept rhysmorgan's definition "the ability to do work" for the moment (and pretend not to notice that we haven't defined "ability" or "work"). There's still a problem with criticising marzillk's use of the word "energy": the physicist's definition isn't the only possible definition of the term. The OED gives seven definitions, of which only the final two are related to the thing that physicists talk about. Furthermore, the word "energy" has only been in use in the physicist's sense since 1807 (and the following year, someone proposed using it for what we now call "momentum"!) So if the practitioners of traditional Chinese medicine (or anyone else) want to re-use the term "energy" (or, for that matter, "meridian") to refer to something else, I have no problem with that in principle.

What I do have a problem with is the extraordinary ignorance of biology betrayed by marzillk's use of this stuff (and if she thinks that it's irrelevant that she works in educational publishing... well, I'm afraid I disagree). I've encountered a lot of skilled martial artists who claim to find qi (or something very similar) an essential component of the way they think about their art, so I'm not willing to totally write it off (perhaps it could be made to work as a high-level abstraction over some low-level biomechanical details), but really, tapping a point over your spleen to cure a cold? How on Earth does that fit with the (extremely well-attested) germ theory of disease?

But you know what, I could be wrong. Maybe tapping your spleen somehow makes it produce more monocytes or something (would that even help with a viral infection? IANAB). But that's the great thing about science: we don't have to rely on arguments from theory. Instead, we just do the experiment; if the experiment contradicts the theory, then the experiment wins. In this respect, marzillk was being more scientific than rhysmorgan, with her "I don't understand it, but I've tried it and it seems to work", approach. XKCD nailed this one: '"Ideas are tested by experiment." That is the core of science. Everything else is bookkeeping.'

To be sure, it's a pretty dodgy experiment. Only one subject, no control, no blinding, results measured by subjective feelings of wellness. One could imagine a much better experiment, in which a large number of subjects were randomly assigned to two groups: one group would receive meridian-tapping therapy from a trained master of the art, and the other would have random points on their body tapped by actors who could spin a convincing line of bullshit about the mystic significance of what they were doing. Then you measure how long it takes everyone to get better from their colds, and see if there's any statistically significant difference in the recovery times of the two groups.

I had a brief look, but couldn't find anyone who'd done that experiment. A fascinating and well-known 2007 study did what I described for acupuncture and lower back pain, though, and found that the actors had a greater success rate than the acupuncturists!

Contrariwise, this study evaluated "Meridian three-combined therapy" (thread embedding, bloodletting, and tapping/pressing) for the treatment of psoriasis, and found a small but significant improvement in effectiveness compared to conventional treatments. However, I'm assigning that limited weight in this context, because (a) it didn't just measure tapping, (b) it was for a different condition, (c) it was painfully (hoho) obvious to the patients which group they were in, and (d) it was performed in a Chinese cultural context, and we know (from experiments!) that cultural context is very important for the placebo effect.

So, anyone with greater scholarship skills able to find anything more relevant?

Update: rhysmorgan responds "I guess my beef with her referring to it as energy was that her form of energy doesn't actually exist." I take his point, but "existence" is kinda problematic in this context. Physicists' energy is an abstraction, a consequence of the time-invariance of physical laws. You can't measure it directly, nor capture it in a pure form. In what sense does it exist? But the theory of physical energy makes useful predictions: we can do calculations with energy and arrive at correct, numerical predictions of what will happen when we perform experiments. This is the important thing. To take a more abstract example: when you learn about the conventional underpinnings of calculus, you discover that there's no object in the system called "dx" or "dy", and that statements involving them are shorthand for more complex statements about the behaviour of limits. But the theory as a whole allows you to manipulate these non-existent objects and arrive at correct results. Analogously, the important question about meridian-tapping is not "does it refer only to directly observable things?" but "does it give correct predictions?"

[identity profile] pozorvlak.livejournal.com 2010-10-27 02:37 pm (UTC)(link)
Having read this (http://health.howstuffworks.com/human-body/systems/nervous-system/pain4.htm), it's not at all clear to me how gate control theory accounts for a thirty-minute acupuncture session every few days having an effect on chronic pain. Am I missing something?

[identity profile] lesmondine (from livejournal.com) 2010-10-27 02:59 pm (UTC)(link)
Can't read the link (browsing on my phone, which makes jumping around links more bother than it's worth!) but I'm pretty sure I know what you're getting at.

It's a good question. Purely hypothesising, I could imagine that the immediate benefit received during the sessions reinforces the idea that the acupuncture is 'working'. And it's well known that pain responds strongly to expectation and placebo. So we might imagine that acupuncture, presented as a long-term solution, has only short-term objective effects (through gate control) but this carries over into a subjective long-term response (through placebo).








[identity profile] pozorvlak.livejournal.com 2010-10-27 11:15 pm (UTC)(link)
I can believe that's part of what's going on, but I somehow doubt it's the whole story. Not sure what experiment you'd do to test it, but there must be some way of finding out...

acupuncture doesn't use gate control

(Anonymous) 2010-10-27 09:06 pm (UTC)(link)
Electroacupuncture does though. Man that shit is awesome. I love it. TENS is gate stuff too.

Standard acupuncture* has a measurable effect on the human body. If you put someone in an MRI machine and needle them, their brain lights up in a way it doesn't under acupressure or nothing. Manipulated needles cause a measurably greater effect than not.

Acupuncture is not very well understood. That doesn't stop it working very well for chronic pain relief. Every physiotherapist I've seen (which is a lot) does acupuncture. There's got to be a reason for that above the placebo effect - which is, admittedly, very powerful.

The meridians/energy stuff is the theatre. The needling is not.

Problem is it's very hard to study acupuncture using standard methods. How do you placebo sticking a needle in someone?


--mmmmat.

* by this I mean some form of needling therapy. meridians and chi are not involved.

Re: acupuncture doesn't use gate control

[identity profile] pozorvlak.livejournal.com 2010-10-27 11:12 pm (UTC)(link)
The meridians/energy stuff is the theatre. The needling is not.

That was definitely what I took away from the 2007 study. And I'm fascinated by Susz's links to the nausea stuff. I don't suppose you have links to the MRI studies you're thinking of?

Re: acupuncture doesn't use gate control

(Anonymous) 2010-10-28 07:18 pm (UTC)(link)
I know studies exist from speaking to physios, but haven't read them myself. Some BBC popsci show put a presenter in a scanner a few years ago and needled them - that I saw.