1085: Traditional Chinese Medicine | Skeptical Sunday

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Speaker 1 Today, traditional Chinese medicine might have started in China, but these days it seems to be everywhere. Acupuncture is practiced worldwide.

Speaker 1 The ancient practice of cupping is growing in popularity, and herbal medicine is in pretty much every pharmacy.

Speaker 1 Everybody knows somebody who swears by one or maybe even all of these practices, but is traditional Chinese medicine effective medicine passed on for millennia or ancient superstition here in the modern world?

Speaker 1 Today, skeptic and comedian Michael Regilio is here to express the Tao, or is it Tao? I would say Tao, of how traditional Chinese medicine works or doesn't work. How's it going, Michael?

Speaker 3 Hey, Jordan, how are you feeling today?

Speaker 1 I'm feeling peachy, man.

Speaker 3 Peachy? Interesting. Did you eat peaches to become peachy? Because in traditional Chinese medicine, maybe.
I don't know. I didn't come across that.

Speaker 1 I thought you were just making a really terrible dad joke, but I know that when you eat certain things like cold or hot foods, something, something, your energy.

Speaker 3 You know what I was really getting at? Is are you feeling balanced?

Speaker 1 Well, I'm not falling out of my chair, so I'm physically balanced. I have a balanced diet, a balance between work and leisure.
So I'm not exactly sure what you're asking. What do you mean?

Speaker 1 Am I feeling balanced?

Speaker 3 I simply meant your yin and your yang.

Speaker 1 Of course. How could I forget? No, I'm not so sure about that.
I don't really know. I don't know what my yang is up to today.

Speaker 3 Well, that's interesting because that is the crux of traditional Chinese medicine.

Speaker 3 A traditional Chinese healer is trying to restore balance between these two complementary forces that flow through not just your body, but throughout the entire universe.

Speaker 3 According to traditional Chinese medicine, a person is healthy when harmony exists between these two forces, and sickness occurs when there's more yin than yang or more yang than yin.

Speaker 1 Okay, it seems like the obvious next question is, what the heck are yin and yang?

Speaker 3 We've all seen the graphic representation on posters in teenagers' rooms and on the walls of suburban dojos.

Speaker 3 For lack of a better example, it looks like a white sperm and a black sperm positioned head to tail in a circle. 69ing? Oh, God.

Speaker 1 Okay. You couldn't have thought for like one second longer and come up with a less crass description.
Tadpole would have worked. You could have added the word whale.

Speaker 1 A sperm whale looks close enough, like a beluga thing. I don't know.
That's totally different, but whatever. And you could have left out the other bit.

Speaker 3 Fine. Okay.

Speaker 3 But even then, these cliched posters I'm talking about, they're just graphic representations of something actually unseen, an invisible life force. Yin is considered the female of these two forces.

Speaker 1 For an ancient, highly patriarchal culture, I'm actually kind of impressed they chose to represent females.

Speaker 3 The female force, Yin, is considered considered cold, dark, and passive.

Speaker 1 Just once, I'd like to be surprised by an ancient patriarchal culture, but not this time, apparently.

Speaker 3 Yin's opposite won't surprise you either, then, because yang represents masculinity.

Speaker 1 Light and warmth actually sound more female than male.

Speaker 3 Yeah, ironically, they got yin and yang mostly backwards, although the female yin does also represent earth, softness, and rain.

Speaker 1 So those are nice.

Speaker 3 As well as blackness, evil, smallness, smallness, and even numbers.

Speaker 1 Okay, even numbers. So the ancient Chinese also had an opinion on even numbers.

Speaker 3 Yeah, as we'll see, much of traditional Chinese medicine isn't that far removed from numerology, astrology, and stuff like that. Yang represents heaven, sunshine, hardness, goodness, the color white.

Speaker 3 largeness, and of course, odd numbers. According to ancient texts, the interplay between these forces make up qi, which is the life force that flows around and through our bodies.

Speaker 1 So, yin and yang represent two opposite polarities within the force of qi, like the positive and negative polarities in electricity.

Speaker 3 Yeah, actually, that's really good. You might have a little side hustle in traditional Chinese medicine in your future.

Speaker 1 I like poking holes in people. Okay, let's leave that there.
But, what is qi like scientifically speaking? What this thing that they thought was qi?

Speaker 3 Okay, look, after a lot of research, I can only say with some generosity that qi is a metaphor, an attempt by ancient peoples to explain complex systems like nature and the human body.

Speaker 3 If I wanted to be really generous, I'd say it's kind of like the force in Star Wars, which that's pretty cool.

Speaker 1 Yeah, that's definitely pretty cool, but it's also definitely made up. But I'm guessing we're going to get to that shortly.

Speaker 3 Yes, and traditional Chinese healers try to correct the imbalances of qi and yin and yang through the practices of herbal medicine, acupuncture, and cupping.

Speaker 3 These practices originated as far back as 22 centuries ago.

Speaker 1 Wow. So people have continually researched qi and yin and yang for 2200 years or so.
That's frankly, that's incredible and impressive.

Speaker 1 And one would normally think speaks to some effectiveness some way.

Speaker 3 No, because right off the bat, there's a misconception there. Traditional Chinese medicine.

Speaker 1 So can we just call it TCM?

Speaker 3 TCM, but people might confuse that with Turner Classic movies.

Speaker 1 I think it'll be all right.

Speaker 3 Okay, fine. So back as far as the 1600s, TCM had been written off as superstition in China.
And by the 1800s, TCM had pretty much been completely abandoned.

Speaker 3 The Chinese were adopting Western medicine and leaving TCM to the fringe few.

Speaker 1 So even 400 years ago, people had walked away from TCM and moved towards Western medicine, which, by the way, at that point, Western medicine was probably something like, oh, she's got the vapors.

Speaker 1 I'll go get the leeches. So that's surprising.
It's so strange to me they were ditching this stuff way back then because it's so huge these days. So what happened?

Speaker 1 Was there an event or something along those lines?

Speaker 3 Let's put it this way. As my weird social studies teacher at high school used to say, communism doesn't work.
And that's what happened.

Speaker 1 Okay, what do you mean by that?

Speaker 3 Chairman Mao and the Chinese Communist Party found themselves in a bit of a pickle in the early 1960s.

Speaker 3 They had promised healthcare to everyone, but didn't have the doctors, facilities, or medicines to make good on that promise. TCM offered a solution.

Speaker 3 Practitioners didn't require the same extent of training as Western doctors.

Speaker 3 The doctor shortage in China was particularly pronounced in rural China, and rather cynically, the Communist Party kind of assumed these, for lack of a better term, hicks, wouldn't know the difference anyway.

Speaker 3 So this gave rise to what they called the quote barefoot doctors, which were basically just farmers who had taken a crash course in TCM. Chairman Mao was happy as he was able to fulfill his promises.

Speaker 3 And in general, people were happy as they had medical care. And after a several centuries-long break, TCM came roaring back.

Speaker 1 I guess everybody was happy with that, right? So Mao, he looks good. The people who are getting treated look good and feel good.

Speaker 1 Well, except for the people who actually needed medical treatment, this was a clever solution.

Speaker 3 Yeah. In fact, Mao himself was an avowed believer in Western medicine.

Speaker 3 His personal physician quotes him as saying, quote, even though I believe we should promote Chinese medicine, I personally do not believe in it. I do not take Chinese medicine.

Speaker 1 So he really could not be any clearer on that. That's funny.
It's so blunt. But how did so many people in America then come to believe in TCM?

Speaker 1 How did it make its way here and then suddenly become like ancient Chinese technology that they don't want you to know?

Speaker 3 Some of the credit goes to, and I'm sure you've probably already guessed this, Richard Nixon.

Speaker 1 Yeah, I was absolutely not going to guess Richard Nixon. What does he have to do with any of this?

Speaker 3 In 1972, Richard Nixon famously visited China. And as always, a press pool followed.
In that that press pool was James Reston of the New York Times, a political reporter.

Speaker 3 While there in China, Ruston fell ill and needed an emergency apamdectomy.

Speaker 1 Oof, ouch. Getting sick in a foreign country is scary.
Getting surgery in a foreign country would be really scary, especially if it's China in 1972.

Speaker 1 So I had a root canal in the former East Germany, which was very developed by the time I got there in the 90s. It was no longer East Germany, of course.

Speaker 1 And the dentist, he had been trained in the Soviet Union and just happened to be out of anesthetic or didn't use it. He only had that banana-flavored spray.

Speaker 1 This spray is what they use when they're like, oh, I'm going to scrape something under your gum. They don't need to inject you.
That's all he had.

Speaker 1 But then I got a root canal with that and it hurt really bad. They had to hold me down.
Not the dentist, obviously. He was working.
His assistants held me down in the chair.

Speaker 1 It was hopefully as close to being tortured as I will ever get.

Speaker 3 And meanwhile, there was an entire room full of anesthetics in the next room over, and it was just this stereotypical, evil East German dentist. No, we have no anesthetic.
Yeah. All right, fuck.

Speaker 1 He really just didn't like me at all, I think, is what it came to.

Speaker 3 And okay, American, huh? No anesthetic. Sorry, we're out.
All right.

Speaker 3 Chinese doctors gave James Reston, who we were originally talking about, almost entirely Western medicine when they performed surgery on him. He had normal anesthesia, antibiotics, et cetera.

Speaker 3 But as a little showcase for TCM, his post-surgery routine included acupuncture.

Speaker 3 Reston, who, as I said, was just a political reporter, he had no medical training or an expertise to judge this, but he went back to America and he wrote a now famous op-ed in the New York Times, completely touting this amazing ancient procedure, acupuncture.

Speaker 3 Even though Reston was clear in the op-ed about the fact that the acupuncture was just a post-procedure addition to his medical care, the rumor mill did what the rumor mill always does, and it churned out these fantastical stories here in the U.S.

Speaker 3 about how only acupuncture was used and no Western medicine. And as a result, TCM in America became all the rage,

Speaker 3 which it remains. With roughly 38,000 licensed acupuncturists in the U.S., it's safe to say they are everywhere.

Speaker 3 In fact, it's so easy to find one that just out of curiosity, I asked my phone where where the nearest one was. Can you do the same? I'd be curious.
Where's your nearest acupuncture?

Speaker 1 Sure. I don't even necessarily need to use my phone.
My wife's parents know plenty of these folks, and I've had it done for pain, and I've done an entire skeptical Sunday episode on acupuncture alone.

Speaker 1 It's everywhere. I live in the Bay Area here in California.

Speaker 1 There are literally hundreds of places to get it around here, but I last had it next door to my house because this friend of my wife's parents just happened to roll through.

Speaker 1 And I was like, sure, I'll do it.

Speaker 3 Wow. Okay.
So you're like 15 yards away.

Speaker 3 Mine says 0.3 miles away is the closest acupuncturist, but then it tells me 0.4 miles away, there are three and a half mile away, there's even more acupuncturists.

Speaker 3 And when I hit the button for directions, the phone defaults to walking directions. That's how close my nearest acupuncturist is.

Speaker 1 Okay, but in truth, you're in LA. And I'm guessing that's not the national norm to have acupuncture within walking distance of your house.

Speaker 3 Yes, I anticipated that you might say that. So I had a friend in Iowa do the same, and he said there are four in his zip code.
The nearest one is under a mile from his house. Wow.

Speaker 1 Point taken, I guess. There's a lot of acupuncturists in America.

Speaker 3 Sheesh. Yeah, that was a good one.
Compare the 38,000 acupuncturists we have here to the measly 18,000 podiatrists in the U.S. It's really wild how many acupuncturists there are in the U.S.

Speaker 3 Could you imagine if you went to China and there was a Navajo medicine man on every corner in China?

Speaker 1 Right. Like nearest Navajo medicine man, I need some burning herbs blown in my face.
Oh, you just walk down the road that way.

Speaker 1 And if you go up to the third floor, that guy's a little bit better in my opinion.

Speaker 3 Wow.

Speaker 1 So it sounds like it's big business giving people little pokes.

Speaker 3 Absolutely. Acupuncture brought in $27 billion in 2021.
So when looking at the reasons these treatments are perpetuated, you really can't overlook the money.

Speaker 3 And that's not to say that there aren't other reasons.

Speaker 1 It seems like a good time to ask since many people won't have recently heard our episode on acupuncture, which was a zillion years ago in podcast timing, what exactly is acupuncture besides stabbing your way to the balance of yin and yang and whatnot?

Speaker 3 Okay, acupuncture, like all things, TCM, has to do with qi, which for the record is spelled QI, if you're looking to Google any of this stuff we're talking about later.

Speaker 3 And qi, which again is an invisible energy, it flows through invisible meridians in the body. Meridians are like channels through which the qi flows.

Speaker 3 According to TCM, there are 12 major meridians that connect to organs, tissue, veins, nerves, cell, atoms, and mother freaking consciousness itself.

Speaker 3 And so then the needles are inserted into the meridians to readjust the flow of the qi in order to readjust the balance between the yin and the yang.

Speaker 1 Okay, so is any of it real? Are the meridians, did they turn out to be nerve pathways that everybody has? Does the human body have 12 of those?

Speaker 1 Can scientists see those on a cadaver or measure or detect any of this stuff?

Speaker 3 Uh, short answer, no.

Speaker 1 Okay, that's a really short answer.

Speaker 3 Fine. Longer answer, hell no.

Speaker 3 Am I being snarky? Hell yes. Is there more to it? Yes.
The big question is if the acupuncture is doing anything or is the relief people receive is it all in the brain.

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Speaker 1 First of all, if I'm not mistaken, my health insurance when I lived in LA covered acupuncture. And I know that there have been studies showing some merit.

Speaker 1 And of course, there's all the people I know who swear by it. We did the episode on acupuncture.
A lot of people emailed in and were like, okay, okay, but you're wrong about a few things.

Speaker 1 And I use it for my pets or whatever. I did it for pain in my shoulder.
And I am open to the idea that it's just placebo.

Speaker 1 But first of all, the placebo effect is certainly real and measurable and well studied.

Speaker 1 It certainly sounds like there's a there there because I will say my shoulder pain was remarkably degraded and I assumed it was placebo, but I'll take it.

Speaker 3 Fine.

Speaker 1 Sign me up.

Speaker 3 Absolutely. I get that.
I understand that. But you mentioned the studies and I want to talk about them.
Let's start with those studies because you're right.

Speaker 3 There have been studies and studies do show acupuncture to be effective, but there's a problem and it's a big problem. Most of the studies that prove a benefit were conducted in China.

Speaker 3 And these Chinese studies stand in contrast to most studies done outside of China. And scientifically speaking, when you have, that's a big red flag.

Speaker 3 And I don't just mean the one with little yellow stars on it.

Speaker 1 So it sounds like you're saying the Chinese cherry-picked or maybe even fabricated the data or the results.

Speaker 3 I don't have to say it. China's food and drug regulators unearthed widespread data fabrication in these studies.
Oh, wow.

Speaker 3 Chinese regulators carried out a one-year review of clinical trials and concluded that more than 80% of clinical data is fabricated. And this doesn't just go for acupuncture, by the way.

Speaker 3 These studies included all the Chinese pharmaceuticals.

Speaker 1 Buyers of Chinese medication online, myself included 10 years ago, beware.

Speaker 3 Yeah, I believe that would be called caveat d'Emperor.

Speaker 1 Sometimes I know a joke is clever, which makes it even more annoying somehow. So Chinese studies can't be trusted when it comes to this stuff, I'm guessing.
I mean, that's what it sounds like.

Speaker 3 Here's the thing. Actually, most studies of acupuncture can't really be trusted because of the impossibility of performing a true double-blind study.

Speaker 3 That is to say, a study in which both the researcher and participant don't know which is the placebo and which is the actual treatment.

Speaker 1 I see. I would imagine that would be difficult because how could the person administering acupuncture not know that they're administering acupuncture?

Speaker 1 It's not like they're giving somebody a pill and they don't know if the pill is placebo or real. They have to stick needles in meridians or whatever.

Speaker 3 Right. Yeah.
And obviously the flip side of that is how could the person receiving the acupuncture not know they're receiving acupuncture?

Speaker 1 Right. So what does an acupuncture placebo even look like? I mean, a needle's a needle.
And I guess that's where we get stuck. No pun intended again.
Sorry.

Speaker 3 Placebo, you could, I don't know, try poking people with insults. Look, to do a proper scientific study, you need a control group.
And that's just not possible with acupuncture.

Speaker 1 So in studies, the control group receives the placebo, right?

Speaker 3 Yes, exactly. So what some studies have done is to test acupuncture against what they call sham acupuncture.
Basically, one group, they use the real meridians, by which I mean the imaginary meridians.

Speaker 3 And in the other group, they just randomly put the needles in non-meridian spots. And I'm guessing the problem with that should seem relatively obvious.

Speaker 1 Right, because why would it matter if needles were placed on imaginary meridians or imaginary non-meridians?

Speaker 1 It sounds all the same. I mean, if you just put a needle anywhere and it'll maybe do something, you're right.

Speaker 1 Because if it's not real and that's what you're testing for, then you can't really check where the meridian is because you can't see it and it's not detectable anywhere.

Speaker 1 Unless you put the needle in it, it does something. Oh, yeah.
We're sort of caught in this weird loop.

Speaker 3 Yeah. And look, that's pretty much what the study showed.
And these were large clinical trials conducted in Germany and the U.S.

Speaker 1 Yeah, not China then.

Speaker 3 Right, which is worth noting.

Speaker 3 And these non-Chinese trials consistently showed traditional acupuncture and sham acupuncture are pretty much the same decreasing pain levels for migraines, lower back pain, and knee pain.

Speaker 1 I'm steel manning this. It sounds like what you're saying is, hey, there is relief from acupuncture because migraines are tough to treat and lower back pain sucks and so does knee pain.

Speaker 1 So sign me up for acupuncture.

Speaker 3 Absolutely. And you'd be right.
But is it the acupuncture? Or is it the placebo effect?

Speaker 3 There's actually a widely touted meta-analysis of acupuncture that shows a difference between real acupuncture and sham acupuncture.

Speaker 3 But in reading about this, there's a lot of critics of this meta-analysis. They point out that the differences are very minute between different people.
Plus.

Speaker 3 There is like these huge criticisms of meta-analysis in general that I, going to be honest with you, I don't understand.

Speaker 1 Yeah, a lot of that stuff is tough to understand because I, at first, I was like, let me read this.

Speaker 1 And there's a lot of Greek symbols that are like, when you use lambda in the wrong way, then, and I'm like, oh, this looks like calculus. I am out.
So I get it.

Speaker 1 This would be hard to understand anyway, because it sounds as silly as doing a meta-analysis of like astrology or something. Where do you start?

Speaker 3 Yeah. Meridians and Qi simply aren't proven.
And balancing yin and yang isn't medically sound. And what are the odds?

Speaker 3 that at the end, science ends up going, hey, look, turns out what ancient people believed with no understanding of biology, and they were totally right about all these invisible things they made up.

Speaker 1 Yeah. It's like saying, what if ancient people were right about sacrificing virgins to volcanoes? First of all, you and I both would have been in deep trouble back in high school.

Speaker 3 That was a private story I told you.

Speaker 1 Not anymore.

Speaker 3 Okay, look, we need to understand if the act of needles stabbing the skin does something real, like tangible. and scientifically provable or is it just all placebo?

Speaker 1 So I guess my little gripe with this is it sounds like by saying placebo, you're almost saying, oh, this is worthless.

Speaker 1 And I'm, yes, I'm baiting you because we've done several episodes on the placebo effect and I've got even more stuff about it in the pipeline.

Speaker 1 And it turns out that it's like quite a legit way to treat pain.

Speaker 3 Yeah. It's awesome.
In fact, in researching this episode, I came across like several full-throated defenses of the placebo effect by some of the most reputable institutions in medicine.

Speaker 3 One article from Harvard Medical School was the one that like really set me straight on placebos, particularly when it comes to pain management. Pain is in the brain.

Speaker 1 Ooh, that is dangerously close to a Cypress Hill lyric, I think.

Speaker 3 That it is. And I may be insane in the membrane, but the fact of the matter is the way our brain perceives the messages from pain receptors is pain.
That's just what pain is.

Speaker 3 So if placebos convince our brains to release endorphins, which relieve pain, the pain relief is as real as if you'd taken a pharmaceutical drug without the risks of taking pharmaceutical drugs.

Speaker 3 Hey, placebos, like seriously, no disrespect. I get you.

Speaker 1 Yeah, I mean, you can't be allergic to your placebo. I don't even know.
Maybe I spoke too soon. It seems like that could be one of the things that triggers his allergies, but whatever.

Speaker 1 So, you asked if acupuncture might be doing something more.

Speaker 1 What would be the more if the idea is to treat the pain?

Speaker 3 Yeah.

Speaker 3 So, it actually, this is where it gets murky because serious professionals who I respect haven't ruled out that causing micro-injuries might be triggering an immune response or sending anti-inflammatory proteins and other infection-fighting and wound-healing chemicals to these micro-injured areas.

Speaker 1 Okay, I can get behind that, right? You're sticking a needle into something and maybe your body's like, hey, send more blood there.

Speaker 1 Because I'll tell you, the areas where I got poked by these little needles definitely turned red and some of them got a little sore and yada, yada.

Speaker 1 But also, on the other hand, the words might be in those sentences that you just previously spoke. It seems like they're doing a little bit of heavy lifting there.

Speaker 3 Yeah.

Speaker 3 Some also propose that these micro-injuries might, and you said it, increase blood flow to the area or might activate nerve receptors.

Speaker 3 Like they're still hypothesizing about it, but there's not a lot of evidence.

Speaker 1 Gotcha. Yeah, and you're still using the word might quite a bit.

Speaker 3 Yeah.

Speaker 3 Look, in this case, might definitely doesn't make right.

Speaker 3 So what if they haven't ruled it out? They also haven't ruled it in. Reputable people do wonder if acupuncture is doing something more than the placebo effect.

Speaker 3 But the fact is, all the evidence suggests that on a neurological level, it's treating pain just like a placebo does.

Speaker 1 So for pain relief, it sounds like acupuncture gets a solid maybe.

Speaker 3 Yeah, I don't know. I'd go so far as to say a solid yes for pain treatment, as long as you believe.
For skeptics, I couldn't help but wonder if the placebo effect is less or even null.

Speaker 3 That might be the study we're looking for. That's the control group.
I'd be interested to see in believers versus skeptics.

Speaker 1 So maybe that's the control group they're looking for. And then again, look, I don't believe that much in acupuncture at all.
I did the episode on it. And I'm extremely skeptical.

Speaker 1 So when I, like I said earlier on the show, I got a chance to have a university professor from China who teaches acupuncture at like a big respected institution of Eastern medicine or Chinese medicine.

Speaker 1 He was just hanging out and he's like, oh, your shoulder hurts? I was like, yeah, I've got something called thoracic outlet syndrome. It's like impingement in my shoulders.

Speaker 1 And he's like, oh, let me jab you with some needles, right? So I was like, what the hey? I'm sitting here in my brother-in-law's house. Why not?

Speaker 1 I was quite surprised when most of the pain went away almost immediately because I was kind of like, I am only doing this for shits and giggles, really, because you're here and you seem like a nice guy.

Speaker 1 I don't think this is going to work. But look, it's not a huge surprise because placebo is legit.

Speaker 1 And maybe it would have worked even better if I wasn't skeptical and decided before I even started that it probably wasn't going to do anything. I don't know, but it certainly did something.

Speaker 1 placebo or not. And it lasted for several days.
It's not like I woke up and I was like, ow, my shoulder. Oh, wait, I had acupuncture.
This isn't supposed to hurt.

Speaker 1 I spent a good week or two where my arms felt more or less fine.

Speaker 3 That is amazing. Look, I don't believe in much either, but I am really determined to find out.
And a lot of people have been working with acupuncture.

Speaker 3 In fact, in 2009, the UK's National Institute for Clinical Excellence.

Speaker 1 That is one of the most British-sounding names ever.

Speaker 3 Yeah, look, Jordan, they still have a king. Everything over there is the royal this or the excellency that.

Speaker 3 So in 2009, the United Kingdom's National Institute for Clinical Excellence did recommend acupuncture for back pain. But I have to keep saying this, back pain is weird.

Speaker 3 Specialists have long understood there's a very real mental alement to overcoming it.

Speaker 3 Just for comparison, I looked up what our National Institute of Health has to say about acupuncture, and I found what they were saying on the subject on their website to be kind of like how polite atheists talk about religion.

Speaker 3 They were like,

Speaker 3 it's good for some people, and sure, you can't prove it, but hey, people aren't dumb for believing it. That's fine.

Speaker 1 Yeah, you said for some people acupuncture is effective.

Speaker 3 Okay, sure, it's effective-ish,

Speaker 3 but for certain things, it can assertively be said it's not effective. And here's the thing: acupuncture makes a lot of claims.
Let's shut a few of those down. Yeah, let's do that.

Speaker 1 Claims such as

Speaker 3 Okay, the evidence strongly suggests it is not effective for rheumatoid arthritis, stopping smoking, irritable bowel syndrome, losing weight, addiction, asthma, stroke, tinnitus, or thinking you're Napoleon Bonaparte or whatever else they are claiming that it works on.

Speaker 1 But it doesn't hurt to try if you're suffering from those things because you might end up with almost like a placebo boost thinking, I can quit smoking because I jab needles into my forearm.

Speaker 1 So I don't need a cigarette right now. I mean, it seems like you could just as easily snap a rubber band around your wrist or something.
You don't really need acupuncture for that, I suppose. Yeah.

Speaker 3 You might say that's like the Dumbo's feather effect. And you asked if it does any harm, though.

Speaker 3 And I guess that all depends on how you feel about, say, death, because in extremely rare cases, it can be fatal. I found examples of it, though.

Speaker 3 In fairness, the only cases of death I came across were not in the U.S.

Speaker 3 But really strange, one instance that I found was in rural China, in which it said that the needles punctured the person's organs. How the hell? I know.

Speaker 1 I just said I had acupuncture. I read the story where the needle went into someone's organ.
The other one, a person had a punctured lung. These needles are so tiny.
They're like hairs.

Speaker 1 And their needles, there's a little, for lack of a better word, handle on it that they can use to tap it in. Obviously, they use the wrong needle if they went and hit an organ or your lungs.

Speaker 1 There's no way this thing could go across anything that's not just skin. and light tissue.

Speaker 1 Sounds like some barefoot doctor using a hammer and chisel because they didn't have acupuncture needles and accidentally killing someone. I just don't know how you could screw up that bad.

Speaker 3 Yeah, it was shocking to me. But the fact of the matter is, soreness, bruising, infection, those can happen anywhere.

Speaker 3 And they do happen very often as a result from acupuncture in whatever country you receive it in. But for the most part, it's pretty darn safe here in the U.S.
Yeah.

Speaker 1 The guy who did it on me from China, he was using alcohol pads, just like you would on a site you were going to use an injection on.

Speaker 1 Now, I have had acupuncture at some of those like Chinese foot reflexology places that my mother-in-law will take me to. And they're just, let me jab this needle into your back.

Speaker 1 And I'm like, shouldn't you sanitize that? I just worked out. You just injected me with my own sweat and whatever the hell else was on my skin.
Thanks, man. And some of those got lightly infected.

Speaker 1 I was not happy about that.

Speaker 3 Wow.

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Speaker 1 Things are safe in the US, aside from that place, Cupertino, due in large part to regulations and certification, I would imagine. And how exactly is acupuncture regulated? What training do you need?

Speaker 1 What certification goes into becoming an acupuncturist? Certainly you can't just tell people that you are one and start hammering needles in. There's no way that we allow that.

Speaker 1 Except for that place in Cupertino. Yeah.

Speaker 3 I would like to see their certification because most states require a master's degree in acupuncture and Eastern medicine. And then there's the state exams and the actual certification process.

Speaker 3 So yes, it is a process.

Speaker 1 Good. Okay.
So most states, you said, are there states where just anybody can poke you with needles and call it acupuncture?

Speaker 3 Absolutely not. A few states, what I say that you have to get the certification, in a few states, there is no certifications.

Speaker 3 Only doctors and nurse practitioners are allowed to administer acupuncture. In Oklahoma, they allow chiropractors.
Plus, the needles are highly regulated by the federal government.

Speaker 3 They are coming out of sterile packages for one use only, unless you go to the place you went.

Speaker 1 Except for that place of Gupertino, where who knows? So a person wanting to try acupuncture, it sounds like they're in good hands if they're in the United States.

Speaker 3 Yes. In fact, I am not trying to belittle acupuncturists.
I've been to a few. They were lovely people.
I even allowed students to practice on me at an accredited college here in L.A.

Speaker 1 You've also had acupuncture. I feel like you buried the lead a little bit there.
So what was it like for you? Did it help with whatever you went in for?

Speaker 3 It was lovely with lovely people. I laid on a bed with needles sticking out of my face and my arms and my chest and legs, and I meditated to New Age music for like 30 minutes.

Speaker 3 And when it was all over, I felt chill and good.

Speaker 1 What ailment were you there for?

Speaker 3 Arm pain.

Speaker 1 It's kind of similar to me, actually. So, did it help?

Speaker 3 No, not even a little bit. Unless you account for the fact that over the course of months of acupuncture and not overusing my arms, it got better.

Speaker 3 Which is exactly what happened the second time in my life I had arm pain, but only took a few months off of strenuous work and did no acupuncture.

Speaker 3 Kind of turns out that we humans heal with or without acupuncture. But you know what? In truth, it was lying in that acupuncturist's office that I first tried meditating.

Speaker 1 You said strenuous work, but dude, you're a comedian. What are you talking about?

Speaker 3 Yeah, Jordan, there is an old saying inside every comedian, there's a great waiter. And I'm not an exception to that rule.
I was waiting till at that time in my life.

Speaker 1 Yeah, I too don't think I could hold my arm up in that sort of like hand behind the head position. I don't even think I'm flexible enough to hold a a tray like that.

Speaker 1 I don't know if they really do that. Good thing I'm not a server.

Speaker 3 Yeah, actually, I knew a bunch of servers back in the day when I was doing it who had tendonitis in their wrist and problems like that from carrying those trays around.

Speaker 3 Oof, yeah, that's a job I could never do.

Speaker 1 That's why I always tip. But how do you know the acupuncture did nothing? You said you healed both times, so

Speaker 3 I don't know if it didn't do anything,

Speaker 3 and neither do the acupuncturists, which is pretty strange for a medical procedure. Have you ever met someone after having a broken bone set or LASIC surgery or disc replacement in their back?

Speaker 3 They couldn't tell you if it actually did anything. Like medicine is a science.
It's based on being able to objectively tell if it's doing anything.

Speaker 1 Yeah, that's a very fair point. That's really good.
Like with acupuncture, you kind of have to go. My brother-in-law had it same day as me, almost the same problem as a frozen shoulder.

Speaker 1 And he's like, hey, do you think it did anything? And I'm like, I think it maybe got rid of some of my pain. What about you? He's like, Yeah, I think maybe it did, but you're right.

Speaker 1 When I separated my shoulder and they put it back into place and put my arm in a sling, it was like, Oh, yeah, that worked. My arm is back in the socket.

Speaker 3 Yeah, that's what medicine should be: objective results.

Speaker 3 And look, while I'm on the subject, and again, nothing but love for acupuncturists since I've known a few and they are truly lovely people, but I looked up what is on the California certification exam,

Speaker 3 and it's a bunch of stuff about the 12 primary meridians and their acupoints, and then something about the eight extra meridians and divergent energy channels. And this is upsetting to me.

Speaker 1 Yeah, it's a state board test on imaginary things, which is not great.

Speaker 3 Yeah, an acupuncture board test should be about hygiene and the safest ways to poke people with a needle. And that's kind of it.

Speaker 1 Keep the witchcraft out of the state government, please if you were trying to stay on the good side of acupuncturists by saying they're lovely people eight times in a row i'm gonna go ahead and guess that the witchcraft comment ended it but tcm is not all acupuncture i know people are like hey i thought this is traditional chinese medicine all you're talking about is acupuncture what about the cupping and the herbal medicine and all that stuff Great question, because those are two totally different treatments.

Speaker 3 So let's go with cupping first.

Speaker 1 All right. So the obvious question is, what is cupping?

Speaker 3 It is a hickey.

Speaker 1 Okay, I'm waiting for you to expand on that, but you seem to have stopped talking.

Speaker 3 Fine, I will expand on it, but you're not going to get any further explanation out of me. It's just a hickey.

Speaker 1 Okay, so it sounds like cupping sucks.

Speaker 3 Yes. Cupping is a technique in which a practitioner takes a glass container, like a cup, heats the air inside, usually with fire, then places it directly on the skin.

Speaker 3 When the hot air inside cools and condenses, you get suction.

Speaker 1 Yeah, I have seen it done in YouTube videos. I actually tried it myself, not for any particular ailment.
I just wanted to do it because where else am I going to do it? It's quite the production.

Speaker 1 There's a whole sort of showmanship element to this cupping thing.

Speaker 3 Right. Yeah.
And that's actually the whole point. When you combine the fire show with the cooling air beginning to suck on your skin, it's pretty cool.

Speaker 3 It looks and feels like some ancient wisdom at work.

Speaker 1 I know it leaves a crazy, kind of scary-looking patchwork of bruises on your back or wherever they do it, but what else?

Speaker 3 You won't be surprised to learn that it's correcting qi and balancing the yin and the yang.

Speaker 3 But just like acupuncture, modern people assign different reasons to the benefits than the people who created it. In this case, they say it improves blood flow.

Speaker 3 which in a way it definitely does, if by improvement, you mean it increases blood flow to the capillaries until they break.

Speaker 1 Oh, that's why it leaves leaves the hickey-looking round bruises. Oh, that makes so much sense.
Okay.

Speaker 3 Yeah, and a lot of them. In fact, anyone who's ever seen a person post-cupping knows it's like crazy what it looks like on their body.
They look like they've been attacked by an octopus.

Speaker 1 Yeah, or made out with an octopus if it's on the face. I've seen, I remember when I first saw it, I saw this girl who she was wearing like a tank top and she had all these bruises.

Speaker 1 And I remember just being so confused and thinking, what could you have fallen on that would have done that to you? And I remember looking at the guy and being like, did he do that to her?

Speaker 1 How would he have done that to her? They seem happy. She doesn't seem scared of him.
I don't understand what's going on.

Speaker 1 So I remember Michael Phelps was covered also in the cupping marks during the Olympics, and that was totally bizarre.

Speaker 3 Yeah. In fact, that's where many people heard of the technique for the first time.
In fact, Phelps made quite a splash with his cupping hickeys, huh?

Speaker 1 You are doing so well with keeping the puns down on this episode, but here we are.

Speaker 3 No, look, you have no idea how hard it was for me to resist the temptation to say I was poking holes in acupuncture.

Speaker 1 And now you can't say you resisted it. Look, Phelps is an Olympic athlete.
He's also maybe a smart guy, or at least he has smart coaches guiding his treatment and training.

Speaker 1 Why would he do the cupping thing if it's total nonsense?

Speaker 3 Because I don't doubt for a second that it makes him feel good. Again, pain, especially minor pain, like sore muscles, is partly just perception in our brains.

Speaker 3 Plus, like with acupuncture, if you believe it and you get an endorphin release from it, then it's real. You're experiencing pain relief.
So what's the harm then with the cupping?

Speaker 3 If it's done repeatedly in the same spots, it can cause permanent skin damage. And if you already have eczema and psoriasis, it can inflame those conditions.

Speaker 1 Okay, so that's kind of a no for cupping. What about Chinese herbal medicine? This is a huge category.

Speaker 1 There's places in Chinatown that have what looks like hundreds of different herbs for different things that you can combine in tens of thousands, maybe more ways.

Speaker 3 It's like walking into a natural history museum or something when you walk into the Chinese herbalist. And in a way, we have saved the best for last.

Speaker 3 And I'm not being altogether snarky because with herbal medicine, there is a there-there.

Speaker 1 Where's there?

Speaker 3 Everywhere. There's a there-there everywhere.

Speaker 1 Okay, Dr. Seuss, how about you just tell us what you mean?

Speaker 3 Okay, to understand herbal medicine, you have to go back, like way, way back. 500 million years ago, the first plants appeared.
Plants are sessile organisms.

Speaker 3 That is to say, they are permanently restricted to spend their lives on the exact site of their germination.

Speaker 1 Can you imagine spending your life on the spot where you were born?

Speaker 3 It's not just born. You're spending your entire life on the spot your parents conceived you.

Speaker 1 Chris, that does not sound like a very good deal.

Speaker 3 Yeah, it's actually really rough.

Speaker 3 And as a result, plants have to deal with everything life throws at them while totally stationary, like environmental assaults, temperature, drought, co-evolving bacteria and fungi, and animals that want to eat them.

Speaker 3 And they do it all with one thing and only one thing to defend themselves: chemistry.

Speaker 1 I'm not sure I've thought of it that way, but obviously that's true. So if you're stuck in one spot for life, you're incredibly limited.

Speaker 3 And as a result of that, and the fact that they've had 500 million years to tinker with chemistry, plants have developed an absolutely jaw-droppingly massive array of chemicals.

Speaker 3 Chemicals that can be helpful to humans, they can be hurtful to humans, and some of these chemicals just make people trip their faces off.

Speaker 3 And like plants experimented with chemicals, humans have experimented with plants for thousands of years.

Speaker 3 So just statistically speaking, If enough people tried enough plants enough times, it stands to reason they would have figured out a few that act as medicine.

Speaker 1 So, Chinese herbal medicine is actually effective?

Speaker 3 Yes and no. Most of it is not proven and almost certainly not effective.
But a tiny fraction of it is, yes, effective.

Speaker 1 As effective as pharmaceutical drugs, then?

Speaker 3 No, probably not. But pharmaceutical drugs owe a lot to plants and will continue to as chemists and pharmaceutical companies still look at plants and plant chemistry.

Speaker 3 Some Chinese herbal medicines have proven to be the basis for modern drugs.

Speaker 3 In fact, the Nobel Prize-winning treatment for malaria artemisinin is a giant leap forward in treating this deadly disease, and the treatment was first written about in ancient Chinese texts.

Speaker 1 Wow, what? Here in the U.S., we live in something of a malaria-less bubble. I'm sure we have it somewhere, but I know in other parts of the world, it's a real problem.
And malaria is no joke.

Speaker 1 It kills like a gazillion people every year.

Speaker 3 Yeah, you got that right. In fact, according to a recent WHO report, 97 countries have a malaria problem.
About 3.4 billion people are at risk of getting malaria and 1.2 billion are at high risk.

Speaker 3 So not a joke. But thanks to Artemisidin, the mortality rate has dropped 42%.

Speaker 3 And Jordan. Key component to the drug was first written about by Gehung in his book, A Handbook for Prescriptions for Emergencies in 340 AD.

Speaker 1 That is pretty amazing. I love that.
I wonder, though, what passed for a handbook 1700 years ago, like giant stacks of papyrus that you needed your hand servants to carry around.

Speaker 1 Most people couldn't even read back then, right? So who's like carrying a handbook of prescriptions for emergencies in their backpack, which wasn't invented yet, maybe?

Speaker 3 Very good questions that unfortunately I don't have answers to, but I like the idea of a handbook was called that because you needed your hand servants to carry it around for you.

Speaker 3 Just as amazing in that handbook, by the way, was his instructions to use cold water instead of hot water to extract the active ingredient, which helps preserve the chemical.

Speaker 3 So he was like really onto something. This dude was making cold brew almost 2,000 years ago.
So take that, Starbucks.

Speaker 1 For a disease that's still rampant, it's actually crazy to hear that there's been an effective treatment for almost 2,000 years. That's incredible.

Speaker 3 Actually, okay, that's where skeptics of herbal medicine point out that in drinking the Artemisia tea, the chemical is eliminated just too quickly from the body.

Speaker 3 And therefore, the original treatment, as it was written about, only led to a temporary reduction in symptoms. The old treatment just reduced fever.

Speaker 3 The new treatment, which exists now, which combines the Artemisia with modern medicine, created a sturdy, stable drug that actually knocks out malaria.

Speaker 1 Still pretty damn impressive. Imagine the amount of trial and error before you figure this one out.
It's unbelievable. It's really cool.

Speaker 3 Right, which is why I say that there is a there there with herbal medicine. Plants have been running trial and error experiments and tinkering with chemistry for 500 million years.

Speaker 3 Some people say Aristotle was the first scientist, but I say plants were the first scientists.

Speaker 1 And people will accuse you of being on certain psychedelic plants for that opinion, for sure.

Speaker 3 That is probably true, but 25% of drugs we use today are either directly from plants or modified versions of molecules we find in plants.

Speaker 1 So Chinese herbal medicine is kind of real?

Speaker 3 Kind of. Like with all things, knowledge is built on previous discoveries.
So, for my money, I'm going with the latest knowledge.

Speaker 3 I think that's way smarter than putting your health in the hands of ancient knowledge. I'm pro-medicine all the way.

Speaker 3 I'm just saying, when it comes to acupuncture and cupping, those were just flawed ideas of ancient people making stuff up about energy flows and meridians. And again, no hate towards the ancients.

Speaker 3 They were doing the best they could with the information they had. But modern people turning to unproven ancient remedies aren't really doing their best with the information they have.

Speaker 3 They're doing the opposite.

Speaker 1 Well, I'm not sure that it's totally fair to make that assumption.

Speaker 1 People who are sick and they're in pain, they're, in my opinion, they're right to try pretty much anything to alleviate their suffering. Not unlike a young Michael Regilio who once had some arm pain.

Speaker 3 Yeah, okay, fair point. And by the way, now an old Michael Regilio has some everything pain.

Speaker 1 Yeah, you might want to try some TCM for that. I've heard it works if you believe it.
Thanks all for listening to and supporting the show.

Speaker 1 Topic suggestions for future episodes of Skeptical Sunday to Jordan at JordanHarbinger.com. Show notes at jordanharbinger.com.
Transcripts in the show notes.

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Speaker 1 Love talking with you there. You You can find Michael at Michael Regilio on Instagram.
Tour dates up now there as well. We'll link to that in the show notes because nobody can spell Regilio.

Speaker 1 This show is created in association with Podcast One. My team is Jen Harbinger, Jace Sanderson, Robert Fogarty, Ian Baird, Milio Campo, and Gabriel Mizrahi.
Our advice and opinions are our own.

Speaker 1 And I'm a lawyer, but I'm not your lawyer. And I'm sure not an acupuncturist or an herbalist.
So do your own research before implementing anything you hear on the show.

Speaker 1 Also, we may get a few things wrong here and there, especially on Skeptical Sunday. So if you think we really dropped the ball on something, let us know.
We're usually pretty receptive to that.

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Speaker 1 If you're looking for another episode of the Jordan Harbinger Show to check out, here's a trailer with Eric Aday.

Speaker 4 Pakistan was just one of the many bad things that happened to me in my life but I've had so many things happen and I just learned to get over it you know you get knocked down six times you get up seven and that's the only way I've ever known how to live when I got out of the cab with the suitcases to leave Pakistan the guy who was there is like next time you come back we'll show you around we'll hip you with some girls you'll have a great time and I'm humoring this guy I'm like yeah sure next time I come back I know for a fact I'm never coming back to Pakistan country sucks that fing country sucks and I'm good at finding like good things that are everywhere.

Speaker 4 So it's early in the morning and I go into international departures and long line curving around the corner.

Speaker 4 I'm waiting in line and the line goes all the way up this wall to where there's customs tables. And when the customs officer sees me and flags me because I'm about six inches taller than everyone.

Speaker 4 And I get brought to another room. Finally, the guy who asked me if there was narcotics in my suitcase comes in.

Speaker 3 He is holding these two sandwich-sealed things.

Speaker 4 And his exact words to me is, what is this? And I said, I don't know what it is yeah sure he says this is ophium

Speaker 4 i said why are you showing me this because it came out of your suitcase

Speaker 3 felt like such a idiot

Speaker 5 yeah because i thought that the dea was gonna hook me up you know because they're gonna see that i'm innocent i truly thought those guys are gonna be there to help me now

Speaker 1 because i wasn't guilty so that this doesn't happen to innocent people

Speaker 4 Three years of my life for a crime I didn't know I was being used to commit.

Speaker 1 To hear the rest of one of the most harrowing stories I've ever heard in my time doing this podcast, check out episode 147 with Eric Aday here on the Jordan Harbinger Show.

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