Angry Doctor

Sunday, November 11, 2007

Cow Dung 6


Fellow-Clearthought blogger i must be stupid spotted this interesting news article, and gives his take on it here.

angry doc reproduces the article here:

(emphasis mine)


No cane, no gain?
Many flocked to Jurong West last week for an offbeat treatment for aches and pains: caning
By Debbie Yong


THEY sat on red plastic stools in a loose circle at an HDB void deck in Jurong West, waiting for their turn to be caned.

They pointed, whispered to one another and occasionally cringed as they watched an elderly man in the middle use a slim wooden rod to repeatedly strike at a bare-bodied man until his flesh turned red and raw.

Some passers-by stopped to stare before continuing on their way with a shudder. Mostly middle-aged and complaining of backaches and muscle soreness, the crowd of about 25 who had gathered at Block 987C in Jurong West Street 93 on Thursday afternoon believed caning to be a form of physiotherapy.

'My shoulders used to be very stiff but after my first caning session four days ago, I feel much better,' said bus driver Chua Cheng Hui, 55, who was on his third visit.

'I want to catch Master Goh one last time before he leaves,' he added, referring to physiotherapist Goh Seng Guan, 72.

Mr Goh, a Malaysian, was on a one-week trip to visit friends in Singapore from last Saturday to Friday.

But he ended up working throughout his holiday after a Shin Min Daily News report on Monday on his unusual form of therapy sent readers knocking on the door of his Singaporean hosts, Mr Png Peng Siah, 60, and Madam Qui Em, 56.

He promptly set up a makeshift shop outside their ground- floor flat, with Mr Png and Madam Qui taking turns to record customers' names and issue queue numbers.

Over the next three days, he whipped a steady stream of about 50 to 70 customers a day, working from 10am to 10pm with short breaks in between for meals.

He charged about $20 per person. The cash was discreetly pocketed at the end of each five-minute caning session.

Mr Goh, who runs two orthopaedic centres in Betong, southern Thailand, and Penang, Malaysia, with his wife, said he learnt the skill from a Tibetan lama when he was 20 and has been doing it for the last 50 years.

He claimed to be a certified Chinese physician in Thailand, but did not have his certificate with him.

His work tools: home-brewed medicated oil with his portrait on the label and 11 wooden rods of varying lengths and thickness laid out on a small wooden table.

The caning helps to loosen up muscles and improve blood circulation, he explained, as he pointed out black bruises that had appeared on clients' skins, indicating 'toxins that were being purged from the blood circulation system'.

Madam Qui, a cleaner, first met him in 1996, when she sought treatment for a pain in her shoulder at his Thailand centre, on a friend's recommendation.

His first visit here was with his wife last December, when Madam Qui invited them for a holiday.

Many of his customers, an equal mix of men and women, said they were trying it out of curiosity.

One resident of the same block, painter Ramdan Sardon, 45, who complained of a chronic backache, said: 'I see so many people here queueing from morning to night, maybe it works.'

Maintenance officer Vincent Loh, 35, said the pain was bearable, but acknowledged that he would have to wait a few days to know if the caning was effective, by which time Mr Goh would have left.

Insurance agent Raymond Goh, 53, said he came because the acupuncture treatment he had received for his sore calf in the past year was not working.

'It's more painful than death - this is the first and last time I'm doing it,' he said as he hobbled away with a swollen calf.

Traditional Chinese medicine (TCM) practitioners interviewed were sceptical about the effectiveness of this treatment.

Physiotherapist Simon Toh, 55, said there used to be a shop specialising in caning therapy at People's Park Complex run by a Taiwanese woman, but it shut after less than a year.

He said: 'Singaporeans prefer to play safe with conventional methods of treatment. People might try it only as a last resort, after taking Western medicine or seeing TCM physicians.'

Retired TCM practitioner Liang Ming Na, 60, said it was a 'very ancient practice' which originated from rural villages and is not orthodox.

Thye Shan Medical Hall's Madam Tang Eng Hua said: 'It does not have any scientific basis. The bruises could be a result of repeated hitting and anyone can rub a sore muscle to make it loosen up and feel better.

'Furthermore, it must be done with skill and care. If not, you could end up hurting someone, especially when it's the elderly.'

One passer-by at the scene, interior designer Wendy Goh, 41, saw the queue and quipped: 'Why should I pay someone to beat me?'


Why indeed, when we can buy a Healing Broom and beat ourselves with it at home?

Of course, there are some reasons to believe that a good caning can relieve pain, but like imbs, angry doc is nevertheless amused to read that a TCM practitioner has criticised the caning therapy as "a 'very ancient practice' which originated from rural villages" that is "not orthodox" and "does not have any scientific basis".

That's just priceless.

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29 Comments:

  • Priceless indeed! haha

    By Blogger I must be stupid, At November 11, 2007 2:51 pm  

  • Suddenly, being ancient, unorthodox and lacking scientific basis now looks bad.

    I thought TCM's main selling point is something like "5000 years of tradition can't be wrong"?

    By Blogger The Key Question, At November 11, 2007 3:26 pm  

  • I think the TCM physician should be more open-minded. Just because TCM cannot explain caning doesn't mean there is no scientific basis behind caning - it can just be a case of TCM not having caught up with caning.

    By Blogger angry doc, At November 11, 2007 3:47 pm  

  • This sounds like the Asian version of the snake-oil salesmen!

    By Blogger aliendoc, At November 11, 2007 8:43 pm  

  • Is it even legal for a supposed tourist to earn money providing services? He is Malaysian but doesn't have an employment pass.

    By Blogger HanSolo, At November 12, 2007 9:13 am  

  • Caning to relieve pain?

    Wah this one is going overboard man! I thought poking with needles causing pain to relieve pain sounded absurd enough.

    Now caning to relieve pain?

    Brings a whole new world to a parent telling the kids "Caning is good for you!"

    LOL!

    Hi angrydoc, what do you make of hypnotherapy. Was reading some articles about how it is used to treat IBS.

    By Blogger Dr Oz bloke, At November 12, 2007 10:20 am  

  • "Hi angrydoc, what do you make of hypnotherapy. Was reading some articles about how it is used to treat IBS."

    Specific to IBS I think there is some evidence that it works, which is not exactly surprising considering IBS is one of those diseases where there is a big psychosomatic component.

    By Blogger angry doc, At November 12, 2007 10:54 am  

  • Just wondering angrydoc, do you know much about hypnotherapy? I don't.

    What's the principle behind how it works?

    Relaxation? Suggestion? Can the principles be proven?

    By Blogger Dr Oz bloke, At November 12, 2007 11:09 am  

  • Not much; one of the psy med lecturers in school was interested in it and talked about it once or twice, but I don't encounter it in my practice.

    Like you said there is a bit of relaxation and a bit of suggestion, but as for how on a physiological or cellular level hypnotherapy makes IBS better I don't think that is clear yet.

    By Blogger angry doc, At November 12, 2007 11:25 am  

  • Hi angrydoc,

    So from a perspective of evidence based medicine, wouldn't the same rules apply to hypnotherapy for you?

    Why practice it or even promote it if the principles behind how it works are not proven?

    Don't doctors have the same responsibility not to practice something that isn't proven?

    I remember watching all those hypnotizing shows on TV and wonder is it real? What's the science behind it?

    Some call it a hoax. I wonder what jim burke would call this one?

    Tan Tock Seng Hospital has started this course in conjunction with a London College and it is accredited with CME points. Interesting that it is so "accepted" when the reasons behind how it works might be as superfluous as qi and meridians.

    By Blogger Dr Oz bloke, At November 12, 2007 11:59 am  

  • Leaving aside the fact that I neither practise or promote hypnotherapy...

    Yes, there are similarities and differences between hypnotherapy and acupuncture.

    On a level they both work, in that they relieve or alleviate certain symptoms.

    They both postulate theories of how they work which can be hard to prove.

    However, existing evidence already do not support the theory behind acupuncture; if evidence emerge that show that observed phenomena do not support the theories of hypnotherapy, then the theories will need to be reviewed.

    For example, if the changes brought about by hypnotherapy can be shown to be due to the release of certain neurotransmitters, then perhaps we can try to explain hypnotherapy without invoking an invisible 'subconscious mind'.

    (As a matter of fact, it used to be theorised that 'Mesmerism' could be explained by a form of 'animal magnetism', but that theory is now only of historic interest.)

    Also, the theories behind hypnotherapy are not used to support a system of therapy based on the same theories, and by and large hypnotherapist do not claim to be able to cure diseases other than a range of diseases with recognised psychosomatic component.

    Not sure about the TV hypnosis shows though...

    By Blogger angry doc, At November 12, 2007 12:47 pm  

  • Hi angrydoc,

    do you know of any studies that were done to prove/disprove theories behind why hypnotherapy works?

    Any links?

    Just curious to know whether there are any such studies and what they say.

    Just because a therapy has not had sufficient research done to disprove it doesn't mean it should be allowed to "get away with it" either.

    I thought the whole principle of the argument was about ethics and how doctors should only give patients treatment that have clear evidence supporting how and why it works.

    By Blogger Dr Oz bloke, At November 12, 2007 2:16 pm  

  • Sorry, Oz Bloke, no sale.

    If you are genuinely interested in hypnotherapy, you can google as well as I can.

    If you are trying to make the argument that if I don't criticise hypnotherapy then I shouldn't criticise TCM, then I will say this: I may or may not come to hypnotherapy and a number of other therapy, but until then I will set my own agenda and criticise whatever therapy I choose to, and readers can look at the evidence I present against and whatever evidence other readers may present for on this blog.

    "I thought the whole principle of the argument was about ethics and how doctors should only give patients treatment that have clear evidence supporting how and why it works."

    When we talk of proof on the subject of treatment, we are talking about two things: proof of efficacy, and proof of veracity of the theory behind it.

    Hypnotherapy and acupuncture fulfill the first for a certain number of conditions; acupuncture fails the second, while hypnotherapy hasn't. Come the day evidence emerges that the current theories of hypnotherapy do not adequately describe observed phenomena, I may criticise them. Until then, I do not think it is fair for me to either affirm or deny the theories.

    By Blogger angry doc, At November 12, 2007 2:37 pm  

  • Hi Angrydoc,

    but you do realise that your final statement has many weaknesses.

    "Hypnotherapy and acupuncture fulfill the first for a certain number of conditions; acupuncture fails the second, while hypnotherapy hasn't. Come the day evidence emerges that the current theories of hypnotherapy do not adequately describe observed phenomena, I may criticise them. Until then, I do not think it is fair for me to either affirm or deny the theories."

    What you are saying is that hypnotherapy has the "advantage" of being not studied and thus disproved rather than TCM.

    Well if you go by the cow dung theory I doubt anyone in their right mind would spend money and time to conduct a study on cow dung as an antiseptic.

    If you go on that logic the more ridiculous a therapy seems the less likely it will be studied and the more likely you will not criticize it?

    I'm not trying to sell anything. I am merely trying to put certain things in perspectives.

    TCM is being attacked strongly because of its popularity and perceived success in treating many conditions so much so that it warranted several studies to prove or disprove them. Whereas other alternative treatments are left to their own devices.

    In the meantime you have chosen to allocate time and effort on this blog to attack TCM but not other alternative treatments. However it must be noted that there was discussion lumping all alternative treatment and not just TCM.

    For example,

    "When was the last time alternative medicine looked at evidence and decided they needed to change their age-old traditional practices?"

    Wouldn't this apply to hypnotherapy as well?

    By Blogger Dr Oz bloke, At November 12, 2007 3:24 pm  

  • Anyway don't get angry angrydoc, just a discussion.

    As I have said I took up TCM not because I believed in it, but that I was more sick of having to face so many patients who kept asking me about it and did not like the answers "It doesn't work or I don't know".

    For laughs take a look at this

    http://images15.fotki.com/v246/photos/1/184161/
    890285/Vulcan_Mind_Meld-vi.jpg

    Spock's Vulcan Mind Meld can be considered as a combination of acupressure and hypnosis. LOL!

    By Blogger Dr Oz bloke, At November 12, 2007 3:42 pm  

  • Dr Oz bloke said...Wah this one is going overboard man! I thought poking with needles causing pain to relieve pain sounded absurd enough.

    Why is it going overboard? Unless you have spent a few years studying "caning therapy" you are hardly in a position to treat it so dismissively. Does this rebuttal sound familiar?

    I remember watching all those hypnotizing shows on TV and wonder is it real? What's the science behind it?

    Some call it a hoax. I wonder what jim burke would call this one?


    If you are referring to the TV shows with the likes of Paul Mckenna ... they are clever show-biz entertainment?

    If you are using this as a counterpoint of an earlier argument ... it is another red herring and false analogy. Angry doc has explained how the analogy is false and where it is different so I will leave it there.

    Tan Tock Seng Hospital has started this course in conjunction with a London College and it is accredited with CME points. Interesting that it is so "accepted" when the reasons behind how it works might be as superfluous as qi and meridians.

    If your point is to suggest hypocrisy and bias against alternative therapies vis-a-vis mainstream "western medicine", you will be happy to know that in Britain, The Department of Health has stated that complementary therapies can feature in a range of local NHS services.

    There are five NHS homeopathic hospitals offering outpatient services, in Bristol, Glasgow, Liverpool, London and Tunbridge Wells. You need to be referred by your GP to attend these.

    Complementary medicine may also be used in the following departments:

    * Acupuncture in pain clinics
    * Yoga and acupuncture in obstetrics
    * Acupuncture and manipulative therapy in rheumatology and physiotherapy
    * Acupuncture in drug and alcohol misuse services

    By Blogger JB, At November 12, 2007 3:53 pm  

  • So why does the NHS spend public funds on quack therapies like acupuncture?

    By Blogger Dr Oz bloke, At November 12, 2007 4:03 pm  

  • "What you are saying is that hypnotherapy has the "advantage" of being not studied and thus disproved rather than TCM."

    Like I said I am not well-versed in the subject of hypnotherapy, but yes, if there is a lack of research on whether the same effects of hypnotherapy can be obtained with techniques that do not conform to the theories of hypnotherapy, then hypnotherapy is at an advantage.

    "Well if you go by the cow dung theory I doubt anyone in their right mind would spend money and time to conduct a study on cow dung as an antiseptic."

    People have studied the effect of cow dung being used as umbilical stump dressing, Oz Bloke.

    Having said that, if some people have been using cow dung as dressing with good outcome, then there would at least be some reasons to study it further.

    "If you go on that logic the more ridiculous a therapy seems the less likely it will be studied and the more likely you will not criticize it?"

    Wrong. A mode of therapy has to first fulfill the first criterion of having efficacy, remember?

    "TCM is being attacked strongly because of its popularity and perceived success in treating many conditions so much so that it warranted several studies to prove or disprove them. Whereas other alternative treatments are left to their own devices."

    The first part is true; and cultural context is a reason why we discuss TCM more than other forms of alternative medicine on this blog. The second part, however, is not true: other forms of alternative medicine are also studied extensively in countries where their use is more prevalent, like homeopathy in UK and Germany.

    " "When was the last time alternative medicine looked at evidence and decided they needed to change their age-old traditional practices?"

    Wouldn't this apply to hypnotherapy as well?"

    Well, there you have it: hypnotherapy abandoned the theory of animal magnetism.

    There are those who will say that hypnotherapy is not alternative medicine, but I think that's a debatable point and your point is still valid.

    By Blogger angry doc, At November 12, 2007 4:08 pm  

  • Dr Oz bloke said...So why does the NHS spend public funds on quack therapies like acupuncture?

    I am not privy to the wisdom of the British Establishment but I do know that Prince Charles is a great advocate of *quack* alternative therapies. He is also probably a great believer in Emoto's water crystals and a fan of The Secret and the Law of Attraction and other new-age stuff.

    Perhaps that would help explain it.

    By Blogger JB, At November 12, 2007 4:15 pm  

  • Actually I've been trying to research hypnotherapy and could not find anything scientific.

    There are no studies published in respectable journals as to any biochemical changes that may occur in the brain when a person is hypnotized. I have yet to find anything like that. The Wikipedia entry for Hypnotherapy shows no such studies. They do mention studies proving efficacy but nothing on how it works.

    So the second part is indeed still a mystery to me. I considered taking up this course to learn more, but seriously I'm tired these days and have found better things to study (eg finance and economics).

    But it would be interesting if someone trained in hypnotherapy could chance upon this blog and give us more information? As I have said I always keep an open mind. :)

    By Blogger Dr Oz bloke, At November 12, 2007 4:19 pm  

  • Just for the record angrydoc, my personal interest in hypnotherapy is that SMC rejected the applications for the grad diploma in Acupuncture for CME points accreditation but approved CME points for hypnotherapy.

    So strangely, if an alternative therapy fulfills criteria one but is shown to fail criteria two then it is not accepted by SMC for CME points. However if the therapy passes criteria one but criteria two is as yet undetermined then it is approved.

    Interesting eh?

    By Blogger Dr Oz bloke, At November 12, 2007 4:22 pm  

  • jb,

    too bad you're not the heir to the throne of England eh? Or for the matter Prime Minister of Britain.

    Just kidding.

    But it goes to show that sometimes evidence based or not, the beliefs of people or even a small group of powerful people can determine how and what doctors accept and reject.

    By Blogger Dr Oz bloke, At November 12, 2007 4:30 pm  

  • "Actually I've been trying to research hypnotherapy and could not find anything scientific."

    You might want to ask your psy med friends for a start.

    "So strangely, if an alternative therapy fulfills criteria one but is shown to fail criteria two then it is not accepted by SMC for CME points. However if the therapy passes criteria one but criteria two is as yet undetermined then it is approved."

    I'm not sure you should assume my view on the subject is the one SMC holds, or vice versa.

    By Blogger angry doc, At November 12, 2007 4:31 pm  

  • Well whatever it is, the fact remains that SMC gave CME points for an alternative treatment like hypnotherapy.

    I mean hypnotherapy is still considered alternative right? Unless it is part of mainstream medicine?

    Does anyone know? Sorry I really don't know about this one.

    But it seems like a political sort of thing more than scientific to me these days.

    By Blogger Dr Oz bloke, At November 12, 2007 4:49 pm  

  • Dr Oz bloke said...But it goes to show that sometimes evidence based or not, the beliefs of people or even a small group of powerful people can determine how and what doctors accept and reject.

    No argument here.

    You only have to recall how Galileo had to recant the Heliocentric Theory and was placed under house arrest until his death only because a few powerful people in the Vatican thought it heretical because it did not square with their religious dogma.

    All the more the lessons of history reinforce the importance of evidence-based knowledge and the need to guard against pseudoscience mumbo-jumbo and reject faith-based beliefs.

    By Blogger JB, At November 12, 2007 4:58 pm  

  • Thye Shan Medical Hall's Madam Tang Eng Hua said: 'It does not have any scientific basis.

    Hmmm.....

    By Blogger Unknown, At November 12, 2007 5:36 pm  

  • Well, oz bloke, if you are truly interested, here is a rather good overview of hypnotherapy/hypnosis in the Mayo Clinic Proceedings dated 2005:

    http://www.mayoclinicproceedings.com/pdf%2F8004%2F8004r2.pdf

    There are literally thousands of articles on hypnotherapy on Pubmed, including this one that titled "Functional neuroanatomy of the hypnotic state" (the full link is too long, but it should google).

    By Blogger angry doc, At November 12, 2007 11:12 pm  

  • Last night I watched this segment on CNA that had this Hypnotherapist explain that when a patient is hypnotized fully, it also keep the T-lymphocytes quiet and thus allows hair follicles to grow hair and can therefore be used to treat hair loss.

    Any studies to show that hypnosis has effects on a cellular level?

    By Blogger Dr Oz bloke, At November 13, 2007 10:15 am  

  • I just did a brief search on hypnotherapy and t cells. Interesting results.

    Small journals mainly european.

    Then I did a search on acupuncture and t cells.

    Small journals mainly chinese.

    By Blogger Dr Oz bloke, At November 13, 2007 10:29 am  

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