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the enigma of indigenous botanical knowledge

October 14, 2010

When performing delicate surgery, surgeons often administer the alkaloid tubocurarine to their patients.  This alkaloid interferes with communication between muscle fibers and the nerves that innervate them, causing skeletal muscle relaxation.  However, tubocurarine’s history extends beyond its role as part of the modern day anesthesiologist’s drug arsenal.  Although tubocurarine used in medicine is a synthetic compound, it’s development originated from the modification of a natural alkaloids extracted from the plant Chondodendron tomentosum. Outside the realm of western medicine, these alkaloids are isolated to produce curare, which is a muscle paralyzing substance that has been used by Amazon hunters for several millenia as a poison.  By tipping their blow-gun darts with curare, Amazon hunters could kill animals without poisoning the meat.  The victim of a curare-tipped dart died by asphyxiation, since its respiratory muscles ceased to function.  In surgery, tubocurarine does not kill the patient because they are kept ventilated until the alkaloid is metabolized.

Most scientists believe that the Amazon Indians stumbled upon the unique properties of curare by accident or chance experimentation.  In order to produce curare, you have to find the correct plant species (the Amazonians have forty types of curares), combine them together, and boil them for three days in order to create the final product: a paste that has to be injected intravenously in order to be effective.  All of this is done while avoiding the mortal fumes given off by boiling these plants.  Arriving at the final product by chance experimentation seems probabilistically unlikely, but when ethnobotanists ask tribes of the Amazon how curare was invented they say that the creator of the universe provided it.

Even more curious is the origin of ayahuasca, a hallucinogenic drink that is consumed by ayahuascueros.  Ayahuascueros are indigenous shamans who claim that the medical properties of plants are revealed by consuming ayahuasca and other psychedelic drugs, and who are referred to by other members of these tribes as sources of tribal knowledge.  Ayahuasca, like curare, is complicated to prepare, and yet the indigenous Amazonians have been preparing it for millenia without the tools of modern day science and molecular biology.  To make ayahuasca, two plants must be boiled together for several hours.  The first plant, the B. caapi vine, contains dimethyltryptamine (DMT), a hallucinogenic substance.  DMT is produced by our own bodies in trace amounts, but its purpose is unknown. When DMT is swallowed, it is neutralized by a stomach enzyme called monoamine oxidase.  In order to make the Caapi vine orally active, a second plant containing monamine oxidase inhibitors is boiled together with B. Caapi so that the hallucinogenic properties of the final ayahuasca brew are revealed. Indigenous people have thus managed to select two plants from 80,000 Amazon plant species that work in conjunction with each other to create a bitter hallucinogenic drink.  When asked how they came across such a molecularly specific concoction, without a knowledge of the molecular particularities of ayahuasca, they claim their knowledge comes from the hallucinogenic plants themselves.

So the Amazon Indians gain molecularly verifiable information regarding hallucinogenic plants from the hallucinogens induced by these same hallucinogenic plants? Somebody be trippin’.

ayahuasca

Actually, a lot of people be trippin’.  Although not all Amazon tribes have hallucinogen-based medical systems (shamans serve as healers within their tribes), you’d be hard-pressed to find a culture in the Western Amazon Basin which does not use psychoactive plants.

Lest I give the impression that the shamans of the Amazon Basin are running around all messed up on psychedelics (although, more than one anthropologist has returned to the western world describing shamans as the “crazy” people in the tribe), I’d like to point out that Amazon shamanism doesn’t resemble recreational hallucinogenic drug use in Western culture.  It is a trade requiring a long apprenticeship with older shamans, which includes, but is not limited to, drinking ayahuasca, or other hallucinogens.  An ayahuascuero’s hallucinatory session requires know-how and discipline, and is accompanied by a lot of dietary and behavioral restrictions.

A lot of what shamans have to say about the world contravenes the basic assumptions upon which biology is based, and I don’t think that biology and indigenous science are compatible as they stand.  However, even if they are incompatible schools of thought, there is huge economic potential in tropical plant medicine, and tapping this resource would require a lot of blind testing without the help of indigenous people.

The case of curare indicates that western science, especially pharmaceutical companies, already recognize the value of indigenous botanical knowledge.  The problem is that pharmaceutical companies sometimes steal plant remedies and use them to synthesize drugs without crediting the original discoverers.  This is what happened with curare, and with over 25% of western pharmaceuticals being derived from rainforest ingredients, Amazon shamans and medicine men should be receiving considerable compensation from pharmaceutical companies, which they, of course, are not.

Curare [Encyclopedia.com]

Curare, A South American Arrow Poison [UCLA Botanical Garden]

Tubocurarine chloride [Wikipedia]

Ayahuasca [Wikipedia]

Dimethyltryptamine [Wikipedia]

Rainforest Facts [rain-tree]

Narby, Jeremy. The Cosmic Serpent: DNA and the Origins of Knowledge. New York: Jeremy P. Tarcher/Putnam, 1998. Print.

embryonic stem cell research under appeal

September 9, 2010

District Court Judge Royce Lamberth recently ruled that federally funded embryonic stem cell research was illegal. Research using these cells is now being blocked with a temporary injunction while the case is appealed. The basis for this ruling is the Dickey-Wicker amendment, an appropriations funding that bars research “in which human embryos are destroy, discarded, or knowingly subjected to risk of injury or death”.

To be clear, embryonic stem cells are used all the time in federally funded research, it’s just that their procurement is not allowed to be federally funded.  Judge Lamberth is now saying that Dickey-Wicker explicitly prohibits the use of embryonic stem cells for research purposes, even if the removal of those stem cells, and the consequent destruction of the fertilized embryos from which they are taken, is privately funded. This is happening almost a decade after the public stem cell debate had largely ceased, following President Bush’s approval of federally funded embryonic stem cell research in August 2001, not to mention President Obama’s removal of the federal funding restriction for embryonic stem cell research in March 2009. Needless to say, it left me a little bit floored, and many NIH researchers and other federally funded scientists are now scrambling to make sure their projects are still legal under the current injunction.

The plaintiffs whose case led to the ban oppose the use of embryonic stem cells in research. The ban on embryonic stem cell development is also supported by various pro-life organizations, who believe that an embryo fertilized in vitro is human life at its earliest stage. Whether this is the case or not (I’m not writing about the ethics of embryonic stem cell research here), it is interesting to note that the Dickey-Wicker amendment does not recognize embryos to be human subjects. Also, ironically, embryonic stem cells are dying in petri dishes all over the country as a result of this ban.

embryonic stem cell research banned

NIH guidelines dictate that cells derived from embryos can be used for research, but the process of removing those cells (which results in the destruction of the embryo) must be done with private money. Judge Lamberth says that this interpretation of the law is incorrect because obtaining embryonic cells for research and conducting research with those cells are two enterprises that are not mutually exclusive, and since the destruction of embryos is an integral part of embryonic stem cell research, federally funded embryonic stem cell research is illegal according to Dickey-Wicker. Furthermore, Judge Lamberth also believes that statute is unambiguous, which means that it is not open to interpretation by the NIH, as an ambiguous statute would be. This is especially staggering when you consider that embryonic stem cell research has been going on for years, with stem cells being obtained mostly from privately funded in vitro fertility clinics. These clinics artificially fertilize female eggs in order to create embryos which can then be implanted to encourage pregnancy. They are tiny clusters of cells undergoing mitosis, and nothing resembling the bloody mess on a pro lifer’s protest sign. If they aren’t used for research, they would probably be discarded, although now embryo adoption services have sprung up to find these orphaned embryos new homes. The resultant births are called “snowflake children“.

It’s very easy to see how those who are against embryonic stem cell research might interpret the NIH’s actions as taking advantage of a loophole in the law, and I think this makes Dickey-Wicker problematic because it makes it look as though the federal government is allowing stem cell research on the condition that private funds be used to do the ‘dirty work’, which just seems shifty. The Dickey-Wicker amendment, however, does have a purpose beyond letting private money do the dirty work. Under this statute, federally funded researchers cannot legally create new embryonic stem cell lines. Regardless, Dickey-Wicker needs to be amended and the language in it clarified.

Beyond quibbling and legal textualism over the wording in the statute, there are some larger questions that need to be asked:

1. What do Congress and the American People want?

2. Is this even worth fighting over?

The Dickey-Wicker amendment was passed by Congress before the type of embryonic stem cell research now funded by the NIH even existed, and they’ve passed it every year since 1996 alongside decisions by President Bush and President Obama to let embryonic stem cell research happen. In 2006 and 2007, legislation was passed by Congress to increase funding for stem cell research, although this was vetoed by President Bush. All this suggests that, had Judge Lamberth relied on the context in which this statute was passed rather than a Random House dictionary, he may have reached a different conclusion.

But all this may be a moot point because it is unclear whether embryonic stem cell research is even useful in the first place. Embryonic stem cells are exciting because they are essentially blank slates with pluripotency, the potential to turn into any cell in the body. This makes them fascinating subjects for studying the pathways involved in cell differentiation. However, progress with these cells has been slow, and no treatments have been found, yet.

There are other sources of stem cells besides embryonic stem cells. These include Adult Stem Cells and IPSCs (Induced Pluripotent Stem Cells). Adult Stem Cells are found in all tissues, but are limited to turning into cells from their tissue of origin. IPSCs are mature cells that have been reprogrammed to be pluripotent. Right now IPSCs work, but cell biology is complicated and it is difficult to create standardized cell lines across labs. For the future of research, I hope we can put the ethical debate over stem cells to rest by perfecting the IPSC reprogramming process and replacing embryonic stem cells in research with reprogrammed mature cells.

Cloning: Dickey-Wicker Amendment [Genetics and Public Policy Center]

Confused by the Stem Cell Ruling? We Were Too. [The New Republic]

U.S. Judge Rules Against Obama’s Stem Cell Policy [New York Times]

Stem Cell Biology and Its Complications [New York Times]

the anti-vaccine movement and my lactardedness

July 29, 2010

While waiting to slide down the Wolf Pack in Surfenburg at Schlitterbahn, a med-student friend of mine asked me if I was going to vaccinate my kids. Before we go any further, she was referring to my way-in-the-future kids who do not get to be born until a long time from now.

My initial thought was that I didn’t understand the question. Of course I’m going to vaccinate my kids, why wouldn’t I? I don’t want them to get sick. But then I realized that she was referring to the rising numbers of people who are concerned about the side effects of vaccinations.

I’m sorry. I didn’t know this was actually a thing. I mean, I know it’s a thing. MMR causes Autism, H1N1 is a government conspiracy, big pharm is evil and wants our money…I know, I’ve heard all that stuff, but I sort of thought this conversation had abated, at least for now, with swine flu and 2009.

So I conducted a survey of one. I asked Roomie. Roomie said, “I don’t know! It’s so scary! Don’t they cause autism?”

*sigh*

Seriously, this needs to be cleared up. I know that autism  occurs at a much higher frequency these days than in the past, and the tendency is to assume that something is in the water – and maybe there is, but people need to be smart about this because diseases that have all but been eradicated are slowly starting to creep back into the population as opponents of immunization begin to poke holes in herd immunity.

Vaccines are scary things. They involve needles and mysterious compounds being injected directly into our bloodstreams. They are often complex cocktails of antigens and adjuvents. Antigens, for one, are scary because they are made up of millions of dead or weakened versions of the bacteria or virus that we are trying to immunize against. That knowledge always brings a certain image to my mind:

antigens with one living bacterium

And, adjuvents – non antigenic agents in vaccines which have been shown to improve the vaccine’s efficacy, or reduce the amount of antigen required for the vaccine to work –  are also scary because we still don’t understand how some of them work. Furthermore, we don’t know what all the side effects of a certain vaccine are until it has been administered to millions of people because a potentially devastating but rare side-effect has a low probability of showing up in a clinical trial.

Skip the next two headers if you aren’t interested in reading about disorders associated with vaccinations.

The 1976 Swine Flu Debacle and Guillain-Barre Syndrome

Guillain-Barre Syndrome (GBS) is a rare neuromuscular automimmune disorder affecting around 1 in 100,000 in the general population. It causes the quick onset of paralysis and can take from a few weeks to years to recover from, depending on the patient. This disease can be triggered by surgery or vaccinations. Most recently, the H1N1 vaccine has been implicated in triggering the onset of this disease, and the risk of GBS due to a flu vaccine is said to be about 1 in 1 mllion. GBS received a lot of press back in 1976, during the last swine flu outbreak. The outbreak prompted the United States to mass immunize millions of people which, apparently, caused an upsurge in GBS, resulting in 500 reported cases and 25 deaths. This, in contrast to the 1 death and 13 hospitalizations caused by the flu strain itself, made the 1976 swine flu vaccine look very, very bad.

The 1976 swine flu debacle prompted several studies on the correlation between GBS and the swine flu vaccine. These are summarized in this CDC report. One of those studies confirmed a correlation and that is where the 1 in 1 million statistic comes from. The CDC report also says that, “the estimate frequency of influenza related GBS was four to seven times higher than the frequency that has been estimated for influenza-vaccine-associated GBS”, meaning  your GBS risk is actually higher if you don’t get the vaccine and contract the flu. Subsequent flu vaccine preparations have not been studied to determine a link to GBS because “obtaining epidemiologic evidence for a small increase in risk for a rare condition with multiple causes is difficult, and no evidence consistently exists for a causal relation between subsequent vaccines prepared for other influenza viruses and GBS.”

MMR and Austism

The MMR immunization protects children against Measles, Mumps, and Rubella, and has long been considered one of the most reliable and safe vaccines. MMR has been licensed in the United States since 1971. In 1998, British scientist Dr. Andrew Wakefield published an article in The Lancet in which he described the cases of 12 children with developmental disorders, including autism, and indicated that their parents believed there was an association between the MMR shot and autism in their kids. This article was later retracted by 10 of the 12 co-authors and Andrew Wakefield was stripped of his medical license this past May by the General Medical Council in Britain. It turned out that Dr. Wakefield’s research and paycheck was being funded by a firm filing a class action suit against vaccine manufacturers, and they wanted to find a relationship between the MMR shot and autism. He also did a bunch of other unethical things, like collecting blood from children at a birthday party for his control trial.

I read the article in The Lancet called Ileal-lymphoid-nodular hyperplasia, non-specific colltls, and pervasive developmental disorder in children. The paper was based on a study done with twelve children who had gastrointestinal inflammation and who developed a loss of acquired skills after getting their MMR immunization. The study concluded that “Onset of behavioural symtoms was associated, by the the parents, with measles, mumps, and rubella vaccination in 8 of the 12 children.” Of the behavioural disorders represented, 9 of the 12 children had autism.

Andrew Wakefield did not claim in his paper that there was an association between the MMR vaccine and autism, but he did write that the parents of his research subjects believed that there was an association. He also recommended, at a conference held in conjunction with the publishing of The Lancet paper, that the MMR combination vaccine be replaced with individual vaccines. The publicity surrounding the paper prompted a journalist to look into Dr. Wakefield’s research. What he uncovered was a really titillating ethics case which resulted in Wakefield’s medical license being revoked. Then Andrew Wakefield moved to Austin, Texas, which is a happy place. No, seriously, he lives….here.

Does this mean that Andrew Wakefield was removed on ethics charges but that his study was scientifically sound? No. Studies done with randomized sample sizes greater than twelve have been unable to replicate Andrew Wakefield’s findings In fact, his findings weren’t even that ground-breaking. It sounds to me like he brought in a bunch of kids who had developmental disorders and gastrointestinal problems, who had received their MMR vaccines, and whose parents believed the MMR shot and their children’s developmental disorders were related. Then, Dr. Wakefield, and 12 other authors concluded that “environmental triggers” could be associated with the the developmental regression in previously normal children. It seems almost ridiculous that this doctor was able to spur a nationwide anti-MMR vaccine movement in Britain (a movement which later founds its way to the US) over this paper. It’s just not the greatest paper.

But, it’s not just the paper. It’s the paper and the press conference compounded by anecdotal evidence in the form of angry parents who were convinced, CONVINCED, that the MMR vaccine had given their child autism because their child became autistic acting after they received the vaccine.

I am of the opinion that what Andrew Wakefield did was not that egregious. In fact, he may have gotten screwed over, just a little. He never claimed in his paper that autism and MMR were related, and he never said that MMR causes autism at that conference. All he did was suggest the problem might have to do with the combination vaccine, suggest that individual vaccines be given instead, and admit his findings required further investigation. And, whether he willingly became a figure-head for the anti-vaccine movement, I don’t know, but I think he was certainly punished for his role in it, and for the rise of measles to endemic levels in Britain.

I do know that I feel sorry for his control group. Way to suck all the fun out of birthdays, Dr. Wakefield. Funsucker.

Andrew Wakefield's birthday party control experiment

Now Andrew Wakefield does what any hard-headed doctor who slogged through fifty bazillion years of school only to find his career in shambles would do: try to redeem himself by writing a book about it and creating and overseeing a clinic for autistic kids. And, if anything, his book would do a better job of undermining public confidence than that terrible paper, but I’m sure it wasn’t nearly as far-reaching because, you know, people like it when you keep your arguments concise…

….

Okay, BACK TO THE EXPOSITION.

In both cases described above the associations being made require further study to be proven conclusively, and care needs to be taken not to scare people who are not easily unscared. It seems to me that the whole anti-vaccine movement is a huge case of incomplete research being muddled by the media or combined with hearsay to fuel anti-vaccine conspiracy theories. These theories become increasingly broad as they trickle down into the general population and turn into blanket theories such as “shots cause autism”. I’m not saying that we shouldn’t, as a society, demand that the drugs in our vaccination schedules be thoroughly tested, but we need to be careful what we believe and insist on good science.

Sometimes, I think that our failure to remember the world without vaccines makes it easier to believe they are a national threat or that their dangers are known and being kept secret by the government. MMR has been implicated in the autism upsurge of the last few decades, but without it children would be subject to a full-on case of measles and 20% of them would develop complications, including pneumonia, encephalitis (brain inflammation), and death. In the first half of the 20th century, whooping cough – another sickness we have vaccinated against since the 70s – was the leading cause of childhood illness and death in the US. We have annual outbreaks of the flu, which kill thousands despite our best efforts to vaccinate against it. Smallpox was a disfiguring and often deadly disease with no cure until it was eradicated in the 80s through a huge immunization campaign.

All of this reminds me that I am mildly lactose intolerant. It’s not too bad – I can eat processed milk products, pizza and ice cream is fine. However, if I go long enough without succumbing to my lactardedness, I always end up convincing myself that I’m no longer lactose intolerant. I proceed to drink a glass of milk, and, sure enough, feel bloated and gross half an hour later. In the same way, as we live in a time of relative health, it’s easy to forget that vaccine schedules are keeping a huge pathogenic army at bay.

moo cowEvery vaccine has a side-effect, and the government weighs the benefits and costs of each immunization in order to decide whether a vaccination is worth it and should be mandated. I believe this cost-benefit analysis should be done at an individual level as well.

Dr. Harvey Kapp, a renowned pediatrician, put this really well in an article for the Huffington Post. He posed the question: Are shots a personal choice or a civic duty? He then went on to say that he suggests that parents struggling over whether to immunize their kids should place shots into two categories:

category 1. shots that protect your kid

category 2. shots that protect your kid and the general population

An example of a category 1 shot would be the flu shot. It doesn’t matter whether you immunize your kid against the flu or not, there will still be an outbreak every freaking year. So, the flu shot is primarily there to protect your kid, not to prevent the outbreak.

An example of a category 2 shot would be the MMR shot. Measles, for example, is very, very contagious. Mass immunization actually halts the passage of this disease through a population, and, by ensuring that your child is not a carrier, you know they won’t give category 2 infections to old people, babies, or immunocompromised people who could die if they contracted the illness.

Dr. Kapp believes that category 1 shots are a personal choice and category 2 shots are a civic responsibility. I agree.

Andrew Wakefield: Struck off! [ScienceBlogs]

Whooping Cough [MayoClinic]

Measles Complications [MayoClinic]

Smallpox [MayoClinic]

acupuncture and philosophy-based medicine

July 22, 2010

I have a friend who is studying oriental medicine at the Academy of Oriental Medicine (AOMA) in Austin. I’ve been trying to shadow her at the intern clinic for the past few weeks, but we’ve been having scheduling issues. However, one of my friends here is getting acupuncture for pain, and I think she is going to let me watch her get poked, so that may be my in. I am becoming really interested in alternative and complementary medicine lately for several reasons: I feel like it has been rising to prominence in the last few years as western medical institutions open acupuncture clinics, offer massage therapy, and otherwise challenge allopathy as the primary western medical model (acupuncture has been established in Japan and China for thousands of years), especially since a lot of patients now educate themselves before going to the doctor and opt for these alternative remedies. I’m also fascinated by the idea of “chi” and “energy” in acupuncture. Lastly, I think acupuncture is cool because – the hardcore oriental medicine enthusiast might diasagree – it harnesses the placebo effect, and I believe the mind’s ability to heal itself is an untapped formulary.  In fact, there have been studies which suggest that, in some cases, fake acupuncture treatments – the needles were inserted at the incorrect points – are just as effective as the real treatments. Some could take this to mean that acupuncture doesn’t work, but it also may mean that acupuncture serves as a strong psychological treatment, in addition to a physical one.

According to ancient chinese medicine, there are twelve energy channels, or “meridians”, running through the body. Illness is caused by obstructed life-force energy or “qi” flow through these channels. Stimulation with acupuncture needles stimulates energy flow in meridians. So, by sticking needles into certain points in the body and stimulating them, you can trigger the body to heal itself of dysfunctions and disease. Acupuncture is a full system of medicine, so in theory it can be used to treat anything. In western practice, however, acupuncture treatment seems a little more limited, although just as varied, and ranges from chronic pain and acute injuries to infertility, irritable bowel, addiction, and problems associated with menopause, as well as pregnancy.

Acupuncture is thought to have its origin in Neolithic (the New Stone Age) healing practices which involved tattooing as therapy, body piercings, and….blood ritual! That’s right, blood-letting is not only an old western practice meant to balance the four humors (black bile, yellow bile, phlegm, and blood) of hippocratic medicine, but also has roots in ancient east asia.  In fact, there are methods of blood-letting, scarification, and cautery in chinese acupuncture, although in western acupuncture, blood-letting is not used much because it has been shown to be ineffective for all but a few diseases, and also carries a stigma. Let me quickly clarify that western acupuncture isn’t it’s own brand of acupuncture. Western acupuncturists still say they practice “traditional” acupuncture, it just seems to have been cleaned up a bit. Along with needles, eastern medicine used small lances and “cupping” was a method used to draw blood when used in conjunction with needles and medical lancets. Modern (western) acupuncturists use this cupping method today to non-invasively cause blood flow to rush to the area by placing a suction or depressurized cup to the patient’s skin in order to remove toxins and restore healthy meridian flow. Recipients of this treatment can end up with dark circular bruises on their skin for a few days, making them look they got attacked by a giant squid. Apparently, it isn’t painful, and actually feels pretty good! Appearing like you got mauled by a large aquatic creature aside, oriental medicine in the United States appears to me to be a much more sanitized and digestible version of the ancient practice.

To me, one of the most interesting acupuncture treatments is for addiction control. This treatments involves inserting needles into three to five points on the outside of the ear. According to the acupuncture theoretical framework, this treatment nourishes the yin. Research indicates that this treatment raises the level of endorphins in the nervous system, which can alleviate the cravings and withdrawal symptoms of patients.

I found tons of internet claims saying that there is strong clinical or research evidence indicating that acupuncture works, but when I actually dug around for this evidence I found a bunch of abstracts suggesting that while acupuncture might be more than a very successful placebo, more evidence was needed to confirm this. Most support of acupuncture then, appears to be anecdotal, at least according to the interweb. It is also natural to be skeptical of a practice which deals with invisible toxins and energy channels, but I’m willing to believe that the pre-scientific ideas of qi, yin, and yang have tangible, scientific equivalents, especially since acupuncture has persisted for so long. There are many things in medicine which work, even if we can’t explain exactly how. However, just because something has persevered, doesn’t mean it is valid and it could be the case that much of the reason why acupuncture has withstood the test of time is simply because the theoretical framework is so appealing. Acupuncture may be 3,000 year old quackery, but I think that, if anything, getting a zenned out 45-minute acupuncture procedure is much more likely to result in a strong placebo effect than simply popping a pill. Also, people who choose to go in for a prescribed amount of acupuncture are probably concerned about their health, want to get better, and, more importantly, believe in acupuncture. All of these things contribute to the psychological role that acupuncture plays in their treatment. Acupuncture may not live up to all its claims or work the way it suggests, but I think that more research in this area needs to be done. Meanwhile, acupuncture’s role as a powerful psychological treatment, and thus it’s ability to tap into our innate healing capabilities, should not be undermined.

Hellraiser

“It’s for my migraines”

Cupping [itmonline]

Bleeding Peripheral Points [itmonline]

What is Acupuncture? [Acupuncture Treatment]

Astrology with Needles [Science-Based Medicine]

Acupuncture and Addiction [Acupuncture Healing Arts]

More Evidence That Acupuncture is a Placebo [Nuerologica]

Hello world!

June 10, 2010

The default subject line is so wonderfully nerdy.

Anyway, this is my new blog. I’m going to use it to write about issues that I find compelling and, hopefully, become a better writer in the process. I’m not really sure what direction these ramblings are going to take. Hopefully this project is as interesting for you as it is for me.

Let’s a go!