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AKTIP Konzultační a terapeutický institut Praha (lit.'Consultation and Therapeutic Institute Prague') was a private institute in Prague run by the public business company Progressive consulting, offering services in the field of psychosomatic care. The head of the institute was Czech psychiatrist Jarmila Klímová.
Controversy about the methods of the institute emerged when the documentary Infiltrace: Obchod se zdravím (Infiltration: Health Business) was broadcast by Czech television on May 21, 2018.
The documentary revealed that the company uses unethical techniques to the detriment of its patients for its financial gain, including pseudoscience, manipulation, and incitement of fear of cancer and anxiety. AKTIP offers examinations and healing by instrumentation and homeopathic preparations of doubtful effectiveness for various somatic diseases, including thyroid disease.
Although it has physicians on staff, this institution is not a legitimate provider of health services. It is not a medical facility.
== Erratic Boulder award in the category of teams 2016 ==
AKTIP is the holder of the Silver Erratic Boulder award in the category of teams for 2016.
"An eventual client meets here imaginary care in a wide range of disciplines. His complex problems will be treated by a graphologist, an expert in oriental diagnostics and bioresonance therapy will also supply its part of information. If it fails, a miraculous ANESA device, known as the non-invasive AMP blood analyzer (Golden Erratic Boulder award for 2011), will come to the scene", said Sisyfos.
In the awards report its representatives also cite the statement of the head of AKTIP Jarmila Klímová that the human body is set for 400 years of life. "If we really lived only by biological hours, we could be at rest between 380 and 460 years, because this age is set up for our body ... And why do we live only 60 or 80 years? No, because the most important influence outside of ourselves, which fundamentally affects the length and quality of life, we do not accept."
== Professional public response ==
The practices of AKTIP was already criticized by the Czech Oncological Society in 2014.
Procedures used by AKTIP employees have been critically evaluated by doctors (f.ex. by cardiologist Věra Adámková) The psychologist Petr Weiss described AKTIP's practices as charlatan fabrications, fraud, and money-pulling activities.
According to the President of the Czech Medical Chamber Milan Kubka, AKTIP's position in the future could be solved by a law on healers that would force "all such charlatan institutions" to mandatory registration. "This institution only looks like a medical facility, and that's a scam from my point of view."
Sisyfos, in response to the AKTIP case, has published an article analyzing the principles of some devices used by individual "consultants" of AKTIP. This article also expresses concern that AKTIP is not an exceptional case, but that it is a fairly common phenomenon among institutions that provide services of alternative medicine.
== End of activities ==
On May 8, 2019, AKTIP announced end of their activities.
== Links ==
=== References ===
=== External links ===
Infiltration: Business with health documentary (in Czech), Czech Television, 21. 5. 2018
AKTIP - The Consultation and Therapeutic Institute Prague (in Czech) Official webpage

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Acupuncture is a form of alternative medicine and a component of traditional Chinese medicine (TCM) in which thin needles are inserted into the body. Acupuncture is a pseudoscience; the theories and practices of TCM are not based on scientific knowledge, and it has been characterized as quackery.
There is a range of acupuncture technological variants that originated in different philosophies, and techniques vary depending on the country in which it is performed. However, it can be divided into two main foundational philosophical applications and approaches; the first being the modern standardized form called eight principles TCM and the second being an older system that is based on the ancient Daoist wuxing, better known as the five elements or phases in the West. Acupuncture is most often used to attempt pain relief, though acupuncturists say that it can also be used for a wide range of other conditions. Acupuncture is typically used in combination with other forms of treatment.
The global acupuncture market was worth US$24.55 billion in 2017. The market was led by Europe with a 32.7% share, followed by Asia-Pacific with a 29.4% share and the Americas with a 25.3% share. It was estimated in 2021 that the industry would reach a market size of US$55 billion by 2023.
The conclusions of trials and systematic reviews of acupuncture generally provide no good evidence of benefits, which suggests that it is not an effective method of healthcare. Acupuncture is generally safe when done by appropriately trained practitioners using clean needle techniques and single-use needles. When properly delivered, it has a low rate of mostly minor adverse effects. When accidents and infections do occur, they are associated with neglect on the part of the practitioner, particularly in the application of sterile techniques. A review conducted in 2013 stated that reports of infection transmission increased significantly in the preceding decade. The most frequently reported adverse events were pneumothorax and infections. Since serious adverse events continue to be reported, it is recommended that acupuncturists be trained sufficiently to reduce the risk.
Scientific investigation has not found any histological or physiological evidence for traditional Chinese concepts such as qi, meridians, and acupuncture points, and many modern practitioners no longer support the existence of qi or meridians, which was a major part of early belief systems. Acupuncture is believed to have originated around 100 BC in China, around the time The Inner Classic of Huang Di (Huangdi Neijing) was published, though some experts suggest it could have been practiced earlier. Over time, conflicting claims and belief systems emerged about the effect of lunar, celestial and earthly cycles, yin and yang energies, and a body's "rhythm" on the effectiveness of treatment. Acupuncture fluctuated in popularity in China due to changes in the country's political leadership and the preferential use of rationalism or scientific evidence-based medicine. Acupuncture spread first to Korea in the 6th century AD, then to Japan through medical missionaries, and then to Europe, beginning with France. In the 20th century, as it spread to the United States and Western countries, spiritual elements of acupuncture that conflicted with scientific knowledge were sometimes abandoned in favor of simply tapping needles into acupuncture points.
== Clinical practice ==

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Acupuncture is a form of alternative medicine. It is used most commonly for pain relief, though it is also used to treat a wide range of conditions. Acupuncture is generally only used in combination with other forms of treatment. For example, the American Society of Anesthesiologists states it may be considered in the treatment of nonspecific, noninflammatory low back pain only in conjunction with conventional therapy.
Acupuncture is the insertion of thin needles into the skin. According to the Mayo Foundation for Medical Education and Research (Mayo Clinic), a typical session entails lying still while approximately five to twenty needles are inserted; for the majority of cases, the needles will be left in place for ten to twenty minutes. It can be associated with the application of heat, pressure, or laser light. Classically, acupuncture is individualized and based on philosophy and intuition, and not on scientific research. There is also a non-invasive therapy developed in early 20th-century Japan using an elaborate set of instruments other than needles for the treatment of children (shōnishin or shōnihari).
Clinical practice varies depending on the country. A comparison of the average number of patients treated per hour found significant differences between China (10) and the United States (1.2). Chinese herbs are often used. There is a diverse range of acupuncture approaches, involving different philosophies. Although various different techniques of acupuncture practice have emerged, the method used in traditional Chinese medicine (TCM) seems to be the most widely adopted in the US. Traditional acupuncture involves needle insertion, moxibustion, and cupping therapy, and may be accompanied by other procedures such as feeling the pulse and other parts of the body and examining the tongue. Traditional acupuncture involves the belief that a "life force" (qi) circulates within the body in lines called meridians. The main methods practiced in the UK are TCM and Western medical acupuncture. The term Western medical acupuncture is used to indicate an adaptation of TCM-based acupuncture which focuses less on TCM. The Western medical acupuncture approach involves using acupuncture after a medical diagnosis. Limited research has compared the contrasting acupuncture systems used in various countries for determining different acupuncture points, and thus there is no defined standard for acupuncture points.
In traditional acupuncture, the acupuncturist decides which points to treat by observing and questioning the patient to make a diagnosis according to the tradition used. In TCM, the four diagnostic methods are: inspection, auscultation and olfaction, inquiring, and palpation. Inspection focuses on the face and particularly on the tongue, including analysis of the tongue placement, size, shape, tension, color and coating, and the absence or presence of teeth marks around the edge. Auscultation and olfaction involve listening for particular sounds, such as wheezing, and observing body odor. Inquiring involves focusing on the "seven inquiries": chills and fever; perspiration; appetite, thirst and taste; defecation and urination; pain; sleep; and menses and leukorrhea. Palpation is focusing on feeling the body for tender A-shi points and feeling the pulse.
=== Needles ===
The most common mechanism of stimulation of acupuncture points employs penetration of the skin by thin metal needles, which are manipulated manually or the needle may be further stimulated by electrical stimulation (electroacupuncture). Acupuncture needles are typically made of stainless steel, making them flexible and preventing them from rusting or breaking. Needles are usually disposed of after each use to prevent contamination. Reusable needles when used should be sterilized between applications. In many areas, only sterile, single-use acupuncture needles are allowed, including the State of California. Needles vary in length between 13 and 130 millimetres (0.51 and 5.12 in), with shorter needles used near the face and eyes, and longer needles in areas with thicker tissues; needle diameters vary from 0.16 mm (0.006 in) to 0.46 mm (0.018 in), with thicker needles used on more robust patients. Thinner needles may be flexible and require tubes for insertion. The tip of the needle should not be made too sharp to prevent breakage, although blunt needles cause more pain.
Apart from the usual filiform needle, other needle types include three-edged needles and the Nine Ancient Needles. Japanese acupuncturists use extremely thin needles that are used superficially, sometimes without penetrating the skin, and surrounded by a guide tube (a 17th-century invention adopted in China and the West). Korean acupuncture uses copper needles and has a greater focus on the hand.
=== Needling technique ===
==== Insertion ====
The skin is sterilized and needles are inserted, frequently with a plastic guide tube. Needles may be manipulated in various ways, including spinning, flicking, or moving up and down relative to the skin. Since most pain is felt in the superficial layers of the skin, a quick insertion of the needle is recommended. Often the needles are stimulated by hand in order to cause a dull, localized, aching sensation that is called de qi, as well as "needle grasp," a tugging feeling felt by the acupuncturist and generated by a mechanical interaction between the needle and skin. Acupuncture can be painful. The acupuncturist's skill level may influence the painfulness of the needle insertion; a sufficiently skilled practitioner may be able to insert the needles without causing any pain.

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== Adoption ==
Acupuncture is most heavily practiced in China and is popular in the US, Australia, and Europe. In Switzerland, acupuncture has become the most frequently used alternative medicine since 2004. In the United Kingdom, a total of 4 million acupuncture treatments were administered in 2009. Acupuncture is used in most pain clinics and hospices in the UK. An estimated 1 in 10 adults in Australia used acupuncture in 2004. In Japan, it is estimated that 25 percent of the population will try acupuncture at some point, though in most cases it is not covered by public health insurance. Users of acupuncture in Japan are more likely to be elderly and to have a limited education. Approximately half of users surveyed indicated a likelihood to seek such remedies in the future, while 37% did not. Less than one percent of the US population reported having used acupuncture in the early 1990s. By the early 2010s, more than 14 million Americans reported having used acupuncture as part of their health care.
In the US, acupuncture is increasingly (as of 2014) used at academic medical centers, and is usually offered through CAM centers or anesthesia and pain management services. Examples include those at Harvard University, Stanford University, Johns Hopkins University, and UCLA. CDC clinical practice guidelines from 2022 list acupuncture among the types of complementary and alternative medicines physicians should consider in preference to opioid prescription for certain kinds of pain.
The use of acupuncture in Germany increased by 20% in 2007, after the German acupuncture trials supported its efficacy for certain uses. In 2011, there were more than one million users, and insurance companies have estimated that two-thirds of German users are women. As a result of the trials, German public health insurers began to cover acupuncture for chronic low back pain and osteoarthritis of the knee, but not tension headache or migraine. This decision was based in part on socio-political reasons. Some insurers in Germany chose to stop reimbursement of acupuncture because of the trials. For other conditions, insurers in Germany were not convinced that acupuncture had adequate benefits over usual care or sham treatments. Highlighting the results of the placebo group, researchers refused to accept a placebo therapy as efficient.
== Regulation ==
There are various government and trade association regulatory bodies for acupuncture in the United Kingdom, the United States, Saudi Arabia, Australia, New Zealand, Japan, Canada, and in European countries and elsewhere. The World Health Organization recommends that an acupuncturist receive 200 hours of specialized training if they are a physician and 2,500 hours for non-physicians before being licensed or certified; many governments have adopted similar standards.
In Hong Kong, the practice of acupuncture is regulated by the Chinese Medicine Council, which was formed in 1999 by the Legislative Council. It includes a licensing exam, registration, and degree courses approved by the board. Canada has acupuncture licensing programs in the provinces of British Columbia, Ontario, Alberta and Quebec; standards set by the Chinese Medicine and Acupuncture Association of Canada are used in provinces without government regulation. Regulation in the US began in the 1970s in California, which was eventually followed by every state but Wyoming and Idaho. Licensing requirements vary greatly from state to state. The needles used in acupuncture are regulated in the US by the Food and Drug Administration. In some states acupuncture is regulated by a board of medical examiners, while in others by the board of licensing, health or education.
In Japan, acupuncturists are licensed by the Minister of Health, Labour and Welfare after passing an examination and graduating from a technical school or university. In Australia, the Chinese Medicine Board of Australia regulates acupuncture, among other Chinese medical traditions, and restricts the use of titles like 'acupuncturist' to registered practitioners only. The practice of Acupuncture in New Zealand in 1990 acupuncture was included into the Governmental Accident Compensation Corporation (ACC) Act. This inclusion granted qualified and professionally registered acupuncturists the ability to provide subsidised care and treatment to citizens, residents, and temporary visitors for work- or sports-related injuries that occurred within the country of New Zealand. The two bodies for the regulation of acupuncture and attainment of ACC treatment provider status in New Zealand are Acupuncture NZ, and The New Zealand Acupuncture Standards Authority. At least 28 countries in Europe have professional associations for acupuncturists. In France, the Académie Nationale de Médecine (National Academy of Medicine) has regulated acupuncture since 1955.
== See also ==
== Notes ==
== References ==
=== Bibliography ===
== Further reading ==
Brown, Brandon P (2011). "Acupuncture." Magill's Medical Guide, 6th ed., vol. 1. Salem Press. ISBN 978-1-63700-107-3.
Ulett GA (2002). "Acupuncture". In Shermer M (ed.). The Skeptic Encyclopedia of Pseudoscience. ABC-CLIO. pp. 283 ff. ISBN 978-1-57607-653-8.
William FW, ed. (2013). "Acupuncture". Encyclopedia of Pseudoscience: From Alien Abductions to Zone Therapy. Routledge. pp. 34. ISBN 978-1-135-95522-9.
Bivins, Roberta E. (2000). Acupuncture, Expertise, and Cross-Cultural Medicine. New York: Palgrave. ISBN 0-333-91893-2.
FRONTLINE: The Alternative Fix - "What is acupuncture?" (4 November 2003). PBS Video.
== External links ==

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==== De-qi sensation ====
De-qi (Chinese: 得气; pinyin: dé qì; "arrival of qi") refers to a claimed sensation of numbness, distension, or electrical tingling at the needling site. If these sensations are not observed then inaccurate location of the acupoint, improper depth of needle insertion, inadequate manual manipulation, are blamed. If de-qi is not immediately observed upon needle insertion, various manual manipulation techniques are often applied to promote it (such as "plucking", "shaking" or "trembling").
Once de-qi is observed, techniques might be used which attempt to "influence" the de-qi; for example, by certain manipulation the de-qi can allegedly be conducted from the needling site towards more distant sites of the body. Other techniques aim at "tonifying" (Chinese: 补; pinyin: bǔ) or "sedating" (Chinese: 泄; pinyin: xiè) qi. The former techniques are used in deficiency patterns, the latter in excess patterns. De qi is more important in Chinese acupuncture, while Western and Japanese patients may not consider it a necessary part of the treatment.
=== Related practices ===
Acupressure, a non-invasive form of bodywork, uses physical pressure applied to acupressure points by the hand or elbow, or with various devices.
Acupuncture is often accompanied by moxibustion, the burning of cone-shaped preparations of moxa (made from dried mugwort) on or near the skin, often but not always near or on an acupuncture point. Traditionally, acupuncture was used to treat acute conditions while moxibustion was used for chronic diseases. Moxibustion could be direct (the cone was placed directly on the skin and allowed to burn the skin, producing a blister and eventually a scar), or indirect (either a cone of moxa was placed on a slice of garlic, ginger or other vegetable, or a cylinder of moxa was held above the skin, close enough to either warm or burn it).
Cupping therapy is an ancient Chinese form of alternative medicine in which a local suction is created on the skin; practitioners believe this mobilizes blood flow in order to promote healing.
Tui na is a TCM method of attempting to stimulate the flow of qi by various bare-handed techniques that do not involve needles.
Electroacupuncture is a form of acupuncture in which acupuncture needles are attached to a device that generates continuous electric pulses (this has been described as "essentially transdermal electrical nerve stimulation [TENS] masquerading as acupuncture").
Fire needle acupuncture also known as fire needling is a technique which involves quickly inserting a flame-heated needle into areas on the body.
Sonopuncture is a stimulation of the body similar to acupuncture using sound instead of needles. This may be done using purpose-built transducers to direct a narrow ultrasound beam to a depth of 68 centimetres at acupuncture meridian points on the body. Alternatively, tuning forks or other sound emitting devices are used.
Acupuncture point injection is the injection of various substances (such as drugs, vitamins or herbal extracts) into acupoints. This technique combines traditional acupuncture with injection of what is often an effective dose of an approved pharmaceutical drug, and proponents claim that it may be more effective than either treatment alone, especially for the treatment of some kinds of chronic pain. However, a 2016 review found that most published trials of the technique were of poor value due to methodology issues and larger trials would be needed to draw useful conclusions.
Auriculotherapy, commonly known as ear acupuncture, auricular acupuncture, or auriculoacupuncture, is considered to date back to ancient China. It involves inserting needles to stimulate points on the outer ear. The modern approach was developed in France during the early 1950s. There is no scientific evidence that it can cure disease; the evidence of effectiveness is negligible.
Scalp acupuncture, developed in Japan, is based on reflexological considerations regarding the scalp.
Koryo hand acupuncture, developed in Korea, centers around assumed reflex zones of the hand. Medical acupuncture attempts to integrate reflexological concepts, the trigger point model, and anatomical insights (such as dermatome distribution) into acupuncture practice, and emphasizes a more formulaic approach to acupuncture point location.
Cosmetic acupuncture is the use of acupuncture in an attempt to reduce wrinkles on the face.
Bee venom acupuncture is a treatment approach of injecting purified, diluted bee venom into acupoints.
Veterinary acupuncture is the use of acupuncture on domesticated animals.
== Efficacy ==
As of 2021, many thousands of papers had been published on the efficacy of acupuncture for the treatment of various adult health conditions, but there was no robust evidence it was beneficial for anything, except shoulder pain and fibromyalgia. The evidence for its efficacy in shoulder pain is low quality and includes only two studies. Its efficacy for fibromyalgia does not appear to be clinically significant. For Science-Based Medicine, Steven Novella wrote that the overall pattern of evidence was reminiscent of that for homeopathy, compatible with the hypothesis that most, if not all, benefits were due to the placebo effect, and strongly suggestive that acupuncture had no beneficial therapeutic effects at all.
Harriet Hall noticed that according to Edzard Ernst in 2011, systematic reviews agreed that acupuncture works for neck pain, but not for every other pain—and that makes its whole enterprise suspicious. A 2024 review concluded that it is no more effective than sham acupuncture for neck pain reduction.
== Research methodology and challenges ==

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=== Sham acupuncture and research ===
It is difficult but not impossible to design rigorous research trials for acupuncture. Due to acupuncture's invasive nature, one of the major challenges in efficacy research is in the design of an appropriate placebo control group. For efficacy studies to determine whether acupuncture has specific effects, "sham" forms of acupuncture where the patient, practitioner, and analyst are blinded seem the most acceptable approach. Sham acupuncture uses non-penetrating needles or needling at non-acupuncture points, e.g. inserting needles on meridians not related to the specific condition being studied, or in places not associated with meridians. The under-performance of acupuncture in such trials may indicate that therapeutic effects are due entirely to non-specific effects, or that the sham treatments are not inert, or that systematic protocols yield less than optimal treatment.
A 2014 review in Nature Reviews Cancer found that "contrary to the claimed mechanism of redirecting the flow of qi through meridians, researchers usually find that it generally does not matter where the needles are inserted, how often (that is, no dose-response effect is observed), or even if needles are actually inserted. In other words, "sham" or "placebo" acupuncture generally produces the same effects as "real" acupuncture and, in some cases, does better." A 2013 meta-analysis found little evidence that the effectiveness of acupuncture on pain (compared to sham) was modified by the location of the needles, the number of needles used, the experience or technique of the practitioner, or by the circumstances of the sessions. The same analysis also suggested that the number of needles and sessions is important, as greater numbers improved the outcomes of acupuncture compared to non-acupuncture controls. There has been little systematic investigation of which components of an acupuncture session may be important for any therapeutic effect, including needle placement and depth, type and intensity of stimulation, and number of needles used. The research seems to suggest that needles do not need to stimulate the traditionally specified acupuncture points or penetrate the skin to attain an anticipated effect (e.g. psychosocial factors).
A response to "sham" acupuncture in osteoarthritis may be used in the elderly, but placebos have usually been regarded as deception and thus unethical. However, some physicians and ethicists have suggested circumstances for applicable uses for placebos such as it might present a theoretical advantage of an inexpensive treatment without adverse reactions or interactions with drugs or other medications. As the evidence for most types of alternative medicine such as acupuncture is far from strong, the use of alternative medicine in regular healthcare can present an ethical question.
Using the principles of evidence-based medicine to research acupuncture is controversial, and has produced different results. Some research suggests acupuncture can alleviate pain but the majority of research suggests that acupuncture's effects are mainly due to placebo. Evidence suggests that any benefits of acupuncture are short-lasting. There is insufficient evidence to support use of acupuncture compared to mainstream medical treatments. Acupuncture is not better than mainstream treatment in the long term.
The use of acupuncture has been criticized owing to there being little scientific evidence for explicit effects, or the mechanisms for its supposed effectiveness, for any condition that is discernible from placebo. Acupuncture has been called "theatrical placebo", and David Gorski argues that when acupuncture proponents advocate "harnessing of placebo effects" or work on developing "meaningful placebos", they essentially concede it is little more than that.
=== Publication bias ===
Publication bias is cited as a concern in the reviews of randomized controlled trials of acupuncture. A 1998 review of studies on acupuncture found that trials originating in China, Japan, Hong Kong, and Taiwan were uniformly favourable to acupuncture, as were ten out of eleven studies conducted in Russia. A 2011 assessment of the quality of randomized controlled trials on traditional Chinese medicine, including acupuncture, concluded that the methodological quality of most such trials (including randomization, experimental control, and blinding) was generally poor, particularly for trials published in Chinese journals (though the quality of acupuncture trials was better than the trials testing traditional Chinese medicine remedies). The study also found that trials published in non-Chinese journals tended to be of higher quality. Chinese authors use more Chinese studies, which have been demonstrated to be uniformly positive. A 2012 review of 88 systematic reviews of acupuncture published in Chinese journals found that less than half of these reviews reported testing for publication bias, and that the majority of these reviews were published in journals with impact factors of zero. A 2015 study comparing pre-registered records of acupuncture trials with their published results found that it was uncommon for such trials to be registered before the trial began. This study also found that selective reporting of results and changing outcome measures to obtain statistically significant results was common in this literature.
Scientist Steven Salzberg identifies acupuncture and Chinese medicine generally as a focus for "fake medical journals" such as the Journal of Acupuncture and Meridian Studies and Acupuncture in Medicine.
== Safety ==

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=== Adverse events ===
Acupuncture is generally safe when administered by an experienced, appropriately trained practitioner using clean-needle technique and sterile single-use needles. When improperly delivered it can cause adverse effects. Accidents and infections are associated with infractions of sterile technique or neglect on the part of the practitioner. To reduce the risk of serious adverse events after acupuncture, acupuncturists should be trained sufficiently. A 2009 overview of Cochrane reviews found acupuncture is not effective for a wide range of conditions. People with serious spinal disease, such as cancer or infection, are not good candidates for acupuncture. Contraindications to acupuncture (conditions that should not be treated with acupuncture) include coagulopathy disorders (e.g. hemophilia and advanced liver disease), warfarin use, severe psychiatric disorders (e.g. psychosis), and skin infections or skin trauma (e.g. burns). Further, electroacupuncture should be avoided at the spot of implanted electrical devices (such as pacemakers).
A 2011 systematic review of systematic reviews (internationally and without language restrictions) found that serious complications following acupuncture continue to be reported. Between 2000 and 2009, ninety-five cases of serious adverse events, including five deaths, were reported. Many such events are not inherent to acupuncture but are due to malpractice of acupuncturists. This might be why such complications have not been reported in surveys of adequately trained acupuncturists. Most such reports originate from Asia, which may reflect the large number of treatments performed there or a relatively higher number of poorly trained Asian acupuncturists. Many serious adverse events were reported from developed countries. These included Australia, Austria, Canada, Croatia, France, Germany, Ireland, the Netherlands, New Zealand, Spain, Sweden, Switzerland, the UK, and the US. The number of adverse effects reported from the UK appears particularly unusual, which may indicate less under-reporting in the UK than other countries. Reports included 38 cases of infections and 42 cases of organ trauma. The most frequent adverse events included pneumothorax, and bacterial and viral infections.
A 2013 review found (without restrictions regarding publication date, study type or language) 295 cases of infections; mycobacterium was the pathogen in at least 96%. Likely sources of infection include towels, hot packs or boiling tank water, and reusing reprocessed needles. Possible sources of infection include contaminated needles, reusing personal needles, a person's skin containing mycobacterium, and reusing needles at various sites in the same person. Although acupuncture is generally considered a safe procedure, a 2013 review stated that the reports of infection transmission increased significantly in the prior decade, including those of mycobacterium. Although it is recommended that practitioners of acupuncture use disposable needles, the reuse of sterilized needles is still permitted. It is also recommended that thorough control practices for preventing infection be implemented and adapted.
==== English-language ====
A 2013 systematic review of the English-language case reports found that serious adverse events associated with acupuncture are rare, but that acupuncture is not without risk. Between 2000 and 2011 the English-language literature from 25 countries and regions reported 294 adverse events. The majority of the reported adverse events were relatively minor, and the incidences were low. For example, a prospective survey of 34,000 acupuncture treatments found no serious adverse events and 43 minor ones, a rate of 1.3 per 1000 interventions. Another survey found there were 7.1% minor adverse events, of which 5 were serious, amid 97,733 acupuncture patients. The most common adverse effect observed was infection (e.g. mycobacterium), and the majority of infections were bacterial in nature, caused by skin contact at the needling site. Infection has also resulted from skin contact with unsterilized equipment or with dirty towels in an unhygienic clinical setting. Other adverse complications included five reported cases of spinal cord injuries (e.g. migrating broken needles or needling too deeply), four brain injuries, four peripheral nerve injuries, five heart injuries, seven other organ and tissue injuries, bilateral hand edema, epithelioid granuloma, pseudolymphoma, argyria, pustules, pancytopenia, and scarring due to hot-needle technique. Adverse reactions from acupuncture, which are unusual and uncommon in typical acupuncture practice, included syncope, galactorrhoea, bilateral nystagmus, pyoderma gangrenosum, hepatotoxicity, eruptive lichen planus, and spontaneous needle migration.
A 2013 systematic review found 31 cases of vascular injuries caused by acupuncture, three causing death. Two died from pericardial tamponade and one was from an aortoduodenal fistula. The same review found vascular injuries were rare, bleeding and pseudoaneurysm were most prevalent. A 2011 systematic review (without restriction in time or language), aiming to summarize all reported case of cardiac tamponade after acupuncture, found 26 cases resulting in 14 deaths, with little doubt about cause in most fatal instances. The same review concluded that cardiac tamponade was a serious, usually fatal, though theoretically avoidable complication following acupuncture, and urged training to minimize risk.
A 2012 review found that a number of adverse events were reported after acupuncture in the UK's National Health Service (NHS), 95% of which were not severe, though miscategorization and under-reporting may alter the total figures. From January 2009 to December 2011, 468 safety incidents were recognized within the NHS organizations. The adverse events recorded included retained needles (31%), dizziness (30%), loss of consciousness/unresponsive (19%), falls (4%), bruising or soreness at needle site (2%), pneumothorax (1%) and other adverse side effects (12%). Acupuncture practitioners should know, and be prepared to be responsible for, any substantial harm from treatments. Some acupuncture proponents argue that the long history of acupuncture suggests it is safe. However, there is an increasing literature on adverse events (e.g. spinal-cord injury).
Acupuncture seems to be safe in people getting anticoagulants, assuming needles are used at the correct location and depth, but studies are required to verify these findings.

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==== Chinese, Korean, and Japanese-language ====
A 2010 systematic review of the Chinese-language literature found numerous acupuncture-related adverse events, including pneumothorax, fainting, subarachnoid hemorrhage, and infection as the most frequent, and cardiovascular injuries, subarachnoid hemorrhage, pneumothorax, and recurrent cerebral hemorrhage as the most serious, most of which were due to improper technique. Between 1980 and 2009, the Chinese-language literature reported 479 adverse events. Prospective surveys show that mild, transient acupuncture-associated adverse events ranged from 6.71% to 15%. In a study with 190,924 patients, the prevalence of serious adverse events was roughly 0.024%. Another study showed a rate of adverse events requiring specific treatment of 2.2%, 4,963 incidences among 229,230 patients. Infections, mainly hepatitis, after acupuncture are reported often in English-language research, though are rarely reported in Chinese-language research, making it plausible that acupuncture-associated infections have been underreported in China. Infections were mostly caused by poor sterilization of acupuncture needles. Other adverse events included spinal epidural hematoma (in the cervical, thoracic and lumbar spine), chylothorax, injuries of abdominal organs and tissues, injuries in the neck region, injuries to the eyes, including orbital hemorrhage, traumatic cataract, injury of the oculomotor nerve and retinal puncture, hemorrhage to the cheeks and the hypoglottis, peripheral motor-nerve injuries and subsequent motor dysfunction, local allergic reactions to metal needles, stroke, and cerebral hemorrhage after acupuncture.
A causal link between acupuncture and the adverse events cardiac arrest, pyknolepsy, shock, fever, cough, thirst, aphonia, leg numbness, and sexual dysfunction remains uncertain. The same review concluded that acupuncture can be considered inherently safe when practiced by properly trained practitioners, but the review also stated there is a need to find effective strategies to minimize the health risks. Between 1999 and 2010, the Korean-language literature contained reports of 1104 adverse events. Between the 1980s and 2002, the Japanese-language literature contained reports of 150 adverse events.
==== Children and pregnancy ====
Although acupuncture has been practiced for thousands of years in China, its use in pediatrics in the United States did not become common until the early 2000s. In 2007, the National Health Interview Survey (NHIS) conducted by the National Center For Health Statistics (NCHS) estimated that approximately 150,000 children had received acupuncture treatment for a variety of conditions.
In 2008, a study determined that the use of acupuncture-needle treatment on children was "questionable" due to the possibility of adverse side-effects and the pain manifestation differences in children versus adults. The study also includes warnings against practicing acupuncture on infants, as well as on children who are over-fatigued, very weak, or have over-eaten.
When used on children, acupuncture is considered safe when administered by well-trained, licensed practitioners using sterile needles; however, a 2011 review found there was limited research to draw definite conclusions about the overall safety of pediatric acupuncture. The same review found 279 adverse events, 25 of them serious. The adverse events were mostly mild in nature (e.g., bruising or bleeding). The prevalence of mild adverse events ranged from 10.1% to 13.5%, an estimated 168 incidences among 1,422 patients. On rare occasions adverse events were serious (e.g. cardiac rupture or hemoptysis); many might have been a result of substandard practice. The incidence of serious adverse events was 5 per one million, which included children and adults.
When used during pregnancy, the majority of adverse events caused by acupuncture were mild and transient, with few serious adverse events. The most frequent mild adverse event was needling or unspecified pain, followed by bleeding. Although two deaths (one stillbirth and one neonatal death) were reported, there was a lack of acupuncture-associated maternal mortality. Limiting the evidence as certain, probable or possible in the causality evaluation, the estimated incidence of adverse events following acupuncture in pregnant women was 131 per 10,000.
Although acupuncture is not contraindicated in pregnant women, some specific acupuncture points are particularly sensitive to needle insertion; these spots, as well as the abdominal region, should be avoided during pregnancy.
==== Moxibustion and cupping ====
Four adverse events associated with moxibustion were bruising, burns and cellulitis, spinal epidural abscess, and large superficial basal cell carcinoma. Ten adverse events were associated with cupping. The minor ones were keloid scarring, burns, and bullae; the serious ones were acquired hemophilia A, stroke following cupping on the back and neck, factitious panniculitis, reversible cardiac hypertrophy, and iron deficiency anemia.
=== Risk of forgoing conventional medical care ===
As with other alternative medicines, unethical or naïve practitioners may induce patients to exhaust financial resources by pursuing ineffective treatment. Professional ethics codes set by accrediting organizations such as the National Certification Commission for Acupuncture and Oriental Medicine require practitioners to make "timely referrals to other health care professionals as may be appropriate." Stephen Barrett states that there is a "risk that an acupuncturist whose approach to diagnosis is not based on scientific concepts will fail to diagnose a dangerous condition".
== Conceptual basis ==
=== Traditional ===

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Acupuncture is a substantial part of traditional Chinese medicine (TCM). Early acupuncture beliefs relied on concepts that are common in TCM, such as a life force energy called qi. Qi was believed to flow from the body's primary organs (zang-fu organs) to the "superficial" body tissues of the skin, muscles, tendons, bones, and joints, through channels called meridians. Acupuncture points where needles are inserted are mainly (but not always) found at locations along the meridians. Acupuncture points not found along a meridian are called extraordinary points and those with no designated site are called A-shi points.
In TCM, disease is generally perceived as a disharmony or imbalance in energies such as yin, yang, qi, xuĕ, zàng-fǔ, meridians, and of the interaction between the body and the environment. Therapy is based on which "pattern of disharmony" can be identified. For example, some diseases are believed to be caused by meridians being invaded with an excess of wind, cold, and damp. In order to determine which pattern is at hand, practitioners examine things like the color and shape of the tongue, the relative strength of pulse-points, the smell of the breath, the quality of breathing, or the sound of the voice. TCM and its concept of disease does not strongly differentiate between the cause and effect of symptoms.
=== Purported scientific basis ===
Many within the scientific community consider acupuncture to be quackery and pseudoscience, having no effect other than as "theatrical placebo". David Gorski has argued that of all forms of quackery, acupuncture has perhaps gained most acceptance among physicians and institutions. Academics Massimo Pigliucci and Maarten Boudry describe acupuncture as a "borderlands science" lying between science and pseudoscience.
A 2015 paper states that acupuncture is "often considered as 'pseudoscience' or 'quackery' with no credible or respectable place in medicine".
==== Rationalizations of traditional medicine ====
It is a generally held belief within the acupuncture community that acupuncture points and meridians structures are special conduits for electrical signals, but no research has established any consistent anatomical structure or function for either acupuncture points or meridians. Human tests to determine whether electrical continuity was significantly different near meridians than other places in the body have been inconclusive. Scientific research has not supported the existence of qi, meridians, or yin and yang. A Nature editorial described TCM as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of action. Quackwatch states that "TCM theory and practice are not based upon the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community. TCM practitioners disagree among themselves about how to diagnose patients and which treatments should go with which diagnoses. Even if they could agree, the TCM theories are so nebulous that no amount of scientific study will enable TCM to offer rational care." Academic discussions of acupuncture still make reference to pseudoscientific concepts such as qi and meridians despite the lack of scientific evidence.
==== Release of endorphins or adenosine ====
Some modern practitioners support the use of acupuncture to treat pain, but have abandoned the use of qi, meridians, yin, yang and other mystical energies as an explanatory frameworks. The use of qi as an explanatory framework has been decreasing in China, even as it becomes more prominent during discussions of acupuncture in the US.
Many acupuncturists attribute pain relief to the release of endorphins when needles penetrate, but no longer support the idea that acupuncture can affect a disease. Some studies suggest acupuncture causes a series of events within the central nervous system, and that it is possible to inhibit acupuncture's analgesic effects with the opioid antagonist compound naloxone, suggesting that the use of acupuncture may trigger the release of endogenous opioids.
Mechanical deformation of the skin by acupuncture needles appears to result in the release of adenosine. The anti-nociceptive effect of acupuncture may be mediated by the adenosine A1 receptor. A 2014 review in Nature Reviews Cancer analyzed mouse studies that suggested acupuncture relieves pain via the local release of adenosine, which then triggered nearby A1 receptors. The review found that in those studies, because acupuncture "caused more tissue damage and inflammation relative to the size of the animal in mice than in humans, such studies unnecessarily muddled a finding that local inflammation can result in the local release of adenosine with analgesic effect."
== History ==
=== Origins ===
Acupuncture, along with moxibustion, is one of the oldest practices of traditional Chinese medicine. Most historians believe the practice began in China, though there are some conflicting narratives on when it originated. Academics David Ramey and Paul Buell said the exact date acupuncture was founded depends on the extent to which dating of ancient texts can be trusted and the interpretation of what constitutes acupuncture.
Acupressure therapy was prevalent in India. Once Buddhism spread to China, the acupressure therapy was also integrated into common medical practice in China and it came to be known as acupuncture. The major points of Indian acupressure and Chinese acupuncture are similar to each other.
According to an article in Rheumatology, the first documentation of an "organized system of diagnosis and treatment" for acupuncture was in Inner Classic of Huang Di (Huangdi Neijing) from about 100 BC. Gold and silver needles found in the tomb of Liu Sheng from around 100 BC are believed to be the earliest archaeological evidence of acupuncture, though it is unclear if that was their purpose. According to Plinio Prioreschi, the earliest known historical record of acupuncture is the Shiji ("Records of the Grand Historian"), written by a historian around 100 BC. It is believed that this text was documenting what was established practice at that time.

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==== Alternative theories ====
The 5,000-year-old mummified body of Ötzi the Iceman was found with 15 groups of tattoos, many of which were located at points on the body where acupuncture needles are used for abdominal or lower back problems. Evidence from the body suggests Ötzi had these conditions. This has been cited as evidence that practices similar to acupuncture may have been practised elsewhere in Eurasia during the early Bronze Age; however, The Oxford Handbook of the History of Medicine calls this theory "speculative". It is considered unlikely that acupuncture was practised before 2000 BC.
Acupuncture may have been practised during the Neolithic era, near the end of the Stone Age, using sharpened stones called Bian shi. Many Chinese texts from later eras refer to sharp stones called "plen", which means "stone probe", that may have been used for acupuncture purposes. The ancient Chinese medical text, Huangdi Neijing, indicates that sharp stones were believed at-the-time to cure illnesses at or near the body's surface, perhaps because of the short depth a stone could penetrate. However, it is more likely that stones were used for other medical purposes, such as puncturing a growth to drain its pus. The Mawangdui texts, which are believed to be from the 2nd century BC, mention the use of pointed stones to open abscesses, and moxibustion, but not for acupuncture. It is also speculated that these stones may have been used for bloodletting, due to the ancient Chinese belief that illnesses were caused by demons within the body that could be killed or released. It is likely bloodletting was an antecedent to acupuncture.
According to historians Lu Gwei-djen and Joseph Needham, there is substantial evidence that acupuncture may have begun around 600 BC. Some hieroglyphs and pictographs from that era suggests acupuncture and moxibustion were practised. However, historians Lu and Needham said it was unlikely a needle could be made out of the materials available in China during this time period. It is possible that bronze was used for early acupuncture needles. Tin, copper, gold and silver are also possibilities, though they are considered less likely, or to have been used in fewer cases. If acupuncture was practised during the Shang dynasty (1766 to 1122 BC), organic materials like thorns, sharpened bones, or bamboo may have been used. Once methods for producing steel were discovered, it would replace all other materials, since it could be used to create a very fine, but sturdy needle. Lu and Needham noted that all the ancient materials that could have been used for acupuncture and which often produce archaeological evidence, such as sharpened bones, bamboo or stones, were also used for other purposes. An article in Rheumatology said that the absence of any mention of acupuncture in documents found in the tomb of Mawangdui from 198 BC suggest that acupuncture was not practised by that time.
==== Belief systems ====
Several different and sometimes conflicting belief systems emerged regarding acupuncture. This may have been the result of competing schools of thought. Some ancient texts referred to using acupuncture to cause bleeding, while others mixed the ideas of blood-letting and spiritual qi energy. Over time, the focus shifted from blood to the concept of puncturing specific points on the body, and eventually to balancing Yin and Yang energies as well. According to David Ramey, no single "method or theory" was ever predominantly adopted as the standard. At the time, scientific knowledge of medicine was not yet developed, especially because in China dissection of the deceased was forbidden, preventing the development of basic anatomical knowledge.
It is not certain when specific acupuncture points were introduced, but the autobiography of Bian Que from around 400500 BC references inserting needles at designated areas. Bian Que believed there was a single acupuncture point at the top of one's skull that he called the point "of the hundred meetings." Texts dated to be from 156 to 186 BC document early beliefs in channels of life force energy called meridians that would later be an element in early acupuncture beliefs.
Ramey and Buell said the "practice and theoretical underpinnings" of modern acupuncture were introduced in The Yellow Emperor's Classic (Huangdi Neijing) around 100 BC. It introduced the concept of using acupuncture to manipulate the flow of life energy (qi) in a network of meridian (channels) in the body. The network concept was made up of acu-tracts, such as a line down the arms, where it said acupoints were located. Some of the sites acupuncturists use needles at today still have the same names as those given to them by the Yellow Emperor's Classic. Numerous additional documents were published over the centuries introducing new acupoints. By the 4th century AD, most of the acupuncture sites in use today had been named and identified.
=== Early development in China ===

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==== Establishment and growth ====
In the first half of the 1st century AD, acupuncturists began promoting the belief that acupuncture's effectiveness was influenced by the time of day or night, the lunar cycle, and the season. The 'science of the yin-yang cycles' (運氣學 yùn qì xué) was a set of beliefs that curing diseases relied on the alignment of both heavenly (tian) and earthly (di) forces that were attuned to cycles like that of the sun and moon. There were several different belief systems that relied on a number of celestial and earthly bodies or elements that rotated and only became aligned at certain times. According to Needham and Lu, these "arbitrary predictions" were depicted by acupuncturists in complex charts and through a set of special terminology.
Acupuncture needles during this period were much thicker than most modern ones and often resulted in infection. Infection is caused by a lack of sterilization, but at that time it was believed to be caused by use of the wrong needle, or needling in the wrong place, or at the wrong time. Later, many needles were heated in boiling water, or in a flame. Sometimes needles were used while they were still hot, creating a cauterizing effect at the injection site. Nine needles were recommended in the Great Compendium of Acupuncture and Moxibustion from 1601, which may have been because of an ancient Chinese belief that nine was a magic number.
Other belief systems were based on the idea that the human body operated on a rhythm and acupuncture had to be applied at the right point in the rhythm to be effective. In some cases a lack of balance between Yin and Yang were believed to be the cause of disease.
In the 1st century AD, many of the first books about acupuncture were published and recognized acupuncturist experts began to emerge. The Zhen Jiu Jia Yi Jing, which was published in the mid-3rd century, became the oldest acupuncture book that is still in existence in the modern era. Other books like the Yu Gui Zhen Jing, written by the Director of Medical Services for China, were also influential during this period, but were not preserved. In the mid 7th century, Sun Simiao published acupuncture-related diagrams and charts that established standardized methods for finding acupuncture sites on people of different sizes and categorized acupuncture sites in a set of modules.
Acupuncture became more established in China as improvements in paper led to the publication of more acupuncture books. The Imperial Medical Service and the Imperial Medical College, which both supported acupuncture, became more established and created medical colleges in every province. The public was also exposed to stories about royal figures being cured of their diseases by prominent acupuncturists. By time the Great Compendium of Acupuncture and Moxibustion was published during the Ming dynasty (13681644 AD), most of the acupuncture practices used in the modern era had been established.
==== Decline ====
By the end of the Song dynasty (1279 AD), acupuncture had lost much of its status in China. It became rarer in the following centuries, and was associated with less prestigious professions like alchemy, shamanism, midwifery and moxibustion. Additionally, by the 18th century, scientific rationality was becoming more popular than traditional superstitious beliefs. By 1757 a book documenting the history of Chinese medicine called acupuncture a "lost art". Its decline was attributed in part to the popularity of prescriptions and medications, as well as its association with the lower classes.
In 1822, the Chinese Emperor signed a decree excluding the practice of acupuncture from the Imperial Medical Institute. He said it was unfit for practice by gentlemen-scholars. In China acupuncture was increasingly associated with lower-class, illiterate practitioners. It was restored for a time, but banned again in 1929 in favor of science-based medicine. Although acupuncture declined in China during this time period, it was also growing in popularity in other countries.
=== International expansion ===

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Korea is believed to be the first country in Asia that acupuncture spread to outside of China. Within Korea there is a legend that acupuncture was developed by emperor Dangun, though it is more likely to have been brought into Korea from a Chinese colonial prefecture in 514 AD. Acupuncture use was commonplace in Korea by the 6th century. It spread to Vietnam in the 8th and 9th centuries. As Vietnam began trading with Japan and China around the 9th century, it was influenced by their acupuncture practices as well. China and Korea sent "medical missionaries" that spread traditional Chinese medicine to Japan, starting around 219 AD. In 553, several Korean and Chinese citizens were appointed to re-organize medical education in Japan and they incorporated acupuncture as part of that system. Japan later sent students back to China and established acupuncture as one of five divisions of the Chinese State Medical Administration System.
Acupuncture began to spread to Europe in the second half of the 17th century. Around this time, Willem ten Rhijne, a physician working for the Dutch East India Company, met Japanese acupuncture practitioners and later encouraged Europeans to further investigate it. He published the first in-depth description of acupuncture for the European audience and created the term "acupuncture" in his 1683 work De Acupunctura. France was an early adopter among the West due to the influence of Jesuit missionaries, who brought the practice to French clinics in the 16th century. The French doctor Louis Berlioz (the father of the composer Hector Berlioz) is usually credited with being the first to experiment with the procedure in Europe in 1810, before publishing his findings in 1816.
By the 19th century, acupuncture had become commonplace in many areas of the world. Americans and Britons began showing interest in acupuncture in the early 19th century, although interest waned by mid-century. Western practitioners abandoned acupuncture's traditional beliefs in spiritual energy, pulse diagnosis, and the cycles of the moon, sun or the body's rhythm. Diagrams of the flow of spiritual energy, for example, conflicted with the West's own anatomical diagrams. It adopted a new set of ideas for acupuncture based on tapping needles into nerves. In Europe it was speculated that acupuncture may allow or prevent the flow of electricity in the body, as electrical pulses were found to make a frog's leg twitch after death.
The West eventually created a belief system based on Travell trigger points that were believed to inhibit pain. They were in the same locations as China's spiritually identified acupuncture points, but under a different nomenclature. The first elaborate Western treatise on acupuncture was published in 1683 by Willem ten Rhijne.
==== Modern era ====
In China, the popularity of acupuncture rebounded in 1949 when Mao Zedong took power and sought to unite China behind traditional cultural values. It was also during this time that many Eastern medical practices were consolidated under the name traditional Chinese medicine (TCM).
New practices were adopted in the 20th century, such as using a cluster of needles, electrified needles, or leaving needles inserted for up to a week. A lot of emphasis developed on using acupuncture on the ear. Acupuncture research organizations such as the International Society of Acupuncture were founded in the 1940s and 1950s and acupuncture services became available in modern hospitals. China, where acupuncture was believed to have originated, was increasingly influenced by Western medicine. Meanwhile, acupuncture grew in popularity in the US. The US Congress created the Office of Alternative Medicine in 1992 and the National Institutes of Health (NIH) declared support for acupuncture for some conditions in November 1997. In 1999, the National Center for Complementary and Alternative Medicine was created within the NIH. Acupuncture became the most popular alternative medicine in the US.
Politicians from the Chinese Communist Party said acupuncture was superstitious and conflicted with the party's commitment to science. Communist Party Chairman Mao Zedong later reversed this position, arguing that the practice was based on scientific principles. During the Cultural Revolution, disbelief in acupuncture anesthesia was subjected to ruthless political repression.
In 1971, New York Times reporter James Reston published an article on his acupuncture experiences in China, which led to more investigation of and support for acupuncture. The US President Richard Nixon visited China in 1972. During one part of the visit, the delegation was shown a patient undergoing major surgery while fully awake, ostensibly receiving acupuncture rather than anesthesia. Later it was found that the patients selected for the surgery had both a high pain tolerance and received heavy indoctrination before the operation; these demonstration cases were also frequently receiving morphine surreptitiously through an intravenous drip that observers were told contained only fluids and nutrients. One patient receiving open heart surgery while awake was ultimately found to have received a combination of three powerful sedatives as well as large injections of a local anesthetic into the wound. After the National Institute of Health expressed support for acupuncture for a limited number of conditions, adoption in the US grew further. In 1972 the first legal acupuncture center in the US was established in Washington DC and in 1973 the American Internal Revenue Service allowed acupuncture to be deducted as a medical expense.
In 2006, a BBC documentary Alternative Medicine filmed a patient undergoing open heart surgery allegedly under acupuncture-induced anesthesia. It was later revealed that the patient had been given a cocktail of anesthetics.
In 2010, UNESCO inscribed "acupuncture and moxibustion of traditional Chinese medicine" on the UNESCO Intangible Cultural Heritage List following China's nomination.

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Adrenal fatigue is a pseudoscientific term used by alternative medicine providers to suggest that the adrenal glands are exhausted and unable to produce adequate quantities of hormones, primarily cortisol, due to chronic stress or infections. There is no scientific basis for the existence of adrenal fatigue, and the term should not be confused with a number of actual forms of adrenal dysfunction such as adrenal insufficiency or Addison's disease.
== Definition ==
Neither the condition nor the symptoms have any stable or recognized definition.
== History ==
The term "adrenal fatigue" was invented in 1998 by chiropractor James Wilson and applied to a collection of mostly non-specific symptoms.
== Lack of evidence ==
A systematic review found no evidence for the condition, supporting the consensus among mainstream endocrinologists that it is a myth. There is no evidence supporting the concept of adrenal fatigue, and it is not a valid diagnosis recognized by the scientific or medical communities.
== Tests ==
Blood or salivary testing is sometimes offered, but there is no evidence that adrenal fatigue exists, or that it can be tested for.
== Diagnosis ==
Adrenal fatigue is not an accepted medical diagnosis.
== Dietary supplements ==
The concept of adrenal fatigue has given rise to an industry of dietary supplements marketed to treat the supposed condition. These supplements are largely unregulated in the U.S.; they are ineffective and costly; and they in some cases may be dangerous. The cortisol cocktail, a drink containing fruit juice, coconut water and salt, was popularised on social media in 2023 as a treatment for adrenal fatigue.
== See also ==
Adrenal insufficiency
Hypocortisolism
List of topics characterized as pseudoscience
== References ==
== External links ==
Adrenal Fatigue from the Endocrine Society

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African traditional medicine is a range of traditional medicine disciplines involving indigenous herbalism and African spirituality, typically including diviners, midwives, and herbalists. Practitioners of traditional African medicine claim, largely without evidence, to be able to cure a variety of diverse conditions including cancer, psychiatric disorders, high blood pressure, cholera, most venereal diseases, epilepsy, asthma, eczema, fever, anxiety, depression, benign prostatic hyperplasia, urinary tract infections, gout, and healing of wounds and burns and Ebola.
Diagnosis is reached through spiritual means and a treatment is prescribed, usually consisting of a herbal remedy that is considered to have not only healing abilities but also symbolic and spiritual significance. Traditional African medicine, with its belief that illness is not derived from chance occurrences, but through spiritual or social imbalance, differs greatly from modern scientific medicine, which is technically and analytically based. In the 21st century, modern pharmaceuticals and medical procedures remain inaccessible to large numbers of African people due to their relatively high cost and concentration of health facilities in urban centres.
Traditional medicine was the dominant medical system for millions of people in Africa prior the arrival of the Europeans, who introduced evidence-based medicine, which was a noticeable turning point in the history of this tradition and culture. Herbal medicines in Africa are generally not adequately researched, and are weakly regulated. There is a lack of the detailed documentation of the traditional knowledge, which is generally transferred orally. Serious adverse effects can result from misidentification or misuse of healing plants.
The geographical reach of this article is Sub-Saharan Africa. Though, neighbouring medical traditions have influenced traditional African medicine.
== History ==
=== Colonial era ===
Modern science has considered methods of traditional knowledge as primitive and under colonial rule some traditional medical practices were outlawed. During this time, attempts were also made to control the sale of herbal medicines. For example, after Mozambique gained independence in 1975, attempts to control traditional medicine went as far as sending diviner-healers to re-education camps. As colonialism and Christianity spread through Africa, colonialists built general hospitals and Christian missionaries built private ones, with the hopes of making headway against widespread diseases. However, little was done to investigate the legitimacy of the traditional medical practices, despite the obvious role that the traditional healers played in the basic health needs of their communities; the colonial authorities along with doctors and health practitioners continued to shun their contributions. It was also believed that during times of conflict people were more likely to resort to supernatural explanations and would seek treatment involving the supernatural.
=== Modern period ===
For various reasons, in the late 20th century the traditional systems of medical care in developing countries underwent a major revival. These countries also realized that modern health care systems and the technologies that they are dependent on are not locally manufactured and maintained thus making them expensive and rendering the population dependent on supply-chains that might be erratic or politicised. Due to this, interest in integrating traditional African medicine into the continent's national health care systems has increased and the use of traditional medicinal plants is being encouraged in some countries.
== Diagnostics ==
The medical diagnoses and chosen methods of treatment in traditional African medicine rely heavily on spiritual aspects, often based on the belief that psycho-spiritual aspects should be addressed before the medical aspects. There is the belief among the practitioners of traditional healing that the ability to diagnose and treat illnesses are a gift from God. Rather than looking for the medical or physical reasons behind an illness (or a spell of bad luck), traditional healers attempt to determine the root cause underlying it, which is believed to stem from a lack of balance between the patient and their social environment or the spiritual world. In other words, supernatural causes, not natural causes, are attributed to illnesses. According to the type of imbalance the individual is experiencing, an appropriate healing plant will be used, which is valued for its symbolic and spiritual significance as well as for its medicinal effect.
When a person falls ill, a traditional practitioner uses incantations to make a diagnosis. The incantations are thought to give the air of mystical and cosmic connections. Divination is typically used if the illness is not easily identified, otherwise, the sickness may be quickly diagnosed and a remedy prescribed. Sometimes the practitioner will advise the patient to consult a diviner who can give a diagnosis and recommend a treatment. It is believed that contact with the spirit world through divination often requires not only medication, but sacrifices.
== Treatments ==
Traditional practitioners use a wide variety of treatments ranging from standard medical treatments to the pseudoscientific and "magical". Treatments may include fasting, dieting, herbal therapies, bathing, massage, and surgical procedures. Examples of the pseudoscientific treatments include:

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The use of "bleed-cupping" (also called "wet cupping"), followed by herbal ointment and herbal drugs to treat Migraines, coughs, abscesses, and pleurisy.
Some cultures rub hot herbal ointment across the patient's eyelids to treat headaches.
A steaming mixture of herbs is both consumed and inhaled in the treatment of Malaria. Fevers are often treated using a steam bath.
Vomiting induced by emetics is used to treat alcoholism.
The fat of a boa constrictor is used to treat gout and rheumatism, and is thought to relieve chest pain when applied topically.
Animals are also sometimes used to transfer the illness to afterward or for the manufacture of medicines for zootherapy. For example, the bones of baboons are used to treat arthritis.
The terpenoids of the blister beetle (Mylabris sp.) are rubbed into the skin as a treatment for skin diseases.
Consensus between traders of the components of the medication used by practitioners of traditional African medicine regarding what should be used to treat different illnesses varies considerably, even within a small area such as the Faraday Street market in Johannesburg, South Africa. However, approximately 60%-80% of the people in Africa rely on traditional remedies to treat themselves for various diseases. A 2018 systematic review estimated that close to 60% of the general population in sub-Saharan Africa regularly use traditional and complementary medicine products for themselves and to treat their animals for various diseases. Ebola survivors in Sierra Leone have recently been reported to use traditional medicine alone or together with conventional medicine.
=== Medicinal plants ===
There are many plants in Africa that can be used for medicinal purposes and more than 4000 are used for this purpose in the tropical regions of Africa. Medicinal plants are used in the treatments of many diseases and illnesses, the uses and effects of which are of growing interest to Western societies. Not only are plants used and chosen for their healing abilities, but they also often have symbolic and spiritual significance. For example, leaves, seeds, and twigs that are white, black and red are seen as especially symbolic or magical and are believed to possess special properties.
One example of a medicinal plant is Pygeum (Prunus africana), which has been used as a treatment for mild benign prostatic hyperplasia in Europe since the 1970s. Although used extensively in Africa, there is insufficient evidence for its effectiveness in treating fever, inflammation, kidney disease, malaria, stomach aches and other conditions. In traditional African practice, the bark is made into tea, whereas elsewhere in the world it is found in powders, tinctures, and pills.
A 2007 study investigated the effectiveness of 16 plants, growing in South Africa's KwaZulu-Natal region, in lowering blood pressure "by acting as an ACE inhibitor." Of the 16 plants, only one (Tulbaghia violacea) showed promise. It then was tested on rats and "demonstrated hypotensive activity", i.e. reduction of blood pressure. The plants included in the study were:
Amaranthus dubius, a flowering plant, also known as spleen amaranth
Amaranthus hybridus, commonly known as smooth pig-weed or slim amaranth
Amaranthus spinosus, also known as spiny amaranth
Asystasia gangetica, an ornamental ground cover known as Chinese violet.
Centella asiatica, a small herbaceous annual plant commonly referred to as Asiatic pennywort
Ceratotheca triloba, a tall annual plant that flowers in summer sometimes referred to as poppy sue
Chenopodium album, also called lamb's quarters, this is a weedy annual plant
Emex australis, commonly known as southern three corner jack
Galinsoga parviflora, commonly referred to as gallant soldier
Justicia flava, also known as yellow justicia
Momordica balsamina, also known as the balsam apple
Oxygonum sinuatum, an invasive weed with no common name
Physalis viscosa, known as starhair ground cherry
Senna occidentalis, a very leafy tropical shrub, also called septic weed
Solanum nodiflorum, also known as white nightshade
Tulbaghia violacea, a bulbous plant with hairless leaves often referred to as society or wild garlic.
A 2008 literature survey was made to assess the botanical knowledge and uses within traditional medicine in Southern Africa for the genus Aloe within the family Asphodeloideae. Most common medical uses were for the treatment of "infections, internal parasites, digestive ailments and injuries." Socially the plants are used as ingredients in tobacco snuff. A 2014 literature survey found that at least 12 palm species in sub-Saharan Africa are used in various ritual practices, including the use of palm oil in healing mixtures.
In 2016 an in vitro study of the essential oil from Erigeron floribundus, used as a medicinal plant in Cameroon, demonstrated good activity against Staphylococcus aureus, "cytotoxicity on colon carcinoma cells" and "ferric reducing antioxidant power." Among the constituents of the essential oil are spathulenol and limonene.
As a result of a study conducted from 2011 to 2016, a traditional medicine from the tropical Olon tree, and another species of genus Zanthoxylum, was found to have synergistic compounds that kill both mosquitoes and their plasmodium parasites.
A 2000 study of thirty-three species of plants, found in the Eastern Cape province of South Africa, that are considered weeds, alien invaders or problem plants were investigated for their uses in traditional medicine. The plants included:
Anredera cordifolia (iDlula). Swollen feet from poor circulation and/or liver and kidney problems are treated with a leaf poultice, while the sap is used to treat a rash caused by contact with dirty water.
Araucaria bidwillii (iNdiyandyiya). Grated bark mixed with water is consumed to treat amenorrhea caused by congenital problems, tuberculosis and malnutrition.
Bidens pilosa (uMhlabangubo). The water from the boiled roots is consumed to treat infertility in women. Bathing in water in which the leaves have been soaked is believed to protect one from evil spirits (imoya emdaka), ill feeling, jealousy or animosity. Also used to treat diarrhoea, colic, rheumatism, syphilis, earache, constipation, intestinal worms, Malaria, ring worm, jaundice and coughs.

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Cannabis sativa (iNtsango). Various parts of the plant are used to treat asthma, bronchitis, headache, epilepsy, pains, colds, influenza, labour pains, hypertension, diabetes, malaria, blackwater fever, blood-poisoning, anthrax, dysentery, tetanus, menstrual cramps and rabies.
Carduus tenuiflorus (uMhlakavuthwa). The patient is given an emetic and instructed to vomit onto the plant. The belief is that the plant will "suck out the cause of the illness."
Datura stramonium (uQhwangu-qhwangu). The leaves are used to treat pain and swelling (including after a circumcision), boils and abscesses, measles, asthma and headaches, tetanus, foot ailments and respiratory conditions.
Emex australis (iNkunzane). A decoction of the root is used to treat constipation, biliousness and other stomach complaints and to stimulate appetite.
Galenia secunda (uMvenyathi). The roots are mixed with Emex australis, boiled and used to treat kidney pains in adults and colic in babies.
Lantana camara (iQunube). The roots are boiled and the liquid consumed for lower back or abdominal pain, or used as an enema to treat gonococcal infections and urinary tract infections. It is also used to treat coughs, colds, jaundice, rheumatism and as a contraceptive.
Opuntia ficus-indica (iTolofiya). A poultice of the cooked leaves is used to treat sores between toes and the fingers caused by fungal infections. The belief is that these sores are caused by "dirty blood" (igazi elimdaka).
Rumex sagittatus (iBhathatha). A cold water infusion of the roots are used as a body wash as it is believed to cleanse the body of misfortunes and evil.
Schinus molle (iPepile or Peperboom). Fever and influenza are treated by consuming a leaf decoction or steaming. A combination of leaves and bark is used to treat wounds.
Araujia sericifera (iQuwa). It is used to treat amafufunyana, which is described by Ngubane as an extreme form of depression coupled with psychotic symptoms such as delusions, hysteria, violent outburst and suicide ideations. The roots are mixed with other medications to treat it.
Argemone mexicana (iKhakhakhakha). This root decoction is mixed with the roots of the rubus pinnatus (iqunube) and is administered through the use of an enema to cure kidney pain.
=== Spirituality ===
Some healers may employ the use of charms, incantations, and the casting of spells in their treatments. For example, there is the belief among the Ibos of Nigeria that medicine men can implant something into a person from a distance to inflict sickness on them, in a process referred to asegba ogwu. To remove the malignant object, the intervention of a second medicine man is typically required, who then removes it by making an incision in the patient. A form of sympathetic magic is also used, in which a model is made of the victim and it is believed that actions performed on the model are transferred to the victim, in a manner similar to the familiar voodoo doll. Superstitious beliefs regarding spirits are also exploited and people are convinced that "spirits of deceased relatives trouble the living and cause illness." In these instances "medicine men prescribe remedies, often in the form of propitiatory sacrifice, in order to put them to rest so that they will no longer trouble the living, especially children."
According to Onwuanibe, Africans hold a religious world view which includes divine or spiritual intervention in medical practice. For example, the !Kung people of the Kalahari Desert believe that the great God Hishe created all things and, therefore, controls all sickness and death. Hishe presents himself to these medicine men in dreams and hallucinations, giving them curative power and this god is generous enough to give this power to the medicine men, they are expected to practice healing freely. The !Kung medicine men effect a treatment by performing a tribal dance.
== Traditional medicinal practitioners ==
Many traditional medicinal practitioners are people without formal education, who have rather received knowledge of medicinal plants and their effects on the human body from their forebears and by observation. Traditional practitioners and their practices vary but common features among them are a personal involvement in the healing process; protection of the therapeutic knowledge by keeping it a secret; and being rewarded for their services.
In a manner similar to orthodox medicinal practice, the practitioners of traditional medicine specialize in particular areas of their profession. Some, such as the inyangas of Eswatini are experts in herbalism, whilst others, such as the South African sangomas, are experts in spiritual healing as diviners, and others specialize in a combination of both forms of practice. There are also traditional bone setters and birth attendants. Herbalists are becoming more and more popular in Africa with an emerging herb trading market in Durban that is said to attract between 700,000 and 900,000 traders per year from South Africa, Zimbabwe, and Mozambique. Smaller trade markets exist in virtually every community. Their knowledge of herbs has been invaluable in African communities and they among the few who could gather them in most societies. Midwives also make extensive use of indigenous plants to aid childbirth. African healers commonly "describe and explain illness in terms of social interaction and act on the belief that religion permeates every aspect of human existence."
=== Payments ===
Traditional healers, like any other profession, are rewarded for their services. In African societies, the payment for a treatment depends on its efficacy. They do not request payment until after the treatment is given. This is another reason many prefer traditional healers to western doctors who require payment before the patient has assessed the effectiveness of the treatment. The payment methods have changed over time, with many practitioners now asking for monetary payment, especially in urban settings, rather than their receiving good in exchange, as happened formerly. There are also a growing number of fraudulent practitioners who are only interested in making money, especially in urban areas.

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=== Learning the trade ===
Some healers learn the trade through personal experience while being treated as a patient who decide to become healers upon recovery. Others become traditional practitioners through a "spiritual calling" and, therefore, their diagnoses and treatments are decided through belief in supernatural intervention. Another route is to receive the knowledge and skills passed down informally from a close family member such as a father or uncle, or even a mother or aunt in the case of midwives. Apprenticeship to an established practitioner, who formally teaches the trade over a long period of time and is paid for their tutoring, is another route to becoming a healer.
=== Importance ===
In Africa, traditional healers and remedies made from indigenous plants play a crucial role in the health of millions since as many as 85% of African routinely use these services for primary health care in Sub-Saharan Africa. The relative ratios of traditional practitioners and university trained doctors in relation to the whole population in African countries underscores this importance. Across Sub-Saharan Africa, from Ghana to Eswatini there are, on average almost, 100 traditional practitioner for every university trained doctor. This equates to one traditional healer for every 200 people in the Southern African region, which is a much greater doctor-to-patient ratio than is found in North America. In many parts of Africa there are few practitioners trained in modern medicine and traditional healers are a large and influential group in primary health care and an integral part of the African culture. Without them, many people would go untreated.
Medications and treatments that Western pharmaceutical companies manufacture are far too costly and not available widely enough for most Africans. Many rural African communities are not able to afford the high price of pharmaceuticals and can not readily obtain them even if they were affordable; therefore, healers are their only means of medical help. Because this form of medicine is "the most affordable and accessible system of health care for the majority of the African rural population," the African Union declared 2001 to 2010 to be the Decade for African Traditional Medicine with the goal of making "safe, efficacious, quality, and affordable traditional medicines available to the vast majority of the people."
Excessive use of plants is an ecological risk, as this may lead to their extinction.
== In relation to women ==
Women in Sub-Saharan rural African communities are almost entirely responsible for domestic work in their households. These women are often at higher risk for disease and poverty than their male counter-parts and have less control over their daily lives than them. A literature survey from 2001 found that these women defined 'good health' as the ability to perform domestic duties and the state of being disease free. Furthermore, the study found that they attributed poor health to supernatural, evil forces, that illness is seen as a form of punishment from spirits. In another study, which explored the HIV/AIDS epidemic in Ghana, women identified HIV/AIDS with reprobate behaviour, such as "prostitution, promiscuity, and extramarital relationships", or traveling to areas outside the community.
These women endure arduous conditions and a traditional healer plays an instrumental role in their daily lives. The traditional healer provides health care to the rural communities and represents him/herself as an honorable cultural leader and educator. An advantage of the traditional healer in rural areas is that they are conveniently located within the community. Modern medicine is normally not as accessible in rural areas because it is much more costly. Older rural women particularly tend to utilize traditional healers in their communities. Younger women and the urbanized have been found to be renouncing the use of traditional healers.
A 2001 study of rural Ethiopian women where HIV was present found that they rejected the presence of HIV in rural villages and claimed it was an urban illness, despite the presence of HIV in the rural communities. However, these women also claimed that their communities did not advocate for prevention, but rather treated an illness once it was present.
== Traditional African healers and HIV/AIDS ==
=== Role ===
For patients with HIV/AIDS, traditional healers provided a local, familiar, and accessible option compared to biomedical personnel who were usually overbooked and located farther away. Traditional healers were seen as having an authoritative role in physical, psychological, and spiritual aspects of health. In the early 1980s in southwestern Uganda, it was reported that many locals infected with the disease ("Slim") after showing symptoms of diarrhoea and weight-loss would consult traditional healers due to their belief in the connection between the disease and witchcraft.

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=== Criticism ===
During the HIV/AIDS epidemic traditional healers' methods were criticised by practitioners of modern medicine, and in particular the use of certain herbal treatments for HIV/AIDS. According to Edward Mills, herbal remedies are used as a therapy for HIV-symptoms such as "dermatological disorders, nausea, depression, insomnia, and weakness." While some of these remedies have been beneficial, the herbal treatments hypoxis and sutherlandia "may put the patients at risk for antiretroviral treatment failure, viral resistance, or drug toxicity" since they interact with antiretroviral treatments and prevent the expression of CYP3A4 and P-glycoprotein. This results in the inhibition of drug metabolism and transport. Peltzer et al. also found that an important issue with herbal medicines used in traditional medicine is that when a patient decides to see a doctor in addition to a traditional healer, they do not always mention that he or she is taking an herbal medicine. Herbal medicines can interact with the modern medicine prescribed by the doctor to treat HIV and negatively impact the patient. Peltzer et al. mentions that a "IGM-1 seem to be effective in symptom improvement, but generally no significant effect on antiviral or immunity enhancement among reviewed herbs was seen" for the treatment of HIV. Since HIV is such a volatile disease, it is imperative to try to boost the patient's immunity, not just relieve symptoms.
The ethical issue, as presented by modern medicine, is the complete lack of clinical trials to test any traditional African medicine before practicing with it on the public. Modern medicine in the United States is subject to The Nuremberg Code and the related Declaration of Helsinki which are the basis for the Code of Federal Regulations issued by the United States Department of Health and Human Services, to oblige humane behavior in experimenting on the public for the good of society. Since traditional African healers do not have to adhere to the Nuremberg code, there is a potential danger to society when healers do not practice medicine humanely.
Traditional healers have also been under scrutiny during the HIV/AIDS epidemic for unsanitary medical practices. The "re-use of medical instruments and lack of hygienic habits such as hand washing" have contributed to the spread of infectious diseases by traditional healers. A study of traditional healers in Nigeria found that 60% of the population was at risk because of the contamination spread by tradition healers.
Women experience the most fatal impact from the HIV/AIDS epidemic. When industrial development required the labor of men from rural communities, the men often left those communities and while away at the migratory camps many of these men would have sex with prostitutes, become infected with HIV and return home with it. Furthermore, since traditional medicine does not have an early detection method, infectious diseases are often spread unknowingly, allowing the 3.1 million people infected with HIV in sub-Saharan Africa to grow exponentially to 25.4 million in 2004. The patriarchal culture that defines traditional marriages in rural areas, places female sexuality under male control and decrees that women are not permitted to discuss and practice safe sex with their partners, which results in a higher risk for HIV exposure for women in rural areas.
=== Modern medicine ===
Sub-Saharan countries have found ways to unite modern medicine with traditional medicine due to the urgency of the HIV/AIDS epidemic. In South Africa, the Kundalia Foundation has provided funding to train traditional healers on HIV/AIDS. The training included prevention, safe sex, and knowledge about the virus.
== Relationship with modern medicine ==
There has been more interest expressed recently in the effects of some of the medicinal plants of Africa. "The pharmaceutical industry has come to consider traditional medicine as a source for identification of bio-active agents that can be used in the preparation of medicine." Pharmaceutical industries are looking into the medicinal effects of the most commonly and widely used plants to use in drugs. In comparing the techniques of African healers and Western techniques, T. Adeoze Lambo, a Nigerian psychiatrist, stated in 1979, "At about three years ago, we made an evaluation, a programme of their work, and compared this with our own, and we discovered that actually they were scoring almost sixty percent success in their treatment of neurosis. And we were scoring forty percent-in fact, less than forty percent."
=== Effectiveness ===
Herbal medicines in Africa are generally not adequately researched and are weakly regulated. There is a lack of the detailed documentation of the traditional knowledge, which is generally transferred orally. A literature survey in 2014, indicated that several African medicinal plants contain bioactive anti-trypanosomal compounds that could be used for the treatment of African trypanosomiasis ("Sleeping sickness") but no clinical studies had been conducted on them. A 2008 literature survey found that only a small proportion of ethnoveterinary medicine plants in South Africa had been researched for biological activity. A literature survey conducted in 2013 identified several compounds (mostly glucosides, sterols and sterolins) contained in the Hypoxis species, (known locally as inkomfe or African potato) that had been isolated and tested with "promising prospects reported in some studies". South African sangomas have been long and vocal advocates of a local traditional plant called unwele or kankerbos (Sutherlandia frutescens) claiming it assists in the treatment of HIV/AIDS, cancer and tuberculosis. A review of preclinical data on Sutherlandia frutescens show no toxity and justify controlled clinical studies. However, when used in conjunction with antiretroviral treatments, the herbal treatments hypoxis and sutherlandia "may put the patients at risk for antiretroviral treatment failure, viral resistance, or drug toxicity" since they interact with antiretroviral treatments and prevent the expression of CYP3A4 and P-glycoprotein.
There have been attempts to assess some traditional medicines through clinical trials, although none have so far reached phase III.

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=== Safety ===
A small proportion of ethnoveterinary medicine plants in South Africa have been researched for toxic effects. The possible adverse effects of South African traditional medicines are not well documented; there has been limited research into mutagenic properties and heavy metal contamination. Serious adverse effects, even death, can result from misidentification or misuse of healing plants. For example, various aloe plants are widely used in traditional African medicine, but some varieties, such as Aloe globuligemma, are toxic and can cause death. The potential for traditional African medicine and pharmacokinetic interactions is unknown, especially interactions between traditional treatments and antiretroviral drugs for HIV/AIDS. Herbal treatments are frequently used in Africa as a primary treatment for HIV/AIDS and for HIV-related issues. Collaboration with traditional healers has been recommended to determine what herbal treatments are used for HIV and to educate people supplying alternative treatments against unsafe practices. Given the demands of the local population on the use of traditional African medicine, it has been proposed that South African medical schools should inform medical students about traditional, supplementary and alternative medicine and the possible conflicts and interactions with modern medicine. Use of traditional African medicines as antivirals instead of using specific antiretroviral drugs, is especially a risk with HIV.
Cultural expectations play an important role in treatment as a 1985 study amongst the Mende people of Sierra Leone showed that treatment decisions were made "largely on traditional notions of the efficacy of a medicine of a particular color, consistency, taste, size and reputed success in treating analogous illnesses". This led to the inappropriate use of many modern medicines by the Mende.
== See also ==
Infant oral mutilation
Pharmacognosy
San healing practices
Traditional and Modern Health Practitioners Together against AIDS
Traditional Hausa medicine
Yorùbá medicine
Plant Resources of Tropical Africa
Ancient Egyptian medicine
== References ==
== External links ==
PROMETRA Official Website
THETA Uganda Official Website
Medicinal plants with Prof Ben-Erik van Wyk YouTube
== Bibliography ==
Bruchhausen, Walter (2018). Medicalized Healing in East Africa: The Separation of Medicine and Religion by Politics and Science. In: Lüddeckens, D., & Schrimpf, M. (2018). Medicine religion spirituality: Global perspectives on traditional, complementary, and alternative healing. Bielefeld: transcript Verlag. ISBN 978-3-8376-4582-8, pp. 2356.
Sobiecki, Jean-Francois (2023). African Psychoactive Plants: Journeys in Phytoalchemy. ISBN 978-0-6397-6385-9

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Alternative cancer treatment describes any cancer treatment or practice that is not part of the conventional standard of cancer care. These include special diets and exercises, chemicals, herbs, devices, and manual procedures. Most alternative cancer treatments do not have high-quality evidence supporting their use and many have been described as fundamentally pseudoscientific. Concerns have been raised about the safety of some purported treatments, and some have been found unsafe in clinical trials. Despite this, many untested and disproven treatments are used around the world.
Alternative cancer treatments are typically contrasted with experimental cancer treatments science-based treatment methods and complementary treatments, which are non-invasive practices used in combination with conventional treatment. All approved chemotherapy medications were considered experimental treatments before completing safety and efficacy testing.
Since the late 19th century, medical researchers have established modern cancer care through the development of chemotherapy, radiation therapy, targeted therapies, and refined surgical techniques. As of 2019, only 32.9% of cancer patients in the United States died within five years of their diagnosis. Despite their effectiveness, many conventional treatments are accompanied by a wide range of side effects, including pain, fatigue, and nausea. Some side effects can even be life-threatening. Many supporters of alternative treatments claim increased effectiveness and decreased side effects when compared to conventional treatments. However, one retrospective cohort study showed that patients using alternative treatments instead of conventional treatments were 2.5 times more likely to die within five years.
Most alternative cancer treatments have not been tested in proper clinical trials. Among studies that have been published, the quality is often poor. A 2006 review of 196 clinical trials that studied unconventional cancer treatments found a lack of early-phase testing, little rationale for dosing regimens, and poor statistical analyses. These treatments have appeared and vanished throughout history.
== Terminology ==
Complementary and alternative cancer treatments are often grouped, in part because of the adoption of the phrase complementary and alternative medicine by the United States Congress. The World Health Organization uses the phrase traditional, complementary, and integrative medicine (TCIM) to describe a similar set of treatments.
Complementary treatments are used in conjunction with proven mainstream treatments. They tend to be pleasant for the patient, not involve substances with any pharmacological effects, inexpensive, and intended to treat side effects rather than to kill cancer cells. Medical massage and self-hypnosis to treat pain are examples of complementary treatments.
About half the practitioners who dispense complementary treatments are physicians, although they tend to be generalists rather than oncologists. As many as 60% of American physicians have referred their patients to a complementary practitioner for some purpose. While conventional physicians should always be kept aware of any complementary treatments used by a patient, many physicians in the United Kingdom are at least tolerant of their use, and some might recommend them.
Alternative treatments, by contrast, are used in place of mainstream treatments. The most popular alternative cancer therapies include restrictive diets, mind-body interventions, bioelectromagnetics, nutritional supplements, and herbs. The popularity and prevalence of different treatments varies widely by region. Cancer Research UK warns that alternative treatments may interact with conventional treatment, may increase the side effects of medication, and can give people false hope.
== Prevalence ==
Survey data about how many cancer patients use alternative or complementary therapies vary from nation to nation as well as from region to region. Reliance on alternative therapies is common in developing countries because people cannot afford effective medical treatment. For example, in Latin America, most cancer patients have used natural products, nutritional supplements, and spiritual practices (such as praying) in addition to, or instead of, medical care. In Africa, where millions of people do not have financial or geographical access to an oncologist, many Africans with cancer rely on traditional African medicine, which uses divination, spiritualism, and herbal medicine. About 40% of African cancer patients take herbal preparations. Three-quarters of Chinese people with cancer use some form of Traditional Chinese medicine, especially Chinese herbal preparations. About a third of people with cancer in India use Ayurveda or other elements of AYUSH.
A 2000 study published by the European Journal of Cancer evaluated a sample of 1023 women from a British cancer registry who had breast cancer and found that 22.4% had consulted with a practitioner of complementary therapies in the previous twelve months. The study concluded that the patients had spent many thousands of pounds on such measures and that use "of practitioners of complementary therapies following diagnosis is a significant and possibly growing phenomenon".
In Australia, one study reported that 46% of children with cancer have been treated with at least one non-traditional therapy. Further, 40% of those of any age receiving palliative care had tried at least one such therapy. Some of the most popular alternative cancer treatments were found to be dietary therapies, antioxidants, high dose vitamins, and herbal therapies.
In the United States, nearly all adults who use non-conventional medical therapies do so in addition to conventional medical treatment, rather than as an alternative to it. Use of unconventional cancer treatments in the United States has been influenced by the U.S. federal government's National Center for Complementary and Alternative Medicine (NCCAM), initially known as the Office of Alternative Medicine (OAM), which was established in 1992 as a National Institutes of Health (NIH) adjunct by the U.S. Congress. More specifically, the NIC's Office of Cancer Complementary and Alternative Medicine sponsors over $105 million a year in grants for pseudoscientific cancer research. Over thirty American medical schools have offered general courses in alternative medicine, including the Georgetown, Columbia, and Harvard university systems, among others.

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== People who choose alternative treatments ==
People drawn to alternative treatments tend to believe that evidence-based medicine is invasive or ineffective, while still hoping that their health could be improved. They are loyal to their alternative healthcare providers and believe that "treatment should concentrate on the whole person". Among people who (correctly or incorrectly) believe their condition is untreatable, "desperation drives them into the hands of anyone with a promise and a smile." Con artists have long exploited patients' perceived lack of options to extract payments for ineffectual and even harmful treatments.
No evidence suggests that the use of alternative treatments improves survival. In 2017, one retrospective, observational study suggested that people who chose alternative medicine instead of conventional treatments were more than twice as likely to die within five years of diagnosis. Breast cancer patients choosing alternative medicine were 5.68 times more likely to die within five years of diagnosis.
Although they are more likely to die than non-users, some users of alternative treatments feel a greater sense of control over their destinies and report less anxiety and depression. They are more likely to engage in benefit finding, which is the psychological process of adapting to a traumatic situation and deciding that the trauma was valuable, usually because of perceived personal and spiritual growth during the crisis.
In a survey of American cancer patients, baby boomers were more likely to support complementary and alternative treatments than people from an older generation. White, female, college-educated patients who had been diagnosed more than a year ago were more likely than others to report a favorable impression of at least some complementary and alternative benefits.
== Unproven and disproven treatments ==
Many therapies without evidence have been promoted to treat or prevent cancer in humans. In many cases, evidence suggests that the treatments do not work. Unlike accepted cancer treatments, unproven and disproven treatments are generally ignored or avoided by the medical community.
Despite this, many of these therapies have continued to be promoted as effective, particularly by promoters of alternative medicine. Scientists consider this practice quackery, and some of those engaged in it have been investigated and prosecuted by public health regulators such as the US Federal Trade Commission, the Mexican Secretariat of Health and the Canadian Competition Bureau. In the United Kingdom, the Cancer Act makes the unauthorized promotion of cancer treatments a criminal offense.
In 2008, the United States Federal Trade Commission acted against some companies that made unsupported claims that their products, some of which included highly toxic chemicals, could cure cancer. Targets included Omega Supply, Native Essence Herb Company, Daniel Chapter One, Gemtronics, Inc., Herbs for Cancer, Nu-Gen Nutrition, Inc., Westberry Enterprises, Inc., Jim Clark's All Natural Cancer Therapy, Bioque Technologies, Cleansing Time Pro, and Premium-essiac-tea-4less.
== Areas of research ==
=== Specific methods ===
Curcumin is a component of turmeric. It is under preliminary research for therapeutic potential, but according to Cancer Research UK no reputable organization supports claims that it can "cure" cancer.
Psilocybin is a psychedelic compound found in more than 100 mushroom species. Three small trials have demonstrated decreased cancer-related psychiatric distress, including anxiety and depression with its use.
HuaChanSu, traditional Chinese medicine derived from the parotoid gland secretion of toads of the genus Bufo.
Medical cannabis (for "appetite stimulation" and "pain")
Selenium
=== Pain relief ===
Most studies of complementary and alternative medicine in the treatment of cancer pain are of low quality in terms of scientific evidence. Studies of massage therapy have produced mixed results, but overall show some temporary benefit for reducing pain, anxiety, and depression and a very low risk of harm, unless the patient is at risk for bleeding disorders. There is weak evidence for a modest benefit from hypnosis, supportive psychotherapy and cognitive therapy. Results about Reiki and touch therapy were inconclusive. The most studied such treatment, acupuncture, has demonstrated no benefit as an adjunct analgesic in cancer pain. The evidence for music therapy is equivocal, and some herbal interventions such as PC-SPES, mistletoe, and saw palmetto are known to be toxic to some cancer patients. The most promising evidence, though still weak, is for mindbody interventions such as biofeedback and relaxation techniques.
== Examples of complementary therapy ==
As stated in the scientific literature, the measures listed below are defined as 'complementary' because they are applied in conjunction with mainstream anti-cancer measures such as chemotherapy, in contrast to the ineffective therapies viewed as 'alternative' since they are offered as substitutes for mainstream measures.
Acupuncture may help with nausea but does not treat the disease. A 2015 Cochrane review found unclear usefulness for cancer pain, though other reviews have found tentative evidence of benefit. It is of unclear effect in hot flashes in people with breast cancer.
The effects of aromatherapy are unclear, with no peer-reviewed research in regards to cancer treatment.
Psychotherapy may reduce anxiety and improve quality of life as well as allow for improving patient moods.
Massage therapy may temporarily reduce pain.
There is no evidence that cannabis has a beneficial effect in preventing or treating cancer in humans.
Hypnosis and meditation may improve the quality of life of cancer patients.
Music therapy eases cancer-related symptoms by helping with mood disturbances.
== Alternative theories of cancer ==
Some alternative cancer treatments are based on unproven or disproven theories of how cancer begins or is sustained in the body. Some common concepts are:

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=== Mind-body connection ===
This idea says that cancer progression is related to a person's mental and emotional state. Treatments based on this idea are mindbody interventions. Proponents say that cancer forms because the person is unhappy or stressed, or that a positive attitude can cure cancer after it has formed. A typical claim is that stress, anger, fear, or sadness depresses the immune system, whereas love, forgiveness, confidence, and happiness cause the immune system to improve, and that this improved immune system will destroy the cancer. This belief that generally boosting the immune system's activity will kill the cancer cells is not supported by any scientific research. In fact, many cancers require the support of an active immune system (especially through inflammation) to establish the tumor microenvironment necessary for a tumor to grow.
=== Toxin theory of cancer ===
In this idea, the body's metabolic processes are overwhelmed by normal byproducts. These byproducts, called "toxins", are said to build up in the cells and cause cancer and other diseases through a process sometimes called autointoxication or autotoxemia. Treatments following this approach are usually aimed at detoxification or body cleansing, such as enemas.
=== Low activity by the immune system ===
This claim asserts that if only the body's immune system were strong enough, it would kill the "invading" or "foreign" cancer. Unfortunately, most cancer cells retain normal cell characteristics, making them appear to the immune system to be a normal part of the body. Cancerous tumors also actively induce immune tolerance, which prevents the immune system from attacking them.
=== Epigenetic disregulation ===
This claim uses research into the mechanism of epigenetics to understand how mutations in the epigenetic machinery of cells will alter histone acetylation patterns to create cancer epigenetics. DNA damage appears to be the primary underlying cause of cancer. If DNA repair is deficient, DNA damage tends to accumulate. Such excess DNA damage can increase mutational errors during DNA replication due to error-prone translesion synthesis. Excess DNA damage can also increase epigenetic alterations due to errors during DNA repair. Such mutations and epigenetic alterations can give rise to cancer.
== See also ==
Diet and cancer
Clinical trial
Placebo effect
Pseudoscience
List of topics characterized as pseudoscience
The Truth About Cancer
== References ==
== External links ==
Cure-ious? Ask. If you or someone you care about has cancer, the last thing you need is a scam from the US Federal Trade Commission
187 Cancer Cure Frauds from the US Food and Drug Administration
Herbs, Botanicals & Other Products from Memorial Sloan-Kettering Cancer Center

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Alternative medicine refers to practices that aim to achieve the healing effects of medicine, but that by definition lack biological plausibility, testability, repeatability, or supporting evidence of effectiveness. Such practices are not part of evidence-based medicine. Unlike modern medicine, which employs the scientific method to test plausible therapies by way of responsible and ethical clinical trials, producing repeatable evidence of either effect or of no effect, alternative therapies reside outside of mainstream medicine and do not originate from using the scientific method, but instead rely on testimonials, anecdotes, religion, tradition, superstition, belief in supernatural "energies", pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources. Frequently used terms for relevant practices are New Age medicine, pseudo-medicine, unorthodox medicine, holistic medicine, fringe medicine, and unconventional medicine, with little distinction from quackery.
Some alternative practices are based on theories that contradict the established science of how the human body works; others appeal to the supernatural or superstitions to explain their effect or lack thereof. In others, the practice has plausibility but lacks a positive riskbenefit outcome probability. Research into alternative therapies often fails to follow proper research protocols (such as placebo-controlled trials, blind experiments and calculation of prior probability), providing invalid results. History has shown that if a method is proven to work, it eventually ceases to be alternative and becomes mainstream medicine.
Much of the perceived effect of an alternative practice arises from a belief that it will be effective, the placebo effect, or from the treated condition resolving on its own (the natural course of disease). This is further exacerbated by the tendency to turn to alternative therapies upon the failure of medicine, at which point the condition will be at its worst and most likely to spontaneously improve. In the absence of this bias, especially for diseases that are not expected to get better by themselves such as cancer or HIV infection, multiple studies have shown significantly worse outcomes if patients turn to alternative therapies. While this may be because these patients avoid effective treatment, some alternative therapies are actively harmful (such as cyanide poisoning from amygdalin, or the intentional ingestion of hydrogen peroxide) or actively interfere with effective treatments.
The alternative medicine sector is a highly profitable industry with a strong lobby, and faces far less regulation over the use and marketing of unproven treatments. Complementary medicine (CM), complementary and alternative medicine (CAM), functional medicine (FM), integrated medicine or integrative medicine (IM), and holistic medicine attempt to combine alternative practices with those of mainstream medicine. Traditional medicine practices become "alternative" when used outside their original settings and without proper scientific explanation and evidence. Alternative methods are often marketed as more "natural" or "holistic" than methods offered by medical science, that is sometimes derogatorily called "Big Pharma" by supporters of alternative medicine. Billions of dollars have been spent studying alternative medicine, with few or no positive results and many methods thoroughly disproven.
== Definitions and terminology ==
The terms alternative medicine, complementary medicine, integrative medicine, holistic medicine, natural medicine, unorthodox medicine, fringe medicine, unconventional medicine, and new age medicine are used interchangeably as having the same meaning and are almost synonymous in most contexts. Terminology has shifted over time, reflecting the preferred branding of practitioners. For example, the department of the United States National Institutes of Health studying alternative medicine is currently named the National Center for Complementary and Integrative Health (NCCIH), but it was established as the Office of Alternative Medicine (OAM) and then renamed the National Center for Complementary and Alternative Medicine (NCCAM) before now. Therapies are often framed as "natural" or "holistic", implicitly and intentionally suggesting that conventional medicine is "artificial" and "narrow in scope".
The meaning of the term "alternative" in the expression "alternative medicine", is not that it is an effective alternative to medical science (though some alternative medicine promoters may use the loose terminology to give the appearance of effectiveness). Loose terminology may also be used to suggest meaning that a dichotomy exists when it does not (such as the use of the expressions Western medicineand Eastern medicine to suggest a cultural difference between the Asian east and the European west, rather than that the difference is between evidence-based medicine and treatments that do not work).
=== Alternative medicine ===
Alternative medicine is defined loosely as a set of products, practices, and theories that are believed or perceived by their users to have the healing effects of medicine, but whose effectiveness has not been established using scientific methods, or whose theory and practice is not part of biomedicine, or whose theories or practices are directly contradicted by scientific evidence or scientific principles used in biomedicine. "Biomedicine" or "medicine" is that part of medical science that applies principles of biology, physiology, molecular biology, biophysics, and other natural sciences to clinical practice, using scientific methods to establish the effectiveness of that practice. Unlike medicine, an alternative product or practice does not originate from using scientific methods, but may instead be based on hearsay, religion, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources.
Some other definitions seek to specify alternative medicine in terms of its social and political marginality to mainstream healthcare. This can refer to the lack of support that alternative therapies receive from medical scientists regarding access to research funding, sympathetic coverage in the medical press, or inclusion in the standard medical curriculum. For example, a widely used definition devised by the National Center for Complementary and Alternative Medicine (NCCIH) calls it "a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine". However, these descriptive definitions are inadequate in the present-day when some conventional doctors offer alternative medical treatments and introductory courses or modules can be offered as part of standard undergraduate medical training; alternative medicine is taught in more than half of US medical schools and US health insurers are increasingly willing to provide reimbursement for alternative therapies.
=== Complementary or integrative medicine ===

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Complementary medicine (CM) or integrative medicine (IM) is when alternative medicine is used together with mainstream medical treatment in a belief that it improves the effect of treatments. Several medical organizations differentiate between complementary and alternative medicine including the UK National Health Service (NHS), Cancer Research UK, and the US Center for Disease Control and Prevention (CDC), the latter of which states that "Complementary medicine is used in addition to standard treatments" whereas "Alternative medicine is used instead of standard treatments." For example, acupuncture (piercing the body with needles to influence the flow of energy) might be believed to increase the effectiveness or "complement" science-based medicine when used at the same time. Significant drug interactions caused by alternative therapies may make treatments less effective, notably in cancer therapy.
Some mainstream academic medical centers have integrative or functional medicine departments, including the Cleveland Clinic, the Mayo Clinic, Stanford University, UCLA, UC San Francisco and Northwestern University. In contrast, other medical practitioners are unconvinced by these practices. For example, surgical oncologist, David Gorski has described integrative medicine as an attempt to bring pseudoscience into academic science-based medicine with skeptics such as Gorski and David Colquhoun referring to this with the pejorative term "quackademia". Robert Todd Carroll described integrative medicine as "a synonym for 'alternative' medicine that, at its worst, integrates sense with nonsense. At its best, integrative medicine supports both consensus treatments of science-based medicine and treatments that the science, while promising perhaps, does not justify." Rose Shapiro has criticized the field of alternative medicine for rebranding the same practices as integrative medicine.
CAM is an acronym for complementary and alternative medicine. The 2019 World Health Organization (WHO) Global Report on Traditional and Complementary Medicine states that the terms complementary and alternative medicine "refer to a broad set of health care practices that are not part of that country's own traditional or conventional medicine and are not fully integrated into the dominant health care system. They are used interchangeably with traditional medicine in some countries."
The Integrative Medicine Exam by the American Board of Physician Specialties includes the following subjects: Manual Therapies, Biofield Therapies, Acupuncture, Movement Therapies, Expressive Arts, Traditional Chinese Medicine, Ayurveda, Indigenous Medical Systems, Homeopathic Medicine, Naturopathic Medicine, Osteopathic Medicine, Chiropractic, and Functional Medicine.
=== Functional medicine ===
Functional medicine (FM) is a form of alternative medicine that encompasses many unproven and disproven methods and treatments. It is a rebranding of complementary and alternative medicine (CAM), and as such is pseudoscientific, and has been described as a form of quackery. In the US, FM practices have been ruled ineligible for course credits by the American Academy of Family Physicians because of concerns they may be harmful. Functional medicine was created by Jeffrey Bland, who founded The Institute for Functional Medicine (IFM), which is based in the US state of Washington, in the early 1990s as part of one of his companies, HealthComm. IFM, which promotes functional medicine, became a registered non-profit in 2001. Mark Hyman became an IFM board member and prominent promoter.
David Gorski, a surgical oncologist at Wayne State University, has written that FM is not well-defined and performs "expensive and generally unnecessary tests". Gorski says FM's vagueness is a deliberate tactic that makes functional medicine difficult to challenge. In an analysis for the Office for Science and Society at McGill University, Jonathan Jarry writes "Test enough people and you get a lot of false positives, which generate anxiety, more invasive tests, and sometimes unnecessary treatments." Proponents of functional medicine oppose established medical knowledge and reject its models, instead adopting a model of disease based on the notion of "antecedents", "triggers", and "mediators". These are meant to correspond to the underlying causes of health issues, the immediate causes, and the particular characteristics of a person's illness. A functional medicine practitioner devises a "matrix" from these factors to serve as the basis for treatment. Treatments, practices, and concepts are generally not supported by medical evidence. Patients of functional medicine practitioners may also be told to undertake unnecessary diets that can limit food choices. Jonathan Stea writes that functional medicine, integrative medicine, and CAM "are marketing terms designed to confuse patients, promote pseudoscience, and sow distrust in mainstream medicine."
In the 1990s, integrative medicine started to be marketed by a new term, "functional medicine". FM practitioners claim to diagnose and treat conditions that have been found by research studies not to exist, such as adrenal fatigue and numerous imbalances in body chemistry. For instance, contrary to scientific evidence, Joe Pizzorno, a major figure in FM, claimed that 25% of people in the United States have heavy metal poisoning and need to undergo detoxification. Many scientists state that such detox supplements are a waste of time and money. Detox has been also called "mass delusion". In 2014, the American Academy of Family Physicians withdrew course credits for functional medicine courses, having identified some of its treatments as "harmful and dangerous". In 2018, it partly lifted the ban, but only to allow overview classes, not to teach its practice. The opening of centers for functional medicine at the Cleveland Clinic and George Washington University was described by David Gorski as an "unfortunate" example of "quackademia" — that is, a quackery infiltrating academic medical centers.
=== Other terms ===

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Alternative therapies typically lack any scientific validation, and their effectiveness either is unproven or has been disproved.
It is usually based on religion, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, or fraud.
Methods may incorporate or base themselves on traditional medicine, folk knowledge, spiritual beliefs, ignorance or misunderstanding of scientific principles, errors in reasoning, or newly conceived approaches claiming to heal.
Research on alternative medicine is frequently of low quality and methodologically flawed.
Treatments are not part of the conventional, science-based healthcare system.
Where alternative therapies have replaced conventional science-based medicine, even with the safest alternative medicines, failure to use or delay in using conventional science-based medicine has caused deaths.
Many alternative medical treatments are not patentable, which may lead to less research funding from the private sector. In addition, in most countries, alternative therapies (in contrast to pharmaceuticals) can be marketed without any proof of efficacy also a disincentive for manufacturers to fund scientific research.
English evolutionary biologist Richard Dawkins, in his 2003 book A Devil's Chaplain, defined alternative medicine as a "set of practices that cannot be tested, refuse to be tested, or consistently fail tests." Dawkins argued that if a technique is demonstrated effective in properly performed trials then it ceases to be alternative and simply becomes medicine.
CAM is also often less regulated than conventional medicine. There are ethical concerns about whether people who perform CAM have the proper knowledge to treat patients. CAM is often done by non-physicians who do not operate with the same medical licensing laws which govern conventional medicine, and it is often described as an issue of non-maleficence.
According to two writers, Wallace Sampson and K. Butler, marketing is part of the training required in alternative medicine, and propaganda methods in alternative medicine have been traced back to those used by Hitler and Goebbels in their promotion of pseudoscience in medicine.
In November 2011 Edzard Ernst stated that the "level of misinformation about alternative medicine has now reached the point where it has become dangerous and unethical. So far, alternative medicine has remained an ethics-free zone. It is time to change this."
Harriet Hall criticized the low standard of evidence accepted by the alternative medicine community:
Science-based medicine has one rigorous standard of evidence, the kind [used for pharmaceuticals] .... CAM has a double standard. They gladly accept a lower standard of evidence for treatments they believe in. However, I suspect they would reject a pharmaceutical if it were approved for marketing on the kind of evidence they accept for CAM.
=== Conflicts of interest ===
Some commentators have said that special consideration must be given to the issue of conflicts of interest in alternative medicine. Edzard Ernst has said that most researchers into alternative medicine are at risk of "unidirectional bias" because of a generally uncritical belief in their chosen subject. Ernst cites as evidence the phenomenon whereby 100% of a sample of acupuncture trials originating in China had positive conclusions. David Gorski contrasts evidence-based medicine, in which researchers try to disprove hyphotheses, with what he says is the frequent practice in pseudoscience-based research, of striving to confirm pre-existing notions. Harriet Hall writes that there is a contrast between the circumstances of alternative medicine practitioners and disinterested scientists: in the case of acupuncture, for example, an acupuncturist would have "a great deal to lose" if acupuncture were rejected by research; but the disinterested skeptic would not lose anything if its effects were confirmed; rather their change of mind would enhance their skeptical credentials.
=== Use of health and research resources ===
Research into alternative therapies has been criticized for "diverting research time, money, and other resources from more fruitful lines of investigation in order to pursue a theory that has no basis in biology." Research methods expert and author of Snake Oil Science, R. Barker Bausell, has stated that "it's become politically correct to investigate nonsense." A commonly cited statistic is that the US National Institute of Health had spent $2.5 billion on investigating alternative therapies prior to 2009, with none being found to be effective.
== See also ==
Alternative therapies for developmental and learning disabilities
Conservation medicine
Ethnomedicine
Psychic surgery
Siddha medicine
Thomsonianism, in United States early 19th century
Chelation of heavy metals in autism
Ancient Greek medicine
== Notes ==
== References ==

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== Bibliography ==
Bivins, R. (2007). Alternative Medicine? A History. Oxford University Press. ISBN 978-0-19-921887-5.
Board of Science and Education, British Medical Association (1993). Complementary Medicine: New Approaches to Good Practice. Oxford University Press. ISBN 978-0-19-286166-5.
Callahan, D., ed. (2004). The Role of Complementary and Alternative Medicine: Accommodating Pluralism. Washington, D.C.: Georgetown University Press. ISBN 978-1-58901-464-0.
Cohen, Michael H. (1998). Complementary & Alternative Medicine: Legal Boundaries and Regulatory Perspectives. Baltimore: Johns Hopkins University Press. ISBN 978-0-8018-5689-1.
Committee on the Use of Complementary and Alternative Medicine by the American Public for the Board on Health Promotion and Disease Prevention, Institute of Medicine (2005). Complementary and Alternative Medicine in the United States. Washington, D.C.: National Academy Press. ISBN 978-0-309-09270-8.
Gevitz, N. (1997) [1993]. "Chapter 28: Unorthodox Medical Theories". In Bynum, W.F.; Porter, R.S. (eds.). Companion Encyclopedia of the History of Medicine. Vol. 1. New York & London: Routledge. ISBN 978-0-415-16419-1.
Hahnemann, S. (1833). The Homœopathic Medical Doctrine, or "Organon of the Healing Art". Translated by Devrient, C.H. Annotated by Stratten, S. Dublin: W.F. Wakeman.
Kasper, Dennis L; Fauci, Anthony S.; Hauser, Stephen L.; Longo, Dan L.; Jameson, J. Larry; Loscalzo, Joseph (2015). Harrison's Principles of Internal Medicine (19th ed.). New York: McGraw Hill Education. ISBN 978-0-07-180215-4.
Kopelman, L. "The Role of Science in Assessing Conventional, Complementary, and Alternative Medicines". In Callahan (2004), pp. 3653.
Mishra, Lakshmi Chandra (2004). Scientific Basis for Ayurvedic Therapies. Boca Raton: CRC Press. ISBN 978-0-8493-1366-0.
O'Connor, Bonnie Blair (1995). Healing Traditions: Alternative Medicine and the Health Professions. Philadelphia: University of Pennsylvania Press. ISBN 978-0-8122-1398-0.
Ruggie, M. (2004). Marginal to Mainstream: Alternative Medicine in America. Cambridge University Press. ISBN 978-0-521-83429-2.
Sagan, C. (1996). The Demon-Haunted World: Science As a Candle in the Dark. New York: Random House. ISBN 978-0-394-53512-8.
Saks, M. (2003). Orthodox and Alternative Medicine: Politics, Professionalization and Health Care. Sage Publications. ISBN 978-1-4462-6536-9.
Sointu, E. (2012). Theorizing Complementary and Alternative Medicines: Wellbeing, Self, Gender, Class. Basingstoke, England: Palgrave Macmillan. ISBN 978-0-230-30931-9.
Taylor, Kim (2005). Chinese Medicine in Early Communist China, 194563: a Medicine of Revolution. Needham Research Institute Studies. London and New York: RoutledgeCurzon. ISBN 978-0-415-34512-5.
Walton J. (2000) [Session 19992000, HL 123]. Sixth Report: Complementary and Alternative Medicine. London: The Stationery Office. ISBN 978-0-10-483100-7.
Wieland, L.S.; et al. (2011). "Development and classification of an operational definition of complementary and alternative medicine for the Cochrane Collaboration". Alternative Therapies in Health and Medicine. 17 (2): 5059. PMC 3196853. PMID 21717826.
Wujastyk, D., ed. (2003). The Roots of Ayurveda: Selections from Sanskrit Medical Writings. Translated by D. Wujastyk. London and New York: Penguin Books. ISBN 978-0-14-044824-5.
General Guidelines for Methodologies on Research and Evaluation of Traditional Medicine (PDF). Vol. WHO/EDM/TRM/2001.1. Geneva: World Health Organization (WHO). 2000. Archived (PDF) from the original on 2022-10-09. This document is not a formal publication of the WHO. The views expressed in documents by named authors are solely the responsibility of those authors.
WHO Guidelines on Basic Training and Safety in Chiropractic (PDF). Geneva: WHO. 2005. ISBN 978-92-4-159371-7. Archived (PDF) from the original on 2022-10-09.
== Further reading ==
Bausell, R.B (2007). Snake oil science: the truth about complementary and alternative medicine. Oxford University Press. ISBN 978-0-19-531368-0.
Benedetti, F.; et al. (2003). "Open versus hidden medical treatments: The patient's knowledge about a therapy affects the therapy outcome". Prevention & Treatment. 6 (1). doi:10.1037/1522-3736.6.1.61a.
Dawkins, R. (2001). "Foreword". In Diamond, J. (ed.). Snake Oil and Other Preoccupations. London: Vintage. ISBN 978-0-09-942833-6. Reprinted in Dawkins 2003.
Downing AM, Hunter DG (2003). "Validating clinical reasoning: A question of perspective, but whose perspective?". Manual Therapy. 8 (2): 117119. doi:10.1016/S1356-689X(02)00077-2. PMID 12890440.
Eisenberg DM (July 1997). "Advising patients who seek alternative medical therapies". Annals of Internal Medicine. 127 (1): 6169. doi:10.7326/0003-4819-127-1-199707010-00010. PMID 9214254. S2CID 23351104.
Gunn IP (December 1998). "A critique of Michael L. Millenson's book, Demanding Medical Excellence: Doctors and Accountability in the Information Age, and its Relevance to CRNAs and Nursing". AANA Journal. 66 (6): 575582. ISSN 0094-6354. PMID 10488264.
Hand, W.D. (1980). "Folk Magical Medicine and Symbolism in the West". Magical Medicine. Berkeley: University of California Press. pp. 305319. ISBN 978-0-520-04129-5. OCLC 6420468.
Illich, I. (1976). Limits to Medicine: Medical Nemesis: The Expropriation of Health. Penguin. ISBN 978-0-14-022009-4. OCLC 4134656.
Mayo Clinic (2007). Mayo Clinic Book of Alternative Medicine: The New Approach to Using the Best of Natural Therapies and Conventional Medicine. Parsippany, New Jersey: Time Home Entertainment. ISBN 978-1-933405-92-6.
Planer, F.E. (1988). Superstition (Rev. ed.). Buffalo, New York: Prometheus Books. ISBN 978-0-87975-494-5. OCLC 18616238.
Rosenfeld, A. (c. 2000). "Where Do Americans Go for Healthcare?". Cleveland, Ohio: Case Western Reserve University. Archived from the original on 2006-05-09. Retrieved 2010-09-23.
Snyder, Mariah; Lindquist, Ruth (May 2001). "Issues in Complementary Therapies: How We Got to Where We Are". Online Journal of Issues in Nursing. 6 (2): 1. PMID 11469921. Archived from the original on 2017-02-03. Retrieved 2017-01-18.
Stevens, P. Jr. (NovemberDecember 2001). "Magical thinking in complementary and alternative medicine". Skeptical Inquirer.
Tonelli MR (2001). "The limits of evidence-based medicine". Respiratory Care. 46 (12): 14351440, discussion 14401441. PMID 11728302.
Trivieri, L. Jr. (2002). Anderson, J.W. (ed.). Alternative Medicine: The Definitive Guide. Berkeley: Ten Speed Press. ISBN 978-1-58761-141-4.
Wisneski, L.A.; et al. (2005). The scientific basis of integrative medicine. CRC Press. ISBN 978-0-8493-2081-1.
Zalewski, Z. (1999). "Importance of philosophy of science to the history of medical thinking". CMJ. 40 (1): 813. PMID 9933889. Archived from the original on 2004-02-06.
=== World Health Organization ===
Benchmarks for training in traditional / complementary and alternative medicine
WHO Kobe Centre; Bodeker, G.; et al. (2005). WHO Global Atlas of Traditional, Complementary and Alternative Medicine. WHO. ISBN 978-92-4-156286-7. Summary.
=== Journals ===
Alternative Medicine Review: A Journal of Clinical Therapeutics. Sandpoint, Idaho : Thorne Research, c. 1996 NLM ID: 9705340 Archived 2018-06-12 at the Wayback Machine
Alternative Therapies in Health and Medicine. Aliso Viejo, California : InnoVision Communications, c1995- NLM ID: 9502013 Archived 2018-06-12 at the Wayback Machine
BMC Complementary and Alternative Medicine Archived 2015-09-24 at the Wayback Machine. London: BioMed Central, 2001 NLM ID: 101088661 Archived 2018-06-12 at the Wayback Machine
Complementary Therapies in Medicine. Edinburgh; New York : Churchill Livingstone, c. 1993 NLM ID: 9308777 Archived 2018-06-12 at the Wayback Machine
Evidence Based Complementary and Alternative Medicine: eCAM. New York: Hindawi, c. 2004 NLM ID: 101215021 Archived 2018-09-14 at the Wayback Machine
Forschende Komplementärmedizin / Research in Complementary Medicine
Journal for Alternative and Complementary Medicine New York : Mary Ann Liebert, c. 1995
Scientific Review of Alternative Medicine (SRAM) Archived 2010-08-22 at the Wayback Machine
== External links ==

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Traditional medicine (TM) refers to certain practices within a culture which have existed since before the advent of medical science, Many TM practices are based on "holistic" approaches to disease and health, versus the scientific evidence-based methods in conventional medicine. The 2019 WHO report defines traditional medicine as "the sum total of the knowledge, skill and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness." When used outside the original setting and in the absence of scientific evidence, TM practices are typically referred to as "alternative medicine".
Holistic medicine is another rebranding of alternative medicine. In this case, the words balance and holism are often used alongside complementary or integrative, claiming to take into fuller account the "whole" person, in contrast to the supposed reductionism of medicine.
=== Challenges in defining alternative medicine ===
Prominent members of the science and biomedical science community say that it is not meaningful to define an alternative medicine that is separate from a conventional medicine because the expressions "conventional medicine", "alternative medicine", "complementary medicine", "integrative medicine", and "holistic medicine" do not refer to any medicine at all. Others say that alternative medicine cannot be precisely defined because of the diversity of theories and practices it includes, and because the boundaries between alternative and conventional medicine overlap, are porous, and change. Healthcare practices categorized as alternative may differ in their historical origin, theoretical basis, diagnostic technique, therapeutic practice and in their relationship to the medical mainstream. Under a definition of alternative medicine as "non-mainstream", treatments considered alternative in one location may be considered conventional in another.
Critics say the expression is deceptive because it implies there is an effective alternative to science-based medicine, and that complementary is deceptive because it implies that the treatment increases the effectiveness of (complements) science-based medicine, while alternative medicines that have been tested nearly always have no measurable positive effect compared to a placebo. Journalist John Diamond wrote that "there is really no such thing as alternative medicine, just medicine that works and medicine that doesn't", a notion later echoed by Paul Offit: "The truth is there's no such thing as conventional or alternative or complementary or integrative or holistic medicine. There's only medicine that works and medicine that doesn't. And the best way to sort it out is by carefully evaluating scientific studies—not by visiting Internet chat rooms, reading magazine articles, or talking to friends."
== Types ==
Alternative medicine consists of a wide range of health care practices, products, and therapies. The shared feature is a claim to heal that is not based on the scientific method. Alternative medicine practices are diverse in their foundations and methodologies. Alternative medicine practices may be classified by their cultural origins or by the types of beliefs upon which they are based. Methods may incorporate or be based on traditional medicinal practices of a particular culture, folk knowledge, superstition, spiritual beliefs, belief in supernatural energies (antiscience), pseudoscience, errors in reasoning, propaganda, fraud, new or different concepts of health and disease, and any bases other than being proven by scientific methods. Different cultures may have their own unique traditional or belief based practices developed recently or over thousands of years, and specific practices or entire systems of practices.
=== Unscientific belief systems ===
Alternative medicine, such as using naturopathy or homeopathy in place of conventional medicine, is based on belief systems not grounded in science.
=== Traditional ethnic systems ===
Alternative medical systems may be based on traditional medicine practices, such as traditional Chinese medicine (TCM), Ayurveda in India, or practices of other cultures around the world. Some useful applications of traditional medicines have been researched and accepted within ordinary medicine, however the underlying belief systems are seldom scientific and are not accepted.
Traditional medicine is considered alternative when it is used outside its home region; or when it is used together with or instead of known functional treatment; or when it can be reasonably expected that the patient or practitioner knows or should know that it will not work such as knowing that the practice is based on superstition.
=== Supernatural energies ===
Bases of belief may include belief in existence of supernatural energies undetected by the science of physics, as in biofields, or in belief in properties of the energies of physics that are inconsistent with the laws of physics, as in energy medicine.
=== Herbal remedies and other substances ===
Substance based practices use substances found in nature such as herbs, foods, non-vitamin supplements and megavitamins, animal and fungal products, and minerals, including use of these products in traditional medical practices that may also incorporate other methods. Examples include healing claims for non-vitamin supplements, fish oil, Omega-3 fatty acid, glucosamine, echinacea, flaxseed oil, and ginseng. Herbal medicine, or phytotherapy, includes not just the use of plant products, but may also include the use of animal and mineral products. It is among the most commercially successful branches of alternative medicine, and includes the tablets, powders and elixirs that are sold as "nutritional supplements". Only a very small percentage of these have been shown to have any efficacy, and there is little regulation as to standards and safety of their contents.
=== Religion, faith healing, and prayer ===
=== NCCIH classification ===
The United States agency National Center for Complementary and Integrative Health (NCCIH) has created a classification system for branches of complementary and alternative medicine that divides them into five major groups. These groups have some overlap, and distinguish two types of energy medicine: veritable which involves scientifically observable energy (including magnet therapy, colorpuncture and light therapy) and putative, which invokes physically undetectable or unverifiable energy. None of these energies have any evidence to support that they affect the body in any positive or health promoting way.

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Whole medical systems: Cut across more than one of the other groups; examples include traditional Chinese medicine, naturopathy, homeopathy, and ayurveda.
Mind-body interventions: Explore the interconnection between the mind, body, and spirit, under the premise that they affect "bodily functions and symptoms". A connection between mind and body is conventional medical fact, and this classification does not include therapies with proven function such as cognitive behavioral therapy.
"Biology"-based practices: Use substances found in nature such as herbs, foods, vitamins, and other natural substances. (As used here, "biology" does not refer to the science of biology, but is a usage newly coined by NCCIH in the primary source used for this article. "Biology-based" as coined by NCCIH may refer to chemicals from a nonbiological source, such as use of the poison lead in traditional Chinese medicine, and to other nonbiological substances.)
Manipulative and body-based practices: feature manipulation or movement of body parts, such as is done in bodywork, chiropractic, and osteopathic manipulation.
Energy medicine: is a domain that deals with putative and verifiable energy fields:
Biofield therapies are intended to influence energy fields that are purported to surround and penetrate the body. The existence of such energy fields have been disproven.
Bioelectromagnetic-based therapies use verifiable electromagnetic fields, such as pulsed fields, alternating-current, or direct-current fields in a non-scientific manner.
== History ==
The history of alternative medicine may refer to the history of a group of diverse medical practices that were collectively promoted as "alternative medicine" beginning in the 1970s, to the collection of individual histories of members of that group, or to the history of western medical practices that were labeled "irregular practices" by the western medical establishment. It includes the histories of complementary medicine and of integrative medicine. Before the 1970s, western practitioners that were not part of the increasingly science-based medical establishment were referred to "irregular practitioners", and were dismissed by the medical establishment as unscientific and as practicing quackery. Until the 1970s, irregular practice became increasingly marginalized as quackery and fraud, as western medicine increasingly incorporated scientific methods and discoveries, and had a corresponding increase in success of its treatments. In the 1970s, irregular practices were grouped with traditional practices of nonwestern cultures and with other unproven or disproven practices that were not part of biomedicine, with the entire group collectively marketed and promoted under the single expression "alternative medicine".
Use of alternative medicine in the west began to rise following the counterculture movement of the 1960s, as part of the rising new age movement of the 1970s. This was due to misleading mass marketing of "alternative medicine" being an effective "alternative" to biomedicine, changing social attitudes about not using chemicals and challenging the establishment and authority of any kind, sensitivity to giving equal measure to beliefs and practices of other cultures (cultural relativism), and growing frustration and desperation by patients about limitations and side effects of science-based medicine. At the same time, in 1975, the American Medical Association, which played the central role in fighting quackery in the United States, abolished its quackery committee and closed down its Department of Investigation. By the early to mid 1970s the expression "alternative medicine" came into widespread use, and the expression became mass marketed as a collection of "natural" and effective treatment "alternatives" to science-based biomedicine. By 1983, mass marketing of "alternative medicine" was so pervasive that the British Medical Journal (BMJ) pointed to "an apparently endless stream of books, articles, and radio and television programmes urge on the public the virtues of (alternative medicine) treatments ranging from meditation to drilling a hole in the skull to let in more oxygen".
An analysis of trends in the criticism of complementary and alternative medicine (CAM) in five prestigious American medical journals during the period of reorganization within medicine (19651999) was reported as showing that the medical profession had responded to the growth of CAM in three phases, and that in each phase, changes in the medical marketplace had influenced the type of response in the journals. Changes included relaxed medical licensing, the development of managed care, rising consumerism, and the establishment of the USA Office of Alternative Medicine (later National Center for Complementary and Alternative Medicine, currently National Center for Complementary and Integrative Health).
=== Medical education ===
Mainly as a result of reforms following the Flexner Report of 1910 medical education in established medical schools in the US has generally not included alternative medicine as a teaching topic. Typically, their teaching is based on current practice and scientific knowledge about: anatomy, physiology, histology, embryology, neuroanatomy, pathology, pharmacology, microbiology and immunology. Medical schools' teaching includes such topics as doctor-patient communication, ethics, the art of medicine, and engaging in complex clinical reasoning (medical decision-making). Writing in 2002, Snyderman and Weil remarked that by the early twentieth century the Flexner model had helped to create the 20th-century academic health center, in which education, research, and practice were inseparable. While this had much improved medical practice by defining with increasing certainty the pathophysiological basis of disease, a single-minded focus on the pathophysiological had diverted much of mainstream American medicine from clinical conditions that were not well understood in mechanistic terms, and were not effectively treated by conventional therapies.
By 2001 some form of CAM training was being offered by at least 75 out of 125 medical schools in the US. Exceptionally, the School of Medicine of the University of Maryland, Baltimore, includes a research institute for integrative medicine (a member entity of the Cochrane Collaboration). Medical schools are responsible for conferring medical degrees, but a physician typically may not legally practice medicine until licensed by the local government authority. Licensed physicians in the US who have attended one of the established medical schools there have usually graduated Doctor of Medicine (MD). All states require that applicants for MD licensure be graduates of an approved medical school and complete the United States Medical Licensing Examination (USMLE).
== Efficacy ==

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There is a general scientific consensus that alternative therapies lack the requisite scientific validation, and their effectiveness is either unproved or disproved. Many of the claims regarding the efficacy of alternative medicines are controversial, since research on them is frequently of low quality and methodologically flawed. Selective publication bias, marked differences in product quality and standardisation, and some companies making unsubstantiated claims call into question the claims of efficacy of isolated examples where there is evidence for alternative therapies.
The Scientific Review of Alternative Medicine points to confusions in the general population a person may attribute symptomatic relief to an otherwise-ineffective therapy just because they are taking something (the placebo effect); the natural recovery from or the cyclical nature of an illness (the regression fallacy) gets misattributed to an alternative medicine being taken; a person not diagnosed with science-based medicine may never originally have had a true illness diagnosed as an alternative disease category.
Edzard Ernst, the first university professor of Complementary and Alternative Medicine, characterized the evidence for many alternative techniques as weak, nonexistent, or negative and in 2011 published his estimate that about 7.4% were based on "sound evidence", although he believes that may be an overestimate. Ernst has concluded that 95% of the alternative therapies he and his team studied, including acupuncture, herbal medicine, homeopathy, and reflexology, are "statistically indistinguishable from placebo treatments", but he also believes there is something that conventional doctors can usefully learn from the chiropractors and homeopath: this is the therapeutic value of the placebo effect, one of the strangest phenomena in medicine.
In 2003, a project funded by the CDC identified 208 condition-treatment pairs, of which 58% had been studied by at least one randomized controlled trial (RCT), and 23% had been assessed with a meta-analysis. According to a 2005 book by a US Institute of Medicine panel, the number of RCTs focused on CAM has risen dramatically.
As of 2005, the Cochrane Library had 145 CAM-related Cochrane systematic reviews and 340 non-Cochrane systematic reviews. An analysis of the conclusions of only the 145 Cochrane reviews was done by two readers. In 83% of the cases, the readers agreed. In the 17% in which they disagreed, a third reader agreed with one of the initial readers to set a rating. These studies found that, for CAM, 38.4% concluded positive effect or possibly positive (12.4%), 4.8% concluded no effect, 0.7% concluded harmful effect, and 56.6% concluded insufficient evidence. An assessment of conventional treatments found that 41.3% concluded positive or possibly positive effect, 20% concluded no effect, 8.1% concluded net harmful effects, and 21.3% concluded insufficient evidence. However, the CAM review used the more developed 2004 Cochrane database, while the conventional review used the initial 1998 Cochrane database.
Alternative therapies do not "complement" (improve the effect of, or mitigate the side effects of) functional medical treatment. Significant drug interactions caused by alternative therapies may instead negatively impact functional treatment by making prescription drugs less effective, such as interference by herbal preparations with warfarin.
In the same way as for conventional therapies, drugs, and interventions, it can be difficult to test the efficacy of alternative medicine in clinical trials. In instances where an established, effective, treatment for a condition is already available, the Helsinki Declaration states that withholding such treatment is unethical in most circumstances. Use of standard-of-care treatment in addition to an alternative technique being tested may produce confounded or difficult-to-interpret results.
Cancer researcher Andrew J. Vickers has stated:
Contrary to much popular and scientific writing, many alternative cancer treatments have been investigated in good-quality clinical trials, and they have been shown to be ineffective. The label "unproven" is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been "disproven".
== Perceived mechanism of effect ==
Anything classified as alternative medicine by definition does not have a proven healing or medical effect. However, there are different mechanisms through which it can be perceived to "work". The common denominator of these mechanisms is that effects are mis-attributed to the alternative treatment.
=== Placebo effect ===
A placebo is a treatment with no intended therapeutic value. An example of a placebo is an inert pill, but it can include more dramatic interventions like sham surgery. The placebo effect is the concept that patients will perceive an improvement after being treated with an inert treatment. The opposite of the placebo effect is the nocebo effect, when patients who expect a treatment to be harmful will perceive harmful effects after taking it.
Placebos do not have a physical effect on diseases or improve overall outcomes, but patients may report improvements in subjective outcomes such as pain and nausea. A 1955 study suggested that a substantial part of a medicine's impact was due to the placebo effect. However, reassessments found the study to have flawed methodology. This and other modern reviews suggest that other factors like natural recovery and reporting bias should also be considered.
All of these are reasons why alternative therapies may be credited for improving a patient's condition even though the objective effect is non-existent, or even harmful. David Gorski argues that alternative treatments should be treated as a placebo, rather than as medicine. Almost none have performed significantly better than a placebo in clinical trials. Furthermore, distrust of conventional medicine may lead to patients experiencing the nocebo effect when taking effective medication.
=== Regression to the mean ===
A patient who receives an inert treatment may report improvements afterwards that it did not cause. Assuming it was the cause without evidence is an example of the regression fallacy. This may be due to a natural recovery from the illness, or a fluctuation in the symptoms of a long-term condition. The concept of regression toward the mean implies that an extreme result is more likely to be followed by a less extreme result.

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=== Other factors ===
There are also reasons why a placebo treatment group may outperform a "no-treatment" group in a test which are not related to a patient's experience. These include patients reporting more favourable results than they really felt due to politeness or "experimental subordination", observer bias, and misleading wording of questions. In their 2010 systematic review of studies into placebos, Asbjørn Hróbjartsson and Peter C. Gøtzsche write that "even if there were no true effect of placebo, one would expect to record differences between placebo and no-treatment groups due to bias associated with lack of blinding." Alternative therapies may also be credited for perceived improvement through decreased use or effect of medical treatment, and therefore either decreased side effects or nocebo effects towards standard treatment.
== Use and regulation ==
=== Appeal ===
Practitioners of complementary medicine usually discuss and advise patients as to available alternative therapies. Patients often express interest in mind-body complementary therapies because they offer a non-drug approach to treating some health conditions.
In addition to the social-cultural underpinnings of the popularity of alternative medicine, there are several psychological issues that are critical to its growth, notably psychological effects, such as the will to believe, cognitive biases that help maintain self-esteem and promote harmonious social functioning, and the post hoc, ergo propter hoc fallacy.
In a 2018 interview with The BMJ, Edzard Ernst stated: "The present popularity of complementary and alternative medicine is also inviting criticism of what we are doing in mainstream medicine. It shows that we aren't fulfilling a certain need-we are not giving patients enough time, compassion, or empathy. These are things that complementary practitioners are very good at. Mainstream medicine could learn something from complementary medicine."
==== Marketing ====
Alternative medicine is a profitable industry with large media advertising expenditures. Accordingly, alternative practices are often portrayed positively and compared favorably to "big pharma".
The popularity of complementary & alternative medicine (CAM) may be related to other factors that Ernst mentioned in a 2008 interview in The Independent:
Why is it so popular, then? Ernst blames the providers, customers and the doctors whose neglect, he says, has created the opening into which alternative therapists have stepped. "People are told lies. There are 40 million websites and 39.9 million tell lies, sometimes outrageous lies. They mislead cancer patients, who are encouraged not only to pay their last penny but to be treated with something that shortens their lives." At the same time, people are gullible. It needs gullibility for the industry to succeed. It doesn't make me popular with the public, but it's the truth.
Paul Offit proposed that "alternative medicine becomes quackery" in four ways: by recommending against conventional therapies that are helpful, promoting potentially harmful therapies without adequate warning, draining patients' bank accounts, or by promoting "magical thinking". Promoting alternative medicine has been called dangerous and unethical.
==== Social factors ====
Authors have speculated on the socio-cultural and psychological reasons for the appeal of alternative medicines among the minority using them in lieu of conventional medicine. There are several socio-cultural reasons for the interest in these treatments centered on the low level of scientific literacy among the public at large and a concomitant increase in antiscientific attitudes and new age mysticism. Related to this are vigorous marketing of extravagant claims by the alternative medical community combined with inadequate media scrutiny and attacks on critics. Alternative medicine is criticized for taking advantage of the least fortunate members of society.
There is also an increase in conspiracy theories toward conventional medicine and pharmaceutical companies, mistrust of traditional authority figures, such as the physician, and a dislike of the current delivery methods of scientific biomedicine, all of which have led patients to seek out alternative medicine to treat a variety of ailments. Many patients lack access to contemporary medicine, due to a lack of private or public health insurance, which leads them to seek out lower-cost alternative medicine. Medical doctors are also aggressively marketing alternative medicine to profit from this market.
Patients can be averse to the painful, unpleasant, and sometimes-dangerous side effects of biomedical treatments. Treatments for severe diseases such as cancer and HIV infection have well-known, significant side-effects. Even low-risk medications such as antibiotics can have potential to cause life-threatening anaphylactic reactions in a very few individuals. Many medications may cause minor but bothersome symptoms such as cough or upset stomach. In all of these cases, patients may be seeking out alternative therapies to avoid the adverse effects of conventional treatments.

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=== Prevalence of use ===
According to research published in 2015, the increasing popularity of CAM needs to be explained by moral convictions or lifestyle choices rather than by economic reasoning.
In developing nations, access to essential medicines is severely restricted by lack of resources and poverty. Traditional remedies, often closely resembling or forming the basis for alternative remedies, may comprise primary healthcare or be integrated into the healthcare system. In Africa, traditional medicine is used for 80% of primary healthcare, and in developing nations as a whole over one-third of the population lack access to essential medicines.
In Latin America, inequities against BIPOC communities keep them tied to their traditional practices and therefore, it is often these communities that constitute the majority of users of alternative medicine. Racist attitudes towards certain communities disable them from accessing more urbanized modes of care. In a study that assessed access to care in rural communities of Latin America, it was found that discrimination is a huge barrier to the ability of citizens to access care; more specifically, women of Indigenous and African descent, and lower-income families were especially hurt. Such exclusion exacerbates the inequities that minorities in Latin America already face. Consistently excluded from many systems of westernized care for socioeconomic and other reasons, low-income communities of color often turn to traditional medicine for care as it has proved reliable to them across generations.
Commentators including David Horrobin have proposed adopting a prize system to reward medical research. This stands in opposition to the current mechanism for funding research proposals in most countries around the world. In the US, the NCCIH provides public research funding for alternative medicine. The NCCIH has spent more than US$2.5 billion on such research since 1992 and this research has not demonstrated the efficacy of alternative therapies. As of 2011, the NCCIH's sister organization in the NIH Office of Cancer Complementary and Alternative Medicine had given out grants of around $105 million each year for several years. Testing alternative medicine that has no scientific basis (as in the aforementioned grants) has been called a waste of scarce research resources.
That alternative medicine has been on the rise "in countries where Western science and scientific method generally are accepted as the major foundations for healthcare, and 'evidence-based' practice is the dominant paradigm" was described as an "enigma" in the Medical Journal of Australia. A 15-year systematic review published in 2022 on the global acceptance and use of CAM among medical specialists found the overall acceptance of CAM at 52% and the overall use at 45%.
==== In the United States ====
In the United States, the 1974 Child Abuse Prevention and Treatment Act (CAPTA) required that for states to receive federal money, they had to grant religious exemptions to child neglect and abuse laws regarding religion-based healing practices. Thirty-one states have child-abuse religious exemptions.
The use of alternative medicine in the US has increased, with a 50 percent increase in expenditures and a 25 percent increase in the use of alternative therapies between 1990 and 1997 in America. According to a national survey conducted in 2002, "36 percent of U.S. adults aged 18 years and over use some form of complementary and alternative medicine." Americans spend many billions on the therapies annually. Most Americans used CAM to treat and/or prevent musculoskeletal conditions or other conditions associated with chronic or recurring pain. In America, women were more likely than men to use CAM, with the biggest difference in use of mind-body therapies including prayer specifically for health reasons". In 2008, more than 37% of American hospitals offered alternative therapies, up from 27 percent in 2005, and 25% in 2004. More than 70% of the hospitals offering CAM were in urban areas.
A survey of Americans found that 88 percent thought that "there are some good ways of treating sickness that medical science does not recognize". Use of magnets was the most common tool in energy medicine in America, and among users of it, 58 percent described it as at least "sort of scientific", when it is not at all scientific. In 2002, at least 60 percent of US medical schools have at least some class time spent teaching alternative therapies. "Therapeutic touch" was taught at more than 100 colleges and universities in 75 countries before the practice was debunked by a nine-year-old child for a school science project.
==== Prevalence of use of specific therapies ====
The most common CAM therapies used in the US in 2002 were prayer (45%), herbalism (19%), breathing meditation (12%), meditation (8%), chiropractic medicine (8%), yoga (56%), body work (5%), diet-based therapy (4%), progressive relaxation (3%), mega-vitamin therapy (3%) and visualization (2%).
In Britain, the most often used alternative therapies were Alexander technique, aromatherapy, Bach and other flower remedies, body work therapies including massage, Counseling stress therapies, hypnotherapy, meditation, reflexology, Shiatsu, Ayurvedic medicine, nutritional medicine, and yoga. Ayurvedic medicine remedies are mainly plant based with some use of animal materials. Safety concerns include the use of herbs containing toxic compounds and the lack of quality control in Ayurvedic facilities.
According to the National Health Service (England), the most commonly used complementary and alternative medicines (CAM) supported by the NHS in the UK are: acupuncture, aromatherapy, chiropractic, homeopathy, massage, osteopathy and clinical hypnotherapy.

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==== In palliative care ====
Complementary therapies are often used in palliative care or by practitioners attempting to manage chronic pain in patients. Integrative medicine is considered more acceptable in the interdisciplinary approach used in palliative care than in other areas of medicine. "From its early experiences of care for the dying, palliative care took for granted the necessity of placing patient values and lifestyle habits at the core of any design and delivery of quality care at the end of life. If the patient desired complementary therapies, and as long as such treatments provided additional support and did not endanger the patient, they were considered acceptable." The non-pharmacologic interventions of complementary medicine can employ mind-body interventions designed to "reduce pain and concomitant mood disturbance and increase quality of life."
=== Regulation ===
The alternative medicine lobby has successfully pushed for alternative therapies to be subject to far less regulation than conventional medicine. Some professions of complementary/traditional/alternative medicine, such as chiropractic, have achieved full regulation in North America and other parts of the world and are regulated in a manner similar to that governing science-based medicine. In contrast, other approaches may be partially recognized and others have no regulation at all. In some cases, promotion of alternative therapies is allowed when there is demonstrably no effect, only a tradition of use. Despite laws making it illegal to market or promote alternative therapies for use in cancer treatment, many practitioners promote them.
Regulation and licensing of alternative medicine ranges widely from country to country, and state to state. In Austria and Germany complementary and alternative medicine is mainly in the hands of doctors with MDs, and half or more of the American alternative practitioners are licensed MDs. In Germany herbs are tightly regulated: half are prescribed by doctors and covered by health insurance.
Government bodies in the US and elsewhere have published information or guidance about alternative medicine. The U.S. Food and Drug Administration (FDA), has issued online warnings for consumers about medication health fraud. This includes a section on Alternative Medicine Fraud, such as a warning that Ayurvedic products generally have not been approved by the FDA before marketing.
== Risks and problems ==
The National Science Foundation has studied the problematic side of the public's attitudes and understandings of science fiction, pseudoscience, and belief in alternative medicine. They use a quote from Robert L. Park to describe some issues with alternative medicine:
Alternative medicine is another concern. As used here, alternative medicine refers to all treatments that have not been proven effective using scientific methods. A scientist's view of the situation appeared in a recent book (Park 2000b)":
Between homeopathy and herbal therapy lies a bewildering array of untested and unregulated treatments, all labeled alternative by their proponents. Alternative seems to define a culture rather than a field of medicine—a culture that is not scientifically demanding. It is a culture in which ancient traditions are given more weight than biological science, and anecdotes are preferred over clinical trials. Alternative therapies steadfastly resist change, often for centuries or even millennia, unaffected by scientific advances in the understanding of physiology or disease. Incredible explanations invoking modern physics are sometimes offered for how alternative therapies might work, but there seems to be little interest in testing these speculations scientifically.
=== Negative outcomes ===
According to the Institute of Medicine, use of alternative medical techniques may result in several types of harm:
"Direct harm, which results in adverse patient outcome."
"Economic harm, which results in monetary loss but presents no health hazard;"
"Indirect harm, which results in a delay of appropriate treatment, or in unreasonable expectations that discourage patients and their families from accepting and dealing effectively with their medical conditions;"
==== Interactions with conventional pharmaceuticals ====
Forms of alternative medicine that are biologically active can be dangerous even when used in conjunction with conventional medicine. Examples include immuno-augmentation therapy, shark cartilage, bioresonance therapy, oxygen and ozone therapies, and insulin potentiation therapy. Some herbal remedies can cause dangerous interactions with chemotherapy drugs, radiation therapy, or anesthetics during surgery, among other problems. An example of these dangers was reported by Associate Professor Alastair MacLennan of Adelaide University, Australia regarding a patient who almost bled to death on the operating table after neglecting to mention that she had been taking "natural" potions to "build up her strength" before the operation, including a powerful anticoagulant that nearly caused her death.
To ABC Online, MacLennan also gives another possible mechanism:
And lastly there's the cynicism and disappointment and depression that some patients get from going on from one alternative medicine to the next, and they find after three months the placebo effect wears off, and they're disappointed and they move on to the next one, and they're disappointed and disillusioned, and that can create depression and make the eventual treatment of the patient with anything effective difficult, because you may not get compliance, because they've seen the failure so often in the past.

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==== Side-effects ====
Conventional treatments are subjected to testing for undesired side-effects, whereas alternative therapies, in general, are not subjected to such testing at all. Any treatment whether conventional or alternative that has a biological or psychological effect on a patient may also have potential to possess dangerous biological or psychological side-effects. Attempts to refute this fact with regard to alternative therapies sometimes use the appeal to nature fallacy, i.e., "That which is natural cannot be harmful." Specific groups of patients such as patients with impaired hepatic or renal function are more susceptible to side effects of alternative remedies.
An exception to the normal thinking regarding side-effects is homeopathy. Since 1938, the FDA has regulated homeopathic products in "several significantly different ways from other drugs." Homeopathic preparations, termed "remedies", are extremely dilute, often far beyond the point where a single molecule of the original active (and possibly toxic) ingredient is likely to remain. They are, thus, considered safe on that count, but "their products are exempt from good manufacturing practice requirements related to expiration dating and from finished product testing for identity and strength", and their alcohol concentration may be much higher than allowed in conventional drugs.
==== Treatment delay ====
Alternative medicine may discourage people from getting the best possible treatment. Those having experienced or perceived success with one alternative therapy for a minor ailment may be convinced of its efficacy and persuaded to extrapolate that success to some other alternative therapy for a more serious, possibly life-threatening illness. For this reason, critics argue that therapies that rely on the placebo effect to define success are very dangerous. According to mental health journalist Scott Lilienfeld in 2002, "unvalidated or scientifically unsupported mental health practices can lead individuals to forgo effective treatments" and refers to this as opportunity cost. Individuals who spend large amounts of time and money on ineffective treatments may be left with precious little of either, and may forfeit the opportunity to obtain treatments that could be more helpful. In short, even innocuous treatments can indirectly produce negative outcomes. Between 2001 and 2003, four children died in Australia because their parents chose ineffective naturopathic, homeopathic, or other alternative medicines and diets rather than conventional therapies.
==== Unconventional cancer "cures" ====
There have always been "many therapies offered outside of conventional cancer treatment centers and based on theories not found in biomedicine. These alternative cancer cures have often been described as 'unproven,' suggesting that appropriate clinical trials have not been conducted and that the therapeutic value of the treatment is unknown." However, "many alternative cancer treatments have been investigated in good-quality clinical trials, and they have been shown to be ineffective.... The label 'unproven' is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been 'disproven'."
Edzard Ernst has stated:
any alternative cancer cure is bogus by definition. There will never be an alternative cancer cure. Why? Because if something looked halfway promising, then mainstream oncology would scrutinize it, and if there is anything to it, it would become mainstream almost automatically and very quickly. All curative "alternative cancer cures" are based on false claims, are bogus, and, I would say, even criminal.
=== Rejection of science ===

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Complementary and alternative medicine (CAM) is not as well researched as conventional medicine, which undergoes intense research before release to the public. Practitioners of science-based medicine also discard practices and treatments when they are shown ineffective, while alternative practitioners do not. Funding for research is also sparse making it difficult to do further research for effectiveness of CAM. Most funding for CAM is funded by government agencies. Proposed research for CAM are rejected by most private funding agencies because the results of research are not reliable. The research for CAM has to meet certain standards from research ethics committees, which most CAM researchers find almost impossible to meet. Even with the little research done on it, CAM has not been proven to be effective. Studies that have been done will be cited by CAM practitioners in an attempt to claim a basis in science. These studies tend to have a variety of problems, such as small samples, various biases, poor research design, lack of controls, negative results, etc. Even those with positive results can be better explained as resulting in false positives due to bias and noisy data.
Alternative medicine may lead to a false understanding of the body and of the process of science. Steven Novella, a neurologist at Yale School of Medicine, wrote that government-funded studies of integrating alternative medicine techniques into the mainstream are "used to lend an appearance of legitimacy to treatments that are not legitimate." Marcia Angell proposed that healthcare practices should be classified based solely on scientific evidence, and if a treatment had been rigorously tested and found safe and effective, science-based medicine will adopt it regardless of whether it was considered "alternative" to begin with. It is possible for a method to change categories (proven vs. unproven), based on increased knowledge of its effectiveness or lack thereof. Prominent supporters of this position are George D. Lundberg, former editor of the Journal of the American Medical Association (JAMA) and the journal's interim editor-in-chief Phil Fontanarosa.
Writing in 1999 in CA: A Cancer Journal for Clinicians Barrie R. Cassileth mentioned a 1997 letter to the United States Senate's Subcommittee on Public Health and Safety, which had deplored the lack of critical thinking and scientific rigor in OAM-supported research, had been signed by four Nobel Laureates and other prominent scientists. (This was supported by the National Institutes of Health (NIH).)
In March 2009, a staff writer for The Washington Post reported that the impending national discussion about broadening access to health care, improving medical practice and saving money was giving a group of scientists an opening to propose shutting down the National Center for Complementary and Alternative Medicine. They quoted one of these scientists, Steven Salzberg, a genome researcher and computational biologist at the University of Maryland, as saying "One of our concerns is that NIH is funding pseudoscience." They noted that the vast majority of studies were based on fundamental misunderstandings of physiology and disease, and had shown little or no effect.
Writers such as Carl Sagan, a noted astrophysicist, advocate of scientific skepticism and the author of The Demon-Haunted World: Science as a Candle in the Dark (1996), have lambasted the lack of empirical evidence to support the existence of the putative energy fields on which these therapies are predicated.
Sampson has also pointed out that CAM tolerated contradiction without thorough reason and experiment. Barrett has pointed out that there is a policy at the NIH of never saying something does not work, only that a different version or dose might give different results. Barrett also expressed concern that, just because some "alternatives" have merit, there is the impression that the rest deserve equal consideration and respect even though most are worthless, since they are all classified under the one heading of alternative medicine.
Some critics of alternative medicine are focused upon health fraud, misinformation, and quackery as public health problems, notably Wallace Sampson and Paul Kurtz founders of Scientific Review of Alternative Medicine and Stephen Barrett, co-founder of The National Council Against Health Fraud and webmaster of Quackwatch. Grounds for opposing alternative medicine include that:

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Amen Clinics is a chain of brain health clinics focused on the treatment of brain activity functions and psychiatric disorders. It was founded in 1989 by Daniel Amen an American medical doctor and psychiatrist. They use brain SPECT (single photon emission computed tomography) imaging to diagnose brain activity patterns in their patients. Amen's marketing of SPECT scans has been condemned by scientists and doctors as lacking scientific validity and as being unethical, especially since the way SPECT is used in his clinics exposes people to harmful radiation with no clear benefit.
== Operations ==
Amen Clinics were founded in 1989. Since 1991, the clinics have performed brain SPECT scans, purportedly to diagnose brain conditions that manifest as psychiatric health issues by evaluating the brain activity amount and location in the brain.
The effectiveness of SPECT scans in treating psychiatric conditions has been the subject of scientific debate. John Seibyl of the Society of Nuclear Medicine and Molecular Imaging has stated that it is settled that SPECT is of no value for diagnosing psychological disorders. In 2008, Tufts professor and writer Daniel Carlat published an article on Amen's use of SPECT imaging. After visiting Amen's clinics, Carlat called Amen's interpretations of the scans "spectacularly meaningless".
Amen Clinics incorporates questionnaires (of clients and their family about the client together), clinical histories, and clinical interviews in its practice. Some Amen Clinics locations also use quantitative electroencephalography as a purported diagnostic tool.
As of 2026, Amen Clinics had a database of more than 200,000 functional brain SPECT scans. The clients are from over 100 countries with ages ranging from 9 months to 105 years old.
== References ==
== External links ==
Official website

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Ancient astronauts (or ancient aliens) refers to a pseudoscientific set of beliefs, also called paleocontact, that hold that intelligent extraterrestrial beings (alien astronauts) visited Earth and made contact with humans in antiquity and prehistoric times. Proponents of the theory suggest that this contact influenced the development of modern cultures, technologies, religions, and human biology. A common position is that deities from most (if not all) religions are extraterrestrial in origin, and that advanced technologies brought to Earth by ancient astronauts were interpreted as evidence of divine status by early humans.
The idea that ancient astronauts existed and visited Earth is not taken seriously by academics and archaeologists, who identify such claims as pseudoarchaeological or unscientific. It has received no credible attention in peer-reviewed studies. When proponents of the idea present evidence in favor of their beliefs, it is often distorted or fabricated. Some authors and scholars also argue that ancient astronaut theories have racist undertones or implications, diminishing the accomplishments and capabilities of indigenous cultures.
Well-known proponents of these beliefs in the latter half of the 20th century who have written numerous books or appear regularly in mass media include Robert Charroux, Jacques Bergier, Jean Sendy, Erich von Däniken, Alexander Kazantsev, Zecharia Sitchin, Robert K. G. Temple, Giorgio A. Tsoukalos, David Hatcher Childress, Peter Kolosimo, and Mauro Biglino.
== Overview ==
Various terms are used to reference claims about ancient astronauts, such as ancient aliens, ancient ufonauts, ancient space pilots, paleocontact, astronaut- or alien gods, or paleo- or biblical-SETI (search for extraterrestrial intelligence).
Believers in such ancient astronaut stories often maintain that all or some humans are either descendants or creations of extraterrestrial intelligence who landed on Earth at some point in the ancient past. An associated idea is that human knowledge, religion, and culture came from extraterrestrial visitors in ancient times, in that ancient astronauts acted as a "mother culture". Additionally, proponents often claim that travelers from outer space built many of the structures on Earth (such as Egyptian pyramids and the Moai stone heads of Easter Island) or aided humans in building them. Proponents contend that the evidence for ancient astronauts comes from documentary gaps in historical and archaeological records while citing archaeological artifacts that they believe, contrary to the mainstream explanations, are anachronistic and supposedly beyond the technical capabilities of the people who made them. These are sometimes referred to as "out-of-place artifacts"; and include artwork and legends which believers reinterpret to fit stories of extraterrestrial contact or technologies.
As a pseudoarcheology, the idea receives notice in fringe pulp media, such as the History Channel series Ancient Aliens. Such shows use a strategy known as 'fire-hosing' to co-mingle fact with fiction in order to spread theories of an alternate past with tropes that follow white supremacist, nativist, imperialist, settler-colonial, and Christian Identity beliefs relevant to the past. The celebrity proponents of ancient aliens profess to be a part of an oppressed minority of academics that 'big archaeology' is conspiring to disenfranchise while their identity of being a maverick or a rogue aligns with the individuals' lack of credentials.
Like archaeological endeavors of the criticized past, these proponents focus primarily on monumental archaeological structures claiming they could have only been constructed with extraterrestrial intervention. The implication is that the non-white Indigenous people in the regions in which these monuments appear could not have built them on their own. However, Dakota/Lakota Sioux writer Ruth H. Burns, in Atmos magazine, counters that ancient alien theory and the idea of extraterrestrials in general supports the viewpoints of indigenous, non-European peoples. She believes the denial of extraterrestrial encounters and indigenous peoples' stories tracing their origins to extraterrestrials is part of "Indigenous erasure," as it minimizes or completely discounts the viewpoints of indigenous peoples. Many indigenous peoples trace their ancestry to "star-people" or the like—extraterrestrials who as the progenitors of indigenous peoples cannot by definition be white or "Aryan."
A common feature in the stories portray the aliens as light-skinned or Aryan in complexion, as prominent alien astronaut proponent Erich von Däniken claims in his foundational work Chariots of the Gods? Some ancient astronaut proponents are thus associated with white supremacism, although their theories are sometimes applied to European cultures as well.
Archaeologists have ignored the existence of these outlandish claims. However due to rising popular belief in fringe theories, they began actively engaging with the public via social media around 2020 to advocate mainstream archeological views. The few dedicated popular science explainers and skeptics who did offer opinions on the ideas universally panned them. For example, Carl Sagan wrote, "In the long litany of 'ancient astronaut' pop archaeology, the cases of apparent interest have perfectly reasonable alternative explanations, or have been misreported, or are simple prevarications, hoaxes and distortions".
== History of ancient aliens beliefs and their proponents ==
Paleocontact or "ancient astronaut" narratives first appeared in the early science fiction of the late 19th and early 20th centuries, including the 1898 novel Edison's Conquest of Mars and the works of H.P. Lovecraft. The idea was proposed in earnest by journalist Harold T. Wilkins in 1954. It grew in popularity in the 1960s, mainly due to the Space Race and the success of Erich von Däniken's works, although it also received limited consideration as a serious hypothesis. Critics emerged throughout the 1970s, discrediting Von Däniken's claims. Ufologists separated the idea from the UFO controversy. By the early 1980s little remaining support could be found.
=== Shklovsky and Sagan ===

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Carl Sagan co-authored a widely popular book Intelligent Life in the Universe, with Soviet astrophysicist Iosif Shklovsky and published in 1966. In his 1979 book Broca's Brain, Sagan suggested that he and Shklovsky might have inspired the wave of 1970s ancient astronaut books, expressing disapproval of "von Däniken and other uncritical writers" who seemingly built on these ideas not as guarded speculations but as "valid evidence of extraterrestrial contact." Sagan pointed out that while many legends, artifacts, and purported out-of-place artifacts were cited in support of ancient astronaut hypotheses, "very few require more than passing mention" and could be easily explained with more conventional hypotheses. Sagan also reiterated his earlier conclusion that extraterrestrial visits to Earth were possible but unproven and improbable.
=== Erich von Däniken ===
Erich von Däniken was a leading proponent of this hypothesis in the late 1960s and early 1970s, gaining a large audience through the 1968 publication of his best-selling book Chariots of the Gods? and its sequels.
According to von Däniken, certain artifacts require a more sophisticated technological ability in their construction than that which was available to the ancient cultures who constructed them. Von Däniken maintains that these artifacts were constructed either directly by extraterrestrial visitors or by humans who learned the necessary knowledge from said visitors. These include Stonehenge, Pumapunku, the Moai of Easter Island, the Great Pyramid of Giza, and the ancient Baghdad electric batteries.
Von Däniken writes that ancient art and iconography throughout the world illustrates air and space vehicles, non-human but intelligent creatures, ancient astronauts, and artifacts of an anachronistically advanced technology. Von Däniken also states that geographically separated historical cultures share artistic themes, which he argues imply a common origin. One such example is von Däniken's interpretation of the sarcophagus lid recovered from the tomb of the Classic-era Maya ruler of Palenque, Pacal the Great. Von Däniken writes that the design represented a seated astronaut. The iconography and accompanying Maya text, however, identifies it as a portrait of the ruler himself with the World Tree of Maya mythology.
The origins of many religions are interpreted by von Däniken as reactions to encounters with an alien race. According to his view, humans considered the technology of the aliens to be supernatural and the aliens themselves to be gods. Von Däniken states that the oral and written traditions of most religions contain references to alien visitors in the way of descriptions of stars and vehicular objects traveling through air and space. One such is Ezekiel's revelation, which Däniken interprets as a detailed description of a landing spacecraft (The Spaceships of Ezekiel).
Von Däniken's hypotheses became popularized in the U.S. after the NBC-TV documentary In Search of Ancient Astronauts hosted by Rod Serling, and the film Chariots of the Gods.
Critics argue that von Däniken misrepresented data, that many of his claims were unfounded, and that none of his core claims have been validated. In particular the Christian creationist community is highly critical of most of von Däniken's work. Young Earth creationist author Clifford A. Wilson published Crash Go the Chariots in 1972 in which he attempted to discredit all the claims made in Chariots of the Gods.
In Chariots of the Gods?, regarding the Nazca Lines, von Däniken states that "Seen from the air, the clear-cut impression that the 37-mile (60 km) long plain of Nazca made on me was that of an airfield." Considering he was in the process of seeking evidence of ancient aliens, von Däniken exhibits confirmation bias, as he does not consider the Nazca Lines to be man-made until after the publication of Chariots of the Gods? This etic perspective that he presents could be easily accepted by a reader familiar with air travel, and an undeveloped knowledge of the nature of the geoglyphs. Furthermore, since the majority of readers of Chariots of the Gods? are not educated in viewing artifacts from ancient civilizations, their interpretations are highly subject to von Däniken's opinions of the artifacts. Kenneth L. Feder argues a reader seeing the Nazca Lines for the first time in a book about aliens would be much more likely to associate those features with extraterrestrial origins, rather than from a civilization that existed on Earth.
In 1970, von Däniken admitted that the Nazca markings "could have been laid out on their gigantic scale by working from a model using a system of coordinates."
=== Zecharia Sitchin ===

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Zecharia Sitchin's series The Earth Chronicles, beginning with The 12th Planet, revolves around Sitchin's unique interpretation of ancient Sumerian and Middle Eastern texts, megalithic sites, and artifacts from around the world. He hypothesizes that the gods of old Mesopotamia were astronauts from the planet "Nibiru", which Sitchin states the Sumerians believed to be a remote "12th planet" (counting the Sun, Moon, and Pluto as planets) associated with the god Marduk. According to Sitchin, Nibiru continues to orbit the Sun on a 3,600-year elongated orbit. Modern astronomy has found no evidence to support Sitchin's ideas.
Sitchin argues that there are Sumerian texts that tell the story that 50 Anunnaki, inhabitants of a planet named Nibiru, came to Earth approximately 400,000 years ago with the intent of mining raw materials, especially gold, for transport back to Nibiru. With their small numbers they soon grew tired of the task and set out to genetically engineer laborers to work the mines. After much trial and error they eventually created Homo sapiens sapiens: the "Adapa" (model man) or Adam of later mythology. Sitchin contended the Anunnaki were active in human affairs until their culture was destroyed by global catastrophes caused by the abrupt end of the last ice age some 12,000 years ago. Seeing that humans survived and all they had built was destroyed, the Anunnaki left Earth after giving humans the opportunity and means to govern themselves. Sitchin's work has not received mainstream scholarly support and has been roundly criticized by professionals that have reviewed his hypotheses. Semitic languages scholar Michael S. Heiser says that many of Sitchin's translations of Sumerian and Mesopotamian words are not consistent with Mesopotamian cuneiform bilingual dictionaries, produced by ancient Akkadian scribes.
Alan F. Alford, author of Gods of the New Millennium (1996), was an adherent of the ancient astronaut hypothesis. Much of his work draws on Sitchin's hypotheses. However, he now finds fault with Sitchin's hypothesis after deeper analysis, stating that: "I am now firmly of the opinion that these gods personified the falling sky; in other words, the descent of the gods was a poetic rendition of the cataclysm myth which stood at the heart of ancient Near Eastern religions."
=== Robert Temple ===
Robert K. G. Temple's 1976 book, The Sirius Mystery, argues that the Dogon people of northwestern Mali preserved an account of extraterrestrial visitation from around 5,000 years ago. He quotes various lines of evidence, including advanced astronomical knowledge inherited by the tribe, descriptions, and comparative belief systems with ancient civilizations such as ancient Egypt and Sumer. His work draws heavily on the studies of cultural anthropologists Marcel Griaule and Germaine Dieterlen.
His conclusions have been criticized by scientists, who point out discrepancies within Temple's account, and suggested that the Dogon may have received some of their astronomical information recently, probably from European sources, and may have misrepresented Dogon ethnography.
=== UFO religions ===
Various new religious movements including some branches of Theosophy, Scientology, Raëlism, Aetherius Society, and Heaven's Gate believe in ancient and present-day contact with extraterrestrial intelligence. Many of these faiths see both ancient scriptures and recent revelations as connected with the action of aliens from other planetary systems. Psychologists have found that UFO religions have similarities which suggest that members of these groups consciously or subliminally associate enchantment with the memes of science fiction.
== Claims of proponents ==
Among scientists, the consensus is that the ancient astronaut hypothesis is not impossible, but unjustified and unnecessary. The "mysteries" cited as evidence for the hypothesis can be explained without having to invoke ancient astronauts; proponents look for mysteries where none exist. Since ancient astronauts are unnecessary, Occam's razor should be applied and the hypothesis rejected according to the scientific consensus.
=== Ancient religious texts ===
Proponents cite ancient mythologies to support their viewpoints based on the idea that ancient creation myths of gods who descend from the heavens to Earth to create or instruct humanity are representations of alien visitors, whose superior technology accounts for their perception as gods. Proponents draw an analogy to occurrences in modern time when isolated cultures are exposed to advanced technology, such as when, in the early 20th century, "cargo cults" were discovered in the South Pacific: cultures who believed various Western ships and their cargo to be sent from the gods as fulfillment of prophecies concerning their return.
The ancient Sumerian myth of Enûma Eliš, inscribed on cuneiform tablets and part of the Library of Ashurbanipal, says humankind was created to serve gods called the "Annunaki". Hypothesis proponents believe that the Annunaki were aliens who came to Earth to mine gold for their own uses. According to the hypothesis proponents, the Annunaki realized mining gold was taking a toll on their race, and then created the human race as slaves.
==== The Bible ====
===== Book of Genesis and Book of Enoch =====
The Book of Genesis, Chapter 6 verses 12 and 4, states:

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When human beings began to increase in number on the earth and daughters were born to them, the sons of God saw that the daughters of humans were beautiful, and they married any of them they chose... The Nephilim were on the earth in those days—and also afterward—when the sons of God went to the daughters of humans and had children by them.
Many Christians consider these groups to be the different families of Adam and Eve's children. Another interpretation is that the Nephilim are the children of the "sons of God" and "daughters of humans", although scholars are uncertain. The King James Version translates "Nephilim" as "giants" (or Gibborim). Ancient Astronaut proponents argue that Adam and Eve ate of the forbidden fruit in order "to be godlike", and this was the first step in human evolution.
The first part of the apocryphal Book of Enoch expands and interprets Genesis 6:1: that the "sons of God" were a group of 200 "angels" called "Watchers", who descended to Earth to breed with humans. Their offspring are the Nephilim, "giants" who "consumed all the acquisitions of men". When humans could no longer sustain the Nephilim, they turned against humanity. The Watchers also instructed humans in metallurgy and metalworking, cosmetics, sorcery, astrology, astronomy, and meteorology. God then ordered the Watchers to be imprisoned in the ground, and created the Great Flood (or the numerous Deluge myths) to rid Earth of the Nephilim and of the humans given knowledge by the Watchers. To ensure humanity's survival, Noah is forewarned of the oncoming destruction. Because they disobeyed God, the book describes the Watchers as "fallen angels".
Some ancient astronaut proponents argue that this story is a historical account of extraterrestrials visiting Earth, called Watchers because their mission was to observe humanity. Some of the extraterrestrials disobeyed orders; they made contact with humans, cross-bred with human females, and shared knowledge with them. The Nephilim were thus half-human-half-extraterrestrial hybrids.
Chuck Missler and Mark Eastman argue that modern UFOs carry the fallen angels, or offspring of fallen angels, and that "Noah's genealogy was not tarnished by the intrusion of fallen angels. It seems that this adulteration of the human gene pool was a major problem on the planet earth".
Von Däniken also suggests that the two angels who visited Lot in Genesis 19 were ancient astronauts, who used atomic weapons to destroy the city of Sodom.
Marc Dem reinterprets the Book of Genesis by writing that humanity started on another planet and that the God of the Bible is an extraterrestrial.
===== Book of Ezekiel =====
Chapter 1 of the Book of Ezekiel recounts a vision in which Ezekiel sees "an immense cloud" that contains fire and emits lightning and "brilliant light". Within the cloud, the passage describes cherubim and ophanim:
...and in the fire was what looked like four living creatures. In appearance their form was human, but each of them had four faces and four wings. Their legs were straight; their feet were like those of a calf and gleamed like burnished bronze. Under their wings on their four sides they had human hands. All four of them had faces and wings, and the wings of one touched the wings of another. Each one went straight ahead; they did not turn as they moved...
As I looked at the living creatures, I saw a wheel on the ground beside each creature with its four faces. This was the appearance and structure of the wheels: They sparkled like topaz, and all four looked alike. Each appeared to be made like a wheel intersecting a wheel. As they moved, they would go in any one of the four directions the creatures faced; the wheels did not change direction as the creatures went. Their rims were high and awesome, and all four rims were full of eyes all around. When the living creatures moved, the wheels beside them moved; and when the living creatures rose from the ground, the wheels also rose.
In Chapter 4 of Chariots of the Gods?, entitled "Was God an Astronaut?", von Däniken suggests that Ezekiel had seen a spaceship or spaceships; this hypothesis had been put forward by Morris Jessup in 1956 and by Arthur W. Orton in 1961. A detailed version of this hypothesis was described by Josef F. Blumrich in his book The Spaceships of Ezekiel (1974).
===== Elsewhere in the Bible =====
The characteristics of the Ark of the Covenant and the Urim and Thummim have been said to suggest high technology, perhaps from alien origins.
Robert Dione and Paul Misraki published books in the 1960s describing the events in the Bible as caused by alien technology. Barry Downing, a Presbyterian minister, wrote a book in 1968 arguing that Jesus was an extraterrestrial, citing John 8:23 and other biblical verses as evidence.
Some ancient astronaut proponents such as Von Däniken and Barry Downing believe that the concept of hell in the Bible could be a real description of the planet Venus brought to Earth by extraterrestrials showing photos of the hot surface on Venus to humans. Proponents of the hypothesis state that 'God' and 'Satan' were aliens that disagreed on whether or not human beings should be allowed the information that is offered by the tree of knowledge. David Childress, a leading proponent of ancient astronaut creation hypothesis, compares this story to the Greek tale of Prometheus, who gave mankind the knowledge of fire. Ancient Astronaut proponents believe the biblical concept of Satan is based on a misunderstood visit by extraterrestrials. Erich von Däniken posited that the descendants of extraterrestrials had children with hominids, and this was referred to in the Bible as the "Original sin." Von Däniken believes that the biblical great flood was punishment after an extraterrestrial 'God' discovered that earthbound, fallen angels were mating with ape-like early humans.

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==== The Book of Invasions ====
Childress and others have written that the passage in the Book of Invasions describing the arrival of the Tuatha Dé Danann in Ireland, records "the arrival of aliens in spacecraft with cloaking devices" at Slieve Anierin. The text states "so that they were the Tuatha De Danand who came to Ireland. In this wise they came, in dark clouds. They landed on the mountains of Conmaicne Rein in Connacht and they brought a darkness over the sun for three days and three nights".
=== Ancient artwork ===
==== Worldwide petroglyphic evidence ====
Ancient astronaut proponents believe Hopi cave drawings of Kachinas (spirit beings) found in the desert link the origins of the Hopi and Zuni tribes with "star people". They point to similar etchings elsewhere as evidence that extraterrestrials visited many different ancient civilizations.
Other artistic support for the ancient astronaut hypothesis has been sought in Palaeolithic cave paintings. Wondjina in Australia and in the Rock Drawings in Valcamonica, in Italy (seen above) are said to bear a resemblance to present day astronauts. Supporters of the ancient astronaut hypothesis sometimes argue that similarities such as dome shaped heads, interpreted as beings wearing space helmets, prove that early man was visited by an extraterrestrial race.
==== Medieval and Renaissance art ====
More support of this hypothesis draws upon what are said to be representations of flying saucers and other unidentified flying objects in Medieval and Renaissance art.
Some examples of these said objects include an ovoid shape in the sky of the painting Madonna con Bambino e San Giovannino (Madonna and Child with the Infant Saint John), an unidentified flying object in the Annunciazione (Annunciation) (1486) by Carlo Crivelli, a "spherical object with antennae" that appears similar to Sputnik in Bonaventura Salimbeni's Santissima Trinita (Holy Trinity) (1595), and many such unidentified flying objects in Masolino Da Panicale's Miracolo della neve (Miracle of the Snow) (1428). According to Italian art expert Diego Cuoghi, these objects contain religious symbolism behind them as most paintings of the time were of religious subjects. In such artworks, he says that angels and "radiant clouds" often appear in the sky. He says the object in the Madonna and Child is one of these radiant clouds, the object in the Annunciazione is a vortex of angels, the Sputnik-like object of Santissima Trinita is a globe representing creation with two sceptres held by God and Christ, and the Miracolo della neve contains many lenticular clouds.
==== Nazca Lines ====
The ancient Nazca Lines are hundreds of huge ground drawings etched into the high desert of southern Peru. Some are stylized animals and humanoid figures, while others are merely straight lines hundreds of meters long. As the figures were made to be seen from a great height, they have been linked with the ancient astronaut hypothesis. In the 1970s, the pseudohistorical writer Erich von Däniken popularized a notion that the Nazca lines and figures could have been made "according to instructions from aircraft" and that the longer and wider lines might be runways for spacecraft. According to archaeologist Kenneth Feder, Von Däniken's extraterrestrial interpretation is not supported by any evidence. Feder wrote that "the lines are interpreted by archaeologists as ceremonial pathways of the ancient Nazca people; they were used precisely in this way in the fairly recent past."
Joe Nickell of the University of Kentucky re-created one of the figures using only wooden stakes and string.
=== Ancient artifacts ===
==== Ancient flying machines ====
Proponents of the ancient astronauts idea say some artifacts discovered in Egypt (the Saqqara Bird) and Colombia-Ecuador (Quimbaya artifacts) are similar to modern planes and gliders. These artifacts have been interpreted by mainstream archaeologists, however, as stylized representations of birds and insects.
=== Ancient structures and megalithic sites ===
Proposed evidence for ancient astronauts includes the existence of ancient monuments and megalithic ruins such as the Giza pyramids of Egypt, Machu Picchu in Peru, or Baalbek in Lebanon, the Moai of Easter Island and Stonehenge of England. Supporters say that these stone structures could not have been built with the technical abilities and tools of the people of the time and further argue that many could not be duplicated even today. They suggest that the large size of the building stones, the precision with which they were laid, and the distances many were transported leaves the question open as to who constructed these sites.
These ideas are categorically rejected by mainstream archeology. Some mainstream archeologists have participated in experiments to move large megaliths. These experiments have succeeded in moving megaliths up to at least 40 tons, and some have speculated that with a larger workforce larger megaliths could be towed with the use of known ancient technology.
==== Pyramids of Egypt ====
Von Däniken states that ancient Egypt, with its great structures of the Giza pyramid complex such as the Great Pyramid of Giza and the Great Sphinx of Giza, became a "fantastic, ready-made civilization" suddenly and without transitions and development. Ancient astronaut proponents suggest that sites like the pyramids of Giza were instead constructed by extraterrestrials. However, archaeological evidence demonstrates not only the long cultural trajectory of prehistoric Egypt but also the developmental processes the ancient Egyptians underwent. Egyptian tombs began with important leaders of villages being buried in the bedrock and covered with mounds of earth. Eventually, the first pharaohs had tombs covered with single-story, mud-brick, square structures called mastabas. The stepped pyramid developed out of multiple mastabas being stacked on each one in one structure. This led to the construction of pharaoh Djoser's Step Pyramid at Saqqara, which is known from records to have been built by the ancient Egyptian architect and advisor Imhotep. It was pharaoh Sneferu who had his pyramid transitioned from a stepped to a true pyramid like the well-known pyramids of Giza. A papyrus document like a logbook kept by an official called inspector Merer has also been discovered with records of the construction of the Great Pyramid.

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==== Moai ====
The Moai statues of Easter Island were moved miles from the Rano Raraku quarry to their current locations, and archaeologists have wondered how massive statues such as these could have been transported. The folklore of the native Rapa Nui people says that chiefs and priests used mana to make the statues of the island walk. In 1982, Czech engineer Pavel Pavel and a group of sixteen people used a replica concrete moai to test a method that could have transported the statues. They tied ropes to it and in two groups pulled and twisted it back and forth, making it move forward in a walking motion. They called it the "refrigerator method" and demonstrated that the massive statues could be easily moved by a small group of people.
=== Religious and cultural practices ===
A number of ancient cultures, such as the ancient Egyptians and some Native Americans, artificially lengthened the skulls of their children. Some ancient astronaut proponents propose that this was done to emulate extraterrestrial visitors, whom they saw as gods.
==== Akhenaten ====
Among the ancient rulers depicted with elongated skulls are pharaoh Akhenaten and his wife Nefertiti. The depiction of Akhenaten and his family with traits like elongated skulls, limbs, underdeveloped torsos, and gynecomastia in Amarna art is hypothesized to be the effect of a familial disease. Marriage between family members, especially siblings, was common in ancient Egyptian royal families, elevating the risk of such disorders. Studies on the remains of the ruling family of 18th Dynasty Egypt have found evidence of deformities and illnesses. Proposed syndromes of Akhenaten include Loeys-Dietz syndrome, Marfan's syndrome, Frohlich syndrome, and Antley-Bixler syndrome. Akhenaten worshipped the sun disk god Aten and it is suggested that such worship could point to a disease that is alleviated by sunlight.
== In popular culture ==
Ancient astronauts have been addressed frequently in science fiction and horror fiction in many different media. In a 2004 article in Skeptic magazine, Jason Colavito writes that von Däniken borrowed many of the book's concepts from Le Matin des magiciens (Morning of the Magicians), that this book in turn was heavily influenced by the Cthulhu Mythos, and that the core of the ancient astronaut hypothesis originates in H. P. Lovecraft's works "The Call of Cthulhu" and At the Mountains of Madness. Colavito later expanded on this idea in his book The Cult of Alien Gods: H. P. Lovecraft and Extraterrestrial Pop Culture.
The idea that aliens visited Earth in the past is frequently seen in works of fiction. For example, the comic book Thor considers that all the Norse mythology is based on actual beings living in other dimensions, who were worshipped as gods by the Vikings and who reappear on Earth in modern times. Däniken's work, however, inspired several works and franchises over time, such as Eternals, Stargate, Indiana Jones and the Kingdom of the Crystal Skull, Prometheus and The X-Files. All those works do not take the idea seriously, but merely use it as a narrative device. Another angle may be to leave the aliens out of the story, and focus instead on devices they left behind, as in the novels Scarlet Dream, Galactic Derelict, World of Ptavvs, Toolmaker Koan, and A Fire Upon the Deep. Aliens may also appear as an elder race that created or shepherded humans in their early times; and may or may not be present in the work's present day.
Ancient Aliens is a television series that features proponents of the ancient astronaut hypothesis, such as Giorgio A. Tsoukalos, David Childress, Erich von Däniken, Steven M. Greer, and Nick Pope.
== Proponents ==
Many publications have argued for the ancient astronauts hypotheses. The following are notable examples:
== See also ==
Archaeoastronomy
Vimana
Extraterrestrials in Meitei culture
Extraterrestrial hypothesis
First contact (science fiction)
List of topics characterized as pseudoscience
Panspermia
Pseudoarchaeology
Science fantasy
Silurian hypothesis
Xenoarchaeology
In film:
2001: A Space Odyssey
== Notes ==
== References ==
=== Bibliography ===
== Further reading ==
Avalos, Hector (2002), "The Ancient Near East in Modern Science Fiction: Zechariah Sitchin's The 12th Planet as Case Study", Journal of Higher Criticism, vol. 9, no. 1, pp. 4970
Colavito, Jason (2005), The Cult of Alien Gods: H. P. Lovecraft and Extraterrestrial Pop Culture, Prometheus Books, ISBN 1-59102-352-1
Fagan, Garrett G. (2006). Archaeological Fantasies: How Pseudoarchaeology Misrepresents the Past and Misleads the Public. Routledge. ISBN 0-415-30593-4
Grünschloß, Andreas (June 2006), ""Ancient Astronaut" Narrations: A Popular Discourse on Our Religious Past" (PDF), Marburg Journal of Religion, vol. 11, no. 1, ISSN 1612-2941, archived (PDF) from the original on March 9, 2008, retrieved December 9, 2006
Harris, Christie. (1975). Sky Man on the Totem Pole?. New York: Atheneum. ISBN 0-689-30450-1
Raël (1974), The Message Given by Extra-terrestrials, Nova Dist, ISBN 2-940252-20-3
Sitchin, Zecharia (1999), The 12th Planet (The Earth Chronicles, Book 1), Avon, ISBN 0-380-39362-X
Stiebing, William H. (1984). Ancient Astronauts, Cosmic Collisions and Other Popular Theories About Man's Past. Prometheus Books. ISBN 0-87975-285-8
Story, Ronald. (1976). The Space Gods Revealed: A Close Look at the Theories of Erich von Däniken. Harper & Row. ISBN 0-06-014141-7
Trefil, James. (2007). "Who Were the Ancient Engineers of Egypt?". Skeptical Inquirer (Committee for Skeptical Inquiry) 17.1.
White, Peter. (1976). The Past Is Human: Debunking Von Daniken's Gee-Whiz Theories. Taplinger. ISBN 978-0-8008-6266-4
== External links ==
'Fringe' or 'cult' archaeology examined by professional archaeologist Keith Fitzpatrick-Matthews, archived from the original on December 14, 2007, retrieved February 4, 2007
Ancient Astronauts Skeptic's Dictionary
Dunning, Brian. "Skeptoid #449: Ancient Astronauts". Skeptoid.

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Anecdotal evidence (or anecdata) is evidence based on descriptions and reports of individual, personal experiences, or observations, collected in a non-systematic manner.
The term anecdotal encompasses a variety of forms of evidence, including personal experiences, self-reported claims, eyewitness accounts of others, and those from fictional sources, making it a broad category that can lead to confusion due to its varied interpretations. Anecdotal evidence can be true or false but is not usually subjected to scholarly methods, scientific methods, or rules of legal, historical, academic, or intellectual rigor, meaning there are little or no safeguards against fabrication or inaccuracy. However, the use of anecdotal reports in advertising or promotion of a product, service, or idea may be considered a testimonial, which is highly regulated in certain jurisdictions.
The persuasiveness of anecdotal evidence compared to that of statistical evidence has been a subject of debate; some studies have argued that there is a generalized tendency to overvalue anecdotal evidence, whereas others argue the contrary.
== Scientific context ==
In science, definitions of anecdotal evidence include:
"casual observations/indications rather than rigorous or scientific analysis"
"information passed along by word-of-mouth but not documented scientifically"
"evidence that comes from an individual experience. This may be the experience of a person with an illness or the experience of a practitioner based on one or more patients outside a formal research study"
"the report of an experience by one or more persons that is not objectively documented or an experience or outcome that occurred outside of a controlled environment"
Anecdotal evidence may be considered within the scope of scientific methods. Some anecdotal evidence can be both empirical and verifiable, e.g., case studies in medicine. Other anecdotal evidence does not qualify as scientific evidence because its nature prevents it from being investigated by the scientific method, such as folklore or intentionally fictional anecdotes. Anecdotal evidence is considered the least certain type of scientific literature. Researchers may use anecdotal evidence for suggesting new hypotheses but never as validating evidence.
Anecdotal evidence varies in formality. For instance, in medicine, published anecdotal evidence by a doctor like a case report is subjected to formal peer review. Although such evidence is seen as inconclusive, researchers sometimes regard it as an invitation to more rigorous scientific study. For instance, one study found that 35 of 47 anecdotal reports of drug side effects were later sustained as "clearly correct".
Where only one or few anecdotes are presented, they risk being unreliable due to cherry-picking or otherwise non-representative sampling. Similarly, psychologists have found that due to cognitive bias, people are more likely to remember notable or unusual examples. Thus, anecdotal evidence is not necessarily representative of a typical experience even when accurate. Determination of whether an anecdote is typical requires statistical evidence. Misuse of anecdotal evidence in the form of argument from anecdote is an informal fallacy and is sometimes referred to as the "person who" fallacy, with statements like "I know a person who..." or "I know of a case where...". This places undue weight on possibly atypical experiences of close peers. If an anecdote illustrates a desired conclusion rather than a logical conclusion, it is considered a faulty generalization.
In medicine, anecdotal evidence may be subject to the placebo effect.
== Legal ==
In the legal sphere, anecdotal evidence, if it passes certain legal requirements and is admitted as testimony, is a common form of evidence used in a court of law. In many cases, anecdotal evidence is the only evidence presented at trial.
For a testimony to be considered evidence, it must be given under oath, where the individual swears they only testify to their words and actions. Someone intentionally lying under oath is subject to perjury. However, these legal rigors do not make testimony in a court of law equal to scientific evidence. Testimony about another person's experiences or words is termed hearsay and is usually not admissible. However, hearsay that is not objected to by a judge is considered evidence for a jury. This means trials contain a considerable amount of anecdotal evidence that juries find relevant. Eyewitness testimony, a type of anecdotal evidence, is considered the most compelling form of evidence by a jury.
== See also ==
== References ==

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Anthroposophic medicine (or anthroposophical medicine) is a form of alternative medicine based on pseudoscientific and occult notions. Devised in the 1920s by Rudolf Steiner (18611925) in conjunction with Ita Wegman (18761943), anthroposophical medicine draws on Steiner's spiritual philosophy, which he called anthroposophy. Practitioners employ a variety of treatment techniques based upon anthroposophic precepts, including massage, exercise, counselling, and administration of substances.
Many drug preparations used in anthroposophic medicine are ultra-diluted, similar to those used in homeopathy. Homeopathic remedies are not medically effective and are generally considered harmless, except when used as a substitute for a scientifically proven and effective prevention and cure. In certain European countries, people with cancer are sometimes prescribed remedies made from specially harvested mistletoe, although no evidence of clinical benefit exists. Some anthroposophic doctors oppose childhood vaccination, and this has led to preventable outbreaks of disease.
Anthroposophic medicine departs from fundamental biological, physical, and chemical principles in several respects. For example, Steiner said that the heart is not a pump, but that the blood, in a sense, pumps itself. Anthroposophic medicine also proposes that patients' past lives may influence their illness and that the course of an illness is subject to karmic destiny. Professor of complementary medicine Edzard Ernst and other physicians and scientists including Simon Singh and David Gorski have characterized anthroposophic medicine as pseudoscientific quackery, with no basis in reason or logic.
== Background ==
=== History ===
According to Egil Asprem, "Steiner's teachings had a clear authoritarian ring, and developed a rather crass polemic against 'materialism', 'liberalism', and cultural 'degeneration'. [...] For example, anthroposophical medicine was developed to contrast with the 'materialistic' (and hence 'degenerate') medicine of the establishment." According to anthroposophy, mainstream medical science is "Ahrimanic".
The first steps toward an anthroposophic approach to medicine were taken before 1920, when homeopathic physicians and pharmacists began working with Steiner, who recommended a new form of pharmacy, Anthroposophic Pharmacy, along with specific preparation methods and an anthroposophic concept of humankind. In 1921, Ita Wegman opened the first anthroposophic medical clinic, now known as the Klinik Arlesheim, in Arlesheim, Switzerland. Wegman was soon joined by several other clinicians, who trained the first anthroposophic nurses for the clinic.
At Wegman's request, Steiner regularly visited the clinic and suggested treatment regimes for particular patients. Between 1920 and 1925, he also gave several series of medical lectures. In 1925, Wegman and Steiner wrote the first book on the anthroposophic approach to medicine, Fundamentals of Therapy.
Wegman later opened a separate clinic and curative home in Ascona. Wegman lectured widely, visiting the Netherlands and England particularly frequently, and an increasing number of physicians began to include the anthroposophic approach in their practices. The Lukas Clinic, a cancer clinic, opened in Arlesheim in 1963.
In 1976, anthroposophic medicine in Germany was regulated by law as a specific therapeutic system (Besondere Therapierichtung) under the Medicines Act and the Social Law Code V. In the 1990s, the Witten/Herdecke University in Germany established a chair in anthroposophical medicine. The press described the appointment as a "death sentence," and the perception that pseudoscience was being taught damaged the university's reputation, bringing it to the brink of financial collapse. A cash injection ultimately saved it from Software AG, a technology corporation with a history of funding anthroposophic projects.
In 2012, the University of Aberdeen considered establishing a chair in holistic health jointly funded by Software AG and the Anthroposophic Health, Education, and Social Care Movement, each of which would provide £1.5 million of endowment. Edzard Ernst commented, "that any decent university should even consider an anthroposophical medicine unit seems incomprehensible. The fact that it would be backed by people who have a financial interest in this bogus approach makes it even worse." The university's governance and nominations committee eventually decided not to proceed with the appointment.
Joseph A. Schwarcz (2022) regards Steiner as a quack.
=== Categorization and conceptual basis ===
The categorization of anthroposophical medicine is complex because it both complements and substitutes conventional medicine. In 2008, Ernst wrote that it was being promoted as an "extension to conventional medicine".
Ernst writes that Steiner used imagination and insight as a basis for his ideas, drawing on mystical knowledge from the occult Akashic Records, a work supposedly situated on the astral plane, which Steiner said he could access via his intuitive powers. On this basis, Steiner proposed "associations between four postulated dimensions of the human body (physical body, etheric body, astral body, and ego), plants, minerals, and the cosmos". Steiner also proposed a connection betweens planets, metals and organs so that, for example, the planet Mercury, the element mercury and the lung were all somehow associated. These propositions form the basis of anthroposophical medicine.
Ernst has said that anthroposophical medicine "includes some of the least plausible theories one could possibly imagine", categorized it as "pure quackery", and said that it "has no basis in science". According to Quackwatch, anthroposophical medicine practitioners regard illness as a "rite of passage" necessary to purge spiritual impurities carried over from past lives, according to the precepts of "karmic destiny".
The French governmental anti-cult agency MIVILUDES reported in 2022 that it remains vigilant about anthroposophy, especially because of its deviant medical applications and its work with underage persons. According to Ernst, "Anthroposophic medicine is based on several bizarre assumptions". Steiner seems to have been right about the role of diet in health maintenance, although his assumptions were erroneous.
== Methods ==
In anthroposophic pharmacy, drugs are prepared according to notions of alchemy and homeopathy rather than the science underlying modern pharmacology. During the preparation process, patterns formed by crystallization are interpreted to see which "etheric force" they most closely resemble. Most anthroposophic preparations are highly diluted, akin to homeopathic remedies. This means that, while they are completely harmless in themselves, using them in place of conventional medicine to treat serious illness carries a risk of severe adverse consequences.
As well as drug remedies, anthroposophical medicine also includes:

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Anthroposophic nursing
Counselling
Eurythmy claimed to affect "inner life functions" leading to a "re-integration of body, soul, and spirit".
External applications
Rhythmic massages
=== Plant-derived treatments ===
To select an anthroposophic substance for a particular illness, practitioners consider the source of the substances used. The character of a mineral, plant, or animal is hypothesised to have been formed by the substances most active within it, in the belief that this character may also influence what those substances accomplish when given to treat another organism. This is related to the doctrine of signatures. Willow, for example, is considered to have an unusual character:
... plants that grow near water are usually heavy, with big, dark green leaves that wilt and break easily. An exception is ... the white willow, a tree that always grows near water and loves light. However, unlike other "watery" plants, the willow has fine, almost dry leaves and looks very light ... Its branches are unbelievably tough. They are elastic and cannot be broken. They bend easily and form "joints" rather than break. These few signatures can give us the clue to what salix can be used for therapeutically: arthritis, deformation of joints, swollen joints ...
There is no scientific evidence that the shape of plants has ever caused a new medical property to be discovered.
=== Beliefs about human biology ===
Steiner described the heart not as a pump but as a regulator of flow, such that the heartbeat itself can be distinguished from the circulation of blood. Anthroposophic medicine claims the flow of blood of the circulatory system is, as Marinelli put it, "propelled with its own biological momentum, as can be seen in the embryo, and boosts itself with induced momenta from the heart".
This view of the heart is not based on any scientific theory and has been characterized as "crank science".
Steiner believed that the sex of a baby was determined at the moment of conception by the alignment of the stars.
Steiner's model of anatomy was based on a three-part notion whereby the head is the "thinking part," the abdomen and limbs the "metabolic part," and the chest and heart a "rhythmic center".
According to Dan Dugan, Steiner challenged established science in the following ways:
by supporting vitalism;
by doubting germ theory;
by ignoring physiological systems;
by hypothesizing that "the heart is not a pump".
=== Reaction to COVID-19 ===
During the COVID-19 pandemic, Steiner hospitals in Germany became notorious amongst healthcare authorities for forcing quack remedies on sedated hospital patients, some of whom were critically ill. Remedies used included ginger poultices and homeopathic pellets claimed to contain the dust of shooting stars. Stefan Kluge, the director of intensive care medicine at Hamburg's University Medical Centre, said the claims of anthroposophic providers during the pandemic were "highly unprofessional" and that they "risk[ed] causing uncertainty among patients".
=== Mistletoe treatment for cancer ===
Rudolf Steiner conjectured that mistletoe could cure cancer based on the observation that the plant was a parasite that eventually killed its host—a process he claimed paralleled the progression of cancer. Steiner believed the plant's medical potential was influenced by the position of the sun, moon, and planets and that it was important to harvest the plant at the right time. Some mistletoe preparations are ultra-diluted; others are made from fermented mistletoe. The most commonly used trade names for mistletoe drugs are Iscador and Helixor.
Although laboratory experiments have suggested that mistletoe extract may affect the immune system and be able to kill some kinds of cancer cells, there is little evidence of its benefit to people with cancer. Most of the clinical research claiming that mistletoe therapy is effective is published in Germany, and it is generally considered unreliable because of major lapses in quality. Edzard Ernst wrote that research by anthroposophic clinicians often reached positive conclusions on mistletoe therapy because it drew on unreliable material; independent researchers tended instead to find no evidence of benefit. The American Cancer Society says that "available evidence from well-designed clinical trials does not support claims that mistletoe can improve length or quality of life".
Mistletoe-based cancer drugs are widely used in Europe, especially in German-speaking countries. In 2002, nearly half a million prescriptions were paid for by German health insurance, and in 2006, there were reportedly around 30 types of mistletoe extract on the market. Mistletoe extracts have been used as an unconventional treatment for cancer patients in the Netherlands, and in Germany, the treatment has been approved as palliative therapy to treat the symptoms of patients with malignant tumors. In Sweden, controversially, mistletoe therapy has been approved for use in the treatment of cancer symptoms.
In other countries, mistletoe therapy is virtually unknown. The United States Food and Drug Administration has not approved mistletoe-based drugs for any purpose; mistletoe extracts may not be distributed in or imported to the U.S. except for research purposes. As of 2015 no mistletoe-based drugs are licensed for use in the United Kingdom.
A 2013 article on mistletoe in Lancet Oncology invoked Ben Goldacre's observation that a geographical preference for certain therapies was a hallmark of quackery, and proposed that the continuing use of this "apparently ineffectual therapy" in a small cluster of countries was based on sociological rather than medical reasons, indicating a need for a more informed consent from patients.
== Immunization ==

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The risks arising from using anthroposophical medicine as a substitute for evidence-based medicine are exemplified by several cases of low vaccination levels in Waldorf schools, since some anthroposophical doctors oppose immunization. A 1999 study of children in Sweden showed that in Waldorf schools, only 18% had received MMR vaccination, compared to a level of 93% in other schools nationally.
A 2003 report of a widespread measles outbreak around Coburg, Germany, identified a Waldorf school as the origin. At the time, the town's mayor had condemned homeopathic doctors who had discouraged vaccination, saying, "Their stronghold is the Waldorf School, which actively encourages people not to have their children vaccinated. Now we have an epidemic."
Paul Offit wrote that Steiner believed vaccination "interferes with karmic development and the cycles of reincarnation", and that adherence to this belief led to a 2008 pertussis outbreak in a Californian Waldorf school, causing its temporary closure.
== See also ==
Alternative cancer treatments
Herbalism
Holistic health
== References ==
== Further reading ==
=== Books and journal articles ===
Ernst, Edzard (2004). "Anthroposophical medicine: A systematic review of randomised clinical trials". Wiener klinische Wochenschrift. 116 (4): 12830. doi:10.1007/bf03040749. PMID 15038403. S2CID 7435250.
Kienle, GS; Kiene, H (2007). "Complementary cancer therapy: A systematic review of prospective clinical trials on anthroposophic mistletoe extracts". European Journal of Medical Research. 12 (3): 10319. PMID 17507307.
Singh, Simon; Ernst, Edzard (2009). "Anthroposophical medicine". Trick or Treatment? Alternative Medicine on Trial. Transworld. ISBN 978-1-4090-8180-7.
=== Lectures by Rudolf Steiner ===
Broken Vessels: The Spiritual Structure of Human Frailty, Michael Lipson (ed.). ISBN 0-88010-503-8.
Fundamentals of Anthroposophical Medicine, ISBN 0-936132-80-9.
Geographic medicine: The secret of the double. ISBN 0-936132-06-X
The Healing Process: Spirit, Nature & Our Bodies, Catherine E. Creeger (ed.). ISBN 0-88010-474-0
Introducing Anthroposophical Medicine (Foundations of Anthroposophical Medicine, v. 1). ISBN 0-88010-463-5
Medicine: An Introductory Reader, Andrew Maendl (ed.). ISBN 1-85584-133-9
Occult Physiology ISBN 1-85584-141-X
Pastoral Medicine: The Collegial Working of Doctors and Priests. ISBN 0-88010-253-5
== External links ==
Medical Section at the Rudolf Steiner Archive, An Online Library
Anthroposophic Medical Library, An Online Resource

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The anti-sunscreen movement is a loosely organized online trend that promotes skepticism about the safety and effectiveness of sunscreen. Adherents commonly claim that commercial sunscreens are toxic, that avoiding sunscreen is healthier for vitamin D status, that dietary changes (such as avoiding so-called "seed oils") can prevent sunburn, or that homemade products offer adequate protection. These claims have been amplified on TikTok, Instagram and other platforms, and have been criticized by dermatologists and public-health organizations as misinforming the public about the prevention of skin cancer.
== Background ==
Sunscreens are over-the-counter drugs in the United States that reduce exposure to ultraviolet (UV) radiation, a known human carcinogen. Dermatology organizations recommend daily use of a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher, applied in sufficient quantity and reapplied regularly when outdoors.
Concerns about ingredient absorption were heightened by U.S. FDAsponsored randomized trials in 2019 and 2020 showing that several organic (chemical) UV filters can be detected in blood after maximal-use application. Regulators and investigators emphasized that absorption does not imply harm and that further toxicology data are needed, while continuing to recommend sun protection.
In 2021, several aerosol sunscreens were voluntarily recalled in the U.S. after testing found contamination with benzene, a carcinogenic solvent. Public-health sources noted that benzene is not a sunscreen ingredient and that the issue was a manufacturing contamination affecting certain batches, primarily sprays.
=== Evidence from randomized trials and reviews ===
A 2011 critical review in Photodermatology, Photoimmunology & Photomedicine concluded that regular sunscreen use prevents squamous cell carcinoma (SCC), while evidence for basal cell carcinoma (BCC) reduction was mixed and melanoma prevention remained inconclusive in older studies conducted with low-SPF, weak-UVA products. The review emphasized that systemic absorption of some organic UV filters does not imply harm, that typical use does not cause vitamin D deficiency, and that zinc oxide/titanium dioxide nanoparticles remain within the stratum corneum in healthy skin. It also found no convincing human evidence that retinyl palmitate in sunscreens is photocarcinogenic. Long-term trials using contemporary broad-spectrum sunscreens were identified as a need.
Randomized evidence from the Nambour, Australia community trial showed that daily sunscreen application prevented SCC during the 4.5-year trial; extended follow-up to 2004 found a ~38% lower SCC tumor incidence in the group originally randomized to daily sunscreen, with no clear benefit for BCC. Reported outdoor time did not differ between groups during follow-up, arguing against risk-compensation as the explanation for SCC reduction.
In children, a randomized trial of broad-spectrum SPF 30 sunscreen over three years found fewer new melanocytic nevi in the intervention group (median 24 vs 28), with modeling suggesting 3040% fewer new nevi among freckled children. Because higher nevus counts are a melanoma risk factor, these findings support sunscreen as a pediatric photoprotection strategy while not serving as direct melanoma-incidence evidence.
== Origins and growth ==
Commentators and reporters identified the movements rise with wellness-influencer communities and short-form video platforms in the early to mid-2020s. Newspaper coverage in 20242025 described creators who discourage sunscreen or promote “natural” alternatives and sun “tolerance,” often framing such content as a corrective to perceived regulatory or industry failures.
=== Key proponents ===
The anti-sunscreen movement is largely decentralized and promoted by numerous online influencers in the wellness and alternative health communities. Reporting by The Wall Street Journal and other outlets has highlighted several social media accounts that have gained large followings while promoting anti-sunscreen content. Such content is often spread by influencers who are not medical professionals.
=== Extremist and antisemitic variants ===
Analyses of the anti-sunscreen movement note that, on fringe and extremist forums, some narratives become explicitly antisemitic—casting sunscreen as part of a supposed “Jewish” plot or linking it to ideologies with antisemitic roots. Research from the Middlebury Institutes Center on Terrorism, Extremism, and Counterterrorism (CTEC) documents posts on imageboards that frame sunscreen as a “Jewish trick” and traces links to Germanic New Medicine, an alternative-medicine ideology whose founder advanced antisemitic conspiracy claims.
Trade and academic commentary similarly report that antisemitic rhetoric appears in “sunscreen truther” content on extremist platforms such as 4chan and alternative social networks, where broader conspiracist tropes (e.g., blaming “Big Pharma” or shadowy elites) are fused with explicit blame directed at Jews.
Mainstream public-health sources and dermatology guidance reject these claims as baseless and emphasize that sunscreen use reduces ultraviolet exposure and related disease risk.
== Narratives and claims ==
This table summarizes the most common narratives promoted by the anti-sunscreen movement and the state of the scientific evidence.
== Public-health and expert responses ==
Professional societies and health systems have issued reminders on evidenced sun-safety practices (seeking shade, protective clothing, and appropriate sunscreen use) and cautioned against untested alternatives and false claims amplified by social media. In August 2025, the FDA warned that certain mousse-format sunscreen products may be ineffective and issued warning letters to companies marketing unapproved drug products, while reiterating the importance of effective sun protection.
Dermatological and cancer-prevention organizations have actively worked to counter the claims of the anti-sunscreen movement. In addition to the American Academy of Dermatology, Canadian dermatologists have labeled the claims as "misinformation," emphasizing that the risk from UV radiation far outweighs any purported risks from sunscreen ingredients. The Cancer Council of Australia explicitly advises against using homemade sunscreens, noting they are not regulated for safety or efficacy and that natural oils provide insufficient protection.
Experts also address the benzene contamination issue by clarifying it was a specific manufacturing problem affecting certain aerosol products and that benzene is not an ingredient in sunscreens. Public health messaging consistently reinforces that proven sun-safety practices—seeking shade, wearing protective clothing, and using a properly-tested, broad-spectrum sunscreen—remain the most effective strategies for preventing skin cancer.
== Media coverage ==
Mainstream reporting has framed anti-sunscreen narratives as part of a broader wave of wellness-oriented health misinformation online, noting the potential for harm if people abandon proven UV protection strategies.
== See also ==
Health misinformation
Sun tanning
Ultraviolet
Photoaging
Sunburn
== References ==
== External links ==
"Sun protection (patient guidance)". American Academy of Dermatology. American Academy of Dermatology Association. Retrieved 25 August 2025.

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Applied kinesiology (AK), also known as muscle testing, is a pseudoscience-based technique in alternative medicine claimed to be able to diagnose illness or choose treatment by testing muscles for strength and weakness.
According to their guidelines on allergy diagnostic testing, the American College of Allergy, Asthma and Immunology stated there is "no evidence of diagnostic validity" of applied kinesiology. Another study indicated that the use of applied kinesiology to evaluate nutrient status is "no more useful than random guessing." The American Cancer Society has said that "scientific evidence does not support the claim that applied kinesiology can diagnose or treat cancer or other illness".
== History and current use ==
George J. Goodheart, a chiropractor, originated applied kinesiology in 1964 and began teaching it to other chiropractors. An organization of Goodheart Study Group Leaders began meeting in 1973, selected the name "The International College of Applied Kinesiology" (ICAK) in 1974, adopted bylaws in 1975, elected officers in 1975, and "certified" its charter members (called "diplomates") in 1976. ICAK now considers 1976 to be the date it was founded and 1973 to be the date that its first chairman took office.
AK grew in popularity among Mormon alternative medicine culture. In Educated, Tara Westover recounts her Mormon mother beginning to practice AK in the mid-to-late 1990s. In 2007, Mormon chiropractor Bradley Nelson published the AK book The Emotion Code, which further popularized the practice.
While AK is primarily used by chiropractors, it is also used by many other practitioners of complementary therapy. In 2003, it was the 10th most frequently used chiropractic technique in the United States, with 37.6% of chiropractors employing this method and 12.9% of patients being treated with it. Some basic AK-based techniques have also been used by nutritional supplement distributors, including multilevel distributors.
== Claims ==
Applied kinesiology is presented as a system that evaluates structural, chemical, and mental aspects of health by using a method referred to as muscle response testing or manual muscle testing (MMT) alongside conventional diagnostic methods. The essential premise of applied kinesiology, which is not shared by mainstream medical theory, is that every organ dysfunction is accompanied by a weakness in a specific corresponding muscle, known as the "viscerosomatic relationship". Treatment modalities relied upon by AK practitioners include joint manipulation and mobilization, myofascial, cranial and meridian therapies, clinical nutrition, and dietary counseling.
=== Muscle testing ===
A manual muscle test in AK is conducted by having the patient use the target muscle or muscle group to resist while the practitioner applies a force. A smooth response is sometimes referred to as a "strong muscle," and a response that was not appropriate is sometimes called a "weak response". This is not a raw test of strength, but rather a subjective evaluation of tension in the muscle and smoothness of response, taken to be indicative of a difference in spindle cell response during contraction. These differences in muscle response are claimed to be indicative of various stresses and imbalances in the body. A weak muscle test is equated to dysfunction and chemical or structural imbalance or mental stress, indicative of suboptimal functioning. It may be suboptimal functioning of the tested target muscle, or a normally optimally functioning muscle can be used as an indicator muscle for other physiological testing. A commonly known and very basic test is the arm-pull-down test, or "Delta test," where the patient resists as the practitioner exerts a downward force on an extended arm. Proper positioning is paramount to ensure that the muscle in question is isolated or positioned as the prime mover, minimizing interference from adjacent muscle groups.
=== Nutrient testing ===
Nutrient testing is used to examine the response of a patient's various muscles to assorted chemicals. Gustatory and olfactory stimulation are said to alter the outcome of a manual muscle test, with previously weak muscles being strengthened by application of the correct nutritional supplement, and previously strong muscles being weakened by exposure to harmful or imbalancing substances or allergens. Though its use is deprecated by the ICAK, stimulation to test muscle response to a certain chemical is also done by contact or proximity (for instance, testing while the patient holds a bottle of pills).
=== Therapy localization ===
Therapy localization is another diagnostic technique using manual muscle testing, which is unique to applied kinesiology. The patient places a hand that is not being tested on the skin over an area suspected to need therapeutic attention. This fingertip contact may lead to a change in muscle response from strong to weak or vice versa when therapeutic intervention is indicated. If the area touched is not associated with a need for such intervention, the muscle response is unaffected.

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== Scientific research ==
In 2015 the Australian Government's Department of Health published the results of a review of alternative therapies that sought to determine if any were suitable for being covered by health insurance; applied kinesiology was one of 17 therapies evaluated for which no clear evidence of effectiveness was found. According to the American Cancer Society, "available scientific evidence does not support the claim that applied kinesiology can diagnose or treat cancer or other illness".
A review of several scientific studies of AK-specific procedures and diagnostic tests concluded: "When AK is disentangled from standard orthopedic muscle testing, the few studies evaluating unique AK procedures either refute or cannot support the validity of AK procedures as diagnostic tests. The evidence to date does not support the use of manual muscle testing for the diagnosis of organic disease or pre/subclinical conditions." Another concluded that "There is little or no scientific rationale for these methods. Results are not reproducible when subject to rigorous testing and do not correlate with clinical evidence of allergy." A double-blind study was conducted by the ALTA Foundation for Sports Medicine Research in Santa Monica, California, and published in the June 1988 Journal of the American Dietetic Association. The study used three experienced AK practitioners and concluded that, "The results of this study indicated that the use of applied kinesiology to evaluate nutrient status is no more useful than random guessing."
Despite more than four decades of review, RCT (randomized, controlled trials) and other evaluative methods, even invested researchers delivered the following opinion:
One shortcoming is the lack of RCTs to substantiate (or refute) the clinical utility (efficacy, effectiveness) of chiropractic interventions based on MMT findings. Also, because the etiology of a muscle weakness may be multifactorial, any RCT that employs only one mode of therapy to only one area of the body may produce outcomes that are poor due to these limitations.
== Criticism ==
Nearly all AK tests are subjective, relying solely on practitioner assessment of muscle response. Specifically, some studies have shown test-retest reliability, inter-tester reliability, and accuracy to have no better than chance correlations. Some skeptics have argued that there is no scientific understanding of the proposed underlying theory of a viscerosomatic relationship, and the efficacy of the modality is unestablished in some cases and doubtful in others. Skeptics have also dismissed AK as "quackery", "magical thinking", and a misinterpretation of the ideomotor effect. It has also been criticized on theoretical and empirical grounds, and characterized as pseudoscience. With only anecdotal accounts claiming to provide positive evidence for the efficacy of the practice, a review of peer-reviewed studies concluded that the "evidence to date does not support the use of [AK] for the diagnosis of organic disease or pre/subclinical conditions."
== Position statements ==
=== Allergy diagnosis ===
In the United States, the American Academy of Allergy, Asthma and Immunology and the National Institute of Allergy and Infectious Diseases have both advised that applied kinesiology should not be used in the diagnosis of allergies. The European Academy of Allergology and Clinical Immunology, the National Institute for Clinical Excellence of the UK, the Australasian Society of Clinical Immunology and Allergy and the Allergy Society of South Africa has also advised similarly. The World Allergy Organization does not have a formal position on applied kinesiology, but in educational materials from its Global Resources In Allergy program, it lists applied kinesiology as an unproven test and describes it as useless. In 1998, a small pilot study published in the International Journal of Neuroscience showed a correlation between applied kinesiology muscle testings and serum immunoglobulin levels for food allergies. In it, 19 of 21 (90.5%) suspected food allergies diagnosed by applied kinesiology were confirmed by serum immunoglobulin tests. A follow-up review published in 2005 in the Current Opinion of Allergy and Clinical Immunology concluded applied kinesiology had no proven basis for diagnosis.
=== American Chiropractic Association ===
According to the American Chiropractic Association, in 2003, applied kinesiology was the 10th most frequently used chiropractic technique in the United States, with 37.6% of chiropractors employing this method and 12.9% of patients being treated with it. They describe AK as follows:
This is an approach to chiropractic treatment in which several specific procedures may be combined. Diversified/manipulative adjusting techniques may be used with nutritional interventions, together with light massage of various points referred to as neurolymphatic and neurovascular points. Clinical decision-making is often based on testing and evaluating muscle strength.
=== Danish Chiropractic Association ===
According to a March 26, 1998, letter from the DKF (Dansk Kiropraktor Forening Danish Chiropractic Association), following public complaints from patients receiving homeopathic care and/or AK instead of standard (DKF-defined) chiropractic care, the DKF has determined that applied kinesiology is not a form of chiropractic care and must not be presented to the public as such. AK and homeopathy can continue to be practiced by chiropractors as long as it is noted to be alternative and adjunctive to chiropractic care and is not performed in a chiropractic clinic. Chiropractors may not infer or imply that the Danish chiropractic profession endorses AK to be legitimate or effective, nor may the word/title chiropractic/chiropractor be used or associated with the practice of AK.
== See also ==
Ideomotor effect
List of ineffective cancer treatments
List of topics characterized as pseudoscience
Nambudripad Allergy Elimination Technique
Observer-expectancy effect
Facilitated Communication
== References ==
== External links ==
=== Promotional sites ===
The International Journal of Applied Kinesiology and Kinesiologic Medicine
=== Skeptical evaluations ===
Applied Kinesiology: Muscle-Testing for "Allergies" and "Nutrient Deficiencies" by Stephen Barrett, Quackwatch
Applied Kinesiology by William T. Jarvis, The National Council Against Health Fraud
Applied kinesiology James Randi Educational Foundation, An Encyclopedia of Claims, Frauds, and Hoaxes of the Occult and Supernatural
The Mischief-Making of Ideomotor Action Archived 2008-02-10 at the Wayback Machine by Ray Hyman, The Scientific Review of Alternative Medicine
Applied Foolishness by John Blanton, The North Texas Skeptics
InteliHealth applied kinesiology article material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.
Muscle Testing by John Ankerberg and John Weldon, The Encyclopedia of New Age Beliefs
Walker, James (1992), "Testing Muscle Testing: Applied Kinesiology", The Watchman Expositor, vol. 9, no. 7, Watchman Fellowship ministry
Applied Kinesiology and Nutritional Muscle Response Testing: A Christian Perspective by Janice Lyons
Applied Kinesiology By Nicholas Brewer, 2006
Applied Kinesiology Archived 2021-03-08 at the Wayback Machine by Harry Edwards, A Skeptic's Guide to the New Age

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title: "Artificial intelligence in spirituality"
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Some users of artificial intelligence (AI) technologies, especially chatbots, may develop beliefs that AI has or can attain supernatural or spiritual powers. AI models such as ChatGPT are turned to for fortune telling, mysticism and remote viewing. Recent and sudden advances in large language models have led to folk myths about their origin or capabilities, as well as their deification or worship by some users. Tucker Carlson has made similar claims, including directly to Sam Altman. Pope Leo XIV advised priests against using LLM models when it came to the creation of sermons.
== See also ==
AI slop
Cargo cult
Chatbot psychosis
Quantum mysticism
Artificial intimacy
Roko's basilisk
Superintelligence
TempleOS
Theta Noir
Way of the Future
== References ==

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The Aryan race is a pseudoscientific historical race concept that emerged in the late-19th century to describe people who descend from the Proto-Indo-Europeans as a racial grouping. The terminology derives from the historical usage of Aryan, used by modern Indo-Iranians as an epithet of "noble". Anthropological, historical, and archaeological evidence does not support the validity of the racial concept.
The concept derives from the notion that the original speakers of the Proto-Indo-European language were distinct progenitors of a superior specimen of humankind, and that their descendants up to the present day constitute either a distinctive race or a sub-race of the Caucasian race, alongside the Semitic race and the Hamitic race. This taxonomic approach to categorizing human population groups is now considered to be misguided and biologically meaningless due to the close genetic similarity and complex interrelationships between these groups.
The term was adopted by various racist and antisemitic writers during the 19th century, including Arthur de Gobineau, Richard Wagner, and Houston Stewart Chamberlain, whose scientific racism influenced later Nazi racial ideology. By the 1930s, the concept had been associated with both Nazism and Nordicism, and used to support the white supremacist ideology of Aryanism that portrayed the Aryan race as a "master race", with non-Aryans regarded as racially inferior (Untermensch, lit.'subhuman') and an existential threat that was to be exterminated. In Nazi Germany, these ideas formed an essential part of the state ideology that led to the Holocaust.
== History ==
=== Debates on linguistic homeland ===
In the late 18th century, Proto-Indo-European (PIE) was constructed as the hypothesized common proto-language of the Indo-European languages. Sir William Jones, who was acclaimed as the "most respected linguist in Europe" for his Grammar of the Persian Language (1771), was appointed one of the three justices of the Supreme Court of Bengal. Jones, who arrived in Calcutta and began his study of Sanskrit and the Rig Veda, was astonished by the lexical similarities between Sanskrit and other Indo-European languages such as Persian, Gothic, Greek, and Latin, and concluded that Sanskrit—as a descendant language—belonged to the same proto- or parent-language in the language family—that is PIE, as the other Indo-European languages, in his Third Anniversary Discourse on the Hindus (1786). However, the linguistic homeland of the original speakers of Proto-Indo-European was a politicized debate among the archaeologists and comparative historical linguists since the start, entangling in chauvinistic causes. Some European nationalists and dictators, most notably the Nazis, later attempted to identify their country or region as the Proto-Indo-European homeland and their people as belonging to a pure and superior race.
According to Leon Poliakov, the concept of the Aryan race was deeply rooted in philology, based on the work of Sir William Jones' claiming that Sanskrit was related to Greco-Roman (European) languages. Other thinkers invented secularized origins for European civilization that were not based on the biblical genealogies from which Europe's aristocracy had long claimed descent.
=== Romanticism and Social Darwinism ===
The influence of Romanticism in Germany saw a revival of the intellectual quest for "the German language and traditions" and a desire to "discard the cold, artificial logic of Enlightenment". After Darwin's 1859 publication of On the Origin of Species and publicization of the theorized model of Proto-Indo-European language (PIE), the Romantics convicted that language was a defining factor in national identity, combined with the new ideas of Darwinism. The German nationalists misemployed the scientific theory of natural selection for the rationalization of the supposed fitness of some races over others, although Darwin himself never applied his theory of fitness to vague entities such as races or languages. The "unfit" races were suggested as a source of genetic weakness, and a threat that might contaminate the superior qualities of the "fit" races. The misleading mixture of pseudoscience and Romanticism produced new racial ideologies which used distorted Social Darwinist interpretations of race to explain "the superior biological-spiritual-linguistic essence of the Northern Europeans" in self-congratulatory studies. Subsequently, the German Romantics' quest for a "pure" national heritage led to the interpretation of the ancient speakers of PIE language as the distinct progenitors of a "racial-linguistic-national stereotype".
== Invention ==
=== Racial association of the term Aryan ===

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The term "Aryan" was originally used as an ethnocultural self-designative identity and epithet of "noble" by Indo-Iranians and the authors of the oldest known religious texts of Rig Veda and Avesta within the Indo-Iranian branch of Indo-European language family—Sanskrit and Iranian, who lived in ancient India and Iran. Although the Sanskrit ā́rya- and Iranian *arya- descended from a form *ā̆rya-, it was only attested to the Indo-Iranian tribes. Benjamin W. Fortson states that there may have been no term for self-designation of Proto-Indo-Europeans, and no such morphemes has survived. J. P. Mallory et al. states although the term "Aryan" takes on an ethnic meaning attesting to Indo-Iranians, there is no grounds for ascribing this semantic use to the Proto-Indo-European reconstruction of lexicon *h₂eryós i.e. there is no evidence that the speakers of proto-language referred to themselves as "Aryans". However, in the 19th century, it was proposed that ā́rya- was not only the tribal self-designation of Indo-Iranians, but self-designation of Proto-Indo-Europeans themselves, a theory rejected by modern scholarships. "Aryan" then came to be used by scholars of the 19th century to refer to Indo-Europeans. The now-discredited and chronologically reconstructed North European hypothesis was endorsed by such scholars who situated the PIE homeland in northern Europe, which led to the association of "Proto-Indo-Europeans", originally a hypothesized linguistic population of Eurasian PIE speakers, with a new, imagined biological category: "a tall, light-complexioned, blonde, blue-eyed race" - supposed phenotypic traits of Nordic race. The anglicized term "Aryan" then developed into a purely racialist meaning implicating Nordic racial type. However, modern scholarship of Indo-European studies use "Aryan" and "Indo-Aryan" in their original senses referring to Indo-Iranian and Indic branch of Indo-Europeans.
Classification of human races based on the now-pseudoscientific study of phenotypical differences developed during the nineteenth century and evidence in support of such theories were sought from the study of language and reconstructions of language families. Scholars of this era established the ethnological term "Aryan" as the race that had spoken the Proto-Indo-European language, and in this context, the term was often used as a synonym for "Indo-Europeans".
There is considerable disagreement as to whether or not the Indo-Iranians actually belonged to a distinct physical type. According to Elena Kuzmina, the Aryans in the Avesta were tall, light-skinned and frequently light-haired or light-eyed. She states that, in the Rig Veda, light skin was the primary physical differentiator between the Aryans and the indigenous population of India, who were darker. Skin color was also the basis of social division among the Vedic Aryans; the varnas of priests and warriors condemned the 'black skinned' aboriginal Dasa.
However, other scholars have opined that Aryan identity as asserted in the Rig Veda was cultural, religious, and linguistic, not racial; and that the Vedas does not contemplate racial purity. Michael Witzel states that term Aryan "does not mean a particular people or even a particular 'racial' group but all those who had joined the tribes speaking Vedic Sanskrit and adhering to their cultural norms, indicating diversity among them. David Anthony said it is "highly doubtful" that the Aryans of south Asia were blond and blue-eyed.
=== North Europe hypothesis and archaeological affirmation ===
The racial interpretation of Aryans stems from the now-discredited culture-historical archaeology theory of Gustaf Kossinna, who asserted a one-to-one correspondence between archaeological culture and archaeological race. According to Kossinna, the continuity of a "culture" exposits the continuity of a "race" which lived continuously in the same area, and the resemblance of a culture in a younger layer to a culture from an older layer indicates that the autochthonous tribe from the homeland had migrated. Kossinna developed an ethnic paradigm in archaeology called settlement archaeology and practiced the nationalistic interpretation of German archaeology for the Third Reich. The obsolete North European hypothesis was endorsed by Kossinna and Karl Penka, including German nationalists, which was later used by the Nazis to condone their genocidal and racist state policies. Kossinna identified the Proto-Indo-Europeans with the Corded Ware culture, and placed the Proto-Indo-European homeland in Schleswig-Holstein. He argued a diffusionist model of culture, and emphasised the racial superiority of Germanic peoples over Romans (Roman Empire) and French, whom he described as destroyers of culture as compared to Germanics. Kossinna's ideas have been heavily criticised for its inherent ambiguities in the method and advocacy for the ideology of a Germanic master race.
=== Earliest utilization of Aryan race ===

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Max Müller popularized the term Aryan in his writings on comparative linguistics, and is often identified as the first writer to mention an Aryan race in English. He began the racial interpretation of the Vedic passages based upon his editing of the Rigveda from 1849 to 1874. He postulated a small Aryan clan living on a high elevation in central Asia, speaking a proto-language ancestral to later Indo-European languages, which later branched off in two directions: one moved towards Europe and the other migrated to Iran, eventually splitting again with one group invading north-western India and conquering the dark-skinned dasas of Scythian origin who lived there. The northern Aryans of Europe became energetic and combative, and they invented the idea of a nation, while the southern Aryans of Iran and India were passive and meditative and focussed on religion and philosophy.
Though he occasionally used the term "Aryan race" afterward, Müller later objected to the mixing of the linguistic and racial categories, and was "deeply saddened by the fact that these classifications later came to be expressed in racist terms". In his 1888 lecture at Oxford, he stated, "[the] science of Language and the science of Man cannot be kept too much asunder [...] it would be as wrong to speak of Aryan blood as of dolichocephalic grammar", and in his Biographies of Words and the Home of the Aryas (1888), he writes, "[the] ethnologist who speaks of Aryan race, Aryan blood, Aryan eyes, and hair, is a great sinner as a linguist [...]".
European scholars of 19th century interpreted the Vedic passages as depicting battle between light-skinned Aryan migrants and dark-skinned indigenous tribes, but modern scholars reject this characterization of racial division as a misreading of the Sanskrit text, and indicate that the Rig Vedic opposition between ārya and dasyu is distinction between "disorder, chaos and dark side of human nature" contrasted with the concepts of "order, purity, goodness and light", and "dark and light worlds". In other contexts of the Vedic passages the dinstiction between ārya and dasyu refers to those who had adopted the Vedic religion, speaking Vedic Sanskrit, and those who opposed it.
However, increasing number of Western writers of this era, especially among anthropologists and non-specialists influenced by Darwinist theories, contrasted Aryans as a "physical-genetic species" rather than an ethnolinguistic category.
Encyclopedias and textbooks of historiography, ethnography, and anthropology from this era, such as Meyers Konversations-Lexikon, Brockhaus Enzyklopädie, Nordisk familjebok, H. G. Wells's A Short History of the World, John Clark Ridpath's Great Races of Mankind, and other works reinforced European racial constructions developed on now-pseudoscientific concepts such as racial taxonomy, Social Darwinism, and scientific racism to classify human races.
=== Theories of racial supremacy ===
The term Aryan was adopted by various racist and antisemitic writers such as Arthur de Gobineau, Theodor Poesche, Houston Chamberlain, Paul Broca, Karl Penka and Hans Günther during the nineteenth century for the promotion of scientific racism, spawning ideologies such as Nordicism and Aryanism. The connotation of the term Aryan was detached from its proper geographic and linguistic confinement as a Indo-Iranian branch of Indo-European language family by this time. The inequality of races and the notion of a "superior race" was universally accepted by the scholars of this era, therefore race was referred to "national character and national culture" beyond biological confinement.
In 1853, Arthur de Gobineau published An Essay on the Inequality of the Human Races, in which he originally identified the Aryan race as the white race, and the only civilized one, and conceived cultural decline and miscegenation as intimately intertwined. He argued that the Aryans represented a superior branch of humanity, and attempted to identify the races of Europe as Aryan and associated them with the sons of Noah, emphasizing superiority, and categorized non-Aryan as an intrusion of the Semitic race. According to him, northern Europeans had migrated across the world and founded the major civilizations, before being diluted through racial mixing with indigenous populations described as racially inferior, leading to the progressive decay of the ancient Aryan civilizations.
In 1878, German American anthropologist Theodor Poesche published a survey of historical references attempting to demonstrate that the Aryans were light-skinned blue-eyed blonds.
In 1899, Houston Stewart Chamberlain published what is described as "one of the most important proto-Nazi texts", The Foundations of the Nineteenth Century, in which he theorized an existential struggle to the death between a superior German-Aryan race and a destructive Jewish-Semitic race.
In 1916, Madison Grant published The Passing of the Great Race, a polemic against interbreeding between "Aryan" Americans, the original Thirteen Colonies settlers of British-Irish-German origin, with immigrant "inferior races", which according to him were, Poles, Czechs, Jews, and Italians. The book was a best-seller at the time.
While the Aryan race theory remained popular, particularly in Germany, some authors opposed it, in particular Otto Schrader, Rudolph von Jhering and the ethnologist Robert Hartmann, who proposed to ban the notion of Aryan from anthropology. The term was also adopted by various occultists and esoteric ideological systems of this era, such as Helena Blavatsky, and Ariosophy.
== Nazism ==
=== Subhuman and inferior races in Nazi Germany ===
The racial policies of Nazi Germany, the 1935 Nuremberg Laws, and the racist doctrines of Adolf Hitler considered Jews, Roma and Slavs, including Poles, Czechs, Russians and Serbs, "racially inferior sub-humans" (German: Untermensch, lit.'sub-human'); the term was also applied to "Mischling" (persons of mixed "Aryan" and non-Aryan, such as Jewish, ancestry) and black people.
=== Connotation of the term Aryan in Nazi racial theories ===

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A definition of Aryan that included all non-Jewish Europeans was deemed unacceptable, and the Expert Committee on Questions of Population and Racial Policy of 1933 brought together important Nazi intellectuals Alfred Ploetz, Fritz Thyssen, and Ernst Rüdin to plan the course of Nazi racial policy, defining an Aryan as one who was "tribally related to the German blood and descendant of a Volk". The term "Volksdeutsche" was used by Nazis to indicate "ethnic Germans" who did not hold German Reich citizenship; Volksdeutsche further consist of "racial groups"—minorities within a state—who are descendants of a Volk domiciled in Europe in a closed tribal settlement and are closely related to German racial community. The Nazi concept of "Volksgemeinschaft" racially unified ethnic Germans, including those living outside the German Reich, propounding only the members of the racial community be considered Aryan.
Members of the SS deemed Aryans not to be of a single ethnic group, and did not have to be exclusively German, but could be selected from populations across Europe to create "master race". Nazi Party established the organization NSDAP/AO to disseminate Nazi propaganda among the ethnic German minorities considered Volksdeutsche in central and eastern Europe. Nazi racial theories considered the "purest stock of Aryans" the Nordic people, identified by physical anthropological features such as tallness, white skin, blue eyes, narrow and straight noses, dolichocephalic skulls, prominent chins, and blond hair, including Scandinavians, Germans, English and French, with Nordic and Germanic people being the "master race" (German: Herrenrasse). Recent archaeogenetic studies contradict these ideas, and instead suggest that Proto-Indo-European speaking peoples probably had brown eyes and hair, and intermediate skin complexion.
=== Historical revisionism ===
After the death of Kossinna, Heinrich Himmler, and other Nazi figures such as Alfred Rosenberg, adopted his nationalistic theories of Germanic peoples and methodologies, including settlement archaeology, and founded the SS organization Ahnenerbe (German: Deutsches Ahnenerbe) for conducting archaeological investigations of a presumed "Germanic expansion in pre-history". Nazi scholars endorsed the now-discredited North European hypothesis in an effort to prove PIE was originally spoken by an "Aryan master race", and associated the Semitic languages with "inferior races". Historical revisionism around race was disseminated through the Nazi think tank Ahnenerbe. Hitler regularly invoked Social Darwinist concepts of Ernst Haeckel such as higher evolution (German: Höherentwicklung), struggle for existence (German: Existenzkampf), selection (German: Auslese), struggle for life (German: Lebenskampf), in his Nazi racial ideology, which is the central theme in the chapter "Nation and Race" of Mein Kampf. Haeckel's Social Darwinism was also praised by Alfred Ploetz, founder of the German Society for Racial Hygiene, who made him an honorary member of the eugenic organization.
=== Nazi eugenics and Nordic supremacy ===
In 1938, the Reich Ministry of Education released the German biology curriculum which reflected the curriculum developed by the National Socialist Teachers League and emphasized the Social Darwinst interpretation of the evolution of human races. Hans Weinert, who had joined the SS and worked for the Kaiser Wilhelm Institute of Anthropology publishing theories of Nazi eugenics and racial evolution, claimed the Nordic race as a highly evolved race, and Aboriginal Australians as being the lowest rank in the racial hierarchy. Hans F. K. Günther was considered to be the most influential Nazi anthropologist, although he was not professionally trained. Günther's racist writings on Nordicism was suffused with the ideas of Gobineau, who believed the Nordic race had originated in northern Europe and spread through conquest; this had expressed approval of the Nazi eugenics policies and had critical influence on scientific racism. Günther's theories gained acclamation from Hitler, who later included his books as a recommended reading material for the Nazi Party members. After the Nazis came to power, selective breeding for supposed Aryan traits such as athleticism, blond hair and blue eyes was encouraged, while the "inferior races" and people with physical or mental illness were deemed "life unworthy of life" (German: lebensunwertes Leben, lit.'lives unworthy of life') and many were interned in concentration camps.
=== Ethnic cleansing and the Holocaust ===
The culmination of Nazi eugenicist and racial hygiene programs of sterilization and extermination aimed at creating an "Aryan master race" and eliminating "inferior non-Aryan types" such as Jews, Slavs, Poles, Roma, homosexuals, and the disabled. Nazi Germany introduced the Anti-Jewish legislation that systemically discriminated against Jews by requiring Aryan certification for a German Reich citizen. After Hitler became the Chancellor of Germany, the public policies of Nazi Germany became increasingly hostile towards supposed "inferior types", particularly Jews, who were considered to be the highest manifestation of the Semitic race, and segregation of Jews in ghettos culminated in the policy of extermination the Nazis called the Final Solution to the Jewish Question. The state-sponsored persecution systematically murdered over 6 million Jews, 5.7 million Slavs, 1.83 million Poles, 270,000 disabled people, among other victims, including children through mass shooting, gas chamber, gas van, and concentration camps, in the process known as the Holocaust. The ethnic Germans considered Volksdeutsche joined the local SS organizations under NSDAP/AO and participated in Nazi-sponsored pogroms in eastern and central Europe during the Holocaust, including seizures of Jewish property. The Aryan race belief was used by the Nazis to justify the persecution, depicting the victims as the "antipode and eternal enemy of the Aryans".
== White supremacy ==
Following Nazi Germany's defeat in World War II, various neo-Nazi and racial nationalist movements developed a more inclusive definition of Aryan claiming to Western European peoples, with Nordic and Germanic peoples being the most "racially pure". However, in the United States, most white nationalists define whiteness broadly as people of European ancestry, and some consider Jews to be white although this is controversial within white nationalist circles.
Many white supremacist neo-Nazi groups and prison gangs, notably in the United States, view themselves as part of an Aryan race, including the Aryan Brotherhood, Aryan Nations, Aryan Guard, Aryan Republican Army, White Aryan Resistance, Aryan Circle, Aryan Brotherhood of Texas, and others.
== Neo-pagan movements ==

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Indo-European history, real and feigned, plays a significant role in various neo-pagan movements.
=== Russian neo-paganism ===
The Russian Slavophile movements borrowed various discrete ideas of a presumed "prestigious Aryan origin" of Europeans from Nazi Germany. Although Russian Orthodoxy was the primary religious influence on Russian nationalists, the primacy of Christianity was treated skeptically by these groups, who later began searching for an ancient text to rationalize a "return to the origins". Various writers in the newspaper Zhar-Ptitsa showed interest in a purported manuscript—the Book of Veles—which supposedly dated to the first century BCE. F. A. Izenbek, a White Army officer, alleged the discovery of this manuscript during the Russian Civil War. However one of Izenbek's friends, Iurii Miroliubov, had forged the manuscript, and used the term "Vedism" to describe Russian neo-paganism; he later appropriated the Indian religious scripture, the Vedas, to aggrandize the manuscript. Nationalistic white Russian émigrés and neo-Pagans consider the manuscript to be an authentic historical source of Slavic antiquity, who claim a direct link between "ancient Aryans" and themselves as Slavs. However, the manuscript is declared literary forgery by scholars. Alexey Dobrovolsky, a Russian neo-Nazi, is considered the founding Nazi ideologue of Slavic Neopaganism.
=== Goddess movement ===
With the rise of first-wave feminism, various authors of the Goddess movement cast the ancient Indo-Europeans as a "patriarchal, warlike invaders who destroyed a utopian prehistoric world of feminine peace and beauty" in various archaeological dramas and books such as Riane Eisler's The Chalice and the Blade (1987) and Marija Gimbutas's Civilization of the Goddess (1991).
== See also ==
== References ==
Notes
Bibliography

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In esotericism, astral projection (also known as astral travel, soul journey, soul wandering, spiritual journey, spiritual travel) is an intentional out-of-body experience (OBE) in which a subtle body, known as the astral body or body of light which consciousness functions separately through from the physical body, travels throughout the astral plane.
The idea of astral travel is ancient and occurs in multiple cultures. The term "astral projection" was coined and promoted by 19th-century Theosophists. It is sometimes associated with dreams and forms of meditation. Some individuals have reported perceptions similar to descriptions of astral projection that were induced through various hallucinogenic and hypnotic means (including self-hypnosis). There is no scientific evidence that there is a consciousness whose embodied functions are separate from normal neural activity, or that one can consciously leave the body and make observations of the physical universe. As a result, astral projection has been characterized as pseudoscience.
== Accounts ==
=== Ancient Egyptian ===
Similar concepts of soul travel appear in various other religious traditions. For example, ancient Egyptian teachings present the soul (ba) as having the ability to hover outside the physical body via the ka, or subtle body.
=== Amazon ===
The yaskomo of the Waiwai is believed to have the ability to perform a soul flight that can serve several functions, such as healing; flying to the sky to consult cosmological beings (the Moon or the Brother of the Moon) to obtain a name for a newborn baby; flying to the cave of peccaries' mountains to ask the father of peccaries for abundance of game; or flying deep down into a river to seek the aid of other beings.
=== Inuit ===
In some Inuit groups, individuals with special capabilities, known as angakkuq, are said to be able to travel to (mythological) remote places, and report their experiences and important matters back to their community. Those abilities would be unavailable to individuals with normal capabilities. Among other things, an angakkuq was said to have the ability to stop bad hunting luck or heal a sick person. Soul wandering is classified as a culture-specific disorder.
=== Hindu ===
Similar ideas such as the Liṅga Śarīra are found in ancient Hindu scriptures such as the Yogavashishta-Maharamayana of Valmiki. Modern Indians who have vouched for astral projection include Paramahansa Yogananda who witnessed Swami Pranabananda doing a miracle through a possible astral projection.
The Indian spiritual teacher Meher Baba described one's use of astral projection:
In the advancing stages leading to the beginning of the path, the aspirant becomes spiritually prepared for being entrusted with free use of the forces of the inner world of the astral bodies. He may then undertake astral journeys in his astral body, leaving the physical body in sleep or wakefulness. The astral journeys that are taken unconsciously are much less important than those undertaken with full consciousness and as a result of deliberate volition. This implies conscious use of the astral body. Conscious separation of the astral body from the outer vehicle of the gross body has its own value in making the soul feel its distinction from the gross body and in arriving at fuller control of the gross body. One can, at will, put on and take off the external gross body as if it were a cloak and use the astral body for experiencing the inner world of the astral and for undertaking journeys through it, if and when necessary. ... The ability to undertake astral journeys therefore involves considerable expansion of one's scope for experience. It brings opportunities for promoting one's own spiritual advancement, which begins with the involution of consciousness.
Astral projection is one of the siddhis ('magical powers') considered achievable by yoga practitioners through self-disciplined practice. In the epic Mahabharata, Drona leaves his physical body to see if his son is alive.
=== Japanese ===
In Japanese mythology, an ikiryō (生霊; also read as shōryō, seirei, or ikisudama) is a manifestation of the soul of a living person separately from their body. Traditionally, if someone holds a sufficient grudge against another person, it is believed that a part or the whole of their soul can temporarily leave their body and appear before the target of their hate in order to curse or otherwise harm them, similar to an evil eye. Souls are also believed to leave a living body when the body is extremely sick or comatose; but such ikiryō are not malevolent.
=== Taoist ===
Taoist alchemical practice involves creation of an energy body by breathing meditations, drawing energy into a 'pearl' that is then circulated.
Xiangzi ... with a drum as his pillow fell fast asleep, snoring and motionless. His primordial spirit, however, went straight into the banquet room and said, "My lords, here I am again." When Tuizhi walked with the officials to take a look, there really was a Taoist sleeping on the ground and snoring like thunder. Yet inside, in the side room, there was another Taoist beating a fisher drum and singing Taoist songs. The officials all said, "Although there are two different people, their faces and clothes are exactly alike. Clearly he is a divine immortal who can divide his body and appear in several places at once. ..." At that moment, the Taoist in the side room came walking out, and the Taoist sleeping on the ground woke up. The two merged into one.

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=== Judaic and Christian ===
Carrington, Muldoon, Peterson, and Williams say that the subtle body is attached to the physical body by means of a psychic silver cord. Ecclesiastes 12:6 is often cited in this respect: "Remember him—before the silver cord is severed, and the golden bowl is broken; before the pitcher is shattered at the spring, and the wheel broken at the well". Rabbi Nosson Scherman, however, contends that the context points to this being merely a metaphor, comparing the body to a machine, with the silver cord referring to the spine.
James Hankins argues that 2 Corinthians 12:2, "I know a man in Christ who fourteen years ago was caught up to the third heaven. Whether it was in the body or out of the body I do not know—God knows", refers to the astral planes.
=== Western esotericism ===
According to the classical, medieval, renaissance Hermeticism, Neoplatonism, and later Theosophist and Rosicrucian thought, the 'astral body' is an intermediate body of light linking the rational soul to the physical body while the astral plane is an intermediate world of light between Heaven and Earth, composed of the spheres of the planets and stars. These astral spheres were held to be populated by angels, demons, and spirits.
In the Neoplatonism of Plotinus, for example, the individual is a microcosm ("small world") of the universe (the macrocosm or "great world"). "The rational soul...is akin to the great Soul of the World" while "the material universe, like the body, is made as a faded image of the Intelligible". Each succeeding plane of manifestation is causal to the next, a world-view known as emanationism; "from the One proceeds Intellect, from Intellect Soul, and from Soul—in its lower phase, or that of Nature—the material universe". The idea of the astral figured prominently in the work of the nineteenth-century French occultist Eliphas Levi, whence it was adopted and developed further by Theosophy, and used afterwards by other esoteric movements.
The subtle bodies, and their associated planes of existence, form an essential part of some esoteric systems that deal with astral phenomena. Often these bodies and their planes of existence are depicted as a series of concentric circles or nested spheres, with a separate body traversing each realm.
== Terminology ==
The expression "astral projection" came to be used in two different ways. For the Hermetic Order of the Golden Dawn and some Theosophists, it retained the classical and medieval philosophers' meaning of journeying to other worlds, heavens, hells, the astrological spheres and other landscapes in the body of light; but outside these circles the term was increasingly applied to non-physical travel around the physical world.
Though this usage continues to be widespread, the term, "etheric travel", used by some later Theosophists, offers a useful distinction. Some experimenters say they visit different times and/or places: etheric, then, is used to represent the sense of being out of the body in the physical world; whereas astral may connote some alteration in time-perception. Robert Monroe describes the former type of projection as "Locale I" or the "Here-Now", involving people and places that exist: Robert Bruce calls it the "Real Time Zone" (RTZ) and describes it as the non-physical dimension-level closest to the physical. This etheric body is usually, though not always, invisible but is often perceived by the experient as connected to the physical body during separation by a silver cord. Some link falling dreams with projection.
According to Max Heindel, the etheric double serves as a medium between the astral and physical realms. In his system the ether, also called prana, is the vital force that empowers the physical forms to change. From his descriptions it can be inferred that, to him, when one views the physical during an out-of-body experience, one is not technically in the astral realm at all.
Other experiments may describe a domain that has no parallel to any known physical setting. Environments may be populated or unpopulated, artificial, natural or abstract, and the experience may be beatific, horrific or neutral. A common Theosophical belief is that one may access a compendium of mystical knowledge called the Akashic records. In many accounts the experiencer correlates the astral world with the world of dreams. Some even report seeing other dreamers enacting dream scenarios unaware of their wider environment.
The astral environment may also be divided into levels or sub-planes by theorists, but there are many different views in various traditions concerning the overall structure of the astral planes: they may include heavens and hells and other after-death spheres, transcendent environments, or other less-easily characterized states.
== Scientific reception ==
There is no known scientific evidence that astral projection as an objective phenomenon exists, although there are cases of patients having experiences suggestive of astral projection from brain stimulation treatments and hallucinogenic drugs, such as ketamine, phencyclidine, and DMT. Subjects in parapsychological experiments have attempted to project their astral bodies to distant rooms and see what was happening. However, such experiments have not produced clear results.
Psychologist Donovan Rawcliffe wrote that astral projection can be explained by delusion, hallucination, and vivid dreams. Arthur W. Wiggins wrote that purported evidence of the ability to astrally travel great distances and give descriptions of places visited is predominantly anecdotal and considers astral travel an illusion. He looks to neuroanatomy, prior knowledge, and human belief and imagination to provide prosaic explanations for those who experience it. Robert Todd Carroll writes that the main evidence to support claims of astral travel is anecdotal and comes "in the form of testimonials of those who claim to have experienced being out of their bodies when they may have been out of their minds."

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== Notable practitioners ==
Emanuel Swedenborg was one of the first practitioners to write extensively about the out-of-body experience, in his Spiritual Diary (17471765). In her book, My Religion, Helen Keller tells of her beliefs in Swedenborgianism and how she once traveled astrally to Athens:
I have been far away all this time, and I haven't left the room...It was clear to me that it was because I was a spirit that I had so vividly 'seen' and felt a place a thousand miles away. Space was nothing to spirit!
In occult traditions, practices range from inducing trance states to the mental construction of a second body, called the "body of light" by Aleister Crowley (18751947), through visualization and controlled breathing, followed by the transfer of consciousness to the secondary body by a mental act of will.
There are many 20th-century publications on astral projection, although only a few writers continue to be cited. These include Edgar Cayce (18771945), Hereward Carrington (18801958), Oliver Fox (18851949), Sylvan Muldoon (19031969), and Robert Monroe (19151995).
Robert Monroe's accounts of journeys to other realms (19711994) popularized the term "OBE" and were translated into a large number of languages. Though his books themselves only placed secondary importance on descriptions of method, Monroe also founded an institute dedicated to research, exploration and non-profit dissemination of auditory technology for assisting others in achieving projection and related altered states of consciousness.
Carlos Castaneda (19251998) discusses his teacher Don Juan's beliefs about "the double" and its abilities in his books Tales of Power (1974), The Second Ring of Power (1977), and The Art of Dreaming (1993). Florinda Donner, a student of Castaneda, further describes methods of using the double to access the physical world while dreaming and access the dream world while in a waking dream state in her 1992 book, Being-in-Dreaming.
Michael Crichton (19422008) gives lengthy and detailed explanations and experience of astral projection in his 1988 non-fiction book Travels. Robert Bruce, William Buhlman, Marilynn Hughes, and Albert Taylor have discussed their theories and findings on the syndicated show Coast to Coast AM several times.
== See also ==
== References ==
=== Citations ===
=== Works cited ===
== Further reading ==
Nema (1995). Maat Magic: a Guide to Self-Initiation. York Beach, Maine: Samuel Weiser. ISBN 0-87728-827-5.

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In Western astrology, astrological signs are the zodiac, twelve 30-degree sectors that are crossed by the Sun's 360-degree orbital path as viewed from Earth in its sky. The signs enumerate from the first day of spring, known as the First Point of Aries, which is the vernal equinox. The astrological signs are Aries, Taurus, Gemini, Cancer, Leo, Virgo, Libra, Scorpio, Sagittarius, Capricorn, Aquarius, and Pisces. The Western zodiac originated in Babylonian astrology, and was later influenced by the Hellenistic culture. Each sign was named after a constellation the sun annually moved through while crossing the sky. This observation is emphasized in the simplified and popular sun sign astrology. Over the centuries, Western astrology's zodiacal divisions have shifted out of alignment with the constellations they were named after by axial precession of the Earth while Hindu astrology measurements correct for this shifting. Astrology (i.e. a system of omina based on celestial appearances) was developed in Chinese and Tibetan cultures as well but these astrologies are not based upon the zodiac but deal with the whole sky.
Astrology is a pseudoscience. Scientific investigations of the theoretical basis and experimental verification of claims have shown it to have no scientific validity or explanatory power. More plausible explanations for the apparent correlation between personality traits and birth months exist, such as the influence of seasonal birth in humans.
According to astrology, celestial phenomena relate to human activity on the principle of "as above, so below", so that the signs are held to represent characteristic modes of expression. Scientific astronomy used the same sectors of the ecliptic as Western astrology until the 19th century.
Various approaches to measuring and dividing the sky are currently used by differing systems of astrology, although the tradition of the Zodiac's names and symbols remain mostly consistent. Western astrology measures from Equinox and Solstice points (points relating to equal, longest, and shortest days of the tropical year), while Hindu astrology measures along the equatorial plane (sidereal year).
== Western zodiac signs ==
=== History ===
Western astrology is a direct continuation of Hellenistic astrology as recorded in Ptolemy's Tetrabiblos in the 2nd century. Hellenistic astrology in turn was partly based on concepts from Babylonian tradition. Specifically, the division of the ecliptic in twelve equal sectors is a Babylonian conceptual construction. This division of the ecliptic originated in the Babylonian "ideal calendar" found in the old compendium MUL.APIN and its combination with the Babylonian lunar calendar, represented as the "path of the moon" in MUL.APIN. In a way, the zodiac is the idealisation of an ideal lunar calendar.
By the 4th century BC, Babylonian astronomy and its system of celestial omens influenced the culture of ancient Greece, as did the astronomy of Egypt by late 2nd century BC. This resulted, unlike the Mesopotamian tradition, in a strong focus on the birth chart of the individual and the creation of Horoscopic astrology, employing the use of the Ascendant (the rising degree of the ecliptic, at the time of birth), and of the twelve houses. Association of the astrological signs with Empedocles' four classical elements was another important development in the characterization of the twelve signs.
The body of the Hellenistic astrological tradition as it stood by the 2nd century is described in Ptolemy's Tetrabiblos. This is the seminal work for later astronomical tradition not only in the West but also in India and the Islamic sphere and has remained a reference for almost seventeen centuries as later traditions made few substantial changes to its core teachings.
=== Western astrological correspondence chart ===
The following table shows the approximate dates of the twelve astrological signs, along with the classical and modern rulerships of each sign. By definition, Aries starts at the First Point of Aries which is the location of the Sun at the March equinox. The precise date of the Equinox varies from year to year but is always between 19 March and 21 March. The consequence is the start date of Aries and therefore the start date of all the other signs can change slightly from year to year. The following Western astrology table enumerates the twelve divisions of celestial longitude with the Latin names. The longitude intervals, are treated as closed for the first endpoint (a) and open for the second (b) for instance, 30° of longitude is the first point of Taurus, not part of Aries. The signs are occasionally numbered 0 through 11 in place of symbols in astronomical works.
The twelve signs are positioned in a circular pattern, creating a pattern of oppositions related to different philosophically polarized attributes. Fire and air elements are generally 180 degrees opposed in Western astrology, as well as earth and water elements. Not all systems of astrology have four elements, notably the Sepher Yetzirah describes only three elements emanating from a central divine source. Spring signs are opposite to autumn ones, winter signs are opposite to summer ones and vice versa.
Aries is opposite to Libra
Taurus is opposite to Scorpio
Gemini is opposite to Sagittarius
Cancer is opposite to Capricorn
Leo is opposite to Aquarius
Virgo is opposite to Pisces
==== Polarity ====
In Western astrology, the polarity divides the zodiac in half and refers to the alignment of a sign's energy as either positive or negative, with various attributes associated to them as a result. Positive polarity signs, also called active, yang, expressive, or masculine signs, are the six odd-numbered signs of the zodiac: Aries, Gemini, Leo, Libra, Sagittarius, and Aquarius. Positive signs make up the fire and air triplicities. Negative polarity signs, also called passive, yin, receptive, or feminine signs, are the six even-numbered signs of the zodiac: Taurus, Cancer, Virgo, Scorpio, Capricorn, and Pisces. Negative signs make up the earth and water triplicities.

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===== Planets =====
Polarity can also be extended to planets, referring to the orientation of their symbolic energy as either masculine (active, expressive, outward-directed) or feminine (receptive, inward-directed, containing). This classification complements the traditional division of the zodiac signs and provides an additional interpretative layer in astrological analysis.
Masculine polarity planets are generally associated with projection, initiative, and outward activity. These include the Sun, Mars, Jupiter, Uranus, Mercury, and Eris. Although Mercury is traditionally considered neutral, most modern approaches emphasize its masculine quality due to its volatility, speed, adaptability, and primarily centrifugal communicative function. Feminine polarity planets are associated with receptivity, consolidation, containment, and inner processes. These include the Moon, Venus, Ceres, Saturn, Neptune, and Pluto. In this framework, all main-belt asteroids are generally considered to have feminine polarity, reflecting their symbolic association with internal processes, cycles, and forms of containment or gestation.
It is also noteworthy that planetary polarity does not necessarily correspond to mythological gender. Some planets with masculine names, such as Saturn, Neptune, and Pluto, are classified as feminine in polarity, whereas Eris, despite having a feminine name, is considered masculine in polarity due to its outward-activating, and catalytic nature.
==== The three modalities ====
The modality or mode of a given sign refers to its position in the season it is found in. Each of the four elements manifests in three modalities: cardinal, fixed, and mutable. Each modality comprehends four signs, also known as Quadruplicities. For example, the sign Aries is found in the first month of spring in the Northern Hemisphere, so practitioners of astrology describe it as having a cardinal modality. The combination of element and modality provides the signs with their unique characterizations. For instance, Capricorn is the cardinal earth sign, impressing its association with action (cardinal modality) in the material world (earth element).
==== Triplicities of the four elements ====
The Greek philosopher Empedocles identified fire, earth, air, and water as elements in the fifth-century BC. He explained the nature of the universe as an interaction of two opposing principles, love and strife, which manipulate the elements into different mixtures that produce the different natures of things. He stated all the elements are equal, the same age, rule their own provinces, and possess their own individual character. Empedocles said that those born with nearly equal proportions of the elements are more intelligent and have the most exact perceptions.
The elemental categories are called triplicities because each classical element is associated with three signs The four astrological elements are also considered as a direct equivalent to Hippocrates' personality types (sanguine = air; choleric = fire; melancholic = earth; phlegmatic = water). A modern approach looks at elements as "the energy substance of experience" and the next table tries to summarize their description through keywords. The elements have grown in importance and some astrologers begin natal chart interpretations by studying the balance of elements in the location of planets (especially the Sun and Moon) and the position of angles in the chart.
==== Celestial body rulerships ====
Rulership is the connection between planet and correlated sign and house. The conventional rulerships are as follows:
Aries: Mars
Taurus: Venus
Gemini: Mercury
Cancer: Moon
Leo: Sun
Virgo: classically Mercury, Ceres in the late 20th century
Libra: classically Venus, Eris starting in the 21st century
Scorpio: classically Mars, Pluto starting in the 20th century
Sagittarius: Jupiter
Capricorn: Saturn
Aquarius: classically Saturn, Uranus starting in the 20th century
Pisces: classically Jupiter, Neptune starting in the 20th century
==== Dignity, detriment, exaltation and fall traditional ====
A traditional belief of astrology, known as essential dignity, is the idea that the Sun, Moon, and planets are more powerful and effective in some signs than others because the basic nature of both is held to be in harmony. By contrast, they are held to find some signs to be weak or difficult to operate in because their natures are thought to be in conflict. These categories are Dignity, Detriment, Exaltation, and Fall.
Dignity and Detriment: A planet is strengthened or dignified if it falls within the sign that it rules. In other words, it is said to exercise Rulership of the sign. For example, the Moon in Cancer is considered "strong" (well-dignified). If a planet is in the sign opposite which it rules (or is dignified in), it is said to be weakened or in Detriment (for example, the Moon in Capricorn). This may also be termed a "debility".
In traditional astrology, other levels of Dignity are recognised in addition to Rulership. These are known as Exaltation, Triplicity, Terms or bounds, and Face or Decan, which together are known as describing a planet's Essential dignity, the quality or ability of one's true nature.
Exaltation and Fall: A planet is also strengthened when it is in its sign of exaltation. In traditional horary astrology, this denotes a dignity just less than rulership. Exaltation was considered to give the planet's significance(s) the dignity of an honoured guest: the centre of attention but constrained in power. Examples of planets in their Exaltation are: Saturn (Libra), Sun (Aries), Venus (Pisces), Moon (Taurus), Mercury (Virgo, although some disagree with this classification), Mars (Capricorn), Jupiter (Cancer). A planet in the opposite sign of this is in its fall, and thus weakened, perhaps more than Detriment. There is discord as to the signs in which the two extra-Saturnian planets may be considered to be exalted.

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In addition to essential dignity, the traditional astrologer considers Accidental dignity of planets. This is placement by house in the chart under examination. Accidental dignity is the planet's "ability to act". So we might have, for example, Moon in Cancer, dignified by rulership, is placed in the 12th house it would have little scope to express its good nature. The twelfth is a cadent house as are the third, sixth and ninth and planets in these houses are considered weak or afflicted. On the other hand, Moon in the first, fourth, seventh, or 10th would be more able to act as these are Angular houses. Planets in Succedent houses of the chart (second, fifth, eighth, eleventh) are generally considered to be of medium ability to act. Besides Accidental Dignity, there are a range of Accidental Debilities, such as retrogradation, Under the Sun's Beams, Combust, and so forth.
==== Additional classifications ====
Each sign can be divided into three 10° sectors known as decans or decanates, though these have fallen into disuse. The first decanate is said to be most emphatically of its own nature and is ruled by the sign ruler. The next decanate is sub-ruled by the planet ruling the next sign in the same triplicity. The last decanate is sub-ruled by the next in order in the same triplicity.
While the element and modality of a sign are together sufficient to define it, they can be grouped to indicate their symbolism. The first four signs, Aries, Taurus, Gemini, and Cancer, form the group of personal signs. The next four signs, Leo, Virgo, Libra, and Scorpio form the group of interpersonal signs. The last four signs of the zodiac, Sagittarius, Capricorn, Aquarius, and Pisces, form the group of transpersonal signs.
Dane Rudhyar presented the tropical zodiac primary factors, used in the curriculum of the RASA School of Astrology. The tropical zodiac is the zodiac of seasonal factors as opposed to the sidereal zodiac (constellation factors). The primary seasonal factors are based on the changing ratio of sunlight and darkness across the year. The first factor is whether the chosen time falls in the half of the year when daylight is increasing, or the half of the year when darkness is increasing. The second factor is whether the chosen time falls in the half of the year when there is more daylight than darkness, or the half when there is more darkness than daylight. The third factor is which of the four seasons the chosen time falls in, defined by the first two factors. Thus
The spring season is when daylight is increasing and there is more daylight than darkness.
The summer season is when darkness is increasing and there is more daylight than darkness.
The autumn season is when darkness is increasing and there is more darkness than daylight.
The winter season is when daylight is increasing and there is more darkness than daylight.
=== Western sign gallery ===
== Indian astrology ==
In Indian astrology (Jyotiṣa), the cosmological framework is based on the Pancha Mahābhūta, the five great elements: Fire (Agni), Earth (Pṛthvī), Air (Vāyu), Water (Jala), and Ether (Ākāśa). The master of fire is Mars, while Mercury is of land, Saturn of air, Venus of water, and Jupiter of ether.
Each of the five visible planets (excluding Sun and Moon) is associated with one of these elements as its ruling principle:
Mars (Maṅgala) is the ruler of Fire (Agni)
Mercury (Budha) rules Earth (Pṛthvī)
Saturn (Śani) governs Air (Vāyu)
Venus (Śukra) rules Water (Jala)
Jupiter (Bṛhaspati) governs Ether (Ākāśa)
Jyotisha recognises twelve zodiac signs (Rāśi), that correspond to those in Western astrology. The relation of the signs to the elements is the same in the two systems.
=== Nakshatras ===
A nakshatra (Devanagari: नक्षत्र, Sanskrit nakshatra, a metaphorical compound of naksha- 'map/chart', and tra- 'guard'), or lunar mansion, is one of the 27 divisions of the sky identified by prominent star(s), as used in Hindu astronomy and astrology (Jyotisha). "Nakshatra" in Sanskrit, Kannada, Tulu and Tamil and Prakrit refers to stars themselves.
== Chinese zodiac signs ==
Chinese astrological signs operate on cycles of years, lunar months, and two-hour periods of the day (also known as shichen). A particular feature of the Chinese zodiac is its operation in a 60-year cycle in combination with the Five Phases of Chinese astrology (Wood, Fire, Metal, Water and Earth).
Nevertheless, some researches say that there is an obvious relationship between the Chinese 12-year cycle and zodiac constellations: each year of the cycle corresponds to a certain disposal of Jupiter. For example, in the year of Snake Jupiter is in the Sign of Gemini, in the year of Horse Jupiter is in the Sign of Cancer and so on. So the Chinese 12-year calendar is a solar-lunar-jovian calendar.
=== Zodiac symbolism ===
The following table shows the twelve signs and their attributes.
=== The twelve signs ===
In Chinese astrology, the zodiac of twelve animal signs represents twelve different types of personality. The zodiac traditionally begins with the sign of the Rat, and there are many stories about the Origins of the Chinese Zodiac which explain why this is so. When the twelve zodiac signs are part of the 60-year calendar in combination with the four elements, they are traditionally called the twelve Earthly Branches. The Chinese zodiac follows the lunisolar Chinese calendar and thus the "changeover" days in a month (when one sign changes to another sign) vary each year. The following are the twelve zodiac signs in order.

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子 Rat (Yang, 1st Trine, Fixed Element Water): Rat years include 1900, 1912, 1924, 1936, 1948, 1960, 1972, 1984, 1996, 2008, 2020, 2032. The Rat also corresponds to a particular month in the year. The hours of the Rat are 11pm 1am.
丑 Ox (Yin, 2nd Trine, Fixed Element Earth: Ox years include 1901, 1913, 1925, 1937, 1949, 1961, 1973, 1985, 1997, 2009, 2021, 2033. The Ox also corresponds to a particular month in the year. The hours of the Ox are 1am 3am.
寅 Tiger (Yang, 3rd Trine, Fixed Element Wood): Tiger years include 1902, 1914, 1926, 1938, 1950, 1962, 1974, 1986, 1998, 2010, 2022, 2034. The Tiger also corresponds to a particular month in the year. The hours of the Tiger are 3am 5am.
卯 Rabbit (Yin, 4th Trine, Fixed Element Wood): Rabbit Years include 1903, 1915, 1927, 1939, 1951, 1963, 1975, 1987, 1999, 2011, 2023, 2035. The Rabbit also corresponds to a particular month in the year. The hours of the Rabbit are 5am 7am.
辰 Dragon (Yang, 1st Trine, Fixed Element Earth): Dragon years include 1904, 1916, 1928, 1940, 1952, 1964, 1976, 1988, 2000, 2012, 2024, 2036. The Dragon also corresponds to a particular month in the year. The hours of the Dragon are 7am 9am.
巳 Snake (Yin, 2nd Trine, Fixed Element Fire): Snake years include 1905, 1917, 1929, 1941, 1953, 1965, 1977, 1989, 2001, 2013, 2025, 2037. The Snake also corresponds to a particular month in the year. The hours of the Snake are 9am 11am.
午 Horse (Yang, 3rd Trine, Fixed Element Fire): Horse years include 1906, 1918, 1930, 1942, 1954, 1966, 1978, 1990, 2002, 2014, 2026, 2038. The Horse also corresponds to a particular month in the year. The hours of the Horse are 11am 1pm.
未 Goat (Yin, 4th Trine, Fixed Element Earth): Goat years include 1907, 1919, 1931, 1943, 1955, 1967, 1979, 1991, 2003, 2015, 2027, 2039. The Goat also corresponds to a particular month in the year. The hours of the Goat are 1pm 3pm.
申 Monkey (Yang, 1st Trine, Fixed Element Metal): Monkey years include 1908, 1920, 1932, 1944, 1956, 1968, 1980, 1992, 2004, 2016, 2028, 2040. The Monkey also corresponds to a particular month in the year. The hours of the Monkey are 3pm 5pm.
酉 Rooster (Yin, 2nd Trine, Fixed Element Metal): Rooster years include 1909, 1921, 1933, 1945, 1957, 1969, 1981, 1993, 2005, 2017, 2029, 2041. The Rooster also corresponds to a particular month in the year. The hours of the Rooster are 5pm 7pm.
戌 Dog (Yang, 3rd Trine, Fixed Element Earth): Dog years include 1910, 1922, 1934, 1946, 1958, 1970, 1982, 1994, 2006, 2018, 2030, 2042. The Dog also corresponds to a particular month in the year. The hours of the Dog are 7pm 9pm.
亥 Pig (Yin, 4th Trine, Fixed Element Water): Pig years include 1911, 1923, 1935, 1947, 1959, 1971, 1983, 1995, 2007, 2019, 2031, 2043. The Pig also corresponds to a particular month in the year. The hours of the Pig are 9pm 11pm.
=== The five elements ===
Wood: The wood person has high morals, is self-confident, expansive and co-operative, with wide and varied interests and idealistic goals. The direction associated with Wood is East, and the season is spring, which makes it the fixed element for the animal signs Tiger and Rabbit.
Fire: The fire person has leadership qualities, dynamic passion, and is decisive, self-confident, positive, and assertive. The direction associated with Fire is South, and the season is summer, which makes it the fixed element for the animal signs Snake and Horse.
Earth: The earth person is serious, logical and methodical, intelligent, objective and good at planning. The direction associated with Earth is Center. The season for Earth is the changeover point of the four seasons. It is the fixed element for the animal signs Ox, Dragon, Goat and Dog.
Metal: The metal person is sincere, has fixed values and opinions, is strong of will, and has eloquence of speech. The direction associated with Metal is West. The season for Metal is Autumn. It is the fixed element for the animal signs Monkey and Rooster.
Water: The water person is persuasive, intuitive, and empathetic. The water person is objective and often sought out for their counsel. The direction associated with water is North. The season for Water is Winter. It is the fixed element for the animal signs Rat and Pig.
The five elements operate together with the twelve animal signs in a 60-year calendar. The five elements appear in the calendar in both their yin and yang forms and are known as the ten Heavenly Stems. The yin/yang split seen in the Gregorian calendar means years that end in an even number are Yang (representing masculine, active, and light), those that end with an odd number are Yin (representing feminine, passive and darkness), subject to Chinese New Year having passed.
== See also ==
Influence of seasonal birth in humans
Chinese zodiac
Glossary of astrology
== Notes ==
== References ==
Arroyo, Stephen (1975). Astrology, Psychology and The Four Elements. California: CCRS Publications
Arroyo, Stephen (1989). Chart Interpretation Handbook. California: CCRS Publications. ISBN 0-916360-49-0
Bobrick, Benson (2005). The Fated Sky: Astrology in History. Simon & Schuster. 369 pp.
Caiozzo, Anna (2003). Images of the Sky. Paris-Sorbonne. Signs and Constellations. Archived 2021-04-17 at the Wayback Machine
Eric Francis (2016). "Why Your Zodiac Sign is Not Wrong"
Hone, Margaret (1978). The Modern Text-Book of Astrology. Revised edition. England: L. N. Fowler & Co. Ltd. ISBN 085243-357-3
Johnsen, Linda (2004 March). A Thousand Suns: Designing Your Future with Vedic Astrology. Yes International Publishers.
Mayo, Jeff (1979). Teach Yourself Astrology. London: Hodder and Stoughton.
Rochberg, Francesca (1998), "Babylonian Horoscopes", American Philosophical Society, New Series, Vol. 88, No. 1, pp. i164. doi:10.2307/1006632. JSTOR 1006632.
Rudhyar, Dane (1943). Astrological Signs The Pulse of Life.
Sachs, Abraham (1948), "A Classification of the Babylonian Astronomical Tablets of the Seleucid Period", Journal of Cuneiform Studies, Vol. 2, No. 4, pp. 271290. doi:10.2307/3515929. JSTOR 3515929.
Sutton, Komilla (1999). The Essentials of Vedic Astrology. England: The Wessex Astrologer Ltd.

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Astrology is a range of divinatory practices, recognized as pseudoscientific since the 18th century, that propose that information about human affairs and terrestrial events may be discerned by studying the apparent positions of celestial objects. Different cultures have employed forms of astrology since at least the 2nd millennium BCE, these practices having originated in calendrical systems used to predict seasonal shifts and to interpret celestial cycles as signs of divine communications.
Most, if not all, cultures have attached importance to what they observed in the sky, and some—such as the Hindus, Chinese, and the Maya—developed elaborate systems for predicting terrestrial events from celestial observations. Western astrology, one of the oldest astrological systems still in use, can trace its roots to 19th17th century BCE Mesopotamia, from where it spread to Ancient Greece, Rome, the Islamic world, and eventually Central and Western Europe. Contemporary Western astrology is often associated with systems of horoscopes that purport to explain aspects of a person's personality and predict significant events in their lives based on the positions of celestial objects; the majority of professional astrologers rely on such systems.
Throughout its history, astrology has had its detractors, competitors and skeptics who opposed it for moral, religious, political, and empirical reasons. Nonetheless, prior to the Enlightenment, astrology was generally considered a scholarly tradition and was common in learned circles, often in close relation with astronomy, meteorology, medicine, and alchemy. It was present in political circles and is mentioned in various works of literature, from Dante Alighieri and Geoffrey Chaucer to William Shakespeare, Lope de Vega, and Pedro Calderón de la Barca. During the Enlightenment, however, astrology lost its status as an area of legitimate scholarly pursuit.
Since the end of the 19th century and the wide-scale adoption of the scientific method, researchers have successfully challenged astrology on both theoretical and experimental grounds and have shown it to have no scientific validity or explanatory power. Astrology thus lost its academic and theoretical standing in the western world, and common belief in it largely declined, until a continuing resurgence starting in the 1960s.
== Etymology ==
The word astrology comes from the early Latin word astrologia, which derives from the Greek ἀστρολογία—from ἄστρον astron ("star") and -λογία -logia, ("study of"—"account of the stars"). The word entered the English language via Latin and medieval French, and its use overlapped considerably with that of astronomy (derived from the Latin astronomia). By the 17th century, astronomy became established as the scientific term, with astrology referring to divinations and schemes for predicting human affairs.
== History ==
Many cultures have attached importance to astronomical events, and the Indians, Chinese, and Maya developed elaborate systems for predicting terrestrial events from celestial observations. A form of astrology was practised in the Old Babylonian period of Mesopotamia, c.1800 BCE. Vedāṅga Jyotiṣa is one of earliest known Hindu texts on astronomy and astrology (Jyotisha). The text is dated between 1400 BCE to final centuries BCE by various scholars according to astronomical and linguistic evidences. Chinese astrology was elaborated in the Zhou dynasty (1046256 BCE). Hellenistic astrology after 332 BCE mixed Babylonian astrology with Egyptian Decanic astrology in Alexandria, creating horoscopic astrology. Alexander the Great's conquest of Asia allowed astrology to spread to Ancient Greece and Rome. In Rome, astrology was associated with "Chaldean wisdom". After the conquest of Alexandria in the 7th century, astrology was taken up by Islamic scholars, and Hellenistic texts were translated into Arabic and Persian. In the 12th century, Arabic texts were imported to Europe and translated into Latin. Major astronomers including Tycho Brahe, Johannes Kepler and Galileo practised as court astrologers. Astrological references appear in literature in the works of poets such as Dante Alighieri and Geoffrey Chaucer, and of playwrights such as Christopher Marlowe and William Shakespeare.
Throughout most of its history, astrology was considered a scholarly tradition. It was accepted in political and academic contexts, and was connected with other studies, such as astronomy, alchemy, meteorology, and medicine. At the end of the 17th century, new scientific concepts in astronomy and physics (such as heliocentrism and Newtonian mechanics) called astrology into question. Astrology thus lost its academic and theoretical standing, and common belief in astrology has largely declined.
=== Ancient world ===
==== Ancient applications ====

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Astrology, in its broadest sense, is the search for meaning in the sky. Early evidence for humans making conscious attempts to measure, record, and predict seasonal changes by reference to astronomical cycles, appears as markings on bones and cave walls, which show that lunar cycles were being noted as early as 25,000 years ago. This was a first step towards recording the Moon's influence upon tides and rivers, and towards organising a communal calendar. Farmers addressed agricultural needs with increasing knowledge of the constellations that appear in the different seasons—and used the rising of particular star-groups to herald annual floods or seasonal activities. By the 3rd millennium BCE, civilisations had sophisticated awareness of celestial cycles, and may have oriented temples in alignment with heliacal risings of the stars.
Scattered evidence suggests that the oldest known astrological references are copies of texts made in the ancient world. The Venus tablet of Ammisaduqa is thought to have been compiled in Babylon around 1700 BCE. A scroll documenting an early use of electional astrology is doubtfully ascribed to the reign of the Sumerian ruler Gudea of Lagash (c.2144 2124 BCE). This describes how the gods revealed to him in a dream the constellations that would be most favourable for the planned construction of a temple. However, there is controversy about whether these were genuinely recorded at the time or merely ascribed to ancient rulers by posterity. The oldest undisputed evidence of the use of astrology as an integrated system of knowledge is therefore attributed to the records of the first dynasty of Babylon (19501651 BCE). This astrology had some parallels with Hellenistic Greek (western) astrology, including the zodiac, a norming point near 9 degrees in Aries, the trine aspect, planetary exaltations, and the dodekatemoria (the twelve divisions of 30 degrees each). The Babylonians viewed celestial events as possible signs rather than as causes of physical events.
The system of Chinese astrology was elaborated during the Zhou dynasty (1046256 BCE) and flourished during the Han dynasty (2nd century BCE to 2nd century CE), during which all the familiar elements of traditional Chinese culture the Yin-Yang philosophy, theory of the five elements, Heaven and Earth, Confucian morality were brought together to formalise the philosophical principles of Chinese medicine and divination, astrology, and alchemy.
The ancient Arabs that inhabited the Arabian Peninsula before the advent of Islam used to profess a widespread belief in fatalism (ḳadar) alongside a fearful consideration for the sky and the stars, which they held to be ultimately responsible for every phenomena that occurs on Earth and for the destiny of humankind. Accordingly, they shaped their entire lives in accordance with their interpretations of astral configurations and phenomena.
==== Ancient objections ====
The Hellenistic schools of philosophical skepticism criticized astrology, alongside all other beliefs. Criticism of astrology by academic skeptics such as Carneades, Cicero, and Favorinus; Pyrrhonists such as Sextus Empiricus; and neoplatonists such as Plotinus, has been preserved.
Carneades argued that belief in fate denies free will and morality; that people born at different times can all die in the same accident or battle; and that contrary to uniform influences from the stars, tribes and cultures are all different.
Cicero, in De Divinatione, leveled a critique of astrology that some modern philosophers consider to be the first working definition of pseudoscience and the answer to the demarcation problem. The philosopher of science Massimo Pigliucci, building on the work of the historian of science, Damian Fernandez-Beanato, argues that Cicero outlined a "convincing distinction between astrology and astronomy that remains valid in the twenty-first century." Cicero stated the twins objection (that with close birth times, personal outcomes can be very different), later developed by Augustine. He argued that since the other planets are much more distant from the Earth than the Moon, they could have only very tiny influence compared to the Moon's. He also argued that if astrology explains everything about a person's fate, then it wrongly ignores the visible effect of inherited ability and parenting, changes in health worked by medicine, or the effects of the weather on people. The historian Stefano Rapisarda notes that the text is formally "equally balanced between pro and contra, and no final or definite answer is given."
Favorinus argued that it was absurd to imagine that stars and planets would affect human bodies in the same way as they affect the tides, and equally absurd that small motions in the heavens cause large changes in people's fates.
Sextus Empiricus argued that it was absurd to link human attributes with myths about the signs of the zodiac, and wrote an entire book, Against the Astrologers (Πρὸς ἀστρολόγους, Pros astrologous), compiling arguments against astrology. Against the Astrologers was the fifth section of a larger work arguing against philosophical and scientific inquiry in general, Against the Professors (Πρὸς μαθηματικούς, Pros mathematikous).
Plotinus, a neoplatonist, had a lasting interest in astrology, including the question of how the world of humans could be affected by the stars, and (if so) whether astrology could predict events on Earth. He argued that since the fixed stars are much more distant than the planets, it is laughable to imagine the planets' effect on human affairs should depend on their position with respect to the zodiac. He also argues that the interpretation of the Moon's conjunction with a planet as good when the moon is full, but bad when the moon is waning, is clearly wrong, as from the Moon's point of view, half of its surface is always in sunlight; and from the planet's point of view, waning should be better, as then the planet sees some light from the Moon, but when the Moon is full to us, it is dark, and therefore bad, on the side facing the planet in question.
=== Hellenistic Egypt ===

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In 525 BCE, Egypt was conquered by the Persians. The 1st century BCE Egyptian Dendera Zodiac shares two signs the Balance and the Scorpion with Mesopotamian astrology.
With the occupation by Alexander the Great in 332 BCE, Egypt became Hellenistic. The city of Alexandria was founded by Alexander after the conquest, becoming the place where Babylonian astrology was mixed with Egyptian Decanic astrology to create Horoscopic astrology. This contained the Babylonian zodiac with its system of planetary exaltations, the triplicities of the signs and the importance of eclipses. It used the Egyptian concept of dividing the zodiac into thirty-six decans of ten degrees each, with an emphasis on the rising decan, and the Greek system of planetary Gods, sign rulership and four elements. 2nd century BCE texts predict positions of planets in zodiac signs at the time of the rising of certain decans, particularly Sothis. The astrologer and astronomer Ptolemy lived in Alexandria. Ptolemy's work the Tetrabiblos formed the basis of Western astrology, and, "...enjoyed almost the authority of a Bible among the astrological writers of a thousand years or more."
=== Greece and Rome ===
The conquest of Asia by Alexander the Great exposed the Greeks to ideas from Syria, Babylon, Persia and central Asia. Around 280 BCE, Berossus, a priest of Bel from Babylon, moved to the Greek island of Kos, teaching astrology and Babylonian culture. By the 1st century BCE, there were two varieties of astrology, one using horoscopes to describe the past, present and future; the other, theurgic, emphasising the soul's ascent to the stars. Greek influence played a crucial role in the transmission of astrological theory to Rome.
Satirist Lucian of Samasota wrote a satirical critique of the astrology in the Roman Empire. Modern scholars of the Second Sophistic consider this an early example of a rationalist polemic against "what the author considers a pseudoscience."
The first definite reference to astrology in Rome comes from the orator Cato, who in 160 BCE warned farm overseers against consulting with Chaldeans, who were described as Babylonian 'star-gazers'. Among both Greeks and Romans, Babylonia (also known as Chaldea) became so identified with astrology that 'Chaldean wisdom' became synonymous with divination using planets and stars. The 2nd-century Roman poet and satirist Juvenal complains about the pervasive influence of Chaldeans, saying, "Still more trusted are the Chaldaeans; every word uttered by the astrologer they will believe has come from Hammon's fountain."
One of the first astrologers to bring Hermetic astrology to Rome was Thrasyllus, astrologer to the emperor Tiberius, the first emperor to have had a court astrologer, though his predecessor Augustus had used astrology to help legitimise his Imperial rights.
=== Medieval world ===
==== Hindu ====
The main texts upon which classical Indian astrology is based are early medieval compilations, notably the Bṛhat Parāśara Horāśāstra, and Sārāvalī by Kalyāṇavarma.
The Horāshastra is a composite work of 71 chapters, of which the first part (chapters 151) dates to the 7th to early 8th centuries and the second part (chapters 5271) to the later 8th century. The Sārāvalī likewise dates to around 800 CE. English translations of these texts were published by N.N. Krishna Rau and V.B. Choudhari in 1963 and 1961, respectively.
==== Islamic ====
Astrology was taken up by Islamic scholars following the collapse of Alexandria to the Arabs in the 7th century, and the founding of the Abbasid empire in the 8th. The second Abbasid caliph, Al Mansur (754775) founded the city of Baghdad to act as a centre of learning, and included in its design a library-translation centre known as Bayt al-Hikma 'House of Wisdom', which continued to receive development from his heirs and was to provide a major impetus for Arabic-Persian translations of Hellenistic astrological texts. The early translators included Mashallah, who helped to elect the time for the foundation of Baghdad, and Sahl ibn Bishr, (a.k.a. Zael), whose texts were directly influential upon later European astrologers such as Guido Bonatti in the 13th century, and William Lilly in the 17th century. Knowledge of Arabic texts started to become imported into Europe during the Latin translations of the 12th century.
==== Jewish ====
Medieval Jewish astrology developed significantly in the Islamic world, where Jewish scholars studied, adapted, and debated astrological knowledge inherited from Greek and Arabic sources. While some, like Maimonides, famously rejected astrology as unscientific and theologically problematic, others, including Saadia Gaon, Sherira Gaon, and Hai Gaon, addressed astrological ideas in their commentaries and responsa. Dunash ibn Tamim, active in Kairouan, incorporated astrology into biblical exegesis and authored a critical treatise on its principles. Astrological texts circulated widely among Jewish communities, as evidenced by hundreds of Hebrew and Judeo-Arabic fragments preserved in the Cairo Geniza, including horoscopes, almanacs, and medical or meteorological prognostications.
The most influential figure was Abraham Ibn Ezra (10891164), who was born in Tudela, in Al-Andalus, and later traveled extensively throughout the Mediterranean and Western Europe. His astrological corpus includes treatises on horoscopy (Sefer ha-Sheelot), electional astrology (Sefer ha-Mivḥarim), medical astrology (Sefer ha-Me'orot), and introductions to theory (Reshit Ḥokhmah, Mishpeṭei ha-Mazalot). His writings served as a bridge between Arabic and Latin astrological traditions and shaped Jewish and Christian astrology in medieval Europe.
==== Europe ====

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In the seventh century, Isidore of Seville argued in his Etymologiae that astronomy described the movements of the heavens, while astrology had two parts: one was scientific, describing the movements of the Sun, the Moon and the stars, while the other, making predictions, was theologically erroneous.
The first astrological book published in Europe was the Liber Planetis et Mundi Climatibus ("Book of the Planets and Regions of the World"), which appeared between 1010 and 1027 AD, and may have been authored by Gerbert of Aurillac. Ptolemy's second century AD Tetrabiblos was translated into Latin by Plato of Tivoli in 1138. The Dominican theologian Thomas Aquinas followed Aristotle in proposing that the stars ruled the imperfect 'sublunary' body, while attempting to reconcile astrology with Christianity by stating that God ruled the soul. The thirteenth century mathematician Campanus of Novara is said to have devised a system of astrological houses that divides the prime vertical into 'houses' of equal 30° arcs, though the system was used earlier in the East. The thirteenth century astronomer Guido Bonatti wrote a textbook, the Liber Astronomicus, a copy of which King Henry VII of England owned at the end of the fifteenth century.
In Paradiso, the final part of the Divine Comedy, the Italian poet Dante Alighieri referred "in countless details" to the astrological planets, though he adapted traditional astrology to suit his Christian viewpoint, for example using astrological thinking in his prophecies of the reform of Christendom.
John Gower in the fourteenth century defined astrology as essentially limited to the making of predictions. The influence of the stars was in turn divided into natural astrology, with for example effects on tides and the growth of plants, and judicial astrology, with supposedly predictable effects on people. The fourteenth-century sceptic Nicole Oresme however included astronomy as a part of astrology in his Livre de divinacions. Oresme argued that current approaches to prediction of events such as plagues, wars, and weather were inappropriate, but that such prediction was a valid field of inquiry. However, he attacked the use of astrology to choose the timing of actions (so-called interrogation and election) as wholly false, and rejected the determination of human action by the stars on grounds of free will. The friar Laurens Pignon (c. 13681449) similarly rejected all forms of divination and determinism, including by the stars, in his 1411 Contre les Devineurs. This was in opposition to the tradition carried by the Arab astronomer Albumasar (787886) whose Introductorium in Astronomiam and De Magnis Coniunctionibus argued the view that both individual actions and larger scale history are determined by the stars.
In the late 15th century, Giovanni Pico della Mirandola forcefully attacked astrology in Disputationes contra Astrologos, arguing that the heavens neither caused, nor heralded earthly events. His contemporary, Pietro Pomponazzi, a "rationalistic and critical thinker", was much more sanguine about astrology and critical of Pico's attack.
=== Renaissance and Early Modern ===
Renaissance scholars commonly practised astrology. Gerolamo Cardano cast the horoscope of king Edward VI of England, while John Dee was the personal astrologer to queen Elizabeth I of England. Catherine de Medici paid Michael Nostradamus in 1566 to verify the prediction of the death of her husband, king Henry II of France, made by her astrologer Lucus Gauricus. Major astronomers who practised as court astrologers included Tycho Brahe in the royal court of Denmark, Johannes Kepler to the Habsburgs, Galileo Galilei to the Medici, and Giordano Bruno who was burnt at the stake for heresy in Rome in 1600. The distinction between astrology and astronomy was not entirely clear. Advances in astronomy were often motivated by the desire to improve the accuracy of astrology. Kepler, for example, was driven by a belief in harmonies between Earthly and celestial affairs, yet he disparaged the activities of most astrologers as "evil-smelling dung".
Ephemerides with complex astrological calculations, and almanacs interpreting celestial events for use in medicine and for choosing times to plant crops, were popular in Elizabethan England. In 1597, the English mathematician and physician Thomas Hood made a set of paper instruments that used revolving overlays to help students work out relationships between fixed stars or constellations, the midheaven, and the twelve astrological houses. Hood's instruments also illustrated, for pedagogical purposes, the supposed relationships between the signs of the zodiac, the planets, and the parts of the human body adherents believed were governed by the planets and signs. While Hood's presentation was innovative, his astrological information was largely standard and was taken from Gerard Mercator's astrological disc made in 1551, or a source used by Mercator. Despite its popularity, Renaissance astrology had what historian Gabor Almasi calls "elite debate", exemplified by the polemical letters of Swiss physician Thomas Erastus who fought against astrology, calling it "vanity" and "superstition." Then around the time of the new star of 1572 and the comet of 1577 there began what Almasi calls an "extended epistemological reform" which began the process of excluding religion, astrology and anthropocentrism from scientific debate. By 1679, the yearly publication La Connoissance des temps eschewed astrology as a legitimate topic.
=== Enlightenment period and onwards ===

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During the Enlightenment, intellectual sympathy for astrology fell away, leaving only a popular following supported by cheap almanacs. One English almanac compiler, Richard Saunders, followed the spirit of the age by printing a derisive Discourse on the Invalidity of Astrology, while in France Pierre Bayle's Dictionnaire of 1697 stated that the subject was puerile. The Anglo-Irish satirist Jonathan Swift ridiculed the Whig political astrologer John Partridge.
In the second half of the 17th century, the Society of Astrologers (16471684), a trade, educational, and social organization, sought to unite London's often fractious astrologers in the task of revitalizing astrology. Following the template of the popular "Feasts of Mathematicians" they endeavored to defend their art in the face of growing religious criticism. The Society hosted banquets, exchanged "instruments and manuscripts", proposed research projects, and funded the publication of sermons that depicted astrology as a legitimate biblical pursuit for Christians. They commissioned sermons that argued Astrology was divine, Hebraic, and scripturally supported by Bible passages about the Magi and the sons of Seth. According to historian Michelle Pfeffer, "The society's public relations campaign ultimately failed." Modern historians have mostly neglected the Society of Astrologers in favor of the still extant Royal Society (1660), even though both organizations initially had some of the same members.
Astrology saw a popular revival starting in the 19th century, as part of a general revival of spiritualism and—later, New Age philosophy, and through the influence of mass media such as newspaper horoscopes. Early in the 20th century the psychiatrist Carl Jung developed some concepts concerning astrology, which led to the development of psychological astrology.
== Principles and practice ==
Advocates have defined astrology as a symbolic language, an art form, a science, and a method of divination. Though most cultural astrology systems share common roots in ancient philosophies that influenced each other, many use methods that differ from those in the West. These include Hindu astrology (also known as "Indian astrology" and in modern times referred to as "Vedic astrology") and Chinese astrology, both of which have influenced the world's cultural history.
=== Western ===
Western astrology is a form of divination based on the construction of a horoscope for an exact moment, such as a person's birth. It uses the tropical zodiac, which is aligned to the equinoctial points.
Western astrology is founded on the movements and relative positions of celestial bodies such as the Sun, Moon and planets, which are analysed by their movement through signs of the zodiac (twelve spatial divisions of the ecliptic) and by their aspects (based on geometric angles) relative to one another. They are also considered by their placement in houses (twelve spatial divisions of the sky). Astrology's modern representation in western popular media is usually reduced to Sun sign astrology, which considers only the zodiac sign of the Sun at an individual's date of birth, and represents only 1/12 of the total chart.
The horoscope visually expresses the set of relationships for the time and place of the chosen event. These relationships are between the seven 'planets', signifying tendencies such as war and love; the twelve signs of the zodiac; and the twelve houses. Each planet is in a particular sign and a particular house at the chosen time, when observed from the chosen place, creating two kinds of relationship. A third kind is the aspect of each planet to every other planet, where for example two planets 120° apart (in 'trine') are in a harmonious relationship, but two planets 90° apart ('square') are in a conflicted relationship. Together these relationships and their interpretations are said to form "...the language of the heavens speaking to learned men."
Along with tarot divination, astrology is one of the core studies of Western esotericism, and as such has influenced systems of magical belief not only among Western esotericists and Hermeticists, but also belief systems such as Wicca, which have borrowed from or been influenced by the Western esoteric tradition. Tanya Luhrmann has said that "all magicians know something about astrology," and refers to a table of correspondences in Starhawk's The Spiral Dance, organised by planet, as an example of the astrological lore studied by magicians.
=== Hindu ===
The earliest Vedic text on astronomy is the Vedanga Jyotisha; Vedic thought later came to include astrology as well.
Hindu natal astrology originated with Hellenistic astrology by the 3rd century BCE, though incorporating the Hindu lunar mansions. The names of the signs (e.g. Greek 'Krios' for Aries, Hindi 'Kriya'), the planets (e.g. Greek 'Helios' for Sun, astrological Hindi 'Heli'), and astrological terms (e.g. Greek 'apoklima' and 'sunaphe' for declination and planetary conjunction, Hindi 'apoklima' and 'sunapha' respectively) in Varaha Mihira's texts are considered conclusive evidence of a Greek origin for Hindu astrology. The Indian techniques may also have been augmented with some of the Babylonian techniques.
=== Chinese and East Asian ===

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Chinese astrology has a close relation with Chinese philosophy (theory of the three harmonies: heaven, earth and man) and uses concepts such as yin and yang, the Five phases, the 10 Celestial stems, the 12 Earthly Branches, and shichen (時辰 a form of timekeeping used for religious purposes). The early use of Chinese astrology was mainly confined to political astrology, the observation of unusual phenomena, identification of portents and the selection of auspicious days for events and decisions.
The constellations of the Zodiac of western Asia and Europe were not used; instead the sky is divided into Three Enclosures (三垣 sān yuán), and Twenty-Eight Mansions (二十八宿 èrshíbā xiù) in twelve Ci (十二次). The Chinese zodiac of twelve animal signs is said to represent twelve different types of personality. It is based on cycles of years, lunar months, and two-hour periods of the day (the shichen). The zodiac traditionally begins with the sign of the Rat, and the cycle proceeds through 11 other animal signs: the Ox, Tiger, Rabbit, Dragon, Snake, Horse, Goat, Monkey, Rooster, Dog, and Pig. Complex systems of predicting fate and destiny based on one's birthday, birth season, and birth hours, such as ziping and Zi Wei Dou Shu (simplified Chinese: 紫微斗数; traditional Chinese: 紫微斗數; pinyin: zǐwēidǒushù) are still used regularly in modern-day Chinese astrology. They do not rely on direct observations of the stars.
The Korean zodiac is identical to the Chinese one. The Vietnamese zodiac is almost identical to the Chinese, except for second animal being the Water Buffalo instead of the Ox, and the fourth animal the Cat instead of the Rabbit. The Japanese have since 1873 celebrated the beginning of the new year on 1 January as per the Gregorian calendar. The Thai zodiac begins, not at Chinese New Year, but either on the first day of the fifth month in the Thai lunar calendar, or during the Songkran festival (now celebrated every 1315 April), depending on the purpose of the use.
== Theological viewpoints ==
=== Ancient ===
Augustine (354430) believed that the determinism of astrology conflicted with the Christian doctrines of man's free will and responsibility, and God not being the cause of evil, but he also grounded his opposition philosophically, citing the failure of astrology to explain twins who behave differently although conceived at the same moment and born at approximately the same time.
=== Medieval ===
Some of the practices of astrology were contested on theological grounds by medieval Muslim astronomers such as Al-Farabi (Alpharabius), Ibn al-Haytham (Alhazen) and Avicenna. They said that the methods of astrologers conflicted with orthodox religious views of Islamic scholars, by suggesting that the Will of God can be known and predicted. For example, Avicenna's 'Refutation against astrology', Risāla fī ibṭāl aḥkām al-nojūm, argues against the practice of astrology while supporting the principle that planets may act as agents of divine causation. Avicenna considered that the movement of the planets influenced life on earth in a deterministic way, but argued against the possibility of determining the exact influence of the stars. Essentially, Avicenna did not deny the core dogma of astrology, but denied our ability to understand it to the extent that precise and fatalistic predictions could be made from it. Ibn Qayyim al-Jawziyya (12921350), in his Miftah Dar al-SaCadah, also used physical arguments in astronomy to question the practice of judicial astrology. He recognised that the stars are much larger than the planets, and argued: And if you astrologers answer that it is precisely because of this distance and smallness that their influences are negligible, then why is it that you claim a great influence for the smallest heavenly body, Mercury? Why is it that you have given an influence to al-Ra's [the head] and al-Dhanab [the tail], which are two imaginary points [ascending and descending nodes]?
=== Modern ===
Martin Luther denounced astrology in his Table Talk. He asked why twins like Esau and Jacob had two different natures yet were born at the same time. Luther also compared astrologers to those who say their dice will always land on a certain number. Although the dice may roll on the number a couple of times, the predictor is silent for all the times the dice fails to land on that number.
What is done by God, ought not to be ascribed to the stars. The upright and true Christian religion opposes and confutes all such fables.
The Catechism of the Catholic Church maintains that divination, including predictive astrology, is incompatible with modern Catholic beliefs such as free will:
All forms of divination are to be rejected: recourse to Satan or demons, conjuring up the dead or other practices falsely supposed to "unveil" the future. Consulting horoscopes, astrology, palm reading, interpretation of omens and lots, the phenomena of clairvoyance, and recourse to mediums all conceal a desire for power over time, history, and, in the last analysis, other human beings, as well as a wish to conciliate hidden powers. They contradict the honor, respect, and loving fear that we owe to God alone.
== Scientific analysis and criticism ==

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The scientific community rejects astrology as having no explanatory power for describing the universe, and considers it a pseudoscience. Scientific testing of astrology has been conducted, and no evidence has been found to support any of the premises or purported effects outlined in astrological traditions. There is no proposed mechanism of action by which the positions and motions of stars and planets could affect people and events on Earth that does not contradict basic and well understood aspects of biology and physics. Those who have faith in astrology have been characterised by scientists including Bart J. Bok as doing so "...in spite of the fact that there is no verified scientific basis for their beliefs, and indeed that there is strong evidence to the contrary".
Confirmation bias is a form of cognitive bias, a psychological factor that contributes to belief in astrology. Astrology believers tend to selectively remember predictions that turn out to be true, and do not remember those that turn out false. Another, separate, form of confirmation bias also plays a role, where believers often fail to distinguish between messages that demonstrate special ability and those that do not. Thus there are two distinct forms of confirmation bias that are under study with respect to astrological belief.
=== Demarcation ===
Under the criterion of falsifiability, first proposed by the philosopher of science Karl Popper, astrology is a pseudoscience. Popper regarded astrology as "pseudo-empirical" in that "it appeals to observation and experiment," but "nevertheless does not come up to scientific standards." In contrast to scientific disciplines, astrology has not responded to falsification through experiment.
In contrast to Popper, the philosopher Thomas Kuhn argued that it was not lack of falsifiability that makes astrology unscientific, but rather that the process and concepts of astrology are non-empirical. Kuhn thought that, though astrologers had, historically, made predictions that categorically failed, this in itself does not make astrology unscientific, nor do attempts by astrologers to explain away failures by saying that creating a horoscope is very difficult. Rather, in Kuhn's eyes, astrology is not science because it was always more akin to medieval medicine; astrologers followed a sequence of rules and guidelines for a seemingly necessary field with known shortcomings, but they did no research because the fields are not amenable to research, and so "they had no puzzles to solve and therefore no science to practise." While an astronomer could correct for failure, an astrologer could not. An astrologer could only explain away failure but could not revise the astrological hypothesis in a meaningful way. As such, to Kuhn, even if the stars could influence the path of humans through life, astrology is not scientific.
The philosopher Paul Thagard asserts that astrology cannot be regarded as falsified in this sense until it has been replaced with a successor. In the case of predicting behaviour, psychology is the alternative. To Thagard a further criterion of demarcation of science from pseudoscience is that the state-of-the-art must progress and that the community of researchers should be attempting to compare the current theory to alternatives, and not be "selective in considering confirmations and disconfirmations." Progress is defined here as explaining new phenomena and solving existing problems, yet astrology has failed to progress having only changed little in nearly 2000 years. To Thagard, astrologers are acting as though engaged in normal science believing that the foundations of astrology were well established despite the "many unsolved problems", and in the face of better alternative theories (psychology). For these reasons Thagard views astrology as pseudoscience.
For the philosopher Edward W. James, astrology is irrational not because of the numerous problems with mechanisms and falsification due to experiments, but because an analysis of the astrological literature shows that it is infused with fallacious logic and poor reasoning.
What if throughout astrological writings we meet little appreciation of coherence, blatant insensitivity to evidence, no sense of a hierarchy of reasons, slight command over the contextual force of critieria, stubborn unwillingness to pursue an argument where it leads, stark naivete concerning the efficacy of explanation and so on? In that case, I think, we are perfectly justified in rejecting astrology as irrational. ... Astrology simply fails to meet the multifarious demands of legitimate reasoning.

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=== Effectiveness ===
Astrology has not demonstrated its effectiveness in controlled studies and has no scientific validity. Where it has made falsifiable predictions under controlled conditions, they have been falsified. One famous experiment included 28 astrologers who were asked to match over a hundred natal charts to psychological profiles generated by the California Psychological Inventory (CPI) questionnaire. The double-blind experimental protocol used in this study was agreed upon by a group of physicists and a group of astrologers nominated by the National Council for Geocosmic Research, who advised the experimenters, helped ensure that the test was fair and helped draw the central proposition of natal astrology to be tested. They also chose 26 out of the 28 astrologers for the tests (two more volunteered afterwards). The study, published in Nature in 1985, found that predictions based on natal astrology were no better than chance, and that the testing "...clearly refutes the astrological hypothesis."
In 1955, the astrologer and psychologist Michel Gauquelin stated that though he had failed to find evidence that supported indicators like zodiacal signs and planetary aspects in astrology, he did find positive correlations between the diurnal positions of some planets and success in professions that astrology traditionally associates with those planets. The best-known of Gauquelin's findings is based on the positions of Mars in the natal charts of successful athletes and became known as the Mars effect. A study conducted by seven French scientists attempted to replicate the claim, but found no statistical evidence. They attributed the effect to selective bias on Gauquelin's part, accusing him of attempting to persuade them to add or delete names from their study.
Geoffrey Dean has suggested that the effect may be caused by self-reporting of birth dates by parents rather than any issue with the study by Gauquelin. The suggestion is that a small subset of the parents may have had changed birth times to be consistent with better astrological charts for a related profession. The number of births under astrologically undesirable conditions was also lower, indicating that parents choose dates and times to suit their beliefs. The sample group was taken from a time when belief in astrology was more common. Gauquelin had failed to find the Mars effect in more recent populations, where a nurse or doctor recorded the birth information.
Dean, a scientist and former astrologer, and psychologist Ivan Kelly conducted a large scale scientific test that involved more than one hundred cognitive, behavioural, physical, and other variables—but found no support for astrology. Furthermore, a meta-analysis pooled 40 studies that involved 700 astrologers and over 1,000 birth charts. Ten of the tests—which involved 300 participants—had the astrologers pick the correct chart interpretation out of a number of others that were not the astrologically correct chart interpretation (usually three to five others). When date and other obvious clues were removed, no significant results suggested there was any preferred chart.
=== Lack of mechanisms and consistency ===
Testing the validity of astrology can be difficult, because there is no consensus amongst astrologers as to what astrology is or what it can predict. Most professional astrologers are paid to predict the future or describe a person's personality and life, but most horoscopes only make vague untestable statements that can apply to almost anyone.
Many astrologers believe that astrology is scientific, while some have proposed conventional causal agents such as electromagnetism and gravity. Scientists reject these mechanisms as implausible since, for example, the magnetic field, when measured from Earth, of a large but distant planet such as Jupiter is far smaller than that produced by ordinary household appliances.
Western astrology has taken the earth's axial precession (also called precession of the equinoxes) into account since Ptolemy's Almagest, so the "first point of Aries", the start of the astrological year, continually moves against the background of the stars. The tropical zodiac has no connection to the stars; tropical astrologers distinguish the constellations from their historically associated sign, thereby avoiding complications involving precession. Charpak and Broch, noting this, referred to astrology based on the tropical zodiac as being "...empty boxes that have nothing to do with anything and are devoid of any consistency or correspondence with the stars." Sole use of the tropical zodiac is inconsistent with references made, by the same astrologers, to the Age of Aquarius, which depends on when the vernal point enters the constellation of Aquarius.
Astrologers usually have only a small knowledge of astronomy, and often do not take into account basic principles—such as the precession of the equinoxes, which changes the position of the Sun with time. They commented on the example of Élizabeth Teissier, who wrote that "The sun ends up in the same place in the sky on the same date each year" as the basis for the idea that two people with the same birthday, but a number of years apart, should be under the same planetary influence. Charpak and Broch noted that, "There is a difference of about twenty-two thousand miles between Earth's location on any specific date in two successive years", and that thus they should not be under the same influence according to astrology. Over a 40-year period there would be a difference greater than 780,000 miles.

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=== Reception in the social sciences ===
The general consensus of astronomers and other natural scientists is that astrology is a pseudoscience which carries no predictive capability, with many philosophers of science considering it a "paradigm or prime example of pseudoscience." Some scholars in the social sciences have cautioned against categorizing astrology, especially ancient astrology, as "just" a pseudoscience or projecting the distinction backwards into the past. Thagard, while demarcating it as a pseudoscience, notes that astrology "should be judged as not pseudoscientific in classical or Renaissance times...Only when the historical and social aspects of science are neglected does it become plausible that pseudoscience is an unchanging category." Historians of science such as Tamsyn Barton, Roger Beck, Francesca Rochberg, and Wouter J. Hanegraaff argue that such a wholesale description is anachronistic when applied to historical contexts, stressing that astrology was not pseudoscience before the 18th century and the importance of the discipline to the development of medieval science. R. J. Hakinson writes in the context of Hellenistic astrology that "the belief in the possibility of [astrology] was, at least some of the time, the result of careful reflection on the nature and structure of the universe."
Nicholas Campion, both an astrologer and academic historian of astrology, argues that Indigenous astronomy is largely used as a synonym for astrology in academia, and that modern Indian and Western astrology are better understood as modes of cultural astronomy or ethnoastronomy. Roy Willis and Patrick Curry draw a distinction between propositional episteme and metaphoric metis in the ancient world, identifying astrology with the latter and noting that the central concern of astrology "is not knowledge (factual, let alone scientific) but wisdom (ethical, spiritual and pragmatic)". Similarly, historian of science Justin Niermeier-Dohoney writes that astrology was "more than simply a science of prediction using the stars and comprised a vast body of beliefs, knowledge, and practices with the overarching theme of understanding the relationship between humanity and the rest of the cosmos through an interpretation of stellar, solar, lunar, and planetary movement." Scholars such as Assyriologist Matthew Rutz have begun using the term "astral knowledge" rather than astrology "to better describe a category of beliefs and practices much broader than the term 'astrology' can capture."
== Cultural impact ==
=== Western politics and society ===
In the West, political leaders have sometimes consulted astrologers. For example, the British intelligence agency MI5 employed Louis de Wohl as an astrologer after it was reported that Adolf Hitler used astrology to time his actions. The War Office was "...interested to know what Hitler's own astrologers would be telling him from week to week." In fact, de Wohl's predictions were so inaccurate that he was soon labelled a "complete charlatan", and later evidence showed that Hitler considered astrology "complete nonsense". After John Hinckley's attempted assassination of US President Ronald Reagan, first lady Nancy Reagan commissioned astrologer Joan Quigley to act as the secret White House astrologer. However, Quigley's role ended in 1988 when it became public through the memoirs of former chief of staff Donald Regan.
There was a boom in interest in astrology in the late 1960s. The sociologist Marcello Truzzi described three levels of involvement of "Astrology-believers" to account for its revived popularity in the face of scientific discrediting. He found that most astrology-believers did not think that it was a scientific explanation with predictive power. Instead, those superficially involved, knowing "next to nothing" about astrology's 'mechanics', read newspaper astrology columns, and could benefit from "tension-management of anxieties" and "a cognitive belief-system that transcends science." Those at the second level usually had their horoscopes cast and sought advice and predictions. They were much younger than those at the first level, and could benefit from knowledge of the language of astrology and the resulting ability to belong to a coherent and exclusive group. Those at the third level were highly involved and usually cast horoscopes for themselves. Astrology provided this small minority of astrology-believers with a "meaningful view of their universe and [gave] them an understanding of their place in it." This third group took astrology seriously, possibly as an overarching religious worldview (a sacred canopy, in Peter L. Berger's phrase), whereas the other two groups took it playfully and irreverently.
In 1953, the sociologist Theodor W. Adorno conducted a study of the astrology column of a Los Angeles newspaper as part of a project examining mass culture in capitalist society. Adorno believed that popular astrology, as a device, invariably leads to statements that encouraged conformity—and that astrologers who go against conformity, by discouraging performance at work etc., risk losing their jobs. Adorno concluded that astrology is a large-scale manifestation of systematic irrationalism, where individuals are subtly led—through flattery and vague generalisations—to believe that the author of the column is addressing them directly. Adorno drew a parallel with the phrase opium of the people, by Karl Marx, by commenting, "occultism is the metaphysic of the dopes."
A 2005 Gallup poll and a 2009 survey by the Pew Research Center reported that 25% of US adults believe in astrology, while a 2024 Pew survey found a figure of 27%. According to data released in the National Science Foundation's 2014 Science and Engineering Indicators study, "Fewer Americans rejected astrology in 2012 than in recent years." The NSF study noted that in 2012, "slightly more than half of Americans said that astrology was 'not at all scientific,' whereas nearly two-thirds gave this response in 2010. The comparable percentage has not been this low since 1983." Astrology apps became popular in the late 2010s, some receiving millions of dollars in Silicon Valley venture capital.
=== India and Japan ===

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In India, there is a long-established and widespread belief in astrology. It is commonly used for daily life, particularly in matters concerning marriage and career, and makes extensive use of electional, horary and karmic astrology, a vertent who believes in reincarnation and in the idea they can read a person's karma in a Natal chart by studying in particular Lunar nodes and retrograde planets. Indian politics have also been influenced by astrology. It is still considered a branch of the Vedanga. In 2001, Indian scientists and politicians debated and critiqued a proposal to use state money to fund research into astrology, resulting in permission for Indian universities to offer courses in Vedic astrology.
In February 2011, the Bombay High Court reaffirmed astrology's standing in India when it dismissed a case that challenged its status as a science.
In Japan, strong belief in astrology has led to dramatic changes in the fertility rate and the number of abortions in the years of Fire Horse. Adherents believe that women born in hinoeuma years are unmarriageable and bring bad luck to their father or husband. In 1966, the number of babies born in Japan dropped by over 25% as parents tried to avoid the stigma of having a daughter born in the hinoeuma year.
=== Literature and music ===
The fourteenth-century English poets John Gower and Geoffrey Chaucer both referred to astrology in their works, including Gower's Confessio Amantis and Chaucer's The Canterbury Tales. Chaucer commented explicitly on astrology in his Treatise on the Astrolabe, demonstrating personal knowledge of one area, judicial astrology, with an account of how to find the ascendant or rising sign.
In the fifteenth century, references to astrology, such as with similes, became "a matter of course" in English literature.
In the sixteenth century, John Lyly's 1597 play, The Woman in the Moon, is wholly motivated by astrology, while Christopher Marlowe makes astrological references in his plays Doctor Faustus and Tamburlaine (both c. 1590), and Sir Philip Sidney refers to astrology at least four times in his romance The Countess of Pembroke's Arcadia (c. 1580). Edmund Spenser uses astrology both decoratively and causally in his poetry, revealing "...unmistakably an abiding interest in the art, an interest shared by a large number of his contemporaries." George Chapman's play, Byron's Conspiracy (1608), similarly uses astrology as a causal mechanism in the drama. William Shakespeare's attitude towards astrology is unclear, with contradictory references in plays including King Lear, Antony and Cleopatra, and Richard II. Shakespeare was familiar with astrology and made use of his knowledge of astrology in nearly every play he wrote, assuming a basic familiarity with the subject in his commercial audience. Outside theatre, the physician and mystic Robert Fludd practised astrology, as did the quack doctor Simon Forman. In Elizabethan England, "The usual feeling about astrology ... [was] that it is the most useful of the sciences."
In seventeenth century Spain, Lope de Vega, with a detailed knowledge of astronomy, wrote plays that ridicule astrology. In his pastoral romance La Arcadia (1598), it leads to absurdity; in his novela Guzman el Bravo (1624), he concludes that the stars were made for man, not man for the stars. Calderón de la Barca wrote the 1641 comedy Astrologo Fingido (The Pretended Astrologer); the plot was borrowed by the French playwright Thomas Corneille for his 1651 comedy Feint Astrologue.
The most famous piece of music influenced by astrology is the orchestral suite The Planets. Written by the British composer Gustav Holst (18741934), and first performed in 1918, the framework of The Planets is based upon the astrological symbolism of the planets. Each of the seven movements of the suite is based upon a different planet, though the movements are not in the order of the planets from the Sun. The composer Colin Matthews wrote an eighth movement entitled Pluto, the Renewer, first performed in 2000, as the suite was written prior to Pluto's discovery. In 1937, another British composer, Constant Lambert, wrote a ballet on astrological themes, called Horoscope. In 1974, the New Zealand composer Edwin Carr wrote The Twelve Signs: An Astrological Entertainment for orchestra without strings. Camille Paglia acknowledges astrology as an influence on her work of literary criticism Sexual Personae (1990). The American comedian Harvey Sid Fisher is known for his comedic songs about astrology.
Astrology features strongly in Eleanor Catton's The Luminaries, recipient of the 2013 Man Booker Prize.
== See also ==
Astrology and science
Astrology software
Barnum effect
Glossary of astrology
List of astrological traditions, types, and systems
List of topics characterised as pseudoscience
Jewish astrology
Scientific skepticism
Worship of heavenly bodies
== Notes ==
== References ==
== External links ==
Digital International Astrology Library (ancient astrological works)
Biblioastrology (www.biblioastrology.com) (specialised bibliography)
Paris Observatory

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Attachment therapy (also called "the Evergreen model", "holding time", "rage-reduction", "compression therapy", "rebirthing", "corrective attachment therapy", "coercive restraint therapy", and "holding therapy") is a pseudoscientific mental health intervention intended to treat attachment disorders in children. During the height of its popularity, the practice was found primarily in the United States; much of it was centered in about a dozen locations in Evergreen, Colorado, where Foster Cline, one of its founders, established a clinic in the 1970s.
The practice has resulted in adverse outcomes for children, including at least six documented child fatalities. Since the 1990s, there have been a number of prosecutions for deaths or serious maltreatment of children at the hands of "holding therapists" or parents following their instructions. Two of the most well-known cases are those of Candace Newmaker in 2000 and the Gravelles in 2003. Following the associated publicity, some advocates of attachment therapy began to alter views and practices to be less potentially dangerous to children. This change may have been hastened by the publication of a task force report on the subject in January 2006, commissioned by the American Professional Society on the Abuse of Children (APSAC), which was largely critical of attachment therapy. In April 2007, ATTACH, an organization originally set up by attachment-based therapists, formally adopted a white paper stating its unequivocal opposition to the use of coercive practices in therapy and parenting, promoting instead newer techniques of attunement, sensitivity and regulation.
Attachment therapy is primarily based on Robert Zaslow's rage-reduction therapy from the 1960s-1970s and on psychoanalytic theories about suppressed rage, catharsis, regression, breaking down of resistance and defence mechanisms. Zaslow and other early proponents such as Nikolas Tinbergen and Martha Welch used it as a treatment for autism, based on the now discredited belief that autism was the result of failures in the attachment relationship with the mother.
This form of treatment differs significantly from attachment-based therapies, as well as talking psychotherapies such as attachment-based psychotherapy and relational psychoanalysis.
== Theory ==
Attachment therapy is a treatment used primarily with fostered or adopted children who have behavioral difficulties, including disobedience and perceived lack of gratitude or affection for their caregivers. The children's problems are ascribed to an inability to bond to their new parents, because of suppressed rage due to past maltreatment and abandonment. Attachment therapy involves a child being firmly held and/or lain upon by therapists or parents. Through this process of restraint and confrontation, therapists seek to produce in the child a range of responses such as rage and despair with the goal of achieving catharsis. In theory, when the child's resistance is overcome and the rage is released, the child is reduced to an infantile state in which he or she can be "re-parented" by methods such as cradling, rocking, bottle feeding and enforced eye contact. The aim is to promote bonding with the new caregivers. Control over the children is usually considered essential, and the therapy is often accompanied by parenting techniques which emphasize obedience. These accompanying parenting techniques are based on the belief that a properly bonded child should comply with parental demands in a manner "fast, snappy and right the first time" and should be "fun to be around". These techniques have been implicated in several child deaths and other harmful effects.
This form of therapy, including diagnosis and accompanying parenting techniques, is not scientifically validated, nor is it considered to be part of mainstream psychology. The form described as "attachment therapy", despite its name, has theoretical foundations inconsistent with those of attachment theory and its guidance is incompatible with the norms of attachment-based therapy.
== Treatment characteristics ==
The controversy, as outlined in the 2006 American Professional Society on the Abuse of Children (APSAC) Task Force Report, has broadly centered around "holding therapy" and coercive, restraining, or aversive procedures. These include deep tissue massage, aversive tickling, punishments related to food and water intake, enforced eye contact, requiring children to submit totally to adult control over all their needs, barring normal social relationships outside the primary caretaker, encouraging children to regress to infant status, reparenting, attachment parenting, or techniques designed to provoke cathartic emotional discharge. Variants of these treatments have carried various labels that change frequently. They may be known as "rebirthing therapy", "compression therapy", "corrective attachment therapy", "the Evergreen model", "holding time", "rage-reduction therapy", or "prolonged parent-child embrace therapy". Some authors critical of this therapeutic approach have used the term Coercive Restraint Therapy. It is this form of treatment for attachment difficulties or disorders which is popularly known as "attachment therapy". Advocates for Children in Therapy, a group that campaigns against attachment therapy, give a list of therapies they state are attachment therapy by another name. They also provide a list of additional therapies used by attachment therapists which they consider to be unvalidated.
Matthew Speltz of the University of Washington School of Medicine describes a typical treatment taken from The Center's material (apparently a replication of the program at the Attachment Center, Evergreen) as follows:

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Like Welsh [sic] (1984, 1989), The Center induces rage by physically restraining the child and forcing eye contact with the therapist (the child must lie across the laps of two therapists, looking up at one of them). In a workshop handout prepared by two therapists at The Center, the following sequence of events is described: (1) therapist 'forces control' by holding (which produces child 'rage'); (2) rage leads to child 'capitulation' to the therapist, as indicated by the child breaking down emotionally ('sobbing'); (3) the therapist takes advantage of the child's capitulation by showing nurturance and warmth; (4) this new trust allows the child to accept 'control' by the therapist and eventually the parent. According to The Center's treatment protocol, if the child 'shuts down' (i.e., refuses to comply), he or she may be threatened with detainment for the day at the clinic or forced placement in a temporary foster home; this is explained to the child as a consequence of not choosing to be a 'family boy or girl.' If the child is actually placed in foster care, the child is then required to 'earn the way back to therapy' and a chance to resume living with the adoptive family.
According to the APSAC Task Force,
A central feature of many of these therapies is the use of psychological, physical, or aggressive means to provoke the child to catharsis, ventilation of rage, or other sorts of acute emotional discharge. To do this, a variety of coercive techniques are used, including scheduled holding, binding, rib cage stimulation (e.g., tickling, pinching, knuckling), and/or licking. Children may be held down, may have several adults lie on top of them, or their faces may be held so they can be forced to engage in prolonged eye contact. Sessions may last from 3 to 5 hours, with some sessions reportedly lasting longer ... Similar but less physically coercive approaches may involve holding the child and psychologically encouraging the child to vent anger toward her or his biological parent.
The APSAC Task Force describes how the conceptual focus of these treatments is the child's individual internal pathology and past caregivers rather than current parent-child relationships or current environment. If the child is well-behaved outside the home, the child's doing so is seen as successful manipulation of outsiders rather than as evidence of a problem in the current home or current parent-child relationship. The APSAC Task Force noted that this perspective has its attractions because it relieves the caregivers of responsibility to change aspects of their own behavior and aspirations. Proponents believe that traditional therapies fail to help children with bonding problems because it is impossible to establish a trusting relationship with them. They believe this is because children with bonding problems actively avoid forming genuine relationships. Proponents emphasize the child's resistance to bonding and the need to break it down. In rebirthing and similar approaches, protests of distress from the child are considered to be resistance that must be overcome by more coercion.
Coercive techniques, such as scheduled or enforced holding, may also serve the intended purpose of demonstrating dominance over the child. Establishing total adult control, demonstrating to the child that they have no control, and demonstrating that all of the child's needs are met through the adult, is a central tenet of many controversial attachment therapies. Similarly, many controversial treatments hold that children described as attachmentdisordered must be pushed to revisit and relive early trauma. Children may be encouraged to regress to an earlier age where trauma was experienced or be reparented through holding sessions. Other features of holding therapy are the "two-week intensive" course of therapy, and the use of "therapeutic foster parents" with whom the child stays whilst undergoing therapy. According to O'Connor and Zeanah, the "holding" approach would be viewed as intrusive and therefore non-sensitive and counter-therapeutic, in contrast with accepted theories of attachment.
According to Advocates for Children in Therapy,
Attachment Therapy almost always involves extremely confrontational, often hostile confrontation of a child by a therapist or parent (sometimes both). Restraint of the child by more powerful adult(s) is considered an essential part of the confrontation." The purported correction is described as "... to force the children into loving (attaching to) their parents; ... there is a hands-on treatment involving physical restraint and discomfort. Attachment Therapy is the imposition of boundary violations most often coercive restraint and verbal abuse on a child, usually for hours at a time; ... Typically, the child is put in a lap hold with the arms pinned down, or alternatively an adult lies on top of a child lying prone on the floor.
Psychiatrist Bruce Perry cites the use of holding therapy techniques by caseworkers and foster parents investigating a Satanic Ritual Abuse case in the late 1980s, early 1990s, as instrumental in obtaining lengthy and detailed alleged "disclosures" from children. In his opinion, using force or coercion on traumatized children simply re-traumatizes them and far from producing love and affection, produces obedience based on fear, as in the trauma bond known as Stockholm syndrome.

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Andrea Swenson, 1990; a 13-year-old adopted girl undergoing attachment therapy at The Attachment Center, Evergreen, Colorado. She was placed with "therapeutic foster parents". When the insurance company refused to continue to pay for her treatment, the adoptive parents were asked to allow the foster parents to adopt Andrea so that a fresh claim could be made. Andrea, having asked her foster parents what would happen if she took an overdose of drugs or slit her wrist, and been told she would die, took an overdose of aspirin. She was violently ill during the night and was incoherent, breathing heavily and still vomiting in the morning. Nevertheless, the foster parents went bowling, leaving her alone. A visitor found her dead in the hallway. The suit was settled out of court.
Lucas Ciambrone, 1995; a seven-year-old adopted boy who was starved, beaten, bitten and forced to sleep in a stripped bathroom at his parents home in Sarasota, Florida. At the post-mortem he was found to have 200 bruises and five old broken ribs. The adoptive mother was convicted as the abuser and the adoptive father of being aware but doing nothing to prevent it or seek help. Foster Cline gave evidence for both parents claiming Lucas had reactive attachment disorder and that living with such a child was like living "in a situation with the same psychic pressures as those experienced in a concentration camp or cult" and that the parents were in no way responsible for the genesis of Lucas' alleged difficult behaviors. No violent or angry behaviors were reported at school.
David Polreis, 1996; a two-year-old adopted boy who was beaten to death by his adoptive mother. Foster Cline gave evidence for the mother claiming David had reactive attachment disorder. The adoptive mother, supported by attachment therapists practising the Evergreen model, claimed he had beaten himself to death as a consequence of his attachment disorder. She subsequently instead claimed he had attacked her and she had acted in self-defense. David had been diagnosed with attachment disorder by an attachment therapist and was undergoing treatment and accompanying attachment parenting techniques. Mourners at the funeral were asked to contribute to The Attachment Center.
Krystal Tibbets, 1997; a three-year-old adopted child who was killed by her adoptive father using holding therapy techniques he claimed had been taught to him by an attachment therapy center in Midvale, Utah. This was denied by the therapist and the adoptive mother. He lay on top of Krystal, a technique known as "compression therapy", and pushed his fist into her abdomen to release "visceral rage" and to enforce bonding. When she stopped screaming and struggling he believed she had "shut down" as a form of "resistance". After his release from a five-year prison sentence the adoptive father campaigned to have attachment therapy banned.
Candace Newmaker, 2000; a ten-year-old adopted girl who was killed by asphyxiation during a rebirthing session used as part of a two-week attachment therapy "intensive". The two attachment therapists, Connell Watkins (formerly of The Attachment Center, Evergreen) and Julie Ponder were each sentenced to 16 years imprisonment for their part in the therapy during which Candace was wrapped in blankets and required to struggle to be reborn, against the weight of several adults. Her inability to struggle out was interpreted as "resistance". Her adoptive mother and the "therapeutic foster parents" with whom she had been placed received lesser penalties. Watkins was released on parole in August 2008 after serving approximately 7 years of her sentence.
Logan Marr, 2001; a five-year-old child who had been fostered by a Maine state caseworker. While having a tantrum, the screaming girl was buckled into a highchair, wrapped with duct tape, including over her mouth, and left in a basement where she suffocated. The foster mother claimed to have used some attachment therapy ideas and techniques she had picked up when working as a caseworker.
Cassandra Killpack, 2002; a four-year-old adopted child who died from complications of hyponatremia secondary to water intoxication. This apparently occurred when she was restrained in a chair and forced to drink excessive amounts of water by her adoptive parents as part of an "attachment-based" treatment using techniques they claimed had been taught to them at the attachment therapy center where Cassandra was undergoing treatment. It appears this was a punishment for having drunk some of her sister's drink.
Gravelles, 2003; 11 children adopted by Michael and Sharon Gravelle. Ten of the 11 children slept in cages. The case also involved allegations of extreme control over food and toileting and severe punishments for disobedience. The children were home-schooled. Some of the children underwent holding therapy from their attachment therapist and the adoptive parents used accompanying attachment therapy parenting techniques at home. The adoptive parents and therapist were prosecuted and convicted in 2003.
Vasquez, 2007: four adopted children, three of them were kept in cages, fed limited diets, and permitted only primitive sanitary facilities. The fourth child, the favorite, was given medication to delay puberty. The adoptive mother received a prison sentence of less than a year and her parental rights were terminated in 2007. There was no therapist in this case but the adoptive mother claimed that three of her four adopted children had reactive attachment disorder.
Skyler Wilson, 2023: A 2-year-old adopted child who died from hypoxic brain injuries after being "swaddled" and allegedly duct-taped to the floor by his adoptive parents, who referenced Nancy Thomas by name in information provided to the police. A former foster parent also alleged that the adoptive parents performed exorcisms. Jodi and Joseph Wilson are currently awaiting trial.
== See also ==
Attachment-based therapy
Traumatic bonding
Child development
Child abuse
Theraplay
Child of Rage
Death of Candace Newmaker
== References ==

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== Further reading ==
Fairlove, Abigail (26 December 2012). "Importance of Strong Sitting for Reactive Attachment Disorder Treatment". Rad Children- Information on Children with Reactive Attachment Disorder ( RAD ). Abigail Fairlove. Archived from the original on 2 May 2014. Retrieved 2 May 2014.
Mercer J, Sarner L, Rosa L (2003), Attachment Therapy on Trial: The Torture and Death of Candace Newmaker, Praeger, ISBN 978-0-275-97675-0
O'Connor TG, Nilsen WJ (2005), "Models versus Metaphors in Translating Attachment Theory to the Clinic and Community", in Berlin LJ, Ziv Y, Amaya-Jackson L, Greenberg MT (eds.), Enhancing Early Attachments: Theory, Research, Intervention and Policy, Duke series in child development and public policy, Guilford Press, ISBN 978-1-59385-470-6
Prior V, Glaser D (2006), Understanding Attachment and Attachment Disorders: Theory, Evidence and Practice, Child and Adolescent Mental Health Series, London: Jessica Kingsley, ISBN 978-1-84310-245-8, OCLC 70663735
Zeanah, Charles H.; Chesher, Tessa; Boris, Neil W.; Walter, Heather J.; Bukstein, Oscar G.; Bellonci, Christopher; Benson, R. Scott; Bussing, Regina; Chrisman, Allan; Hamilton, John; Hayek, Munya; Keable, Helene; Rockhill, Carol; Siegel, Matthew; Stock, Saundra (November 2016). "Practice Parameter for the Assessment and Treatment of Children and Adolescents With Reactive Attachment Disorder and Disinhibited Social Engagement Disorder". Journal of the American Academy of Child & Adolescent Psychiatry. 55 (11): 9901003. doi:10.1016/j.jaac.2016.08.004. PMID 27806867.
== External links ==
Advocates for Children in Therapy
Science based medicine
Report of the APSAC Task Force on Attachment Therapy, Reactive Attachment Disorder, and Attachment Problems

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=== Parenting techniques ===
Therapists often instruct parents to follow programs of treatment at home, for example obedience-training techniques such as "strong sitting" (frequent periods of required silence and immobility) and withholding or limiting food. Earlier authors sometimes referred to this as "German Shepherd training". In some programs children undergoing the two-week intensive stay with "therapeutic foster parents" for the duration or beyond and the adoptive parents are trained in their techniques.
According to the APSAC Task Force, because it is believed children with bonding problems resist bonding, fight against it and seek to control others to avoid bonding, the child's character flaws must be broken before bonding can occur. According to proponents, their idea of attachment parenting may include keeping the child at home with no social contacts, home schooling, hard labor or meaningless repetitive chores throughout the day, motionless sitting for prolonged periods of time, and control of all food and water intake and bathroom needs. Children described as attachment-disordered are expected by attachment therapists to comply with parental commands "fast and snappy and right the first time", and to always be "fun to be around" for their parents. Deviation from this standard, such as not finishing chores or arguing, is interpreted as a sign of attachment disorder that must be forcibly eradicated. From this perspective, parenting a child with an attachment disorder is a battle, and winning the battle by defeating the child is paramount.
Proper appreciation of total adult control is also considered vital, and information, such as how long a child will be with therapeutic foster parents or what will happen to him or her next, is deliberately withheld. Attachment parenting expert Nancy Thomas states that attachment-disordered children act worse when given information about what is going to occur because they will use the information to manipulate their environment and everyone in it.
In addition to restrictive behavior, parents are advised to provide daily sessions in which older children are treated as if they were babies to create attachment. The child is held in the caregiver's lap, rocked, hugged and kissed, and fed with a bottle and given sweets. These sessions are carried out at the caregiver's wish and not upon the child's request.
Attachment-based parenting is the widely acknowledged to be the opposite of what holding therapy proponents describe. Attachment is an affectionate, mutually satisfying relationship between a child and a caregiver that serves the purpose of making the child feel safe, secure, protected from danger, and comforted especially after exposure to danger. In addition, bonding and attachment involve overlapping concepts but describe different phenomenon.
=== Contrasting attachment theory-based methods ===
In contrast, traditional attachment theory holds that the provision of a safe and predictable environment and caregiver qualities such as sensitivity, responsiveness to children's physical and emotional needs and consistency, support the development of healthy attachment. Therapy based on this viewpoint emphasizes providing a stable environment and taking a calm, sensitive, non-intrusive, non-threatening, patient, predictable, and nurturing approach toward children. Further, as attachment patterns develop within relationships, methods to correct problems with attachment focus on improving the stability and positive qualities of the caregiver-child interactions and relationship. All mainstream interventions with an existing or developing evidential foundation focus on enhancing caregiver sensitivity, creating positive interactions with caregivers, or change of caregiver if that is not possible with existing caregivers. Some interventions focus specifically on increasing caregiver sensitivity in foster parents.

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== Theoretical principles ==
Like a number of other alternative mental health treatments for children, attachment therapy is based on some assumptions that differ strongly from the theoretical foundations of other attachment-based therapies. In contrast to traditional attachment theory, the theory of attachment described by attachment therapy proponents is that young children who experience adversity (including maltreatment, loss, separations, adoption, frequent changes in child care, colic or even frequent ear infections) become enraged at a very deep and primitive level. This results in a lack of ability to bond, attach, or to be genuinely affectionate to others. Suppressed or unconscious rage is theorized to prevent the child from forming bonds with caregivers and leads to behavior problems when the rage erupts into unchecked aggression. Such children are said to fail to develop a conscience, to not trust others, to seek control rather than closeness, to resist the authority of caregivers, and to engage in endless power struggles. They are seen as highly manipulative and as trying to avoid true attachments while simultaneously striving to control those around them through manipulation and superficial sociability. Such children are said to be at risk of becoming psychopaths who will go on to engage in very serious delinquent, criminal, and antisocial behaviors if left untreated. The tone in which the attributes of these children are described has been characterized as "demonizing".
Advocates of this treatment also believe that emotional attachment of a child to a caregiver begins during the prenatal period, during which the unborn child is aware of the mother's thoughts and emotions. If the mother is distressed by the pregnancy, especially if she considers abortion, the child responds with distress and anger that continue through postnatal life. If the child is separated from the mother after birth, no matter how early this occurs, the child again feels distress and rage that will block attachment to a foster or adoptive caregiver. To the contrary, attachment research establishes that the attachment system is not activated until a child is approximately seven months old.
If the child has had a peaceful gestation, but after birth suffers pain or ungratified needs during the first year, attachment will again be blocked. If the child reaches the toddler period safely, but is not treated with strict authority during the second year, according to the so-called "attachment cycle", attachment problems will result. Failure of attachment results in a lengthy list of mood and behavior problems, but these may not be revealed until the child is much older. According to attachment therapist Elizabeth Randolph, attachment problems can be diagnosed even in an asymptomatic child through observation of the child's inability to crawl backward on command.
Critics say holding therapies have been promoted as "attachment" therapies, even though they are more antithetical to than consistent with attachment theory, and not based on attachment theory or research. Indeed, they are considered incompatible. There are many ways in which holding therapy/attachment therapy contradicts Bowlby's attachment theory, e.g. attachment theory's fundamental and evidence-based statement that security is promoted by sensitivity. According to Mary Dozier, "holding therapy does not emanate in any logical way from attachment theory or from attachment research".
== Diagnosis and attachment disorder ==
To the extent that attachment disorders exist or can be diagnosed, holding therapy methods were not recognized in mainstream practice. Prior and Glaser describe two discourses on attachment disorder. One is science-based, found in academic journals and books with careful reference to theory, international classifications and evidence. They list Bowlby, Ainsworth, Tizard, Hodges, Chisholm, O'Connor and Zeanah and colleagues as respected attachment theorists and researchers in the field. The other discourse is found in clinical practice, non-academic literature and on the Internet where claims are made which have no basis in attachment theory and for which there is no empirical evidence. In particular unfounded claims are made as to efficacy of treatments. The Internet is considered essential to the popularization of holding therapy as an "attachment" therapy.
The APSAC Task Force describes the relationship between the proponents of holding therapy and mainstream therapies as polarized. "This polarization is compounded by the fact that holding therapy has largely developed outside the mainstream scientific and professional community and flourishes within its own networks of attachment therapists, treatment centers, caseworkers, and parent support groups. Indeed, proponents and critics of the controversial attachment therapies appear to move in different worlds."

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=== Diagnosis lists and questionnaires ===
Both the APSAC Task Force and Prior and Glaser describe the proliferation of alternative "lists" and diagnoses, particularly on the Internet, by proponents of holding therapy, that are not in accord with either DSM or ICD classifications and which are partly based on the unsubstantiated views of Zaslow and Menta and Cline. According to the Task Force, "These types of lists are so nonspecific that high rates of false-positive diagnoses are virtually certain. Posting these types of lists on internet sites that also serve as marketing tools may lead many parents or others to conclude inaccurately that their children have attachment disorders."
Prior and Glaser describe the lists as "wildly inclusive" and state that many of the behaviors in the lists are likely to be the consequences of neglect and abuse rather than located within the attachment paradigm. Descriptions of children are frequently highly pejorative and "demonizing". Examples given from lists of attachment disorder symptoms found on the internet include lying, avoiding eye contact except when lying, persistent nonsense questions or incessant chatter, fascination with fire, blood, gore and evil, food related issues (such as gorging or hoarding), cruelty to animals and lack of conscience. They also give an example from the Evergreen Consultants in Human Behavior which offers a 45-symptom checklist including bossiness, stealing, enuresis and language disorders.
A commonly used diagnostic checklist in attachment therapy is the Randolph Attachment Disorder Questionnaire or "RADQ", which originated at the Institute for Attachment in Evergreen. It is presented not as an assessment of reactive attachment disorder but rather attachment disorder. The checklist includes 93 discrete behaviors, many of which either overlap with other disorders, like Conduct Disorder and Oppositional Defiant Disorder or are not related to attachment difficulties. It is largely based on the earlier Attachment Disorder Symptom Checklist which itself shows considerable overlap with even earlier checklists for indicators of sexual abuse. The Attachment Disorder Symptom Checklist includes statements about the parent's feelings toward the child as well as statements about the child's behavior. For example, parental feelings are evaluated through responses to such statements as "Parent feels used" and "is wary of the child's motives if affection is expressed", and "Parents feel more angry and frustrated with this child than with other children". The child's behavior is referred to in such statements as "Child has a grandiose sense of self-importance" and "Child 'forgets' parental instructions or directives". The compiler of the RADQ claims validity by reference to the Attachment Disorder Symptom Checklist. It also purports to diagnose attachment disorder for which there is no classification. A critic has stated that a major problem of the RADQ is that it has not been validated against any established objective measure of emotional disturbance.
=== Patient recruitment ===
In addition to concerns about the use of non-specific diagnostic checklists on the Internet being used as a marketing tool, the Task Force also noted the extreme claims made by proponents as to both the prevalence and effect of attachment disorders. Some proponents suggest most or a high proportion of adopted children are likely to have an attachment or bonding disorder. Statistics on the prevalence of maltreatment are wrongly used to estimate the prevalence of RAD. Problematical or less desirable styles such as insecure or disorganized attachment are conflated with attachment disorder. Children are labeled as "RADs", "RAD-kids" or "RADishes". They are seen as manipulative, dishonest, without conscience and dangerous. Some holding therapy sites predict that attachment-disordered children will grow up to become violent predators or psychopaths unless they receive the treatment proposed. A sense of urgency is created which serves to justify the application of aggressive and unconventional techniques. One site was noted to contain the argument that Saddam Hussein, Adolf Hitler, and Jeffrey Dahmer were examples of children who were attachment-disordered who "did not get help in time". Foster Cline, in his seminal work on holding therapy, Hope for High Risk and Rage Filled Children, uses the example of Ted Bundy.
In answering the question posed as to how a treatment widely regarded by attachment clinicians and researchers as destructive and unethical came to be linked with attachment theory and to be seen as a viable and useful treatment, O'Connor and Nilson cite the use of the Internet to publicize holding therapy and the lack of knowledgeable mainstream professionals or appropriate mainstream treatments or interventions. They set out recommendations for the better dissemination of both understanding of attachment theory and knowledge of the more recent evidence-based treatment options available.
Rachel Stryker in her anthropological study The Road to Evergreen argues that adoptive families of institutionalized children who have difficulties transitioning to a nuclear family are attracted to the Evergreen model despite the controversy, because it legitimises and reanimates the same ideas about family and domesticity as does the adoption process itself, offering renewed hope of "normal" family life. Institutionalized or abused children often do not conform to adopters conceptualizations of family behaviours and roles. The Evergreen model pathologizes the child's behaviour by a medical diagnosis, thus legitimising the family. As well as the promise of working where traditional therapies fail, holding therapy also offers the idea of attachment as a negotiable social contract that can be enforced in order to convert the unsatisfactory adoptee into the "emotional asset" the family requires. By the use of confrontation the model offers the means to condition children to comply with parental expectations. Where the therapy fails to achieve this the fault is attributed to the child's conscious choice to not be a family member, or the child's inability to perform as family material.
=== Contrasting mainstream position ===

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Within mainstream practice, disorders of attachment are classified in DSM-5 and ICD-10 as reactive attachment disorder (generally known as RAD), and Disinhibited social engagement disorder. Both classification systems warn against automatic diagnosis based on abuse or neglect. Many symptoms are present in a variety of other more common and more easily treatable disorders. There is as yet no other accepted definition of attachment disorders.
According to the American Academy of Child and Adolescent Psychiatry (AACAP) practice parameter published in 2005, the question of whether attachment disorders can be reliably diagnosed in older children and adults has not been resolved. Attachment behaviors used for the diagnosis of RAD change markedly with development and defining analogous behaviors in older children is difficult. There are no substantially validated measures of attachment in middle childhood or early adolescence.
== Prevalence ==
Holding therapy prospered during the 1980s and 1990s as a consequence of both the influx of older adopted orphans from Eastern European and third world countries and the inclusion of reactive attachment disorder in the 1980 Diagnostic and Statistical Manual of Mental Disorders which attachment therapists adopted as an alternative name for their existing unvalidated diagnosis of attachment disorder.
According to the APSAC Task Force, these therapies are sufficiently prevalent to have prompted position statements or specific prohibitions against using coercion or restraint as a treatment by mainstream professional societies such as: American Psychological Association (Division on Child Maltreatment), National Association of Social Workers (and its Utah Chapter), American Professional Society on the Abuse of Children, American Academy of Child and Adolescent Psychiatry, and American Psychiatric Association. The Association for the Treatment and Training in the Attachment of Children, (ATTACh), an organization for professionals and families associated with holding therapy, has also issued statements against coercive practices. Two American states, Colorado and North Carolina, have outlawed rebirthing. There have been professional licensure sanctions against some leading proponents and successful criminal prosecutions and imprisonment of therapists and parents using holding therapy techniques. Despite this, the treatments appear to be continuing among networks of attachment therapists, attachment therapy centers, caseworkers, and adoptive or foster parents. The advocacy group ACT states, "Attachment Therapy is a growing, underground movement for the 'treatment' of children who pose disciplinary problems to their parents or caregivers."
Rachel Stryker in her anthropological study The Road to Evergreen states that attachment therapies "of all stripes" are increasingly popular in the US and that the number of therapists associated with the Evergreen model registering with ATTACh grows each year. She cites the large number of formerly institutionalized domestic and foreign adoptees in the US and the apparently higher risk of disruption of foreign adoptions, of which there were 216,000 between 1998 and 2008.
The practice of holding therapy is not confined to the US. Prior and Glaser cite at least one clinic in the UK. Attachment therapists from the USA have conducted conferences in the UK. The British Association for Adoption and Fostering, (BAAF), has issued an extensive position statement on the subject which covers not only physical coercion but also the underlying theoretical principles. It had been thought, until recently, that therapists calling themselves "attachment therapists" practising in the UK tended to be practising conventional forms of psychotherapy based on attachment theory. In 2009 The British Journal of Social Work accepted an article rehabilitating holding therapy, "To Have and to Hold: Questions about a Therapeutic Service for Children" describing an earlier study involving the Keys Attachment Centre in Rossendale, Lancashire and the surrounding Keys Attachment Homes. In 2012, first-hand accounts from a survivor and a number of professionals provided evidence that the coercive Evergreen model of holding therapy had been systematically used to treat children in Local Authority care within a programme in North West England.

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== Developments ==
The APSAC Task Force stated that proponents of holding therapy correctly point out that most critics have never actually observed any of the treatments they criticize or visited any of the centers where the controversial therapies are practiced. Proponents argue that their therapies present no physical risk if undertaken properly and that critics' concerns are based on unrepresentative occurrences and misapplications of techniques, or misunderstanding by parents. Holding is described as gentle or nurturing and it is maintained that intense, cathartic approaches are necessary to help children with attachment disorders. Their evidence for this is primarily clinical experience and testimonials.
According to the APSAC Task Force, there are controversies within the holding therapy community about coercive practices. There has been a move away from coercive and confrontational models towards attunement and emotional regulation amongst some leaders in the field, notably Hughes, Kelly and Popper. A number of therapies are quite different from those that have led to the abuse and deaths of children in much publicized court cases. The Task Force, however, points out that all the therapies, including those using frankly coercive practices, present themselves as humane, respectful and nurturing; therefore caution is advised. Some practitioners condemn the most dangerous techniques but continue to practice other coercive techniques. Others have taken a public stand against coercion. The Task Force was of the view that all could benefit from more transparency and specificity as to how the therapy is behaviorally delivered.
In 2001, 2003 and 2006, ATTACh, an organization set up by Foster Cline and associates, issued a series of statements in which they progressively changed their stance on coercive practices. In 2001, after the death of Candace Newmaker they stated "The child will never be restrained or have pressure put on them in such a manner that would interfere with their basic life functions such as breathing, circulation, temperature, etc." A White Paper, formally accepted in April 2007, "unequivocally state(s) our opposition to the use of coercive practices in therapy and parenting." They acknowledge ATTACh's historical links with catharsis, provocation of rage, and intense confrontation, among other overtly coercive techniques (and indeed continue to offer for sale books by controversial proponents) but state that the organization has evolved significantly away from earlier positions. They state that their recent evolution is due to a number of factors including tragic events resulting from such techniques, an influx of members practicing other techniques such as attunement and a "fundamental shift ... away from viewing these children as driven by a conscious need for control toward an understanding that their often controlling and aggressive behaviors are automatic, learned defensive responses to profoundly overwhelming experiences of fear and terror." While being of the view that authoritative practices are necessary, and that nurturing touch and treatment aimed at the perceived developmental rather than chronological age are an integral part of the therapy, the White Paper promotes the techniques of attunement, sensitivity and regulation and deprecates coercive practices such as enforced holding or enforced eye contact.

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They also considered the lack of available and suitable interventions from mainstream professionals as essential to the popularization of holding therapy as an attachment therapy. In 2003, an issue of Attachment & Human Development was devoted to the subject of attachment therapy with articles by well-known experts in the field of attachment. Attachment researchers and authors condemned holding therapy as empirically unfounded, theoretically flawed and clinically unethical. It has also been described as potentially abusive and a pseudoscientific intervention, not based on attachment theory or research, that has resulted in tragic outcomes for children including at least six documented child fatalities. In 2006, the American Professional Society on the Abuse of Children (APSAC) Task Force reported on the subjects of attachment therapy, reactive attachment disorder, and attachment problems and laid down guidelines for the future diagnosis and treatment of attachment disorders. The APSAC Task Force was largely critical of Attachment Therapy's theoretical base, practices, claims to an evidence base, non-specific symptoms lists published on the internet, claims that traditional treatments do not work and dire predictions for the future of children who do not receive attachment therapy. "Although focused primarily on specific attachment therapy techniques, the controversy also extends to the theories, diagnoses, diagnostic practices, beliefs, and social group norms supporting these techniques, and to the patient recruitment and advertising practices used by their proponents." In 2007, Scott Lilienfeld included holding therapy as one of the potentially harmful therapies (PHT's) at level 1 in his Psychological Science review. Describing it as "unfortunately" referred to as "attachment therapy", Mary Dozier and Michael Rutter consider it critical to differentiate it from treatments derived from attachment theory. A mistaken association between attachment therapy and attachment theory may have resulted in a relatively unenthusiastic view towards the latter among some practitioners despite its relatively profound lines of research in the field of socioemotional development.

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== Claims ==
According to the APSAC Task Force, proponents of holding therapy commonly assert that their therapies alone are effective for attachment-disordered children and that traditional treatments are ineffective or harmful. The APSAC Task Force expressed concern over claims by therapies to be "evidence-based", or the only evidence-based therapy, when the Task Force found no credible evidence base for any such therapy so advertised. Nor did it accept more recent claims to evidence base in its November 2006 Reply.
Two approaches on which published studies have been undertaken are holding therapy and dyadic developmental psychotherapy. Each of these non-randomized studies concluded that the treatment method studied was effective. Both the APSAC Task Force and Prior and Glaser cite and criticize the one published study on holding therapy undertaken by Myeroff et al., which "purports to be an evaluation of holding therapy". This study covers the "across the lap" approach, described as "not restraint" by Howe and Fearnley but "being held whilst unable to gain release." Prior and Glaser state that although the Myeroff study claims it is based on attachment theory, the theoretical basis for the treatment is in fact Zaslow.
Dyadic developmental psychotherapy was developed by psychologist Daniel Hughes, described by the Task Force as a "leading attachment therapist". Hughes' website gave a list of attachment therapy techniques, repeated by the APSAC Task Force from an earlier website, which he stated do not or should not form part of dyadic developmental psychotherapy, which the Task Force took as a description of attachment therapy techniques. Two studies on dyadic developmental psychotherapy have been published by Becker-Weidman, the second being a four-year follow up of the first. Prior and Glaser state Hughes' therapy reads as good therapy for abused and neglected children, though with "little application of attachment theory", but the advocacy group ACT and the Task Force place Hughes within the attachment therapy paradigm.
In 2004, Saunders, Berliner and Hanson developed a system of categories for social work interventions which has proved somewhat controversial. In their first analysis, holding therapy was placed in Category 6 as a "Concerning treatment". In 2006 Craven and Lee classified 18 studies in a literature review under the Saunders, Berliner & Hanson system. They considered both dyadic developmental psychotherapy and holding therapy. They placed both in Category 3 as "Supported and acceptable". This categorization by Craven and Lee has been criticized as unduly favorable, a point to which Craven and Lee responded by arguments in support of holding therapy. Both Myeroff et al.'s study and Becker-Weidman's first study (published after the main Report) were examined in the Task Force's November 2006 Reply to Letters and were criticized as to their methodology. Becker-Weidman's study was described by the Task Force as "an important first step toward learning the facts about DDP outcomes" but falling far short of the criteria necessary to constitute an evidence base.
Some studies are still being undertaken on coercive therapies. A non-randomized, before-and-after 2006 pilot study by Welch (the progenitor of "holding time") et al. on Welch's "prolonged parent-child embrace therapy" was conducted on children with a range of diagnoses for behavioral disorders and claimed to show significant improvement.
In March 2007, attachment therapy was placed on a list of treatments that have the potential to cause harm to clients in the APS journal, Perspectives on Psychological Science. Concern was expressed about methods that involve holding and restraint, and the lack of randomized, controlled experiments showing the effectiveness of the treatment.
In 2010 a modest social work study and "invitation to a debate", based on interviews with the deliverers and recipients of a therapeutic intervention incorporating non-coercive holding at one centre in the UK, called for further consideration of the use of this type of intervention. The intervention was not described as "holding therapy" but as using a degree of holding in the course of therapy. Although recipients were generally positive about the therapy received, the holding aspect was the least liked. The authors call for research and a debate on issues of what constitutes "coercion" and the distinctions between the different variants of "holding" in therapy.
== Cases of harm and death ==
There have been a number of cases of serious harm to children, all adopted, while using the therapy. An estimated six children have died as a consequence of the more coercive forms of such treatments or the application of the accompanying parenting techniques.

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Attunement was the early term adopted by practitioners of the pseudoscientific discipline of energy medicine, originally developed by Lloyd Arthur Meeker (19071954) and his colleagues. Meeker taught and practiced Attunement as a central feature of his spiritual teaching and ministry, Emissaries of Divine Light. Attunement is taught as a personal spiritual practice and as a healing modality offered through the hands. Emissaries of Divine Light believe that Attunement is a pivotal factor in the conscious evolution of humanity.
Like qigong, reiki, and therapeutic touch, attunement is a putative practice as defined by the United States National Center for Complementary and Integrative Health (NCCIH), lacking published scientific study of its effectiveness. Attunement practitioners and clients rely on personal and anecdotal experience to promote it.
== History ==
=== Beginnings ===
Lloyd Arthur Meeker shared the first Attunement with Rudolph Plagge in Wichita, Kansas, in 1929, and developed the teaching and practice of Attunement with colleagues until his death in 1954. From September 14 to 16, 1932, Meeker had a spiritual awakening experience that he described as a “heavenly ordination.” He marked that experience as the initiation of Emissaries of Divine Light. That same year he instituted a series of energy medicine experiments. Meeker reported that he could stand across the room from the client and the client could feel the intensification of life force. He also reported excellent results when his hands were one to six inches from the client.
Lloyd Arthur Meeker wrote and lectured using the name Uranda, which was how he was known to his followers. From 1935 to 1945, Meeker traveled across the United States and Canada, establishing centers for healing and spiritual teaching for varying periods of time in Atascadero, Oakland, Burbank and Long Beach, California; Buffalo, New York; Grand Forks, Iowa; and Loveland, Colorado. In December 1945 Meeker established his headquarters at Sunrise Ranch in Loveland, where Attunement continues to be taught and practiced.
=== The role of G-P-C chiropractors ===
The G-P-C movement played a significant role in the development of attunement. G-P-C stood for God Patient Chiropractor. It was a no-fee system of service that George Shears created in the late 1930s after he, himself, had a severely debilitating ruptured disk, and vowed to offer his services on a donation basis. Shears had been a Major League Baseball pitcher in 1912, and then a graduate of the Palmer School of Chiropractic in 1917. He experimented with "no-force" chiropractic adjustments in which he believed it was the healing energy through his hands that brought positive results, shown through x-rays. The G-P-C movement saw the relationship between the chiropractor and the patient as the base of a triangle with God at the apex. Meeker eventually embraced this model for the healing relationship.
In 1949, Albert Ackerley, a G-P-C chiropractor in Toronto, Ontario, Canada, was introduced to Lloyd Arthur Meeker's writings. In June 1949, when Ackerley was preparing to offer an adjustment to his patient, he saw that the patient's spine had aligned before he had given the adjustment. He believed that this result was a consequence of the flow of subtle energy between himself and the patient, rather than any physical intervention. Ackerley met Meeker in July 1949 and began to practice Attunement under his tutelage. Up to this point, Meeker had referred to Attunements as “treatments.” It was Albert Ackerley who named those treatments “Attunements.” With Lloyd Meeker's urging, Ackerley began to experiment with long-distance Attunements in which the person receiving the Attunement was not in the physical presence of the practitioner. Albert Ackerley and G.P.C. President, Virgil Givens, were both prosecuted legally due to their practice of energy medicine, but continued to practice nonetheless.
In May 1950, Lloyd Arthur Meeker met George Shears. Meeker's meeting with Shears was followed by G-P-C meetings at a Chiropractic Convention in August 1950 in Davenport, Iowa, and then a G-P-C conference in Huntingburg, Indiana, which was attended by Meeker. Following these events, about twenty-five chiropractors attended a G-P-C Convention from September 2 through 8 of that year at Sunrise Ranch.
The prospect of joining with Meeker and Emissaries of Divine Light raised suspicion and concerns among the G-P-C chiropractors. Nonetheless, at the G-P-C Convention in the home of George Shears in Huntingburg, Indiana, on February 24 and 25, 1951, the G-P-C board of directors voted to cooperate with the Emissaries to establish a G-P-C Servers Training School at Sunrise Ranch. Lloyd Arthur Meeker led three six-month G-P-C Servers Training School sessions at Sunrise Ranch from 1952 to 1954. His classes from the 1952 session were transcribed and published as The Divine Design of Man, # 1 and # 2. The audio recordings and the transcripts of Meeker's classes from the 1953 and 1954 sessions are still extant. The sessions included Attunement technique, nutrition, psychology and a broad spectrum of spiritual teachings.
In August 1954, Lloyd Arthur Meeker, his wife, Kathy Meeker, Albert Ackerley and two children died in the crash of Meeker's small plane in San Francisco Bay. A close associate of Meeker's, Martin Cecil, assumed the responsibility for the leadership of Emissaries of Divine Light and for carrying forward Meeker's Attunement work. With assistance from G-P-C chiropractors, James Wellemeyer and Bill Bahan, and from Roger de Winton, Alan Hammond and others, Martin Cecil continued the Servers Training School at Sunrise Ranch and the teaching of Attunement. George Shears eventually moved to Sunrise Ranch in 1968 where he practiced Attunement until he died in 1978.

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=== Development ===
As Emissaries of Divine Light grew in the 1960s, '70s and '80s, so did the teaching and practice of Attunement. Martin Cecil emphasized in his teaching of Attunement that the basis of it was a spiritual practice. While many of the early Attunement practitioners were chiropractors, lay people became increasingly active in the practice. Building on the early work of Lloyd Arthur Meeker, Attunement evolved to include groups of people practicing it together. In 1993, a World Blessing time was established for practitioners to share a time of collective Attunement and healing prayer. In the '80s and '90s, the teaching and practice of long-distance Attunement was developed further.
Following Martin Cecil's death in 1988, his son, Michael Cecil, become the Spiritual Leader of the Emissaries. In 1996, Emissaries of Divine Light formed an Attunement Guild, which established standards for the teaching and certification of Attunement practitioners. A group of Attunement practitioners, including Chris Jorgensen and Andrew Shier, formed the International Association of Attunement Practitioners (IAAP) in 1999. IAAP developed and taught the practice of Attunement separate from the organization of Emissaries of Divine Light. Roger de Winton continued his Attunement trainings through Attunement Intensives offered at Sunrise Ranch. He also continued his work of long-distance Attunement until his death in 2001.
In 1996, Michael Cecil left Emissaries of Divine Light to continue his own work, which includes Attunement through The Ashland Institute. A group of trustees assumed the leadership of Emissaries of Divine Light with Michael Cecil's departure. In August 2004, the trustees of Emissaries of Divine Light named David Karchere as the leader of the global network. Since becoming the leader of the Emissaries, Karchere has developed programs, including Life Destiny Immersion and Journey into the Fire, that are designed to assist people to transform the spiritual and emotional factors that block the experience of Attunement. In 2010, with other Attunement practitioners, David Karchere founded the Attunement School at Sunrise Ranch.
== Philosophy ==
Attunement is based on Lloyd Arthur Meeker's vision that the human body is designed to be the temple of God. The foundational principle underlying Attunement is what Meeker named as The One Law, or the Law of Cause and Effect. Emissaries of Divine Light teach that the causative factor in spiritual regeneration is the universal power and intelligence within all people, and that through response and opening to that power and intelligence, people experience healing. Attunement practitioners believe that positive shifts in consciousness release a healing energy through a person's body, mind and emotions. Traditionally, the Attunement practitioner is referred to as a server and the recipient is referred to as a servee.
Attunement servers believe they transmit universal life energy through their hands to the servee. The primary connecting points on the servee are the endocrine glands. Attunement servers teach that the endocrine glands are portals for universal life energy that operates through the physical body, and through the mental and emotional function of the individual, and that the servee has the opportunity to open more fully to the life energy within them through receiving an Attunement.
Emissaries of Divine Light hold that the origin of universal life energy is divine in nature and that the core reality of all people is divine. The goal of Attunement is to increase the energetic flow while removing blockages to that flow so that a person's core reality can emerge.
Lloyd Meeker taught that the human connection to universal life energy relies on pneumaplasm, which was his name for the aura of subtle energy, or etheric body surrounding the physical body. Attunement practitioners believe that pneumaplasm is generated when the universal life energy flows through a person, and that the clarity of the pneumaplasmic body depends on the clarity of that energy flow. Attunement practitioners focus on clarifying and enriching the pneumaplasm associated with the endocrine glands and the anatomical systems of the body.
Practitioners believe that the endocrine glands translate seven aspects of the universal life energy into the human experience. They name these as the Seven Spirits.
Attunement practitioners relate these Seven Spirits to the Seven Spirits of God referenced in the book of Revelation in the Bible. Some Attunement practitioners correlate the seven endocrine glands with seven chakras.
== Technique ==
At the core of the teaching of the technique is the establishment of an energetic circuit between the practitioner (server) and the client (servee). Practitioners seek to establish that circuit by the radiant extension of life energy through the dominant hand of the practitioner to the gland or organ of the client, and the receiving of life energy through the opposite hand from a corresponding contact point in the body.
Meeker taught that the first step in the Attunement process was the alignment of the cervical vertebrae by the radiation of healing energy through the hands on either side of the neck. Contemporary Attunement practitioners continue to teach attunement technique that begins and ends with an Attunement of the cervical vertebrae. Often, the cervical Attunement is followed by Attunement of the endocrine glands and some of the major organs of the body.
== Spiritual practice ==
As a spiritual practice, Attunement is intended to connect a person more closely to their spiritual source and to open the flow of life current. The practice includes conscious attention to the quality of spirit expressing through the practitioner in the daily living of life, and specific periods of meditation in the beginning and ending of each day, taught as Sanctification in the Evening and the Morning.
A central aspect of Attunement as a spiritual practice is referred to by Emissaries of Divine Light as spiritual centering, which they define as a daily practice of opening thoughts and emotions to the spiritual.
== References ==

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Auditing, also called processing, is a central practice in Scientology in which a trained "auditor" asks structured questions intended to help a participant identify and address past experiences and emotional difficulties. Most auditing uses an E-meter, a device the Church of Scientology describes as a spiritual tool for detecting areas of mental or spiritual trauma, though courts and scientists have found it to have no medical or scientific validity. Auditing is presented as the primary method for advancing up Scientology's Bridge to Total Freedom, a graded series of levels involving procedures and rundowns, using concepts such as the reactive mind, engrams, and pastlife incidents and implants. Scholars and critics have variously described auditing as a form of psychological conditioning, hypnosis, or pseudotherapy, and have raised concerns about its methods, the misuse of confidential session records, and its spaceopera cosmology. There have been legal, regulatory, and ethical controversies related to its unproven medical claims, misuse of private information, the use of child labor, and the death of some participants.
== Terminology ==
L. Ron Hubbard assigned special meanings to many ordinary English words when he wrote about Scientology, and Scientologese has become a language in itself. These are some very basic meanings of words Scientology uses when describing this subject.
Auditing
The procedures where two individuals work together to improve one of the person's abilities and to reduce or eliminate their neuroses.
Auditor
A trained Scientologist who is helping another individual through the use of auditing techniques. An auditor is only allowed to audit processes (on others) up to the level of training they have completed (their 'class').
Preclear
The person being questioned by an auditor. Also called a "PC".
Case
The collection of all the preclear's upsets and emotional baggage which auditing is trying to relieve. A preclear's case level is how far a preclear has advanced on the Bridge to Total Freedom.
Session
A single time when an auditor and preclear sit down to audit. The duration of a session can range from a few minutes to several hours.
Process
A specific step in auditing. It may consist of repeatedly asking the preclear the same question (an auditing command) until there is no more upset on that question. Many processes are run during a single session.
Rundown
A series of processes designed to handle a specific aspect of a case, such as communication, problems, or happiness. It may take many sessions to complete a rundown.
End phenomenon
Abbreviated "EP", it is what an auditor is looking for that indicates a process, session or rundown has been completed. The EP of a process might be that the preclear realizes something, is happy about it, and the e-meter is showing certain needle movements. The EP of a session might be that several processes have been performed, and the preclear is very happy about it so it is a good point to stop for the day. A rundown would have a specific EP, such as all auditing questions for the rundown have been asked, and the preclear has experienced some sort of realization such as saying they feel they could now communicate freely with anyone on any subject.
Intensive
An "intensive" is a block of 12 1/2 hours purchased in advance by the preclear for auditing services. Auditing is to occur intensively so that the 12 1/2 hours is performed within one week. At the end of each session, the hours and minutes used are written down on a form in the preclear's folder, deducted from the amount on account, and the balance is calculated.
== Description ==
The term "auditing" was coined by L. Ron Hubbard in 1950. Auditing in Scientology is an activity where a trained Scientologist, known as an auditor, listens and asks various questions to the subject, who is referred to as a "preclear" or "PC".
Auditing involves the use of "processes", which are sets of questions asked or directions given by an auditor. Based on a prior interview looking for "charged" subjects—"charge" being that which prevents the PC from thinking on a subject or getting rid of a subject or approaching a subject—on the E-meter, found by asking questions to the PC in regard to them and their fancied case. When the specific objective of any one "process" is achieved, the process is ended, and another can then be started. Through auditing, the subjects are said to free themselves from barriers that inhibit their natural abilities. Charged areas can be viewed as areas of misinformation or lies. Once uncovered, they dissipate as their truth becomes apparent and the charge is eliminated once viewed for what it really is, an untruth.
The Auditor's Code outlines a series of 29 promises which an auditor pledges, such as:
Not to evaluate for the preclear or tell him what he should think about his case in session
Not to invalidate the preclear's case or gains in or out of session
Never to use the secrets of a preclear divulged in session for punishment or personal gain
The main intention of an auditing session is to remove "charged incidents" that have caused trauma, which are believed in Scientology to be stored in the "reactive mind". These incidents must then be eliminated for proper functioning.
In 1952, auditing techniques "began to focus on the goal of exteriorizing the thetan" with the goal of providing complete spiritual awareness.

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