A rebuttal to the article in Point Issue 30 page 14
By Benjamin Carruth
Jason King's recent article in the point is a fine example of the fundamentally flawed approach to scientific method and argumentation currently perpetrated by the majority of the piercing industry. While I wish this were an exception, that this sort of fatuous disregard for basic deductive process was uncommon, it all too clearly illustrates a cultural problem hampering the growth of our industry, and our acceptance as skilled and knowledgeable professionals.
In order to appropriately assess the content, I will be addressing it sequentially.
The suitability of glass is a hotly debated subject in the piercing industry, and the fact that it has not been resolved is an indication of the selective application of reference data common to apologist reasoning (a method in which one draws conclusions then seeks out data that supports them). This selective application of reference, as well as applicable criteria, is evident in the presentation of the suitability of gold, platinum, and niobium, as will be shown shortly.
The categories of glass presented are misleading on several points. First, the definition of soft glass as being soda-lime glass is simply without foundation. Barium crystal is a form of soft glass as commonly used in jewelry as soda-lime, and presents particular problems unique to its composition. The primary problem with these categories is that after their presentation they are not appropriately used. The distinction between the two is presented at this point in the treatise, but that distinction is not applied to the presented rejection criteria. There are numerous points (addressed in sequence) that apply to one grade of glass but not others, and this distinction is not explored at all. I hope that this is a simple mistake, as it bears the features of intentional selective distinction. This is a tactic in which the arguer presents distinct categories, but dissolves those distinctions when it would be harmful to their argument to maintain that clarity. This allows the argument to project an illusion of precision while preventing contrary attributes presented by the categories from interfering with cohesion. It’s an underhanded debate tactic that has no place in public policy discussion.
The argument for the inclusion of gold, platinum, and niobium presents similar problems. The reasoning behind the use of gold (“has been used successfully in piercing for literally thousands of years”) is a morass of logical absurdity. The use of anecdotal validation (it’s been used, so and so said so, it’s been done before) has no merit as a justification for a clinical decision, especially when more empirical data is available. The biocompatibility of gold and platinum has been thoroughly assessed, with a great deal of information available on the subject. The use of the term “successful” begs an entire category of questions that the author seems willing to take a priori: by what criteria is success determined? Have those criteria changed? Has the determination changed? As great a concern is the question of WHY these criteria have been met. What are the traits of Gold that make it a suitable material? What properties does it possess that make it acceptable according to our requirements for deeming success? All these, and countless other questions, are presented in absentia, i.e. as if they have been answered and were so unimportant that the answers need not be presented. By failing to state such substantial predicates at the beginning of his argument, the author has built his reasoning on unfounded assumptions, the antithesis of deductive method.
Applying similar criteria to the assessment of Platinum and Niobium is also necessary, as they are defended using the same anecdotal framework. The proposition that Niobium is acceptable because it is used as a component in implant alloys is absurd. Is cobalt acceptable?
If this same level of purely anecdotal argumentation is all that is required to deem acceptability, then it is worth mentioning that borosilicate glass is used as the control medium for implant certification testing, used for the containers for tissue generation, cloning, cell culturing, and is surgically used for maxillofacial reconstruction and vertebral replacement. The latter example is particularly interesting, as it illustrates a load-bearing use far more demanding than jewelry. While this argumentation raises some interesting questions, it is far from adequate to establish the clinical acceptability of the material. Fortunately, such acceptability may be established through other avenues.
The posit that gold and platinum do not have implant standards due to cost is pure speculation, and has no place in an attempt to rationally explore the subject at hand. For that matter, I am unclear as to why the points on these metals were included at all, as it seems their only contributions are distraction and confusion.
The listing of testing methodologies is an interesting inclusion, though their full listing bears merit only if they are cited in their entirety (i.e. quote what you reference). Similarly, application of the cited criteria must be complete in order for said citation to be of any merit. This is another example of apologetic reasoning, where data is selectively used to support ones argument. In this example, the fitness for purpose of glass for jewelry is being called into question. Of the available criteria, the only one applied (and incorrectly) is physical. That leaves chemical, toxicological, electrical, morphological, and mechanical criteria still to be assessed. Mechanical criteria are partially inapplicable for these purposes (unless we’re trying to thread glass???), as is electrical. Glass is of sufficient malleability to allow for a wide variety of shapes, though some shapes are unsuitable, thus allowing for conditional morphological acceptability.
The primary concerns in assessing jewelry materials fall to chemical, toxicological, and physical properties, and it is here that continuing to hold distinctions between differing grades of glass would be crucial, as well as a more thorough examination of the applied criteria. For example:
“Due to fragility glass that is 10 gauge or smaller may not hold up to everyday wear, therefore it does not show fitness for purpose”
In order to make such a statement we must state WHICH glass we are talking about, in what proportions, subjected to what conditions (and how those conditions reflect an appropriate test of the suitability and durability of materials for every day wear), and for how long. For example, I can snap a 2mm thick 40mm rod of barium crystal with one hand. The same thickness and material at 20mm long is much harder to break due to the lessened application of leverage. 2mmX20mm of borosilicate is MUCH harder to break. Breaking a 2mmX5mm rod of borosilicate requires a hard surface or tools, and a 2mmX5mm rod of kiln-annealed quartz crystal withstood two hard blows from a hard rubber shaping mallet before cracking. Exactly which glass we’re talking about is obviously important for assessing its properties. The chemical and toxicological aspects of the differing forms of glass vary broadly, but I will address that when the author does.
Also in need of addressing is the ambiguous word choice occurring in that posit. The notion that glass “may not” hold up under normal stress conditions is speculative, and while it certainly merits investigation, it should not be treated as a conclusion per se. Therefore, the authors use of “therefore” is premature. It’s also interesting that he assumes that piercings are going to be done at 10 gauge or smaller, and that the only way to exceed that size for an initial piercing is some sort of Frankensteinian procedure involving biopsy punches or implantation. The appropriate techniques for using lancet cannulae for larger piercings is not within the scope of this response, but the author’s feigned ignorance of such techniques lends his argument little credibility.
Nor does his credibility improve in stating that there are three, and only three, medical uses for glass. Listing the tasks that glass is used for in medical science and its satellite disciplines is also well beyond the scope of this document and would take far too much time, as glass is one of the most commonly and diversely used materials in these or any other disciplines. Even extending the benefit of the doubt, and providing that the author meant to say implant applications rather than general medical, his list falls far short of the reality. An F-1538 chemically compliant grade of borosilicate is used for everything from facial reconstruction (they build cheekbones out of it) to the plates in which tissue cultures for graft are grown (if they need to grow skin, they do it in glass).
On a brief side note, F-1538 is a frequently misunderstood reference. Many people assume that since F-1538 INCLUDES provisions for bioglass that it is only applicable to bioglass, even though it explicitly states otherwise.
The biocompatibility of glass has been a convention of medical science for so long that it is the reference standard by which biocompatibility of a material is assessed (by means of implantation of glass fiber under the skin, NOT fiberglass inhalation studies as the author suggests. The line of speculation the author follows from this unfounded assumption is similarly questionable).
Indeed, this is a large part of the problem that people looking for biocompatibility testing for glass run into: there is little recent raw evaluation data because the histological, chemical, and morphological inertness of glass was established, and has been consistently upheld, before the time of Pasteur. This desire to rail against centuries of medical data extends far beyond our selection of materials. In everything from material science to procedural precautions (the fact that there is even debate on sterile gloves and the wear of masks is a crowning absurdity), the piercing industry stands in defiance or ignorance of basic knowledge so old and thoroughly tested (in some cases predating the industrial revolution) that modern medicine is no longer concerned with providing still more proof of its veracity
This base defiance of established medical knowledge extends to ignorance of its methods, as the quality of the research data presented demonstrates. Representing that Schott glass is one of three borosilicate manufacturers is patently absurd. A quick scan of the registers on http://www.glassindustry.info lists more than 30 manufacturers of raw material alone, and such a list is by no means complete. Likewise, asserting that Schott is exceptionally respected has little or no merit in this context, but it does make very clear what the author is trying to do: appeal to authority, and he is doing so very poorly.
For example, there is the nagging question of the ambiguous identity of Andy Lagotte. Who is he? What does he do at Schott, and how does that reflect the expertise necessary to give the statements he makes any semblance of authority? Is he a researcher? Is he a chemist? Is he a high-level planner? Unless we can in some way identify his qualifications and expertise, his opinions simply have no merit.
And frankly speaking, there is much reason to doubt his expertise. He states that to his knowledge “biocompatibility testing has not been done on either borosilicate or quartz glass, because there is no application for putting these glasses in the body, therefore there was no demand for these tests”. Momentarily ignoring the fact that this is the most nebulous run-on sentence I’ve seen in a while, Mr. Lagotte seems to be in ignorance of the heaps of information on the biocompatibility of glass, such as its use for tissue growth containers and reference standards against which other materials are assessed.
Contrary to the author’s assertion, manufacturers of glass with intended medical use do not, and legally cannot, “assume that their products are biocompatible”. Fortunately for all of us, the medical field is more thorough in its evaluations than the piercing industry. There are very specific standards for chemical and structural purity which must be conformed to, depending on the intended use of the glass in question.
Another point on which the author seems woefully confused is the nature of empirical testing methodology. The repeated cries of “what are they comparing it to?” demonstrate a failure to grasp the concept of inherent qualities, rather seeing everything as a matter of comparisons. Appropriate scientific testing includes, but is not limited to, observational comparisons. A working understanding of molecular chemistry and basic particle physics, for example, allows one to understand WHY an object acts in a certain way, allowing for positive statements rather than crude comparisons.
Chemical resistance is one such property. Rather than it being an assessment of “glass is more corrosion resistant when immersed in this than…” it is a statement of the nature of the molecular and crystalline structure of glass that inhibits the action of chemical factors to impact its molecular and structural bonding. It’s not a comparison, it’s an inherent quality. While that quality can be used in comparisons, its coherence and relevance is not contingent on those comparisons. The notion that qualities or traits may only be determined as matters of comparison is a symptom of a relativistic thinking which permits no truth but those accountable to opinion. This is a very attractive school of thought for people who do not understand the processes by which truth is determined, and are thus unable to differentiate between demonstrable fact and personal opinion.
The illustration of Pyrex (a specific grade of borosilicate) being susceptible to thermal shock is irrelevant and misleading. The author illustrates that radical thermal shock exposure can compromise the structural integrity of Pyrex, but concludes that this indicates a fault in its chemical stability. The author then goes on to compare these traits to those of steel, thus showing that steel has a higher melting point than glass. He then goes on to conclude that this proves that borosilicate and quartz glasses are not chemically stable, since they are susceptible to thermal shock (which is a physical property, not a chemical one).
Perhaps the greatest irony of this article is that glass is implied as being less stable a material than steel. Indeed, the use of steel is never directly or implicitly questioned in the article, and is used as a standard against which the desirability of glass should be assessed. Given the wealth of information on the tissue damage caused by any nickel chromium steel (in which the medical community is comparing it unfavorably to glass), the numerous regulations restricting or outright banning its use in consumer contact applications, and the remarkably unsuitable chemical properties that nickel chromium steel exhibits, one must question the ability of its defenders to accurately assess the suitability of other materials.
The specific points of objection over the use of glass as an initial piercing material are inadequate to justify so wide a deviation from proven scientific knowledge. The first objection (if we’re going to use glass, we’ll have to test every type) ignores that there is already a wealth of research and assessment data available and applicable to the determination of the suitability of different types of glass for our purposes.
The second objection (some glass leaches, but we don’t know how much) is similarly absurd, as leaching data is part of the specifications for suitable application mentioned above. Beyond that, there is some simple logic that can be applied to this question. If we do not know how much of the composite materials in a given glass mixture will leach, then we should assess those composite materials as if they will leach. As such, we should avoid glass mixtures with large concentrations of potentially toxic materials in direct skin contact (heavy metals, etc). The alternative is to encase such materials in a material of greater structural density, thus forcing a reversal of the osmotic process to keep the undesired materials from reaching the skin. Of course, the final option is to simply avoid composites that contain toxic materials at all.
The third objection raises serious questions about core competence. The author is attempting to provide valid research data to cite, and is instead quoting from patent text. Patent text is commentary, preamble, speculation, whatever the writer of the patent wants to include, and not necessarily actual research data. It’s common practice to include speculation in the text of a patent to create a recorded precedent of a given hypothesis for follow-up research and subsequent patents. To wit, citing patent text as research material is about as valid as quoting personal correspondence: not at all.
The commentary nature of this text is evident in its word choice: conventional, difficult, relatively, generally, etc. This is very general language, very informal, and makes no definitive assertions, regardless of how the author of this article wishes to skew them. Additionally, the confusion about the definition of “fibrous scar tissue” seems to indicate unfamiliarity with very basic epidemiological terms. Fibrous scar tissue, or fibrous encapsulation, is the clinical term for the scar tissue that forms to seal a breach in the skin or around a foreign object present in the body (i.e. EVERY PIERCING).
In sum, due to the wealth of historical support, documentation on biocompatibility, and the author’s inability to find it, correctly interpret it, or contextually cite it, we cannot support the APP’s position that glass is an inappropriate material for contact with a fresh piercing.