Talk:Allopathy

Oh Boy

Lol, you coulda given Howard one day off! D. Matt Innis 02:53, 5 January 2009 (UTC)

Like me, sigh, Howard is an old man -- so, like Satchel Paige, we gotta keep those juices flowing, stay away from them fatty foods, and think calming thoughts to cool the digestive system. I just know that this article will calm Howard.... Hayford Peirce 03:29, 5 January 2009 (UTC)

I'm not sure about Hayford's comment that it might be in vein; he's trying to cell me on the id-ea, but I'm sore enough to just lymph away. No, there still is a vas deferens between homeopathic and allopathic paradigms. Howard C. Berkowitz 04:10, 5 January 2009 (UTC)

Very seriously

(also to be put on Forum, where an interdisciplinary group will also be suggested.)

For all practical purposes, this is an ancient word that really tells nothing about current science or medicine, which are not based on anything remotely resembling the theory of opposites. In terms of replacing it, I will say, cautiously, that many drug interactions are modeled on mechanisms involving cellular surface receptors, ion channels, and a very wide range of chemical messengers. Indirect effects such as rendering oral contraceptives, antibiotics or anticonvulsants ineffective due to up-regulation of an excretory pathway by theophylline (given for respiratory disease) are hardly as simplistic as similars or opposites.

It is one thing if some citizens want to deal with history or philosophy of medicine; it is quite another if such articles become a "time sink" constantly draining the time of mediators, experts from other disciplines, and other scarce Citizendium resources. Obviously, in a volunteer project, much is driven from what people want to write, as opposed necessarily to what the user base wants to read. Nevertheless, given the scarcity of contributors at present, some attention has to be paid to inquiring if a proposed area of effort will distract us from reaching a critical mass.

Rather that "opposites" or "similars" related to macro-level physiological behavior and even emotions, terms that come into play include agonists, antagonists, and sometimes modulators of various chemical "messengers", which are most often described with respect to subclasses: cytokines in the immune system, neurotransmitters in the neuromuscular system, etc. Completely different behavior, still molecular, relates to biological "programs" minimally expressed as nucleic acid sequences, but, just as the behavior of a minimally complex computer is not defined by the kernel functionality but by the interaction of external interrupts, automata, ordering of events, etc.

I raise this concern here based on an few edit comments, which may or may not indicate the desire of some citizens, given the rather stressful last-minute protests on homeopathy, to try to derive a program of work centered on ancient figures who indeed were idea-producing, but rarely had actual models, or even rules, that are of continuing utility. It's one thing to speak of the evolution of Koch's postulates, which, while they have been extended and modified, still retain an internal consistency. It is another to quote Hippocrates on a matter such as surgery being a separate discipline than medicine ("I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.") Physicians may not use the knife? No IV cutdowns? No incision and drainage? Sufferers from stone...hmmm, what does the Oath say about lithotripsy? Hippocrates made flat statements on ethical issues where many more choices exist: "I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy." Is the first a proscription against euthanasia? Passive euthanasia? What about mechanical life support? Is therapy with a lethal dose of a folic acid antagonists followed by leucovorin rescue licit? Obviously, one can very easily get into endless abortion and contraception debates.

Hayford mentioned he put this up more as an exercise; I get very nervous about suggesting that this is even being considered as an entry point to substantial article development. Howard C. Berkowitz 14:45, 5 January 2009 (UTC)

Howard, Very Seriously, what did you hope to accomplish by the above remarks? You begin by complaining about a word (of course, what you dislike are the discredited theories behind the word). I especially have no idea, and am very anxious to know, what you really wanted to accomplish, by discussing drug interactions, agonists, etc. Saying that "allopathy" is "an ancient word that really tells nothing about current science or medicine" is idle. There are many such words and we ought to have articles on very many of them. For example, we should have an article about ether (or aether) and about geocentrism. We should not try to prevent people from starting articles on legitimate historical ideas, even if the ideas are long discredited. You say, "I get very nervous about suggesting that this is even being considered as an entry point to substantial article development." If somebody wants to write a very long, meaty, historically accurate article about allopathy, I think that's great. It almost sounds (since you seem to think the business about drug interactions etc. is relevant) like you want to exclude such articles just because they are outdated and discredited. But, of course, the interest can be purely historical. We can learn a lot about the history of science and knowledge generally from the study of discredited ideas.

More briefly, it sounds to me as if the purpose of your remarks is to discourage others from writing more articles on discredited theories, like allopathy. If that was indeed your purpose, I strongly disagree with you. On the other hand, if your concern is simply that terms like "hypenantiosis" are obscure, I would ask you to leave that to people who are actually familiar with the history of the area, and bear our CZ:Maintainability policy in mind. But I should acknowledge that I am merely assuming that among your many areas of knowledge is not the history of homeopathy...I could be wrong, but given your entire failure to acknowledge the possible historical value of the topic, I suspect I am not. --Larry Sanger 04:02, 6 January 2009 (UTC)

Could a point be explained?

With the exception of its use as a derogatory term by alternative, not complementary or integrative health practitioners, and the specialized and traditional use to distinguish non-osteopathic medical schools, allopathy is as relevant a term as mesmerism. What, then, is the point of introducing an even more obscure term, hypenantiosis, that is even less used?

What is the value to an arbitrary reader to know the word hypenantiosis exists? I'll match my knowledge of history of medicine with most professionals; I've been the last-minute editor of one book on the history of medicine, and I freely admit that I've never seen the word. I feel no less enlightened now that I know it exists, and worry that it might displace useful information, such as the insertion point of the pectoral muscle or, perhaps, one of the subclasses of 5-HT receptor.

Are we running a trivia contest? Let's get out the board game if so; it can be fun, especially when one can observe that some of Trivial Pursuit's "right" answers were wrong. Himmler, for example, was head of the Gestapo only in the sense that he was two levels above the head of RSHA Amt IV. What? This is irrelevant trivia? Pity. Howard C. Berkowitz 16:11, 5 January 2009 (UTC)

I have removed the information in question. It may well be worthy of a separate article of its own, but it has no place in this one. Hayford Peirce 16:42, 5 January 2009 (UTC)

As Howard points out, hypenantiosis has 3 hits in Google, surely close to being a world record for total obscurity and non-notability; allopathy, by contrast, has 204,000 hits. Hayford Peirce 16:46, 5 January 2009 (UTC)

Of course it's extremely rare. But see below. The pointed I wanted to make is... ah, use private email if you really want to know. Not a big deal.--Pierre-Alain Gouanvic 18:35, 5 January 2009 (UTC)

I don't get the above exchange at all. I see no justification for this deletion from Hayford. Sorry, Hayford. It looks perfectly relevant to me, based on what the text says: it's apparently a synonym relevant to the era in which the term "allopathy" was mainly in use. But I don't see what the point of saying "Again, in the 21st century, hypenantiosis is even less used and less relevant to actual practice than allopathy; the term gives three Google hits." Whoever said it was "relevant to actual [current???] practice"?

I am rather disturbed my discouraging remarks like, "Are we running a trivia contest?" No, we are running an encyclopedia, a place where things like this can be explained, if they are explained anywhere. What's wrong with that?

And, Hayford, I think the number of hits in Google is a bad indicator of relevance especially when it comes to historical concepts. Take it from me--I was trained in history of philosophy. There are many terms of art that are somewhat important in the history of ideas that never appear on anybody's blog, and even in academic papers. But the experts are familiar with them, and it would warm their hearts to see articles about them. Of course, there are terms that are truly obscure and unimportant and really would be best left out. But the way to determine what terms those are is not to consult Google.

Don't homeopaths still use "allopath" in a different way than the way described in this article at present (to mean something like "mainstream medical doctor"?). If so, that should be mentioned early on in the article, I think, and the first sentence must be revised to reflect this fact ("a term, widely considered archaic"--obviously, it isn't an "archaic" term in this sense, is it?).

I leave you with this thought before signing off: the world and CZ are big enough for medicine, homeopathy, allopathy in both senses, and...the history of ideas. --Larry Sanger 04:17, 6 January 2009 (UTC)

There is room for both kinds of allopathy, as long as the context is structured and clear (e.g., joint allopathic/osteopathic is a historical and to some extent teaching method usage), versus a homeopath referring to what Osler termed the cult of allopathy, versus a general disparagement of contemporary medicine. Howard C. Berkowitz 04:46, 6 January 2009 (UTC)

please a source or citations for the last paragraph

"One contemporary usage, which is not considered derogatory and respects historical tradition, is used to distinguish between U.S. osteopathic medical schools that grant the Doctor of Osteopathy (D.O.) degree versus "allopathic" medical schools that grant the degree Doctor of Medicine (Latin Medicinae doctorum, or M.D.)."

What is the source of the above statement? If it's the United States Department of Health, then I agree, it's not derogatory. If it's a homeopathy association or alt. med. source, then I would strongly suspect that it is indeed meant to derogatory, even if in a subtle way. In which case this paragraph will have to be either rewritten or deleted. Hayford Peirce 17:28, 5 January 2009 (UTC)

NEW last paragraph - let's not go off on tangents

I absolutely don't see what this new paragraph has to do with the matter in hand, ie, allopathy. Is there a connection? I think that unless there is a clear connection to the topic, that it should be removed in its entirety. The paragraph above this one, to which I have also objected, at least is directly *connected* with the topic -- it was only its sourcing that bothers me. Hayford Peirce 18:04, 5 January 2009 (UTC)

The absolute connection is that "allopathic" is the term routinely used to refer to the M.D.-granting institutions. They are not using "allopathic" in the Hahnemann sense, but just as a convention for non-osteopathic. Look at the title of that family medicine program in Pennsylvania calling itself allopathic/osteopathic. No tangent. Common distinction having nothing to do with opposites, but as a term that's more esthetically pleasing than "non-osteopathic". The osteopathic physicians insist on the full term, since U.K. ostepaths, for example, are not qualified as full practitioners of medicine. U.S. D.O.'s are in every accredited specialty, although they do tend to primary care. Not surprisingly, however, they are well represented in orthopedic surgery, physical & rehabilitation management, and certain subspecialties such as pain management. For that matter, some subspecialties, can be entered from dental school, perhaps with a general internship first, but it's not uncommon to see dentists in maxillofacial/head and neck surgery, or anesthesiology oHoward C. Berkowitz 19:35, 5 January 2009 (UTC)

Okie, two questions: 1.) If I used the word "allopathy" to my primary doc, who has something or other in Internal Medicine and is also a Geezer Specialist, and seems to be a pretty smart guy in general, would *he* be expected to know what it means? and 2.) Could *you* do a little rewriting of the last paragraph to make whatever connection to want, but at *least* using the word "allopathy" once or twice so that the *general* reader of this article will see what the connection is? Thanks. And by the way, does your response above *also* validate the existence of the *next-to-the-last* paragraph? Is all a puzzlement to me! Hayford Peirce 19:42, 5 January 2009 (UTC)

Answer to question #1: Most MD's I know, would assume you meant non-osteopathically trained. The DO's I know simply use it to refer to their MD colleagues. It gets ambiguous if used by a non-physician practitioner.

I'm not sure about your last question, and I'm trying to think of a non-anecdotal explanation of #2. At one dinner (happened to be RAH devotees), one of our members (yes, she is a rocket scientist) was complaining of pain from computer overuse. We had an MD and DO in the bunch. The MD was about to go to his car and get some very reasonable anti-inflammatories, but the DO, who was sitting next to her, did some pushing and poking on her back, there was a loud click, and the pain was gone. Now, Matt may hit me for this, but the DO once explained that he got a full medical education plus "the good stuff from the chiropractors".

Osteopathic and allopathic medical schools (yes, those are the terms used when a medical education person is speaking of them) have the same core training, but sometimes I'll say a different teaching style. I have known all permutations of competent and incompetent MDs and DOs. Howard C. Berkowitz 20:02, 5 January 2009 (UTC)

A comment here was deleted by The Constabulary on grounds of making complaints about fellow Citizens. If you have a complaint about the behavior of another Citizen, e-mail constables@citizendium.org. It is contrary to Citizendium policy to air your complaints on the wiki. See also CZ:Professionalism.

Just popped by

Just popped by to say that I think Pierre did a fine job here in kicking this off well. Don't see any need for steam here, happy writing! Gareth Leng 13:51, 11 January 2009 (UTC)

Ruling needed - might be constable, might be editor; flavor of revert war

The general principle here is that an outside discipline doesn't have the right to argue with definitions of how the discipline defines itself. Other than in a very narrow historical sense (i.e., U.S. allopathic vs. osteopathic) training, no one calls themselves an allopath anymore; the people that did consider it archaic.

If alternative medicine practitioners want to use it as a derogatory term, let them do so -- but they cannot, for example, remove the comment that allopathy, always used for "convention" medicine, is considered archaic by the people who are accused of practicing it.

This has become a revert war and needs to be stopped. Howard C. Berkowitz 19:14, 5 September 2010 (UTC)

a sentence that isn't clear, at least not to me, and I hate the word "paradigm" -- what does it *really* mean?

"Some of the criticism was by medical associations that saw it as a bludgeon to use against other health paradigms." WHO is using it as a bludgeon against WHOM precisely? Hayford Peirce 17:23, 19 December 2010 (UTC)

Isn't there a Depression era song, updated by modern management consultants, "Brother can't you paradigm?"

Now, are you saying that the World Heath Organization is bludgeoning someone?

Seriously, the word has gone through several variants, the 19th century usage by Hahnemann probably being most precise. Where he defined homeopathy as a doctrine of similars, he could reasonably observe that a good deal of 19th century medicine did operate on a principle of "opposites". As Osler and the Flexner Report observed, 1918 or so without looking it up, both doctrines were supplanted by one of science- and evidence-based medicine, which is constantly reviewing and changing. I've regretted that my cardiac bypass graft didn't use the techniques of 10 years later, yet I'm amazed how much of homeopathic remedies trace back to 1830. I'd be hard-pressed to find 10 drugs still used from that time -- even derivatives such as synthetic digitoxin rather than foxglove tea.

There are specific legal precedents in the litigation between the American Medical Association and American Osteopathic Association, and, while the degrees and residencies are interchangeable, there is a tradition of referring to allopathy as not-osteopathic. Howard C. Berkowitz 17:34, 19 December 2010 (UTC)

Fine, sure, I don't care about any of that -- please just rewrite the sentence so that it's understandable by the average citizen in the streets. Thanks! Hayford Peirce 17:42, 19 December 2010 (UTC)