Talk:Homeopathy/Archive 13: Difference between revisions

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== Some ground rules (please do not delete from top of the page) ==
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Here are some brief comments that I hope will help reinforce our ground rules. I'm sorry I don't have time for more detailed engagement right now.


Some Citizens have complained to me that homeopathy's advocates on this page are tending to purge criticisms.  On this I will absolutely put my foot down.  You may not do so.  You may maintain that (and say in the article ''how'') homeopaths reject the criticisms, but you may not simply delete points, and source material, simply because you disagree with them or you think they are misinformed.  If you have a strong disagreement about a published criticism, you should voice it in the article, rather than removing the criticism.  There may be exceptions to this rule, but (I understand) not in several recent cases in the present article.
==APPROVED Version 1.1==


Of course, the "reply, don't delete" rule assumes that a source and criticism are important enough ''from the point of view of homeopathy's critics'' to be included. While they can have input of course, this is not ultimately a matter that homeopathy's defenders are best placed to decide.
<div class="usermessage plainlinks">Discussion for Version 1.1 stopped here. Please continue further discussion under this break. </div>


The word "skeptic" ''should not'' be used, pejoratively, to identify those who reject homeopathy in the article.  If there is a need repeatedly to identify the skeptics of homeopathy, you ''may not'' use a term that the skeptics themselves reject.  You ''must'' find a mutually agreeable term. I suggest "mainstream physicians."  "Allopaths" won't do, either, although it certainly can be introduced, and it should be.
The Approval includes two copyedits [http://en.citizendium.org/wiki?title=Homeopathy&diff=100587554&oldid=100587549] [[User:Hayford Peirce|Hayford Peirce]] 19:13, 11 October 2009 (UTC)


It should not be necessary for me to point out that the article can neither endorse nor roundly condemn homeopathy.  The article does not take a stand; it presents both (or all) sides on all controversial issues it presents, and leaves it up to the reader to decide for himself. ''The article does not endorse a position.''
:I'm not sure how to add yet another archive and get things to show up properly in the header here. Could someone do so? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:22, 11 October 2009 (UTC)


Precisely because homeopathy happens to be a minority viewpoint when it comes to the health issues it discusses, criticism of homeopathy does ''not'' belong in a separate "criticisms" section of the article. I have my doubts whether there is any need for a "criticisms" section at all, but I can't say so until I've read the current version, which I haven't done.
== Beginning with semi-lower-case editorial... ==


Selective and uncritical reporting of references is contrary to CZ's neutrality policy: this makes it appear that ''we officially think'' the literature says such-and-such, when there is legitimate disagreement about whether it does say that.  When, therefore, a "skeptic" raises a question about a statistic such as 18% of Americans, we must absolutely deal with this question.  I am very uncomfortable publishing information about the percentage of Americans who accept homeopathy, when it has not been made clear what "acceptance" amounts to ''in the survey that was performed.''  Therefore, either this essential interpretive information must be included in the article, or the information about the statistic must be excluded.  Anything else would be, quite simply, misleading and unscientific.
As a first step, I'm going to all footnotes that contain other than bibliographic material or definitions, and either moving the substantive text into the main article, or, in some cases, linking to a subarticle.


More generally, on a topic with this much disagreement, we simply cannot add heaps of studies and statistics to the article ''without adequate explanation'' and without critical responses where such may exist or be possible.  Uncritical reportage of the results of disputed studies has an inherently biasing effect.
While it may be reasonable, in a printed book or journal, to have bottom-of-the-page notes, in this format, the content of the notes will not be seen unless the reader clicks on them. How many readers do that? In effect, the text is being hidden. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:37, 11 October 2009 (UTC)


Finally, I want to underscore that if ''anyone'' repeatedly reverts significant parts of the text without explaining and defending his actions here on the talk page, I will consider banning that person.  I would ask those who are following the article more closely to make a list of such unexplained reversions, and provide it to me privately.  On the basis of such information I will either issue a warning or, if the problem is very serious, a temporary ban.
== A balanced blog post on the subject ==


Let me finish on a positive note.  Despite the amount of struggle over this article, or perhaps because of it, this article has grown and in many ways improved, and other articles have spun off. This is a good thing. As I like to say, if everybody is equally frustrated, that means that work is getting done and the article isn't ''too'' biased one way or the other.  Still, if we can all follow the above ground rules, I think we'll get along quite a bit better. --[[User:Larry Sanger|Larry Sanger]] 16:22, 20 October 2008 (UTC)
can be found [http://scienceblogs.com/neurotopia/2009/12/homeopathy_the_basics.php here]. --[[User:Daniel Mietchen|Daniel Mietchen]] 09:21, 16 December 2009 (UTC)


I want to add another point.  While I do not endorse Wikipedia's inane and abusable rule "assume good faith," I do want to suggest that we need something a little like that.  I might say, instead, "Assume your opponent is reasonable enough to be open to compromise."  If you make ''that'' assumption, you will yourself be much more likely to propose a compromise, and to be open to one. Then, if the other person shows himself to be completely closed to any compromise, whether yours or any that he might propose, the matter suddenly becomes much clearer. Then you can contact me, saying, "Look, I proposed a compromise, so-and-so did not accept it or propose any compromise in response. What do we do?" --[[User:Larry Sanger|Larry Sanger]] 15:17, 24 October 2008 (UTC)
:I added a comment, as did Paul.  Truly delightful, however, is <blockquote>Personally, I would really like to see a homeopathic treatment for dehydration. You'd have to have a compound that causes dehydration, but what would you dilute it in? you can't dilute it in water or saline, because those will rehydrate, and in homeopathy, you have to CAUSE dehydration to cure it...but you can't having anything that CAUSES dehydration because it would have to be diluted to the point where none of the dehydrating agent remains...</blockquote>


</td></tr></table>
:It should be noted that some camping supply stores, in the same aisle as freeze-dried foods, offer cans of "dehydrated water". Ethical staff makes sure that new users understand the purpose of same. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:06, 16 December 2009 (UTC)


== History of ==


Having noted the above debate, it seems that Paracelsus DOES have enough of a role in the history of homeopathy to deserve a mention, if not in the intor, in the relevant section. So I've put him back there. I do think those removing him earlier should have considered doing this kind of 'constructive' change rather than the 'deletionist' kind. In fact, the link ot the 'history of' page is not very impressive - there is little new materail here, and indeed much of the current page's scientific interests are rehearsed. The c&a medicine page is not in fact a page indicating or even hinting at the wide variety of information and material there is on this to be (eventually) found, but rather a brief and IMO crude dismissal of the topic. We can surely do better than this![[User:Martin Cohen|Martin Cohen]] 21:09, 10 December 2008 (UTC)
Howard, you gave the wrong link for Sympathetic magic. It's http://en.citizendium.org/wiki/Sympathetic_magic  And make sure the period at the end does not get connected to the link. [[User:Chris Day|Chris Day]] 15:26, 16 December 2009 (UTC)


: Martin, in due respect, you must provide references (and credible ones) to your ideas about Paraselsus being the "father of homeopathy."  When I previously deleted this info in the intro, I provided concerns about this which you still have not answered.  Please answer them here before going to the article. Paraselsus' concept of "signature" is a very primative understanding of the principle of similars.  Hahnemann brought a specific experimental method to this principle, learned the value of potentization, and coined the word. There is only one "father of homeopathy" and Paracelsus ain't him.  [[User:Dana Ullman|Dana Ullman]] 06:15, 11 December 2008 (UTC)
That's a reasonable way to look at it, which is unusual for a blog. [[User:D. Matt Innis|D. Matt Innis]] 18:43, 16 December 2009 (UTC)


:: I did add back in some info about Paracelsus.  I have also deleted a bunch of inaccurate info about Galen and 4 humors.  Actually, most medical historicans assert that Galen and the humors had nothing to do with homeopathy or the principle of similars (it is mostly the use of opposites!).  This section is much improved, though it needs more improvement.  By the way, for people interested in history, the [[History of Homeopathy]] needs a lot of work, especially because very little info there is on history...it is mostly a review of homeopathic theories.  Eeeks.  [[User:Dana Ullman|Dana Ullman]] 07:36, 11 December 2008 (UTC)
::Put it into the External Links. --[[User:Daniel Mietchen|Daniel Mietchen]] 19:27, 16 December 2009 (UTC)
::: (written while Dana was writing the preceding response:)
::: I have googled Paracelsus+Hahnemann. My conclusion is that the influence of Paracelsus on Hahnemann, a very erudite person, was major. There are far more resemblances between P and H than this (signatures). Should we say "father of homeopathy"? perhaps, with a cautionary note. Should we have references, and well researched article on Paracelsus that we could link to? Sure. But the last things that are needed are hasty deletions and fragmentations of this article. Yes, CZ is an hypertext. But we're still creating this homeopathy article! The scientific aspect of homeopathy was transferred to a controversial article, "memory of water", without proper examination of the non-controversial aspects of the materials science of water or homeopathic preparations, described in Martin Chaplin's website. Now, we are supposed to give up Paracelsus, until Martin Cohen can find references and back "his" case? This is not collaboration. There are no material scientists who have studied water in CZ. There are no specialists of Paracelsus. But there are some persons who want to learn.
::Returning to fragmentation. What's happening here is a process that took place in Diderot's Encyclopedia. The subarticles contain tools and info to question and actually rewrite the root article. Encyclopedists found that it was a good way to transmit info that would have been  rejected if they had been in top topics. Who decides, in CZ, when it is appropriate to put things about the material science of water as an ancillary topic, under a highly controversial heading ("memory of water"), thus effectively presenting homeopathy as a scientifically undefendable superstition or hoax? Who decides that Paracelsus, the magician, the alchemist, cannot be associated with Hahnemann?
::: Asking the question answers it.
::: Matt Innis pointed out this problem in the forum discussion about neutrality notes. I agreed, and Martin had comments along those lines. How is it possible to have a Neutrality note about an article if it is the absence of some things in the article that is considered (by some) as the bias? This is the problem of demarcation.
:: When I first began researching on the materials science relevant to our case, the motto was Matt's "let's take our time and do it right". So I work, with very little help (but some support). Suddenly, I get the message that the article should get approved sooner than later. My work gets transferred elsewhere, I give up... and weeks later I notice that the timeline has changed: people are taking  their time again.
::: What if I told you that Paracelsus' influence seems to require more "let's take our time and do it right" and less "give your references, build your case, and don't forget you're not an expert"?
::: I'm going to tell you why I chose to embark in this homeopathy article adventure. I wanted to test if CZ can handle scientific controversies. Yes, if and only if we take our time, discuss, build closer collaborative ties, and invite experts (by recruiting or through readings).
:::--[[User:Pierre-Alain Gouanvic|Pierre-Alain Gouanvic]] 07:57, 11 December 2008 (UTC)


::::The most important thing is to accept what an expert says.e.g.I had a tough time inserting the sentence that homeopaths treat acute bronchitis, until Gareth looked up the Net and found it to be true. I think Larry should look into this.�[[User:Ramanand Jhingade|Ramanand Jhingade]] 08:42, 11 December 2008 (UTC)
== Ramanand's changes  ==


Pierre-Alain and anyone else, I welcome whatever references you provide that verify that Paracelsus was the "father" or "founder" of homeopathy, but I insist that this should not be placed in the article until there are good references for it and there is consensus on the Discussion pages.  I can tell you that I am fairly knowledgeable about Hahnemann's history and have written and published widely on the subject, and I cannot remember a single incident in which Hahnemann quoted or referenced Paracelsus.  Even if someone were to find some specific statement, it is unlikely that it would be adequate enough to supercede Hahnemann as being the father or founder of homeopathy.  I've said enough on this subject and don't plan to say more until substantial evidence is provided. [[User:Dana Ullman|Dana Ullman]] 23:51, 11 December 2008 (UTC)
First, the word " most <u>biased</u> medical " is argumentative, does not fit the language of the lede, and is clearly advocacy.


== Rolled back "if it doesn't work" ==
The statement supporting homeopathy in the lede, even if the references were solid, belongs, stylistically, in a later section on the mechanisms of homeopathy. One reference is, as far as I can tell, from a Brazilian university with a site in, presumably, Portuguese, which I do not read. We generally don't use non-English references, especially when they are not clearly from peer-reviewed journals or otherwise reviewed sources.


I rolled back "if it doesn't work", which Ramanand added to a sentence about when to call for conventional medicine. The context suggests that homeopathic treatment should always be the first form of therapy, and conventional physicians called in only "if it doesn't work."  Ramanand did not qualify the context to indicate if the homeopath has any medical training, to make a rational choice if the condition is one in which there could be immediate danger without appropriate treatment.
The other reference is from Khuda-Bukhsh, whom, I believe, has been in the memory of water controversy, is a review of possible molecular mechanisms of action. On first glance, it's an interesting paper, but does not talk at all about efficacy &mdash; just how homeopathic remedies may work, if they work. It doesn't belong in the lede, although it's not unreasonable to use it as a reference in a later section.


Versions of this point have, to an extent, been an edit war. Dana made the reasonable point yesterday that with cholera, the medical training of most homeopaths would say that oral replacement therapy (ORT) must come before everything else, other than IV fluid replacement if the patient cannot swallow. Not replacing fluids and electrolytes, in acute cholera (as defined by the WHO and CDC), is quite likely. ORT is hardly a toxic conventional drug: it contains water, sodium, potassium and carbohydrate. A quite useful improvised ORT, for developing countries, is to take the water in which rice boiled, put in a spoonful of salt, and mash part of a banana or pour orange juice into it (both are rich in potassium).
Neither addition works where it is. The first is advocacy and non-neutral. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:45, 7 January 2010 (UTC)
:The use of "biased" is definitely adversarial. [[User:Chris Day|Chris Day]] 21:12, 7 January 2010 (UTC)
:With regard to the rebuttal (it works, and we know how), I am loath to see this article head down the direction of he says, she says tit for tat. [[User:Chris Day|Chris Day]] 21:21, 7 January 2010 (UTC)


The idea of trying homeopathic treatment first for everything is at the center of the fears by conventional medical physicians and scientists. If the practitioner is dual-trained and chooses, with informed patient consent, to try a homeopathic remedy for a non-life-threatening condition, that's between the patient and practitioner. Indeed, if, in that case, the homeopathic remedy worked, I'll call that patient choice.
::The whole article is full of oxymorons, containng both viewpoints, so I don't see anything wrong with what I've inserted, unless the critics' statement is also removed (about what scientists feel). I'm fine if the word <u>biased</u> is removed, if it seems adversarial. The Portuguese and French is only in the references section and shouldn't be a problem.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 10:28, 8 January 2010 (UTC)


Gareth and Chris, I believe, have tried various rewrites saying that the chief concern about safety is that inappropriate delay in providing medical treatment can cause dangerous delays. An unqualified "if it doesn't work" is simply not acceptable from the medical standpoint, unless, for example, Dana is correct that most homeopaths are medically as well as homeopathically trained. I still would like to see sourcing on that training, and I believe Dana agreed that there are unlicensed practitioners. It is the latter, practicing pure homeopathy, that are of the greatest medical safety concern. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:12, 11 December 2008 (UTC)
:::Well, Ramanand, the general CZ, policy, especially in the Charter, is that articles don't equally present all views. They present the preponderance of the expert views, and, in this case, the experts are in health sciences; there isn't a unifying discipline among healing arts. Not all healing arts support homeopathy.


:Homeopaths do use homeopathy as the first line of treatment, so we should have that matter I inserted or remove the whole sentence.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 10:10, 12 December 2008 (UTC)
::::Everyone needs to [[CZ:Neutrality Policy|Neutrally]] present all views. [[User:D. Matt Innis|D. Matt Innis]] 02:31, 9 January 2010 (UTC)


::I'm hearing a fundamental difference between Dana and Ramanand. Dana suggests most homeopaths are medically trained, and, if a patient presents with a potential medical emergency, they will use nedical techniques within their scope of practice and refer otherwise, quite possibly complementing the medical with homeopathic remedies.  If, for example, such a practitioner, especially one already part of a multidiscipinary team, wanted to use homeopathic methods as part of the treatment of a condition such as fibromyalgia, I might be comfortable with that.
::The foreign language citations have been a problem in many other articles, not just here.  


::Ramanand seems to be saying that India has both conventional medical and classical homeopathic training and certification, and that 10 percent of the population uses homeopaths as primary care providers. It is this 10 percent that especially concerns me, as Ramandand has offered no information that students in the homeopathic curricula get thorough medical training. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 11:24, 12 December 2008 (UTC)
:I think you mean contradictions or rather or challenges, not oxymorons. An oxymoron would be a "heroically large dose of a homeopathic simillum." An oxymoron is a contradiction in terms.


== Deletionism and do people read things properly before deleting?  ==
:Sorry, I'm in favor of removing both additions. You will need to face the reality that the article will not be as pro-homeopathy as you want, just as others wish it weren't here at all. It's a compromise. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:48, 8 January 2010 (UTC)


Dana has deleted my Paracelus point although reinstated him later, for which I thank her - magnaminous!
::I applaud, encourage and appreciate collaborative efforts to work toward improvements, but I think this lead still needs significant work to add any substantial improvement to the approved version's lead. [[User:D. Matt Innis|D. Matt Innis]] 02:28, 9 January 2010 (UTC)


She also announced problems with the history of Homeopathy page - exactly the problems I just pointed to above - did she read that? At least we agree t here is a problem. The page could be said to be advancing... but my mina concern is certainly not being addressed. I don't say everyone has to change their way of operating, but I do think there needs to be some restraint on deleting contributions, as Pierre hints too, as though a 'rule' has been established and ''certain persons are entitled to interpret and enforce it on the page.''<small>Certain persons are entitled to do just that. See below</small>[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 21:38, 11 December 2008 (UTC)
:::I forgot to wish all of you a Happy (belated) New Year. The presently approved article's Lead isn't 'neutal' at the moment. It should either explain homeopathy plainly or if y'all want criticism in the Lead, it should contain both viewpoints. Where's Dana, by the way, in Germany again?—[[User:Ramanand Jhingade|Ramanand Jhingade]] 09:14, 9 January 2010 (UTC)


Here is the text again:
:::: Happy New Year to you, too! Please let me know where you think the present Approved version lead (as opposed to the draft lead) is lacking and I'll be glad to take a look.  Dana approved the current lead, too, but I'm sure he'd take a look if we asked him.  [[User:D. Matt Innis|D. Matt Innis]] 15:00, 9 January 2010 (UTC)


"Paracelsus (1493-1541) is considered by some as the "founder" of homeopathy, and is also credited with popularizing the theory "of signatures". According to this, the medicinal use of plants is revealed in exterior signs such as colours or shapes. "
:::::I'd posted a whole lot of links to homeopathic articles, late last year, but did not have the time to add it in the article. I was expecting someone here to do it, but no one did (not even Dana)! I already wrote what I wanted above, "It should either explain homeopathy plainly (without criticism in the very 1st sentence) or if y'all want criticism in the Lead, it should contain both viewpoints."—[[User:Ramanand Jhingade|Ramanand Jhingade]] 08:34, 12 January 2010 (UTC)


There is nothing remotely controversial about this, and I changed the text to ensure that. Dana can look it up for herself in any reputable homeopathic source.
::::::We certainly can't add every link ever written to this article.  This is the overview article in an encyclopedia type format and summarizes homeopathy pretty well, I think.  Again, don't confuse the lead in the Draft with the lead in the main [[Homeopathy]] article. I agree the lead in the draft needs more work and is not an improvement in its current form. [[User:D. Matt Innis|D. Matt Innis]] 12:45, 12 January 2010 (UTC)


(Here's a typical reference: "The doctrine of signatures was a purely philosophical notion until Boehme's predecessor, the alchemist Paracelsus, had applied it to medicine ..." from page 27 of  The American Institute of Homeopathy Handbook by Edward, M.D., D.Ht. Shalts (Paperback  2005))
:::::::If nothing else, bibliographic links not directly related to the text belong on the bibliography page, preferably in articles. Also, in other articles, there is some selectivity. In some cases, reviews are more appropriate than small primary studies. In other cases, peer review and responsible publications are appropriate. In yet other cases, there is more leeway on publications but the reason needs to be explained.


I don't think the contribution is terribly original, or interesting. It is however relevant to the history of the subject and leads us towards other areas. I'd like to see it reinstated, and if not, I shall raise it as an issue on the forum for general discussion. Many historical, cultural and 'traditional' aspects of homeopathy are are neglected in this page which, to repeat, is adopting an inappropriately narrow and exclusive 'scientistic' approach. Most of the debate paraded here as 'central' is 'marginal' - Dana makes that point too, in a way, in her edit here:
:::::::It's not necessarily reasonable to assume someone else will edit and add articles with which they aren't familiar, or with which they might disagree.  


"Although homeopathy is practiced by medical doctors, other health professionals, and consumers in virtually every country in the world, homeopathy is not accepted by majority of mainstream medical doctors or conventional scientists today."
:::::::What principles of homeopathy are in not in the lead?  It should go without saying that homeopathists believe what they are doing, or the article wouldn't be here at all. Having a small number of dissenting comments from people who question hematology simply establish it isn't universally accepted, and the details and pros and cons should be in the article, but later. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 13:27, 12 January 2010 (UTC)


Calling this 'improving the sentence" is disingenuous, though, Dana, and I don't think it improved the article. It struck a political note where one would expect a neutral tone. However, as I say, Dan in my view raises the issue of the gap between the 'scientific-medical' and the 'health care' or indeed general public perspectives. The homeopathy article should not be constructed from the first approaches perspective at the expense of excluding the others. At the moment, it is - and so is the 'history of homeopathy page', and the 'alternative and complementary medicine' page. We have to accept new perspectives in order to start to balance the pages. A start would be by restoring Paracelus to his proper place, which, whether it is as elevated as 'some' claim - is certainly important. [[User:Martin Cohen|Martin Cohen]] 21:25, 11 December 2008 (UTC)
::::::::RE: provided references from Ramanand, [http://en.citizendium.org/wiki/Talk:Homeopathy/Archive_11#Long_time_no_see_.28post.29.21 this must be the list] and I do remember it, but it's mostly primary research.  They could be used for a more detailed article to support a specific claim where reviews aren't available, but to cite them here would result in too much detail for the general nature of this article. Primary research doesn't belong in a bibliography either.  I'm not sure that we have a subpage that would be appropriate for primary research, though it's an interesting idea for some other project, or way in the future for this one. Otherwise, I'd think it would be a problem with [[CZ:Maintainability]]. There are other sites that do list all the research for each particular subject. [[User:D. Matt Innis|D. Matt Innis]] 14:51, 12 January 2010 (UTC)


::Please do not roll back a revert without discussion on this page, and usually Editor approval. Revert wars are regarded quite severely here.
:::::::::This is one page ([[Homeopathy/Trials]]) that exists with a tabulated summary of some of the voluminous primary literature. I agree maintainability is an issue.  I bet there are hundreds of articles like this and the main problem is reducing it to the most important articles in the field. If that could be done well it might make a good catalog. [[User:Chris Day|Chris Day]] 17:18, 12 January 2010 (UTC)


::Incidentally, Paracelsus must have some powerful techniques, as you appear to have performed gender reassignment on Dana. Seriously, I'm not sure what you mean by a "first approaches" perspective, but the general philosophy of CZ is not to insist on bringing in every idea that might bear on a subject. Actually, under CZ, "certain persons are entitled to interpret and enforce it on the page". They are called Editors for the workgroup. Dana is a Healing Arts Workgroup editor, and, whether I agree with him on the deletion or not, I do know, as an Editor in other workgroups, that his ruling will stand and be reinforced unless more Editors disagree, or his ruling is disapproved by the Editor-in-Chief or Editorial Council (of which I am a new member, but I'm not guessing).
:::::::::Matt, I made some time to read the entire (presently) approved article. I don't see any sentence saying there is evidence for homeopathy (the feg pdf document I've inserted in the present draft is accepted by 'mainstream' scientists as well). I object to the term 'placebo' in the lead (Edzard Ernst is known to be a ridiculed homeopathic baiter in the U.K.). I also object to the term 'fraud' in the Overview section<blockquote>They also are interested in whether positive results against expectation sometimes reflect manipulation of data or perhaps even fraud. </blockquote>. Like you said, can we edit the (presently) approved article?—[[User:Ramanand Jhingade|Ramanand Jhingade]] 17:34, 23 January 2010 (UTC)
:::::::::David (Ellis), can you please tell me what objections you have to the feg pdf document?—[[User:Ramanand Jhingade|Ramanand Jhingade]] 17:42, 23 January 2010 (UTC)


::Who is "we" such that "we have to accept new perspectives?", and who will compel "us"?  [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 21:38, 11 December 2008 (UTC)
(undent)
Placebo in the lead is perfectly appropriate; conventional medicine routinely accepts the placebo effect as a component of therapies.


:::Martin, I asked for a reference for your "fact," and the reference that you provided did NOT verify it.  In the future, please do not reinsert deleted comments, creating an edit war, until there is some consensus from the Discussion page.  Your assertion that Paracelsus was the father or founder of homeopathy is not simply "controversial," it doesn't seem to be true.  I showed good faith by incorporating what you were trying to say about Paracelsus, and I will continue to try to collaborate with you and others to create the best possible article. [[User:Dana Ullman|Dana Ullman]] 23:19, 11 December 2008 (UTC)
Fraud is mentioned gently as a possibility by some observers, seemingly far more gently than some of the homeopathic claims of the danger of medicine. Sorry, it's not unbalanced.  Please do not go to "known" homeopathic baiters anywhere, else that you start having people bring in medical baiters from homeopathy. The problem with bait is that it often has a hook inside.


::::As an aside, i thought that Dana is male? [[User:Chris Day|Chris Day]] 02:55, 12 December 2008 (UTC)
By edit the presently approved article, no, other than for typos, it's frozen. It is possible to edit the draft, and eventually to have the edited draft become the newly approved.


:::::That had been my impression as well, but do remember that Martin is an advocate of alternate positions. :-)  [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:12, 12 December 2008 (UTC)
Again, what specific principles of homeopathy '''are not'' in the lede? --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:03, 23 January 2010 (UTC)


::::::Geez, all you gotta do is go to [[User:Dana Ullman]], where Mr. (Dr.?) refers to himself a gazillion times as "he" or "him" or some such.... [[User:Hayford Peirce|Hayford Peirce]] 03:18, 12 December 2008 (UTC)
:Friends, it has been a while since I check-in here.  I have not re-read most of the new draft, but I can tell you that I do not like the lede paragraph.  It is simply not encyclopedic or impartial.  Anyway, we only recently spent a lot of time approving the previous edition. I suggest that we let it sit for 3-6 months or more before we re-do it. [[User:Dana Ullman|Dana Ullman]] 05:28, 1 February 2010 (UTC)


:::::::I rest my case. [[User:Chris Day|Chris Day]] 03:21, 12 December 2008 (UTC)
::Dana, I hope you can insert sentences that read something like, "there is scientific evidence for homeopathy", using the PDF for "Scientific framework of homeopathy: evidence-based homeopathy" available at http://www.feg.unesp.br/~ojs/index.php/ijhdr/article/viewFile/286/354 wherever appropriate.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 08:21, 2 March 2010 (UTC)


== Friendly amendment further improving precision? ==
=== British House of Commons Science and Technology Committee report ===


Dana,
The committee commissioned by the British government has reassessed homeopathy as a treatment option under the national health service. It's enquiry sought written evidence and submissions from concerned parties (See [http://www.timeshighereducation.co.uk/story.asp?sectioncode=26&storycode=408852&c=1 News in brief: Homeopathic assessment] and [http://www.parliament.uk/parliamentary_committees/science_technology/s_t_pn05_091020.cfm Evidence check: Homeopathy]). Both sides of the debate were represented and presented written evidence to the committee. In addition there were oral presentations from the following individuals:


I like your last
*Mr Mike O'Brien QC MP, Minister for Health Services, Department of Health;
<blockquote>Some of the principles of homeopathy has been utilized in some form for thousands of years, but its basic principles were first methodically set out by a German physician, [[Samuel Hahnemann]] (1755�1843), who observed that a medicine sometimes evoked symptoms similar to those of the illness for which it was prescribed.</blockquote>
*Professor David Harper CBE, Director General, Health Improvement and Protection, and Chief Scientist, Department of Health;
*Professor Kent Woods, Chief Executive, Medicines and Healthcare Products Regulatory Agency
*Professor Jayne Lawrence, Chief Scientific Adviser, Royal Pharmaceutical Society of Great Britain;
*Robert Wilson, Chairman, British Association of Homeopathic Manufacturers;
*Paul Bennett, Professional Standards Director, Boots;
*Tracey Brown, Managing Director, Sense About Science;
*Dr Ben Goldacre, Journalist.
*Dr Peter Fisher, Director of Research, Royal London Homeopathic Hospital;
*Professor Edzard Ernst, Director, Complementary Medicine Group, Peninsula Medical School;
*Dr James Thallon, Medical Director, NHS West Kent;
*Dr Robert Mathie, Research Development Adviser, British Homeopathic Association.


Would it be even more precise to say,
A summary statement from the House of Commons Science and Technology Committee was released with the report in Feb 2010:
{{quote|... the NHS should cease funding homeopathy. It also concludes that the Medicines and Healthcare products Regulatory Agency (MHRA) should not allow homeopathic product labels to make medical claims without evidence of efficacy. As they are not medicines, homeopathic products should no longer be licensed by the MHRA.


"Some of the principles of used in homeopathy has been utilized in some form for thousands of years. The term '''homeopathy''' and its formal definition came from  German physician, [[Samuel Hahnemann]] (1755�1843). His key observation was that a medicine sometimes evoked symptoms similar to those of the illness for which it was prescribed, and his key theory was that very small doses of such a medicine would heal a matching set of symptoms."
The Committee concurred with the Government that the evidence base shows that homeopathy is not efficacious (that is, it does not work beyond the placebo effect) and that explanations for why homeopathy would work are scientifically implausible.  


I'm not happy with ...and his key theory..., but I think breaking up the first sentence both makes it clear what Hahnemann actually did, as opposed to what influenced him. Since this is not rocket science, I'll borrow the analogy that Kostantin Tsiolkovsky can't be said to have originated rocket-propelled space flight, since it was Robert Goddard that actually developed a rocket engine designed, as his book was titled, ''A Method of Reaching Extreme Altitudes''.  Short-range gunpowder rockets that stayed at low altitudes had been around for centuries, and Tsiolkovsky and others talked about an evolved rocket that could go to high altitude, but it was Goddard that defined the actual technique.  Paracelsus might have described a goal, but did not, as far as I know, speak of the key concept of similars.[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:09, 11 December 2008 (UTC)
The Committee concluded - given that the existing scientific literature showed no good evidence of efficacy - that further clinical trials of homeopathy could not be justified.


: Thanx Howard. However, Hahnemann did not simply define "homeopathy;" he created the methodology underlying this system of healing. Further, we would be more precise if we said that his "experiments" (not simply "observations"). Therefore, my suggestion would be:
In the Committee’s view, homeopathy is a placebo treatment and the Government should have a policy on prescribing placebos. The Government is reluctant to address the appropriateness and ethics of prescribing placebos to patients, which usually relies on some degree of patient deception. Prescribing of placebos is not consistent with informed patient choice-which the Government claims is very important-as it means patients do not have all the information needed to make choice meaningful.


: "Some of the principles of used in homeopathy has been utilized in some form for thousands of years. The term '''homeopathy''', its formal definition, and the methodology of this medical system derived from  German physician, [[Samuel Hahnemann]] (1755�1843). Hahnemann's experiments on human subjects discovered that a medicine will elicit a curative effect on people who exhibit the similar symptoms to which the substance causes in overdose. Later, Hahnemann developed a specific pharmacological method, called potentization, that significantly reduces the size of the dose of the medicine while seemingly increasing its therapeutic effects." [[User:Dana Ullman|Dana Ullman]] 23:42, 11 December 2008 (UTC)
Beyond ethical issues and the integrity of the doctor-patient relationship, prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS. <br/>'''Source:''' UK Parliamentary Committee Science and Technology Committee - [http://www.parliament.uk/parliamentary_committees/science_technology/s_t_homeopathy_inquiry.cfm "Evidence Check 2: Homeopathy"]}}


::No problem. It was, I thought, essential, aside from anything else, to say explicitly that he was the first to use the term, and then explain his other work. Whether or not one believes in the paradigm, it is only fair to say, as you did, that he both defined "homeopathy" and "potentization". Paracelsus made some observations and connections, but it was Hahnemann that defined an actual system. Is there any serious argument that we are not working from Hahnemann's definitions in this article? We may have arguments about efficacy and other matters, but, up to a couple of days ago, there didn't seem to be much disagreement about the starting point.
From the full report the committee also stated:  
{{quote|
We conclude that placebos should not be routinely prescribed on the NHS. The funding of homeopathic hospitals — hospitals that specialise in the administration of placebos — should not continue, and NHS doctors should not refer patients to homeopaths.<br/>'''Source:''' [http://www.publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/45.pdf Evidence Check 2: Homeopathy, Fourth Report of Session 2009–10], House of Commons Science and Technology Committee, 20 October 2009, parliament.uk}}


::While some may want to bring other ideas in CAM into this article, it's fair to say that several people have been struggling for precision for months, and, until there is consensus there, insistence that alternate perspectives need to be considered now, in this article, takes us back to a starting point. It may well be that some of the alternative perspective ideas could go into the [[complementary and alternative medicine]], but this article is about a specific system. Even in the CAM article, the CZ way to do things is building on what is already there, or, if one really wants to tear apart what is done, either reaching a  consensus that is needed, or waiting until it's fairly obvious no one is concerned with changes. I have torn apart articles, but I gave plenty of warning I was doing so. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:55, 11 December 2008 (UTC)
In conclusion the chairman of the committee said:
{{quote|
This was a challenging inquiry which provoked strong reactions. We were seeking to determine whether the Government's policies on homeopathy are evidence based on current evidence. They are not.


:::We need to mention Paracelsus in a way that doesn't diminish the importance of Hahnemann.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 10:46, 12 December 2008 (UTC)
It sets an unfortunate precedent for the Department of Health to consider that the existence of a community which believes that homeopathy works is 'evidence' enough to continue spending public money on it. This also sends out a confused message, and has potentially harmful consequences. We await the Government's response to our report with interest.<br/>'''Source:''' UK Parliamentary Committee Science and Technology Committee - [http://www.parliament.uk/parliamentary_committees/science_technology/s_t_homeopathy_inquiry.cfm "Evidence Check 2: Homeopathy"]}}


== MCI ==
: The Evidence Check definitely needs to be in the article. It has been hilarious watching the homeopaths squirming around trying to explain it away by butchering the quote from Cucherat's systematic review. It is like those reviews you see on movie posters where it says something like "Tremendous, Exciting (Evening Standard)" and then you go and look and see what the Evening Standard actually say and it is "A tremendous waste of time and money, has difficulty exciting all but the clinically insane". –[[User:Tom Morris|Tom Morris]] 15:12, 3 March 2010 (UTC)


I'm providing a ref to the Medical Council of India web-site to show that the Dept. of AYUSH is a separate entity.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 11:37, 12 December 2008 (UTC)
:: For some reason, I couldn't access Citizendium yesterday at this time. Meanwhile, I got a reply from Dr Peter Fisher to my e-mail in which he says that the individual specific rules of Homeopathy were not followed in prescribing/administering the Homeopathic remedy, so I hope good sense prevails over the 'UK Parliamentary Committee Science and Technology Committee'.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 13:43, 12 March 2010 (UTC)


== Potency/Dilution ==
:::With regard to "the individual specific rules of Homeopathy were not followed in prescribing/administering the Homeopathic remedy" what is Peter Fisher referring to? How does that impact the report? [[User:Chris Day|Chris Day]] 16:25, 12 March 2010 (UTC)


I've started putting together a table at [[Homeopathy/Catalogs]].  However, I'm not sure which are the standard potencies that are used.  I added LM as 1LM 2LM and 3LM just as experimentation but maybe 1LM (or just LM?) is the only one that is in standard usage?  I saw a few references to 10L, 20L and 50L, are these commonly used?  Are there others?  Some notes on the reasons for the different dilutions and their relationships would be interesting to our readers, I think. [[User:Chris Day|Chris Day]] 15:38, 12 December 2008 (UTC)
::::As I understand it, the individual specific rules of homeopathy mean that every patient is unique and the remedies appropriate for one will not be appropriate for another. Let's assume this is exactly correct. That would make classic randomized clinical trials, in which there is a standard treatment arm and a control arm, inappropriate, because there is no homeopathic standard.


Those potencies are designated, 'L/1', 'L/2', 'L/3', 'L/4', 'L/5', 'L/6', etc., with 'L/3', 'L/6', 'L/9', 'L/12' being the most used.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:00, 13 December 2008 (UTC)
::::A very similar problem, however, applies to highly individualized [[pharmacogenomics|pharmacogenomic]] therapies: within a cohort of patients with, say, metastatic breast adenocarcinoma, the experimental hypothesis may be that a given treatment is applicable only to those patients with a specific BRCA gene coding. Panaceamycin is only expected to be effective in patients with that characteristic, and the others should get an aromatase inhibitor, the standard of care. Given there is a treatment, a placebo control is ethically unacceptable.


: In due respect, I have never seen reference to "L" potencies.  I assume that you mean "LM" potencies.  "LM" refers to 50,000, and it refers to dilutions of 1:50,000 (instead of 1:10 or 1:100). [[User:Dana Ullman|Dana Ullman]] 17:48, 13 December 2008 (UTC)
::::RCT's have been designed that still have statistical power, but are testing the diagnostic and treatment model, not panaceamycin.  The clinician selects the treatment and sends an order to the pharmacy, where the pharmacist opens the next blind assignment envelope. If the patient is assigned to the experimental arm, the IV drug unit sent back to the care unit has panaceamycin in it if the genomic model calls for it, and the control treatment if not. If the patient is assigned to control, she gets control. It is the decision to assign that is being tested, more than the drug itself.


::Really, I found several references to L potencies (or in some case M); 1:1000 dilution? LM potencies i also saw used with a Q nomenclature. This was part of the reason i thought some kind of table would be useful to clear up the inconsistencies as well as explaining  which are the major ones used and for what purposes. [[User:Chris Day|Chris Day]] 21:07, 13 December 2008 (UTC)
::::In like manner, homeopaths could prescribe a totally individualized remedy, but they would be blinded to whether or not the patient gets the remedy -- control could be placebo, or a medical treatment. With a sufficiently large sample, if the homeopathic model is correct, the patients receiving the remedy should do better.


::<b>Dana</b>, it was the LM potencies I was refering to.
::::It is not clear that homeopaths are willing to be tested in such a manner, which should obviate the argument about individualization not being permitted. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:05, 12 March 2010 (UTC)
::<b>Chris</b>, I believe it's best you leave all that to a homeopath, because an M (1000) potency is different from an LM potency, which is different from a Q potency (mother tincture).&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:34, 15 December 2008 (UTC)


:::Well that's what I was suggesting. I was asking you to fill in the blanks and make it relevant. All I did was add some things I found on the web. [[User:Chris Day|Chris Day]] 10:07, 15 December 2008 (UTC)
:::::Brings me back to a question that I have never seen an answer to. How can remedies be mass marketed and sold off the shelf at places like wal-mart and whole foods and be so effective (as claimed)? These remedies are either robust or need to be highly individualized. If the latter, I don't see how how a mass market product will work.  If the former, then they have indeed being found wanting (no better than placebo). Their defense against accepting the failed results of clinical trials precludes claiming successes from the mass market products. Which is it? [[User:Chris Day|Chris Day]] 19:15, 12 March 2010 (UTC)


==Reference Integrity==
::::::A question, Chris, that I've asked myself. Let me respond indirectly. One of the major mass-marketed products is [[Oscillococcinum]], about which I did write an article. What is the sound that is made by the creature from which the simillium is obtained? --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:28, 12 March 2010 (UTC)
A reference from an Indian Government site states that homeopathy is recognised as one of the Indian 'National Systems of Medicine'. Another contributor is recverting this to 'Alternative Systems of Medicine'. The issue is simple - what does the reference say? it says National not Alternative. So please, either find a reference which says something different, or else leave this alone, but do not make a lie of the reference by changing the wording to be inconsistent with what the reference says. '''This rule is absolute - never change the wording of a directly referenced statement in a way that makes it inconsistent with what the reference says.'''[[User:Gareth Leng|Gareth Leng]] 16:23, 12 December 2008 (UTC)


::Please check your email. [[User:D. Matt Innis|D. Matt Innis]] 16:52, 12 December 2008 (UTC)
:::::::Given that they are a £1.5bn industry we can expect to hear a lot of noise like that in the next few months. [[User:Chris Day|Chris Day]] 19:40, 12 March 2010 (UTC)


:::If some aspect of this continues, it would be nice to know, briefly, what India means by "national system" (traditionally Indian, such as ayurvedic?), and where conventional medicine fits. An article, comparable to [[National Center for Complementary and Alternative Medicine]], for [[Indian National Systems of Medicine]] could be a nice addition to CZ. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:19, 12 December 2008 (UTC)
:::::::: Howard, you got it right - for example, Ipecacuanha can't be given where Antim. Tart is indicated. Chris, classical homeopaths don't accept 'over the counter'/'off the shelf' products because anything between 2 to 20 remedies are mixed in one 'combination' (Hahnemann used to call such homeopaths the 'mongrel sect'), but since it's popular, the classical homeopaths can't do much about it. In India, homeopathy is a half a Billion $ 'industry' - and that is only counting the medicines sold 'over the counter' and not what is spent on homeopathic doctors - so we're not gonna let people talk rubbish about it. It really works (See the 'feg' pdf document I've posted in the previous section)!—[[User:Ramanand Jhingade|Ramanand Jhingade]] 09:22, 13 March 2010 (UTC)


::::The ref mentioned is the official web-site, so I don't think I can find a 'better' ref. There is a mention of, 'these complementary alternative systems of therapeutics' at the end of that page, so I hope you can look into it. You (Gareth) and possibly Dana should correct that.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:20, 13 December 2008 (UTC)
Ramanand, you didn't get right the essence of what I was saying: there are statistically powerful testing methods, which have been developed for biological therapies that indeed are individualized, which could answer the homeopathic objection to more traditional randomized clinical trials. I have not seen any evidence that homeopaths are willing to use such methods, but instead continue to insist on either statistically weak retrospective analyses or anecdotal/testimonial evidence. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:21, 13 March 2010 (UTC)


:::::Here's what I am reading from [http://indianmedicine.nic.in/html/homoeopathy/homoe.htm], with <u>emphasis</u>. "In 1948, the Committee by Planning Commission in 1951 and the Homoeopathic Pharmacopoeia Committee in 1962 testify to this. At the instance of the recommendation of these Committees, the Government of India have accepted Homoeopathy as one of the <u>national System of Medicine</u> and started releasing funds for its development"  A different sentence says "Homoeopathy in India enjoys Government support along with the other systems of medicine because Government is of the view that presence of all these <u>complementary alternative systems of therapeutics</u> offers a much wider spectrum of curative medicine than is available in any other country." 
:Howard, it is very simple: the homeopaths are perfectly happy to use clinical evidence when it shows that homeopathy works. But when it shows that it doesn't work, then the clinical trial methodology must be at fault! Heads I win, tails you lose. If clinical trials are unable to detect the effects of homeopathy, why is the British Homeopathic Association quote-mining Cucherat? What seems more likely: that homeopathy works but not to the point where the clinical trial can detect it, or homeopaths cynically misuse evidence to support their pre-ordained conclusions? It has been so amusing to watch: our politicians have seen that the <s>King</s> alternative therapist is actually nude. All the homeopaths have been able to do is spin, quote-mine and clutch at straws. –[[User:Tom Morris|Tom Morris]] 18:38, 13 March 2010 (UTC)


:::::I can see this as confusing. The home page of this section says that"The Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) was established as Department of Indian Systems of Medicines and Homoeopathy (ISM & H)". 
::I suppose there isn't really anything to do about it until there's a new Editorial Council and a reevaluation of workgroups. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:04, 13 March 2010 (UTC)
:::::*The first direct quote says "homeopathy is one of the <u>national systems of medicine</u>." It doesn't say the national systems are alternative, or even what the systems may be.
:::::*The second sentence includes "Government is of the view that presence of all these <u>complementary alternative systems of therapeutics</u>" It doesn't use the word "national" with "alternative", although they are on the same page
:::::*Nowhere on either page is any mention of conventional medicine.
:::::So, I agree that the reference never calls homeopathy an "alternative", but rather a "national", system of medicine. The reference does say that homeopathy is among a recognized set of CAM, but doesn't use the word "national"  Putting the two sentences together, one can infer homeopathy is a national systems and the national systems, which do not mention conventional medicine at all, are complementary and alternative. In other words, it never explicitly calls homeopathy one of the alternative systems of medicine, but I can see how one could infer it from the text. "National" does seem the only phrasing that can be supported with a direct quote, although it can be inferred, but not quoted, that homeopathy is one of the government-recognized systems of medicine.


:::::Could everyone restate what this comment and reference are trying to establish?  I think it's fair to say that a branch of the Indian government recognizes homeopathy as an established method of care, and it is of the national standards. The specific department, like the U.S. NCCAM, is only concerned with alternative medicine.  The reference never explicitly calls homeopathy an alternative system of medicine, but it suggests that it is. It's just not a site that supports the "alternative system of medicine" as a direct quote.[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 10:41, 13 December 2008 (UTC)
:::The draft is open to rewrite and, while I can't speak for everyone, I'll be glad to look at anything that gets put in it. I agree with Russell. [[User:D. Matt Innis|D. Matt Innis]] 03:17, 14 March 2010 (UTC)


== badly worded sentence in lede paragraph that can lead to confusion ==
::::Howard, there is a lot of research going on in Homeopathy. Dr.Peter Fisher heads a research group in London and Dr.Rastogi heads a research group in India. I will email them about your suggestion. Tom, please look at the 'feg' .pdf document I posted - it is good, solid evidence that Homeopathy works!—[[User:Ramanand Jhingade|Ramanand Jhingade]] 11:44, 14 March 2010 (UTC)


The third sentence: "Although homeopathy is practiced by medical doctors, other health professionals, and consumers in virtually every country in the world, homeopathy is not accepted by the majority of mainstream medical doctors or conventional scientists today." is badly worded and potentially confusing.
Friends...in due respect, anyone who takes this "report" seriously has an axe to grind or is simply under-informed.


It first says that "homeopathy is practiced by medical doctors", then goes on to say that it "is not accepted by the majority of mainstream medical doctors". This makes the reader say, "Whuuuh?"
Any rational person should and must be very suspicious of this "report." The MPs (Members of Parliament) who were a part of the Science and Technology Committee which voted for this anti-homeopathy report comprised of five members, with three members barely eking out their victory. Of the three votes, two members did not attend any of the investigational meetings, one of whom was such a new member of the committee that he wasn't even a member of the committee during the hearings, and the remaining "yes" vote was from Evan Harris, a medical doctor and devout antagonist to homeopathy. This report was not exactly a vote of and for the people.  This information alone should entirely discount this "report" as a kangeroo court report that deserves that round circular file.


The easiest solution is to rewrite the first part to say "homeopathy is practiced by some medical doctors" by adding the word "some". If, of course, this is what the sentence actually intends to say. Since I don't think that pure homeopaths are called "medical doctors", I *suppose* this is the intended meaning. If not, then the entire sentence should be clarified by rewriting. [[User:Hayford Peirce|Hayford Peirce]] 19:11, 12 December 2008 (UTC)
The very limited number of people who represented homeopathy were primarily three people. The others were entirely antagonistic to homeopathy or simply uninformed about it (such as the rep from Boots).


:I agree, Hayford. That entire paragraph seems repetative. We are going to lose most readers by the second paragraph. It needs consolidating. [[User:D. Matt Innis|D. Matt Innis]] 03:23, 13 December 2008 (UTC)
Despite the use and acceptance of homeopathy throughout the U.K., there is a very active group of skeptics, with significant Big Pharma funding, who work vigorously to attack this system of natural medicine. Even though there is a wide variety of serious and significant pressing issues in British medicine and science today, an active group of skeptics of homeopathy successfully resurrected in October, 2009, a House of Commons committee, called the Science and Technology Committee, with the intent to issue a report on homeopathy. A leading skeptics organization, Sense about Science, that has been pushing for the re-creation of this Committee is led by a former public relations professional who worked for a PR company that represents many Big Pharma companies. Of additional interest is the fact that other Directors of the Sense about Science organization are a mixture of former or present libertarians, Marxists, and Trotskyists who also, strangely enough, seem to advocate for the GMO industry (ironically, libertarians normally advocate for a "live and let live" philosophy, but in this instance, it seems that they prefer to take choice in medical treatment away from British consumers).


::Good edit. [[User:Dana Ullman|Dana Ullman]] 17:43, 13 December 2008 (UTC)
Sense about Science is a registered UK charity despite being a political pressure group. As such they have to divulge their sources of income which they do on their website. Not surprisingly, much of this comes from named pharmaceutical manufacturers.


==Matters arising==
One of the investigators for the House of Commons Science Committee is a Liberal Democrat MP, Evan Harris. He has collaborated with Sense About Science on various projects, and he was also one of the skeptic demonstrators against the national pharmacy chain, Boots, which sells homeopathic medicines. This advocacy role does not make him an unprejudiced observer as is required for this type of investigation.


First of all, this page is too long, can 'the page's owner' archive some of it, please?
A report from this kangaroo court was issued recommending that the National Health Service stop funding for homeopathy and homeopathic doctors, despite the support for homeopathy and for consumer choice from Mike O'Brien, the country's present Health Minister. This report is only of an advisory nature, and because the Health Minister has already expressed his support for consumers' right to choose their own health care, it is uncertain what, if anything, will result of this report. What was most surprising about this report was that it verified that when people repeat a lie frequently enough, such as "there is no research on homeopathy," many people actually believe it, despite its transparent falsity.[[User:Dana Ullman|Dana Ullman]] 05:33, 7 May 2010 (UTC)


Secondly, Dana, my apologies for misstating your gender, a false assumption about the name 'Dana'.
== Sources ==
{{nocomplaints}}


It is a matter of easily verifed fact that 'some people' consider Paracelsus to be the 'Father of Homeopathy'. Here is another such 'person':
I'm surprised that this article does not reference or discuss Paul Starr's Pulitzer Prize and the Bancroft Prize winning book on the social transformation of American medicine.  Any article that wishes to understand the difference between allopathy and homeopathy needs to understand that this debate has less to do with science or medicine and everything to do with politics as the British report makes clear.  [[User:Russell D. Jones|Russell D. Jones]] 15:41, 2 March 2010 (UTC)


http://www.angelfire.com/in4/alchemy2084/paracelsus.html
:At one time, it was indeed appropriate to compare allopathy and homeopathy. While some dictionary definitions still use allopathy as a synonym for conventional medicine, I find the modern usage to be more often by CAM practitioners, as that-which-we-do-not-do. (For the record, I happen to find some ''complementary'' medicine useful, or at least worthy of trial in non-critical situations.)


Robert Coon, the author in this case, is what we might call an 'unreliable source' - except in one thing - he knows his own opinion. He is a 'lectureer' in homeopathy, and he thinks that Paracelsus is the Father of ... am I making a point clear?
:As far as a "modern" comparison, however, I cannot do better than William Osler:
:<blockquote>A new school of practitioners has arisen which cares nothing for homeopathy and still less for so-called allopathy. It seeks to study, rationally and scientifically, the action of drugs, old and new."(Flexner report, page 162)</blockquote>


I am open to the idea that the page would be 'overstating' his claim, if we used the formulation I first of all offered, but my statement is NOT factually incorrect.
:Unquestionably, there was once a competition between something one could legitimately call allopathy, as a "doctrine of opposites", and homeopathy as a "doctrine of similars". Homeopaths often selectively quote Osler as saying that the homeopathic remedies were safer than most allopathic remedies of his era (i.e., late 19th-early 20th century). You'll note that there was insistence on keeping the 1905 quote from von Behring.
{{nocomplaints}}


Much of the world considers homeopathic medicine to be 'real' medicine, I understand (without being there at the time, so 'some' may dispute it) that Gandhi said this:
:It ain't the 20th century any more, and conventional physicians don't prescribe based on opposites, nohow. Yes, there are political residues, but there's now a lot more in the way of evidence-based medicine...and protecting turf. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:37, 12 March 2010 (UTC)


"Homeopathy cures a larger percentage of cases than any other method of treatment and is beyond doubt safer, more economical and a most complete complete medical science."
::My favorite quote from Paul Starr's book is:  “Because homeopathy was simultaneously philosophical and experimental, it seemed to many people to be more rather than less scientific than orthodox medicine.” [[User:Dana Ullman|Dana Ullman]] 05:37, 7 May 2010 (UTC)
{{nocomplaints}}


My benchmarks are these:
== The memory of sugar ==


The page should reflect these:
is being discussed [http://ff.im/gOS59 here] and provides a nice illustration of the topic. --[[User:Daniel Mietchen|Daniel Mietchen]] 21:56, 3 March 2010 (UTC)
Homeopathy is a subject much larger than the Western European 200 year old invention version ...
Paracelsus belongs 'somewhere'  in the 'true' history of homeopathy.


Here is a link to some well-founded comment on that. I suggest Dana incorporate some - or perhaps a Constable would confirm that I and others will be allowed to without having our entire contribution swiftly and indiscriminately deleted (as happened to me here originally) and followed up with inaccurate and ad hominem comments on the talk pages.
:I thought the "memory of sugar" tended to go either to the abdomen or buttocks, depending on genetics? :-)


I still believe we can work together on this topic! The page is NOT at a 'final stage', it is woefully lop-sided and and much needs to be done. Recently, despite all that is said above, the page has made progress - hasn't it? [[User:Martin Cohen|Martin Cohen]] 22:06, 12 December 2008 (UTC)'
:Seriously, the discussion at that link is what I'd suggest is an expectation. It is possible to be neutral, I think, and mention, in the lede, that homeopathy is not generally accepted. We still do not have a way of dealing with the situation where homeopathy supporters will support a lede that doesn't consider it reasonably credible. Of course, in no other workgroup do we have an equivalent to the health sciences/healing art splits. Should Religion be joined by Atheism?  Alternatively, is it possible to have a reasonable Atheism article in Religion? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:46, 3 March 2010 (UTC)


:Hi Martin, you "own' this page!  Just cut and paste the sections that you want to archive into [http://en.citizendium.org/wiki/Talk:Homeopathy/Archive_8 this page].  You can do this any time you like. Just remember to keep active sections on this page.  [[User:D. Matt Innis|D. Matt Innis]] 03:32, 13 December 2008 (UTC)
::The problem just isn't there with religion and atheism. If you, say, are interested in philosophy of religion, you can get a degree in it regardless of whether you are an atheist or a theist (or something else entirely). I say this from experience - I have a BA in Philosophy, Religion and Ethics from a Catholic college but am an atheist. There are some - I guess the polite way of saying it is 'non-mainstream' - ways of getting a doctorate in religion. You could become a "Doctor of Scientology" (D.Scn) - I read today that Ron DeWolf - Hubbard's son - had been given one, and stated in court that he wasn't sure whether they gave him the Doctorate before or after he'd been given the Bachelors! Or you could get a phony Ph.D from a diploma mill - as quite a lot of the creationists have. The problem with Healing Arts is that you can quite feasibly become a Healing Arts editor with a degree from a non-mainstream parallel academic institution. When mainstream academia isn't bending over backwards to certify degrees in quackery (as two universities in Britain shamefully have), the quacks create their own academic institutions.


Martin, I've just now read your comments above--I'm afraid I must ask you please to refrain from attempting to characterize your fellow contributors. That's common practice on WP and many online forums, but not here. You can think of us as a "moderated discussion group" similar to old-fashioned mailing lists with [[CZ:Professionalism|rules about collegial behavior]].
::"Dr" Gillian McKeith "PhD" has a degree from a place called Clayton College of Natural Health in Birmingham, Alabama. Said college is not accredited by any accrediting body recognized by the Department of Education, and a number of states in the U.S. list it as unaccredited on their websites for student loans (etc.). This does not stop McKeith claiming to have a PhD on her website, nor did it stop Channel 4 television or her publisher from touting this to promote her books and TV programme. She also likes to mention how she is a member of the American Association of Nutritional Consultants. You too can be a member of the American Association of Nutritional Consultants if you send them $60! McKeith has pushed notorious nonsense like the idea that green vegetables are good for you because the green shows they have chlorophyll (true), and the chlorophyll will oxidate your blood (how? Human beings are not plants. They tend to get their oxygen through respiration rather than photosynthesis. And even if they were getting their oxygen through photosynthesis, even your local tanning salon lamps aren't quite powerful enough to penetrate your small intestines).


On the more substantive matter of whether Paracelsus has an important founding role in homeopathy (is ''that'' the issue under dispute?  I really couldn't tell precisely), I think that your case would benefit greatly if you were to lay out more evidence in greater detail.  This is especially obvious if a true expert about homeopathy in our midst, Dana, expresses considerable skepticism about a text you describe as "nothing remotely controversial."  (Obviously, it was, or it wouldn't have been deleted, eh?)  All this discussion would be rendered unnecessary if you were to (1) state ''exactly'' the minimum claims you want to ensure are in the article, and (2) find some credible sources supporting those claims, ''if'' after exact formulation they still turn out to be controversial.
::Another graduate of the Clayton College of Natural Health is cancer quack Hulda Clark who sells a whole variety of magic 'zapping' toys that make funny noises and shine lights and do little more to cure cancer than extract money from punters - I mean, cancer sufferers.


On the other hand, if the one sentence about Paracelsus now in the article is enough for you, then no more needs to be said on the subject, I guess (please! :-) ). --[[User:Larry Sanger|Larry Sanger]] 04:14, 18 December 2008 (UTC)
::Take any philosopher of religion or even most theologians - they'll certainly be able to say something useful on an article about atheism in the Religion WG. Same for the non-believers within the same fields. The problem with Healing Arts is it lets people with completely bonkers views about reality approve articles on their favourite pseudoscience. If the claims of the homeopaths were true (and, blimey, even our politicians can tell what a big pile of nothing the evidence of two hundred years of homeopathy has amounted to), then most of the articles in the Biology and Chemistry workgroup need rewriting.


::: The role of Paracelsus reflects the view one takes of homeopathy - that is to say, if one looks at it from a cultural and historical perspective or from a 'scientific' perspective  as a medical 'method'. To some extent then, yes ther eis m09re to be said about Paracelsus's role in medicine, but given the page's overall character, perhaps not here. In a few wrods - yes, one sentence will do! [[User:Martin Cohen|Martin Cohen]] 13:20, 18 December 2008 (UTC)
::I'll repeat myself again: we need to fix the Healing Arts bug. It is nothing more than a bug. It is a bug that is bringing down the great work done by other WGs. It says to anyone who has spent years of their life working on getting a PhD in physics or literature or psychology or whatever that you can get a fake degree from a non-accredited university and also be considered an expert on the same level. How can I, in good conscience, tell the experts in my field to contribute given this significant vulnerability in the Editorship system? –[[User:Tom Morris|Tom Morris]] 01:21, 4 March 2010 (UTC)


==More on Paracelsus ==
:::Religion seemed the obvious parallel, but we could, I suppose, have an Absolute Pacifism workgroup with Military -- not that quite a few professional soldiers don't hate war. Why can Engineering debunk a hoax theory but Health Sciences cannot? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 02:15, 4 March 2010 (UTC)


"A text on pharmacology in nursing credits Paracelsus with exerting �a profound influence upon the medical beliefs of his time and of succeeding centuries� (Bergersen and Goth, 1979). In Remington�s Pharmaceutical Sciences, Higby (1990) lauds Paracelsus for �sparking the growth of the modern pharmaceutical sciences.� Countless textbooks, handbooks, encyclopedias and dictionaries (general and special), and monographs give him similar credit. Other sources refer to him as the �Father of Toxicology.� Furthermore, his name appears as a significant figure among voluminous numbers of works on homeopathy, natural medicine, alternative medicine, and botanical studies. A Web-based Paracelsus mailing list is part of a �health web system,� and the Paracelsus Healthcare Corporation runs the Bledsoe County General Hospital of Pineville, Tennessee."
::::Howard, you're one of the eight Charterists. Are you a loud and strong voice therein trying to *remove* Healing Arts as a Workgroup, so that some of this nonsense could then be addressed in the future in a rational way? [[User:Hayford Peirce|Hayford Peirce]] 02:49, 4 March 2010 (UTC)


from http://www.mindfully.org/Pesticide/Paracelsus-Dose-ToxicologyOct01.htm
:::::Compromise in the Charter Committee, I believe, means that the Workgroup and some other details will be passed, without detailed guidance, to the Editorial Council. Personally, I am urging the draft to go to discussion and markup, so we can proceed to the next steps after ratification. While this is an especially galling problem, there are less egregious workgroup structure problems that also need addressing and can't happen at the Charter level. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:21, 4 March 2010 (UTC)


[[User:Martin Cohen|Martin Cohen]] 22:08, 12 December 2008 (UTC)
::::Even with Pacifism and the Military, there is an implicit understanding that most of the facts are the same. The Pacifist will agree with the General that the U.S. dropped the bomb on Hiroshima or that Nelson died in 1805. They have different opinions, but they do not care out their own ''facts'' in quite the same way as the Healing Arts gang. –[[User:Tom Morris|Tom Morris]] 07:32, 4 March 2010 (UTC)


::Clearly, Dana was aware of such evidence, and no doubt what stopped him was (1) a failure to get ''very'' clear on ''what'' the article should say about Paracelsus, and (2) if what you want to say is that ''many informed people'' think he is a ''founder'' of homeopathy, offering evidence on ''that precise point'' is necessary.  The items you listed above don't support the precise claim in my (2) here.  They support the less controversial claim that Paracelsus is lauded and discussed a lot by homeopathic practitioners and medical doctors alike. -- But it appears that in the days since the above was written, a suitable conclusion was arrived at.  It's a shame that so much digital ink was spilled over just one sentence. --[[User:Larry Sanger|Larry Sanger]] 04:34, 18 December 2008 (UTC)
:::::No, the analogy may hold. There are those that will insist that any enemy can be defeated through passive resistance and good thoughts, just as some of the healing arts believe that it is utterly wrong to immunize against an infectious organism or use an antibiotic against one. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 07:43, 4 March 2010 (UTC)


:There is no question that Paracelsus is a major historical figure in medicine. Paracelsus belongs in any history of medicine article that covers his era.
::::::Tom mentions non-mainstream ways of getting doctorates in religion. In fact the Archbishop of Canterbury still has the legal power to award them, which might explain why Church of England bishops always seem to be Dr. [[User:Peter Jackson|Peter Jackson]] 14:29, 12 March 2010 (UTC)


:This is not a general article on the history of medicine. It is on the specific subject of homeopathy. Every available reference says that Samuel Hahnemann created the word, definition, and basic methodology. While it may be in the parthenogenetic sense, that makes him the father of homeopathy. Unless you can find a source that Hahnemann specifically said his methodology is built on that of Paracelsus, there is no more justification for saying he is the father of homeopathy than was Hippocrates, Galen, Aristotle, or Bucephalus.
==How well does it work?==


:Further, a Healing Arts editor has made, I believe, an editorial ruling on fact, under CZ rules, that Paracelsus was not the father of homeopathy. Again under CZ rules, that ruling stands, unless it is overruled by at least two Workgroup-specific Editors, the Editorial Council, or the Editor-in-Chief. These rules are in existence precisely to stop the sort of endless content arguments that characterize Wikipedia. I agree with Dana on very little, but, as an Editor in other workgroups and as secretary of the Editorial Council, he seems to have made a straightforward ruling with which I agree. Gareth Lang is the other active Editor in this article; you may ask him as well, but I doubt you are goig to get a different answer.  
We use double-blind studies to tell how well a particular medicine works. The person handout out the medicine does not know whether it's a "real medicine" just a sugar pill. In the case of pain relievers, the potency of an [[analgesic]] is rated in terms of how much more effective it is than a [[placebo]].


:If necessary, that ruling can be enforced, by the Constabulary. May I suggest that you drop the Paracelsus argument before enforcement measures are taken? I'd note that this is a very difficult article for reaching consensus, and the Paracelsus argument is a tangent from several months of work. If anything, people are trying to reduce the article size, putting, again by CZ policy, some materials into subarticles. Please try to understand the rules and customs of this community and not try to substitute your own. If there are policy issues with which you disagree, you may variously address them to the Editor-in-Chief, the Editorial Council, or discuss them on the Forums.
If I recall correctly, as much as 75% to 90% of the effective pain relief you get from the pills comes from the placebo effect: you take your aspirin or ibuprofen or (without knowing it) your sugar pill, and your headache starts going away within an hour no matter what. The real stuff is only slightly better.  


:This is a talk page for Homeopathy. An authorized Editor has ruled that Paracelsus is not within its scope. Further argument about Paracelsus is not appropriate here. Is there anything ambiguous about that? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:41, 12 December 2008 (UTC)
Given all that, how would we design a study to compare homeopathic treatment with conventional treatment? Is it possible to conduct a blind study, if the way the healer deals with the patient is a key ingredient of the therapeutic effect?


::We need to mention Paracelsus in a way that doesn't diminish the importance of Hahnemann.�[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:50, 13 December 2008 (UTC)
For that matter, how can we compare Freudian [[psychoanalysis]] to Berne's [[transactional analysis]] or modern [[rational-emotive therapy]] or to a frank chat with a trusted friend or mentor (like Father O'Malley down at the local Catholic church)?


:: I'd like a look at this by Constables, then. Not on the claim Howard has just unhelpfully rehearsed despite my long explanation to the contrary just above, but on the 'actual' issue:
* I daresay one result of a careful attempt to measure outcomes could be that "bedside manner" is much more important than we've allowed ourselves to realize.


I think the Homeopathy page should include Paracelsus, who 'some' people consider to have had a major influence on the subject. I have given a couple of explicit examples and references to indicate this, I think it would be fair to say that Ramanand and Pierre have supported the notion (from their more expert perspectives) that Paracelsus is part of the history of homeopathy, and that Dana himself has allowed a mention on the page. Yet Howard is stating  - again - as a 'rule':
But I ask again, how do we study and quantify it? --[[User:Ed Poor|Ed Poor]] 02:04, 28 March 2010 (UTC)


"This is a talk page for Homeopathy. An authorized Editor has ruled that Paracelsus is not within its scope. Further argument about Paracelsus is not appropriate here."
::If one were to review the entire body of experiments that Thomas Edison conducted on electricity, one would have to say that the vast majority of his experiments were failures...and one might fall into a trap by saying that he was a failure. Of course, we KNOW that this is not true. Just because some studies have shown that homeopathic medicines don't work, there is a greater body of research to show that it does.  The trick is to know WHEN homeopathic medicines work...and when they don't.


If this statement is left unaddressed, I fear it undermines the basic principles of CZ.  
:: If anyone here wants to review a body of homeopathic research on a specific group of diseases (respiratory allergies) that have primarily been published in high impact conventional journals, such as the Lancet and the BMJ, you might consider reading this review of research I co-authored in a peer-review journal:  http://www.ncbi.nlm.nih.gov/pubmed/20359268  -- you can read the entire article online at: www.altmedrev.com (It is in the Spring, 2010, issue, article #6). [[User:Dana Ullman|Dana Ullman]] 05:43, 7 May 2010 (UTC)


THREE notes:
== Unsupported assertions ==


1. The original edit offering 'Paracelsus IS the Father of Homeopathy' has been amended, willingly, by me, as indicated above - it is a view held by some, and can be argued for, but the'decision' of Dana and others here has been accepted and no one is arguing that that phrase should be used. It's repetition by Dana and Howard is misleading and seems to be intended as a 'strawman' tactic.
The current text has "Even in Europe, homeopathy is practiced by many conventional physicians, including 30-40% of French doctors and 20% of German doctors." and in the next paragraph "Some medical doctors, particularly in Germany, France, and several other European countries prescribe homeopathic medicines for wide variety of both self-limiting conditions and serious diseases with a high rate of patient satisfaction." There are no supporting citations.


2. The current text on the page (as edited by the major contributors to this page) now INCLUDES  a reference to the role of Paracelsus, which in 'content' terms, seems satisfactory to me. However, Howard's statement attempts to set a precedent that would exclude such adjustments.
This is obviously redundant; we need ''at most'' one of these statements. However, neither strikes me as believable without support, so I am inclined to delete both. Anyone care to comment before I edit? [[User:Sandy Harris|Sandy Harris]] 15:29, 26 June 2010 (UTC)
{{nocomplaints}}


'''Constable Response:'''  The question of Paracelsus is a content decision for which there are remedies through the editorial and author conflict resolution processes. I suggest that everyone review them.  They are there to allow articles to progress through dissagreements such as these.  Constables remain at arms length from these decisions for good reason.  There is nothing that asks or allows a constable to stop a citizen from making comments on article or user talk pages so long as they are professional.  However, it can become an issue if metadiscussions spread from one article page to another as they become inflammatory and this gets dangerously close to unprofessional behavior.  We cannot solve professional disputes on Citizendium, we only report them. Again, use your workgroups. [[User:D. Matt Innis|D. Matt Innis]] 16:09, 13 December 2008 (UTC)
:Your point about unsupported assertions has come up before, and the current text, in my opinion, is significantly misleading. "homeopathy is practiced by many conventional physicians" does not, as much as some may want it to do so, imply that conventional positions endorse all of homeopathy. By definition, if they are conventional physicians, they are ''not'' practicing homeopathy as alternative medicine, but are using some complementary techniques from homeopathy. When I was last in my internist's office, I banged my shoulder against a piece of equipment. He rubbed it a bit. Does that mean he practices massage therapy?


== "if it doesn't work" is back again ==
:"Patient satisfaction" is a purely subjective assessment and is in no way evidence of efficacy.  I could take the sentence starting "Some medical doctors..." and substitute "chemically pure water that has not been exposed to a simillium" and demonstrate high patient satisfaction.


I see that this sentence has once again been edited to read: "Some physicians, however, still maintain that even benign homeopathic treatment is relatively unsafe, because it might delay effective, conventional medical treatment, if it doesn't work."
:I agree with deleting both. Even if citations are offered, they must be of a quality that indicates that homeopathic methods are a significant part of the practice of these physicians and they are not using it with the intent of creating placebo effects. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:05, 26 June 2010 (UTC)


I thought it had been agreed, or possibly even ordered, that "if it doesn't work." would no longer be attached. (In any case, if it *is* permitted to stand, it should be rewritten as "does not" rather than "doesn't". [[User:Hayford Peirce|Hayford Peirce]] 19:05, 13 December 2008 (UTC)
:: It is a fact that at universities in Germany and Austria there are chairs and lectures on homeopathy (in Vienna also at the veterinary university). There are doctors who practice both. --[[User:Peter Schmitt|Peter Schmitt]] 23:10, 26 June 2010 (UTC)


:That was my understanding. It reappeared at 06:55, 12 December 2008.  There was discussion about it a few hours later, but no one actually took it out. That may be nothing but an oversight. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:54, 13 December 2008 (UTC)
::: I have no problem if the two sentences ar combined. I think we've gone over this several times on the talk pages.  As Peter points out, there are obviously well established 'conventional' medical professionals that use homeopathy for treatment of medical conditions. This is pretty much common knowledge at this point, so I don't see the need for citing a source for the mere fact that some medical physicians use homeopathy in their practices.  However, when we add specific numbers such as 30-40%, it does seem to beg for a reference.  It shouldn't be hard to find such a reference if it is out there. Otherwise, removing the numbers and just stating the fact shouldn't be a problem.


::Well, it's easy to take out -- I'll do it right now. [[User:Hayford Peirce|Hayford Peirce]] 20:04, 13 December 2008 (UTC)
::: I don't think we will be able to find any scientific sources that conclude that they use it only on undereducated healthy people as a placebo. In fact, I think the opposite is more likely the case. [[User:D. Matt Innis|D. Matt Innis]] 01:22, 29 June 2010 (UTC)


:::Hey, I thought I explained that adequately. That sentence needs to be qualified. The, 'if it does not work' conveys the meaning that not all homeopathic treatment is unsafe.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:03, 15 December 2008 (UTC)
Would someone who has access care to correct the glaring English mistake in the first paragraph of this approved article? [[User:Ro Thorpe|Ro Thorpe]] 00:16, 2 July 2010 (UTC)
How would, 'unless it works' be?&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:16, 15 December 2008 (UTC)


::::How about ""Some physicians, however, still maintain that even benign homeopathic treatment is relatively unsafe, because it might delay more effective, conventional medical treatment."  Oh, and a reference for the assertion, of course.  [[User:Richard Pinch|Richard Pinch]] 07:25, 15 December 2008 (UTC)
:I'm sorry, Ro, I must have a blind spot that is preventing me from seeing this glaring error.  Could you be so kind as to point it out? [[User:D. Matt Innis|D. Matt Innis]] 01:42, 2 July 2010 (UTC)


::::There's no reference for that quote, so I think it's better to delete that sentence.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:45, 15 December 2008 (UTC)
::Oh, so go ahead and shoot me!  I found it (after reading your request for Hayford to repair it :) [[User:D. Matt Innis|D. Matt Innis]] 01:46, 2 July 2010 (UTC)


:::::Dana has 'toned' it and I'm OK with what it says now.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:57, 15 December 2008 (UTC)
:::Bang, bang - but you've removed it! Many thanks! [[User:Ro Thorpe|Ro Thorpe]] 12:16, 2 July 2010 (UTC)


::::::I'm going to have to demand, Ramanand, that you leave this text alone in the future.  You repeatedly re-inserted this bit, and it was clearly explained that your addition made the statement virtually nonsensical.  One iron-clad, absolute rule of wiki editing is that you ''must not'' edit sentences in a way that makes nonsense of the point they were trying to make.  Obviously, you were trying to "neutralize" the sentence there, which I respect, but you went about it in the wrong way.
I provide many solid references to the use of homeopathic medicines by physicians in Europe in an article I wrote at: http://www.huffingtonpost.com/dana-ullman/homeopathic-medicine-euro_b_402490.html  (It is NOT my intent for anyone to reference this article in OUR article at this website.  Instead, we can use many of the references provided.  This article also has many references throughout the article showing that people who use homeopathic medicines tend to have more education than those who don't.)  


::::::The most recent edits to this not only removes your "if it does not work," it even removes "while homeopaths assert there is far greater danger by first using conventional medications due to their questionable efficacy and their side effects." Gareth made these edits.  Since he is an editor, you are not free to re-insert that text, which I suspect you'll want to do when you notice it.
I urge us to be very careful in significant changing this article because a lot of time and thought went into it previously.  [[User:Dana Ullman|Dana Ullman]] 18:05, 14 July 2010 (UTC)


::::::If I'm not mistaken, the reason he removed that additional text is that the "Safety" section immediately goes on to discuss those concerns. If you want to make sure the homeopathic view on the safety of modern drugs and vaccines is stated sympathetically (but bearing in mind that the other side must also be stated sympathetically as well), that would be the place, I think. --[[User:Larry Sanger|Larry Sanger]] 05:17, 16 December 2008 (UTC)
== Review by a sceptical layman (i.e. me) ==


:::::::I'm not gonna add/remove anything there now - I'll leave it to Gareth and Dana (I hope they do the needful). My point was that that sentence needs to be qualified. The, 'if it does not work' conveys the meaning that not all homeopathic treatment is considered unsafe.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:18, 16 December 2008 (UTC)
I'm reviewing the draft. Here is a rough summary of my changes and concerns:


== "not even a single molecule" -- why I think this should be restored ==
* I rewrote the paragraph in the lede section about the "long safety record". The reason homeopathy has a long safety record is the very same reason that not travelling has a long safety record: if something is inert and chemically indistinguishable from the delivery mechanism, it will be safe. Safety and efficacy is a balancing act. The reason homeopathy is safe is precisely because it isn't efficacious.


I definitely think that ''to such an extreme degree that in most homeopathic remedies, that, by later understanding of [[#Molecular concentration|molecular concentration]], "not even a single molecule of the original substance remains."'', although perhaps in another place in the overall article.
* I'm not wild about long, windy footnotes about Romanization. I've thus split off the Romanization note about the word "[[qi]]" on to a separate page.


You don't have to discuss the nature or structure of water in order to have this phrase -- it is a well-known argument by anti-homeopathic skeptics such as Martin Gardner and others. And it is one that is pretty easily understood even by people with very little grounding in science.
* The section that is disputed about the number of practitioners in France and Germany is ''in the wrong place''. The way in which homeopathy is prescribed or accessed doesn't seem to be to be a principle of homeopathy - homeopathy is homepathy whether it is prescribed by a homeopath or bought over the counter. I've thus moved it into the section which used to be titled "Professional homeopaths: who are they?" which I have retitled "Homeopathy in practice". This section seems to be the place to discuss provision, prescription, education, regulation and the like.


If you want, you could then add something like, ''an assertion that homeopaths dispute on several grounds.'' [[User:Hayford Peirce|Hayford Peirce]] 22:56, 14 December 2008 (UTC)
* The paragraph starting "Homeopathic remedies can be prescribed by professional homeopaths" seems to be a tricky one. Depending on the country and the regulatory regime, homeopathy can be prescribed by a wide variety of people. Sadly (in my opinion), in Britain, quacks of all sorts can have their merry way with the public. Pretty much anyone can set themselves up as an alternative practitioner, so long as they don't make their claims too specific. But in other countries, this varies. It seems the important distinction that needs to be made is that homeopathy - unlike, for want of a better description, ''real'' medicine - can be prescribed by anyone.


:A possible location could be in the dilutions table at [[Homeopathy/Catalogs]].  One problem is that this all depends on the concentration of the orignal mother tincture. Nevertheless we can add in the notes the point at which dilutions to less than one molecule per drop (or percontainer) occurs for most remedies. [[User:Chris Day|Chris Day]] 23:30, 14 December 2008 (UTC)
* The rest of the section on "A typical homeopathic visit" seems to have some glaring problems. The homeopath is supposed to have EMT training in order to be "adequately trained"? (Heh. Surely, if heart attacks are the problem, what you need to do is to dilute high-fructose corn syrup into non-existence and it'll clear right up? I thought they believed in the law of similars. What's a defibrilator doing in the homeopath's office?) But anyway, this adequate training is according to ''who''? According to government regulations? According to the homeopathic groups? According to us? According to some third-party regulator like the [http://www.cnhc.org.uk/pages/index.cfm CNHC]?


::Isn't it generally assumed that 24X or 12C is the point in which there should be no remaining molecules (beyond Avogadro's number).  Homeopaths do not deny that there may not be any molecules in these potencies, but this is like asserting that a magnetic field doesn't exist because a magnetic field does not have any molecules in it (THAT isn't the point).  And for the record, a large number of homeopathic medicines that are sold in health food stores and pharmacies throughout the world are in lower potencies, 1X to 23X (or 1C to 11C), which are doses in which it is not proper or accurate to say that there is "nothing" there. [[User:Dana Ullman|Dana Ullman]] 00:53, 16 December 2008 (UTC)
* The article describes "classical homeopathy" at length, but I haven't seen any discussion of what the alternatives are to classical.


:::I think this is the main reason it would be useful in the table, to put some perspective on the different potencies that are available.  I think the notes section in the table could have a lot of interesting tid bits that would destroy the flow of the article itself. [[User:Chris Day|Chris Day]] 04:09, 16 December 2008 (UTC)
* There is a lot of repetition of parts of the article. The 'Principles' section is repeated in the section on 'The claims for homeopathy'.


== Representative Remedies table ==
* No criticism seems to be made of the "treating the whole person" idea. I'm not even sure that this is a desirable thing. If I break my arm, I want my arm fixed, not someone to waffle about my "disturbance in the overall homeostasis of the overall being". In fact, when I broke my arm as a child, I'm very glad that I had access to a surgeon to fix it. This kind of rhetoric seems to be just an evasion tactic - if the studies don't show that homeopathy actually fixes anything (and, well, it wasn't going to put the bones in my elbow back together), then they can justify this kind of thing by pointing out that the person feels vaguely better in some holistic sense.


I originally formatted some existing text about remedies into a table, but, at this point, does the information actually add to the article?  We have an article on [[Oscillococcinum]] and perhaps someone would like to write an article on some other remedy mentioned in the text (e.g., in a trial). Otherwise, let's either fill it in more solidly, or delete it. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:47, 15 December 2008 (UTC)
* The paragraph about corticosteroids seems to be totally out of place. Oh, it sort of makes sense - it is a follow on from the last paragraph about homeopathy and asthma.


==Absolutely not==
I've got a more radical suggestion. This article obviously needs a fairly ground-up rewrite. Here's what I reckon we should do. The current article seems to have been put together in a rather piecemeal way. Instead, I think the best way is to see if we can come together and work out a list of the fundamental questions that a good article on homeopathy should answer - then build a simple structure around those questions, and fill them in. We may be able to repurpose some of the text from the existing article.
"Where a cause cannot be found, for example a viral attack which does not have a reliable method of testing yet, homeopathy can be more effective."


This is an opinion, possibly a fair one, but has no place in this article. We must not assert efficacy as though it was an editorial judgement. The question of efficacy is one that we are accepting as being in dispute and one that we are leaving to the article on Testing. So please no insertions anuywhere in the text of editorial claims that homeopathy is effective or editorial assertions that it is ineffective. (Though we may report such claims and assertions, judiciously).
I'd suggest the following list of questions:


To emphasis, '''any''' statement in this article that implies that homeopathic treatment has an efficacy above placebo will be disputed. This article must not include any editorial assertion of this form; to include any such statement would be to make an editorial judgement of disputed fact, and I will delete any I see.[[User:Gareth Leng|Gareth Leng]] 17:37, 15 December 2008 (UTC)
# What is homeopathy?
# Is there any known mechanism for homeopathy?
# Is homeopathy clinically effective?
# What are the main issues of contention regarding homeopathy?
# Why have there been campaigns against homeopathy like the 10:23 campaign?
# What is the history of homeopathy? Who is Samuel Hahnemann?
# How is homeopathic care provisioned and regulated in different countries?


:Thanx Gareth.  I agree.  That said, it may be more appropriate to say:  Homeopathy has a history of efficacy in the treatment of 19th century infectious disease epidemics, and because there is modern-day research that has shown efficacy in using homeopathic medicines in treating select viral illnesses, such as influenza, it may be prudent to consider homeopathic medicines as a part of a comprehensive treatment program for viral illnesses.
Before formulating a structure for any potential rewrite, I'm interested in seeing if anyone has any other questions that they'd want to add. –[[User:Tom Morris|Tom Morris]] 12:30, 4 July 2010 (UTC)


:Also, I haven't looked to see exactly where an editor placed the previous statement (or where Gareth deleted it), but I want to inform others on this site that because a conventional medical diagnosis is not necessary for homeopathic treatment to be determined, homeopathic care can be considered for those patients whose ill-health is not adequately diagnosed or understood. [[User:Dana Ullman|Dana Ullman]] 01:07, 16 December 2008 (UTC)
:Tom, I only have a few minutes right now, but let me share a thought or two. My greatest unanswered question is "what is the cognitive process of a homeopath in a patient interaction?"  In other words, homeopaths say that every remedy is individualized. Whenever I posed this question to Dana, it was brushed aside, saying that one had to be a trained homeopath to understand.


::I have much less problem with your second paragraph than the first. Especially for diffuse chronic diseases, such as fibromyalgia, where conventional treatment may or may not help, I'd certainly agree that it is only fair to inform a patient that there have been some clinical trials indicating that homeopathy might help. Complementary (I'm not saying alternative) therapies are certainly worth of consideration.  
:Odd, but I have written quite a few articles on differential diagnosis in medicine, and some of my most interesting professional work is in expert systems to "individualize" (e.g., what dosage forms are most convenient for the patient and are most likely to be taken on schedule? What other diseases are present -- are there synergistic as well as problem interactions? Are there patient preferences?  Are certain side effects more or less likely?  Somehow, I manage to muddle through this sort of thing, yet I keep being told there are Inner Secrets to Homeopathy that prevent a straightforward explanation. Now, I'm not a classic layman in conventional medicine, but I can't think of a field where I don't have a basic understanding and the ability to quickly get a much deeper understanding -- and also know what I don't know. In the last six months or so, I've had to do the research to do peer interactions, on the specific diseases of people (two- and four-legged) for whom I'm an advocate and case manager -- involving [[human iron metabolism]], [[feline squamous cell carcinoma]], and [[peripheral nerve myelin protein 22]] and [[inflammatory polyneuropathy]]. But I can't begin to understand how a homeopath thinks?


::As far as considering homeopathic medicines as part of a treatment program for viral illnesses, I am far less willing to agree with that being in the article, at least with respect to influenzas. We now know immensely more about not just epidemic influenza in general, but the specific extreme virulence factors of the 1918-1920 pandemic. Given that there are finite budgets, I would want to be comfortable that there were adequate stockpiles of the demonstrably efficacious neuraminidase inhibitors, and even the less effective hemagglutinin inhibitors before expending additional resources on homeopathic remedies. Since we do have a good molecular understanding of the pathogenic mechanisms, and we know that Roy's assumptions that went into [[Oscillococcinum]] were wrong, I don't think, at least with respect to epidemic influenza, that CZ can justify including "it may be prudent to consider homeopathic medicines as a part of a comprehensive treatment program for viral illnesses."  Using homeopathic medications in a viral infection, when there are no known treatments, and it doesn't divert resources, could be patient and clinician choice. There's not much to lose with rabies or Ebola by trying complementary therapies. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 01:49, 16 December 2008 (UTC)
:In fairness, I'm not sure how much time I'm willing to expend on homeopathy, at least unless I get comparable collaboration on less controversial, and possibly useful to more people, health science articles (to say nothing of other fields). [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 13:26, 4 July 2010 (UTC)


:::(Just popping in quickly and probably popping out.)  I am confused.  Gareth made what I thought was a very definite, clear-cut statement: "To emphasis, '''any''' statement in this article that implies that homeopathic treatment has an efficacy above placebo will be disputed.  This article must not include any editorial assertion of this form..."  Then you, Dana, said: "Thanx Gareth.  I agree."  And then your very next statement was: "That said, it may be more appropriate to say:  Homeopathy has a history of efficacy in the treatment of 19th century infectious disease epidemics, and because there is modern-day research that has shown efficacy in using homeopathic medicines in treating select viral illnesses, such as influenza, it may be prudent to consider homeopathic medicines as a part of a comprehensive treatment program for viral illnesses."
== Luc Montagnier ==


:::It seems to me that while you ''say'' you agree, you are not in fact agreeing with Gareth, or perhaps you misunderstood him (but that would be hard to believe, because he was, as I said, quite clear). Dana, you want the article to say, (a) "Homeopathy has a history of efficacy in the treatment of 19th century infectious disease epidemics" and (b) "in treating select viral illnesses."  These seem to me to be ''precisely'' two statements that imply that "homeopathic treatment has an efficacy above placebo."  Gareth says that such statements "will be disputed" and that we "must not include any editorial assertion of this form."  So, Dana, will you please clarify?  It seems you should say one of three things.  (1) That you think the article should make your statements (a) and (b), but these statements do not imply that homeopathic treatment has an efficacy above placebo.  (Explaining that would be a trick!)  (2) That you think the article should make your statements (a) and (b), and since these statements do in fact contradict what Gareth said, you are in fact disagreeing with him and were wrong to say you agreed with him. (That would be puzzling.)  (3) That, actually, you somehow misspoke or misunderstood and that you didn't mean to assert (a) and (b), but some revised (a') and (b'), which do not imply that homeopathic treatment has an efficacy above placebo. (This seems most promising.)  I leave it to you to straighten this out. --[[User:Larry Sanger|Larry Sanger]] 04:24, 16 December 2008 (UTC)
French virologist Luc Montagnier has said at a prestigious international conference when he presented a new method for detecting viral infections that it bore close parallels to the basic tenets of homeopathy. This has been published in the 'Sunday Times' (London), as well as 'The Australian' - here's a link to the article: http://www.theaustralian.com.au/news/health-science/nobel-laureate-gives-homeopathy-a-boost/story-e6frg8y6-1225887772305
:I hope one of you (at least Dana) make time (I don't have the time) to insert this matter into this article.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 16:26, 5 July 2010 (UTC)
Here's another link: http://epaper.timesofindia.com/Archive/skins/pastissues2/navigator.asp?login=default&AW=1279125246109
—[[User:Ramanand Jhingade|Ramanand Jhingade]] 16:37, 14 July 2010 (UTC)


: There are important things that I agree with Dana about. In particular, I agree with him that in the 19th century, conventional medicine was pretty rotten, and their "cures" were often toxic - worse than the disease; conventional medicine at the time sought treatment based on theory - on understanding the disease, but they didn't have much clue, nor did they have a systematic way to evaluate efficacy anyway. I agree that Hahnemann saw this very clearly, he rejected theory, relied on his own judgement and observations of patients, and sought to use the lowest effective doses to avoid side effects. As the drugs actually were ineffective, there ''was'' no lowest dose. He was also a humane and insightful health reformer, who promoted cleanliness, good nutrition, careful nursing - and homeopathic hospitals which implemented these and avoided toxic cures did better than conventional hospitals. So they had a history of relative efficacy compared with a frankly counterproductive conventional medicine. But their death rates then do not indicate any efficacy compared with modern active treatments, (he comparison is inappropriate of course). I have no objection to the article stating claims for homeopathy (I have inserted a section on these); my only objection would be to endorsing them; I don't think it's for CZ to say what is prudent and have tried to avoid that - we can say what homeopathy advises and what conventional medicine advises and leave it at that.[[User:Gareth Leng|Gareth Leng]] 13:51, 16 December 2008 (UTC)
::I certainly have no intention of amending the article with newspaper articles, especially those that indicate nothing but a "close parallel." Has Dr. Montagnier's proposal been discussed in mainstream journals? 


::::Both sides here have agreed that, "Especially for diffuse chronic diseases, such as fibromyalgia, where conventional treatment may or may not help, I'd certainly agree that it is only fair to inform a patient that there have been some clinical trials indicating that homeopathy might help" and "There's not much to lose with rabies or Ebola by trying complementary therapies". I hope you (Dana) can insert that appropriately.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:48, 16 December 2008 (UTC)
::The first article, in ''The Australian'', mentions a "memory of water" type argument, and cites rejection by other scientists. I'd note that his Nobel was for virology, not physical chemistry. The second is behind a paywall. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:58, 14 July 2010 (UTC)


::::Since you are quoting me, Ramanand, you are incorrectly quoting me. That I might personally agree that it is useful to inform a patient is a general comment on informed consent. That is my personal opinion. I would also insist that the clinician would say there is no evidence that they will help, and going to homeopathy may create false hope.
:::Hi friends!  Actually, I got sent this link to a recent issue of the "New Scientists" by none other than Nobelist Brian Josephson:  <http://www.newscientist.com/article/mg20727682.300-60-seconds.html>


::::If I had rabies or Ebola, I would not, myself, accept homeopathic treatment. Instead, I would request ICU support that has, in well over a century, saved one patient with clinical rabies. If I had no response to that, I would explicitly ask for appropriate terminal comfort care, such as high-dose opioids and/or barbiturates. I would not consent to homeopathic treatment. So, when I speak of a hypothetical informing of a patient, that is not "both sides agreeing". It was stated as an option. There are complementary therapies that I would try in otherwise unresponsive fibromyalgia, but, again, I would not consent to homeopathic treatment. Now, if one wanted to inform the patient "There's not much to lose with rabies or Ebola by trying complementary therapies, but there is no evidence they will help, and trying them may simply lead to a more unpleasant death because they are incompatible with terminal sedation," I'm OK with that. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 13:27, 16 December 2008 (UTC)
:::"Clear as a Nobel"
:::Luc Montagnier, the French virologist who won a Nobel prize in 2008 for linking HIV with AIDS, last week made controversial claims that highly dilute solutions of harmful viruses and bacteria emit low-frequency radio waves, allegedly from watery nanostructures formed around the pathogens. Similar claims have been made for homeopathic remedies."  [[User:Dana Ullman|Dana Ullman]] 17:40, 14 July 2010 (UTC)


I'm certainly willing to insert that homeopathists are willing to treat rabies and Ebola. Not willing to offer advice to patients in any form.[[User:Gareth Leng|Gareth Leng]] 13:55, 16 December 2008 (UTC)
::::That link goes to the daily news summary, not anything on homeopathy.  As quoted, though, they are "controversial claims". No details. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:57, 14 July 2010 (UTC)


:Thanx Larry for waking me up on my confusing statement.  What I meant was that I agreed with Gareth on his rejection of the statement in the article "Where a cause cannot be found, for example a viral attack which does not have a reliable method of testing yet, homeopathy can be more effective."  I believe that there should be some research on the homeopathic treatment of a specific condition before we include reference to it.  That said, we have given reference here to a Cochrane Report that review four large clinical trials testing Oscillococcinum in the treatment of influenza. There IS a body of research here!  As for fibromyalgia, there are two trials here, one of which was published in the BMJ (1989) (this was a double-blind, placebo control trial WITH a crossover...a very impressive trial) and one of which was published in Rheumatology, 2004, which found clinical relevance AND objective changes in EEG readings in homeopathic vs. placebo patients. 
:::::It is necessary to have that link in this article to show that homeopathic remedies are not 'placebos', as some people allege.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:40, 16 July 2010 (UTC)


:We could also say that it may be prudent to consider trying homeopathic medicines in the treatment of conditions for which conventional medicine has no known efficacy, but we need to be very careful on creating this list.  We have to word this so that it doesn't sound as though homeopaths claim efficacy for such conditions (unless someone can provide evidence). [[User:Dana Ullman|Dana Ullman]] 15:12, 16 December 2008 (UTC)
::::::It is another piece in the puzzle.  It is primary research, but it is by a Nobel Prize winner, so it is news about homeopathy.  We shouldn't treat it as scientific fact, but it is a fact that a prominent scientist has made the statement that involves a quality of water.  It is in no way scientific consensus, an in fact may lead to this guys ruin for whatever reason.  We have included news about the British Medical Association's recent position statement concerning homeopathy and [http://www.theaustralian.com.au/news/health-science/nobel-laureate-gives-homeopathy-a-boost/story-e6frg8y6-1225887772305 this article] specifically mentions that statement as well.  This is the draft, so I won't categorically remove something that is written comprehensively, neutrally, and objectively about the subject. [[User:D. Matt Innis|D. Matt Innis]] 12:59, 17 July 2010 (UTC)


::There are two issues here. First, yes, there are studies described as "promising" in comparing homeopathy with placebo in upper respiratory infections. Unfortunately, I don't remember if these were specifically for influenza, and, if so, for which types of the virus.
(undent) Matt, you give it a perfectly good context--as news. It doesn't show, or not show, anything about homeopathic remedies being placebos, or effective, or ineffective, or any particular clinical correlation. As far as I understand, he's made an observation in physical chemistry and RF fields interacting with water, nothing else. I sincerely hope he's not hurt, as he was incredibly dignified while there were attempts to discredit his initial discovery and characterization of HIV -- his Nobel was very deserved.  [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:42, 17 July 2010 (UTC)


::The second issue, however, would apply specifically to influenza treatment.  If homeopathy demonstrably was better than placebo, that is indeed worth reporting.
:My point in providing the link to the NEW SCIENTIST is to verify that this research is "notable," and as such, a short note is worthy here.  [[User:Dana Ullman|Dana Ullman]] 05:35, 21 July 2010 (UTC)


::For true influenza viruses, however, there are conventional medications that have demonstrated efficacy and are in general medical use: the neuraminidase inhibitors [[zanamivir]] and [[oseltamivir]], which are effective against both Influenza A and B, and the hemagglutin inhibitors [[amantadine]] and [[rimantadine]], effective against A only and to which resistance is being seen.  Proper perspective, if discussing influenza, would assess efficacy with respect to the best available conventional treatment, not to placebo alone. Let's not get too enthusiastic about placebo controls when there are accepted means of medical treatment; the general pharmaceutical industry is, properly, being challenged to demonstrate that their new drugs are better than what is already available. "Better" can mean safer, if efficacy is roughly equivalet. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:25, 16 December 2008 (UTC)


:::Howard, there IS presently reference to this review of research on homeopathy and influenza from the Cochrane Reports (see reference #65). While those conventional drugs may presently be proven to have greater impact on influenza symptoms than homeopathic medicines, these conventional drugs also presently have much greater risks too, especially in comparison with homeopathic medicines.  One could also say that heroin gets rid of pain with greater frequency than homeopathic medicines, but many people determine what medicine they want to take in light of the various benefits and risks.  For many people, they prefer greater safety in their treatments.  Also, there is growing evidence that Tamiflu and other flu medicines are having decreasing benefits as the viruses adapt to them.  [[User:Dana Ullman|Dana Ullman]] 03:28, 17 December 2008 (UTC)
::Matt, you are wonderfully reasonable.  Howard is not accurate when he says that Montagnier has "made an observation".  Montagnier conducted RESEARCH, and he wrote about it in a peer-review journal. He spoke about it to a group of fellow Nobel Prize winners.  And ALL of this was so notable that the "New Scientist" commented about it...and linked it directly to homeopathy. I have no problem if we choose to have the word "controversial" used in describing this new work.  The fact of the matter is that this new work discusses "electromagnetic signaling" which may help explain how homeopathic medicines may work.  [[User:Dana Ullman|Dana Ullman]] 18:29, 9 September 2010 (UTC)


::::Under the Declaration of Helsinki (see [[informed consent]]), it is unethical to give a placebo if an established treatment exists. There are existing treatments for influenza, which is of major pandemic concern. I'm not really interested in handwaving about the possible risks. Either homeopathic remedies are more effective against influenza than neuraminidase inhibitors, the gold standard of treatment, or they are not. In preparing for pandemics, there are resources to stockpile one or two classes of drugs.
:::Then why isn't the peer-reviewed journal cited, rather than ''Wired'' and ''The Australian''? Further, one may write (e.g., an editorial) ''in'' a peer-reviewed journal, but not have one's work peer-reviewed ''by'' that journal. The peer review process becomes more credible if another independent researcher reproduces of these results. Please provide citations of these events if you want me to believe this is substantive.
::::<blockquote>While those conventional drugs may presently be proven to have greater impact on influenza symptoms than homeopathic medicines</blockquote>
::::Thank you. In an influenza pandemic, increased risk of side effects is quite acceptable, if the drug with proven greater efficacy can limit or stop an outbreak. Gareth said
::::<blockquote>clear and irrefutable evidence for the effectiveness of homeopathic remedies</blockquote>
::::and that certainly would be the overriding public health consideration in an epidemic.  


::::Oh -- heroin is a safe and effective drug for severe pain. Diacetylmorphine simply crosses the blood-brain barrier faster than morphine, but not as fast as some of the new synthetics. It is banned in the U.S. only for political posturing. Fentanyl and sufentanyl are more addictive by any reasonable standard. Please stop changing the subject. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:50, 17 December 2008 (UTC)
:::Nobel Prize winners, rather by definition, tend to be specialists. One might speak on medicine to a group of Chemistry laureates, and have no special critical review.  


:::::Dana, Homeopathy is equally effective in influenza, as long as one has prescribed the simillimum.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:20, 17 December 2008 (UTC)
:::It's interesting that we are still arguing how homeopathic medicines "may" work, when it's rather routine to understand the molecular pharmacology of conventional medicines. Sorry, this still comes across as hand-waving for something with a trivial base of evidence.


I think that Howard has exaggerated the case of "proven" efficacy of conventional drugs by asserting that it is "unethical" to use other treatments for the flu.  Please give a notable reference for this specific situation.  When we consider the additional risks to these drugs, the ethical equation changes.  Further, increased use of these conventional Rx in minor flu symptoms decrease their potential efficacy for more serious flu syndromes as flu viruses adapt to these drugs.  There is a case that can be made for how widespread use of these conventional drugs prior to the emergence of a deadly bird flu can have the potential to create public health crisis because such overuse can reduce their benefits if or when the real bird flu hits.  [[User:Dana Ullman|Dana Ullman]] 03:56, 19 December 2008 (UTC)
::::Have I fired five or six rounds? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:38, 9 September 2010 (UTC)


{{civil}}
== Evidence that homeopathy works ==


{{nocomplaints}}
I hope one of you (at least Dana) can insert sentences that read something like, "there is scientific evidence for homeopathy", using the PDF for "Scientific framework of homeopathy: evidence-based homeopathy" available at http://www.feg.unesp.br/~ojs/index.php/ijhdr/article/viewFile/286/354 wherever appropriate. I haven't seen anyone object to it here anyway.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:15, 21 July 2010 (UTC)


== Scientific basis ==
== the word "skeptic" ==


Gareth, while I think I wrote the last bullet under "Scientific Basis of Homeopathy", would you agree it should read:
Wasn't it decided a long time ago that aside from the two existing examples in the article that pro-homeopathy advocates (and anyone else) could NOT use the word "skeptic" in future edits?  Just want to make sure. [[User:Hayford Peirce|Hayford Peirce]] 21:50, 5 August 2010 (UTC)


*clear and irrefutable evidence for the effectiveness of homeopathic remedies, evidence that can<s>not</s> be explained in <s>conventional</s> ''scientifically acceptable'' terms
:I remember that as a specific ruling by Larry. In my experience, it's almost always used by advocates of a position; the neutrality policy wouldn't be hurt if it were banned. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:41, 5 August 2010 (UTC)


If the section were not entitled "Scientific basis", I could settle for: ''clear and statistically significant evidence..."  Obviously, there are any number of areas, in conventional medicine, where a treatment works, and either the mechanism remains incompletely understood, or the wrong mechanism was long assumed. As an example of the latter, think of all the approaches to treating gastric ulcers until two Australians figured out the role of ''Helicopter pylori'' and earned a trip to Stockholm.  I'm not sure where, however, I would move a sentence saying there would be acceptance if the statistical evidence was overwhelming even though the full mechanism was unknown.
::But what about people who ''are'' skeptics? Are we not allowed to say that Michael Shermer - who runs the Skeptic's Society and publishes ''Skeptic'' magazine - is a skeptic? –[[User:Tom Morris|Tom Morris]] 23:02, 5 August 2010 (UTC)


[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:29, 15 December 2008 (UTC)
:::As a direct quote or a self-identification, sure. As condescension to disbelievers, no. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:04, 5 August 2010 (UTC)


Thanks, my phrasing was clumsy and clearly I didn't get the intent across. I meant that we need a) robust evidence that the remedies are effective and b) to be convinced that the efficacy doesn't have a conventional explanation (e.g. the placebo effect). Have a go please if my intent is clearer now[[User:Gareth Leng|Gareth Leng]] 18:42, 15 December 2008 (UTC)
::::Ah, but is it? I consider 'skeptic' to be much less of an insult than 'homeopath'! –[[User:Tom Morris|Tom Morris]] 23:06, 5 August 2010 (UTC)


:You were looking at a different aspect than I was; perhaps we need to converge. When you said "conventional means", I wasn't thinking of a placebo effect, but something that was measurable but hadn't been observed before. Hypothetically, if one observed that after a homeopathic remedy was administered, there were reproducible objective changes versus placebo (e.g., creatinine level no longer rising in renal failure, CD4 count increasing in HIV), but no explanation for the mechanism of those changes, one would still have to accept that they were accomplishing something.  When you speak of placebo effect, I'm assuming you mean that the placebo arm and the homeopathic arm of a trial had the same results.
:::::I think it is -- it comes up repeatedly in fringe articles, be they moon landing hoax, UFO, etc. -- anything not a true believer. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:13, 5 August 2010 (UTC)


:Is this closer? The key points are safety and efficacy are demonstrable, without requiring the mechanism to be understood
::::::If *I* use the word, Tom, it's a compliment.  If Dana uses it, it's pejorative.  That's why Larry (or someone) banned it from this article, if I recall correctly. (I have 20 years' of Skeptical Inquirer on my bookshelf.) [[User:Hayford Peirce|Hayford Peirce]] 23:21, 5 August 2010 (UTC)


:*clear and irrefutable evidence for the efficacy of homeopathic remedies, evidence that cannot be explained by placebo effects and does show statistical significance of efficacy
== What the...? ==
:*clear and irrefutable evidence for fewer side effects of homeopathic treatment, with equal or better efficacy, than the accepted standard of medical treatment.


<blockquote>Homeopaths respond to these concerns by noting that using homeopathic medicines can delay or reduce the use of conventional medicines that are ineffective and dangerous.</blockquote>


::: I've modified - but not added side-effects; I don't doubt that homeopathy has no side effects.[[User:Gareth Leng|Gareth Leng]] 14:23, 17 December 2008 (UTC)
If this were The Other Wiki, that'd be an instant "citation needed"! I know homeopaths like to bang on about the evil 'allopaths', but do they honestly respond to the [[opportunity cost]] argument with a reversed opportunity cost argument? That's so... indescribably crazy. I certainly would like some verification on that. –[[User:Tom Morris|Tom Morris]] 00:42, 6 August 2010 (UTC)
:Remember our motto: '''be bold''' -- remove it, and let whoever put it there back it up with some facts if they want to restore it. [[User:Hayford Peirce|Hayford Peirce]] 01:42, 6 August 2010 (UTC)


:Of course, that doesn't solve the problem of comparing, in a statistically meaningful way, when the homeopathic assumption of individualization would seem to imply that there is no concept of an effect that is replicated throughout a treatment cohorts; the idea of a cohort doesn't seem to be acceptable in homeopathic models. The ''sine qua non'' is that there has to be a mutually accepted statistical paradigm, such as some being proposed for pharmacogenetics.
::Oh, now we're bold, haha.  It's a response to the use of homeopathy for use with things like childhood ear infections, a commonly self limiting condition that is often treated with antibiotics which have unwanted and sometimes dangerous side effects. It probably could be explained a little better when it's all cleaned up. After all, that is the homeopath response. [[User:D. Matt Innis|D. Matt Innis]] 21:50, 7 August 2010 (UTC)


:Sadly, I am not aware of any research by homeopaths into "how can we define a meaningful controlled trial given our constraints", rather than "we reject controlled trials." As I've mentioned for genomic medicine, this is a problem that is wider than homeopathy &mdash; yet the researchers in the new paradigms are trying to find statistical methodology that makes sense. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:18, 15 December 2008 (UTC)
:::On the other hand, I can point to many medical studies advising against antibiotics in uncomplicated otitis media. Going back to Osler at the turn of the 20th century, he correctly pointed out that "allopathic" drugs were often harmful -- but he then said both homeopathy and (classically defined) allopathy were "cults" that needed to be replaced. One doesn't need to turn to homeopathy to find best practices that avoid both overprescribing and underprescribing. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 21:59, 7 August 2010 (UTC)


::Remedy selection is highly individualised in Homeopathy, so if a person catches cold immediately after getting wet in the rain and if another person catches a cold only after getting wet in the rain everyday for 3-4 consecutive days, the remedy each would get would be different, because their susceptibility/immunity differs. Now having said that, there are enough refs in the article to show that Homeopathy is more effective than 'placebo'.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 08:19, 16 December 2008 (UTC)
::::Yup, absolutely agree. [[User:D. Matt Innis|D. Matt Innis]] 01:10, 8 August 2010 (UTC)


:::Gareth Leng, a responsible Editor, has ruled  that he will not approve a statement, in the article, that flatly says homeopathy is superior to be placebo. When an Editor has made that sort of content ruling at CZ, it becomes CZ policy for the article, unless it is overruled. It may be overrule in one of three ways: two or more relevant editors, the editor-in-chief, or the Editorial Council determines the ruling is wrong. 
== principle of infintesimals ==


:::There is little point in arguing it on the talk page. You need to take find two or more editors to overrule Gareth, get Larry to overrule, or take it before the Editorial Council. My own observation is the articles do not, paraphrasing Gareth, such superiority, establish an unquestionable superiority, but I understand the process well enough that if I disagreed with him, I would be starting an appeal, rather than continuing to argue the point. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 13:15, 16 December 2008 (UTC)
I'm thinking that [http://en.citizendium.org/wiki?title=Homeopathy%2FDraft&diff=100701656&oldid=100701655this principle] needs defining.  I'm thinking that the 'principle of infintesimals' is the concept that is controversial.  Perhaps one of our homeopaths could explain? [[User:D. Matt Innis|D. Matt Innis]] 12:32, 12 August 2010 (UTC)
:Throughout this article, the infinitesimal dose and law of similars have been used interchangeably, but they aren't the same. http://www.similima.com/org20.html has given a brief description of the "infinitesimal dose". The law of similars is just, "using the most similar remedy" - to put it plainly. I don't have the time to check and insert those changes, but I hope you Matt, or may be Dana can do so. The infinitesimal dose can also be defended with the "memory of water" and Monsieur Montagnier's research (see Dana's post above).-[[User:Ramanand Jhingade|Ramanand Jhingade]] 13:49, 13 August 2010 (UTC)
::Certainly using them interchangeably is not accurate. [[User:D. Matt Innis|D. Matt Innis]] 15:05, 13 August 2010 (UTC)
:::I think the term "interchangeably" was wrong to use - what I meant was that the term "law of similars" is used in the article and draft article, when it's supposed to be "the infinitesimal dose", in some places.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:50, 13 August 2010 (UTC)
::::So it seems to me that infinitesimal dose needs to be defined.  The law of similars can obviously involve large doses of products.  Obviously Homeopaths use more than infinitesimal doses in their treatments; otherwise we wouldn't have side effects from a nasal product that has zinc in it. We are not getting this point across. [[User:D. Matt Innis|D. Matt Innis]] 17:47, 13 August 2010 (UTC)


::::Just to clear up some things in Howard's comment: While I think two or more relevent editors would certainly apply some pressure, there aren't any rules that suggest that they can or cannot overrule another editor.  Currently, this is the status of the [http://en.citizendium.org/wiki/CZ:Dispute_Resolution#The_role_of_editors_in_conflict_resolution the role of editors in conflict resollution] in our editorial policy on dispute resolution.  [[User:D. Matt Innis|D. Matt Innis]] 14:13, 16 December 2008 (UTC)
::::<font color=red>I don't think it's worth the time, since that will also be criticized here (maybe you can use the web-site I mentioned above to do that). The nasal product, "Zicam" wasn't a homeopathic product at all, because it had milligram doses of zinc, which is against homeopathic principles. Homeopathic remedies start with mother tinctures and can go up to higher potencies (more dilute) from there.</font>—[[User:Ramanand Jhingade|Ramanand Jhingade]] 09:50, 23 August 2010 (UTC)


:::::Matt, I agree in principle that the rules don't specifically have a provision for overriding, I realize I had a special case in mind. If that unlikely event took place, I'm sure it would wind up in the Editorial Council or some quickly formed community response.
:::::Zicam was marketed as homeopathic, and licensed under special regulations applying to homeopathic products. Sorry, for legal purposes in the US, it ''was'' a homeopathic product. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:49, 24 August 2010 (UTC)


:::::As I read the Approval process, and I am not saying this is completely clear-cut, it would appear that two or more Editors could Approve an article even if another workgroup editor disagreed. I have no idea what would happen if there were only two relevant workgroup editors and they disagreed.  You are right that the policy could be more clear; this is my interpretation as an individual contributor. 
:::::<font color=green>I know it was, but it was against homeopathic principles.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:39, 25 August 2010 (UTC)</font>


:::::Nevertheless, I believe one point I made is valid: if a relevant Editor, such as Gareth, makes a content ruling and asked the Constabulary to enforce it, there is no real value to continue arguing it on the talk page. The rational course, at such time, would be to invoke an appeal process. Seriously, is that a fair interpretation? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 14:30, 16 December 2008 (UTC)
(undent) Please do not use color for emphasis.


::::::Ahh, I see why you made that assumption - ''it would appear that two or more Editors could Approve an article even if another workgroup editor disagreed.'' This is covered in the [[CZ:Approval Process#Overview]] where it explains that one editor may remove the ToApprove tag:
In the context of the  United States, your simple statment that it "was against homeopathic principles" is legally irrelevant, as the FDA makes the decision if something is to be regulated as a homeopathic preparation (or food supplement), exempt from a good deal of the regulation of other drugs, or if it is a conventional regulated substance. The FDA determined Zircam was homeopathic, and, while I suppose you might argue, in an article about homeopathy and the FDA, such an argument is irrelevant here. If you reject the argument that a governmental organization cannot make such decisions for a country, then I can argue that homeopathy can't be accepted as a national means of practice in India.   
::::::*''If another editor in the article's workgroup finds that the article is so objectionable that approval, in his considered opinion, should not be granted, then the "ToApprove" metadata is removed by this editor, who puts his reasons for this action on the talk page. (This is a fail safe rule, to prevent the approval of articles that are inaccurate or misleading.)''
::::::So there is nothing that dictates that two ediotrs can overrule another.  Otherwise, the policy seems to encourage discussions away from the article talk page, perhaps shifting to the workgroup talkpage/emails to editors/the appeals process which your last paragraph illustrates.  Hope that helps.
::::::[[User:D. Matt Innis|D. Matt Innis]] 14:58, 16 December 2008 (UTC)


::::::So are y'all suggesting I e-mail Larry, since there are enough refs in the article to show that Homeopathy is more effective than 'placebo'?�[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:30, 17 December 2008 (UTC)
With all things that it approves, the FDA depends on the manufacturer's application.  More is accepted is fact in a homeopathic New Drug Application that isn't required to undergo controlled trials. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:57, 5 September 2010 (UTC)


:::::::First, there are not enough references to say, generically, "homeopathy is more effective than placebo." There could be a reference that says that "homeopathy is, with high statistical confidence, superior for placebo in well-defined (e.g., ICD) condition X". Second, if there is a medically accepted treatment for condition X, it is unethical, under the Declaration of Helsinki, to do a placebo-controlled trial, with some specialized exception. The generally accepted standard of proof, when there is an accepted treatment, is that the experimental treatment is equal or superior to the established treatment."
== Answer to an "unanswered question": Popularity is no metric of efficacy ==


:::::::There is, incidentally, a difference between y'all and all y'all, :-) [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:25, 17 December 2008 (UTC)
Sorry, but the addition "The simple reason for homeopathy's growing popularity is because it works." is completely unacceptable without overwhelming evidence that it does work.  Were this to be accepted without sourcing, the logic could be applied to popularity of politicians, especially not in office, supporting the premises their programs work.


::::::::Ramanand, I'm not suggesting you do anything, however, if you are not satisfied with an editor's decision, [http://en.citizendium.org/wiki/CZ:Dispute_Resolution#The_role_of_editors_in_conflict_resolution this is one place where it is discussed]. [[User:D. Matt Innis|D. Matt Innis]] 18:36, 17 December 2008 (UTC)
I propose to delete this. Popularity is relevant to marketing but not efficacy. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:48, 24 August 2010 (UTC)


===measures of efficacy===
:Those questions were begging for an answer. If you delete my answer, you must  delete the questions preceding my statement as well!—[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:45, 25 August 2010 (UTC)


Joining the conversation rather late - I don't agree that this sort of issue should be deemed 'not open to discussion' - such language seems not merely regressively hierachical, not merely to stifle the free flow of ideas, but also to create scope for ill-thought-out and inappropriate views to be inserted in pages without the normal benefits of collective review and editing.  
::Your statement, unsourced, was not an answer. It was purely your opinion, phrased as informal commentary. Also, it is a rather sweeping opinion that goes to the heart of the article, with no evidence behind it. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:45, 25 August 2010 (UTC)


On the precise issue of homeopathy's benefits, it seems to me that there are legitimate benefits to treatments 'perceived' to work, even if 'in fact' they do not. That is to say, many 'conventional' medical treatments are counted as having a medicinal value even when statistical evidence shows them to not merely ineffective but actually associated with worse health outcomes! Healing Arts writers will know better than me the cases - but I might tentnatively point at heart disease in particular (whereconventionally tested and 'approved' drugs still result in worse health otucomes) and cancers.
:::While Howard is right in saying that "popularity" is not a metric of efficacy, popularity is (by definition) its own metric, and statistics about homeopathy's popularity now and in the past has a place in an encyclopedia.  Further, I give reference to a half-dozen
surveys that further verify that people who tend to receive homeopathic care tend to be more educated than those who don't.


A related example we might consider in passing, is the very plain example of broken wrists. These are treated in UK hospitals with 'rigid' repairs, surgery and pins included, but in China through manipulation of the wrists and tight bandages. Often homeopathic remedies will be added. The Western treatments have appallingly low success rates (in terms of return to normal use of the wrist) compared to the 'alternative'. Yet the language of this page in 'ruling out' any evidence of medicinal effect for homeopathy contributes to the perception that (say) someone who has broken their wrist will be better treated through surgical intervention in a UK hospital than through visiting a traditional Chinese doctor.
:::The following link to an article that I authored provides references to this information (please know that I am not suggesting that we link to this article but only to use the references in this article in our encyclopedia listing:  http://www.huffingtonpost.com/dana-ullman/homeopathic-medicine-euro_b_402490.html  [[User:Dana Ullman|Dana Ullman]] 19:14, 9 September 2010 (UTC)


My suggestion would be that specific claims here and elsewhere for health benefits can be justifiied through appropriate 'scientific' trials, or through 'user satisfaction' and surveys of actual effects and results. Ramanand's contributions (which seem to have been edited out largely?) on this are IMO relevant and should be incorporated.
::::''Post hoc, ergo prompter hoc?'' I can give even more studies that verify more people who drink milk become heroin addicts. Popularity is a principally a metric of efficacy -- of marketing. If it is significant here, Lady Gaga should be even more expert than Dana, and probably has a better figure. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:20, 9 September 2010 (UTC)


Secondly, conventional health treatments should be described and discussed in an equally sceptical way to their 'unconventional' ones. Any thoughts? [[User:Martin Cohen|Martin Cohen]] 14:17, 17 December 2008 (UTC)
== Allopathy ==


:::::Martin, as I was telling Ramanand, if you are not satisfied with an editor's decision, [http://en.citizendium.org/wiki/CZ:Dispute_Resolution#The_role_of_editors_in_conflict_resolution this is one place where it is discussed]. [[User:D. Matt Innis|D. Matt Innis]] 02:33, 18 December 2008 (UTC)
"Today, "allopathy" is used by practitioners of alternative and complementary medicine, like homeopaths, osteopaths, naturopaths, chiropractors and so on to refer to conventional, western medicine."


:::::: Thanks, Matt.  It seems one thing to deal with an author on a particular matter and then say 'end of discussion' - but the matter itself, in particular when it is central to the page, needs must remain open to discussion - or (IMO) we do not have a collaborative system at all. Can we clarify this matter? I've had no response to these points, which is as though they ARE 'banned topics' - would someone say that is the policy - if it is!
Since practitioners of conventional, western medicine rarely use the term, however, there's no good argument to insist on calling them allopaths. Yes, there are a few historical references, especially when talking of osteopathic vs. allopathic medical schools, but the term used by conventional western physicians tends to be...conventional western physicians.


:::::: I'd understand it better if the objection is simply that the issues ahve been 'done to death' already - but even then, new ideas need to be permitted and treated on their merits. [[User:Martin Cohen|Martin Cohen]] 13:06, 18 December 2008 (UTC)
Ramanand, if I refused to call you anything other than Jean-Paul, would that change your name? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:57, 24 August 2010 (UTC)


:::::::Martin, this community is your community, which means that you have input.  Citizendium's model is spelled out in the [[CZ:Neutrality Policy]], [[CZ:The Editor Role]], [[CZ:The Author Role]], [[CZ:Professionalism]] (to name a few).  The way I do my job is spelled out in [[CZ:Constabulary Blocking Procedures]].  The model is designed to be maleable according to community input through the forums and the [[CZ:Editorial Council]], and other projects are in their infancy (or in some case, prenatal) stages, such as the [[CZ:Editorial Appeals Committee]] and likely [[CZ:Judicial Committee]].  There is nothing wrong with Gareth making a decision from the outset, but I assure you that it has a history beginning with Archive1 and several reverts on the article page.  We encourage editors to make these decisions to avoid the type of metadiscussions from occurring on these talk pages and keeping work from progressing. That is not to say that you are discouraged from talking about it; you just have to do it through other means (the link I gave you before).  Please feel free to open those doors. If there is no workgroup there, by all means, please help us start one. (Also notice that Larry has already checked in - that was one of your choices in that link).    [[User:D. Matt Innis|D. Matt Innis]] 04:47, 19 December 2008 (UTC)
:Practitioners of alternative and complementary medicine, like homeopaths, osteopaths, naturopaths, chiropractors and so on refer to conventional, western medicine as "allopathy" even today. If you don't like it, you can add something like, "conventional, western physicians do not refer to themselves as allopaths".—[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:50, 25 August 2010 (UTC)


::Each profession defines what it calls itself. That is not the role of other professions. Would you accept the specific words "practitioners of conventional western medicine call homeopaths frauds?"  No?  Then why do you have the right to define a name, regarded by many as either historically inaccurate -- they don't use the principle of opposites -- or a sneering attack?. I wouldn't have the slightest objection if homeopaths called themselves Similarists, Hahnemannists, etc. -- but that is how they characterize themselves, not how they characterize others. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:44, 25 August 2010 (UTC)
===Ruling needed===
Mr. Jhingade reinserted "although osteopaths, homeopaths, naturopaths and other alternative medicine practitioners continue to call it allopathy." I will remove this unless an Editor says otherwise, as I believe it has been ruled that one discipline is not permitted to define a name for another. Shall I say "although biologically-oriented scientists consider homeopaths to be quacks? (noise made by the simillium of [[Oscillococcinum]], of course)"  At best, this might go in the [[allopathy]] article.


ps.[ note: this relates to the earlier, not the immediately preceding paragraphs - MC]
Osler deprecated both allopathy and homeopathy by the time of the Flexner report, although, somewhat earlier, he had attacked some of the drugs used by self-descibed allopaths.  I'd note the latter was 19th century.


And it seems to me that certain statements are breaching this principle: "It should not be necessary for me to point out that the article can neither endorse nor roundly condemn homeopathy.  The article does not take a stand; it presents both (or all) sides on all controversial issues it presents, and leaves it up to the reader to decide for himself.  The article does not endorse a position"[[User:Martin Cohen|Martin Cohen]] 14:31, 17 December 2008 (UTC)
Be very careful, incidentally, in using "osteopath" versus "osteopathic physician". The latter, in the US, does use "allopath" but in a very narrow context dealing with the history of schools. Undergraduate and graduate medical education from traditionally "osteopathic" or "allopathic" education is largely identical, although some additional manipulative techniques may be taught in ''some'' historically osteopathic programs -- or by qualified faculty in historically "allopathic" programs. Assuming equal certification,  with many boards merging, the scope of practice of DO's and MD's are identical.  U.S. osteopathic physicians do not use the term allopathy in regular practice. Indeed, I know a few that don't use manipulation or any special osteopathic methods. As an aside, in the state of Virginia, to perform acupuncture, one must be licensed as a physician; the two I used were, respectively an MD with a OMD degree from Vietnam and a OB/GYN certification from FACOG; the other was an DO internist board-certified in internal medicine.


:: I'm not going to extend this discussion; I've made an editorial ruling here that implements my understanding of Citizendium neutrality policy. The article should nowhere make an editorial statement affirming the efficacy of homeopathy, nor should it make an editorial conclusion denying efficacy; it should report the views of homeopaths (that their treatments are effective) and report those of conventional science and medicine (that they are placenbo effects), with attribution and leave it to the reader.
In the UK -- I can't speak authoritatively  for the rest of Europe -- osteopathy is indeed a CAM discipline and its practitioners' scope of practice is not the same as a physician.  


::If there is anything you think is in breach of this principle, be specific please.[[User:Gareth Leng|Gareth Leng]] 14:54, 17 December 2008 (UTC)
I would add that the opinions of naturopaths are irrelevant to this article.
::: Well, how about this section:


:::::The theory underlying homeopathy is not considered plausible by most scientists working in academic institutions in Europe and the U.S.A. ... The conventional view is that homeopathy, insofar as it has any effect at all, exploits the placebo effect - i.e. that the only benefits are those induced by the power of suggestion, by arousing hope, and by alleviating anxiety.
Could we please stop refighting this revert battle?  My impression is that rulings have been made.[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:30, 5 September 2010 (UTC)


::This seems exactly as it should be - the article is reporting the opinions of mainstream scientists and physicians and attributing the opinions to that group. If the article said "The theory underlying homeopathy is not plausible; homeopathy, insofar as it has any effect at all, exploits the placebo effect - i.e. the only benefits are those induced by the power of suggestion, by arousing hope, and by alleviating anxiety." then it would be expressing an editorial opinion and would be contrary to neutrality policy.[[User:Gareth Leng|Gareth Leng]] 16:14, 17 December 2008 (UTC)  
:Practitioners of alt. med. still call it allopathy (Look at the American Association of Osteopathic Physicians web-site, the National Center for Homeopathy web-site and so on). I'm sure Dana will support me on this one. I'm looking forward to a ruling too and I believe such a ruling will support the homeopaths' viewpoint, because this article is titled Homeopathy and not, "Criticism of Homeopathy".—[[User:Ramanand Jhingade|Ramanand Jhingade]] 08:44, 6 September 2010 (UTC)


::: The 'safety' section implies that  homeopathic remedies are responsible for some half a million deaths a year too! [[User:Martin Cohen|Martin Cohen]] 15:57, 17 December 2008 (UTC)
::If you are arguing from the perspective of the American Association of Osteopathic Physicians, you are either ignorant of the historical reason they do that, or deliberately making a false argument that American osteopathic physicians, as distinct from osteopaths in Europe, are in any way "alternative". DOs pass the same undergraduate and graduate certifications as MDs. I suppose I'll have to remind one of my DO friends, a world authority on field and disaster medicine, that he's "alt" and the surgeons shouldn't listen to him. If nothing else, there ''is'' a distinction between alternate and complementary.


That's nonsense, of course it doesn't; it says that the measles vaccination programme was followed by a massive fall in deaths; that's a fact, introduced to explain why conventional medicine considers anti-vaccination advice as irresponsible. [[User:Gareth Leng|Gareth Leng]] 16:21, 17 December 2008 (UTC)
::As far as the National Center for Homeopathy website, what part of "one discipline doesn't specify what another calls itself" do you fail to grasp?  I'm sure I can find medical sites that call homeopaths frauds and quacks; would you accept that designation? I'd have to go back into the archives, but I seem to recall that Larry ruled on this a long, long time ago. Dana does not have any editorial authority over what non-alternative practitioners call themselves.  


:: Well, Gareth, your overt rejection of discussion of this important, indeed central issue, seems to me to be wrong. I'm not sure that editors should be able to block general discussion of key issues - perhaps this would benefit from some exploration more generally in the Forum. As a 'philosopher', perhaps I can hlp spot where language is prejudicial to the neutrality policy we I'm sure accept, and where it falls short.
::If you think these comments are "attack on homeopathy", I refer you to the commentary of Dirty Harry Callaghan regarding the .44 Magnum. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 01:46, 7 September 2010 (UTC)


:::Yes, Martin, this is not the place to discuss policies. [[User:D. Matt Innis|D. Matt Innis]] 02:33, 18 December 2008 (UTC)
== Matt's reversions ==


::Secondly, if your policy here:  'nor should it make an editorial conclusion denying efficacy' allows statements like :"The theory underlying homeopathy is not considered plausible by most scientists working in academic institutions in Europe and the U.S.A. ... The conventional view is that homeopathy, insofar as it has any effect at all, exploits the placebo effect - i.e. that the only benefits are those induced by the power of suggestion, by arousing hope, and by alleviating anxiety. " then it is not one I have got the finer points of. I t seems to me to be inconsistent with the neutrality policy and I shall suggest an improvement here now. See what you think! But if you don't like the change, I think it would be useful, in a positive spirit, to then use this as a dscussion starter in the Forum to help us all understand how to implement the neutrality policy in practice. [[User:Martin Cohen|Martin Cohen]] 19:50, 17 December 2008 (UTC)
Matt, I see you have already reverted what I had added. I don't want to indulge in any "edit warring", so please restore what I had added. I have mentioned the reasons in the sections preceding this.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 16:20, 25 August 2010 (UTC)


::: This text looks messy left on the page as a footnote, although I think it 'could' be justifed there. But better would be on a page discussing vaccination policy.  
:Since you merely identify this a "Matt's reversions", it's difficult to what you specifically have in mind. Did Matt move the questionable material here for discussion?  If he did, then it's appropriate to discuss it here, within policy limits, before it goes back.


::::<ref> [[Measles]] is not a major killer in the western world, where most children are vaccinated at about two years old. However, in 1999 there were 875,000 deaths from measles worldwide, mostly in Africa. In 2001, a "Measles Initiative" was initiated involving the American Red Cross, UNICEF and the [[World Health Organization]], By 2005 more than 360 million children had been vaccinated, and the death toll had dropped to 345,000. <ref name=BBC2007-01-19>{{citation
:If he deleted without making it clear what he was deleting, or why he was making a Healing Arts Editor decision to delete it, he needs to put it here. Otherwise, you cannot simply demand that it be put back without consensus or an Editor ruling. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:51, 5 September 2010 (UTC)
| url = http://news.bbc.co.uk/1/hi/health/6276139.stm
| title = Vaccine drive cuts measles deaths
| journal = BBC
| date = 19 January 2007 }}
Adult [[herpes zoster]] infection is a reactivation of childhood chickenpox, affects 1 in 3 adults, and can cause chronic, severe [[neuralgia|nerve pain ("postherpetic neuralgia"} in 10-18% of cases, and eye involvement in 10-25%. Chickenpox immunization prevents this; a herpes zoster vaccine is now recommended for all adults 60 years and older. <ref name=MMWR-HZ>{{citation
| date =2008
| volume = 57
| pages =1-30
| title =Prevention of Herpes Zoster: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
| journal = Morbidity and Mortality Weekly Report
| first1 =R| last1 =Harpaz | first2=IR | last2=Ortega-Sanchez | first3 =JF | last3 =Seward
| |url =http://www.cdc.gov/mmwr/preview/mmwrhtml/rr57e0515a1.htm }}</ref> Childhood immunization against chickenpox prevents herpes zoster.</ref> [[User:Martin Cohen|Martin Cohen]] 20:29, 17 December 2008 (UTC)


:::::Martin--first, you say, "I'm not sure that editors should be able to block general discussion of key issues," thereby implying that Gareth ''had'' attempted to block discussion of key issues.  It is obvious to me, at least, that he had ''not'' attempted to do so.  Second, having worked with Gareth a fair bit over the last 18 months or however long it's been, I trust his judgment on neutrality issues very well.  Third, this whole discussion suffers greatly from a lack of clarity about ''what,'' precisely, you are disagreeing with Gareth ''about.''  What ''text'' is problematic?  Fourth and finally, ''if'' the entire exchange here concerns ''only'' whether the text beginning "The theory underlying homeopathy is not considered plausible" and ending "by alleviating anxiety" is neutral or not, then I am confused.  You have not made it clear ''why'' you think this text is not neutral.  I'm sure that Gareth and I would be very interested to know your reasons for thinking so, but I don't see that you have offered any reasons yet. For my part, I see nothing wrong whatsoever with the text.  It (I assume) factually describes a situation and, I imagine, even homeopaths can agree with it, grudgingly, even if they don't like the situation factually described: that homeopathic theory is rejected by most mainstream physicians.  It is also obviously important that we say this in the article, if it is true.  Of course, we should also make it clear in the article--whether we do now or not, I won't comment on here--that the mere fact that mainstream physicians do reject homeopathic theory does not mean that the theory is wrong.  Of course, anybody who blindly follows mainstream medicine will draw that conclusion, but that is their choice, not a conclusion we are forcing them to make.
:I'm in a hurry, but will make a quick reply. I hope Matt brings things here for discussion in future.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 08:38, 6 September 2010 (UTC)


:::::Anyway, Martin, if you can clarify why, precisely, you think the text is not neutral, then we can make some better progress here.  And please--let's have no more comparing of credentials about who has the right to declare what is or is not neutral; let's compare arguments instead. --[[User:Larry Sanger|Larry Sanger]] 03:54, 18 December 2008 (UTC)
== "Attack piece" ==


:::::: You are quite right Larry that we need to make clear that science is fallible, and to be aware that even if the reader accords authority to the opinions of scientists, arguments must be judged on their own merits. I hope that the article is moving to (very concisely) encapsulate the reasons behind the views of scientists, not merely asserting those views; please take a look at the Overview section. [[User:Gareth Leng|Gareth Leng]] 12:06, 18 December 2008 (UTC)
The statement "Some other researchers claim that there is scientific evidence that homeopathy helps in many problems and diseases[3]" was added with the edit note that "the lede can't be an attack piece."


==Avogadros==
The lede also cannot be a place where non-substantive opinion can be used to "neutralize" the main thrust of expert opinion. Again and again, it's been pointed out that CZ's current neutrality policy does not mean that equal emphasis must be given to each position.
Deleted the first use of this because it is repeated later, but mainly because the calculation given was I think wrong. Maybe someone can check mine - I think seawater contains about 35 g NaCl/litre, so the deleted footnote was incorrect.[[User:Gareth Leng|Gareth Leng]] 13:19, 16 December 2008 (UTC)
:It depends which sea. :) [[User:Chris Day|Chris Day]] 15:40, 16 December 2008 (UTC)
::I almost said that. It also depend, I suppose, if you make your molecular guacamole from Florida or California avogadros. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:47, 16 December 2008 (UTC)
:::California Avogadros, LOL, now that is funny, I don't care who you are :-D [[User:D. Matt Innis|D. Matt Innis]] 16:09, 16 December 2008 (UTC)


::::Yes that is droll. Salinity of 3.5% by weight is sort of standard for sea water. I compute that one spoonful gives 1/3 molecule NaCl per liter water after dilution by a factor 10<sup>&minus;24</sup>. Same order of magnitude.--[[User:Paul Wormer|Paul Wormer]] 17:15, 16 December 2008 (UTC)
I recommend deletion of the above statement as far too general, and, for that matter, worded in a manner that really doesn't counter but says "well, yes but..."  There's an old medical story about a radiologist who crawls, bloody and battered, into his emergency room.  Asked what happened, he said it was "consistent with being mugged."  Things in the lede need a bit more substance than "consistent with."  [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:19, 5 September 2010 (UTC)


:::::That's also the order of magnitude that Dana cites above in the [[#.22not_even_a_single_molecule.22_--_why_I_think_this_should_be_restored|not even a single molecule]] section. [[User:Chris Day|Chris Day]] 18:51, 16 December 2008 (UTC)
:I don't see any probs with that ref and I'm sure Dana, the only other Homeopath here will support me on that.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 08:34, 6 September 2010 (UTC)


Avocado's number has a very high calorie content, I think. (Glad to see us go off the deep end at times). [[User:Dana Ullman|Dana Ullman]] 03:34, 17 December 2008 (UTC)
== Similars and "allopathic drugs" ==


Avocado, Dana?&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:36, 17 December 2008 (UTC)
First, I contend there is no such thing, in modern terms, as an allopathic drug.  Got any references, such as Goodman and Gilman, that use the term? No, homeopathic texts don't get to define practices in general medicine. Taking a recent addition that I believe must be either radically changed or updated, I quote:


:Ramanand, hopefully this will be an enjoyable contribution. Avocados are a fruit that grow in semi-tropical areas of the United States; they may have another name or not grow in your region. Unusual among fruits, they are very high in fat content. California and Florida avocados look very different on the outside, although the inside is comparable. It was merely meant as a play on words. A low-calorie serving of avocado would have to use a good deal of dilution. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 14:59, 17 December 2008 (UTC)
:"Recent research has shown that some conventional drugs, which are normally used to do something, can do the opposite also - a rebound effect, similar to homeopathy's law of similars.<ref>{{cite journal |author=Kales A, Scharf MB, Kales JD |title=Rebound insomnia: a new clinical syndrome |journal=Science (journal) |volume=201 |issue=4360 |pages=1039–41 |year=1978 |month=September |pmid=684426 |doi= |url=}}</ref><ref>{{cite journal |author=Kirkwood CK |title=Management of insomnia |journal=J Am Pharm Assoc (Wash) |volume=39 |issue=5 |pages=688–96; quiz 713–4 |year=1999 |pmid=10533351 |doi= |url=}}</ref>
<ref>{{cite journal |author=Tsutsui S |title=A double-blind comparative study of zolpidem versus zopiclone in the treatment of chronic primary insomnia |journal=J. Int. Med. Res. |volume=29 |issue=3 |pages=163–77 |year=2001 |pmid=11471853 |doi= |url=http://openurl.ingenta.com/content/nlm?genre=article&issn=0300-0605&volume=29&issue=3&spage=163&aulast=Tsutsui |last2=Zolipidem Study |first2=Group}}</ref><ref>{{cite journal |author=Hohagen F, Rink K, Käppler C, ''et al.'' |title=Prevalence and treatment of insomnia in general practice. A longitudinal study |journal=Eur Arch Psychiatry Clin Neurosci |volume=242 |issue=6 |pages=329–36 |year=1993 |pmid=8323982 |doi= 10.1007/BF02190245|url=}}</ref>.
<ref>{{cite book | last = Reber  | first = Arthur S. | authorlink = | coauthors = Reber, Emily S. | title = Dictionary of Psychology | publisher = Penguin Reference | date = 2001 | location = | pages = | url = | doi = | id = | isbn = 0-140-51451-1}}</ref><ref>{{cite journal |author=Kales A, Soldatos CR, Bixler EO, Kales JD |title=Early morning insomnia with rapidly eliminated benzodiazepines |journal=Science (journal) |volume=220 |issue=4592 |pages=95–7 |year=1983 |month=April |pmid=6131538 |doi= |url=}}</ref>
<ref>{{cite journal |author=Lee A, Lader M |title=Tolerance and rebound during and after short-term administration of quazepam, triazolam and placebo to healthy human volunteers |journal=Int Clin Psychopharmacol |volume=3 |issue=1 |pages=31–47 |year=1988 |month=January |pmid=2895786 |doi= 10.1097/00004850-198801000-00002|url=}}</ref><ref>{{cite journal |author=Kales A |title=Quazepam: hypnotic efficacy and side effects |journal=Pharmacotherapy |volume=10 |issue=1 |pages=1–10; discussion 10–2 |year=1990 |pmid=1969151 |doi= |url=}}</ref>.
<ref>{{cite journal |author=Hilbert JM, Battista D |title=Quazepam and flurazepam: differential pharmacokinetic and pharmacodynamic characteristics |journal=J Clin Psychiatry |volume=52 Suppl |issue= |pages=21–6 |year=1991 |month=September |pmid=1680120 |doi= |url=}}</ref><ref>{{cite journal| journal =Pharmacopsychiatry | year =1989 | month =May | volume =22| issue =3| pages =115–9| title =Can a rapidly-eliminated hypnotic cause daytime anxiety? | author =Adam K | coauthors =Oswald I| pmid =2748714| doi =10.1055/s-2007-1014592}}</ref>"


== Mithridates ==
First, it's impossible to respond to this deluge of citations without any details. Second, for these to be "allopathic" drugs, based on the "principle of opposites", the papers must include that language. Do they?


Mithridates was King of Pontus, not a Roman emperor, so I've corrected that. However there appears to be some confusion in the classical sources as to whether he took poisons to habituate himself or whether he had a special antidote or ''theriac'' called "Mithridatum", supposed to have been rediscovered or improved by [[Galen]]. In any case I doubt that the story is much use as anything other than a metaphor. [[User:Richard Pinch|Richard Pinch]] 19:56, 16 December 2008 (UTC)
Second, it's a leap to equate a rebound phenomenon to allopathy; the dose-over-time, molecular control mechanisms, etc., are much more than "opposites". One of the classic examples of rebound, nasally applied vasoconstrictors, doesn't take place when the dose and duration are properly controlled. In general, if the vasoconstrictor is needed for long enough to cause rebound, use of antiinflammatories, such as corticosteroids, cromolyns, or antihistamines should be under active consideration to replace the  direct vasoconstrictor.


:I just put in a footnote about the Housman poem.  Also, I am gonna look up his actual name -- the VI in the middle seems weird to me. [[User:Hayford Peirce|Hayford Peirce]] 21:00, 16 December 2008 (UTC)
It was with considerable restraint that I didn't immediately move this to the talk page. Ironically, there are very pleasant, collaborative discussions going on in a number of military and history articles.  Maybe getting to kill people makes for more restrained discussion. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:04, 5 September 2010 (UTC)


::Funnily enough Mithridates VI Eupator ''is'' his "actual name". Why would you assume it wasn't?  [[User:Richard Pinch|Richard Pinch]] 21:15, 16 December 2008 (UTC)
:The rebound effect is well documented and accepted in medical circles, so please don't delete that sentence or the refs I inserted (I've improved on the way it used to read, so pls take a look).—[[User:Ramanand Jhingade|Ramanand Jhingade]] 08:31, 6 September 2010 (UTC)


:::Because I googled it and got very conflicting info; some hits call him that, others say he was *also* called that, others say a third thing altogether. I'm now turning the pages of my '''Webster's New Biographical Dictionary''', let's see what they call him. "Mithridates VI Eupator. Called the Great". Hmmm. That's pretty authoritative. Let's see, what my 1940 EB calls him. They call him "Mithradates VI. Eupator, called the Great". With an "a" in his name (they say that the "i" is commonly used but is incorrect). And, for some reason, a period after the VI. That's good enough for me -- I'll change it back. [[User:Hayford Peirce|Hayford Peirce]] 21:24, 16 December 2008 (UTC)
::Well documented? "Rebound effect' doesn't appear in the index of the standard textbook, ''Goodman and Gilman's The Pharmacologic Basis of Therapeutics (9th Edition)''. Now, as I have mentioned, the term "rebound" is indeed used in very specific contexts, such as the response of nasal mucosa to topical vasoconstrictors.  


== Over-the-counter ==
::"can lead to the opposite effect, when stopped - a rebound effect, which means they are following homeopathy's law of similars." is not especially an improvement. Of course there are drugs that have adverse effects when stopped inappropriately. Corticosteroids, selective neurotransmitter uptake inhibitors and opioids all come to mind. "Similars" have nothing to do with it, in the sense that a corticosteroid, in a Proving, would be inflammatory.  Instead, the adrenal cortex has reduced its production of endogenous steroids because it has sensed a certain blood level.


Gareth, do you have a total OTC sales figure for non-homeopathic medications, to put it in context?
::It's vaguely amusing to hear you comment about people ignorant of homeopathy, when there seem to be so many opportunities to be unaware of molecular pharmacology. But, there are different tastes -- where's the eye of newt and blood of bat when you need them? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 01:18, 7 September 2010 (UTC)


:: £1.2 billion total OTC in 1994, haven't found anything more recent[[User:Gareth Leng|Gareth Leng]] 18:14, 17 December 2008 (UTC)
==Dead link==
http://www.medscape.com/viewarticle/511604  Reference 102 about the value of talking to patients. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:08, 5 September 2010 (UTC)


Stray question: do you know the EU/EC or UK labeling requirements for OTC preparations? In the U.S., the normal FDA requirements are that all ingredients must be identified, on the package, with the standard nonpoprietary name. The box of [[Oscillococcinum]], however, only identified the active ingredient in Latinate traditional homeopathic terminology. Is that a universal exception for homeopathic remedies? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:01, 17 December 2008 (UTC)
:Then I suggest we remove the sentence attributed to Vandenbroucke.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 13:56, 6 September 2010 (UTC)


==The homeopathy-placebo ruling; some practical advice==
==Thankless CZ==
I don't think it's useful now to question Gareth's editorial ruling.  
Editing CZ is a thankless job. I'm sure the people who are ignorant about a subject (like Homeopathy) can move on to Facebook, Orkut, Linked in, Twitter or some other networking site/s and make a lot of friends and get to know them really well - we hardly know anything about each other here. Howard, you're probably a nice guy I can get to know better and probably dine with. Sandy, Im sure I can make an interesting 'date'. Why don't y'all look for me on Facebook?—[[User:Ramanand Jhingade|Ramanand Jhingade]] 13:56, 6 September 2010 (UTC)
:I have nothing against friendship, and I do think I've found a number of good friends here. Nevertheless, the essence of what I see as appropriate writing at CZ depends on courtesy, but above all, logic -- western if you will -- and evidence. I have a LinkedIn account, but not Facebook, Twitter, etc. -- and don't want them. On the other hand, I am very active on an assortment of professional mailing lists. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:50, 6 September 2010 (UTC)


You see, I just added [http://en.citizendium.org/wiki?title=Tests_of_the_efficacy_of_homeopathy&curid=100091447&diff=100424412&oldid=100420647 a research update] to one of the 2 ''other'' homeopathy articles ([[Memory of water]] is one, [[Tests of the efficacy of homeopathy]]‎ is the other). These two articles address the core issues of the scientific plausibility of homeopathy theoretically and clinically, respectively (they were part of the homeopathy article initially).
:: First off, I greatly doubt either of us would enjoy a date. 'Sandy' is a short form of 'Alexander', and I'm neither unattached nor gay.
:: Second, some of your other apparent assumptions are just as bogus. People generally aren't here for social networking, but to contribute toward building an encyclopedia. Nor does not being an expert on homeopathy preclude contributing.
:: I'm resisting the urge to write a more pointed reply because it would violate [[CZ:Professionalism#What_behaviors_are_unprofessional.3F]]. [[User:Sandy Harris|Sandy Harris]] 23:47, 6 September 2010 (UTC)


For now, ''this'' [[Homeopathy]] page tells that there is a majority of conventional clinicians thinking that homeopathy is no better than a placebo, and pro-homeopaths who think the opposite.
==Confusing deletions==
Those are facts, but presenting this as a useful way to deal with such a topic is biased.  
It's somewhat difficult to tell why things are deleted when the only reasons given are in edit notes, which aren't always easily accessible if, for example, minor edits follow them in the log.


The Journal of Clinical Epidemiology published a refutation of the famous 2005 Lancet (the meta-analysis claiming that homeopathy is at best a placebo). It used the same data and showed the opposite. The point is that you could have a number of competent epidemiologists agreeing that the Lancet study actually supported the superiority of homeopathy over placebo, it wouldn't change the "majority view vs minority view". We're dealing with mass behaviors; Martin would have a lot to say about this.
This was deleted, possibly due a claim that it was unsourced -- yet it is sourced. It's a reasonable statement and belongs in the article. <blockquote>This does not mean that that people treated with homeopathy do feel better as a result - the clinical literature clearly shows this, but Vandenbroucke suggested that this could be because its practitioners treatments spend more time with people than doctors do. "Even if people give you the wrong explanation about what you seek treatment for, the fact that they spend a long time speaking with you might help," Vandenbroucke suggests.<ref>[http://www.medscape.com/viewarticle/511604 medscape]</ref></blockquote>
So if neutrality in this Homeopathy article means presenting majority vs minority dichotomies, instead of going to the key issues:
*the controversy over the Lancet study,  
*the replication of Benveniste's study (see above, Madeleine Ennis),
*The media debunking that followed (see Dana's correspondance with Ennis)
*The materials science of water at the *mesoscopic* scale and Martin Chaplin's respected work,
*the placebo-independent studies in plants, animals and cell cultures,
*The publication bias against homeopathy,


... those interested will just have to move on and work in the background, since it's been put there by editors.
"Homeopaths contend that flawed trials cannot be used to show that homeopathic treatment is ineffective <u>(please read the previous paragraph for information about the positive trials)</u>."  This new sentence, especially the underlined words, is argumentative rather than informative. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:50, 6 September 2010 (UTC)</i>
--[[User:Pierre-Alain Gouanvic|Pierre-Alain Gouanvic]] 08:59, 18 December 2008 (UTC)


::: I've looked at the JCI paper; to call it a refutation is I think not true. Indeed the paper (from two homeopaths) confirmed that Shang's calculations were correct, they look at how the calculations are influenced by chosen cutoffs. What Shang et al showed was that the size of the reported effects of homeopathy diminished with the size and quality of the trials, so that if only the biggest and best trials were analysed there was no significant effect seen above placebo. What the JCI paper shows, (perhaps not surprisingly), is that this depends on the cutoff chosen; if, instead of counting just trials with more than 98 subjects (Shang's cutoff), trials with more than 66 are included, then there is an overall significant effect in favour of homepathy. The JCI authors say "This result can be interpreted differently. Following Shang's perspective it can be explained by small study bias (which includes publication bias). In contrast, one may hypothesize that Shang's result is falsely negative." In their conclusions they thus state "Our results do neither prove that homeopathic medicines are superior to placebo nor do they prove the opposite. " Perhaps the most interesting aspect of this paper is their analysis of variance in study outcomes. The outcomes were more variable than expected from a random distribution, so one possibility is that homeopathy is effective in some conditions not others. The JCI authors noted that four of the 21 best trials dealt with preventing or treating muscle soreness - these consistently found no benefits to homeopathy, so if it is accepted that homeopathy is not useful in this condition, the remaining 17 trials show an overall significant effect. However, the overall positive result "was mainly determined by the two trials on influenza-like diseases"
:I didn't do the above editing, though I support it.  Just because Vandenbroucke says that statement does not mean it is true, especially when there is at present no data to support it. This idea borders on the preposterous that the "extra" time that homeopaths spend with their patients leads to the therapeutic benefits that homeopathic patients experience.  If THAT were the case, then, psychologists would be our finest healers (and sadly, they are not). Although the first interview with a homeopath is typically an hour, the follow-up visits are usually 10-30 minutes, just a little longer than a conventional MD. 


:::Generally, for any statistical analysis to be valid, it must be guided a priori by a clear hypothesis - in most simple terms, if you have a sample population with different heights, you can't take the tallest 10%, compare their heights with the shortest 10%, and conclude they are significantly different. This is fundamentally the difficulty with selecting the two influenza trials (the top 10%) and the four muscle soreness trials (the bottom 10%), you just can't do this and expect the statistical conclusions to be sensible. (I'm simplifying; the JCI paper was more subtle, and they didn't claim that they can draw such conclusions, but raised them as a possibility). Shang's hypothesis was that all homeopathy is placebo effect; it's a hypothesis that, like all scientific hypotheses, can ''never'' be proved, but only tested - exposed to attempted disproof. Their hypothesis survived attempted disproof; this is how science works. It's counter-intuitive for non-scientists - we work by trying to show that our ideas are wrong, not by trying to show they are right.
:As for "flawed" trials, see my longer message in the next section where I talk about the importance of "internal validity" in trials AND "external validity."  [[User:Dana Ullman|Dana Ullman]] 01:09, 14 September 2010 (UTC)


:::It was ''never'' the case that the Shang study proved homeopathy was all placebo - and nobody should state it in these terms - what it showed was that the results overall from the trials analysed were consistent with them being placebo effects. The JCI paper says that they are equally consistent with some treatments (muscle soreness) being ineffective and treatments for influenza being effective. This seems fair. Overall, the results of trials do not provide compelling evidence for the efficacy of homeopathy, but leave open the possibility that it is effective in some conditions and ineffective in others.
==Dana Ullman's thoughts on this article to date==


:::Dana, do any homeopathy sites advise practitioners against treating muscle soreness on the grounds that treatments are ineffective?[[User:Gareth Leng|Gareth Leng]] 13:38, 19 December 2008 (UTC)
Sorry to be away from the article for so long...


I am very concerned about this present “draft” of the homeopathy article.  I feel that it has lost its “encyclopedic” tone, and instead, it is a mixture of encyclopedic information along with strong “point of view” skepticism.  Although I do not have a problem with proper skepticism, it is the tone of it AND where it is placed in the article that is critical. 


Each of these issues is interesting, and appropriate to explore carefully but to do so in a way that is clear and accurate will just take a lot of space and a lot of time. Pragmatically, this article is ''never'' going to get approved if these issues are introduced here. Arguments about statistical analyses get highly technical and are often irresolvable objectively - and in the end the bottom line is clear, scientists do not consider the evidence for efficacy to be compelling. Attempted replication of Benveniste's study is covered elsewhere and is disputed, Martin Chaplin seems a sensible person and I'm sure deserves respect as we all do; but don't imply that he's well known or highly cited or influential; he's an academic in a minor teaching University and not as far as I'm aware research active - and as far as I am aware he's an agnostic rather than a believer in homeopathy (I agree that agnosticism is rare among scientists). The memory of water explanation lapses on the key issues of a) how the structure in water could be detected (and how a mechanism for detection could have evolved) b) how a detection mechanism can be specific for the type of memory and then linked to a specific adaptive response and c) how the structure is preserved in pills without water. Thus the memory of water notions do not explain homeopathy, but at best would provide a possible small starting point. Placebo-independent studies - well there has to be some reality check here; there are several thousand journals in PubMed alone and this excludes many many shoddier journals. Now even in the best journals, ''many papers just get it wrong'' and virtually all studies (of everything) are flawed in some key way. Scientists do ''not'' take ''any'' study at face value - because they know of so many ways in which people can just get it wrong. They ''do'' read papers look for flaws and filter - the results of the filtering you can see for example by looking at citation data - is the paper regarded as sound and important - ''is'' it cited, who is it cited by, ''how'' is it cited - and what is it cited for? You can easily these days find ''every'' paper that has cited any published paper. We cannot here write a commentary on every published paper and its weaknesses but have to filter by impact and notability in some way. If there is enough reason to interrogate these studies then OK, but it will be a harsh blitz I'm afraid - but maybe needed. On publication bias - careful about the wording because publication bias technically refers to bias in favour of reporting study outcomes when they are significant and not when the outcome is not significant - this is a bias that favours reporting of positive outcomes. Bias against publishing papers from homeopaths - well its questionable whether it exists; hard to separate this objectively from judgements about scientific quality of the study.[[User:Gareth Leng|Gareth Leng]] 09:46, 18 December 2008 (UTC)
For instance, in the very top portion of this article are paragraphs #3 and #4 which are not encyclopedic in tone or content.


: I agree, Pierre-Alain, those are all good and worthy topics.  I hope that you can make some headway here.  I hope that you will begin to take a stab to a NPOV review of each item.  I think that it is not hard to summarize the recent Journal of Clinical Epidemiology review of research in a non-technical way.  As for memory of water issues, I'm glad that Gareth acknowledges that Martin Chaplin is a good objective source who is not an "advocate."  His website is reference-laden, and although he doesn't seem to conduct research himself, he provides the blessed service of reviewing objectively the research of others.  The challenge is to keep it simple (non-technical) and non-detailed, with links to the best references.  [[User:Dana Ullman|Dana Ullman]] 03:48, 19 December 2008 (UTC)
I will try to avoid doing “editing” the article myself.  Instead, I will propose here in the TALK section my ideas for what should be said, and I hope that those people who want to maintain a high-quality objective and encyclopedic article will make appropriate changes to the Draft.  Needless to say, I will not sign my name, as a Healing Arts Editor, to anything that does not maintain a certain objective tone.  And by “objective tone,” I obviously do not mean that this article should just a promo for homeopathy.


The major problem with this topic from my perspective is that once you open this door the whole article gets swamped with the discussions of mechanisms of homeopathy.  And given that much of this work does not generalize very well, and is contested, it detracts for where the focus of the article should be. As a reader i want the big picture perspective of homeopathy. Bring in too many details and the article is less enjoyable and IMO, less informative. [[User:Chris Day|Chris Day]] 03:59, 19 December 2008 (UTC)
:My sincere thanx for whoever re-formating my contribution so that we can communicate about them in bit-sizeable chunks.  Good work! [[User:Dana Ullman|Dana Ullman]] 15:37, 14 September 2010 (UTC)


:Following up on Chris' comment here, I think it is key and feasible not to limit the number of appropriately linked articles, so, for example, one gives the big picture of homeopathy. The possible mechanisms of homeopathy is a different topic at a different level of detail. Certain articles, as in many technical fields, may have to have (preferably stated) assumptions about the reader's background.
=== Dana on 3rd paragraph===
Ultimately, I recommend some changes in the 3rd paragraph…here’s what I suggest for replacement for this paragraph.


:There are the questions about publication and acceptance bias. There are questions, to which Gareth gave me an interesting U.K. government report link, about how to assess things that simply don't lend themselves to classical clinical trials.
::While many medical practitioners prescribe some homeopathic remedies, a significant majority of the scientific and conventional medical community (including a number of national medical representative bodies like the British Medical Association), consider homeopathy to be unfounded and pseudoscientific.[1] Skeptics of homeopathy insist that there is no plausible mechanism to explain how the remedies might work, given that many of them are so dilute that they contain not a single molecule of the active ingredient. However, homeopaths and scientists from varied specialties, including Nobel Prize winning virologist Luc Montagnier, assert that there are viable theories about how homeopathic medicines may act, though as yet, no one explanation has been verified.  Advocates assert that the homeopathic “principle of similars” is, in part, the basis for modern day immunizations, allergy treatments, and select other conventional treatments (ie, the use of Ritalin and other amphetamine-like drugs used to treat hyperactive children), while critics have compared it to sympathetic magic.


:I have started on an article, [[integrative medicine]], for which I have a fairly specific focus in mind, and I would hope people can collaborate in that focus. The article is intended to look at the current practice of interdisciplinary groups that consciously mix conventional and complementary disciplines, and, for that matter, exclude certain conventional and alternative methods. The article is focused on current practice, and I really would hope to avoid arguments about "well, why don't they include discipline XXX" &mdash; because I think it is useful to see how working interdisciplinary teams, trying for best patient health, use different disciplines. Incidentally, has anyone else noticed there is no article on [[nursing]], one of the most integrative approaches around (at the leading edge)? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:49, 19 December 2008 (UTC)
::: I wrote the current text. To me it seems accurate and encyclopedic, much better than either what it replaced or your suggestion.


==Martin's changes==
::: My "While the founder of modern homeopathy was a medical doctor, some modern medical practitioners do prescribe some homeopathic remedies, and some governments do recognise homeopathy as legitimate treatment" instead of your "While many medical practitioners prescribe some homeopathic remedies" gives more arguments favorable to homeopathy, but states them more carefully, your "many" seems dubious to me.
The Measles section I'm perfectly happy to see in a footnote; it's important to include because the issue of vaccination misadvice is probably the single biggest reason for deep antagonism to hemeopathy, but is tangential.


On the minor change that I reverted - here it's simple, the article is declaring the consensus view, not a suggestion. Is it the consensus scientific view? - well here we differ from Wikipedia because we have experts who should know what the consensus view is and I am one and other Health Sciences editors will correct me if I am wrong in this.[[User:Gareth Leng|Gareth Leng]] 09:21, 18 December 2008 (UTC)
::: My "the consensus of medical and scientific opinion is that homeopathy is unfounded." seems to me a simple statement of fact.


Good! I think the article conveys better now what I am sure was the original intention.[[User:Martin Cohen|Martin Cohen]] 11:18, 18 December 2008 (UTC)
::: I removed the claim that it is "pseudoscientific", which seems to me true but unnecessary here. Criticism is fine; gratuitous insults are not.


Re.Larry's question above and the role of Paracelsus - this question reflects the view one takes of homeopathy - that is to say, if one looks at it from a cultural and historical perspective or from a 'scientific' perspective  as a medical 'method'. To some extent then, yes there is more to be said about Paracelsus's role in medicine, but given the page's overall character, perhaps not here. In a few words - yes, one sentence will do! [[User:Martin Cohen|Martin Cohen]] 13:29, 18 December 2008 (UTC)
::: I do not think the British Medical Association or your "However, ..." or "Advocates assert ..." belong in the lede. The lede needs to be a simple summary of key points. The BMA, Montaignier and Ritalin might all be discussed later, but they do not belong here. [[User:Sandy Harris|Sandy Harris]] 03:34, 14 September 2010 (UTC)


Re. Matt and Larry and 'stifling debate' - I am not intending to reduce thhis to a personal matter - as far as I'm concerned Gareth , Howard, Dana and I are all 'trying' to reach the same ends... Apologies if I have implied otherwise!
Greetings, Sandy...we've not interacted yet...let's work together.  First, the claim in the present draft that "There is no plausible mechanism..." is false and has no place here.  There ARE plausible explanations, though simply none that have been confirmed. [[User:Dana Ullman|Dana Ullman]] 15:20, 14 September 2010 (UTC)


Re. Matt, above. Thanks, Matt.  My idea was that it seems one thing to deal with an author on a particular matter and then say 'end of discussion' - but the matter itself, in particular when it is central to the page, needs must remain open to discussion - or (IMO) we do not have a collaborative system at all. Can we clarify this matter? I've had no response to these points, which is as though they ARE 'banned topics' - would someone say that is the policy - if it is!
:: It depends on the interpretation of the word "plausible". Certainly there are explanations, but I'd say none are plausible. [[User:Sandy Harris|Sandy Harris]] 02:31, 15 September 2010 (UTC)


I'd understand it better if the objection is simply that the issues have been 'done to death' already - but even then, 'surely' new ideas need to be permitted and treated on their merits. [[User:Martin Cohen|Martin Cohen]] 13:29, 18 December 2008 (UTC)
: Sandy suggests above that my reference to "many physicians" prescribing homeopathic medicines "seems dubious."  Perhaps it would help if he re-read our article here where in the "Homeopathy in Practice" section gives some specific figures:  "In Europe homeopathy is practiced by many conventional physicians, including 30-40% of French doctors and 20% of German doctors. Some homeopathic treatment is partly covered by some European public health services, including in France and Denmark. In France, 35% of the costs of homeopathic medicine prescribed by a medical doctor are reimbursed from health insurance."...Clearly, the term "many" is not dubious. [[User:Dana Ullman|Dana Ullman]] 15:48, 14 September 2010 (UTC)


:Martin, perhaps I can put this into some perspective.  If you wanted to pursue a debate about a "cultural and historical perspective" on homeopathy, as you say, then given that the others here evidently don't share your understanding about this, I think you ought to try to explain your thoughts ''in more depth.''  Right now, as far as I can tell, you've just made a bare, and to me quite vague, assertion about a "cultural and historical" character of homeopathy, and complained that this is not well represented in the article.  I'm sorry, but by itself, this unadorned complaint is shrugworthy, and that is no doubt why nobody has responded much to it.  To rectify the situation, you might write several paragraphs that explain this broader view, and which might or might not be included in the article.  Then, you might offer some sources, credible to those who know about homeopathy, that explicitly or at least ''clearly'' endorse this broader view.  (Just as a data point, it obviously was not at all clear that the sources you offered above supported the notion that Paracelsus was the father of ''homeopathy'' per se.  As far as I can tell, you might say he was a precursor of homeopathy in about the same way that Locke was as precursor of the political thinking of the founders of the United States.  But you'll find many people disputing that Locke was literally a founder of the U.S.A.)  Just try to understand the situation, please.  When you, a philosopher like me, come to this venue where there are two practicing homeopaths (one of them a leading published authority on homeopathy from a homeopath's persective), a professor of physiology who knows a lot about homeopathy, a chiropractor who is also a healing arts editor, and someone who just happens to know a fair bit about medicine--and others!--have all been working for months on an article, and you start complaining that the article lacks certain legitimate perspectives, the burden is decidedly on ''you'' to explain the allegedly missing perspectives clearly and to provide adequate evidence of them. The burden really cannot be on others to guess at what you might mean, and to judge claims that are plainly ''not'' obvious to them (the experts, after all!) without any evidence.  The point here is that nobody is attempting to silence you or stifle debate.  If there has been a disappointing lack of response, my guess is that it is because the others feel they have not been given enough to respond to.
:: See the discussion under "unsupported assertions" above. Those claims do belong somewhere in the article, if they can be supported, but the lede as it stands seems to me a good summary. [[User:Sandy Harris|Sandy Harris]] 23:21, 14 September 2010 (UTC)


:Also, to everyone: ''please sign '''all''' of your comments!'' It's very annoying to have to figure out who wrote what. --[[User:Larry Sanger|Larry Sanger]] 15:28, 18 December 2008 (UTC)
: I have a question for Sandy and Howard and other skeptics.  At present, in this lede, there is the sentence: "To a skeptic, the 'principle of similars' is merely an appeal to sympathetic magic."  Out of curiosity, do you believe that there is a certain wisdom of the body?  Do you believe that the human organism tries to adapt to infection and/or stress by creating symptoms in order to survive?  If you answer YES or MAYBE to EITHER of these questions, then using drugs that mimic the body's defenses make sense, and as such, we HAVE to delete or change this ill-founded sentence.  Please also remember that the "high potencies" is only a part of homeopathy and that most homeopathic medicines sold in health food stores and pharmacies today are in small, material doses. It is inappropriate (and inaccurate) to assume that ALL homeopathic medicines are in doses beyond Avogadro's number. [[User:Dana Ullman|Dana Ullman]] 16:34, 14 September 2010 (UTC)


::Larry, I see that some people here are deleting names/signatures - I hope you can warn/ban them.
:: That sentence is fine. What we believe is not at issue. The paragraph is trying to summarise the position about homeopathy of skeptics and critics. I'd say that, if anything, it understates their revulsion. Granted, other parts of the article should give a much more favorable view, but the negative views should be there as well. [[User:Sandy Harris|Sandy Harris]] 23:21, 14 September 2010 (UTC)
::Martin, I got this quote from the Encyclopedia Brittanica at, 'http://www.britannica.com/EBchecked/topic/270182/homeopathy':-
<blockquote>practiced by Paracelsus ( in Paracelsus: Assessment. )
...for sin administered by mountain spirits. He was the first to declare that, if given in small doses, “what makes a man ill also cures him,” an anticipation of the modern practice of homeopathy. Paracelsus is said to have cured many persons in the plague-stricken town of Stertzing in the summer of 1534 by administering orally a pill made of bread containing a minute amount of the [pateient's excreta]... </blockquote>
I'm sure you can condense & insert it because it's a reliable source (of course you should mention that web-site as a reference).&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 08:29, 19 December 2008 (UTC)
::No problem I've added this - but on checking it seems this report comes from Paracelsus' own account, so I have ammended the wording.[[User:Gareth Leng|Gareth Leng]] 16:19, 19 December 2008 (UTC)


:::Excuuuuse me, friends, but using "excreta" is not the homeopathic principle of similars!  Although Edward Bach (the bacteriologist who experimented with homeopathy and who later developed the Bach flower remedies) used bacteria from stools and potentized them, this is a minor and little known series of homeopathic medicines.  It is not notable, and the sentence that Gareth crafted has no place here.  [[User:Dana Ullman|Dana Ullman]] 17:46, 20 December 2008 (UTC)
:::Individual belief is outside the scope of the article, but no, I don't think there is a "wisdom of the body", and, using the medical definition of [[symptom (medical)|symptom]], the body doesn't create any symptoms -- the mind does. Symptoms are subjective, and signs are objective. A sign may be evidence of a defense mechanism, but it's far more likely to be evidence of a disease process.


==Back to Paracelsus! Response to Larry's questions==
:::The great fallacy I see here is the assumption that proving-based drug mimic the actual defenses. The body's direct defenses against ''[[Clostridium tetani]]'' exotoxin in [[tetanus]] are immunologic. Those defenses are supported by administering synthetic tetanus immune globulin -- we learned to avoid the horse serum preparation as too risky -- to give initial passive immunity, and tetanus toxoid to build active immunity. These don't "mimic" the defenses; they '''are'''  the defenses.  The body really doesn't have defenses against the neurologic effects of the toxin, but benzodiazepines, neuromuscular blocking agents, baclofen and dantrolene provide what, I suppose, could be called "symptomatic" relief. Without getting into all the receptors, we have a pretty decent idea '''how''' these drugs reduce the spasticity; we don't need to go the route of finding similars.


Thanks Ramanand - another well-chosen suggestion in my view - but look Larry, and Gareth and Howard - you've made heavy weather of the Paracelus contribution so far, so I'd ask someone else to add this sort of information in.
:::I'm not opposed to using unusual explanations when there are no better ones. "Wisdom of the body" sounds like something for a Religion Editor. I do use complementary methods when I have some reason to believe in a favorable risk-benefit. As soon as I hear that something is risk free, alarm bells go off. There are always tradeoffs. I'm facing a terrible one now, as the American Veterinary Medical Association described euthanasia as a means of comfort care that has the side effect of death -- yet I have a beloved cat who has a greater will to live than any human I've ever encountered. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:56, 14 September 2010 (UTC)


And yes, it is hard to 'navigate'  on this talk page, I made that point earlier, but it's clearly 'more than my life's worth' to archive it myself...!
The text you are questioning is "There is no plausible mechanism to explain how the remedies might work, given that many of them are so dilute that they contain not a single molecule of the active ingredient. To a skeptic, the "principle of similars" is merely an appeal to sympathetic magic." I think that is OK as it stands.


To respond to Larry above - and my edit adding Paracelus - well, what was the problem with it? Larry, contributors to CZ do not need to make lengthy 'pre-edit' arrangements do they? My contribution was barely a line long based on the odd failure to mention Paracelus in the article. I expected this to have been corrected without complaint or controversy - yet it has led to endless wrangling! `None too friendly either..
It could be replaced with something that both states the skeptical position better and mentions that not everyone is skeptical:


As mentioned above, I suspect the problem is that the article is attempting to impose a narrowly Western interpretation of the science of the subject. That's not an accusation against the other editors/ authors, it is a 'suggestion' that despite the best intentions, things have gone amiss here and there. Not necessarily big issues either. I think the 'roots' of homeopathy have been downplayed, and the disputes about scientific testing overstressed. Larry, you say this sort of feedback is 'shrugworthy' and I should write a small essay on it instead! Well, I think we have two kinds of feedfback. One is a sentence long and may or amy not be right. The other is an essay and is equally debatable and takes everyone too long both to read and write. Summation is not a bad thing. If people are open-minded, they will consider my point. They don't need an essay with it.  
: To a skeptic, there is neither any solid evidence that homeopathy is effective nor any plausible explanation of why it should be, and the "principle of similars" is merely an appeal to sympathetic magic. Homeopaths, however, believe that they have good answers to these criticisms.


But I'm not asking to ''determine'' the nature of the page, only to be able to make suggestions - usually as edits to the page proper, for that is what a collaborative encylopedia is about - and offer feedback. I'm sorry to 'apparently' find myself and see other contributors being 'warned off' for doing the same - or do I misread things?
::Close.  Let me urge that [[sympathetic magic]] show as a wikilink, as it is not just a throwaway pejorative, but an anthropological term that shows up across many cultures. Consider dropping the "merely". When I wrote the article on sympathetic magic, it wasn't intended to disparage, but to explain a cultural pattern.


Larry, the fact' is that Paracelus is a noteworthy figure in the history of homeopathy. Even as I was being told flatly on the Talk page that he was 'NOT to be mentioned again", one of the Health editors was reinserting a reference. Nonetheless, the initial editing judgement was made to delete my original contribution in its entirety, rather than modify it. This, I think was wrong, and reflects something also wrong with the way CZ is operating. I suggest instead that when a contribution is made which is 'controversial' in one respect, that aspect is modified, and the rest of it, assuming that it is 'uncontroversial', is accepted. In the case of my edit, I reinstated the text modifying it to remove the 'controversial' claim (I'd say it is ambiguous, rather) that he is the 'Father' of Homeopathy to say this:
::Is it necessary to bring up both the Avogadro argument ''and'' similars in the lede, purely from a standpoint of complexity?  Yes, I understand that potentiation is an argument that can be countered with the Avogadro point, but similars seem more basic than potentiation in understanding the core argument of homeopathy. 


[[Paracelsus]] (1493-1541) is regarded by many as the 'founder' of homeopathy, and is also credited with popularising the theory  "of signatures". According to this, the medicinal use of plants is revealed in exterior signs such as colours or shapes.
::I am ''not'' trying to be argumentative when I say that arguing that the principle of similars is an equivalent or superior explanation, to a drug that was designed using molecular structure-activity relationships, is inflammatory. It's one thing for the homeopaths to say why their own preparations work, but it's pushing too hard to say that the homeopaths have better explanations for the drugs developed under different paradigms. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 02:46, 15 September 2010 (UTC)


Note that I changed the word 'Father' to 'Founder' and I inserted the word 'many'. I'm not saying that this edit was brilliant, the final word, etc etc, but I am saying that I modifed my modest contribution in response to the criticism of the first version. 'Founder' may have been WORSE than 'Father' in fact, but it was an attempt to deal with the objection.  I additionally added some examples to the Talk page (see Ramanand above too!) of people according Paracelsus a significant role. The Theory of Signature is discussed on the page (in the form of the related 'Law of Similars')  - again without reference to Paracelus. The text I thought went some way to correcting that too. I acted in a positive spirit of co-operation throughout and I can't see the encylopedia benefitting from the precedent advanced here - even now by Larry? - where contributors have to justify their material 'off the page' rather than make them directly.  
=== 4th paragraph===
I believe that the present 4th paragraph has NO place in the top section.  Discussion of the “possible dangers” from the patient or the doctor’s decision to not use conventional treatments has NO place here. If others wish to insert this information under its proper section, I do not have a problem, though we must then acknowledge:  Homeopaths respond to the possible dangers from using homeopathic medicines in replacement of conventional medical care by asserting that there are much greater dangers by using conventional medicines as a first method of treatment.


By editing the page directly, what has been the outcome?  A good 'compromise'has emerged, I think, in that Paracelus is allowed a role in the development of homeopathy, albeit a minor one, and the link between the theory of signatures and hoemeopathy is indicated, which others can expand on through a new page I am sure if they wished. In other wrods, the page has benefitted and improved from the process of collaborative editing of the page proper.
: It probably needs mention of the fact that homeopaths retort that conventional medicines may also have large risks. I'm inclined to think it does belong in the lede, since these risks are a basic issue about homeopathy. However, I don't feel remarkably strongly about that and would be interested in hearing other opinions. [[User:Sandy Harris|Sandy Harris]] 03:44, 14 September 2010 (UTC)


So far, the message here however is against direct editing of pages. Can I have some reasurance that that is not the intention?  [[User:Martin Cohen|Martin Cohen]] 13:57, 19 December 2008 (UTC)
::I would prefer to see it go unless the homeopaths present a statistical risk-benefit argument, based on modern medical practices, not 1900, that the hypothesis is true that the clinical outcome is better with homeopathic treatment than medical or no treatment. The risks of most medical treatments are quantifiable, as are the benefits, with the understanding that statistical aggregates do not apply to individuals.


:Martin, I didn't say there was anything wrong with your edit adding Paracelsus.  I don't claim to know anything about Paracelsus or have an opinion about the merits of anything you're saying about homeopathy.  I was responding to your own complaint that there a "cultural and historical perspective" on homeopathy is lacking.  I thought ''you'' were saying that this perspective would be added satisfactorily (to you) only if the article were rewritten or added to somehow, with far more than just the Paracelsus sentence. Or, as you now put it, the article suffers from a "narrowly Western interpretation of the science of the subject."  (I don't know what Paracelsus has to do with the non-Western perspectives, frankly.)  You responded to me by saying, "Larry, you say this sort of feedback is 'shrugworthy' and I should write a small essay on it instead!"  Sorry, but you are incorrect.  I did not say that ''this sort'' of feedback is "shrugworthy," but that ''a particular'' "unadorned complaint" was shrugworthy.  Which, I reiterate, it was.  Sorry, but it's true.
::There are any number of times I've chosen something with significant risk, because there was reasonable evidence the risk was greater than the benefit. Obviously, a cardioplegia solution that stopped my beating heart was risky, but the risk of not having the open-heart surgery was greater.  There was reliable data for risk at each stage of the procedure.   


:My point, which should not be at all controversial or even insulting, is that if you were to elaborate your complaint, so that people knew what you were talking about, then they might not shrug it off!  If you think that there is a problem about a "narrow Western interpretation" of homeopathy here, I'm afraid the burden ''is'' on you to give some of the information about the non-Western perspectives that are missing.  Since we are all volunteers here, with minds of our own, we cannot demand others to include some perspective they're not familiar with, or even agree to it if they are; but we do have the right to engage them in a dialogue, of course.  (And here, your collaborators may have been in the wrong in one or two instances.)  You say, "If people are open-minded, they will consider my point. They don't need an essay with it." But I'm not seeing evidence that they understand your point about non-Western perspectives, at least, in the first place. You have to elaborate that point at least ''some more,'' it appears, if you want them to consider it. Isn't that, well, kind of obvious?  And if ''all'' you want to do is to make a suggestion and offer feedback, and not persuade others, then apparently you've done that to your own satisfaction--right?  But your behavior here indicates that you don't just want to make suggestions and offer feedback, but that instead you want to persuade others.
::When other children would chant "your mother wears army boots," I'd point out that they were part of her uniform. The "medical treatment is more dangerous", without substantial data, rings equally relevant to me. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:34, 14 September 2010 (UTC)


:You say: "I'm sorry to 'apparently' find myself and see other contributors being 'warned off' for doing the same - or do I misread things?"  If anybody warned you off, the comment should have been deleted by the Constabulary with {{tl|nocomplaints}}. Show me where the warnings-off are, and I will delete them myself. In any case, consider yourself officially welcomed by the Editor-in-Chief. And you also say that someone told you that Paracelsus was "NOT to be mentioned again"--I can't find that exact quote on this page or in [[/Archive 8|/Archive 8]], so this apparently was not an exact quote, ''or'' it was (properly) deleted by the Constabulary.  As Editor-in-Chief, I hereby declare that you have the right to discuss Paracelsus on this talk page.  It is pointless to complain about this sort of thing.  Just know that anybody who presumes to warn you off, or instruct you that a certain subject cannot be discussed, probably doesn't know what he is talking about.
::: "I would prefer to see it go unless ..." is not clear to me. Are you saying that text on homeopathic rejoinders should not be inserted, or that we should follow Dana's suggestion and remove the current 4th paragraph from the lede? [[User:Sandy Harris|Sandy Harris]] 05:30, 14 September 2010 (UTC)


:You also say: "Larry, the fact' is that Paracelus is a noteworthy figure in the history of homeopathy."  Wait a moment--Paracelsus was a Western figure and perspectives on him are presumably not non-Western perspectives. Do you have two separate concerns, then, one about Paracelsus and one about the dearth of some (as yet undescribed) non-Western perspectives?
::::Unless the homeopathic rejoinder has strong statistical support, it should not be in the article. It's one thing if there is a formal risk-benefit analysis proving a hypothesis, but if it's no more than "well, medical treatments are dangerous," it's irrelevant defense. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 06:25, 14 September 2010 (UTC)


:You say again: "Nonetheless, the initial editing judgement was made to delete my original contribution in its entirety, rather than modify it. This, I think was wrong, and reflects something also wrong with the way CZ is operating." That's your opinion; I disagree.  If its removal was discussed, it was within the boundaries of acceptable practice on CZ.  Do we really need to keep talking about this?
In due respect, the formal risk-benefit analysis needs to go BOTH ways.  What evidence do you have for the "dangers" of receiving homeopathic treatment...and please do not give individual cases.  I do have access to numerous cost-effectiveness studies showing significant cost savings to people who utilize homeopathic medicines.  [[User:Dana Ullman|Dana Ullman]] 15:34, 14 September 2010 (UTC)


:You also say: "I suggest instead that when a contribution is made which is 'controversial' in one respect, that aspect is modified, and the rest of it, assuming that it is 'uncontroversial', is accepted."  That sounds reasonable.  I would hope that that is what we already do in most cases.  If we didn't do that in this particular case, probably somebody ''did'' make a very minor mistake--not a major mistake that merits going on and on about.
:Bluntly, it does not need to go both ways. Homeopathy is desperately trying to claim a place at the table in the face of enormous evidence that molecular medicine is effective. It seems your position is that homeopathy and medicine are of equal status and that every claim against homeopathy must be counterattacked by one about medicine.  If, indeed, homeopathy is so much an alternative to medicine, this is useless.


:You say:
:Incidentally, it would be wise for you to identify your financial interests in the promotion of homeopathy, such as (from http://www.homeopathic.com/main/bio_dana.jsp):
:*Dana Ullman, M.P.H. (Masters in Public Health, U.C. Berkeley) is "homeopathic.com" and is widely recognized as the foremost spokesperson for homeopathic medicine in the U.S.
:*Dana founded Homeopathic Educational Services, America's largest publisher and distributor of homeopathic books, tapes, software, and medicine kits. For 10 years he served as formulator and spokesperson for a line of homeopathic medicine manufactured by Nature's Way, one of America's leading natural products companies.


:In the case of my edit, I reinstated the text modifying it to remove the 'controversial' claim (I'd say it is ambiguous, rather) that he is the 'Father' of Homeopathy to say this:
:See Bob Badgett's developing article on [[conflict of interest]]. It is one thing for a practitioner to charge for professional services, but it is generally considered unethical for physicians to refer patients to testing facilities, publications, etc., from which they derive income.


:[[Paracelsus]] (1493-1541) is regarded by many as the 'founder' of homeopathy, and is also credited with popularising the theory  "of signatures". According to this, the medicinal use of plants is revealed in exterior signs such as colours or shapes.
:You are the one making the claims that medicine is so dangerous. I didn't make claims about ""dangers" of receiving homeopathic treatment", which is a change of subject. I will say, however, that it is dangerous to seek homeopathic treatment in lieu of medical treatments of established efficacy.  Now, that seems a backing-off from the dangers of conventional medicine, but there seems a dearth of such studies from sources not vested in homeopathy. Again, these studies need to be overwhelming to dispute the CZ policy of providing the mainstream view.  


:Note that I changed the word 'Father' to 'Founder' and I inserted the word 'many'. I'm not saying that this edit was brilliant, the final word, etc etc, but I am saying that I modifed my modest contribution in response to the criticism of the first version. 'Founder' may have been WORSE than 'Father' in fact, but it was an attempt to deal with the objection.
:"NPOV", incidentally, is WP-speak and discouraged here.  


:This looks fine to me as described.  You've just described what happens in the rough-and-tumble of collaborative editing.  The text as it is now is, I hope, fine with everybody.
:Incidentally, apropos of being encyclopedic, how about contributions other than your single subject? Some of us are interested in building an encyclopedia, not fighting a never-ending battle with single-issue advocates or, as Sandy responded to Ramanand, social networking. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:48, 14 September 2010 (UTC)


:A bit more from you: "...and I can't see the encylopedia benefitting from the precedent advanced here - even now by Larry? - where contributors have to justify their material 'off the page' rather than make them directly."  That's incorrect as a generalization.  ''Sometimes'' contributors do have to justify additions on the talk page first, but very rarely and only for good reasons, I would say.  On the one hand, you were in the right to make the addition to the page that you made, as you saw fit.  On the other hand, others were in the right to remove your addition and then ask you to discuss it and give more evidence.
:: Wow, Howard, you're now getting disperate...and I'm sorry to see this.  First, for your information, I was personally asked by Larry Sanger (the founder of Citizendium) to edit here, and he asked me to become a Healing Arts Editor.  I have never hid any fact about my background.  In fact, most people appreciate my knowledge and expertise, except those few people who are threatened by facts, research, references to data, and the substantiation of information.


:"So far, the message here however is against direct editing of pages. Can I have some reasurance that that is not the intention?" Of course, but I think it was hasty to draw the conclusion or suggest otherwise in the first place.
:: You and Sandy were asking me for "evidence" that conventional medicine has certain risks. While I could have laughed at this seemingly innocent (or naive) request, I simply responded by asking you to provide evidence that there was danger to homeopathic treatment. Instead of providing this evidence, you have chosen a different strategy to get your bias into this article.  Let's avoid such tactics...and let's try to work together to write something fair, accurate, verifiable, and encyclopedic. [[User:Dana Ullman|Dana Ullman]] 22:26, 14 September 2010 (UTC)


:Anyone who suggests that articles may not be edited directly and vigorously, and that ''all'' or even ''most'' editing must be done only after lengthy discussion, is just wrong. But then, I don't think that anybody was suggesting that here, frankly. I do agree with you, Martin, that some people might have been wrong in their attempts to "shoo you away."  Shame on them.  But is it ''really'' necessary to complain or discuss any more about this?
:::No, I don't believe it is possible to collaborate with you to write something that is fair, accurate, and is not far more supportive of the benefits of homeopathy than is supportable by the views recognized by the bulk of medical opinion and data. I believe the best I can do is point out evasions, selective and often inaccurate statements about pharmacology, misquotations (e.g., saying Sandy or I asked for "evidence" medicine has risks), and what I believe to be a significant conflict of interest. I do so in discussion here, to be sure other members of the community see it, rather than jump into revert wars.


:Can we stop the meta-discussion now, and turn to elaborating those unelaborated non-Western perspectives?  For my part I'm pretty sure this is all I'm going to be able to contribute to this page, unless something very dramatic happens... *groan* --[[User:Larry Sanger|Larry Sanger]] 17:34, 19 December 2008 (UTC)
:::I have never suggested that medical treatment does not has risks; medical treatment ''always'' has risks. What I find to be hand-waving is the implication that homeopathy has no risks, including the delay of effective treatment.  


:: Larry, thanks for going through all this, and I think, quite honestly, it's more about not knowing other people's style and methods than any great issue, worthy of so much attention! I'm reassured about the spirit of CZ and any further referencing/ explanation of the points above will just waste your time, so I won't offer any. As far as I'm concerned, the debate over this page has been rather fraught but nonetheless productive. But most of all, I agree, it's a good idea to bring it to a close! [[User:Martin Cohen|Martin Cohen]] 19:43, 19 December 2008 (UTC)
:::You will note that I have asked for an Editor ruling on what I consider continued misues of von Behring as an authority that homeopathy works. I find it sad that regardless of what was done to design a treatment, the data-free argument that similars ''might'' be an explanation continues to be brought up.


::::Hi Martin, as for archiving, you might have missed it when you went out of town, but Hayford did archive just after you asked for it [http://en.citizendium.org/wiki?title=Talk%3AHomeopathy&diff=100422658&oldid=100422652].  You are allowed to do this as well anytime you like. [[User:D. Matt Innis|D. Matt Innis]] 05:17, 20 December 2008 (UTC)
:::Larry Sanger is not a health professional, and, I suspect, asked you to be a Healing Arts Editor because you are visible in that field.  I would be much less antagonistic to your contributions were you to focus on what homeopaths believe and do, rather than the frequent -- and frequent inaccurate -- attacks on medicine, such as your condescending remark that there are no antifungal and antiviral agents of demonstrated efficacy, and, indeed, demonstrated risk. Indeed, the risk of unmodified amphotericin B has led to significant molecular work to reduce toxicity. You give the impression, however, that Hahnemann got it all right in the early 19th century, and medicine continues to get it wrong.  


:::::I was going to archive again, but some of the discussions are just coming to conclusions and I want to make sure everyone has the opportunity to follow-up. [[User:D. Matt Innis|D. Matt Innis]] 06:17, 20 December 2008 (UTC)
:::Professional collaboration does not require that participants like one another. It does not help when they are patronizing, and, if they can't take focused criticism without changing the subject, perhaps the kitchen of knowledge is a bit too hot. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:53, 14 September 2010 (UTC)


:::::Martin, Hahnemann has quoted Hippocrates supporting the idea of 'likes cure likes' (in the 6th edition of Organon), but no one here is going to accept either Paracelsus or Hippocrates as the Fathers/Founders of homeopathy.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 12:07, 20 December 2008 (UTC)
Howard, my concern about your editing is that you are just fabricating fights.  You wrote above that I said
"there are no antifungal and antiviral agents of demonstrated efficacy."  Where (!) did I say OR simply imply that?  Nowhere!  I even repeated my point that we all have to be careful in making broad statement such as the "collective weight of evidence". THIS is what I mean by "straw men."  You create arguments with yourself by making up what I say. 


::::::Some people here may be knowledgeable about Paracelsus, but in due respect, I wonder how much people who have been adding info about him here understand about homeopathy and what the "principle of similars" means (please note that I am just wondering; I am not saying something emphatic here).  My new concern is the statement in the article, "This led him, for example, to teach that the pricking of thistles cures internal inflammation, and is sometimes cited as an early form of the 'principle of similars'."  Unless someone explains to me the "thistles cures internal inflammation" is an early form of "similars," I will delete this unclear reference. At best, this is a crude and non-specific reference. Did Paracelsus assert that thistles cure all internal inflammation?  This is a overly simplistic assertion and has no place in THIS article. I will withhold deleting it right now, but it is likely that I will do so shortly. 
:Where did you imply that? In an unsigned entry following mine of    Howard C. Berkowitz 04:25, 14 September 2010 (UTC)
:''I am surprised and even a bit shocked to hear your assertion that antibiotics are effective for viral and fungal infections,''
:Obviously, I disagree, because I then listed numerous examples of antimicrobials effective against such infections.
:If you want to accuse me of starting fights with myself, I'll simply conclude that one of me will always win. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:38, 15 September 2010 (UTC)


::::::I understand that one of Paracelsus' real contributions to healing was that he was one of the first (perhaps the first) to use minerals as a medicine (previously, herbs/plants and animal were the primary medicines).  That said, this info has little place in this article and has a place on an article about Paracelsus.  [[User:Dana Ullman|Dana Ullman]] 18:05, 20 December 2008 (UTC)


:::::::Martin, after those two comments from Ramanand and Dana, our resident homeopaths, the burden is now clearly on you to show that there ''are'' homeopaths who regard Paracelsus as a father or founder of homeopathy.  Again, nobody is preventing you from offering this evidence.  Indeed, I'm specifically asking for it, and Dana is specifically asking for evidence/clarification on another point.  The mere fact that Paracelsus is mentioned in homeopathy texts does not come close to clinching the point. --[[User:Larry Sanger|Larry Sanger]] 18:10, 20 December 2008 (UTC)
To clarify (again), my point is not that there are no risks to homeopathic treatment.  However, IF we wish to highlight that there are certain risks to homeopathic treatment, we also have to acknowledge that it is widely recognized that there are much greater risks from conventional medical treatment.  [[User:Dana Ullman|Dana Ullman]] 03:43, 15 September 2010 (UTC)


===Final Arguments in the Case of Paracelus===
: Certainly we should say somewhere in the article that there are also risks with other treatments, and that one of the arguments for homeopathy is that many of its remedies are low-risk. However, "it is widely recognized that there are much greater risks from conventional medical treatment" strikes me as something an encyclopedia cannot subscribe to without a lot more evidence.


I 'think' that is an invitation to use the P-word again, having also been asked to not stir things up needlessly! So, with all efforts to be avoid stepping on expert toes, here is the point about Paracelus summed up:
: In any case, I do not think a detailed discussion of risk issues belongs in the lede. I am inclined to thin the lede should raise the question, and in my opinion the current text does that adequately. [[User:Sandy Harris|Sandy Harris]] 04:12, 15 September 2010 (UTC)


1. The central principle - as stated in the meta notes for this page - is
::I agree that a detailed discussion is out of place in the lede. If I may, I'll offer a fairly well-established risk of using homeopathic therapy as a first resort: [[myocardial infarction]] (heart attack). Assuming there are no contraindications to thrombolytic therapy, the window for optimal benefit from thrombolysis is 3-6 hours after onset, with declining benefit out to 12 hours. Thrombolysis can reverse the damage to the heart muscle if done within the window. I can cite any number of conditions where death can occur in hours or days  without definitive therapy--tetanus is one. Of course, the best treatment for tetanus is prevention -- and TDAP and other immunizations are not designed by the principle of similars.


"Alternative medicine that uses extremely small specially prepared doses of the drugs that cause the similar syndrome of symptoms as the person's illness."
::It's one thing to say that homeopathic remedies might be lower-risk in non-emergent situations, but that isn't what is being said. Of course, one could also say "it is widely recognized that there are much greater benefits, in serious conditions, from appropriate conventional therapy." No, appropriate conventional therapy does not, as been charged, extend to antibiotics for uncomplicated otitis media. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:38, 15 September 2010 (UTC)


This is the idea that prompted P to connect 'thistle scratches' with inflammation, and 'miniscule parts of plague excreata' with curing the illness itself. As noted already, the quote are in the historical origins section and illustrate the central homeopathic idea of 'like cures like'. It may not be 'homeopathic' in the current sense, but it has historical notability.
:::In due respect, no one (!) has said or suggested that homeopathic medicines should be a treatment of first resort for heart attacks.  THIS is what I mean by my concern for your tendency to create fights/arguments.  Let's both avoid creating straw men.  That said, I agree with Sandy that the lede should not have a detailed discussion of risks issues, though I would think that we might all agree that it is widely recognized that homeopathic medicines themselves are "basically safe."  Also, can I ask us all to try to avoid inserting our own comments within the comments of other writers because it makes it challenging for people to determine who is saying what.  Thanx.  [[User:Dana Ullman|Dana Ullman]] 16:51, 19 September 2010 (UTC)


2. Paracelsus popularised this idea, influencing Hahnemann. Pierre-Alain provided a quote confirming that:
::::If it's alternative medicine, then it is the first resort. If it's complementary medicine, then there should be guidelines for the scope of practice of homeopathy. In the past, however, Ramanand has said homeopathy should be a first reatment for all manner of conditions.  There was an extensive argument about acute asthmatic attacks, which, as I remember,


"Peter Morell (historian of medicine, with training in homeopathy and conventional biology), "Hahnemann and Homoeopathy". ... Hahnemann was reluctant to associate his new system of medicine with the name of Theophrastus or Paracelsus for fear of being misunderstood or being accused of plagiarism. (p. 15)... The truth is of course, that Hahnemann was a second Paracelsus, but he felt he had to hide this fact. (p.72)"
::::I am not creating a straw man. Please document when homeopathy should not be the treatment of first resort. Otherwise, I'll assume alternative medicine with no limitations.  


3. I do not especially wish to argue for P as either the 'Father' of Homeopathy -  or as a 'founding figure'. In response to Dana's request, I gave examples showing that 'some' people say he is the former, and others consider him the latter.  
::::Let me clarify my position. I would tend to say that homeopathic medications, themselves, are basically safe. I am very concerned that homeopa<u>thy</u>, as a system of treatment, can be as deadly dangerous as a non-surgeon trying an advanced surgical procedure. You have yet to give information that documents what limitations homeopaths accept.  


I also offered: ""The doctrine of signatures was a purely philosophical notion until Boehme's predecessor, the alchemist Paracelsus, had applied it to medicine ..." from page 27 of The American Institute of Homeopathy Handbook by Edward, M.D., D.Ht. Shalts"
::::Please stop with the straw man accusations. I do not believe that any consensus is possible between alternative (i.e., not complementary) medicine and coventional medicine. Actually, I'd be far more likely to consult a shamanic healer than a homeopath, as there's a fair bit of documentation that shamans have a good understanding of psychosomatic medicine. I don't know what consensus could exist between someone that rejects the idea of treating the pathogens of infectious disease, and someone that has an understanding of modern microbiology. We, sir, are not on the same side and will not be. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:24, 19 September 2010 (UTC)


As Pierre-Alain put it:
=== Rest of article ===
Further evidence of the strong POV and non-encyclopedic tone of this Draft is:


"My conclusion is that the influence of Paracelsus on Hahnemann, a very erudite person, was major. There are far more resemblances between P and H than this (signatures). Should we say "father of homeopathy"? perhaps, with a cautionary note."
--under OVERVIEW:  The first two sentences are “attack sentence.”  It is clearly inappropriate to provide critique of a subject before adequately describing it FIRST. Those sentences must be removed or placed elsewhere.


It is enough, in my view, to recognise he had a 'noteworthy' influence. Ramanand has provided several good points in this regard,such as that the Brittannica article on Homeopathy states that P "was the first to declare that, if given in small doses, “what makes a man ill also cures him,” an anticipation of the modern practice of homeopathy. "
: I'd say at least the entire first paragraph and probably the whole "Overview" section should be deleted. None of it is real overview of the field. [[User:Sandy Harris|Sandy Harris]] 03:50, 14 September 2010 (UTC)


[[User:Martin Cohen|Martin Cohen]] 18:43, 21 December 2008 (UTC)
:: I agree with Sandy.  There is no need for this "Overview" section, though I do believe that we need to place some of this information about the status and popularity of homeopathy in a section "Homeopathy in Practice." [[User:Dana Ullman|Dana Ullman]] 15:45, 14 September 2010 (UTC)
:Martin, please take this as a constructive suggestion. To quote one of your earlier comments, "problem is that the article is attempting to impose a narrowly Western interpretation of the science of the subject", that observation reminds me of a classic comment in the computer industry, "that's not a bug. It's a feature."


:So, I would agree that the article is attempting to impose a narrowly Western interpretation ''of the contemporary Western interpretation of the term '''homeopathy'''''. I see that as a good thing. In no way does that preclude having a separate article(s) on common historical features of signatures, similars, and other ideas, including Frazier's anthropological statement of the Law of Similars.  
-- under OVERVIEW: Some sentences here are just confusing, especially this one and especially its last phrase:  They are interested too in why some studies appear to have positive outcomes—do these reflect real efficacy, or can they be accounted for by flaws in study design or in statistical analysis, or "publication bias"—the tendency for small studies with chance positive outcomes to be published while studies with negative or inconclusive outcomes are not.


:Speaking from a computer and information science background, the fundamental idea of hyperdocuments (a superset of the World Wide Web, which is a superset of wikis, which is a superset of CZ) is that the reader can link to whatever level of background and detail as the reader desires. The full background and detail need not be replicated in each wikilinked article. As a technical book author, one of the challenges is how much detail I need to give in background, before referring to a reference the physical book reader may not have. That is ''not'' a restriction in hyperdocuments.  
-- under HISTORICAL ORIGINS, it is confusing and surprising how or why Paracelsus was described as an “astrologer.”  This field was not a primary area of his contributions.  Just as the bio for Isaac Newton does not describe him as an astrologer, even though he actually wrote more on THIS subject than on mechanistic physics, we editors here know that Newton’s primary contributions to the modern-day have nothing to do with astrology. Needless to say, people here who want homeopathy to sound “quackish” tend to provide this biased information.


:I believe it is fair to say that a reader using a wiki will usually want, as a first approximation, the most widely used current meaning of a term. Depending on the subject, there may well be some summary of history and philosophy, but the details do not need to be ''in'' the article. No one seems to be arguing that Hahnemann neither create the term homeopathy nor establish its basic western expression, which I see as the main focus of this article. Paracelsus and Hippocrates and others may or may not have been formative influences on Hahnemann, but this is simply not an argument over an original discovery.  If you want to see such an argument, look at [[human immunodeficiency virus]] and the roles of [[Luc Montagnier]] and [[Robert Gallo]]. ''That'' is the sort of thing where intense debate is appropriate: two contemporaries where there is debate about whether there were independent or derivative discoveries. Paracelsus and Hahnemann were not contemporaries. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:08, 21 December 2008 (UTC)  
-- under HISTORICAL ORIGINS: Inaccurate information has been provided about the present status of the word “allopathy.” There is a long AND significant modern-day usage of this term by conventional medical organizations, medical schools, and state and national governments. Evidence for this is at: http://en.wikipedia.org/wiki/Talk:Allopathic_medicine (see “Hopping's huge list of links).  Clearly, the term “allopathy” is still in extremely common usage, and it is simply inaccurate to say that it isn’t.  In this light, Osler’s quote has no meaning here, though it may have a place in the article on “allopathy.”
== Apropos signatures, homeopathic parallels, etc. ==


Hopefully to avoid some conflicts, I'm working on some other articles that may be of interest. Some may appear to overlap, and some are defined in a way that they really do not.
-- under THE LAW OF SIMILARS:  As much as I like the subject of “hormesis,” I do not associate its application with the law of similars nor do I know any reference to that. As such, the word “hormesis” has no place in THIS section.  We could replace this word, hormesis, with the word “pheromones” because these substances are known to have a powerful effect in extremely small doses AND it is widely known that pheromones from one species are only sensed by those of a “similar” species.


First, let me mention something I wrote after discovering something from a U.K. link that Gareth sent me: [[Bach flower therapy]].  Bach makes clear that he is ''not'' talking about [[homeopathy]], but does credit the British Homeopathic Pharmacopeia for the method he uses to create his "mother essence" or "mother tincture". He makes it clear, however, that he is not using the Law of Similars, and that he doesn't ultradilute. Why I thought it interesting, however, is that while he does not explicitly credit Paracelsus, he specifically uses the term "signatures" and also speaks of shapes, colors, etc. It might provide an interesting compare-and-contrast.
-- under CLINICAL TRIALS TESTING THE EFFICACY…
There are many sentences and paragraphs here that I could recommend changes, but I will emphasize those that are most important or most incorrect:


Another new article, which I'm still editing and creating -- there will be tables that are being rearranged -- is [[integrative medicine]]. This is a relatively new paradigm that I've sourced to a number of highly regarded medical institutions (e.g., Mayo Clinic, Johns Hopkins, Duke, Columbia) where they have a joint center where biomedically trained physicians and selected alternative practitioners collaborate. In that article, I am specifically trying to cover which medical and complementary techniques are being used together '''now''', and how the groups address such things as interactions, different paradigms, and possible interactions. I would appeal not to add arguments that "X,Y or Z" should be added, because I'm trying to describe current practices and their arguments for the choices they have made. Truly "alternative" systems that want their models used exclusively simply are not part of integrative medicine, but, hypothetically, if a patient had a chronic pain syndrome, the patient might, simultaneously have analgesics or muscle relaxants prescribed by a rheumatologist, a homeopathic remedy that the homeopath and physician agree is compatible, acupuncture, massage with essential oils prepared by an aromatherapist, etc.  All these practitioners have agreed, in their model, that the combination could be safe and effective, although it will be closely monitored. I am going to be discussing the paradigm these practices use, and I'd appreciate not trying to superimpose other paradigms or disciplines they "should" use.
I recommend removal of the following short paragraph & its accompanying quote.   


One striking contrast is that they have a great deal of [[nursing]] involvement, which, by and large, is not discussed anywhere on CZ. Columbia's center, indeed, is part of their School of Nursing. There is a strong movement in the nursing profession toward wellness and chronic disease management, with their focus not being on "cure". [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:38, 19 December 2008 (UTC)
::While many of these have indicated positive effects, generally, trials that are larger high-quality trials have tended to show little or no statistically significant effects, as was concluded by the authors of the second Lancet study cited above when they re-analyzed these trials.  
:: “There is increasing evidence that more rigorous trials tend to yield less optimistic results than trials with less precautions against bias.”[98]


{{freshstart}}
My explanation:  First, the quote does not verify the sentence it is supposed to substantiate.  Second, the article it quotes also asserts that it is a general finding in ALL clinical research that the higher quality trials tend to show less positive results.  Third, the fact of the matter is that there are many high quality trials published in “high impact” journals that have shown statistically significant effects, including the four trials by Reilly, et al, the four trials on the treatment of influenza using Oscillococcinum, and the three trials on childhood diarrhea by Jacobs, et al.


:I'm not sure of the problem here, but the only reason I mentioned this is to let people know of a related article being developed, [[integrative medicine]]. Gareth gave me a U.K. government report on CAM, and I have been creating brief articles for all the CAM disciplines that the report lists. Bach flower therapy, of which I freely admit I had never heard, was one of them. I summarized information from the Bach site into an article, then did some quick literature searches, and didn't plan to do anything else.
We need to be careful in our review of research to avoid skewing the facts with “fudge” words.  For instance, one could say that the “collective evidence” of the thousands of studies conducted by Thomas Edison was that electricity was not possible (because only ONE experiment in 1,000+ worked).


:Since the Bach page does specifically speak of following British Homeopathic Pharmacopeia methods to produce mother tinctures, but then explicitly uses them in a non-homeopathic way, it struck me that homeopaths might be interested in the article. I have no particular views on the subject. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:34, 20 December 2008 (UTC)
The challenge that we have in describing the efficacy (or lack of it) using homeopathic medicines is that we have to evaluate internal validity (how “high quality” were the trials?) AND external validity (is the specific medicine tested commonly used by homeopaths to treat people with that specific condition?).  Skeptics of homeopathy tend to evaluate the internal validity issues and totally ignore the external validity issues…and BOTH are essential. To ignore external validity is akin to saying that antibiotics do not work for infections because the “collective weight” of studies on viral, fungal, and bacterial infection shows that these drugs do not work for this common group of diseases. Get it?


==Done for now==
:No. I don't get it, because I can demonstrate, ''in vivo'' and ''in vitro'', that antibiotics do work for viral, fungal and bacterial infections. This is hand-waving and hardly encyclopedic.
My concern has been to get this article in a swift state for approval so that we can all relax and get on with other less heated things - including the many related articles that should appear and which should be less problematical. As I see things, this article is "about there" - I've inserted an example proving - I've done my best with what I could find, I chose bamboo jusy because I could find two commentaries on the proving, both of which declared it as exemplary. I've tried to stay close to the words of the reviewers. But the example may not be representative, I wouldn't know. I've trimmed and revised the testing section, including at the end what I think is a clear statement of homeopathic objections. I've added an Overview section, mainly from a scientists's perspective (I can't really help that) but acknowledging the fallibility of science. I've also extended the bibliography and external links. I've added references and detail as I found them for things that I thought needed checking, and the process of checking has led to occasional revisions. I would prefer it if the article had at least one or two illustrations, but I am not competent in that sphere.


I've tried to nudge the prose to be clear and direct natural language rather than technical language or jargon. Basically I've followed the rule "if it's not obvious to me what something is saying then it must be changed". So, I'll stand back now, and watch.[[User:Gareth Leng|Gareth Leng]] 22:53, 19 December 2008 (UTC)
:I have repeatedly challenged you to respond to why homeopaths seem uninterested in the sort of trials used for customized pharmacogenomic medicine, which do have internal and external validity, and never have gotten an answer. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:25, 14 September 2010 (UTC)
===Great job===
It's in far, far better shape. There are a few places where edits may have lost some transitional words, and I will provide those soon. Just to avoid edit conflicts, I'm not going to make even the typographical edits.
====Section: Homeopathic manufacture of remedies====
*may I suggest that (preferably) the very visually impactful but incomplete table of four representative remedies be removed, and perhaps replaced with a link to appropriate online references? I assume, but am not certain, that would be a ''materia medica'', and I have seen several links.
*The 3,000 remedies seems to have gotten separated from the text in the 5th (last) paragraph of ''Conflict with conventional medicine''. See below.
====Section: Similia similibus curentur : the law of similars====
*typo: should be analogous
*Given that there's only a small amount of text before the subhead, I do think "Homeopaths consider that two conventional concepts, vaccination, and hormesis, can be considered as anal<u>a</u>gous to homeopathy's law of similars and the use of small doses." needs a note that these analogies, for technical reasons mentioned below, are not accepted by mainstream sciences.
====Section: A typical homeopathic visit====
There were, I thought, some references that indicated patients of homeopaths were especially satisfied with the quality of the interaction, and this should be noted. Now that the times of the initial and subsequent visits have been noted, I wonder if it might be observed that many conventional physicians, if they are freed from economic pressures, prefer those ranges as well.  Recognizing that anecdote is not the singular of data, my personal experience is that the physicians I've found do best often do a 45-120 minute first visit and 5-20 for followups, the latter when no procedures are involved.
====Section: Conflict with conventional medicine====
*5th (last) paragraph: the numbers of conventional drugs here were originally a compare-and-contrast made with 3,000 remedies, and were making a point that conventional physicians do individualize and have a wide range of methods, especially when polypharmacy is considered, to do so. This should either move up to ''Manufacture of homeopathic remedies'' or the 3,000 remedies should move here, but I did see them as an appropriate description of the compare-and-contrast.
*Gareth, there is good discussions on alternatives to the classic [[randomized controlled trial]]s in the Parliamentary report link you gave me, <nowiki><ref name=UKselect-summary>{{citation
| url = http://www.parliament.the-stationery-office.co.uk/pa/ld199900/ldselect/ldsctech/123/12315.htm
| author = Select Committee appointed to consider Science and Technology, U.K. Parliament
| contribution = Chapter 7: Research and Development
| title = Science and Technology, Sixth Report, Complementary and Alternative Medicine
| date = 21 November 2000
}}</ref></nowiki>  That might be very good to work in here.
====General====
Without looking at the metadata, I thought the original language variant was AE, but, not surprisingly with Gareth's work, it's now tending more toward BE. When any more substantive changes are made, may I suggest that we decide on one or the other, and do an appropriate copy edit?
[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:40, 19 December 2008 (UTC)


The language is American English.  This is not something we have ever changed in an article just because somebody made a lot of edits without consideration of the language variant we're using. --[[User:Larry Sanger|Larry Sanger]] 05:54, 20 December 2008 (UTC)
:: I am surprised and even a bit shocked to hear your assertion that antibiotics are effective for viral and fungal infections, but I have no interest in arguing with you about these subjects here, though these strange assertions may influence your credibility with others.  I take much more seriously your unfounded assertion that homeopaths are not interested in research that has internal and external validity. What is your evidence here? 
:Fine. Just didn't know which direction to copy edit. Thanks. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 06:07, 20 December 2008 (UTC)


::Shouldn't that be "Juss dang know wutt direction ter copy edit?"[[User:Gareth Leng|Gareth Leng]] 09:03, 20 December 2008 (UTC)- Please Howard, go ahead and fix whatever seems appropriate (including the points above)[[User:Gareth Leng|Gareth Leng]] 14:37, 20 December 2008 (UTC)
:::Shocked? Now, if you are holding to the generally obsolete assertion that antibiotics are purely natural products, that's one thing. Let's see...viral? Neuraminidase inhibitors for influenza (as well as the older amantadine and rimantidine), ribavirin for Lassa fever and possibly other hemorrhagic fevers, protease inhibitors (as part of HAART) in lowering HIV levels...well, interferons might or might not be considered antibiotics, but have distinct roles in treating viral diseases. Fungal? Amphotericin B (amphotericin B lipid complex, amphotericin B cholesteryl sulfate, and liposomal amphotericin B); the conazole series; griseofulvin; flucytosine -- and that's not considering topical-only agents. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:07, 14 September 2010 (UTC)


::I don't mind making the changes, but I would ask for some assistance. My thought is that it would be better to replace a remedy table with a link to an online homeopathic source; I see several materia medicas online but I would like an expert recommendation on which to use.
::::Howard, you're missing my point here. My point is that one must be careful using the term "weight of evidence" because such terms group together various disparate treatments for various disparate conditions.  Although I used the term "antibiotics," perhaps I should have used a name of a specific antibiotic, thereby showing that it may be effective for one type of infection but not for "all types" of infection.  Likewise, testing homeopathic Arnica for one ailment may prove efficacious, but testing it for two other ailments might show that it is ineffective. One should not say that the "weight of evidence" is that Arnica is not effective.  Instead, it is more accurate to say that Arnica is effective one condition but ineffective for two others.  Get it now?  I hope so...


::Apropos the sections under "Homeopaths consider that two conventional concepts, vaccination, and hormesis, can be considered as anal<u>a</u>gous to homeopathy's law of similars and the use of small doses.", my preferences would be to delete the details completely. The sections on vaccination and mithridization are more argumentative than neutral, I think. Do you think they should stay?
::::My intention is not to "fight." My intention is for us to work together to provide verifable accuracy. [[User:Dana Ullman|Dana Ullman]] 22:37, 14 September 2010 (UTC)


::The other changes seem straightforward enough. Since the visit lengths were stated in ranges, I don't see a conflict between homeopathy and what is considered good practice of medicine. When a conventional physician always sees everyone for six minutes, that's usually an economic or business issue; few physicians would recommend it. Since homeopathy, in many countries, does not have third-party reimbursement, the patient and clinician are more likely to agree on adequate visit length, than a physician employee working under a capitation model of reimbursement. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:51, 20 December 2008 (UTC)
:::::Now I am confused. When you challenged fungi and viruses, it seemed you were challenging the existence of antimicrobial agents (a better term than antibiotic) for those organisms. I gave counterexamples.  


== content cleanup edit ==
::::No person with reasonable competence in [[infectious disease]] suggests there exists Panaceamycin, good for everything, any more than, presumably, Arnica is good for everything. Antimicrobial agents have reasonably well defined spectra, but, since they are directed against mutable living organisms, any competent hospital has a table ("antibiotogram") of the preferred agents for community-acquired and hospital-acquired infections ''in that locality''.


This sentence was purposely edited to include the word kingdoms. I'm not sure that it is accurate to call minerals a part of a kingdom, but it looks like a content decision rather than copyedit, so I just brought it here.
::::Now, does the "weight of evidence" support appropriate antibiotic use? Yes! "Appropriate" does not include using antibiotics for self-limiting conditions unlikely to be affected by any antibiotic. Appropriate means considering the overall clinical picture -- sounds like the argument you make about syndromes -- such as not using penicillin G for exquisitely penicillin-sensitive streptococci, if the culture shows coinfection with [[Staphylococcus aureus]] or other penicillinase-secreting organism. One has to consider potential development of resistance, as well as the practical means of administration--if there is no one qualified to inject a parenteral antibiotic in home care, the antibiotic is irrelevant no matter how effective it may be against the organism. If there's a choice in a patient with a hearing loss, you avoid the especially ototoxic aminoglycosides.  


*Other remedies are derived from the mineral and animal kingdoms.  
::::Incidentally, I was just scratching the cognitive process in determining how to treat an infection. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:03, 15 September 2010 (UTC)
[[User:D. Matt Innis|D. Matt Innis]] 06:43, 20 December 2008 (UTC)


:Wasn't Elvis the King of Rock? (yes, I had wondered about that as well) [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 06:45, 20 December 2008 (UTC)
:: Just as doing double-blind and placebo controlled research testing surgical procedures have their methodological and ethical challenges, research on homeopathy has to be sensitive to the method itself.  You cannot just test a homeopathic medicine and its effects on a bacteria in a petrie dish, nor can I test acupuncture by putting a needle in a petric dish full of bacteria.  You've been told this many times in the past, and yet, you repeatedly feign ignorance about homeopathy and homeopathic research.  Please...you're a smart guy. Let's discuss research that does exist.  [[User:Dana Ullman|Dana Ullman]] 15:59, 14 September 2010 (UTC)


I inserted the word Kingdom to show that it is not the whole animal that's used in some Homeopathic remedies made from animal products (it used to read......made from animals).&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 12:38, 20 December 2008 (UTC)
:::I repeat: there are usable methods that have been described for pharmacogenetic medicine. Let the clinician diagnose the individual treatment and send orders for it to the pharmacy. The pharmacy breaks the blinding code and dispenses either the ordered individual treatment or the control arm, the latter which may or may not be placebo. The safety committee monitors, and, assuming the study goes to completion, statistically evaluates the hypothesis that the experimental treatment arm is superior to control.


:Yes, there is a mineral kingdom, and the word "kingdom" is a good one. [[User:Dana Ullman|Dana Ullman]] 18:13, 20 December 2008 (UTC)
:::Incidentally, the piece of laboratory glassware is a Petri dish. If, however, you are referring to bacterial sensitivity testing, production tends to be done with radiochemistry, radioimmune reactions, or immunofluorescence. Consider me dumb since I don't know I'm feigning ignorance about homeopathy. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:07, 14 September 2010 (UTC)


::Who uses "mineral kingdom"? I have not heard of this usage and have always found the "mineral and animal kingdoms" section a bit confusing. [[User:Chris Day|Chris Day]] 18:18, 20 December 2008 (UTC)
:::"I've been told"...but by someone I find plausible? You have yet to answer my question about the cognitive process of a homeopathic session, claiming that only a homeopath can understand it, yet no medical discipline makes such a claim of inner mysteries. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:07, 14 September 2010 (UTC)


:::OK, I did a google and found the term used in quite a few general articles ([http://www.sciencedaily.com/releases/2008/11/081113181035.htm one example]).  So it should be fine. [[User:Chris Day|Chris Day]] 18:30, 20 December 2008 (UTC)
::::Howard, I am perfectly able to describe the cognitive process of a homeopath, but I don't think THAT has a place here.  I've told you this before (many times!), and yet, you repeated request it. I'm writing this again because it seems that you don't want to remember. Sadly, you consistently seem to want to pick a fight, and you make these strange claims about homeopathy and homeopaths without evidence.  To me, it just seems that you have a chip on the shoulder. I have no problems with you making verifiable statements or asking questions, but I do have a problem with you creating boogey-men when none exist. 


::::Oh, good, glad I asked! I guess I could have done a google search, huh.  My bad. [[User:D. Matt Innis|D. Matt Innis]] 01:09, 21 December 2008 (UTC)
:::: I will say this: homeopaths usually prescribe their medicines for the overall "syndrome" of the patient, not just their "disease." [[User:Dana Ullman|Dana Ullman]] 22:46, 14 September 2010 (UTC)


===Pending issues?===
:::::I keep repeating it because you keep refusing to answer it, which I remember very well. Apparently, homeopathy is unique among healing arts and health  sciences in not addressing cognition in practitioners.


I think the page is a lot better than it was even two weeks ago, but not ready by any means. Here are some suggestions.
:::::I suppose that if I can't do better than century-old immunology and pronouncements that regardless of the molecular pharmacology that went into developing a drug, our old buddy similars ''might'' be the real explanation.  


The section 'historical origins' is inadequate - we only recently added in Paraceluss (sorry, yes him again) but there are other pre-Hahnemann figures and cases to note, particularly as we discuss the theories of similars and signatures on the page. Perhaps there should be a paragraph or two on the alchemical and chemical debates/ discoveries leading up to Hahnemann>
:::::Sadly, you consistently want to pick a fight with anyone who doesn't regard homeopathy as the greatest thing for health. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:14, 14 September 2010 (UTC)
::I'm not convinced of the value of adding more history here - but we need Dana's view on that. I think that in an article on "Medicine", material on the history of medicine prior to the mid 20th century would tell us very little about medicine today, and I suspect that something of that is true here - homeopathy today, throughout the world, dericves from Mahnemann and his disciples. Dana?[[User:Gareth Leng|Gareth Leng]] 17:20, 20 December 2008 (UTC)


Secondly, the 'philosophical' issue of the 'dilution' and 'potencies' of homeopathic remedies is not explicit - there is a debate over this that needs to be brought out.
--Under GOVERNMENT AND INSTITUTIONAL…
-- If we choose to include reference to the Great Britain’s House of Commons’ Science and Technology’s report on homeopathy, we have to make it clear that this report was voted on by an extremely small minority of its members.  Of the 14 members, 10 did not consider this issue worthy of voting.  Ultimately, a “majority” of only THREE members voted for this anti-homeopathy report.  Of these 3 votes, two members were so new to the Committee that they did not attend a single hearing on the subject of homeopathy.  The third vote for the “report” came from Evan Harris, a vitriolic antagonist to homeopathy who was not re-elected this year, losing to a 20-something year old political neophyte.  Finally, because this report was “advisory” only in nature, the health minister overruled it and didn’t accept its conclusions.  If anyone wants to make reference to THIS report, we have to add these important facts.  I personally suggest that we do not cover this complicated and inconclusive decisions.


Thirdly, the issue of how 'mainstream' homeopathy is in some countries has been left a little unresolved. We seem to have settled for a US-European perspective. Garth notes on teh CAM talk page the dangers of splitting 'conventional' and 'alternative' medicine too tidily...  
It should also be noted that whoever wrote the above was obviously also aware of these facts and choose not to present them. This type of biased reporting should not have a voice here.  Let’s strive for more encyclopedic objectivity.
::As far as I can see, in India (the main user of homeopathy), homeopathy as practised there is directly derived from Hahnemann (i.e. it was imported from the West); the most notable figure there is Kent and I've added a bit on his views.[[User:Gareth Leng|Gareth Leng]] 17:20, 20 December 2008 (UTC)
[[User:Dana Ullman|Dana Ullman]] 01:21, 14 September 2010 (UTC)


Fourthly, perhaps there is a bit more to be said on the idea of 'homeoprophylaxis', that is, immunization by homeopathy.
:Repeated defenses of homeopathy, with nothing more than supposition and coincidences, don't belong here either. In my opinion, Mr. Ullman, you will not regard anything short of an article that gives homeopathy as much credibility as conventional medicine as acceptable -- and that, sir, is a promo. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:25, 14 September 2010 (UTC)
:: OK, tried this in a box - obviously this is the aspect of homeopathy that arouses deep anger in conventional medicine[[User:Gareth Leng|Gareth Leng]] 15:20, 20 December 2008 (UTC)


::: looks good - useful addition ... [[User:Martin Cohen|Martin Cohen]] 19:39, 22 December 2008 (UTC)
===Logical fallacies===
Take the proposed statement "Advocates assert that the homeopathic “principle of similars” is, in part, the basis for modern day immunizations, allergy treatments, and select other conventional treatments (ie, the use of Ritalin and other amphetamine-like drugs used to treat hyperactive children), while critics have compared it to
sympathetic magic. "


And finally, is there not more to be said on the role of water itself in homeopathic thinking?  This also draws on ancient philosophical views of the nature of 'reality'...
If anyone used the principle of similars to plan these treatments, there might be a case. I sincerely doubt, however, that this was ever done; the advocates making after-the-fact, observational rather than molecular, correlations that are extremely dubious.  Take a modern immunization, especially an acellular one -- it is designed on a molecular basis to produce desired immunoglobulins and other specific substances; similars were not involved in the design.  It's rather hard to say that "similars" is a ''better'' explanation than what the molecular pharmacologists intended, and can demonstrate.
::The role of water in homeopathic thinking - I can see how that might explain a lot, but I don't know how to express that suggestion neutrally. :-)[[User:Gareth Leng|Gareth Leng]] 15:25, 20 December 2008 (UTC)
:::The 'memory of water' article/stub should be good enough, never mind the 'neutrality'.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 16:52, 20 December 2008 (UTC)


I admit I don't know what the CZ conventions are, but 'lay-out' wise, the page is very rough. Shouldn't it be put in a 'neat' state now - with boxes replacing somem of the sections  (like the Law of Similars) and those missing graphics located? [[User:Martin Cohen|Martin Cohen]] 13:20, 20 December 2008 (UTC)
Are there homeopathic provings that demonstrate that large doses of cromolyns cause basophil and mast cell degranulation? If not, the molecular explanation that they desensitize the granules, and in turn block the release of histamine and other inflammatory messengers, is a much better shave with Occam's Razor.


(On that last, at least, here's a suggestion: http://en.wikipedia.org/wiki/File:Beydeman_Gomeopatiya_vzir.jpg ) [[User:Martin Cohen|Martin Cohen]] 13:35, 20 December 2008 (UTC)
I hope we do not have as lengthy a debate on the Tooth Fairy, especially from advocates that are America's leading spokesman for tooth fairies and thus have a financial conflict of interest. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 01:57, 14 September 2010 (UTC)


-I like that, if it can be put in[[User:Gareth Leng|Gareth Leng]] 14:39, 20 December 2008 (UTC)
:Just to throw yet another bit of reality, the use of amphetamine-like drugs, as well as non-amphetamine drugs such as Strattera, for attention deficit disorder &mdash; not limited to children &mdash; and not discussing other psychotropic drugs is, to put it mildly, showing selection bias. There's as much evidence of neurotransmitter effects than of "similars". Further, if one were to generalize to other psychotropic drugs, one couldn't use the principles of similars to produce hypomania in a normal control.  It has repeatedly been demonstrated that lithium carbonate, for example, is not euphoriant. In high doses, it's a depressant -- remarkably so, since the subject will be dead. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:25, 14 September 2010 (UTC)


::While there have been no hard and fast conventions defined, we have been getting some complaints about boxed text. They don't work well with text-to-speech systems for people with visual handicaps, and also may not render well on small screens. This has been discussed on the Forum without a firm decision.
:: We cite in this article a quote from Emil Adolph von Behring (the "father of immunology") who asserts, "In spite of all scientific speculations and experiments regarding smallpox vaccination, Jenner’s discovery remained an erratic blocking medicine, till the biochemically thinking Pasteur, devoid of all medical classroom knowledge, traced the origin of this therapeutic block to a principle which cannot better be characterized than by Hahnemann’s word: homeopathic."  Whether physicians today (or yesterday) refuse to believe that the "principle of similars" is utilized in medicine, it still can be asserted that they are consciously or subconsciously utilizing it. This is NOT to say that ALL drugs are prescribed by this principle (Howard creates a straw man argument with his reference to lithium carbonate).  Further, just because there are other explanations for how or why Ritalin works does not take away the fact that the "similars" principle may also be at play. [[User:Dana Ullman|Dana Ullman]] 16:14, 14 September 2010 (UTC)


::In general, I will use a table when the nature of the information is tabular, but I'd rather have things be accessible than having the most artistically elegant layout. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:17, 20 December 2008 (UTC)
:::Ah yes. von Behring. 1901 Nobel Prize for 19th century work. Got some authoritative immunology less than a century old?  Maybe someone that knew about immunoglobulins?


::: Happy to go with whatever others prefer, but I think boxes are useful if the information is tangential to the flow. It's not just elegance - it's to mark things as asides.[[User:Gareth Leng|Gareth Leng]] 17:28, 20 December 2008 (UTC)
:::"It can be asserted" and "just because there are other explanations" doesn't support similars, any more than the Illuminati ''might'' be responsible for all evil in international relations. "Might" isn't encyclopedic.


::::: re. boxes - I also think the boxes are more than just 'decorations' - they are crucial to the usability of CZ. Until there is a general decision taken against them, at which point I presume all boxes would be removed and the code blocked for them!, I'd ask Howard to be careful not to present their use as somehow to be avoided. That would prejudge the issue.
:::Actually, I prefer the wicker man to the straw man.  


::::: re. Dana's excreta issue! I'm not clear what the issue was, but if it helps, Dana, the quote is in the historical origins section and illustrates the central homopathic idea of like cures like. It may not (one bows to his expertise) be 'homeopathic' in the current sense, but it has historical notability. Secondly, if it helps! I did NOT suggest the addition (although I support it) nor did I make it - Gareth did. Can we have it restored now please?[[User:Martin Cohen|Martin Cohen]]
:::I'm disgusted, but I will not give up because the integrity of CZ means something to me. To stop responding to handwaving would be to give in to the stamina of homeopathic advocates.  
:::::::: Just to clarify; the quote was Ramanand's find and suggestion; he proposed it, I inserted it[[User:Gareth Leng|Gareth Leng]] 19:17, 20 December 2008 (UTC)


::::::I like the boxes a lot for the tngntal issues. If there are issues with repect to "visual handicaps" then we should solve the problem within the box, not just remove them altogether. Howard, can you give us a link to the forum discussion? [[User:Chris Day|Chris Day]] 18:25, 20 December 2008 (UTC)  
:::You were the one that brought up various drugs. I added lithium carbonate as one example. How is it a straw man?  In therapeutic doses, it has no effect on non-hypomanic patients. Easy to call things straw men when you don't like them, and drop back to "it can be asserted." The capability of assertion does not make for encyclopedic quality. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:16, 14 September 2010 (UTC)


::::::::Chris, we are starting an article that includes these topics. For now, see [[ Usability/External Links]] for the Forum links. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:53, 23 December 2008 (UTC)
===Regarding 'point of view'===


:::::::I'll have to search for the forum discussion, Chris.  This is really not the place to have this discussion. I may well pull out some of the technical material that has been produced for compliance with the Americans with Disabilities Act and Section 508 of the Rehabilitation Act. Remember the discussion, though, not too long ago, of color-coding links and such, and the number of people who had colorblindness? A blind person can use a text-to-speech converter across a web screen, but the problems of suddenly going into new columns or boxes confuses most such converters. Accessibility is an area where I do have professional experience.
No "point-of-view" disparagement required for conclusions/inferences drawn from science. Any such disparagement itself reflects "point-of-view". The lede as it reads now reflects medical science's judgment of homeopathy. Personally, as a scientist, I consider an open mind a virtue, but I try not to have it so open my skeptical inquirer falls out. [[User:Anthony.Sebastian|Anthony.Sebastian]] 03:16, 14 September 2010 (UTC)
:::::::Martin, I am being careful to present the use of boxes from my own professional area of competence, so I'm not "prejudging" but making a suggestion. I am a Computers Workgroup Editor, have been an invited speaker at the Usability Professionals Association, and quite a number of years experience in building computer systems that are accessible. I made a suggestion that boxes can be problematic in web interface design, from my direct professional experience. Not only can they be a problem for people with visual handicaps, but they also can be a problem when trying to print a page, especially when they have a colored background. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:08, 20 December 2008 (UTC)


== Some questions on refs while editing ==
:As I've suggested, we have to face the issue that the two advocates appear not to want the general judgment to appear, unless it is immediately accompanied by a Seinfeld-like "but that's OK, and homeopathy works." [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:25, 14 September 2010 (UTC)


For the material in the text box starting "When a homeopath is conducting an interview...", the citation goes to an article on treating rhinitis, rather than clear definitions of the homeopathic meaning of these terms. Is there a better reference?
== Biology-Health Sciences Editor ruling needed ==


Also, the statement is made, "Modern physicians, however, are constrained by ethical codes that forbid them from deliberately misleading their patients; rather than prescribing placebos themselves, some therefore prefer to refer patients to regulated practitioners of alternative medicine. "  What code is being violated here?  I think we need a citation; I don't think this is in the Declaration of Helsinki. There are some specific things about misleading about risks, especially in a clinical trial, but even "misleading" is vague. After all, it's extremely common to tell patients they have "bad cholesterol", when there's only one kind of cholesterol, but multiple types of lipoproteins. That's vaguely misleading. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:29, 20 December 2008 (UTC)
Immunology clearly falls into these fields, ''not'' Healing Arts. I contend that it is ludicrous for this article to be using von Behring as a source of authority. It's fair enough to mention a 1901 Nobel Prize winner in a historic context, but a ruling is needed if his statements on homeopathy and immunotherapy can be used as substantiation for plausible modes of immune response. Immunology has progressed a bit in over a century.


Ethics example here [http://www.medpagetoday.com/MeetingCoverage/AMA/3555][[User:Gareth Leng|Gareth Leng]] 19:06, 20 December 2008 (UTC)
It's futile to argue this with Mr. Ullman, and I believe we have enough relevant Editors to settle this point. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:35, 14 September 2010 (UTC)
:Agreed (sorry for butting in). ([[User:Chunbum Park|Chunbum Park]] 09:56, 15 September 2010 (UTC))
::Don't feel sorry, Chunbum, your particpation and opinion is a valued part of the decision process.
::This appears to be a bigger issue than homeopathy.  It appears that you are asking to limit an editor on an article.  We don't have a mechanism for that.  We've really left that to the devices of other editors to challenge unusual statements by other editors.  I would expect that even Dana would appreciate a immunologist's input, but regardless, they'd both still need resources to cite. I'm not sure that a Health Sciences Editor can overrule a Healing Arts editor on an article, but he can certainly challenge anything that counters his beliefs. I would think the EC or EiC would have to rule on something like that.  Of course, that would be the Managing Editor should the new charter take effect. [[User:D. Matt Innis|D. Matt Innis]] 12:59, 15 September 2010 (UTC)
:::That's much what I was thinking. To take a parallel example relevant to Howard, the article on the [[Iraq War]] might, and in my view should, discuss the question of its legality. But I don't suppose the article is affiliated to the Law Workgroup. So what happens with a hypothetical conflict between, say, Howard and a law editor on that question? I think the new EC has to think about the whole system here, not just leave it to the ME to invent precedents. [[User:Peter Jackson|Peter Jackson]] 15:03, 15 September 2010 (UTC)
::::Perfect example, Peter.  The new charter should allow the new ME to make a decision on the fly based on ample input from everyone (especially editors) and then the EC can take its time to review the ME decision and either overrule it or support it.  Hopefully, that will develop a sort of "case law" that eventually develop into policy based on a democratically expert debated concepts rather than customary consensus. Meanwhile, authors will be able to move on to different content while the decision is reached elsewhere.  [[User:D. Matt Innis|D. Matt Innis]]


:Remember that the majority of U.S. physicians do not belong to the American Medical Association, and this is not even a full AMA position, but a committee. I'd be more comfortable seeing this in the context of an amendment to the Declaration of Helsinki. I really question if a large portion of referrals to alternative practitioners are being made as a subtle way to avoid prescribing placebo.  There are some quite specific guidelines about placebos in clinical trials, but clinical practice is another matter. Most literature references seem to deal with trials, but here's one, from a bioethics journal, indicating that placebos may be appropriate in general clinical practice. [http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15574442].  I don't know of any firm recommendations, outside clinical trials, in using them, although the cite I gave does put constraints on their use. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:31, 20 December 2008 (UTC)
(undent) All of you make good points, but the specific may be a little easier. If I were to state the problem in EC terms, it is that different disciplines acquire knowledge at different rates. Were this, for example, a Literature article, Oscar Wilde or G. B. Shaw's comments would be relevant. If this were aviation engineering, however, I think it is relatively obvious that Orville and Wilbur Wright's commentary would not be very relevant to an Airbus (most recent model) or Boeing 787 Dreamliner. While I've often wondered how a classic military genius such as Belisarius would do with airmobile forces, he'd have a bit of catching up.


Declaration of Helsinki is not relevant -it's about medical research. It seems that ethical codes don't bar its use [http://www.medscape.com/viewarticle/582794_4] - in the USA about half are willing to. Here it reports in a survay that 60% of British doctors are willing to prescribe placebos [http://indian-medicos.blogspot.com/2008/10/many-us-doctors-give-patients-placebo.html] (by which they mean treatments that they don't expect to work for the particular condition, including e.g. aspirin). The statement needs modifying I agree - doctors here are taight medical ethics and that it is unethical to deliberately mislead the patient. This is the conflict. I'll reword.[[User:Gareth Leng|Gareth Leng]] 19:52, 20 December 2008 (UTC)
Von Behring, and indeed Hahnemann, were giants in their time. Today, however, von Behring wouldn't know how to find  his way to the protein sequencer or the molecular visualization workstation.  


:An article for [[placebo]] is on my list. For that matter, the whole issue of physician-patient communications ethics probably is worth an article; there are many issues, some having to do with cultural expectations. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 20:05, 20 December 2008 (UTC)
The policy, therefore, might say that to cite an authority as more than a historic point, that authority has to be reasonably familiar with current concepts. It may be even faster now, but, a few years ago, based on MEDLINE growth, the amount of information in health sciences doubled every seven years. Some fields, such as molecular pharmacology, went from nonexistent to major disciplines. There's not going to be a citation that "Von Behring is obsolete", but that's a reasonable inference.


==Some clarifications==
Peter, I would be absolutely delighted to have an article on the legality of the Iraq War. The article is not now affiliated with law, or several other relevant workgroups, due to the three workgroup limit. In doing the main draft of these articles, I had quite enough to do with the "what" and "how" without getting into the just war theory or international law. I would be happy, over an appropriate beverage, to discuss what I personally consider to be vague language in the UN Charter.
I'm having trouble with "A fundamental reasons for conflict between conventional medicine and homeopathy is that homeopathy rejects the concept of treatments that target common ''mechanisms'' of disease, but seeks individualized treatment."


Could people live with removing the last four words? Few physicians would say they do not individualize. Even with a common diagnosis, there are many choices of drugs, which gets especially individualized when there are multiple diagnoses. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:32, 20 December 2008 (UTC)
Unquestionably, Matt, workgroups need to be revised. I have been doing some experimentation with subgroups, but they are not a sole answer. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:19, 15 September 2010 (UTC)


== 30C Potency and Hahnemann ==
: I think the word "ruling" in the section title is an error. Certainly ''comment'', or even ''contributions'', from those editors would be useful and (I assume) welcomed by all concerned, but I do not think they have the authority to ''rule'' here.
Someone wrote in the article that Hahnemann recommended 30C for most situations.  I have never heard this.  Unless someone can provide a reference, we will need to take it out.  What I do know is that Hahnemann primarily used very low potencies for the first 2 decades of his use of homeopathic medicines. When some fellow homeopaths told him about their use of the 200th, 1,000th, and 1,500th potencies, he expressed strong skepticism initially, until he actually tried these potencies himself and found surprisingly good results when properly used according to the principle of similars, not to simple pathology. [[User:Dana Ullman|Dana Ullman]] 18:59, 20 December 2008 (UTC)


:I wrote that so I must have read it somewhere, but not necessarily a reliable source - I didn't register it as potentially controversial. But here is a clear and good source [http://www.homeoint.org/morrell/articles/pm_pote1.htm HAHNEMANN'S USE OF POTENCY OVER TIME by Peter Morrell] "Finally, we can safely say that Hahnemann at the end of his career mainly used potencies 12, 18, 24 and 30 and that this comprised some 81% of his total prescribing" ....and here ...."In 1816 30c makes its first appearance and this remained for all intents and purposes his most extensively used and most highly recommended potency of all"  [[User:Gareth Leng|Gareth Leng]] 19:11, 20 December 2008 (UTC)
: The paragraph quoting von Behrig starts "Scientists and medical doctors today do not think that the principle of similars is generally true or useful, and they explain the efficacy of vaccination without referring to it. Physicians of the 19th century however did consider that the principle could be valuable." That strikes me as fair. Given that context-creating text, I see no objection to the von B quote.


== Toxicology ==
: As I see it, there are serious issues with this article, and Howard is right about most of them. However, on this particular point, I see him as tilting at a windmill. [[User:Sandy Harris|Sandy Harris]] 02:52, 16 September 2010 (UTC)


Is there another term that could be used rather than toxicology? Quoting from ''Medical Subject Headings'', toxicology is "The science concerned with the detection, chemical composition, and biological action of toxic substances or poisons and the treatment and prevention of toxic manifestations."  Is it a homeopathic term of art? In general pharmacology, the effects of excessive dosages are not necessarily considered "toxic", although they may certainly be "undesirable".
:::One never knows...the windmills ''might'' be giants. Seriously, I really don't have a problem with historical quotes in historical contexts. Such contexts, though, would include both Osler's preference for 19th century homeopathy over 19th century allopathy, and his later statement that both allopathy (as used at the time) and homeopathy were both "cults" that needed to be replaced by scientific medicine.


"Toxic" has quite a few connotations for chemical safety labeling, and even in law (e.g., Toxic Substances Control Act [http://www.epa.gov/lawsregs/laws/tsca.html]). 
:::Recent comments on this talk page, however:
:::<blockquote>Whether physicians today (or yesterday) refuse to believe that the "principle of similars" is utilized in medicine, it still can be asserted that they are consciously or subconsciously utilizing it. This is NOT to say that ALL drugs are prescribed by this principle (Howard creates a straw man argument with his reference to lithium carbonate). Further, just because there are other explanations for how or why Ritalin works does not take away the fact that the "similars" principle may also be at play. Dana Ullman 16:14, 14 September 2010 (UTC) </blockquote>
::: made me concerned that advocate(s) wanted to reintroduce the von B quote ''without'' the qualifiers, and suggesting that similars ''are'' the mechanism of medical immunization. That is not acceptable and is flatly wrong. I suspect that some of the molecular immunologists building acellular vaccines may never have heard of similars and certainly aren't designing with that principle, rather than protein structure-activity.
:::Lithium carbonate is hardly a straw man, as its activity would not be demonstrated in a proving on a non-hypomanic individual, only toxic effects in high doses. When things demonstate exceptions to basic concepts such as similars and proving, they become significant negative data. "It can be asserted" is hardly encyclopedic, thinking of the classic assertion that if my aunt had testicles, she'd be my uncle.--[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:33, 17 September 2010 (UTC)
[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:26, 17 September 2010 (UTC)


The usage, as in provings, may be understood in a pure homeopathic context, but I'm thinking of the nonspecialist reader. Is there a synonym that might be less ambiguous? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 19:20, 20 December 2008 (UTC)
== Followup on Anthony's comment about alternative medicine ==


::Just take it out - it's certainly not toxicology and there's no term that's readily recognized.[[User:Gareth Leng|Gareth Leng]] 20:41, 20 December 2008 (UTC)
While I agree with your addition, I wonder if it goes far enough. Complementary and alternative medicine, while often grouped together, are not the same. Alternative medicine, to use NCCAM's definition, is a ''substitute'' for conventional medicine, while complementary medicine can be [[integrative medicine|integrated]] with conventional medicine. Rather by definition, alternative medicine will not agree with conventional medicine, and never the twain shall meet.


==Latest nudges==
It's not implausible that there ''could'' be complementary homeopathy, but I find it interesting that the article really doesn't address it. At best, there are arguments that homeopathy is superior to conventional methods for specific disorders. There's some hand-waving that conventional physicians use homeopathic remedies in their practice, but no discussion of the indications and rationale for doing so.  In other articles, there is discussion of the complemntary use of acupuncture, chiropractic, etc.  
I altered the phrasing about "more gentle alternatives" because Hahnemann generally used the same drugs as conventional medicine but at high dilutions.


I've deleted the reference to the Law of molecular concentration - this is the name given to Fick's Law (1858) and doesn't seem to be relevant here - I think the intended allusion is to the Law of Dosology introduced by Grafen Ceasre Mattei (Count Ceasre Mattei,1809-1896) which asserted that the more grave the disease, the more the remedy must be diluted (potentised). I don't know if this is worth mentioning - we can't cover everything, and I don't know how significant this Law is; comments Dana?
Whether or not homeopathy is CAM rather than AM, this article overwhelmingly treats it as AM. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 21:50, 14 September 2010 (UTC)


Side-effects - these aren't really mentioned, and perhaps it's as well; it's often said that homeopathy has no side-effects and I don't dispute that - but this seems at odds with the method of provings, which records transient symptoms that in conventional medical terminology would be classed as side-effects. Homeopaths also say that remedies often additionally aggravate symptoms - these effects in conventional medicine would always be clased as adverse events (side-effects). Thus there will be a difficulty - clearly homeopaths and conventional medicine are using side-effect to encompass quite different things. If side-effects are mentioned it will be important to note these issues. [[User:Gareth Leng|Gareth Leng]] 11:11, 21 December 2008 (UTC)
:Howard, I took a long rest from this article, and it seems that you would really benefit from doing so too.  I realize that by saying this you may now want to edit more often than ever.  My concern is that you are beginning to lash out at me and at this subject in an extremely emotional way. It seems that you are no longer trying to create an encyclopedic article but one that pushes your POV which remain inadequately informed about this subject of homeopathy.  Heck, even when Dr. J sought to reach out to Sandy and be friendly, rather than adverserial, Sandy told him that he wasn't interested.  That's OK too...and Dr. J didn't seek to connect personally. Let's not make this effort by Dr. J to be as "bad" as you've tried to make it. [[User:Dana Ullman|Dana Ullman]] 22:54, 14 September 2010 (UTC)


:Provings aren't treatments; aggravation, which happens rarely, can't be considered side-effects; homeopaths are generally agreed that homeopathic remedies don't cause 'side-effects'.—[[User:Ramanand Jhingade|Ramanand Jhingade]] 18:43, 22 December 2008 (UTC)
::Well, gee. I've been discovered: my whole motivation is attacking homeopathy, and I '''never, ever''' contribute to anything else at Citizendium.  Obviously, [[New Delhi metallo-beta-lactamase-1 enzyme]] is just an attack on homeopathy, as is [[CZ: Pacific War Subgroup]], as is (quite friendly) collaboration on [[opportunistic encryption]].


::Mattei's statement is not worth mentioning because the potency issue is much more complex than that, and there is a school of thought in homeopathy that people with severe pathology need frequent doses of low potencies.  I personally believe that these are technical issues and don't have a place here.
::Why is this in a subsection where I was addressing the complementary and alternative aspects of homeopathy? That was hardly emotional. I neither need nor want your advice or concern on what I should do.  


::As for the side-effects issue, this is a bit complex too. You are right that "provings" do create symptoms in healthy people who are sensitive to the substance being tested, but these are not "side effects" (they are the intended and direct effect of the medicine). Separate from provings, homeopathic treatment sometimes creates a "healing crisis" (also called an "aggravation") in which certain symptoms start shortly after a homeopathic medicine is taken.  These symptoms are usually "externalizations" of the disease process (i.e. a skin rash, an early profuse and/or clotted menstruation, a productive cough, etc.) or a re-experience of old symptoms (that have been "treated" or suppressed with ineffective treatment).  "Hering's law of cure" makes reference to these observations of the healing process after a homeopathic medicine and may desire mention here. [[User:Dana Ullman|Dana Ullman]] 17:22, 24 December 2008 (UTC)
::It ''is'' adversarial. Deal with it. Mortality & Morbidity conferences, military After-Action Reviews, engineering design reviews, etc., benefit from an adversarial approach.  


== Need for [[vital force]] article ==
::As far as I can tell, your definition of "adequately informed" is to accept homeopathy. The Ormus article hurt Citizendium, and I am convinced that homeopathy does as well.  I do know that I have had people refuse to join CZ specifically due to the homeopathy article. I'll believe you want to be encyclopedic when I see you contribute to things other than a single issue.


There really is a need for a unifying article on varying concepts of vital force, including non-Western ideas such as ''qi'', and variant Western ideas as in homeopathy, traditional [[phytotherapy|herbalism]], [[naturopathy]], etc.  I'm not sure if the [[chiropractic]] term "innate intelligence" should be covered as yet another variant.
::If I get extremely emotional about something, I tend to be more quiet, and perhaps smile a lot. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:07, 14 September 2010 (UTC)


I'm really not the best person to start this; it would best be started by someone from a background outside conventional medicine. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:42, 21 December 2008 (UTC)
== Encyclopedia Britannica Online: Homeopathy lede ==


Possibly of interest:


:see [[Vitalism]], written long back, by me and Matt (imported from Wikipedia days)[[User:Gareth Leng|Gareth Leng]] 23:27, 21 December 2008 (UTC)
"Homeopathy"


::OK, I've redirected to it from [[vital force]]. Dana and Ramanand, you may want to make any appropriate updates. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 00:27, 22 December 2008 (UTC)
"a system of therapeutics, notably popular in the 19th century, which was founded on the stated principle that “like cures like,” similia similibus curantur, and which prescribed for patients drugs or other treatments that would produce in healthy persons symptoms of the diseases being treated."


"This system of therapeutics based upon the “law of similars” was introduced in 1796 by the German physician Samuel Hahnemann. He claimed that a large dose of quinine, which had been widely used for the successful treatment of malaria, produced in him effects similar to the symptoms of malaria patients. He thus concluded that all diseases were best treated by drugs that produced in healthy persons effects similar to the symptoms of those diseases. He also undertook experiments with a variety of drugs in an effort to prove this. Hahnemann believed that large doses of drugs aggravate illness and that the efficacy of medicines thus increases with dilution. Accordingly, most homeopathists believed in the action of minute doses of medicine."


::: Looks rather like what the Theories of Alternative Medicine was working towards too... a link will be useful/ do the job here too. And I'll place it in "philosophy' for future updates... Gareth, I did specifically ask for comments on this page - this sort of feedback would have been useful...
"To many patients and some physicians, homeopathy was a mild, welcome alternative to bleeding, purging, polypharmacy, and other heavy-handed therapies of the day. In the 20th century, however, homeopathy has been viewed with little favour and has been criticized for focusing on the symptoms rather than on the underlying causes of disease. Homeopathy still has some adherents, and there are a number of national and international societies, including the International Homoeopathic Medical League, headquartered in Bloemendaal, Neth."
:::::: - I commented on the Theories page at length in the Talk, but forgot about [[Vitalism]] completely - I guess I didn't see it as specific to Alt Med.[[User:Gareth Leng|Gareth Leng]] 21:31, 22 December 2008 (UTC)


:::::::There is a lesson for all of us in forgetting things we have already written, although I forget what it is. :-)  Seriously, I do this myself; before I start an article, I do try to search to see if there are existing topics, at least that should be linked in the article or via a Related Articles page. More than once, I've found I've already written something similar. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 21:54, 22 December 2008 (UTC)
http://www.britannica.com/EBchecked/topic/270182/homeopathy


::::::I shall note that this section of the talk page did not address Paracelsus. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:33, 22 December 2008 (UTC)
[[User:Anthony.Sebastian|Anthony.Sebastian]] 03:27, 16 September 2010 (UTC)


:::::::Humble apologies, Gareth, of course you provided loads of very helpful feedback there. I've been meaning to thank you but got behind - especially with this! ... [[User:Martin Cohen|Martin Cohen]] 00:12, 23 December 2008 (UTC)
:The first two paragraphs, I hope, are not controversial. The talk page controversy, however, has significantly involved both homeopathic attempts to claim medical logic, as well as a broader assumption, by the homeopathy advocates, that homeopathy needs to be regarded as having equal credibility to conventional medicine.  Attempts to claim that the principle of similars is the underlying mechanism for medical treatments developed, or validated, using methods of molecular pharmacology fall under my first point. Closely coupled is the homeopathic argument that homeopathy mimics body defenses manifested as symptoms, when the actual defense is quite different than the symptom producing factor -- tetanus is a good example, where the defenses are immunoglobins that have no particular symptom-producing quality, but the symptoms of  spasticity and convulsions are caused ("indirectly") by the exotoxin of ''[[Clostridium tetani]]'' and can be lethal. The defenses neutralize the toxin, and, coupled with antibiotics and surgery, eradicate the source of the toxin.


:::::::It appears that Martin deleted parts of the paragraphs above. Perhaps this was an error. If not, it is my understanding that while entire sections of talk pages may be archived by any Citizen, deletion of another Citizen's comments, all or in part, is reserved to Constables. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 00:23, 23 December 2008 (UTC)
:In other words, there's a refutation of molecular medical arguments, but no molecular explanation of how similars affect the body. Hand-waving about memory of water isn't on the same level as immune reactions that can be demonstrated ''in vitro'' and ''in vivo'', or structure-activity interactions with cellular receptors. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:12, 16 September 2010 (UTC)


::::::::I restored Martin's post above.  It looks like there was an edit mistake that accidentally deleted some of Howard's comment and Howard then reverted it.  [[User:D. Matt Innis|D. Matt Innis]] 19:25, 23 December 2008 (UTC)
== "Alternative Medicine and the Laws of Physics" ==


==Paracelsus==
Of possible interest:
::::All: Can we have somne decision on Paracelsus, please? (As summarised above) [[User:Martin Cohen|Martin Cohen]] 10:51, 22 December 2008 (UTC)


:::::Martin, with all due respect, you have just said that a page on [[vitalism]] was useful. It turned out to have been written some time ago, and simply not linked. It was something, however, that was accepted as an axiom while the bulk of the article details were worked out. The discussion was not diverted to it. Virtually everyone who has been a participant in this discussion has given their opinion on Paracelsus. I believe it is fair to summarize that while Paracelsus is a significant figure in the history of medicine, he is not a primary figure in the current Western thinking about homeopathy. There are discussions, on totally unrelated pages, about how much background, history, and philosophy is relevant to a main article. There are times, and I am disputing one, where the history is absolutely relevant -- but it still goes under what might be called an "index" or "top-level" article, and is linked separately from the main article. That is exactly what is done with vital force: it has been an undefined element of the homeopathy discussion from the first draft of the article, and I personally have a sense of completion that the link is no longer red. There are questions I still have about homeopathy, but I am not hammering about them.
Alternative Medicine and the Laws of Physics


:::::Might I suggest that not every article belongs in the philosophy workgroup, or must have the history presented first?
Robert L. Park


:::::::: Whose doing either?
''Skeptical Inquirer'', Volume 21.5, September / October 1997


Not every article needs a dissertation on eastern and western philosophy? The material should be available for those who want it, but I was able to write, for example, the current new draft of the week, [[Dien Bien Phu]], with a link to an article on the ideological factors of the Vietnamese ''[[dau trinh]]''. We don't have an article on [[colonialism]],and we should; it still should be linked. There isn't a good article on [[containment policy]]. It was possible to write [[nuclear weapon]] without going back to Democritus.  
http://www.csicop.org/si/show/alternative_medicine_and_the_laws_of_physics/


::::::::: Impossible!
[[User:Anthony.Sebastian|Anthony.Sebastian]] 03:59, 16 September 2010 (UTC)
:Having read the article I feel a neutral way of presenting homeopathy would be something like "it is a type of medicine supported by neither scientific reasoning nor data. that being said this is what homeopaths think: 1, 2, 3." ([[User:Chunbum Park|Chunbum Park]] 05:40, 16 September 2010 (UTC))


:::::::::  Seriously, this is not a helpful argumentative tactic - ridiculing others's position. The historical development of the 'like cures like' idea, is central to understanding of the "Father of Homeopathy' (the H one - not the P one). It's true we have a link ot a seperate page on the history, so we could skip it here, but IMO a bit of history is a good idea, and the section exists.
:: I think that overstates the case. Homeopathy is based on a system that includes reasoning which is at least pseudo-scientific. There is data, though much of it is of dubious quality; in particular, "data" is not the plural of "anecdote". I don't think your text above is neutral in any sense I'd recognise.


There indeed should be links to the ethics of nuclear weapons use, but there is, in the article, reference to that from a pure military standpoint, the need for many nuclear weapons no longer exists.
:: The current draft includes "the consensus of medical and scientific opinion is that homeopathy is unfounded." I think that is accurate, neutrally stated, and sufficiently direct.


:::::I really, truly don't understand what "decision on Paracelsus" you want that you have't been given extensively. Could you please be specific on what is lacking?
:: That said, I do think we should link to highly critical articles such as that one, possibly the [http://rationalwiki.org/wiki/Homeopathy rational wiki] page, and certainly the [http://xkcd.com/765/ lovely cartoon] they use. [[User:Sandy Harris|Sandy Harris]] 07:40, 16 September 2010 (UTC)


::::::::: What I am saying is that the material OTHERS - not me! -  added to the piece should be kept there, rather than deleted without giving good reasons or adequate explanation. 'Bad reasons' do not suffice. I also would extend the same general principle to contributions by myself, but as it happens, I have avoided adding text on this to the article as there seems to be a tendency for such to be deleted straight after. For this reason I'm reluctant to add the image mentioned above (and Gareth supported) - but if others can indicate agreement on adding that, I'm happy to do it.
::: See rational wiki's article "Citizendium" first. [[User:Anthony.Sebastian|Anthony.Sebastian]] 03:57, 17 September 2010 (UTC)


The consensus [on P], as far as I can see, is that a link is all that is really needed.
== Suggest ending Main Article draft at end of lede ==


:::::::::  WADRH (with all due respect, Howard) Pierre-Alain, Ramanand, Gareth and I have tried to add some detail on Paracelus. Even Dana has thought some detail was needed. Who makes up your 'consensus'?
Let reader use Biblio to get further information. Concentrate on thorough Biblio subpage. 06:39, 17 September 2010 (UTC)


He was mentioned in [[Bach flower therapy]], because Bach expressly mentions ''signatures''. I certainly wouldn't object to symmetrical links between [[Paracelsus]] and [[sympathetic magic]]. There are many other places where his work is relevant, at least as a link. Are you saying you still believe there needs to be more than a comment and link in this article?
: I don't think that is an adequate approach for an encyclopedia. We want a reasonably detailed explanation here. That said, the article could likely be shortened significantly without losing anything valuable. [[User:Sandy Harris|Sandy Harris]] 12:14, 17 September 2010 (UTC)


:::::::::  Yup.
::At home much resource cost that could be going into even copy edit of other articles, articles that deal with topics that are likely to have more serious users? I'd wager that a good part of the hit count on this article is due to people at other wikis looking for controversy.


I'm honestly trying to understand what you are requesting. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 14:44, 22 December 2008 (UTC)
::That being said, I'm not sure how feasible it is under present policy. Assume three Health Sciences and Biology Editors are willing to nominate the truncated approach for Approval. Healing Arts Editors say it is not Approvable.  It would be one thing for a Mathematics Editor to question approval for a cryptographic topic written by a computers person, but we've gotten through effective collaboration among, say, Computers, Mathematics, and Military. Health Sciences and Healing Arts, among the workgroups, are the only case where we have different workgroups for fundamentally different views on the same subject area. It's a bug, not a feature; we don't have separate-but-equal Religion and Atheism workgroups. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:53, 17 September 2010 (UTC)


:::::::::  I'm trying to clarify the issue. Then we can put it behind us. I ''thought'' it was there already until Dana recently re-opened it with his deletion of the plague section and querying of the 'thistles'. [[User:Martin Cohen|Martin Cohen]] 18:19, 22 December 2008 (UTC)
== Definition ==


::::::<b>Dana,</b> I've used, 'Faecalis', the bowel nosode, in the 200th (homeopathic) potency successfully, so I hope you can re-insert that Paracelsus reference-I think it worked (for Paracelsus) on the same principles.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 18:24, 22 December 2008 (UTC)
The current definition reads "System of alternative medicine that asserts — contrary to scientific  evidence — that substances known to cause specific syndromes of symptoms can also, in very low and specially prepared doses, help to cure people who are ill with a similar syndrome of symptoms." I think that is a moderately awful definition. The problems I see are:
: The "contrary to scientific evidence" bit, or similar text, has been added at least twice and reverted at least once. I don't think it belongs in the definition.
: "syndrome of symptoms" is used twice. That's ghastly stylistically, "syndrome" is a technical medical term that may not belong here, and in any case, I suspect "syndrome of symptoms" is redundant. What else could you have a syndrome of? Or does a syndrome include more than just symptoms?
My version would be: A system of alternate medicine based on the idea that substances known to cause particular combinations of symptoms can, in very low and specially prepared doses, help to cure people who are ill with similar symptoms.
(sig added later [[User:Sandy Harris|Sandy Harris]] 23:14, 17 September 2010 (UTC))


:::::::I cannot follow your interspersed references well enough to respond. PLEASE: either put your responses in a block indented not more than one space, or, if the indentation goes too deep to read, back to the left by one. If you cannot do this, at least copy the signature of the person to whom you are responding. I'll simply say that I believe the matter of Paracelsus was settled, but it keeps getting reentered.[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:32, 22 December 2008 (UTC)
""Syndrome of sympoms", indeed, is ghastly. Unfortunately, it touches on a difference between homeopathic and current medical thinking that is as important as similars. Modern physicians look first for an etiological diagnosis: what is the cause of the patient's distress? (Note here that "symptom" is being used in a lay sense here -- there are differences of theory as well). Homeopaths consider that the "disease model", not patient-centric, and often reject a causality-based approach. Their focus is on the products of the cause (in medical thinking) or the body wisdom expressing its defenses.


Martin, in due respect, I do not think that your scholarship is good here. Just because one author referred to Hahnemann the "second Paracelsus" does not have the meaning you suggest.  Paracelsus was a medical revolutionary, as was Hahnemann, and both were hated by the orthodoxy. That is the point. This certainly does not mean that Paracelsus is or was the "father" or "founder" of homeopathy. What I am concerned about now is that you have been repeatedly told by several people here that they do not agree with you, and yet, you are not listening. I hope that you begin to listen better so that collaboration can be most effective. 
:A better wording would be welcome, but the rejection of etiologic thinking, and the focus on similars as a means of reducing symptoms, is fundamental. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 15:53, 17 September 2010 (UTC)


And in reference to Ramanand making reference to a single (very rare) homeopathic medicine that is taken from feces does not have a clear reference to the homeopathic principle of similars.  Martin's previous point on this was the principle of similars, and I just don't see it. [[User:Dana Ullman|Dana Ullman]] 05:38, 24 December 2008 (UTC)
Sandy's version:
*A system of alternate medicine based on the idea that substances known to cause particular combinations of symptoms can, in very low and specially prepared doses, help to cure people who are ill with similar symptoms.


:: Dana, I make no claims for my expertise in this matter, just recording certain factoids. One might throw the accusation back at you, but I won't as I don't think we want this to be a case of 'personal authroities' - surely you are an expert on homeopathy, I am less sure that having stated you knew nothing at all about Paracelus (earlier on this page) you should also take this high stand on his activities here.


Ramanand, Pierre-Alain, Gareth and myself have all contributed material to this page on Paracelus which you have deleted offering only fleeting explanation, usually (IMO) irrelavent to the issue. Over 200 words have been deleted now. This normally requires some degree of explanation and consensus reaching, doesn' it. None has been sought here. No compromise wordings offered. Ramanand, Pierre-Alain and even Gareth have added extra references and supporting material. All of this effort is being discarded.
My understanding:
*A system of alternate medicine based on the idea that large dosages of substances known to cause particular combinations of symptoms in healthy individuals can, in very low and specially prepared doses, help to cure a person whose illness causes similar symptoms.
[[User:D. Matt Innis|D. Matt Innis]] 21:49, 17 September 2010 (UTC)


Here is my suggestion again:
::I  am quite willing to be corrected here, but I think the idea of an illness that creates similar symptoms is still too close to an etiologic model of disease to be accepted by homeopaths. While I don't have better words, my sense is they would say the symptoms are produced by the "wisdom of the body" as "defenses" and the remedies strengthen the defenses. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:59, 17 September 2010 (UTC)


1. We have an historical origins section. (Re. Howard's point of the 24 December - if we didn't well, yes, we could leave the article explicitly NOT covering the pre_H history of Homeopathy).  Paracelus and Hippocrates belong in this section. See 'Final Arguments in the Case of Paracelus' above. Numerous citations to this effet, from the Britanica:


"He was the first to declare that, if given in small doses, “what makes a man ill also cures him,” an anticipation of the modern practice of homeopathy..."onwards have been given - see above too. Ramanand and Gareth's work describing the two celebrated historical cases of 'like-cures-like' examples of P using thistles to cure inflammation,  and P using excrement affected bread to cure plague should be restored.  
::: That could be the next sentence.  


Here is the text deleted:


([[Paracelsus]] asserted the healing power of "signatures", meaning that the appearance of a substance in nature (its color and its shape), represented the types of diseases which it could cure. )0This led him, for example, to teach that the pricking of thistles cures internal inflammation, and is sometimes cited as an early form of the "principle of similars". ref[http://www.newadvent.org/cathen/11468a.htm Theophrastus Paracelsus] Catholic Encyclopedia entry/ref In the summer of 1534, Paracelsius claimed to have cured many in the plague-stricken town of Stertzing with pills containing a minute amount of the patient's excreta.ref. Cited by [http://www.britannica.com/EBchecked/topic/270182/homeopathy Homeopathy] ''Encyclopedia Brittanica.'' According to [http://www.archive.org/stream/lifeofparacelsus00stoduoft/lifeofparacelsus00stoduoft_djvu.txt" The life of Paracelsus, Theophrastus von Hohenheim, 1493-1541"] by Anna M. Stoddart (1911) "Paracelsus stayed some weeks at Stertzing and was appalled at the ignorance and helplessness of the local doctors... He decided to put his own experience and opinion into writing for the benefit of the afflicted town.... He appended to his diagnosis of the plague a series of counsels as to its treatment and a number of prescriptions and recipes. The little book in four chapters was presented to the " Burgomaster and Magistrates of Stertzingen, ... He received little thanks for his book from the civic worthies, but it is probable that during his stay in Stertzing he practised as one knowing the plague and made enough of money to provide himself with necessary clothing, food, and lodging."/ref
:::*A system of alternate medicine based on the idea that large dosages of substances known to cause particular combinations of symptoms in healthy individuals can, in very low and specially prepared doses, help to cure a person whose illness causes similar symptoms. In essence, they believe that symptoms are produced by the "wisdom of the body" as "defenses" and homeopathic remedies are designed to strengthen those defenses.


I am trying to follow the 'conflict resolution' process here - advice from Constables appreciated - so I am not going to add the material back myself. But it seems to me that the process has not been respected by others.
:::[[User:D. Matt Innis|D. Matt Innis]] 03:22, 18 September 2010 (UTC)
[[User:Martin Cohen|Martin Cohen]] 14:56, 24 December 2008 (UTC)


'''Constable comment:'''  In response to Martin's query, it is my opinion that, now that Dana has responded, the discussion on this page should be stopped and if the author is still not satisfied, the [[CZ:Dispute Resolution]] process should be followed and notice that there are specific duties that the constable is obligated to perform according to the section [[CZ:Dispute Resolution#Procedural issues]].  Thanks, everyone, for respecting the purpose of the process. [[User:D. Matt Innis|D. Matt Innis]] 15:16, 24 December 2008 (UTC)
::::Add: They do not use the disease model of conventional medicine, in which there is a disease rather than an individual set of symptoms, and treatment directed at a cause of that disease as it presents in multiple patients. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:29, 18 September 2010 (UTC)
:::::More work:
:::::*This contrasts with conventional medicine's "disease model" of treatment that looks to treat the disease process and therefore relieve the symptoms.
:::::I'm not sure that's totally true, though.  Many conventional treatments are directed at relieving symptoms, too.
:::::[[User:D. Matt Innis|D. Matt Innis]] 03:54, 18 September 2010 (UTC)


== Merry Christmas! ==
(edit conflict) (undent)
There's a different philosophy in symptomatic treatment. If I sprained my ankle badly enough to need surgical repair, the cause would be relevant to a conventional orthopedist who needs to work on the damaged structures. Otherwise, the exact ligament stretch might be known, but it's not of therapeutic benefit. Symptomatic pain relief is the first consideration -- yes, rehabilitation may focus on exact etiology, but, for the sake of argument, assume it's self-limiting.


Merry Christmas and Hanukkah (to Dana)! May the joy of these festivals dilute our differences/nihilism!&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 16:42, 22 December 2008 (UTC)
Sometimes, as with uncomplicated childhood otitis media, even if it is bacterial, antibiotic therapy may not be justified. Presumably, though, the child can still get acetaminophen.


:Thank you! Are there some Indian festivals around this time that deserve recognition? I'll also add Solstice and Kwanzaa. I've greatly been amused by the reactions of some African friends who think Kwanzaa is quite American, but they like the idea and have added it [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:48, 22 December 2008 (UTC)
In both of the cases above, there was awareness of an etiology, but a choice to treat only symptoms. Palliative care is often largely but not exclusively symptomatic -- still, an etiology would be necessary for chemotherapy or radiotherapy to slow the growth of an incurable tumor.  Pain management, though, is symptomatic and even more important. Where does nursing care fit?


::Everybody celebrates the Gregorian New Year (although non-christians follow other calenders as well), but the next Hindu (not all Indians are Hindus) festival is on Jan.14, when spring commences. If one goes back in time, it can be observed that many Hindu festivals and Pagan festivals of the Roman Empire were celebrated at the same time (probably because both are descendants of the Aryans).&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 18:14, 22 December 2008 (UTC)
The homeopaths, however, appear to exclude the idea of treatment based on etiology, as opposed to symptom relief when the cause is either self-limiting or not treatable. I spend hours daily giving comfort care to my cat buddy, relatively little of which is directed at the cancer itself, but much more in nutrition, emotional support and wound care. Indeed, I am using some complementary medicine along with a lot more conventional things.  Homeopathic ideas of symptom-oriented remedies don't enter into it. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:28, 18 September 2010 (UTC)


==Confusing homeopathy with complementary and alternative medicine?==
: I don't think either that long definitions are a good idea in general, or that the proposed "next sentences" are needed in this definition. In the article, certainly; in the lede, probably. However, the definition needs to be short and direct. In particular, it needs to be short enough to look reasonable when cited on a related articles page. [[User:Sandy Harris|Sandy Harris]] 04:46, 18 September 2010 (UTC)
The basis of homeopathy is the using of small doses of products that cause symptoms like those of the disease to be treated ({{MeSH|Homeopathy}}). Some of the content of this article and related articles are about herbal medicines that are thought to treat illness through direct, physiologic mechanisms and not be inducing symptoms like those of the disease to be treated. - [[User:Robert Badgett|Robert Badgett]] 16:22, 23 December 2008 (UTC)


:Perhaps a nit on terminology, but the [[National Center for Complementary and Alternative Medicine]] does classify homeopathy as CAM. Your point is well taken, as there are some edge cases that may no longer be in this article, where the source referred to using a plant extract but not necessarily in homeopathic dosages. I would welcome your comments at the stub article [[phytotherapy]], which is the preferred MeSH term for herbal medicine, and to which I've made assorted redirects. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:43, 23 December 2008 (UTC)
::If the definition is to be short, then, I believe the rejection of etiology is far, far more significant to homeopathy than the better-known issues of small doses. It appears to me that Hahnemann's insight dealt with symptoms being the essential manifestation of health or not-health, and only ''then'' did he go to the idea of provings and similars. My understanding is that his using provings for malaria had to do with the symptom production of quinine.  


:: Can you be more specific, please Robert? [[User:Martin Cohen|Martin Cohen]] 21:15, 23 December 2008 (UTC)
:::Absolutely, I forgot that we were working on the definition!  You're right, Sandy. [[User:D. Matt Innis|D. Matt Innis]] 21:27, 18 September 2010 (UTC)


::: Has Oscillococcinum, in higher doses, been shown to actually cause influenza symptoms and thus meet the criterion of "Principle of Similars"? - [[User:Robert Badgett|Robert Badgett]] 03:29, 24 December 2008 (UTC)
::I believe there's a comment on this page, from a homeopath, that homeopathic remedies are not always administered in homeopathic femtodoses.


::::Yes Robert. Oscillo has undergone provings, and it does cause flu-like symptoms. This is not at all surprising when biologists note that ducks carry various influenza viruses in their digestive tract, and epidemiologists have confirmed that ducks are flu "reseviors."  Oscillo makes sense; there is a body of research to confirm it, and it has a long history of use and success internationally since the 1920s. [[User:Dana Ullman|Dana Ullman]] 05:29, 24 December 2008 (UTC)
::The rejection of etiology is also key to much of the dispute with medicine, as I mentioned in terms of clinical trials. It is also, however, central to the medical rejection of some homeopathic approaches, such as the principal treatment for malaria being based on reducing ''Plasmodium'' parasites in the blood. Quinine remains a third-line drug for malaria, but its action in reducing fever and chills is due to its ability to suppress the parasites, not (in a medical view) what effects are caused by high doses of quinine. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:56, 18 September 2010 (UTC)
:::Quinine remains a third-line drug for malaria, but its action in reducing fever and chills is due to its ability to suppress the parasites, not (in a medical view) what effects are caused by high doses of quinine.


:::::If I understand the technique of provings, the remedy is not diluted, or potentized, as much as in treatment. At the concentration used that produced the flu-like symptoms, and ducks carry influenza virus, was it ruled out, using virological and immunologic methods, that the duck preparation did not contain either virus or antigenic fragments? If so, that could explain the symptoms, although it would be less clear whether a dilution would protect. Just wondering... [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 05:36, 24 December 2008 (UTC)
::::I think that's the point; it's not that homeopath's don't care about etiology, they just don't concern themselves with it. If it causes the same symptoms in a normal person, then it's used to treat the person that has those same symptoms, regardless of the cause. As you say, they might contend that the plasmodium is not what causes the symptoms, rather the symptoms are the body's response to plasmodium. To them it doesn't matter. [[User:D. Matt Innis|D. Matt Innis]] 21:28, 18 September 2010 (UTC)


Howard, actually, provings are conducted usually using potentized doses, most commonly 30C.  THIS is why homeopaths consider "skeptics" of the power of the potentized medicine as misinformed or uninformed. These medicines have the power to heal AND they have the power to create symptoms in select (sensitive) healthy people who take daily doses of them.  Provings do not usually work on ill people because their body is already busy working to heal them, and they are simply not sensitive to a proving. [[User:Dana Ullman|Dana Ullman]] 16:57, 24 December 2008 (UTC)
:::::As my grandmother might have said, ah-HAH! Admittedly, I'm taking the example of the worst form of malaria, but a patient presenting with the cerebral form of ''[[Plasmodium falciparum]]'' malaria may well die in 18 hours. In general, the standard of medical care would be [[artemisinin|artemisinin-based combination therapy]], with [[critical care]] support for effects such as  [[acute respiratory distress syndrome]] or [[disseminated intravascular coagulation]].


:(assuming the above response is from Dana). Thank you. I had misunderstood that provings were now done on potentized varsions; Hahnemann's discussions of quinine, for example, seemed to suggest that pharmacologic doses were used in provings.  
:::::Quinine, in substantial doses and '''in combination with''' doxycycline, tetracycline, or clindamycin, be lifesaving. If I were the patient, however, and someone offered me homeopathic oral doses of oral quinine, I'd prefer a lethal dose of barbiturates, or a large-caliber bullet to the back of the neck (messy but fast).  


:As I understand, Oscillo was developed in the 1930s, however, when sensitive virus or virus fragment tests did not exist. This is not a challenge, but serious interest; I wonder if anyone has done PCR or another amplification technique on it looking for viral material. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:15, 24 December 2008 (UTC)
:::::Now, I'd have every respect for a ''complementary'' homeopath that suspected severe falciparum malaria, and immediately transferred the patient to medical care. Assuming such care were available, I'd regard an ''alternative'' practitioner as having, as the lawyers put it, ''depraved indifference for human life.''.  [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:02, 18 September 2010 (UTC)
:::::: I suspect the cerebral form would have different symptoms, therefore different remedies as well. A bullet is probably not one of them. ;-) [[User:D. Matt Innis|D. Matt Innis]] 23:40, 19 September 2010 (UTC)


== can consumers "practice"? I think not ==
:::::::Are you doubting the efficacy of a .45 caliber ACP 254-grain round, which is lead in a hardly homeopathic dose? Nevertheless, if I had cerebral P. falciparum malaria, I know that active medical treatment is still very iffy. Seriously, we have the problem of any validation here; I cannot imagine an ethics review board that would approve any treatment for such a life-threatening disease without overwhelming laboratory evidence for the control arm. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:21, 20 September 2010 (UTC)


In the second paragraph, we have: "Although homeopathy is practiced by some medical doctors, as well as other health professionals and consumers in virtually every country in the world...." I question the wording. We say, in correct English, "Doctors practice medicine."  We don't say, however, that "Patients practice medicine." So why should we say that homeopathy is "practiced" by "consumers"? We can say "used" or "utilized", perhaps, though this will necessitate rephrasing the sentence somewhat. [[User:Hayford Peirce|Hayford Peirce]] 16:35, 24 December 2008 (UTC)
===Sandy's edit to the definition===
...specifically "help to cure or prevent  illnesses involving similar symptoms."  While a homeopath will have to review this, I don't think "illnesses involving similar symptoms" is really a homeopathic concept. They certainly object to "diseases with similar symptoms", and tend to reject "disease" as a medical conceit. The symptoms are signals of the body's defenses to be strengthened, not the effects of a causative factor. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:59, 18 September 2010 (UTC)


:Hayford, good point, but it is a bit more complex than you may initially realize.  First, we should change the word "consumer" here.  The point is that there are "professional homeopaths" who are not licensed in any conventional medical or health professions who "practice" homeopathy.  Ultimately, because we can and should consider "professional homeopaths" to be a type of "health professional," I suggest that we remove the word "consumer."  [[User:Dana Ullman|Dana Ullman]] 16:51, 24 December 2008 (UTC)
:I think you're splitting hairs, but, yes, let's hear from a homeopath on this. [[User:D. Matt Innis|D. Matt Innis]] 21:27, 18 September 2010 (UTC)


::Yes, that makes sense to me. [[User:Hayford Peirce|Hayford Peirce]] 16:54, 24 December 2008 (UTC)
:Sandy's new definition is definitely an improvement. [[User:D. Matt Innis|D. Matt Innis]] 21:32, 18 September 2010 (UTC)


==Really friendly amendment==
::Li'l hard pressed for time. I'm happy with Alexander's definition, but if you guys feel it needs to be simpler, I have a 'simpler definition', which would read:-<blockquote>(Homeopathy is) an alternative system of medicine, which stimulates the natural healing processes of the body (with the help of sub-physiological doses of a remedy, by using its rebound effect), to restore health (homeostasis) in a sick person.</blockquote>
I removed the sentence "Even most surgical procedures have never been proven to be effective through double-blind and placebo controlled trials."  From a pure stylistic aspect, it distracts from the flow of going from the true statement that the role of aspirin, a drug, was not understood, and then going to homeopathic remedies, which are much more similar to drugs than to surgery. I think Dana's point is better made without that sentence.
:::The matter in brackets is optional.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:36, 19 September 2010 (UTC)
:::Note that it is '''alternative medicine''' and not '''alternate medicine'''.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:44, 19 September 2010 (UTC)


I fully agree that surgical procedures are not tested to the extent that are drugs and some medical devices. Nevertheless, bringing in surgery, along with placebo controls, will bring in side issues, such as the ethics of risk by "sham" (term of art used rather than placebo in surgery) controls versus the risk of a placebo controlled drug trial.
::::Unfortunately, "rebound effect" is not a well-defined term, certainly in medicine, so should not be used in a definition unless it is well defined in an article of its own.  The alternate definition depends heavily on homeopathic terminology, such as "natural healing processes", as well as using homeostasis is far broader a context than is used in the biological sciences -- to say nothing amout emerging concepts such as [[allostasis]].  


Incidentally, I would suggest avoiding anything that assumes all [[randomized controlled trial]]s are placebo controlled. They are usually not considered ethical if a treatment believed to be efficacious exists. See [[informed consent]]. The basic rule, with specific exceptions, is that if a treatment with some efficacy exists, the best current treatment becomes the control arm. A good example would be several major trials in chemotherapy of breast cancer in postmenopausal women: the control arm used [[tamoxifen]] while the experimental arm used [[aromatase inhibitor]]s. Most of these trials, incidentally, were stopped early and the aromatase inhibitors offered to all patients, as their superiority was judged, by independent reviewers, so great that it would be unethical to keep the control patients on tamoxifen. Ironically, the earlier trials with tamoxifen were halted and the control patients offered tamoxifen because it was much more effective than the standard treatment arm.  
::::The proposed new definition also overemphasizes the aspect of small doses and does not address the apparent rejection, by homeopathy, of the idea of "disease". Instead, it speaks of "restoring health", without addressing the meaning of the state of non-health.  


There are means of statistically acceptable clinical trials that use neither placebos nor double blinding. It would be my hope that some of these methods could be used with homeopathic remedies. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:15, 24 December 2008 (UTC)
:::Please confirm or correct the statement that homeopaths do not believe in the concept of disease, in the sense that disease has an etiologic cause and the cause needs to be corrected. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 08:30, 19 September 2010 (UTC)


== "Tweak" to overview. ==
::::I agree with Howard here, Ramanand, that your version introduces too many vague terms to be considered for use as a one sentence definition. [[User:D. Matt Innis|D. Matt Innis]] 23:44, 19 September 2010 (UTC)


I'm sorry, but what was described as a "tweak" is a substantive change, which I see as completely reversing the earlier words speaking of
What about <blockquote>A system of alternative medicine based on the idea of stimulating the body's natural healing processes by administering tiny doses of substances which, when given in large doses to healthy individuals, cause similar combinations of symptoms.</blockquote> I agree that Ramanand's definition has some problems, and I think the full version is too long, but it seems to me the point about stimulating natural defenses is central. [[User:Sandy Harris|Sandy Harris]] 03:07, 20 September 2010 (UTC)
 
"Homeopaths are proud of their history, and are convinced of the efficacy of their remedies based mainly on their clinical experience, bolstered by the outcomes of
 
'''previous text'''...some, mainly small trials.
 
'''changed text''' ...the majority of clinical trials.
 
I reverted to the previous text; this needs to be discussed and agreed-to by all editors. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:31, 24 December 2008 (UTC)
 
:Actually, according to the Linde meta-analysis, the average size trial in homeopathy was 60 subjects.  While 60 subjects may not be considered "large," it also should not be considered "small."  The bottomline is that the majority of trials DO have a positive outcome.  Please note that I have spent a lot of time creating a new body of info on research, and earlier today, I added some of this to the article, plus I will be adding what I think is a good summary of the Shang article and its responses.  I tried to write it objectively and look forward to others' input.  [[User:Dana Ullman|Dana Ullman]] 20:34, 24 December 2008 (UTC)
 
::I agree you are trying to create something useful, and thank you for it. If these were non-homeopathic trials, for any common disease, I'd have to call them small. They would be a reasonable size for Phase I trials, and, depending on the disease, orphan diseases being a special case, might be sufficient for a Phase II recommendation to move to multicenter trials. Without going through the specific studies, I'd say "promising and justifying further evaluation" would be fair.
 
::If I were reading about trials of a purely conventional treatment, I'd normally interpret "majority of trials" to imply that they were multicenter Phase III, and showed statistical significance. When Linde's 1999 paper says “There is increasing evidence that more rigorous trials tend to yield less optimistic results than trials with less precautions against bias.” I'd have to be cautious in saying that efficacy was demonstrated. Again without having the paper, let me ask if any of these trials were multicenter, for the same indication?
 
::Again referring purely to conventional medicine, small trials can be very important when there are no treatments at all for a condition, or the trial is for individuals that failed treatment for a fatal disease. If the trials were for something self-limiting, I think there would be an expectation of more rigor. I just don't have the information here to know what "positive" really means, considering the multiple factors of safety, efficacy, and severity of conditions. I'll wait for your additional material. Thanks. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 20:50, 24 December 2008 (UTC)
 
:::It is important to know that high quality clinical trials (homeopathic OR not!) tend to yield less positive results.  This is not simply observed in homeopathic trials.  A couple of the Oscillo trials were in the Linde trials, both of which were multi-center and with 300+ subjects.  [[User:Dana Ullman|Dana Ullman]] 22:19, 24 December 2008 (UTC)
 
== Comments welcome on changes to [[placebo]] article ==
 
I have added a substantial amount of text to the prior article on [[placebo]], which I did not originate. That article dealt principally with the use of placebos in [[randomized controlled trial]]s, not in general clinical practice. Some of the questions I raise below may not strictly deal with placebo, but may be fair subjects for this article.
 
I am really looking for serious comment and have no hidden agendas here. There are some very challenging ethical issues here.
 
There are times where a medically prescribed placebo may be, according to some ethicists, appropriate as part of conventional treatment. Inevitably, these issues blur into issues of if and when a conventional practitioner may:
*Refer a patient, whom he cannot help, to a practitioner of a CAM discipline that the physician believes will not be dangerous, but will have no more than placebo effect.
*Refer a patient, whom he cannot help, to a practitioner of a CAM discipline that the physician thinks might be of benefit, although the conventional physician does not understand the mechanisms of the CAM technique
*Discourage a patient from seeking a CAM treatment that the physician believes is ineffective, but is not likely to be harmful. In such a case, assume that the physician has no conventional treatment to offer, or the patient has declined to give informed consent.
*Discourage a patient from seeking a CAM treatment that the physician believes is likely to be harmful, or would be used in lieu of a treatment the conventional practitioner does believe will be of benefit.
 
In other words, the conventional physician might have cases where she believes the CAM practice is equivalent to the ethical use of placebo. How do homeopaths, especially nonphysician homeopaths, deal with physician referrals? If a patient self-refers, and remains under the care of a conventional practitioner, is there an ethical duty for the homeopath to consult with the other clinician?
 
[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 00:52, 25 December 2008 (UTC)
==Related articles==
I, and I believe some other Citizens, are trying to create at least stub articles for CAM topics, and have been trying to use MeSH definitions for it. Much to my surprise, I discovered that MeSH puts homeopathy under several categories, one including [[spiritual therapies]]. While I might disagree on other definitions of homeopathy, I personally don't think it belongs under this heading, but, since I was quoting from MeSH, needed to include it. Under [[spiritual therapies]], I did put in a sentence that I thought was a reasonable disclaimer from a homeopathic standpoint, but please feel free to improve it. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 21:28, 25 December 2008 (UTC)
 
:I appreciate your "disclaimer," but why should homeopathy be listed at all under the category of [[spiritual healing]]?  I suggest that we delete it entirely.  [[User:Dana Ullman|Dana Ullman]] 16:39, 26 December 2008 (UTC)
 
::Fundamentally, to keep consistent with the major indexing system in healthcare. It's not the only place homeopathy is listed in MeSH.
 
::In discussing CAM in general, several people have suggested that MeSH names be used for consistency and neutrality. This is the first real surprise I've had in following that convention, and I would note that MeSH does have homeopathy under several categories. Now, if the top-level heading was vitalism-based methods, they might have a point. The only reason I think they might have done it is that there is a parallel to sympathetic magic because its classic anthropological statement does include a law of similars.
 
::It's bad indexing; I don't know who does the categorizing, but, having worked for the Library of Congress, I suspect staff but with comments and consultation. Still, I hesitate to make any exceptions from the practice of using MeSH. I will have to check, but there is, I believe, an Editorial Council resolution (passed? I don't know) to use MeSH for biomedical article, and I believe that is the reference Robert Badgett and others use. I really hesitate to start making exceptions. I'd sign a letter to NLM that either it doesn't belong here, or then quite a few other disciplines do. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:33, 26 December 2008 (UTC)
 
==Replaced section==
I hope we're converging now on an article that can be approved, and I've had a fresh go at the one remaining section where I can see problems.
 
Dana, you made a great shot at trying a balanced approach to this, and I've kept all your references in, though some details are down in the notes rather than in the body in line with the intent to leave this section relatively uncluttered. You brought in the Shang Lancet article - I think it was right and inevitable because it was so influential.
 
There were a couple of problems that I saw, most obviously it wasn't clear a) exactly what the fuss was about with this particular article -  a) why did it make such a scientific impact (not just another meta analysis)- what was so unusual about it, b) what exactly was that impact, and how did homeopaths respond.
 
The "two recent analyses" are not two but one - the lead author is the same, presenting the same re-analysis for two audiences, (and  is a homeopath). I've lifted quotes from the JCI article to bring out the conclusions.
 
Most importantly, I've tried as Dana did to write this section as a report of the controversy, trying not to infiltrate an editorial position. I saw with Dana's version the problem that even when you write neutrally, the order in which things are presented conveys an implicit bias - selecting some things as important to say first. I also saw that there is a problem of choosing what to say - obviously Dana sees the problems with the Shang study as being the important things to get across, from my point of view I see those problems as besides the point, the important point being not that the Shang study showed that all effects were placebo effects - they never claimed this; the important point was that it showed that it was plausible that they could be - and that was not disputed by the JCI study. But I'm not saying that my perspective is better than Dana's - it's just that from different perspectives different things show up as important.
 
I've tried to avoid this by starting with overtly neutral sentences, and then following a chronological account, keeping to the statements of authors and others, including study critics, trying to avoid interpolating my own interpretations. I've included a lengthy quote from the SVHA because I thought it important to let that argument be heard here, even though it can be argued that it's not relevant to the evaluation of trials.[[User:Gareth Leng|Gareth Leng]] 21:10, 26 December 2008 (UTC)
 
: Good work, Gareth.  However, this material is challenging, and I felt that I needed to place the specific disease meta-analyses into the body of the article, not just the footnotes, because reviewing just the global meta-analyses misses some important and notable specific disease treatment effects.  I also felt that you gutted some of the critic of the Shang paper.  I still want to edit it further.  I don't know if that quote from the Swiss homeopaths is adequately representative because the vast majority of the letters to the Lancet were strongly critical of how Shang selected trials, how he evaluated them, and the limited number of trials in the final analysis (from 220 to 14!).  [[User:Dana Ullman|Dana Ullman]] 03:16, 27 December 2008 (UTC)
 
::Thanks Dana; - on the selection of trials for the final phase  - this was intrinsic to the study design as the hypothesis was that larger trials would show less effect than smaller trials - and that the largest would show no effect. Of course whether a selection still shows an effect depends on the cutoff - in a sense this is Shang's point - the higher the cutoff the less of an effect there is.
 
The Shang study shows clearly that in all trials, conventional or not, the results from small trials are very unreliable. What is a small trial? Virtually all of the trials in the Shang study were small by conventional standards - it's not a representative sample of conventional trials, but a matched sample. To check, I looked at PubMed at the most recent 20 trials reported; 7 had over 1,000 subjects and only 6 fewer than 100 - all of the 6 small trials were rare cancer conditions. The median size was 400.
 
The SHVA are classical homeopaths - in a later statement they declared that ”Most homoeopathy effectiveness studies do not comply with basic homoeopathic rules, in no way correspond to real treatment practice and are – unlike studies of conventional medicine – irrelevant to practice. These studies are only carried out as external justification for homoeopathy. In real practice the selection of homoeopathic remedies is carried out completely on an individual basis. The remedy does not have a universal effect; rather it proves to be effective for the individual. In contrast, for study purposes, homoeopathic practices are usually distorted and standardised and forced into irrelevant research schemes. The result of this is a considerable risk of obtaining falsely negative results“[[User:Gareth Leng|Gareth Leng]] 09:22, 27 December 2008 (UTC)
 
: The big difference between the large homeopathic and allopathic clinical trials is that the allopathic trials previously tested the treatment on smaller numbers of subjects and based on positive results, they created a larger trial.  The homeopathic trials did not do this, so some trials were simple large pilot trials.  Testing Oscillococcinum for the "prevention" of the flu is a good example. The study was actually conducted by a French company that was competitive with Boiron (makers of Oscillo) to test their product (with the SAME ingredient) as a preventative...but it doesn't work well as a preventative medicine, only as a treatment method. 
 
: And for unknown reasons, Shang, et al chose to include only 1 treatment trial with Oscillo, even there are THREE trials with over 300 (!) subjects.  The exclusion of these other trials was never addressed.
 
: And yes, we are making good headway here.  I am confused why Gareth deleted the specific reference I provided that noted that 3 (!) of the 8 allopathic trials showed efficacy of a drug in the short-term but these drugs were removed from the medical marketplace later on when they were found to be more dangerous than effective (this fact suggests that "efficacy" of allopathic drug trials provides only a partial picture of their effects.
 
: Finally, Gareth, I appreciate ALL of the time you are devoting here, but can I ask you to make a greater effort to type something in the Summary for your edits? [[User:Dana Ullman|Dana Ullman]] 17:08, 27 December 2008 (UTC)
 
:: I thought my edits accepted that some drugs that pass efficacy are subsequently withdrawn because of side effects - you didn't give a ref (that's what I thought - Did I delete a reference - if I did I'm sorry, hadn't intended to, I'll check) to this so I deleted the specific phrasing (I couldnt verify) but I'm not saying its not correct - but what's the point here? Seems irrelevant to the issue of whether homeopathic remedies are placebo effects or not - so I acknowledged the point (in the last para, its likely to be true, it's what I'd expect) - but it's not germane to the issue of efficacy. [[User:Gareth Leng|Gareth Leng]] 21:47, 27 December 2008 (UTC)
::: Yes, on checking there's no reference for this point. Happy for something like this to be in a footnote, but not with that precise wording - the Shang analysis was ''not'' a comparison of conventional medicine and homeopathy, wasn't designed that way - it was purely and simply a test of the hypothesis that the effects are placebo effects - in this sense, for them the conventional medicine analysis was simply a "positive control" - to show that their approach was capable of factoring out publication bias. So saying that it wasn't a fair comparison of conventional medicine and homeopathy is missing the point - it didn't try to be a comparison, and we should avoid suggesting that it was one. It is also true that some of the conventional treatments were ineffective - as should be the case. Trials are done to weed out ineffective treatments, that's their purpose.[[User:Gareth Leng|Gareth Leng]] 22:02, 27 December 2008 (UTC)
 
:::Whooops...I didn't mean that you deleted any reference.  My concern was that you deleted the specific fact that 3 of the 8 trials used drugs that were withdrawn.  To me, just saying that "some" drugs were withdrawn wasn't specific enough (having 3 of the 8 withdrawn is significant).  [[User:Dana Ullman|Dana Ullman]] 03:54, 28 December 2008 (UTC)
 
== Appreciation ==
 
Dana and Gareth, I'm impressed with the way the Shang et al discussion is developing.
 
Not here, but perhaps in the "Overview" wrapup, would there be any point in mentioning some alternative controlled trial approaches that are being considered for low-responder or such things as individualized genomic medicine? As I understand the blinding mechanism for such trials, they essentially are testing the diagnostic and remedy/drug selection ''process'', as opposed to the remedy/drug itself. The clinician determines whatever treatment would be appropriate, and then sends that order off to the pharmacy. The pharmacy, in turn, opens the next random assignment envelope, and either prepares exactly what was ordered, or a control preparation. I'm inclined to think that these will need to be placebo controlled rather than best-existing-treatment, for how would you define the latter?
 
The U.K. Parliament report to which Gareth referred me does discuss such alternatives to traditional RCTs.
 
Just a thought; if homeopaths think this is a potentially fair means of future testing, and there's at least some discussion on this, it might be worth mentioning. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 08:23, 27 December 2008 (UTC)
: Interesting thought, but think its better to cover that in the trials article - we shouldn't here get too tied up in the testing issue, and now we're close to approval I'd rather close this article down for further major editing. [[User:Gareth Leng|Gareth Leng]] 10:41, 28 December 2008 (UTC)
::Good idea; good place. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 17:27, 28 December 2008 (UTC)
===Absolutely silly aside I had to share===
Don't worry, if you are not a ''Star Trek'' fan, this will make no sense whatsoever. It may or may not even make sense to fans.
 
As I've been reading this, I remember Gareth's institution is in Edinburgh. Now, I don't know if he himself is Scottish, but the discussion of the trials is bringing up a very odd mental image. I'm visualizing an alternate-universe version of the original ''Star Trek'', but with a Dr. Scott and Chief Engineer McCoy.  I hear, Gareth, playing the Doctor, saying to Kirk:
<blockquote>Kiptin, ye canna violate the laws of experimental design!</blockquote>
I haven't yet figured out if Dana is playing Kirk or McCoy.
 
If I find myself in this vision, I must be Mr. Spock, muttering "fascinating".
 
[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:01, 27 December 2008 (UTC)
 
: I once gave a lecture as "Capt. Dana T. Kirk" of the Star Ship Enterprise.  I'm glad that you see me possibly as Capt. Kirk rather than a tribble...or some other alien.  We are making progress.  [[User:Dana Ullman|Dana Ullman]] 03:57, 28 December 2008 (UTC)
 
:: "It's life Jim, but not as we know it!"  ??[[User:Gareth Leng|Gareth Leng]] 10:41, 28 December 2008 (UTC)
 
== yes or no, did Hippocrates ever say "like cures like" or not? ==
 
I looked at the origins of this article (several years ago, as a matter of fact) and although the "like cures like" has been there from the start, there was no mention of Hippocrates in the first months of editing.
 
When did he make his appearance, and who did the editing?  And what is the sourcing for this? Martin, over in a Forum discussion, is making the flat assertion that this is 100% false.
 
For a flat statement in the lede paragraph, we ought to make doubly certain that it really is correct.
 
What's the story on this? [[User:Hayford Peirce|Hayford Peirce]] 18:39, 28 December 2008 (UTC)
 
:I don't know 'for sure' it is wrong, but it is very unlikely. Here is the page for the quote in the Forum. It is such a complicated link it may not work - we shall see,
 
::http://books.google.co.uk/books?id=1Wez4pgWp3AC&pg=PA96&lpg=PA96&dq=hippocrates+text+%22like+cures+like%22+hippocrates+'like+cures+like'&source=web&ots=0iJ2zp9j2q&sig=ODWqxhd4_ddm8DHzIGhaeJd9EJU&hl=en&ei=HYFWSc60J-KYjAfYlcSsDw&sa=X&oi=book_result&resnum=1&ct=result
 
:Note also that Hippocrates' approach is quite opposed to the homeopathic idea. This is directly linked to Paracelsus who i have argued about already as the key 'populariser' of this idea - but  am not supposed to be able to raise again, so I won't! [[User:Martin Cohen|Martin Cohen]] 20:46, 28 December 2008 (UTC)
 
::Well, here's a quote from someone apparently at the Univ. of Michigan, writing in something called ''Medicina Antiqua'' at[http://www.ucl.ac.uk/~ucgajpd/medicina%20antiqua/index.html]
:::Hippocratics find it important to absorb all human diseases within their medical technê, including the very difficult sicknesses of sudden seizures and premenarchic madness, and to this end they not only assign mechanical causes that interact with the anatomy and physiology they endorse, but they also employ therapies that reverse a diseased condition in accordance with the same mechanical principles. "Opposites cure opposites" is a deliberate intellectual stance in opposition to the "like cures like" of sympathetic magic. Hippocratics know how to speak the language of science, and they are certainly the first in the Western tradition to write medical science in a form that has survived to our time.
::I don't know how conclusive that is, but I think that it indicates that whoever put in the Hippocrates citation ought to source it pretty carefully for us. [[User:Hayford Peirce|Hayford Peirce]] 21:11, 28 December 2008 (UTC)
 
:::Hahnemann has quoted Hippocrates in many of his books, notably the Organon. I hope someone can find some of those quotes online (I don't have the time).&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 03:01, 29 December 2008 (UTC)
 
::::I'm increasingly dubious about this assertion. We have to put our sources into hierarchies, for the following reasons:
::::*If we had a '''primary''' source, ie, a surviving work by Hippocrates stating this, that would be no-brainer.
::::*If we had a '''secondary''' source, such as [[Thucydides]], circa 450 BC, writing in an aside to one of his works on history that "the noted Hippocrates has stated that etc. etc.", that would be a pretty good source.
::::*If all we apparently have are citations of Hahnemann supposedly quoting Hippocrates, that, to me, is not a very reliable source. In fact, I would say that it is no source at all.
::::*If Hahnemann is going to be the only source for this assertion, then I think that we should absolutely remove it.  This doesn't mean, to be absolutely fair, that at some point you can't say that "Hahnemann said that Hippocrates etc.", but it certainly should not be in the lede paragraph as a flat assertion that Hippocrates said it. [[User:Hayford Peirce|Hayford Peirce]] 04:38, 29 December 2008 (UTC)
 
:::::William Howard Taft did have a pygmy hippopotamus in the White House. If he used homeopathic remedies, is that close enough? I can source the hippo part. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 05:02, 29 December 2008 (UTC)
 
:::::: Skipping the above, I agree with that. In this case, a direct statement by Hippocrates would be needed, interpretations by others are irrelevant. I know of no such direct statement, but Dana thinks he can come up with one. Well, fine if he can, but Hayford is surely right to shelve the claim for the time being. Even a 'category 2' reference requires a rewrite of the claim, which makes it a bit too weak to justify prominence - eg. According to so and so writing x hundred years later, Hippocrates believed that ... Re. Dana - there is nothing 'odd' that I think Paracelus promotes the principle and Hippocrates does not - or is there some subtle contradiction he could explain? [[User:Martin Cohen|Martin Cohen]] 18:50, 29 December 2008 (UTC)
 
===Adding to Philosophy Workgroup===
 
Following Matt's comments in the Forum, I believe it is appropariate and uncontroversial to add this to the Philosophy workgroup. For information, I would say the parts that are philosophical here are those concerning the general theory 'like cures like',  the historical development of basic underlying concepts and ideas concerning human health and nature, and certain peculiar features of homeopathy, such as the question of how somehting with no active content in conventional terms can affect health.  Most of the article, don't worry! is well outside 'philosophy'. [[User:Martin Cohen|Martin Cohen]] 20:54, 28 December 2008 (UTC)
 
:''Res ipsa loquitur.'' [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 21:04, 28 December 2008 (UTC)
 
:: I cannot remember if I am the source of the reference for Hippocrates or not, but I am 100% confident that the previous reference was accurate.  Hippocrates was a medical historian who reported on different treatments used in his time. In fact, he may have been the first to report that some physicians used the principle of similars in treatment. Medical historian Harris Coulter devotes much of volume 1 (of his 4-volume treatise on Western medical history) to the Hippocratic writings, and he gives specific references.  I will see if I can find them. I did look at the link that Martin provided, and I consider that source to be dubious because he asserts that like "never" cures like but only aggravates the condition.  This author clearly doesn't understand the use of small doses of like to cure like.  It is also a bit surprising that this reference would come from Martin who has previously championed Paracelsus who also recognized the value of the principle of similars.  [[User:Dana Ullman|Dana Ullman]] 05:00, 29 December 2008 (UTC)
 
:::I have confirmed that the above book reference given by Martin was material derived from the writings and thought of Galen, who lived 400-500 years after Hippocrates.  Galen believed in using opposites to cure.  Hippocrates, however, recognized numerous instances when using similars was vital.  For example, people who had a fever needed warm or hot remedies, not cold ones.  He referred to this as "coction," a process in which the fever is burning something out, and the body needed help in this coction process.  Harris Coulter notes in Divided Legacy (volume I, p. 206) that "cure by similars, which had been suggested in the Group I and IV writings (of Hippocrates) is developed extensively. Not only are fevers treated with heating remedies, expectoration and coughs with medicines which provoke expectoration and cough, and phlegmatic diseases with liquids, treatment by similars is proposed as a general principle:  diseases are caused by similars, and by the similars which he takes the patient is saved."  [[User:Dana Ullman|Dana Ullman]] 19:23, 29 December 2008 (UTC)
 
On adding this article to the Philosophy Workgroup: no.  I agree with Howard on this one: ''res ipsa loquitur.''  But I'll say a few things.  Even if Hippocrates were deeply important to this article, it would establish nothing, since most philosophers, even specialists in ancient philosophy, do not study Hippocrates; I imagine classicists and historians of medicine do.  And another thing: Martin's reasons would ultimately make it possible to add the Philosophy Workgroup to every article; that won't happen.  Similarly specious reasoning can be imagined for adding the History Workgroup to the management of nearly every article.  Anyway, please consider the question decided.  By the way, Martin, your "and uncontroversial" beggars belief--it's hard to believe anyone could really think the suggestion would be "uncontroversial."  If you wish to contest this, please don't discuss it here on this page.  Propose a new resolution for the Editorial Council--if you can get anyone to support it, that is.  ''Please'' just drop this suggestion; I don't want us to waste any time discussing it. --[[User:Larry Sanger|Larry Sanger]] 20:27, 29 December 2008 (UTC)
 
::Adding Philosophy as a workgroup - utter nonsense at this stage. Thnis article has been developed as a key article of Healing Arts; this is its primary home as written, it might have been written another way for another home, but it wasn't, and adding workgroups at this stage is unacceptable. I'm happy to delete Hippocrates fix the wording or see it fixed, but this is a trivial point. Dana, on the article as a whole I'm generally happy if you are to put it up for approval? [[User:Gareth Leng|Gareth Leng]] 21:48, 29 December 2008 (UTC)
 
:::As frightened and amazed I am to say it, yes, it is there or almost there. Some subarticles might be opportunties for development. I want to go through now with an eye to copy and flow edit, but it is very close. Hmmm...the rules do say you need 3 editors to approve if all have worked on it. If you need a third, define it as a war and I'll give Military approval. :-) [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 00:08, 30 December 2008 (UTC)
 
== Flow editing -- looking at last paragraph  of intro ==
 
Did some text get deleted here? As I remembered, perhaps incorrectly, one of the characteristics of ''classical'' was that it would only use one remedy at a time. ''User-friendly'' was intended to be for the over-the-counter remedies that could be self-selected by a layman.
 
Was there not something inbetween, which covered the use of multiple remedies by a professional homeopath, or possibly homeopathic techniques being used in a complementary manner to other disciplines?
 
If I rememeber incorrectly, does anyone else see problems with the transition between the two sentences? [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 00:32, 30 December 2008 (UTC)
 
:Yes, I think some stuff has been deleted but as far as I can see, there's no problem with the present flow. [[User:Hayford Peirce|Hayford Peirce]] 00:41, 30 December 2008 (UTC)
 
::I have no idea who changed those definitions of "classical" homeopathy and "commercial" homeopathy but both were not accurate.  I have corrected this, but I may want to improve them.  I also need to give the article a look-over, though we have all done a fine collaboration.  [[User:Dana Ullman|Dana Ullman]] 05:43, 30 December 2008 (UTC)
 
:::Thanks. I'm glad I spotted something was off, even if I didn't know what. I'm sure that sort of error crept in elsewhere, and it's going to take fine reading. At this point, I'd say that whenever something seems "off" in phrasing or flow, it's worth mentioning neutrally and see if it's an edit error. Not my stuff, of course. My riteing is Prefect. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 05:50, 30 December 2008 (UTC)
 
::::Howard, are you getting a lot more funny these days or am I simply learning to appreciate your odd (and wonderful) sense of humor (with no regard of Galen's take on humors).  [[User:Dana Ullman|Dana Ullman]] 17:51, 30 December 2008 (UTC)
 
:::::I shall be phlegmatic in response. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 18:00, 30 December 2008 (UTC)
== Enormous improvement in a mere 90 character ==
 
Dana, the rewrite around syndrome, constitution, and psychology makes it immensely clearer. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 06:49, 30 December 2008 (UTC)
 
==Thanks==
Special thanks to Hayford for his assiduousness and to Howard for his alertness and good humour.
 
I really think we're close, after Dana's careful and balanced mopping operation. Matt is a Healing Arts editor, and Larry an everything editor - so with Dana and myself we seem to be replete. Lets go for Approval, and end what's finished very amicably on a high?[[User:Gareth Leng|Gareth Leng]] 18:12, 30 December 2008 (UTC)
:Does this mean that if I find another AE variant to be changed I can still do it right up until the final Approval, or are things frozen even will the Approval process is ongoing? [[User:Hayford Peirce|Hayford Peirce]] 18:16, 30 December 2008 (UTC)
 
::Hayford, what will happen is that Gareth or Dana will put it up ToApprove and will give everyone some time to look it over and make their tweaks (somewhere between 3 to 14 days perhaps).  If at anytime one of the editors does not like what they see, they can remove the ToApprove tag and we start over.  If the date is reached, the article then becomes approved and frozen in place.  A copy will be made and further changes will be made to the 'draft version'.  This draft will then to be re-approved by the same process.  Meanwhile, the approved version is the version that the public will see.
 
::For me to become an editor on this page, I think I will need some sort of special clearance because I acted as a constable.  I think the conflict of interest clause was to keep a constable from forcing his wishes on the article.  If anyone feels that I have, then it probably is not appropriate for me to be the third editor.  So, if it is okay with all the necessary powers to be, I'll be honored to take part. [[User:D. Matt Innis|D. Matt Innis]] 18:33, 30 December 2008 (UTC)
 
:::Under the circumstances, I think it will be fine. --[[User:Larry Sanger|Larry Sanger]] 21:54, 30 December 2008 (UTC)
 
:::::Okay then, I think it is only appropriate then that I switch hats and only be an editor while someone else takes over the constable duties and I actually read the article and see if I can support it! [[User:D. Matt Innis|D. Matt Innis]] 02:10, 31 December 2008 (UTC)
 
::::As long as he can't get out of having the standard horrible picture on the clearance badge. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 21:58, 30 December 2008 (UTC)
 
::::::So when did you see my picture ;-D [[User:D. Matt Innis|D. Matt Innis]] 04:36, 31 December 2008 (UTC)
 
:::::Can someone clarify what happens after the article is approved?  Is it still edit-able?  Is it edit-able by anyone who signs up on CZ?  And by the way, I want to give a shout-out thanks to Gareth for his yeoman's work in mediation and to Matt for helping to keep the "fighting" clean...and to ALL of us for not fighting too much, and even when we did, none of us seemed stuck in fighting mode.  This was all quite gentlemanly (strangely, there were no women in this one, were there?).  [[User:Dana Ullman|Dana Ullman]] 22:46, 30 December 2008 (UTC)
 
::::::Dana, the approved version of the article will be locked with page protection so no-one will edit it and will be the version that the public will see when they type in [[Homeopathy]].  A copy will be made and placed under the name [[Homeopathy/Draft]] that we can continue to work on behind the scenes.  The editing works the same way only the changes will not be seen by the public until the article gets re-approved by three editors again in which case that may be next week, next month, next year, or never again.  At this point, I think we should only approve the main page and not the subpages so we can continue to work on those subarticles.  Did that help?  Otherwise, read through [[CZ:Approval Process]]. [[User:D. Matt Innis|D. Matt Innis]] 02:10, 31 December 2008 (UTC)
 
Thanx. This process make so much sense.  Bless Larry!  [[User:Dana Ullman|Dana Ullman]] 03:58, 31 December 2008 (UTC)
 
==Gangrene?==
Friends, can I suggest that we change this example from gangrene (a very rare condition these days...and a very medical condition in any case!) to a more common contemporary ailment such as ear infection or to hayfever?  [[User:Dana Ullman|Dana Ullman]] 22:36, 30 December 2008 (UTC)
 
:I agree a more common example would be better. Having been involved in lab support for some cases of gangrene, I wish it were less common. May I never see, or, especially, smell it again. Still too often as a complication of diabetes.
 
:On a more cheerful note, hayfever? What's the normal temperature of hay?  [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:13, 30 December 2008 (UTC)
 
:: Happy to see hay fever as well - I put gangrene in, mainly to show that homeopathic remedies were used for serious and rare medical conditions as well as common, generally mild ones; I think this is important to show, but do add a more common example as well.[[User:Gareth Leng|Gareth Leng]] 11:36, 31 December 2008 (UTC)
 
==Cuban study==
A heads-up...I just added a reference to what seems to be an important study on homeoprophylaxis that was sponsored by the Cuban government and that involved 5 million people.  Other editors are encouraged to review the abstracts at the reference provided, though the details of this study are not expected to be published until some time in early 2009.  [[User:Dana Ullman|Dana Ullman]] 23:05, 30 December 2008 (UTC)
 
:Larry, this is exactly the kind of thing I meant when, in part, I answered your "should we have a CAM article" with "if for no other reason than health policy and economics."[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:13, 30 December 2008 (UTC)
 
== Friendly amendment on double-distilled water ==
 
Having done a fair bit of biochemical preparations, I would avoid being specific to "double-distilled". "Chemically pure", "Purified to Pharmacopeia standard", or other term might be safer.
 
Real-world example: we had a project in the physical chemistry of hemoglobin, where the pH of the water was critical. The receiver bottle's vent had a soda lime trap on it, to prevent CO<sub>2</sub> absorption. The solution preparation was done in a glove box under nitrogen. They were then sealed and typically taken out with a hypodermic syringe and injected into reaction ports, never being exposed to air.
 
Given clathrates have been suggested in the memory of water, it might be wise not to lock yourself into a single means of water purification. Small gas molecules are typically in the center of clathrates; some ocean scientist friends have told me there are significant, and even potentially dangerous, accumulations of methane clathrates on the sea floor. While I haven't researched it, I'd assume there could be carbon dioxide clathrates; there are even clathrates (might have been the first discovered) of inert gases such as xenon.
 
[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:47, 30 December 2008 (UTC)
 
: Let's figure this out. I thought that "double-distilled" refers to a specific process of distillation twice that is "purified to Pharmacopeia standard."  It seems (to me) that we cannot say the latter without saying the former.  [[User:Dana Ullman|Dana Ullman]] 03:49, 31 December 2008 (UTC)
 
Seems to me we just say whatever is done. Frankly, "chemically pure" only makes sense if it is understood that below a certain concentration trace elements are irrelevant - there's no known process that can yield water without trace quantities of many other substances. If concentrations of less than 10(-12) matter, then there is no pure water.[[User:Gareth Leng|Gareth Leng]] 11:44, 31 December 2008 (UTC)
 
== Citing one's own books ==
 
Let me share some things I've done. We probably should have a policy, since there are a fair number of authors here.
 
In one case, where one of my books is a general reference to the field, I put in on a bibliography page, along with those of some colleagues [http://en.citizendium.org/wiki/Border_Gateway_Protocol/Bibliography]. In that case, I chose not to annotate the books, although, depending on someone's needs, I'd recommending having 3 or all of the listed books.
 
I'm embarrassed to mention that I can't find where I did it, but when I had a specific page referenced, I put a disclaimer on the talk page. At the time, someone pointed out that while these weren't strictly peer reviewed, they were through major publishers with known technical review structures, and that helped.
 
Actually, looking at the BGP bibliography page, I realized I never went in and filled in the NANOG presentations, which I need to do. I'll refer to mine along with some others. This is easier since these are all public domain.
 
In like manner, I've never worried about citing peer-reviewed work of mine.
 
As a suggestion only, unless you are quoting pages or figures, I think it removes any appearance of conflict of interest to have some comment encouraging readers to get further information in the bibliography, and have several authors there.
 
It may depend on how wide the market for the book may be. I think Milton Beychok cites some of his own work, but I doubt the definitive book on stack gas emission engineering is making Tom Clancy insomniac worrying about lost royalties.
 
Anybody else here have books? How did you handle it?  This is probably a good forum discussion. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 00:02, 31 December 2008 (UTC)
 
[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 00:02, 31 December 2008 (UTC)
 
:I'd encourage you to look up our existing policy on this.  :-) --[[User:Larry Sanger|Larry Sanger]] 04:07, 31 December 2008 (UTC)
 
::Larry, had I known there was a policy, I wouldn't have guessed. Perhaps I searched under the wrong term. Would you mind giving a link? I found some material about peer-reviewed material being OK, and I remember some discussions about textbooks and monographs that went through a review process. I was not at all sure about books meant for a wider audience. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:15, 31 December 2008 (UTC)
 
:::[[CZ:Policy on Self-Promotion]] and there are long debates about this in the forums from last year, or maybe it was early this year, I forget. --[[User:Larry Sanger|Larry Sanger]] 20:56, 31 December 2008 (UTC)
 
== which government? ==
 
A recent edit about a conference in Cuba says:  "a manufacturer of conventional vaccines for the government." But which? Cuban, Brit, 'Merkin, Chinese? [[User:Hayford Peirce|Hayford Peirce]] 01:51, 31 December 2008 (UTC)
 
:That needs attention if it's to stay a)I'll check out the conference links but b) conferences aren't peer reviewed and the status of what is reported there is at best weak (and hopelessly weak if the conference is basically volunteer)[[User:Gareth Leng|Gareth Leng]] 11:24, 31 December 2008 (UTC)
 
:: It's a Cuban business that manufactures sboth vaccines and homeopathic products (for the Cuban government). The conference is not peer reviewed in any form, the scientific committee is wholly Cuban, the abstracts give bare details, not enough for any evaluation - they are mere guides to what is being presented. The link as given doesn't work but this does [http://www.finlay.sld.cu/nosodes/en/ProgramaNOSODES2008Eng.pdf]. So I'd say that this is unhelpful except in establishing that there are still homeopaths who think that this works. It's not helpful as a source of information. I'll look up details of the specific (and I have to say rather bizarre sounding) Cuban programme against the perceived threat of a Leptospirosis outbreak after flooding in 2007, see if I can find an informative account.[[User:Gareth Leng|Gareth Leng]] 12:22, 31 December 2008 (UTC)
::: Leptospirosis is an emerging infectious bacterial disease common in tropical regions (spread by rats, risk factor is contamination of water after flooding), generally mild and flu like, mostly transient and mild, more severe forms normally well treated with antibiotics. No vaccine except in Cuba, produced by the Finlay Institute - used since 2004. Cuba had epidemic levels of leptospirisis in 1994, subsequently falling dramatically - but, with hurricanes in 2007, the Cuban government was worried about the possibility of a repeat epidemic. They distributed 5 million doses of a homeopathic agent also produced by Finlay. There seems to have been no extensive mortality that year. So? Was it the vaccine? was it the homeoprophylaxis? or did the sewers survive this time? Or was conventional treatment better this time? Who knows. I don't recommend mentioning it unless it is worth noting that the Cuban government thinks it worth trying this.[[User:Gareth Leng|Gareth Leng]] 12:51, 31 December 2008 (UTC)
 
== A key sentence that MUST be agreed upon by all editors ==
 
"Why do many trials report positive outcomes for homeopathy, but some show no effect, and how is it that the positive evidence does not persuade most scientists and leaders of academic medicine?"
 
The word "many" has been changed, back and forth to "most", "a majority", etc., over and over now. It is a *vital* word. What is the final consensus on it? [[User:Hayford Peirce|Hayford Peirce]] 02:04, 31 December 2008 (UTC)
 
: Good questions..."many" suggests a non-majority, while "most" refers to a majority.  The BMJ (1991) and the Lancet (1997) meta-analyses found that most studies showed a positive effect.  [[User:Dana Ullman|Dana Ullman]] 03:54, 31 December 2008 (UTC)
 
: The BMJ (1991) evaluated 105 trials, 81 of which showed a positive result.  I don't have the 1997 study in front of me, but I remember it being a significant majority too.  [[User:Dana Ullman|Dana Ullman]] 03:57, 31 December 2008 (UTC)
 
:: I agree with Dana, I think there's no question that on a simple count most published trials are positive. It's right to be straight and clear on this.[[User:Gareth Leng|Gareth Leng]] 11:26, 31 December 2008 (UTC)
 
:::I'm fine with 'most' and since 'most' would be a 'majority', I wouldn't split hairs unless it was something really close like 51% to 49%.  So, Ill go with whatever Dana feels comfortable with. [[User:D. Matt Innis|D. Matt Innis]] 18:57, 31 December 2008 (UTC)
 
== Which They? ==
 
In the "Who are the professional homeopaths", we have this sentence:
*Classical homeopaths place emphasis on the patient's unique symptoms and their psychological state, and they gather this information from an interview, typically lasting from 15 minutes to two hours, with one or more follow-up consultations of 15 to 45 minutes. Consultations of these lengths are comparable to conventional physicians using their clinical judgment, rather than shorter visits demanded by third-party economic constraints. '''They''' place more emphasis on the way the patient experiences their disease rather than only diagnosing the disease...
 
The bold '''They''' seems to be referring to 'conventional physicians', but I know that is not what we meant. 
[[User:D. Matt Innis|D. Matt Innis]] 02:58, 31 December 2008 (UTC)
 
==This list needs a title or something to introduce what it is trying to convey ==
 
*A physician qualified in both homeopathy and conventional medicine, after diagnosing a chronic condition that does not medical urgency, will usually first prescribe a homeopathic remedy which he feels may be more effective and is likely to have fewer side effects than conventional drugs.
*Homeopaths recognize that trauma might require conventional medical attention but may complement the conventional treatment with homeopathy.
*Homeopaths disagree with conventional medicine about the role of immunization and chemoprophylaxis for infectious diseases and prefer to prescribe homeopathic remedies that they believe will strengthen a person's immune and defense system.
*Homeopathic practitioners prescribe remedies for people who suffer from various disease states. For some disease conditions, such as [[asthma]] and [[acute bronchitis]], remedies are often prescribed not only to alleviate chronic symptoms, but also to treat acute attacks. Homeopathic remedies might also be used after an asthmatic episode with the intent to prevent recurrences.
*An adequately trained homeopath is expected to recognize symptoms that indicate an acute and potentially fatal condition. The practitioner is expected to have emergency medical training and equipment appropriate to his or her level of training in the place of practice (e.g., dressings and basic airway management tools for an individual with training at the [[Emergency Medical Technician]] (EMT) of Basic or higher level, and preferably an [[defibrillator|automatic external defibrillator]] and [[advanced cardiac life support]] resources generally accepted as appropriate for an office. Potentially serious acute ailments may require medical supervision, but homeopaths sometimes prescribe remedies either for adjunctive use or as alternatives to conventional treatment.
[[User:D. Matt Innis|D. Matt Innis]] 03:20, 31 December 2008 (UTC)
 
== Changes to ToApprove version ==
 
Okay, I've made my first go-through and agree that you have all done a really good job in transforming this article.  I made some changes to the version that Gareth approved and subsequently Dana and Hayford also changed.  The difference between the version that Gareth is willing to approve and this current version is [http://en.citizendium.org/wiki?title=Homeopathy&oldid=100429384 this].  I'll take a break for tonight (here) and let everyone look it over again before I go through it again. [[User:D. Matt Innis|D. Matt Innis]] 04:17, 31 December 2008 (UTC)
 
:'''Many''' many many thanks Matt.[[User:Gareth Leng|Gareth Leng]] 11:48, 31 December 2008 (UTC)
 
== The lead ==
 
I did not make any substantial content changes to the lead, but I did re-arrange it so that it flowed from idea to idea.  There were two sentences that I combined as we were repeating somewhat. [[User:D. Matt Innis|D. Matt Innis]] 20:53, 31 December 2008 (UTC)

Latest revision as of 16:21, 20 September 2010

This article is developed but not approved.
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APPROVED Version 1.1

Discussion for Version 1.1 stopped here. Please continue further discussion under this break.

The Approval includes two copyedits [1] Hayford Peirce 19:13, 11 October 2009 (UTC)

I'm not sure how to add yet another archive and get things to show up properly in the header here. Could someone do so? Howard C. Berkowitz 19:22, 11 October 2009 (UTC)

Beginning with semi-lower-case editorial...

As a first step, I'm going to all footnotes that contain other than bibliographic material or definitions, and either moving the substantive text into the main article, or, in some cases, linking to a subarticle.

While it may be reasonable, in a printed book or journal, to have bottom-of-the-page notes, in this format, the content of the notes will not be seen unless the reader clicks on them. How many readers do that? In effect, the text is being hidden. Howard C. Berkowitz 19:37, 11 October 2009 (UTC)

A balanced blog post on the subject

can be found here. --Daniel Mietchen 09:21, 16 December 2009 (UTC)

I added a comment, as did Paul. Truly delightful, however, is

Personally, I would really like to see a homeopathic treatment for dehydration. You'd have to have a compound that causes dehydration, but what would you dilute it in? you can't dilute it in water or saline, because those will rehydrate, and in homeopathy, you have to CAUSE dehydration to cure it...but you can't having anything that CAUSES dehydration because it would have to be diluted to the point where none of the dehydrating agent remains...

It should be noted that some camping supply stores, in the same aisle as freeze-dried foods, offer cans of "dehydrated water". Ethical staff makes sure that new users understand the purpose of same. Howard C. Berkowitz 15:06, 16 December 2009 (UTC)


Howard, you gave the wrong link for Sympathetic magic. It's http://en.citizendium.org/wiki/Sympathetic_magic And make sure the period at the end does not get connected to the link. Chris Day 15:26, 16 December 2009 (UTC)

That's a reasonable way to look at it, which is unusual for a blog. D. Matt Innis 18:43, 16 December 2009 (UTC)

Put it into the External Links. --Daniel Mietchen 19:27, 16 December 2009 (UTC)

Ramanand's changes

First, the word " most biased medical " is argumentative, does not fit the language of the lede, and is clearly advocacy.

The statement supporting homeopathy in the lede, even if the references were solid, belongs, stylistically, in a later section on the mechanisms of homeopathy. One reference is, as far as I can tell, from a Brazilian university with a site in, presumably, Portuguese, which I do not read. We generally don't use non-English references, especially when they are not clearly from peer-reviewed journals or otherwise reviewed sources.

The other reference is from Khuda-Bukhsh, whom, I believe, has been in the memory of water controversy, is a review of possible molecular mechanisms of action. On first glance, it's an interesting paper, but does not talk at all about efficacy — just how homeopathic remedies may work, if they work. It doesn't belong in the lede, although it's not unreasonable to use it as a reference in a later section.

Neither addition works where it is. The first is advocacy and non-neutral. --Howard C. Berkowitz 17:45, 7 January 2010 (UTC)

The use of "biased" is definitely adversarial. Chris Day 21:12, 7 January 2010 (UTC)
With regard to the rebuttal (it works, and we know how), I am loath to see this article head down the direction of he says, she says tit for tat. Chris Day 21:21, 7 January 2010 (UTC)
The whole article is full of oxymorons, containng both viewpoints, so I don't see anything wrong with what I've inserted, unless the critics' statement is also removed (about what scientists feel). I'm fine if the word biased is removed, if it seems adversarial. The Portuguese and French is only in the references section and shouldn't be a problem.—Ramanand Jhingade 10:28, 8 January 2010 (UTC)
Well, Ramanand, the general CZ, policy, especially in the Charter, is that articles don't equally present all views. They present the preponderance of the expert views, and, in this case, the experts are in health sciences; there isn't a unifying discipline among healing arts. Not all healing arts support homeopathy.
Everyone needs to Neutrally present all views. D. Matt Innis 02:31, 9 January 2010 (UTC)
The foreign language citations have been a problem in many other articles, not just here.
I think you mean contradictions or rather or challenges, not oxymorons. An oxymoron would be a "heroically large dose of a homeopathic simillum." An oxymoron is a contradiction in terms.
Sorry, I'm in favor of removing both additions. You will need to face the reality that the article will not be as pro-homeopathy as you want, just as others wish it weren't here at all. It's a compromise. --Howard C. Berkowitz 15:48, 8 January 2010 (UTC)
I applaud, encourage and appreciate collaborative efforts to work toward improvements, but I think this lead still needs significant work to add any substantial improvement to the approved version's lead. D. Matt Innis 02:28, 9 January 2010 (UTC)
I forgot to wish all of you a Happy (belated) New Year. The presently approved article's Lead isn't 'neutal' at the moment. It should either explain homeopathy plainly or if y'all want criticism in the Lead, it should contain both viewpoints. Where's Dana, by the way, in Germany again?—Ramanand Jhingade 09:14, 9 January 2010 (UTC)
Happy New Year to you, too! Please let me know where you think the present Approved version lead (as opposed to the draft lead) is lacking and I'll be glad to take a look. Dana approved the current lead, too, but I'm sure he'd take a look if we asked him. D. Matt Innis 15:00, 9 January 2010 (UTC)
I'd posted a whole lot of links to homeopathic articles, late last year, but did not have the time to add it in the article. I was expecting someone here to do it, but no one did (not even Dana)! I already wrote what I wanted above, "It should either explain homeopathy plainly (without criticism in the very 1st sentence) or if y'all want criticism in the Lead, it should contain both viewpoints."—Ramanand Jhingade 08:34, 12 January 2010 (UTC)
We certainly can't add every link ever written to this article. This is the overview article in an encyclopedia type format and summarizes homeopathy pretty well, I think. Again, don't confuse the lead in the Draft with the lead in the main Homeopathy article. I agree the lead in the draft needs more work and is not an improvement in its current form. D. Matt Innis 12:45, 12 January 2010 (UTC)
If nothing else, bibliographic links not directly related to the text belong on the bibliography page, preferably in articles. Also, in other articles, there is some selectivity. In some cases, reviews are more appropriate than small primary studies. In other cases, peer review and responsible publications are appropriate. In yet other cases, there is more leeway on publications but the reason needs to be explained.
It's not necessarily reasonable to assume someone else will edit and add articles with which they aren't familiar, or with which they might disagree.
What principles of homeopathy are in not in the lead? It should go without saying that homeopathists believe what they are doing, or the article wouldn't be here at all. Having a small number of dissenting comments from people who question hematology simply establish it isn't universally accepted, and the details and pros and cons should be in the article, but later. Howard C. Berkowitz 13:27, 12 January 2010 (UTC)
RE: provided references from Ramanand, this must be the list and I do remember it, but it's mostly primary research. They could be used for a more detailed article to support a specific claim where reviews aren't available, but to cite them here would result in too much detail for the general nature of this article. Primary research doesn't belong in a bibliography either. I'm not sure that we have a subpage that would be appropriate for primary research, though it's an interesting idea for some other project, or way in the future for this one. Otherwise, I'd think it would be a problem with CZ:Maintainability. There are other sites that do list all the research for each particular subject. D. Matt Innis 14:51, 12 January 2010 (UTC)
This is one page (Homeopathy/Trials) that exists with a tabulated summary of some of the voluminous primary literature. I agree maintainability is an issue. I bet there are hundreds of articles like this and the main problem is reducing it to the most important articles in the field. If that could be done well it might make a good catalog. Chris Day 17:18, 12 January 2010 (UTC)
Matt, I made some time to read the entire (presently) approved article. I don't see any sentence saying there is evidence for homeopathy (the feg pdf document I've inserted in the present draft is accepted by 'mainstream' scientists as well). I object to the term 'placebo' in the lead (Edzard Ernst is known to be a ridiculed homeopathic baiter in the U.K.). I also object to the term 'fraud' in the Overview section

They also are interested in whether positive results against expectation sometimes reflect manipulation of data or perhaps even fraud.

. Like you said, can we edit the (presently) approved article?—Ramanand Jhingade 17:34, 23 January 2010 (UTC)
David (Ellis), can you please tell me what objections you have to the feg pdf document?—Ramanand Jhingade 17:42, 23 January 2010 (UTC)

(undent) Placebo in the lead is perfectly appropriate; conventional medicine routinely accepts the placebo effect as a component of therapies.

Fraud is mentioned gently as a possibility by some observers, seemingly far more gently than some of the homeopathic claims of the danger of medicine. Sorry, it's not unbalanced. Please do not go to "known" homeopathic baiters anywhere, else that you start having people bring in medical baiters from homeopathy. The problem with bait is that it often has a hook inside.

By edit the presently approved article, no, other than for typos, it's frozen. It is possible to edit the draft, and eventually to have the edited draft become the newly approved.

Again, what specific principles of homeopathy 'are not in the lede? --Howard C. Berkowitz 18:03, 23 January 2010 (UTC)

Friends, it has been a while since I check-in here. I have not re-read most of the new draft, but I can tell you that I do not like the lede paragraph. It is simply not encyclopedic or impartial. Anyway, we only recently spent a lot of time approving the previous edition. I suggest that we let it sit for 3-6 months or more before we re-do it. Dana Ullman 05:28, 1 February 2010 (UTC)
Dana, I hope you can insert sentences that read something like, "there is scientific evidence for homeopathy", using the PDF for "Scientific framework of homeopathy: evidence-based homeopathy" available at http://www.feg.unesp.br/~ojs/index.php/ijhdr/article/viewFile/286/354 wherever appropriate.—Ramanand Jhingade 08:21, 2 March 2010 (UTC)

British House of Commons Science and Technology Committee report

The committee commissioned by the British government has reassessed homeopathy as a treatment option under the national health service. It's enquiry sought written evidence and submissions from concerned parties (See News in brief: Homeopathic assessment and Evidence check: Homeopathy). Both sides of the debate were represented and presented written evidence to the committee. In addition there were oral presentations from the following individuals:

  • Mr Mike O'Brien QC MP, Minister for Health Services, Department of Health;
  • Professor David Harper CBE, Director General, Health Improvement and Protection, and Chief Scientist, Department of Health;
  • Professor Kent Woods, Chief Executive, Medicines and Healthcare Products Regulatory Agency
  • Professor Jayne Lawrence, Chief Scientific Adviser, Royal Pharmaceutical Society of Great Britain;
  • Robert Wilson, Chairman, British Association of Homeopathic Manufacturers;
  • Paul Bennett, Professional Standards Director, Boots;
  • Tracey Brown, Managing Director, Sense About Science;
  • Dr Ben Goldacre, Journalist.
  • Dr Peter Fisher, Director of Research, Royal London Homeopathic Hospital;
  • Professor Edzard Ernst, Director, Complementary Medicine Group, Peninsula Medical School;
  • Dr James Thallon, Medical Director, NHS West Kent;
  • Dr Robert Mathie, Research Development Adviser, British Homeopathic Association.

A summary statement from the House of Commons Science and Technology Committee was released with the report in Feb 2010:

‘ ... the NHS should cease funding homeopathy. It also concludes that the Medicines and Healthcare products Regulatory Agency (MHRA) should not allow homeopathic product labels to make medical claims without evidence of efficacy. As they are not medicines, homeopathic products should no longer be licensed by the MHRA.

The Committee concurred with the Government that the evidence base shows that homeopathy is not efficacious (that is, it does not work beyond the placebo effect) and that explanations for why homeopathy would work are scientifically implausible.

The Committee concluded - given that the existing scientific literature showed no good evidence of efficacy - that further clinical trials of homeopathy could not be justified.

In the Committee’s view, homeopathy is a placebo treatment and the Government should have a policy on prescribing placebos. The Government is reluctant to address the appropriateness and ethics of prescribing placebos to patients, which usually relies on some degree of patient deception. Prescribing of placebos is not consistent with informed patient choice-which the Government claims is very important-as it means patients do not have all the information needed to make choice meaningful.

Beyond ethical issues and the integrity of the doctor-patient relationship, prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS.
Source: UK Parliamentary Committee Science and Technology Committee - "Evidence Check 2: Homeopathy"

’

From the full report the committee also stated:

‘

We conclude that placebos should not be routinely prescribed on the NHS. The funding of homeopathic hospitals — hospitals that specialise in the administration of placebos — should not continue, and NHS doctors should not refer patients to homeopaths.
Source: Evidence Check 2: Homeopathy, Fourth Report of Session 2009–10, House of Commons Science and Technology Committee, 20 October 2009, parliament.uk

’

In conclusion the chairman of the committee said:

‘

This was a challenging inquiry which provoked strong reactions. We were seeking to determine whether the Government's policies on homeopathy are evidence based on current evidence. They are not.

It sets an unfortunate precedent for the Department of Health to consider that the existence of a community which believes that homeopathy works is 'evidence' enough to continue spending public money on it. This also sends out a confused message, and has potentially harmful consequences. We await the Government's response to our report with interest.
Source: UK Parliamentary Committee Science and Technology Committee - "Evidence Check 2: Homeopathy"

’
The Evidence Check definitely needs to be in the article. It has been hilarious watching the homeopaths squirming around trying to explain it away by butchering the quote from Cucherat's systematic review. It is like those reviews you see on movie posters where it says something like "Tremendous, Exciting (Evening Standard)" and then you go and look and see what the Evening Standard actually say and it is "A tremendous waste of time and money, has difficulty exciting all but the clinically insane". –Tom Morris 15:12, 3 March 2010 (UTC)
For some reason, I couldn't access Citizendium yesterday at this time. Meanwhile, I got a reply from Dr Peter Fisher to my e-mail in which he says that the individual specific rules of Homeopathy were not followed in prescribing/administering the Homeopathic remedy, so I hope good sense prevails over the 'UK Parliamentary Committee Science and Technology Committee'.—Ramanand Jhingade 13:43, 12 March 2010 (UTC)
With regard to "the individual specific rules of Homeopathy were not followed in prescribing/administering the Homeopathic remedy" what is Peter Fisher referring to? How does that impact the report? Chris Day 16:25, 12 March 2010 (UTC)
As I understand it, the individual specific rules of homeopathy mean that every patient is unique and the remedies appropriate for one will not be appropriate for another. Let's assume this is exactly correct. That would make classic randomized clinical trials, in which there is a standard treatment arm and a control arm, inappropriate, because there is no homeopathic standard.
A very similar problem, however, applies to highly individualized pharmacogenomic therapies: within a cohort of patients with, say, metastatic breast adenocarcinoma, the experimental hypothesis may be that a given treatment is applicable only to those patients with a specific BRCA gene coding. Panaceamycin is only expected to be effective in patients with that characteristic, and the others should get an aromatase inhibitor, the standard of care. Given there is a treatment, a placebo control is ethically unacceptable.
RCT's have been designed that still have statistical power, but are testing the diagnostic and treatment model, not panaceamycin. The clinician selects the treatment and sends an order to the pharmacy, where the pharmacist opens the next blind assignment envelope. If the patient is assigned to the experimental arm, the IV drug unit sent back to the care unit has panaceamycin in it if the genomic model calls for it, and the control treatment if not. If the patient is assigned to control, she gets control. It is the decision to assign that is being tested, more than the drug itself.
In like manner, homeopaths could prescribe a totally individualized remedy, but they would be blinded to whether or not the patient gets the remedy -- control could be placebo, or a medical treatment. With a sufficiently large sample, if the homeopathic model is correct, the patients receiving the remedy should do better.
It is not clear that homeopaths are willing to be tested in such a manner, which should obviate the argument about individualization not being permitted. --Howard C. Berkowitz 17:05, 12 March 2010 (UTC)
Brings me back to a question that I have never seen an answer to. How can remedies be mass marketed and sold off the shelf at places like wal-mart and whole foods and be so effective (as claimed)? These remedies are either robust or need to be highly individualized. If the latter, I don't see how how a mass market product will work. If the former, then they have indeed being found wanting (no better than placebo). Their defense against accepting the failed results of clinical trials precludes claiming successes from the mass market products. Which is it? Chris Day 19:15, 12 March 2010 (UTC)
A question, Chris, that I've asked myself. Let me respond indirectly. One of the major mass-marketed products is Oscillococcinum, about which I did write an article. What is the sound that is made by the creature from which the simillium is obtained? --Howard C. Berkowitz 19:28, 12 March 2010 (UTC)
Given that they are a £1.5bn industry we can expect to hear a lot of noise like that in the next few months. Chris Day 19:40, 12 March 2010 (UTC)
Howard, you got it right - for example, Ipecacuanha can't be given where Antim. Tart is indicated. Chris, classical homeopaths don't accept 'over the counter'/'off the shelf' products because anything between 2 to 20 remedies are mixed in one 'combination' (Hahnemann used to call such homeopaths the 'mongrel sect'), but since it's popular, the classical homeopaths can't do much about it. In India, homeopathy is a half a Billion $ 'industry' - and that is only counting the medicines sold 'over the counter' and not what is spent on homeopathic doctors - so we're not gonna let people talk rubbish about it. It really works (See the 'feg' pdf document I've posted in the previous section)!—Ramanand Jhingade 09:22, 13 March 2010 (UTC)

Ramanand, you didn't get right the essence of what I was saying: there are statistically powerful testing methods, which have been developed for biological therapies that indeed are individualized, which could answer the homeopathic objection to more traditional randomized clinical trials. I have not seen any evidence that homeopaths are willing to use such methods, but instead continue to insist on either statistically weak retrospective analyses or anecdotal/testimonial evidence. Howard C. Berkowitz 16:21, 13 March 2010 (UTC)

Howard, it is very simple: the homeopaths are perfectly happy to use clinical evidence when it shows that homeopathy works. But when it shows that it doesn't work, then the clinical trial methodology must be at fault! Heads I win, tails you lose. If clinical trials are unable to detect the effects of homeopathy, why is the British Homeopathic Association quote-mining Cucherat? What seems more likely: that homeopathy works but not to the point where the clinical trial can detect it, or homeopaths cynically misuse evidence to support their pre-ordained conclusions? It has been so amusing to watch: our politicians have seen that the King alternative therapist is actually nude. All the homeopaths have been able to do is spin, quote-mine and clutch at straws. –Tom Morris 18:38, 13 March 2010 (UTC)
I suppose there isn't really anything to do about it until there's a new Editorial Council and a reevaluation of workgroups. Howard C. Berkowitz 19:04, 13 March 2010 (UTC)
The draft is open to rewrite and, while I can't speak for everyone, I'll be glad to look at anything that gets put in it. I agree with Russell. D. Matt Innis 03:17, 14 March 2010 (UTC)
Howard, there is a lot of research going on in Homeopathy. Dr.Peter Fisher heads a research group in London and Dr.Rastogi heads a research group in India. I will email them about your suggestion. Tom, please look at the 'feg' .pdf document I posted - it is good, solid evidence that Homeopathy works!—Ramanand Jhingade 11:44, 14 March 2010 (UTC)

Friends...in due respect, anyone who takes this "report" seriously has an axe to grind or is simply under-informed.

Any rational person should and must be very suspicious of this "report." The MPs (Members of Parliament) who were a part of the Science and Technology Committee which voted for this anti-homeopathy report comprised of five members, with three members barely eking out their victory. Of the three votes, two members did not attend any of the investigational meetings, one of whom was such a new member of the committee that he wasn't even a member of the committee during the hearings, and the remaining "yes" vote was from Evan Harris, a medical doctor and devout antagonist to homeopathy. This report was not exactly a vote of and for the people. This information alone should entirely discount this "report" as a kangeroo court report that deserves that round circular file.

The very limited number of people who represented homeopathy were primarily three people. The others were entirely antagonistic to homeopathy or simply uninformed about it (such as the rep from Boots).

Despite the use and acceptance of homeopathy throughout the U.K., there is a very active group of skeptics, with significant Big Pharma funding, who work vigorously to attack this system of natural medicine. Even though there is a wide variety of serious and significant pressing issues in British medicine and science today, an active group of skeptics of homeopathy successfully resurrected in October, 2009, a House of Commons committee, called the Science and Technology Committee, with the intent to issue a report on homeopathy. A leading skeptics organization, Sense about Science, that has been pushing for the re-creation of this Committee is led by a former public relations professional who worked for a PR company that represents many Big Pharma companies. Of additional interest is the fact that other Directors of the Sense about Science organization are a mixture of former or present libertarians, Marxists, and Trotskyists who also, strangely enough, seem to advocate for the GMO industry (ironically, libertarians normally advocate for a "live and let live" philosophy, but in this instance, it seems that they prefer to take choice in medical treatment away from British consumers).

Sense about Science is a registered UK charity despite being a political pressure group. As such they have to divulge their sources of income which they do on their website. Not surprisingly, much of this comes from named pharmaceutical manufacturers.

One of the investigators for the House of Commons Science Committee is a Liberal Democrat MP, Evan Harris. He has collaborated with Sense About Science on various projects, and he was also one of the skeptic demonstrators against the national pharmacy chain, Boots, which sells homeopathic medicines. This advocacy role does not make him an unprejudiced observer as is required for this type of investigation.

A report from this kangaroo court was issued recommending that the National Health Service stop funding for homeopathy and homeopathic doctors, despite the support for homeopathy and for consumer choice from Mike O'Brien, the country's present Health Minister. This report is only of an advisory nature, and because the Health Minister has already expressed his support for consumers' right to choose their own health care, it is uncertain what, if anything, will result of this report. What was most surprising about this report was that it verified that when people repeat a lie frequently enough, such as "there is no research on homeopathy," many people actually believe it, despite its transparent falsity.Dana Ullman 05:33, 7 May 2010 (UTC)

Sources

I'm surprised that this article does not reference or discuss Paul Starr's Pulitzer Prize and the Bancroft Prize winning book on the social transformation of American medicine. Any article that wishes to understand the difference between allopathy and homeopathy needs to understand that this debate has less to do with science or medicine and everything to do with politics as the British report makes clear. Russell D. Jones 15:41, 2 March 2010 (UTC)

At one time, it was indeed appropriate to compare allopathy and homeopathy. While some dictionary definitions still use allopathy as a synonym for conventional medicine, I find the modern usage to be more often by CAM practitioners, as that-which-we-do-not-do. (For the record, I happen to find some complementary medicine useful, or at least worthy of trial in non-critical situations.)
As far as a "modern" comparison, however, I cannot do better than William Osler:

A new school of practitioners has arisen which cares nothing for homeopathy and still less for so-called allopathy. It seeks to study, rationally and scientifically, the action of drugs, old and new."(Flexner report, page 162)

Unquestionably, there was once a competition between something one could legitimately call allopathy, as a "doctrine of opposites", and homeopathy as a "doctrine of similars". Homeopaths often selectively quote Osler as saying that the homeopathic remedies were safer than most allopathic remedies of his era (i.e., late 19th-early 20th century). You'll note that there was insistence on keeping the 1905 quote from von Behring.
It ain't the 20th century any more, and conventional physicians don't prescribe based on opposites, nohow. Yes, there are political residues, but there's now a lot more in the way of evidence-based medicine...and protecting turf. Howard C. Berkowitz 19:37, 12 March 2010 (UTC)
My favorite quote from Paul Starr's book is: “Because homeopathy was simultaneously philosophical and experimental, it seemed to many people to be more rather than less scientific than orthodox medicine.” Dana Ullman 05:37, 7 May 2010 (UTC)

The memory of sugar

is being discussed here and provides a nice illustration of the topic. --Daniel Mietchen 21:56, 3 March 2010 (UTC)

I thought the "memory of sugar" tended to go either to the abdomen or buttocks, depending on genetics? :-)
Seriously, the discussion at that link is what I'd suggest is an expectation. It is possible to be neutral, I think, and mention, in the lede, that homeopathy is not generally accepted. We still do not have a way of dealing with the situation where homeopathy supporters will support a lede that doesn't consider it reasonably credible. Of course, in no other workgroup do we have an equivalent to the health sciences/healing art splits. Should Religion be joined by Atheism? Alternatively, is it possible to have a reasonable Atheism article in Religion? Howard C. Berkowitz 22:46, 3 March 2010 (UTC)
The problem just isn't there with religion and atheism. If you, say, are interested in philosophy of religion, you can get a degree in it regardless of whether you are an atheist or a theist (or something else entirely). I say this from experience - I have a BA in Philosophy, Religion and Ethics from a Catholic college but am an atheist. There are some - I guess the polite way of saying it is 'non-mainstream' - ways of getting a doctorate in religion. You could become a "Doctor of Scientology" (D.Scn) - I read today that Ron DeWolf - Hubbard's son - had been given one, and stated in court that he wasn't sure whether they gave him the Doctorate before or after he'd been given the Bachelors! Or you could get a phony Ph.D from a diploma mill - as quite a lot of the creationists have. The problem with Healing Arts is that you can quite feasibly become a Healing Arts editor with a degree from a non-mainstream parallel academic institution. When mainstream academia isn't bending over backwards to certify degrees in quackery (as two universities in Britain shamefully have), the quacks create their own academic institutions.
"Dr" Gillian McKeith "PhD" has a degree from a place called Clayton College of Natural Health in Birmingham, Alabama. Said college is not accredited by any accrediting body recognized by the Department of Education, and a number of states in the U.S. list it as unaccredited on their websites for student loans (etc.). This does not stop McKeith claiming to have a PhD on her website, nor did it stop Channel 4 television or her publisher from touting this to promote her books and TV programme. She also likes to mention how she is a member of the American Association of Nutritional Consultants. You too can be a member of the American Association of Nutritional Consultants if you send them $60! McKeith has pushed notorious nonsense like the idea that green vegetables are good for you because the green shows they have chlorophyll (true), and the chlorophyll will oxidate your blood (how? Human beings are not plants. They tend to get their oxygen through respiration rather than photosynthesis. And even if they were getting their oxygen through photosynthesis, even your local tanning salon lamps aren't quite powerful enough to penetrate your small intestines).
Another graduate of the Clayton College of Natural Health is cancer quack Hulda Clark who sells a whole variety of magic 'zapping' toys that make funny noises and shine lights and do little more to cure cancer than extract money from punters - I mean, cancer sufferers.
Take any philosopher of religion or even most theologians - they'll certainly be able to say something useful on an article about atheism in the Religion WG. Same for the non-believers within the same fields. The problem with Healing Arts is it lets people with completely bonkers views about reality approve articles on their favourite pseudoscience. If the claims of the homeopaths were true (and, blimey, even our politicians can tell what a big pile of nothing the evidence of two hundred years of homeopathy has amounted to), then most of the articles in the Biology and Chemistry workgroup need rewriting.
I'll repeat myself again: we need to fix the Healing Arts bug. It is nothing more than a bug. It is a bug that is bringing down the great work done by other WGs. It says to anyone who has spent years of their life working on getting a PhD in physics or literature or psychology or whatever that you can get a fake degree from a non-accredited university and also be considered an expert on the same level. How can I, in good conscience, tell the experts in my field to contribute given this significant vulnerability in the Editorship system? –Tom Morris 01:21, 4 March 2010 (UTC)
Religion seemed the obvious parallel, but we could, I suppose, have an Absolute Pacifism workgroup with Military -- not that quite a few professional soldiers don't hate war. Why can Engineering debunk a hoax theory but Health Sciences cannot? Howard C. Berkowitz 02:15, 4 March 2010 (UTC)
Howard, you're one of the eight Charterists. Are you a loud and strong voice therein trying to *remove* Healing Arts as a Workgroup, so that some of this nonsense could then be addressed in the future in a rational way? Hayford Peirce 02:49, 4 March 2010 (UTC)
Compromise in the Charter Committee, I believe, means that the Workgroup and some other details will be passed, without detailed guidance, to the Editorial Council. Personally, I am urging the draft to go to discussion and markup, so we can proceed to the next steps after ratification. While this is an especially galling problem, there are less egregious workgroup structure problems that also need addressing and can't happen at the Charter level. --Howard C. Berkowitz 03:21, 4 March 2010 (UTC)
Even with Pacifism and the Military, there is an implicit understanding that most of the facts are the same. The Pacifist will agree with the General that the U.S. dropped the bomb on Hiroshima or that Nelson died in 1805. They have different opinions, but they do not care out their own facts in quite the same way as the Healing Arts gang. –Tom Morris 07:32, 4 March 2010 (UTC)
No, the analogy may hold. There are those that will insist that any enemy can be defeated through passive resistance and good thoughts, just as some of the healing arts believe that it is utterly wrong to immunize against an infectious organism or use an antibiotic against one. Howard C. Berkowitz 07:43, 4 March 2010 (UTC)
Tom mentions non-mainstream ways of getting doctorates in religion. In fact the Archbishop of Canterbury still has the legal power to award them, which might explain why Church of England bishops always seem to be Dr. Peter Jackson 14:29, 12 March 2010 (UTC)

How well does it work?

We use double-blind studies to tell how well a particular medicine works. The person handout out the medicine does not know whether it's a "real medicine" just a sugar pill. In the case of pain relievers, the potency of an analgesic is rated in terms of how much more effective it is than a placebo.

If I recall correctly, as much as 75% to 90% of the effective pain relief you get from the pills comes from the placebo effect: you take your aspirin or ibuprofen or (without knowing it) your sugar pill, and your headache starts going away within an hour no matter what. The real stuff is only slightly better.

Given all that, how would we design a study to compare homeopathic treatment with conventional treatment? Is it possible to conduct a blind study, if the way the healer deals with the patient is a key ingredient of the therapeutic effect?

For that matter, how can we compare Freudian psychoanalysis to Berne's transactional analysis or modern rational-emotive therapy or to a frank chat with a trusted friend or mentor (like Father O'Malley down at the local Catholic church)?

  • I daresay one result of a careful attempt to measure outcomes could be that "bedside manner" is much more important than we've allowed ourselves to realize.

But I ask again, how do we study and quantify it? --Ed Poor 02:04, 28 March 2010 (UTC)

If one were to review the entire body of experiments that Thomas Edison conducted on electricity, one would have to say that the vast majority of his experiments were failures...and one might fall into a trap by saying that he was a failure. Of course, we KNOW that this is not true. Just because some studies have shown that homeopathic medicines don't work, there is a greater body of research to show that it does. The trick is to know WHEN homeopathic medicines work...and when they don't.
If anyone here wants to review a body of homeopathic research on a specific group of diseases (respiratory allergies) that have primarily been published in high impact conventional journals, such as the Lancet and the BMJ, you might consider reading this review of research I co-authored in a peer-review journal: http://www.ncbi.nlm.nih.gov/pubmed/20359268 -- you can read the entire article online at: www.altmedrev.com (It is in the Spring, 2010, issue, article #6). Dana Ullman 05:43, 7 May 2010 (UTC)

Unsupported assertions

The current text has "Even in Europe, homeopathy is practiced by many conventional physicians, including 30-40% of French doctors and 20% of German doctors." and in the next paragraph "Some medical doctors, particularly in Germany, France, and several other European countries prescribe homeopathic medicines for wide variety of both self-limiting conditions and serious diseases with a high rate of patient satisfaction." There are no supporting citations.

This is obviously redundant; we need at most one of these statements. However, neither strikes me as believable without support, so I am inclined to delete both. Anyone care to comment before I edit? Sandy Harris 15:29, 26 June 2010 (UTC)

Your point about unsupported assertions has come up before, and the current text, in my opinion, is significantly misleading. "homeopathy is practiced by many conventional physicians" does not, as much as some may want it to do so, imply that conventional positions endorse all of homeopathy. By definition, if they are conventional physicians, they are not practicing homeopathy as alternative medicine, but are using some complementary techniques from homeopathy. When I was last in my internist's office, I banged my shoulder against a piece of equipment. He rubbed it a bit. Does that mean he practices massage therapy?
"Patient satisfaction" is a purely subjective assessment and is in no way evidence of efficacy. I could take the sentence starting "Some medical doctors..." and substitute "chemically pure water that has not been exposed to a simillium" and demonstrate high patient satisfaction.
I agree with deleting both. Even if citations are offered, they must be of a quality that indicates that homeopathic methods are a significant part of the practice of these physicians and they are not using it with the intent of creating placebo effects. --Howard C. Berkowitz 17:05, 26 June 2010 (UTC)
It is a fact that at universities in Germany and Austria there are chairs and lectures on homeopathy (in Vienna also at the veterinary university). There are doctors who practice both. --Peter Schmitt 23:10, 26 June 2010 (UTC)
I have no problem if the two sentences ar combined. I think we've gone over this several times on the talk pages. As Peter points out, there are obviously well established 'conventional' medical professionals that use homeopathy for treatment of medical conditions. This is pretty much common knowledge at this point, so I don't see the need for citing a source for the mere fact that some medical physicians use homeopathy in their practices. However, when we add specific numbers such as 30-40%, it does seem to beg for a reference. It shouldn't be hard to find such a reference if it is out there. Otherwise, removing the numbers and just stating the fact shouldn't be a problem.
I don't think we will be able to find any scientific sources that conclude that they use it only on undereducated healthy people as a placebo. In fact, I think the opposite is more likely the case. D. Matt Innis 01:22, 29 June 2010 (UTC)

Would someone who has access care to correct the glaring English mistake in the first paragraph of this approved article? Ro Thorpe 00:16, 2 July 2010 (UTC)

I'm sorry, Ro, I must have a blind spot that is preventing me from seeing this glaring error. Could you be so kind as to point it out? D. Matt Innis 01:42, 2 July 2010 (UTC)
Oh, so go ahead and shoot me! I found it (after reading your request for Hayford to repair it :) D. Matt Innis 01:46, 2 July 2010 (UTC)
Bang, bang - but you've removed it! Many thanks! Ro Thorpe 12:16, 2 July 2010 (UTC)

I provide many solid references to the use of homeopathic medicines by physicians in Europe in an article I wrote at: http://www.huffingtonpost.com/dana-ullman/homeopathic-medicine-euro_b_402490.html (It is NOT my intent for anyone to reference this article in OUR article at this website. Instead, we can use many of the references provided. This article also has many references throughout the article showing that people who use homeopathic medicines tend to have more education than those who don't.)

I urge us to be very careful in significant changing this article because a lot of time and thought went into it previously. Dana Ullman 18:05, 14 July 2010 (UTC)

Review by a sceptical layman (i.e. me)

I'm reviewing the draft. Here is a rough summary of my changes and concerns:

  • I rewrote the paragraph in the lede section about the "long safety record". The reason homeopathy has a long safety record is the very same reason that not travelling has a long safety record: if something is inert and chemically indistinguishable from the delivery mechanism, it will be safe. Safety and efficacy is a balancing act. The reason homeopathy is safe is precisely because it isn't efficacious.
  • I'm not wild about long, windy footnotes about Romanization. I've thus split off the Romanization note about the word "qi" on to a separate page.
  • The section that is disputed about the number of practitioners in France and Germany is in the wrong place. The way in which homeopathy is prescribed or accessed doesn't seem to be to be a principle of homeopathy - homeopathy is homepathy whether it is prescribed by a homeopath or bought over the counter. I've thus moved it into the section which used to be titled "Professional homeopaths: who are they?" which I have retitled "Homeopathy in practice". This section seems to be the place to discuss provision, prescription, education, regulation and the like.
  • The paragraph starting "Homeopathic remedies can be prescribed by professional homeopaths" seems to be a tricky one. Depending on the country and the regulatory regime, homeopathy can be prescribed by a wide variety of people. Sadly (in my opinion), in Britain, quacks of all sorts can have their merry way with the public. Pretty much anyone can set themselves up as an alternative practitioner, so long as they don't make their claims too specific. But in other countries, this varies. It seems the important distinction that needs to be made is that homeopathy - unlike, for want of a better description, real medicine - can be prescribed by anyone.
  • The rest of the section on "A typical homeopathic visit" seems to have some glaring problems. The homeopath is supposed to have EMT training in order to be "adequately trained"? (Heh. Surely, if heart attacks are the problem, what you need to do is to dilute high-fructose corn syrup into non-existence and it'll clear right up? I thought they believed in the law of similars. What's a defibrilator doing in the homeopath's office?) But anyway, this adequate training is according to who? According to government regulations? According to the homeopathic groups? According to us? According to some third-party regulator like the CNHC?
  • The article describes "classical homeopathy" at length, but I haven't seen any discussion of what the alternatives are to classical.
  • There is a lot of repetition of parts of the article. The 'Principles' section is repeated in the section on 'The claims for homeopathy'.
  • No criticism seems to be made of the "treating the whole person" idea. I'm not even sure that this is a desirable thing. If I break my arm, I want my arm fixed, not someone to waffle about my "disturbance in the overall homeostasis of the overall being". In fact, when I broke my arm as a child, I'm very glad that I had access to a surgeon to fix it. This kind of rhetoric seems to be just an evasion tactic - if the studies don't show that homeopathy actually fixes anything (and, well, it wasn't going to put the bones in my elbow back together), then they can justify this kind of thing by pointing out that the person feels vaguely better in some holistic sense.
  • The paragraph about corticosteroids seems to be totally out of place. Oh, it sort of makes sense - it is a follow on from the last paragraph about homeopathy and asthma.

I've got a more radical suggestion. This article obviously needs a fairly ground-up rewrite. Here's what I reckon we should do. The current article seems to have been put together in a rather piecemeal way. Instead, I think the best way is to see if we can come together and work out a list of the fundamental questions that a good article on homeopathy should answer - then build a simple structure around those questions, and fill them in. We may be able to repurpose some of the text from the existing article.

I'd suggest the following list of questions:

  1. What is homeopathy?
  2. Is there any known mechanism for homeopathy?
  3. Is homeopathy clinically effective?
  4. What are the main issues of contention regarding homeopathy?
  5. Why have there been campaigns against homeopathy like the 10:23 campaign?
  6. What is the history of homeopathy? Who is Samuel Hahnemann?
  7. How is homeopathic care provisioned and regulated in different countries?

Before formulating a structure for any potential rewrite, I'm interested in seeing if anyone has any other questions that they'd want to add. –Tom Morris 12:30, 4 July 2010 (UTC)

Tom, I only have a few minutes right now, but let me share a thought or two. My greatest unanswered question is "what is the cognitive process of a homeopath in a patient interaction?" In other words, homeopaths say that every remedy is individualized. Whenever I posed this question to Dana, it was brushed aside, saying that one had to be a trained homeopath to understand.
Odd, but I have written quite a few articles on differential diagnosis in medicine, and some of my most interesting professional work is in expert systems to "individualize" (e.g., what dosage forms are most convenient for the patient and are most likely to be taken on schedule? What other diseases are present -- are there synergistic as well as problem interactions? Are there patient preferences? Are certain side effects more or less likely? Somehow, I manage to muddle through this sort of thing, yet I keep being told there are Inner Secrets to Homeopathy that prevent a straightforward explanation. Now, I'm not a classic layman in conventional medicine, but I can't think of a field where I don't have a basic understanding and the ability to quickly get a much deeper understanding -- and also know what I don't know. In the last six months or so, I've had to do the research to do peer interactions, on the specific diseases of people (two- and four-legged) for whom I'm an advocate and case manager -- involving human iron metabolism, feline squamous cell carcinoma, and peripheral nerve myelin protein 22 and inflammatory polyneuropathy. But I can't begin to understand how a homeopath thinks?
In fairness, I'm not sure how much time I'm willing to expend on homeopathy, at least unless I get comparable collaboration on less controversial, and possibly useful to more people, health science articles (to say nothing of other fields). Howard C. Berkowitz 13:26, 4 July 2010 (UTC)

Luc Montagnier

French virologist Luc Montagnier has said at a prestigious international conference when he presented a new method for detecting viral infections that it bore close parallels to the basic tenets of homeopathy. This has been published in the 'Sunday Times' (London), as well as 'The Australian' - here's a link to the article: http://www.theaustralian.com.au/news/health-science/nobel-laureate-gives-homeopathy-a-boost/story-e6frg8y6-1225887772305

I hope one of you (at least Dana) make time (I don't have the time) to insert this matter into this article.—Ramanand Jhingade 16:26, 5 July 2010 (UTC)

Here's another link: http://epaper.timesofindia.com/Archive/skins/pastissues2/navigator.asp?login=default&AW=1279125246109 —Ramanand Jhingade 16:37, 14 July 2010 (UTC)

I certainly have no intention of amending the article with newspaper articles, especially those that indicate nothing but a "close parallel." Has Dr. Montagnier's proposal been discussed in mainstream journals?
The first article, in The Australian, mentions a "memory of water" type argument, and cites rejection by other scientists. I'd note that his Nobel was for virology, not physical chemistry. The second is behind a paywall. Howard C. Berkowitz 16:58, 14 July 2010 (UTC)
Hi friends! Actually, I got sent this link to a recent issue of the "New Scientists" by none other than Nobelist Brian Josephson: <http://www.newscientist.com/article/mg20727682.300-60-seconds.html>
"Clear as a Nobel"
Luc Montagnier, the French virologist who won a Nobel prize in 2008 for linking HIV with AIDS, last week made controversial claims that highly dilute solutions of harmful viruses and bacteria emit low-frequency radio waves, allegedly from watery nanostructures formed around the pathogens. Similar claims have been made for homeopathic remedies." Dana Ullman 17:40, 14 July 2010 (UTC)
That link goes to the daily news summary, not anything on homeopathy. As quoted, though, they are "controversial claims". No details. Howard C. Berkowitz 17:57, 14 July 2010 (UTC)
It is necessary to have that link in this article to show that homeopathic remedies are not 'placebos', as some people allege.—Ramanand Jhingade 15:40, 16 July 2010 (UTC)
It is another piece in the puzzle. It is primary research, but it is by a Nobel Prize winner, so it is news about homeopathy. We shouldn't treat it as scientific fact, but it is a fact that a prominent scientist has made the statement that involves a quality of water. It is in no way scientific consensus, an in fact may lead to this guys ruin for whatever reason. We have included news about the British Medical Association's recent position statement concerning homeopathy and this article specifically mentions that statement as well. This is the draft, so I won't categorically remove something that is written comprehensively, neutrally, and objectively about the subject. D. Matt Innis 12:59, 17 July 2010 (UTC)

(undent) Matt, you give it a perfectly good context--as news. It doesn't show, or not show, anything about homeopathic remedies being placebos, or effective, or ineffective, or any particular clinical correlation. As far as I understand, he's made an observation in physical chemistry and RF fields interacting with water, nothing else. I sincerely hope he's not hurt, as he was incredibly dignified while there were attempts to discredit his initial discovery and characterization of HIV -- his Nobel was very deserved. Howard C. Berkowitz 19:42, 17 July 2010 (UTC)

My point in providing the link to the NEW SCIENTIST is to verify that this research is "notable," and as such, a short note is worthy here. Dana Ullman 05:35, 21 July 2010 (UTC)


Matt, you are wonderfully reasonable. Howard is not accurate when he says that Montagnier has "made an observation". Montagnier conducted RESEARCH, and he wrote about it in a peer-review journal. He spoke about it to a group of fellow Nobel Prize winners. And ALL of this was so notable that the "New Scientist" commented about it...and linked it directly to homeopathy. I have no problem if we choose to have the word "controversial" used in describing this new work. The fact of the matter is that this new work discusses "electromagnetic signaling" which may help explain how homeopathic medicines may work. Dana Ullman 18:29, 9 September 2010 (UTC)
Then why isn't the peer-reviewed journal cited, rather than Wired and The Australian? Further, one may write (e.g., an editorial) in a peer-reviewed journal, but not have one's work peer-reviewed by that journal. The peer review process becomes more credible if another independent researcher reproduces of these results. Please provide citations of these events if you want me to believe this is substantive.
Nobel Prize winners, rather by definition, tend to be specialists. One might speak on medicine to a group of Chemistry laureates, and have no special critical review.
It's interesting that we are still arguing how homeopathic medicines "may" work, when it's rather routine to understand the molecular pharmacology of conventional medicines. Sorry, this still comes across as hand-waving for something with a trivial base of evidence.
Have I fired five or six rounds? Howard C. Berkowitz 18:38, 9 September 2010 (UTC)

Evidence that homeopathy works

I hope one of you (at least Dana) can insert sentences that read something like, "there is scientific evidence for homeopathy", using the PDF for "Scientific framework of homeopathy: evidence-based homeopathy" available at http://www.feg.unesp.br/~ojs/index.php/ijhdr/article/viewFile/286/354 wherever appropriate. I haven't seen anyone object to it here anyway.—Ramanand Jhingade 15:15, 21 July 2010 (UTC)

the word "skeptic"

Wasn't it decided a long time ago that aside from the two existing examples in the article that pro-homeopathy advocates (and anyone else) could NOT use the word "skeptic" in future edits? Just want to make sure. Hayford Peirce 21:50, 5 August 2010 (UTC)

I remember that as a specific ruling by Larry. In my experience, it's almost always used by advocates of a position; the neutrality policy wouldn't be hurt if it were banned. Howard C. Berkowitz 22:41, 5 August 2010 (UTC)
But what about people who are skeptics? Are we not allowed to say that Michael Shermer - who runs the Skeptic's Society and publishes Skeptic magazine - is a skeptic? –Tom Morris 23:02, 5 August 2010 (UTC)
As a direct quote or a self-identification, sure. As condescension to disbelievers, no. Howard C. Berkowitz 23:04, 5 August 2010 (UTC)
Ah, but is it? I consider 'skeptic' to be much less of an insult than 'homeopath'! –Tom Morris 23:06, 5 August 2010 (UTC)
I think it is -- it comes up repeatedly in fringe articles, be they moon landing hoax, UFO, etc. -- anything not a true believer. Howard C. Berkowitz 23:13, 5 August 2010 (UTC)
If *I* use the word, Tom, it's a compliment. If Dana uses it, it's pejorative. That's why Larry (or someone) banned it from this article, if I recall correctly. (I have 20 years' of Skeptical Inquirer on my bookshelf.) Hayford Peirce 23:21, 5 August 2010 (UTC)

What the...?

Homeopaths respond to these concerns by noting that using homeopathic medicines can delay or reduce the use of conventional medicines that are ineffective and dangerous.

If this were The Other Wiki, that'd be an instant "citation needed"! I know homeopaths like to bang on about the evil 'allopaths', but do they honestly respond to the opportunity cost argument with a reversed opportunity cost argument? That's so... indescribably crazy. I certainly would like some verification on that. –Tom Morris 00:42, 6 August 2010 (UTC)

Remember our motto: be bold -- remove it, and let whoever put it there back it up with some facts if they want to restore it. Hayford Peirce 01:42, 6 August 2010 (UTC)
Oh, now we're bold, haha. It's a response to the use of homeopathy for use with things like childhood ear infections, a commonly self limiting condition that is often treated with antibiotics which have unwanted and sometimes dangerous side effects. It probably could be explained a little better when it's all cleaned up. After all, that is the homeopath response. D. Matt Innis 21:50, 7 August 2010 (UTC)
On the other hand, I can point to many medical studies advising against antibiotics in uncomplicated otitis media. Going back to Osler at the turn of the 20th century, he correctly pointed out that "allopathic" drugs were often harmful -- but he then said both homeopathy and (classically defined) allopathy were "cults" that needed to be replaced. One doesn't need to turn to homeopathy to find best practices that avoid both overprescribing and underprescribing. Howard C. Berkowitz 21:59, 7 August 2010 (UTC)
Yup, absolutely agree. D. Matt Innis 01:10, 8 August 2010 (UTC)

principle of infintesimals

I'm thinking that principle needs defining. I'm thinking that the 'principle of infintesimals' is the concept that is controversial. Perhaps one of our homeopaths could explain? D. Matt Innis 12:32, 12 August 2010 (UTC)

Throughout this article, the infinitesimal dose and law of similars have been used interchangeably, but they aren't the same. http://www.similima.com/org20.html has given a brief description of the "infinitesimal dose". The law of similars is just, "using the most similar remedy" - to put it plainly. I don't have the time to check and insert those changes, but I hope you Matt, or may be Dana can do so. The infinitesimal dose can also be defended with the "memory of water" and Monsieur Montagnier's research (see Dana's post above).-Ramanand Jhingade 13:49, 13 August 2010 (UTC)
Certainly using them interchangeably is not accurate. D. Matt Innis 15:05, 13 August 2010 (UTC)
I think the term "interchangeably" was wrong to use - what I meant was that the term "law of similars" is used in the article and draft article, when it's supposed to be "the infinitesimal dose", in some places.—Ramanand Jhingade 15:50, 13 August 2010 (UTC)
So it seems to me that infinitesimal dose needs to be defined. The law of similars can obviously involve large doses of products. Obviously Homeopaths use more than infinitesimal doses in their treatments; otherwise we wouldn't have side effects from a nasal product that has zinc in it. We are not getting this point across. D. Matt Innis 17:47, 13 August 2010 (UTC)
I don't think it's worth the time, since that will also be criticized here (maybe you can use the web-site I mentioned above to do that). The nasal product, "Zicam" wasn't a homeopathic product at all, because it had milligram doses of zinc, which is against homeopathic principles. Homeopathic remedies start with mother tinctures and can go up to higher potencies (more dilute) from there.—Ramanand Jhingade 09:50, 23 August 2010 (UTC)
Zicam was marketed as homeopathic, and licensed under special regulations applying to homeopathic products. Sorry, for legal purposes in the US, it was a homeopathic product. Howard C. Berkowitz 15:49, 24 August 2010 (UTC)
I know it was, but it was against homeopathic principles.—Ramanand Jhingade 15:39, 25 August 2010 (UTC)

(undent) Please do not use color for emphasis.

In the context of the United States, your simple statment that it "was against homeopathic principles" is legally irrelevant, as the FDA makes the decision if something is to be regulated as a homeopathic preparation (or food supplement), exempt from a good deal of the regulation of other drugs, or if it is a conventional regulated substance. The FDA determined Zircam was homeopathic, and, while I suppose you might argue, in an article about homeopathy and the FDA, such an argument is irrelevant here. If you reject the argument that a governmental organization cannot make such decisions for a country, then I can argue that homeopathy can't be accepted as a national means of practice in India.

With all things that it approves, the FDA depends on the manufacturer's application. More is accepted is fact in a homeopathic New Drug Application that isn't required to undergo controlled trials. Howard C. Berkowitz 16:57, 5 September 2010 (UTC)

Answer to an "unanswered question": Popularity is no metric of efficacy

Sorry, but the addition "The simple reason for homeopathy's growing popularity is because it works." is completely unacceptable without overwhelming evidence that it does work. Were this to be accepted without sourcing, the logic could be applied to popularity of politicians, especially not in office, supporting the premises their programs work.

I propose to delete this. Popularity is relevant to marketing but not efficacy. Howard C. Berkowitz 15:48, 24 August 2010 (UTC)

Those questions were begging for an answer. If you delete my answer, you must delete the questions preceding my statement as well!—Ramanand Jhingade 15:45, 25 August 2010 (UTC)
Your statement, unsourced, was not an answer. It was purely your opinion, phrased as informal commentary. Also, it is a rather sweeping opinion that goes to the heart of the article, with no evidence behind it. Howard C. Berkowitz 16:45, 25 August 2010 (UTC)
While Howard is right in saying that "popularity" is not a metric of efficacy, popularity is (by definition) its own metric, and statistics about homeopathy's popularity now and in the past has a place in an encyclopedia. Further, I give reference to a half-dozen

surveys that further verify that people who tend to receive homeopathic care tend to be more educated than those who don't.

The following link to an article that I authored provides references to this information (please know that I am not suggesting that we link to this article but only to use the references in this article in our encyclopedia listing: http://www.huffingtonpost.com/dana-ullman/homeopathic-medicine-euro_b_402490.html Dana Ullman 19:14, 9 September 2010 (UTC)
Post hoc, ergo prompter hoc? I can give even more studies that verify more people who drink milk become heroin addicts. Popularity is a principally a metric of efficacy -- of marketing. If it is significant here, Lady Gaga should be even more expert than Dana, and probably has a better figure. Howard C. Berkowitz 19:20, 9 September 2010 (UTC)

Allopathy

"Today, "allopathy" is used by practitioners of alternative and complementary medicine, like homeopaths, osteopaths, naturopaths, chiropractors and so on to refer to conventional, western medicine."

Since practitioners of conventional, western medicine rarely use the term, however, there's no good argument to insist on calling them allopaths. Yes, there are a few historical references, especially when talking of osteopathic vs. allopathic medical schools, but the term used by conventional western physicians tends to be...conventional western physicians.

Ramanand, if I refused to call you anything other than Jean-Paul, would that change your name? Howard C. Berkowitz 16:57, 24 August 2010 (UTC)

Practitioners of alternative and complementary medicine, like homeopaths, osteopaths, naturopaths, chiropractors and so on refer to conventional, western medicine as "allopathy" even today. If you don't like it, you can add something like, "conventional, western physicians do not refer to themselves as allopaths".—Ramanand Jhingade 15:50, 25 August 2010 (UTC)
Each profession defines what it calls itself. That is not the role of other professions. Would you accept the specific words "practitioners of conventional western medicine call homeopaths frauds?" No? Then why do you have the right to define a name, regarded by many as either historically inaccurate -- they don't use the principle of opposites -- or a sneering attack?. I wouldn't have the slightest objection if homeopaths called themselves Similarists, Hahnemannists, etc. -- but that is how they characterize themselves, not how they characterize others. Howard C. Berkowitz 16:44, 25 August 2010 (UTC)

Ruling needed

Mr. Jhingade reinserted "although osteopaths, homeopaths, naturopaths and other alternative medicine practitioners continue to call it allopathy." I will remove this unless an Editor says otherwise, as I believe it has been ruled that one discipline is not permitted to define a name for another. Shall I say "although biologically-oriented scientists consider homeopaths to be quacks? (noise made by the simillium of Oscillococcinum, of course)" At best, this might go in the allopathy article.

Osler deprecated both allopathy and homeopathy by the time of the Flexner report, although, somewhat earlier, he had attacked some of the drugs used by self-descibed allopaths. I'd note the latter was 19th century.

Be very careful, incidentally, in using "osteopath" versus "osteopathic physician". The latter, in the US, does use "allopath" but in a very narrow context dealing with the history of schools. Undergraduate and graduate medical education from traditionally "osteopathic" or "allopathic" education is largely identical, although some additional manipulative techniques may be taught in some historically osteopathic programs -- or by qualified faculty in historically "allopathic" programs. Assuming equal certification, with many boards merging, the scope of practice of DO's and MD's are identical. U.S. osteopathic physicians do not use the term allopathy in regular practice. Indeed, I know a few that don't use manipulation or any special osteopathic methods. As an aside, in the state of Virginia, to perform acupuncture, one must be licensed as a physician; the two I used were, respectively an MD with a OMD degree from Vietnam and a OB/GYN certification from FACOG; the other was an DO internist board-certified in internal medicine.

In the UK -- I can't speak authoritatively for the rest of Europe -- osteopathy is indeed a CAM discipline and its practitioners' scope of practice is not the same as a physician.

I would add that the opinions of naturopaths are irrelevant to this article.

Could we please stop refighting this revert battle? My impression is that rulings have been made.Howard C. Berkowitz 17:30, 5 September 2010 (UTC)

Practitioners of alt. med. still call it allopathy (Look at the American Association of Osteopathic Physicians web-site, the National Center for Homeopathy web-site and so on). I'm sure Dana will support me on this one. I'm looking forward to a ruling too and I believe such a ruling will support the homeopaths' viewpoint, because this article is titled Homeopathy and not, "Criticism of Homeopathy".—Ramanand Jhingade 08:44, 6 September 2010 (UTC)
If you are arguing from the perspective of the American Association of Osteopathic Physicians, you are either ignorant of the historical reason they do that, or deliberately making a false argument that American osteopathic physicians, as distinct from osteopaths in Europe, are in any way "alternative". DOs pass the same undergraduate and graduate certifications as MDs. I suppose I'll have to remind one of my DO friends, a world authority on field and disaster medicine, that he's "alt" and the surgeons shouldn't listen to him. If nothing else, there is a distinction between alternate and complementary.
As far as the National Center for Homeopathy website, what part of "one discipline doesn't specify what another calls itself" do you fail to grasp? I'm sure I can find medical sites that call homeopaths frauds and quacks; would you accept that designation? I'd have to go back into the archives, but I seem to recall that Larry ruled on this a long, long time ago. Dana does not have any editorial authority over what non-alternative practitioners call themselves.
If you think these comments are "attack on homeopathy", I refer you to the commentary of Dirty Harry Callaghan regarding the .44 Magnum. Howard C. Berkowitz 01:46, 7 September 2010 (UTC)

Matt's reversions

Matt, I see you have already reverted what I had added. I don't want to indulge in any "edit warring", so please restore what I had added. I have mentioned the reasons in the sections preceding this.—Ramanand Jhingade 16:20, 25 August 2010 (UTC)

Since you merely identify this a "Matt's reversions", it's difficult to what you specifically have in mind. Did Matt move the questionable material here for discussion? If he did, then it's appropriate to discuss it here, within policy limits, before it goes back.
If he deleted without making it clear what he was deleting, or why he was making a Healing Arts Editor decision to delete it, he needs to put it here. Otherwise, you cannot simply demand that it be put back without consensus or an Editor ruling. Howard C. Berkowitz 16:51, 5 September 2010 (UTC)
I'm in a hurry, but will make a quick reply. I hope Matt brings things here for discussion in future.—Ramanand Jhingade 08:38, 6 September 2010 (UTC)

"Attack piece"

The statement "Some other researchers claim that there is scientific evidence that homeopathy helps in many problems and diseases[3]" was added with the edit note that "the lede can't be an attack piece."

The lede also cannot be a place where non-substantive opinion can be used to "neutralize" the main thrust of expert opinion. Again and again, it's been pointed out that CZ's current neutrality policy does not mean that equal emphasis must be given to each position.

I recommend deletion of the above statement as far too general, and, for that matter, worded in a manner that really doesn't counter but says "well, yes but..." There's an old medical story about a radiologist who crawls, bloody and battered, into his emergency room. Asked what happened, he said it was "consistent with being mugged." Things in the lede need a bit more substance than "consistent with." Howard C. Berkowitz 17:19, 5 September 2010 (UTC)

I don't see any probs with that ref and I'm sure Dana, the only other Homeopath here will support me on that.—Ramanand Jhingade 08:34, 6 September 2010 (UTC)

Similars and "allopathic drugs"

First, I contend there is no such thing, in modern terms, as an allopathic drug. Got any references, such as Goodman and Gilman, that use the term? No, homeopathic texts don't get to define practices in general medicine. Taking a recent addition that I believe must be either radically changed or updated, I quote:

"Recent research has shown that some conventional drugs, which are normally used to do something, can do the opposite also - a rebound effect, similar to homeopathy's law of similars.[1][2]

[3][4]. [5][6] [7][8]. [9][10]"

First, it's impossible to respond to this deluge of citations without any details. Second, for these to be "allopathic" drugs, based on the "principle of opposites", the papers must include that language. Do they?

Second, it's a leap to equate a rebound phenomenon to allopathy; the dose-over-time, molecular control mechanisms, etc., are much more than "opposites". One of the classic examples of rebound, nasally applied vasoconstrictors, doesn't take place when the dose and duration are properly controlled. In general, if the vasoconstrictor is needed for long enough to cause rebound, use of antiinflammatories, such as corticosteroids, cromolyns, or antihistamines should be under active consideration to replace the direct vasoconstrictor.

It was with considerable restraint that I didn't immediately move this to the talk page. Ironically, there are very pleasant, collaborative discussions going on in a number of military and history articles. Maybe getting to kill people makes for more restrained discussion. Howard C. Berkowitz 19:04, 5 September 2010 (UTC)

The rebound effect is well documented and accepted in medical circles, so please don't delete that sentence or the refs I inserted (I've improved on the way it used to read, so pls take a look).—Ramanand Jhingade 08:31, 6 September 2010 (UTC)
Well documented? "Rebound effect' doesn't appear in the index of the standard textbook, Goodman and Gilman's The Pharmacologic Basis of Therapeutics (9th Edition). Now, as I have mentioned, the term "rebound" is indeed used in very specific contexts, such as the response of nasal mucosa to topical vasoconstrictors.
"can lead to the opposite effect, when stopped - a rebound effect, which means they are following homeopathy's law of similars." is not especially an improvement. Of course there are drugs that have adverse effects when stopped inappropriately. Corticosteroids, selective neurotransmitter uptake inhibitors and opioids all come to mind. "Similars" have nothing to do with it, in the sense that a corticosteroid, in a Proving, would be inflammatory. Instead, the adrenal cortex has reduced its production of endogenous steroids because it has sensed a certain blood level.
It's vaguely amusing to hear you comment about people ignorant of homeopathy, when there seem to be so many opportunities to be unaware of molecular pharmacology. But, there are different tastes -- where's the eye of newt and blood of bat when you need them? Howard C. Berkowitz 01:18, 7 September 2010 (UTC)

Dead link

http://www.medscape.com/viewarticle/511604 Reference 102 about the value of talking to patients. Howard C. Berkowitz 19:08, 5 September 2010 (UTC)

Then I suggest we remove the sentence attributed to Vandenbroucke.—Ramanand Jhingade 13:56, 6 September 2010 (UTC)

Thankless CZ

Editing CZ is a thankless job. I'm sure the people who are ignorant about a subject (like Homeopathy) can move on to Facebook, Orkut, Linked in, Twitter or some other networking site/s and make a lot of friends and get to know them really well - we hardly know anything about each other here. Howard, you're probably a nice guy I can get to know better and probably dine with. Sandy, Im sure I can make an interesting 'date'. Why don't y'all look for me on Facebook?—Ramanand Jhingade 13:56, 6 September 2010 (UTC)

I have nothing against friendship, and I do think I've found a number of good friends here. Nevertheless, the essence of what I see as appropriate writing at CZ depends on courtesy, but above all, logic -- western if you will -- and evidence. I have a LinkedIn account, but not Facebook, Twitter, etc. -- and don't want them. On the other hand, I am very active on an assortment of professional mailing lists. Howard C. Berkowitz 18:50, 6 September 2010 (UTC)
First off, I greatly doubt either of us would enjoy a date. 'Sandy' is a short form of 'Alexander', and I'm neither unattached nor gay.
Second, some of your other apparent assumptions are just as bogus. People generally aren't here for social networking, but to contribute toward building an encyclopedia. Nor does not being an expert on homeopathy preclude contributing.
I'm resisting the urge to write a more pointed reply because it would violate CZ:Professionalism#What_behaviors_are_unprofessional.3F. Sandy Harris 23:47, 6 September 2010 (UTC)

Confusing deletions

It's somewhat difficult to tell why things are deleted when the only reasons given are in edit notes, which aren't always easily accessible if, for example, minor edits follow them in the log.

This was deleted, possibly due a claim that it was unsourced -- yet it is sourced. It's a reasonable statement and belongs in the article.

This does not mean that that people treated with homeopathy do feel better as a result - the clinical literature clearly shows this, but Vandenbroucke suggested that this could be because its practitioners treatments spend more time with people than doctors do. "Even if people give you the wrong explanation about what you seek treatment for, the fact that they spend a long time speaking with you might help," Vandenbroucke suggests.[11]

"Homeopaths contend that flawed trials cannot be used to show that homeopathic treatment is ineffective (please read the previous paragraph for information about the positive trials)." This new sentence, especially the underlined words, is argumentative rather than informative. --Howard C. Berkowitz 18:50, 6 September 2010 (UTC)

I didn't do the above editing, though I support it. Just because Vandenbroucke says that statement does not mean it is true, especially when there is at present no data to support it. This idea borders on the preposterous that the "extra" time that homeopaths spend with their patients leads to the therapeutic benefits that homeopathic patients experience. If THAT were the case, then, psychologists would be our finest healers (and sadly, they are not). Although the first interview with a homeopath is typically an hour, the follow-up visits are usually 10-30 minutes, just a little longer than a conventional MD.
As for "flawed" trials, see my longer message in the next section where I talk about the importance of "internal validity" in trials AND "external validity." Dana Ullman 01:09, 14 September 2010 (UTC)

Dana Ullman's thoughts on this article to date

Sorry to be away from the article for so long...

I am very concerned about this present “draft” of the homeopathy article. I feel that it has lost its “encyclopedic” tone, and instead, it is a mixture of encyclopedic information along with strong “point of view” skepticism. Although I do not have a problem with proper skepticism, it is the tone of it AND where it is placed in the article that is critical.

For instance, in the very top portion of this article are paragraphs #3 and #4 which are not encyclopedic in tone or content.

I will try to avoid doing “editing” the article myself. Instead, I will propose here in the TALK section my ideas for what should be said, and I hope that those people who want to maintain a high-quality objective and encyclopedic article will make appropriate changes to the Draft. Needless to say, I will not sign my name, as a Healing Arts Editor, to anything that does not maintain a certain objective tone. And by “objective tone,” I obviously do not mean that this article should just a promo for homeopathy.

My sincere thanx for whoever re-formating my contribution so that we can communicate about them in bit-sizeable chunks. Good work! Dana Ullman 15:37, 14 September 2010 (UTC)

Dana on 3rd paragraph

Ultimately, I recommend some changes in the 3rd paragraph…here’s what I suggest for replacement for this paragraph.

While many medical practitioners prescribe some homeopathic remedies, a significant majority of the scientific and conventional medical community (including a number of national medical representative bodies like the British Medical Association), consider homeopathy to be unfounded and pseudoscientific.[1] Skeptics of homeopathy insist that there is no plausible mechanism to explain how the remedies might work, given that many of them are so dilute that they contain not a single molecule of the active ingredient. However, homeopaths and scientists from varied specialties, including Nobel Prize winning virologist Luc Montagnier, assert that there are viable theories about how homeopathic medicines may act, though as yet, no one explanation has been verified. Advocates assert that the homeopathic “principle of similars” is, in part, the basis for modern day immunizations, allergy treatments, and select other conventional treatments (ie, the use of Ritalin and other amphetamine-like drugs used to treat hyperactive children), while critics have compared it to sympathetic magic.
I wrote the current text. To me it seems accurate and encyclopedic, much better than either what it replaced or your suggestion.
My "While the founder of modern homeopathy was a medical doctor, some modern medical practitioners do prescribe some homeopathic remedies, and some governments do recognise homeopathy as legitimate treatment" instead of your "While many medical practitioners prescribe some homeopathic remedies" gives more arguments favorable to homeopathy, but states them more carefully, your "many" seems dubious to me.
My "the consensus of medical and scientific opinion is that homeopathy is unfounded." seems to me a simple statement of fact.
I removed the claim that it is "pseudoscientific", which seems to me true but unnecessary here. Criticism is fine; gratuitous insults are not.
I do not think the British Medical Association or your "However, ..." or "Advocates assert ..." belong in the lede. The lede needs to be a simple summary of key points. The BMA, Montaignier and Ritalin might all be discussed later, but they do not belong here. Sandy Harris 03:34, 14 September 2010 (UTC)

Greetings, Sandy...we've not interacted yet...let's work together. First, the claim in the present draft that "There is no plausible mechanism..." is false and has no place here. There ARE plausible explanations, though simply none that have been confirmed. Dana Ullman 15:20, 14 September 2010 (UTC)

It depends on the interpretation of the word "plausible". Certainly there are explanations, but I'd say none are plausible. Sandy Harris 02:31, 15 September 2010 (UTC)
Sandy suggests above that my reference to "many physicians" prescribing homeopathic medicines "seems dubious." Perhaps it would help if he re-read our article here where in the "Homeopathy in Practice" section gives some specific figures: "In Europe homeopathy is practiced by many conventional physicians, including 30-40% of French doctors and 20% of German doctors. Some homeopathic treatment is partly covered by some European public health services, including in France and Denmark. In France, 35% of the costs of homeopathic medicine prescribed by a medical doctor are reimbursed from health insurance."...Clearly, the term "many" is not dubious. Dana Ullman 15:48, 14 September 2010 (UTC)
See the discussion under "unsupported assertions" above. Those claims do belong somewhere in the article, if they can be supported, but the lede as it stands seems to me a good summary. Sandy Harris 23:21, 14 September 2010 (UTC)
I have a question for Sandy and Howard and other skeptics. At present, in this lede, there is the sentence: "To a skeptic, the 'principle of similars' is merely an appeal to sympathetic magic." Out of curiosity, do you believe that there is a certain wisdom of the body? Do you believe that the human organism tries to adapt to infection and/or stress by creating symptoms in order to survive? If you answer YES or MAYBE to EITHER of these questions, then using drugs that mimic the body's defenses make sense, and as such, we HAVE to delete or change this ill-founded sentence. Please also remember that the "high potencies" is only a part of homeopathy and that most homeopathic medicines sold in health food stores and pharmacies today are in small, material doses. It is inappropriate (and inaccurate) to assume that ALL homeopathic medicines are in doses beyond Avogadro's number. Dana Ullman 16:34, 14 September 2010 (UTC)
That sentence is fine. What we believe is not at issue. The paragraph is trying to summarise the position about homeopathy of skeptics and critics. I'd say that, if anything, it understates their revulsion. Granted, other parts of the article should give a much more favorable view, but the negative views should be there as well. Sandy Harris 23:21, 14 September 2010 (UTC)
Individual belief is outside the scope of the article, but no, I don't think there is a "wisdom of the body", and, using the medical definition of symptom, the body doesn't create any symptoms -- the mind does. Symptoms are subjective, and signs are objective. A sign may be evidence of a defense mechanism, but it's far more likely to be evidence of a disease process.
The great fallacy I see here is the assumption that proving-based drug mimic the actual defenses. The body's direct defenses against Clostridium tetani exotoxin in tetanus are immunologic. Those defenses are supported by administering synthetic tetanus immune globulin -- we learned to avoid the horse serum preparation as too risky -- to give initial passive immunity, and tetanus toxoid to build active immunity. These don't "mimic" the defenses; they are the defenses. The body really doesn't have defenses against the neurologic effects of the toxin, but benzodiazepines, neuromuscular blocking agents, baclofen and dantrolene provide what, I suppose, could be called "symptomatic" relief. Without getting into all the receptors, we have a pretty decent idea how these drugs reduce the spasticity; we don't need to go the route of finding similars.
I'm not opposed to using unusual explanations when there are no better ones. "Wisdom of the body" sounds like something for a Religion Editor. I do use complementary methods when I have some reason to believe in a favorable risk-benefit. As soon as I hear that something is risk free, alarm bells go off. There are always tradeoffs. I'm facing a terrible one now, as the American Veterinary Medical Association described euthanasia as a means of comfort care that has the side effect of death -- yet I have a beloved cat who has a greater will to live than any human I've ever encountered. Howard C. Berkowitz 23:56, 14 September 2010 (UTC)

The text you are questioning is "There is no plausible mechanism to explain how the remedies might work, given that many of them are so dilute that they contain not a single molecule of the active ingredient. To a skeptic, the "principle of similars" is merely an appeal to sympathetic magic." I think that is OK as it stands.

It could be replaced with something that both states the skeptical position better and mentions that not everyone is skeptical:

To a skeptic, there is neither any solid evidence that homeopathy is effective nor any plausible explanation of why it should be, and the "principle of similars" is merely an appeal to sympathetic magic. Homeopaths, however, believe that they have good answers to these criticisms.
Close. Let me urge that sympathetic magic show as a wikilink, as it is not just a throwaway pejorative, but an anthropological term that shows up across many cultures. Consider dropping the "merely". When I wrote the article on sympathetic magic, it wasn't intended to disparage, but to explain a cultural pattern.
Is it necessary to bring up both the Avogadro argument and similars in the lede, purely from a standpoint of complexity? Yes, I understand that potentiation is an argument that can be countered with the Avogadro point, but similars seem more basic than potentiation in understanding the core argument of homeopathy.
I am not trying to be argumentative when I say that arguing that the principle of similars is an equivalent or superior explanation, to a drug that was designed using molecular structure-activity relationships, is inflammatory. It's one thing for the homeopaths to say why their own preparations work, but it's pushing too hard to say that the homeopaths have better explanations for the drugs developed under different paradigms. Howard C. Berkowitz 02:46, 15 September 2010 (UTC)

4th paragraph

I believe that the present 4th paragraph has NO place in the top section. Discussion of the “possible dangers” from the patient or the doctor’s decision to not use conventional treatments has NO place here. If others wish to insert this information under its proper section, I do not have a problem, though we must then acknowledge: Homeopaths respond to the possible dangers from using homeopathic medicines in replacement of conventional medical care by asserting that there are much greater dangers by using conventional medicines as a first method of treatment.

It probably needs mention of the fact that homeopaths retort that conventional medicines may also have large risks. I'm inclined to think it does belong in the lede, since these risks are a basic issue about homeopathy. However, I don't feel remarkably strongly about that and would be interested in hearing other opinions. Sandy Harris 03:44, 14 September 2010 (UTC)
I would prefer to see it go unless the homeopaths present a statistical risk-benefit argument, based on modern medical practices, not 1900, that the hypothesis is true that the clinical outcome is better with homeopathic treatment than medical or no treatment. The risks of most medical treatments are quantifiable, as are the benefits, with the understanding that statistical aggregates do not apply to individuals.
There are any number of times I've chosen something with significant risk, because there was reasonable evidence the risk was greater than the benefit. Obviously, a cardioplegia solution that stopped my beating heart was risky, but the risk of not having the open-heart surgery was greater. There was reliable data for risk at each stage of the procedure.
When other children would chant "your mother wears army boots," I'd point out that they were part of her uniform. The "medical treatment is more dangerous", without substantial data, rings equally relevant to me. Howard C. Berkowitz 04:34, 14 September 2010 (UTC)
"I would prefer to see it go unless ..." is not clear to me. Are you saying that text on homeopathic rejoinders should not be inserted, or that we should follow Dana's suggestion and remove the current 4th paragraph from the lede? Sandy Harris 05:30, 14 September 2010 (UTC)
Unless the homeopathic rejoinder has strong statistical support, it should not be in the article. It's one thing if there is a formal risk-benefit analysis proving a hypothesis, but if it's no more than "well, medical treatments are dangerous," it's irrelevant defense. Howard C. Berkowitz 06:25, 14 September 2010 (UTC)

In due respect, the formal risk-benefit analysis needs to go BOTH ways. What evidence do you have for the "dangers" of receiving homeopathic treatment...and please do not give individual cases. I do have access to numerous cost-effectiveness studies showing significant cost savings to people who utilize homeopathic medicines. Dana Ullman 15:34, 14 September 2010 (UTC)

Bluntly, it does not need to go both ways. Homeopathy is desperately trying to claim a place at the table in the face of enormous evidence that molecular medicine is effective. It seems your position is that homeopathy and medicine are of equal status and that every claim against homeopathy must be counterattacked by one about medicine. If, indeed, homeopathy is so much an alternative to medicine, this is useless.
Incidentally, it would be wise for you to identify your financial interests in the promotion of homeopathy, such as (from http://www.homeopathic.com/main/bio_dana.jsp):
  • Dana Ullman, M.P.H. (Masters in Public Health, U.C. Berkeley) is "homeopathic.com" and is widely recognized as the foremost spokesperson for homeopathic medicine in the U.S.
  • Dana founded Homeopathic Educational Services, America's largest publisher and distributor of homeopathic books, tapes, software, and medicine kits. For 10 years he served as formulator and spokesperson for a line of homeopathic medicine manufactured by Nature's Way, one of America's leading natural products companies.
See Bob Badgett's developing article on conflict of interest. It is one thing for a practitioner to charge for professional services, but it is generally considered unethical for physicians to refer patients to testing facilities, publications, etc., from which they derive income.
You are the one making the claims that medicine is so dangerous. I didn't make claims about ""dangers" of receiving homeopathic treatment", which is a change of subject. I will say, however, that it is dangerous to seek homeopathic treatment in lieu of medical treatments of established efficacy. Now, that seems a backing-off from the dangers of conventional medicine, but there seems a dearth of such studies from sources not vested in homeopathy. Again, these studies need to be overwhelming to dispute the CZ policy of providing the mainstream view.
"NPOV", incidentally, is WP-speak and discouraged here.
Incidentally, apropos of being encyclopedic, how about contributions other than your single subject? Some of us are interested in building an encyclopedia, not fighting a never-ending battle with single-issue advocates or, as Sandy responded to Ramanand, social networking. Howard C. Berkowitz 16:48, 14 September 2010 (UTC)
Wow, Howard, you're now getting disperate...and I'm sorry to see this. First, for your information, I was personally asked by Larry Sanger (the founder of Citizendium) to edit here, and he asked me to become a Healing Arts Editor. I have never hid any fact about my background. In fact, most people appreciate my knowledge and expertise, except those few people who are threatened by facts, research, references to data, and the substantiation of information.
You and Sandy were asking me for "evidence" that conventional medicine has certain risks. While I could have laughed at this seemingly innocent (or naive) request, I simply responded by asking you to provide evidence that there was danger to homeopathic treatment. Instead of providing this evidence, you have chosen a different strategy to get your bias into this article. Let's avoid such tactics...and let's try to work together to write something fair, accurate, verifiable, and encyclopedic. Dana Ullman 22:26, 14 September 2010 (UTC)
No, I don't believe it is possible to collaborate with you to write something that is fair, accurate, and is not far more supportive of the benefits of homeopathy than is supportable by the views recognized by the bulk of medical opinion and data. I believe the best I can do is point out evasions, selective and often inaccurate statements about pharmacology, misquotations (e.g., saying Sandy or I asked for "evidence" medicine has risks), and what I believe to be a significant conflict of interest. I do so in discussion here, to be sure other members of the community see it, rather than jump into revert wars.
I have never suggested that medical treatment does not has risks; medical treatment always has risks. What I find to be hand-waving is the implication that homeopathy has no risks, including the delay of effective treatment.
You will note that I have asked for an Editor ruling on what I consider continued misues of von Behring as an authority that homeopathy works. I find it sad that regardless of what was done to design a treatment, the data-free argument that similars might be an explanation continues to be brought up.
Larry Sanger is not a health professional, and, I suspect, asked you to be a Healing Arts Editor because you are visible in that field. I would be much less antagonistic to your contributions were you to focus on what homeopaths believe and do, rather than the frequent -- and frequent inaccurate -- attacks on medicine, such as your condescending remark that there are no antifungal and antiviral agents of demonstrated efficacy, and, indeed, demonstrated risk. Indeed, the risk of unmodified amphotericin B has led to significant molecular work to reduce toxicity. You give the impression, however, that Hahnemann got it all right in the early 19th century, and medicine continues to get it wrong.
Professional collaboration does not require that participants like one another. It does not help when they are patronizing, and, if they can't take focused criticism without changing the subject, perhaps the kitchen of knowledge is a bit too hot. Howard C. Berkowitz 22:53, 14 September 2010 (UTC)

Howard, my concern about your editing is that you are just fabricating fights. You wrote above that I said "there are no antifungal and antiviral agents of demonstrated efficacy." Where (!) did I say OR simply imply that? Nowhere! I even repeated my point that we all have to be careful in making broad statement such as the "collective weight of evidence". THIS is what I mean by "straw men." You create arguments with yourself by making up what I say.

Where did you imply that? In an unsigned entry following mine of Howard C. Berkowitz 04:25, 14 September 2010 (UTC)
I am surprised and even a bit shocked to hear your assertion that antibiotics are effective for viral and fungal infections,
Obviously, I disagree, because I then listed numerous examples of antimicrobials effective against such infections.
If you want to accuse me of starting fights with myself, I'll simply conclude that one of me will always win. Howard C. Berkowitz 04:38, 15 September 2010 (UTC)


To clarify (again), my point is not that there are no risks to homeopathic treatment. However, IF we wish to highlight that there are certain risks to homeopathic treatment, we also have to acknowledge that it is widely recognized that there are much greater risks from conventional medical treatment. Dana Ullman 03:43, 15 September 2010 (UTC)

Certainly we should say somewhere in the article that there are also risks with other treatments, and that one of the arguments for homeopathy is that many of its remedies are low-risk. However, "it is widely recognized that there are much greater risks from conventional medical treatment" strikes me as something an encyclopedia cannot subscribe to without a lot more evidence.
In any case, I do not think a detailed discussion of risk issues belongs in the lede. I am inclined to thin the lede should raise the question, and in my opinion the current text does that adequately. Sandy Harris 04:12, 15 September 2010 (UTC)
I agree that a detailed discussion is out of place in the lede. If I may, I'll offer a fairly well-established risk of using homeopathic therapy as a first resort: myocardial infarction (heart attack). Assuming there are no contraindications to thrombolytic therapy, the window for optimal benefit from thrombolysis is 3-6 hours after onset, with declining benefit out to 12 hours. Thrombolysis can reverse the damage to the heart muscle if done within the window. I can cite any number of conditions where death can occur in hours or days without definitive therapy--tetanus is one. Of course, the best treatment for tetanus is prevention -- and TDAP and other immunizations are not designed by the principle of similars.
It's one thing to say that homeopathic remedies might be lower-risk in non-emergent situations, but that isn't what is being said. Of course, one could also say "it is widely recognized that there are much greater benefits, in serious conditions, from appropriate conventional therapy." No, appropriate conventional therapy does not, as been charged, extend to antibiotics for uncomplicated otitis media. Howard C. Berkowitz 04:38, 15 September 2010 (UTC)
In due respect, no one (!) has said or suggested that homeopathic medicines should be a treatment of first resort for heart attacks. THIS is what I mean by my concern for your tendency to create fights/arguments. Let's both avoid creating straw men. That said, I agree with Sandy that the lede should not have a detailed discussion of risks issues, though I would think that we might all agree that it is widely recognized that homeopathic medicines themselves are "basically safe." Also, can I ask us all to try to avoid inserting our own comments within the comments of other writers because it makes it challenging for people to determine who is saying what. Thanx. Dana Ullman 16:51, 19 September 2010 (UTC)
If it's alternative medicine, then it is the first resort. If it's complementary medicine, then there should be guidelines for the scope of practice of homeopathy. In the past, however, Ramanand has said homeopathy should be a first reatment for all manner of conditions. There was an extensive argument about acute asthmatic attacks, which, as I remember,
I am not creating a straw man. Please document when homeopathy should not be the treatment of first resort. Otherwise, I'll assume alternative medicine with no limitations.
Let me clarify my position. I would tend to say that homeopathic medications, themselves, are basically safe. I am very concerned that homeopathy, as a system of treatment, can be as deadly dangerous as a non-surgeon trying an advanced surgical procedure. You have yet to give information that documents what limitations homeopaths accept.
Please stop with the straw man accusations. I do not believe that any consensus is possible between alternative (i.e., not complementary) medicine and coventional medicine. Actually, I'd be far more likely to consult a shamanic healer than a homeopath, as there's a fair bit of documentation that shamans have a good understanding of psychosomatic medicine. I don't know what consensus could exist between someone that rejects the idea of treating the pathogens of infectious disease, and someone that has an understanding of modern microbiology. We, sir, are not on the same side and will not be. Howard C. Berkowitz 17:24, 19 September 2010 (UTC)

Rest of article

Further evidence of the strong POV and non-encyclopedic tone of this Draft is:

--under OVERVIEW: The first two sentences are “attack sentence.” It is clearly inappropriate to provide critique of a subject before adequately describing it FIRST. Those sentences must be removed or placed elsewhere.

I'd say at least the entire first paragraph and probably the whole "Overview" section should be deleted. None of it is real overview of the field. Sandy Harris 03:50, 14 September 2010 (UTC)
I agree with Sandy. There is no need for this "Overview" section, though I do believe that we need to place some of this information about the status and popularity of homeopathy in a section "Homeopathy in Practice." Dana Ullman 15:45, 14 September 2010 (UTC)

-- under OVERVIEW: Some sentences here are just confusing, especially this one and especially its last phrase: They are interested too in why some studies appear to have positive outcomes—do these reflect real efficacy, or can they be accounted for by flaws in study design or in statistical analysis, or "publication bias"—the tendency for small studies with chance positive outcomes to be published while studies with negative or inconclusive outcomes are not.

-- under HISTORICAL ORIGINS, it is confusing and surprising how or why Paracelsus was described as an “astrologer.” This field was not a primary area of his contributions. Just as the bio for Isaac Newton does not describe him as an astrologer, even though he actually wrote more on THIS subject than on mechanistic physics, we editors here know that Newton’s primary contributions to the modern-day have nothing to do with astrology. Needless to say, people here who want homeopathy to sound “quackish” tend to provide this biased information.

-- under HISTORICAL ORIGINS: Inaccurate information has been provided about the present status of the word “allopathy.” There is a long AND significant modern-day usage of this term by conventional medical organizations, medical schools, and state and national governments. Evidence for this is at: http://en.wikipedia.org/wiki/Talk:Allopathic_medicine (see “Hopping's huge list of links). Clearly, the term “allopathy” is still in extremely common usage, and it is simply inaccurate to say that it isn’t. In this light, Osler’s quote has no meaning here, though it may have a place in the article on “allopathy.”

-- under THE LAW OF SIMILARS: As much as I like the subject of “hormesis,” I do not associate its application with the law of similars nor do I know any reference to that. As such, the word “hormesis” has no place in THIS section. We could replace this word, hormesis, with the word “pheromones” because these substances are known to have a powerful effect in extremely small doses AND it is widely known that pheromones from one species are only sensed by those of a “similar” species.

-- under CLINICAL TRIALS TESTING THE EFFICACY… There are many sentences and paragraphs here that I could recommend changes, but I will emphasize those that are most important or most incorrect:

I recommend removal of the following short paragraph & its accompanying quote.

While many of these have indicated positive effects, generally, trials that are larger high-quality trials have tended to show little or no statistically significant effects, as was concluded by the authors of the second Lancet study cited above when they re-analyzed these trials.
“There is increasing evidence that more rigorous trials tend to yield less optimistic results than trials with less precautions against bias.”[98]

My explanation: First, the quote does not verify the sentence it is supposed to substantiate. Second, the article it quotes also asserts that it is a general finding in ALL clinical research that the higher quality trials tend to show less positive results. Third, the fact of the matter is that there are many high quality trials published in “high impact” journals that have shown statistically significant effects, including the four trials by Reilly, et al, the four trials on the treatment of influenza using Oscillococcinum, and the three trials on childhood diarrhea by Jacobs, et al.

We need to be careful in our review of research to avoid skewing the facts with “fudge” words. For instance, one could say that the “collective evidence” of the thousands of studies conducted by Thomas Edison was that electricity was not possible (because only ONE experiment in 1,000+ worked).

The challenge that we have in describing the efficacy (or lack of it) using homeopathic medicines is that we have to evaluate internal validity (how “high quality” were the trials?) AND external validity (is the specific medicine tested commonly used by homeopaths to treat people with that specific condition?). Skeptics of homeopathy tend to evaluate the internal validity issues and totally ignore the external validity issues…and BOTH are essential. To ignore external validity is akin to saying that antibiotics do not work for infections because the “collective weight” of studies on viral, fungal, and bacterial infection shows that these drugs do not work for this common group of diseases. Get it?

No. I don't get it, because I can demonstrate, in vivo and in vitro, that antibiotics do work for viral, fungal and bacterial infections. This is hand-waving and hardly encyclopedic.
I have repeatedly challenged you to respond to why homeopaths seem uninterested in the sort of trials used for customized pharmacogenomic medicine, which do have internal and external validity, and never have gotten an answer. Howard C. Berkowitz 04:25, 14 September 2010 (UTC)
I am surprised and even a bit shocked to hear your assertion that antibiotics are effective for viral and fungal infections, but I have no interest in arguing with you about these subjects here, though these strange assertions may influence your credibility with others. I take much more seriously your unfounded assertion that homeopaths are not interested in research that has internal and external validity. What is your evidence here?
Shocked? Now, if you are holding to the generally obsolete assertion that antibiotics are purely natural products, that's one thing. Let's see...viral? Neuraminidase inhibitors for influenza (as well as the older amantadine and rimantidine), ribavirin for Lassa fever and possibly other hemorrhagic fevers, protease inhibitors (as part of HAART) in lowering HIV levels...well, interferons might or might not be considered antibiotics, but have distinct roles in treating viral diseases. Fungal? Amphotericin B (amphotericin B lipid complex, amphotericin B cholesteryl sulfate, and liposomal amphotericin B); the conazole series; griseofulvin; flucytosine -- and that's not considering topical-only agents. Howard C. Berkowitz 17:07, 14 September 2010 (UTC)
Howard, you're missing my point here. My point is that one must be careful using the term "weight of evidence" because such terms group together various disparate treatments for various disparate conditions. Although I used the term "antibiotics," perhaps I should have used a name of a specific antibiotic, thereby showing that it may be effective for one type of infection but not for "all types" of infection. Likewise, testing homeopathic Arnica for one ailment may prove efficacious, but testing it for two other ailments might show that it is ineffective. One should not say that the "weight of evidence" is that Arnica is not effective. Instead, it is more accurate to say that Arnica is effective one condition but ineffective for two others. Get it now? I hope so...
My intention is not to "fight." My intention is for us to work together to provide verifable accuracy. Dana Ullman 22:37, 14 September 2010 (UTC)
Now I am confused. When you challenged fungi and viruses, it seemed you were challenging the existence of antimicrobial agents (a better term than antibiotic) for those organisms. I gave counterexamples.
No person with reasonable competence in infectious disease suggests there exists Panaceamycin, good for everything, any more than, presumably, Arnica is good for everything. Antimicrobial agents have reasonably well defined spectra, but, since they are directed against mutable living organisms, any competent hospital has a table ("antibiotogram") of the preferred agents for community-acquired and hospital-acquired infections in that locality.
Now, does the "weight of evidence" support appropriate antibiotic use? Yes! "Appropriate" does not include using antibiotics for self-limiting conditions unlikely to be affected by any antibiotic. Appropriate means considering the overall clinical picture -- sounds like the argument you make about syndromes -- such as not using penicillin G for exquisitely penicillin-sensitive streptococci, if the culture shows coinfection with Staphylococcus aureus or other penicillinase-secreting organism. One has to consider potential development of resistance, as well as the practical means of administration--if there is no one qualified to inject a parenteral antibiotic in home care, the antibiotic is irrelevant no matter how effective it may be against the organism. If there's a choice in a patient with a hearing loss, you avoid the especially ototoxic aminoglycosides.
Incidentally, I was just scratching the cognitive process in determining how to treat an infection. Howard C. Berkowitz 03:03, 15 September 2010 (UTC)
Just as doing double-blind and placebo controlled research testing surgical procedures have their methodological and ethical challenges, research on homeopathy has to be sensitive to the method itself. You cannot just test a homeopathic medicine and its effects on a bacteria in a petrie dish, nor can I test acupuncture by putting a needle in a petric dish full of bacteria. You've been told this many times in the past, and yet, you repeatedly feign ignorance about homeopathy and homeopathic research. Please...you're a smart guy. Let's discuss research that does exist. Dana Ullman 15:59, 14 September 2010 (UTC)
I repeat: there are usable methods that have been described for pharmacogenetic medicine. Let the clinician diagnose the individual treatment and send orders for it to the pharmacy. The pharmacy breaks the blinding code and dispenses either the ordered individual treatment or the control arm, the latter which may or may not be placebo. The safety committee monitors, and, assuming the study goes to completion, statistically evaluates the hypothesis that the experimental treatment arm is superior to control.
Incidentally, the piece of laboratory glassware is a Petri dish. If, however, you are referring to bacterial sensitivity testing, production tends to be done with radiochemistry, radioimmune reactions, or immunofluorescence. Consider me dumb since I don't know I'm feigning ignorance about homeopathy. Howard C. Berkowitz 17:07, 14 September 2010 (UTC)
"I've been told"...but by someone I find plausible? You have yet to answer my question about the cognitive process of a homeopathic session, claiming that only a homeopath can understand it, yet no medical discipline makes such a claim of inner mysteries. Howard C. Berkowitz 17:07, 14 September 2010 (UTC)
Howard, I am perfectly able to describe the cognitive process of a homeopath, but I don't think THAT has a place here. I've told you this before (many times!), and yet, you repeated request it. I'm writing this again because it seems that you don't want to remember. Sadly, you consistently seem to want to pick a fight, and you make these strange claims about homeopathy and homeopaths without evidence. To me, it just seems that you have a chip on the shoulder. I have no problems with you making verifiable statements or asking questions, but I do have a problem with you creating boogey-men when none exist.
I will say this: homeopaths usually prescribe their medicines for the overall "syndrome" of the patient, not just their "disease." Dana Ullman 22:46, 14 September 2010 (UTC)
I keep repeating it because you keep refusing to answer it, which I remember very well. Apparently, homeopathy is unique among healing arts and health sciences in not addressing cognition in practitioners.
I suppose that if I can't do better than century-old immunology and pronouncements that regardless of the molecular pharmacology that went into developing a drug, our old buddy similars might be the real explanation.
Sadly, you consistently want to pick a fight with anyone who doesn't regard homeopathy as the greatest thing for health. Howard C. Berkowitz 23:14, 14 September 2010 (UTC)

--Under GOVERNMENT AND INSTITUTIONAL… -- If we choose to include reference to the Great Britain’s House of Commons’ Science and Technology’s report on homeopathy, we have to make it clear that this report was voted on by an extremely small minority of its members. Of the 14 members, 10 did not consider this issue worthy of voting. Ultimately, a “majority” of only THREE members voted for this anti-homeopathy report. Of these 3 votes, two members were so new to the Committee that they did not attend a single hearing on the subject of homeopathy. The third vote for the “report” came from Evan Harris, a vitriolic antagonist to homeopathy who was not re-elected this year, losing to a 20-something year old political neophyte. Finally, because this report was “advisory” only in nature, the health minister overruled it and didn’t accept its conclusions. If anyone wants to make reference to THIS report, we have to add these important facts. I personally suggest that we do not cover this complicated and inconclusive decisions.

It should also be noted that whoever wrote the above was obviously also aware of these facts and choose not to present them. This type of biased reporting should not have a voice here. Let’s strive for more encyclopedic objectivity. Dana Ullman 01:21, 14 September 2010 (UTC)

Repeated defenses of homeopathy, with nothing more than supposition and coincidences, don't belong here either. In my opinion, Mr. Ullman, you will not regard anything short of an article that gives homeopathy as much credibility as conventional medicine as acceptable -- and that, sir, is a promo. Howard C. Berkowitz 04:25, 14 September 2010 (UTC)

Logical fallacies

Take the proposed statement "Advocates assert that the homeopathic “principle of similars” is, in part, the basis for modern day immunizations, allergy treatments, and select other conventional treatments (ie, the use of Ritalin and other amphetamine-like drugs used to treat hyperactive children), while critics have compared it to sympathetic magic. "

If anyone used the principle of similars to plan these treatments, there might be a case. I sincerely doubt, however, that this was ever done; the advocates making after-the-fact, observational rather than molecular, correlations that are extremely dubious. Take a modern immunization, especially an acellular one -- it is designed on a molecular basis to produce desired immunoglobulins and other specific substances; similars were not involved in the design. It's rather hard to say that "similars" is a better explanation than what the molecular pharmacologists intended, and can demonstrate.

Are there homeopathic provings that demonstrate that large doses of cromolyns cause basophil and mast cell degranulation? If not, the molecular explanation that they desensitize the granules, and in turn block the release of histamine and other inflammatory messengers, is a much better shave with Occam's Razor.

I hope we do not have as lengthy a debate on the Tooth Fairy, especially from advocates that are America's leading spokesman for tooth fairies and thus have a financial conflict of interest. Howard C. Berkowitz 01:57, 14 September 2010 (UTC)

Just to throw yet another bit of reality, the use of amphetamine-like drugs, as well as non-amphetamine drugs such as Strattera, for attention deficit disorder — not limited to children — and not discussing other psychotropic drugs is, to put it mildly, showing selection bias. There's as much evidence of neurotransmitter effects than of "similars". Further, if one were to generalize to other psychotropic drugs, one couldn't use the principles of similars to produce hypomania in a normal control. It has repeatedly been demonstrated that lithium carbonate, for example, is not euphoriant. In high doses, it's a depressant -- remarkably so, since the subject will be dead. Howard C. Berkowitz 04:25, 14 September 2010 (UTC)
We cite in this article a quote from Emil Adolph von Behring (the "father of immunology") who asserts, "In spite of all scientific speculations and experiments regarding smallpox vaccination, Jenner’s discovery remained an erratic blocking medicine, till the biochemically thinking Pasteur, devoid of all medical classroom knowledge, traced the origin of this therapeutic block to a principle which cannot better be characterized than by Hahnemann’s word: homeopathic." Whether physicians today (or yesterday) refuse to believe that the "principle of similars" is utilized in medicine, it still can be asserted that they are consciously or subconsciously utilizing it. This is NOT to say that ALL drugs are prescribed by this principle (Howard creates a straw man argument with his reference to lithium carbonate). Further, just because there are other explanations for how or why Ritalin works does not take away the fact that the "similars" principle may also be at play. Dana Ullman 16:14, 14 September 2010 (UTC)
Ah yes. von Behring. 1901 Nobel Prize for 19th century work. Got some authoritative immunology less than a century old? Maybe someone that knew about immunoglobulins?
"It can be asserted" and "just because there are other explanations" doesn't support similars, any more than the Illuminati might be responsible for all evil in international relations. "Might" isn't encyclopedic.
Actually, I prefer the wicker man to the straw man.
I'm disgusted, but I will not give up because the integrity of CZ means something to me. To stop responding to handwaving would be to give in to the stamina of homeopathic advocates.
You were the one that brought up various drugs. I added lithium carbonate as one example. How is it a straw man? In therapeutic doses, it has no effect on non-hypomanic patients. Easy to call things straw men when you don't like them, and drop back to "it can be asserted." The capability of assertion does not make for encyclopedic quality. Howard C. Berkowitz 17:16, 14 September 2010 (UTC)

Regarding 'point of view'

No "point-of-view" disparagement required for conclusions/inferences drawn from science. Any such disparagement itself reflects "point-of-view". The lede as it reads now reflects medical science's judgment of homeopathy. Personally, as a scientist, I consider an open mind a virtue, but I try not to have it so open my skeptical inquirer falls out. Anthony.Sebastian 03:16, 14 September 2010 (UTC)

As I've suggested, we have to face the issue that the two advocates appear not to want the general judgment to appear, unless it is immediately accompanied by a Seinfeld-like "but that's OK, and homeopathy works." Howard C. Berkowitz 04:25, 14 September 2010 (UTC)

Biology-Health Sciences Editor ruling needed

Immunology clearly falls into these fields, not Healing Arts. I contend that it is ludicrous for this article to be using von Behring as a source of authority. It's fair enough to mention a 1901 Nobel Prize winner in a historic context, but a ruling is needed if his statements on homeopathy and immunotherapy can be used as substantiation for plausible modes of immune response. Immunology has progressed a bit in over a century.

It's futile to argue this with Mr. Ullman, and I believe we have enough relevant Editors to settle this point. Howard C. Berkowitz 18:35, 14 September 2010 (UTC)

Agreed (sorry for butting in). (Chunbum Park 09:56, 15 September 2010 (UTC))
Don't feel sorry, Chunbum, your particpation and opinion is a valued part of the decision process.
This appears to be a bigger issue than homeopathy. It appears that you are asking to limit an editor on an article. We don't have a mechanism for that. We've really left that to the devices of other editors to challenge unusual statements by other editors. I would expect that even Dana would appreciate a immunologist's input, but regardless, they'd both still need resources to cite. I'm not sure that a Health Sciences Editor can overrule a Healing Arts editor on an article, but he can certainly challenge anything that counters his beliefs. I would think the EC or EiC would have to rule on something like that. Of course, that would be the Managing Editor should the new charter take effect. D. Matt Innis 12:59, 15 September 2010 (UTC)
That's much what I was thinking. To take a parallel example relevant to Howard, the article on the Iraq War might, and in my view should, discuss the question of its legality. But I don't suppose the article is affiliated to the Law Workgroup. So what happens with a hypothetical conflict between, say, Howard and a law editor on that question? I think the new EC has to think about the whole system here, not just leave it to the ME to invent precedents. Peter Jackson 15:03, 15 September 2010 (UTC)
Perfect example, Peter. The new charter should allow the new ME to make a decision on the fly based on ample input from everyone (especially editors) and then the EC can take its time to review the ME decision and either overrule it or support it. Hopefully, that will develop a sort of "case law" that eventually develop into policy based on a democratically expert debated concepts rather than customary consensus. Meanwhile, authors will be able to move on to different content while the decision is reached elsewhere. D. Matt Innis

(undent) All of you make good points, but the specific may be a little easier. If I were to state the problem in EC terms, it is that different disciplines acquire knowledge at different rates. Were this, for example, a Literature article, Oscar Wilde or G. B. Shaw's comments would be relevant. If this were aviation engineering, however, I think it is relatively obvious that Orville and Wilbur Wright's commentary would not be very relevant to an Airbus (most recent model) or Boeing 787 Dreamliner. While I've often wondered how a classic military genius such as Belisarius would do with airmobile forces, he'd have a bit of catching up.

Von Behring, and indeed Hahnemann, were giants in their time. Today, however, von Behring wouldn't know how to find his way to the protein sequencer or the molecular visualization workstation.

The policy, therefore, might say that to cite an authority as more than a historic point, that authority has to be reasonably familiar with current concepts. It may be even faster now, but, a few years ago, based on MEDLINE growth, the amount of information in health sciences doubled every seven years. Some fields, such as molecular pharmacology, went from nonexistent to major disciplines. There's not going to be a citation that "Von Behring is obsolete", but that's a reasonable inference.

Peter, I would be absolutely delighted to have an article on the legality of the Iraq War. The article is not now affiliated with law, or several other relevant workgroups, due to the three workgroup limit. In doing the main draft of these articles, I had quite enough to do with the "what" and "how" without getting into the just war theory or international law. I would be happy, over an appropriate beverage, to discuss what I personally consider to be vague language in the UN Charter.

Unquestionably, Matt, workgroups need to be revised. I have been doing some experimentation with subgroups, but they are not a sole answer. Howard C. Berkowitz 17:19, 15 September 2010 (UTC)

I think the word "ruling" in the section title is an error. Certainly comment, or even contributions, from those editors would be useful and (I assume) welcomed by all concerned, but I do not think they have the authority to rule here.
The paragraph quoting von Behrig starts "Scientists and medical doctors today do not think that the principle of similars is generally true or useful, and they explain the efficacy of vaccination without referring to it. Physicians of the 19th century however did consider that the principle could be valuable." That strikes me as fair. Given that context-creating text, I see no objection to the von B quote.
As I see it, there are serious issues with this article, and Howard is right about most of them. However, on this particular point, I see him as tilting at a windmill. Sandy Harris 02:52, 16 September 2010 (UTC)
One never knows...the windmills might be giants. Seriously, I really don't have a problem with historical quotes in historical contexts. Such contexts, though, would include both Osler's preference for 19th century homeopathy over 19th century allopathy, and his later statement that both allopathy (as used at the time) and homeopathy were both "cults" that needed to be replaced by scientific medicine.
Recent comments on this talk page, however:

Whether physicians today (or yesterday) refuse to believe that the "principle of similars" is utilized in medicine, it still can be asserted that they are consciously or subconsciously utilizing it. This is NOT to say that ALL drugs are prescribed by this principle (Howard creates a straw man argument with his reference to lithium carbonate). Further, just because there are other explanations for how or why Ritalin works does not take away the fact that the "similars" principle may also be at play. Dana Ullman 16:14, 14 September 2010 (UTC)

made me concerned that advocate(s) wanted to reintroduce the von B quote without the qualifiers, and suggesting that similars are the mechanism of medical immunization. That is not acceptable and is flatly wrong. I suspect that some of the molecular immunologists building acellular vaccines may never have heard of similars and certainly aren't designing with that principle, rather than protein structure-activity.
Lithium carbonate is hardly a straw man, as its activity would not be demonstrated in a proving on a non-hypomanic individual, only toxic effects in high doses. When things demonstate exceptions to basic concepts such as similars and proving, they become significant negative data. "It can be asserted" is hardly encyclopedic, thinking of the classic assertion that if my aunt had testicles, she'd be my uncle.--Howard C. Berkowitz 04:33, 17 September 2010 (UTC)

Howard C. Berkowitz 04:26, 17 September 2010 (UTC)

Followup on Anthony's comment about alternative medicine

While I agree with your addition, I wonder if it goes far enough. Complementary and alternative medicine, while often grouped together, are not the same. Alternative medicine, to use NCCAM's definition, is a substitute for conventional medicine, while complementary medicine can be integrated with conventional medicine. Rather by definition, alternative medicine will not agree with conventional medicine, and never the twain shall meet.

It's not implausible that there could be complementary homeopathy, but I find it interesting that the article really doesn't address it. At best, there are arguments that homeopathy is superior to conventional methods for specific disorders. There's some hand-waving that conventional physicians use homeopathic remedies in their practice, but no discussion of the indications and rationale for doing so. In other articles, there is discussion of the complemntary use of acupuncture, chiropractic, etc.

Whether or not homeopathy is CAM rather than AM, this article overwhelmingly treats it as AM. Howard C. Berkowitz 21:50, 14 September 2010 (UTC)

Howard, I took a long rest from this article, and it seems that you would really benefit from doing so too. I realize that by saying this you may now want to edit more often than ever. My concern is that you are beginning to lash out at me and at this subject in an extremely emotional way. It seems that you are no longer trying to create an encyclopedic article but one that pushes your POV which remain inadequately informed about this subject of homeopathy. Heck, even when Dr. J sought to reach out to Sandy and be friendly, rather than adverserial, Sandy told him that he wasn't interested. That's OK too...and Dr. J didn't seek to connect personally. Let's not make this effort by Dr. J to be as "bad" as you've tried to make it. Dana Ullman 22:54, 14 September 2010 (UTC)
Well, gee. I've been discovered: my whole motivation is attacking homeopathy, and I never, ever contribute to anything else at Citizendium. Obviously, New Delhi metallo-beta-lactamase-1 enzyme is just an attack on homeopathy, as is CZ: Pacific War Subgroup, as is (quite friendly) collaboration on opportunistic encryption.
Why is this in a subsection where I was addressing the complementary and alternative aspects of homeopathy? That was hardly emotional. I neither need nor want your advice or concern on what I should do.
It is adversarial. Deal with it. Mortality & Morbidity conferences, military After-Action Reviews, engineering design reviews, etc., benefit from an adversarial approach.
As far as I can tell, your definition of "adequately informed" is to accept homeopathy. The Ormus article hurt Citizendium, and I am convinced that homeopathy does as well. I do know that I have had people refuse to join CZ specifically due to the homeopathy article. I'll believe you want to be encyclopedic when I see you contribute to things other than a single issue.
If I get extremely emotional about something, I tend to be more quiet, and perhaps smile a lot. Howard C. Berkowitz 23:07, 14 September 2010 (UTC)

Encyclopedia Britannica Online: Homeopathy lede

Possibly of interest:

"Homeopathy"

"a system of therapeutics, notably popular in the 19th century, which was founded on the stated principle that “like cures like,” similia similibus curantur, and which prescribed for patients drugs or other treatments that would produce in healthy persons symptoms of the diseases being treated."

"This system of therapeutics based upon the “law of similars” was introduced in 1796 by the German physician Samuel Hahnemann. He claimed that a large dose of quinine, which had been widely used for the successful treatment of malaria, produced in him effects similar to the symptoms of malaria patients. He thus concluded that all diseases were best treated by drugs that produced in healthy persons effects similar to the symptoms of those diseases. He also undertook experiments with a variety of drugs in an effort to prove this. Hahnemann believed that large doses of drugs aggravate illness and that the efficacy of medicines thus increases with dilution. Accordingly, most homeopathists believed in the action of minute doses of medicine."

"To many patients and some physicians, homeopathy was a mild, welcome alternative to bleeding, purging, polypharmacy, and other heavy-handed therapies of the day. In the 20th century, however, homeopathy has been viewed with little favour and has been criticized for focusing on the symptoms rather than on the underlying causes of disease. Homeopathy still has some adherents, and there are a number of national and international societies, including the International Homoeopathic Medical League, headquartered in Bloemendaal, Neth."

http://www.britannica.com/EBchecked/topic/270182/homeopathy

Anthony.Sebastian 03:27, 16 September 2010 (UTC)

The first two paragraphs, I hope, are not controversial. The talk page controversy, however, has significantly involved both homeopathic attempts to claim medical logic, as well as a broader assumption, by the homeopathy advocates, that homeopathy needs to be regarded as having equal credibility to conventional medicine. Attempts to claim that the principle of similars is the underlying mechanism for medical treatments developed, or validated, using methods of molecular pharmacology fall under my first point. Closely coupled is the homeopathic argument that homeopathy mimics body defenses manifested as symptoms, when the actual defense is quite different than the symptom producing factor -- tetanus is a good example, where the defenses are immunoglobins that have no particular symptom-producing quality, but the symptoms of spasticity and convulsions are caused ("indirectly") by the exotoxin of Clostridium tetani and can be lethal. The defenses neutralize the toxin, and, coupled with antibiotics and surgery, eradicate the source of the toxin.
In other words, there's a refutation of molecular medical arguments, but no molecular explanation of how similars affect the body. Hand-waving about memory of water isn't on the same level as immune reactions that can be demonstrated in vitro and in vivo, or structure-activity interactions with cellular receptors. --Howard C. Berkowitz 23:12, 16 September 2010 (UTC)

"Alternative Medicine and the Laws of Physics"

Of possible interest:

Alternative Medicine and the Laws of Physics

Robert L. Park

Skeptical Inquirer, Volume 21.5, September / October 1997

http://www.csicop.org/si/show/alternative_medicine_and_the_laws_of_physics/

Anthony.Sebastian 03:59, 16 September 2010 (UTC)

Having read the article I feel a neutral way of presenting homeopathy would be something like "it is a type of medicine supported by neither scientific reasoning nor data. that being said this is what homeopaths think: 1, 2, 3." (Chunbum Park 05:40, 16 September 2010 (UTC))
I think that overstates the case. Homeopathy is based on a system that includes reasoning which is at least pseudo-scientific. There is data, though much of it is of dubious quality; in particular, "data" is not the plural of "anecdote". I don't think your text above is neutral in any sense I'd recognise.
The current draft includes "the consensus of medical and scientific opinion is that homeopathy is unfounded." I think that is accurate, neutrally stated, and sufficiently direct.
That said, I do think we should link to highly critical articles such as that one, possibly the rational wiki page, and certainly the lovely cartoon they use. Sandy Harris 07:40, 16 September 2010 (UTC)
See rational wiki's article "Citizendium" first. Anthony.Sebastian 03:57, 17 September 2010 (UTC)

Suggest ending Main Article draft at end of lede

Let reader use Biblio to get further information. Concentrate on thorough Biblio subpage. 06:39, 17 September 2010 (UTC)

I don't think that is an adequate approach for an encyclopedia. We want a reasonably detailed explanation here. That said, the article could likely be shortened significantly without losing anything valuable. Sandy Harris 12:14, 17 September 2010 (UTC)
At home much resource cost that could be going into even copy edit of other articles, articles that deal with topics that are likely to have more serious users? I'd wager that a good part of the hit count on this article is due to people at other wikis looking for controversy.
That being said, I'm not sure how feasible it is under present policy. Assume three Health Sciences and Biology Editors are willing to nominate the truncated approach for Approval. Healing Arts Editors say it is not Approvable. It would be one thing for a Mathematics Editor to question approval for a cryptographic topic written by a computers person, but we've gotten through effective collaboration among, say, Computers, Mathematics, and Military. Health Sciences and Healing Arts, among the workgroups, are the only case where we have different workgroups for fundamentally different views on the same subject area. It's a bug, not a feature; we don't have separate-but-equal Religion and Atheism workgroups. Howard C. Berkowitz 15:53, 17 September 2010 (UTC)

Definition

The current definition reads "System of alternative medicine that asserts — contrary to scientific evidence — that substances known to cause specific syndromes of symptoms can also, in very low and specially prepared doses, help to cure people who are ill with a similar syndrome of symptoms." I think that is a moderately awful definition. The problems I see are:

The "contrary to scientific evidence" bit, or similar text, has been added at least twice and reverted at least once. I don't think it belongs in the definition.
"syndrome of symptoms" is used twice. That's ghastly stylistically, "syndrome" is a technical medical term that may not belong here, and in any case, I suspect "syndrome of symptoms" is redundant. What else could you have a syndrome of? Or does a syndrome include more than just symptoms?

My version would be: A system of alternate medicine based on the idea that substances known to cause particular combinations of symptoms can, in very low and specially prepared doses, help to cure people who are ill with similar symptoms. (sig added later Sandy Harris 23:14, 17 September 2010 (UTC))

""Syndrome of sympoms", indeed, is ghastly. Unfortunately, it touches on a difference between homeopathic and current medical thinking that is as important as similars. Modern physicians look first for an etiological diagnosis: what is the cause of the patient's distress? (Note here that "symptom" is being used in a lay sense here -- there are differences of theory as well). Homeopaths consider that the "disease model", not patient-centric, and often reject a causality-based approach. Their focus is on the products of the cause (in medical thinking) or the body wisdom expressing its defenses.

A better wording would be welcome, but the rejection of etiologic thinking, and the focus on similars as a means of reducing symptoms, is fundamental. Howard C. Berkowitz 15:53, 17 September 2010 (UTC)

Sandy's version:

  • A system of alternate medicine based on the idea that substances known to cause particular combinations of symptoms can, in very low and specially prepared doses, help to cure people who are ill with similar symptoms.


My understanding:

  • A system of alternate medicine based on the idea that large dosages of substances known to cause particular combinations of symptoms in healthy individuals can, in very low and specially prepared doses, help to cure a person whose illness causes similar symptoms.

D. Matt Innis 21:49, 17 September 2010 (UTC)

I am quite willing to be corrected here, but I think the idea of an illness that creates similar symptoms is still too close to an etiologic model of disease to be accepted by homeopaths. While I don't have better words, my sense is they would say the symptoms are produced by the "wisdom of the body" as "defenses" and the remedies strengthen the defenses. --Howard C. Berkowitz 23:59, 17 September 2010 (UTC)


That could be the next sentence.


  • A system of alternate medicine based on the idea that large dosages of substances known to cause particular combinations of symptoms in healthy individuals can, in very low and specially prepared doses, help to cure a person whose illness causes similar symptoms. In essence, they believe that symptoms are produced by the "wisdom of the body" as "defenses" and homeopathic remedies are designed to strengthen those defenses.
D. Matt Innis 03:22, 18 September 2010 (UTC)
Add: They do not use the disease model of conventional medicine, in which there is a disease rather than an individual set of symptoms, and treatment directed at a cause of that disease as it presents in multiple patients. Howard C. Berkowitz 03:29, 18 September 2010 (UTC)
More work:
  • This contrasts with conventional medicine's "disease model" of treatment that looks to treat the disease process and therefore relieve the symptoms.
I'm not sure that's totally true, though. Many conventional treatments are directed at relieving symptoms, too.
D. Matt Innis 03:54, 18 September 2010 (UTC)

(edit conflict) (undent) There's a different philosophy in symptomatic treatment. If I sprained my ankle badly enough to need surgical repair, the cause would be relevant to a conventional orthopedist who needs to work on the damaged structures. Otherwise, the exact ligament stretch might be known, but it's not of therapeutic benefit. Symptomatic pain relief is the first consideration -- yes, rehabilitation may focus on exact etiology, but, for the sake of argument, assume it's self-limiting.

Sometimes, as with uncomplicated childhood otitis media, even if it is bacterial, antibiotic therapy may not be justified. Presumably, though, the child can still get acetaminophen.

In both of the cases above, there was awareness of an etiology, but a choice to treat only symptoms. Palliative care is often largely but not exclusively symptomatic -- still, an etiology would be necessary for chemotherapy or radiotherapy to slow the growth of an incurable tumor. Pain management, though, is symptomatic and even more important. Where does nursing care fit?

The homeopaths, however, appear to exclude the idea of treatment based on etiology, as opposed to symptom relief when the cause is either self-limiting or not treatable. I spend hours daily giving comfort care to my cat buddy, relatively little of which is directed at the cancer itself, but much more in nutrition, emotional support and wound care. Indeed, I am using some complementary medicine along with a lot more conventional things. Homeopathic ideas of symptom-oriented remedies don't enter into it. --Howard C. Berkowitz 04:28, 18 September 2010 (UTC)

I don't think either that long definitions are a good idea in general, or that the proposed "next sentences" are needed in this definition. In the article, certainly; in the lede, probably. However, the definition needs to be short and direct. In particular, it needs to be short enough to look reasonable when cited on a related articles page. Sandy Harris 04:46, 18 September 2010 (UTC)
If the definition is to be short, then, I believe the rejection of etiology is far, far more significant to homeopathy than the better-known issues of small doses. It appears to me that Hahnemann's insight dealt with symptoms being the essential manifestation of health or not-health, and only then did he go to the idea of provings and similars. My understanding is that his using provings for malaria had to do with the symptom production of quinine.
Absolutely, I forgot that we were working on the definition! You're right, Sandy. D. Matt Innis 21:27, 18 September 2010 (UTC)
I believe there's a comment on this page, from a homeopath, that homeopathic remedies are not always administered in homeopathic femtodoses.
The rejection of etiology is also key to much of the dispute with medicine, as I mentioned in terms of clinical trials. It is also, however, central to the medical rejection of some homeopathic approaches, such as the principal treatment for malaria being based on reducing Plasmodium parasites in the blood. Quinine remains a third-line drug for malaria, but its action in reducing fever and chills is due to its ability to suppress the parasites, not (in a medical view) what effects are caused by high doses of quinine. Howard C. Berkowitz 04:56, 18 September 2010 (UTC)
Quinine remains a third-line drug for malaria, but its action in reducing fever and chills is due to its ability to suppress the parasites, not (in a medical view) what effects are caused by high doses of quinine.
I think that's the point; it's not that homeopath's don't care about etiology, they just don't concern themselves with it. If it causes the same symptoms in a normal person, then it's used to treat the person that has those same symptoms, regardless of the cause. As you say, they might contend that the plasmodium is not what causes the symptoms, rather the symptoms are the body's response to plasmodium. To them it doesn't matter. D. Matt Innis 21:28, 18 September 2010 (UTC)
As my grandmother might have said, ah-HAH! Admittedly, I'm taking the example of the worst form of malaria, but a patient presenting with the cerebral form of Plasmodium falciparum malaria may well die in 18 hours. In general, the standard of medical care would be artemisinin-based combination therapy, with critical care support for effects such as acute respiratory distress syndrome or disseminated intravascular coagulation.
Quinine, in substantial doses and in combination with doxycycline, tetracycline, or clindamycin, be lifesaving. If I were the patient, however, and someone offered me homeopathic oral doses of oral quinine, I'd prefer a lethal dose of barbiturates, or a large-caliber bullet to the back of the neck (messy but fast).
Now, I'd have every respect for a complementary homeopath that suspected severe falciparum malaria, and immediately transferred the patient to medical care. Assuming such care were available, I'd regard an alternative practitioner as having, as the lawyers put it, depraved indifference for human life.. Howard C. Berkowitz 22:02, 18 September 2010 (UTC)
I suspect the cerebral form would have different symptoms, therefore different remedies as well. A bullet is probably not one of them. ;-) D. Matt Innis 23:40, 19 September 2010 (UTC)
Are you doubting the efficacy of a .45 caliber ACP 254-grain round, which is lead in a hardly homeopathic dose? Nevertheless, if I had cerebral P. falciparum malaria, I know that active medical treatment is still very iffy. Seriously, we have the problem of any validation here; I cannot imagine an ethics review board that would approve any treatment for such a life-threatening disease without overwhelming laboratory evidence for the control arm. Howard C. Berkowitz 22:21, 20 September 2010 (UTC)

Sandy's edit to the definition

...specifically "help to cure or prevent illnesses involving similar symptoms." While a homeopath will have to review this, I don't think "illnesses involving similar symptoms" is really a homeopathic concept. They certainly object to "diseases with similar symptoms", and tend to reject "disease" as a medical conceit. The symptoms are signals of the body's defenses to be strengthened, not the effects of a causative factor. Howard C. Berkowitz 04:59, 18 September 2010 (UTC)

I think you're splitting hairs, but, yes, let's hear from a homeopath on this. D. Matt Innis 21:27, 18 September 2010 (UTC)
Sandy's new definition is definitely an improvement. D. Matt Innis 21:32, 18 September 2010 (UTC)
Li'l hard pressed for time. I'm happy with Alexander's definition, but if you guys feel it needs to be simpler, I have a 'simpler definition', which would read:-

(Homeopathy is) an alternative system of medicine, which stimulates the natural healing processes of the body (with the help of sub-physiological doses of a remedy, by using its rebound effect), to restore health (homeostasis) in a sick person.

The matter in brackets is optional.—Ramanand Jhingade 07:36, 19 September 2010 (UTC)
Note that it is alternative medicine and not alternate medicine.—Ramanand Jhingade 07:44, 19 September 2010 (UTC)
Unfortunately, "rebound effect" is not a well-defined term, certainly in medicine, so should not be used in a definition unless it is well defined in an article of its own. The alternate definition depends heavily on homeopathic terminology, such as "natural healing processes", as well as using homeostasis is far broader a context than is used in the biological sciences -- to say nothing amout emerging concepts such as allostasis.
The proposed new definition also overemphasizes the aspect of small doses and does not address the apparent rejection, by homeopathy, of the idea of "disease". Instead, it speaks of "restoring health", without addressing the meaning of the state of non-health.
Please confirm or correct the statement that homeopaths do not believe in the concept of disease, in the sense that disease has an etiologic cause and the cause needs to be corrected. Howard C. Berkowitz 08:30, 19 September 2010 (UTC)
I agree with Howard here, Ramanand, that your version introduces too many vague terms to be considered for use as a one sentence definition. D. Matt Innis 23:44, 19 September 2010 (UTC)

What about

A system of alternative medicine based on the idea of stimulating the body's natural healing processes by administering tiny doses of substances which, when given in large doses to healthy individuals, cause similar combinations of symptoms.

I agree that Ramanand's definition has some problems, and I think the full version is too long, but it seems to me the point about stimulating natural defenses is central. Sandy Harris 03:07, 20 September 2010 (UTC)

  1. ↑ Kales A, Scharf MB, Kales JD (September 1978). "Rebound insomnia: a new clinical syndrome". Science (journal) 201 (4360): 1039–41. PMID 684426. [e]
  2. ↑ Kirkwood CK (1999). "Management of insomnia". J Am Pharm Assoc (Wash) 39 (5): 688–96; quiz 713–4. PMID 10533351. [e]
  3. ↑ Tsutsui S (2001). "A double-blind comparative study of zolpidem versus zopiclone in the treatment of chronic primary insomnia". J. Int. Med. Res. 29 (3): 163–77. PMID 11471853. [e]
  4. ↑ Hohagen F, Rink K, Käppler C, et al. (1993). "Prevalence and treatment of insomnia in general practice. A longitudinal study". Eur Arch Psychiatry Clin Neurosci 242 (6): 329–36. DOI:10.1007/BF02190245. PMID 8323982. Research Blogging.
  5. ↑ Reber, Arthur S.; Reber, Emily S. (2001). Dictionary of Psychology. Penguin Reference. ISBN 0-140-51451-1. 
  6. ↑ Kales A, Soldatos CR, Bixler EO, Kales JD (April 1983). "Early morning insomnia with rapidly eliminated benzodiazepines". Science (journal) 220 (4592): 95–7. PMID 6131538. [e]
  7. ↑ Lee A, Lader M (January 1988). "Tolerance and rebound during and after short-term administration of quazepam, triazolam and placebo to healthy human volunteers". Int Clin Psychopharmacol 3 (1): 31–47. DOI:10.1097/00004850-198801000-00002. PMID 2895786. Research Blogging.
  8. ↑ Kales A (1990). "Quazepam: hypnotic efficacy and side effects". Pharmacotherapy 10 (1): 1–10; discussion 10–2. PMID 1969151. [e]
  9. ↑ Hilbert JM, Battista D (September 1991). "Quazepam and flurazepam: differential pharmacokinetic and pharmacodynamic characteristics". J Clin Psychiatry 52 Suppl: 21–6. PMID 1680120. [e]
  10. ↑ Adam K; Oswald I (May 1989). "Can a rapidly-eliminated hypnotic cause daytime anxiety?". Pharmacopsychiatry 22 (3): 115–9. DOI:10.1055/s-2007-1014592. PMID 2748714. Research Blogging.
  11. ↑ medscape
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