Talk:Homeopathy/Archive 13

Notable information and formidible [sic] survey

Interesting. The content added followed a market research document about popularity, with no indications of effectiveness to go with the popularity. The BMJ citation speaks of actions, with no rationale or outcomes data. How about some indications not of the popularity of these referrals, not of the hypothesized mechanisms of homeopathy, but of the outcomes of these referrals? Howard C. Berkowitz 00:28, 10 October 2008 (CDT)

Your comment reminds me of skeptics who expect controlled clinical research reports to explain "mechanism of action." Clinical studies are clinical studies. They report results, not theories or explanations about how homeopathics work or may work. Likewise, surveys ask some questions, not all questions. I cannot help but sense that you don't want this information because it suggests greater popularity about homeopathy that you don't want to accept. There is no doubt (!) about the notability about the BMJ article, and the market research survey seems to confirm and expand upon what the BMJ reported. Dana Ullman 16:29, 11 October 2008 (UTC)

"Skeptic", as you use the term, Dana, is something that, whether you intend it to be or not, is becoming offensive. "Sensing" my reasons is offensive, and, I believe, something you have been asked not to do. If you "sense" I am doing something, let me suggest a novel diagnostic technique: ask me, in so many words, to explain my reasoning. That, incidentally, is considered a professional means of collaborative editing.

Given that my comment specifically said "not of the hypothesized mechanisms of homeopathy, but of the outcomes of these referrals", why are you raising the question about randomized controlled trials (RCT) and mechanism of action? In point of fact, most RCT do not define mechanisms of action. In the U.S., when the investigators make the initial application for human subject research to their Institutional Review Board, and (usual sequence) then to the Food and Drug Administration for the Investigational New Drug Application (IND) that grants additional permissions, they will present a proposed experimental protocol as part of those applications. It is those applications that will contain the best understanding of the mechanism of action, which, with current methods, is apt to come from in vitro or animal models. In some cases, it may use human data from a human subject trial for pure research, which thus goes to the IRB but not the FDA.

Certainly, additional insight into mechanisms may come from clinical trials, but that is not their major intent. The intent of phase II and phase III is to demonstrate efficacy, which is an aspect of the question I asked, not the one you assumed I asked, about outcomes.

As to popularity, cigarettes are more popular than medicine, to say nothing of television. There is no "popularity" section in the article on medicine. Speaking editorially, popularity, in general, would be appropriate for the Sociology Workgroup, or for groups dealing with popular culture. I don't see a strong reason for it in something where we are concerned not with social behavior, but effectiveness of health methods.

The market research study is not from an authoritative source by the standards of Wikipedia, and it should be deleted. I intend to do so unless I am overruled, or you come up with more data on its methodology and why the market research group should be considered as credible as the BMJ. That it is consistent with the BMJ report is no more authoritative than a television talking-head arguing about a political speech, unless it passes the criteria for peer-reviewed or otherwise authoritative sources. CZ generally accepts books from reputable publishers, which usually involves review. Not everything has to come from a journal.

Apropos of the BMJ study, I note its date was 1994. You deleted several references I had inserted (see below) on the grounds there were "more recent" studies. The earliest of those studies, however, was 2001, and you have supported a number of quotes from 1905 and earlier, so date alone does not justify deletion. These particular trials were notable in another way, which I shall make even clearer when I reinsert them: they were the first homeopathic trials funded by NCCAM, or peer-reviewed secondary sources abut them. The principal investigator on each was Iris Rose, on the faculty of the University of Arizona and both an MD and homeopathically qualified. Since I cite some of her later publications, I believe it appropriate to establish her pattern of being funded and able to qualify for additional funding. Howard C. Berkowitz 17:14, 11 October 2008 (UTC)

<ref name=NCCAM-FM>{{citation | title = Homeopaths Conduct Groundbreaking NIH Fibromyalgia Study | journal = Townsend Letter for Doctors and Patients | date = April 2001 | url = http://findarticles.com/p/articles/mi_m0ISW/is_/ai_72297189}}</ref> <ref name=Bell2004>{{citation | title = EEG alpha sensitization in individualized homeopathic treatment of fibromyalgia | author = Bell IR; Lewis DA; Lewis SE; Schwartz GE; Brooks AJ; Scott A; Baldwin CM | journal = Int J Neurosci | year = 2004 | volume = 114(9) | pages = 1195-220 | url = http://www.medscape.com/medline/abstract/15370183}}</ref> A 2003 review of CAM methods for fibromyalgia found the most effective methods were "acupuncture, some herbal and nutritional supplements (magnesium, SAMe) and massage therapy"; there were positive results but methodological problems with a study on homeopathy.<ref name=>{{citation | title = Complementary and alternative medicine in fibromyalgia and related syndromes | journal = Best Pract Res Clin Rheumatol | year =2003 | volume = 17(4) | pages = 667-83 | author = Holdcraft LC; Assefi N; Buchwald D | url = http://www.medscape.com/medline/abstract/12849718}}</ref>

Howard, I believe that your desire to not allow the BMJ article about the use and status of homeopathy by doctors in Europe because it does not provide information on what was the result of the use of the medicines or what was the result of the referrals borders on the ridiculous. Yes, it is that bad. I am not saying that your desire for this information is bad or wrong; what I am saying is that the BMJ survey information is notable, but just because the survey doesn't provide this information does not make it less notable. I do appreciate some of your contributions, but I seriously question others, such as the ones above in this section. If you happen to have more recent survey information, please provide it. If not, this survey information still provides value. I did delete some older articles because there were newer studies. The 2003 review of CAM methods did not account for the high quality homeopathic trial on fibromyalgia published in 2004 (by Iris Bell, not Iris Rose). For the record, I am not against information in this article that is negative nor do I want it simply in the skeptics' section. I simply do not want misinformation, and Killen's statement was clearly misinformed. Dana Ullman 18:09, 12 October 2008 (UTC)

Reason for reverting "other compounds"

In an earlier version, the homeopathic remedies were described as small quantities of an ingredient "dissolved" in "water, ethanol and/or other compounds". Dana changed this to "water or ethanol" with an edit note to be more accurate.

Among other compounds are quartz and lactose, mentioned elsewhere in the article, for ingredients that are insoluble in water or ethanol. If these other compounds are no longer used, the article should reflect the reason they were no longer used, which might be interesting and relevant on how homeopathy refines its methods.

Let's assume they are not used, but ethanol is. Is there an assertion and supporting evidence that ethanol has a memory? I could see nanobubbles and silicate chips forming in ethanol, but I haven't heard — doesn't mean it can't exist in authoritative sources — of clathrates with ethanol. There is no question of the existence of clathrates, merely that they would have a physiological effect and they are commonly produced by homeopathic preparations.

Water (H₂O) is among the simplest of molecules, so the idea that it can be affected makes more sense than with other molecules. Ethanol (C₂H₅OH) is a larger molecule, so it may be more stable in forming complexes.

Water is a polar solvent; ethanol is considered both positive and nonpolar, depending on whether or not you are looking at its hydroxyl group. Are there reports of its being involved in clathrate formation?

If not, since there seems no question ethanol is used in homeopathic remedies, are clathrates eliminated? Since the Avogadro limit would still hold, is there a homeopathic assertion that ethanol has a memory?

Assuming the preparations with quartz (impure silicon dioxide) and lactose are still in use, how do they have memory, if the Avogadro question still applies?Howard C. Berkowitz 17:32, 11 October 2008 (UTC)

Explanation of deletion text making statement not supported by available citation

While only the abstract is available without a subscription, <ref>Eskinazi D (1999) Homeopathy re-revisited: Is homeopathy compatible With biomedical observations? ''Arch Intern Med'' [http://archinte.ama-assn.org/cgi/content/extract/159/17/1981 159:1981-7 ]</ref> only says,

Increasing numbers of medical consumers seem to seek out homeopathic treatment.

The next citation doesn't actually point to a specific article, but to a BMJ special article on homeopathy. http://www.sciencedirect.com/science/journal/14754916. Correction: that reference isn't the British Medical Journal, but the former British Journal of Homeopathy, now retitled Homeopathy.Howard C. Berkowitz 19:15, 11 October 2008 (UTC)

Dana added the text, "There is body of evidence that suggests that homeopathic medicines are fully compatible with modern biomedical observations and scientific perspectives." fully is questionable on the face of it. Further, "suggests" is more of a qualified word than, say, "confirms". If the evidence confirms, say so. Howard C. Berkowitz 18:27, 11 October 2008 (UTC)

Howard, you are welcome to delete the word "fully." That said, please read this article; it is well-referenced and published in a high-impact journal. Dana Ullman 18:17, 12 October 2008 (UTC)

Scientific basis of homeopathy

Let me assume I were a homeopath, trained as a biochemist, and an experienced writer (well, 2 of 3). If I were trying to convince people with conventional scientific training, I'd tend to go more with a smaller selection of articles of very well chosen articles. There is one paper here that stands out from the others, but it's not emphasized, yet it probably is stronger support than the rest put together, and doesn't apper to depend

First, I was reminded that even if "memory of water" was proven, that doesn't explain modes of action in remedies that use ethanol, quartz, or lactose, all mentioned.

Second, simply to mention that homeopathic remedy preparation creates changes in water, but that these changes have no understood physiological relationship, it is getting into speculation inappropriate for an encyclopedia article. Examples:

<ref>Rey L. Thermoluminescence of ultra-high dilutions of lithium chloride and sodium chloride, Physica (A) 2003; 323: 67–74.</ref>

What physiological mechanism is affected by thermoluminescence?

<ref>Bell IR, Lewis DA, Brooks AJ, et al. Gas discharge visualisation evaluation of ultramolecular doses of homeopathic medicines under blinded, controlled conditions. J Altern Complement Med 2003; 9: 25–38.</ref>

Nothing here identifies a cellular interaction, and solving memory of water doesn't solve the Avogadro problem in non-aqueous diluents.

<ref> Elia V, Niccoli M. Thermodynamics of extremely diluted aqueous solutions. Ann N Y Acad Sci 1999; 879: 241–8. </ref>

Same as above.

<ref>Linde K, Jonas WB, Melchart D, et al. Critical review and meta-analysis of serial agitated dilutions in experimental toxicology. Hum Exp Toxicol 1994; 13: 481–92.</ref>

Same as above.

<ref>Belon P, Cumps J, Ennis M, et al. Histamine dilutions modulate basophil activation. Inflamm Res 2004; 53: 181–8.</ref>

The above paper is one you should use, and explain further. Modulated basophil response is something that would affect asthma. (addition: not having access to the paper itself, I assume histamine is the active homeopathic ingredient. Correct? Interesting, if so, in that histamine has to be extracted or synthesized; it's not a naturally occuring isolated compount. Howard C. Berkowitz 03:42, 13 October 2008 (UTC)

<ref>Zausner C, Lassnig H, Endler PC, et al. Influence of a homoeopathically prepared thyroxine dilution on the metamorphosis of highland frogs – results of a multicenter controlled trial. Perfusion (Nürnberg) 2002; 17: 268–76. </ref> "that were different from the "control" effects of the water used for the dilutions. The work resulted in considerable controversy, and some other labs were unable to reproduce the reported effects."

Is this the sort of report that strengthens a case?Howard C. Berkowitz 18:22, 12 October 2008 (UTC)

I'm not clear on your point here, but let me simply say that skeptics of homeopathy insist that there is NO difference between the biological activity and clinical efficacy of a homeopathic medicine in comparison with a placebo. All of the above studies that you cite prove otherwise. I also want to clarify that the "active ingredient" in a homeopathic medicine is the entire substsance that is potentized, not any individual chemical within that substance but the whole thing. Like I have said several times in the past, you will become an even better CZ editor when you understand the system of homeopathy, not just individual controlled trials. Dana Ullman 23:55, 13 October 2008 (UTC)

Constabulary: The previous characterization of "making me a better editor" is patronizing and unprofessional. I have repeatedly objected to Dana's analyzing my motives, and also of being extremely patronizing.

It is rather disingenuous to say "I don't understand your point" and then go off about "skeptics" and placebos. I did not write one word about placebo. Let me rephrase: was histamine the substance added to water to produce the remedy? That is what I meant by "active ingredient". Would you prefer "precursor". "Simillum"? The authors did not title the article "the effects of histamine-treated water", but of diluted histamine. The abstract speaks of a preparation.

And, Dana, you don't seem to understand that my lack of interest in learning the depths of homeopathy is irrelevant to my editing this article. An effective encyclopedia article educates. It does not require going off and immersing oneself in the field to understand the nuances of the article. Please stop telling me to go off and study homeopathy, or making sarcastic observations about my "newfound passion" for homeopathy. While I don't know if it can be done, I want to see this article stand on its own and give a coherent explanation. I want it to stop contradicting itself, and I want it to stop usurping and redefining well defined terms. I want non-authoritative testimonials and popularity contests gone.Howard C. Berkowitz 02:39, 14 October 2008 (UTC)

Howard C. Berkowitz 02:39, 14 October 2008 (UTC)

Pinning down some terminology

From the article,

In homeopathic theory, every person has "life energy," sometimes called a "vital force," which today's homeopaths consider to include a person's immune system.

Is the term "life energy" or "vital force", and can it be defined? Is it the same or different than "wisdom of the body"? Some of these terms are wikilinked to null articles, which suggests to me someone thinks they can be defined.

"Immune system", and there's really not one immune system, has a generally accepted meaning among any medical personnel that have studied current immunology. What do homeopaths mean by immune system? Is it wiser to use "vital force' (or your choice of terms) so there isn't an apparent redefinition. The MeSH definition is "The body's defense mechanism against foreign organisms or substances and deviant native cells. It includes the humoral immune response and the cell-mediated response and consists of a complex of interrelated cellular, molecular, and genetic components." Since some of its parts act in opposition/regularizing o the other, "strengthening" just doesn't make much sense.

The training of the homeopathic practitioner, MD, DO, RN, etc., shouldn't make much difference; any would receive similar training. Howard C. Berkowitz 21:22, 13 October 2008 (UTC)

Someone has changed what I previously wrote. Originally, I had written that a person's life force or vital force (they are synonymous), but I referred to it in today's language as similar to what we call a person's "immune and defense system." Because our body's defenses are not just its immune responses, I recommend that we re-insert what was originally written. I did not write that homeopathic medicines "stimulate" the body's immune system; I had written that they seem to "augment" immune response because there is evidence that these medicines stimulate immune function and at other times they tonify an overly active immune system. A reference for this is: http://ecam.oxfordjournals.org/cgi/content/abstract/3/1/13

Dana Ullman 00:04, 14 October 2008 (UTC)

For vital force or life force, may I ask that one be picked, for the benefit of readers who do not know they are synomomous.

I would argue strongly against "immune and defense system", but have no objection to "defense system". Since "immune system" is a well-defined technical term in biomedical sciences, if that term is used, it is reasonable that it be used precisely, which, in part, means using it with that precision. "seems" to is not acceptable scientific language and immune system is a scientific term. An authoritative article in the field might use "seems" in an abstract, but I am confident that no quality journal would allow that unless there is hard statistical data, with quantitative values of trust/error, elsewhere.

Indeed, what your cited article actually says, in the last sentences of its abstract, are "It is our hope that this review of literature unknown to most people will give an original and useful insight into the ‘state-of-the-art’ of homeopathy, without final conclusions ‘for’ or ‘against’ this modality. This kind of uncertainty may be difficult to accept, but is conceivably the most open-minded position now." That's a lot weaker than "seems to". I would appreciate that when you cite abstracts, you stay with the level of certainty they have, not spin it into greater support than is written.

I have absolutely no idea what it may mean to "tonify" an immune systems. I could describe a number of mechanisms that modulate specific immune mechanisms, or, if they faily, result in immune disease, but that is inappropriate at this level and in this article. Now, I shall go back to the article and edit it so it does not give the impression of pre-empting precise terms. Incidentally, I have been adding articles that carry referenced definitions of immunological terms. Perhaps, if you want to use such terms, you also might contribute in that manner. So many proteins, so little time...Howard C. Berkowitz 00:39, 14 October 2008 (UTC)

"Unsubstantianted and vague"

Dana deleted my addition of a sentence "Not all homeopaths recognize the model of a disease being a disturbance that needs to be corrected." He did not follow the practice of explaining a deletion on the talk page, which I have tried to do.

I would observe that homeopaths in this article, and certainly in easily obtained references, repeatedly reject the concept of disease, especially as something that causes symptoms, and instead insist that the symptoms are merely the manifestation of the body's own healing. Doing anything that is not focused on those symptoms gets away from the concept of simillium.

So, Dana, how many references do you need? Give me a number. Howard C. Berkowitz 02:29, 14 October 2008 (UTC)

I think I would have deleted that one myself, Howard ;-) I'm not sure what it means. I think I know what you are trying to say, but that wasn't it. Keep trying.

I don't see anything wrong with homeopaths entering the 21st century trying to explain what they do in modern terms. I also don't see that we can take this article space to try to explain how the body defends itself, especially since this is extremely difficult to fathom, much less explain. As our previous reference suggests, we don't know the mechanism that makes homeopathy work, assuming it does, but that does not mean that it has no value, whatever that might be. Our error is in trying to suggest that we know anything about how it works, or whether it works. I like the idea of succinctly describing "life force" or "vital force" as a centuries old metaphor for explaining everything we don't know about what makes us tick, and even that the "immune system" and our "body's defenses" are part of that, especially if this is what homeopaths tell their patients. However, we need to be sure that the reader knows that we don't know how it affects the immune system, or for that matter "vital force". I think you are both working in that direction, so I don't see any need to drastically interfere with your progress other than a few clarifying or copy edits.

D. Matt Innis 02:58, 15 October 2008 (UTC)

The problem here Matt, is that some theorizing, skeptical, critics who have never tried homeopathy think they know more about homeopathy than homeopaths themselves.—Ramanand Jhingade 03:04, 15 October 2008 (UTC)

That's part the problem :-) Though theorizing and skeptical are pretty much the definition of scientist. Criticism can be constructive if given and taken in the right way. Homeopathy has it's place, as evidenced by the fact that it has a place. We just need to explain it that way. As professionals, we work every day taking care of our patients, but we don't really know if we are helping our patients better than other forms of therapy are working. For this we need the research. D. Matt Innis 03:33, 15 October 2008 (UTC)

You make a very good point, Matt, about the 21st century. I am impressed, in a way, about the amount of commentary up to 1905 or so, but then dropping radically. I don't dispute that Osler questioned the doses being given by physicians of the time; very few modern physicians will argue that there were very, very few effective drugs at the time Osler spoke well of homeopathic dosages. I would make the point, however, that just a little has been learned in 103 years, including the rejection of things that don't work, and the substitution of things that do. I'd like to find, for example, a contemporary equivalent, in homeopathy, to the continuous improvement of treatment of metastatic breast cancer in postmenopausal women. Offhand, in 20-30 years, I can think of at least 5 changes, all demonstrating better efficacy, to the standard treatment, from the 5-drug Cooper regimen to aromatase inhibitors. Howard C. Berkowitz 03:32, 15 October 2008 (UTC)

Homeopathy was working then as well as now, so why change something if it's good?—Ramanand Jhingade 03:36, 15 October 2008 (UTC)

Well, of course Abraham Flexner played a big role in that along with the AMA. Homeopaths were the majority practioners before the turn of the century. The AMA started somewhere around 1845, right. Somewhere in the late 1800's, they began to investigate the ingredients in nostrums and homeopathic remedies. Homeopaths, still invoking the vital concepts of "life force", had not placed much emphasis on scientific evaluation, because they considered the active ingredients to be immaterial and thus, by definition, undetectable. As most physicians of the times used homepathic remedies at least with some illnesses, they didn't question much. Rockefellar/Carnegie and Flexnor forced things to change in 1906-1910 - effectively placing healthcare squarely in the hands of science and materialists. Doctors virtually stopped practicing homeopathy. Of course, then comes WWI, the flu epidemic, then penicillin, the great depression, vaccines, WWII, the polio outbreak, railroad insurance, federal funding of university research, etc... until the late 1960s (Vietnam) and the social unrest and distrust of authority (Nixon) - which included the AMA. That is when interest in alternative medicine was renewed... but Medicine hadn't noticed until 1996, when the research showed that their patients were spending as much on alternative medicine as they were on primary care. It's all very interesting. D. Matt Innis 04:05, 15 October 2008 (UTC)

Matt, I'd hesitate to use U.S. healthcare economics as evidence for anything related to reality. As I've suggested before, I'd be very interested in seeing outcomes and spending in a situation where there are no economic incentives or disincentives to a form of therapy. The AMA, incidentally, has been declining for years; their membership is distinctly a minority, for all the complaints against it.

For-profit insurers do things that minimize their costs, but it is a complex situation involving short-term and long-term costs. If, however, there was substantial evidence of efficacy for homeopathic treatment, I'd suspect the insurers would be screaming for it to be tried before other methods. There is a lot of very interesting economic analysis that could be in this article.

It isn't just that the amount of medical knowledge is increasing, but the rate of acquisition is increasing. In the seventies, the number of citations in MEDLINE doubled about every 7 years. They are now doubling every 3-4 years, and it's a matter of tools and techniques of research as well as funding. Witness, for example, that the R&D budgets of most pharmaceutical companies is exceeded by their marketing budgets; the peer-reviewed articles keep coming. It appears that homeopathy has not especially changed in the last century or so, which is not the case for all forms of CAM. Some here suggest, apparently, that it was immaculately conceived, or the equivalent, and does not need to improve. Howard C. Berkowitz 04:19, 15 October 2008 (UTC)

The National Center for Homeopathy

Dana, I believe the National Center for Homeopathy (web-site: www.nationalcenterforhomeopathy.org)needs to be mentioned in this article - I hope you can look into it.—Ramanand Jhingade 03:01, 15 October 2008 (UTC)

Preparation with other than water

The section entitled "Preparation of homeopathic remedies" still includes quartz and lactose. Quartz was removed in the lead. Should it be removed here? If both are to be removed, is it to be concluded that homeopathy no longer uses similliums that are insoluble in water?

What about ethanol? For chemical as well as regulatory reasons, it is unlikely that 100% ethanol is used; given the formation of an azeotrope at approximately 95 percent, it's hard even to get 100% ethanol. Is ethanol used only for initial solutions, which are then diluted in water, a common enough chemical technique?

If a substantial amount of ethanol remains in subsequent dilutions, is there an assumption that it has a memory, or is ethanol simply a means of exposing the simillium to water?

If I am using "simillium" incorrectly, please give me the correct term for that which is added to the solvent. I have been chastised for calling it an active ingredient; I would prefer to call is a solute that is dispersed in solution. "Remedy" is something I would prefer not to use, as the term makes assumptions. Howard C. Berkowitz 16:47, 15 October 2008 (UTC)

I do not know where you are getting your information on homeopathy, and I am again concerned that you're wasting your and my time here. I urge to consider decreasing your questioning my actions UNLESS you have evidence that I've erred (heck, we all err). I just don't understand how you can say or defend that homeopathic medicines are dispensed in quartz. Nor do I understand why you want to create a hyper-technical lead to this article. The people who edit on CZ are supposedly experts. I urge you to edit on your expertise and keep your questions to your expertise. In the future, I will avoid answering your Talk points that stray, like this one above.

To clarify, the word "simillimum" is the word that means: the homeopathic medicine that is most similar to the overall symptoms of the sick person. I do not want to see homeopathic lingo in the lead, nor do I want to see any hyper-technical information there. Dana Ullman 22:01, 15 October 2008 (UTC)

Above you say that "The people who edit on CZ are supposedly experts." This is not true. Anyone with an account can edit any article in CZ, in a similar way to wikipedia. The difference is that you need to provide your name to get an account and there are some experts available to approve articles and adjudicate arguments over content if necessary. Chris Day 22:11, 15 October 2008 (UTC)

And may I add that contributors to CZ are not supposed to push any specific agenda or hobbyhorses of their own -- they are supposed to both write and edit with a scrupulous neutrality, which you are obviously not doing. Hayford Peirce 22:56, 15 October 2008 (UTC)

Where have I gotten quartz? From the lead of the homeopathy article itself. It was there when I first saw the article, and I had no reason to challenge it. If you don't want "homeopathic lingo", give me a term to use for the substance dissolved in water. When I said "active ingredient", there was homeopathic objection to that, because it was said the "entire preparation" is active. Will "solute" suit you, or is that term, from high school chemistry, "hypertechnical".

Please define what you mean by "hyper-technical". It's no more technical than in any health sciences article, and less so, than, say. complement or eosinophil. So far, I'm afraid I find that anything that is less than supportive of homeopathy is taken to task for some reason. Comments about wasting time get very close to unprofessional conduct, as do judgments on peoples' motivations.

If you didn't like quartz in the introduction of the article, or in the body of the part on preparation, you have had weeks to remove it. I didn't put it there. Howard C. Berkowitz 23:50, 15 October 2008 (UTC)

"Synonymous with" and other items

I deleted this: "is synonymous with what people today refer to be a patient's over defense system." Since most people today do not use any such term as "life force"--even I know that is taken as a long-discarded, antiquated notion--it certainly is not "synonymous with what people today refer to" as the body's defense system. This is simply to say that most people do not equate it with anything that they believe exists, because they think a "life force" doesn't exist. If I am mistaken, I'd like to see some explanation. Also, "a patient's over defense system" doesn't make sense to me. --Larry Sanger 00:39, 16 October 2008 (UTC)

By the way, on the above point, I'm very open to restating the point so that it makes a claim about what all or some homeopaths believe. If homeopaths use the phrase "life force" (or whatever), and if they equate that with the the body's "immune and defense system," grand--say so. Just don't say (or imply) that this is an equation that physicians would make, because (I gather) the vast majority of them would scoff at the notion of "life force," which went out of style along with the vitalism that it implies. --Larry Sanger 01:37, 16 October 2008 (UTC)

I also deleted this:

Because of their "respect for the wisdom of the body," homeopaths do not try to inhibit symptoms or suppress disease. The extremely small and specially prepared doses of remedies that homeopaths use are chosen for what they consider to be the unique ability of remedies to mimic the body's own defenses and initiate the healing process.

This, the first sentence in particular, does not make sense in context. The very word "remedy" implies that homeopaths are trying to inhibit symptoms or "suppress" (I assume this means cure?) disease. Is there supposed to be a difference between "suppressing disease" and "initiating the healing process"? If so, the article should explain that explicitly and then make the point in light of that distinction.

Also, what any of this has to do with something called "the wisdom of the body" is completely cryptic to me. That, too, needs to be explained in advance. --Larry Sanger 00:44, 16 October 2008 (UTC)

This is very confusing and seems overstated: "Some randomized controlled trials that have tested the efficacy of all forms of homeopathic medicines have reported positive results..." This sounds like there were several trials that each tested every homeopathic "remedy," and secured positive results for every remedy thus tested. That surely can't be correct; and "positive results" is vague, anyway. I've reworded it to mean what I believe the author meant. --Larry Sanger 00:54, 16 October 2008 (UTC)

Larry, it is always a pleasure to have you come visit and to give your input. To clarify, the words "life force" or "vital force" are homeopathic lingo for what most people today refer to as a person's "overall" defenses (I mis-typed previously and simply used the confusing word "over"). As such, it does make sense. And yes, homeopaths have a GREAT respect for the wisdom of the body...and for symptoms. Thus, because the correct homeopathic medicine is one that will "mimic" the person's symptoms and help the body's defenses. This should not be cryptic.

Larry's last comment is a good one. I believe that we should delete "all forms of" and replace it with "select". Dana Ullman 03:17, 16 October 2008 (UTC)

Text reverts on 12 October...ongoing

Ramanand, I restored changes made by both Hayford and myself. Let me try to explain.

"because homeopathic remedy selection may take time; homeopathic remedies may be used after an asthmatic episode to optimize the immune system and prevent recurrences."

Of course homeopathic remedy selection takes time; most non-emergency selection of medical drugs take time. Even in an acute asthmatic attack, it may take corticosteroids, even intravenously, 8 hours to have an appreciable effect. Saying it may take time to select long-term drugs simply adds words without adding information

As far as "optimize the immune system", that has no meaning in the general scientific usage of "immune system". Why is it wrong to remove those words and leave "prevent recurrences", which is presumably the objective?

If you are using "immune system" in a special homeopathic way, such as the way it has been suggested as a synonym for "vital force", say so. Otherwise, and this is probably not the place in the article, describe exactly what happens in the immune system, as the term is generally accepted. Mast cell desensitization? Neutralization or movement of immunoglobulins? Causing the inflammatory cells, such as leukocytes, to move out of the inflamed area?

Please don't take well-defined medical terms and give them new meanings, or use oversimplifications. Doing so breaks down any hope of communication between conventional and homeopathic participants here. Truly, I would not object if you had said "vital force" rather than "immune system". I don't know what a vital force is and whether it exists, but I am quite willing to accept that it is meaningful to homeopaths, and saying a remedy increases it does not conflict with medical terminology. Without insisting on a definition of vital force, if it were substituted for immune system in several places, I think the article would be more readable for all disciplines. Howard C. Berkowitz 17:17, 12 October 2008 (UTC)

Quite a few reverts later. The inclusion of "because homeopathic remedy selection may take time" has been removed by Howard, Gareth and myself. An explanaition for why this is a critical sentence other than "this is how I treat myself" would be useful to move us forward. Chris Day 14:03, 15 October 2008 (UTC)

Just got reverted again, is "I use it in acute attacks also-most homeopaths do; justify deletion (if you do) on the Talk Page " a convincing explanation? One that convinces Gareth and Howard? Is CZ comfortable "messing with anaphylactic shock"? I thought Gareth made a reasonable point, not to mention the addition seems redundant with the sentence that follows. Ramanand seems to imply that remedy selection does not take much time since he seems to be describing the use of homeopathy to control anaphylactic shock/acute attacks of ashma. I saw that Ramanand reduced the typical time for consultation with a homeopath from one hour to fifteen minutes, I assume with this scenario of "acute attacks" in mind (since it was the edit right after his revert). How do we know this is not an exaggeration or is there no consultation with "acute attacks" (even 15 minutes sounds on the long side here)? And if this remedy for "acute attacks" works so well, have any trials been done to prove to the skeptics that homeopathy is effective, at least for this type of case? This remedy would seem to be a perfect candidate for a double blind trial since individualisation appears not to be required in these cases and alleviation of the attacks should be easy to quantify. Chris Day 04:14, 16 October 2008 (UTC)

Part of the problem is that the severity of the attack is not clear. Is it, as you suggest, anaphylactic shock? Status asthmaticus? Things where it's a minute-by-minute call on whether to intubate, because laryngeal edema is one possibility? Do you have a rapid sequence intubation kit open and ready? Are arterial blood gases available? Even for a relatively mild but urgent case, that patient needs pulse oximetry, O₂ by nasal cannula and by more intrusive means if the SpO₂ drops. Nebulized albuterol,probably with intermittent ipratropium bromide, is almost certainly appropriate, while establishing IV access for epinephrine (unless it's intratracheal). Again assuming a serious event, a loading dose of methylpredisolone should be going on board. Howard C. Berkowitz 04:34, 16 October 2008 (UTC)

Gareth was the one that brought up anaphylactic shock, ramanand uses the phrase acute attacks. You tell me if they are the same? Either way, if homeopathic remedies can alleviate acute attacks in minutes, I'm impressed. That's definitely quantifiable and publishable. Chris Day 04:42, 16 October 2008 (UTC)

I've been verifying this with a reasonably current Lange emergency medicine text, and, while there are similarities between anaphylactic shock and the most severe form of exacerbation of asthma, there are differences.

In both, you want tight monitoring of the airway, but laryngeal edema is far more a threat in anaphylactic shock than status asthmaticus. The tendency to secure the airway by intubation is greater in anaphylaxis, because with sufficient edema, you may not be able to intubate -- you may have to do cricothryotomy or something more invasive. Epinephrine is the first-line drug for analphylaxis, with antihistamines (H₁ and H₂ both). and beta-adrenergic agonists as backup drugs; in severe asthma, beta-adrenergic agonists are the first-line, supplemented with anticholinergics. Both call for parenteral corticosteroids, but those take hours to take effect.

On occasion, my ex-wife managed both. Howard C. Berkowitz 04:56, 16 October 2008 (UTC)