Talk:Homeopathy/Archive 13

Some ground rules (please do not delete from top of the page)

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.

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.

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.

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.

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.

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.

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.

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.

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. --Larry Sanger 16:22, 20 October 2008 (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?" --Larry Sanger 15:17, 24 October 2008 (UTC)

'Mad' Ennis

Should'nt we have a bit on this?

MADELEINE Ennis, a pharmacologist at Queen's University, Belfast, was the scourge of homeopathy. She railed against its claims that a chemical remedy could be diluted to the point where a sample was unlikely to contain a single molecule of anything but water, and yet still have a healing effect. Until, that is, she set out to prove once and for all that homeopathy was bunkum. Ennis and her team found that ultra-dilute solutions of histamine – so dilute that they probably didn't contain a single histamine molecule – worked on the human body just like histamine. The study, replicated in four different labs, forced Ennis to admit that something inexplicable is going on with homeopathy.

And now some eminent chemists are weighing into the debate, claiming that our “understanding” of the properties of water is based on false assumptions: water, they say, has such peculiar quantum mechanical properties that we really do need to go back to the drawing board when it comes to our understanding of this root of life.

As a chemist who (co)authored some papers on the quantum mechanical properties of water, I'm naturally interested in the names of the eminent chemists who are weighing into the debate and also where this debate is taking place. Thank you in advance for your giving me the names and place(s). --Paul Wormer 10:25, 2 December 2008 (UTC)

[summarised from '13 Things that Don't Make Sense', (2008) by Michael Brooks]

I see the 'other place' mentions Ennis but dismisses her research in line with the BBC's 'debunking'. Brooks is linked to the BBC.

I read an article 'somewhere' about two weeks ago on good, solid evidence of 'memory' in liquids - but blow me - now I can't find it!

Martin Cohen 17:22, 30 November 2008 (UTC)

Welcome Martin!

Yes, Ennis' work IS important for several reasons. First, initially, she was a skeptic. Second, her study was replicated by 3 other university laboratories. And NO (!), her work was NOT debunked by the BBC or ABC News. For details about this "TV junk science," read Ennis' letter to me about how different this tv "study" was from hers: http://www.homeopathic.com/articles/view,55 and see also http://www.homeopathic.com/articles/view,58

As for articles on the memory of water in liquid, there are several good articles, though I am not certain to which you refer. I am certain that you will find whatever you may want on THIS subject here at the site of Professor Martin Chaplin: http://www.lsbu.ac.uk/water/memory.html Dana Ullman 17:55, 30 November 2008 (UTC)

This work is already covered in Memory of water Gareth Leng 13:06, 1 December 2008 (UTC)

Net problems

Hit technical problems at the weekend - first CZ went down here just as I was starting, then my net service went down, so apologies - I'd scarcely begun; I'll get vback when I can but life is now tight for the next week or so. However, the article is too large in my view and I'd suggest moving the bulk of material on the efficacy into a focussed article on Testing the efficacy of homeopathy. Comments?Gareth Leng 13:04, 1 December 2008 (UTC)

Hi Gareth (and everybody), whenever CZ goes down, please send me an e-mail ASAP. Often I'm the only person available who can do anything about the problem, and while I typically visit CZ several times a day, there are often gaps of many hours... --Larry Sanger 14:41, 1 December 2008 (UTC)

Gareth's extensive editing

A very nice job! As you know, I had given up on this article several weeks ago and proposed that it simply be put in mothballs for at least a year. Thanks to the goodwill on many people's part, and particularly your own expertise in rewriting, I may have changed my mind. A *fine* article may yet come out of this.... Hayford Peirce 02:49, 2 December 2008 (UTC)

Gareth, I have only just begun to review your work, though my initial review is also quite positive. I am, however, concerned that the section "Contrasting views of homeopathy and conventional medicine" is placed even before "The basics of homeopathy." It seems odd to provide a critique of homeopathy BEFORE describing what homeopathy is! Dana Ullman 03:20, 2 December 2008 (UTC)

I agree - I've been more concerned not to lose text that I take out of sections and haven't given close thought to the order of sections.Gareth Leng 17:24, 2 December 2008 (UTC)

On Testing - I've moved this, agree fully with Chris that there needs to be a succinct summary here, that should also be the lead of the new article.

There is still a lot to be done, especially reorganisation! I have just started really, but will have to do my bit intermittently. Gareth Leng 17:49, 2 December 2008 (UTC)

I agree the organisation needs some work. The "Professional homeopaths: who are they?" section is currently a hodge podge of stuff that does not necessarily connect well. Chris Day 18:04, 2 December 2008 (UTC)

Several things in this section need to be written carefully. While there are homeopaths with full medical credentials, there are also CAM practitioners that have only classical homeopathic training. When physicians express concern about homeopaths, the concern is most likely about pure homeopathic approaches; it is not fair to imply that all homeopaths are medically qualified and only select homeopathic treatment after a considered balancing of approaches.

Again, there may be much valuable material available in the interpersonal dynamics. Howard C. Berkowitz 18:12, 2 December 2008 (UTC)

Safety and Vaccine Issues

Under the section on "Safety," there is this paragraph which I recommend that we delete, except for the 1st sentence (or that we rewrite entirely. The reference does not say that the chickenpox vaccine reduces incidence of herpes zoster (there seems to be a separate vaccine for that).

"Such advice is generally considered irresponsible by public health professionals. Adult herpes zoster infection is a reactivation of childhood chickenpox, which recurs along nerve paths, affects 1 in 3 adults, and can cause chronic, severe nerve pain of postherpetic neuralgia in 10-18% of cases, and eye involvement in 10-25% of cases. Chickenpox immunization prevents adult herpes zoster; a herpes zoster vaccine is now recommended for all adults 60 years and older. [69] Childhood immunization against chickenpox prevents herpes zoster. Measles is not a major killer in the western world, where the vast majority of children are vaccinated against the disease at about two years old. However, in less developed countries the death toll is much higher, and in 1999 there were 875,000 deaths from measles worldwide, mostly in Africa. In 2001, a "Measles Initiative" was initiated involving organisations such as the American Red Cross, UNICEF and the World Health Organization, and between 1999 and 2005 more than 360 million children across the world were vaccinated. By 2005 the death toll had dropped by 60% to 345,000. [70]" Dana Ullman 05:38, 3 December 2008 (UTC)

To clarify the specific, herpes zoster is a reactivation of childhood chickenpox, where the virus has entered cutaneous nerves and become dormant. If chickenpox is prevented, than the vulnerability for adult herpes zoster never develops. Both vaccines target the same virus, but in different manifestations — symptom complexes if you will. Now, Neustadter, a homeopath, wrote that the only benefit for chickenpox immunization is economic, variously keeping parents from losing time from work, and generating revenue for vaccine makers.

Neustadter, although well published in non-scientific circles as a critic of vaccines, does not, in any of his material I have read, seems to understadnd the relationship between herpes zoster (chickenpox) and herpes zoster (shingles). His biography shows training in oriental medicine and homeopathy, but nothing from a biomedical perspective. I didn't bring in his work in the first place; homeopaths did. His work, stands as a very good example of the sort of thing that frightens medical scientists and physicians about alternative practitioners that do not have the knowledge to understand the potential implications of what they claim. Now, if Neustadter had denied the relationship between these different viral diseases, it would be one thing, but it is, to me, telling that a prominent homeopathic author doesn't even seem to know it exists.

Dana, are you saying the materials about more generic anti-vaccine claims also be dropped? It was my understanding that Neustadter objected to it because "in part because some childhood infectious diseases may actually strengthen immune response, thereby reducing the incidence of certain chronic ailments such as asthma." Now, if he were to say "strengthen vital force", I'd say that is homeopathic art and I'd accept it as valid within the homeopathic system. As soon as the words "immune system", however, are mentioned, that seems far to ask about precisely what measurable immune factors are improved by childhood diseases. Generically, for example, are some protective of T4 lymphocytes? To deal with asthma specifically, I'd certainly hesitate to say a "strengthened" immune response reduces asthma, because the mechanism of asthma is hyperreactivity in immune system cells called basophils and mast cells, or their hypersensitization by immunoglobulin-generating lymphocytes. Conventional treatment deliberately weakens these hypersensitive immune components, blocking the release of histamine and other inflammatory factors that cause, among other things the bronchospasm of asthma. How does not giving childhood vaccines reduce inappropriate immunoglobin production or basophil/mast cell degranulation? If I made comments about similliums, a homeopath would have every justification to demand I explain my apparently superficial reason. Turnabout seems perfectly neutral fair play, presenting a claim in the context of the other discipline.

So, after all this time the assorted vaccine-related things have been brought in as homeopathic arguments, and not removed, or even questions raised from concerned homeopaths, these words seem a perfect example of the sort of issue that concerns physicians about homeopaths objecting to treatments that may very well have long-term serious consequences. Further explanation might help, but removing the material now would appear covering up very public homeopathic statements that show a lack of understanding of the knowledge a trained conventional physician should have. Howard C. Berkowitz 07:43, 3 December 2008 (UTC)

Sorry, I can't get back to consider this before the weekend; for now I've done some trimming and tightening; whether its needed depends on phrasing elsewhere I think. Gareth Leng 08:51, 3 December 2008 (UTC)

Question: is there no homeopathic pollution problem?

I often wondered what happens to the medicinal water that is necessarily discarded during the preparation of a, say, 30C solution. I would guess that this water, having medicinal/healing properties, is not safe to simply flush into a city sewer system. Isn't there a pollution problem here? Storing and saving the whole batch cannot solve the problem either, because, suppose we start preparation from 1 (one) microliter (10⁻⁶ L) of tincture, then a 30C dilution, i.e., dilution by a factor 10⁶⁰, gives 10⁵⁴ L. The volume of the Earth is 10²⁴ L, so we need 10³⁰ times the volume of the Earth to store all the succussed water that has been in contact with the medicinal substance during preparation. Hence it seems to me that discarding large volumes of the intermediate solutions is the only way out.

I wonder, are by any chance the more concentrated intermediate solutions less powerful so that flushing them is safe? Or do the concentrated solutions lose their essential healing properties sooner than the "beyond Avogadro" solutions? Or is there some mechanism in the sewer that annihilates the healing property of concentrated solutions and makes them safe? I hope that the homeopathic industry investigated this and found a solution (no pun), I don't like my drinking water contaminated with medicinal water. --Paul Wormer 13:31, 3 December 2008 (UTC)

Paul, no one knows with certainty what good or bad that dispensed homeopathic water has, though the premise of homeopathy suggests that only those biological systems that will react to a specific homeopathic medicine will be those that have some similarity or resonance to it. Also, heat and extreme cold as well as various fragrant substances have been known to neutralize homeopathic medicines, so whatever effects may happen in nature are usually undone. I file this subject under: interesting to investigate (if possible) but probably no big deal. Dana Ullman 06:32, 4 December 2008 (UTC)

I am not clear how long the below paragraph has been in this article as is, but it is full of spectulation and straw man thinking. A weak and incorrect description of the memory of water theory is provided. Also, whoever wrote this does not seem to understand that ALL homeopathic medicines are made with a double-distilled water. This pharmaceutical grade water creates a standard for water which responds to the unsubstantiated concerns about "pollution" in the water used in homeopathy. Further, the ideas expressed below about the extreme views of the "memory of water" are quite slopply intellectually and have no basis as being a problem. The statement about memory from "contact" is not even accurate because homeopathic medicines are made by contact, dilution, and succussion (vigorous shaking). Because of all this, I have deleted this paragraph because it seems not worthy.

"Non-homeopaths question if homepathic theory is logically consistent, pointing out what appear to be inconsistency. The theory assumes that water is imprinted by the properties of molecules that it once came in contact with, even when the molecules are diluted away. If so, then where did the pure water used in this process come from? The water that homeopaths use was once in contact with other chemicals, including chemical wastes, radioactive metals, dinosaur urine, and various poisons. According to this interpretation of homeopathic theory, all water in the world should remember its contact with millions of chemical substances and not just the properties of the chemicals that the homeopath claims will be useful.[61] Homeopaths respond by asserting that homeopathic manufacturers use a double-distilled water which may clear the "memory" of past water history." Dana Ullman 07:03, 4 December 2008 (UTC)

Has anyone studied the half life of homeopathic medicines? How long can they stay on a stores shelf before they become inactive? Chris Day 13:36, 4 December 2008 (UTC)

Half-life determinations, normally part of FDA Good Manufacturing Practices, are explicitly waived for homeopathic medicines. Howard C. Berkowitz 13:39, 4 December 2008 (UTC)

So the homeopathic medicines don't become inactive? Or does FDA just classify them as inactive? As for the latter, is that why the FDA does not regulate homeopathic medicine or is their stated reason that there are no serious side effects? Chris Day 13:47, 4 December 2008 (UTC)

Unfortunately, and without trying to be snarky, this is politics rather than science. The enabling legislation was enacted in 1938, when there was very little science of pharamacology. There was the Elixir Sulfanilamide disaster, which was the trigger. During debate, Sen. Royal Copeland, a homeopathic physician but apparently an objective man, did not want to see homeopathic medicines that had "passed the test of time" be subject to the the newfangled rules. As FDA and related regulatory organizations passed Good Manufacturing Processes, New Drug Application clinical trials, and the rest, homeopathy always managed to be grandfathered; I can't testify if that was a scientific determination of stability, a scientific determination that there was nothing to degrade, or a political maneuver.

In other words, Chris, there's never been a serious U.S., scientifically mediated discussion about the points you raise. It is clear that homeopathic drugs, for whatever reasons, are in a sanctuary from oversight except in egregious cases of misbranding. To some extent, the laws of other Western countries have some parallels. Is this valid material for the article? Should there be a stronger link to New Drug Application with compare-and-contrast?Howard C. Berkowitz 13:59, 4 December 2008 (UTC)

I'm not sure where it should be, possibly history, but these are things that have always intrigued me with regard to homeopathy. I think it would be good if CZ had this material somewhere. Chris Day 14:23, 4 December 2008 (UTC)

Howard, you didn't try too hard to avoid being snarky. If you are going to say or suggest something about "newfangled rules" (a very snarky reference), please quote and reference it. It would be more accurate to say that Copeland understood that the paradigm of homeopathy was different than that of allopathic pharmacology...therefore, grandfathering was perfectly appropriate. Please know that the manufacture of homeopathic medicines are strictly enforced. Manufacturers receive regular and unannounced visits, and the level of review is much more significant than the people here realize...and it is obvious that people here are not speaking/writing from real knowledge but just guesswork. Let's get beyond this... Dana Ullman 03:41, 5 December 2008 (UTC)

"the level of review is much more significant than the people here realize...". But it is not in this article, shouldn't it be? Especially if everyone is ignorant in this area. Chris Day 03:46, 5 December 2008 (UTC)

The Code of Federal Regulations is snarky?

I'm not going to argue whether Coleman's 1938 insight is appropriate for today. Further, there is little if any allopathic manufacturing today, since allopathy is an obsolete term in medicine, except when being used in a historic derogatory manner by homeopaths. Again, I'll remind you that Osler said that both allopathy and homeopathy needed to be succeeded by science-based medicine.

Want a quote? Nevertheless, the good manufacturing product is hardly guesswork; I suggest an apology is in order. Or did you want more of the actual language of the regulations?

21 Code of Federal Regulations: CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL PART 211 - CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS:

§ 211.137 - Expiration dating.
- (a) To assure that a drug product meets applicable standards of identity, strength, quality, and purity at the time of use, it shall bear an expiration date determined by appropriate stability testing described in 211.166.
- (b) Expiration dates shall be related to any storage conditions stated on the labeling, as determined by stability studies described in 211.166.
- (c) If the drug product is to be reconstituted at the time of dispensing, its labeling shall bear expiration information for both the reconstituted and unreconstituted drug products.
- (d) Expiration dates shall appear on labeling in accordance with the requirements of 201.17 of this chapter.
- (e) Homeopathic drug products shall be exempt from the requirements of this section.

If part (e) is not clear, homeopathic products are exempt from stability studies and expiration dating. Howard C. Berkowitz 03:53, 5 December 2008 (UTC)

Apropos of double-distilled water

From direct laboratory experience, double-distilled water isn't a panacea. When we prepared it for physical chemistry of protein, the bottles always had to be under soda lime locks to prevent carbon dioxide uptake, or had to be hermetically sealed with the reaction under inert gas.

Double distillation, without additional measures, does not prevent other gases from entering the water. IIRC, the first clanthrates involved xenon, and double distillation would be unlikely to exclude it.

Until the early 1940s, intravenous fluids were not safe even if prepared from double-distilled water. It turned out that pyrogens leached even from good-grade laboratory grade glass containers, and, until this was discovered and special containers (as well as tubing) developed, IVs could cause fevers of unknown origin. It is not an accident that most IV units are of a plastic very carefully designed not to leach impurities. Howard C. Berkowitz 14:06, 4 December 2008 (UTC)

5-45

In "with 5-45 minute follow-up consultations" does this mean there are typically five consultations that are 45 minutes long, or that there is an indeterminate number of follow-up consultations that range from 5 to 45 minutes long? --Larry Sanger 18:13, 3 December 2008 (UTC)

It was meant as 5 to 45 minute follow-up consultations (some consults are very short and others take more time). Dana Ullman 06:25, 4 December 2008 (UTC)

Paracelsus and alternative medicine

First, there is a History of Homeopathy page. Some participants here object to moving any history there, while others, including myself, feel the lead is too long and too argumentative and should shift. Howard C. Berkowitz 14:42, 4 December

There is a big difference between a look at the history of homeopathy and the theory of homeopathy. This new page serves a quite different purpose. Martin Cohen 17:42, 4 December

Given that there has been an intense discussion at Homeopathy, going back six archives' worth, involving the Editor-In-Chief, a current rewrite by an Editor, and extensive arguments, were I to see such a situation, I would hesitate before going ahead and creaing new pages, new models, and changing the text without presenting them on the talk page. Howard C. Berkowitz 17:57, 4 December

Second, I'm not clear whether you are proposing an alternative medicine page rather than complementary and alternative medicine. The latter is a generally preferred term, and there are very strong reasons not to separate the two. Synergy of disciplines, a potential benefit, is not going to come from separation. Howard C. Berkowitz 14:42, 4 December

I was 'suggesting' that the page title 'Alternative medecine' worked perfectly well, and that the inclusion of complementary medecine in the text itself was not thereby excluded. The longer title seems clumsy, makes linking more long-winded, and as I say, has left some links 'stranded'. Surely, as a general rule, we should respect page authors' choices of names for their pages except where there is a pressing need to do otherwise. Now I'm not saying you are wrong in this case, but I asked for the 'thinking' behind it. Martin Cohen 17:42, 4 December

Stranded links can be fixed. At least Matt and I on the talk page, and others in email, have specifically discussed the reason for the page name change. Complementary and alternative medicine have a well-understood meaning. Surely, as a general rule, I have little respect for page name choices by people that come into the midst of an extensive discussion, create new pages and paradigms without discussion, and do without asking. Again, the goal here is collaboration, not WP bold edit and revert, especially in tense situations. Howard C. Berkowitz 17:57, 4 December

Up to this point, the homeopaths have emphasized Hippocrates and Hahnemann. Bringing in Paracelsus, especially in the lead, is a rather radical change that should be discussed first. Howard C. Berkowitz 14:42, 4 December 2008 (UTC)

No founder is indicated in the lead to the article, an ommission that needed to be corrected. Hippocrates has nothing to do with the debate, other than having 'observed' that "By similar things a disease is produced and through the application of the like is cured” and Paracelus rather predates the Internet favorite Hahnemann. Many of Paracelus's actual remedies were based on the belief and approach that "like cures like" and in this he was practising what is today regarded as homeopathy. The article, correctly if ambiguously (because it might have led some to think that he also developed the principles) states that Hahnemann "described the principles". It seems a contradiction to me to say that he is the founder of the approach, and offer Classical references to its practise. At most, he could be the 'father of modern homeopathy', as some have put it. Martin Cohen 17:42, 4 December

You are making some flat statements that are not consistent with months of discussion. You haven't even presented your thinking on the Talk Page. Again, this is not WP, and, in an article with extensive rewrites and edit wars, bold changes and reverts do not fit the culture. Howard C. Berkowitz 17:57, 4 December

The aim of my addition is to broaden the discussion and include more contributors, including new perpectives. Alternative medecine, like homeopathy, should be described from an historical, a literary, a cultural, a sociological and most of all 'an alternative' point of view as well as the 'scientific' one. We don't need to, and should not seek to, impose blocks on the natural spread of information on CZ seeking to do this, as long as the new pages are suitably 'neutral' and follow normal standards of academic discourse. Martin Cohen 17:42, 4 December 2008 (UTC)

I suggest you ask Gareth Lang or Larry Sanger if "broadening the discussion" seems constructive for the dispute resolution that's been going on or months. Whether or not the material is or is not neutral, I find that you have unilaterally redefined the grounds for coverage or discourse, made no effort to seek consensus, and imposed your views on how the process should proceed. When I join an electronic forum, I tend to observe first until I understand the social dynamics. Howard C. Berkowitz 17:57, 4 December 2008 (UTC)

My name is invoked, and so I appear on the spot, Voldemort-like. Two things here--first, I would instead ask Martin to clarify his proposal, because I at least didn't find it entirely clear what he was asking for (what, for example would it mean to describe homeopathy as a "literary" "point of view"--which is literally what Martin said?), and also to explain a little more why he wants the change to be made. Second, it is a little wrong-headed to suggest that such issues are always to be decided by some "higher authority" rather than dialogue and that avoiding controversy is a higher priority than taking on board new suggestions--surely we should not simply cut off debate simply on grounds that someone is new to the discussion. --Larry Sanger 19:40, 4 December 2008 (UTC)

Voldemort, old boy, thanks for the promptness. Larry, if I may use the informal, I have spent a good forty years working on electronic discussion groups. One of the basic rules of the Internet Engineering Task Force, which has managed to get quite a bit done, is that lurking to get the sense of a discussion is usually very wise. Otherwise, as we have seen at The Other Place, an active discussion can be disrupted because a newcomer arrives and wants explanation, or has proposals that might have been discussed three archives ago. Yes, you describe an ideal, but it isn't always practical if there is a goal of getting an article to some level of completeness. Even if this reaches Approval, there is always the opportunity for Draft Version 2. No, I don't regard that as wrong-headed but realistic. Howard C. Berkowitz 19:51, 4 December 2008 (UTC)

Yes, well, in my 15 years in and creating online communities, I have also frequently observed a self-appointed "old guard" arise and shoo away newcomers, which is probably a more serious problem on wikis. Anyway, my point, Howard, stands: let the man talk. He isn't raising any issue that hasn't already been raised, as far as I know. The first step, I think, is to ask him to clarify himself. You might find that, after you get more clarification, you have nothing to object to. --Larry Sanger 20:09, 4 December 2008 (UTC)

Let us agree to disagree in part. Where I do see a repeating issue, however, is where WP assumptions are taken here. Bold-revert is not especially the custom, and we seem increasingly to be trying to make our pages link better; suddenly creating new pages about alternate paradigms are not conducive to navigation.

Nothing I have seen at CZ suggests that bold rewriting or creating of new pages, without talk page discussion of the issue, is a good direction. In fact, I had asked for clarification on some of these new pages; perhaps part of the problem is that what the man is saying is in no single place.Howard C. Berkowitz 20:23, 4 December 2008 (UTC)

If we agree to disagree, Howard, you are thereby overruled. My point was ultimately very simple. You were wrong to imply that Martin may not speak his piece. Yes, he may. End of discussion on that point.

Also, the idea that we are now forbidding the editing of articles or creating new articles without prior discussion, which is exactly what you said, Howard, is just absolutely wrong. When we introduce that rule, CZ will have come to an end. This is far too much ado about nothing (or little anyway). As far as I can tell, Martin introduced some text that people disagreed with. The proper response is to discuss the offending text. Over and out. No response is necessary, Howard. --Larry Sanger 02:14, 5 December 2008 (UTC)

Whatever the merits of the above arguments, it looks to me as if Martin has royally screwed up the formatting here, along with duplicating some of the text. I wish you'd learn to do things properly here, Martin -- it doesn't take much effort to reply (and indent, among other things) correctly. Hayford Peirce 18:09, 4 December 2008 (UTC)

Actually the problem was this edit from Howard. I think it was an edit clash with my previous one that resulted in duplicating much of the text. Chris Day 19:18, 4 December 2008 (UTC)

Ah, in that case, I must humbly apologize, Martin. Sorry -- it really looked as if you had done it.... Hayford Peirce 19:24, 4 December 2008 (UTC)

In partial defense of Martin, I may have induced some formating errors. When I first saw his remarks and replied, I had an edit conflict but was running late to an appointment. My very quick cut and paste to re-merge the comments may have caused some formatting or duplication problems.

That being said, looking at unusual formatting at, say the alternative Medicine (theories) page, I would have to agree that Martin might want to look at some of the customs and conventions. For example, Alternative Medicine (theories) has a nonstandard bold heading. It only links to homeopathy, lacking, in particular, a link to the existing complementary and alternative medicine. While I'm not compulsive of filling out entire clusters, complementary and alternative medicine at least has a fairly extensive, if redlink-filled, Related Articles page.

It would have been one thing to have questioned the links between homeopathy and complementary and alternative medicine, and discussed, in the talk page of the latter, why changes are needed. With the existing links, however, Alternative Medicine (theories) only seems to be there as an adjunct to homeopathy. In other words, there's no plausibly expected page where the issues are discussed; they are not specific to homeopathy so don't belong on those very full talk pages. Martin says he wants to broaden a discussion, but, in fact, there are ongoing, stressful, and active discussion with complex social dynamics. I'd be cautious before unilaterally saying they need to be broadened. Howard C. Berkowitz 19:20, 4 December 2008 (UTC)

I chose to delete Martin's addition on Paracelsus because it is simply incorrect. Hahnemann was a highly academic writer/author, and yet, he never ever referenced any of Paracelsus writings. Paracelsus may have written about the "doctrine of signatures," but many other healers over time wrote about the principle of similars, and yet, no one suggests that they are the "father" of homeopathy. Hahnemann coined the word, but more important, Hahnemann introduced "provings" (experiments in toxicology) to this system, thereby creating an experimental method to verify what a substance causes...and what it cures. Paracelsus' "signatures" concept is completely theoretical, suggesting that what a substance looks like is what it is effective in treating. This concept is simply vague. Hahnemann's significant background in chemistry and apothecary practice led him to various experiments that uncover "potentization" as the most effective way to increase a medicine's efficacy while decreasing its toxicity.

I appreciate Martin's boldness, though I encourage him to bringing significant changes or changes to the lead to the Discussion page first. The challenge here is to be bold but humble...and discuss, discuss, discuss. A fine balance. Dana Ullman 03:51, 5 December 2008 (UTC)

Constable input

Martin has not violated any Citizendium policy that I can see. We have nothing that states that newcomers (to the conversation) have to behave any differently than those that have been here longer. Do respect other authors and editors when making changes by clarifying your thinking on the talk pages. While large deletions without explanation are unprofessional, additions are encouraged as far as I interpret. More importantly, let's treat each other as we would like to be treated. D. Matt Innis 00:34, 5 December 2008 (UTC)

I think that Martin's contribution was quite useful. I will reference to the Work of Peter Morell (historian of medicine, with training in homeopathy and conventional biology), "Hahnemann and Homoeopathy".

Book review: Novel ideas / findings in the book

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)

--Pierre-Alain Gouanvic 18:37, 7 December 2008 (UTC)

On the road, but 'en passant', thanks to everyone for their 'attention' in this matter: I assume we share the same aims, so the thanks is to EVERYONE even those who on the face of it seem to want to assign 'bad faith' to their fellow contributors at all turns... And Dana, to remove Paracelsus who certainly has an important role in the history of homeopathy ENTIRELY is a little like the application of a censor's pencil... he certainly belongs somewhere in the new 'history of' section. 'Some' people say he is the father of homeopathy, remains true, even if 'many experts' dispute it. But I'm not an expert, and I'm certainly not trying to impose a contrary view of the 'facts' on you or anyone else here.

But that leads me to my main point - this article is written from a technica-scientific-rationalist perspective - it does not attempt to speak either to the general reader or to include other perspectives. And yes, Valdemort-Larry was right to draw attention to it! I did want literary perspectives, cultural perspectives, and 'alternative' science too given space somwhere to make their distinctive contributions. The tentatively drafted 'alternative theories' page was an attempt to reconcile the apparent unwillingness of the authors and editors of this page to blend such with their text. But in service to readers of the encylopedia, there have to be links from the text of the homeopathy page to indicate the other material. Gareth says there is a page on 'water memory' already, for instance - who will navigate there is another question! Martin Cohen 20:11, 10 December 2008 (UTC)

While I find myself a little unnerved to be agreeing with Dana, I tend to feel some stronger sourcing than one book is needed to suggest that Paracelsus is the founder of homeopathy, at least as Hahnemann defined homeopathy. Hahnemann's writings make it very clear that he was focused on symptoms, so there really needs to be some documentation that he was actively considering Paracelsus' ideas on such things as shape or color of remedies. Assuming Morell had no ability to consult the ghost of Hahnemann, what basis does Morell for flatly stating the "truth" about what Hahnemann thought? Is there anything written by Hahnemann, or someoone that worked with him, that credits Paracelsus?

As far as "who will navigate" to another page, Martin, Citizendium is a hyperdocument. Again and again, the argument has been made, by people who think very little of the web navigational skills of readers, that they will not link to other pages. I believe it is fairly well established CZ policy, established in many subject areas, that we assume that the reader will, in fact, navigate, and the general editorial standards reflect that. We do not assume pages have to be self-contained for the "general reader". There are practical and technical reasons as well: you should notice the warning, at the top of the edit-mode page, that certain browsers have trouble with very large pages. Very large pages also increase the probability of edit conflicts. There are discussions about general CZ navigation where your ideas could be argued, but they are bucking a consensus about general article design. Howard C. Berkowitz 21:16, 10 December 2008 (UTC)

elan vital

Is homeopathy's "vital force" in any way similar to Bergson's élan vital -- "vital force" or, apparently, more correctly, "vital impetus"? Hayford Peirce 18:02, 4 December 2008 (UTC)

Neutrality Notes?

Would anyone like to take a crack at making Neutrality Notes for this article?

I'd like to see how someone else would do this...and whether anyone is motivated...and whether we'll be able to agree on the results...and whether they will help at all. Also, I'd need another example for the use of the Editorial Council. --Larry Sanger 19:31, 4 December 2008 (UTC)

Bioavailability, proving, safety

I'm not sure who wrote the text comparing provings to safety tests; while it has my edit note appended; I didn't write that and wouldn't have written it.

Nevertheless, I agree there is no equivalence to bioavailability when something cannot be tested. I don't really understand Dana's edit comment, which I wish had been put on the discussion page.

Dana's note:

Safety and efficacy of homeopathy: Provings are NOT like safety tests. They are experiments in toxicology to see what each substance CAUSES, even in potentized doses, in healthy people.)

This confuses me. Toxicology, in general use, is the study of substances that interfere with normal processes. In medical terms, a toxicology experiment that does not assess safety simply doesn't make sense. Does "toxicology" have a specialized meaning in homeopathy?

Actually, this brings up a question: are there new homeopathic remedies for which provings are needed, or is the list of remedies closed? If there are new remedies, is it correct to assume there is no safety testing in the sense of pharmacology, and it may safely be assumed all homeopathic drugs are risk-free? That's not snark, but what seems to be an assertion I'd like to understand. Howard C. Berkowitz 21:10, 5 December 2008 (UTC)

Allopathy and asthma

First, I have deleted several references to "allopathy" when it appears to be used as a means of describing current medicine. I believe the ground rules established that this, even more than "skeptic", is considered a biased word and needlessly inflammatory. Further, the term is simply no longer used except in historical (e.g., 100 year old) discussions of philosophies of health, and, regretfully, in what seem to be attacks on conventional medicine by homeopaths. There are many other ways to describe non-homeopathic approaches to treatment which are more accurate than allopathy.

Second, flat statements that allopathy can't cure diseases need sourcing, not just a statement of opinion. "Cure", itself, needs statistical definition. It is fair to say that on the basic of large-scale, evidence-based studies, conventional medicine, with relatively recent therapies, can control asthma. Control means that there are few or no symptoms that distress the patient. "Cure" would mean the disease disappears for all time, with no need for further acute or maintenance treatment.

In this area, where evidence-based data is available, it does not seem reasonable to claim that small trials (10s of patients over short periods) flatly prove the advantage of homeopathy over large trials (thousands to tens of thousands) of conventional methods. Howard C. Berkowitz 13:32, 6 December 2008 (UTC)

With respect to "allopathy" does anyone claim to be able to cure asthma? Likewise, would anyone claim to cure cystic fibrosis? Having said this, I'm not sure of the context in which this comes up.

Does this mean homeopaths do not distinguish between infectious disease and genetic disease?
How does the comment "allopathy can't cure diseases" relate to homeopathy? Is it to say that homeopathy is as good as conventional drugs or is there a claim that homeopathy can cure?
What is the best study available to show that acute asthma can be controlled by homeopathy. These claims of treating acute asthma are remarkable and either prove the efficacy of homeopathic treatment beyond doubt or are an exaggeration.

Howard, are you commenting on a specific paragraph here, one only dealing with asthma, or is this a more general comment? Chris Day 16:50, 6 December 2008 (UTC) edit: just found the relevant edits [1] [2]

Although I had no problem with deleting the word "allopathy" in the one instance of deletion that I just found, people here should know that the word "allopathy" is not just a historical word but is COMMONLY used today by many of the most prominent medical organizations. For an impressive list of sources, see: http://en.wikipedia.org/wiki/Talk:Allopathic_medicine#Additional_references

Sadly, however, the editors at wikipedia have rewritten history and present status of this word, and their article on allopathy is typical of many health articles at this site (it is ridden with POV and strong bias).

That said, I agree with others here who express concern about the statement "allopathy can't cure diseases." Dana Ullman 18:50, 7 December 2008 (UTC)

First, Wikipedia is rarely considered an "impressive" source at CZ. Many of the references it cites, however, do not treat allopathy as an antonym of homeopathy, but of osteopathic medicine. Many of the references are historical clarifications from administrative bodies.

Second, I believe the ground rules have established that allopathy is not considered a current term for describing mainstream medicine. Specifically,

"Allopaths" won't do, either, although it certainly can be introduced, and it should be.

I agree it is commonly used by critics of mainstream medicine, but William Osler described, in a quote I have frequently provided, that he considered both homeopathy and allopathy to be obsolete. By all means define it, but in proper historical context, explicitly including the Osler quote to which I refer. Howard C. Berkowitz 19:03, 7 December 2008 (UTC)

Did anyone browse through that talk page at wikipedia? It is painful. Why is there such a need by proponents of CAM to use the term allopathic? The amount of time and effort popularise a term that is hardly used, or worse, incorrectly used by people that should know better, is mind boggling.

Interesting commentary here: Katherine E. Gundling When Did I Become an "Allopath"? Arch Intern Med. 1998;158:2185-2186.

Or have we already moved into an era that this term has been reinvented and now has a different meaning to Oslers time? Certainly terms such as epigenetic and gene have evolved in that time. If the usage has changed we need to be very clear that allopathy from 200 years ago is not synonymous with this current usage by some. Just out of interest, what is the exact definition as proposed by Hannemahn. Chris Day 19:25, 7 December 2008 (UTC)

I too have serious concerns about wikipedia, but I was referring to ONE specific reference at wikipedia that provides a detailed body of evidence of the modern (!) use of the term "allopathic". I was actually surprised myself how many leading medical organization self-define themselves using the term allopathic. See for yourself by going to the link that I provided. That said, K.E. Gundling's piece is just one voice...the reference above provides much more substantative evidence. Dana Ullman 01:46, 8 December 2008 (UTC)

The more I think about this the more I think this is effectively an evolving term. This would explain why some physicians object strongly to the usage of the term while others embrace it; it all depends on their own working definition. As I mentioned above, this happens with science terms too and frequently leads to pedantic arguments ([3]). Hopefully we can navigate this without going wikipedia. One good starting point is to acknowledge that the term is possibly confusing and not assume that the usage of allopath is similar between eras or even similar between all people now. Chris Day 02:38, 8 December 2008 (UTC)

Unilateral revision of edit because "it is not acceptable to homeopaths"

To avoid edit and revert wars, especially when there have been multiple intervening edit, I refer to Ramanand's changes of Revision as of 06:00, 6 December 2008 with the edit comment "→this is what there was earlier-the new edit isn't acceptable to the homeopaths"

If the language is that unacceptable to homeopaths, than mutually agreeable language has to be worked out on the talk page. Otherwise, we have a revert war. I object to the language to which the material was reverted.

Is this a constable matter of avoiding a revert war? Howard C. Berkowitz 13:36, 6 December 2008 (UTC)

I agree that a reversion of a section that had previously cleared two editors should not be reverted by an author. I have reverted to the last version that was reviewed by an editor and brought both versions to the talk page where you can discuss issues. D. Matt Innis 16:52, 6 December 2008 (UTC)

Conventional physicians take a medical history according to medical principles, classical homeopaths will take a history only using homeopathic priciples, and homeopaths with both medical and homeopathic training will then take additional history according to homeopathic principles, Classical homeopaths do not use medical physical examination, diagnostic imaging and tests from the clinical pathology laboratories as suggested by the differential diagnosis, and questions raised by the history and physical examination. Homeopaths that are licensed to perform these additional studies do not practice classic homeopathy, but rather a an alternative or "mixed" form.

Classical homeopaths place more emphasis on the way a person experiences their disease than on diagnosing the disease - i.e. they give priority to the syndrome of symptoms rather than to the results of conventional medical tests. This differs strongly from the conventional medical approach to finding the etiology of the disease proper, not its syndrome of symptoms.

This is completely wrong-the diagnosis is important, for example the list of remedies used for bronchitis can't be used for cholera. That is why I replaced it with the earlier version.—Ramanand Jhingade 08:15, 8 December 2008 (UTC)

It would seem, then, that part of the problem that non-homeopaths have with accepting these assertions is that it is not clear to them how homeopaths diagnose, and, once they have diagnosed, if there is any more to selecting remedies than looking up a set of symptoms in a repertory. This, again, comes back to what I've been calling the "cognitive process", which, in medicine, is the thought process that includes both diagnosis and selection of treatment. In contrast, the "procedural" process in medicine is performing a treatment, or perhaps an invasive diagnostic procedure, such as surgery.

At the core of the commuications problems here, I suggest, is that homeopaths have internalized certain approaches to interacting with patients, and it is so internal that there is difficulty in accepting that anyone who has not gone through homeopathic training does not think the same way. In like manner, however, people writing reasonable articles about conventional medicine understand that the average reader has not had professional training, so they explain the thinking, either in the article, or in a series of linked articles that go back to basics.

The homeopathic approaches might get more attention if the homeopathic authors concentrating on explaining what they do, including, if I quote Gareth correctly, the things that homeopathy is claimed to help. Continuing arguments about history, early studies about potential modes of action, etc., take the article away from that absolute core information. Simple assertions of "it doesn't work that way" are not enough to be convincing to someone trained in a different paradigm, for which the training is based on a fairly formal structure.

Constable/Editor: since I believe this is one edit back, I don't want to revert. I do believe, however, that this discussion needs to be worked out on the talk page, not with inline edits in the article. Howard C. Berkowitz 16:45, 8 December 2008 (UTC)

Constable response: Thank you for not reverting. Improvements are always allowed so long as large amounts of material are not deleted without discussion or editors have asked that the text not be altered. At this point, I believe the paragraphs in question have pretty much been struck by an editor. It's up to the editors to decide what stays in. As Gareth has acted on this one, any improvements would obviously have to make it through him as well as Dana. D. Matt Innis 18:25, 8 December 2008 (UTC)

- Qualified medical and other Health professionals who practice homeopathy perform medical history taking, which is supplemented with homeopathic history taking. They also perform a basic physical examination, with additional examination of body parts or systems that may be associated with a symptom; diagnostic imaging and tests from the clinical pathology laboratories as suggested by the differential diagnosis, questions raised by the history, and physical examination. Investigations like blood and urine analysis and diagnostic imaging, can be helpful but are generally not essential for selecting a homeopathic remedy.

- To determine which remedy to prescribe, classical homeopaths place more emphasis on the way a person experiences whatever disease they have more than the name of the disease s/he has. They thus give higher priority to the unique syndrome of symptoms of the patient than the objective results of conventional medical tests.

These 2 paragraphs are more accurate.—Ramanand Jhingade 08:15, 8 December 2008 (UTC)

In all due respect, I don't see the difference. Please elaborate on when the "diagnosis is important", as much of the homeopathic writing seems to emphasize that the medical model of a diagnosis, which is a direct consequence of a pathological etiology, is irrelevant; it is symptoms that are important. It may be that homoeopaths use the word diagnosis differently than do physician, diagnosis is principally derived from a determination of etiology, in combination with models of physiology and pathology. Etiology, in turn, considers history, physical, and laboratory tests Right now, I'm completely confused on what homeopaths mean by diagnosis, as it seems they make a diagnosis without determining an etiology, depending instead on syndromes of symptoms. If this is not the case, please clarify.

To a conventionally trained practitioner, the results of the tests, combined with the history and physical, form the basis for diagnosis. Treatment/remedy selection is a next step, as is the prognosis.Howard C. Berkowitz 18:29, 8 December 2008 (UTC) (left out date/time in earlier comment and don't know how to get it back. Sorry> It is in response to Ramanand Jhingade's comment of 08:15, 8 December)

The 'method' of diagnosis is the same, it is only the 'method' of remedy selection that differs.—Ramanand Jhingade 06:27, 9 December 2008 (UTC)

Pharmacopœia (or whatever the plural may be)

There may be a usage difference between homeopathy and conventional medicine. The general, non-homeopathic United States Pharmacopœia, as well as the related but subtly different National Formulary, is not that uncommon to find on the reference shelves of physicians especially interested in pharmacology, along with a standard textbook such as Goodman & Gilman's The Pharmacological Basis of Therapeutics, along with more specialized works.

There is an organization called the United States Pharmacopœia that produces several books, the USP and NF being the core ("basic" in the sense they are fundamental references), but also a practitioner guide called USPDI. I'll have to look up the "DI", which I think stands for Drug Indications, and is a specifically practitioner oriented book, or, as I use it, a database. It's better written than the Physician's Drug Reference, which is a compendium of the exact text of FDA-approved package inserts, basically written by lawyers.

One of the reasons that conventional physicians may keep the USP is that it can be the best place to find "inert" ingredients that really are not. For example, many tablets are colored with tartrazine, also known as "Yellow No. 5". This dye can trigger asthma in susceptible patients. The USP may indicate if an approved tablet can contain tartrazine, which may be very important to know.

My point is not to be so abrupt at assuming that a reference has only one purpose, or, at least, to indicate it has only one purpose in homeopathy. My assumption that a Pharmacopœia is of clinical interest is based on experience, not guesswork. Unfortunately, I find a certain tendency, in this article, to assume that the homeopathic usage of a term is the only possible interpretation, which leads to ambiguity. As, I believe, Chris said, it cannot be assumed that the reader of the article is a trained homeopath, so if words are used in a specialized way, they need to be disambiguated. It is not helpful to put down people that have experience with a term in mainstream medicine and have no reason to know homeopaths use the word differently. The article needs to educate on such matters, not huffily suggest going to read a homeopathy textbook. Howard C. Berkowitz 20:52, 6 December 2008 (UTC)

Text here was removed by the Constabulary on grounds of civility. (The author may replace this template with an edited version of the original remarks.)

Second, I know how the Food and Drug Administration in the U.S., as well as equivalent regulatory bodies in other countries, use pharmacopeias. I repeat: a pharmacopeia is a basic document, at least to a manufacturer, "basic" in the sense that it is a foundation of good practice. The United States Pharmacopeia, for example, is a basic reference for drug manufacturing in the United States, although it has clinical applications besides manufacturing. The Handbook of Chemistry and Physics is a basic document, but "basic" does not equate to "elementary".

As an "author, publisher, and seller" of homeopathic books, perhaps one might wonder if you should be making flat statements about things where you may have a financial interest? I am indeed a book author, but don't sell them directly; when I do write for profit, I clearly identify any possible relationships in other writings. I recommend this practice.

So, yes, I do know that those familiar with Good Manufacturing Practice (a legally defined term of art) of drugs, non-homeopathic and homeopathic, generally accept certain things to be true. You denied that the FDA exempted homeopathic drugs from certain aspects of Good Manufacturing Practice. I responded not only with the citation from the U.S. Code of Federal Regulations, but with the actual text of the exception. After your initial complaint, you have made no comment on the requested documentation that I provided. Do you still maintain that the FDA does not exempt homeopathic drugs from parts of the Good Manufacturing Practices that apply to every mainstream product it regulates? Howard C. Berkowitz 18:52, 7 December 2008 (UTC)

Howard, I never denied that the Homeopathic Pharmacopeia isn't a standard reference for homeopathic drug manufacturers, and in fact, this is exactly what I have asserted. I cannot help but sense that you've never seen or read the homeopathic pharmacopeia because, if you had, you would know that there is NO clinical information about any medicine in it. This text is ONLY of interest to drug manufacturers, not to clinicians or consumers, and THAT is why I didn't want to confuse readers here by saying that the Homeopathic Pharmacopeia was the "third standard reference" book in homeopathy. It is not such. These facts have NOTHING to do with any financial interest on my part...they are simply statements of fact. I am confused how or why you would suggest that such facts somehow are tainted in any way.

Dana Ullman 01:59, 8 December 2008 (UTC)

Text here was removed by the Constabulary on grounds that it is needlessly inflammatory. (The author may replace this template with an edited version of the original remarks.)

Individualization and permutation

Gareth, I certainly agree there are limits to polypharmacy in mainstream medicine. In some of my work with expert systems in prescribing, one of our first tasks is often to figure out just what the patient is taking, often from multiple prescribers that do not talk to one another. One of my research areas is analyzing multidrug regimens to see if they can be simplified, to increase compliance, avoid side effects, and, when possible, optimize combinations that address comorbidities.

Nevertheless, the point has been hammered that homeopaths "individualize" to a greater extent than do mainstream physicians, and this is a refutation that medicine is a rigid structure that does not consider individual patient needs. That's all I'm trying to accomplish. If the homeopaths stop making the distinction that physicians do not individualize for specific patients, I'm happy to drop the whole issue, but as long as that insistence is made, I see it as non-neutral and inaccurate.

Treatment of a patient with clinical AIDS, for example, is highly individualized, starting with the selection among many highly active antiretroviral therapy (HAART) regimens, then adding prophylaxis as indicated by the degree of immunosuppression and specific risk factors, then treating associated clinical disorders such as AIDS wasting syndrome.

Can we come to some agreement that both disciplines individualize according to their own model, and not continue to have a superiority clash that one side is the only one that understands individualized treatment? I'm talking about widely used treatment, incidentally, and not yet touching genetic medicine. Howard C. Berkowitz 22:24, 7 December 2008 (UTC)

This "more personalalized/individualized" experience claim reads too much like an ad. Since there are homeopathy practitioners contributing here, the article could easily have some pictures. (Chunbum Park 22:43, 7 December 2008 (UTC))

Hi Howard, yes this is an issue that needs to be handled - at present the "Conflict" sections are like minutes of unresolved editorial disagreement rather than helping the reader and we need to fix these - but that requires a bit more time and thought than I'm able to give immediately. I'm afraid I'm going for what seem to be the most obvious fixes first - what I've left I've left not because I think its OK but because it needs more care. However, yes I agree that the article should not seem to imply that conventional medicine does not seek individualized treatment - that would be inconsistent with at least a large trend in modern medicine to identify individual genetic risk factors.Gareth Leng 22:46, 7 December 2008 (UTC)

There are some clear omissions from this article. Most obviously to me, there needs to be a section stating clearly exactly what claims are made for homeopathic remedies. This needs to be phrased in such a way that it is clear that the claims are being reported not asserted, but this section is very important. This will not be the place to discuss the validity of the claims - that's the job of the testing article - so this shouldnt be controversial if phrased properly. It seems to me essential to understand exactly what homeopaths say homeopathy can be used for.

I'd also like to see a very specific example of a particular proving.Gareth Leng 22:55, 7 December 2008 (UTC)

Thanks; you are going in a good direction. I like your " It seems to me essential to understand exactly what homeopaths say homeopathy can be used for." To me, this is what I have been asking and asking about what I've termed the "cognitive process" of a homeopath-patient encounter, and still have not gotten an answer.

In some cases, the answer has been that the practitioner uses all their training, homeopathic or not, to decide what is appropriate. To me, that's a non-answer, although it's usually coupled with a comment that everything is individualized and I'm not accepting the homeopathic paradigm, but expecting an etiological one. Even if that is literally true, then the homeopathic paradigm needs to be explained in enough detail for a non-homeopath to have an idea what is done. Saying that the syndrome is looked up in a repertory until something matches and a remedy is prescribed, again, feels like a non-answer. If there are cases where a homeopathically qualified physician selects medical treatment, or complementary medical and homeopathic treatments, I really can't accept that no concrete examples can be given. Isn't that what would be taught in homeopathy school?

Apropos of provings, I have not seen anything mentioned that indicates active work in proving new remedies. Perhaps the reference books (not trying to distinguish among repertory, materia medica, or pharmacopeia) are, indeed, considered to be closed systems needing no additions. If so, I'd like that to be stated explicitly. If homeopaths do research new remedies, I'd like to know what aspects of treatment they are trying to improve — that's not in the least meant to be sarcastic or snarky. Howard C. Berkowitz 00:21, 8 December 2008 (UTC)

Vaccination

Ramanand Jhingade just added the bolded text to complete the following point:

"Homeopathy is based on "the principle of similars", which asserts that substances known to cause particular symptoms can also, in low and specially prepared doses help to cure diseases that cause similar symptoms. This principle is not accepted by mainstream medicine or by conventional scientists today, although the principle is used in vaccination."

Do all vaccinations cause symptoms? I realise that some do, if using attenuated viruses but i don't think most vaccinations cause symptoms. I think this addition is only valid if the recreation of symptoms is a key to the success of vaccination but i don't think this is the case at all. Any doctors want to comment here? Chris Day 07:10, 9 December 2008 (UTC)

Many people report symptoms after vaccination. e.g. Koplik's spots after a measles vaccination.—Ramanand Jhingade 08:07, 9 December 2008 (UTC)

Ramanand, that doesn't quite respond to Chris' excellent point. OK--sometimes, people report symptoms after vaccination. But isn't it more often, as when my little boy is vaccinated for various things, that there are no symptoms at all? I myself would ask, "What does it mean to say the principle is used in vaccination?" Obviously, the doctors who perform vaccinations do not understand themselves to be following a principle of similars, since (I assume) they would regard that as old, long-outmoded medical thinking. We should not imply that they think they are following the principle. In this context, it looks like we are saying that mainstream medicine concedes an important point; surely they don't. I leave this to others, but I would suggest that this go in a footnote, saying, "(Some?) homeopaths suggest (believe?) that vaccinations operate on a principle of similars. Here, homeopaths find an inconsistency or mismatch betweeen mainstream medical opinion and actual practice. For their part, mainstream medical doctors point out that the efficacy of vaccination has long been well explained without a principle of similars. [Right?]" --Larry Sanger 15:19, 9 December 2008 (UTC)

I went ahead and added a few edits, attributing the opinion to unnamed homeopaths. But again, that's all I'll do...I leave it to others, I'm merely trying to illustrate how I in my relative ignorance would deal with the issue. --Larry Sanger 15:55, 9 December 2008 (UTC)

"Many people report" is, at best, saying "some people have symptoms that may or may not be related to the specific antigen for which immunity is being triggered". Anecdotal reports with no statistics do not address Chris' questions. Further, many of the symptoms that are caused by conventional vaccines have nothing to do with the specific antigen for which the vaccine are given, but to other chemicals introduced by the vaccine manufacturing process, such as formaldehyde used to kill viruses. Some of the more serious reactions are from the culture medium, such as egg yolk.

Are we not going onto an irrelevant side track? A vaccination is objectively judged effective if it produces measurable changes in antibodies or other immune factors. If it doesn't, whether there are or are not symptoms, a doctor will judge that it failed. Howard C. Berkowitz 12:19, 9 December 2008 (UTC)

Chris asks a good question that could clarify some things if we could answer it properly; "Do all vaccinations cause symptoms?". According to our article, the law of similars would suggest that a condition is treated with something that causes the same symptoms, without having to know the condition specifically. So, it seems, for instance, if someone presents with hydrophobia and foaming of the mouth, a homeopath would treat the sick person with a remedy that caused these same symptoms in a normal person whether or not you knew it was rabies - in an effort to boost the body's immune system for whatever is causing the symptoms. Whereas, vaccination is treating a normal person with a causative agent (the attenuated virus itself) to prevent an epidemic. However, one treats sick people and the other treats well people. The idea of boosting the "body's natural defenses against disease" is certainly homeopathic and could be construed to include the concepts in vaccination. I think the claim is that the budding science of immunology was thinking like a homeopath when they discovered the benefits of vaccination by injecting a normal person with small doses of a causative agent, but that is really as far as it can go. Can we explain it? Or should we just leave it alone? D. Matt Innis 21:33, 10 December 2008 (UTC)

But the context here is not limited to when immunology was a "budding science"; it suggests to me, and I believe to Chris, that it is arguing that current vaccination is based on symptoms. There is continuing work with modern vaccine development to eliminate symptoms caused by the vaccine; that's one reason why the bleeding-edge vaccines don't use killed or attenuated microorganisms, but protein or nucleic acid fragments from them. Since lymphocytes, triggering the start of a specific immune response, have receptors for antigens at the molecular, not cellular, level, there's no reason to use cells (or viruses) at all. If a particular disease causes symptoms from a toxin, but the lymphocytes can be trained to recognize some surface protein of that invader, a protein that has nothing to do with the toxin, the invaders will be attacked without ever introducing the symptom-producing substance during vaccination. For this reason, I absolutely object to describing current immunotherapy in terms of similars; symptom avoidance is a conscious goal.

It would be speculative, at best, to say Jenner was thinking of symptoms. The last time I read Jenner's papers, the language was more suggestive of a focus on epidemiology than on specific symptoms: he observed that if someone had had a cowpox infection, they would not contract smallpox. He didn't speak in terms of the symptomatic similarities, but in terms of entire syndromes. (see link to review)

Part of the problem here is that "vaccine" is used in a generic way, describing two completely different kinds of immunotherapy. [4] It should be noted that while Jenner produced true active immunity, Pasteur's initial rabies "vaccine" was not a vaccine, but an antitoxin that conveyed passive immunity if given before the virus replicated to an infective level and started producing "hydrophobia". So far, one person in history has survived, intact, after clinical rabies developed; all other survivors of rabies exposure received antitoxin. Rabies vaccines given to animals and animal workers do produce active immunity, although they have sufficiently nasty side effects in humans that veterinarians and the like are tested for rabies antibody levels before giving them a booster. In other words, if it is at all possible to avoid giving a booster that will produce symptoms, that is the current standard of practice. We have separate antitoxins and vaccines for a number of diseases, such as diptheria and tetanus, we have antitoxins only for others such as botulism, and we have vaccines only for the majority of preventable diseases. Howard C. Berkowitz 22:03, 10 December 2008 (UTC)

I hadn't seen any reference to antitoxins, but that seems more in line with what homeopaths consider likes curing likes because the patient is sick and is experiencing symptoms. That doesn't change the fact that vaccines are used on people who are not experiencing any symptoms, i.e. are well. I haven't seen anything in our article that suggests that homeopaths treat well people with anything to prevent a disease. Am I missing something? D. Matt Innis 22:15, 10 December 2008 (UTC)

Look at the section Similia similibus curentur: the law of similars

It says "Today, two notions, vaccination, and hormesis, are used as analogies for homeopathy's law of similars and the use of small doses". For much of the reasons you suggest, the analogy between vaccination and homeopathy is very, very strained.

The reference from Behring, which I now, even more, want to see removed as out-of-date and confusing. Behring cites Pasteur, and, while I hesitate to make assumptions about "general readers", I would wager that most such people, when they think of "Pasteur treatment", think of rabies. Pasteur's treatment for rabies is an antitoxin.

He did, in fact, develop a true vaccine for anthrax in sheep. To respond to "suggests that homeopaths treat well people with anything to prevent a disease", I semi-agree, and believe that the entire idea of relating vaccination to similars is both historically wrong and also misleading. If, and I agree, the homeopaths are bringing up vaccination as an example of similars, and the classic vaccination of Jenner was preventive, I really don't see it as a terribly useful metaphor.

So -- if homeopaths don't believe in giving preventive things to well people, why is there a lengthy section about vaccination, which, in its original literal definition, involved giving cowpox to well people to keep them from contracting smallpox? Personally, I recommend getting rid of Behring, vaccination, and mithridization. They are potentially confusing to anyone who doesn't understand that the immunology being discussed is a century or more out of tune with current thinking, yet the article seems to push for endorsing homeopathy as analogous to vaccination. That's contradictory. Howard C. Berkowitz 22:35, 10 December 2008 (UTC)

Now you see what I mean. For purposes of closure, I'll repeat what I said above:

The idea of boosting the "body's natural defenses against disease" is certainly homeopathic and could be construed to include the concepts in vaccination. I think the claim is that the budding science of immunology was thinking like a homeopath when they discovered the benefits of vaccination by injecting a normal person with small doses of a causative agent, but that is really as far as it can go. Can we explain it? Or should we just leave it alone?

D. Matt Innis 23:04, 10 December 2008 (UTC)

First, I simply do not agree that budding immunologists, specifically Jenner, thought like homeopaths. His papers do not indicate that he was boosting natural defenses, but was introducing an external substance, cowpox, that prevented smallpox. He specifically talked about populations who had had cowpox, rather than some natural property that was boosted by cowpox.

Second, I really would like to see it not just left alone, but removed. The idea that homeopathic principles guided Jenner is not reflected in his actual papers. While John Snow was a few decades in the future, Jenner's theories were much more like Snow's, seeing an external cause of cholera (the contaminated well at Broad Street) and stopping it by an external measure (disabling the Broad Street Pump). Jenner saw an external infection, smallpox, that could be stopped by cowpox. There's nothing there about similars, body defenses, or anything that could be extended to use Jenner as thinking homeopathically.

I could make a little better argument for Pasteur thinking in similars only that he consciously used an attenuated rabies product, but the reality is that the Pasteur antitoxin treatment, as opposed to later and complementary rabies preventive immunization, doesn't strengthen the body's defenses either. If there isn't enough antitoxin to neutralize the rabies pathogen in the patient, the patient is going to die. In the Pasteur treatment, it's the externally introduced antibodies that fight the rabies virus; it's only in rabies vaccination where the body's defenses are taught to fight rabies.

Gareth, I really think that whole "Similia similibus curentur: the law of similars" section is not supportable on the actual work of Jenner and Pasteur, overemphasizes the authority of a Nobelist's immunologic thinking over a century out of date, and mithridization quickly goes into conventional allergic desesitization, which is not based on homeopathic doses and results in measurable changes in immunity. Move the title somewhere to keep the Hahnemann quote, and delete everything else in that section. Howard C. Berkowitz 23:35, 10 December 2008 (UTC)

Friends, some people here are mis-understanding Ramanand here. The point is not: do vaccines "cause" symptoms? The point is: do OVERDOSES of a vaccine or a specific substance in a vaccine cause symptoms? The quote from Von Behring connects the concept underlying vaccination with the concept underlying homeopathy. This is an important point. Dana Ullman 07:02, 11 December 2008 (UTC)

Couple of edits

Homeopathy is not considered an Indian system of medicine in India.
there are references (already a part of the article) for the fact that homeopathy can treat acute bronchitis effectively

—Ramanand Jhingade 07:25, 9 December 2008 (UTC)

If homeopathy is not an Indian system of medicine in India, what is it? Is everything not ayurvedic considered not-Indian?

The comment about references seems argumentative. I have not seen anything more than assertions and small trials that homeopathy can treat bronchitis effectively, nor even enough information to believe that the same definition of bronchitis is being used by all writers. It would add information, rather than argue, to point to the references — this note tells nothing specific. Howard C. Berkowitz 12:24, 9 December 2008 (UTC)

Series of reverts of material from Gareth

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

Generally, to keep the temperature here low, our policy is that if you wish to complain about the behavior of another contributor here, the way to do it is to report it to the Constabulary. More specifically, if you want to point to a series of edits that allegedly constitute a behavioral problem, the way to establish that is to provide several "diff" links that a constable can examine. Note that unexplained reversions would be the potential problems here. If the complaint is not about "bad behavior" but simply about bad editorial judgment, that is up to the editors and since Gareth himself is now, thankfully, watching this article, presumably he can evaluate the matter for himself. --Larry Sanger 15:08, 9 December 2008 (UTC)

Wording

Ramanand just wrote "this certification is a must" when adding the bolded text to complete the following point:

"Homeopathy is practiced worldwide by many licensed practitioners, including some conventional physicians, with the necessary homeopathic certification."

This has been an ongoing edit war and I think the problem is we are comprehending this sentence differently. From my perspective that addition is completely redundant. Without the bolded text it reads that there are "many licensed practitioners" and some of them are conventional physicians. Why would we need to then reiterate they are licensed or certified? The affirmation of what has gone before makes the sentence hard to parse as one assumes this must be a different point. And if it is a different point, then I have no idea what it is? Is there a distinction between being certified and licensed? Chris Day 16:22, 9 December 2008 (UTC)

As an English major (back in the day, of course, but not *that* long ago), and a one-time professional writer who was, I supposed, more concerned with my style and the choice of words than anything else (why I wasn't as successful as Stephen King, perhaps, who lives about three houses up the street from where I grew up), I have to say that Chris has parsed this situation perfectly. I can't see any reason at all for having the additional with the necessary homeopathic certification. It seems clearly redundant, and the fact that it is there, leads to the speculation that something else is trying to be conveyed. So there are two solutions:

Delete the phrase, because it's redundant. Or:

Completely rewrite the phrase so that it really does express a completely different thought. Hayford Peirce 18:46, 9 December 2008 (UTC)

Conventional physicians can't practise homeopathy without that additional certification, so is it OK to put that before the 'licensed practitioners'?—Ramanand Jhingade 07:28, 10 December 2008 (UTC)

But isn't that what it says? To me licensed practitioners is referring to a qualification in homeopathy? It sounds like you think it means something different? Chris Day 08:00, 10 December 2008 (UTC)

It seemed to convey that conventional physicians can practice homeopathy without the additional certification, which I have corrected now.—Ramanand Jhingade 09:07, 10 December 2008 (UTC)

Ramanand, at least in the United States, if a conventional physician, without one bit of training in homeopathy, chose to prescribe a homeopathic drug, there is absolutely nothing that would stop him or her from doing so. With some specific exceptions, any licensed physician can prescrine any prescription drug. The most common example has nothing to do with homeopathy, but with the rule that the Food and Drug Administration licenses prescription drugs only for specific "indications", for which acceptable clinical trial data has been presented. It is within the professional judgment of a physician to do "off-label" prescribing, which means that if the physician judges a drug to be useful for a condition not in the FDA indication, he is perfectly free to do so. For example, carbemazepine had an initial indication only for certain types of epilepsy, but was fairly quickly found to be effective in neurogenic pain, especially tic douloreux, and for bipolar mood disorder. It now is, formally, a first-line drug in both areas.

So if an American physician chose to prescribe a homeopathic preparation, who would stop him? While he might not go through the same diagnostic process as a homeopath, the fact that he prescribes a homeopathic remedy, and is responsible for the safety of his patient, says that he is effectively practicing homeopathy as well as conventional medicine. Gareth, would this be the case in the UK?

Going back to the special cases, however, there are drugs, called controlled substances by the Drug Enforcement Administration (DEA) (see schedules in article) that can only be prescribed by a practitioner with an additional DEA license. There are both federal and local requirements for a controlled substance requirement. In general, a fully licensed U.S. MD/DO/DDS can get the license with no difficulty, and states vary wither advanced practice nurses can have a full, partial, or no DEA license. I am rather certain that the DEA would not give a license to someone with only homeopathic training and licensure.

So, the reverse of what you are saying is true in the US, and I believe quite a few other countries. A conventional physician, who chose to do so, could use homeopathic treatment. A person licensed only in homeopathy could not prescribe controlled substances, and, in all likelihood, could not prescribe non-homeopathic remedies that require a prescription. Howard C. Berkowitz 15:29, 10 December 2008 (UTC)

Howard C. Berkowitz 15:14, 10 December 2008 (UTC)

Ramandand is simply wrong here. There are many places in the world where NO certification in homeopathy is necessary for physician or even consumers to prescribe homeopathic medicines. In the UK, for instance, there is "common law" that allows full freedom to practice homeopathy or any health care. i believe that the sentence should say: Worldwide, homeopathy is mostly practiced by licensed health professionals, including many conventionally trained medical doctors, and some countries and some states within countries allow unlicensed practitioners to engage in homeopathic care. Dana Ullman 06:52, 11 December 2008 (UTC)

Frightening as it may be, you and I might be moving toward an agreement. For much of the history of this article, there has been no particular reference to homeopaths having medical training. Especially when this has been said in the context of treating something that could well be life-threatening without immediate medical treatments, this worries a number of readers.

Can we agree on something along the lines that unlicensed practitioners may not be qualified to manage severe disease and injury? I am far less worried that the dual-trained professional will miss something that I've seen "classical" alternative practitioners, not, incidentially, homeopaths, by inaction lead to the death or permanent disability of real people. While the individual involved was not a homeopath, I lost a very close relative because the alternative practitioner spent two weeks missing increasingly obvious indications of an internal bleed. I am equally angry at licensed MDs that don't know when to call for help, and I can give many examples -- yet I don't think they are the majority. If the majority of homepaths have a reasonable amount of conventional training, such that they will recognize emergent situations, I will feel much, much better.

I would appreciate sourced numbers on the dual-trained homeopaths and identification of areas where people trained only in classic homeopathy, or any other alternative system, are permitted to practice. I know there are areas in the United States where such unlicensed practice is allowed, but also where there were manslaughter charges or wrongful death lawsuits if consultation was not recommended. Howard C. Berkowitz 07:12, 11 December 2008 (UTC)

Reference

The cited reference states"It is more than a century and a half now that Homoeopathy is being practiced in India. It has blended so well into the roots and traditions of the country that it has been recognised as one of the National Systems of Medicine" The reference nowhere referes to "Alternative Systems of Medicine". Please either find a better reference or leave the wording, but respect the references.Gareth Leng 22:41, 9 December 2008 (UTC)

Constable comment: I consider this a directive from an editor on this page, which means that no author should change that text. It may still be discussed on this talk page or on the forums. D. Matt Innis 22:48, 9 December 2008 (UTC)

I returned it to the text that Gareth had asked to remain until you clear it with him. Otherwise, it's an an editorial issue. Please don't consider this time a warning, but do be careful. D. Matt Innis 19:36, 10 December 2008 (UTC)

Homeopathy is not considered Indian in India. I hope Gareth or you can do something about that sentence.—Ramanand Jhingade 09:16, 11 December 2008 (UTC)

More wording: "'may or may not"

Ramanand says that "'either this matter should be removed or it should have the "may or may not", because these conditions may not go". For contexte see the following text, the disputed words are bolded:

In the USA, if a homeopathic remedy is claimed to treat a serious disease such as cancer, it can be sold only by prescription. Only products sold for “self-limiting conditions”--colds, coughs, fever, headaches, and other minor health problems that eventually may or may not go away on their own--can be sold without a prescription (over-the-counter).

I have removed the bolded text with the following question "Surely by definition minor colds, coughs, fever etc. go away on there own?". Gareth has removed this text too. I want to hear Ramanand's specific reason for including this text since it seems to contradict the whole premise the the sentence ("self-limiting conditions" and "minor"). Which diseases in this category may not go away? I'm not sure I understand the usage of "may not go away" in the context of the two sentences above. Chris Day 23:15, 9 December 2008 (UTC)

Those conditions may or may not go away on their own. In fact, if a cold is left untreated, it can lead to a cough/fever and if a cough is left untreated it can lead to pneumonia. Fevers and pneumonia can be life threatening. If y'all don't want that addition, the whole matter between the hyphens should be removed.—Ramanand Jhingade 07:42, 10 December 2008 (UTC)

You are describing a situation for people with a compromised immune system. That is not a "self limiting condition". Normal people have a full recovery from "minor" colds and fevers with no treatment whatsoever. Chris Day 07:55, 10 December 2008 (UTC)

Even normal people don't have a full recovery from all colds and fevers with 'no treatment whatsoever'.—Ramanand Jhingade 09:12, 10 December 2008 (UTC)

We'll have to disagree about that. And the big point you are missing is that by definition a "self limiting condition" is one that people recover from. Having "self limiting condition" and "may not go away" associated as above is contradictory. Chris Day 09:21, 10 December 2008 (UTC)

Agreed, Chris. I'd add that most over-the-counter products for self-limiting conditions give a list of reasons (e.g., fever lasting over a week or above a certain temperature, blood in the sputum, etc.) to stop taking the product and consult a physician. This is true even for non-homeopathic, non-medical remedies; there is a point when my grandmother would stop feeding me chicken soup and call the pediatrician. Howard C. Berkowitz 15:42, 10 December 2008 (UTC)

I think that it is obvious that the words "may or may not" do not have a place here and that they are confusing. For the record, there are several, not just one, reason that a homeopathic drug is an OTC one: if the condition for which it treats is self-limited, that the condition does not required medical diagnosis or medical monitoring, and that the dose in which the medicine is prescribed is basically safe (these are the FDA's rules). Dana Ullman 06:39, 11 December 2008 (UTC)

Help parsing a sentence from typical homeopathic visit section?

"A diagnosis will also be used to rule out treatment with unnecessary remedies. "

I'm not sure this sentence, where it is, actually adds anything. If it's meant to mean that the homeopathic diagnosis rules out unnecessary medical treatment, make that clear. Since it uses the term of art "remedy", however, it would seem to apply to homeopathic treatment.

If that's the case, then if it fits anywhere, it presumably belongs two paragraphs or more down, when the simillium is being selected. It's still confusing even there, since my understanding is that classical homeopaths usually select only one remedy — so what would be ruled out? Doesn't selecting a single simillium inherently do that?

I suspect it's a leftover sentence, but I didn't want to delete it in the event it's saying something that I don't understand. Howard C. Berkowitz 23:53, 9 December 2008 (UTC)

No it was added recently by Ramanand, referring us to the Talk Page here. I believe he is trying to emphasis that homeopaths do diagnose, possibly to address some of the points made in the section above. As written it is a bit of a throw-away statement. What is the major point we are trying to make here? Chris Day 00:11, 10 December 2008 (UTC)

Why is a diagnosis important for a homeopath?

For cholera, the remedies used are generally Verat.alb, Camph., Cup.met. etc., while for acute bronchitis it would be Ipecac., Blatta Ori., Nat. Sulph. etc.

This sentence:-

"A diagnosis will also be used to rule out treatment with unnecessary remedies. "

therefore should be there.—Ramanand Jhingade 07:51, 10 December 2008 (UTC)

Sorry, this still doesn't make sense. By diagnosing cholera, why would one even consider treatments for bronchitis? By diagnosing bronchitis, why would one even consider treatments for cholera? If the symptoms of both are present, it might be perfectly reasonable to rule out both. The sentence still doesn't make any sense.

This is, however, an excellent example of why conventional physicians are very afraid of the safety of homeopathic treatment rather than conventional. From the World Health Organization down, the absolutely mandatory treatment for cholera is fluid replacement, preferably oral replacement fluid (ORF) but intravenous fluids if necessary. It is the massive fluid loss that kills patients with cholera. While antibiotic can reduce the duration and severity, it is perfectly acceptable, in major epidemics with limited resources, to put patients over a bucket to collect their liquid feces, and have laymen making them drink all the ORF they can. If rehydration is not the core of treatment, the patient will quite likely die. The homeopathic remedies you cite do not include the desperately needed sodium and potassium and water replacement, as well as the supplementary carbohydrate that is the key to getting them absorbed through the gastrointestinal tract. Civility prevents me from saying what I'd do if I saw someone trying to treat cholera with anything not including ORF or IV fluid replacement, other than to say a bullet would be kindler and gentler. Howard C. Berkowitz 15:39, 10 December 2008 (UTC)

Howard, the vast majority of homeopaths in this world are trained in medical diagnosis. In cases of cholera, ORT is (!) a necessity, and homeopathic medicines are adjunctive to that...as is good public health measures. And as you may remember, Jennifer Jacobs conducted that important trial in PEDIATRICS on childhood diarrea, and it showed that efficacy (and even greater efficacy when a defined pathogen was found in the stool of children).

That said, it is important to note that although there are certain medicines that are more commonly given in certain pathologies, certain unique symptoms can and do call for unusual other medicines that may not be typical of a specific pathology...but can be therapeutic. Remember, good homeopathic care is not necessarily a "this for that." Instead, individualizing a medicine to the overall syndrome is thought to bring the best results. Dana Ullman 06:27, 11 December 2008 (UTC)

Dana, I do not understand that the majority of homeopaths in the world are trained in medical diagnosis. While that may be true in the West, the issue of cholera only came up when Ramanand volunteered "For cholera, the remedies used are generally Verat.alb, Camph., Cup.met. etc., while for acute bronchitis it would be Ipecac., Blatta Ori., Nat. Sulph. etc." The remedies mentioned make no mention of ORT, and Ramanand's examples, so far, have not mentioned medical approaches as well. I completely agree that ORT is a necessity, but Ramanand, whom you have accepted here as a professional homeopath, did not mention it at all. Even in the context of my remark that I found Ramanand's not mentionng ORT to be frightening to a medical perspective, just above your reply to me that I should not worry about homeopaths because they have no medical training, you did not address Ramanand's comment. Please do so.

Please supply sources that the majority of homeopaths in the world have medical training, and at what level. Apparently, some areas of the world allow classical homeopaths, without medical training, to practice. Do you deny this? Whatever Jennifer Jacobs may have done, the subject being discussed is cholera, not childhood diarrhea, in the context of this discussion. 06:49, 11 December 2008 (UTC)

Actually, the 100,000 (!) homeopaths in India attend a 4 or 5 year homeopathic medical college and are legally called "homeopathic doctors." There are over 100 such homeopathic colleges in India. The fact that Ramanand mentioned specific homeopathic medicines for cholera does not necessarily mean that these medicines are the ONLY treatments he provides. Ramanand also didn't mention nutrition or public health or other health advice, but that doesn't mean that these are not a part of a homeopath's knowledge or usage. Please avoid over-simplifying homeopathy or homeopaths. In efforts to avoid too much detail, let's not go on tangents. Dana Ullman 07:43, 11 December 2008 (UTC)

Wait a minute. I was just talking about the different set of remedies in different diseases. I did not say I would not use ORT/ORF.—Ramanand Jhingade 08:30, 11 December

Constable: I believe "Please avoid over-simplifying homeopathy or homeopaths. In efforts to avoid too much detail, let's not go on tangents." is a personal attack violating civility.

Where did I oversimplify? I didn't bring up cholera or bronchitis. Ramanand chose to use them as examples. Since I am not a homeopath, but I am quite familiar with the medical emergency management of cholera through work in developing emergency and field protocols, all I could see is the most critical component not. I think my questioning was quite valid.

Gareth, can you help here? Conventional medical people do not, it is true, give the benefit of the doubt to someone calling themselves, without qualification, a "homeopath", is also fully trained in conventional medicine. If the statement can be made and sourced that homeopaths always use appropriate medical therapy for critical conditions, there would be much less doubt. Can that statement be made? Howard C. Berkowitz 16:22, 11 December 2008 (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!Martin Cohen 21:09, 10 December 2008 (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. Dana Ullman 06:15, 11 December 2008 (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. Dana Ullman 07:36, 11 December 2008 (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).

--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.—Ramanand Jhingade 08:42, 11 December 2008 (UTC)

Rolled back "if it doesn't work"

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.

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).

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.

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. Howard C. Berkowitz 16:12, 11 December 2008 (UTC)

Talk:Homeopathy/Archive 13

Contents

Some ground rules (please do not delete from top of the page)

'Mad' Ennis

Net problems

Gareth's extensive editing

Safety and Vaccine Issues

Question: is there no homeopathic pollution problem?

The Code of Federal Regulations is snarky?

Apropos of double-distilled water

5-45

Paracelsus and alternative medicine

Constable input

elan vital

Neutrality Notes?

Bioavailability, proving, safety

Allopathy and asthma

Unilateral revision of edit because "it is not acceptable to homeopaths"

Pharmacopœia (or whatever the plural may be)

Individualization and permutation

Vaccination

Couple of edits

Series of reverts of material from Gareth

Wording

Reference

More wording: "'may or may not"

Help parsing a sentence from typical homeopathic visit section?

Why is a diagnosis important for a homeopath?

History of

Rolled back "if it doesn't work"

Navigation menu

Talk:Homeopathy/Archive 13

Some ground rules (please do not delete from top of the page)

'Mad' Ennis

Net problems

Gareth's extensive editing

Safety and Vaccine Issues

Question: is there no homeopathic pollution problem?

The Code of Federal Regulations is snarky?

Apropos of double-distilled water

5-45

Paracelsus and alternative medicine

Constable input

elan vital

Neutrality Notes?

Bioavailability, proving, safety

Allopathy and asthma

Unilateral revision of edit because "it is not acceptable to homeopaths"

Pharmacopœia (or whatever the plural may be)

Individualization and permutation

Vaccination

Couple of edits

Series of reverts of material from Gareth

Wording

Reference

More wording: "'may or may not"

Help parsing a sentence from typical homeopathic visit section?

Why is a diagnosis important for a homeopath?

History of

Rolled back "if it doesn't work"

Navigation menu

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