Talk:Homeopathy/Archive 13

Further categories added

I just added Chemistry and Health Sciences as categories most close to this topic, and I hope this stimulates some of the necessary rewriting. --Daniel Mietchen 18:22, 28 April 2009 (UTC)

I suggest, as a starter, that since there seem to be a number of people who feel that the Overview is buried far too far from the top, that it be either moved or the lede be rewritten. Let's start taking to heart the posted CZ Neutrality policy:

• "Expert knowledge and opinion receives top billing and the most extensive exposition."
• "The task is to represent the majority (scientific) view as the majority view and the minority (sometimes pseudoscientific) view as the minority view." Hayford Peirce 18:30, 28 April 2009 (UTC)

Think that's right, and I've moved the Overview up and tightened the wording a bit.Gareth Leng 12:03, 8 May 2009 (UTC)

Lately I have been reading about water memory, its scientific evidence is even less than I expected. I see clearly now that much of the discussion in the section "Scientific basis of homeopathy" is neither here nor there. Ortho/para water, isotopomers, glass chips, it is all true but what is the connection to homeopathy? We could extend the list of true, but meaningless, facts ad infinitum. So I propose to shorten this section, beginning with taking out the reference to solitons, clathrates, and nanobubbles. --Paul Wormer 12:29, 8 May 2009 (UTC)

A proposal that will, no doubt, cause consternation

I propose that we take the bull by the horns and rewrite the lede sentence to read:

Homeopathy or homoeopathy is a system of alternative medicine whose principles, however, are not accepted by most medical doctors and scientists, particularly those in the West.

Is that anything about that simple statement that is false, misleading, or unprofessional? If not, then I *strongly* urge that we begin the article with it, and then do the necessary rewriting in the rest of the article. Hayford Peirce 17:57, 8 May 2009 (UTC)

No, it's accurate. Still, I might be tempted to add "It is an alternative system that uses a fundamentally different model of health, and whose proponents say is difficult if not impossible to judge by standards of evidence-based medicine; it has to evaluated in its own frame of reference." That's wordy and can be improved, but I think it states a fair point. Howard C. Berkowitz 18:04, 8 May 2009 (UTC)

I could certainly live with that, and I think that any other fair-minded person (which, of course, defines ALL Citizens!) could too. So why don't you do the rewrite and I'll do the copyedit if needed? Hayford Peirce 18:07, 8 May 2009 (UTC)

What is the basis for the qualifier "particularly those in the West"? I'm aware that homeopathy is more accepted in the region of the Indian subcontinent than in the West, but I've not seen evidence that it is accepted by non-Western doctors and scientists more generally. Note that homeopaths have expressed regret that "nobody knows anything about homeopathy" in China, for example. Raymond Arritt 20:30, 9 May 2009 (UTC)

Further: I don't agree with the general proposal. In my view the first paragraph (and certainly the first sentence) should state what homeopathy is. We have the rest of the lead to comment on its acceptance and so on. I've done a bit of rearranging of the lead in an attempt to make it read more smoothly, but please feel free to revert my changes if you disagree. Raymond Arritt 21:02, 9 May 2009 (UTC)

It's certainly more accepted in India, I gather. Otherwise, I agree with you on the "non-Western" part -- I wish it could be rewritten. As to the rest, you have simply restored the old version with which we were concerned about its lack of skepticism. If, to stretch the point, we have an article about Flat Earth, we don't wait until paragraph umpty-ump to say that all mainstream scientists consider this idea to be nonsense. Everyone except you, for the last couple of weeks, has agreed that the homeopathy article waited *way* to long to point out, and then to point out strongly, that mainstream science does *not* consider it to be useful. We are, therefore, in this draft article, consciously trying to change the balance of the article. We don't "own" the article -- you're certainly welcome to make suggestions and changes, but I think that if you try to restore the old framework, you are going to run into considerable opposition. Hayford Peirce 21:20, 9 May 2009 (UTC)

I emphatically agree that the approved version waits far too long to state the prevailing scientific and medical view (and does an embarrassingly poor job when it finally gets there). I don't agree that it needs to be right up front in the first sentence, but if everyone else believes it should be in the first sentence I won't argue the point further. I must note that in its present form the lead paragraph is very poorly written in terms of clarity and style; it will have to be cleaned up if we expect the new draft to be taken seriously. Raymond Arritt 21:34, 9 May 2009 (UTC)

I think the lede para. is a perfect model of clarity and concision, saying exactly what we want it to. You obviously disagree, but how about giving us a "for instance"? Or how about rewriting it so that its "clarity and style" are improved. Not changing what it says, as you did before, but improving the existing text. I think that all of us would welcome that.... Hayford Peirce 04:04, 10 May 2009 (UTC)

You really don't see the style problems? I suppose everyone read things differently. For a start the use of "however" is strange, because it does not make a contrast. The paragraph also is made up entirely of loose sentences. How about something like:

Homeopathy or homoeopathy is a system of alternative medicine. Its principles are not accepted by most medical doctors and scientists, particularly those in the West. As an alternative system it uses a fundamentally different model of health that, its proponents say, cannot be judged by standards of evidence-based medicine and must instead be evaluated in its own frame of reference.

Another possibility is that the long second sentence could be tweaked to say:

Homeopathy or homoeopathy is a system of alternative medicine. Its principles are not accepted by most medical doctors and scientists, particularly those in the West. Its proponents say that as an alternative system it cannot be judged by standards of evidence-based medicine and must instead be evaluated in its own frame of reference.

No change in meaning, but (I think) either of these versions, or something similar, would read more smoothly. The main points are: (1) lead with a simple declarative sentence; (2) remove the "however"; (3) tighten to eliminate redundancy or other unnecesary words. Raymond Arritt 17:21, 10 May 2009 (UTC)

Removal of para

Daniel commented out the irrelevant paragraph on "scientists may have it wrong". I agree completely.--Paul Wormer 13:44, 9 May 2009 (UTC)

To lede?

IMHO the following sentence should go from the section Scientific basis of homeopathy. As far as I'm concerned it could go to the lede, or to clinical trials, or may be deleted (because I suspect that something similar has been stated already in the present article):

Further, homeopaths assert that the overall evidence for homeopathy, including clinical research, animal research, basic sciences research, historical usage of homeopathic medicines in the successful treatment of people in various infectious disease epidemics, and widespread and international usage of homeopathic medicines today, indeed provide the required extraordinary evidence for the benefits of this system.

--Paul Wormer 13:44, 9 May 2009 (UTC)

First, the paragraph now in the lede,

"Classical homeopathy" or "Hahnemannian homeopathy" refers to the original principles of this medical system in which a single remedy is chosen according to the physical, emotional, and mental symptoms that the sick individual is experiencing rather than only the diagnosis of a disease. "Commercial" or "user-friendly" homeopathy refers to the use of a mixture of remedies in a single formula containing individual ingredients that are generally chosen by the manufacturer for treating specific ailments. Such homeopathic remedies are used by consumers all over the world for self-treatment of common self-limiting ailments and injuries.

fits better at the end of the section "preparation of homeopathic remedies", perhaps with a little flow editing.

Second, if the paragraph you suggest moving to the lede were to go there, it needs to be introduced with something including the sentence "These stringent demands are often summarised by the maxim "Extraordinary claims require extraordinary proof".", and editing the paragraph so there is a transition to the "extraordinary proof" in the "homeopaths assert..." I'm not sure if the material between "extraordinary claims" and "Further" needs to be there so it's coherent. The "Further" sentence doesn't quite make sense on its own in the lede.

On a different subject, some material either needs to be deleted or move to history of homeopathy. Given a century of progress in immunology, is there any point to quoting Von Behring here? The only point seems to be to explain 19th century thinking, which does have the justification that 19th century medical drugs tended to be toxic and ineffective. In like manner, can we really leave "Homeopaths consider that two conventional concepts, vaccination, and hormesis, can be considered as analagous to homeopathy's law of similars and the use of small doses. " unchallenged, vaccination being a completely different and understood mechanism, and hormesis still being explored?

I'd also get rid of mithridization, or move it to history. There's no modern belief in that concept. Howard C. Berkowitz 17:57, 9 May 2009 (UTC)

The sentence that Paul mentions is very badly written in any case -- it needs to be simplified and redone so that it makes sense. Hayford Peirce 18:10, 9 May 2009 (UTC)

I don't want to get into a revert war here, but I think fairness does call for mentioning the basic vital force and similars principles in the first paragraph. Don't get me wrong; I don't think there's substance to homeopathy, but the current first paragraph just deprecates their model without any text about what it includes. Howard C. Berkowitz 17:30, 11 May 2009 (UTC)

I agree with Howard on this. In fact I was going to ask the same question myself: Daniel, why did you cut this bit out? I think that it is, in fact, important that it be restored. Hayford Peirce 18:07, 11 May 2009 (UTC)

Odd sentence

The lede contains the sentence:

A number of homeopaths also are strongly opposed to vaccines, which public health officials, including ones with homeopathic training, consider a danger to the community.

What is the danger? The fact that unvaccinated people are in the community? Or the opposition of homeopaths? I don't see it.--Paul Wormer 07:46, 10 May 2009 (UTC)

I think what it's *trying* to say is: A number of homeopaths also are strongly opposed to vaccines, which they consider a danger to the community; some public health officials, especially those with homeopathic training, agree with them. But it's unwieldy and should be further revised, or shortened (eliminate second phrase), or just deleted. Hayford Peirce 16:34, 10 May 2009 (UTC)

No. Vaccination is an accepted technique, in public health, for preventing infectious diseases. A number of homeopaths consider vaccines to be actively dangerous and recommend they not be used, which presents a danger to the community. Some homeopaths advise against the use of drugs to prevent malaria, to which even the director of the Royal Homeopathic Hospital objects.. Howard C. Berkowitz 17:40, 10 May 2009 (UTC)

Is that your proposed rewrite as opposed to mine? If so, stick it in. Whadda *I* know about this stuff? Hayford Peirce 18:20, 10 May 2009 (UTC)

Weasel wording in the last section, "Safety"

I have done some editing here to get rid of either contradictory words and/or weasel-wording. If it's really true, and can be *shown* to be true, that only "many public health professionals" disagree about the safety of vaccines, instead of "nearly all", then change it back, slap me on the wrist, and I will depart from Citizendium forever. How can we possibly permit such weaselry in our major articles? Hayford Peirce 02:15, 13 May 2009 (UTC)

Moves to History of Homeopathy

I moved the comment of von Behring to history of homeopathy, linking it. Tomorrow, I'll put in some of Osler's comments about both the toxicity of conventional drugs at that time, and also Osler's view that both allopathy and homeopathy were "medical cults" to be superceded.

Why do we have the material on mithridization? It seems to be random, not especially tied to homeopathic concepts, other than perhaps indirectly through hormesis. While hormesis probably should be there, I'd get rid of mithridization completely. Howard C. Berkowitz 04:30, 13 May 2009 (UTC)

On further reflection, I moved up hormesis, but then took out the material below, which I simply can't relate to the discussion.

Mithridatization (which is not a term used in contemporary science or medicine) may be a better metaphor than vaccination for homeopathic treatment. Mithridatization is the chronic administration of subtoxic doses of a toxin, in an attempt to develop resistance (or "tolerance") to large doses of the toxin. It is said that Mithridates VI Eupator, King of Pontus (132-63 BC), used this technique to protect himself from his enemies.

There are many different mechanisms by which tolerance can develop - and exposure to repeated small doses does not always result in tolerance. A herpetologist who receives many small doses of snake venom may indeed become tolerant to them. A beekeeper, however, may become hypersensitive to the venom and, after receiving a sting, go into anaphylaxis. This type of response to small, not necessarily precisely measured, doses is not predictable on an individual basis. "Allergic desensitization" is a technique used in conventional medicine to treat individuals who have a specific allergy to something that they cannot easily avoid. This involves exposing the patient repeatedly to tightly controlled doses, increasing the doses gradually over time. This treatment can be dangerous (exposure of sensitive individuals to an allergen can produce anaphylaxis), and it has very inconsistent efficacy, so is normally only attempted when the allergy poses serious restrictions on the patient's normal life.

Both mithridatization and homeopathy might be considered as instances of [hormesis] Howard C. Berkowitz 21:02, 13 May 2009 (UTC)

I can see where the first paragraph is starting to head, but then the second paragraph wanders off... somewhere. Raymond Arritt 00:21, 14 May 2009 (UTC)

Still, I'm not sure homeopaths routinely refer to mithridization; I vaguely recall a non-homeopath brought it into the article.

Immunization is a tricky area when talking about homeopathy; yes, it involves small doses of something that could cause symptoms, but the similarity stops there, unless one wants to make the rather sweeping statement that the vital force is equivalent to the immune system. Immune response doesn't really explain homeopathic cures for non-infectious disease or symptoms. Howard C. Berkowitz 02:51, 14 May 2009 (UTC)

I'm the guy who kept trying to put in, "I tell the tale that I hear told, Mitridates, he died old." But, of course, as the article title says, It Never Got Me Anywhere.... John Brock, le nom de secret agent de Hayford Peirce 03:40, 14 May 2009 (UTC)

Seriously, does this tale come from homeopathic literature? Howard C. Berkowitz 04:00, 14 May 2009 (UTC)

Repetitiveness

It seems to me that there still are many Wikipedia-like repetitions in this article. For instance, the lede says twice: [homeopaths] use a fundamentally different model. I noticed more of these kinds of repetitions. Before re-approval we should get rid of most that because they look silly and non-professional.--Paul Wormer 07:15, 13 May 2009 (UTC)

I agree -- please do as much editing on this stuff as you can! Hayford Peirce 16:04, 13 May 2009 (UTC)

Retitled section

I changed the section title "Attempts to provide a scientific foundation for homeopathy" to "Proposed scientific foundations for homeopathy." To my ears "attempts to..." sounds a little more judgmental than we probably want, while simply saying "proposed" doesn't imply anything either favorable or unfavorable. Is this OK? Raymond Arritt 00:28, 14 May 2009 (UTC)

It's fine by me, and I agree with your reasoning. Hayford Peirce 01:32, 14 May 2009 (UTC)

Ortho-para water

The difference between ortho-para water is due to the Pauli principle: protons are fermions and have a totally (spin + space) antisymmetric wave function. Ortho stands for spin triplet (is symmetric in spin and antisymmetric in space); para stands for spin singlet (antisymmetric spin, symmetric space). The ratio 3:1 is the triplet(3) : singlet(1) ratio. I removed nuclear because these spins can be flipped by paramagnetic interactions on a molecular level. If a homeopathic tincture contains an open-shell, paramagnetic, transition-metal center, then it is conceivable that it can change the 3:1 ratio. Also some catalysts (e.g. active charcoal) may change the ratio. That is why I added the proviso that even if such a change happens its healing power is still unclear.

Personally I see isotopologues as something completely different from ortho/para, which is why I put them into two different paragraphs. I realize that this view is academic and that seen from a distance the two concepts belong in the same remote corner of molecular physics.

--Paul Wormer 06:11, 14 May 2009 (UTC)

First paragraph

I'm still dissatisfied with the first paragraph. Currently it reads:

Homeopathy or homoeopathy is a system of alternative medicine whose principles are not accepted by most medical doctors and scientists, particularly in the West. As an alternative system, it uses a fundamentally different model of health that, its proponents say, cannot be judged by standards of evidence-based medicine and must instead be evaluated within its own frame of reference.

My proposed revision is:

Homeopathy or homoeopathy is a system of alternative medicine. As an alternative system, it uses a fundamentally different model of health whose principles are not accepted by most medical doctors and scientists, particularly in the West. Its proponents say that cannot be judged by standards of evidence-based medicine and must instead be evaluated within its own frame of reference.

The main points of my revision are: (1) it starts with a simple declarative "what it is" sentence; (2) the next two sentences state the scientific and medical view in its own sentence, contrasted with the homeopaths' response in its own sentence. Comments? Raymond Arritt 17:43, 14 May 2009 (UTC)

Assume this is the first paragraph. I think it's essential, then that it transition to a second paragraph that, as succinctly as possible, defines the fundamentally different model. Howard C. Berkowitz 18:31, 14 May 2009 (UTC)

It looks as if the Bug is back! I put in a comment here about half an hour ago, it shows up on my Contributions log, but it's gone! It's that rat Howard, deletin' my stuff! Anyway, here's what I said, if I can recall: "Your suggestion looks fine to me if you think that's an improvement. But there should be an it after Its proponents say that".... Hayford Peirce 18:42, 14 May 2009 (UTC)

On this note I'm 99.9% certain that I signed my comment below under "Reapproval" in the usual way, but apparently it didn't show up. Has anyone noticed signatures getting dropped off? Raymond Arritt 16:48, 15 May 2009 (UTC)

I *think* that what you did was maybe just type three tildes instead of four -- the date was there, but not your name.... Hayford Peirce 17:04, 15 May 2009 (UTC)

...particularly in the West

I have deleted the qualifier "particularly in the West." The qualifier was added by Martin Cohen in this edit.[1] In looking at the Talk page around that time I see no specific argument favoring this statement (here[2] is a snapshot of the Talk page around that time). Homeopathy has no general non-Western prevalence; for example, homeopaths themselves have lamented that "nobody knows anything about homeopathy" in China.[3] From what I've been able to find out it appears the correct form of the qualifier would be "outside the Indian subcontinent" but do we want to be that specific? Raymond Arritt 00:56, 15 May 2009 (UTC)

No. I'm glad to see that it's gone. Your next project, should you accept it: check the verifications of the weird (to me) statements about the percentage of French and German doctors who believe in it, or don't disbelieve in it. I lived in Tahiti for 25 years, a French territory, and knew about half the non-hospital doctors there and was close friends with a number of them. There was *never* a homeopath in Tahiti, none of the doctors ever mentioned them, and I find it hard to believe that 30 or 40 percent of French doctors believe in this. Hayford Peirce 01:31, 15 May 2009 (UTC)

Reapproval?

Does anyone think the current draft is essentially ready for reapproval? There have been significant changes that have (in my view) gone a long way toward fixing the most glaring problems with the original approved version. I think there's something to be said for reapproving the article at incremental points (say every few months or so) rather than springing a wholesale rewrite on people, especially with a controversial topic like this. Raymond Arritt16:07, 15 May 2009 (UTC)

Yes, you're probably right. Also, we don't want to keep the improved version away from the general public for too long. I'll ask Joe Quick, the Approvals Manager, to take a look and tell us what he thinks needs to be done. Hayford Peirce 16:40, 15 May 2009 (UTC)

Text in footnotes

Given that this is a hyperdocument, not a professional journal, I don't like the practice of putting any substantial amount of text (e.g., measles or gangrene) into footnotes. An online reader is not necessarily going to get to endnotes, and there's no way the reader can know that a given footnote is more than bibliographic.

My rule is that any substantive text either belongs in the article, or in a linked subarticle. Howard C. Berkowitz 20:30, 15 May 2009 (UTC)

I don't quite know what Howard is referring to here, but I certainly agree with him -- text should be in the article or a related subarticle except for the minor sort of footnote material that we all learned about in school. Hayford Peirce 20:53, 15 May 2009 (UTC)

I never liked these footnoted comments but thought "maybe that's the way it's done around here." I'm glad to see others agree. Most of these footnoted remarks have little or nothing to do with the topic at hand and can simply be deleted. The few that are on point are best merged into the text, per Howard. Raymond Arritt 21:05, 15 May 2009 (UTC)

Allez-y, mon pote! Hayford Peirce 21:06, 15 May 2009 (UTC)

Confused on source

In the section "a typical homeopathic visit", we have:

At other times, a professional homeopath will often treat these patients with a constitutional remedy based on the patient’s genetic history, health history, and present overall physical and psychological state, with the intent to strengthen the person’s general health, thereby reducing the frequency or intensity of the symptoms of hay fever.[44]

with the source information: ↑ Dennis Chernin (2006) The Complete Homeopathic Resource for Common Illnesses. Berkeley: North Atlantic. Stephen Cummings and Dana Ullman (2004). Everybody's Guide to Homeopathic Medicines. New York: Jeremy Tarcher/Putnam.

I'm confused -- we have three sources, none easily checked, with no page references. Look at the quote: is it plausible that homeopaths are really using genetic history? Howard C. Berkowitz 02:45, 16 May 2009 (UTC)