Talk:Homeopathy/Archive 15: Difference between revisions

From Citizendium
Jump to navigation Jump to search
imported>D. Matt Innis
imported>Peter Schmitt
(rm subpages)
 
(497 intermediate revisions by 20 users not shown)
Line 1: Line 1:
{{subpages}}
{{archive box}}  


'''The talk page has been moved to [[Talk:Homeopathy/Archive 13]] because of its size. <br>
'''The talk page has been moved to [[Talk:Homeopathy/Archive 14]] because of its size. <br>
If you want to continue some topic please copy the relevant excerpts to this new page.'''
If you want to continue some topic please copy the relevant excerpts to this new page.'''
----
----


== Sandy's edit to the definition ==
== Next step ==


...specifically "help to cure or prevent illnesses involving similar symptoms." While a homeopath will have to review this, I don't think "illnesses involving similar symptoms" is really a homeopathic concept. They certainly object to "diseases with similar symptoms", and tend to reject "disease" as a medical conceit. The symptoms are signals of the body's defenses to be strengthened, not the effects of a causative factor. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:59, 18 September 2010 (UTC)
I've re-read both this latest version along with the current approved version and consider [http://en.citizendium.org/wiki?title=Homeopathy/Draft&oldid=100737927 this version] as an improvement that I can endorse.  Gareth has done a great job cleaning and pruning this article.  It would be a shame to lose this opportunity to upgrade our current approved version.  I'm sure that there are more details that could be added, but they can continue to be added to the draft or begin new articles and link here. It will need two more editors to join to lock this version, so I've given 6 days. [[User:D. Matt Innis|D. Matt Innis]] 03:27, 6 December 2010 (UTC)
: I'd go with that; I think technically you are not an author so could move to approve, but other eyes welcome[[User:Gareth Leng|Gareth Leng]] 09:26, 7 December 2010 (UTC)


:I think you're splitting hairs, but, yes, let's hear from a homeopath on this. [[User:D. Matt Innis|D. Matt Innis]] 21:27, 18 September 2010 (UTC)
== EU and labels ==


:Sandy's new definition is definitely an improvement. [[User:D. Matt Innis|D. Matt Innis]] 21:32, 18 September 2010 (UTC)
I am a little confused. What exactly is meant by:
: (in the EU) "no specific therapeutic indication may be given on the product label."
In fact, the label tells when the remedy is to applied (e.g., influenza).
--[[User:Peter Schmitt|Peter Schmitt]] 01:22, 8 December 2010 (UTC)


::Li'l hard pressed for time. I'm happy with Alexander's definition, but if you guys feel it needs to be simpler, I have a 'simpler definition', which would read:-<blockquote>(Homeopathy is) an alternative system of medicine, which stimulates the natural healing processes of the body (with the help of sub-physiological doses of a remedy, by using its rebound effect), to restore health (homeostasis) in a sick person.</blockquote>
:See article 14 of the cited source: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:32001L0083:EN:HTML
:::The matter in brackets is optional.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:36, 19 September 2010 (UTC)
:Let me know if you interpret it differently. [[User:D. Matt Innis|D. Matt Innis]] 02:19, 9 December 2010 (UTC)
:::Note that it is '''alternative medicine''' and not '''alternate medicine'''.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 07:44, 19 September 2010 (UTC)


::::Unfortunately, "rebound effect" is not a well-defined term, certainly in medicine, so should not be used in a definition unless it is well defined in an article of its own.  The alternate definition depends heavily on homeopathic terminology, such as "natural healing processes", as well as using homeostasis is far broader a context than is used in the biological sciences -- to say nothing amout emerging concepts such as [[allostasis]].
:: Are you talking about Art.14(1)? It is only about "a special, simplified registration procedure", not a rule for all remedies. --[[User:Peter Schmitt|Peter Schmitt]] 23:47, 11 December 2010 (UTC)
:::Yes, do you interpret that the "special, simplified registration procedure" is not the procedure for the '''OTC remedies''' that are the subject of the cited sentence (below)?
:::*''The European Union allows remedies to be sold OTC if they are prepared according to the European Pharmacopoeia or the pharmacopoeias used in the Member States, and if they are at least 3X (i.e. they may not contain more than one part per 10,000 of the mother tincture or more than 1/100th of the smallest effective dose of an active substance); no specific therapeutic indication may be given on the product label.''
:::[[User:D. Matt Innis|D. Matt Innis]] 00:24, 12 December 2010 (UTC)
:::: As I read this the producer may also choose the "normal" registration procedure (instead of the special simplified one), and then this restriction is not imposed. --[[User:Peter Schmitt|Peter Schmitt]] 02:34, 12 December 2010 (UTC)
:::::Unless we can verify that this is the regulation for OTC medicines, the sentence needs to go anyway.  I don't get the impression that the regulation is saying anything about OTC.  My searches seem to agree with you that "the other" method of registration is available for any dose as well (in which case they could label with a therapeutic benefit on the label).  I'd still remove the sentence until we can reword it properly. [[User:D. Matt Innis|D. Matt Innis]] 03:38, 12 December 2010 (UTC)
:::::: Removing this may be the best solution. Obviously, the situation is complicated - regulations in detail may be different from member state to member state. However, in Austria many (all?) remedies can be bought '''in pharmacies''' OTC, and they usually (always?) are labelled with a purpose. --[[User:Peter Schmitt|Peter Schmitt]] 10:03, 12 December 2010 (UTC)


::::The proposed new definition also overemphasizes the aspect of small doses and does not address the apparent rejection, by homeopathy, of the idea of "disease". Instead, it speaks of "restoring health", without addressing the  meaning of the state of non-health.
----


:::Please confirm or correct the statement that homeopaths do not believe in the concept of disease, in the sense that disease has an etiologic cause and the cause needs to be corrected. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 08:30, 19 September 2010 (UTC)
In the section "A typical homeopathic visit":
: (which they feel may be ineffective and/or likely to have side effects).
should probably read
: (which they feel may be ineffective and/or '''not''' likely to have side effects).  
--[[User:Peter Schmitt|Peter Schmitt]] 01:27, 9 December 2010 (UTC)


::::I agree with Howard here, Ramanand, that your version introduces too many vague terms to be considered for use as a one sentence definition. [[User:D. Matt Innis|D. Matt Innis]] 23:44, 19 September 2010 (UTC)
::"might prescribe a remedy ''rather than a conventional medicine'' (which they feel may be ineffective and/or likely to have side effects)."
::Homeopaths consider that the ''conventional medicine "may be ineffective and/or likely to have side effects"'', not their remedy.
::[[User:D. Matt Innis|D. Matt Innis]] 01:38, 9 December 2010 (UTC)
::: Yes, I have misread the sentence. --[[User:Peter Schmitt|Peter Schmitt]] 23:47, 11 December 2010 (UTC)


What about <blockquote>A system of alternative medicine based on the idea of stimulating the body's natural healing processes by administering tiny doses of substances which, when given in large doses to healthy individuals, cause similar combinations of symptoms.</blockquote> I agree that Ramanand's definition has some problems, and I think the full version is too long, but it seems to me the point about stimulating natural defenses is central. [[User:Sandy Harris|Sandy Harris]] 03:07, 20 September 2010 (UTC)
== Case study on objectivity ==
:Looks good.  I have no problem with replacing your previous version with this new version. [[User:D. Matt Innis|D. Matt Innis]] 17:27, 20 September 2010 (UTC)


::Friends...first, I understand the need to archive material, but I wish that one would have not archived the most recent material.  There was still some important discussion to complete there. Can I encourage someone to consider re-inserting some of it?
Some time back, I rewrote the lede of this article. I had:


::I agree with others' concerns about Ramanand's proposal, and I like Matt's proposal, though here's my slight tweak on it (the words in italics are my new ones): 
{{quotation|Homeopathy is well established worldwide; both homeopathic practitioners and over-the-counter homeopathic remedies are widely available. Many national health insurance schemes include homeopathic treatments among the things they will pay for, and some medical doctors sometimes prescribe homeopathic remedies. There have been national and international homeopathic associations since the 19th century. See our external links for a list.}}
<blockquote>A system of alternative medicine based on the idea of stimulating the body's natural healing processes by administering tiny ''specially prepared'' doses of substances which, when given in large doses to healthy individuals, cause ''a similar syndrome'' of symptoms.</blockquote> [[User:Dana Ullman|Dana Ullman]] 08:40, 21 September 2010 (UTC)


{{quotation|That said, the consensus of medical and scientific judgment is that homeopathy is unfounded.[2] Most importantly, there is little, if any, objective evidence that homeopathy is effective. Neither of the main homeopathic principles — similars and infinitisimals — makes sense to the critical scientific mind. The "principle of similars" appears to be merely an appeal to sympathetic magic, or at best an over-generalisation of a principle that actually applies in only a few cases. The "principle of infinitisimals" contradicts both common sense and scientific results; there is no plausible mechanism to explain how the remedies might work, given that many of them are so dilute that they contain not a single molecule of the active ingredient. See our external links for some strongly critical assessments.}}


The current draft has:


----
{{quotation|Homeopathy is used mainly by consumers who use it to treat common non-life-threatening acute conditions, by a relatively small number of licensed homeopaths, and by some medical doctors and other licensed health practitioners as an alternative or a complement to conventional treatment. Homeopathic medicines (referred to in this article as "remedies" to avoid confusion with conventional medicines) are widely available without a doctor's prescription. Some health insurers cover homeopathic treatment if it is provided by a medical doctor or a naturopathic physician.}}
The above comments have been copied from the [[Talk:Homeopathy/Archive 13|Archive]]. --[[User:Peter Schmitt|Peter Schmitt]] 10:28, 20 September 2010 (UTC)
 
----
{{quotation|Homeopathy is alleged to be unfounded by the medical and scientific community. Some studies and meta-analyses have shown that homeopathic medicines have a statistically significant benefits over placebo, but other studies and meta-analyses have shown no difference between homeopathic treatment and placebo. Although many high quality studies have been published in leading conventional medical journals and have shown that homeopathic remedies might be effective in particular conditions, there are not enough replication of this research to establish a reliable body of evidence base for homeopathy.}}
===Natural defenses===
 
There is an implicit homeopathic assumption here here that natural defenses are always sufficient, that restoring natural defenses equates to health. From a medical standpoint, that is sufficiently wrong that "natural defenses", or the idea that full health is a matter of restoring defenses, is rather basic. Consider, for example, genetic diseases such as [[cystic fibrosis]] or [[hemophilia]]. The problem, from a medical standpoint, is that the "natural" state is incomplete for health. With genes missing to produce the proteins that produce health in a "normal" person, all the "strengthening" in the world will not strengthen something that isn't there. In [[severe combined immune deficiency disorder]], the most pronmising research to externally insert the gene that encodes the manufacture of the key missing enzyme, adenosine deaminase.
There is some fascinating stuff here, and elsewhere in the article, showing how biased rewrites can affect text. I think the rewrite of the first paragraph is an improvement, but the second a disaster of bias. Here, I want to discuss mainly the first sentence of the second paragraph. It makes an interesting case study.
 
I had "the consensus of medical and scientific judgement is that homeopathy is unfounded.[2]", with a link to Simon Singh's book, a well-known source. Now, I believe I could have written "Most scientists consider homeopathy's theories nonsense and most doctors consider its practice dangerous quackery." That is, I think, objectively accurate. However, I consciously chose not to do that and went for what I think is a neutral formulation.
 
Dana removed the link, which I think is an offence against neutrality. He made the text:
 
{{quotation|The consensus of medical and scientific judgment is that homeopathy is equivocal. Some studies and meta-analyses have shown that homeopathic medicines have a statistically significant benefits over placebo, but other studies and meta-analyses have shown no difference between homeopathic treatment and placebo. Although many high quality studies have been published in leading conventional medical journals and have shown that homeopathic remedies might be effective in particular conditions, there are not enough replication of this research to establish a reliable body of evidence base for homeopathy.}}
 
I changed "equivocal" back to "unfounded". Not only is "homeopathy is equivocal" horrendously ungrammatical, I think even a claim that is "the consensus of medical and scientific is that the evidence for homeopathy is equivocal" would be a serious distortion.
 
Nobody corrected my typo, judgment for judgement. So much for quality control.
 
Ramanand then altered the first sentence to "Homeopathy is alleged to be unfounded by the medical and scientific community." and removed the last section "there are not enough replication of this research to establish a reliable body of evidence base for homeopathy." To his credit, Dana re-inserted the last bit.
 
Fascinating. [[User:Sandy Harris|Sandy Harris]] 01:36, 8 December 2010 (UTC)
 
:Fascinating indeed. In due respect, the very fact that you chose to quote Simon Singh, a well-known strong antagonist to homeopathy, is clearly evidence of a strongly biased point of view.  Further, the word "equivocal" is the PERFECT word in the light of THIS article that shows both positive and negative trials and meta-analyses. 
 
:If Sandy thinks that the grammar is off, then fix it, just as I fix many of others' sentences...but the fact of the matter is that the LEDE should provide a summary of what is in the article...and the term "equivocal" shows my OBJECTIVITY.


In other words, sometimes the wisdom of the body is pretty damn stupid, and all the strengthening in the world can't replace something that isn't there. It doesn't help explain etiology when etiology can be due to an absent rather than a present cause -- but how else do you talk about sensibly about deficiency and genetic diseases? The evidence that [[scurvy]] comes from inadequate vitamin C is overwhelming.
:As for the term "sympathetic magic," this term is only used by the most extreme antagonists to homeopathy...and I personally cannot remember many references to it in respectable journals and academic reviews.  Further, I had previously quoted Emil Adolph von Behring (the "father of immunology" who discovered the tetanus and diptheria vaccines), and it was HE who acknowledged the link with homeopathy and immunology.  To therefore say that homeopathy is "unfounded" is to baste in bias...and sadly, Sandy's statement above is infused in this, which has no place in an encyclopedia.  


Proposal:
:Please note that the term "unfounded" is extreme, especially in light of this article which shows so much connection between homeopathy and modern day (and futuristic) medical thinking.  [[User:Dana Ullman|Dana Ullman]] 06:10, 8 December 2010 (UTC)


"Homeopathy is a form of [[alternative medicine]] that holds that good health is achieved purely by strengthening what homeopaths, but not conventional medicine, calls "wisdom of the body" or "natural defenses". Homeopaths further believe that all problems of natural defenses manifest themselves as symptom complexes, and reject the idea that disease has a cause and health is restored by the removal of the cause. They hold that the symptoms show the defenses that need to be strengthened, and their remedies are based on a symptom, not cause, oriented paradigm. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 11:05, 20 September 2010 (UTC)
:: I disagree with almost everything else you say above, but I do think the von Behring quote, and the Osler quote discussed [[#Allopathy.2C_and_revert_wars_over_Osler_quote|above]] should go back in. [[User:Sandy Harris|Sandy Harris]] 06:48, 8 December 2010 (UTC)


: The definition is supposed to ''briefly'' say what homeopathy ''is''. It needs to be short enough to fit into a related articles page. To me, your suggestion fails at those goals; either the current text or my suggestion above seems far better.
::: All, if we were to go into that much detail on each argument, the article would again outgrow the interest of the average reader. We have to narrow the focus of this article to an introductory article on homeopathy.  The Osler quotes and entire argument would be quite important and appropriate for the [[History of Homeopathy]] or even the [[History of Medicine]] article. Some of the other points that Dana makes can be made in related pages as well with links back to this one. 
: There needs to be discussion of these issues somewhere in the article, perhaps even in the lede, but it does not belong in the definition. [[User:Sandy Harris|Sandy Harris]] 12:17, 20 September 2010 (UTC)


::I'm fine with both of Sandy's definitions. I hope one of you can make time to correct the definition at the top of this page - it should be '''alternative''' and not '''alternate'''.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:21, 20 September 2010 (UTC)
:::The changes that I see to the lead are again driving us back to where we were before. I am quite sure that we will now see a skeptic response that will double the size of the arguments without adding any value.  The bottom line is that the reduction that Gareth has given us states the homeopathic position in a positive light and the science and mainstream positions in a similar light.  He has removed fluff and gruff from both the homeopathic and skeptic viewpoints and boiled the arguments down to their lowest common denominator.  It is neutral, objective, concise and an improvement over the current approved article.  The new information can remain in the draft where we can continue to manipulate the text until we get it the way we want it.  


:::Absolute minimum: Homeopathy is a form of [[alternative medicine]] that holds that good health is achieved purely by strengthening what homeopaths, but not conventional medicine, calls "wisdom of the body" or "natural defenses", rejecting the medical model that the etiologic cause must be corrected.
:::Dana, please consider adding your name to the version that I have chosen only as an improvement over the last version and we can continue to adjust according to new information. [[User:D. Matt Innis|D. Matt Innis]] 13:43, 8 December 2010 (UTC)


:::The method by which remedies are selected (i.e., provings) and prepared are irrelevant to the core definition. According to Mr. Ullman, not every homeopathic remedy is given in "homeopathic doses", so let's not overemphasize the small dose issue. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:32, 20 September 2010 (UTC)
::::Matt, I put a considerable amount of attention to correcting minor and not-so-minor errors in fact and grammar issues.  I also feel strongly that the lede MUST be changed from that edition you want to get approved because the term "unfounded" is a black-and-white term that has no place in a good encyclopedia. Further, that 3rd paragraph is NOT an adequate summary of the review of research described in this article.  I personally thought that referring to the research on homeopathy as "equivocal" was objective and appropriate.  That said, I'm open to something that says that homeopathy is "inadequately founded"...but to say that it is "unfounded" suggests that there is "NO" foundation to homeopathy (and this article shows that this is simply not true. [[User:Dana Ullman|Dana Ullman]] 03:59, 10 December 2010 (UTC)


(unindent)<br>
:::::Dana, my expertise is not on the science.  That is Gareth's domain.  My donation is assuring that the art and alternative ideas are stated accurately.  I think this article does state the homeopathic position in a positive light and you have done a good job stating it.  We have to allow the same for the scientific and medical outlook.  Surely you agree that most scientists and the majority of the medical community consider homeopathy to be on shaky ground. They think chiropractic is as well, but most have a distorted view of what we (and you) do.  We're not advocating that they are right in this view, only stating what their view is.  To state anything else would be wrong.  It is up to the reader to decide.
I suggest something like:
: "A system of alternative medicine, developed around 1800 by Samuel Hahnemann, based on the assumption that self-healing can be stimulated by small doses of substances that cause the <s>same</s>similar symptoms as those to be treated."
--[[User:Peter Schmitt|Peter Schmitt]] 21:58, 20 September 2010 (UTC)


::I am very concerned about Howard's "implicit assumptions" about homeopathy because he is simply wrong about them.  Homeopaths do NOT believe that the body's natural defenses are always sufficient for restoring health. To be candid, this is a totally ridicious assumption, and after ALL of this time in which Howard has been editing this article, I am surprised that he would believe such a ridicious assumption.  I urge all editors to avoid guessing at what homeopaths think or do. Please consider ASKING before assuming or at least making reference to a specific established expert who made a specific statement. Our encyclopedia here deserves better scholarship than something based on assumptions, let alone "implicit assumptions." When an editor here has some deep antagonism to homeopathy, it is particularly important to avoid making assumptions without specific and references FACTS because such assumptions tend to create "straw men" (a problem about which I have frequently expressed concern in the past).
:::::Concerning the new study, it's great, but it's too new and it is only one study.  We can't present it as fact, but, again, I defer to Gareth to evaluate the science.  I'd be interested to hear what he thinks of your changes concerning the science before I'd change the version number.
:::::[[User:D. Matt Innis|D. Matt Innis]] 05:00, 10 December 2010 (UTC)


::IF the natural defenses were always sufficient, there would not be any need for healing treatments.  That said, homeopaths do believe that our symptoms represent the best defensive efforts that the bodymind can deploy at that time based on its present internal resources.  However, such efforts are often not enough, and therefore, medicinal and/or therapeutic efforts are necessary.  Homeopaths believe that those efforts that mimic and augment these natural defenses will be the most effective, while methods that suppress, inhibit, or work by counteracting the body's symptoms may provide "benefit" briefly but will tend to create more serious physical and psychological symptoms and syndromes in the longer term (homeopaths refer to this phenonmenon as "suppression of disease," while conventional physicians simply refer to them as "side effects"). 
Matt, I agree with you on most of what you say above.  However, when the new draft says that homeopathis is "unfounded", this is VERY different than saying that it is on "shaky ground." To me (and I assume most others), the lede should be a summary of what is below...and that 3rd paragarph is an inaccurate summary of that.  [[User:Dana Ullman|Dana Ullman]] 15:06, 10 December 2010 (UTC)


::Howard is also inaccurate about his understanding above about "homeopathic provings."  Howard wrote: "The method by which remedies are selected (i.e., provings)" -- To clarify, "provings" are experiments in toxicology that verify the specific symptoms and syndromes that each substance CAUSES in overdose.  After a homeopath interviews a patient, the homeopath looks to find a substance that has been found to cause in healthy people the similar syndrome of symptoms that the sick person is presently experiencing. 
== EC decision pending ==


::I urge Howard to prove and verify that a homeopath and an allopath would have different definitions of "the wisdom of the body."  I personally do not know of any such difference. Yes, I do have a deep antipathy to homeopathy, but it's rather hard to come up with citations for negative information. Harrison's and Cecil's, as a start, don't use the term.
The [[CZ:Editorial Council|Editorial Council]]  is currently discussing a motion to approve the [http://en.citizendium.org/wiki?title=Homeopathy/Draft&oldid=100737927 revision as of 16:32, 5 December 2010] of the Homeopathy draft. The deliberations in connection with this can be followed on the [http://locke.citizendium.org/cz_ec/DR-2010-004 EC wiki]. [[User:Johan A. Förberg|Johan A. Förberg]] 23:59, 8 December 2010 (UTC)


::BTW, Peter's defintiion above is inaccurate.  Homeopaths do not use substances "that cause the SAME symptoms..." but instead "that cause SIMILAR symptoms."  Get it?  Homeopathy IS based on the principle of SIMILARS.  That said, there ARE some applications in homeopathy that "treat SAMES with SAMES" (as in the 4 studies by Reilly and his team at the University of Glasgow in their treatment of people with various allergic ailments, where they used potentized doses of specific ALLERGENS to which people were most reactive.  [[User:Dana Ullman|Dana Ullman]] 09:08, 21 September 2010 (UTC)
== Remarks on version to be approved ==
:::::: I changed the text accordingly. --[[User:Peter Schmitt|Peter Schmitt]] 23:12, 22 September 2010 (UTC)


:::Thank you, Dana, because you are now being more specific and more limiting about some things that either have been said previously by you, or by Ramanand.
'''Question:''' With respect to all these studies: What about studies on high dilutions vs. moderate dilutions? --[[User:Peter Schmitt|Peter Schmitt]] 00:19, 10 December 2010 (UTC)


:::I have never said that an allopath has any assumptions about the wisdom of the body, because I don't know any allopaths. If, by "allopath", conventional physician is meant, the proof is easy: "wisdom of the body" is simply not a medical concept. I don't see it in the index of any of my major textbooks of internal medicine. Ignoring the continued insistence on allopath, the difference on wisdom of the body is binary: one discipline believes in it and one does not. You asked an apparently rhetorical question about belief in wisdom of the body, which I answered that I, and most medical scientists, do not believe there is such a thing.
'''Homeopathic response''':
<s>
* "This review of research also found '''that the''' 21 "high quality" '''studies''' testing homeopathic medicines '''had a more beneficial effect''' than a placebo," ? </s> Sorry, wrong version.
* "the 8 largest trials of homeopathy showed that '''no?''' benefits," --[[User:Peter Schmitt|Peter Schmitt]] 01:48, 11 December 2010 (UTC)
* "Several studies that had been defined as "high quality" by Linde et al. (1997) were not defined '''by?''' high quality by Shang "
--[[User:Peter Schmitt|Peter Schmitt]] 00:24, 10 December 2010 (UTC)


:::Whether or not there is a historic use of allopathy, in the United States, people are licensed as physicians (nurse practitioners, physician assistants, etc.), not allopaths. Homeopaths, where licensing applies are, as far as I know, licensed as homeopaths. I can ask him to see if there's a difference, but my best DO friend's licenses to practice in Missouri and Louisiana are for the practice of medicine, not allopathic or osteopathic medicine.
'''Safety''':
* "it would be better for mankind-and all the worse for the fishes." This should be an mdash. --[[User:Peter Schmitt|Peter Schmitt]] 01:01, 10 December 2010 (UTC)


:::"However, such efforts are often not enough, and therefore, medicinal and/or therapeutic efforts are necessary. " Agreed, but please be specific. The existing alternate rather than complementary emphasis of the article has made quite a point of saying homeopathy comes first.  A short list of examples where a homeopath would call for an ambulance would be very informative.
'''Scientific foundations? '''
* In brief, for homeopathy to receive serious scientific consideration, there must be plausible explanations for:
** how an ultradiluted solution can have any specific biological activity
** by what biological mechanism could the specific nature of a remedy be recognised
Style: the second line continues the first, the third line is an inedependent question.


:::Correction. Remedies are not selected by provings, but are they not the means to find a simillium?
<s>
* "a remedy diluted to more than 12C was assumed to all probability to contain not a single molecule of the original substance. <br> However, new research has confirmed that even extremely diluted homeopathic medicines contain ponderal doses of the original substance"
This needs some explanation -- how much diluted? What is meant by "ponderable" -- is this in contradiction to the first part?
</s> Sorry, wrong version. --[[User:Peter Schmitt|Peter Schmitt]] 00:15, 11 December 2010 (UTC)


:::It's now on the archive page, Dana, but I thought you said homeopathic remedies were not always given in homeopathic dosages. If I remember that correctly, then the "wisdom of the body" and strengthening defenses, perhaps with a few words about the difference with medicine, is more central to the definition than the aspect of small and specially prepared doses. Both belong early in the introduction. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 10:40, 21 September 2010 (UTC)
* "hormesis(the phenomenon" there is space missing before the bracket
--[[User:Peter Schmitt|Peter Schmitt]] 01:24, 10 December 2010 (UTC)


Howard, thanx for clarifying some issues.  You have suggested above that conventional physicians really do not have a specific meaning for or appreciation of "the wisdom of the body." To me, that alone says volumes...and I agree with that.  In fact, it seems that the average physician has distrust of the ability of the human body to defend and repair itself, thereby requiring intervention that usually (though certainly not always) works counter to the body's present symptoms.
::Peter, I'm not clear what you mean by "moderate" doses, though doing clinical studies that compared different doses would require very large numbers of patients. Most research simply compares ONE dose with a placebo (or with a conventional Rx).


As for the use of the word "allopathy" and "allopathic," you may be very surprised and even shocked how many conventional medical schools, licensing boards, institutions, US governmental agencies, and accrediting agencies still utilize this word. I highly recommend that you see the "huge body of references" compiled by Brian Hopping at:  http://en.wikipedia.org/wiki/Talk:Allopathic_medicine
::The 2nd point under "Homeopathic Response" should replace the word "by" with "as".


To clarify on the licensing of homeopaths, there are only 3 states in the USA that license MDs who practice homeopathy (CT, AZ, and NV).  Licensing in homeopathy is NOT necessary to practice homeopathy.  FYI, these 3 states licensed MD/homeopaths because some MDs who practiced homeopathy were being harrassed by conventional MDs, so they set up their own licensing board.  Most MD/homeopaths are NOT being harrassed by other MDs, so it is not necessary to set-up their own boards.
::It seems that many people here (and elsewhere) use the word "plausible" in different way.  Normally, plausible does not mean PROVEN, but just a possible explanation.  There ARE possible explanations for homeopathic medicines in all doses, though there are no "proven" explanations for them in all doses.  


In addition to MDs who practice homeopathy, virtually every type of health/medical professions have some people who practice homeopathy, PLUS there are "professional homeopaths" (individuals who specialize in homeopathy and who are not licensed in any other health/medical profession).
::"Ponderable" doses means that there is "something there" in the dose, and I referenced a new study from one of India's leading scientific institutions that shows that there IS something measurable in homeopathic potencies, even at 30C and 200C (that is 30 to the 100th power and 200 to the 100th power).   [[User:Dana Ullman|Dana Ullman]] 03:43, 10 December 2010 (UTC)


As for when a homeopath would call an ambulance...it would be the same protocols for which conventional MDs would call an ambulance.  Is that clear enough?  [[User:Dana Ullman|Dana Ullman]] 17:11, 21 September 2010 (UTC)
Peter,
* "This review of research also found '''that the''' 21 "high quality"....  
**sentence is in the latest draft and not in the nominated version


:OK, please take the following on ...well, good "faith" is singularly inappropriate, for a reason I think you'll soon see. I'm not exactly suggesting there is a consensus, but I would hope that it might be possible for the different sides to have their incompatibilities, and indeed fears, clearly stated.
* the '''by''' can be changed to '''as''' with a copyedit once the article is approved.
* "it would be better for mankind-and all the worse for the fishes." This should be an mdash.  
**these can be changed as copy edits once approved.
* "a remedy diluted to more than 12C was assumed to all probability to contain not a single molecule of the original substance. <br> However, new research has confirmed that even extremely diluted homeopathic medicines contain ponderal doses of the original substance"
**Is not in the nominated version.
:::: Ooops sorry -- it seems that (while reading it) -- I happened to change versions without noticing it. I'll have to reread it. --[[User:Peter Schmitt|Peter Schmitt]] 09:39, 10 December 2010 (UTC)


:I could get along with "wisdom of the body" in the context of religion or transpersonal psychology, but not medicine. By "medicine", I use Marcia Angell's definition: there are two kinds of medicine. Medicine that works and medicine that doesn't work. Yes, adults have a right to faith healing -- but courts have held they do not have a right to do so for children. It frightens me, quite literally, that a parent might take a child with diabetes, or a treatable cancer, to a homeopath.
'''Scientific foundations? '''
* In brief, for homeopathy to receive serious scientific consideration, there must be plausible explanations for:
** how an ultradiluted solution can have any specific biological activity
** by what biological mechanism could the specific nature of a remedy be recognised
Style: the second line continues the first, the third line is an inedependent question.


:The rejection of etiology also frightens me, given the level of improved certainty that comes with genetic and molecular medicine. I see, in homeopathic writing, a pattern of encouraging fear of medical sciences. I see the emphasis on using the word "allopath" as trying to reopen old political and just plain angry battles.
***purely a style issue.


:Now, remember that this discussion has been international, in the sense that Ramanand has been bringing up Indian practices. Perhaps Western homeopaths would never do such things, but he has given me the impression that ambulances -- and yes, they might not be available in some countries -- would not be called until late or never.
[[User:D. Matt Innis|D. Matt Innis]] 04:30, 10 December 2010 (UTC)


:That most homeopaths are not licensed or reviewed is not very confidence building.
'''Regulation'''
* "any commercial operation - such as" The hyphen should be an mdash
* "Most homeopaths are not medically-trained" Better without a hyphen?
* "the instruction '''to "to''' consult a doctor if symptoms persist". " There is a "to" too many.
Matt, of course, these are minor quibbles (style, grammar, typographical). They do not concern approval, but they should be considered nevertheless.
And since this is not the top revision they cannot be corrected directly.
Sorry for confusing versions!
--[[User:Peter Schmitt|Peter Schmitt]] 10:18, 11 December 2010 (UTC)
::No problem for the confusion; it's totally understandable.  You get a feel for part of our problem where draft versions change so quickly in different places.  It is difficult to endorse a version that has changes with which you agree, but others that you don't. It's easier to find a version that I can endorse and improve again from there.  Copyedits such as you describe are still very much appreciated and can be made to the approved version, as you are aware. [[User:D. Matt Innis|D. Matt Innis]] 23:19, 11 December 2010 (UTC)


:I can only say that in several decades of working with health care, I have ''never'' met a physician who used homeopathic methods. I'm not saying they don't exist -- I'm saying that at least in the U.S., homeopathy does not appear to be a significant form of complementary medicine. I do know quite a few physicians that either themselves use other alternative methods, or integrate care with alternative practitioners.
=== Clarification ===


:[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 20:53, 21 September 2010 (UTC)
With moderate vs. high dilutions I wanted to address the difference between, say, 3-5D and 12C. Does this difference enter the trials? Are there different results. (The arguments against 12C cannot be used against 3D.)


::OK, I may need to be more focused.  There's been too much talk page discussion that doesn't have anything to do with improving the article. I'm probably especially irritable about health care at the moment, as I'm dealing with the last comfort-care-versus-euthanasia decisions for my best friend--who, incidentally, may well have benefited from some complementary veterinary medicine.
I don't have problems with the word "plausible". I only addressed the style: "explanations for: how ... can have ..., by what ... could ..."


::The "wisdom of the body" discussion is the only thing I'll raise right now.  While I don't see that historically as the core of homeopathy, certainly the article can say this is something in which many homeopaths believe, and define it in declarative sentences. Also in declarative sentences, it is fair to say that biologically oriented clinicians find it to have no information that will help a patient, and denies that which has been learned in over a century (well, maybe since somewhere mid-20th century) about etiology and efficacy. Neither side will convince the other, and both sides have equally intense beliefs.  Treat it as a religious difference based on faith, stop trying to argue the positions ''in the article'', and move on. Dana can say wisdom of the body is a matter of core faith for him and have it respected as such; note equal respect for the faith of the nonhomeopaths, and move to the next subtopic. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 22:50, 21 September 2010 (UTC)
--[[User:Peter Schmitt|Peter Schmitt]] 10:48, 11 December 2010 (UTC)


:::Howard, I'm glad that you recognize how much of your writing here is not practical to THIS article, as is your arbitrary differentiation between your "assumed" different definitions of the wisdom of the body.  If one believe in evolution, I believes that organisms automatically strive to defend themselves and to survive.  I could quote Hans Selye, MD, PhD, AND Walter B. Cannon (author of the classic text, "Wisdom of the Body") in many places where they assert its presence.  Even MDs recognize its presence, but they tend to ignore it or have a certain disdain when treating people.  Their loss.  In any case, unless you can cite a reputable source for your different definitions, please STOP making assumptions and please stop making up your own defintiions.  [[User:Dana Ullman|Dana Ullman]] 02:50, 22 September 2010 (UTC)


::::I need to also say that Howard's assertion that homeopaths do not believe in "etiology" is just one more unfounded assumption he has made (no big surprise).  Homeopaths simply have a more sophisticated viewpoint on etiology than Howard and reductionistic scientists do.  For infectious disease, for example, we believe in germs, but we also believe in host resistence.  While conventional medicine only focusses on the germ, homeopaths focus on both the germ and host resistence.  I am beginning to think that Howard is simply unable to understand homeopathy.  Despite editing here for now a long time, it seems that he doesn't seem to adequately understand basic homeopathic principles and methodology (and/or he doesn't want to understand them). I urge us all to ignore what he says unless he provides us with specific reliable references so that we can be more confident that he is not wasting our time. I look forward to Howard's contributions if he can show real intellectual effort here rather than creating straw men and creating arguments/fights when none exist.  [[User:Dana Ullman|Dana Ullman]] 03:00, 22 September 2010 (UTC)
:I've brought this point up myself; that there are homeopathic treatments that do have measurable amounts of product.  I think we have improved some on this, but we could still be more clear.  Unfortunately, the research on these products appears to be lacking in one way or the other as well, but I stay tuned to listen for more evidence to the contrary.  I haven't seen any, yet. The section on hormesis did hint that there were some effects at these 'low dilutions' that were measurable. Although the research remains interesting, the sum total is still probably not yet convincing. [[User:D. Matt Innis|D. Matt Innis]] 23:19, 11 December 2010 (UTC)


===Strawment Produce text, not attacks===
== Comment by Anthony.Sebastian ==
Cannon, I would note, is a 1963 book, which appears to be aimed at a lay audience. Of course, rather than the sarcastic "I could quote", a far more constructive approach would  be to do so.


Please stop yelling about strawmen and propose text. Please stop making sweeping inferences such as the theory of evolution proving the wisdom of the body, which you have yet to define rigorously. "Even MDs" is meaningless without citation, and citation of current and authoritative ones. As I mentioned, it simply does not appear in the indexes major textbooks:  ''Harrison's Principles of Internal Medicine'', the Hopkins ''Principles and Practices of Medicine'', ''Best and Taylor's Physiological Basis of Medical Practice'', or the Guyton-Hall ''Textbook of Medical Physiology.''  My copy of Cecil's Internal Medicine does not come immediately to hand. If it is such an accepted, well-defined concept, one might think that some of the most widely used medical school textbooks might mention it, might one? 
I have added my name to approve this draft of 05 December 2010 because I find it superior to the currently approved version. Suggest that the new post-approval draft incorporate the NCCAM report, now given as a signed article, into the Main Article, or as an Addendum subpage, and that the full report be included. Suggest that then the approval be updated. [[User:Anthony.Sebastian|Anthony.Sebastian]] 07:35, 10 December 2010 (UTC)
<hr><br>


'''PROFESSIONALISM ALERT for <nowiki>{{nocomplaints}}</nowiki>''' <blockquote> I am beginning to think that Howard is simply unable to understand homeopathy.  Despite editing here for now a long time, it seems that he doesn't seem to adequately understand basic homeopathic principles and methodology (and/or he doesn't want to understand them). I urge us all to ignore what he says unless he provides us with specific reliable references so that we can be more confident that he is not wasting our time. </blockquote>
== To Dana ==


"While conventional medicine only focusses on the germ, homeopaths focus on both the germ and host resistence [sic]." Nonsense. [[B-lymphocyte]] and [[T-lymphocyte]] immune response are clearly host defenses, although, in some cases, [[immunoglobulin]]s may be provided externally. [[Interleukin]]s and other [[cytokines]] are signaling mechanisms for host defenses. [[Granulocyte-macrophage colony-stimulating factor]] deals with improving cellular responses.
Dana,
:I'm not happy with your last edit to the draft, in which you have added the sentence I removed again, but shall refrain from arguing about it. I must quote Shakespeare's Julius Caesar here though, "Et tu Dané? Then fall scissor".—[[User:Ramanand Jhingade|Ramanand Jhingade]] 14:23, 10 December 2010 (UTC)


[[Tumor necrosis factor-alpha]] is a host defense that frequently becomes hyperactive and needs to be returned to safe levels; the area of overactive host defenses is an important one, as in [[anemia of chronic disease]] with the fairly recently recognized roles of [[hepcidin]] and interleukin-6, or, overwhelmingly, in [[autoimmune disease]]. In other words, sometimes the body is about as wise as a teenager being challenged by peers after non-homeopathic dosages of a remedy with the (vivid) memory of ethanol. --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 03:53, 22 September 2010 (UTC)
::Dana, I've made some changes and I hope you can go through them before you approve what the others are proposing that Gareth, Matt and you approve.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:41, 11 December 2010 (UTC)
== Rationalwiki ==
I hope one of you can write an article on the retionalwiki refuting their allegations about CZ as well as the CZ article on homeopathy.&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 15:43, 20 September 2010 (UTC)


:And why, precisely, don't you do it? I have never read Rationalwiki and have no reason to do so. I certainly won't defend the CZ article on homeopathy, because I frankly wish it were gone.    [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 16:32, 20 September 2010 (UTC)
==APPROVED Version 2.0==
=== A Decision by the Editorial Council ===


::Unfortunately, as long as there is a CZ with which I work, I will defend its integrity -- and my first view of its integrity is that this article, and the interminable arguments to reach a "consensus" on irreconcilable ideas, continues to damage CZ. I am absolutely unconcerned with anonymous criticisms from wikis or stone tablets. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 10:12, 21 September 2010 (UTC)
The Editorial Council has decided by unanimous vote that the [http://en.citizendium.org/wiki?title=Homeopathy/Draft&oldid=100737927 revision of this article as of 16:32, 5 December 2010] by [[User:D. Matt Innis|D. Matt Innis]] shall be approved.


:::I quote: ''I am absolutely unconcerned with anonymous criticisms from wikis or stone tablets.''</quote>  A huge, gigantic, mega 'Hear, hear!' from me, Howard.  Well said! [[User:Aleta Curry|Aleta Curry]] 21:39, 21 September 2010 (UTC)
The reasoning of the Council can be viewed at the EC wiki, [http://locke.citizendium.org/cz_ec/EC-D-2010-006 EC-D-2010-006] [[User:Johan A. Förberg|Johan A. Förberg]] 19:41, 13 December 2010 (UTC)


::::Yes, and 'hear, hear' to Howard's comments on homeopathy above, too. [[User:Ro Thorpe|Ro Thorpe]] 22:14, 21 September 2010 (UTC)
The Approved version includes [http://en.citizendium.org/wiki?title=Homeopathy&diff=100740341&oldid=100740318 copyedits discussed above and one ambiguous and unverified sentence is removed]. [[User:D. Matt Innis|D. Matt Innis]] 01:40, 14 December 2010 (UTC)


== When to refer; when to call emergency services ==
<div class="usermessage plainlinks">Discussion for [http://en.citizendium.org/wiki?title=Homeopathy/Draft&oldid=100737927 Version 2.0] stopped here. Please continue further discussion under this break. </div>


I'm afraid that saying a homeopath would call an ambulance when a conventional physician would call one really isn't very informative. If the person using homeopathy is a fully qualified physician, he or she may not even be beginning to use homeopathic principles in the decision. The clinician also may have more facilities and training for emergency interventions.
<hr><br>


To make the point that is entirely possible to be [[specific about]] either referring or using special care, see [[integrative medicine# Examples from chiropractic |examples from chiropractic]]. I see no reason why a competent homeopath, who claims general health knowledge, can't write a similar list. Alternatively, while we don't have a non-trauma [[triage]] list at CZ, another good starting point would be emergency room, or even ambulance dispatch, criteria for putting a patient into the most urgent category. (thinks of a couple of personal experiences when I was more or less tackled in the ER, and run into the treatment area, while still calmly giving a history). --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 02:01, 22 September 2010 (UTC)
== What the hell? ==


== Allopathy, and revert wars over Osler quote ==
I thought all 3 editors, Matt, Gareth and Dana were supposed to approve the draft, before it gets approved. Is there a change in policy?&mdash;[[User:Ramanand Jhingade|Ramanand Jhingade]] 16:16, 14 December 2010 (UTC)
:Please read the section just above -- it ought to be very clear: the Editorial Council made a formal decision that that particular version was to be Approved, and *ordered* the Constabulary to do so. The EC is responsible for ALL content in the CZ project -- this falls under that responsibility. We will now be considering what to do with the Draft version. The Secretary of the Editorial Council, [[User:Hayford Peirce|Hayford Peirce]] 17:14, 14 December 2010 (UTC)


First, precisely what is the value, in other than specific historical contexts, of continuing to insist on the word allopathy being used?  It is frequently used, by supporters of alternative medicine, in a rather sneering way that removes context.  Osler, below, uses it in a 19th century concept based on "opposites", which make no more sense in molecular biology than do "similars".
== Removal of Singh ref from draft is misguided ==


Sir [[William Osler]] is widely celebrated as one of the true greats of medicine. One reason for the continued popularity of his comments is that they focus on the interaction with the patient rather than try to continue century-old explanations for much better understood phenomena.
Dana Ullman seems to have removed the Singh footnote from the draft because he's an "antagonist" or something. What silliness. The point of the footnote is to establish, as the main article puts it:


Material introducing the Osler quote to follow was deleted, as have several variants of:
: The consensus of medical and scientific judgment is that homeopathy is unfounded.
"Other than in some narrow usages (for example, to differentiate conventional medicine from osteopathy), conventional doctors contend that "allopathy" is not a synonym for the paradigms of contemporary medicine, although osteopaths, homeopaths, naturopaths and other alternative medicine practitioners continue to call it allopathy."


There is, however, a revert war on the Osler quote, deleted again: <blockquote>A new school of practitioners has arisen which cares nothing for homeopathy and still less for so-called allopathy. It seeks to study, rationally and scientifically, the action of drugs, old and new."<nowiki><ref>[[Flexner Report]], page 162</ref></nowiki></blockquote>[http://www.carnegiefoundation.org/files/elibrary/flexner_report.pdf]
Whether you think Singh and Ernst are "antagonistic" or not, the source does just that. It argues that homeopathy is unfounded from a medical and scientific basis. To fully justify it, you'd have to get a whole stack more sources, but this is not difficult.


Note that Osler disapproves of both 19th century-early 20th century allopathy as well as homeopathy; the quote, in broader context, calls both "sects" that will be replaced by science-based medicine. Prior to making this comment, Osler indeed did speak of the superiority of contemporary homeopathy over contemporary allopathy, but the comment, in context, refers to high doses of toxic doses of drugs with no established mechanism of action. <blockquote>A desire to take medicine is, perhaps, the great feature which distinguishes man from other animals.</blockquote> 
Let's see...


The 1905 edition of ''The Principles and Practices of Medicine'' lists only a few drugs as effecitve (e.g., nitroglycerin and amyl nitrite for coronary artery pain, diptheria and tetanuxus antitoxins, and the arsenicals as an improvement in the mercury treatment of syphilis. On the other hand, the text decidedly did not take a avoid-risk-above-all approach as with homeopathy; he was quite aggressive in recommending surgery -- which was also in need of improvement. With the disclaimer that I was a volunteer copy editor, see ''A Brief History of Disease, Science & Medicine'' by Michael Kennedy, a faculty member of the University of Southern California who teaches the first- and second-year Introduction to Clinical Medicine program, another place where one might expect to see the "wisdom of the body" should that be widely accepted in medicine.
* [http://www.nhs.uk/Conditions/Homeopathy/Pages/Introduction.aspx NHS]:
*: Homeopathy is a type of complementary and alternative medicine (CAM). CAMs are treatments that are not based on conventional scientific theories.
* [http://www.nature.com/nature/journal/v446/n7134/full/446352a.html Nature]: "Degrees in homeopathy slated as unscientific"
* The Evidence Check report and plenty of media reports on it e.g. [http://ibnlive.in.com/news/homeopathy-unscientific-bad-medicine-brit-panel/110539-17.html]
* The British Medical Association vote against homeopathy
* The many sources on Wikipedia that say homeopathy is scientifically unfounded


'''Constables''', could we please have enforcement of stopping repeated deletions of the Osler quote about the "new school of practitioners"? --[[User:Howard C. Berkowitz|Howard C. Berkowitz]] 04:18, 22 September 2010 (UTC)
Now, Dana and Ramandand may protest about this. That's fine. They can disagree with it all they like and invoke the bogeyman of Big Pharma or evil skeptics or "antagonists" (critics tend to be antagonistic you know...). They believe homeopathy works. What they seem to not understand is that the article must contain sufficient resources to point out that the current consensus on homeopathy is that it is scientifically implausible and lacks clinical efficacy. You may disagree with the conclusion, but the point of the article must be to point out how things are, not how you fervently wish them to be.


:I await constable comment before restoring. This is behavioral; there is no Editor ruling on excluding the quote, and, in any case, it would be unfair to have a ruling from an Editor of only one concerned workgroup. [[User:Howard C. Berkowitz|Howard C. Berkowitz]] 23:46, 22 September 2010 (UTC)
If the pro-homeopathy editors are unable to edit according to the CZ [[CZ:Neutral point of view|Neutral point of view]] policy, I do hope the Editorial Council and Constabulary will deal with them appropriately. —[[User:Tom Morris|Tom Morris]] 21:36, 14 December 2010 (UTC)
<nowiki>Insert non-formatted text here</nowiki>


== A Request for a Decision to the Editorial Council about blanking the Draft article ==


::Howard, a quick search of the [http://search0.ama-assn.org/search/search?database=public+amnews&query=allopathic AMA website] for "allopathic" gives us some pretty significant current hits.  Looking through the links pretty much shows them calling themselves allopathic often and sometimes specifically.  Maybe it's not meant to be negative. [[User:D. Matt Innis|D. Matt Innis]] 23:57, 22 September 2010 (UTC)
An official Request for a Decision has been made to the Editorial Council to blank the Draft article in its entirety and to also Archive the present Talk page.  The Request is now in the Seconding stage.  It may be read at:


http://locke.citizendium.org/cz_ec/DR-2010-006


::*''State Medical Licensure Requirements and Statistics—The 2009 edition provides updated information on licensing
The Secretary of the Editorial Council [[User:Hayford Peirce|Hayford Peirce]] 22:32, 14 December 2010 (UTC)
board requirements for the 54 '''allopathic''' and 13 osteopathic boards of medical examiners in the US and territories.''

Latest revision as of 03:11, 17 December 2010

1, 2, 3, 4, 5, 6, 7, 8, 9, 10
11, 12, 13, 14, 15, 16


The talk page has been moved to Talk:Homeopathy/Archive 14 because of its size.
If you want to continue some topic please copy the relevant excerpts to this new page.

Next step

I've re-read both this latest version along with the current approved version and consider this version as an improvement that I can endorse. Gareth has done a great job cleaning and pruning this article. It would be a shame to lose this opportunity to upgrade our current approved version. I'm sure that there are more details that could be added, but they can continue to be added to the draft or begin new articles and link here. It will need two more editors to join to lock this version, so I've given 6 days. D. Matt Innis 03:27, 6 December 2010 (UTC)

I'd go with that; I think technically you are not an author so could move to approve, but other eyes welcomeGareth Leng 09:26, 7 December 2010 (UTC)

EU and labels

I am a little confused. What exactly is meant by:

(in the EU) "no specific therapeutic indication may be given on the product label."

In fact, the label tells when the remedy is to applied (e.g., influenza). --Peter Schmitt 01:22, 8 December 2010 (UTC)

See article 14 of the cited source: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:32001L0083:EN:HTML
Let me know if you interpret it differently. D. Matt Innis 02:19, 9 December 2010 (UTC)
Are you talking about Art.14(1)? It is only about "a special, simplified registration procedure", not a rule for all remedies. --Peter Schmitt 23:47, 11 December 2010 (UTC)
Yes, do you interpret that the "special, simplified registration procedure" is not the procedure for the OTC remedies that are the subject of the cited sentence (below)?
  • The European Union allows remedies to be sold OTC if they are prepared according to the European Pharmacopoeia or the pharmacopoeias used in the Member States, and if they are at least 3X (i.e. they may not contain more than one part per 10,000 of the mother tincture or more than 1/100th of the smallest effective dose of an active substance); no specific therapeutic indication may be given on the product label.
D. Matt Innis 00:24, 12 December 2010 (UTC)
As I read this the producer may also choose the "normal" registration procedure (instead of the special simplified one), and then this restriction is not imposed. --Peter Schmitt 02:34, 12 December 2010 (UTC)
Unless we can verify that this is the regulation for OTC medicines, the sentence needs to go anyway. I don't get the impression that the regulation is saying anything about OTC. My searches seem to agree with you that "the other" method of registration is available for any dose as well (in which case they could label with a therapeutic benefit on the label). I'd still remove the sentence until we can reword it properly. D. Matt Innis 03:38, 12 December 2010 (UTC)
Removing this may be the best solution. Obviously, the situation is complicated - regulations in detail may be different from member state to member state. However, in Austria many (all?) remedies can be bought in pharmacies OTC, and they usually (always?) are labelled with a purpose. --Peter Schmitt 10:03, 12 December 2010 (UTC)

In the section "A typical homeopathic visit":

(which they feel may be ineffective and/or likely to have side effects).

should probably read

(which they feel may be ineffective and/or not likely to have side effects).

--Peter Schmitt 01:27, 9 December 2010 (UTC)

"might prescribe a remedy rather than a conventional medicine (which they feel may be ineffective and/or likely to have side effects)."
Homeopaths consider that the conventional medicine "may be ineffective and/or likely to have side effects", not their remedy.
D. Matt Innis 01:38, 9 December 2010 (UTC)
Yes, I have misread the sentence. --Peter Schmitt 23:47, 11 December 2010 (UTC)

Case study on objectivity

Some time back, I rewrote the lede of this article. I had:

Homeopathy is well established worldwide; both homeopathic practitioners and over-the-counter homeopathic remedies are widely available. Many national health insurance schemes include homeopathic treatments among the things they will pay for, and some medical doctors sometimes prescribe homeopathic remedies. There have been national and international homeopathic associations since the 19th century. See our external links for a list.

That said, the consensus of medical and scientific judgment is that homeopathy is unfounded.[2] Most importantly, there is little, if any, objective evidence that homeopathy is effective. Neither of the main homeopathic principles — similars and infinitisimals — makes sense to the critical scientific mind. The "principle of similars" appears to be merely an appeal to sympathetic magic, or at best an over-generalisation of a principle that actually applies in only a few cases. The "principle of infinitisimals" contradicts both common sense and scientific results; there is no plausible mechanism to explain how the remedies might work, given that many of them are so dilute that they contain not a single molecule of the active ingredient. See our external links for some strongly critical assessments.

The current draft has:

Homeopathy is used mainly by consumers who use it to treat common non-life-threatening acute conditions, by a relatively small number of licensed homeopaths, and by some medical doctors and other licensed health practitioners as an alternative or a complement to conventional treatment. Homeopathic medicines (referred to in this article as "remedies" to avoid confusion with conventional medicines) are widely available without a doctor's prescription. Some health insurers cover homeopathic treatment if it is provided by a medical doctor or a naturopathic physician.

Homeopathy is alleged to be unfounded by the medical and scientific community. Some studies and meta-analyses have shown that homeopathic medicines have a statistically significant benefits over placebo, but other studies and meta-analyses have shown no difference between homeopathic treatment and placebo. Although many high quality studies have been published in leading conventional medical journals and have shown that homeopathic remedies might be effective in particular conditions, there are not enough replication of this research to establish a reliable body of evidence base for homeopathy.

There is some fascinating stuff here, and elsewhere in the article, showing how biased rewrites can affect text. I think the rewrite of the first paragraph is an improvement, but the second a disaster of bias. Here, I want to discuss mainly the first sentence of the second paragraph. It makes an interesting case study.

I had "the consensus of medical and scientific judgement is that homeopathy is unfounded.[2]", with a link to Simon Singh's book, a well-known source. Now, I believe I could have written "Most scientists consider homeopathy's theories nonsense and most doctors consider its practice dangerous quackery." That is, I think, objectively accurate. However, I consciously chose not to do that and went for what I think is a neutral formulation.

Dana removed the link, which I think is an offence against neutrality. He made the text:

The consensus of medical and scientific judgment is that homeopathy is equivocal. Some studies and meta-analyses have shown that homeopathic medicines have a statistically significant benefits over placebo, but other studies and meta-analyses have shown no difference between homeopathic treatment and placebo. Although many high quality studies have been published in leading conventional medical journals and have shown that homeopathic remedies might be effective in particular conditions, there are not enough replication of this research to establish a reliable body of evidence base for homeopathy.

I changed "equivocal" back to "unfounded". Not only is "homeopathy is equivocal" horrendously ungrammatical, I think even a claim that is "the consensus of medical and scientific is that the evidence for homeopathy is equivocal" would be a serious distortion.

Nobody corrected my typo, judgment for judgement. So much for quality control.

Ramanand then altered the first sentence to "Homeopathy is alleged to be unfounded by the medical and scientific community." and removed the last section "there are not enough replication of this research to establish a reliable body of evidence base for homeopathy." To his credit, Dana re-inserted the last bit.

Fascinating. Sandy Harris 01:36, 8 December 2010 (UTC)

Fascinating indeed. In due respect, the very fact that you chose to quote Simon Singh, a well-known strong antagonist to homeopathy, is clearly evidence of a strongly biased point of view. Further, the word "equivocal" is the PERFECT word in the light of THIS article that shows both positive and negative trials and meta-analyses.
If Sandy thinks that the grammar is off, then fix it, just as I fix many of others' sentences...but the fact of the matter is that the LEDE should provide a summary of what is in the article...and the term "equivocal" shows my OBJECTIVITY.
As for the term "sympathetic magic," this term is only used by the most extreme antagonists to homeopathy...and I personally cannot remember many references to it in respectable journals and academic reviews. Further, I had previously quoted Emil Adolph von Behring (the "father of immunology" who discovered the tetanus and diptheria vaccines), and it was HE who acknowledged the link with homeopathy and immunology. To therefore say that homeopathy is "unfounded" is to baste in bias...and sadly, Sandy's statement above is infused in this, which has no place in an encyclopedia.
Please note that the term "unfounded" is extreme, especially in light of this article which shows so much connection between homeopathy and modern day (and futuristic) medical thinking. Dana Ullman 06:10, 8 December 2010 (UTC)
I disagree with almost everything else you say above, but I do think the von Behring quote, and the Osler quote discussed above should go back in. Sandy Harris 06:48, 8 December 2010 (UTC)
All, if we were to go into that much detail on each argument, the article would again outgrow the interest of the average reader. We have to narrow the focus of this article to an introductory article on homeopathy. The Osler quotes and entire argument would be quite important and appropriate for the History of Homeopathy or even the History of Medicine article. Some of the other points that Dana makes can be made in related pages as well with links back to this one.
The changes that I see to the lead are again driving us back to where we were before. I am quite sure that we will now see a skeptic response that will double the size of the arguments without adding any value. The bottom line is that the reduction that Gareth has given us states the homeopathic position in a positive light and the science and mainstream positions in a similar light. He has removed fluff and gruff from both the homeopathic and skeptic viewpoints and boiled the arguments down to their lowest common denominator. It is neutral, objective, concise and an improvement over the current approved article. The new information can remain in the draft where we can continue to manipulate the text until we get it the way we want it.
Dana, please consider adding your name to the version that I have chosen only as an improvement over the last version and we can continue to adjust according to new information. D. Matt Innis 13:43, 8 December 2010 (UTC)
Matt, I put a considerable amount of attention to correcting minor and not-so-minor errors in fact and grammar issues. I also feel strongly that the lede MUST be changed from that edition you want to get approved because the term "unfounded" is a black-and-white term that has no place in a good encyclopedia. Further, that 3rd paragraph is NOT an adequate summary of the review of research described in this article. I personally thought that referring to the research on homeopathy as "equivocal" was objective and appropriate. That said, I'm open to something that says that homeopathy is "inadequately founded"...but to say that it is "unfounded" suggests that there is "NO" foundation to homeopathy (and this article shows that this is simply not true. Dana Ullman 03:59, 10 December 2010 (UTC)
Dana, my expertise is not on the science. That is Gareth's domain. My donation is assuring that the art and alternative ideas are stated accurately. I think this article does state the homeopathic position in a positive light and you have done a good job stating it. We have to allow the same for the scientific and medical outlook. Surely you agree that most scientists and the majority of the medical community consider homeopathy to be on shaky ground. They think chiropractic is as well, but most have a distorted view of what we (and you) do. We're not advocating that they are right in this view, only stating what their view is. To state anything else would be wrong. It is up to the reader to decide.
Concerning the new study, it's great, but it's too new and it is only one study. We can't present it as fact, but, again, I defer to Gareth to evaluate the science. I'd be interested to hear what he thinks of your changes concerning the science before I'd change the version number.
D. Matt Innis 05:00, 10 December 2010 (UTC)

Matt, I agree with you on most of what you say above. However, when the new draft says that homeopathis is "unfounded", this is VERY different than saying that it is on "shaky ground." To me (and I assume most others), the lede should be a summary of what is below...and that 3rd paragarph is an inaccurate summary of that. Dana Ullman 15:06, 10 December 2010 (UTC)

EC decision pending

The Editorial Council is currently discussing a motion to approve the revision as of 16:32, 5 December 2010 of the Homeopathy draft. The deliberations in connection with this can be followed on the EC wiki. Johan A. Förberg 23:59, 8 December 2010 (UTC)

Remarks on version to be approved

Question: With respect to all these studies: What about studies on high dilutions vs. moderate dilutions? --Peter Schmitt 00:19, 10 December 2010 (UTC)

Homeopathic response:

  • "This review of research also found that the 21 "high quality" studies testing homeopathic medicines had a more beneficial effect than a placebo," ? Sorry, wrong version.
  • "the 8 largest trials of homeopathy showed that no? benefits," --Peter Schmitt 01:48, 11 December 2010 (UTC)
  • "Several studies that had been defined as "high quality" by Linde et al. (1997) were not defined by? high quality by Shang "

--Peter Schmitt 00:24, 10 December 2010 (UTC)

Safety:

  • "it would be better for mankind-and all the worse for the fishes." This should be an mdash. --Peter Schmitt 01:01, 10 December 2010 (UTC)

Scientific foundations?

  • In brief, for homeopathy to receive serious scientific consideration, there must be plausible explanations for:
    • how an ultradiluted solution can have any specific biological activity
    • by what biological mechanism could the specific nature of a remedy be recognised

Style: the second line continues the first, the third line is an inedependent question.

  • "a remedy diluted to more than 12C was assumed to all probability to contain not a single molecule of the original substance.
    However, new research has confirmed that even extremely diluted homeopathic medicines contain ponderal doses of the original substance"

This needs some explanation -- how much diluted? What is meant by "ponderable" -- is this in contradiction to the first part? Sorry, wrong version. --Peter Schmitt 00:15, 11 December 2010 (UTC)

  • "hormesis(the phenomenon" there is space missing before the bracket

--Peter Schmitt 01:24, 10 December 2010 (UTC)

Peter, I'm not clear what you mean by "moderate" doses, though doing clinical studies that compared different doses would require very large numbers of patients. Most research simply compares ONE dose with a placebo (or with a conventional Rx).
The 2nd point under "Homeopathic Response" should replace the word "by" with "as".
It seems that many people here (and elsewhere) use the word "plausible" in different way. Normally, plausible does not mean PROVEN, but just a possible explanation. There ARE possible explanations for homeopathic medicines in all doses, though there are no "proven" explanations for them in all doses.
"Ponderable" doses means that there is "something there" in the dose, and I referenced a new study from one of India's leading scientific institutions that shows that there IS something measurable in homeopathic potencies, even at 30C and 200C (that is 30 to the 100th power and 200 to the 100th power). Dana Ullman 03:43, 10 December 2010 (UTC)

Peter,

  • "This review of research also found that the 21 "high quality"....
    • sentence is in the latest draft and not in the nominated version
  • the by can be changed to as with a copyedit once the article is approved.
  • "it would be better for mankind-and all the worse for the fishes." This should be an mdash.
    • these can be changed as copy edits once approved.
  • "a remedy diluted to more than 12C was assumed to all probability to contain not a single molecule of the original substance.
    However, new research has confirmed that even extremely diluted homeopathic medicines contain ponderal doses of the original substance"
    • Is not in the nominated version.
Ooops sorry -- it seems that (while reading it) -- I happened to change versions without noticing it. I'll have to reread it. --Peter Schmitt 09:39, 10 December 2010 (UTC)

Scientific foundations?

  • In brief, for homeopathy to receive serious scientific consideration, there must be plausible explanations for:
    • how an ultradiluted solution can have any specific biological activity
    • by what biological mechanism could the specific nature of a remedy be recognised

Style: the second line continues the first, the third line is an inedependent question.

      • purely a style issue.

D. Matt Innis 04:30, 10 December 2010 (UTC)

Regulation

  • "any commercial operation - such as" The hyphen should be an mdash
  • "Most homeopaths are not medically-trained" Better without a hyphen?
  • "the instruction to "to consult a doctor if symptoms persist". " There is a "to" too many.

Matt, of course, these are minor quibbles (style, grammar, typographical). They do not concern approval, but they should be considered nevertheless. And since this is not the top revision they cannot be corrected directly. Sorry for confusing versions! --Peter Schmitt 10:18, 11 December 2010 (UTC)

No problem for the confusion; it's totally understandable. You get a feel for part of our problem where draft versions change so quickly in different places. It is difficult to endorse a version that has changes with which you agree, but others that you don't. It's easier to find a version that I can endorse and improve again from there. Copyedits such as you describe are still very much appreciated and can be made to the approved version, as you are aware. D. Matt Innis 23:19, 11 December 2010 (UTC)

Clarification

With moderate vs. high dilutions I wanted to address the difference between, say, 3-5D and 12C. Does this difference enter the trials? Are there different results. (The arguments against 12C cannot be used against 3D.)

I don't have problems with the word "plausible". I only addressed the style: "explanations for: how ... can have ..., by what ... could ..."

--Peter Schmitt 10:48, 11 December 2010 (UTC)


I've brought this point up myself; that there are homeopathic treatments that do have measurable amounts of product. I think we have improved some on this, but we could still be more clear. Unfortunately, the research on these products appears to be lacking in one way or the other as well, but I stay tuned to listen for more evidence to the contrary. I haven't seen any, yet. The section on hormesis did hint that there were some effects at these 'low dilutions' that were measurable. Although the research remains interesting, the sum total is still probably not yet convincing. D. Matt Innis 23:19, 11 December 2010 (UTC)

Comment by Anthony.Sebastian

I have added my name to approve this draft of 05 December 2010 because I find it superior to the currently approved version. Suggest that the new post-approval draft incorporate the NCCAM report, now given as a signed article, into the Main Article, or as an Addendum subpage, and that the full report be included. Suggest that then the approval be updated. Anthony.Sebastian 07:35, 10 December 2010 (UTC)


To Dana

Dana,

I'm not happy with your last edit to the draft, in which you have added the sentence I removed again, but shall refrain from arguing about it. I must quote Shakespeare's Julius Caesar here though, "Et tu Dané? Then fall scissor".—Ramanand Jhingade 14:23, 10 December 2010 (UTC)
Dana, I've made some changes and I hope you can go through them before you approve what the others are proposing that Gareth, Matt and you approve.—Ramanand Jhingade 15:41, 11 December 2010 (UTC)

APPROVED Version 2.0

A Decision by the Editorial Council

The Editorial Council has decided by unanimous vote that the revision of this article as of 16:32, 5 December 2010 by D. Matt Innis shall be approved.

The reasoning of the Council can be viewed at the EC wiki, EC-D-2010-006 Johan A. Förberg 19:41, 13 December 2010 (UTC)

The Approved version includes copyedits discussed above and one ambiguous and unverified sentence is removed. D. Matt Innis 01:40, 14 December 2010 (UTC)

Discussion for Version 2.0 stopped here. Please continue further discussion under this break.


What the hell?

I thought all 3 editors, Matt, Gareth and Dana were supposed to approve the draft, before it gets approved. Is there a change in policy?—Ramanand Jhingade 16:16, 14 December 2010 (UTC)

Please read the section just above -- it ought to be very clear: the Editorial Council made a formal decision that that particular version was to be Approved, and *ordered* the Constabulary to do so. The EC is responsible for ALL content in the CZ project -- this falls under that responsibility. We will now be considering what to do with the Draft version. The Secretary of the Editorial Council, Hayford Peirce 17:14, 14 December 2010 (UTC)

Removal of Singh ref from draft is misguided

Dana Ullman seems to have removed the Singh footnote from the draft because he's an "antagonist" or something. What silliness. The point of the footnote is to establish, as the main article puts it:

The consensus of medical and scientific judgment is that homeopathy is unfounded.

Whether you think Singh and Ernst are "antagonistic" or not, the source does just that. It argues that homeopathy is unfounded from a medical and scientific basis. To fully justify it, you'd have to get a whole stack more sources, but this is not difficult.

Let's see...

  • NHS:
    Homeopathy is a type of complementary and alternative medicine (CAM). CAMs are treatments that are not based on conventional scientific theories.
  • Nature: "Degrees in homeopathy slated as unscientific"
  • The Evidence Check report and plenty of media reports on it e.g. [1]
  • The British Medical Association vote against homeopathy
  • The many sources on Wikipedia that say homeopathy is scientifically unfounded

Now, Dana and Ramandand may protest about this. That's fine. They can disagree with it all they like and invoke the bogeyman of Big Pharma or evil skeptics or "antagonists" (critics tend to be antagonistic you know...). They believe homeopathy works. What they seem to not understand is that the article must contain sufficient resources to point out that the current consensus on homeopathy is that it is scientifically implausible and lacks clinical efficacy. You may disagree with the conclusion, but the point of the article must be to point out how things are, not how you fervently wish them to be.

If the pro-homeopathy editors are unable to edit according to the CZ Neutral point of view policy, I do hope the Editorial Council and Constabulary will deal with them appropriately. —Tom Morris 21:36, 14 December 2010 (UTC) Insert non-formatted text here

A Request for a Decision to the Editorial Council about blanking the Draft article

An official Request for a Decision has been made to the Editorial Council to blank the Draft article in its entirety and to also Archive the present Talk page. The Request is now in the Seconding stage. It may be read at:

http://locke.citizendium.org/cz_ec/DR-2010-006

The Secretary of the Editorial Council Hayford Peirce 22:32, 14 December 2010 (UTC)

Retrieved from "https://citizendium.org/wiki/index.php?title=Talk:Homeopathy/Archive_15&oldid=749334"